The International Association for the Study of Pain issued a declaration saying it is. People have a right to receive pain relief, without discrimination, via medications and non-medication techniques; to have pain assessed as a vital sign; to be treated by medical personnel trained in pain management; and to have chronic pain recognized as a disease entity that requires comprehensive treatment.
In a related story, Human Rights Watch published a report revealing that “most Kenyan children with diseases such as cancer or HIV/AIDS are unable to get palliative care or pain medicines,” because existing programs don’t serve children, health-care workers are inadequately trained in managing pain, and inexpensive opioid medications are scarce due to government policy and providers’ reluctance to give these drugs to children.
I learned of these developments while I was also reading—actually, devouring—Melanie Thernstrom’s acclaimed new book, The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing and the Science of Suffering. The meticulously researched book covers the history of how we interpret and treat pain; the relationship among pain, the body, and the brain; and Thernstrom’s story of living with chronic musculoskeletal pain.
Thernstrom describes injustices in how pain is perceived and treated. For example, women with chronic pain are more likely to receive medications for depression and anxiety, while men are more likely to receive opioids, surgery, and complete exams. She says women who aggressively demand pain treatment are more likely to be dismissed as hysterical, and women’s fears of being perceived as demanding make them hesitant to report pain. African Americans are also more likely to be under-treated for pain, denied opioids, and to “have their requests for medication interpreted as ‘drug-seeking behavior,'” she writes.
Thernstrom also documents an “opioid backlash”—an overzealous response to prescription painkiller abuse. The backlash has left some patients unable to get relief, as more doctors are reluctant to prescribe opioids as they witness colleagues being prosecuted, sometimes unfairly, for prescribing the drugs. Thernstrom predicts that decades from now, people will look back with pity on patients from whom opioid pain medication was withheld because of misguided fears and misinformation, just as we pity our ancestors who, sickened by infectious disease, were subjected to bizarre, cruel, and ineffective “treatments” before the germ theory came along.
This backlash might lead, unjustly, to the criminalization of people who take opioids with legitimate prescriptions for legitimate pain. As one of those people, I was alarmed to read about some North Carolina sheriffs who want to obtain a list of state residents with prescriptions for pain drugs. Claiming that the list will help them fight prescription drug abuse, these law enforcers apparently believe they need to keep tabs on people like me, as they do sex offenders and ex-felons.
While some Americans are subjected to stereotypes or inadequate responses to severe or chronic pain, residents of poorer countries often lack access to more basic pain relief. In parts of China and Africa, surgery is still often performed without anesthesia (although in China, there is some documented success with using acupuncture to prevent surgical pain). Non-prescription pain medicine is a luxury in many developing countries. I recently loaded up my shopping cart with children’s Advil and Tylenol for a friend to take on a trip to an Ethiopian orphanage, where children get no relief from the pain of sprains, fevers, headaches, and broken bones.
I have a genetic bone disorder that causes both acute pain (due to frequent broken bones) and chronic pain (due to joint and bone deformities). My oldest child shares my diagnosis. If you were to ask me for an image to illustrate what grace looks like, I would tell you about the EMT who responded last summer when my daughter had an accident resulting in multiple fractures. As my daughter lay in agony on the hot asphalt, the EMT lay down next to her and, from that awkward position, quickly and almost painlessly started an IV, through which my daughter received morphine to ease her pain for the ambulance ride. Adequate pain medication, administered by a skilled professional who saw pain relief as a primary duty, made a terrible day a bit more bearable. It was a gift for which I will always be grateful.
Thernstrom notes that “pain never simply ‘hurts.’ It insults, puzzles, disturbs, dislocates, devastates,” leaving those in pain feeling that they have lost their real lives, even lost themselves. As people concerned about justice, dignity, and wholeness, Christians might pay more attention to the emerging movement to relieve those whose selves are threatened by pain. Every human, including Kenyan children dying of HIV/AIDS and the estimated 70 million Americans who live with chronic pain, deserves to have their terrible days made a bit more bearable.
This is the first of two posts on Christian responses to physical pain. The next post will explore Christian understandings of pain as transformative and redemptive.
