TEDTALK The agony of opioid withdrawal — and what doctors should tell patients about it

As the symptoms dialed up in intensity, my internal thermostat seemed to go haywire.

As the symptoms dialed up in intensity, my internal thermostat seemed to go haywire.

I was given what I now know is a much too aggressive tapering regimen, according to which I divided my medication into four doses, dropping one each week over the course of the month.

The result is that I was launched into acute opioid withdrawal.

Sadiye became concerned, and she called the prescribing doctor who very helpfully advised lots of fluids for the nausea.

The pain docs saw their job as getting pain under control and when I couldn't get off the medication, they saw me as the purview of addiction medicine.

So I was back in my orthopedic surgeon's office for yet another follow-up appointment.

I became nauseated, lost my appetite, I ached everywhere, had increased pain in my rather mangled foot; I developed trouble sleeping due to a general feeling of restlessness.

At the time they felt like a neural misfire, similar to the goosebumps.

I was given what I now know is a much too aggressive tapering regimen, according to which I divided my medication into four doses, dropping one each week over the course of the month.

00:49 In two months of escalating prescriptions, this was the first time that anyone had expressed concern.

The pain docs saw their job as getting pain under control and when I couldn't get off the medication, they saw me as the purview of addiction medicine.

America's epidemic is far bigger than that, but when a medication is responsible for tens of thousands of deaths a year, reckless management of that medication is indefensible.

"Look," he told us, "my initial advice to you is clearly bad, so my official recommendation is that Travis go back on the medication until he can find someone more competent to wean him off."

I alternated between cooling my feverish head against the ceramic tiles and trying violently to throw up despite not having eaten anything in days.

06:24 The insomnia became unbearable and after two days with virtually no sleep, I spent a whole night on the floor of our basement bathroom.

Several times a day I would get that welling in my chest where you know the tears are coming, but I couldn't stop them and with them came desperation and hopelessness.

I would sweat profusely almost constantly, and yet if I managed to get myself out into the hot August sun, I might look down and find myself covered in goosebumps.

00:49 In two months of escalating prescriptions, this was the first time that anyone had expressed concern.

I was nonchalant, having given this information to many doctors many times before, but this time was different.

My dependence on opioids was entirely predictable given the amount that I was prescribed and the duration for which I was prescribed it.

01:09 What happened next really came to define my entire experience of medical trauma.

The tears that had felt like a misfire before now felt meaningful.

I basically stopped eating, and I barely slept at all thanks to the jitters that would keep me writhing all night.

06:24 The insomnia became unbearable and after two days with virtually no sleep, I spent a whole night on the floor of our basement bathroom.

I became nauseated, lost my appetite, I ached everywhere, had increased pain in my rather mangled foot; I developed trouble sleeping due to a general feeling of restlessness.

When my desperation was clearly coming through my voice, much as it is now, the receptionist took a deep breath and said, "Mr. Rieder, it sounds like perhaps what you need is a rehab facility or a methadone clinic."

06:24 The insomnia became unbearable and after two days with virtually no sleep, I spent a whole night on the floor of our basement bathroom.

I would find myself with tears coming on for seemingly no reason and with no warning.

Well, after I initially published my story in an academic journal, someone from the CDC sent me their pocket guide for tapering opioids.

It was a deep sense of jitters that would keep me twitching.

10:31 This is a recipe for disaster and any such disaster would be interesting and worth talking about -- probably worth a TED Talk -- but the failure of opioid tapering is a particular concern at this moment in America because we are in the midst of an epidemic in which 33,000 people died from overdose in 2015.

But I believed it to my core because I no longer had any hope that I would be normal again.

But focusing only on the rate of prescribing risks overlooking two crucially important points.

My dependence on opioids was entirely predictable given the amount that I was prescribed and the duration for which I was prescribed it.

I fell asleep, I slept through the night and when I woke up, the most severe symptoms had abated dramatically.

And second: we can still fight the epidemic while judiciously prescribing opioids to people who really need them by requiring that doctors properly manage the pills that they do prescribe.

I alternated between cooling my feverish head against the ceramic tiles and trying violently to throw up despite not having eaten anything in days.

I hung up and I started calling those places, but it took me virtually no time at all to discover that many of these facilities are geared towards those battling long-term substance use disorder.

Sadiye became concerned, and she called the prescribing doctor who very helpfully advised lots of fluids for the nausea.

As the symptoms dialed up in intensity, my internal thermostat seemed to go haywire.

This story is important precisely because I'm not special; because nothing that happened to me was all that unique.

The result is that I was launched into acute opioid withdrawal.

America's epidemic is far bigger than that, but when a medication is responsible for tens of thousands of deaths a year, reckless management of that medication is indefensible.

"Look," he told us, "my initial advice to you is clearly bad, so my official recommendation is that Travis go back on the medication until he can find someone more competent to wean him off."

I basically stopped eating, and I barely slept at all thanks to the jitters that would keep me writhing all night.

Furious, we called the prescriber back and begged him for anything -- anything that could help me -- but instead he apologized, saying that he was out of his depth.

I was in agony.

So for instance, we're now gaining evidence that American physicians often prescribe medication even when it's not necessary in the case of opioids.

The result is that I was launched into acute opioid withdrawal.

01:09 What happened next really came to define my entire experience of medical trauma.

These sorts of considerations help to explain why America, despite accounting for only five percent of the global population, consumes nearly 70 percent of the total global opioid supply.

I assumed I would die --

09:11 So -- I'm sorry, I have to gather myself just a little bit.

As somebody who has had severe, real, long-lasting pain, I can assure you these medications can make life worth living.

08:09 After being turned away from a rehab facility, I finally admitted defeat.