MADAWASKA, Maine — For more than two decades after Gaeten Bourgoin hurt his back at the mill where he worked, the Madawaska native suffered through chronic back and leg pain, and lived through an opioid-induced haze to fight the pain.
Now that he is enjoying a more normal life by using medical marijuana, Gaeten says he does not want to go back to those hard-core pain killers that nearly killed him.
He may have difficulty doing that, however, if the insurance company representing the Twin Rivers Paper Co. wins its case before the Maine Supreme Judicial Court to stop reimbursing him for his medical marijuana.
“Chronic pain is not a life I chose. But, it’s a life I live,” Gaeten said recently, while sitting in his Madawaska home with his wife Nancy.
Now 58, he started working at what was then Fraser Papers in 1980. He was 29 and worked on the No. 8 machine at the Madawaska mill when he injured his back in 1989. He first went to the mill nurse but then was transported to the emergency department at Northern Maine Medical Center in Fort Kent, due to pain and back spasms.
He later returned to light duty work for a few months until he finally left for good after qualifying for disability benefits in 1992.
“I couldn’t bend at the waist. It would hurt so much,” Gaeten said. “I never thought this was going to be a permanent thing.
The injury led to persistent and eventually debilitating pain, which Gaeten and his doctors initially addressed with various opioid medications and eventually medical marijuana.
Switching to medical pot five years ago, according to Gaeten and Nancy, not only helped alleviate his chronic pain but allowed him to crawl out from behind the dark walls that long-term opioid use had built around his life.
“I said, ‘Thank God,’ when I first tried medical marijuana,” Gaeten recalled.
Nancy said she has seen a big positive difference in his personality and quality of life since the transition from opioids to medical marijuana in 2012.
“Wow. Our lives have changed,” she said.
The switch to medicinal pot, and whether or not insurances should pay for it as a medication, are at the crux of Gaeten’s court case.
In 2015, the Maine Workers’ Compensation Board ordered Sedgwick Claims Management Services of Memphis, Tennessee, which administers Twin Rivers’ insurance plan, to reimburse Gaeten for his medical marijuana costs.
Attorneys for the mill and Sedgwick appealed that decision, arguing that an insurer cannot be ordered to pay for marijuana since it is illegal under federal law.
The Maine Supreme Judicial Court justices heard arguments in the case in September, but have not handed down an opinion.
“Chronic pain is not a life I chose. But, it’s a life I live,” Gaeten said.
Before his injury, Gaeten and Nancy were not yet married, but were enjoying a very active life together, they said.
“I did everything,” he said. “Motorcycling, canoeing. We used to travel a lot. That all stopped.”
Severe pain and a reduction in strength and range of motion in his legs made walking extremely difficult and using stairs nearly impossible. He said doctors have told him the pain is caused by damaged nerves and not any issues with his vertebrae or discs.
It was in 1990, at the recommendation of a neurologist in Caribou, that Gaeten first began using opioids for pain relief.
“She said there was nothing more she could do to help,” he said.
Gaeten also sought relief of his chronic pain from chiropractors, which proved unsuccessful. He continued seeking treatment from doctors and pain specialists.
“I have been to some big hospitals,” including facilities affiliated with Tufts Medical Center in Massachusetts, Yale School of Medicine in Connecticut, and the Mayo Clinic in Minnesota, he said.
In his nearly 20 years of opioid use, Gaeten’s personality changed and he was still not free of the pain.
“He looked like a person who was addicted to drugs,” Nancy said.
“I had zero quality of life on opioids,” Gaeten said, adding that he rarely got out of the house.
“I was in bed right after dinner, every day,” he said. “These opioids play in your brain.”
For Gaeten, who had worked since he was 16 years old and served 12 years in the Maine Army National Guard in Fort Kent, being out of work has been especially frustrating.
While the pain was mitigated somewhat by the prescription medications, Gaeten said his mind was still clouded and his interest in interacting with the world was muted.
“I was depressed,” he said. “When I was on opioids I wanted to die. The pain was so bad.”
Living with her husband on opioids also was difficult for Nancy.
“It wasn’t pretty,” she said. “His eyes were always half closed and his speech was slurred. I would tell doctors to get him off those pills.”
“I wanted her to leave [me], for having no quality of life for herself,” said Gaeten.
“Being patient is important,” she said. “Married or not, when you love someone you stay.”
Five or six years ago, Gaeten said he was taking either morphine or fentanyl, and a bad reaction to the drugs sent him to the emergency room.
“I told the doctor I was all done with opioids,” recalled Gaeten.
Following that last ER visit and a subsequent stay in an adult psychiatric unit because of his suicidal thoughts, Dr. Silwana Sidorczuk, a family practice doctor with Northern Maine Medical Center in Fort Kent, suggested Gaeten consider medical marijuana.
“She told me she was scared when I was on opioids,” he recalled.
Gaeten stressed that the doctor listened to him and did not take recommending the switch to medical marijuana lightly.
“I think doctors need to trust patients before agreeing to prescribe pot,” he said.
Sidorczuk put Gaeten in touch with Dr. Dustin Sulak of Integr8 Health in Falmouth, who worked with Gaeten to get him certified under the Maine Medical Use of Marijuana Act.
“It doesn’t take the pain away,” Gaeten said of the pot. “But it does calm it down. The pain is not overloading you, like on opioids.”
Bourgoin said he has tried nerve blockers and other medical procedures over the years, but none has worked. He anticipates needing to use medical marijuana for the rest of his life.
“I am still disabled,” he said. “I still struggle with chronic pain every day. But, my head is clearer.”
Gaeten said that since using medical marijuana he has largely returned to the world and gets out more, interacting with friends and family again.
“I don’t smoke 24 hours a day,” he said. “Just enough to calm down the pain.”
At first, Gaeten tried edibles containing the medical marijuana. Today, he uses a combination of edibles, vaporizing and smoking.
While Gaeten declined to talk about the specifics of his court case, he did say that the cost of medical marijuana is substantially less than that of opioids.
“They were a lot more expensive,” he said, adding that his medical marijuana is about $300 each month, compared to $2,500 or more for the opioids he was on.
Gaeten said he never did drugs of any kind in his youth and would not be interested in pot if it were not as a medical treatment. The stigma that sometimes accompanies medical pot is not of particular concern to the Bourgoins.
“The people that know him — they see a big difference,” from when he was taking opioids, Nancy said.
“I wish the federal government and states would work together on this. These opioids are bad news,” said Gaeten. “I was lucky to get out without dying.”
There is no timeframe for when the state’s high court justices must hand down an opinion in his case.
“We argued our case on Sept. 13,” Gaeten’s attorney Norman Trask said on Oct. 25. “Hopefully, we will get a decision within the next month or so.”
For Gaeten, taking his concerns to the level of lawsuits and a review by the high court was not a decision made lightly.
As he listened to the oral arguments being made to the high court last month via an internet link, Gaeten’s very private story and struggles were suddenly very public.
“It was all about me,” he said. “They were talking about me, at the supreme court. It felt strange.”
Gaeten is hopeful he will prevail in his particular case. Regardless, however, he wants people and lawmakers to realize that medical marijuana is a legitimate alternative to manufactured medications that may be addictive and carry with them serious side effects, which can lead some patients down a dark path.
Bangor Daily News writer Judy Harrison contributed to this report.
