Who Suffers the Most from Chronic Pain?

Who Suffers the Most from Chronic Pain?

By Staff

Americans who are poor or are less educated are more likely to suffer in chronic pain than those who are more wealthy and more educated, according to new research published in the journal Pain1.  The disparity between the groups has skyrocketed as high as 370% in certain categories.

Sociologist, Hanna Grol-Prokopczyk, an assistant professor of sociology at University of Buffalo and the paper’s author, reviewed 12 years of data from more than 19,000 subjects aged 51 and older who suffered in non-cancer related chronic pain.

She found that chronic pain levels are rising by period and not just by age, meaning people who were in their 60s in 2010 reported more pain than people who were in their 60s in 1998.

Grol-Prokopczyk’s groundbreaking study is among the first to look beyond either the presence or absence of chronic pain to examine instead matters of degree, asking whether the pain was mild, moderate or severe. Her research, based on the Health and Retirement Study, which asked participants if they were “often troubled with pain,” also follows the same subjects over 12 years, as opposed to most studies that illuminate a point in time.

“There are a lot of pressures right now to reduce opioid prescription,” says Grol-Prokopczyk. “In part, this study should be a reminder that many people are legitimately suffering from pain. Health care providers shouldn’t assume that someone who shows up in their office complaining of pain is just trying to get an opioid prescription.”

“We have to remember that pain is a legitimate and widespread problem,” she says.

The study also serves as an argument for investing more into research for other treatments.

“We don’t have particularly good treatments for chronic pain. If opioids are to some extent being taken off the table, it becomes even more important to find other ways of addressing this big public health problem.”

People with the least education are 80% more likely to experience chronic pain than people with the most. Looking exclusively at severe pain, subjects who didn’t finish high school are 370% more likely to experience severe chronic pain than those with graduate degrees.

“I found that people with lower levels of education and wealth don’t just have more pain, they also have more severe pain,” she says. “I also looked at pain-related disability, meaning that pain is interfering with the ability to do normal work or household activities. And again, people with less wealth and education are more likely to experience this disability.”

“If you’re looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups. And other studies have shown that. But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it.”

More research needs to be done to understand why pain is so unequally distributed in the population, but Grol-Prokopczyk says it’s critical to keep the high burden of pain in mind in this period of concern over the opioid epidemic.

“If we as a society decide that opioid analgesics are often too high risk as a treatment for chronic pain, then we need to invest in other effective treatments for chronic pain, and/or figure out how to prevent it in the first place,” she says.

  1. Hanna Grol-Prokopczyk. Sociodemographic disparities in chronic pain, based on 12-year longitudinal data. PAIN, 2017; 158 (2): 313 DOI: 10.1097/j.pain.0000000000000762

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Authored by: Staff

There are 30 comments for this article
  1. Sandy Auriene Sullivan at 8:42 am

    “Americans who are poor or are less educated are more likely to suffer in chronic pain than those who are more wealthy and more educated,”

    Money buys a lot of health care guys! It’s really simple. Think of it in terms of who has equality now in the US and who is fighting for it. So the poor obviously do not have access to funding if their insurance won’t cover cost of medications. They probably can’t change doctors and are on an HMO and/or state or Federal insurance – even MEDICARE is a process.

    It’s not about how you look but gender plays a role and there are many studies out there for post surgical pain control that states women have to ask 2-3 times more than their male counterparts after same surgery and comparable health. Men ask on average once or twice for better post surgical pain control before receiving it. Women do not.

    We already know that illnesses that disproportionately affect women are never taken as seriously by the medical community. I dunno if the myth that women whine more or complain faster than men is the cause. [I call it a myth because women tolerate a lot more pain than their male counterparts before asking for relief. Men on the other hand tend to wait to ask for relief at all….]

    Now imagine you are a poor black woman? Do you think they get the same care as I do right off? [middle-class white woman w/Federal health care] Do you think that a black male would? People assume terrible things now without realizing they do it when they see black males – do you think it would be different for a doctor? It isn’t and guess what? Yup there are studies out there that show the black community is nearly dead last on the list of who gets pain relief and who doesn’t….. if you are black not only will you be expected to understand your illness as well as the staff, you have to be in more control too.

    If I cry, my doctor is dismissive of me; I cry when frustrated, angry, in pain and finally sad. So crying at my docs is usually the first 2. Only once due to the pain during treatment.

    Finally, education. Ah yes. What defines educated? Because many here may not have traditional degrees but are experts in their illnesses. Have to be don’t we?

    But how you communicate that to the doctor is going to determine their opinion of you. Speak clearly, no slang, no swearing [should be obvious; unless its due to something else like sh*t that hurts…]

    If you write letters to the doctor, spell and grammar check [I have rubbish grammar] and do not be shy about printing out new research for your doctor. My doctor once asked me if I thought he was stupid and that’s why I had all this research.

    Told him, no, I think you are very busy and unable to keep up with the many new things that are coming out that help me specifically. My research is for you at your leisure.

    It’s an issue though that I tried to tell the CDC, doctors, pharmacist and women’s groups who fight for other women’s equal rights issues. They were the ones who wanted to see the studies about it. Yet, I still work with them too. They still struggle to understand because they’re not suffering.

    Chronic pain illnesses are the Great Equalizer in the end. We all suffer. Even the educated and wealthier. They might get better assistance in the beginning and maybe even faster response to treatments. The downside is, for the very very wealthy – no one wants to say NO.
    But now all doctors are forced to say it more often and now these folks will suffer the CDC guidelines with the rest of us. Their group seems to have more over-doses too. Access.

  2. Tim Mason at 8:13 pm

    I would have to have a show of hands of those setting on the panel “Raise you had if you suffer from Chronic Pain” “Next, anyone have a close friend or relative that suffers or has died from a disease that caused chronic pain”
    I doubt that there would be many hands waived.
    These people that make these decisions must be vetted much like those we send to the supreme court.
    It is imperative that those setting in these seats much have an in-depth experience with the topic. Anything else is pure injustice.

  3. Krissy at 8:47 am

    Great, Robert!

    I will send a letter and perhaps a link to my last article where many comments talk about the losses in our lives.

  4. Tim Mason at 4:16 am

    Krissy
    I am leaving my contact information with Ed Coghlan so you can reach out to me about this trip and venue in Atlanta. Please reference this comment in this thread as I will do the same.
    I will be waiting to hear from you.
    All the best,
    Tim

  5. Robert Dean Rose Jr. at 9:29 pm

    Ten Million Letters March to the Whitehouse – Millions of veterans and civilians are suffering as Chronic Pain Patients (CPPs). We are under attack by the abuses of our own government. Many of us are unable to put up a united front in defending our right to Pursue Happiness as promised by our forefathers. I know it is next to impossible for me to participate in a local rally or an actual march on Washington considering I can barely make it to my own mailbox. Which is why this weekend, we need to unite in one goal; TEN MILLION copies of a single letter to President Trump’s webpage by Monday. This way, individual stories do not get lost and shoved under a rug somewhere never to see the light of day again. It will force his assistants to actually see we are uniting; the same as the colonists of old. Our bodies maybe fragile from the ravages of disease and injuries but as ONE PEOPLE we are not going to stand for the abuse any longer. Please if you are a veteran, a Chronic Pain Patient or simply know someone, such as a loved one, PLEASE take a moment to visit President Trump’s website (below). Copy and paste, paste and paste as many times as you are comfortable with our message. We will not be silenced. We will not go quietly into the night. We are Americans and our voices deserve to be heard. This cruel and inhumane treatment must stop. This genocide must end here now. I for one choose to LIVE and to FIGHT to my very last breath for this great nation and for ALL her citizens. Will you join me in this fight? Will you help defend so many suffering Americans by taking a moment and posting this letter?
    I have shared this letter (which fits nicely in the 5,000 character limit) seven times over the last week and an additional thirteen times this morning. When finished simply type in the comments Done x 20… or however many times you are able to share our voice. Even once is more than I could ask… (Likes to this comment do not count – it takes a little more action on your part to get the word out to President Trump!)
    Thank you, may God bless. Respectfully, Robert D. Rose Jr., BSW, MEd. USMC, Semper Fidelis — “Teufelshunde”
    My letter requesting help from President Trump…
    https://www.facebook.com/download/preview/246093632511860
    President Trump’s webpage comment page…
    https://www.whitehouse.gov/contact#page
    Or everything BELOW this line… Copy and paste, paste, paste….
    +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
    Dear President Trump:
    First in the words of my students – “you da bomb!” With the exception of Dr. Shulkin, I applaud your appointees and feel completely confident you are going to keep your promises. If they do not act in our best interests, I would love to be there as you give them the news – “You’re FIRED!” Enough of the ass kissing… 🙂
    I am a United States Marine and like you I took an oath to defend this great nation. I would be honored if you would assign just one of your assistants to the problem facing tens of thousands of veterans and millions of Chronic Pain Patients across the land. I know the problem would quickly be resolved ending so much suffering from the cruel and inhumane treatment being inflicted by governmental agencies. Please visit Vets Fight Back for additional information and to witness my resolve firsthand of defending our veterans and citizens from this insidious enemy.
    At present, our greatest enemy is from within; uncaring, blinded and deaf politicians and administrators who allow torture of these brave heroes as defined by International Treaties signed by the United States. I have sent numerous letters to Congress and members of the press. As Gen. James “Mad Dog” Mattis states: “You cannot allow any of your people to avoid the brutal facts. If they start living in a dream world, it’s going to be bad.”
    As a Marine, a Christian, as a man, I implore one of your assistants to contact me. (423) REDACTED. There has been enough suffering in this great nation. Please do not force our hand to file complaints with the United Nations. A simple phone call can prevent a further escalation as we open an exchange of the truth to the horrors being inflicted on millions of our citizens.
    I am certain you understand that I will fight to my dying breath to protect my brothers and sister in uniform. I will do everything in my power to LEGALLY defend the citizens of the United States from harm. As Gen. “Mad Dog” Mattis stated “Marines don’t know how to spell the word defeat.” I will fight these policies denying quality healthcare to Americans.
    Thank you sir; you are doing an awesome job! Thank you, take care and may God bless.
    “Teufelshunde”
    Respectfully,
    Robert D. Rose Jr.
    Semper Fidelis

  6. nicky at 9:03 pm

    This may be true. However ; I am educated and have worked all my life. It was not until chronic pain disabled me did I fall into the “poor” category . I have made over 6 figures for.over 13 years. The cdc came and changed the guidelines , cutting my medication from 205 MG to 180 to 60 MG per day . I can hardly get out of bed now , and have lost my job. Where are these new ” guidelines ” putting us ?????? I know where they have “taken” me . From an executive , to a realtor , to unemployed. It’s a disgrace to have always worked and all of sudden you have to rely on your spouse to help you with everything . There have been times I have been unable to get out of the bath because my joints just say “no” . I don’t think it will stop, and frankly it reminds me of the halocaust, getting rid of individuals and trying to make it seem politically correct. Sure, people abuses drugs but those ” people” have been around always. I’ve pretty much lost 80 percent of my “quality” of life , while i am sure the “abusers” not able to get opiods have moved onto other things . When will it stop? My 20 year old comes home from college and I see him trying to hide his tears as I struggle to get out of bed .. my 10 year old always tells his father first about events , etc with school because he also sees I can barely walk most days . What do we have to do ?? Has our new president even been made aware of this website, has anyone tried to petition or contact him ? Are we all going to sit back and wait for death ?? There has to be someone willing to start a petition for Mr Trump so that he understands the “other side” of the story . I would start it , but I don’t know how ….

  7. Kristine (Krissy Anderson at 12:46 pm

    Tim, will you write up an article for national pain report afterward?

    I’m going to check on discounts for press members, however, I doubt they will have them. If I could go, could I meet you in Atlanta at the airport? This is a stretch to even see if I could go both financially and physically. But I’d love to be a reporter at this thing. I have press credentials for any event, and you could likely come as my associate if I can get us discounts. Also, if five people register together there is a $100 discount.

  8. Maureen at 9:22 am

    Tim, I checked it all out also and thought the same re: the only possible impact might be for lots of CP folks to show up and if not allowed in… then demonstrate outside 🙂 Like the sufferings of the meek and mild Christian world… evil will prevail and overcome if we don’t make some noise back at them.

  9. Jean Price at 6:26 am

    Usually people who have lower incomes work more physically demanding jobs. Much persistent pain comes from physical harm, accidents or the complications of surgeries to fix injuries. Also, as many have said, the access to care and the quality of care may be an issue. (Although I am not at all sure the ACA allowed many low middle income people to find medical care more easily. What the ones I know reported was it actually kept them from it…by $5000 deductibles and such high monthly premiums…($900 to $1500, what I’ve heard…that they still couldn’t afford care. Prior to this plan, they had more pocket money to pay for needed care!). Yet another factor for lower income jobs, as several have said here, time off work means less money! So there are a lot of possible reasons for these finding, obviously. Yet what do we do to help when NO ONE is getting good care now??

    I must say I am once again amazed at the things we spend money on, this was obvious funded somehow. Does it get to the root of pain, and offer solutions? No! Does it explain anything about pain that would generate a new treatment being developed? No, unless it would be to raise the income of millions of people so they might have less pain…yet then they might be more able to go skiing and be injured anyway! (Just a snide remark! Excuse me!).

    At any rate, the author says our providers need to not assume we are there to just get medications! That’s appropriate! Plus true! And also that pain in real and growing! Yes, I agree! Yet I also must take issue with JUST WHO the society is that’s deciding opioid pain medications are evil and the (faked) epidemic means they must all be done away with! You see, WE are part of society…and we all have the biggest stake in this! If the CDC and others had spoken the truth, their guidelines would be long gone and pain care would be back in the twenty first century instead of the dark ages. Public opinion would support those in pain and not the fear based, trumped up campaign we have now….that isn’t even helping curb addiction to illegal drugs! Because that is a SEPARATE ISSUE.

    I hope the author can sense from these comments how wrong these guidelines and the witchhunt involving opioids has been…how it has damaged people, lives, families, marriages, an the like! And I hope she also realizes she is hearing our physical pain and mental anguish over this…our UNTREATED OR POORLY TREATED PAIN talking! We communicate sometimes without the tact we would like to both use and be addressed with! Yet for years, we’ve not been met with tact nor compassion…we are scorned, rebuked, discriminated against, labeled, and considered guilty until proven guilty…with urine tests and pill counts! At doctors offices, clinics, ERs, hospitals, pharmacies, in the media, in our government, and now in the eyes of the public too!! Our confidentiality is invaded and our histories of compliant use and continued need ignored! As a responsible law abiding adult, who has used pain medication compliantly for decades, I resent this thoroughly, as do many others!! And I still do resent it, even after all this time since the guidelines first reared their nonsensical and poisonous head! Because I’m in way more pain! And tend not to forgive abuse based on the greed of others! I know our anger over NOT being treated appropriately and responsibly by our doctors and our government just spills over into our speech and our life. Yet what does anyone expect of us? We are in pain as we type, in pain as we sleep, in pain as we kiss our grandkids, or even try to shower and take care for ourselves or maybe hold a part time job. And to make it worse, a great deal of it is unnecessary pain, from denied or drastically decreased medication that once helped us be more productive and have some quality to life.

    We ARE society, TOO… and we know this opioid bashing is wrong…opioids are a useful and necessary part of pain care, an adjunct THERAPY to combine with many other modalities…which most of us have used, tried, or still use…to help us live more fully with less pain. To have a life, to know liberty as freedom from pain, and to pursue happiness, LIKE rejoining our families, workplaces, churches, friends, and even be allowed the energy from less pain to buy groceries! Isn’t that all part of what our government is supposed to help us all with? Well, maybe not the groceries part, I suppose! WE NEED HELP HERE. Will your interest in researching pain extend to helping those who live with it? Please?

  10. Tim Mason at 11:22 pm

    Carla, This meeting is being held by an author, Steve Quinones and a Senator Brad Schimel. One is out to make money selling books the other is out to get more dollars for law enforcement in Wisconsin.
    The only patients invited are heroin addicts and family of heroin addicts. They will seek to create a thermodynamically stable bond between prescription pain medication and heroin.
    Both seek to line their pockets at this summit. Selling professional on their OPINIONS. The last people they want in the audience are people that benefit from opioid pain medication.
    But the real lecture will be talking about Heroin. No one gets heroin at a pharmacy. Their money and status has granted them this venue and medical leaders will send employees there to learn the so called truth. Neither one of these actors is a pain specialist.
    If were gasoline and drunk driving they were discussing they would be trying to convince gas station owners, fuel refiners and others that Gasoline needs to be banned. If there were no gasoline we would not have drunk drivers…
    What really needs to happen is several bus loads of chronic pain patients show up, some on crutches some in wheel chairs and some carried in.
    This looks like an addiction summit. Something we are not. addicts.
    Until next time…

  11. Maureen at 6:55 pm

    @Robert Rose, so very good to hear from you again. I keep you in my prayers.
    Bravo for your posts. Thank you for your fine efforts and words, once again.

    @Dr. Tall ….keep reading and following our comments on different subjects here at the NPR..
    Perhaps you will come to know that your suggestions haVe already been greatly experienced by us CP folks!
    And they DO NOT help us and in turn can actually tend to hurt us. WE can teach our doctors great lessons on the bodies of CP patients. WE NEED TO BE LISTENED TO!
    This is not a joke to us… We suffer greatly and know what works best for our bodies. Please hear us…. Maureen

  12. Kristine (Krissy) Anderson at 5:21 pm

    Dr. Tall, you are not entirely correct in your statements. I believe you must be talking to those who have acute pain and very little of it. Am I correct? Perhaps you are young or new to the severe, intractable pain patient community? First, insurance paid for the alternative treatments you mention, and more of them in the past. This was back when my problems began in the 1980s. I tried everything, save for aromatherapy. Second, I got hurt by every PT I saw; they all wanted to be in sports medicine which was about to become a big industry. They knew nothing about fibromyalgia and RA, they were young and not well-educated at that time. I believe now they have been more properly educated (hope).They thought by pushing hard, cranking joints and giving an exercise routine that would kill a small animal was the way to cure pain. Third, I was a wealthy woman, and on top if it, insurance was good and steady. Now I am a disabled 64-year-old financially-poor woman who lost everything (a thriving international business) like so many people I meet in the pain community. My conditions have gotten worse and I have many more conditions than I did then. Why would those alternative therapies help me now? I’ve tried them over and over again, for years. People like me learned meditation long ago, and I do it. Same with special exercises, which I do. But your statement is a story we hear all too often from people who do not understand the kind of pain we have. You can’t understand it unless you have enough patients or feel it yourself. Biofeedback and a yoga routine will not bring bone back, will not make me younger and will not ease pain for me. If it did, I’d be on it everyday. I speak for MILLIONS. I am a researcher and writer in this field and belong to many organizations, websites and social groups. Opioids WORK for us. Patients and addicts MUST be separated into two groups for “this atrocity” to work. But we’ve been stigmatized and put into a group that encompasses beliefs that we are bad, addicts, a waste. If quality of life is lessened any more than what I have now, I will pull the trigger. You don’t understand. Please educate yourself more and please listen. That’s what we want. We need doctors to speak up, and we’re glad to hear from you, but not only on scientifics, not only on non-use of opioids and alternates, but also on the faring of their patients and why they are faring as they are.

  13. Tim Mason at 4:59 pm

    Carla,
    Atlanta is an hour drive south from my house. Thank you for this link. I think I should attend since I am a Georgia resident.
    All the Best,
    Tim

  14. Carla Cheshire at 2:51 pm

    Thank you Tim Mason. When I hear how Americans are using so many more opiates than the rest of the world I think of Michael Moore’s recent film “Where to Invade Next? where he visits factories and businesses in Italy. There it is common to have 5-7 weeks vacation a year and be paid for a 13-month year with the extra months pay to help fund vacation time. They have 2-hour lunch period, go home to eat and then go back to work. They are less stressed and have less illness. We work much harder here with many people working 2-3 jobs and with layoffs many are expected to pick up the laid off workers workload. This has gone on for years. Companies have cut back on health benefits so people don’t go for care unless it’s an emergency. This is in effect rationing. We don’t have preventative care. They have Universal Care and don’t have to worry if an illness hits about how they’ll afford to pay for it. The stress of that worry when you are fighting for your life makes things much harder. I know, I’ve had cancer.

    The CDC and DEA are using drug addiction to opioids as the reason NOT to treat our pain.
    We are NOT the ones addicted or expressing addictive behavior even though we take opioids and I believe this confounds them as it doesn’t fit their narrative, so therefore we must go. To them everyone using opioids is addicted. You know, I know and our doctors know this is simply NOT true.

    There is a National Rx Drug Abuse & Heroin Summit, in Atlanta, GA April 17-20, 2017. https://vendome.swoogo.com/2017-rx-summit/ Check the topics. I doubt there will be anyone advocating for Chronic Pain Patients. Would any of you care to attend, to try and express our views? This summit is for people who make policy. They need to hear from us!

  15. Robert Dean Rose Jr. at 12:27 pm

    Dr. Joann Tall, I would be willing to bet from your comments that you come from a privileged background and have never experienced chronic pain 24/7/365 much less the years many of us have had to deal these issues. The DEA targets our doctors as they are easy marks and make for big headlines instead of going after the Mexican drug cartels or the Chinese syndicates shipping millions of pounds of illicit opioids such as heroin and fentanyl pills into this country.

    As for the CDC, they are so blinded by their own get rich policies they fail to see the irony of their own reports. For example the CDCs fact sheet states in 2015 overdoses by opioid addiction is driving the opioid epidemic; 20,101 overdose deaths related to prescription pain relievers with 12,990 of those overdose deaths related to heroin and illicit fentanyl.

    Then a few pages later the CDC reports cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. These deaths do not include the number of smokeless tobacco related deaths due to cancer of the mouth, esophagus (the passage that connects the throat to the stomach), and pancreas (a gland that helps with digestion and maintaining proper blood sugar levels).

    With the numbers representing nearly twenty-five times the numbers of death caused by tobacco; where is the tobacco epidemic? Why haven’t the CDC and DEA gone after these murderous companies? Or why haven’t the politicians passed laws targeting the individual company owners and their lobbyists? Are these lives not more important than us lowly Chronic Pain Patients?

    Surely so many deaths in one population require the same drastic measures as are being employed against those of us who have been compliant with our NEEDED medications for years and years. Chronic Pain Patients have used their medications responsibly not only to survive but to be able to function in society as productive members giving back to our families and communities. The major difference between the two groups; DEBILITATING PAIN! It is difficult to organize and raise funds for a sustained effort to fight off these attacks against us and our pain medications. How is it possible for me to attend a rally in my hometown when I can barely take Sparky to the back yard? How can I possibly afford an attorney to file a civil suit for all the abuses against my civil rights guaranteed by our own Constitution when every dime goes toward surviving paycheck to paycheck?

    And getting doctors to join us in speaking out against these harmful policies? Right! Doctors, rightfully so, are afraid of losing their licenses, even their very freedoms. I know if I had spent the money they have on education and invested the time and energy for residency programs, I would be concerned as to how I could continue my practice to help as many as possible without jeopardizing my career on a “few” the government and news outlets paints as addicts. I could still do some good with my training; just not for all patients.

    And I am certain you are aware of the millions spent by big pharmaceuticals not only in the negative advertisement portraying junkies as the root of the problem but also in maintaining politicians who pass laws favorable to their enterprises. Just look at the pharmaceutical stock purchased by Rep. Tom Price who for some reason ($$$), Congress approved his confirmation even after it was revealed he had made millions off legislation favorable to a company which had given him stocks at a price below what a regular citizen could purchase.

    Or how about this tidbit of information; like Gibbs of NCIS, I do not believe in coincidences. It is my belief (my opinion if you will until hard evidence surfaces) that the former VA Secretary Robert McDonald (or members of his family) is somehow benefiting from the CDC guidelines and the targeted cities strategy the VA used to implement its “opioid safety initiative” in 2014. It simply does not make sense for the President and CEO of Proctor & Gamble to give up that kind of paycheck to be just another bureaucrat. In 2014 when obama appointed him as the head of the VA, it was the same time frame we became aware of the “opioid safety initiative.” As indicated in my “Targeted Cities Strategy,” it was first enacted in St. Cloud, Fargo, Andover & Minneapolis (according to my research). This is the same year in which Naloxone began being pushed by the VA to all patients receiving pain medications. A good idea but 2014 was also the same year the manufacturer, Evzio, increased their prices to over $4,200 a unit. Additionally, after the initiative went into effect, the “addicts” (or should I say the doctors of the VA) best friend became Suboxone. Another drug manufactured in Richmond, Virginia and one which also saw a dramatic price hike in 2014. In fact, the company is being sued by several state attorney generals for price gouging which is currently pending hearings (which will of course take years as they rake in the profits). A suit in which I could not find the VA or the federal government listed with the states as co-defendants. As I stated, this is all speculation but logically it makes sense to think that Secretary McDonald is somehow involved; why else would he give up a million dollar salary for lowly government wages?

    So yes Dr. Tall, these policies are no more than genocide against tens of millions of Americans, many from the lower socioeconomic levels. These policies are motivated by greed and fear. The greed of the big pharmaceutical companies, the greed of bureaucrats who implement them and the greed of the politicians who look the other way as their stocks soar. The fear is from so many afraid to rock the boat or the status quo such as doctors with huge student loans and mortgages to think about. The fear of so many Chronic Pain Patients who are afraid of losing even more than they have already lost due to these policies. Which category do you fit in Dr. Tall? Greed? or Fear? – My bet is greed. Robert D. Rose Jr., BSW, MEd., USMC — “Teufelshunde”

    For more information, please visit my FB page, Vets Fight Back

  16. BL at 11:20 am

    Those will little education usually work physical labor jobs. They can’t miss work because if they do, they usually lose their job. If they lose their job or can’t work they lose their place to live and other things.

    Until the ACA was passed, many in low income jobs coud not afford to go to the doctor until they could no longer stand the pain and a great deal of damage had been done. They aren’t paid for the hours they do not work and don’t have days they can take off with pay like those in better jobs.

    Those with low income have to go to teaching hospitals and other Medicaid providers and they don’t receive the quality care those with private insurance do. They also don’t have the money for things like accupuncture, massage, or to take off work for a few weeks while an injury heals.

    For those on Medicaid, it is far, far more difficult to get a prescription for opiates now. Research indicates those on Medicaid were prescribed opiates at twice the rate of other patients and are at three to six times greater risk for overdose. (See link below)

    With the repeal of the ACA or at best severe cuts to Medicaid and low income health programs, this situation is going to get much worse.

    https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a2.htm

  17. Sandrag at 11:00 am

    Until we stand up for our rights nothing will change, Nothing changes Nothing changes. We just talk. We can hold up our picket signs an March or we can hire a lawyer as a group. Nothing else will help us. Any one have another idea that would work ?

  18. Kristine (Krissy) Anderson at 10:52 am

    Among agreeing with everyone’s comments, I, too, take great offense to the quote (last paragraph). It’s so bad I nearly lost a mouthful of cereal, which would have blown onto my computer screen, which would have caused a seriously difficult problem: People on disability can’t afford new computers. This person’s attitude just confirms that researchers and scientists are NOT LISTENING to patients, just like the government agencies. So sad, such a ridiculous statement! This study isn’t necessary. STUDY USING GENETICS FOR US SO WE CAN BE PROPERLY TREATED!

  19. I. Ben Aiken Longfellow at 10:16 am

    Here is truth. It is not that opioid medication is being “more or less taken off of the table”. It is fact. The CDC states that the “guideline” is just a recommendation of prescribing for our doctors. Our doctors ARE being challenged by the CDC and the CDC has the upper hand when a physicians LICENSE is being held for ransom.Everyone can not have a college education for one reason or another.With no education, even a high school diploma, manual labor becomes ……your life. If a human being must work vigorously to earn a living, depending on the job, it is MUCH more likely that the body will take more abuse leading to earlier possible chronic pain. Makes sense to me.It doesn’t matter if a person is wealthy or educated, pain can come from disease, accident, botched surgery, and elderly age. If a person IS well to do , it is unlikely that this person will be found crawling under your house to repair a plumbing leak……over and over again, for years and decades. Do you think this may have some negative affect on the human body? Some of us have to actually do manual labor! The opioid mortality rate statistically s the MAIN agenda of the CDC,so it states. It is irrelevant to the CDC HOW the rate is lowered and furthermore it is irrelevant if the highest percentage of death comes from illicit opiid use or if the prescribed chronic pain folks make up the highest percentage of the “statistic”. Regardless, to force our doctors with threat of licensure revocation to lower all prescribing and dosage of life enhancing opioid medication is a discriminating, inhumane act toward the medication prescribed patient abiding people that have ZERO offenses in their medicaton use. The CDC method using the “guideline” and 4 million plus dollars to influence the non chronic pain public into agreeing with the lowering of prescribing and lowering of dosage of opioid medication prescribed to gain justification for the CDC guideline is morally corrupt. The attempt to lower opioid use mortality WILL cause unnecessary, innocent suffering to the TENS of MILLIONS of good people that have in no way abused their medication yet, we are included in the “guideline” to our doctors as well. Studies, group studies, that reveal the ages, education, and wealth statistics is all well and good to try to understand what factor stands out when one has more or less pain. Are we going to deny a high school “dropout” sufficient pain medication just because of education? Maybe he or she has built buildings all their lives, who knows. If someone drives to their physician in a brand new mercedes car, does that mean automatic prescribing of medication because they say they have pain? Opioid pain medication prescribing needs to be left to our doctors. An examination, in person, along with the patients history of “treatment’ and an analysis of the condition to see if a different method of treatment is possible. Every single different individual has variables in their life and conditions that needs a doctor to analyze the best and most efficient method to treat the patient for SUFFICIENT pain control. The “one shoe fits all” CDC method of prescribing is a joke. Once again, the CDC states that their “guideline” is a JUST a recommendation of opioid use and opioid prescribing. The :guideline” is published and appears to be just that, a guideline. The TRUTH of the matter is that the penalty to our physicians for non compliance to the CDC “guideline” is SEVERE. The penalty is not published but, it is WELL understood by our doctors. I am not sure if all physicians attended a meeting or just those doctors who are considered pain specialists attended a meeting presided over by CDC and possibly the DEA Representatives stated VERBALLY the penalty for non compliance in the new prescribing of opioid medication. The penalty is license suspension OR license revocation. This from an agency that “prevents” disease and controls disease? I and millions of other opioid medication users are guilty of no type of opioid medicine abuse or any other unlawful act.in regards to the prescribing of needed medication for a condition that is well documented. recognized as needing treatment, and will always be a factor in human health. The issue is to how BEST to curtail misuse of opioids and opioid prescribed medication. All chronic pain patients can NOT be made to unnecessarily suffer to achieve a more desirable mortality rate statistic. This is liken to jailing a party of 100 because it is known that one of the hundred has broken the law. ????? Just words. Write your state politicians, write your medical board, write congress or your congressmen, write the President. Is class action a possibility? Will a petition from 10’s of millions reach a compassionate, justice seeking ear?

  20. Veronica at 9:42 am

    Wow. I read all of the comments, and am almost speechless. The gist of the study, in my opinion, was, once again, to try to eliminate opioid use permanently. Simply because many suffering, use them to commit suicide. An ‘easy’ way out, sadly to put.
    I, myself,have been suffering since the early 90’s. Did everything under the sun to attempt to eliminate the pain. Nothing worked. Some even made me worse. The sjogrens, I was apparently born with. Explains a lot there. But, fibro myalgia, well, that’s something else. So is degenerative disc disease. So is my heart defect, which eliminates many of the pain meds I can take. So is the severe migraines I get all of the time.
    So, don’t tell me I ‘fit’ into any one pain category. I don’t. I also have gone without pain meds. Makes me want to curl in a ball and cry, as the pain is enormous.
    We also have medical insurance – yippee to us. The ‘deductible’ is $20,000. So, that hinders what I do and don’t, as far as doctoring goes.
    And, to top all off, I just got a phone call yesterday from doc, telling me that the entire clinic has opted not to prescribe pain meds from now on. Really? That’s what this government of ours has done to us. Guarantee they will see one hell of a rise in suicides because of this. It isn’t because of addiction – it’s because of PAIN!!!

  21. Dr. Joann Tall at 9:28 am

    Perhaps the simplest thought is that people with the lowest income can not afford to investigate or try alternative methods of pain treatment; which are often very effective and have little or no side effects. Acupuncture, herbs, specific massage techniques and acupressure, neurofeedback, etc. There are many other modalities that are often offered for free in many community health clinics and centers- tai chi, yoga, meditation, visualization, self massage,-the list is very long- the problem is that most patients need a primary doctor or some health advocate to guide them. This just doesn’t happen often to the poor or lower end of our health department. We are wonderful at passing out pills and then wondering why patients have so many side effects and problems. We are not very good at taking the time and trouble to educate our patients about other choices that may help them and then following up on how they are doing.
    It is a two part problem – patients need to take more responsibility for their health and we need to have a different system that helps them understand how to do that and support them in their efforts to do so.

  22. Angel at 9:21 am

    Pain and disease create poverty. My husband and I made over 200k a year until disease dismantled our lives piece by piece chipped away at our resources. Disease is costly pain is disabling. Many have disease in childhood many low skilled workers have dangerous jobs resulting in injury. There’s many reasons but really what needs to be addressed is why anyone but the patient gets to decide how their pain is treated. It’s a patients choice why have we taken that away? It’s cruel and a standard we don’t apply to anything else.

  23. Pain Patient at 8:54 am

    There are several valuable missing parts of this study. What were the jobs that the lower SES community had? How did all people in the study get in chronic pain? Who had health insurance? Who had medicaid? What kind of treatments did they receive initially? I could go on and on, but this study is filled with holes and unfair to those who are poor, or less educated.

  24. Robert Dean Rose Jr. at 8:47 am

    Is this a joke? People with less education suffer more incident of pain due to the hard lives they live doing the jobs educated people believe is beneath them. Then there is the issue of affordability of healthcare. A person working a forty to fifty or more hour a week in a factory is not going to have the same access to quality doctors or time off a person working to put food on the table. I have several of the same injuries as Peyton Manning, Tony Romo and Rob Gronkowski (compression fractures in the cervical, thoracic and lumbar along with bulging disks and other things). I am almost completely reliant on a secondhand electric wheelchair to get around, even to walk my dog. They on the other hand can afford to pay for the best healthcare in the world and return to playing professional football. So of course it stand to reason that someone from the lower socioeconomic classes suffer more from chronic pain because we are not afforded the same level of healthcare. And just in case you are wondering, I have a Bachelor of Social Work and Masters of Education and since being forced to medically retire in 2012 from injuries sustained in the Marines back in the 90s, I still do not have access to that type of care. And if you care to know, I spent 31 years of life working, the last twelve in a classroom teaching high school, so I haven’t been out trying to score drugs for my chronic pain nor was I trying to milk the system on social security. With the type of care they have access to, I could still be a productive member of society, teaching young minds in my classroom, and not having to fight the VA, the CDC or even Congress for a chance at a decent quality of life. Robert D. Rose Jr., BSW, MEd. USMC. — “Teufelshunde”

  25. Mark Oldfield at 7:40 am

    Serving on groups that are addressing the opiate addiction problem, sadly, their focus seems to be to eliminate the medical prescription use of pain medicine. This would include chronic pain sufferers.
    The belief that everyone who receives Dr prescribed pain medication will become illegal users.
    It seems like with any type of movement that the extreme position becomes the goal dooming it to fail. Such as the idea to virtually eliminate the use opiates for all but patients in the final stages of cancer or for surgery.

  26. Maureen at 6:40 am

    In my opinion…here we go again! it’s just another study of ‘not’ listening to the ‘average’ person in pain.
    I would think that the poor may be at a ‘disadvantage’ or considered to be ‘suffering more’ simply because they aren’t getting the proper care that folks in pain with insurance and/or other financial means can get.
    Therefore, they probably are suffering greatly.
    Also, when are they going to study the ‘general population’ of all of us in pain.
    We’re trying hard to be heard. We are trying hard to tell them what works for us in general.
    In regard to that last paragraph…. we’ve expressed over and over all that we have all already been through and ‘WE’ KNOW WHAT WORKS BEST FOR OUR PAIN! Please LISTEN to us!! for WE have the answers. It’s that simple.

  27. Judy at 6:30 am

    I take exception to the last paragraph in this article,
    “If we as a society decide that opioid analgesics are often too high risk as a treatment for chronic pain, then we need to invest in other effective treatments for chronic pain, and/or figure out how to prevent it in the first place,” she says.
    “WE THE PEOPLE” HAVE NOT MADE THIS DECISION….this was a decision made by the CDC, FDA, DEA, and the big boys club in Washington, DC…….who don’t have a CLUE what chronic pain patients go through on a daily basis. They need to stop controlling what meds they deem effective or not effective. They need to put health care back in the hands of the doctor/patient.. They need to go after the ILLEGAL drugs, the heroin addiction is the biggest part of the problem. They need to stop allowing “off label” use of many medications….I’ve noticed many pain patients taking meds that were never approved for pain management. I’m sick to death of government interference in our health care.

  28. connie at 5:08 am

    The only reason that would make this article anything more than pure [edit] would be if those in a lower socio-economic work physically harder and have less access to early intervention for things that eventually cause chronic pain. Looked at in any other light the assertion of this article are pure [edit]! People of all socio-economic groups suffer from very real chronic pain!

  29. Tim Mason at 4:09 am

    Good observations and study. People with less education get low skill jobs which require more physical labor. Ergonomic design in the work place was not considered valuable 2 decades ago, now, it is all the buzz.
    How many years can a person “lay bricks” or “lay shingles on a roof”? How many years can a construction worker operate a “jack hammer”? What are the life cycle of intra-articular joints of the people that do these jobs? Pay for the jobs is low therefore, disability payments are equally low.
    It is apparent that the people in this study (now 60+) had an excellent work ethic that has diminished in the work place now.
    Mentally stressful jobs, doctors dentists now work 4 days a week. Mental stress affects our muscular and skeletal systems as well.
    Europeans usually get much more time off from work i.e. shorter days and extended vacations for mind and body recovery.
    The “Jack Lalane” body in older people is a rarity and perhaps a myth.
    “Genetics loads the gun and lifestyle (job) pulls the trigger”
    The quote above is from my pain management physician.

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