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Distributed for ForeEdge

Needless Suffering

How Society Fails Those with Chronic Pain

Distributed for ForeEdge

Needless Suffering

How Society Fails Those with Chronic Pain

Needless Suffering offers a sociological examination of a complex medical problem: chronic pain and the inability of doctors and other health professionals to understand and manage it in their patients. People in pain, writes Dr. David Nagel, are the poor of the medical world. Like the poor, they are stigmatized and left at the mercy of powerful social actors who tend to work in their own self-interest, frequently at the expense of those they propose to serve. This leaves those who suffer with little control over their own destinies and creates a dysfunctional status quo that harms instead of helps. Drawing on his own experience witnessing his mother’s chronic pain and numerous clinical stories from over thirty years’ expertise as a pain management specialist, Nagel looks first at patients, their families, and their doctors (usually not trained in pain management), and then broadens his canvas to elaborate a pain power structure that includes the entire healthcare community, insurers, lawyers, government regulators, employers, politicians, law enforcement agencies, and painkilling drugs. Concluding with concrete reforms to create more effective and compassionate pain care, this book is designed for pain patients and their families, healthcare providers, legislators and other public policymakers, judges, personal injury and other attorneys, insurers, government regulators, law enforcement personnel, and health care businesspeople.

320 pages | 6 x 9 | © 2016

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Table of Contents

Foreword • Acknowledgments • Prologue: The Forest for the Trees • PART 1: POOR MAN, PAINED MAN • A Young Doctor Transformed by a Man in Pain • What Is Pain? Its Neurophysiology and Psychology: Chasing Two Moving Targets • You Do Have to Suffer . . . Just Not as Much as We Make You • PART 2: THE CAST OF CHARACTERS • The Patient: Making Lemonade When Stuck with a Lemon • Family, Friends, and Community • The Physician and the Pain Patient: Poorly Equipped for the Role? • Regulatory Agencies and Pain Management: Overregulation Breeds Underregulation • The Business of Health Care: Whose Bottom Line Are We Treating? • The Workplace and Entitlements: Creating “Inability” out of “Disability” • Health and Disability Insurance: The Law of Unintended Consequences • The Legal System: Disorder in the Court! • What It Means to “Do No Harm”: Is There a Safe Way to Medicate Pain? • Opiates and Opioids • Cannabinoids and Pain: Reefer Madness or Compassionate Care? • Health-Care Reform and Chronic Pain: We All Have a Role to Play • Epilogue: Living in the Forest • Notes • Index

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