Painful Precarity: Medicine, Social Policy, and Chronic Pain in the U.S. And France

Jane Pryma, Boston University

In recent years, pain specialists have promoted the "biopsychosocial model" of pain as a standard of pain management, encouraging medical professionals to consider the biological, psychological and social causes of their patients' chronic pain. This paper analyzes how U.S. and French pain specialists recognize the populations they serve as predominantly women, low SES and socially precarious. These observations reflect statistics on chronic pain prevalence, in both the U.S. and France, which indicate that chronic pain patients are predominantly working class and women. Current scholarship debates whether the U.S. opioid crisis is a “crisis of desperation.” However extant research does not examine how surging rates of reported chronic pain, which contributed to the over-prescription of opioid analgesics, could also be attributed to social suffering caused by welfare retrenchment, rising rates of unemployment, and the gendered burden of care-work, domestic violence, and unequal pay. I find that doctors in the U.S. and France emphasize that social, health, and economic policy changes in the U.S. and France exacerbate the challenges that their patients face in their daily lives and when attempting to access quality pain care. My analysis reveals how medical and state actors, in two different healthcare and welfare systems, envision the responsibility of medical professionals vis-a-vis the state in relieving pain and suffering.

No extended abstract or paper available

 Presented in Session 137. Classifying States, Gender, and the Creation of the Deserving and Undeserving