Last year, I served on a committee looking into reasons for resistance by the healthcare community to adopt opioid prescribing guidelines. At first blush, this reluctance was perplexing.
Opioids are certainly in the news. The US Surgeon General recently issued a statement on the relationship between their widespread use for chronic pain and the subsequent epidemics of opioid addiction and accidental overdose (US Surgeon General, 2016). The US National Institute for Drug Abuse and Centers for Disease Control have also issued concerns (see here and here, respectively). Mainstream media reports on the problems of opioids appear almost daily.
We tend to stigmatize pain because we misunderstand its nature. Specifically, we fail to acknowledge the role that the nervous system plays in producing the experience of pain. If we more fully appreciated this role, we would understand that chronic pain is similar to other health conditions that we don’t stigmatize much, such as high hypertension (i.e., high blood pressure) or type II diabetes.
On initial reaction, it might seem absurd to talk about the benefits of self-managing chronic pain without opioid medications. "What," one might ask, "would you use to reduce pain? You wouldn't want to live the rest of your life in pain, would you?" The topic seems absurd because pain reduction reflexively seems so important. Indeed, pain reduction from the use of opioids seems so important that it trumps everything else, even problems associated with the use of opioids.