Friday, June 24, 2016
Just take a pill!
I've written quite a bit here about chronic pain. As your humble correspondent has written many times, long-term opioid use is not just dangerous, it is ineffective. And most people don't benefit from other pharmaceutical treatments. They might be worth a try, but if you do have chronic pain of neurogenic origin, you will probably need what we call a bio-psycho-social approach. That means learning how not to let pain get the better of you. Physical therapy, graded exercise, cognitive behavioral therapy, all can help.
I don't buy the full menu of non-pharmaceutical options listed by NYT reporters Meier and Goodnough -- acupuncture and chiropractic are bunk -- but I do draw your attention to the basic point. Insurers will pay for pills, but they won't pay for a comprehensive bio-psycho-social approach to chronic pain. I would add that doctors don't really know how to do it either, all they know how to do is write prescriptions.
This is a fundamental problem in our culture. We expect a pill to make everything better, whether we are anxious, or sad, or in pain. But they really don't work for those problems and the idea that what your problem is really bad chemicals that can be fixed by other chemicals is a basic misreading of your situation.
What you suffer from is the human condition. We can work hard to make that better, but there isn't any pill for it.