Maths & Empathy Lessons for Politicians

There’s been a bit of a hoo haa on Twitter recently over the changes to how opiate painkillers are prescribed in the US. Not unsurprisingly, it’s left a number of chronic pain suffers rather nervous. And not just in the US, but over here in the UK where we have a distasteful habit of following on America’s heels like a irritating younger sibling.

There’s a lot of political bluster about the whole thing and lots of statistics being used to show what a terrible problem opiates cause. But I have some questions:

Opioids (including prescription opioid pain relievers and heroin) killed more than 28,000 people in 2014, more than any year on record. At least half of all opioid overdose deaths involve a prescription opioid

– CDC

Firstly, there were 318.9 million people in the US in 2014, so 0.0127% of the population died of opiate related causes. And 0.00639% of the population died from prescription based drugs (we can assume the rest were illegal…). Of this, how many were accidental or addiction related overdoses? No? Ok. How many were deliberate overdoses?
Is this a drug problem, or a mental health care issue?

Ok, let’s keep going with the maths (basically because maths is amazing)…

In the same year, there were 13000 gun related deaths. So put side by side:

Prescription Opiates: 0.006%
Gun Related: 0.004%

Now neither of these figures takes suicide & accidental death into consideration, but one has a potential to be used to help those with terminal illness (Just for total clarification, I’m referring to the opiates), so there is the potential statistically that the numbers are skewed as how were those deaths classified? But also, why is the 0.006% an epidemic that must be crushed, but 0.004% can only be solved by introducing more of the metal things killing people?

Ahem, a quick interlude for a nod to ‘Guns don’t kill people’. (Also, US friends – check out their alternate song, Your mother’s got a penis. You’ll thank me)
https://youtu.be/ICG0MuzEYzw

Right. Now that’s done…
Why are people so pissed off by politicians telling chronic pain patients no more opiates? Well, their carefully thought out alternative is over the counter drugs like paracetamol.

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Now before telling me that I probably just need a paracetamol because pain is mostly mental, I’d like you to yank your finger out of its socket. (We’ll start small). Hurts doesn’t it? Have a paracetamol.

Give it 24 hours. Now yank your elbow out. No, actually dislocate it & tear some muscle for good measure. Different arm. Take a paracetamol. And keep working. Don’t expect any handouts. That’s just laziness.

Same day, shift your hip out of its socket. Not all the way, but enough to grind bone against bone. That’s a big one, so you can have ibroprofen & an ice pack.

Next day… You’re not healed? Aw… tough. Go to work. Your spine shifts out. Paracetamol.

Next day, out goes the knee… am I making my point yet? I haven’t even got to the internal organs, muscle spasms, co-morbid diagnoses, & CRPS. It’s crap. The very fact that opiates make my general pain levels bareable means that I continue to be a productive member of society albeit on wheels & a bit wonky. Your alternative is a screaming mess.

This week one of our online EDS community took her own life because she couldn’t go on with the continued pain. She was 23. I’ve found myself several times this week staring at my phone & wondering if there were any signs that we could’ve spotted, or more support offered. But constant long term acute pain does that to you. It makes you stir crazy & pushes you to the point where you just want a break. Her death sent ripples of shock through many communities and it hit home how close some of us are to just saying enough. It would be easy to blame the conduit for her passing – it’s a tangible thing to blame. But the root cause was unmanaged, daily & unrelenting pain. I wish she knew how her loss has rippled through people shed never even met and that each of us empathises and wishes her peace now without any judgement as to why she didn’t fight longer. 

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I think the laboured point I was trying to make there is that you can’t have it both ways. Pain relief, or productivity. With sufficient pain management, we have incredible potential, but left to ‘man up’, there will be more like Sarah.

And how horrendously offensive to casually place people with chronic pain taking controlled drugs in the same category as heroin addicts taking Street drugs cut with God knows what. That’s not just sloppy science, that’s bad maths. And there’s no excuse for that.

Bad show America. Very bad show.

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