A Nation in Pain: Healing Our Nation’s Biggest Health Problem

The shadow pain casts and the toll it takes on individuals and society are revealed in this remarkable book by nationally syndicated health columnist Foreman, who chronicles the genetics of pain, types of pain receptors, and the effect of hormones and gender on pain and pain relief. Beginning this journey from personal experience with chronic pain, she discusses how pain can be “catastrophized” (leading to an obsessive focus on the pain) or cause depression. Foreman also describes the difficulties in assessing the pain of others and how this, combined with longstanding prejudices from the house of medicine in particular and society in general, influence the administration—or lack of administration—of pain medications. Foreman effectively juxtaposes her portrayal of a society in pain and a national attempt to limit access to adequate pain therapy. As she notes: “people with chronic pain (often older people with no history of substance abuse) can’t get the opioids they need and could probably use responsibly, while street abusers, often young people, get them all too easily.” Whether or not readers agree that the failure to treat pain is “torture by omission,” this work is thoughtful and thought-provoking reading for the medical community, policymakers, and patients, especially in light of the F.D.A’s recent call for tightening regulations in the administering of pain medications. Agent: Jim Levine, Levine Greenberg. (Feb.)