As a pain patient with over 20 years of successful opioid treatment experience, I’m offended by all these pain guidelines that assume I am stupid and lazy (if my pain is even real in the first place) and that my doctor is ignorant and negligent.
I’m insulted by all their extremely negative assumptions and appalled that they broadcast such a devastating stereotype of pain patients. Coming from the central government these guidelines stigmatize patients more powerfully than anything I’ve seen so far.
They paint pain patients as lying, lazy, ignorant, whining scammers, assuming the very worst of human motives and behavior. This reminds me of the psychological truth that we are generally most bothered by others when they reflect our own shortcomings.
This leads me to the inference that the rule-makers themselves are actually the lying, lazy, ignorant scammers they accuse pain patients of being.
The lies are exhibited in the deliberately flawed statistics they used, the laziness is evident in their refusal to work on the real problem, which is addiction, ignorance is obvious in their many flawed assumptions (that they believe are facts), and the scam is that they are trying to make people desperate enough to submit to extremely profitable interventional surgeries or push them into extremely profitable addiction recovery programs.
The people who are fabricating all these new rules about opioids assume I don’t exercise (and probably never have), that I’m totally out of shape, that I’m completely unaware of nutrition and eat nothing but junk food.
They assume I went whining to my doctor with some annoying aches and pains (which I mainly brought upon myself), upon which my doctor just whipped out a prescription pad and prescribed huge amounts of opioids, for which I keep getting refills even though I haven’t been examined in years.
Why do the guideline writers assume that opioids are one of the first pain management methods prescribed by doctors and used by patients?
They assume I didn’t already spend thousands of dollars to try multiple ineffective “alternative” medicine treatments (which also have no evidence for long-term effectiveness), that I didn’t try multiple rounds of physical therapy.
They assume I never tried non-opioid medications, that I never almost lost my sanity taking the recommended antidepressant (Cymbalta), that I didn’t almost fall down with dizziness from the recommended anti-epileptic (Lyrica), that I didn’t buy and consume huge bottles of ibuprofen and acetaminophen tablets.
And they insult me even further by claiming I’m so unaware that I’m “thinking myself into pain”.
They assume I haven’t already for years applied mental techniques to reduce my pain perceptions, that I haven’t been scouring the psychological literature for decades seeking mental pain remedies and that I haven’t tried all kinds of “visualizations” and meditations.
They assume I’m catastrophizing, magnifying my negative thoughts, dwelling on my pain, and that I need Cognitive Behavior Therapy to straighten out all my “not really true” negative or fearful thoughts.
But what if anticipating catastrophic pain and fatigue is not just a negative belief, but an appropriate life concern?
The guideline writers never consider the “on the ground” realities–physical, emotional, social, financial–of living in this country with permanent and constant pain.
They assume I’m just a dumb, passive and exceedingly annoying pain patient, someone who doesn’t know anything about their body and doesn’t want to know, someone just complaining and waiting to be fixed by a magic pill.
They assume I haven’t suffered enough, am not desperate enough to do anything and everything in my power that has even a tiny chance of easing my pain.