What the Columbine shooting taught me about pain and addiction | Austin Eubanks | TEDxMileHigh

"Less than an hour after scrambling out the back door of the Columbine High School library, I was lying in a hospital bed, medicated on a variety of substances intended to relieve my pain," recalls survivor Austin Eubanks. That was the beginning of a decade-long addiction that led to a profound realization about the current opioid epidemic: how we manage pain is both the problem and the solution.

An injured survivor of the Columbine shooting, Austin Eubanks' traumatic experience as a teen was the catalyst to his painful journey through addiction. Now in long-term recovery, he is a nationally recognized speaker on addiction recovery and the Chief Operations Officer of The Foundry Treatment Center, a 30-bed treatment program in Steamboat Springs, Colorado.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

Do you remember where you were
on June 12th, 2016?

A few of you might, but I'm betting
the vast majority probably don't.

On June 12th, 2016, a lone gunman walked
into Pulse Nightclub, killing 46 people

in the deadliest mass shooting
by a single gunman in U.S. history.

Now let's go back about a decade.

How about August 29th, 2005.

Do you remember where you were?

We've got a few heads nodding out there.

That was Hurricane Katrina.

Over 1,800 dead
in the costliest natural disaster

ever to hit the North American continent.

Now let's go back another few years
and go for 100 percent recognition.

Do you remember where you were
on September 11th, 2001?

Everybody's head nodding now.

The September 11th attacks
left over 3,000 dead

in the worst terrorist attack
in U.S. history.

Do you remember how you felt?

Were you confused?

Afraid?

Did you feel sick?

Were you vulnerable?

Every time this happens, we're becoming
more and more desensitized.

We frequently see news coverage
of mass shootings, natural disasters

that result in enormous loss of life,

terrorist attacks,

and then we change the channel
to watch something more friendly.

This is the society that we live in today,
but the impact of these traumatic events

are no less serious
on those who are directly affected,

and now the impact
of emotional pain on our society

is more problematic than ever.

Do you remember where you were
on April 20th, 1999?

Two students walked
into Columbine High School

armed with shotguns, semi-automatic
rifles, and a bevy of homemade explosives,

killing 12 students and a teacher,

in what was, at the time, the worst
high school shooting in U.S. history.

I remember where I was.

I had just walked into the library
with my best friend

in order to meet others
preparing to go to lunch.

Moments later, a teacher ran through
the same doors we'd just entered

yelling for everyone to get under
the tables; that somebody had a gun.

I remember how I felt.

I was confused.

I was afraid.

I felt sick.

And I was vulnerable.

And just minutes later,
I was playing dead underneath a table

next to a pool of blood.

I had just been shot,

and I had witnessed my best friend
murdered right in front of me

as we were huddled together
waiting for help to come.

I was broken.

I was in shock,

and I was in pain.

But my understanding of pain that day

was nothing like
my understanding of pain today.

What's the first thing you think of
when you think of pain?

Is it a broken arm?
Headache? Sprained ankle?

Maybe a gunshot wound?

Those are the things
that I used to associate with pain,

and they're pretty in line
with the medical definition of pain:

A variably unpleasant sensation associated
with actual or potential tissue damage

and mediated by
specific nerve fibers to the brain

where its conscious appreciation
may be modified by various factors.

Do you notice anything missing
from that definition?

Do you see any mention
of the emotional components of pain?

Me neither.

In 1996, the American Pain Society
introduced the phrase,

"Pain is the fifth vital sign,"

meaning that when you walked
into an emergency room,

the initial assessment of your condition
was based on five data points:

pulse rate, temperature, respiration rate,
blood pressure, and pain.

This was brought about
by a cultural movement

that was adamant
that we were under-treating pain.

And patient satisfaction surveys
were put in place in order to track

the outcome and effectiveness
of this new implementation.

And what better way to promote
these new policies

than to tie physician and hospital
compensation to patient satisfaction?

A recent survey by the industry
group Physicians Practice

reports that three
out of ten doctors are paid bonuses

based upon patient satisfaction surveys,

and hospitals with better scores
receive bigger payments from insurers.

Naturally, administrators and physicians
began to support this new movement

with the goal being to get everyone's
pain to zero on the scale.

That was the mark.

The ethical dilemma immediately became,

"Do I issue this person narcotics
in order to keep them happy,

or deny them, and potentially
hurt my compensation,

the revenue of the hospital,

or at worst, open myself up to a grievance
for under-treating pain

that could potentially result
in the loss of my job?"

I have experience with pain.

Less than an hour
after scrambling out the back door

of the Columbine High School library,
I was medicated on a variety of substances

that were intended to sedate
and to relieve pain.

I was 17 years old and I'd never
drank a beer or smoked weed,

much less anything harder.

I had no idea of what these medications
were even supposed to do.

All I knew at age 17
was that a lot of highly educated people

had prescribed me medications
that were intended to make me feel better

and they were working,

only not in the fashion
that they were intended.

Now if you only remember one thing
from my talk today, let it be this:

Opioids are profoundly more effective

at relieving the symptoms
of emotional pain

than they are at relieving
the symptoms of physical pain.

I often think back to my pain that day

and if I were to rate it
on the pain scale,

my physical pain
would've been a three or a four,

and that was likely the response
I offered when I was asked.

But my emotional pain was an absolute ten.

I was in agony beyond comprehension.

But that was never asked;

it was never talked about.

Acute physical pain ends relatively quick;
complex emotional pain does not.

My physical pain had subsided
in just a matter of days

but my emotional pain
was just as debilitating

as it was lying
in the hospital bed that day,

so I continued taking the medication
that was prescribed for my pain.

I was addicted before
I even knew what was happening.

A recent survey by the American Society
of Addiction Medicine

reports that 86 percent of heroin users
began by taking prescription opioids.

And in 2012 alone, over 259 million
opioid prescriptions

were filled in the U.S.

That is more than enough
to give every American adult

their own bottle of pills.

I very quickly began drug-seeking
in order to soothe my emotional pain

and it was only a matter of months

before the prescriptions had turned to
alcohol, marijuana, and elicit narcotics.

And as addiction always does,
over the course of the next decade,

my tolerance continued to build,
my life continued to be unmanageable,

and my emotional pain stayed unresolved.

It was like I had pressed a pause button
on my emotional growth.

I was managing my pain
in the only way I knew how,

and I wasn't alone.

I believe that emotional pain
is what's driving the addiction epidemic.

Think of someone you know
who struggles with addiction.

I'm betting you can point to an element

of unaddressed or unresolved
emotional pain in that person.

Now think of a time
you were in intense emotional pain

and how desperate you were to stop it.

What if you had been offered
an immediate route to feeling better.

Imagine for a moment
breaking your leg in an avalanche.

Now that injury alone
can be a fairly traumatic experience,

but it's manageable.

With short term pain management,
most would make a full recovery.

But now imagine sustaining
that exact same injury,

only this time your close friend
was skiing next to you,

and they didn't make it
out of the avalanche alive.

It seems so crystal clear to me

that there would be two very different
pain management strategies

for what would appear to be
an identical physiological injury,

only there's not.

Emotional pain is toxic, it's pervasive,
and society has programmed us to avoid it.

We medicate with alcohol and drugs,
sex and pornography,

even television and technology,

and oftentimes, we're doing this
without even knowing it.

Our society is literally
being defined by this pain.

And now, more and more people
are dying every month

because they're looking for solace
in the only way they know how.

It's the way they were programmed.

Everyone has pain; it's unavoidable.

And I have a simple summary
for how we got here.

We built a society that is filled
with emotional pain and trauma.

We combined that with a healthcare system

that's intended to primarily treat
physiological symptoms,

and then we put Big Pharma
in the driver's seat,

aimed directly at profits with regulations
that are easy to manipulate.

And now we're in the midst
of what the former Surgeon General

called the worst public health crisis
the nation has ever seen -

two years ago.

It has since worsened,
and what was then the addiction epidemic

is now commonly referred to
as the addiction pandemic.

And here's a glimpse
of where we're at today.

The New York Times reported last month

that overdose deaths rose
by 19 percent in 2016,

and preliminary data for 2017
shows that this trend is only worsening.

We've now far surpassed the worst years
ever recorded for deaths caused by guns,

AIDS, and automobile accidents.

This data is appalling to me.

There are people in our society today
who will still write this off

under the guise of,
"They're just a bunch of junkies."

Well, I'm here to tell you ...

they're not.

They're fathers, mothers,

brothers, sisters,

they're children,
sometimes not even in their teens.

They're people just like you and me,

trying to cope
in the only way they know how,

and they're dying by the thousands
every single month

at an ever-increasing rate.

Addiction is the only disease
where we commonly wait

until it's at the highest levels of acuity
before we try to do something about it.

And by then, it's often too late.

We have to start sooner.

We have to practice early interventions.

We have to educate youth
with real world methods.

We have to stop thinking that people
can be rehabilitated in thirty days,

and then we have to improve accessibility
to long-term treatment.

We have to eliminate the stigma
associated with addiction

and most importantly, we have to reform
a broken healthcare system

that is slowly coming to terms

with the fact that they are responsible
for this pandemic.

(Applause) (Cheers)

It took me over a decade
of active addiction

and many more in recovery

before I finally learned the difference
between feeling better

and actually being better.

Because I had to learn
to lean into the pain.

I had to quit looking
for the fast road to relief.

I had to do the emotional work
that needed to be done

no matter how much it hurt.

And after multiple attempts
at short-term treatment,

I finally found a willingness
to do whatever it took,

and I stayed in a continuum of care
for 14 consecutive months

in order to figure it out.

I had to go through the stages of grief
that I should've been going through

at age 17, at age 29.

But I refused to keep running,

and it worked.

(Applause)

Fortunately for us, there is such a thing
as post-traumatic growth,

and you're witnessing that
on the stage before you today.

Post-traumatic growth is defined

as the positive psychological change
that can occur in a person

after they've experienced
a traumatic life event.

It implies that by finding a way
to endure through significant suffering,

you can actually have meaningful
development of personal character

and elevate yourself
to a higher level of functioning.

But achieving post-traumatic growth
requires that you lean into the pain.

You can't run from it.

You can't medicate it.

So now I have a challenge for you.

Take an audit of your current level
of emotional pain.

Do you have grief or heartache
that you aren't dealing with?

Has something traumatic happened to you
that you haven't healed from?

If so, take a step towards
addressing this pain.

Call a friend, talk to a therapist,
just speak your truth to a stranger.

Take one small step
to shed light on this darkness

because I've seen what darkness can do.

I've seen it in hospital rooms

when just one more
didn't end up the way it was intended.

I've seen it in jails
with people who were born addicted

and never had a chance
to learn anything else.

I've seen it at funerals for children

who died before they ever
had a chance to truly live.

And I've seen it from underneath a table
in the library of my high school.

I want to leave you all with something
that I wish I had known at age 17.

Whoever you are,
whatever you're going through,

in whatever way you might be
going through it, just know this:

in order to heal it, you have to feel it.

We're not going to solve
the addiction pandemic overnight

but we will make progress
when people start to understand

the difference between
physical and emotional pain,

and then choose to do something about it.

In recovery, we often say, you keep
what you have by giving it away.

Find the courage to lean into the pain,
and you can be a force in helping others.

Thank you.

(Applause)