【英语语言学习】上瘾与疼痛

SCOTT SIMON, HOST:

The debate on approving new drugs to treat pain can sometimes get as polarized as abortion¹ or gun control, as the number of people who become addicted² or who have died from overdoses of legal painkillers⁴ increases. Several states are now trying to ban Zohydro, the newest FDA-approved painkiller³. If you're a patient from who suffers from chronic⁵ pain and live in a state with regulatory barriers, it can be nearly impossible to get a doctor to prescribe anything for long-term relief.

An epidemic⁶ of abuse, as well as fear, means that pain is going untreated, says medical journalist Judy Foreman. The author of "A Nation in Pain" believes that it's not only cruel, but unnecessary. Judy Foreman joins us from Boston. Thanks so much for being with us.

JUDY FOREMAN: You're very welcome.

SIMON: There were complaints for years that doctors were handing out painkillers like candy; and now, there are complaints that doctors don't like to prescribe anything stronger than an aspirin⁷. What's changed?

FOREMAN: Well, you know, the whole pendulum⁸ has gone back and forth⁹ for decades. We haven't been able to really ever get it right, in my opinion. And it's really been very tough on pain patients who legitimately¹⁰ need the medications. And at the same time, the more prescription¹¹ opioids there are floating around out there, the more people who are inclined to - or feel they need to - are abusing them. So it's colliding epidemics¹².

SIMON: I read a lot of material that suggests that there's got to be a way better than opioids in any case.

FOREMAN: Yeah, opiods are not fantastic drugs, when you get right down to it. They only really reduce pain about 30 to 40 percent. And that matters if your pain is a 10 on a 10-point scale, and you can knock it down to a 6 or 7. But that doesn't really totally get rid of the pain.

So we absolutely need better things. And there are some better things, or some nonpharmacological things, already on the market and available to people, including things like acupuncture¹³ and massage¹⁴ and nonsteroidal anti-inflammatories - although they cause a certain number of deaths every year, and acetaminophen - and that causes something like 30,000 hospitalizations. So there are other things but clearly, we need something better.

SIMON: Let me ask you about Zohydro. Gov. Patrick, of Massachusetts there, calls it - and I quote - "a potentially lethal¹⁵ narcotic¹⁶ painkiller." Twenty-nine states have asked the FDA to reconsider its approval. Are they wrong, in your judgment¹⁷?

FOREMAN: Yes, they are. And it's very complicated, but the FDA did do a big study of Zohydro and concluded that it was safe and effective. The big benefit of Zohydro is that unlike a lot of other drugs on the market, it's just a single-agent thing. It just has hydrocodone. It doesn't also have acetaminophen. And even though it's sort of hard for laypeople to understand, it's the acetaminophen, which is the active ingredient in Tylenol, that actually is the dose-limiting thing about a lot of combination medication. So I do think it's good to have Zohydro available to people.

SIMON: You've written that serious chronic pain is a bigger problem than cancer - and for that matter, cancer, heart disease and diabetes¹⁸ combined.

FOREMAN: And you can even throw in AIDS. There are more people suffering from chronic pain than all those four other things put together. That's 100 million American - American adults, by the way; not kids, not people - military returning from the wars, or even people in nursing homes. So that may actually be an underestimate. That figure comes from a report in 2011 from the Institute of Medicine. They're not all in excruciating, debilitating¹⁹ pain, but an estimated 10 to 30 percent are. So that's a lot of people.

SIMON: Well, help remind people what that means for someone's life.

FOREMAN: Oh, my God. Some people can't get out of bed, or they can't walk. Many people get very depressed²⁰, and it really is a life-wrecking thing. And in some cases, it's a life-ending thing because what a lot of people don't realize is that the suicide risk among people in chronic pain is twice that for people not in pain.

SIMON: And what is the line - and I suspect there's no clear answer on this - between dependence²¹, somebody who needs something for chronic pain; and addiction²²?

FOREMAN: Yeah, that's a great question. There are some doctors who are in the very anti-opioid camp who think that that's a distinction without a meaningful difference. But more doctors believe that it is an important difference. Addiction is defined as a neurobiological condition where people use the drugs compulsively. They use them despite knowing they're doing harm.

Physical dependence is different. If you go on opiods for even two or three weeks, you will become physically²³ dependent. That's 100 percent guaranteed, but that's not the same as addiction. That is a state of adaptation that your body makes to the opioids. It means your opioid receptors in your nervous system are full of the drugs. So that can be dealt with and often, it is - after surgery or after...

SIMON: Yeah.

FOREMAN: ...Lots of medical interventions²⁴...

SIMON: People routinely will take painkillers for a month or so after surgery.

FOREMAN: And get off them without making any headlines at all.

SIMON: When you survey the medical world, Ms. Foreman, does it seem to be divided between people who perceive addiction as the great danger, and those who perceive pain as the great danger?

FOREMAN: Yes. Unfortunately, it's become very, very polarized. You're either for the pain patients, or you're for the addicts²⁵. And that seems crazy because among other things, there a number of people who have both chronic pain and addiction. And of course, those are the patients who have the hardest time. Doctors want to run away from them because they just really don't know quite how to manage the pain without triggering an addiction. So yes, we need more people who really do understand both. And there's an argument to be made that both should be taught at the same time in medical schools.

SIMON: Judy Foreman, who is the author of "A Nation in Pain," speaking to us from studios on the campus of Harvard University. Thanks so much for being with us.

FOREMAN: Thank you.

1 abortion   

n.流产，堕胎

参考例句：

• She had an abortion at the women's health clinic.她在妇女保健医院做了流产手术。
• A number of considerations have led her to have a wilful abortion.多种考虑使她执意堕胎。

2 addicted   

adj.沉溺于....的，对...上瘾的

参考例句：

• He was addicted to heroin at the age of 17.他17岁的时候对海洛因上了瘾。
• She's become addicted to love stories.她迷上了爱情小说。

3 painkiller   

n.止痛药

参考例句：

• I shall persuade him to take the painkiller.我将说服他把药吃下去。
• The painkiller only provides him a short respite from his pain.止痛药仅仅让他在疼痛中有短暂的疏解。

4 painkillers   

n.止痛药( painkiller的名词复数 )

参考例句：

• The doctor gave him some painkillers to ease the pain. 医生给了他一些止疼片以减缓疼痛。 来自辞典例句
• The primary painkillers - opiates, like OxyContin - are widely feared, misunderstood and underused. 人们对主要的镇痛药——如鸦片剂奥施康定——存在广泛的恐惧、误解，因此没有充分利用。 来自时文部分

5 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

6 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

7 aspirin   

n.阿司匹林

参考例句：

• The aspirin seems to quiet the headache.阿司匹林似乎使头痛减轻了。
• She went into a chemist's and bought some aspirin.她进了一家药店，买了些阿司匹林。

8 pendulum   

n.摆，钟摆

参考例句：

• The pendulum swung slowly to and fro.钟摆在慢慢地来回摆动。
• He accidentally found that the desk clock did not swing its pendulum.他无意中发现座钟不摇摆了。

9 forth   

adv.向前；向外，往外

参考例句：

• The wind moved the trees gently back and forth.风吹得树轻轻地来回摇晃。
• He gave forth a series of works in rapid succession.他很快连续发表了一系列的作品。

10 legitimately   

ad.合法地；正当地，合理地

参考例句：

• The radio is legitimately owned by the company. 该电台为这家公司所合法拥有。
• She looked for nothing save what might come legitimately and without the appearance of special favour. 她要的并不是男人们的额外恩赐，而是合法正当地得到的工作。 来自英汉文学 - 嘉莉妹妹

11 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

12 epidemics   

n．流行病

参考例句：

• Reliance upon natural epidemics may be both time-consuming and misleading. 依靠天然的流行既浪费时间，又会引入歧途。
• The antibiotic epidemics usually start stop when the summer rainy season begins. 传染病通常会在夏天的雨季停止传播。

13 acupuncture   

n.针灸，针刺法，针疗法

参考例句：

• Written records show that acupuncture dates back to the Song Dynasty.文字记载表明，宋朝就已经有了针灸。
• It's known that acupuncture originated in China.众所周知，针灸起源于中国。

14 massage   

n.按摩，揉；vt.按摩，揉，美化，奉承，篡改数据

参考例句：

• He is really quite skilled in doing massage.他的按摩技术确实不错。
• Massage helps relieve the tension in one's muscles.按摩可使僵硬的肌肉松弛。

15 lethal   

adj.致死的；毁灭性的

参考例句：

• A hammer can be a lethal weapon.铁锤可以是致命的武器。
• She took a lethal amount of poison and died.她服了致命剂量的毒药死了。

16 narcotic   

n.麻醉药，镇静剂；adj.麻醉的，催眠的

参考例句：

• Opium is classed under the head of narcotic.鸦片是归入麻醉剂一类的东西。
• No medical worker is allowed to prescribe any narcotic drug for herself.医务人员不得为自己开处方使用麻醉药品。

17 judgment   

n.审判；判断力，识别力，看法，意见

参考例句：

• The chairman flatters himself on his judgment of people.主席自认为他审视人比别人高明。
• He's a man of excellent judgment.他眼力过人。

18 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

19 debilitating   

a.使衰弱的

参考例句：

• The debilitating disease made him too weak to work. 这个令他衰弱的病，使他弱到没有办法工作。
• You may soon leave one debilitating condition or relationship forever. 你即将永远地和这段霉运说拜拜了。

20 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

21 dependence   

n.依靠，依赖；信任，信赖；隶属

参考例句：

• Doctors keep trying to break her dependence of the drug.医生们尽力使她戒除毒瘾。
• He was freed from financial dependence on his parents.他在经济上摆脱了对父母的依赖。

22 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

23 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。

24 interventions   

n.介入，干涉，干预( intervention的名词复数 )

参考例句：

• Economic analysis of government interventions deserves detailed discussion. 政府对经济的干预应该给予充分的论述。 来自辞典例句
• The judge's frequent interventions made a mockery of justice. 法官的屡屡干预是对正义的践踏。 来自互联网

25 addicts   

有…瘾的人( addict的名词复数 )； 入迷的人

参考例句：

• a unit for rehabilitating drug addicts 帮助吸毒者恢复正常生活的机构
• There is counseling to help Internet addicts?even online. 有咨询机构帮助网络沉迷者。 来自超越目标英语 第3册