The announcement this past week that the pop/rock musician Prince died from an overdose of fentanyl confirmed what had been suspected since his untimely death in April 2016. Prince had become addicted to prescription opiate painkillers. Sadly, his was a very public face to what many are calling an epidemic. Though a devoted Jehovah’s Witness and by all reports fastidious about his health, his attempt to alleviate chronic pain morphed into an addiction that eventually took his life.

Over the past two years, there has hardly been a week without a headline or sobering story concerning the record number of deaths from opiate overdose in the United States. A New York Times article announced an unexpected rise in the death rate for the United States. Death rates—the number of deaths per hundred thousand people—have been in decline for many years, the article noted. Yet a sharp rise has occurred, in part, because of the prescription drug epidemic. If the rise continues, the researchers noted, it could be a signal of distress in the overall health of the nation.(1)

The struggle with chronic pain and the difficult and complex task for professionals who treat it made me wonder about how societies deal with pain in general. In a recent article from The Economist called “The Problem of Pain,” global treatment and attitudes toward pain were explored in light of the U.S. epidemic of opiate prescriptions and overdose. The author notes that when illness strikes, patients in poorer countries expect to suffer. Even when the tumor on his hip grew to the size of a football, Mato Samaile, a frail 50 year-old Nigerian cattle farmer, was reluctant to go to the hospital. “When I found the lump I said to my son: ‘We can’t leave the farm. We should stay until after the rain falls.’” Amina Ibrahim, a surgeon at the hospital where Mato was eventually admitted, notes, “People are brought up to tolerate pain. If you don’t you are a coward. That is just our culture. So even doctors are not liberal on painkillers.”(2)

Of course, in many parts of the world, there is little or no access to any kind of palliative care or pain management. The Economist reported a story about a young boy with cancer in rural India. He had visited several clinics nearer to his home in search of pain relief before stumbling into a Hyderabad hospital, ragged and short of breath. It had taken him more than 12 hours to get there, and he died soon afterwards.(3)

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