08 Jul No More WAR
Declaring war on anything; a country, a concept, or a person, is a bad idea. This is not to say that we should not defend ourselves when attacked, but declaring war is a mistake. I have been thinking about this concept of war in regards to the 2011 decision by the Institute of medicine to declare pain a disease in and of itself. Their goal was to marshal resources in order to find a “cure” for this disease. However, naming a disease, or an illness, is problematic. The point that I am making is a linguistic one rather than a medical one.
I am not arguing that people are not experiencing pain in epidemic proportions. Instead, I am pointing out that looking at the situation as a crisis that must be battled, rather than a situation that must be approached with calm and openness is problematic. I believe that declaring war on pain won’t solve the problem. Instead it will likely lead to an even more intensive focus on physical/mechanistic causes rather than psychological/emotional ones. There is a great deal of data that points to the repression of emotions as a causative factor in pain syndrome, but very few resources make their way towards the study of this connection.
If we look at the on drugs, and the war on crime, we can see why this is problematic. When the “war on drugs” began in the early 1970’s there were well under 50 thousand people on jail for drug violations. Now there are just under 500,000 people in jail, and a wildly disproportionate number of them are Black or Latino. The rate of addiction has stayed essentially the same, as has the proportion of use across racial groups. Spending on this war went from 100 million a year to 20 Billion dollars a year. The level of drug use has stayed pretty much the same, but the potency of drugs has gone up and the price has come down.
In other words, the attempt to define a problem and fight it, rather than accept and understand it, has had absolutely disastrous consequences. The parallel between the drug war and the way in which pain has been approached in the last 80 years is direct. As Dr. Nortin Hadler point out in his book, “Stabbed In the Back”, regional pain syndromes are a part of the normal course of life. However, medicalizing (ie attacking, or “declaring war on pain”) clearly correlates with an increase in both pain and disability.
If instead, we recognize that some people will do drugs, and we support them with a range of treatments rather than punishment, we will mitigate a great deal of suffering. The results of the legalization of marijuana in Colorado seem clear on that point. In terms of pain, if instead of declaring war on the symptoms, we instead look at the emotional basis of the problem and then treat people with respect and empathy, it is likely that the costs and suffering will drop precipitously.
War clouds our vision. Let us declare a truce with our bodies and our minds.