Why Asians prefer to tough it out than resort to painkillers

Are Asians gluttons for punishment? Experts who spoke at a Hong Kong Pain Society workshop last month seem to think so. They say a passive attitude towards seeking treatment among Hongkongers and a reluctance to resort to pain relief medication are two reasons why so few are being treated for chronic pain in the city.

Opioids are a case in point. Those such as morphine have long been used in Western medicine to manage severe pain following surgery or to ease the suffering of advanced cancer patients. But despite strong evidence supporting their pain-relieving benefits and 25 years of responsible use globally, opioids remain little used in Asia.

A survey by the International Narcotics Control Board published last year that looked at opioid use for medical and scientific purposes found that more than 80 per cent of East and Southeast Asian countries reported consumption levels of below 200 daily doses of opioids per million inhabitants per day. Hong Kong ranked 62nd in the world at 208 doses, well below top-ranked United States at 39,487 daily doses.

"Chinese people say, 'I don't need to take pain medication; I'm a strong person,'" says Dr Cheung Chi-wai, president of the Society of Anaesthetists. "Even post-surgery patients are refusing pain medication because they think that is the way to act."

He adds that sensitive historical memories of the opium wars could also be a factor.

The media also play a large role in public feelings towards drugs, according to Dr Steven Stanos, medical director of the Rehabilitation Institute of Chicago's Centre for Pain Management.