The politics of pain management

Doctors make a general distinction between acute pain from an injury that’s going to heal or disease that’s going to be cured, and chronic pain where you will be forced to deal with pain over a long period of time. So, for acute pain, all you need is a few pills and patience while the pain slowly fades away. Chronic pain should have a different approach but, for the following reasons, doctors prefer the pill bottle. If you look at the way the US healthcare service is organized, the basic motivation is making a profit. Because most patients carry some insurance, the strategy for doctors is to see as many patients in the day as possible so they can maximize the bill presented to the insurers for payment. In the good old days, a caring physician would take the time to get to know the patient and understand his or her needs. Now it’s straight to the business of writing out a prescription and calling for the next patient. Very few doctors ever take the time to investigate the underlying causes of the pain and find the best treatments because this takes time and time is money. Of course, the patients with the top-of-the-line insurance plans are covered. And the wealthy can afford to pay their own way to the best treatment. But the average citizen is on a conveyor belt to the fastest and easiest treatment which, by some strange coincidence, just happens to be a drug.

Why a coincidence?

Because all the ads you see on television and in the newspapers and magazines, are paid for by the pharmaceutical industry. The corporations making the drugs are using hard-selling techniques to reinforce your dependence on pills as the primary form of treatment. That way, you go into your doctor’s clinic with the brand names of the relevant drugs on your lips. You are brainwashed into thinking the use of drugs should be the first response to all your problems. Why is this a problem? Because it’s turning the US into a country of addicts. Worse, as people continue to use many of the drugs, their tolerance increases and the effectiveness of the drugs declines. According to the National Centers for Health Statistics, approximately 75 million people in the US suffer some degree of chronic pain, i.e. pain giving them a poor quality of life. Agreeing, the American Pain Foundation offers a simple comparison. If you count up all the people who have cancer, strokes and heart disease every year, only a million or so die every year, but the pharmaceutical industry, hospitals and clinics devote vast amounts of time and money to offering treatments. Because there’s not the same amount of money to be made out of people suffering chronic pain, you are offered second-best service.

This is a political problem and, so far, there’s no sign the reform bills going through the House and Congress will deal with this. It all comes down to the priorities of how limited money is to be spent. On the one hand, you can be offered painkillers on a take-it-or-leave it basis. This is not so bad. Tramadol is an excellent drug and gives consistent relief from moderate to severe pain. Or you can be offered access to proper diagnosis and treatment. While we wait for a revolution, buy tramadol and find some relief from the pain of your condition.