For Travis Rieder, experience with opioids began after a 2015 motorcycle accident. The medication helped him through six operations but, as he recovered from the injuries, he discovered that withdrawal from the drugs caused excruciating pain of its own. Rather than risk addiction by following his doctors' advice to return to the opioids, Rieder endured the struggle of withdrawal.
In his new book, In Pain (HarperCollins), Rieder, a research scholar and director of the Master of Bioethics Program at the Johns Hopkins Berman Institute of Bioethics, combines this harrowing experience with his professional training.
Rieder's experience exposes a dark secret of American pain management: a health care system that is so conflicted about opioids and so inept at managing them that the crisis of addiction and overdose is both unsurprising and inevitable. As he recounts his story, Rieder unpacks the history of the drugs, which were first invented in the 1800s, as well as the changing attitudes about pain management over the following decades and the implementation of the pain scale at the beginning of the 21st century. He explores both the science of addiction and the systemic and cultural barriers that must be overcome in order to address the problem effectively in the contemporary American health care system.
Kirkus Reviews calls In Pain "a bioethicist's eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic."
The book grew out of a 2017 essay Rieder published in Health Affairs titled "In Opioid Withdrawal, With No Help in Sight." An essay adapted from In Pain appeared this month in The Wall Street Journal.