The Politics of Pain

While our country and states debate whether health care should be accessible for all, there is a constant struggle for those who are covered by health insurance as to what the insurer will pay for.  Interestingly enough, insurance companies will spend hundreds of thousands of dollars a year on pain medication for me and other chronic pain sufferers, inpatient treatments, and a variety of specialists to try and help cope with pain.  However, they will not pay for acupuncture, reiki, massage, biofeedback or unlimited therapy.  All of the aforementioned therapies are ones that have been scientifically proven to have benefit to those suffering from chronic pain.

This emphasis on medication leads me to believe that the pharmaceutical industry has a much tighter grip on the insurance companies than most Americans are willing to believe.  For instance, my last hospital stay was 8 days.  I had a picc line.  I was given numerous medications via the picc line.  It was never once questioned whether I needed any of those medications or not.  However, when I went to see my therapist (every person dealing with chronic pain MUST have a therapist - preferably one trained to deal with chronic pain and its complex issues) I was denied coverage for more than 10 sessions.  Basically, the insurance company would rather spend literally thousands of dollars on medication than a thousand dollars for 10 sessions for me?  "People with chronic pain are twice as likely to suffer from depression and anxiety as those without.  You enjoy your loved ones less, and you are less enjoyable to them. If pain affects body, mind and spirit, then treatment must address these three pillars of the human condition."  Clearly, the mental component of chronic pain is an extremely complex one and those suffering need a place to decompress, learn new coping skills, and vent frustration in a safe and constructive way of being forced to live a life different than we had planned.

The statistics in the Time article that I link to are staggering:
76 Million Americans experience chronic pain
Chronic pain costs close to $50 billion dollars a year
45 million Americans suffer from chronic headaches


These figures shock me.  I know many many people and there are very few of them who suffer from chronic pain.  Either people are not sharing their experience with me or I am staggeringly blind.  Both of those scenarios I have trouble accepting.  No, I don't think I am some sort of God's gift to those in chronic pain but I know that for me, I had to search to find others struggling with the same issues I was.  Even when we were living in Madison WI, I knew few people who were struggling with chronic pain.  So that leads me to ask two questions: what constitutes chronic pain and where is everyone?

I don't like the pain scale of 1 - 10 because every person handles and feels pain differently.  Not to mention that when you have been in pain as long as I have, your baseline is different.  Allow me to explain.  On a scale of 1 - 10 of "normal" people, my baseline is a 7.  But, if that is my baseline then doesn't a 7 = 0 for me?  This scale becomes even messier when I am trying to sort out head pain from back pain.  See, I tolerate head pain better than back pain because I have a headache every single second of my life.  So, are researchers considering chronic pain people who are in pain (including a 1 or 2) every day of their life without any change in their day to day life or are they restricting that designation for those whose life has been greatly changed due to pain i.e. cannot work or have had to change amount of work, bedridden, require extra home care, etc.?

Where is everyone?  If 76 million Americans are have chronic pain, why are we not banding together and shouting from the rooftops?  Why is it so difficult to find others?  Why has the insurance industry continued to throw medication at us instead of supporting alternative therapies?

There are many concerns with opioid and narcotic abuse in chronic pain patients but those concerns are complex.  First, are patients addicted or habituated?  If you are taking medication as prescribed and then suddenly have to stop, you will have withdrawal because your body is habituated to taking the medication.  Some would view that as an addiction.  They would be incorrect.  An addiction is using medication in a non-prescribed way.  One of the largest concerns I hear and read about is the prescribing of narcotics and opioids for patients who then have the medication stolen from them or willingly share their prescriptions with friends or family member.  Americans are using 99% of the worlds supply of hydrocodone.   That is an awfully high amount.  When you look at the data on mortality and addiction, it becomes increasingly stupefying to me that insurance companies continue to pay for these medications and not encourage or pay for alternative therapies.

There are no easy answers for chronic pain and for the prescribing of medications.  Nor am I implying that medications should not be given for those who need it.  What I am advocating for is that insurance companies, and the medical profession, realize that there are alternative therapies that are helpful to those coping with chronic pain and we should be given every option to decrease our pain and increase our productivity and happiness in this life.