Rx Opioids Are Not a Cure… and Neither Is Anything Else
/By Neen Monty
They deliver it like it’s some kind of mic drop.
“Opioids are not a cure,” they say.
But here’s the important thing: Almost nothing in medicine is a cure.
Insulin doesn’t cure diabetes. But it keeps people alive.
Methotrexate and Xeljanz don’t cure rheumatoid arthritis. They slow down disease progression though.
Intravenous immunoglobulin is not a cure for Chronic Inflammatory Demyelinating Polyneuropathy. But it slows down the demyelination of my nerves.
Prednisone is not a cure for autoimmune disease. But it reduces inflammation, which improves pain and quality of life.
Anti-inflammatories do not cure inflammatory arthritis, but they decrease pain, increase function and improve quality of life.
Metformin, thyroxine, even chemotherapy in many cases… none are cures.
They manage symptoms, reduce harm, and improve quality of life.
That’s medicine’s job.
Medicine is not purely about curing disease. In fact, it’s rarely about curing disease. That does not mean that all the wonderful things that medicine can do are worthless.
So why is pain relief held to a higher standard than every other kind of treatment?
Why are opioids dismissed simply because they don’t cure the underlying disease that causes the pain?
Pain relief is not a moral failing. It’s medicine doing what it’s meant to do: Alleviate suffering and restore function.
That’s what opioids do. Alleviate suffering, restore function and improve quality of life. Those are good things.
If you can move again, sleep again, think clearly again, participate in life again, isn’t that a good thing?
But no. Dismiss opioids because they’re not a cure.
Such a stupid point of view.
Now that we’ve shown that chronic pain patients hardly ever become addicted or overdose on their pain medication, people are really reaching for reasons to demonize opioids. Saying that opioids are not a cure is reaching pretty hard.
Opioids reduce pain temporarily. I am under no illusions. And I do wish there was a cure for my diseases. I really do. But there is no cure. There is only palliative treatment -- with opioids.
And so many people would like to take that pain relief away from me. People who have never experienced severe pain at 1am. So severe that sleep is impossible. So constant that it happens every night. And all day, every day.
Except for the few hours when I have pain medication to reduce that pain – while not curing it.
Opioids don’t cure pain any more than insulin cures diabetes. They treat a symptom. A devastating symptom – severe pain - that profoundly affects function and quality of life.
Reducing that pain, even temporarily, is not a failure.
That’s a treatment working.
It’s the best treatment we’ve got for severe pain, acute or chronic.
To say “opioids are not a cure” is to fundamentally misunderstand what they’re for.
You know, those glasses you wear won’t cure your shortsightedness. Let’s take your glasses away. They’re not a cure!
That wheelchair won’t cure paralysis. You don’t need a wheelchair.
We don’t apply this logic to any other condition or treatment. Only pain. Only opioids.
We don’t tell people with heart failure to throw away their meds because they don’t “fix” the heart.
We don’t tell people with asthma to stop their inhalers because they don’t “cure” the lungs.
We treat to relieve symptoms, to restore life and dignity, because that’s the ethical duty of medicine.
Relief of suffering is an outcome. Improved function is an outcome. But a cure is wishful thinking.
So the next time someone says, “Opioids are not a cure,” remember that neither is anything else we use to keep people alive, moving, and human.
And that’s okay. Because that’s the best we can do, in many situations.
Because the goal of medicine isn’t always to cure. It’s to care.
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. She has created a website for Pain Patient Advocacy Australia to show that prescription opioids can be safe and effective, even when taken long term. You can subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”
