Doug Ventura will never forget that fall day in 1981. He and two other police officers from Montgomery County, Maryland, were trying to arrest a man strung out on angel dust when the suspect started kicking Ventura in the side and face, again and again and again. It took four operations for doctors to repair Ventura's fractured spine. But the pain never really went away. It was as if someone had forgotten to turn off a switch somewhere deep inside his body.
The only painkiller strong enough to relieve his suffering was morphine, a narcotic that is, like heroin, derived from opium. But Ventura's doctors were reluctant to give him an open prescription for fear he would become addicted. Forced to retire, Ventura spent much of the next 10 years confined to a hospital bed in his living room. Sometimes in his despair his thoughts turned to suicide.
Then in 1990 a new doctor suggested a radical solution: Ventura should go back on morphine and stay on it. Drug companies had developed a timed-release formula that had proved helpful in other cases. The treatment allowed Ventura to abandon his hospital bed and, for the first time, lift his infant son. The downside was that he was chemically dependent on morphine; the upside was that he was no longer in pain. "I had a lot of trepidation about taking narcotics," says the ex-cop, now 46. "But until I was put on sustained-release morphine, I had no life."
Look behind today's headlines about physician-assisted suicide and the right to die, and you'll find that what people are really talking about is the management of pain. Or rather, the mismanagement of pain. For the more neurologists learn about pain--what it is and how it is experienced--the more they are convinced that the key to pain relief is already at hand. Most kinds of severe pain, these scientists say, could be treated safely and effectively if doctors would only make more liberal use of narcotic drugs, particularly morphine.
Narcotics. The word conjures up images of dope peddlers, undercover cops and mandatory prison terms. No matter that morphine is more effective than most prescription-strength painkillers. No matter that the vast majority of patients today can take the drug without becoming addicted. Quite a few doctors, a large number of their patients and much of the health-care establishment want no part of it. Even specialists in the treatment of pain who prescribe narcotics on a regular basis refer to the drugs as "opiate medications," as if calling them by a different name would counter their shady reputation.
No one is advocating the use of narcotics to treat a stubbed toe. These powerful drugs are indicated only for the most severe, disabling pain. But research conducted over the past 20 years into the mechanisms by which the body experiences grievous pain suggests that certain narcotic drugs are so well suited to relieving suffering that it seems callous, maybe even negligent, not to use them.