“Men Without Chests”: A Tragic Consequence of Opioid Addiction

Opioid addiction has become a major health epidemic in the United States, and the issue has emerged as an important political one. It surfaced quite early in the 2016 presidential campaign, when Donald Trump made some strong comments on the devastating impact opioid addiction had on New Hampshire, the state which conducted the earliest presidential primary.

In the lead article in the Autumn 2017 issue of The American Scholar, David Brown, who is both a physician and a journalist, supplies alarming statistics on just how serious a societal problem opioid addiction has become. He concludes that this epidemic has created a “new underclass, mostly white,” which “is stymied by economic obsolescence, a sense of victimhood, and an exaggerated view of its own physical damage.” This new underclass is particularly represented in white males aged 25 to 54.

In support of his argument, Brown cites a presentation made to the Federal Reserve Bank of Boston by Alan Krueger, a Princeton economist, in 2016. Krueger concluded that of the males in this age group, “about 12 percent… are not even looking for work: 43 percent of those in prime age describe their health as fair or poor, 44 percent take painkilling drugs on any given day, and 40 percent say that pain prevents them from taking a job for which they qualify.” This age group is the nucleus of our workforce but, in Brown’s words, “Today, millions of these men are living passive, depressed, bored, and isolated lives. For many, chronic pain is how they announce their status to the world.” They have become, in G.K. Chesterton’s memorable phrase, “men without chests.” They spend 30 percent of their time alone, and many of these men are on long term disability. Brown reports that “only one in 25 disabled workers receives benefits because of an actual injury, while three times as many attribute their disability to a mood disorder, such as depression.”

In Brown’s analysis, much of the opioid epidemic can be traced to physicians too easily satisfying a patient’s insistence upon receiving opioid medications, and renewing them regularly when any need for them has long since passed. This permits chronic pain to become “an identity as much as…a sensation.” In what will undoubtedly become a politically unpopular conclusion, Brown states that “depression and anxiety about unpleasant sensations (‘catastrophizing’) make pain worse. Acceptance of pain, on the other hand, makes it more tolerable.” In addition, “The road from prescription narcotics to heroin addiction is now wide and well-traveled. Doctors need to do everything they can to keep their patients off it. The first step is to say no.”

These statistics validate Chesterton’s observation that “We make men without chests and expect from them virtue and enterprise.” The Abolition of Man (1943).


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