Living with Pain: Chronic Pain and Gun Violence

gun and bullets on flag

In this column I want to explore an aspect of gun violence and gunshot wounds rarely discussed publicly: chronic pain.

In the interest of transparency, I need to state at the beginning that while I support reforms to help stem the tide of gun violence, this column isn’t directly about gun control.

In order to place gunshot wounds in some perspective, a look at recent gun statistics will help frame the discussion.

We spend $11 billion on guns and ammunition every year. According to the U.S. Centers for Disease Control, Americans own approximately 270,000,000 guns, which amount to 90 guns for every 100 people. That makes the U.S. the most heavily armed nation in the world.

According to the United Nations Office of Drugs and Crimes there were over 30,000 gun related deaths in the U.S in 2010. Over half were suicides. 19,392 citizens died from self-inflicted gunshot wounds, while 11,078 of our citizens were murdered by gun violence. The number of gun deaths is partially responsible for placing the U.S. life expectancy near the bottom of industrialized nations, an eye opening statistic.

For added perspective, the number of gun deaths is more than double the reported number of people dying from opioid medicines.

The Brady Campaign to Prevent Gun Violence estimates the cost of treating gunshot wounds reached $2.3 billion in 1999, or over $6 million a day. Taxpayers paid almost half that amount. Of course, the amount we spend now must be quite a bit higher as health care costs keep skyrocketing in the U.S.

Recently, the Robert Woods Johnson Foundation reported a small research project examining chronic pain post recovery for gunshot wounds. Investigators interviewed 40 gunshot victims and found that just over half the victims retained, for various medical reasons, the bullet in their bodies.

Researchers reported that those who retained the bullet in their bodies live with chronic or debilitating pain, and often suffered from anxiety and stress. What wasn’t reported was whether any of the victims also suffered from post-traumatic stress disorder (PTSD) in consequence of the violence.

Researchers also reported that those with chronic pain often suffered from disfigurement and social stigma. The pain of these victims was likely exacerbated by depression that often flows from being a victim of gun violence. The understanding and treatment of chronic pain from gun violence is fraught with complexity and cries out for resources to be applied to continuing research.

Among other findings reported in the Journal of Neurosurgery, victims of gunshot wounds suffer more pain than those who suffered spinal cord injuries. This suggests that there may be something about theses wounds that causes more pain than other sources of injury.

According to Marian Wright Edelman in “The Massive Human and Moral Cost of Gun Violence,” there have been 119,079 children and teens killed by guns since 1979. That is two and a half times greater than the number of military personnel killed in Vietnam (47,434) or Korea (33,739), and over 22 times greater than American military personnel killed in Afghanistan (1,712) and in Iraq (3,518).

I cite these statistics to clear away the ideological rubbish at the heart of the debate over meaningful reforms of our gun laws, while providing a framework for the central argument in this column: the reallocation of resources to research the chronic pain of gunshot victims.

In looking at the statistics, it is undeniable that the combined cost of gun violence at home and the mind numbing treasure we’ve spent on two wars might have been, with better and more honest debate, spent differently. This, of course, calls into question our national priorities and what we’re collectively willing to spend on them.

While I don’t think spending priorities will change anytime soon, we can still explore ways to deal with the massive challenge to us in dealing with chronic pain brought about by all sources — including gun violence.

We need to determine how much of our annual expense on pain care, $635 billion each year and climbing, can be laid at the feet of gunshot wounds.

I propose that we should add a tax or surcharge on sales of guns and ammunition. Not only on private weapons, but those sold to law enforcement and the military, as well as imposing this surcharge on all weapons sold abroad.

Imagine, if you will, if we collected a surcharge equal to 10% of the total spent by Americans on guns. Or think of the money we could raise if we simply added a $1 surcharge to every gun bought in the U.S. What impact could this amount of money have on the diagnosis and treatment of pain in general and on gun wounds specifically?

It’s a moral stain on our country that expenditures on weapons outstrips money spent on research to combat the epidemic of pain in the U.S.

It’s time we collected and spent a healthy amount of resources on life affirming behavior, as opposed to the dealing of millions of guns among us. Those who use and profit from these guns should be required to pitch in a small amount of money to develop better means to treat all chronic pain and gun wounds in particular.


Mark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog can be found here

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