A Fentanyl Vaccine Is a Horrible Idea

By Crystal Lindell

A few years ago, I saved a loved one’s life when he was overdosing on fentanyl.

His lips and fingertips were blue when I found him, and as I administered NARCAN (naloxone), all I could think at that moment was that if he was dead, I never got the chance to say good-bye.

It was one of the most traumatizing experiences of my life, and I’m forever grateful that my efforts to save him were successful.

Even with that experience, I’m here to tell you that a fentanyl vaccine is an absolutely horrible idea. And I pray that nobody I love ever takes it – even the man who’s life I saved.

This week, JAMA published an article about the current status of the fentanyl vaccine, which is in development.

In the article, Associate Managing Editor Kate Schweitzer interviews Collin Gage, a cofounder and chief executive officer of ARMR Sciences, which has begun early-phase human trials of a fentanyl vaccine in the Netherlands.

Schweitzer seems to think such a vaccine would be a net positive for the world.

"If proven safe and effective, it could become the first proactive pharmaceutical approach designed to prevent fentanyl overdose and, potentially, treat addiction," she writes.

However, as both a chronic pain sufferer and someone whose loved one struggled with fentanyl addiction, I’m here to tell you that this entire research project should be ended right now.  

First and foremost, my biggest concern is that such a vaccine would be pushed onto people who do not want or need it, including pain patients.

I can already see doctors having a policy where they won’t prescribe opioids unless the patient agrees to receive the fentanyl vaccine. They’ll claim the policy is meant to protect patients, when in reality, it would only cause them more harm.

The article even points out what those harms could look like. Schweitzer quotes Kathryn Frietze, PhD, associate professor of molecular genetics and microbiology at the University of New Mexico, who is one of many researchers working to develop vaccines against drugs of abuse.

Doctors, according to Frietze, have expressed concern about how a vaccine could complicate medical care, given that prescription fentanyl is a widely used medication for acute pain control and anesthesia.

“Can they increase the fentanyl dose medically if needed, or is it going to completely eliminate fentanyl as an option?” Fritze asked. 

Read that again. Do we really want to eliminate fentanyl as an option for pain control and anesthesia? This is a medication used in hospitals, usually on patients in severe trauma or undergoing surgery.

Do we really want a vaccine to make fentanyl ineffective for them? 

Do we really want a vaccine that requires more fentanyl to be administered?

In practice, either scenario could be disastrous, especially in an emergency situation where an unconscious patient would be unable to explain to doctors that they had the fentanyl vaccine.

The thing about fentanyl is that you have no idea that you might need it someday. We don’t usually know when we’ll need anesthesia or acute pain control.

That is particularly relevant in this situation, because the article quotes multiple experts who seem excited about pushing a fentanyl vaccine onto high-risk groups, such as college students and young adults, who are experimenting with drugs. They may not be aware that the counterfeit pill they bought or got from a friend has a lethal dose of fentanyl. 

“Overdose from fentanyl doesn’t just happen to people who are purposely taking fentanyl,” Frietze said. “People may be exposed without their knowledge.” 

So they want to go to college campuses and give students a vaccine against a very valid pain medication, when they have no idea if they will ever need it?

Schweitzer says a vaccine that specifically targets fentanyl could still allow for the use of other analgesics, such as morphine and propofol. 

As a pain patient, I’m skeptical about that. If a vaccine blocks the effects of one opioid, it may also dampen the effects of other ones.  

The other major issue with a potential fentanyl vaccine is a phrase coined by Richard Cowan in 1986: “The Iron Law of Prohibition.” That essentially means that when law enforcement targets a specific drug, the potency of other prohibited substances increases.

Or, as Cowan said, "The harder the enforcement, the harder the drugs."

If you give everyone fentanyl vaccines, people will just find even stronger drugs to take. And those drugs will likely be more deadly. It’s no coincidence that illicit fentanyl arrived on the black market just as opioid pain medication became harder to get. 

As such, a fentanyl vaccine could result in more overdose deaths, not less, as people seek substitute drugs that bypass the vaccine.

Gage’s response to that possibility is to call the fentanyl vaccine “a platform technology—one that we plan to adapt."

In other words, they will just make new vaccines for new drugs. But in practice, how long would it take to actually develop new ones? And how long would it take to get them to drug users, who are often difficult for the medical community to reach?

Trust me when I tell you that drug users and their dealers will move exponentially faster than any research and development team ever could.

In practice, the reason street fentanyl is so deadly is because it’s unregulated. Users don’t know how much they are taking or what is mixed in with it – and those two things make it more likely that the drug will cause an overdose.

The solution then is to offer drug users a regulated supply, which is what methadone treatment is. In a perfect world, if they really wanted to help fentanyl users, these researchers would be working to make methadone treatment more accessible.

Instead, they’d rather make it so patients can’t use one of the most effective pain and anesthesia medications on the market, while pushing them onto harder or less effective drugs.

It’s a bad idea, and I hope these researchers see the error of their ways before it’s too late.

AMA Calls for Complete Ban on Sales of 7-OH

By Pat Anson

The American Medical Association (AMA) is calling for a complete ban on the sale, distribution and marketing of products containing 7-hydroxymitragynine (7-OH), a kratom alkaloid that is of growing concern for its potential to cause dependence and addiction.

7-OH occurs naturally in kratom in trace amounts, but when concentrated acts as a potent pain reliever and stimulant with “opioid-like” effects.

The policy adopted by the AMA at its annual meeting urges the FDA to classify “7-OH kratom products” as adulterated or misbranded. It is particularly concerned about sales to minors and the packaging of 7-OH in colorful, child-friendly forms that could be mistaken for candy.

“We cannot ignore the growing availability of unregulated products marketed in ways that appeal to children and adolescents. Concentrated 7-OH products are being sold in forms that can resemble candy and other treats, creating unnecessary risks for young people,” Dr. Melissa Garretson, a member of the AMA Board of Trustees, said in a statement.

As for kratom itself, the AMA’s House of Delegates passed Resolution 201, saying that “kratom, and its derivatives, should be regulated by the FDA, and its safety and efficacy should be determined through clinical trials before it can be marketed or prescribed as treatment for any condition.”

As dietary supplements, kratom and 7-OH are currently regulated as food — not as drugs — by the FDA, as long as unverified claims are not made about their medical uses. The FDA has repeatedly warned kratom distributors not to make such claims.

Several states and dozens of cities and counties have already banned 7-OH or put age restrictions on sales. The AMA’s new policy position will likely add weight to further efforts to ban 7-OH.

The American Kratom Association (AKA), an association of natural leaf kratom vendors, supports efforts to ban 7-OH products. but is concerned the AMA was not specific enough about its concerns.

“The AMA correctly identifies the danger posed by concentrated 7-OH products, but it stops short of making the most important distinction,” Mac Haddow, an AKA lobbyist, said in a statement. “These chemically manipulated 7-OH opioids are not traditional kratom products. They are highly concentrated opioids manufactured through chemical conversion processes that fundamentally alter the natural composition of kratom.” 

The AKA’s position is at odds with the 7-HOPE Alliance and the Holistic Alternative Recovery Trust (HART), which represent 7-OH consumers and manufacturers. Those groups support age restrictions and regulation of 7-OH, but not outright bans.  

“As discussions surrounding kratom continue, HART urges policymakers, medical organizations, and regulators to engage with the available scientific evidence and work toward regulatory solutions that protect children and consumers while preserving access for responsible adults,” Jeff Smith, HART’s National Policy Director, said in a statement to PNN.

“The fixation and misinformation on 7-OH is a deliberate distraction from far more concerning products that remain widely available to consumers. Instead of pursuing misguided bans on naturally occurring compounds, policymakers and regulators should focus on protecting consumers through consistent, science-based standards that apply equally across all kratom products.”

(Editor’s note: An earlier version of this story incorrectly reported that the AMA only wanted a ban on sales of 7-OH products to minors. PNN regrets the error.)

Kratom and 7-OH Often Confused

The lines between kratom and 7-OH often get blurred. A case in point is a recent news release from the Laguna Treatment Center, an addiction recovery clinic in Southern California, which warned of the “growing threat of kratom and its byproducts.”

In the first 5 months of 2026, the center said it was treating 25 patients “who sought help for kratom dependence.” That represents a 525% increase from the 4 kratom consumers who sought treatment at the center in all of 2025. The center makes no distinction between the different forms of kratom. 

“An alarming number of patients are coming in dependent on and addicted to kratom and its byproducts, such as 7-OH, who were previously unaware of the risks. This is relatively new territory for many providers, and we encourage insurance providers to expand and prioritize coverage for those seeking treatment for kratom misuse,” said Trace Swartzfager, Executive Director of the Laguna Treatment Center. 

Federal policies about kratom and 7-OH are also confusing, if not incoherent. Last month, President Trump said his administration would support the approval of “natural 7-OH,” without clarifying whether he was talking about natural leaf kratom or concentrated 7-OH versions.  

Nearly a year ago, FDA commissioner Marty Makary, MD, called on the DEA to classify 7-OH as an illegal Schedule I controlled substance, but not “natural kratom leaf products.” The DEA has yet to act on the FDA’s request and Makary has since been fired. The Trump administration has yet to replace him.

Claims are often made that 7-OH and kratom are opioids that cause addiction and overdoses. Technically, they are alkaloids and are not derived from poppy plants. Kratom and 7-OH stimulate endorphin nerve receptors in the brain – often called “opioid receptors” – but the same could be said about chocolate and coffee, which stimulate the production of endorphins and other natural “feel good” hormones.

Most of the overdose deaths attributed to kratom and 7-OH involve other substances, so it is not clear if they were the actual causes – much as opioid pain medications were mistakenly blamed for many overdose deaths. The FDA admits there is “ambiguity about the contributory role of 7-OH” in many overdoses.

Further muddying the waters about kratom, the National Institutes of Health (NIH) recently said it would study one of its purported health benefits. The NIH is launching a preliminary study to see if the kratom alkaloid  mitragynine could be used as a treatment for opioid addiction. Many kratom consumers already use the herbal supplement to help reduce their cravings for opioids and alcohol. 

A previous NIH study concluded that kratom is an effective treatment for pain, helps users reduce their use of opioids, and is “relatively safe” to use.

Black Patients Consider Many Things Before Deciding on Surgery

By Crystal Lindell

When Black patients with carpal tunnel syndrome are deciding whether to have surgery, they aren’t just considering their doctor’s recommendations. 

They are also thinking about a range of social, cultural and financial issues, such as how much work they’ll miss, whether insurance will pay for surgery, and what their loved ones think. That’s according to a new study published in JAMA. 

Researchers were inspired to look into the matter because Black patients in the U.S. are significantly less likely than White patients to have surgery for carpal tunnel syndrome, even when their symptoms are similar or more severe.

Carpal tunnel syndrome (CTS) is a common condition caused by compression of a nerve that passes through the wrist. Symptoms include numbness, tingling, weakness, and pain in the thumb and fingers.

The research team recruited 28 Black patients with CTS and asked them in individual interviews what their decision-making process was like. All had reached a point where their pain and loss of hand function prompted them to consider surgery. 

Although the study focused on Blacks, the same basic questions are faced by all patients: Will the surgery help and can I afford it? But due to treatment disparities and racial bias in the healthcare system, Black patients are more likely to be cautious about trusting doctors. 

“Participants emphasized the importance of being heard, respected, and actively involved in decisions; they carried prior experiences forward, shaping how they approached future interactions, including their willingness to trust clinicians, ask questions, or pursue recommended treatments,” wrote lead author Rachel Hooper, MD, a plastic surgeon and Assistant Professor of Surgery at University of Michigan Medical School. 

The patients who were interviewed welcomed collaborative and transparent approaches to their treatment, and wanted to have space to make informed, independent decisions about their surgery. As one participant said: 

“I just like my doctor to have an open communication, not tell me … ‘You need to do this. You need to do that’ but, ‘What can we do to get this working for you?’”

Researchers found that patients' social influences were an important part of the decision-making process. Some participants prioritized advice from friends, family, or coworkers over a doctor’s recommendation. They valued the experiences of other people in their lives:

"People from work... that was the other thing that discouraged me... surgery wasn't a help to them."

Patients also said financial concerns and a lack of paid leave led to delays in moving forward: 

"I kind of did prolong it... I didn't want to stop at work...never wanted to take the time off."

The authors suggested a number of ways to address these issues. They said surgeons should develop more educational material to clarify the impact that delaying surgery could have on hand function and long-term recovery.

They also recommended training in humility and how to collaborate more with patients. For example, surgeons could ask patients, "What matters most to you about hand use?"

They said surgical practices should be more involved in discussing financial issues, such as co-pays, time off, and insurance coverage. It would also be helpful to have patient advocates and social workers available to assist with insurance coverage, charity care applications, and to offer flexible scheduling to help hourly or shift workers.

Long-term, the researchers recommended more recruitment, hiring and mentorship of minorities in surgical teams.

It’s great to see a medical study published in JAMA that focuses entirely on the patient perspective, going so far as to do one-on-one interviews with patients.

Frankly, it’s long past time to acknowledge the full scope of patient decision making when it comes to things like surgery. In my experience, doctors are often shocked to discover that a patient might want to consider things like cost, time-off work, or post-op support.

Research like this is vital to help the medical community better understand patient perspectives. Ideally, it will help doctors better respond to the very real – and very valid – concerns that all patients have.

Glucosamine May Contribute to Alzheimer’s Disease

By Pat Anson

An over-the-counter supplement used by millions of people around the world to relieve joint pain has been associated with Alzheimer’s disease and other advanced forms of dementia, according to a new study.

Neuroscientists at the University of Florida say glucosamine raises the risk of someone progressing from mild cognitive impairment to Alzheimer’s disease by about 25 percent.

Glucosamine is an amino sugar found in shellfish that helps build cartilage, ligaments, tendons, and synovial fluid in joints. It is used annually by about 40 million Americans, many of them elderly, to reduce inflammation and symptoms of osteoarthritis.

What many seniors don’t realize is that glucosamine may also be accelerating the formation of protein plaques in their brain, which have been linked to dementia. 

“A lot of these people actively take an over-the-counter supplement that could be making their disease progression worse,” senior author Ramon Sun, PhD, a biochemist and molecular biologist, said in a press release.

It’s important to note that the study findings, published in the journal Nature Metabolism, are preliminary and don’t establish a cause and effect relationship between glucosamine and Alzheimer’s – only an association.

The findings are based on a large retrospective analysis of health records for over 50,000 patients diagnosed with Alzheimer’s disease-related dementias (ADRDs) or mild cognitive impairment (MCI). While most patients with MCI remained stable or even recovered cognitive ability, about 5% progressed to ADRD, representing a clinical worsening of cognitive decline. 

About 8% of the patients studied reported taking glucosamine supplements. When compared to patients who didn’t take glucosamine, researchers saw a 25% higher risk of patients with MCI transitioning to ADRD in the glucosamine user group. In addition, glucosamine use was associated with a 25% increase in mortality risk among ADRD patients.

Researchers believe glucosamine crosses the blood-brain barrier and feeds into pathways that build sugar residue on protein cells. Patients with Alzheimer’s appear to be more vulnerable to this metabolic activity than those with healthy brains.

“The electronic health record data are very provocative,” said co-author Matt Gentry, PhD, chair of UF’s Department of Biochemistry and Molecular Biology. “While it’s an association and not proof of causality, it does raise an important clinical question that now deserves much more attention.”

In tests on genetically modified mice, the UF research team found that glucosamine significantly increased sugar residue on proteins in the brain and reduced the social recognition behavior of mice. When researchers chemically suppressed this process, their “social memory” improved.

Advanced imaging studies on human Alzheimer’s brains also showed significantly increased sugar attachment to proteins compared to healthy brains. 

Taken together, the findings suggest that metabolic dysfunction is not simply a secondary aspect of Alzheimer’s pathology, but a contributing cause. 

“Proteins are the cell’s molecular machines, and many of them need sugar tags added in just the right way to fold correctly, travel to the right place and do their jobs,” Gentry said. “What we found in Alzheimer’s is that this sugar-tagging system appears to be overactive. The Alzheimer’s brain is adding too many of these sugar structures, and this seems to contribute to the disease rather than protect against it.”

The good news about this research is that it could lead to new ways to prevent Alzheimer’s or slow its development.

“Our results suggest that altered metabolism is a significant contributor to Alzheimer’s progression and, in addition, addressing the metabolic defect could be an important complement to approaches focused on Alzheimer’s plaques and tangles,” Sun said.    

Glucosamine is the fourth most widely used supplement in the United States. It is also widely used in China and Europe. Glucosamine is often combined with chondroitin to help build or restore joint cartilage. 

While further studies are needed, the Mayo Clinic says glucosamine “might provide some pain relief” for people with knee osteoarthritis. 

Tell Me Who the Real Criminals Are

By Cathy Kean 

Close your eyes. Go back to the worst pain you have ever known. A broken bone. A car wreck. Surgery. Childbirth without relief. Stay there for fifteen seconds. 

Feel the desperation. The begging. The need for it to stop.

Now imagine never leaving that place. You feel that pain every second. Every day. No break. Not in sleep. Not ever.

That is my life. Millions of us live here.

There is something that helps. Prescription opioids do not erase my pain, but they turn down the volume enough for me to be able to shower. To work. To keep my home. To hug my grand child without screaming inside.

Then they took them away. They said it was for my own good.

Before my chronic pain worsened after the release of the CDC opioid guideline, I worked as a real estate agent and special education advocate. 

Now I cannot walk. I have lost my job. My home of 32 years is in foreclosure. Friends stopped calling. I need help to use the bathroom. My independence is a corpse they are still kicking.

And the final cruelty? The people who did this lied to you.

CATHY KEAN

The Lies Behind the ‘Opioid Crisis’

You have been told prescription opioids are killing America. In 2021, the CDC reported a 1,040% increase in overdose deaths involving synthetic opioids from 2013 to 2019. They said those deaths were largely caused by illicitly manufactured fentanyl.

Here is what they didn’t tell you in that report: For many years, CDC misclassified most of those overdoses as prescription opioid deaths, and those deaths were used to help justify the agency’s 2016 opioid guideline, which led to wholesale restrictions on opioid prescribing. 

Not until 2018 was the error quietly acknowledged by four CDC researchers. And that tens of thousands of illicit fentanyl deaths were misclassified for years as prescription opioid deaths. 

The error was so serious that in 2016 alone, over 15,000 deaths caused by illicit fentanyl were mistakenly attributed to prescription opioids. Millions of Americans were misled by these and other errors that inflated the overdose numbers.

The White House told you prescription painkillers were the enemy. The media screamed it. Meanwhile, the real causes – illicit fentanyl, heroin and methadone – were hidden inside the CDC's overdose numbers.

The Death Toll They Won't Count

Because of the CDC guideline, thousands of chronic pain patients killed themselves. 

Not because they wanted to die, but because they could no longer get the prescription opioids that made life bearable. The pain became more than they could endure. And suicide offered a way out.

Others died slowly. From heart failure. Stroke. Organ collapse. The brutal physics of untreated pain grinding a body into dust.

No one in power keeps track of those deaths or says a word about them. No government agency. No major news outlet. No one with a microphone stands up and says, "We made a mistake. We are killing innocent people."

Instead, they push Suboxone and “alternative treatments.” For money. Not thy fellow man.

We have lost our First Amendment rights in the doctor's office. If you speak up about your pain, you are labeled a drug seeker and abandoned as a patient. I would rather die at home than face contempt again in the ER.

What I Want You to Do

Now imagine those 15 seconds of the worst pain you’ve ever felt. Really do them. Feel that pain.

Could you live like that? For one week? One year?

I am not asking for your pity. I am demanding your understanding. Your voice. Your outrage.

We are not criminals. We are not drug seekers. We are not addicts. We are not statistics on a CDC spreadsheet.

We are mothers and fathers. Veterans who served you. Construction workers who built your cities. Nurses who held your hand. Grandparents who babysat your children.

And we are dying. Some by suicide. And some by the slow, grinding destruction of our lives and bodies.

So here is what I need from you:

Do not look away. Say our names. Help us get our lives back.

Because if you could spend fifteen seconds in my body — really spent them — you would not need to be asked twice. You would be screaming with us.

Cathy Kean lives in California. She is a grandmother of 9 and mother of 4. Cathy lives with intractable pain from a botched surgery, along with fibromyalgia, arachnoiditis, stiff person syndrome, lupus, Parkinson's disease and insomnia. 

Cathy is the creator and administrator of the Facebook pages Chronic Illness Awareness and Advocacy Coalition and Pain is Pain. She writes to give a voice to the millions of chronic pain patients who have been silenced, stigmatized, and left to suffer—and to ensure her grandchildren never have to ask why Grandma couldn't be there. 

Chronic Pain Shouldn’t Be Judged With Brain Scans

By Jan Vollert

In 2006, Carl Koch sued his employer for damages after burn injuries during a workplace accident left him with chronic pain. The employer accused him of malingering, so the judge admitted a neuroscientist as an expert witness, who testified that he could see Koch’s pain on a brain scan. The case was settled for more than ten times the amount the employer initially offered.

This case is not unusual, as chronic pain can be severely debilitating. It can make it impossible to work, exercise and have a social life. It can make you depressed and anxious.

Having pain recognised by insurers, employers and government agencies can mean the difference between receiving benefits and being left without support. So it’s understandable that a judge wants to see objective evidence, such as a brain scan, showing chronic pain.

The problem is that it doesn’t work. However, as Koch’s case shows, it is used anyway. Good for Mr. Koch, in this case, but what if the neuroscientist had told the judge that he is faking his pain?

Who Is Believed?

Chronic pain is invisible, and everyone living with it has stories to tell about the time someone did not believe them: employers, friends, family, partners and doctors. Is it really that bad? Are you sure it’s not just in your head? Have you tried to toughen up a bit?

Who we believe and who faces more scepticism is not random either: women, people of colour, poor people and the less educated are far less likely to be believed that their pain is real. The cruelty is doubled as these are the groups most likely to experience chronic pain in the first place.

With modern brain scanners and AI, it seems tempting to develop what is effectively a pain-lie detector test. The pictures brain scanners show have been too complex to fully understand before, but AI can often solve such problems of complexity. Two studies published in Nature Neuroscience and Nature Medicine seemed to promise to be a first step towards a pain lie detector.

In the US, AI tools are already used to decide who should be prescribed opioids for their pain and who is probably an addict pretending to be in pain. An article in the technology magazine Wired uncovered how flawed the system was, and that it had a tendency to distrust all the groups mentioned above.

This is a problem with AI: even when it seems to work, it does not tell you how. This makes it dangerous to put too much confidence in it.

There can be no such thing as a pain lie detector for the same reasons that regular lie detectors do not measure if you lie; they measure if you are nervous – but you might be nervous telling the truth in a high-stakes situation.

It is similar for measuring pain. Pain causes distress, so any brain pattern of pain will also be a pattern of stress – and often anxiety. We cannot factor that into our pain lie detector: when we develop it, it will be with curious participants volunteering for a scientific study (not very stressful).

When we use it, it will be for the patient who has been disbelieved for years and knows if the scan does not “prove” their pain, no one will ever believe them, and they will not get compensation or benefits (as stressful as it gets). It will always be a catch-22, as explained in The Conversation in 2025.

A Private Experience

Pain is a personal and very private experience. It depends on your history with it, and on the context, meaning everyone’s pain is different, and your pain today can be different from your pain tomorrow. Some pain can even be pleasurable – spicy food being an obvious everyday example. This means that your brain scan of pain may look very different from mine. Until we have measured both, we cannot know.

It is for these reasons that the International Association for the Study of Pain has stated that pain lie detectors are useless. In a new article in Nature Neuroscience, my colleagues and I discuss technical and fundamental problems with the idea and ask the scientific community to abandon the idea.

So what does this mean for you? If someone tells you about their chronic pain, put all scepticism aside. Remember that most forms of chronic pain are invisible. Back pain, for example, is the biggest cause of disability worldwide, according to the World Health Organization, and a physical cause can rarely be found.

Keep in mind that machines make mistakes as well, and that they have the same stereotypes as we do. That is especially true for AI.

A pain scan will not tell us who is suffering and who is lying. But it may tell us something else: how easily we mistake technological confidence for truth. In medicine, insurance and law, that mistake could make already invisible pain even harder to prove – and easier to dismiss.

Jan Vollert, PhD, is chronic pain researcher and lecturer at the University of Exeter.

This article originally appeared in The Conversation and is republished with permission.  

How I Finally Got Health Insurance Again

By Crystal Lindell

In 2022, I was unceremoniously laid off from my job of 12 years. During the exit meeting, I was told that it would all be okay because I could sign up for COBRA!

That way, despite losing my job, I’d at least have health insurance until I could find something else.

Then, I saw the price of COBRA. It was about $500 a month. 

That’s a lot of money when you have a job, but it’s an obscene amount of money when you’ve just been laid off. 

People with a lot more wealth than me were flabbergasted that I turned it down. Extended relatives and former co-workers could not grasp why I decided to instead try the alternative health insurance plan, known as “Hope for the best.”

But looking back, “Hope for the best” has served me relatively well for almost four years now. 

I paid out-of-pocket for my routine doctor appointments, and cash for all of my monthly prescriptions. But I had to skip all my recommended preventative care, like getting mammograms. 

I also prayed every night that I wouldn’t have a medical emergency.

About 27 million Americans do that too, because they can’t afford private health insurance or the higher premiums of Affordable Car Act plans. They’ll soon be joined by over 5 million adults and children due to tougher Medicaid work rules

Yes, I still have medical debt to worry about. But I finally have real-life health insurance again! 

Oddly, it’s all thanks to the war with Iran. Let me explain.

For the last year, I had been earning a few hundred dollars a week delivering meals for DoorDash. But after we went to war, gas prices went from $2.79/gallon to $4.29/gallon in northern Illinois almost overnight. 

Suddenly, the math for most deliveries just didn’t make sense anymore. There were some orders where I was literally paying to bring someone McDonald’s.

When I factored in the wear and tear on my car, it became obvious that even a part-time minimum wage job would make more sense financially.

So, I applied at a Michael’s Craft Store because I thought it sounded fun, and then I applied at a gas station 12 minutes from my house because I thought it sounded convenient. The next day, the gas station called me back.

While I was initially hired as part-time, as of June 1, I am officially full-time.

And full-time employees get health insurance!

I signed up online right away and immediately scrolled to the most expensive plan, which was $68/week. But then I was given a $15/week discount for not being a tobacco user. (Thanks D.A.R.E.!) I also added on a $3.83/week dental plan, bringing my total health insurance cost to about $227/month.

That’s less than half the cost of the COBRA I was offered, plus now I have a weekly income to help cover it.

After years of paying out-of-pocket for all my medical care, my new plan includes some exciting features – like $10 co-pay for two medications I need every month; free preventative care like those mammograms I missed; and $20-co-pays for my doctor, who is thankfully in-network.

I’m going to call and make multiple appointments that I have been putting off, and then when they ask me how I’ll be paying for the visit, I will proudly tell them that I will be using my very own Blue Cross Blue Shield health insurance!

You might be wondering how I’m able to physically do a gas station cashier job with my chronic pain, and the answer to that question is 7-OH, a potent form of kratom. I started taking it a few months ago, and it has greatly improved my daily quality of life.

Yes, 7-OH is expensive, and yes, it does cause withdrawal symptoms if you stop abruptly, so it’s not perfect. But for me, it’s been life-changing in all the best ways. It relieves pain while also giving me energy, making me more functional than I have been in years. 

I am not exaggerating when I say that 7-OH is the reason that I am now able to work a job full-time. And by extension it’s the reason that I am able to have health insurance now.

So tonight, when I go to sleep, I’ll be praying to a God I don’t really believe in that 7-OH remains legal. For now, anyway.

But hey, at least I no longer have to worry about what happens if I break a bone or have a heart attack. Because I finally, after four long years, really do have health insurance again!

Feds to Study Kratom as Treatment for Opioid Use Disorder

By Pat Anson

After years of demonizing kratom as an addictive, opioid-like substance with no approved medical use, federal health officials are finally acknowledging the herbal supplement could actually be used to treat opioid addiction.

The National Institutes of Health (NIH) has approved an Investigational New Drug application to see if mitragynine – one of the many alkaloids in kratom – could be used to treat opioid use disorder (OUD). 

In a small Phase One clinical study, NIH and University of Florida researchers will test a purified formulation of mitragynine on 32 healthy volunteers with a recent history of opioid use. In preclinical studies on animals, researchers said several doses of mitragynine did not raise any significant safety concerns.

“We’ve seen the potential of mitragynine in the lab, and now we’re finally able to examine its potential in people. Hopefully this work will lead to a new treatment option for people with opioid use disorder and support a path to recovery,” Joni Rutter, PhD, Director of the NIH’s National Center for Advancing Translational Sciences, said in a press release.

Although the main purpose of the placebo-controlled trial is to test the safety and tolerability of mitragynine – not whether it can treat OUD – the fact that NIH is even conducting such a study is being hailed as a “major milestone” by kratom advocates.

"For years, opponents of kratom have attempted to portray natural kratom leaf as a public health threat," said Mac Haddow, Senior Fellow on Public Policy for the American Kratom Association (AKA), an association of kratom vendors. 

"The decision by NIH to move forward with this research sends exactly the opposite message. Federal scientists believe the available evidence justifies studying kratom's potential role in helping address one of the most devastating public health crises in America, the opioid overdose epidemic." 

Kratom comes from the leaves of a tropical tree that grows in Southeast Asia, where it has been used for centuries as a natural stimulant and pain reliever. That’s primarily how it’s used today around the world. 

‘It Saved My Life’

A lesser known therapeutic use of kratom is to reduce cravings for opioids and other substances. Susan Ash, the founder of the AKA, used kratom as a substitute for Suboxone, a medication used to treat OUD.

Ash is not alone. In a PNN survey of over 6,000 kratom users, about one in ten said they used kratom as a treatment for OUD or alcoholism, with over 90% saying it was “very effective.” Many said kratom reduced their cravings and helped ween them from drugs.

“Kratom is the one thing that has kept me from using opiates and other illegal substances. I've been able to stay clean for 3 years now. It's given me my life back,” said one kratom user.

“It has saved my life. I am a mother of 4 and have anxiety, depression, acute back pain, and I am an opioid addict. It has kept all these at bay for me,” said another.

“This is an herbal blessing that has kept me from drinking. I don't get high (on kratom). I just can tell that it takes away my cravings for alcohol. If it becomes illegal, I fear we may never truly be able to study and treat ailments that kratom helps with,” wrote another survey respondent.

While the federal government has backed away from plans to make kratom illegal, the FDA has asked the DEA to ban another kratom alkaloid – 7-hydroxymitragynine (7-OH) – which is more potent than mitragynine. 

The DEA has yet to move forward on the FDA’s request, but dozens of states and local governments have. They’ve banned 7-OH and other “synthetic” versions of kratom, as well as natural leaf kratom, due to fears they can cause addiction and overdoses..

Ironically, much of the hysteria about kratom has been fueled by the same federal health agencies that now want to learn about its benefits. 

In 2022, the NIH released a study warning that nearly a third of kratom users met the diagnostic criteria for “kratom use disorder,” such as increased use, tolerance, withdrawal, and craving. Nearly 10% also reported “psychosocial impairments” that caused them to withdraw from social, work, or recreational activities — classic signs of someone with a drug abuse problem.

That same year, the FDA sent warning letters to four companies, telling them to stop marketing kratom as a treatment for opioid addiction.  

“You market kratom products for the treatment or cure of opioid addiction and withdrawal symptoms. However, these products have not been determined by FDA to be safe and effective,” warned one letter. “Further, the unproven treatments could cause patients to forego or delay FDA-approved treatments for opioid addiction or withdrawal.”

The new NIH study means the government has come full circle on kratom’s therapeutic potential. Once dismissed as “unproven,” kratom is finally being recognized as a potential solution to one of America’s biggest health problems.    

“This (study) is a major step toward expanding treatment options for the millions of Americans struggling with opioid use disorder, which has contributed to historically high overdose mortality rates,” said Nora Volkow, MD, director of the NIH’s National Institute on Drug Abuse. 

President Trump recently said his administration would seek to have “natural 7-OH” approved. Although it’s unclear if the president was referring to 7-OH or natural leaf kratom, it’s another sign the feds have turned over a new leaf on kratom.

A Letter to My Younger Self on Living With Chronic Pain

By Crystal Lindell

This is a letter to myself. A letter I wish I had been able to write 13 years ago, when I first developed chronic pain at age 29. Hopefully, my fellow chronic pain survivors will find practical advice mixed with some hope in the words below.  

Dear Crystal,

I have some bad news. The pain you have in your ribs is not going to go away. 

It’s going to linger and spike, and sometimes it will make you want to slit your wrists in the bathtub. It’s going to completely change your entire life. 

In fact, the stabbing pain you’re now dealing with is going to alter your very soul.

Your entire life is going to change so dramatically, that 13 years later, it’ll be difficult for me to even put myself back in your shoes.

While I vividly remember the hopelessness, confusion and fear that’s crushing you right now, it’s difficult for me today, at age 42, to even remember your world view in 2013.

So much of what you think about the world around you, the people in it, and even of yourself is going to change. That change is going to be forced onto you by this new physical pain, which in 2026 will still have no cure. 

However, over time, and through lots of trial and error, you will eventually find a medication regime that mostly works for you. You will also finally find a doctor who believes you, and treats your pain as seriously as it demands.

There is so much other good stuff in store for you too. I promise. 

I know the concept of “good stuff” feels impossible right now, but I swear that good things will happen to you in the years to come. And so many of those good things will only happen because of the very pain that currently feels like it’s ruining your life.

For starters, the pain you’re feeling is eventually going to lead you to the love of your life.

Yes, I know you’re currently dating someone. But he is not the love of your life. Over the next few years, as your body betrays you, he will do the same. 

I know that since he is more than a decade older than you, you expect to help him through his health problems as he ages – but he is not expecting the same in return. He does not like that you now have a chronic illness, and he does not want to take care of you. He will even say this to you directly at one point. 

He is very selfish. But you’ll linger with him longer than you should because even selfish support feels like support with everything else that you’re going through. It’s ok. You’ll need time to process the loss of him in your life. And you need to play it all out – so that when you do finally meet your true love, you’ll understand what makes him so important.

The two of you will meet at a political event. You’ll both be there to advocate for pain patients to have better access to opioids. That’s right, the love of your life has chronic pain too. It’s the kind of double bad luck that almost cancels out, when you realize that it’s the very thing that brings the two of you into each other’s lives in the first place.

He’s handsome, he’s funny, and best of all, he doesn’t mind taking care of you for the rest of his life. 

You’re also going to move. And I don’t mean across town.  

Eventually you will realize that living with family is the only way you can endure all of this. But that is something you’ve already begun to realize. It will take you less than six months to decide to move in with your mom.

Yes, this means losing your part-time job as a youth leader that you love so much. It will be a heartbreaking loss. A loss you don’t deserve. There is not much good to say about this loss, other than the fact that you will survive it. And through that loss, your ability to empathize will expand. 

And while you will be able to maintain your career and even your current full-time job for the next nine years, eventually you will lose that too. That loss is only partly because of the chronic pain though. It’s more because of the burn out, which the chronic pain doesn’t exactly help with.

But it’s ok. You will still find other ways to write, and even ways to get paid a little to do it. And you will be happier without your former corporate overlords making you so miserable.

Plus, writing about all of your experiences will help countless people endure their own chronic pain. Many of them will even reach out to you to thank you for the many ways you helped them cope. Your pain will go out into the world and make it a slightly better place.

Also, in a few years, you’re going to get a cat. And that cat will lead to three more cats. I know, I know. It sounds impossible right now, but for some reason your cat allergies will fade, and those cats will eventually come to help you get through the especially bad pain flares.

For now, my most practical advice is to talk to your doctor about a prescription sleeping pill so that you can finally get some real rest. He will give it to you, I promise. 

Also, remember that doctors are not gods. They will get a lot of stuff wrong in the years to come, and you’re going to have to advocate for yourself if you want to survive. The confidence to do that will come to you first as a necessity, and then as something that’s part of your very being. You’ll wonder how you ever navigated the world without it.

One last thing – and this is especially important – I really need you to keep going. 

I need you to survive each long day – and each even longer night – so that we can make it to 2026. I need you to stay alive long enough to start to see that even a life with debilitating chronic pain is worth living. Because it very much is.

I wish that I was writing to tell you that your pain will be cured, and that everything will go back to how it was before your ribs started to feel like someone was stabbing them with a butcher knife every night.

But I really believe that your actual future is even better. Nothing goes back to the way it was before the pain started. And that’s the very best part.

CBD Enhances Oxycodone’s Pain Relieving Effects

By Pat Anson

Some pain sufferers firmly believe that cannabis can help boost the pain relieving effects of prescription opioids. The evidence behind that belief is mostly anecdotal, but some new research lends some credence to it.

In studies on laboratory rats, researchers at the University of Florida and Texas A&M University College of Dentistry found that cannabidiol (CBD) appeared to enhance the pain-relieving effects of oxycodone without increasing the risk of addiction. 

CBD is one of the many cannabinoids found in cannabis. It does not have the same psychoactive effects of tetrahydrocannabinol (THC), but is believed to have some therapeutic benefits.

The rats were treated with CBD, oxycodone or a combination of the two daily for two weeks, while acute pain was induced in the laboratory.

The study findings, published in The Journal of Pain, found that CBD enhanced oxycodone’s antinociceptive effect, meaning it blocked pain signals from reaching sensory neurons in the brain. CBD also did not affect the “rearing behavior” or “place preference” of rats, activities that may have suggested they were becoming dependent or addicted to oxycodone.

“Together, these findings suggest that cannabidiol potentiates the analgesic effects of oxycodone without affecting its reward-related properties. These results support the potential of cannabidiol as an adjunctive, opioid-sparing agent in pain management,” researchers wrote.

A recent study of 21 people with knee osteoarthritis reached a very different conclusion, finding that a low-dose of opioids taken with a cannabis-based medicine did not relieve acute pain. 

That study, however, was deeply flawed. The cannabis-based medicine was dronabinol (Marinol), a synthetic version of THC. Dronabil is FDA-approved to treat nausea and improve appetite, but is not intended to provide pain relief. The medication also has little in common with the various forms of cannabis (edibles, smoking, vaping) used in the real world.  

Granted, the use of dronabil and laboratory rats are major weaknesses in both studies, which highlights how cannabis research has long been stifled in the U.S. by marijuana’s status as an illegal Schedule I controlled substance.     

The DEA is now allowing more cannabis to be used for research purposes and recently reclassified medical marijuana as a Schedule III drug, which allows for medical uses. It could be years, however, before we see more high-quality studies about the risks and benefits of cannabis products.  

Electric Nerve Stimulation May Help Manage Osteoarthritis

By Louise Burgess

An estimated 595 million people globally are living with osteoarthritis. This makes it one of the leading causes of pain and disability.

Osteoarthritis is a degenerative joint disease, in which tissues in the joint break down over time. The condition can affect any joint, but most commonly the knees, hips, hands and spine.

However, the impact of osteoarthritis often goes beyond the affected joint. The condition can have profound effects on daily life.

Research shows that people with osteoarthritis are less likely to remain in work and more likely to develop additional health problems, such as diabetes, obesity and poor mental health, than those without the disease.

One of the key approaches recommended for managing osteoarthritis is exercise, including aerobic exercise and muscle strengthening. It’s shown to be extremely beneficial for managing the condition and its associated symptoms.

But not everyone who has osteoarthritis is able to exercise due to pain and limited mobility. This is why electrical muscle stimulation, a novel technology that uses small electrical impulses to help muscles contract, is being investigated for managing osteoarthritis.

Exercise for Osteoarthritis

Aerobic and muscle strengthening exercises are both proven to address key drivers of osteoarthritis symptoms.

Aerobic exercise can help manage body weight and improve pain by enhancing circulation and reducing inflammation.

Muscle strengthening exercise improves joint stability by supporting the surrounding musculature. This reduces stress on the joint and improves movement.

Together, these approaches can help to break the cycle of pain, inactivity, weight gain and physical decline that can happen in osteoarthritis.

But as beneficial as exercise is, many people with osteoarthritis are reluctant to try it or struggle to adhere to physical activity long term.

In fact, data suggests that people with musculoskeletal conditions (such as osteoarthritis) are around twice as likely to be physically inactive as their healthy counterparts.

Reported barriers to physical activity include pain, limited mobility, negative experiences of physical activity and a lack of motivation. But the less we move, the more muscle mass and strength we gradually lose.

A difficult cycle can then emerge, whereby pain, stiffness and fear of making symptoms worse all discourage movement. Then, without movement, stiffness and pain worsen.

An Alternative Approach

When exercise feels too painful or isn’t possible, electrical muscle stimulation (EMS) may offer an alternative method for maintaining and improving strength.

This works by placing electrodes on the skin to deliver small electrical impulses, causing muscles to contract without the joint needing to move. The electrical impulse is similar to the signal we normally send from our nervous system when we want to perform a movement.

When performed instead of exercise over several weeks and sessions, EMS has been shown to increase muscle size and strength and improve function in people with hip and knee osteoarthritis. For example, in people with knee osteoarthritis, EMS performed on the quadriceps muscles three days per week for 4-8 weeks has led to benefits.

The therapy can be used in isolation, or it can be applied during exercise to activate even more muscle fibres in what is called a superimposed muscle contraction.

Electrical muscle stimulation also shows promise for those with severe, end-stage osteoarthritis who are preparing for surgery.

For example, one study compared the effects of performing EMS or exercise before surgery for knee osteoarthritis on postoperative outcomes. The study found that participants who used EMS for 20 minutes a day, five days a week in the six weeks before surgery saw greater improvements in postoperative muscle mass, strength and function, compared with patients who performed physical exercise.

Muscle weakness is common both before and after surgery, partly due to pain and reduced movement. While exercise programmes before and after surgery are widely recommended, research suggests they often only have modest effects on functional recovery from joint replacement surgery.

One explanation may be that people with severe osteoarthritis cannot tolerate the level of intensity needed while exercising to build muscle effectively. In addition, joint trauma and swelling from surgery can cause disruption to the signalling pathways that are required to activate muscles.

Because EMS can bypass some of these signalling issues, it may help to maintain or rebuild muscle where conventional exercise is not feasible immediately after surgery. It’s often used in sports settings for this reason, such as when athletes require anterior cruciate ligament surgery.

That said, electrical muscle stimulation is not a magic solution and has its limitations. In many cases, it works best as a complement to, not a substitute for, active rehabilitation.

The body of evidence for its effectiveness in osteoarthritis is also still evolving. Some studies showed inconsistent results or were only conducted using a small sample.

Some people find the sensation of electrical stimulation uncomfortable. Some aren’t suitable for its use (for example, those with pacemakers) and devices can be expensive to buy.

Nonetheless, for those who cannot exercise due to pain, swelling or limited mobility, EMS offers a practical tool to maintain muscle strength. This can help them stay active and independent for longer, recover quicker from surgery, and maintain a better quality of life.

Louise Burgess, PhD, is a Lecturer in the School of Allied Health and Exercise Sciences at  Bournemouth University. She specialises in neuromuscular electrical stimulation (NMES), with a focus on its application in musculoskeletal rehabilitation and performance. Her research has also explored the use of NMES for healthy aging, osteoarthritis, joint replacement, intensive care patients with Covid-19, deep vein thrombosis prevention, and ankle sprains.

This article originally appeared in The Conversation and is republished with permission.  

Can Prayer Reduce Pain and Anxiety?

By Crystal Lindell

One of the strangest things about developing a chronic illness was realizing just how many people would suggest prayer to me as a medical treatment. They would say it as though they were suggesting surgery or a new medication.

New research seems to show that they may have been on to something. Not only that, the amount of relief is significant and could last two weeks or longer.

Having someone pray for you, which the study dubs “proximal intercessory prayer” – PIP for short – helped both pain and anxiety. Unfortunately, despite patients reporting lower pain scores, the researchers found that the pain relief did not result in reduced use of pain medication.

The study, which was published in The Annals of Family Medicine, was led by researchers at the University of Maryland and involved 180 patients with moderate-to-severe pain and/or anxiety.

Half the participants received 5 minutes of Christian prayer from a trained volunteer prayer practitioner, which included a “laying-on-of-hands.” The other half listened to Christian-themed piano music intended to promote meditation and relaxation.

At the start of the study, both groups had pain scores that averaged about 5.8 on the zero to ten pain scale.

Those who received prayer reported large reductions in pain immediately after, with pain scores falling to about 2.6 on average. Pain levels rose to 4.22 after two weeks and leveled off at 4.03 after six weeks.

Patients who listened to music also said their pain levels were reduced, although not as significantly.

Pain Levels Before and After Treatment

THE ANNALS OF INTERNAL MEDICINE

Participants reported similar reductions in anxiety immediately after PIP, but anxiety levels edged up again in the following weeks.

Interestingly, researchers found that the religious affiliation of patients and the intensity of their religious beliefs had no major effect on outcomes. Whether or not participants believed statements like “God heals through prayer” or “I expect to receive some healing through prayer” did not predict the amount of relief they felt.

“Our findings suggest that PIP may be effective for a wide range of patients, including non-Christians and those who do not expect the intervention to be effective,” researchers concluded.  “The results suggest that PIP may be a safe, quick, effective intervention that can be performed in medical settings as an adjunct to standard health care.”

Participants reported no adverse events, and most said they would want in-person prayer to be offered at future medical visits.

It’s great that many of the patients experienced significant pain relief, and it’s even better than it lasted multiple weeks. However, as with all studies involving unconventional pain treatments, such as mindfulness and cognitive behavioral therapy, my concern is that in-person prayer will be forced onto patients who aren’t interested.

Anyone who has ever been in true pain will tell you that they are willing to try just about anything to find relief. That includes atheists being offered prayer. So if it works, that’s great.

We just need to make sure that prayer is not used as a substitute for opioids and other conventional treatments. In the grand scheme of things, who’s to say that pain medication isn’t just God’s way of answering prayers for relief in the first place?

21 Million Americans in Severe Pain Don’t Have a Diagnosis

By Pat Anson 

A new study has found what many chronic pain patients have already learned the hard way: It’s difficult to get a diagnosis.

Researchers at The University of Texas at Arlington (UTA) estimate that 21 million Americans living with severe pain have never received a medical diagnosis for what’s causing it.

Their findings, recently published in the journal PAIN, are based on four years of federal health data, which found a significant gap between the painful symptoms that patients report and what actually appears in their medical records.

“What this study shows is that a significant number of people experience pain that interferes with their work and daily activities, yet the healthcare system does not capture a reason for that pain,” said lead author Feinuo Sun, PhD, an Assistant Professor of Kinesiology at UTA. “That mismatch represents a real problem.”

Pain is one of the most difficult conditions to diagnose because of its subjective nature. What may be “severe” pain to one patient may be “minor” to someone else.

Given the well-known disparities in healthcare access in the United States, it’s not surprising that undiagnosed pain is more common in some groups than others.

Compared to white and native born Americans, people who are Black, Asian or foreign born are more likely to have undiagnosed pain, due to barriers in getting treatment and more limited healthcare resources. People without health insurance and those with poor mental health face similar obstacles in getting a diagnosis.

Undiagnosed pain is also more common among men and young or middle-aged adults. Researchers think that may be due to the fact that women and older adults are more likely to see a doctor and describe their symptoms in a more detailed way – making them more likely to get a diagnosis.

Geography also plays a role. Americans living in the West are more likely to have pain, and more likely to be without a medical diagnosis. A previous study by Sun found that people have less access to healthcare in rural areas, and have greater distances to travel for treatment.

Two findings were unexpected: People with higher incomes and those who are employed are more likely to have undiagnosed pain. That’s because wealthier people are more likely to self-manage minor pain with over-the-counter painkillers and alternative treatments. And people who have jobs may be reluctant to take time off to see a doctor or to use up their sick days.

Overall, about 30% of Americans who have some degree of pain do not have a corresponding medical diagnosis. The percentage of undiagnosed pain drops to 17.8% for those with moderate-to-severe pain. 

It’s worth noting that the UTA study analyzed health data from 2016–2019, a period when pain was still classified as a symptom rather than a disease. That changed in 2022, when the World Health Organization updated the International Classification of Disease (ICD) coding system to recognize chronic pain as a disease for the first time.

The implementation of a new ICD-11 code may help narrow the diagnosis gap by bringing greater clinical attention to chronic pain, leading to quicker diagnosis and treatment. 

“Because pain was not classified as a disease during the years we studied, many people likely had their pain overlooked or inadequately documented, even when it significantly affected their quality of life,” Sun said. “When pain goes undiagnosed, it is very likely to be undertreated or poorly managed.” 

A recent study found that rates of chronic pain and disabling pain surged in the U.S. after the Covid pandemic, reaching the highest levels ever recorded. Today, about 60 million Americans have chronic pain, and 21 million have “high impact” pain severe enough to interfere with work and everyday life.

Inflation Is Especially Hard on Chronic Pain Patients

By Crystal Lindell

These days it feels like just walking into a grocery store costs $100. And topping off your gas tank is the kind of thing you have to start a savings plan to achieve.

It’s not your imagination. Everything has gotten outrageously more expensive, and it’s only getting worse.

According to a recent PBS article, overall food prices are up 3.2% in the last year, with foods like beef (+15%), coffee (+18.5%), and fresh tomatoes (+40%) rising even more.

Gas prices have soared to a nationwide average of $4.49 a gallon – up from $2.98 just before the Iran war began at the end of February.

Rent and utilities are also going up, and consumer confidence is so gloomy that two-thirds of Americans are cutting back on spending.

There seems to be no aspect of life where people can catch a break financially these days, but it’s especially difficult for chronic pain patients.

Many of us live on fixed incomes, and rely on aid programs like food stamps and Medicaid.

Unfortunately, the government is not increasing the amount of money recipients get from those programs to account for inflation. So as prices go up, the only choice is to live on less.

Of course, it’s not really a choice, because many patients are already living on a bare bones budget to begin with. You can’t shift down by going to a food pantry if you’ve already been going to a food pantry for the last three years.  

So what actually happens is that we end up cutting back on essentials. We’re eating less, moving in with relatives to save money, and never turn on the A/C to keep the electric bill down. 

There’s also the fact that patients have ongoing medical expenses to contend with, like prescriptions, insurance premiums, and co-pays. Those have all increased as well.

Those of us who are able to work can’t physically endure working more hours or taking a second job to help with the constant price increases.

It also means that we have less money for the types of services that are considered a “convenience” by healthy people, but are necessities when you have a chronic illness and can’t get around well. Things like grocery and restaurant delivery services become extravagances.

On the other side of that, jobs with DoorDash and Uber used to be good side gigs, because you can choose your own hours, and take a day off when you’re having a pain flare.

I personally spent the last year earning extra cash that way, but had to give it up when gas prices spiked because DoorDash refused to increase driver pay to cover the higher cost. It was costing me more to make deliveries than I was earning. 

With all the constant financial pressure, it just feels important to lay everything out in one place, and to validate what many patients are struggling with these days. 

When you’re already dealing with chronic pain that makes it painful to live, it’s easy for the whole situation to make you feel depressed, despondent, and lose hope. 

Making it worse is that there doesn’t seem to be any sort of path or plan to make any of this better. Sure, maybe gas prices will inch down a few cents, and maybe you’ll be able to find a good two-for-one deal on beans at the grocery store. 

But in the grand scheme of things, when your health is bad and your financial health is worse, it’s difficult to keep going.

But keep going is exactly what you need to do. Because if you’re still here, then the world still needs you in it. And you have no idea how much you may be helping others to endure all this as well.

Maybe one day, the government will finally start working for the people again, and we can start to dig our way out of this. Crazier things have happened.

A Simple Chart Destroys a Myth About the Opioid Crisis

By Neen Monty

There’s a simple reason the narrative around the “opioid crisis” falls apart when you actually look at the overdose data.

Because the data doesn’t show what they claim it shows. 

And that false narrative has been retrofitted to cover the deception and lies wrought by bad actors in the U.S. healthcare system.

The chart below tracking overdose deaths by opioid type tells two stories:

1. Prescription opioid deaths rose, stabilized, and then fell.

2. Fentanyl arrived… and everything exploded.

Those are not the same curve. Those are not the same problem.

There are two epidemics. And one deliberately blurred narrative.

In the United States, prescription opioid deaths peaked around 2012, at about 5 deaths per 100,000 Americans. 

Meanwhile, fentanyl-related deaths – almost non-existent before 2012 – began rising exponentially as illicit fentanyl entered the black market.

In 2023, they peaked at 22.2 deaths per 100,000 people. By then, overdoses linked to prescription opioids had fallen to 3.8 deaths per 100,000.

That means there are almost 6 times the number of overdose deaths caused by illicit fentanyl than prescription opioids.

Yet prescription opioids remain the target.

That “opioid crisis” curve?

That’s illicit fentanyl. Not pain patients. Not prescription opioids. Not doctors treating disease.

The Uncomfortable Truth

When overdose deaths skyrocketed, prescription opioid deaths were already flattening out and falling. That should have changed the narrative right there.

But the narrative stayed the same.

The explosion in deaths aligns with one thing: iIlicit fentanyl and its analogues flooded the U.S. drug supply with counterfeit pills of unknown, often lethal, potency.

That is why deaths surged, not because someone with intractable rheumatoid arthritis got oxycodone prescribed for their pain.

The numbers don’t lie. If the opioid crisis were really about prescriptions, the lines on the chart would look very different.

So why didn’t the narrative charge?

Because blaming illicit fentanyl means:

• Confronting illicit drug supply chains

• Admitting policy failure

• Acknowledging complexity

Blaming prescriptions is easier. It creates easy villains to target:

• Doctors

• Patients

• Pain medication

And it opens the door to:

• Restrictions

• Guidelines

• “Education programs”

• Entire industries built on fear

Who paid the price?

Pain patients. People with cancer, autoimmune disease, neurological damage, and severe structural pathology.

People who were stable. Functioning. Living.

Until they were cut off.

This was never about prescriptions. The chart makes one thing brutally clear: The U.S. overdose crisis is a fentanyl crisis.

Everything else is a false narrative. A fairy story. One designed to vilify people who are already among the most vulnerable people in our communities – the ill, the disabled, people living with severe pain.

It’s important to note that by the time Physicians for Responsible Opioid Prescribing (PROP) was created in 2012, prescription opioid deaths had already stabilised and were falling.

PROP was instrumental in creating the CDC’s infamous 2016 opioid prescribing guidelines. But there was no need to restrict opioid prescribing. There was no need for forced tapers that lead to suicides and overdose deaths. There was no need for dose ceilings that meant people’s pain was no longer treated adequately.

There was also no need for the fabrication of “evidence” that does not stand up to even a little scrutiny. Just read the studies that the CDC guidelines are based on. They do not show what you have been told they show.

But no one actually reads the studies. No one examines the data. No one questions. Doctors just blindly follow the guidelines. It’s hard to blame them when they face prison time if they don’t.

It has been ten years since the forced tapers started in the U.S. Six years since Australia blindly copied this failed policy. No one in Australia bothered to read the research. Australia just copied the U.S. guideline and allowed politicians to decide who gets pain relief and who does not.

Australia could see the policy going horribly wrong in the U.S. Yet it implemented those same policies and tortured Australian chronic pain patients the same way. The same is true for Canada and the UK as well.

This should never have happened.

Patients on three continents have been abandoned, left to suffer in agony day after day. Given psychological therapies for physical disease and injury. And no one says a word. 

I have contacted many politicians, journalists, and senior public servants in Australia.  No one will take this on. No one will right this wrong.

And the media continues to push a false narrative about an opioid crisis that does not exist. But it gets clicks.

It may be futile, but my life and those of many others depend on access to safe and effective opioid therapy.

And so, I will continue to fight.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. For more information on chronic pain, the science, the politics and the lived experience, go to Pain Patient Advocacy Australia. You can also subscribe to Neen’s free newsletter on Substack: “Arthritic Chick on Chronic Pain.”