The authors of this Harvard Business Review article appropriately report an association between economic insecurity and the rise in painkiller consumption. Of course, a person’s painkiller consumption may increase for many reasons, but augmented pain due to stress certainly may be one reason.
The Experience of Pain
People consume painkillers primarily because of pain which is a bio/psych/social/spiritual disorder. The experience of pain is the sum of all of life’s experience. The combination of fear, anxiety, and stress will factor into that pain experience.
Financial stress and the anxiety created by poverty can profoundly affect a person’s pain level and ability to cope with pain. Some people think the inability to handle pain is just a weakness of character. It is not. Financial stress can change the structure and function of the brain in a way that’s similar to the effect of other neurologic disorders.
Financial Stress Correlation to Pain
The cost of medications is one of the contributing factors to economic stress. Most people in chronic pain struggle to stay afloat and often have minimal income due to their disability or near disability. They often aren’t able to work and may have difficulty receiving disability benefits because it’s not easy to convince people that you have chronic pain. You may look “normal.”
The more medical problems people have, the more medications they will likely be prescribed. Also, the greater intensity of pain, the greater the probability of more pain prescriptions.
Each prescription has a co-pay that adds to financial stress. It is a spiral of events that unfairly places a larger burden on the poor or near poor.
Other Options
Cognitive behavioral therapy and other talk therapies can mitigate the stress associated increased pain. However, most payors–and certainly Medicaid–fail to provide coverage for the non pharmacologic methods to offset the biologic factors that enhance pain.
It is ironic that those who argue for less opioid prescribing (presumably, to safeguard people who are in pain from risks associated with opioids) in the absence of a realistic alternative are only increasing the suffering of people in pain.
A healthy body is more likely when there is a healthy mind and spirit. It is tougher to achieve physical health when, emotionally and spiritually, you’re floundering.
Economic insecurity increases the chances of greater pain and opioid misuse. We all want relief from our misery, whether it is physical or emotional relief. To those in pain, it’s all the same thing.
Purchase my book The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon) or read a free excerpt here.
Copyright 2016, Lynn Webster, MD