“Pain has become our fifth vital sign.” Speaking last fall at a New Jersey symposium on pain management called “Do No Harm,” the chairman of emergency services at Hackensack University Medical Center said what his audience of doctors and nurses hardly needed to be told. The speaker was borrowing a line from the American Pain Society, a patient-advocacy group whose research is supported by pharmaceutical companies. “In a certain way,” he confessed, “we have created our own monster.”
The speaker was referring to the nationwide surge in prescription drug addiction, particularly opioid painkillers, which now kill nearly 17,000 Americans per year.
There was no mistaking the focus of the day: thorny legal issues rather than lessons in care. If the audience came expecting guidance in the clinical management of pain, they went away disappointed. Who gets to measure suffering? Who draws the line between legitimate relief and drug abuse?
Americans are simultaneously overmedicated and undertreated. Despite the promise of relief through pills and significant medical advances, effective and nuanced care for pain continues to prove elusive, and prohibitively expensive. While some suffer, others are overdosing at alarming rates. And society’s tolerance for addicts is about as generous as its tolerance for pain.
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