It’s also forgotten that, for much of the twentieth century, doctors were discouraged from treating even terminally ill patients with opioid analgesics; the assumption was that alleviating pain was less important than avoiding addiction. But pioneers in the hospice and palliative care movement denounced such views, insisting that allowing a patient to suffer needlessly was unethical medical practice. For patient advocacy groups, this is a vital historical fact: before we had an addiction and overdose crisis, there was first the crisis of undertreated pain.
Both the National Institute on Drug Abuse and the latest edition of the Diagnostic and Statistical Manual of Mental Disorders support this view.
These insurance companies, once responsible for incentivizing the prescription of inexpensive pills, are now, by and large, refusing to cover safer alternative drugs and therapies — leaving patients who have little money with few options when their opioid medication is withdrawn.
For people of color, like Sell, the prospect of untreated pain is even greater: according to one recent study, black patients are about half as likely to receive medication as their white counterparts, even if their complaints are identical.