62 Comments

So much about pain perception is linked to our emotional well-being, or lack of, and Americans are stressed out and mentally ill thanks to the hypercapitalism and all that rugged individualism. It's at the heart of the problems in the U.S. with all manner of addictions as an entire population made sick by their living conditions tries to soothe the pain of existence by any means available.

All kinds of inflammatory diseases and chronic pain conditions, Lupus, psoriasis, fibromyalgia, MS, etc. are running rampant in the U.S. due to how stressful it is to just exist there.

Just by moving out of the U.S. to Portugal, my family members and I who were disabled by life in America are living well, largely pain-free, and off all or most of our medications. My son, who had been diagnosed with a disabling and painful inflammatory disease at age 19 has never been better and his skin, formerly painful when touched, has cleared up. I'm off all of the many prescription medications I was on there, including high blood pressure medication, a stimulant for ADHD, a mood stabilizer, and daily asthma medication, among others. They simply haven't been needed here.

Related to all this, I highly recommend reading The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture by Dr. Gabor Mate.

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.."an entire population made sick by their living conditions tries to soothe the pain of existence by any means available." Very well expressed. Thank you.

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The United States makes up 4.4% of the world's population, and consumes over 80% of the world's opioids. That is a STAGGERING statistic 😳

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That statistic jumped out at me as well, Jeff...Whoah!

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Thank you for posting. A very interesting topic. A capitalist country makes sacrificing people for money not only easy but rewarded. That's why I'm living in Portugal. :)

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Nail on Head.

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Call me a cynic but I think the answer is simple: money and insurance companies.

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Hi Cynic…you raise a good point. Money! Somehow I missed that one….

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It is a little more complex than money and insurance, but those are the biggest players in the 80% statistics. As with all things, capitalism included, Americans can afford to consume more and are therefore consuming more and targeted for such. Cannot trust!! Glad to be in Portugal too. It has been very good for me medically speaking... big differences.

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My thought exactly: Money and insurance companies! Combine the two and one outcome is the number of TV ads for drugs. We watch a lot of US Hulu and are constantly surprised by the number of ads for drugs. I think the US is one of only a few countries (if any others) that allow drug ads. (No research backs that up, just questionable memory.)

But Nanc W, here's a topic for future research: Why is there a seeming outbreak of psoriasis in the US? There are at least 5 or 6 drugs being advertised. This seems to have emerged in the last few years. Inquiring minds want to know! And thanks for this post, very well done.

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1. You are correct about Rx ads not allowed in Europe, 2. Possible cause of psoriasis….stress?

Calma, calma

Obrigada

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Thank God there are no Rx ads here!!! My doc in the states used to tell me she knew when new drugs were advertised because some percentage of her patients would all show up asking to try it.

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Drug and alcohol ads used to be non-existent. We have a weak FCC to thank …of course corporate donations to thank for weakening.

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I also watch HULU and am amazed and disgusted by the number of drug ads. Endless!! It's difficult to tune them all out.

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Nancy, I'm glad your surgeries had positive outcomes. It's stressful enough to have a procedure in a familiar setting but to be in a different country must have added a little anxiety. With the level of activity you and Denise maintain I'm glad you're in a place that will keep you in tip-top shape.

As for my answer to your question, For years I mistakenly attributed a quote to Mark Twain but it was Darrell Huff who said: “proper treatment will cure a cold in seven days, but left to itself a cold will hang on for a week.”

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We are transplants from USA and were just told at a health seminar we organized last week here in the Algarve that "Americans are overdosed and over diagnosed" 😳

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If you haven't read "Demon Copperhead" by Barbara Kingsolver, it's a fictional treatment of this same issue.

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Very well researched. I had no idea that a pain index existed and I always appreciate facts & data.

IMHO the influence of Big Pharma was always the main differentiator.

Combine lobbying of government officials, conditioning the consumer through commercialization (only happy faces in drug commercials) and incentivizing physicians (would love to see a comment from a former pharma rep here).

But in reality there are so many more facets in response to your blog.

With that being said, I am undergoing collarbone surgery later today and I am already sure that they will just top off my paracetamol prescription that has carried me through the first week of living with the fracture :-)

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I wonder if it’s that it can take so much longer to receive care in the U.S.? Also perhaps greater opioid use equals less nurse needs (because patients are unconscious) so you can staff less. And charge more :/

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Just want to thank you for this well-researched article. I had no idea about the pain index, have had direct experience with the whimpy parametecol, and appreciate knowing why pain management is so different here.

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Did you see the mini-series? If not, I highly recommend it. By watching I learned that the Pain Index chart (the smiley and sad faces) that adorn every US hospital room was created by Perdue Pharmaceuticals (maker of Oxygen).

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Spot on Nancy! Once again, deeply appreciative of your words. As one who works with biospiritual trauma transformation through nervous system regulation, your words speaks to me. In the US, Big Pharma rules. Ergo, our shameful and broken health care system. How pharmaceutical companies woos medical students at gatherings and conferences to push their drugs is one answer. A May 2023 essay by NYT's Nicholas Kristof makes a brilliant connection between chronic pain and class. https://www.nytimes.com/2023/05/03/opinion/chronic-pain-america-working-class.html?te=1&nl=nicholas-kristof&emc=edit_nk_20230503. In a nation and society, whose moral fiber has ruptured and its political structures are imploding, I have coined the motto: Keep them Doped, Keep them Duped. Doped citizens lose their resiliency to question, resist, and persist. Portugal does appear to have a common sense approach to pain management. Yet, let us not overlook the pain and suffering that also exists here behind close doors as in the existence of domestic violence. 2022 had the highest number of incidents of the last four years, with 30,389 incidents registered with PSP and GNR. Also 28 death were registered in the context of domestic violence: 24 women and 4 children. See the portal on the website of the Commission for Citizenship and Gender Equality (CIG). This is an aspect of human suffering that deeply deserves attention in our adopted and beautiful country.

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I’m not surprised that there’s a difference in opioid consumption but that 80% statistic is staggering! Pain is complex and influenced by biological, psychological, and social factors. There’s a lot of fascinating research out there in the pain science field. “The Way Out” by Alan Gordon is an interesting book on the topic, and an app called “Curable” has made a significant impact on my own chronic pain via education, meditation and exercises.

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Well done Nancy,

Obrigada

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America is sick in so many ways.

As a child growing up overseas (including some 3rd world countries) we didn't get medicated or seek sketchy medical attention unless it was broken or bleeding arterially. Perhaps Portuguese had similar conditions?

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I think it's about the money, and the high-pitch sales between drug companies and physicians/hospitals. It's very sad.

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Deepak Chopra said American doctors are legalized pill pushers. He was the chief doctor at Massachusetts General Hospital so it isn’t just a philosophical statement.

The default action is to give you a pill that makes things go away immediately and for the short term and if they screw up your kidneys or your mind well, we’re in the business of sick people, so that’s all OK.

Let the buyer beware.

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John, you raise a very good point regarding the need to provide immediate gratification only to have it cause a longer term side effect.

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