Coming out as a Chronic Pain Pariah: Part 1

In part one of this two part series, I explain how people with chronic pain are treated like pariahs by our healthcare systems and government. In part two, I’ll talk about how consciousness raising needs to be done for the chronic pain community to get our invisible disabilities accommodated.

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Everybody already knows. I haven’t worked in years. I have to do a course of physical therapy a few times a year. I get angry a lot, sometimes inappropriately. Doctors give me the side eye, and people look at me and gasp with wide-eyed, pearl-clutching horror, when I tell them I need opioid medication to manage my pain. I am a Chronic Pain Pariah.

I decided to start this blog because I’m done with the shaming and the hiding. I want to come out and be what I am in the open, and I want to claim the label the same way other groups have claimed hateful words of othering and disdain and transformed them into words of endearment and belonging. I want to own it. And I want all the other Chronic Pain Pariahs to join me in solidarity.

People with chronic pain are hiding in plain sight. They’re in the grocery store using the electric cart; they’re at the drug store being judged and denied their medication by the pharmacist; they’re in the parking lot waiting in their vehicles because it’s too painful to join their partners in the store; they’re fidgeting in their seats at the restaurant, rocking back and forth, putting their weight on one foot and then the other, bending over, or busting out a stretch while waiting in line at the grocery store to try and avoid pain. I see you.

‘Haven’t you seen Dopesick?’ the ignorati will ‘splain to us constantly, as if one book, one movie, one addiction, is enough justification to criminalize opioid use worldwide. (“I’m sorry, did you just say you’ve been hit over the head with a dope stick?” I want to reply…).

We are being wrongly punished for the loss of life due to illicit drug overdoses and constantly bludgeoned with a false narrative that prescription opioids and doctors who prescribe them are to blame for the illicit drug overdose epidemic. “Haven’t you seen Dopesick?” the ignorati will ‘splain to us constantly, as if one book, one movie, one addiction, is enough justification to criminalize opioid use worldwide. (“I’m sorry, did you just say you’ve been hit over the head with a dope stick?” I want to reply. The show is full of gross exaggerations.) And while there’s no disputing that Purdue Pharma used their marketing machine to get doctors to prescribe in a way that created dependency to increase demand for their product, it doesn’t change the fact that opioid medication is, hands down, the most effective treatment for pain known to humankind for millennia.

Exposing the Lies

It doesn’t matter how many people say otherwise; it’s a lie. Stating that opioids are not effective for pain (whether acute or chronic) is like saying the earth is flat; like saying vaccines and masking don’t work; like saying the holocaust was a hoax. It’s like saying you have a foolproof way to lose weight and keep it off forever without dieting or exercise. Everyone knows you’re full of shit. Trying to keep opioids out of medicine is like saying people have drowned in two inches of water, so let’s prohibit water. It’s like saying people die in automobile accidents, so let’s outlaw vehicles of any kind. It’s a lie that’s being repeated because it is profitable and politically popular to repeat it.

Law enforcement benefits by characterizing doctors as criminals because they are easy prey for the Department of Emasculated Appendages (DEA), the useless, impotent government agency that was founded in the 60s to marginalize Black people and that will never be able to stop the cartels.

Moral entrepreneurs with financial conflicts of interest, one of them tied to buprenorphine according to the TheDoctorPatientForum.com, and others who get paid to testify against doctors who prescribe opioids , are trying to outlaw opioid medication (except buprenorphine!) for profit. And, I would argue, some of them seem to enjoy the fear, pain, and torture they engender.

They are exploiting the pain and misery of people who have lost loved ones to illicit drug overdoses to get them on board with wholesale opioid prohibition in medicine, and this is harming all patients, but especially chronic pain patients, who have been depending on opioid medication to have quality of life and functionality. People are dying.

The media has exploited the spectacle of it all by continually publicizing the misery associated with illicit drug overdose. Every subscription streaming service, Netflix, HBO, Hulu, etc., has dozens of drug-related TV series and movies in their repertoire. Stories about illicit and pharmaceutical drugs are always about addiction and death, drug-related criminal activity and gun violence, because Americans get off on watching violence and death on TV. The media have done a bang-up job vilifying opioid use for any reason whatsoever.

What you never hear about is how opioids saved someone’s life because they allowed them to function so that they can keep their job, take care of their kids, avoid having to go on disability and welfare, or just simply avoid the misery that drives people to suicide. When you google “opioids save lives,” all you get are links about naloxone and the evils of addiction and how everyone who’s ever stood next to a single opioid pill, or who’s ever taken and antidepressant or confided in a doctor about depression is an addict.

Exposing the Corruption

The media has made it easy for the moral entrepreneurs to start lumping in chronic pain patients with illicit and recreational users. Simply being a chronic pain patient is now a red flag in prescription drug monitoring programs (PDMPs) that are in use in nearly every state in the US, and which accumulate data from both medical and non-medical sources, including method of payment for medication, criminal justice records, insurance claims, and possibly data from banking and real estate and other commercial transactions to calculate a supposed drug abuse risk score. This is a tool that has never been tested or validated as accurate and is not approved by the FDA for use in making medical decisions, yet our doctors are required to use in on each of us, and it is known to have built-in bias against black and brown people, women, and poor people.

The PDMP was originally developed by law enforcement to target doctors who prescribe “outside the norms,” according to the weaponized CDC guidelines for opioid prescribing of 2016 and 2022. The PDMP is said by its developers to excel at finding and criminalizing doctors who prescribe opioids, particularly (again) black and brown doctors who may operate in neighborhoods that aren’t wealthy or middle class.

The CDC guidelines are written by the foxes in the henhouse. You know the saying, never let a good crisis go to waste? This is the exploitation of the drug-poisoning deaths of hundreds of thousands of people in the US for fun and profit. The CDC guidelines were written to keep pain medication away from people who need it. The prescribing “recommendations,” according to TheDoctorPatientForum.com, are based on a single doctor’s subjective experience and coauthored by practitioners who have a financial stake in Indivior, the company that makes Suboxone, a mixture of buprenorphine and naloxone, used to treat addiction that’s at least as difficult to withdraw from as morphine or heroin, and which is associated with dental decay.

Medication-deprived pain patients who are desperate for relief are vulnerable to interventional pain management predators who steer them toward expensive and dangerous procedures, such as spinal steroid injections, spinal cord stimulators and pain pump implants. Spinal steroid injections put them at risk for paralysis, stroke, adhesive arachnoiditis, and death. Desperate patients are gaslit into paying to be gaslit by lots of expensive, long-term, cognitive behavioral therapy. And they are more likely to turn to the illicit market, which will enable doctors to then characterize them as people with opioid use disorder who need, you guessed it, Suboxone! Bonus: doctors can also feed these legacy chronic pain patients into the addiction and recovery industrial complex. And it’s all okay, because we are Chronic Pain Pariahs to them, the patients nobody wants because you can’t get an easy therapeutic win out of us. In this scenario, chronic pain patients (CPPs) are transformed into nothing more than a revenue center.

What’s disturbing to me is how we, as a nation, have been exposed to the same kind of market and government manipulation we saw from Purdue Pharma, and nobody else seems to see it for what it is, or give a damn.

So, fellow Chronic Pain Pariahs, how the hell are we going to stop this madness? We can start by making the invisible visible.

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If you’re reading this, I hope you’ll comment. How do you react when someone mentions Dopesick? Do you think it’s right to punish chronic pain patients and blame the doctors who prescribe for them for the illicit drug overdose problem? How have opioids saved or improved your life? If you like what you read here, please Donate, share a link, and Subscribe for email notifications of new posts!