Lift The Label: My Experience with Opioids

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Photo: Mike Thurk

This post is sponsored by the Colorado Department of Human Services, Office of Behavioral Health’s Lift The Label campaign.

Pain and I have an interesting relationship. As an athlete – and runner – I’m pretty comfortable with it. In fact, a main goal of training is to get comfortable in the uncomfortable. The only way to do this is to experience pain, to invite pain into my training, to wrestle with the physical sensation of wanting to quit, wanting to stop moving, but continuing, despite the physical cues insisting otherwise. Then, do it again.

Pain is my training tool, and I think many other athletes can relate to this well. I’m describing a hard workout, a race or an ‘off day’ in training. They are painful. These hard days are instrumental in getting stronger mentally, but also physically. Some of the best-trained athletes are those that have the highest tolerance to pain, at their peak in a training season (Endure by Alex Hutchinson). I know that’s the case for me.

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So what is my relationship to pain, besides familiar? Is it healthy? Extreme, maybe? I experience pain on a daily basis and use it as a barometer to effort level, progress and the onset of an injury. Although my relationship with pain is a bit extreme compared to most, I think it is my familiarity with pain that allowed me to avoid other potentially dangerous conditions.

After my near fatal fall in Tromso, Norway, I sustained multiple, serious injuries. I was admitted to the hospital for nearly two weeks, had a total of five surgeries with twelve broken bones, and a very lengthy recovery process. Even as someone very familiar with pain, this pain was new, more intense, and at times, unbearable.

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I remember the first nights in the hospital, being unable to sleep due to an unrelenting pain. In order to receive some comfort and relief, the nurses gave me morphine and other prescription opioids so I could relax, sleep, and my body could try to repair itself. At this point in my recovery, I needed the relief so I could start to heal, so I could rest and not focus on the unyielding sensation of pain. But, as I made the transition to home, after my last round of surgeries and new prescriptions of painkillers, when was it appropriate to stop taking them? A sensation that I referred to as useful, as a mark of progress, had now turned into a sensation linked to fear. I was now afraid to feel pain. I didn’t want to feel it. I wanted to numb it. I wanted to be able to sleep, to relax, to feel normal. If I was in pain, I couldn’t sleep, I could hardly focus. I couldn’t live that way.

But the more I read about the effects of my painkillers – opioids – on healing my bones and ligaments, the more I questioned my use of them. I was instructed by my physicians to take the painkillers, insisting they would help me as my body healed from my accident. Opioids are prescribed extremely regularly – in fact, the prescribing rate for opioids in Colorado is 59.8 opioid prescriptions per 100 people. Yet, I was unconvinced. So I stopped. I didn’t refill my prescriptions and I became re-acquainted with my body, and how it was truly feeling.

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My story with opioids isn’t how everyone’s story goes, unfortunately. In the U.S., 2.1 million people suffer from opioid addiction and 115 people die every day from opioid overdose. Prescription opioids are incredibly normal – they’re prescribed to everyone, regularly. Grandmothers, teachers, children, you or me – we could all receive an opioid prescription from a doctor, so they can seem harmless to take. The truth is, opioid use is not so straightforward. It’s terrifying to think it can take as little as 7 days of opioid use for a person’s brain to become dependent on them.

Some people may be able to choose not to take them, like in my circumstance; some may take them and be fine.  Others may one day find themselves a part of the 2.1 million statistic. Prescriptions are often cited as the way many people first come into contact with opioids – 80% of people who use heroin first misused opioids from a prescription, and 40% of those overdose deaths I mentioned come from prescription opioids.

In addition to my familiarity with pain and its use as a training tool, I also have a master’s in neuroscience. So, my knowledge of the brain, addiction and its response to chemicals made my skepticism of opioid use even higher. Often, opioid use has the stigma of being seen as a moral failing, something a person chooses to do. This is just not true, it’s not how the brain works. Can you stop yourself from feeling hungry or thirsty? Or from telling your heart to beat or your lungs to breathe? There are certain things your brain overrides, and this is what happens when addiction takes over. It’s no longer a choice. Scientifically, we know that opioid addiction is actually a brain disorder – an actual illness that needs medical treatment.

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Photo credit: Mike Thurk

In Colorado, there are 22 certified opioid treatment programs and 600 doctors, physicians assistants and nurse practitioners statewide who can prescribe buprenorphine treatment. Often, what keeps those with opioid addiction from seeking help from these resources is that same stigma. The one that equates addiction with failure or poor choices. These labels only cause more harm, so, if you’re looking to make a difference in the opioid crisis, I’d encourage you to remember this –  beneath the label of opioid addiction is a person just like you or me, whose use of opioids may have started innocently, but then found themselves wrestling with a very real medical struggle.

If you or someone you love is suffering from opioid addiction, please reach out! You can also visit LiftTheLabel.org for more information, or if you feel your or another’s life is in immediate danger, call the Crisis Hotline at 1-844-493-8255.

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Past the Limit

Ultra running is a niche sport, an extreme one at that. It can take many forms as far as terrain, but the definition is simple: covering a distance more than a marathon. Covering that distance in one piece however, is not so simple.

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I first discovered ultra running in the form of mountain running. This quickly turned into a love for an even more extreme form of mountain running known as skyrunning. Here, courses take you from the sea to the sky, in the most direct path imaginable. This year I’ve been lucky enough to compete in La palama (Transvulcania 75km), Madeira (Madeira ultra sky 50km), the Dolomites (Cortina Trail 50km), and the Pyrenees (Buff Epic 110km). I find motivation and challenge in skyrunning, due to the demanding technicality and steep grades. However, my most recent race, the Buff Epic, at the skyrunning world championships in Valle de Boí, forced me to places I had never been before.

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I’m not going into the details of a race report, but for background, this race was 110km with 8000m of positive gain (about 69 miles and 26,500ft). Extreme.

 

I knew this race would challenge me, maybe even break me, but never did I expect the day I had.

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I started comfortable, anticipating all the climbs, letting the steepness dictate my pace. I felt comfortable, calm to be running. Within the first 20k I had already managed to go off course for a few minutes, to fall on some slippery rocks, but even that couldn’t get my spirits down. I knew I was going to be out there all day, mentally I was ready to be patient.

Then, all of a sudden it hit me. Nausea. I was being proactive about my nutrition, but suddenly, around the 25km mark, even the smell of food made my stomach turn. I would vomit when I tried to eat anything!

I thought things would turn around if I stuck to liquid calories and salt to get back in some electrolytes, but things just got progressively worse. Sipping coca cola soon lead to vomiting and by the 50km mark I was stuck to drinking a salt solution provided by the aid station, with very little caloric value. I was worried and I wanted to quit.

I had an amazing support crew who were meeting me around all sections of the course (which were really hard to get to), so perhaps that was a source of motivation. But, for me, running is so personal. I won’t simple do a race or a run because someone tells me to, I must be convicted to do it myself. So I kept going.

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This time, every uphill, or slightly steep pitch I was dry heaving. Pushing my body past a certain pace caused me to double over with nausea. I was 67km in.

My mind was spiraling. I worried about my place. How I was competing – I wasn’t competing. I wondered what people would think about my performance, it was the world championships, I wondered if I was a horrible runner now. I thought about quitting simply because I wasn’t in a podium position like I imagined I would be. Right then, I stopped on the trail, and told myself out-loud: ‘That’s a horrible reason to quit Hill, and it’s not why you run.”

 

So I kept moving forward. Around 75km now.

 

I wanted to quit! Why wasn’t I quitting?? Should I quit? Am I causing myself damage? How am I able to walk up this mountain with no food in me??

 

I carried these questions with me into the last major aid station at 81.5km, convinced this was the time to call it quits. I had run 50 miles – that was good enough. Plus, I didn’t want to run in the dark. I was ready to quit, like I had told myself around the 30km mark.

 

My crew had everything prepared. My headlamp, water, more water – water was the only thing I could stomach now. I looked at their faces to confirm my defeat, but they told me they’d see me at the finish. I didn’t believe I’d make it. But I got up, making my way towards the door, hesitant. I wanted to quit, to end the suffering, but I was still moving toward the door. I left in a slow trudging jog.

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Where was the hope, the perseverance, and this determination within me? Why were my feet still moving me forward? How? Why won’t my stomach stop hurting? How in the world am I still dry heaving? Why am I not quitting?? I still want to quit.

 

These words played like a broken record within my head. Repeating, circling, questioning, begging myself to quit. I really had no idea how I was still moving or if there was anything to be proud of with my performance. I was absolutely defeated. Yet, still moving. How were these two things possible?

 

The last few hours of my race were all a blur. The dull ache of my stomach and my circling questions made time irrelevant. I came to when I say the 1km mark on the side of the trail. I had made it to the finish, but not in a triumphant manner, or with any extra surge of energy. I was relieved and confused crossing the finish line. Why and how did I keep going? How did I make it hear.

 

Over the next few days, I kept reliving my experience and I still can’t explain what transpired that day. I’ve always said I run for the challenge, and the strength it gives me as a person. That day I felt the weakest and most challenged in a race or run. Extraordinarily, I still had something more. Nothing tangible or explicable, but I had something deeper that kept me moving forward, something that wouldn’t let me give up or give in to the pain, the challenge and doubt.

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I wouldn’t have discovered this silent strength, this powerful force within me, unless I was pushed past my limit. I would have never known I possessed this immeasurable strength if I had not kept going that day. This is my silver lining, and the true reason why I run. There is strength in the struggle and grace in the challenge. All I must do, is simply run.

 

 

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Thank you to The North FaceSky RunnerUltimate DirectionSkratch LabsSwiftwick Socks and Real Athlete Diets (RAD) for their continued support.