We live in a nation of needless pain, where tens of millions suffer daily despite the existence of effective treatments. Yet policy decisions and misplaced fears have steered patients away from appropriate care and toward alternatives that often carry their own significant\u2014and sometimes greater\u2014risks.<\/p>\n
We live in a nation of needless\u00a0pain!<\/p>\n
According to CDC data<\/a> from 2021, over 50 million Americans, (21% of adults) experienced chronic pain that persisted for more than three months. Among these,\u00a0 approximately\u00a017 to 21 million US adults<\/a> currently experience persistent, high-impact pain on most days \u2013 pain that severely limits daily life or work activities.<\/p>\n Increasing numbers of these patients are being\u00a0denied pain relief\u00a0<\/a>by US healthcare agency policies that discourage the use of prescription opioid analgesics and penalize pain management doctors or pharmacists who employ them on behalf of their patients.\u00a0 Related to this trend, increasing numbers of patients are being prescribed \u201cor recommended\u201d Non Steroidal Anti-Inflammatory Drugs (NSAIDs).\u00a0 NSAID prescriptions in the US showed an increasing trend <\/a>in ambulatory care settings from 2006 to 2016, rising from about 8.1% to 9.6% of visits, coinciding with opioid prescription declines after 2012.\u00a0 This worldwide trend has\u00a0continued since.<\/a><\/p>\n In the same period,\u00a0Adverse Drug Events (ADEs)\u00a0 were involved in about 1.6 million US hospital admissions per year.\u00a0 NSAIDs accounted for about 10-30% of hospital admissions linked to ADRs — primarily GI bleeds, renal failure, heart failure exacerbations, or bleeding, with ibuprofen as a common culprit due to its widespread OTC and prescription use.<\/p>\n Acetaminophen alone\u00a0<\/a>(although it is not an NSAID) is involved in over 56,000 Emergency Room visits per year and is the number one cause of acute liver failure in the U.S. Roughly 160,000-480,000 NSAID-linked admissions occur yearly.<\/p>\n Without a doubt, NSAIDs are effective in pain relief for large numbers of people.\u00a0 However, when purchased over the counter rather than under the supervision of a clinician, this class of drugs is highly problematic.\u00a0When they are effective, patients continue using these medications, often at high doses.\u00a0<\/p>\n \u00a0<\/p>\n One clinician \u2013 Dr. Saurabh Sethi \u2013 who shares clinical advice online, asserts that there are critical reasons he personally avoids excessive use of this medication.\u00a0<\/p>\n \u00a0<\/p>\n On\u00a0Instagram<\/a>, Dr Sethi shared: “75% of people who take them regularly develop gut inflammation, and one in four can develop ulcers. I perform endoscopies regularly, and see these ulcers firsthand.\u201d<\/p>\n \u00a0“NSAIDs reduce blood flow to the gut, which can harm its lining. I’ve seen young, otherwise healthy people come in with gut damage so severe they’ve ended up in the ER just because they did not know the risk of these medications.\u201d [end quote]<\/p>\n Contrast this record of disaster against the performance record of prescription opioid analgesics.\u00a0 It is now understood widely<\/a> that the incidence of valid diagnoses for opioid use disorder among patients treated for chronic pain with opioid analgesics, is on the order of one patient per thousand treated.\u00a0Similar incidence rates are also documented for\u00a0the treatment of acute pain.<\/a><\/p>\n It is said that one can lead a horse to water, but one cannot make him drink.\u00a0 Ironically, this seems to be nowhere more true than when the horse is a government Agency bureaucrat who is effectively immune from lawsuits or even effective legislative oversight.\u00a0 It’s enough to make a person long for the solution advocated by one of Shakespeare’s characters in \u201cA Midsummer Night’s Dream\u201d:\u00a0<\/p>\n \u201cLet’s hang all the lawyers\u201d… and a few healthcare bureaucrats too!<\/p>\n Richard A. Lawhern<\/a>\u00a0is a nationally recognized health care educator and patient advocate who has spent nearly three decades researching pain management and addiction policy. His extensive body of work, including over 300 published papers and interviews, reflects a deep critique of U.S. health care agencies and their approaches to chronic pain treatment. Now retired from formal academic affiliations, he continues to engage with professional and public audiences through platforms such as\u00a0LinkedIn<\/a>,\u00a0Facebook<\/a>, and his contributions to\u00a0KevinMD<\/a>. His advocacy extends to online communities like\u00a0Protect People in Pain<\/a>, where he works to elevate the voices of patients navigating restrictive opioid policies. Among his many publications is a guideline on\u00a0opioid use for chronic non-cancer pain<\/a>, reflecting his commitment to evidence-based reform in pain medicine.<\/p>\n Patricia Irving, M. Ed., RN, is a retired nurse.\u00a0 She was once the US National patient safety leader for the Kaiser Permanente healthcare insurance system.<\/p>\n Both authors are members of the Speakers Bureau of the\u00a0National Campaign to Protect People in Pain.\u00a0<\/a><\/p>\n