Sunday, April 25, 2010

Chronic Pain and Torture

A pretty usual sight at my house. 
Heating pads on back, hip and knee. Ice around foot. 
I am quite miserable here, as you can tell from my face. 
A 'normal' night for me.

We deal with horrific chronic pain. Some days we cry simply out of frustration, and some days those tears are shed out of pure, constant, unimaginable pain. We may not be 'victims of torture,' and I would never undermine what tortured persons or animals suffer through; however, this article does a great job of explaining how chronic pain can be likened to torture for the 'victim,' and how important it is to recognize this and work on finding solutions.

I was very impressed by this article. I hope you enjoy it as well.

Much love to you all - and have a low-pain day!
xo
dani

***
Chronic Pain and Torture
Human Rights Campaign
written by Joe Amon



Human Rights Watch researchers have interviewed thousands of victims of torture. But it may come as a surprise for a lot of people that our interviews with people experiencing severe, chronic pain are very similar to those who have been tortured.

Severe pain undermines quality of life. Pain is known to affect sleep, appetite and social interaction, and to cause anxiety. A World Health Organization study found that people who live with pain are four times as likely as others to suffer from depression.

Like torture victims, patients in severe pain told us that all they had wanted was for the pain to stop. Many torture victims do or say anything they think might stop the torture. Patients with untreated pain told us that they had contemplated suicide, told friends and relatives that they wanted to die, and prayed for death.

A Human Rights Watch report on access to pain treatment includes an advertisement from a Colombian newspaper that read: "Cancer is killing us. Pain is killing me because for several days I have been unable to find injectable morphine in any place. Please Mr. Secretary of Health, do not make us suffer any more."

As this advertisement attests, this suffering that so many endure is treatable, and treating it is also almost entirely in the hands of governments. Morphine is a restricted drug, and governments must estimate the amount they need and request it from the International Narcotics Control Board - the UN agency assigned the task of controlling licit opiod production and distribution.

In a recently published article in BMC Medicine, "Access to Pain Treatment as a Human Right," three researchers from Human Rights Watch discuss barriers to effective pain treatment. These include problems with procurement and distribution systems for pain medications, the need for adequate government policies to address the issue, poor instruction for healthcare workers, complex drug control regulations, fear of legal penalties among healthcare professionals, and the cost of medications.

But what is really shocking in the article is the estimates some countries give for their annual morphine needs. Burkina Faso estimates that 8 people need morphine per year. Gabon estimates 14. The Gambia, 31. Those lucky few. Even when the estimates are larger, they still represent a shockingly small percentage of those in pain. Kenya, for example, estimates that close to 5,000 people will need morphine. But that represents only 4 percent of the 115,000 people expected to experience severe pain from cancer or HIV/AIDS. The calculations don't even consider those who experience acute pain or chronic pain from other causes.

The Human Rights Watch report, "Unbearable Pain: India's Obligation to Ensure Palliative Care," took an in-depth look at palliative care and access to pain medicines in India. The report found that even though more than 70 percent of patients in India's major cancer care hospitals were incurable and likely to require pain treatment, the hospitals did not provide patients with morphine. Some simply did not have morphine, and some had doctors and nurses who were not trained to prescribe it. India has invested in advanced cancer treatment centers providing state-of-the art treatment. But for the large majority of cancer patients who arrive for diagnosis late and seek only medicine to address their pain, cheap, effective morphine, produced in India, is not available.

More needs to be done to help the tens of millions of people worldwide experiencing untreated severe pain. I wish I could say that the solution was simple. In one sense it is: morphine is cheap and it is effective. In another it is not: political commitment is needed to help those suffering, and to overcome the regulatory barriers and lack of training of health providers worldwide.

One patient told us: "I just kept crying...with that pain you think death is the only solution." We need to ensure that better solutions are available.


This was originally published in The Huffington Post.


xo
dani

8 comments:

Wacky Lisa said...

I'm not having a particularly bad day but even today I found this sad and validating at the same time. Thank you for sharing this article.

Samantha said...

I too have EDS, along with Crohn's Disease, osteonecrosis, MVP, and the most horrific Post-Herpetic Neuralgia in my face from when I got Shingles and it invaded my ear canal (I am about 75% deaf in that ear) and we think the nerve canal of my 7th Cranio-Facial nerve and the Trigeminal Nerve. I am lucky in having a good pain management doctor and a lot of the time my pain is controlled.

But there are nights (like tonight) when the pain is so bad I cannot even pinpoint if my legs, knees, ankles, foot or face is worst. You feel so alone then--can't sleep, can't eat, can't concentrate well enough to read a book or even watch TV. You can't even pray because there are times when the pain is so bad, all you can pray for is death so the pain will stop. But because I have a 7-year-old daughter who needs me, I can't even do that. I gave up the right to even think about death when I decided to become a mother, but there are times when it is hard to push it out of my mind because I long for the peaceful rest that I believe it would give me. And worst of all, I can't even talk about it because I don't want to be labeled a suicide-risk because I know they will want to take away the medications that are helpful most of the time. What can you do? All I can do is find that place I found when I was in labor where you shut the world out and just think about breathing in and breathing out.

I'm so sorry for what you are going through. I truly understand what you are talking about and you inspire me to try some alternative treatments. Wow--this post is way longer than I intended. Sorry about that. I guess I just want you to know that there are people out there who have thoughts and feelings similar to you. I wish I could help, but all I can offer are the good and pleasant intentions I will send your way. Wishing you a pain-free or even a "pain-reduced" day...S

Vegan Danielle Davis said...

@Wacky Lisa - you are welcome! I thought it was well worth posting - not every day you come across an article from a big time media outlet that validates what we live with on a daily basis. :) (Or mostly a daily basis.)

Vegan Danielle Davis said...

@Samantha - I am so sorry to hear about everything you are dealing with as well. It isn't an easy battle, that is for sure, and I can definitely relate to where you are and where you have been. Sometimes it seems like there is no 'up'...I am glad you keep pushing through, and I am glad I have too. I offer you my love and support, and I wish you all the best in your journey as well! I look forward to more comments from you, and to hearing about how you are doing. :) Thank you for your kindess! xo

Mr. chronic pain said...

What can I say, I understand the pain that must cause many, I hope also to get ahead but I know it will be difficult but you will do will and support are in these difficult moments when we know who are around us, and not to conquer chronic pain Must get stronger to fight adversity.

Anonymous said...

I have POTS with neuropathy, fibromyalgia, chronic fatigue syndrome, TMJ, irritable bowel syndrome, irritable bladder, IgG subset 3 deficiency, and fibrocystic breast condition from which I have suffered varying degrees of pain for the past 6 years. Thank you for this article, and especially your Web site. I'm so sorry that everyone who posts here can relate to this kind of chronic, day-in-day-out pain that tries to sap the life right out of us. At least through this forum we can all connect and lend support to one another, as people without this pain cannot fully relate to what we endure. May we all remain STRONG today and continue to do the best we can with what we've got.

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