Reprinted with permission from the PAINS Project.
Lynn Webster, author of the blog below, is a member of PAINS’ Steering Committee. He is also one of the most authoritative and committed experts in the United States working on both pain and addiction. PAINS has been benefited tremendously from his involvement in our efforts to “transform the way pain is perceived, judged and treated.”
Over the last couple of years, PAINS has come to understand the importance of embracing the need for dramatic change in the way two diseases – chronic pain and substance abuse disorders, especially opioid addiction — are addressed, and that by advocates focused on both working together, we are far more likely to improve the health and well-being of all Americans.
Although the relationship between these two public issues is not yet clearly understood, there is without question a correlation between the two. Unfortunately, these two patient populations have often been pitted against one another by the media and fear-mongers for personal or political advantage. PAINS has attempted to reach out to those focused on opioid addiction and to neutralize some of the ill-will between those focused on pain and those focused on addiction.
These efforts are gaining some traction with people of goodwill – no matter their primary locus of concern. PAINS is committed to this work because we are confident that there are shared values and common ground upon which we can collaborate.
We are grateful to Dr. Webster for allowing us to post a blog he wrote shortly after the sudden death of one of America’s great artists, Prince. We believe it makes a compelling case for what PAINS is trying to do.
This Is How Prince’s Death Begins Conversation About Addiction
by Lynn Webster, MD
The Conversation Is About Compassion and Addiction
When I published my recent blog, Prince and Why We Need More Compassion About Addiction, I began by saying that we didn’t yet know why Prince died. The facts weren’t in, and I didn’t want to draw conclusions until I had more information. I still don’t have all the facts about the circumstances surrounding Prince’s death. I wasn’t Prince’s physician during his lifetime, and I had no opportunity to look at his medical records either before or after his death.
All I know about Prince’s death is what you know. Some entertainment media outlets (TMZ, Variety, and more) initially reported that Prince was treated with naloxone, which is the antidote for opioids including heroin, in the days before his death. An autopsy (in which I had no participation) was conducted on Prince’s remains, and according to CNN, it could be weeks before we know why the beloved musical icon is no longer with us.
Several of my colleagues and friends posted a link to my blog on their social networks, and they told me they were surprised to see that some of their supporters had reacted swiftly and furiously. For example, Jan Favero Chambers, President / Founder of the National Fibromyalgia & Chronic Pain Association, was gracious enough to post a link to my blog on her Facebook page.
Among the negative comments she shared with me was this one:
“Jumping the gun a bit. We don’t know the cause of death.
Respect his memory, by not posting this.”
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If you look at the comments below my original blog, you’ll find someone raised an objection there, too:
“Why are you using Prince to draw people into this article?
Do you know his medical history? Have the autopsy results come back? Please school me on your knowledge,” reads the comment.
Empathize, Don’t Blame, People in Pain or With Addiction
As I said in my response to that comment, part of my life’s work is to teach people to empathize with, and not blame, people in pain or with addiction. The untimely death of a beloved musical icon provides an opportunity to test our ability to demonstrate compassion. That is why I blogged about it.
I blogged about the death of Prince not because I jumped to conclusions about how he died. As I wrote then, I didn’t know any more about the cause, or causes, of his death than anyone else who hadn’t treated him or viewed his medical records.
But what I did know is that we, as members of society, had experienced a communal loss. While that’s tragic and sad, it provides us with one benefit: an opportunity to compassionately discuss the difficult topic of addiction and related issues.
Since TMZ, Variety, and other entertainment media had linked Prince’s death with naloxone, which is the antidote for opioids including heroin, I believed (and I still believe) that it was a good time to discuss addiction.
Addiction Is a Disease, Not a Character Flaw
Addiction is a disease, and yet it frequently elicits anger and judgment rather than sympathy and support. This is true for everyone, famous or not, with addiction.
I don’t know whether Prince was one of the people with addiction. But what I do know is that, as an addiction specialist, I treated thousands of people with addiction over the years. My professional background qualifies me to make the observation that it’s wrong to deny compassion to the people in various stages of the disease of addiction.
When we blame people with addictions for the choices that led to their addictions, we overlook the fact that addiction is a complex problem. Because there are so many factors involved in addiction, it’s inaccurate and unfair to point a finger at an individual and say, “This disease is your fault.”
It is true that we all own some agency for our decisions, but once the disease of addiction is firmly rooted, the power to choose is stolen by the brain.
My concern was that, if the medical evidence supported the conclusion that Prince died of addiction, the outpouring of devotion that his memory had inspired would turn to rage against him. That, in my opinion, would be a shame, because the people we care about — whether they are family members, friends, colleagues, or celebrities whom we’re unlikely to meet in person — are as worthy of our love in their sickness as they are when they enjoy their full health.
It provides us all with an opportunity to open up our hearts
and listen to people in pain and with addiction.
The Pain Action Alliance to Implement a National Strategy (PAINS) is an alliance of leaders working in professional societies, patient advocacy organizations, policy groups, people with pain, payers, and the private sector striving together toward a common vision and mission. Recognizing the tremendous changes that are transpiring in healthcare, PAINS is working to integrate bio-psychosocial pain care into efforts to create patient-centered medical homes and accountable care organizations. PAINS is also reaching out to other national coalitions and alliances involved in healthcare reform to encourage them to integrate improved pain care into their efforts and to learn how we can support their work as well.