As the opioid crisis rages unchecked in North America and addicts are dying in record numbers, the voices of law enforcement and politicians braying for action are drowning out those of terminal cancer patients whose remaining quality of life depends on fentanyl — the only drug that keeps their relentless pain at bay.
In 2013, at the age of thirty-seven, I was marketing director at the Nature Conservancy of Canada. My husband and I had just bought our first home. I was training for a half-marathon. And I had pain—excruciating pain that I managed by taking Advil and Tylenol as often as the packaging allowed. It didn’t really help. The ache was deep in my bones, like the worst toothache you’ve ever had, writ large. It throbbed and spasmed and shot like needles throughout my body. The pain grew so intense that I went to emergency, but doctors just gave me more painkillers and sent me on my way. It hurt too much to sit, so I stood and leaned through meetings at work.
The pain finally made sense when I was diagnosed with metastatic breast cancer (mbc). It wasn’t stress from over-training causing me pain, as I had initially thought; it was cancer in my bones—cancer that had metastasized to remote parts of the body to form new tumours. Even though I have cancer in my bones, my liver, my lungs, and elsewhere, it’s all breast cancer. mbc is terminal. It is incurable. But it can be treated for an indeterminate amount of time.
Fentanyl patches have not only given me relief from pain for three years now; they have given me my life back. I can now usually sleep through the night. I can now sit at a table for a meal or at a desk to write. I still can’t run, but I can walk. And fentanyl doesn’t slow down my bowels to the point of near-failure. I never have to experience the agony of feeling my medication completely wear off—that raw and naked pain, all-consuming like the darkest night. Pain and its management no longer dominate my thoughts every minute of the day. And because I am acclimated to narcotics and using just enough, neither pain nor opioids cloud my mind any longer.
I was barely a person. I was pain incarnate. A drug is neither good nor bad in its own right. Fentanyl is neither evil nor benign. It just is. And for many people, people like me, it is a crucial tool that allows us to live.