The Surprising Connection Between Pain and Politics

By Pat Anson, PNN Editor

“I feel your pain. I feel your pain.”

Bill Clinton was mocked by political pundits for saying that to an AIDS activist while running for president in 1992. Whether he was sincere or not, it was a public display of empathy that helped get Clinton elected.

Clinton may have been prescient about a connection between pain and politics. A large new study suggests that pain could have played a surprising role in the 2020 presidential election. Researchers found that liberals with high levels of pain sensitivity were more likely to vote for Donald Trump, while conservatives who were highly sensitive to pain were more likely to vote for Joe Biden.

Huh? I was skeptical. Initially, so was lead researcher Spike W.S. Lee, an associate professor of marketing at the University of Toronto’s Rotman School of Management.     

“We were honestly not expecting to see this kind of cross-aisle effects of pain sensitivity,” Lee said in a news release. “When we first found it, we thought it might be a fluke. That’s why we ran a replication study. We found it again. We ran extended replications and follow-up studies. We kept finding it.”

Lee and his colleagues ran seven different studies involving over 7,000 U.S. participants to see how pain sensitivity affects our moral and political views. Does it heighten them and make us hold more tightly to them? Or does the pain experience make us more sensitive and accepting of what other people believe?

Lee started thinking about that as a research topic during a dental appointment. He is very sensitive to pain, and asked that a freezing procedure be used to numb his mouth before his teeth were cleaned. Lee found himself enjoying the experience so much that he wondered what having no sensitivity to pain would do to someone’s moral compass.

His research found that liberals with higher pain sensitivity were more likely to endorse traditional conservative values such as loyalty and authority; while pain sensitive conservatives showed more support for traditional liberal values such as caring and fairness.   

The pattern continued when participants were asked about their 2020 voting intentions. As the graphic shows below, liberals (blue line) said they were more likely to vote for Trump if they had more pain sensitivity. Similarly, conservatives (red line) were less likely to vote for Trump over Biden if they were more sensitive to pain.

Journal of Personality and Social Psychology

The pattern not only held up for how participants actually voted in the presidential election, it influenced their support for a diverse group of liberal and conservative politicians, such as Kamala Harris, Mike Pence, Mitch McConnell and Bernie Sanders.

Pain sensitivity also significantly changed the way liberals and conservatives thought about hot button issues such as immigration, global warming, unions, the free-market system and Obamacare.

Does that mean pain sensitivity makes people confused about their political views? Not necessarily. Lee says the more likely explanation is that the pain experience gives people more empathy for others and a greater willingness to look at issues from both sides.

In an age of polarized and often heated politics, that’s not a bad thing. Maybe Bill Clinton was on to something.

The study appears in the Journal of Personality and Social Psychology: Attitudes and Social Cognition.

CDC Is Prioritizing Politics Over Science

By Dr. Lynn Webster, PNN Columnist

For most of my career, I have revered the Centers for Disease Control and Prevention (CDC). I believed it had the best scientists in the world, and that we could and should believe everything they said.

Not anymore. Unfortunately, the CDC has devolved into a partisan mouthpiece for politicians and people with agendas not supported by science.

The Academy Award-winning documentary Under Our Skin first showed me how politics can influence decisions at the CDC. The film illustrates how chronic Lyme disease (CLD) can cause a great deal of suffering, including chronic pain and fatigue. But the medical community has been unwilling to respond appropriately because the government has determined that CLD is a "controversial" diagnosis.

As a result, patients with Lyme disease often go undiagnosed and untreated until their symptoms worsen. The ongoing "Lyme wars" make it difficult for them to get testing and treatment.

Contagion is a theatrical movie about a pandemic that shows the CDC making decisions based on the political aspirations of key CDC officers. But this fictional story about a pandemic and the power-seeking nature of CDC officials was unfortunately prescient.

CDC Has Done Better

We have seen the tremendous work the CDC can do worldwide. The Ebola virus was contained, and potentially millions of lives were saved, because of the stellar work of enormously talented and dedicated CDC scientists.

The CDC activated its Emergency Response Center to protect the United States and its territories from the threat of the Zika virus, which can cause birth defects and Guillain-Barré Syndrome. My childbearing-age daughter cancelled trips to areas that the CDC warned posed a high risk.

The agency conducted more than 160,000 Zika virus tests, created registries to track pregnant women who were known to be infected with the virus, and provided $251 million in grants to state and local health departments. Their ongoing efforts to minimize the damage from Zika demonstrates the exemplary work the CDC can perform.

CDC's Politicization Is Not Partisan

The politicizing of the CDC is nothing new. During the Obama administration, the CDC became a tool of anti-opioid zealots. Republican Rep. Harold (Hal) Rogers of Kentucky is a senior member of the House Appropriations Committee. You may have heard his name recently, because he helped determine the amount of the CDC's emergency funding for the coronavirus.  

President Obama joined Rogers at the National RX Drug Abuse and Heroin Summit in 2016 to support increased funding to address prescription drug abuse. That action ignored the larger problem of illicit drug abuse and the fact that the opioid crisis has been mischaracterized as a prescription drug problem.

CDC Harmed Millions With Its Opioid Guideline

When Physicians for Responsible Opioid Prescribing (PROP), an anti-opioid activist group, was unable to get what they demanded from the FDA through a citizen petition, they turned to the CDC, where they found political allies. This led to the now infamous CDC Guideline for Prescribing Opioids for Chronic Pain in 2016. 

The guideline has caused enormous harm to millions of Americans. Recently, the American Medical Association implored the CDC to significantly change the guideline "to protect patients with pain from the ongoing unintended consequences and misapplication of the guidance." Even the guideline’s authors have backpedaled, acknowledging it has been misapplied to withhold opioid medication from patients who need it.

Yet the harm continues. Alarmingly, the Department of Justice interprets the guideline as a mandate, warning and sometimes prosecuting doctors who do not follow its voluntary recommendations. Dozens of states have blindly adopted the guideline in a naïve attempt to address the rising number of drug overdose deaths, either not understanding or ignoring the fact that most overdoses are due to illicit, rather than prescription drugs. 

COVID-19 Flip Flops

Now we see the CDC yo-yoing with their recommendations regarding COVID-19. Initially, the CDC said that masks were not necessary, except for those who were sick or taking care of someone who was sick. Now they recommend that everyone wear a mask. The Trump administration wants to leave that decision up to individuals, so they have not issued a federal mask mandate. This is contrary to the advice of most experts.

The CDC has also stated that testing for COVID-19 is important. But when the administration apparently pressured the CDC to change their position and recommend that asymptomatic people who were exposed to the virus not get tested, they did so, allowing politics to trump (no pun intended) science. CDC Director Dr. Robert Redfeld has now reversed his position and said COVID-19 testing is important for those who have been exposed to the virus, even if they are asymptomatic.

I agree with Dr. Leana Wen, a well-recognized authority on public health, who wrote in The Washington Post that the CDC’s testing guidance was “nonsensical.”

"I worry that this CDC change is part of a larger pattern of diluting recommendations when the federal government can’t do its job properly," Wen wrote.

Perhaps we all should worry. Who and what are we to believe? I, for one, can no longer believe what the CDC says unless it is verified by non-partisan scientific bodies.

This is a sad time. Our health is being played with as if it were a game. I feel like a commoner in Game of Thrones, as the kings fight for power and ignore their people. We, the commoners, should insist that the CDC become an independent agency no longer headed by a political appointee, so it would be unassailable by politicians who are more interested in controlling messages than diseases. 

Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book The Painful Truth, and co-producer of the documentary It Hurts Until You Die. Opinions expressed here are those of the author alone and do not reflect the views or policy of PRA Health Sciences. You can find him on Twitter: @LynnRWebsterMD.

A Pain Platform: What Patients Should Look for in 2020 Candidates

By Crystal Lindell, PNN Columnist

I met my boyfriend, who also is a chronic pain patient, at a local county Democrat meeting a little over a year ago. We’re both crazy liberals, but he always says he knew it was love when I turned to him during the meeting and said, “If Donald Trump made hydrocodone over-the-counter, I’d vote for him in 2020.”

I have a political science bachelor’s degree and spent hours in my college classes lamenting about the surge of single-issue voters. Why would anyone vote for a presidential candidate just because they were pro-choice?

But now that I’m sick and depend on pain pills to function, I have to tell you, I kind of get it. If there were a candidate who supported my right to pain medication, I’d go work for their campaign.

Unfortunately though, there aren’t any candidates who really seem to represent the things pain patients need — not yet anyway. Both major parties have pushed for limits on opioid medication, regardless of whether your doctor thinks you need it. And both have ignored the pleas of pain patients for access to alternative treatments.

Here’s a list of 13 things that pain patients should be looking for in 2020 presidential candidates — a “Pain Platform” if you will. I’m not sure any candidate will truly live up to this ideal, but we won’t know until we ask.

1. Eliminate regulations for prescription opioids

This is the big one, obviously. And the most important. In a misguided attempt to respond to the opioid epidemic, there has been a surge in the number of regulations for opioid prescriptions that includes everything from limiting the amount a patient can get to arresting doctors who prescribe too much. That needs to stop.

2. Require insurers to fully cover alternative pain treatments

This one is also obvious. If they truly believe that opioids shouldn’t be the only pain treatment, then they need to support other treatments financially. And specifically the $0 co-pay is so important.

Insurance companies may think that a $30 co-pay for a physical therapy session isn’t that much, but if you need three sessions a week for three months suddenly you’re looking at more than $1,000. That’s too much. Especially for pain patients, who tend to have less income than the general population.

3. Provide research grants for new pain treatments

Even patients who use opioids know they aren’t a cure-all. But unfortunately, there aren’t many good alternatives for treating pain. That needs to change and requires research into new therapies that could help. If the government really wants people to use fewer opioids, they need to research alternatives that actually work.

4. Legalize recreational marijuana at the federal level

Personally, marijuana doesn’t help me much with pain. But for some people it’s exactly what they need, which is why it needs to be legalized. And yes, I think it needs to be legalized recreationally, because patients shouldn’t have to go a doctor and get a prescription to treat their pain.

5. Make kratom legal in all 50 states

I personally have found kratom to be extremely helpful for treating my chronic pain. In Illinois, I can get it over-the-counter, so I don’t have to drive over an hour each way to see a doctor every time I need a refill. Unfortunately, several states have made kratom illegal and some are considering it. That needs to change.

6. Forgive all medical debt

I have great insurance through a great job and I still have literally thousands of dollars in medical debt — all from co-pays. I can’t catch up because anytime I make any progress on it, I have another flare and rack up more bills. We live in the richest country in the world. Healthcare shouldn’t be what kills your credit.

7. Launch Medicare for all

I shouldn’t have to be over a certain age or legally disabled to get good health insurance. Everyone should have access to that. It’s not hard.

8. Make it easier to get disability while still working

The problem with disability is that you have to be out of work for a long period of time before you get your benefits. That’s impossible for anyone who’s responsible for their own bills. Yes, they give you back pay if you eventually qualify for disability, but landlords aren’t typically the type of people who will let you back pay them. You should be able to apply for disability while you’re still working so that you have steady income throughout.

9. Make disability pay a living wage

You’re barely allowed to make any income if you collect disability. But disability alone isn’t enough to live on in most places. People who depend on it shouldn’t also be relegated to poverty.

10. Allow people on disability to get married without penalty

This is a big one. As it stands right now, if you’re currently getting disability and Medicare you can lose those benefits if you get married because they count your spouse's income toward your income. Losing both kills your independence and can drastically increase your medical bills.

We should be encouraging love for people who are already dealing with so much, not discouraging it.

11. Require all government services for seniors to be provided to the disabled

This one is mind-blowing to me and I’m shocked that it’s not already the case. If you’re too sick to work, you are effectively retired no matter what your age. And you should have access to the same services seniors receive, such as transportation and other assistance. Some people lose their health early and basing benefits solely on age unfairly punishes those people.

12. Fund a public awareness program for invisible disabilities

I cannot read one more Facebook story about some poor person being screamed at for using a handicap spot because they “don’t look sick.” Lots of sick people look perfectly healthy. I look perfectly healthy, but I’m really sick. You can’t judge someone’s health by how they look. A public awareness campaign about invisible illness would go a long way toward making the lives of disabled people better.

13. Provide more medication-based addiction treatment centers

I know, I know. Patients aren’t addicts. But guess what, a lot of people who get addicted to opioids start with medications for legitimate pain. We shouldn’t abandon them. Providing more medication-based treatment centers is the first step toward helping them. There is a real need for those treatment centers in rural areas, which have been the hardest hit by the opioid crisis. The more addicts we help, the less we’ll have to deal with politicians blaming pain patients for the opioid crisis. 

What else would you add to the Pain Platform? What’s your wish list for 2020 candidates? Maybe if we all share our ideas, they’ll finally start listening to us. 

Crystal Lindell is a journalist who lives in Illinois. She eats too much Taco Bell, drinks too much espresso, and spends too much time looking for the perfect pink lipstick. Crystal has hypermobile Ehlers-Danlos syndrome. 

Crystal writes about it on her blog, “The Only Certainty is Bad Grammar.”

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represent the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.