Oxycodone, 30 mg. Photo: CVS
For the rest of his time on Earth, one of my best friends will be walking the fine line between the life-preserving benefits of opioid pain medication and addiction.
I call my friend The Mayor of Martha's Vineyard. For The Mayor, powerful pain medications have been a blessing since 2002, when both of his lower legs were shattered in a horrific car crash on the island. The driver, one of his best friends, died in the driver seat beside him.
"My body will never be the same, and I need surgeries every two years just to be functional," The Mayor told me this week. He has been "tapered off" all opioid medication this year, but knows he will go back on oxycodone or Percocet following a hip replacement procedure in the fall, another consequence of the deadly wreck.
The Mayor is resigned to his need for opioid medication and the necessity to take steps to avoid addiction. A pain management doctor has been working alongside his primary care physician for the past three years, and monthly urinalysis testing is part of the pain doc's deal.
"That's probably the best thing as part of their treatment program," he said of the urinalysis tests, which not only keep patients honest but also provide pain doctors with solid data to help manage medication dosage. "And most people will do [the urinalysis voluntarily]. They are not addicts. They're law-abiding citizens."