Pertinent pain data

Here's a little gem I found while cleaning up my hard drive. It's from early last year...

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Each year, 80,000,000 (that's eighty million) Americans seek professional care for pain.

Combine the numbers of Americans who seek care for diabetes, heart disease, or cancer -- three much sexier issues -- and they still aren't as many as those who seek care for pain.

• Pain is the cause of 25% of all sick days.
• 50% of those with nonmalignant pain have considered suicide.  (That puts a real crimp in a family's earning power.)

The consequent costs of lost productivity and reduced contribution to the tax base & economic flow, the social impact with concomitant loss of productivity, etc., has never been quantified (that I know of), although it certainly exists. With that large a base, and that wide a ripple-effect, it has to run into billions of dollars per year.


Each year, we spend $100,000,000,000 (that's one hundred billion) on the direct costs of dealing -- badly, expensively, and inconclusively -- with pain.

That same amount could buy:

• More than one-fifth of Medicare’s entire 2010 budget.
• 60% of 2010 Federal spending on long-term unemployment (to which disability is the single biggest contributing factor, and pain is the single most common factor in disability.)
• 5 weeks of current military spending, with two wars to prosecute and unprecedented numbers of walking wounded to care for.

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I had forgotten those facts.  I was geekishly delighted to find them. But it is definitely an answer in search of a question, and in this case the question is this: why the hell are we wasting so much money, time, life and energy on handling pain so badly??

There are profound cultural and economic reasons why the present, appalling system is still in place.  I'm not rich enough to face those reasons down so I'll leave that as an exercise in logic for the reader: follow the money.  Who profits by this system?  Who funds it?  Who benefits, and of those who benefit, exactly how do they benefit? What do they give up or pay, in order to reap those benefits? What are the benefit/drawback profiles for the many different stakeholders in this system?

Pain patients are the least important stakeholders in this system, and that doesn't seem right to me. I realize I may be biased.

Sorting out the answers could keep you busy for awhile, but once you figure out a couple of common denominators, it starts to fall into place very easily. It's a bit disconcerting at first, though.

The point, as far as pain control is concerned, is this: we're studying the wrong things about it, and we're treating it the wrong way around.  There is no conclusive success path on the present trajectory, just increasingly expensive ways of mitigating these largely failed clinical (and economic) strategies.

And that's today's ray of sunshine! :)

References:
“Chronic Pain Fact Sheet”, http://www.cssa-inc.org/Articles/Chronic_Pain.htm (journalistic summary)
“AAPM Facts and Figures on Pain” , http://www.painmed.org/patient/facts.html (cited sources include the AMA, ADA, AHA, NIH)
THOMAS (Library of Congress online)
Office of ppp, http://www.whitehouse.gov/sites/default/files/omb/budget/fy2011