A Note to the Chronic Pain Community: We All Deserve Better Care

If you live with chronic pain and feel frustrated, unheard, or even angry about how pain care has changed since the opioid overdose crisis—you’re not alone. As an anesthesiologist and addiction medicine physician, I've read your comments, listened to your stories, and I want you to know: I understand where you’re coming from.

I've lived with chronic pain

In 2023, I had two spine surgeries just seven weeks apart. I experienced persistent nerve pain, disrupted sleep, mobility issues, and all the emotional weight that comes with not knowing if things will get better. I don’t pretend to know every pain journey, but I do know what it’s like to navigate a healthcare system while in constant discomfort and to feel like relief is just out of reach.

Many people living with chronic pain have told me they feel like they’re being punished for the opioid overdose crisis. Some believe people with addiction are the reason it’s now so difficult to access medications they once relied on. That reaction makes sense when you’ve been cut off or treated with suspicion. But I want to gently offer some context, because the full story is more complex.

How did we get here?

It’s true that there was a time in this country when far too many opioids were prescribed—more than any other nation in the world. Some providers operated “pill mills,” prescribing huge quantities with little or no patient evaluation. These were real crimes that harmed both individuals and public trust.

But many doctors were misled, too—told that these medications were safer than they were. Pain was labeled “the fifth vital sign,” and opioids were aggressively marketed as a humane solution. Some doctors did the best they could with the information they had at the time. Others have since been wrongly accused or penalized for trying to help patients in a system that changed suddenly around them. Like most things in medicine, there’s no one-size-fits-all explanation.

Where does that leave us now?

In the wake of that crisis, laws and guidelines shifted—often quickly and sometimes without enough flexibility. Doctors began prescribing more cautiously. Pharmacies set stricter limits. And yes, access became more difficult. That experience has been devastating for many people with chronic pain who were stable and functioning on these medications. I want to validate that. It’s a real loss, and it shouldn’t be ignored.

At the same time, it’s important to understand that opioid use disorder (OUD) is a medical diagnosis—not just physical dependence, but a pattern of compulsive use despite harm. It affects the brain, not just behavior. And it often begins exactly where many chronic pain journeys begin: with a prescription. This doesn’t mean everyone who takes opioids will become addicted. Most don’t. But for those who do, it’s not a matter of willpower—it’s a disease process, and it deserves treatment.

So when people say those with addiction are “the reason” others can’t get pain meds, I want to be clear: they’re not the enemy. They’re people too, many of whom started with the same trust in the medical system. It’s not helpful or fair to pit two suffering groups against each other.

Where can we go from here?

Pain care has to evolve—not by eliminating opioids, but by using them thoughtfully and in combination with other tools. That might include interventional procedures, nerve-stabilizing medications, physical therapy, movement therapies, and approaches like cognitive behavioral therapy. These aren’t easy fixes, and they’re not always accessible. But they matter. And they can help.

I speak out about things like counterfeit pills and overdose risks because they’re killing people—including teens, veterans, and people who thought they were taking legitimate medications. Raising awareness about those dangers doesn’t mean I’m trying to take medication away from chronic pain patients. Quite the opposite—I want safe, effective pain care to be available to those who truly need it.

We can hold space for both truths: that chronic pain patients deserve better options and dignity in their care, and that people with addiction need evidence-based support without stigma. We should never have to choose between compassion and safety—we can, and must, build systems that provide both.