Mortality rates for middle-aged whites in the U.S. are rising due to drugs, alcohol, and depression. Unique to our country, these “deaths of despair” disproportionately occur among the under-educated, who are at particular risk for dying young. At one time, less-educated persons aspired to work in the same factory as their parents, at union wages, with benefits. Those jobs, and the sense of community and prosperity and security they allowed, are evaporating. Many former workers suffer from chronic pain, which underlies America's ongoing opioid overdose epidemic. The pain is not only physical. It is psychic, spiritual, and economic.
Get full access to this article
View all access options for this article.
References
1.
D.Johnson, Jesus' Son (Picador Press, Farrar, Straus & Giroux, 1992): at 53.
2.
D. F.Wallace, Infinite Jest (Little, Brown and Company, 1996): at 345.
3.
B. D.Sites, M. L.Beach, and M.Davis, “Increases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users,”Regional Anesthesia & Pain Medicine39, no. 1 (2014): 6-12.
4.
B. F.Mandell, “The Fifth Vital Sign: A Complex Story of Politics and Patient Care,”Cleveland Clinic Journal of Medicine83, no. 6 (2016): 4-5.
5.
L.Martin, M.Laderman, J.Hyatt, and J.Krueger, “Addressing the Opioid Crisis in the United States,”IHI Innovation Report (April2016): 4–5.
W. A.Rayet al., “Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain,”The Journal of the American Medical Association315, no. 22 (2016): 2415-2423.
J. L.Riskowski, “Associations of Socioeconomic Position and Pain Prevalence in the United States: Findings From the National Health and Nutrition Examination Survey,”Pain Medicine9, no.9 (2014): 1508-1521.
