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New research by economists in the United States and Iceland has put a price tag on what it's worth to Americans to live without chronic pain.
The researchers, using a massive government survey of Americans over age 50, estimated in a new working paper published by the National Bureau of Economic Research that living with chronic pain makes people so unhappy that they'd need to earn between $20,000 and $50,000 per year more to be as happy as they would be otherwise with no pain. Another way of looking at it: People would pay between $56 and $145 per day to be just as happy as they otherwise are, but pain-free.
There are a lot of people in the US who deal with pain — a 2012 National Institutes of Health survey found that 25 million Americans reported daily chronic pain, with 23 million more complaining about severe pain.
The United States spends billions of dollars to treat chronic pain — and so researchers want to know how much it's worth to people to have that pain alleviated. The economists who did this study say it's important so that policymakers can decide how much money they should assign to pain treatment versus other spending priorities.
That's a big question as the United States continues to wrestle with the opioid crisis. Heavily addictive painkillers were originally marketed as a way to treat the pain that afflicts millions of Americans. Instead, they contributed to a drug epidemic that's killing tens of thousands of people each year. Putting a price tag on pain can help evaluate new and less addictive approaches to pain treatment.
The researchers, Thorhildur Ólafsdóttir and Tinna Laufey Ásgeirsdóttir from the University of Iceland and Edward Norton from the University of Michigan, examined data from the US Health and Retirement Study, a survey that asks Americans over 50 about their income,chronic pain levels, and reported life satisfaction.
They controlled for other factors that could affect pain or happiness, including underlying health conditions and marital status. Their results showed that people in chronic pain would need an additional $56 to $145 per day in household income to be as happy as they would be when they were pain-free. The more severe the pain, the greater the compensation they'd need.
That's actually lower than values determined in previous research — a 2014 study of Australian data found people in pain would need $645 per day, or more than $235,000 per year, to make up the lost life satisfaction.
Of course it's not that simple — people don't get a choice to simply pay to be pain-free. But as a society, the US spends billions to try to fix people's pain: $88 billion on back and neck pain alone in 2013.
In a 2011 study by Johns Hopkins University and George Washington University, researchers found that if you combine the health care costs to treat pain with lost productivity from people missing days at work, chronic pain costs the US health care system between $560 billion and $635 billion per year — far more than the cost of cancer, diabetes, or heart disease.
Finding out how much pain is worth to people can help evaluate different ways of treating pain relief. It can also help with trade-offs between programs to treat pain or other policies meant to help improve people's well-being in other ways.
In the 1990s, drug companies pushed doctors to take pain seriously. The result was a drug epidemic. America is awash in opioids; the standard daily dose per million people is 50,000 doses of opioids. That's far more than any other developed country in the world.
In a recent survey, 38 percent of the US population reported using prescription opioids for pain — compared to just 4.5 percent in Germany. And America's costly pain problem has led to an even deadlier one: the addiction crisis. The death toll is continuing to rise as people who became hooked on addictive prescription opioids move to heroin and deadlier synthetic opioids like fentanyl.
On top of that, using opioids to treat chronic pain may have been largely ineffective. There's a new body of research that shows chronic opioid use can actually make pain worse, and favors simpler methods like exercise, yoga, acupuncture, and anti-inflammatory medication.
In response to the crisis, medical groups and the federal government are starting to emphasize controlling pain rather than eliminating it entirely. The federal government's evaluation of hospitals, for example, will no longer grade them on how much they've reduced their patients' pain.
These changes are controversial. Getting more precise about how pain affects people's lives — including the difference between mild and severe pain — can give policymakers more tools as they consider them.