Pain is designed to scare us.
It's a warning that we're hurting, a red flag that something is wrong.
It's a universal human experience, but it's also a very personal one, so you can't really know how other people feel in it. Most of us would really like to avoid that.
I've been thinking a lot about acute and chronic pain since my mom broke her arm last month. After a complex surgery to repair her fracture, surgeons prescribed opioids to deal with the pain. This is standard medical protocol.
But anyone paying attention to this country's opioid crisis may wonder about the safety of taking these painkillers. In its Morbidity and Mortality Weekly Report issued last spring, the U.S. Centers for Disease Control and Prevention found that more than 51 million Americans, or more than 20% of adults, have chronic pain; It was estimated that 17 million people live with chronic pain. Adults – have severe chronic pain (pain that limits their activities most if not every day).
Chronic pain is more common in older people than in any other age group. But their treatments come with significant risks, including dependence on painkillers.
The billionaires sitting at the top of America's pain empire are the Sackler family, owners of Purdue Pharma and the highly addictive and highly profitable drug OxyContin.
Oxy's excessive marketing contributed to a devastating and worsening national epidemic. According to the CDC, from 1999 to 2021, nearly 645,000 people died from opioid overdoses, including prescription and illicit opioids.
In December, the Supreme Court heard the government's challenge to a multibillion-dollar bankruptcy settlement with Purdue Pharma. The settlement would reorganize the company as a nonprofit organization to address the public health crisis caused by the epidemic.
Members of the Sackler family agreed to contribute up to $6 billion to the plan in exchange for immunity from future civil liability for opioid-related claims. The Sacklers want to protect the $10 billion that was moved into offshore accounts in the years leading up to Purdue Pharma's bankruptcy. (Sackler's lawyers say more than 40% of that money went to pay Purdue taxes.)
The Supreme Court will decide later this year whether the Sacklers will receive this shield of immunity and remain one of the world's wealthiest families.
In a sane society, the high court would decide whether the Sacklers should rot in prison.
In a 2021 Bulwark article, author Saul Lerczak asked if the Sacklers were “the most evil family in American history.” He argued that the Sackler family caused widespread harm to America's social fabric and caused correspondingly more American deaths than any other American family in history.
If they do that, they should be able to win the title.
I asked older readers living with chronic pain to describe what it's like to try to manage their pain with opioids. Until recently, he had been working while taking a painkiller called tramadol. But they believe he may have fractured his back, which caused the pain to spike, and doctors are now prescribing oxycodone, a stronger opioid.
“Taking enough painkillers to reduce (rather than eliminate) the pain means that even the simplest chores require special care to make sure they're done correctly.” “It means I can't think clearly unless I make a real effort,” he wrote. Every basic life activity, like checking your checkbook or putting away your groceries, requires special attention.
In addition to physical stress, mental stress also increases.
“And looking away and groaning in pain is really not good for your relationship with your wife,” he added.
The most disturbing part of his explanation was explaining how little the medication was helping him get better.
“Unfortunately, the pain continues to increase, and with it, the doses increase,” he says. “The worst part is that it's not a pleasant 'high.' ”
The last thing I want to do is scare my mother, who is still suffering from post-surgery pain, about the risks of painkillers. She knows better.
This double-edged sword is all the doctor can offer her.
Meanwhile, the Sacklers are waiting for a shield of protection.