Summary of The Pain Refugees

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Writer and anthropologist Brian Goldstone presents a rebuttal of the idea that pain patients who take opioids will become addicts. He leads with the heartbreaking story of chronic pain patient Austin Sell, for whom prescription opioids used to be a lifeline. Goldstone then zooms out to show a whole community of sufferers who will likely never again have access to the medication they need to function. He backs up anecdotal evidence with studies and expert opinions from credible sources. His argument is as convincing as its implications are disturbing. getAbstract recommends this counternarrative to anyone who’s read about Big Pharma’s role in triggering the opioid crisis.

In this summary, you will learn

  • What differentiates physical dependence from addiction,
  • Why health professionals have been depriving many opioid-dependent patients with chronic pain of their medication, and
  • How this change has affected one patient, Austin Sell.

About the Author

Brian Goldstone is an anthropologist and writer.



Austin Sell had suffered from severe back pain since he was a boy, but at age 21, a misstep caused a worse injury. Emergency room doctors diagnosed a bulging disk which would improve within weeks. Instead, his pain worsened. Although Sell fought to hold onto his job, the pain eventually forced him into unpaid medical leave. After a while, one physician assistant at Benefis Pain Management Center, Rod Lutes, was sympathetic and thorough. He asked about the impact of Sell’s pain on of his life and explained that chronic pain can require lifelong management. He recommended physical therapy, lifestyle improvements and opioids. Sell feared addiction, but Lutes felt that “a drug regimen, carefully overseen, could provide an affordable, relatively dependable source of relief.” In time, Sell felt so much better that he got a new job and went back to college.

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