The Politics of Pain

by JONATHAN CARP

One of the first things I learned in my health care career is that pain is an inherently subjective experience. Different people experience different levels of pain in different situations, and everyone has their own idiosyncratic problem areas — one can’t bear dental pain while another finds back injuries unbearable. Because of this fact, backed up by neurological research, I was taught that we cannot take a cookie-cutter approach to pain management and that each patient deserves individual attention and an individual pain management plan, which is as important an aspect of the overall plan of care as any other therapy.

Our betters in the Food and Drug Administration know better. They know what my teachers and peers did not, and are prepared to implement a nationwide cookie-cutter pain management plan for every single one of three hundred million Americans. In their infinite wisdom, they have decided to make hydrocodone/acetaminophen combinations — the most well-known of which is Vicodin — harder to come by and to require patients to see their doctors — and pay for an office visit, of course — every time they need a refill of these fairly mild drugs.

And mild drugs they are. Opioid pain killers are measured by how they compare to morphine taken orally. Hydrocodone is 1.5 times as potent as oral morphine, which compares very poorly to some of our modern pain killers, such as hydromorphone (Dilaudid) — five times as potent — and fentanyl, which delivered via patch on the skin is eighty times as potent as morphine. And in Vicodin, a mere 5mg of this weak tea opioid is combined with a standard, over the counter dose of acetaminophen (Tylenol) to provide a pretty mild analgesic effect.

But of course it’s not their pain relieving power that concerns our betters. The real issue is that some people use these pills to feel good, and sometimes go too far and suffer for it. No one is shoving pills down anyone’s throat. These unfortunates are taking the pills because they want to, because medicating themselves into oblivion seems like their best option. But in true progressive fashion, rather than wonder what it is about the suffocating state capitalist system that drives people to such fates, our betters in the FDA would rather plunge even more innocents into misery in the name of preventing a few of their victims from using chemicals to escape for a little while.

We can tell it’s pleasure that is the problem, as some of the most dangerous drugs on the market are available freely over the counter even to small children. Tylenol, for instance, sends 80,000 people to the emergency room every year, but it does not make anyone high, so it does not draw the interest of our Puritan masters.

Among the dangers lurking in the doctor’s office and the hospital Vicodin still does not impress — the most lethal thing that happens in our health care system is not people getting high but doctors and nurses screwing up. 98,000 of our fellow Americans die from simple mistakes every year, mistakes often made by overworked nursing staff on inadequately staffed floors run at a substantial profit by politically connected businesses and executives paying themselves absurd salaries. But this too does not exercise our progressive friends, as that most insidious of dangers — people feeling good — is not here lurking.

No, our progressive friends in the FDA and the Obama administration want to save you from the danger that you might use a chemical to feel good, might like the experience, and might want to repeat it. And they will not even blink at the thought of trampling over the care of people in pain to stop us from getting high. Suffering, after all, purifies the soul, while demon pleasures tempt us away from the puritan, progressive path.

Jonathan Carp is a member of Iraq Veterans Against the War and a nurse. He lives in Tacoma, WA.

Jonathan Carp is a fellow at the Center for a Stateless Society (c4ss.org) and a member of Iraq Veterans Against the War. He works as a nurse in Tacoma, WA.

Like What You’ve Read? Support CounterPunch
August 31, 2015
Michael Hudson
Whitewashing the IMF’s Destructive Role in Greece
Conn Hallinan
Europe’s New Barbarians
Lawrence Ware
George Bush (Still) Doesn’t Care About Black People
Joseph Natoli
Plutocracy, Gentrification and Racial Violence
Franklin Spinney
One Presidential Debate You Won’t Hear: Why It is Time to Adopt a Sensible Grand Strategy
Dave Lindorff
What’s Wrong with Police in America
Louis Proyect
Jacobin and “The War on Syria”
Lawrence Wittner
Militarism Run Amok: How Russians and Americans are Preparing Their Children for War
Binoy Kampmark
Tales of Darkness: Europe’s Refugee Woes
Ralph Nader
Lo, the Poor Enlightened Billionaire!
Peter Koenig
Greece: a New Beginning? A New Hope?
Dean Baker
America Needs an “Idiot-Proof” Retirement System
Vijay Prashad
Why the Iran Deal is Essential
Tom Clifford
The Marco Polo Bridge Incident: a History That Continues to Resonate
Peter Belmont
The Salaita Affair: a Scandal That Never Should Have Happened
Weekend Edition
August 28-30, 2015
Randy Blazak
Donald Trump is the New Face of White Supremacy
Jeffrey St. Clair
Long Time Coming, Long Time Gone
Mike Whitney
Looting Made Easy: the $2 Trillion Buyback Binge
Alan Nasser
The Myth of the Middle Class: Have Most Americans Always Been Poor?
Rob Urie
Wall Street and the Cycle of Crises
Andrew Levine
Viva Trump?
Ismael Hossein-Zadeh
Behind the Congressional Disagreements Over the Iran Nuclear Deal
Lawrence Ware – Marcus T. McCullough
I Won’t Say Amen: Three Black Christian Clichés That Must Go
Evan Jones
Zionism in Britain: a Neglected Chronicle
John Wight
Learning About the Migration Crisis From Ancient Rome
Andre Vltchek
Lebanon – What if it Fell?
Charles Pierson
How the US and the WTO Crushed India’s Subsidies for Solar Energy
Robert Fantina
Hillary Clinton, Palestine and the Long View
Ben Burgis
Gore Vidal Was Right: What Best of Enemies Leaves Out
Suzanne Gordon
How Vets May Suffer From McCain’s Latest Captivity
Robert Sandels - Nelson P. Valdés
The Cuban Adjustment Act: the Other Immigration Mess
Uri Avnery
The Molten Three: Israel’s Aborted Strike on Iran
John Stanton
Israel’s JINSA Earns Return on Investment: 190 Americans Admirals and Generals Oppose Iran Deal
Bill Yousman
The Fire This Time: Ta-Nehisi Coates’s “Between the World and Me”
Scott Parkin
Katrina Plus Ten: Climate Justice in Action
Michael Welton
The Conversable World: Finding a Compass in Post-9/11 Times
Brian Cloughley
Don’t be Black in America
Kent Paterson
In Search of the Great New Mexico Chile Pepper in a Post-NAFTA Era
Binoy Kampmark
Live Death on Air: The Killings at WDBJ
Gui Rochat
The Guise of American Democracy
Emma Scully
Vultures Over Puerto Rico: the Financial Implications of Dependency
Chuck Churchill
Is “White Skin Privilege” the Key to Understanding Racism?
Kathleen Wallace
The Id(iots) Emerge
Andrew Stewart
Zionist Hip-Hop: a Critical Look at Matisyahu
Gregg Shotwell
The Fate of the UAW: Study, Aim, Fire