UN Says Untreated Pain Is “Inhumane and Cruel”

Editor’s Memo October 2017: United Nations Says Untreated Pain Is “Inhumane and Cruel” – Oct 2017 – Forrest Tenant

The national debate on the proper use of opioids continues to build as the high prevalence of addiction and overdoses fuel the continuing attention to this “public health crisis.”

Much of the anti-opioid rhetoric regarding the “opioid epidemic” implies that pain is a nuisance that really doesn’t require treatment.

Instead of making the focus one of achieving good pain relief, far too much attention has been directed solely at the risks of opioid prescribing and how we must provide naloxone on every street corner where an opioid might be sold.  

What we need now is a proper discussion about the immense risks of untreated pain.

Simply put, untreated severe and chronic pain are not only forms of torture but put patients on the road to death. 

We have known for ages that untreated moderate to severe pain, whether slowly or rapidly, may lead to hyperlipidemia, hypertension, tachycardia, adrenal exhaustion, cardiovascular collapse, and at times to suicide.

In the search for answers, I’d like to call immediate attention to the General Assembly of the United Nations (UN), which is on record as having declared that “untreated pain is tantamount to torture or cruel, inhuman or degrading treatment or punishment”. 

If only our legislators and government agency leaders would read the “Report of the Special Rapporteur on Torture and Other Cruel Degrading Treatment or Punishment” before acting to diminish patients’ access to needed pain medicines.

Following the UN report, Human Rights Watch weighed in, stating that “the poor availability of pain treatment is both perplexing and inexcusable”

Given the urgent need for a reasonable and responsible approach to pain care, every pain practitioner and all pain patients should become familiar with these reports, which make a case for profound governmental failures; but that’s not enough.

The time has come to demand that every pain treatment critic in the United States government, the insurance industry, members of the press, religious leaders, and anyone else for that matter who is addressing this subject seek solutions that do more than tie the hands of credentialed medical professionals who are treating patients with chronic pain.

As well, there is a need to distinguish between addiction, abuse, and a medically confirmed need for opioid treatment in forming future programs.

Know the Facts Before Withholding Pain  Care

The UN report laid out the reality of suffering with pain and presented recommendations that need more widespread dissemination. 

In particular, people who use drugs are not necessarily addicts or substances abusers, as many are simply patients who developed a medical condition that has left them unable to function without adequate treatment for severe, chronic, or intractable pain

Although resource constraints may justify only partial fulfillment of some aspects of the right to health, a State cannot justify its non-compliance with core obligations, such as the absolute prohibition of torture, under any circumstances. (Committee on Economic, Social and Cultural Rights, general comment No. 14).”

Aiming to protect people with pain conditions, UN Special Rapporteur Juan E. Mendez recommended the following:

“Safeguard free and informed consent on an equal basis for all individuals without any exception, through a legal framework and judicial and administrative mechanisms, including through policies and practices to protect against abuses.

To work against denial of pain relief, Juan E. Mendez recommended that all states:

“Adopt a human rights-based approach to drug control as a matter of priority to prevent the continuing violations of rights stemming from the current approaches to curtailing supply and demand (A/65/255, para. 48).

Ensure that national drug control laws recognize the indispensable nature of narcotic and psychotropic drugs for the relief of pain and suffering; review national legislation and administrative procedures to guarantee adequate availability of those medicines for legitimate medical uses;

Ensure full access to palliative care and overcome current regulatory, educational and attitudinal obstacles that restrict availability to essential palliative care medications, especially oral morphine.

States should devise and implement policies that promote widespread understanding about the therapeutic usefulness of controlled substances and their rational use;

Develop and integrate palliative care into the public health system by including it in all national health plans and policies, curricula and training programmes and developing the necessary standards, guidelines, and clinical protocols.”

Inadequate Pain Care Is a Worldwide Concern

Eighty-three percent of the world population has either no or inadequate access to treatment for moderate to severe pain.

See ‘Opiophobia’ Leaves Millions Dying in Chronic Pain

Thirty-two countries in Africa alone, for example, have almost no morphine available. In France, a study found that doctors underestimated pain in over half of their AIDS patients. In India, more than half of the country’s regional cancer centers do not have morphine or doctors trained in using it. This is despite the fact that 70% or more of their patients have advanced cancer and are likely to require pain treatment.

A Better Approach to Pain Is a US Imperative

It’s time that we openly acknowledge that we are in a most profound and serious battle over the most basic of human rights—the relief of pain and suffering. Let’s call it what it is. Many entities want to deprive patients who are suffering from moderate to severe pain their human right to adequate pain treatment.

These same opioid epidemic-defenders would not admit publicly or to themselves that by withholding access to all available pharmacotherapies, they are in effect promoting torture, cruelty, or degrading treatment.  

In my opinion, the problem with our failed approach to pain care stems from a narrow view of pain that misses the point. Withholding all means of pain treatment goes against the view advocated by the UN, WHO, and Human Rights Watch.

It is past due for each and every one of us, including our pain patients and their families, to use our voices to tell all concerned parties that we support the UN view that untreated pain is tantamount to torture, and is cruel, inhuman, or degrading punishment. We need a more medically informed approach to treating people with severe, chronic, intractable pain.  

7 thoughts on “UN Says Untreated Pain Is “Inhumane and Cruel”

  1. scott michaels

    THANK GOD! WHAT CAN I DO TO HELP. I AM A VICTIM OF INHUMANE TORTURE. AFTER 7 YEARS OF SUCCESS ON HIGH DOSE OPIOID THERAPY I HAVE BEEN FORCED TO REDUCE. OW O AT HALF THE NEEDED DOSE AND MY PAIN IS FOREVER AND INTENSE. THE MEDICATION I GET HELPS A LITTLE BUT NOT ENOUGH FOR ME TO GET OUT OF BED FOR MORE THE 2/3 HOURS A DAY. ANY ACTIVITY CAUSES PAIN TJATS IS SLOWLY BECOMING UN LIVABLE.

    Liked by 1 person

    Reply
  2. Laura P. Schulman, MD, MA

    And another thing: yes, there are individuals who are, in fact, opioid addicts, who have chronic painful conditions. These are physical issues, not moral failings! They need treated like everyone else, except with more care, because they have a delicate balance to tread with both pain and addiction. In the current condition of our society, these people are getting a bad deal from every angle.

    Liked by 1 person

    Reply
    1. scott michaels

      When itcomes to opioid addictsthat are alsoin severe chronic pain, Sorry, they must avoid opioids at all costs. They will lie about painto get medication, which is what got us here. 1 IS TOO MANY AND 1000 IS NOT ENOUGH.
      Opioid Addicts will relapse unless another has 100% disgression of distributing medication on a daily basis. Medication must also be locked is a heavy duty safe.
      IF THE ADDICT DISAPPEARS YOU CAN ASSUME THEY WENT TO SCORE ILLEGAL DRUGS. GENERALLY THEY SHOULD USE EVERY OTHER METOD AVAILABLE. A RECOVERING OPIOID ADDICT WITH TIME, OVER 1 YEAR WOULD MOST LIKELY REJECT and opioid therapy anyway. THEY ARE TOO FEARFUL OF RELAPSE. I KNEW MANY THAT WOULD HAVE SURGERY AND DEMAND NO OPIOIDS!
      BUT THEY ARE NOT MY CONCERN!!!!
      MY CONCERN IS ME AND THOSE LIKE ME THAT ARENT ADDICT, YET WE ARE TREATED AS SUCH. WE TAKE AS DIRECTED EVEN THOUGH WERE AT 20/50% OF OUR USUAL DOSE, WE KNOW TO MAKE IT LAST A MONTH AND LIVE WITH THIS EXCRUCIATING PAIN. AN ADDICT WOULD GENERALLY BE OUT OF MEDICINE IN A FEW DAYS. OUR NUMBERS ARE IN THE 10S OF MILLIONS, YET THE POLITICAL LIARS AND GREEDY INSURANCE COMPANIES FEEL DENYING US OUR MEDICATION IS OKAY, WE’LL LIVE
      ACTUALLY MANY OF US ARE TAKING OUR OWN LIVESS, ONLY A FEW ARE GOING THE ILLEGAL ROUTE. BUT DUE TO THIS TORTURE.MOST WILL DIE LONG BEFORE TGIER TIME BECAUSE PAIN CAUSES DEPRESSION, CARDIO VASCULAR DESEASE, MENTAL INSTABILITY AND FINALLY SUICIDE.

      Liked by 1 person

      Reply
      1. Laura P. Schulman, MD, MA

        That’s why all drugs need to be legal. Policing the behavior of individuals is fruitless and results only in more damage. An addict does have drug seeking behaviors, but most of the exaggerated behaviours we observe are due to the gauntlet of illegal moves that he is forced through by the fact of the drug’s illegality. As we have seen in other countries, those behaviors disappear once the drug is legal.

        The only barrier to understanding this is the fixed delusion that addicts are bad, immoral people.

        Liked by 1 person

        Reply
        1. scott michaels

          I absolutely agree.This country comes off as putitan, yet commit the most sins on the planet, have more people in prisons and disrespect anybody not like them.
          Its out of control. SLAVERY IS NOT DEAD, WE ARE ALL SLAVES TO OUR GOVERNMENT AND OUR PLACE IN SOCIETY. ILLEGAL DRUGS OBVIOUSLY ARE INHERINTNLY BAD, BUT THEY ARE GOING AWAY. IT COST MORE TO.IMPRISON.A.DRUG ADDICT, THEYTHE AVERAGE.PERSON MAKES.ON DISABILITY OR SOCIAL SECURITY. IF WE TOOK THOSE MILLIONS OUT OF PRISON AND LEGALIZED DRUGS, THOSE ON DISABILITY AND SOC.SEC. CAN AFFORD FOOD SHELTER AND HEALTH.CARE. OUR PRIORITUES ARE SO SCREWED UP AND IT WILL NEVER CHANGE.

          Liked by 1 person

          Reply
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