Scientific Review Dismantles Myths Behind ‘Opiophobia’

By Crystal Lindell

“There is little evidence that physicians and surgeons prescribing opioids for short-term pain relief leads to substantial levels of opioid use disorder (OUD), addiction, or death.”

That one sentence, found in a new scientific review, cuts straight to the heart of America’s irrational fear of opioids — also known as opiophobia.

Published in ACS Pharmacology & Translational Science and authored by John Bumpus, PhD, the paper looks at the irrational fear that prescribing opioids in any capacity is harmful – and how little evidence there is to back up such claims. 

Bumpus opens his report by saying that there is a false narrative that “even short-term (seven days or less) use of opioids under medical supervision to treat acute pain will often lead to opioid use disorder (OUD) and/or addiction.”

As a result of that narrative, many healthcare professionals and policy makers believe that the best way to address this problem is to “avoid using opioids altogether or to severely limit the use of prescription opioids, especially after surgery.” 

Bumpus says many providers also assume that limiting prescriptions will significantly reduce overdose deaths. Then he adds the line that cuts to the heart of opiophobia: 

“There is, however, substantial evidence that this is not the case.”

In that one sentence, Bumpus dismantles the main argument that’s often used to claim that opioid restrictions are necessary: the idea that such restrictions are “evidence-based.” 

His report lays out how opioid-related misconceptions have led to policy decisions that are not only unsupported by evidence — but are often harmful. Anyone who has had trouble accessing needed opioid medications over the last few years will find the article both cathartic and affirming.  

Bumpus, who’s a Professor of Chemistry and Biochemistry at the University of Northern Iowa, starts the paper by defining "'opiophobia'" based on the definition shared in a 2023 paper, “Opiophobia and the tragedy of needless pain”

Opiophobia led many patients and providers to “fear, avoid or condemn the use of these compounds,” which Bumpus calls ‘the most effective family of analgesics known.”

While large chunks of the report focuses on surgical patients in post-operative pain, Bumpus says that many chronic pain patients use opioids “successfully and appropriately,” but have been “adversely affected by the catastrophization of issues and misinformation surrounding the use of opioids and the opiophobia it has generated."

Bumpus asserts that anti-opioid zealots have gone too far. 

“Although opioid-free protocols and policies may have their benefits and role, for some physicians, researchers, administrators, and politicians, the elimination of opioids appears to have become a goal in and of itself,” he warns. 

Bumpus says there's an underlying assumption "that physicians and surgeons are currently overprescribing opioids." He then adds, "Nationally, this does not appear to be the case."

While the number of opioid prescriptions decreased by about 50% from 2010 to 2022, Bumpus says deaths involving prescription opioids have remained constant. Meanwhile, fatal overdoses from illicit fentanyl and other synthetic opioids have skyrocketed.

“It does not appear that prescription opioids are the major problem here,” Bumpus concludes

He says those advocating for severe opioid limitation often ignore the adverse effects of alternatives like acetaminophen.

"For example, annually in the U.S., acetaminophen overdose is responsible for over 56,000 emergency department visits, 2600 hospitalizations and 500 deaths,” he writes. “Acetaminophen overdose is also the most common cause of acute liver failure and the most common reason for liver transplants in the U.S."

He says that "the narrative that the opioid crisis is caused by the prescribing habits of ethical, conscientious, and caring physicians is patently untrue."

Rather, what is true is that the “undertreatment of postoperative pain is a serious ongoing concern.”

Misleading Data Used to Justify Opioid Restrictions

While opioid-restricting polices may be well-intentioned, Bumpus says there is little evidence that physicians prescribing opioids for short-term pain leads to substantial levels of misuse.

For example, some of the claims used to justify opioid restrictions rely on a study that found 30% of Medicaid patients prescribed an opioid for the first time developed opioid dependency.

That is claim is misleading. The researcher was simply citing the fact that 30% of patients who filled a single opioid prescription needed a refill 3 to 9 months later. Getting a refill alone hardly meets the criteria for opioid dependency, much less addiction.

Bumpus says opioid restrictive policies have had the unintended effect of encouraging patients to store leftover opioids at home, which only makes them more likely to be misused by someone else. 

"Ironically, programs aimed at reducing access to opioids and their long-term storage may actually incentivize the hoarding of these medications," he says. 

People storing leftover opioids is understandable though, when patients fear their future pain will be untreated or they won’t be able to see a doctor.

"Long-term storage of opioid medications and self-medication may not be behaviors endorsed by the medical profession,” Bumpus says. “However, such behaviors are understandable human reactions, and they undoubtedly occur." 

Bumpus argues that while it’s illegal and medically unsupervised, using leftover prescription opioids is safer than turning to street drugs:

“These drugs serve as a relatively safe supply of opioids for people who use them,” he writes.

Ultimately, Bumpus says the public “should have access to information that accurately portrays the benefits as well as the risks associated with the medicinal use of opioids.” 

His paper is heavily researched and includes over 200 footnotes, including several PNN articles that debunk the narrative about opioid misuse being common. 

Bumpus says his paper is important for administrators, policymakers, and lawmakers to read, “so that mistakes of the past are not repeated, making sure that ill-conceived laws and policies are not put in place that do more harm than good.”

Bumpus is correct, of course, and his message is urgent. Now the medical community and policymakers just need to actually listen to him. 

OxyContin Fueled the Opioid Crisis, But Not How You Might Think

By Crystal Lindell

Attorneys General from 55 U.S. states and territories recently accepted a $7.4 billion settlement with Purdue Pharma and the Sackler family, potentially ending over a decade of legal wrangling over the company’s role in the opioid crisis.  

But much of the media coverage still doesn’t seem to grasp what Purdue Pharma actually did wrong with its marketing of OxyContin. Purdue Pharma’s original sin was not flooding the market with too many OxyContin pills – it was too few.

OxyContin’s share of the opioid market was never more than 4 percent. That small share, however, was magnified by higher dose pills, which made OxyContin more likely to be misused. 

The company drove misuse by claiming that OxyContin pills lasted for 12 hours. In reality, they only lasted 4-6 hours. I know, because I’ve been on them myself for chronic pain.

This is how the Los Angeles Times described Purdue’s marketing campaign in 2016: 

“Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours. That approach creates risks of its own. Research shows that the more potent the dose of an opioid such as OxyContin, the greater the possibility of overdose and death."

So if a patient wasn’t getting steady relief from two 10mg OxyContin a day, the doctors would be encouraged to up it to two 20mg OxyContin pills a day. In reality, it would have been better to keep the dose at 10 mg and increase the frequency to four pills a day.

Purdue was well aware of the problem. They knew the pills did not last the full 12 hours. But it was OxyContin’s 12-hour dosing regimen that was its main selling point. It was supposed to set it apart from much cheaper opioid options like hydrocodone, morphine and oxycodone. 

Here’s what happened when doctors prescribed more OxyContin pills to give patients relief, according to the LA Times:

“When many doctors began prescribing OxyContin at shorter intervals in the late 1990s, Purdue executives mobilized hundreds of sales reps to ‘refocus’ physicians on 12-hour dosing. Anything shorter ‘needs to be nipped in the bud. NOW!!’ one manager wrote to her staff.”

Purdue then encouraged doctors to prescribe higher dose 80mg pills, because the higher the dose, the more Purdue made off the pills. While the company charged wholesalers about $97 for a bottle of 10mg pills, a bottle of the 80mg version went for $630. 

The company also based the commissions and performance evaluations for its sales team on the proportion of high-dose pills they sold. 

‘The Dose Makes the Poison’

Over 500 years ago, Swiss physician Paracelsus coined the phrase, “The dose makes the poison.” For Purdue Pharma, that was especially true. It was the high doses at long intervals that made OxyContin so dangerous.

Patients would go through cycles of withdrawal as their high doses wore off early, or they would just take a few extra pills each day. That meant they would run out of their prescription early, leaving them to go through days or even weeks of withdrawal. 

And make no mistake, even short intervals of withdrawal from 80mg OxyContin would make anyone feel like hell. God forbid you run out early and have to go through that. It’s the perfect recipe for driving patients to seek other sources of relief, whether that means buying pills from someone else or buying street opioids. 

Understanding that the root cause of OxyContin’s danger was not that doctors were prescribing too many pills, but prescribing too few of them challenges the popular narrative of how the opioid crisis started.  

The actual problem was not that doctors were treating pain with opioids. They were treating pain with opioids at the wrong intervals. 

Media coverage of Purdue still often frames OxyContin as the same as every other opioid though. But OxyContin isn’t fentanyl and it’s not hydrocodone, either.

Low and frequent doses of hydrocodone are relatively safe for the vast majority of patients. Which makes sense, since the reason OxyContin led some patients to misuse was because it was literally the opposite: High doses taken infrequently. 

That message seems to get lost in current opioid-phobia coverage. Just last week, the LA Times ran a column headlined, “Surgeons give patients too many opioids. A few simple steps could curb excess prescribing”

The column is authored by Zachary Wagner, PhD, a health economist at USC, and Craig Fox, PhD, a psychology professor at UCLA who specializes in studying behavioral risk. Neither of them are medical doctors.

In their op/ed, Wagner and Fox spread the misinformation that it’s leftover post-op pills that are driving opioid deaths. They think surgeons should be encouraged to prescribe fewer opioids. 

“If we could get surgeons to prescribe only the number of pills patients need for their own use, this could greatly reduce the number of excess pills available for diversion and misuse,” they wrote. 

This is dangerous and misleading. Opioids are so difficult to get today that pain patients are far more likely to hoard their “excess pills” than to sell or divert them. Opioid diversion rates are quite low, according to the DEA, which estimates less than half of one percent of oxycodone (0.493%) and hydrocodone (0.379%) are used by someone they are not intended for. 

Do surgeons really need lectures from economists and psychology professors about what they should prescribe?

I have seen first-hand how many surgeons already give post-op patients a regimen of only ibuprofen or acetaminophen due to opioid-phobia laws and regulations. Providing adequate post-op pain relief isn’t just the ethical thing to do, it’s also important for the healing process and to prevent acute pain from becoming chronic.. 

The bottom line is that pain refuses to be ignored. People will find ways to treat it, regardless of whether or not their doctor helps them. Simply refusing to give people opioids won’t solve anything. It will, however, drive people to street drugs or to self-medicate with alcohol and other substances. 

If doctors actually want to help patients, they should still be prescribing low-dose opioids, which are relatively safe. And they should prescribe high-dose opioids to people who really need them, just at realistic intervals.

Purdue Pharma’s sins were real – but letting that justify complete bans on pain treatment only results in more suffering, not less.

Dose and Type of Opioid May Increase Risk of Constipation

By Pat Anson

Constipation is one of the most common – yet least talked about – side effects of opioid pain medication. About 80% of patients on daily opioid therapy experience constipation, even when taking laxatives, which can severely impact quality of life and sleep.

But talking about constipation brings little sympathy and often starts a round of potty jokes. When AstraZeneca aired a commercial during the 2016 Super Bowl promoting its opioid induced constipation (OIC) drug, the ad was greeted with derision..

“The Super Bowl is known for inspiring lots of eating and lavish spreads of food. So why would advertisers pay millions to air ads focusing on constipation?” asked Eric Deggans of National Public Radio.

“Was that really an ad for junkies who can’t sh**? America, I luv ya but I just can’t keep up,” comedian Bill Maher wrote on Twitter.  

All jokes aside, constipation really is a health problem. Which makes a new study at the UK’s University of Manchester all the more valuable because it identifies which opioid painkillers are most likely to be associated with constipation and which ones are not.

"Constipation is a frequent adverse event associated with opioid medications that can have a considerable impact on patients' quality of life,” says lead author Meghna Jani, PhD, an epidemiologist and Senior Clinical Lecturer at The University of Manchester. “Opioid-induced constipation has also been associated with longer hospital stays, higher hospital costs, and increased emergency department visits."

Jani and her colleagues analyzed hospital health records for over 80,000 non-cancer patients on opioids in England between 2009 and 2020. About 8% suffered from constipation severe enough to require an enema or suppository.

The study findings, recently published in BMC Medicine, show that morphine, oxycodone, fentanyl and combination opioids were associated with a significantly higher risk of severe constipation compared to codeine. Tramadol and buprenorphine had the least amount of constipation risk.

Tramadol and buprenorphine have different mechanisms of action than other opioids, which may explain their lower risk, while codeine and tramadol are considered less potent opioids.

The risk of constipation was also found to be dose-dependent. Patients taking less than 50 morphine milligram equivalents (MME) a day had the lowest risk of constipation, while those taking 50 to 120 MME daily had a risk twice as high. Fifty MME per day is roughly equal to taking either 50mg of morphine or 33 mg of oxycodone each day.

The Faculty of Pain Medicine of the Royal College of Anaesthetists says the dose above which opioid harms likely outweigh their benefits is 120 MME per day. Guidance in the U.S. and Canada is more cautious, recommending that opioid doses be kept at or below 90 MME.

This is believed to be largest study of its kind to evaluate constipation risk based on types of opioids, and one of the first to assess the impact of doses. Researchers say previous estimates of constipation rates probably under-represent their true prevalence, because constipation is often not seen as a serious issue and may not be coded in medical records. Patients may also be reluctant to openly talk about their bowel habits with a healthcare provider.

"Previously, we didn't know enough about the risk associated with specific opioids, given the different ways they act on the body, as well as the effect of daily dose,” said Jani. "This study will allow clinical prescribers and patients to make better shared decisions about what pain relief is best for them, to minimize the risks of this side effect of opioids, and thus improve patients' quality of life.

"If patients need to be on opioids, we urge prescribers to be cautious with opioid dosing, and aim for the lowest effective dose to manage pain while mitigating the risk of constipation and other side effects."

Should Pharmacists Tell Your Doctor How to Treat Pain?

By Pat Anson

Would you like a pharmacist to consult with your doctor about how to treat your chronic pain before you even see the doctor?

Given all the problems that pain patients already have getting pharmacies to fill their opioid prescriptions, that sounds counter-intuitive. But embedding a pharmacist in doctors’ offices and giving them advice is the premise behind a new article published in the Drug Topics Journal, written by Sarah Schang and Madison Irwin, who both have medical degrees in pharmacy (PharmD).   

They think giving pharmacists a prominent and early voice in your pain care will lead to better treatment and reduce the risk of controlled substances being misused. In their eyes, pharmacists “play key roles in educating other health care professionals and patients about safe and effective chronic pain management.”

Under federal law, pharmacists have a “corresponding responsibility” when filling prescriptions for opioids and other controlled substances – a legal right to refuse to fill prescriptions they consider unusual or improper. Usually that “responsibility” begins at the pharmacy level, but Drs. Schang and Irwin think it should start before prescriptions are even written for chronic pain conditions.

“Despite the high prevalence of chronic pain and its far-reaching consequences, it often has suboptimal management, typically involving a combination of pharmacotherapy that can quickly become complex and require expertise. Pharmacists are uniquely well positioned to provide this expertise and optimize medication management for chronic pain,” they wrote.

“There is an immense need for safe and effective medication management in chronic pain, and pharmacists have a unique role to play in meeting this need.”

Schang and Irwin cite several old pilot studies to support their claims. One study, published in 2018, involved 45 pain patients on high-dose opioids being treated at a large family medicine practice. A few days before their appointments, two pharmacists embedded in the practice reviewed patient charts and pain management plans, and recommended changes to their treating physicians.

Almost always, the recommendations were to taper the patients off opioids, switch to non-opioid analgesics, refer the patients to a pain specialist, and offer them a naloxone prescription to reverse overdoses. Those recommendations were often implemented.        

How did that work out for the patients? According to Schang and Irwin, there was a 14% average decrease in their daily dose of opioids in morphine milligram equivalents (MME), a tapering that was achieved “without impacting pain scores.”  

Is that what happened? Not really. A close look at the study itself shows that the average pain score went up after doses were lowered, from 5.3 before the pharmacists’ intervention to 5.5 afterward, based on a zero to 10 pain scale.

It’s also worth noting that these “high-risk” patients were on relatively high opioid doses before the intervention (135 MMEs daily). Even with the 14% reduction in dose, they were still getting an average of 116 MMEs daily – a dose that’s unattainable for most patients today due to fears about “overprescribing” opioids. Most patients in 2025 get less than 90 MME, in many cases substantially less.

Another pilot study cited by Schang and Irwin dates back to 2016. It involved a community pharmacy in an academic medical center in southern California. Pharmacists there reviewed the treatment plans of 23 patients on high dose opioids and recommended changes in their treatment, such as tapering, regular drug tests, and naloxone.

How the changes impacted the patients’ pain levels was apparently not evaluated, but particular attention was paid to their mental health. The most common problems identified by the pharmacists were “untreated” depression, anxiety, insomnia, and substance misuse.

“Notably, substance misuse was identified in nearly a third of patients, which allowed for subsequent referral to substance use disorder treatment when appropriate. Similar interventions in the community pharmacy setting also demonstrated significant value, with pharmacists identifying unaddressed issues with mood in nearly two-thirds of patients and increasing the uptake of naloxone,” Schang and Irwin wrote.

Being referred to addiction treatment or a psychiatrist probably isn’t the goal of most pain patients, who simply want their pain managed. That would go a long way toward resolving their “unaddressed” mental health issues.

Many pain patients today are already frustrated with pharmacists. They can’t get their opioid prescriptions filled due to opioid rationing, and are tired of the stigma and hostility they often face at pharmacies. The pharmacy industry itself is also going through a major contraction, with big chain pharmacies closing thousands of stores, leaving behind a dwindling supply of overworked pharmacists who are just as frustrated as the patients.

This is probably not a good time to embed pharmacists in clinical practices, and make a bad situation even worse.

Meloxicam Almost Killed My Mom, Now FDA Has Approved an IV Version

By Crystal Lindell

Buried in the fine print for the newest non-opioid pain medication to be approved by the FDA is a stark warning that hits close to home. 

The FDA just approved Xifyrm, which is the branded IV version of the non-steroidal anti-inflammatory drug meloxicam for adults with moderate-to-severe pain.

It offers once daily dosing, and of course, manufacturer Azurity Pharmaceuticals highlights the fact that "Xifyrm provides a non-opioid analgesic" in its press release about the drug. 

There’s just one problem: it’s the same drug that almost killed my mom in 2022. 

If you look at the fine print in the prescribing information, you’ll see the disclaimer that points to one of the major risks that come with this medication. 

"NSAIDs, including meloxicam, can cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal,” Azurity warns.

They go on to say that these serious adverse events “can occur at any time, with or without warning symptoms.”

And 4 out 5 patients who develop these complications have no warning signs at all. 

Azurity then shares how common these complications are, writing that they occur in “1% of patients treated for 3-6 months, and in about 2-4% of patients treated for one year.”

They also add that “even short-term NSAID therapy is not without risk.”

Unfortunately, my mom was in the group of 2-4% of patients who were treated with mexlicam for one year and then had serious complications. 

Her doctor gave her the oral version for chronic hip pain because he didn’t want to give her opioids. She took it exactly as prescribed, and about one year later, meloxicam almost killed her. 

She had a very sudden and very serious perforated ulcer. 

My mom had no warning symptoms, just as the fine print for Xifyrm warns can happen. She collapsed at work and then was taken to the emergency room via ambulance. There, her sudden intense stomach pain was dismissed by staff for 9 hours before she finally got a CT scan. She was then immediately rushed into emergency surgery for a perforated ulcer. 

My mom spent the next week in critical care, unable to eat or drink anything at all for a full week while her stomach healed. 

It was a harrowing experience made worse by the fact that all of this happened during the height of the COVID lockdown, meaning none of us were able to visit her at all while she was in the hospital. 

And the thing is, she is one of the lucky ones, because she survived. 

We often hear harrowing tales of opioids causing overdose deaths, but that doesn’t mean that alternatives like NSAIDs are safe. The fact that 2-4% of patients could have a potentially fatal complication from this drug should scare both doctors and patients. 

Many doctors hesitate to prescribe opioid pain medications these days, even for post-surgical and cancer pain, and my fear is that this new IV version of meloxicam will quickly become one of their favorite alternatives, just as the oral version already is. 

Interestingly, the FDA recently released a boxed warning for veterinarians on the use of meloxicam in cats before surgery, saying repeated off-label use can cause sudden kidney failure and even death. 

When it comes to humans, it’s also noteworthy that Azuirty also makes it clear that this new IV medication shouldn’t be used alone when rapid pain relief is needed. That allows for the potential use of opioids, but I’m skeptical that doctors will heed that advice. 

A lot of doctors have an “avoid opioids at all costs” approach to pain care these days, but many of them have not reckoned with what that can actually mean for patients. They also rarely go over the true risks of NSAIDs with their patients, despite the fact that lectures about the dangers of opioids are common in medical care. 

These days, my mom is in good health, and in fact we just celebrated her 64th birthday. It’s a milestone that’s now all the more precious after we almost lost her.

I would urge doctors to exercise extreme caution when turning to opioid alternatives like Xifyrm, and other NSAIDs. They are not without risk. And in fact, they can be more dangerous than opioids. 

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. 

Pain Research and Treatment Missing From 2026 HHS Budget

By Pat Anson

An estimated 60 million Americans suffer from chronic pain, costing the U.S. healthcare system about $77 billion a year.  According to the National Institutes of Health (NIH), chronic pain affects more Americans than diabetes, heart disease, and cancer combined.

You’d never know it though by reading the proposed $94.7 billion budget for the Department of Health and Human Services (HHS) released on Friday by the Trump administration.

There are nearly 21,000 words in the 55-page budget for 2026, and not a single word or dollar is devoted to pain research, treatment, or how to help those 60 million Americans.   

The only reference to pain is a quote attributed to HHS Secretary Robert F. Kennedy, Jr.

“A healthy person has a thousand dreams. A sick person only has one, and right now, there’s 60% of the people in this country who have only one dream – that they can make it through the day without pain, with energy, without having to take medications, and we are going to change that for this country,” Kennedy is quoted as saying.

One can quibble about whether RFK Jr. actually said those exact words or if they were invented for the budget document. In either case, many Americans living with chronic pain already get through the day without taking an effective pain medication, although its not by choice.

Kennedy has previously used the line about “a healthy person has a thousand dreams,” which is paraphrased from Confucius. Kennedy used it without attribution in his Senate confirmation hearing in January and again when he was sworn in as HHS Secretary a month later, but didn’t mention pain in either instance.   

Perhaps it’s only fitting, given how the topic of pain is notably absent from the HHS budget. What we get instead are platitudes about “making Americans the healthiest in the world,” while at the same time reducing the HHS budget by 26 percent, and downsizing or eliminating dozens of federal health programs.

The NIH faces some of the steepest cuts, with its $27.5 billion budget cutback to $18 billion. The Trump administration has already gutted the NIH’s Office of Pain Policy and Planning (OPPP), which focused on pain research. The OPPP’s entire staff was fired in April.

“Even though chronic pain is one of the leading health issues in America, it has never had a true home at NIH with a dedicated institute. Many pain researchers have described the NIH as a place where ‘pain lives everywhere and nowhere,’ and now, with the dismantling of the OPPP, I fear that pain may literally have no home at all,” Dr. Juan Hincapie-Castillo, an assistant professor at UNC Chapel Hill, wrote in The Charlotte Observer. Hincapie-Castillo received funding from OPPP for his studies of trigeminal neuralgia.

‘Embrace Radical Change’

In all, HHS plans to consolidate 28 operating divisions into 15, close five of its regional offices, and end funding for 5,000 contracts – all in the name of saving money.

“This planned realignment will allow the Department to do more at a lower cost to taxpayers by increasing operational efficiency and cutting bureaucratic sprawl,” the budget document states.

“America spends nearly one-third of the federal budget on healthcare, only to rank last in terms of health among developed nations. Americans are seeing declines in life expectancy and facing the highest rates of chronic disease in the world. HHS is committed to making Americans healthy again, making the American health system the best in the world, and putting patients first. To accomplish this, we need to embrace radical change.”

HHS is planning to move several agencies — including the Substance Abuse and Mental Health Services Administration (SAMHSA) and some programs in the Centers for Disease Control and Prevention (CDC) -- into a new agency called the Administration for a Healthy America (AHA), which would be under Kennedy’s direct control. AHA will administer $14 billion in discretionary funding to combat the “chronic disease epidemic.”

“(AHA) will prioritize prevention — a missing piece in the American health system — primary care, maternal and child health, mental health, substance use prevention and treatment, environmental health, HIV/AIDS, workforce development, and policy, research, and oversight,” the HHS says.

Note the absence of pain prevention and treatment in that sentence.

Opioids are mentioned nearly half a dozen times in the budget, but only in the context of addiction treatment, not pain management. Many of the CDC programs that deal with opioid abuse and treatment are being moved to AHA, and $4 billion in block grants for mental health and substance abuse treatment is earmarked for states and rural communities.

“States and local communities best know the way to serve their populations – not the federal government,” HHS said.

When he was running for president, Kennedy had ambitious plans to create a series of “wellness farms” in rural areas, where people addicted to illicit or prescription drugs could get treatment, job training and grow their own organic food.

“I’m going to create these wellness farms where they can go to get off of illegal drugs, off of opiates, but also legal drugs, psychiatric drugs, if they want to, to get off of SSRIs, to get off of benzos, to get off of Adderall, and to spend time, as much time as they need — three or four years if they need it — to learn to get re-parented, to reconnect with communities, to understand how to talk to people,” Kennedy said in 2024.

There is no mention of wellness farms or anything like it in the HHS budget, or in the “Make America Healthy Again (MAHA) Report,” which was also released by the Trump Administration last month.

Like the budget document, pain research and treatment are not discussed in the MAHA report, which has been widely criticized for its sloppy science and fake citations, including some that were apparently generated by artificial intelligence (AI).        

Eli Lilly Bet $1 Billion on Non-Opioids: Will Pain Patients Pay the Price?

By Crystal Lindell

Eli Lilly is investing heavily in new non-opioid pain treatments with its latest acquisition. The pharmaceutical company announced this week that it was acquiring SiteOne Therapeutics in a deal worth as much as $1 billion. 

SiteOne describes itself as “dedicated to the development of safe and effective pain therapeutics without the significant addiction potential and side effects of opioids.” 

The company has been working on a new class of non-opioid medication that targets sodium channels in the peripheral nervous system to treat pain and other nerve conditions. Blocking pain signals in peripheral nerves before they reach the brain means the drug is unlikely to lead to addiction or overdoses.

Its drug STC-004 is in Phase 2 of clinical trials. In a February 2025 press release about the medication, SiteOne said it's an oral medication that would likely be taken once a day “for acute and chronic peripheral pain.” 

Eli Lilly said it has high hopes that STC-004 “may represent a next-generation, non-opioid treatment for patients suffering from chronic pain.” 

It’s noteworthy that Lilly doesn’t even mention acute pain, which suggests the company sees the most potential for STC-004 as a chronic pain treatment.  

While any advancement in pain treatment is obviously welcome, it seems prudent to remain skeptical of any company touting a new medication because its a “non-opioid.”

Vertex Pharmaceuticals recently won FDA approval for Journavx (suzetrigine) a non-opioid that also blocks pain signals in the peripheral nervous system. The FDA approved Journavx for acute pain only, despite lackluster results in clinical trials showing that it works no better than a low dose of hydrocodone.

There’s been a gold rush over the last decade by Vertex, Lilly and other pharmaceutical companies hoping to cash in on the opioid-phobia that resulted from the 2016 CDC opioid guidelines. But it remains unclear if it will just result in fool’s gold for pain patients desperate for relief. 

Mark Mintun, VP of Neuroscience Research and Development for Lilly, admits that thus far “effective non-opioid treatment remains elusive.”

According to one estimate, the global chronic pain market was worth over $72 billion in 2024 and is projected to grow to $115 billion by 2031.

With so much money on the line for any company that even partially succeeds in developing new pain relievers, resources are going to keep pouring into these non-opioid alternatives, regardless of how effective they actually are. 

The sad fact is that there just isn’t as much money in reliable, well-researched generic opioid medications like morphine, which are vastly cheaper than the non-opioids being developed to replace them. 

For chronic pain patients, the $1 billion that Eli Lilly used to acquire SiteOne would be more beneficial if it was spent on lobbying the government and medical professionals to expand access to opioid pain relievers. 

While my hope is that these types of opioid alternatives will deliver on their promises — my fear is that patients will eventually be forced onto them, even if they don't work nearly as well as opioids.

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. 

Doctors Finally Told to Take IUD Pain More Seriously

By Crystal Lindell

The American College of Obstetricians and Gynecologists (ACOG) is finally acknowledging just how painful some uterine and cervical procedures can be for women. 

They are now recommending pain treatment for in-office procedures that patients have long complained were under-addressed. 

The ACOG’s new guidelines address pain from intrauterine device (IUD) insertion, endometrial biopsy, hysteroscopy, intrauterine imaging, cervical biopsy, and other similar procedures. 

“There is an urgent need for health care professionals to have a better understanding of pain-management options and to not underestimate the pain experienced by patients and for patients to have more autonomy over pain-control options during in-office procedures,’ the ACOG said. 

While the recommendations vary by procedure, most of them involve some version of lidocaine, and a few recommend NSAIDs and naproxen. For more intense procedures and conditions like hysteroscopy, ablation, and polypectomy, they recommend local anesthesia. 

For IUD insertion, a procedure that patients have long complained was extremely painful, the ACOG recommends local anesthetic agents. More specifically, they recommend applying lidocaine cream, lidocaine spray, or a paracervical lidocaine block injection. 

The ACOG says pain management options “should be discussed with and offered to all patients seeking in-office gynecologic procedures."

However, there is a telling couple of sentences in the new guidelines that reveal how doctor-centered the thought processes around pain management still are. 

The ACOG acknowledges that some healthcare professionals tend to underestimate the pain that patients experience and that pain management “may not be discussed with or offered to patients.” Basically, some doctors don’t believe that patients experience pain, so they don’t even bother to offer pain treatment options. 

There may also be a false belief that a pain treatment that works for one patient must work for everyone.

“Several pain-management interventions being used have limited or conflicting evidence supporting their effectiveness at providing adequate pain control during in-office gynecologic procedures,” the ACOG said.

“Health care professionals therefore must be cautious when extrapolating data on what works for one procedure to another. Shared decision making with the patient should be practiced when discussing pain-management options because options that work for one patient may not work for another.”

It’s good they are acknowledging the issue. I always say that other people’s pain is always easier to endure. Of course doctors think pain management is unnecessary – they aren’t the ones in pain!

The ACOG adds that “despite patients reporting a higher level of pain than clinicians expect, patients still report a high level of satisfaction with office procedures.”

It’s so telling that they think that patient satisfaction scores should even be mentioned when deciding pain treatment guidance. As usual, there tends to be a focus on how patient pain impacts the doctor and their practice. And it’s even more telling that they think they don’t need to treat pain as long as patients don’t complain. 

In reality, doctors should be treating pain because pain sucks, and it’s the right thing to do!

I am glad to finally see more official guidance for doctors to treat pain that patients have long reported. But if doctors would just believe their patients when they report pain, they wouldn’t need the ACOG to tell them to treat it. 

Are 1 in 10 Americans Really Using Illicit Opioids?

By Crystal Lindell

A new study claims to have found that nearly 11% of Americans reported using illicit opioids in 2024, with 7.5% of them using illicit fentanyl.

It's a startling claim, in large part because those numbers are significantly higher than what's been reported in previous research. When the National Survey on Drug Use and Health asked about illicit fentanyl use in 2022, they found that just 0.3% of American adults used it in the past year

The study by researchers at the RAND corporation and USC led to a number of splashy headlines, including one in U.S. News and World Report reading: "U.S. Illicit Opioid Use Could Be 20 Times Higher Than Previously Estimated"

That is indeed a pretty striking claim – which is a large reason I am so skeptical of the research.

How did the study authors arrive at those figures? They developed and fielded a survey with Respondi, an online platform often used in academic research. So essentially, they did an online survey of 1,515 adults.

Participants were asked about their use of nonprescription opioids within the past 12 months, with heroin and illicitly manufactured fentanyl given as examples.

Among the respondents, they found that 166 (10.96%) reported illicit opioid use and 114 (7.5%) said they used illicit fentanyl. 

While I understand that population data is often collected with a relatively small sample size, it feels rushed to claim that 7.5% of adults used illicit fentanyl based on responses from 114 people in an online survey.

It feels equally rushed to claim that because 166 people reported illicit opioid use, that must mean that 11% of the population did so. 

There are about 262 million adults in the United States. If those survey numbers are accurate, that would mean 19.7 million Americans are using illicit fentanyl. And 28.8 million are using illicit opioids. That’s a lot of people. 

Overdose Deaths Declining

Keep in mind that the CDC just reported that U.S. overdose deaths fell by nearly 27% in 2024, the largest annual decline since they started tracking overdoses 45 years ago. 

Of the 80,391 drug deaths reported in 2024, the CDC estimates that 48,422 of those deaths involved synthetic opioids, primarily fentanyl. That’s nearly 28,000 fewer fentanyl deaths than the year before.

How can fentanyl deaths be declining when so many Americans claim they used the potent and often deadly street drug?     

The numbers just don’t add up. They suggest that illicit fentanyl isn’t nearly as dangerous as we’ve been led to believe, although I doubt that that’s the point the study authors were hoping to make. 

The RAND and USC researchers say their findings add to evidence that the CDC may significantly underestimate illicit drug use and that new methods are necessary to keep better track of them.  

“Estimates of illicit opioid use are rare and typically are available only years after the information is collected, limiting our ability to monitor trends on a near-term basis,” says lead author David Powell, PhD, a senior economist and Professor of Policy Analysis at RAND. “Our study offers a method to quickly and repeatedly monitor illicit opioid prevalence at low cost.”

All of this matters because studies like this are often used to punish people who use any opioids – both legal and illegal. 

For example, if 11% of the population truly is using illicit opioids, then the medical community may use that statistic to claim that opioid prescribing is still too high and that too many prescription opioids are finding their way onto the black market. 

They might also claim more public funding is needed for the addiction treatment industry. Or that the overdose reversal drug naloxone should be required for anyone getting an opioid prescription. 

There’s also the prevailing myth that prescription opioids are what lead people to use fentanyl and other street drugs, a claim that the RAND/USC researchers believe is true.

“As the opioid crisis has evolved, attention to the role of prescription opioids has waned, even though overdose deaths from prescription opioids remain high and prescription opioids may operate as critical pathways to illicit opioid use,” they reported.  

That’s why it is so important for researchers to be more cautious in how they frame their results, and it’s also important for the media to be skeptical of research that shows extreme outlier data. 

Maybe 11% of people are using illicit opioids, and 7.5% are using illicit fentanyl. Both of those things could very well be true. But I think additional research replicating those results is needed before regulators and opioid prohibitionists act on them – especially if that means further restricting access to pain medication. 

Anti-Inflammatory Drugs May Increase Risk of Pain Becoming Chronic

By Pat Anson

Aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) have long been used to relieve back pain, muscle aches and other types of acute, short-term pain. The medications work by reducing inflammation, and are consider safer than stronger analgesics like opioids.

It turns out NSAIDs may do more harm than good by increasing the risk of acute pain becoming chronic.

In a series of studies on lab animals and humans, a team of researchers at McGill University found the NSAIDs, steroids, and other drugs that block inflammation may inhibit the body’s natural healing process. That can make the pain last longer than it should, according to research findings published in Science Translational Medicine.

“Clinical data showed that the use of anti-inflammatory drugs was associated with increased risk of persistent pain, suggesting that anti-inflammatory treatments might have negative effects on pain duration,” wrote lead author Jeffrey Mogil, PhD, a Professor of Pain Research at McGill University.

Mogill and his colleagues studied the transition from acute to chronic low back pain (LBP) in 98 adults by analyzing their immune cells. They focused on neutrophils, a type of white blood cell that is attracted to sites of inflammation and releases chemicals that promote an immune response to fight infection and heal tissue.

In participants whose lower back pain resolved and did not become chronic, researchers found evidence that their neutrophils and other natural biological processes performed normally, protecting them from transitioning to chronic pain.

Participants whose pain turned chronic showed signs that the healing process and neutrophils were impaired. This suggests that anti-inflammatory drugs that block neutrophils may interfere with the healing process by reducing inflammation too soon.

To test their theory, researchers analyzed health data from 500,000 people in the UK Biobank project, a long-term research study, to see if the medications they took for acute back pain had any negative consequences. They found that people who took NSAIDs had a higher risk of reporting chronic back pain 2 to 6 years later. Those who took antidepressants, which do not interfere with inflammation, did not have a higher risk of chronic pain.   

In animal studies, the McGill researchers found that laboratory mice given anti-inflammatory drugs had pain that lasted up to ten times longer than normal. Interestingly, mice given gabapentin, morphine or lidocaine – analgesics that do not have anti-inflammatory properties – did not experience longer pain episodes.

None of this proves anything – correlation is not causation – but it suggests that anti-inflammatory drugs may not be good for long-term pain management. They may be effective for short-term pain relief, but have the unintended effect of making pain last longer. If confirmed in future studies, researchers say their findings could have a substantial impact in how we manage pain.

“Together, our results suggest that active immune processes confer adaptation at the acute pain stage, and impairment of such inflammatory responses in subjects with acute LBP increases the risk of developing chronic pain,” researchers said. “Specifically, our data suggest that the long-term effects of anti-inflammatory drugs should be further investigated in the treatment of acute LBP and likely other pain conditions.”     

FDA Warns Again About ‘Gas Station Heroin’

By Pat Anson

The Food and Drug Administration is once again warning Americans about the harmful effects of tianeptine, an antidepressant found in supplements sold online and in convenience stores to help with energy, mood, pain and sexual performance.

Tianeptine is essentially an unregulated drug in the United States. It is not currently scheduled under the Controlled Substances Act, but is also not approved by the FDA for any medical use. It is, however, approved in low doses as a treatment for depression and anxiety in several European, Asian and Latin American counties.

The problem in the U.S. is that tianeptine is being sold in supplements without a prescription at doses up to 250 times higher than what is typically recommended in foreign drug products. At high doses, tianeptine can cause confusion, agitation and euphoria – which has led some to call it “gas station heroin.”

“I am very concerned. I want the public to be especially aware of this dangerous product and the serious and continuing risk it poses to America’s youth,” FDA Commissioner Dr. Martin Makary said in a “Dear Colleagues” letter to healthcare professionals.

“While the FDA is closely following the distribution and sale of these products, it is critical that you appreciate the magnitude of the underlying danger of these products, and disseminate information about it.”

This isn’t the first time the FDA has warned about tianeptine. In 2023, the agency warned consumers not to purchase or consume tianeptine products sold under the brand name Neptune’s Fix, which it blamed for “severe adverse events” such as seizures and loss of consciousness. A few months later, the FDA sent a warning letter to retailers telling them to stop selling Neptune’s Fix and any other products containing tianeptine.

Makary’s letter does not make clear why another warning about tianeptine is needed. It implies the drug is increasingly used by young people, but provides no statistics or examples of it harming users.

Since 2023, the FDA’s Adverse Events Reporting System has recorded less than a hundred cases of adverse health events involving tianeptine, most of them involving “persistent genital arousal disorder.”

Like other antidepressants, tianeptine can be used to relieve pain. A 2023 study on laboratory mice found tianeptine to be a fast-acting pain reliever, with low risk of addiction.

“We hope this revives the potential of using tianeptine for the treatment of chronic pain and associated conditions, such as anxiety and depression,” said lead author Venetia Zachariou, PhD, Chair of Pharmacology at Boston University’s School of Medicine. “By further refining this molecule, we could arrive at a pain treatment that is more effective, fast acting, and has a mild side effect profile.”

Other studies have show tianeptine may be effective as a treatment for asthma, irritable bowel syndrome, fibromyalgia, and ADHD. Like any drug, however, tianeptine can be harmful when its abused, taken in high doses, or combined with other drugs.

“Tianeptine is often taken recreationally, but it has also been used to self-treat a variety of ailments. It is frequently used chronically and, if stopped abruptly, users may experience withdrawal symptoms,” Makary said in his letter. “Historically, there has been a delayed recognition of fast-growing trends, such as opioid abuse and vaping addiction in youth. Let’s be proactive in understanding and addressing the use of tianeptine products.”

Cancer Patients Were Supposed to Be Exempt From CDC Opioid Guideline. They’re Not.

By Crystal Lindell

Cancer patients needing pain treatment were always meant to be exempt from the recommendations of the 2016 CDC opioid guideline, including the updated guideline released in 2022:

“This clinical practice guideline does not apply to patients undergoing cancer-related pain treatment, palliative care, or end-of-life care because… for many persons at the end of life, serious potential long-term opioid-related harms such as opioid use disorder might not be relevant.” 

A new study reveals that many older cancer patients were deprived of opioids anyway, even though they often require opioids as a first-line pain treatment.

The study looked at nearly 12,000 older adults on Medicare who were being treated for cancer from 2010 to 2020, including about 1,300 with advanced cancer or cancer pain.

Researchers found a significant 24% decline in opioid prescribing to cancer patients after the 2016 guideline was released. What did they get instead for pain relief?

There was a 7.5% increase in tramadol prescribing for cancer pain, while gabapentinoid prescribing for cancer patients rose by 25%. Even patients with advanced cancer were switched to tramadol or gabapentinoids, a class of nerve medication originally developed to treat seizures, not pain. 

“These findings suggest the 2016 guideline may have led to pain management shifts from first-line opioids to less-safe tramadol and less-effective gabapentinoids for older adults with cancer,” wrote lead author Rebecca Rodin, MD, Assistant Professor of Geriatrics and Palliative Medicine at the Icahn Mount School of Medicine at Mount Sinai.

It’s great to see the study authors call out tramadol and gabapentinoids as being “less safe” and “less effective.” Pain patients have long known that to be true, but the medical community still seems resistant to this information. 

While tramadol is technically an opioid, the DEA classifies it as a weaker Schedule IV drug, unlike oxycodone, hydrocodone and other opioids classified as Schedule II. The differentiation means doctors face less restrictions for prescribing it and less risk of going to prison. 

Gapabentin (Neurontin), pregabalin (Lyrica) and other gabapentinoids are prescribed off-label for cancer pain and chemotherapy-induced neuropathy —  even though they are medical conditions the drugs are not approved for. Gabapentinoids are not only ineffective analgesics for cancer pain, they can cause sedation and confusion, particularly in older adults.

Opioids, on the other hand, are very effective for moderate-to-severe cancer pain, with a response rate of 75% and a 50% average reduction in pain intensity.

Studies like this validate what the pain community has been trying to warn about for almost a decade: opioid-phobia has gone too far. It has reached a point where even cancer patients can’t get the pain relief they need.

Part of why this persists is that most people don’t think opioid restrictions are a problem until they or a loved one needs them. But if you wait until you’re dying from cancer to oppose opioid restrictions, it will be far, far too late. 

Of course, the other problem is, cancer is not the only thing that can cause debilitating pain. And people with other types of pain also deserve effective relief.

Another recent study by Dr. Rodin found that seriously ill patients in palliative and hospice care also have trouble getting opioids, due to inadequate supplies in pharmacies and insurance obstacles.

“The reality is that hundreds of thousands of seriously ill patients in the U.S. rely on opioids as a first-line treatment for pain. For people with advanced cancer, chronic organ failure, or other life-limiting conditions, opioids are often the only medications that can effectively control pain and allow them to function, Rodin wrote in a recent op/ed in STAT .  

Opioids have been used for centuries to treat pain for a reason: They work very well, and the risks of opioid addiction and.overdose are far less than what the public has been led to believe. 

Now we just need to convince doctors and the CDC of that. 

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.