The pain dilemma.
The lives of millions of Americans are altered for the worse by chronic pain, especially in the back and neck. A significant population suffers pain due to motor vehicle accidents. Regardless of the cause, however, a lifetime of terrible pain debilitates people’s lives. Doctors commonly prescribe pain pills. With chronic pain, however, any solution to the problem must be lifelong, not merely temporary. Whether the pain is extreme or less than extreme, people can become addicted to pain pills. Thus a great controversy over access to pain medication exists.
Richard Paey was injured in a car accident. After an unsuccessful surgery, Richard had chronic pain that he compared to being in a blast furnace. 60 Minutes told his story. (*) He and his family moved to Florida. There he couldn’t find a doctor willing to prescribe enough pain pills for him to make it through. He went back to his doctor in another state for the prescriptions, which he filled in Florida. Eventually, in desperation for more pain medication, authorities say, Richard forged prescriptions for himself. Now he will sit in prison for decades. Ironically, his prison doctor prescribed him a morphine pump and a wheelchair. Now Richard has the pain relief he needs.
The outlines of Richard’s story, from chronic pain to being accused of drug dependency, addiction, or even out-of-control behavior, is far from unique.
To allow doctors to prescribe the huge amounts of pain drugs necessary for chronic pain patients without fear of prosecution, the DEA drafted guidelines. In 2004, however, the DEA took back the guidelines. (†) Dr. Nora Volkow, director of the National Institute for Drug Abuse, is a strong advocate for fighting prescription drug abuse and addiction. She claims two million Americans abuse prescription drugs. (‡) Democrat Patrick Kennedy (chronic back pain) (§) and conservative Rush Limbaugh (ear pain) (**) are two prominent Americans who have faced a glaring public spotlight on their addictive behaviors and their pain problems.
The other side is respresented by Pain Relief Network, a group of patients, doctors, and others who see the grave harm that is done when palliative drugs are denied people who do suffer from debilitating chronic pain. (††) PRN aims to not let those who suffer such pain be forgotten.
As the debate goes forward, we should bear in mind the basic facts of pain. First, medicine has not yet devised a useful objective test for pain. There is no machine that they can hook you up to to get a reading on a “pain-ometer.” Pain is felt internally. We get the impression that another person is in pain when they cry out, complain, wince, or otherwise act as if they were in pain. This inability to directly experience another’s pain gives rise to many suspicions and accusations of faking. Indeed, faking pain is a problem. If a medical scientist came up with a device for measuring pain, it would be one of history’s great medical advances.
If technology remains unable to sense pain, as many believe, we will have to find ways to match our national goals with our actions. We want to defeat drug addiction, and we want to defeat chronic pain. Both are highly important national priorities. At this point, there might not be any obvious solution. Dialogue is called for. Those who experience the problem of pain and those who experience the problem of addiction need to share their experiences so that society can grow wiser. If citizens don’t get involved and tell their stories, all the important decisions will be made by bureaucrats.
Above all, however, all possible steps must be taken to prevent the onset of chronic pain. For example, in your car, don’t keep the headrest in the lowest position unless you are short. For most people, the headrest should be adjusted upward to help prevent a neck injury in the event you are rear-ended or in another collision. Perhaps auto manufacturers should be forced to increase the size of seatbacks to prevent this problem altogether. (‡‡) Post-market products (§§) might help.
Let’s hope Congress wakes up and takes action to prevent chronic pain relief, and that a dialogue can begin on the topic of chronic pain and its treatment.