Bridging the Divide: Chronic Pain, Addiction, and the Compassion We All Deserve

There’s a tension in medicine that many people feel but few want to talk about: the strained relationship between chronic pain patients and people living with addiction. As someone who has treated both, and who has lived with serious chronic pain myself, I think it’s time we opened that conversation with compassion, honesty, and nuance.

My personal journey with pain

In 2023, I had two spine surgeries within seven weeks of each other. I lived through months of neuropathic pain, limited mobility, and the emotional toll that comes with feeling like your body is betraying you.

I’ve experienced the middle-of-the-night nerve pain that doesn’t respond to stretching or rest. I’ve stood in the pharmacy line hoping the prescription that might help is covered, or even available. I’ve felt vulnerable, frustrated, and afraid.

So I want to say this plainly to chronic pain patients: I see you. I know this isn’t easy. I know many of you are carrying a double burden of pain and of stigma. You deserve respect, relief, and individualized care.

Understanding the struggle of addiction

But I’ve also devoted my career to helping people with substance use disorders — people whose brains, often through no fault of their own, became wired to seek relief in dangerous ways. Some started after a sports injury. Others after surgery or while coping with unaddressed trauma.

Many never expected to become addicted. And yet here they are, in the throes of a disease that distorts judgment and behavior, facing a healthcare system that too often meets them with punishment instead of help.

The truth about our fractured system

Here’s the hard truth: I’ve watched chronic pain patients grow to resent those with addiction. I’ve heard them say, “They ruined it for the rest of us.” They blame "addicts" for their declining access to pain medications, tighter prescribing rules, and doctors who now hesitate to treat them at all.

And I get it. That resentment comes from a place of deep, lived frustration. But it also oversimplifies the story.

The reality is more complicated. Yes, the opioid crisis changed how we prescribe. Yes, some policies swung too far, too fast. But the shift wasn’t caused by people with addiction. It was caused by a system that failed to recognize the warning signs early, and then reacted with fear instead of thoughtful reform.

So what do we do now?

We start by rejecting the false divide. We stop pitting pain patients against people with addiction. Because the truth is, many people are both.

I’ve treated patients who developed opioid use disorder after years of being responsibly prescribed medications for legitimate pain. I’ve helped others regain control of their lives through buprenorphine or naltrexone, even while managing residual pain through integrative approaches. These conditions aren’t mutually exclusive — and neither group is disposable.

As a physician trained in both anesthesiology and addiction medicine, I believe strongly that we can, and must, care for both groups without diminishing either. Chronic pain deserves real treatment, not just regulation. Addiction deserves medical attention, not criminalization or shame. And we, as a society, must stop letting stigma dictate who is “deserving” of compassion.

Awareness and education are necessary

I’ll be honest: I’ve taken criticism online for speaking out about counterfeit pills and overdose risks. Some people assumed I was shaming pain patients or trying to take their medications away. I’m not. I’m trying to save lives.

Counterfeit pills are killing teenagers, veterans, parents, and yes, even people with chronic pain who thought they were buying real medication. Awareness doesn’t equal blame. Education doesn’t have to come at the cost of empathy.

A call for empathy and change

So to those living with chronic pain: Your suffering is real. I will always stand up for your right to access safe, effective care.

And to those struggling with addiction: Your life matters. Recovery is possible. You deserve support, not scorn.

My hope is that we can stop seeing this as a battle of “us versus them.” Because when pain of any kind is met with judgment instead of compassion, we all lose.

Let’s build a healthcare system where no one has to prove their worthiness of care. Where pain is treated, addiction is healed, and humanity is never forgotten.