David Becker is a social worker, patient advocate and political activist, residing in New York City, who believes the needs and concerns of pain sufferers are not adequately addressed by the National Pain Strategy. He comments often on National Pain Report stories and we asked him to share his thoughts expressing his views which we thought are interesting, provocative and worth sharing.
The U.S. should encourage diverse and independent thought in pain care and help to build capacity of all Americans in a way that is other-regarding. Building capacity doesn’t mean the average Joe will think just like someone from the American Academy of Pain Medicine (AAPM) about pain care. To the contrary, Americans need to be much more fluid and flexible in their thinking than members of the AAPM could imagine.
Too many Americans in pain have been marginalized, disenfranchised, and left to suffer from a pain care system that for too long has been one rough beast. Yet, remarkably, politicians believe more of the same biomedical research – the cures initiative or precision medicine will work.
People like myself, who have seen the failures of the decade of the brain, (where Dr. Judd in the 1990’s claimed we would “largely conquer mental illness by the year 2000”) and the last decade of pain research and control, are ignored because we are doubtful “a new and improved” biomedical pain care will make a difference. And so the government and the experts turn their heads when they are faced with opinions that are vastly different then their own. When you look at pain care in the last decade, new and improved drugs and treatments have done little to lower the prevalence of pain or the satisfaction of pain sufferers.
A new and much more sophisticated model needs to be developed – and there is no recognition of such from the power elite. They neurotically believe the same old deference to powerful special interest groups is the answer to everything as they see those groups as a well sharpened Swiss Army Knife that can be used for any problem. The only trouble is we aren’t lowering the costs or prevalence of pain – not to mention those special interest groups don’t even care about such.
Think about this for a moment – over 12,000 RCT’s have been done on opioids. Last year a report sponsored by NIH indicated they lack evidence for chronic non-cancer pain – so what is the government planning to do? More research on opioids. Why not do more research on anti-convulsants or lasers or ultrasound for pain, instead? Why not give a fair and full chance to other treatments for pain? From where I sit, it’s clear to see our government isn’t about helping the many people in pain – they wish to help the health care industry grow regardless of how Americans are hurt or helped.
And so discursive imperialism from the AAPM or the American Pain Society or those “professional voices” is just another reflection of their failure to get it right when it comes to pain care. And so, from where I sit, it is plain to see that pain care in America is not about Americans suffering from pain – it is about managerialism and social darwinism. People in pain will remain an underclass due to the longstanding indifference and managerialism of power elites who don’t engage in reflective practice. And that magic “soma” dream they have will only drain the financial resources of our Nation.
Since inquiry is not obligated to the words of authorities, so I will continue to fully and freely explore our pain care system.
Let us hear from those at the margin, let us have the benefit of independent and diverse thought about pain – that’s what a vibrant democracy is about – and that is the best way to remedy those in government and industry who would make all Americans ripe for their ill-conceived designs.
Editor’s Note: The deadline for public comment is May 20th. You can leave your comments online. Here’s the link.