Description: A big part of the current opioid crisis that does not perhaps get the level of attention it deserves is that many people caught up in it got there through their experiences and issues with pain management. Pain experience and pain management is a very complex area of psychological and medical research and a big part of what makes it challenging is the lack of a full understanding of haw pain is carried and managed within our brain and nervous system. While case studies are typically viewed almost as novelties that tell us interesting stories about individual people which, while sometime fascinating, do not provide us with a lot that we can generalize to other people or to larger populations. But sometimes that can provide us with starting points for potentially hugely valuable lines of research and eventual application of interventions/treatments to a great many people. The article linked below describes one such case study – that of a woman who, throughout her life, has essentially not experiences any pain or anxiety, not because she has led a lucky or charmed life but because of something in her genetic code or genotype. Think for a minute about what such a case might provide to pain researchers and then give the article a read.
Source: At 71, She’s Never Felt Pain or Anxiety. Now Scientists Know Why. Heather Murphy, The New York Times.
Date: March 28, 2019
Video Credit: Mary Turner for The New York Times
The account of how the women whose experiences (or the lack thereof) with pain and anxiety came to the attention pf pain researchers and what they found when they began to try and account t for her pain/anxiety non-experiences is quite fascinating. While it seems clear that there are downsides to the nature of her pain/anxiety experiences due to the mutations on her FAAH-OUT gene — pain IS usually an important clue to things we need to attend to in life – understanding of how these mutations play out in development and life may provide some deep insights into the human pain process. The researchers quoted in the article do, appropriately, indicate that the route from finding cases like this and the FAAH-OUT mutations do not immediately or easily point to any clear pathways to applications or pain or anxiety related interventions, but they DO provide a new window into part of the processes involved in experiencing and perhaps managing pain. There will be more to see on this in the not to distant research future.
Questions for Discussion:
- What might some of the day-to-day life implications be of having the gene mutations that resulted in the women discussed in the article not experiencing pain or anxiety?
- What are some of the next research steps that might be worth considering in light of the information reported in this case study?
- Are there ways in which you can see possible connections between this case study and the opioid crisis?
References (Read Further):
Habib, Abdella M. et al (in press, 2019) Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity, British Journal of Anaesthesia. https://www.sciencedirect.com/science/article/pii/S0007091219301382
Waxman, S. G. (2018). Chasing Men on Fire: The Story of the Search for a Pain Gene. MIT Press.
Hayasaki, Erika (2017) End Pain Forever, Wired, https://www.wired.com/2017/04/the-cure-for-pain/
Hansen, G. R., & Streltzer, J. (2005). The psychology of pain. Emergency Medicine Clinics, 23(2), 339-348. http://www.medicine.wisc.edu/~williams/painpsychology.pdf
Scholz, J., & Woolf, C. J. (2002). Can we conquer pain?. Nature neuroscience, 5(11s), 1062.
Keane, H., & Hamill, K. (2010). Variations in addiction: The molecular and the molar in neuroscience and pain medicine. BioSocieties, 5(1), 52-69. http://www.academia.edu/download/31438733/variationsinaddiction.pdf
Giordano, J. (2010). The neuroscience of pain, and a Neuroethics of pain care. Neuroethics, 3(1), 89-94. https://link.springer.com/article/10.1007/s12152-009-9034-z