Viewpoint: Why understanding pain is crucial to fighting opioid abuse

Although the U.S. Senate recently approved a bill to address the opioid crisis, to truly curb painkiller abuse, it is crucial to understand why Americans are turning to these powerful drugs, Susan Sered, PhD, professor of sociology at Boston-based Suffolk University, argues in an op-ed.

"I am particularly interested in developing better understandings of the root causes of the current crisis," Dr. Sered wrote. "Why are so many Americans willing to ingest substances that, they most likely know, can lead to grievous harm?"

Here are five takeaways from the op-ed.

1. Dr. Sered discussed how primary prevention, which analyzes the reasons people turn to opioids, is mentioned in the Senate bill a few places, but is not fleshed out in a research plan or in terms of public health strategies. Additionally, President Donald Trump's commission report briefly addresses prevention through school and media programs aimed at informing children and parents about the dangers of opioid use. But Dr. Sered argues these initiatives do not address a number of the issues that lead to opioid abuse.

2. From working with women in Massachusetts who have had issues with substance abuse, Dr. Sered found some of the root causes of this abuse stemmed from childhood or intimate partner abuse, untreated underlying health problems, mental pain or physical pain. "Often, the pain wasn't taken seriously by employers, who insisted that minimum wage workers show up even when they are unwell, family members or healthcare providers," Dr. Sered wrote. "While substantive help often wasn't available, psychotropic and pain medication was easy to get hold of, whether from doctors or drug dealers or both."

3. Additionally, the Senate bill does not explicitly suggest research to explore why certain demographic groups are more affected by the opioid epidemic, Dr. Sered said. Recent population data indicates opioid abuse primarily affects males in working-class and low-income white communities, but is expanding to Hispanic communities. 

4. "Information of this sort lays the groundwork for primary prevention," Dr. Sered wrote." To begin to address these issues, Dr. Sered laid out several questions to ask, including what factors in certain demographic groups make opioids attractive, whether there are occupational or educational policies that encourage or discourage substance abuse and whether these policies can be adjusted to reduce both pain and substance abuse.

5. "America must deal with our pain epidemic if we have any hope of dealing with the painkiller epidemic," Dr. Sered wrote.

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