The following is a recent interchange with a patient. He had sustained a leg injury while working construction, and the pain did not resolve. He was eventually diagnosed as having _RSD_ (CPRS Type I) and entered a pain center where he was placed on increasing dosages of narcotics.
He has a 10th grade education and no GED. Just prior to injury, he had married a woman several years his senior who had four children and an ex-husband in prison. She did not work, and the family was now living on his $275.76workers_ compensation check.
He relates the following about his days, his future and his life:
_I usually take my Oxycontin three times a day_sometimes I take four and then run out of them. My cousin had a back injury, and he has some left over because they make him sick so I take his.
I take oxycodone for what they call _breakthrough_ pain, and my mom and sister have a lot of them because they are both disabled. I guess I take 6 a day on some days but mostly about four.
If it (the pain) really gets bad, I drink a six pack or two. Alcohol is not a problem for me, and I have not had a DUI in almost three years. Sometimes I run short on money for cigarettes. I have smoked a couple packs a day for a long time, but with nothing to do, I smoke even more nowadays.
My wife is on me to get back to work, but I know that the insurance company is watching me. People tell me that they always do. I could work with my brother-in-law, who has a landscaping business, and he has some easy work and would pay me good money, but I was told that this would hurt my settlement. A guy down the street got three hundred thousand for a car wreck so I am thinking that I_ll get more than that.
My wife complains that I do not get up and help her with the apartment or the kids, but even when I take a lot of pain medicine at night, I don_t sleep very well and am beat in the morning. She sleeps late and wants me to feed them. Her oldest son has gotten into a lot of trouble. Her other son does real good in school when he goes. Her daughters are 13 and 15, and some nights they don_t come home at all.