5 Cool Things to Help You Endure Summer Heat With Chronic Pain

By Crystal Lindell

As temperatures heat up this summer, it can be difficult to get through hot sunny days when you’re also dealing with chronic pain and chronic illness. 

Weather is such a huge factor in the severity of day-to-day chronic pain levels, and if you’re on certain medications heat can also impact your body in other ways, like skin irritation and ankle swelling. 

Here are 5 things I use to get through the summer months while also dealing with chronic pain and chronic illness. 

Gold Bond Friction Defense Stick

My number one summer survival item is the Gold Bond Friction Defense Stick. I use it on my arms and thighs to prevent the heat and humidity from chaffing my skin if I’m wearing shorts, a tank top, a bathing suit or any light summer clothing. 

And this stuff seriously works! Putting it on after my morning shower makes such a huge difference in my quality of life throughout the summer. 

If you have a long day of walking, or swimming you may need to re-apply a few times, but for most day-to-day activities, I have found that once in the morning is more than adequate. 

Find it on Amazon here.

Compression Socks

Every summer my excessive ibuprofen use combines forces with my Ehler-Danlos Syndrome to make my ankles swell up – especially if the humidity is high.

So I swear by these compression socks, which virtually eliminate that symptom, even after long car rides. I have multiple packs of these in multiple colors, and throughout the summer months, I wear them almost daily. 

No, they aren’t super stylish with shorts, but if you wear them underneath pants, nobody can even tell. 

Find them on Amazon here. 

Light, Airy Pants

Speaking of pants, I tend to prefer them to shorts most of the time, even in the summer months. And these light, airy pants are great for enduring the heat. 

They offer all the comfort of pants, with all the breathability of shorts. I use them as pajamas, as well as pants to wear over my bathing suit at the pool, and even for lounging around during the day.

According to my Amazon order history, I have literally ordered these pants eight times! I have them in every color and even in multiple sizes. They’re also great at enduring weight fluctuations that are common when you’re on a lot of medications and dealing with chronic pain because of how stretchy the waist is. 

But the best things about these pants might be that they have pockets! If you’re familiar with the world of women’s pants, you know just how valuable and rare that feature is! 

Find them on Amazon here. 

Adjustable Fan

Sometimes chronic pain and related medications make us especially sensitive to heat and humidity, but a personal, adjustable fan can be a great way to cope. 

We have this fan in multiple colors, and we use them throughout the summer to direct air flow exactly where we want it. 

It’s relatively quiet for a fan, but it still packs a punch when it comes to cooling you off during the summer months. 

Find it on Amazon here. 

Summer Reading Club

If you’re looking for a comforting summer read, I can’t recommend “Garden Spells” by Sarah Addison Allen enough. It’s a very light, easy read that follows the stories of two sisters who have to navigate common sibling friction with the added stress of coming from a magical family that the whole town thinks is “weird.”

I read it for a book club recently and flew through it in two days. It’s a great light read, even if you’re have a chronic pain flare and can’t get off the couch. It also takes place in the south, and the heat is a common theme, making it perfect for getting into the summer state of mind.

Find it on Amazon here. 

What products do you use to get through the hot and humid summer months while dealing with chronic pain? We’d love to hear your recommendations in the comments below! 

The Pain News Network may make a small commission on items purchased through the links above. 

Brandeis Must Confront the Human Cost of Opioid Restrictions

By Arianne Grand-Gassaway

As a mother who lost my 35-year-old daughter, Desiree, to a counterfeit Xanax pill in the wake of restrictive prescribing policies, I am calling on Brandeis University to reckon with its role in a public health crisis.

The 2016 CDC Guideline on Opioid Prescribing, heavily influenced by Physicians for Responsible Opioid Prescribing (PROP) and its founder, Dr. Andrew Kolodny— Co-Director of Opioid Policy Research at Brandeis -- has helped fuel a humanitarian disaster.

Tens of millions of Americans with chronic pain and mental health conditions face untreated suffering, forced tapers, and abandonment by providers terrified of prosecution for prescribing opioids and other controlled substances like Xanax.

I am one of those Americans. I suffer from intractable pain and was denied opioid medication for a decade, before I found a provider who is treating my pain now. That decade of no pain care did irreparable damage to my body though.

Jewish wisdom, a cornerstone of Brandeis’s identity, teaches that saving one life is akin to saving the world (Mishnah Sanhedrin 4:5). Yet, these policies have done the opposite. My daughter, unable to access medically necessary medication for her panic disorder, turned to someone she thought she could trust—a desperate act that cost her life.

So many now are dehumanized by a system that prioritizes fear and suspicion over compassion. My family’s story is not unique. Despite a recent decline in overdoses, drug poisonings remain near record levels, with over 80,000 fatal overdoses in 2024.

Most of these deaths involve illicit fentanyl, while legitimate prescriptions remain out of reach for those who need them most: the sick, injured, and elderly.

On May 7, 2025, I wrote a letter to Brandeis Interim President Arthur Levine, urging dialogue that includes patient voices. Weeks later, after a follow-up call, I have received no response. This silence mirrors the broader dismissal of patients crying out for relief.

Brandeis, a self-proclaimed beacon of social justice, has a moral obligation to examine how Dr. Kolodny’s influence and advocacy have contributed to this crisis. Limiting prescriptions has not reduced addiction or overdoses — it has punished the vulnerable while illicit drugs continue to flood our streets.

By his own testimony, Dr. Kolodny only works part-time at Brandeis, which enables him to continue his work as an expert witness and consultant for plaintiff law firms involved in opioid litigation, for which he charges $780 per hour.

In 2022, Dr. Kolodny testified in West Virginia that “it’s been lucrative” work for him personally, although he declined to state the total amount of money he’s been paid by law firms over the years. Under questioning, he didn’t dispute estimates that it was a million dollars or more.   

I call on Brandeis to host a public forum with patients, providers, and policymakers to confront the harms caused by the CDC guideline and restore the doctor-patient relationship. Providers must be free to prescribe based on good faith and informed consent, without fear. We can prevent addiction and treat it compassionately without sacrificing those whose lives depend on these medications.

This is not just my story — it’s the story of many millions. If Brandeis and other organizations in positions of power to change the trajectory of this tragedy continue to remain silent, I will continue to speak, for Desiree and for all those suffering and dying. The time for action is now. 

People in Pain Need Healthy People to Fight for Them

By Neen Monty,

I haven’t written much lately, because I am sick.

I am not lazy, I do not lack commitment. Or motivation. Or determination.

That is an unfair characterization, an unfair criticism. One that is not uncommon for people who live with chronic pain or a chronic illness.

We are judged to be lazy, exaggerating, malingering, drug seeking. None of it is true.

I am sick. And I am disabled. But I am not just a “chronic pain patient,” as many like to reduce me to. “Chronic pain” is not my identity. It’s not who I am.

However, pain does dictate what I can and cannot do. Every decision I make is influenced and decided by my pain levels. Or rather, how much pain medication I am allowed to utilize.

If I did not have pain, I would still be disabled and sick every day. I never feel “good” in the way that healthy people feel good. I am always fatigued, weak and in pain. And I sure as heck do not choose that. No one would.

We, people like me, need allies. We need people to help us. Because we are too unwell to put 40 hours a week into advocacy and awareness raising. We don’t have that kind of time and energy.

We need people who are healthy to fight for us.

Because helping people who live with painful, progressive, incurable disease should be a given. Helping people who have experienced severe physical trauma and injuries should be a given. People should feel empathy for the ill and infirm. For the injured and traumatized.

Societies are judged on how they treat their weakest members. By this standard, our society is not doing well.

To help, you first have to understand, listen, and believe. You must trust that what we are saying is true.

You cannot be that doctor who “knows better.” The one who makes snap judgements about the woman who walks into the exam room limping, dressed in old clothes, and unkempt. Clearly a hysterical woman with psychological issues.

It’s doctors like that who misjudged me, leaving my serious and rare neurological disease undiagnosed. Because of those four neurologists who judged me, I now must live with constant and severe neuropathic pain every second for the rest of my life.

The insult to injury is that no doctor wants to prescribe opioid pain medication to allow me to manage that pain. To make the pain bearable. To make my life functional.

Had the first neurologist, or even the second one, done their job and diagnosed my disease over ten years ago, I would have had a chance at remission or even reversing the damage. Now? Not much hope of that. I’ll be lucky if the disease is slowed down a tad.

Judgement vs. Empathy

People who have no pain cannot understand what it is like to live with constant, severe pain.

But everyone can show empathy and compassion and kindness -- if they choose to.

I don’t receive a lot of empathy, compassion or kindness. I receive a lot of judgement. I receive a lot of trolling.  I have even been stalked.

Recently, when I had a crisis due to pain and forced opioid tapers, several very kind, empathetic and compassionate people reached out to me. Most were physiotherapists, also known as physical therapists. I cannot tell you how much their support and kindness meant to me. I will never forget.

These are some of the best people I have ever had the privilege to meet or chat with. Some don’t agree with my opioid use, and my opioid advocacy. But they still reached out to help me. I am so very grateful for that.

Many people still don’t believe my various illnesses are real. As I said, I went undiagnosed for over a decade because four neurologists decided I was just a hysterical woman.

Turned out I have a very serious disease. It took neurologist number five, and ten years, to get that diagnoses.

That should never happen, but it’s very common. Women are very often ignored, dismissed, accused of exaggerating or being hysterical.

I used to be a gym junkie, nutrition nazi, a super fit person. I did not bring any of this on myself though poor choices. Though people do love to tell me I did.

All I’m asking for is a better quality of life. And less pain.

I advocate strongly for people like me to have access to whatever pain treatments work. I am not pro-opioid. I am pro pain relief.

When I was in crisis, I also received messages from two doctors. One told me opioids do not work for pain, and that I should be ashamed of myself for promoting them. The other told me if doctors are not prescribing, I must be an addict.

Very unkind. They saw a person in crisis and thought that was a good time to attack. I cannot imagine that they treat their patients with respect, kindness and compassion, if that’s the way they treat me.

I am not able to do much work at the moment. I am far too unwell. My colleagues who live with constant, severe pain also have periods like this.

We support each other as much as we can, but we need support from healthier people.

We need allies.

We need people who live with less severe pain to help.

We need healthy people to help.

We need doctors, therapists, nurses and pharmacists to unlearn the crock science they’ve been taught and learn about real chronic pain. All the many types of chronic pain, not just one.

We need them to learn about chronic pain from the people who live with it. Not the people who profit from it.

We need allies.

Neen Monty is a writer and 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.”

Sen. Joni Ernst Said the Quiet Part Out Loud

By Crystal Lindell

Last week Sen. Joni Ernst (R) of Iowa said the quiet part out loud at a town hall meeting. 

While responding to a comment about President Trump’s planned Medicaid cuts possibly killing people, Ernst shrugged and said, “Well, we all are going to die.”

Her remark drew a chorus of boos, as you’ll see in the video:

Ernst may have been talking about Medicaid, but the implication was that everyone was going to die eventually. Of course, the key word here is “eventually.”

There’s a big difference between dying at 21 and dying at 97. Just because someone is going to die eventually, that doesn’t mean that it’s OK for them to die today. In fact, that’s why when someone cuts another person’s life short via murder, we usually punish them for doing so. 

I’m sure Ernst can understand this concept when it comes to herself. After all, I doubt she’d be OK with being denied urgent medical care herself, and then being met with a shrug and a dismissive, “Well she was going to die anyway.” 

The thing is, Ernst wasn’t thinking of herself when she made the comment. Rather, she was thinking of the general public, the masses if you will.  

She was thinking of you and me. 

And to Ernst, our lives are disposable. We are just the peasants who are going to die eventually, so we might as well die today as far as she’s concerned.

Just in case you thought that perhaps Ernst misspoke or was taken out of context, she doubled down a day later with a weird selfie video filmed in a cemetery, of all places. 

“I made an incorrect assumption that everyone in the auditorium understood that yes, we are all going to perish from this Earth. So I apologize,” she said in the video, before glibly adding, “And I'm really, really glad that I did not have to bring up the subject of the tooth fairy as well."

You can see her full “apology” here:

Our lives are truly just a joke to Sen. Ernst.

The thing is, as a chronically ill patient with a bachelor’s degree in political science, I can report that Ernst’s blase attitude about our deaths is all too common. Both our political leaders and many of our healthcare professionals view the (lack of) value of our lives the same way she does. 

You saw it in the government’s poor response to the COVID pandemic, when they did things like prioritizing the economy over people’s lives. 

You also see it Trump’s “One Big Beautiful Bill,” which would take healthcare benefits away from 10 million people and cut $700 billion from Medicaid

And you see it in the way that chronic pain patients are treated by doctors and government policies. 

Many doctors will do anything to avoid the personal stress and intense scrutiny from law enforcement and state medical boards for prescribing opioids. And some don’t care if it means that patients suffer or even die as a result. Doctors know that untreated pain can be dangerous, especially if it pushes patients to the black market looking for relief. 

They share the same attitude that Ernst expressed: “We all are going to die.”

Most doctors would do anything possible to extend their own lives. They would also do anything possible to extend the quality of their lives, even if that means taking the same opioids they might deny pain patients. 

The root of these issues is that a lot of people with power – whether its political power or power in the exam room – see themselves as belonging to a superior class of humans. And anytime a human feels like they are superior to another human, they can start to justify some really awful things. 

Ernst saying, “We all are going to die” is the natural end point of that thought process. 

But she wasn’t talking about herself.

What Ernst really meant was much darker: “You are all going to die – and I don’t care.”

5 Tips for Showering with Chronic Pain

By Crystal Lindell

One of the first things I had to come to terms with when I developed chronic pain in 2013 was that showers were no longer something I could do on a whim. 

My pain, which was eventually diagnosed as intercostal neuralgia in my right ribs, flares up when I put the energy and work into taking a shower. 

I’m not sure why showering seems to aggravate it, but I assume it’s related to the fact that I’m standing in one place for a long time, moving my arms in a certain way to clean my hair, and then the movements I do to get dressed afterward. 

All this means that I have to plan my showering schedule the way other people plan their gym workouts – with the expectation that I’ll need rest afterwards. 

I do still shower almost every day, because it’s important to me and I like feeling clean. But that doesn’t mean it’s not a struggle. And I will confess that there are some days when the pain is just too intense to get through a full shower. 

However, there are things you can do to make it both easier to shower with chronic pain, and to go longer periods of time between showers. 

Below are suggestions and advice that I’ve learned from living with chronic pain and caring for disabled relatives who live near me. 

Tip 1: Change your showering schedule to nights 

The first thing I did when I realized that showering was going to be an ordeal was to shift to showering at night. This sounds like a small thing, but for me it was a major change in my daily routine. 

Back when I started having chronic pain, I was still driving into an office everyday for a day job. Getting up to take a full shower, wash my long hair, and then get dressed in office clothes sometimes meant that I didn’t have the ability to drive into the office at all. I would literally have to call my boss to ask if I could work from home or take a sick day. 

When I realized that I no longer had the luxury of showering in the morning, I shifted to doing it the night before. That way, I could save my morning energy for throwing on clothes and light make-up before heading to work.

I no longer drive into an office job everyday, but I do still shower at night if I have anything I have to do outside of the house in the morning. 

It’s honestly one of the foundations of living with chronic pain: you have to plan out things that you didn’t have to think about before. You have to make sure you’re rationing your energy to get the most out of your limited supply. 

For showering, that means scheduling it for times when it doesn’t conflict with other high-energy activities. 

Tip 2: Use dry shampoo when you can’t shower

A lot of people already know about the wonders of dry shampoo, and how it can help you go longer between washing your hair. But most people don’t realize that it works best when it’s used as a preventative measure to keep your hair relatively clean. 

The trick to getting it to work best is to use it on freshly washed and dried hair, so that it can absorb the hair’s natural oil as it comes in. 

There are a ton of dry shampoo options on the market, but in my experience, the more expensive ones aren’t necessarily better. So feel free to reach for whatever you see at your local drug store. 

Personally, I’ve had a lot of success with the Batiste Brand. I like that their shampoos come in a lot of different scents and that they even offer versions for brunettes, who want to avoid the white residue that’s common with dry shampoos. 

Tip 3: Sponge roller curls can help you go longer between hair washings

After watching Agent Carter – a 1940s Marvel super hero TV show – I went through a phase where I was obsessed with all things 1940s style, including hair. 

That’s how I accidentally stumbled onto my next tip: setting your wet hair in foam sponge rollers will help you go a lot longer between washes. The women of the 1940s did this because shampoo was rationed or hard to come by during World War 2. It turns out they knew what they were doing. 

That’s because curly hair, even if it’s been brushed out, does not get oily as fast as straight hair. So if you add curls to straight hair, you won’t have to wash it as often. 

Here’s a quick Youtube tutorial that goes over the basics of using sponge rollers. There are tons more in-depth tutorials if you’re interested. Just make sure your hair is completely dry before you take the curlers out, otherwise they won’t set.

There are sponge rollers on Amazon currently listed for less than $10, but you can also find them at almost every drug store and discount retailer. 

Of course, there is one massive downside to using sponge rollers or any type of curling method at home – they take a lot of time and energy to do your hair. 

However, most salons will offer a service called a “wet set” for a reasonable price. It’s a tried and true service for older women, who tend to be in the demographic of people who aren’t able to wash their hair every day. 

As part of a wet set, the stylist will usually use rollers to give you tight curls, and then style it afterwards so that you can go longer between hair washes. 

Tip 4: Invest in a shower chair 

There are also accommodations that you can use to get through a shower easier. For example, I think a lot of people don’t realize just how helpful a shower chair can be. 

While I don’t use one myself, I have relatives who use a shower chair, which often is the difference between them being able to shower vs. not being able to shower at all. 

These days, you don’t have to order shower chairs from special medical supply services. You can get them for a very reasonable price online. This shower chair on Amazon is currently listed for less than $40, and it features a removable back. 

Tip 5: Use cleansing wipes between showers

Of course, there may be days when you just can’t get through a full shower, but you don’t want to feel dirty. In that case, I suggest investing in some bath wipes for adults. 

Again, I have not personally used a product like this, but I have multiple disabled relatives who found them to be extremely helpful. 

These bath wipes on Amazon are currently listed for less than $20, and they claim to both cleanse and soften your skin. 

You don’t need bath wipes to achieve this effect though. A wet washcloth with some soap used in a few key places can also achieve a similar effect. 

Hopefully you found some good tips on this list, and if you have any other tips or advice for getting through a life where showering is sometimes a luxury, please share them in the comments below!

Pain News Network may receive a small commission from the Amazon links listed in this article.

American Doctors Are Moving to Canada to Escape Trump Administration

By Brett Kelman, KFF Health News

Earlier this year, as President Donald Trump was beginning to reshape the American government, Michael, an emergency room doctor who was born, raised, and trained in the United States, packed up his family and got out.

Michael now works in a small-town hospital in Canada. KFF Health News and NPR granted him anonymity because of fears he might face reprisal from the Trump administration if he returns to the U.S. He said he feels some guilt that he did not stay to resist the Trump agenda but is assured in his decision to leave. Too much of America has simply grown too comfortable with violence and cruelty, he said.

“Part of being a physician is being kind to people who are in their weakest place,” Michael said. “And I feel like our country is devolving to really step on people who are weak and vulnerable.”

Michael is among a new wave of doctors who are leaving the United States to escape the Trump administration. In the months since Trump was reelected and returned to the White House, American doctors have shown skyrocketing interest in becoming licensed in Canada, where dozens more than normal have already been cleared to practice, according to Canadian licensing officials and recruiting businesses.

The Medical Council of Canada said in an email statement that the number of American doctors creating accounts on physiciansapply.ca, which is “typically the first step” to being licensed in Canada, has increased more than 750% over the past seven months compared with the same time period last year — from 71 applicants to 615. Separately, medical licensing organizations in Canada’s most populous provinces reported a rise in Americans either applying for or receiving Canadian licenses, with at least some doctors disclosing they were moving specifically because of Trump.

“The doctors that we are talking to are embarrassed to say they’re Americans,” said John Philpott, CEO of CanAm Physician Recruiting, which recruits doctors into Canada. “They state that right out of the gate: ‘I have to leave this country. It is not what it used to be.’”

Canada, which has universal publicly funded health care, has long been an option for U.S.-trained doctors seeking an alternative to the American health care system. While it was once more difficult for American doctors to practice in Canada due to discrepancies in medical education standards, Canadian provinces have relaxed some licensing regulations in recent years, and some are expediting licensing for U.S.-trained physicians.

In mere months, the Trump administration has jeopardized the economy with tariffs, ignored court orders and due process, and threatened the sovereignty of U.S. allies, including Canada. The administration has also taken steps that may unnerve doctors specifically, including appointing Robert F. Kennedy Jr. to lead federal health agencies, shifting money away from pandemic preparedness, discouraging gender-affirming care, demonizing fluoride, and supporting deep cuts to Medicaid.

The Trump administration did not provide any comment for this article. When asked to respond to doctors’ leaving the U.S. for Canada, White House spokesperson Kush Desai asked whether KFF Health News knew the precise number of doctors and their “citizenship status,” then provided no further comment. KFF Health News did not have or provide this information.

Philpott, who founded CanAm Physician Recruiting in the 1990s, said the cross-border movement of American and Canadian doctors has for decades ebbed and flowed in reaction to political and economic fluctuations, but that the pull toward Canada has never been as strong as now.

Philpott said CanAm had seen a 65% increase in American doctors looking for Canadian jobs from January to April, and that the company has been contacted by as many as 15 American doctors a day.

Rohini Patel, a CanAm recruiter and doctor, said some consider pay cuts to move quickly.

“They’re ready to move to Canada tomorrow,” she said. “They are not concerned about what their income is.”

The College of Physicians and Surgeons of Ontario, which handles licensing in Canada’s most populous province, said in a statement that it registered 116 U.S.-trained doctors in the first quarter of 2025 — an increase of at least 50% over the prior two quarters. Ontario also received license applications from about 260 U.S.-trained doctors in the first quarter of this year, the organization said.

British Columbia, another populous province, saw a surge of licensure applications from U.S.-trained doctors after Election Day, according to an email statement from the College of Physicians and Surgeons of British Columbia. The statement also said the organization licensed 28 such doctors in the fiscal year that ended in February — triple the total of the prior year.

Quebec’s College of Physicians said applications from U.S.-trained doctors have increased, along with the number of Canadian doctors returning from America to practice within the province, but it did not provide specifics. In a statement, the organization said some applicants were trying to get permitted to practice in Canada “specifically because of the actual presidential administration.”

Michael, the physician who moved to Canada this year, said he had long been wary of what he described as escalating right-ring political rhetoric and unchecked gun violence in the United States, the latter of which he witnessed firsthand during a decade working in American emergency rooms.

Michael said he began considering the move as Trump was running for reelection in 2020. His breaking point came on Jan. 6, 2021, when a violent mob of Trump supporters besieged the U.S. Capitol in an attempt to stop the certification of the election of Joe Biden as president.

“Civil discourse was falling apart,” he said. “I had a conversation with my family about how Biden was going to be a one-term president and we were still headed in a direction of being increasingly radicalized toward the right and an acceptance of vigilantism.”

It then took about a year for Michael to become licensed in Canada, then longer for him to finalize his job and move, he said. While the licensing process was “not difficult,” he said, it did require him to obtain certified documents from his medical school and residency program.

“The process wasn’t any harder than getting your first license in the United States, which is also very bureaucratic,” Michael said. “The difference is, I think most people practicing in the U.S. have got so much administrative fatigue that they don’t want to go through that process again.”

Michael said he now receives near-daily emails or texts from American doctors who are seeking advice about moving to Canada.

‘You Left Just in Time’

This desire to leave has also been striking to Hippocratic Adventures, a small business that helps American doctors practice medicine in other countries.

The company was co-founded by Ashwini Bapat, a Yale-educated doctor who moved to Portugal in 2020 in part because she was “terrified that Trump would win again.” For years, Hippocratic Adventures catered to physicians with wanderlust, guiding them through the bureaucracy of getting licensed in foreign nations or conducting telemedicine from afar, Bapat said.

But after Trump was reelected, customers were no longer seeking grand travels across the globe, Bapat said. Now they were searching for the nearest emergency exit, she said.

“Previously it had been about adventure,” Bapat said. “But the biggest spike that we saw, for sure, hands down, was when Trump won reelection in November. And then Inauguration Day. And basically every single day since then.”

At least one Canadian province is actively marketing itself to American doctors.

Doctors Manitoba, which represents physicians in the rural province that struggles with one of Canada’s worst doctor shortages, launched a recruiting campaign after the election to capitalize on Trump and the rise of far-right politics in the U.S.

The campaign focuses on Florida and North and South Dakota and advertises “zero political interference in physician patient relationship” as a selling point.

Alison Carleton, a family medicine doctor who moved from Iowa to Manitoba in 2017, said she left to escape the daily grind of America’s for-profit health care system and because she was appalled that Trump was elected the first time.

Carleton said she now runs a small-town clinic with low stress, less paperwork, and no fear of burying her patients in medical debt.

She dropped her American citizenship last year.

“People I know have said, ‘You left just in time,’” Carleton said. “I tell people, ‘I know. When are you going to move?’”

KFF Health News is a national newsroom that produces in-depth journalism about health issues.

‘I Can Do It With a Broken Body’: How I Learned to Live with Chronic Pain

By Crystal Lindell

I can still remember the exact day when everything I thought I knew about physical pain was destroyed.

It was 2013, and I had just started to have chronic pain in my ribs a few months prior. Although it would eventually be diagnosed as intercostal neuralgia, and then years later as Ehlers-Danlos Syndrome, at the time nobody seemed to know what was going on. 

The pain was debilitating and I had no idea how to cope with it. Every doctor I saw told me that my imaging and labs were “normal” so there was nothing they could do. They just repeatedly upped my dose of gabapentin and sent me on my way – wash, rinse, repeat as the gabapentin failed to help. 

I had spent another sleepless night tossing and turning in agony as the pain on my right side wrapped around my torso like a spiked metal snake tightening its hold on me. I was stuck in that impossible cycle where the less I slept, the more pain I felt – and the more pain I felt, the less I slept. 

At the time, I didn’t even know the term "chronic pain” yet, and I was struggling to find anyone else who seemed to understand what I was going through. Pain that never goes away was not supposed to happen – especially if there was no underlying injury that could be fixed with surgery. So it had not occurred to me to add "chronic" to my pain.

After being awake most of the night, I got up, dressed and drove myself to immediate care, hoping for a miracle. 

The miracle never came. 

I felt like I was going to die and thought that such a pain level would warrant some sort of response from a doctor – some sort of urgency. But instead, I was dismissed. Actually, worse than that, I was chastised for coming in again when they had already seen me a few weeks prior. 

After waiting over two hours to be seen, the doctor walked into the small exam room, looked up at me, recognized me from previous visits and scolded me, saying, “You still haven’t gotten this figured out?” 

As if I was the one who refused to figure it out. As if the doctors who all refused to help me couldn’t be held responsible because I was the one who was not doing my part. 

The only problem was, I had no idea what my part was even supposed to be. And more than a decade later, I’m still not always sure.

The doctor then quickly told me there was nothing they could do, and that I would need to follow up with my primary care physician. Then she told me to check out at the front desk. 

They did nothing to help me. Nothing at all. And the pain had only gotten more intense during all this. I went to my car feeling hopeless. And then I realized that my day was going to get worse. 

I had been dealing with this pain for multiple months at this point, which means I had already missed weeks worth of work. I suddenly realized that I was going to have to go to the office for the day. 

In pain. 

After spending all morning in immediate care. 

I was going to have to go to work. 

It’s a situation that would have seemed impossible to my healthy body just a few months before.. 

Up until that point, a trip to immediate care would have easily warranted a sick day from work. But even though it was only spring, I had already used up all my sick days for the year and then some. I couldn’t afford to miss a day for a health issue that was now as normal for me as it was horrific. 

After all, normal things require normal days. The pain was normal. So I had to go about my normal day and go to work. 

I sobbed in my car. It was the first time I truly understood that I was going to have to live my regular life in what was now regular pain. Prior to that moment, I would have assumed that the level of pain I was enduring was more than enough to make the world stop – or at least to make my world stop. 

I often think of the lyrics from the Taylor Swift song, “I Can Do It With a Broken Heart.” 

In the song, she laments having to go about her life with a smile after a bad romantic breakup left her feeling depressed, singing:

I was grinnin' like I'm winnin'

I was hittin' my marks

'Cause I can do it with a broken heart

For me, and millions of other people living with chronic pain, the title is slightly different: “I can do it with a broken body.”

Because that’s the thing about chronic pain, it seeps out into every aspect of your life like an oil spill, and you just have to live around it. I still have to work, feed my cats, feed myself, shower, pay bills, and see my family. 

It’s just that most days I have to do all that while also living with horrible pain. 

After more than a decade of living this way, I am relieved to report that I have found some coping strategies. I also moved and found new doctors, who took my pain more seriously, despite the lack of proof on MRI scans and blood work. 

I also meticulously scaled back my life over the years, peeling away things that I now understood were unnecessary. I live a quiet, low-commitment life, so that there is room to breathe while pain takes up all my oxygen. 

Things are not as bad as they were that day back in 2013. My pain is well managed, and my daily life is much more accommodating. 

And yet, the pain persists. It remains chronic. So I still spend most days “doing it with a broken body.”  Or as Taylor Swift put it:

Lights, camera, bitch, smile.

Even when you wanna die

Except for chronic pain patients, there are no lights and no camera. Just a life in pain. 

Are ‘Addicts’ to Blame for Prescription Opioid Crackdowns?

By Crystal Lindell

It’s been nearly a decade since the CDC released its infamous 2016 opioid guideline. In the years since, millions of pain patients have endured immense suffering, as doctors significantly reduced the amount of opioid medication they prescribe.

But who is really responsible for all that pain?

It’s tempting to lay the blame for all the crackdowns on “addicts.” After all, if it wasn’t for them, the rest of us could still get opioids for pain relief, right?

Unfortunately, it’s not so simple. 

The real culprits are the DEA, CDC, and the medical community at large, all of which have worked together to criminalize pain and punish patients.

But blaming ‘addicts” for the crackdown on opioids is exactly what the people with real power are hoping you will do. First and foremost, it has the effect of pitting opioid users against each other, when in reality we’re already on the same team. And as the old saying warns: United we stand, divided we fall. 

Many people who use opioids illegally have chronic pain or other health issues that opioids help address. In a country that does not have guaranteed healthcare, much less guaranteed pain treatment, they are left to fend for themselves. So, it’s no wonder that some of them turn to illegal drugs for relief. 

Using opioids illegally will get you labeled as “an addict,” regardless of the circumstances. In fact, that’s a big part of the reason why I no longer use the word “addict” when talking about illegal users. It’s a murky diagnosis that's often given to deprive patients of a controversial but effective treatment. 

Furthermore, blaming people who use illegal opioids for the fact that many pain patients can’t get an opioid prescription only serves to let the true oppressors off the hook for their crimes. 

We have to remember, it’s not “legal users vs. illegal users.” It’s “all users vs. the DEA, CDC and the medical community.”

I understand where the desire to blame “addicts” comes from. After all, illegal users make a very tempting target. It’s much easier to hate them than to admit that maybe your doctor, who has a lot of power over your life, is actually the one causing you harm. 

It’s also human nature to want to identify yourself as “one of the good ones.” As in: Yes, I use opioids. But I’m different and have a legitimate medical need. 

I mean, obviously, it’s not that simple. But I get why pain patients want to tell themselves that it is. 

The thing is, there are real solutions to the lack of access to opioid pain medication. But we won’t achieve them unless we all work together. 

For example, we could advocate for selling hydrocodone the same way we sell nicotine, alcohol and caffeine: over-the-counter and without a prescription. Eliminating doctors from the equation would help countless pain patients finally get relief, whether they used opioids illegally or legally. And it would be a whole lot safer than the Russian Roulette of drugs on the black market. 

That’s the kind of solution that’s only possible if all opioid users unite in the fight against opioid restrictions. But it won’t happen as long as pain patients insist on telling themselves that there are “addicts” out there that aren’t as worthy as they are.

Because that’s the crux of the issue, isn’t it? Deep down, a lot of pain patients think that people using medications illegally are a separate class of people that need to be banned from accessing opioids “for their own good.” 

Here’s the secret that your doctors won’t tell you though: The medical community has already put you into that group as well. They already think you need to be kept away from opioids “for your own good.” 

In their eyes, both legal and illegal users are one group – so we might as well embrace it. After all, we’re all worthy of pain relief. And all of us should have the right and the ability to treat our own pain as we see fit. 

If we all work together, maybe one day we can make the right to pain treatment a reality. 

How and Where the Trump Administration Will Cut Healthcare Spending

By Elisabeth Rosenthal, KFF Health News

Health care has proved a vulnerable target for the firehose of cuts and policy changes President Donald Trump ordered in the name of reducing waste and improving efficiency. But most of the impact isn’t as tangible as, say, higher egg prices at the grocery store.

One thing experts from a wide range of fields, from basic science to public health, agree on: The damage will be varied and immense.

“It’s exceedingly foolish to cut funding in this way,” said Harold Varmus, a Nobel Prize-winning scientist and former director of both the National Institutes of Health and the National Cancer Institute.

The blaze of cuts have yielded nonsensical and perhaps unintended consequences. Consider instances in which grant funding gets canceled after two years of a three-year project. That means, for example, that $2 million has already been spent but there will be no return on that investment.

Some of the targeted areas are not administration priorities. That includes the abrupt termination of studies on long covid, which afflicts more than 100,000 Americans, and the interruption of work on mRNA vaccines, which hold promise not just in infectious disease but also in treating cancer.

While charitable dollars have flowed in to plug some gaps, “philanthropy cannot replace federal funding,” said Dustin Sposato, communications manager for the Science Philanthropy Alliance, a group that works to boost support from charities for basic science research.

Here are critical ways in which Trump administration cuts — proposed and actual — could affect American health care and, more important, the health of American patients.

Cuts to the National Institutes of Health

The Trump administration has cut $2.3 billion in new grant funding since its term began, as well as terminated existing grants on a wide range of topics — vaccine hesitancy, HIV/AIDS, and covid-19 — that do not align with its priorities. National Institutes of Health grants do have yearly renewal clauses, but it is rare for them to be terminated, experts say. The administration has also cut “training grants” for young scientists to join the NIH.

Why It Matters: The NIH has long been a crucible of basic science research — the kind of work that industry generally does not do. Most pharmaceutical patents have their roots in work done or supported by the NIH, and many scientists at pharmaceutical manufacturers learned their craft at institutions supported by the NIH or at the NIH itself.

The termination of some grants will directly affect patients since they involved ongoing clinical studies on a range of conditions, including pediatric cancer, diabetes, and long covid. And, more broadly, cuts in public funding for research could be costly in the longer term as a paucity of new discoveries will mean fewer new products:

A 25% cut to public research and development spending would reduce the nation’s economic output by an amount comparable to the decline in gross domestic product during the Great Recession, a new study found.

Cuts to Universities

The Trump administration also tried to deal a harrowing blow — currently blocked by the courts — to scientific research at universities by slashing extra money that accompanies research grants for “indirect costs,” like libraries, lab animal care, support staff, and computer systems.

Why It Matters: Wealthier universities may find the funds to make up for draconian indirect cost cuts. But poorer ones — and many state schools, many of them in red states — will simply stop doing research. A good number of crucial discoveries emerge from these labs.

“Medical research is a money-losing proposition,” said one state school dean with former ties to the Ivies. (The dean requested anonymity because his current employer told him he could not speak on the record.) “If you want to shut down research, this will do it, and it will go first at places like the University of Tennessee and the University of Arkansas.”

That also means fewer opportunities for students at state universities to become scientists.

Cuts to Public Health

These hits came in many forms. The administration has cut or threatened to cut long-standing block grants from the Centers for Disease Control and Prevention; covid-related grants; and grants related to diversity, equity, and inclusion activities — which often translated into grants to improve health care for the underserved. Though the covid pandemic has faded, those grants were being used by states to enhance lab capacity to improve detection and surveillance. And they were used to formally train the nation’s public health workforce, many of whom learn on the job.

Why It Matters: Public health officials and researchers were working hard to facilitate a quicker, more thoughtful response to future pandemics, of particular concern as bird flu looms and measles is having a resurgence. Mati Hlatshwayo Davis, the St. Louis health director, had four grants canceled, three in one day.

One grant that fell under the covid rubric included programs to help community members make lifestyle changes to reduce the risk of hypertension and diabetes — the kind of chronic diseases that Health and Human Services Secretary Robert F. Kennedy Jr. has said he will focus on fighting. Others paid the salaries of support staff for a wide variety of public health initiatives.

“What has been disappointing is that decisions have been made without due diligence,” Davis said.

Health-Related Impact of Tariffs

Though Trump has exempted prescription drugs from his sweeping tariffs on most imports thus far, he has not ruled out the possibility of imposing such tariffs. “It’s a moving target,” said Michael Strain, an economist at the American Enterprise Institute, noting that since high drug prices are already a burden, adding any tax to them is problematic.

Why It Matters: That supposed exemption doesn’t fully insulate American patients from higher costs. About two-thirds of prescription drugs are already manufactured in the U.S. But their raw materials are often imported from China — and those enjoy no tariff exemption. Many basic supplies used in hospitals and doctors’ offices — syringes, surgical drapes, and personal protective equipment — are imported, too.

Finally, even if the tariffs somehow don’t themselves magnify the price to purchase ingredients and medical supplies, Americans may suffer: Across-the-board tariffs on such a wide range of products, from steel to clothing, means fewer ships will be crossing the Pacific to make deliveries — and that means delays.

“I think there’s an uncomfortably high probability that something breaks in the supply chain and we end up with shortages,” Strain said.

Changes to Medicaid

Trump has vowed to protect Medicaid, the state-federal health insurance program for Americans with low incomes and disabilities. But House Republicans have eyed the program as a possible source of offsets to help pay for what Trump calls “the big, beautiful bill” — a sweeping piece of budget legislation to extend his 2017 tax cuts.

The amount of money GOP leaders have indicated they could squeeze from Medicaid, which now covers about 20% of Americans, has been in the hundreds of billions of dollars. But deep cuts are politically fraught.

To generate some savings, administration officials have at times indicated they are open to at least some tweaks to Medicaid. One idea on the table — work requirements — would require adults on Medicaid to be working or in some kind of job training. (Nearly two-thirds of Medicaid recipients ages 19-64 already work.)

Why It Matters: In 2024 the uninsured rate was 8.2%, near the all-time low, in large part because of the Medicaid expansion under the 2010 Affordable Care Act. Critics say work requirements are a backhanded way to slim down the Medicaid rolls, since the paperwork requirements of such programs have proved so onerous that eligible people drop out, causing the uninsured rate to rise.

A Congressional Budget Office report estimates that the proposed change would reduce coverage by at least 7.7 million in a decade. This leads to higher rates of uncompensated care, putting vulnerable health care facilities — think rural hospitals — at risk.

KFF Health News is a national newsroom that produces in-depth journalism about health issues.  

Banning Kratom is Foolish. Governments Should Avoid Hysteria

By Crystal Lindell

I always say the way you know that kratom is among the rare herbal supplements that actually relieves pain is that everyone is always trying to ban it. 

Unfortunately, two towns in my state - Illinois - have done just that. City councils in Marion and Herrin voted this week to ban the sale and delivery of kratom. 

The reported justifications for the bans are naive at best and outright dishonest at worst. 

According to an article about the bans, the Marion city council acted after hearing from the widow of 41-year old Blake Pieroni, who died two months ago. She blames kratom for his death.

“He initially believed, as many do, that kratom was a safe natural supplement,” said Emily Pieroni. “The first time he tried kratom was when the owner of a gas station here in Marion offered Blake kratom as an energy shot. He told him it was like a 5-Hour Energy, but safer and more natural.”

I was especially interested in this anecdote because it would indeed be quite noteworthy if kratom alone had directly caused someone's death. Such cases are incredibly rare. However, when I looked into it, I quickly found that this was not the case. 

In fact, Emily Pieroni has written publicly that her husband died by suicide. She even includes this information in her Change.org petition asking for kratom to be banned:

“At first, it seemed harmless — just a boost of energy. But it quickly became an addiction. He tried to quit three times in seven months. The withdrawal was unbearable. Eventually, the emotional toll was too much, and kratom addiction led my husband to take his own life.”

Someone committing suicide is not the same thing as someone accidentally overdosing on a substance. If her husband had been trying to avoid coffee when he died, would that be enough to blame caffeine for his death? No. 

While I’m sympathetic to the immense grief Emily Pieroni is no doubt going through, especially as someone who has lost a loved one to suicide myself, her advocacy to have kratom banned is going to cause more harm. 

In fact, it is because she is still dealing with such raw grief that the Marion and Herrin city councils should have acted with clearer heads. 

Instead, they embraced kratom hysteria, with Marion Mayor Mike Absher even calling it “gas station heroin.” 

I want to be very clear here: Kratom is not gas station heroin. It’s an incredibly mild supplement similar to coffee. In fact, kratom comes from the leaves of the Mitragyna speciosa tree, which is literally part of the coffee family.

I could also call coffee “gas station meth” but that doesn’t make it true. And it would actually be more accurate to describe kratom as “herbal coffee.”

Because in reality, kratom helps countless people, including me. I have taken kratom for years for chronic pain. It is the only thing sold over the counter that actually helps me. 

For me, kratom withdrawal symptoms are as mild as withdrawing from coffee. Yes, some people may struggle to stop drinking coffee completely, but we as a society have decided that does not mean coffee should be illegal.

I also want to note that the Herrin city ordinance bans “possession” specifically, which means police can now use it to cite or even arrest people who bought kratom elsewhere, ensnaring them in the legal system and all its ill effects. 

Many kratom users are just people with chronic pain or other health issues looking for relief. We should let them use kratom in peace. Kratom is legal in most states and the vast majority of people use it safely. About 100 deaths have been linked to kratom use, but other drugs and illicit substances were usually involved. 

I hope that other towns and municipalities considering kratom bans will also consider the immense harm those bans will cause. 

Kratom is a very mild alternative to other drugs that treat chronic pain and other health issues. That should be celebrated, not demonized. 

Instead of trying to falsely claim that kratom is the same as heroin, we should be lauding the fact that it’s nowhere near as strong as heroin, and yet it is still quite effective at treating pain.

A Pained Life: Riding the Medical Merry-Go-Round

By Carol Levy

I recently went to an Urgent Care clinic because the left side of my face -- the side with the trigeminal neuralgia and phantom pain -- was swollen.

Had it been the right side of my face, I have no doubt they would have prescribed antibiotics and sent me home. Instead, because it was the left side, it became a major issue of “What is it?”

That earned me another ride on the medical merry-go-round.

Urgent care recommended I see an otolaryngologist; an ear, nose and throat specialist. He did nothing for me, but did pronounce, “Yep, it's swollen.”

My family doctor prescribed steroids, ordered blood tests, and a CAT scan of my facial bones. That was no help.

Next came a dermatologist who said, “No idea. See your neurologist.”

So I did. She ordered an MRI of my facial bones and more blood work. Again, all negative.

My GP suggested another otolaryngologist. The second one said she didn’t know what was causing my face to swell, but prescribed an antibiotic anyway.

At the next appointment, I was floored when she asked, “Has anyone else told you your face is swollen?”

That implied I was making it all up. Even though the swelling was obvious. 

Pain is not obvious.  Articles tell us not to exaggerate our pain or to pretend that we’re not in pain. The lesson seems to be to avoid stigma or judgement by not indicating one way or another if we have pain.

Is it any wonder then that we're asked, “Are you sure it's really that bad?” Or it’s suggested that we’re not really hurting, and could work or get out of bed if we really wanted to.

Being questioned about the reality of our pain is an awful discussion to have. We say we have it. That should be enough. And to some doctors, very few it seems, it is.  We say we have pain and they accept it.

Then, of course, there are the doctors whose philosophy is “seeing is believing.” Because our pain is often invisible to the eye, they refuse to believe us.

Until now, it never occurred to me that also applies when we go to a doctor with a normal everyday complaint. They still didn’t believe me, even when the swelling was plainly visible.

I still have the swelling. No one has figured it out. It’s just one more instance where a chronic pain condition interferes with getting the medical care that we need. And send us for another ride on the merry-go-round.

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 30 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here. 

I Hate That I Need Opioid Pain Medication

By Crystal Lindell

I genuinely hate that I need opioid pain medication. 

I hate that I need it to function. I hate how expensive it is. I hate how I have to endure background checks like drug tests and interrogations to get it — like I was a criminal. 

I hate how tired it makes me. 

I hate that I can’t just buy it over-the-counter. I hate that I have to deal with judgmental doctors and pharmacists every single month to get it. I hate how vulnerable it makes me feel. I  hate how much stigma there still is around it. 

I hate that I hate it as much as I do, and yet people still think that I only take it because I’m a lazy loser who loves to get high. 

I hate that when I take it — it actually works — because that just shows how much I need it. 

Chronic pain sucks. But needing daily pain meds for a chronic condition also sucks. 

I have gone to great lengths to try to get off opioids — to try to live without them. 

I’ve done painful nerve block procedures, weekly lidocaine infusions at a hospital over an hour from my house, and gone to every specialist in that hospital. I’ve tried THC, kratom, nicotine gum, wine, and capsaicin cream. I’ve tried yoga, chiropractors, and acupuncture. I’ve tried gluten-free diets, losing weight, daily walking, and prayer.

I’ve also tried to just live with the pain. 

But I can’t. I still need opioid medication. 

I need it to shower. I need it to work. I need it to relieve the pain that makes me suicidal if left untreated.

Without opioid pain meds, I’d either be too disabled to function, or in too much pain to live. 

And I hate that so much. 

I wish that was not the case. I wish I could just exist in this stupid world without needing opioids to be alive, to actually live. 

I wish there was some other way to manage my chronic pain or even better, that I didn’t have chronic pain to begin with.

But alas, that is not the case. I literally need opioid pain medication to survive. 

So I keep taking it. 

I keep submitting to all the stupid hurdles put in place by doctors, pharmacists, and the DEA. I keep coming up with money to pay for my appointments and prescriptions. And I keep enduring the stigma that comes with it.

But I still have hope that one day people who need opioid pain medication won’t have to hate that they need it. That they’ll have access to it, and that they won’t have to submit to dehumanizing treatment to get it. 

I hope that one day needing opioid pain medication won’t be a burden to patients that must be endured on top of whatever ailments they already have. I’d rather they just bring the relief they were intended for.

The healthcare system doesn’t have to be like this. We can change it. Opioid pain medication could be accessible, inexpensive, and stigma-free. We just have to make it so.

Forced Tapering: Only Chronic Pain Patients Are Treated This Way

By Neen Monty

Imagine this: A patient, let’s call her Sue, has severe depression. Her GP prescribes an anti-depressant and refers her to a psychologist. Sue is advised to come back in four weeks. Which she does.

She’s not doing better, so the dose is increased. Sue is reviewed two more times over the next eight weeks, and each time her dose is increased.

Sue starts feeling better. The medication is working. The darkness has lifted, the black dog has been banished. She is grateful to her GP.

The GP is also happy. It has taken many weeks, but the GP raised the dose to find the minimum effective dose that controls Sue’s depression.

Sue comes back in another four weeks. She is happy, back at work, and socialising again. Life is good!

That’s when the GP tells her that it’s time to taper the anti-depressants.

Wait, what?

Or how about this: Sue has high blood pressure. She is at her GP for her yearly physical and the hypertension is discovered. The doctor prescribes a blood pressure medication and advises Sue to return in two weeks. At this review, her blood pressure is still too high, so the dose is increased.

Sue has two more dose increases, and her blood pressure falls into the normal range. She is experiencing no side effects and is very happy with the treatment.

When Sue sees her GP again with perfect blood pressure, he is pleased. Then he tells her it’s time to taper off the medication.

What if Sue had high cholesterol? Or high blood sugar? Or asthma? Epilepsy maybe?

I think you see where I am going with this.

The tapering would never happen, because it’s ludicrous and makes no sense, medically or otherwise. In these situations, people like Sue are often advised that they need to be on a medication for rest of their lives.

Where in medicine do doctors increase the dose of a medication until the symptoms are well managed and the patient is doing better -- and then gets tapered?

Only when the patient has chronic pain and is on opioid therapy. Doctors will prescribe a trial of opioids, which prove to be effective. The patient reports well-controlled pain, no significant side effects, and they are back at work, socialising, and living life again.

And then the doctor starts tapering the opioids. Against the patient’s wishes.

Utter insanity.

That’s not “evidence-based medicine.” There is no evidence to support this practice. I know what the theory is, and what doctors have been taught. But it’s not realistic. Yet many doctors don’t question it.

The theory is that once a patient gets pain relief, they will learn how to manage it without opioids. They’ll start to exercise and meditate, see a psychologist, work on their sleep hygiene, and get proper nutrition.

Except these other modalities will do nothing for severe, disabling pain.

Please point me to one study that shows that improving sleep will reduce the pain of multiple sclerosis, chronic inflammatory demyelinating polyneuropathy, or Parkinson’s disease. Or one study that shows cognitive behavioral therapy or mindfulness will reduce the pain of rheumatoid arthritis and lupus.

Those treatments may be helpful in very small ways. But their effect has been vastly overstated for chronic secondary pain -- pain that is caused by an injury, tissue damage, or disease.

Lifestyle modification can have an impact on a person who has mild to moderate primary pain -- chronic pain that does not have a known pathological cause. That pain is sometimes driven by emotional or psychological causes, so psychological treatments might be effective.

But they are ineffective for chronic secondary pain.

People will feel better on opioids, but its not “euphoria.” It’s because they can start exercising again, restart their hobbies, and return to work. They’ll feel happy again. Those positive things happen because their pain is now being treated.

Take away the pain medication, and the pain will return. The career grinds to a halt, the social life disappears, depression returns. Exercise is impossible while in severe pain. Everything returns to terrible.

There is no magic trick that can replace opioids. There is nothing else that will touch severe pain, be it acute or chronic.

And so, for doctors to provide a trial of opioids for secondary pain with the goal of eventually tapering patients is insanity. The only reason opioids should be tapered is if there are intolerable side effects, if they are not effective for the pain, or the patient wants to taper.

No one should be forcibly tapered. Ever. Forced tapering leads to a pain crisis, suicidal ideation, overdose and death. That’s what the science says.

Opioids are safe and effective when taken long term by a select minority of people – those who live with severe, disabling pain due to an incurable disease or injury.

Think about how cruel it is to provide them with a solution to their pain, to give them their life back, and then take it away.

Its abhorrent.

Its barbaric.

It’s not medicine. It’s not science. It’s not human.

Neen Monty is a writer and patient advocate in Australia who is dedicated to challenging misinformation about pain management. Drawing on lived experience and scientific research, Neen has created a website for Pain Patient Advocacy Australia that is full of evidence that opioids can be safe and effective, even when taken long term. You can also subscribe to her free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

Top 3 Ways I Make Money While Living With Chronic Pain

By Crystal Lindell 

Living with chronic pain can make it difficult to navigate traditional employment, due to the physical challenges and the unpredictability of our symptoms   

Unfortunately, we still need money to exist in our society, so I cobble together a living every month with various side jobs that I try to make into a whole job. Below is a look at some of those jobs, and the pros and cons of doing them if you have chronic pain or any sort of chronic illness.  

One large disclaimer is that none of these jobs offer health insurance. For me, for now, that just means that I don’t have insurance and I pay for medical care with cash. But I know a lot of others in a similar situation who either qualify for government insurance or they are able to purchase insurance on the government marketplace. 

Another disclaimer is that having a bunch of side jobs will make doing your taxes much more difficult, so try to put money away for that throughout the year in preparation for it. 

DoorDash

Pros: Flexible schedule, options for same-day pay, low barrier to entry. 

Cons: Success varies greatly based on where you live; the work can be physically exhausting; customers can be unpredictable and difficult; and there’s wear and tear on your car.

I started doing DoorDash in March after my cat Princess D was diagnosed with feline diabetes, and I needed to come up with some extra money for her treatment fast. 

I had a friend who told me she made $400 in four days doing DoorDash, and that was enough incentive to get me to sign up for the Dasher app. 

I live in a rural area where there are few DoorDash customers, so I drive about 20 minutes to a mid-sized city, where there are more customers and I can easily make $100 in about 4-6 hours of work. I’ve noticed that about 10 percent of my earnings go to gas, so I usually do one extra order each night to cover that. 

While there is the possibility of very low-paying orders of just $2, as long as customers tip, each order is usually at least $5 or as much as $15 in my area. 

There’s also an option to do “shop and deliver” orders, where you basically do someone’s grocery shopping. You don’t get offered those jobs at first, but as you get more experience in the app, they will start to give them to you. I had one that paid $60 for a little over an hour of shopping, because I was shopping three grocery orders simultaneously. That’s a great way to increase your earnings. 

I really, really like how flexible DoorDash is and that they offer a couple different ways to get paid the day you work. So if you need some quick cash for something like a utility bill or even just a fun outing, it’s possible to make the money fast and get paid fast. 

In the beginning, I worked mostly dinner hours and focused on Thursday through Sunday, because that’s when the app is the busiest. But after you earn various status levels, they give you more options for working whatever hours you want. Now I’m able to go out during the day, if that works for me. 

Best of all, if I’m having a bad pain day, I don’t do Doordash or can I work a very short shift. That’s flexibility that most traditional jobs don’t offer. 

Plus, if you need to stay below certain income thresholds to qualify for government benefits, it allows you to work exactly as much as you want/need to. 

If you decide to try it, I highly recommend joining some online DoorDash support groups on places like Facebook and Reddit. They are full of tips for drivers and can help you navigate the app and the job as a whole. 

Obviously, doing gig work like DoorDash will put a lot of wear and tear on your car, so you’ll need to keep up with vehicle maintenance. 

But if you’re looking for quick cash that you can make working your own schedule, then DoorDash and other similar gig work like UberEats can be a great way to do that. 

Freelance Writing

Pros: Some flexibility, can pay well, and can often be done at home

Cons: High barrier to entry; basically have to have connections to get work; and the work can be very unsteady.

I have a lot of professional experience as a writer and editor, so after I got laid off from my full-time journalism job in 2022, I had a few people reach out to me with freelance opportunities. 

This has been one of the better paying ways I make money, with some jobs paying as much as $50/hour or more. 

Even if you don’t have experience, that doesn’t mean you can’t freelance. If you have a special skill of any sort, whether it’s painting, photography or house cleaning, you can usually just post on your social media that you’re looking for work and you may be surprised by how many people reach out. 

My main advice would be to charge by the project rather than by the hour, so that you don’t have to track your hours as you go, and you don’t have to worry about any awkwardness between you and the client regarding how fast you’re working. 

If you’re setting your own rates, you have to factor in taxes and healthcare, so you should aim to make about as much per hour as you’d want to make yearly if you multiplied it by 1,000. So if you want to make $60,000 a year, you’ll want to charge a rate that works out to about $60/hour.

The biggest con to freelancing is that the work can be unsteady, which means you can’t really count on the income from month to month. For me, it’s usually based on what the publication or company I’m writing for needs at any given time. If they don’t need me, there’s no work, and thus, no money. 

Also, in the last few years, Generative AI, like ChapGPT, has dried up some of the writing and marketing work that used to be more plentiful for me. I suspect that trend will continue for my industry and others. 

However, I love writing, and freelancing allows me to be choosy about which writing jobs I want to take, so that I can focus on the things l’m passionate about, like writing for Pain News Network. Plus, making any money at all from my writing always feels like a victory to me. 

Selling Used Lego Online 

Pros: Fully done at home, can lead to a decent daily income stream, immediate pay, and it’s fun.

Cons: Relatively high barrier to entry because you have to invest in Legos and set up your own virtual store. It takes many hours of work to get things off the ground.

My fiance and I also run a virtual store where we sell used Lego. We buy bulk Lego from private sellers, wash them, sort them, inventory what we have, and then sell them by the piece. 

I’m not entirely sure I would really recommend this unless it’s something you’re passionate about, as it has been a LOT of work to run the store. And we have to use multiple rooms in our house to store Lego. 

We’ve also had some generous help from relatives, who have helped front the cost of the bulk Lego purchases we get, which helps a lot. 

But we’ve been running the store for a few years now, and it brings in a very steady stream of daily proceeds. And the more we expand the store, the more we tend to make. 

It’s also great to be able to work on the store at home and on our own schedule. 

There are other ways to make money selling used items online, and I know a lot of people make a living selling things on sites like eBay. But again, I really don’t recommend it unless it’s a product you’re really passionate about. 

For example, if you already love thrifting clothes, you may be able to find some cheap but valuable items that you can resell online. But you’ll quickly grow bored and frustrated with how much work is involved if you don’t love the process of sourcing in the first place. 

I will confess that even with all of these jobs, we are often tight on money. But we are very rich in other ways. We choose our own schedules, we are happy, we are able to rest when our bodies need it, and we get to spend a lot of time with our beloved cats. 

Maybe some day I’ll be healthy enough, both mentally and physically, to work full-time again, but for now, I’m just enjoying this chapter in our lives and all the flexibility it gives us. 

How I Learned to Sleep Better and Keep My Mobility

By Madora Pennington

What do you lose when lose your ability to get up, walk, move about, and do things for yourself?

Independence.

Moving your body around requires muscles, stability, balance, good joints, and brain function. If that is lost, you need others to help you do things.

You may not be able to do your own cooking and cleaning. Getting groceries yourself might be too difficult. Even if you get them delivered, you might not be able to put them away. You risk falling and getting injured or not being able to get up. You miss out on social events. You may find yourself isolated and depressed. You’ll need more healthcare services. You might even end up in assisted living.

The number one cause of disability in the United States is loss of mobility, affecting 13% of adults. Many chronic conditions can lead to it: Parkinson's, multiple sclerosis, diabetes, arthritis.

One thing has been shown to slow the loss of mobility for all of them: good sleep.

A 2024 study followed over 70,000 women for eight years. Those that slept enough kept their ability to move and use their bodies. Those that didn’t reported being very sleepy during the day and lost mobility over time.

It seems that no matter what your chronic condition is — or even if you have none – sleeping too little may speed you towards disability.

These results are not surprising. A healthy diet, exercise, and good sleep are accepted as pillars of good health. Improving diet and exercise can be hard, requiring time, effort and education. But solving poor sleep can be a nightmare.

Here are some things I learned from a therapist years ago, when I was having night terrors every night. I would awaken in a state of hyper-arousal, confused about where I was and very afraid. I was diagnosed with PTSD, which is thought to be a disorder of circadian rhythm.

My body, I was told, had lost its sense of when it was time to rest and rejuvenate, and when it was time to be in action and face challenges. The therapist recommended fixing my dysregulated internal clock.

You do that by making sure the bedroom is used for sleep only. That means you avoid hanging out in bed or the bedroom — no eating, no watching TV, no knitting, reading, whatever.

“Can I fold the laundry on the bed?” I asked.

“It would be better to do it elsewhere,” the therapist said. “Stay out of your bedroom during the day as much as possible, so the bedroom itself signals sleepy time.”

Another tip was to avoid bright lights in the hours before bedtime. And to get some red lights to mimic the sun setting.

If you lie in bed feeling anxious and frustrated, you risk training your brain and body that the bed is a stressful place and not for sleep.

If you can’t sleep or go back to sleep, get out of bed and leave the bedroom. Keep the lights low, or even better, make them red. Move around. Unload the dishwasher. Pet the cat. Get right back in bed when drowsiness returns.

Get into bed at the same time every night, before 10 p.m. Set an alarm and get out of bed after eight hours, no matter what. No naps. Don’t confuse the body.

As odd as they seemed at the time, these simple suggestions went a long way in improving my sleep and my whole PTSD phenomena. I still stick to them. I don’t read, relax or watch TV in bed, unless I’m doing it as part of my bedtime routine. If I am sick, I rest elsewhere during the day.

I’ll admit, I do love a weekend nap sometimes. But I only take one if it’s before 2 p.m. Any later than that, and I might not fall asleep easily at night, a habit I do not want to promote.

When I do take a nap, I sleep upright on a bean bag or the couch, with the curtains open and a video playing. That way, my body understands this is a shallow nap – I have not entered a different time zone.

To wake up refreshed and rested is a gift to yourself and those around you. Many issues can prevent regular, deep, restorative sleep. Pain is a sleep interrupter. Antihistamines, benzodiazepines, opioids and alcohol may help put you to sleep, but keep you out of the REM stages of sleep that are needed for repair.

Find knowledgeable practitioners and good advice to help. The right solutions for good sleep are the ones that work for you.