Chronic Pain and Torture – U.S. in Violation of International Laws Against Inhuman Suffering

-Kelly Merrill

“Failure to make essential medicines available or to take reasonable steps to make pain management and palliative care services available will result in a violation of the right to health. In some cases, failure to ensure patients have access to treatment for severe pain will also give rise to a violation of the prohibition of cruel, inhuman and degrading treatment.”  Access to Pain Treatment as a Human Right, Human Rights Watch (March 3, 2009)

I’ve been thinking a lot about terror.  And torture.

We must alert the international human rights community of what is happening here in the U.S….and the terror of being a pain patient when every kind of discrimination and denial of treatment have, inconceivably, become commonplace, regardless of whether for cancer or AIDs or the dozens of devastating pain-generating illnesses patients suffer.

As the opioid epidemic rages, pain patients have become the most marginalized subpopulation in the U.S.

We must acknowledge the severe toll of human suffering to change it.  We must start by demanding internationally-recognized, acceptable standards of pain management as established by human rights advocates around the world…for the effective management of physiologically-damaging, dehumanizing pain.

While government entities must balance this need with steps to prevent diversion, they must do so in a way that does not unnecessarily impede access to essential medications. Further, even the International Narcotics Control Board has stated that such diversion is relatively rare.

And yet…

Dr. Forest Tennant, the foremost intractable pain specialist in the nation, always expressed incredulity that the World Health Organization had already developed internationally-recognized, basic standards of care for pain management – and that practitioners and Government routinely ignored the need to balance the relief of suffering patients with attempts to control drugs diversion; therefore denying fundamental human rights’ protections for people who suffer devastating illnesses.

Draconian U.S. government practices have had a chilling effect upon the prescribing practices upon physicians, in direct violation of WHO and other international initiatives, causing many to stop writing opioid prescriptions WHO considers “absolutely necessary” to treat moderate and severe pain.

And who can blame them?  They are only trying desperately to avoid getting caught-up in the crush of anti-opioid McCarthyism amping up physician persecutions of the past decade; persecutions that now include Tennant, who was raided by the DEA after responsibly and conscientiously treating some of the most severe intractable pain cases in the country for over 40 illustrious years – and a standing open-invitation to the agency,  for whom he himself has consulted.

And he’s certainly not the only one…to be persecuted…or to suffer.  Physicians, pharmacists, patients and activists across the US are mobilizing in a fight for their lives.

The US have been cited as having significant barriers to effective pain treatment for decades, including the divisive and restrictive drug control regulations and practices that have only grown exponentially, creating a state of emergency for pain patients.  These one-sided policies do not balance the need to treat the millions in chronic pain along with government’s desire to control the flow of illicit substances.

That must change if we are to survive this.  And it is a matter of survival.


The Human Rights Watch recognizes that pain has a profound impact on the quality of life and can have physical, psychological and social consequences.  Under- or un-treated, it can reduce mobility result in a loss of strength; it compromises the immune system and interferes with a person’s ability to eat, concentrate, sleep, or interact with others.

It also causes muscle wasting and brain loss.  Unmitigated, it causes cardiac and drives legitimate pain patients to suicide.  It is all-consuming.  This level of unnecessary agony tears apart communities and creates collateral damage of our children and families who suffer along with us.

The right to be free from torture, cruel, inhuman and degrading treatment or punishment is a fundamental human right that is recognized in numerous international human rights advocacy organizations.

Besides prohibiting such human rights violations, governments also has an obligation to protect their people from such treatment.  In other words, they must take steps to alleviate the pain of health conditions under recognized, international standards.  In the U.S., that starts with the Government not attacking its own citizens.

Agencies of the U.S. Government have partnered with anti-opioid zealots.  They have willfully and knowingly chosen to disregard what scientists and the best pain management physicians have been telling them for years; there is scientific certainty that opioids are effective for the management of pain and that the vast majority of patients do not abuse or become addicted to their medications, including those who require high doses.

“Governments [must] protect people under their jurisdiction from inhuman and degrading treatment. Failure of governments to take reasonable measures to ensure accessibility of pain treatment, which leaves millions of people to suffer needlessly from severe and often prolonged pain, raises questions whether they have adequately discharged this obligation.”

-UN Special Rapporteur on Torture, Cruel, Inhuman and Degrading Treatment and Punishment

(in a joint letter with the UN Special Rapporteur on the Right to Health to the Commission on Narcotic Drugs, December 2008).


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