For anyone who hasn’t already seen it, this article in the NY Times, “A Soldier’s War on Pain,” is worth a careful read.
It’s generally accepted that our current prescription drug epidemic– the one the article mentions in connection with 16,000 deaths annually– was motivated in large part by Big Pharma’s desire to get new opioid products into widespread use. From a purely selfish economic standpoint, chronic pain patients represent the best possible customer for drug companies, precisely because they don’t improve that much over time. Instead, they’re likely to become perennial consumers, dependent on the medication, whether or not it’s actually still doing all that much to suppress their pain.
The insurance industry understandably has a natural bias in favor of medications for chronic disorders. Over time, they represent the least expensive option. And as the article notes, many physicians were misled by experts who insisted the risk of addiction was low in cases of chronic pain — based on what turned out to be some highly questionable research.
Apologies if this is starting to sound like a conspiracy– it wasn’t. It was an unfortunate alliance between the self-interest of corporations with a need for increased earnings, and some well-meaning but flawed efforts by advocacy groups. The adverse consequences were all unintended. That shouldn’t make us feel better about our healthcare system.
Here’s a consideration: Opioids suppress pain, but they also have a depressant effect on central nervous system (brain) function. Long-term dependence on these medications can adversely affect mood and motivation. Mood and motivation are, of course, a big part of the discomfort associated with having chronic pain.
In other words, the treatment may actually be interfering with prospects for recovery.
From my viewpoint, that’s justification for the time and effort involved in exploring newer approaches like those described in the Times article. Let’s hope our insurance and pharmaceutical companies agree.
