What the Doctors on the Vox Podcast Missed When Advocating for 'Pain Acceptance'

In the wake of the opioid crisis, a recent podcast of Vox’s “The Impact” was puzzling over alternatives to opioids for chronic pain patients (“The
Controversial Way Doctors Fight Pain without Opioids“). As the government and others in charge are limiting the availability of opioids, “pain acceptance” may be the future for those of us experiencing chronic pain. The podcast’s host Sarah Kliff explains, “Pain acceptance is kind of just what it sounds like. It means asking patients to live with a certain level of pain — for months, years or even for the rest of their lives.”

Is it just me, or is everyone dealing with chronic pain out there snickering or groaning or rolling your eyes after reading that?

We’ve been “accepting” our pain forever, because for many of us, it’s always there. Even if we have a medication that works, chances are it doesn’t work every minute of every day. And honestly, I don’t know anyone whose meds take all the pain away.

This pain I feel from multiple autoimmune disorders and other conditions… anyone else would think they’ve been shot, or stabbed, or set on fire.  Yes, it’s often agonizing, but it’s something I just live with, live through. Every cell in my body is clamoring for rest and relief; there’s no way for me to turn off that feeling. Does that mean I’ve accepted it? Probably. But it doesn’t mean I’ll ever stop looking for relief.

I do have a small amount of medication I save for super bad pain (which is different from my normal “bad pain”) or when I need to get things done but am almost bed-bound by the throbbing and stiffness in my joints. It doesn’t make the pain disappear, or dull it; it simply makes it possible to get out of bed to see my family, or fold some clothes, or do a quick grocery run (with help). The reason the amount is so small is that it was all my primary doctor could give me. He said I’d have to go to a pain clinic to get more (if they’d even prescribe it). So I’m holding on to my few pills like they’re precious jewels, doling them out to myself maybe once a week. I know from experience that taking them regularly would help their efficacy, but I don’t have enough for that kind of frivolousness. Strange, isn’t it, that relieving my pain has to be “frivolous,” like wearing a silly hat or having a heated toilet seat?

In the podcast, Dr. Jane Ballantyne, a professor at the University of Washington School of Medicine, asks of the ubiquitous 0–10 pain scale that health care workers use to determine a patient’s level of pain, “What if we stop focusing on zero?” Most of us who deal with chronic pain or illness never expect to see a zero. For many of us, we’ll happily take a six or seven. With a six, I could go to work and run a few errands and make dinner and take a shower.

As it is right now, I must choose one of the above. Ballantyne and her co-author Mark Sullivan, M.D., in an article in the New England Journal of Medicine, offered patients no alternatives for treating pain other than learning to live with pain. Which we all do, anyway.

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