Relieving Pain and Fighting Addiction: We Have to Come to Grips with the Challenge
Lex Pelger - AlterNet
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June 23, 2016

Killing not just pain: Strong painkillers make people drug addicted (RT)

"If God made anything better, he kept it for himself." - William Burroughs

The phenomena of pain still befuddles modern science. Ever since Hippocrates hypothesized it resulted from an imbalance of the vital fluids, physician debated on the cause and classification of pain. Descartes revolutionized the field with his theory that pain resulted from inputs that traveled down nerve cells and notify the brain of unpleasant phenomena. But what pain is and how to treat it remains a field in need of a revolution.

At it's most basic, a painful sensation is a sharp notification of noxious stimuli to be avoided – whether that be a hot stove, a stinging nettle or a brutal ex-wife. All animals seem to share this ability to detect pain and avoid it. In evolutionary terms, Richard Dawkins asked why the sensation of pain existed when perhaps a simple alternative like a mental 'red flag' might serve the same purpose. He decided that pain was made so painful because it needed to stand out from all the other competing drives of the body like hunger or sex. People congenitally insensitive to pain have a shorter life expectancy. The intense reflexive nature of pain allows an organism to save itself. Fitness might then be defined as the balance of pains.

The many types of pain currently measured in the laboratory speak to their evolutionary usefulness. The obvious types such as thermal, chemical, electrical and mechanical pain result from detection of the harmful stimuli by the nociceptors of the body and the signal then transmitted along the peripheral nerve fibers to brain. The category of neuropathic pain results from damage done directly to the nerves and nervous system. It ranges from bumping your funny bone to the brutal pain of cancer, late term AIDS and the mysterious phantom limb syndrome first noted by William James and Walt Whitman that can cause amputees to record pain in their missing limb. Idiopathic pain, a particularly troubling mystery, is defined pain as persisting after the apparent healing of an injury. To delineate between chronic and acute pain, an arbitrary timeline says that it's defined as chronic pain once the pain lasted from 3 months to a year after it began.

One of the most vexing aspects of pain management for doctors and drug warriors is that no independent tests exists to measure pain. The self-report of a patient is still the doctors most trusted method of assessing pain. While more nuanced questionnaires have been developed since the 60s, they only expand on the old question: On a scale of 1 to 10, how much does it hurt? With pain causing half of all ER visits and a third of family physician cases, it's astonishing that pain management is not required for medical school and according to experts like Will Rowe of the American Pain Foundation, it's not even on the radar of most medical schools.

Read the rest at AlterNet

Related: What Is Chronic Pain and Why Is It Hard to Treat? (The Conversation)

Related: Danger, Deceit, and Death: The Story of Opiates in America (The Fix)

Related: Heroin Use at 20-year high in US Drug 'Epidemic', UN Says (Fox News)

Related: After Prince's Tragic Overdose, Here's What You Need to Know About Fentanyl (Drug Policy Alliance)

Related: For Much of World, Painkiller Problem Is Absence, Not Abuse (Seattle Times)

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