Ian Welsh

The horizon is not so far as we can see, but as far as we can imagine

Category: Ethics Page 6 of 9

How People Crack or Succeed

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On May 30, 2018

15 Comments

After a recent school shooting, the shooter’s father deflected blame from his son, saying that he had been bullied, but was a good kid.

He was immediately jumped on by critics. Most of them  had an argument that ran as follows, “I was bullied all the time and never turned into a mass shooter.”

This argument is a corollary of the standard one for not caring about poor people, “I grew up poor/sick/whatever and I still got rich.”

Now obviously a kid who goes on a mass shooting isn’t a good kid, and obviously also, I hope, a father who loves his son, in the immediate aftermath of something like this, may be in denial and that denial should lead to more sympathy than mockery. If you can’t manage that, at least understand.

But the larger argument is important: the bullying may have been necessary but not sufficient. In other words, the kid, had he not been bullied a lot, might not have gone on a killing spree.

For other people the bullying was not enough.

People are different. What breaks one person doesn’t break another. One succeeds in circumstances another wouldn’t succeed in. A broken down loser like the Civil War’s General Grant (before the war) becomes the war’s greatest general and a two-term president. No war, he’d probably have stayed a loser.

No bullying and that kid might not have gone on a killing spree, even though bullying doesn’t make most people go on killing sprees. But chronic bullying is high stress, and it does break some people, and some of them will be violent.

There are always the extremes: the people on the edges, who are close to breaking or exploding anyway. Push them, poison them, and something goes wrong.

This should be obvious.

What should also be obvious is that explaining something isn’t excusing it. Of course being bullied doesn’t justify going on a killing spree.

But since it is a known factor in causing mass killing sprees maybe we should admit that, and try not to push the one in ten million kid (or adult) over the edge?

Life is luck. Your genetic endowment was luck. Your parents were luck. Your character is luck. It all comes from being born with a specific body in a specific place and time, and everything flows from that.

We want to run from this. We want to believe were are in full control, that we would never do something like “that”, whatever that is. That we would never obey Hitler’s orders (most of us would have, and if you don’t have a record of standing up even when you knew you would be hurt for doing so, you probably would have.)

The kid did something monstrous. The father, understandably, tried to hold onto his view of his kid as good. And while bullying is no excuse, it may be a reason.

And just because you’re rich and were once poor doesn’t mean everyone else should be able to pull themselves up by their bootstraps.

And yeah, although following a mob is a different thing, you almost certainly would have done what Hitler told you to; would have been chopping with a machete in Rwanda, and so on.

This doesn’t mean no one is good, of course. There are those who didn’t obey Hitler. A small minority. There are those who won’t shock a subject in the Millgram experiment, no matter  how hard the authority figure pushes (about 5% at the extreme end.) There are always good people.

But most people aren’t good, and they aren’t bad. They are weak, and they follow their personal mob, doing whatever other people they identify with do.

And some people are close to breaking, and one day something, usually some cruelty, pushes them over the edge.

And they become monsters.

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The Bleak View of the World’s Problems (Or: They’re All Going to Have to Die)

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On March 16, 2018

70 Comments

The Course of Empire by Thomas Cole

The Course of Empire by Thomas Cole

So then, the simplest gloss of humanity’s problems is that the world’s problem is humans.

We have clear threats to our existence, threats which, at the least, will credibly kill hundreds of millions to billions of people. We have known about these problems for a long time (recently, a friend told me about learning the science of climate change in 70s high school) and we have done nothing.

Well, not nothing…in most respects, we made it worse. When we did do something, we knew did what we were doing was not enough.

This is a human problem, caused by humans. It is simple to say “Well, the more powerful bear more responsibility,” and this is true, but as a whole, these are the leaders humanity has selected (this doesn’t imply most people want them).

As a race, we have proven incapable of managing the collective action problem and the leadership problem.

This is true despite what appear to be our great success: We can take massive actions, but we cannot control our actions for the common good.

Common good does occur at times; sometimes it is even intended, but we repeatedly drive ourselves off cliffs.

WWII being the easily predicted consequence of WWI is a good example. But take another example: the cradle of civilization, Mesopotamia. Understand that from the invention of agriculture, to today, about 10K years, Mesopotamia was probably the most advanced region in the world. Only Egypt and India were competitors.

Mesopotomia declined because they kept chopping down trees and draining swamps, and eventually turned their land into a desert or near-desert.

They had to know they were doing it, it was obvious. But they kept doing it.

We simply have never been good at collective action with a time-span beyond a generation. Sometimes we can act for three generations. And that, essentially, is it.  And those periods during which we manage to act for three generations are rare, and come out of successfully handled crises, like the Great Depression and World War II. They last as long as the generations which experienced and understood the causes of the crisis exist, and then as long as the momentum of whatever works they created last.

So the New Deal generation and the post-war liberals created institutions and infrastructure, which despite their problems, worked. When these entities started to fail in the 70s, they did not collapse and they continue to stand, buttressing against the worst. As each component has been destroyed, a crisis has ensued; the most recent example being the financial crisis, which was the result of the removal of laws that control the financial industry, put in place after the Crash of ’29 (the removal of these laws was signed by Bill Clinton).

The New Deal generation over-built: They created bridges and roads meant to last a long time. They laid down more infrastructure than needed. But they didn’t, and couldn’t, build forever-infrastructure.

Their great work has concealed the nature of the decline, the nature of the ongoing collapse.

But the accounts of work they put away is mostly gone, in many cases in deficit.

Those who replaced them, having never survived a real crisis by pulling together, do not know how to do so. They cannot run a society for the common good, nor a society for the future.

And so billions will die and there is a great die-off of non-human species.

The common good and future generations matter because they are a way of making sure that what economists call negative externalities don’t get out of control. When we think only of ourselves and a few people we care about, rather than thinking about everyone and everyone’s grandchildren, we don’t properly manage society’s real wealth: people, knowledge, and the environment.

And we haven’t.

And the problem is this keeps happening. Over and over again.

We have too much power, and we cannot control it, because as a species we cannot control ourselves.

We claim, at times, to be creatures of reason, but not only are we driven by short-sighted, selfish desires, even when we use reason, we use it as a slave to those selfish desires.

And so the only solution to our problems is going to be a lot of death. It is nature’s solution, “you have exceeded carrying capacity, now you will die.”

It is too late to stop a lot of it. But mitigation requires different leadership than we have now. That leadership must be replaced, and it must be replaced by whatever means necessary.

Meanwhile, we need to understand that we, the masses, are complicit. The leaders are worse, of course, but they are the leaders which have arisen from humanity. They are not separate, they are a symptom of our pathologies.

We must become different people, different humans, if this is to end. That is, perhaps, possible, since we do most of our adaptation socially.

It’s that or die, and possibly wiped out.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

What the Tao Teaches Us About the Good Society’s Devolution to the Bad

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On March 8, 2018

34 Comments

In the Tao Te Ching there is a famous passage, as follows:

When a truly kind man does something, he leaves nothing undone.
When a just man does something, he leaves a great deal to be done.
When a disciplinarian does something and no one responds,
He rolls up his sleeves in an attempt to enforce order

Therefore when Tao is lost, there is goodness.
When goodness is lost, there is kindness.
When kindness is lost, there is justice.
When justice is lost, there is ritual.
Now ritual is the husk of faith and loyalty, the beginning of confusion.

The idea that when one is in the Tao nothing is done causes a lot of confusion. This is a psychological / physical state, where there is no feeling of effort. One takes the actions appropriate to the circumstance without any sense of doing anything, even though things are still done. Because this is a very clear mental state, what is appropriate tends to be obvious.

The key word, for social ethics, however is “appropriate.” What is appropriate isn’t always what is good, but what is good makes up the vast majority of what is appropriate.

When one no longer knows what is appropriate, one devolves to the good and is still doing most of what should be done.

Kindness makes up most of what is good, so when one loses what is good, one devolves to kindness and retains most of what is good.

Losing kindness, one retreats to justice. The loss here is steep. Justice is maybe half of what is kind, because justice without kindness is about balance and tends to not restore people, but punish them: “an eye for an eye” and all that.

And then there is ritual, and ritual, in this context, is without any of the higher virtues, and thus leads to injustice, cruelty and evil, because it has lost almost all of appropriateness: it simply accepts that action A should lead to action B, and that will often be the wrong action, unguided by appropriateness, goodness, kindness or even justice.

I would add that when even ritual is lost; when people no longer obey the rules and are guided by no sense of ethics, that all chances of a good society and good results are lost.

Regular readers will know that I tend to emphasize kindness as a golden rule. I think it’s the highest guiding star the vast majority of people in our society can use: most people still know how to act kind, they just don’t do it and they have many justifications for not doing so. But they do know what it is, with exceptions like warped market disciples, libertarians, and so on, who are so identified with ritual ideologies (market outcomes are just) that they cannot see when they are not even that.

The reform of society comes through the proper use of ritual, ironically. You work your way back up. Ritual done right attaches appropriate emotions to appropriate circumstances to appropriate objects of attention, and once that is the case, one can climb back up the ladder. Indeed, done right, one can jump past justice back to kindness.

But only when done right. Ritual is an obsidian knife: It cuts everything and it’s dangerous, and it’s only a useful tool when both made and used just right. Only someone operating at a level higher than ritual can design rituals which will do more good than harm.

In the meantime, unless you’ve been deformed by the wrong ideology, you probably still understand kindness. I suggest living there. It’s also a rather nice place to live.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

Morally Neutral Virtues

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On January 24, 2018

32 Comments

Something is moral if it is good for people you know. Something is ethical if it is good for people you don’t know.

One of the most important concepts to understand for judging oneself and others is “morally/ethically neutral virtues.”

A virtue is something that makes a person a better person.

Better is not a synonym for good.

It is a virtue, in most cultures to be generous, to keep one’s word, to be kind, to work hard, or to be courageous.

Three of those five virtues are morally and ethically neutral.

A brave person who is doing evil (many Nazi war heroes to give the most socially acceptable example) is worse than a coward doing evil. A hard-working person doing evil is worse than a lazy person doing evil (usually). A person who keeps their oath (their word) to a tyrant, is worse than someone who doesn’t keep their word to a tyrant.

We admire people who are hard working, courageous, or honorable.

But people who are all of those things, or even one, in service to a bad cause, do more harm than those without them.

I find a great deal to admire in Genghis Khan, but he left a wasteland behind him. (And note that Khan was generally moral. He took very good care of almost everyone around him. He was not, however, ethical.)

Although Dick Cheney was not a brave man (he sought and received Vietnam deferments), even those who hate him will admit he worked like a dog. That is unfortunate. One of the things I liked best about George W. Bush is that he was lazy, which, because what he wanted to do was almost all evil, was a good thing. Left-wingers whining about him (or Trump) taking holidays were fools.

The virtues of our enemies are virtues.

Note also, very carefully, the distinction between ethics and morality. A person can be moral (look after his family, friends, and other people he knows) and deeply unethical. Joe Biden is a deeply moral man: He loves his family and friends and would do anything for them.

He is also a deeply unethical man, who has supported many monstrous policies which have hurt millions and millions of people. He’s, frankly, evil, if you don’t know him. But what a friend he would be.

However, he’s not your friend, and if you vote for him because of how wonderful he is to people he knows, you will get hurt badly, and be somewhat responsible for that hurt.

It is also possible to be ethical and immoral, as in leaders who treat people they know like shit and people they don’t know well. Huey Long fell mostly into this category. To the extent that JFK did good things (his legacy is mixed), he certainly was.

A wise peon, and most of us are peons, prefers as a leader someone who is immoral but ethical, because they know that they aren’t their leader’s friend, or family, or direct servitor.

And, generally speaking, an enemy who is lazy, stupid, and so on, is preferable to one who isn’t. The only broad exception is that honorable enemies are better than dishonorable ones, because you can cut deals with them, and it is enemies, above all, with whom you must be able to negotiate.

In the small world, of small people, there are many we admire for their virtues who have turned themselves into creatures of bad leaders. Take, for example, special forces, whom many worship. In many cases they have done truly amazing things to become special forces: worked brutally hard, put up with privation, been loyal, and disciplined.

But when you let other men (or, more rarely, women) turn you into a weapon or tool, you are responsible for how they wield you. If your loyalty, skill, and discipline make you a better weapon or tool for doing evil, then your virtues have been corrupted.

(Ivy League graduates as well as military men and women should think deeply on this. But so should those who consider themselves elites in the financial industry, for example.)

Virtue in the service of a bad cause or evil master is still virtue. It is still admirable. But it turns virtue to the service of evil.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

How Society Creates Ability

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On August 7, 2017

88 Comments

Let’s start with biological sex and the differences between men and women.

There are obvious differences, in size and upper body strength. There are large differences in some of the senses, such as taste and smell (women tend to be far more acute).

Other differences appear biological, but this is not as clear cut as it seems, because socialization feeds into biology.

A simple example is that people raised under constant stress have differences in their brains from people who aren’t raised under constant stress.

So let’s take a simple claim: Men are better at math. Seems straightforward, quite robust, but it turns out that in Iceland, which is very egalitarian, young women are now outperforming young men.

There is a well-known effect in the social sciences that runs as follows: People who feel inferior, perform worse. This is quite robust. Tell someone they suck, or that they are lower on the totem pole, and they will do worse by pretty much every metric.

So, if you live in a society where men are widely considered superior to women (and let’s not pretend our societies aren’t like this), then that will have an effect. If this goes on as people grow up, it’s unlikely that this effect won’t get baked into brain and body.

Take another standard observation: Women are more prone to anxiety and neuroticism.

The problem with this is that women live in societies where they are less powerful than men, have less money, and are less violently proficient, when violence is often used as coercion.

Put more brutally: They live amongst a bunch of potential rapists who are larger and stronger than them.

So, they’re under constant stress, a point which I don’t think many men truly understand. That constant fear has effects on the brain and body; again, if you’re constantly exposed to stress, you actually become more sensitive to it.

The point here is that it is very hard to determine what is “natural” and what is “social.” We can say, “This is natural in this sort of society,” but that can’t be used as a reason not to change society.

What we do know, I hope, is that it sucks to be scared and it sucks to be told you’re inferior, and that underperforming not because you are inferior but because you’ve been told you are, is unfair and a stupid way for us to run our society.

This feeds into a lot of different things, but the simplest is the misunderstanding of fitness to mean “winning in the current scheme.”

IQ correlates well to success in our society, so we say, “They’re smarter, they deserve success.” But IQ correlates well to success in society because it correlates to two things: (1) academic success, which gates almost all the good jobs in our lives, and; (2) verbal and cultural fluency in the dominant culture, which are necessary to get ahead as well.

In other words, we’ve created a society which says, “If you have a high IQ, we will let you have good jobs.” Well yes, that’s how we made it, it’s not independent. (The getting along with the dominant culture may always be with us, but that doesn’t mean we should always approve of it as a necessity, nor try not to mitigate it.)

Fitness, in racial terms, is actually about being able to survive changes in the environment. Fit species are diverse, and able to adapt, and if a species loses diversity, it is less likely to survive changes.

Much of our environment, as humans, is social. But society changes. The cluster of skills which make up IQ weren’t always highly valued, rather the contrary. Brave-to-the-point-of-insanity dunderheads were what many feudal and aristocratic societies wanted (reading 19th century British colonial military biographies makes this clear). Right now, geeks rule, but when I was growing up they sure as heck didn’t (and their rule, today, is somewhat exaggerated).

These periods come and go. There was a time in the 19th and early 20th century when geeks (actual engineers and scientists) did very well, seeming to rule the roost. Edison is a good example. But as the industries they had invented became mature, they were forced out and down. This took time, but basically after about 40 to 80 years, the engineers become nothing but tools of management: The money men and social glad-handers will eventually take over.

What you’re good at is at least 50 percent due to a simple luck of the draw (arguably entirely, as you didn’t choose your parents, and thus when or where you were born). At that point any genetic endowment you may have (innate ability) meets the environment, and the environment has the final say, in almost all cases, about how well that endowment flourishes, and certainly about how well it is rewarded.

Most of what seems like merit, in other words, is luck. If you have it, be grateful. If it’s rewarded, be even more grateful.

And don’t assume you know exactly which is which.

Those who have been lucky, and thus have merit in a society or environment, should recognize their luck, and be humble, knowing how little it had to do with them. And if you want a metric upon which to measure your life, perhaps it could be how much good you have done divided by how much “merit” you have.

By this measure, the rich are rarely worth saving, because as studies show, the poor give more compared to what they have than the rich do.

That fact should be chewed on very carefully.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

More Death Is Worse than Less Death, Amirite?

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On June 29, 2017

43 Comments

(MANDOS POST AGAIN…)

That less death is better than more death and less suffering is better than more suffering is something that Ian has emphasized a number of times throughout the years, just to clear up the odd ethical confusion that people sometimes have. It sounds obvious, but it’s easy to get lost in the weeds, and there are moral orders that view the suffering of other people as socially purgative, spiritually redeeming, as well as other ideas of non-scalable ethics, and so on.

But I’m always still a little taken aback when I read arguments to the contrary or that trivialize that distinction.  Such as in this article at Naked Capitalism:

4) Liberal Democrats have yet to answer the question why it’s terrifying that 540,000 people will die in the next decade under the AHCA/BCRA, but not terrifying that 320,000 will die under the ACA. They have no moral standing at all.

and particularly this one:

Don’t get me wrong. Trumpcare is undoubtedly worse. The estimates are that by 2026 as many as 51 MILLION Americans would be uninsured. As of 2016 there were still 27 million Americans without health insurance. But saying Trumpcare is worse and Obamacare is better is like saying, “It’s better to catch crabs from sleeping with a hot young lady, than to get it from a used gym towel.” Sure. I guess. But shouldn’t we just be focusing on the fact you have crabs? Who gives a shit about the towel? And shouldn’t you also switch gyms?

If you’re in the, uh, 220 kilopeople additionally likely to die under the Trumpcare regime or the 24 megapeople additionally likely to be uninsured, then surely the difference between Trumpcare and Obamacare is worth more than the difference between getting an STD from a sexual encounter or without one. (And what if you’re one of the 24 million additionally uninsured, and you’re the one who got the STD…?)

Certainly, it cuts both ways. Single payer will dramatically cut the death rate from lack of health care access (although I am skeptical that it will cut it to 0, there is still complexity and austerity in the Canadian system that means that some necessary care is not perfectly accessible, even though I would never recommend trading the Canadian system for any other existing system…) So, Obamacare is certainly worse than single payer.

Thus, by all means, advocate for why single payer is better than Obamacare (it is). Absolutely, make the argument that a Republican Congress dominated by people who really like the ritual of tax cutting for visible increased suffering (remember what I said above: there is a widely held moral position that increased suffering is a moral good) should consider something that reduces the suffering for which they openly wish. Certainly, make the argument that a neoliberally-dominated Democratic party should yield up control to people who reject the market-fascination of neoliberalism. Or whatever strategy takes your fancy.

But don’t pretend that Obamacare vs. Trumpcare is not a real choice and that the distinction between the two doesn’t mean something, that the fact that the immediate political choice is between the two and not between Obamacare and single payer doesn’t say something very important about US society.

Clio, the Muse of History

Heaven on Earth: The Kindness Maxim

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On December 19, 2016

27 Comments

In the past, I have noted that kindness is generally the best policy and always the best policy default. If you don’t have an ironclad reason not to be kind, be kind.

Let’s run through this.

People who are treated badly, become bad. The abused grow up to abuse. The sick make others sick and cannot contribute to society. Happy people are better to be around. Prosperous people can afford your products and services.

Happy, healthy, loving, and prosperous people are the people we want in our societies.

We evolved in bands. Forty to fifty people running around the Savannah. We would have been friendly to some other bands (those with whom we shared ancestors) and we were hostile to most other humans, who were our competitors. The level of hostility varied with carrying capacity; if resources were short because of too many humans, quite hostile, otherwise not very.

We did not evolve to take into consideration the needs of large groups of people. In order to do so, we evolved cultural methods: fictive kinship, culture, story, myth, and religion. These things created fictional identities which went beyond people we knew of or saw every day.

Theses are all hacks for a fundamental evolutionary problem: We’ve evolved to be pretty good to those we see all the time, and not to care much about people we don’t.

This was fine when were just a particularly clever animal. Even when we got to the point of making wholesale changes to the environment (usually through agriculture), the worst we could do is ruin a local ecosystem–we couldn’t mess up the world.

But, today, for good or ill, we live in that “interconnected world” and the “global society” everyone talks about. What happens to someone in Nigeria, Brazil, or China matters to me. Their happiness, their health, their prosperity affects mine.

And how they affect the environment affects me, too. How I, a first-worlder with a huge carbon footprint, affect the environment, affects them.

Their well-being affects mine. It is in my interest for them to be better off.

This isn’t what you’ve been told. Economics treats the world as a zero-sum game, a matter of managing scarcity.

The world has scarcities: resources, dumps for pollution like carbon, etc. But civilization isn’t, usually, a zero sum game. Instead, it’s usually negative sum or positive sum, or both. For some time for Westerners, and a few other developed nations, it has been positive sum, and there have been many other periods of positive-sum games.

My win is everyone else’s win.

Creating a good society requires both managing actual scarcities and understanding that actual scarcities are scarce, and that most things people want to do are positive sum. It requires turning most of what we do into positive-sum games. A good society is one in which “your win is my win” is made true far more often than not.

“We win together” is a prescriptive statement which must be made into a descriptive statement. (It is also a descriptive statement in general, because if my win isn’t your win more often than not, we don’t live in a good world.)

So humans must see beyond their identities, their tribes, and their nations, to treat all humans as people whom we want to be healthy, happy, prosperous, and loving. For their sakes and for our sakes.

But there is an additional step required to create a good society, a good world, a good civilization.

We must care for non-human life.

The mass-death of trees and plankton affects you, it affects me. The mass death of fish affects you, it affects me. The destruction of marshlands causes floods and reduces water quality; it affects you, and it affects me. Ecosystem collapse—well, you get it.

The problem here is that I’ve given you the rational argument.

Rationality is marginal. It’s not that humans can’t be rational, it’s that rationality is the lesser part of why we do things or how we make decisions. We make decisions based on emotions, and those emotions are based on our ideologies and identities.

Rationality, or “reason,” allows us to weasel out of doing the right thing too often. It is a tool for our emotions; emotions which right now scream: “My interests, my ideology, my identity, my people matter MOST!”

For a good world to exist, we must feel that other humans should be treated kindly simply because it is the right thing to do. We should be revolted by anyone going hungry, anyone being tortured, anyone being raped. The moment we think “They had it coming,” we’re on the wrong track. (Punishment is not the point, removing the ability of bad actors to continue to act badly is.)

And this principle needs to be extended to non-human life. We need to feel bad when animals are dying in large numbers and going extinct–bad enough to do something about it. We need to instinctively, by default, move to protect them. We should be as revolted by images of dolphins being slaughtered as we are by humans being slaughtered. If we kill for meat (and I eat meat), we should insist it be done humanely.

This must be based on values, principles, and identity, of feeling that humans and animals and even plants are all alive–and because they are alive, they must be treated with respect.

There are sound, pragmatic reasons for doing so; there are also sound moral reasons for doing so (read the Hidden Life of Trees). Anyone who doesn’t think most animals don’t feel pain, or don’t suffer, is on a profoundly unethical, immoral track.

This is the right thing to do, morally and pragmatically, and if we don’t figure out how to do it, we’re little better than bacteria that grow until they destroy their own environment and experience a great die-off.

Be kind. It creates the world you want to live in, and it may well save your life and the lives of those you claim to care about. By granting life the love you reserve only for a few, you give those few (and yourself, as it happens) their best chance at long life and prosperity–and grant it to your descendants as well.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

The White Opiate “Epidemic” Is Not About Pain Killer Prescriptions

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On June 22, 2016

23 Comments

I’ve spent a lot of of my life in pain, and often in a LOT of pain. I’ve taken a lot of pain killers.

The best, in most cases, were opiates. Codeine and morphine (forget all the fancy pills designed to cost more, morphine does the job).

Now, in the US, white middle class people are getting addicted to opiates in large numbers and there are screams to make it harder to get opiate prescriptions for pain.

But the simple reality is this: According to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them–obtained from a friend, family member or dealer.

…

In general, new addictions are uncommon among people who take opioids for pain in general. A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent.

It is already hard to find a doctor who will prescribe opiates for chronic pain. They’re worried about law enforcement coming for them, and they’re paranoid about addiction. When I was in my 20s and in a lot of pain, it took me seven doctors to find one who who would prescribe opiates, and I was in so much agony, standing from sitting down was nearly impossible and I often didn’t sit at all, knowing I might be stuck for hours.

This level of pain, in Canada, and it took seven doctors before one was willing to chance that I might not be lying. One asshole rushed me out of his office after screaming at me that I was a fucking addict who just wanted a fix.

In one of those neat catch-22’s, if I hadn’t been in so much pain, I would likely have beat him to a pulp.  (Yes, yes, I said that someone like that is someone I would have broken if I could. It took almost a month for me to find a doctor who would help me, that man put me through agony most people cannot even imagine.)

People who are in serious pain need serious pain killers. That often means opiates, sometimes it means cannabis. People who stop chronic pain sufferers from getting the pain relief they need are responsible for huge amounts of suffering.

Don’t do that.

When I was in hospital, in so much pain I could not even push myself up in bed, I said to my doctor at the time, “What if I get addicted?”

He replied, “Take the pain relief you need and we’ll worry about the addiction later.”

Later I was slightly addicted–I couldn’t sleep without a pill. One night I simply stayed up until I slept without it. As it happened, that was about a 40 hour day. But the addiction was broken, and it wasn’t much of an addiction to begin with.

Even if it had been a terrible addiction, I still would have said that the pain killers were worth it, because without them I was in so much pain I could barely walk. I remember taking well over ten minutes to walk a single block. I once ate breakfast at a restaurant standing up, because I knew if I sat down I might not be able to stand again.

Pain.

It sucks.

Don’t deprive people who need pain killers of them.

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