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“He preaches patience that never knew pain.”

These sage words were published in the Handbook of Proverbs in 1855. Today, pain is the most common medical symptom that plagues mankind. But when does it kill? The number of people suffering from pain depends on the source of data. Some reports claim 25 to 100 million have some level of pain, and over 10 million suffer from considerable pain every day.

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Dr. Emiko Petrosky, at the U.S. Center for Injury Prevention and Control, analyzed data on 123,000 suicides. His report, published in the Annals of Internal Medicine, shows that one in 10 patients with sizable pain decided to end their life.

Top causes for suicide are cancer, arthritis and spinal pain. And 54% of victims of chronic pain used a gun, while 6% chose opioid overdose. The underlying cause is a combination of depression and pain.

Several reports have stressed that suicide could be prevented if patients received better pain control and counselling. But some famous people treated at world-famous clinics have nevertheless ended their lives.