How we think about pain has changed over the centuries—here's why it might have culminated in the opioid crisis today, writes RobertCSmithMD
Until around 1500 A.D., people understood"why" they had pain: God willed it infor their sins. This led them to actively work to correct their sins to achieve salvation. From 1500 to 1700 A.D., this magical, all-powerful image of God gradually gave way to Deism, the idea that He no longer acted in the world after designing it, and that man must use his God-given potential to prosper. Humans could now thrive on Earth rather than achievingonly in the hereafter.
After 1700 A.D., society extended this view: human fulfillment could occur during our earthly lives and reduction in pain and suffering was a desirable part of this. Pain had become escapable and something to be cured. This fit nicely with the influence of philosopher René Descartes and the burgeoning medical and scientific progress of the Scientific Revolution.
Several societal events set the stage for what would become America’s effort to completely eradicate pain. Following the horrors of World War II, Western nations formed the United Nations, which published its Declaration of Human Rights in 1948; later amendments established the right to pain relief at the end of life, as did a U.S. Supreme Court decision.
Tremendous efforts followed to promote opioid use for chronic pain using this rationale: if we could completely relieve pain in terminal patients and surgical patients, why not do the same for chronic pain patients. To achieve this, pain organizations, U.S. government regulators, and Congress promoted pain as safely relieved by opioids and advised its use.
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