Effective Opioids Declared Ineffective – by Zyp Czyk
In all the reporting about pain research, opioids are always declared ineffective for long-term chronic pain relief.
The full truth is that there have been NO long term studies and there is NO evidence proving they are INeffective either, but that isn’t mentioned.
This situation allows doctors and researchers to state only one side of the full truth, that there is no evidence opioids are effective and still feel like they are telling the “truth”.
This half-truth has created a nightmare scenario for pain patients:
- After countless medical appointments, much expense, and many trials of many other treatments, at some point, we were prescribed opioids. They are miraculously effective 95% of the time (if given in sufficient doses), so we rejoice when we finally find some relief.
- We carefully follow all the irrelevant, intrusive, and demeaning conditions of the coercive pain contracts we have to sign because these pain-relieving medicines are literally worth more than gold to us.
- Then we see a different doctor, or even the same one, and suddenly we’re told that “opioids aren’t effective for chronic pain” and “if you’re taking opioids for more than three months, you’re addicted”. No matter how much they helped, the doctor will no longer prescribe opioids.
This happened to me years ago at the Stanford Pain Clinic when I went for my initial evaluation. At that time, my diagnosis was still only fibromyalgia, and the underlying cause of my pain, a connective tissue disorder called Ehlers-Danlos Syndrome, had not been identified yet.
My evaluation for the Stanford clinic consisted of two lengthy interviews and one short talk with a physical therapist, a psychiatrist, and a medical doctor. The first two went very well and I began to think this clinic would be able to help me, but then came the visit with a Stanford medical doctor.
This doctor talked with me, mostly just speaking at me, for about 10 minutes. She was cold and clinical with a frown on her face. She fired off a few quick questions, jotted down some quick notes, and then got up to leave. As she was walking out the door, she turned back and casually mentioned that “Oh, we haven’t found opioids to be effective for fibromyalgia, so the first thing we’ll do is get you off those”, and then walked out.
I was shocked.
And then angry.
“Of course, YOU don’t find opioids effective – it’s not YOUR pain!” I thought.
The doctor’s statement alarmed me with its casual dismissal of my long and fruitless search for any other methods of pain control. Being weaned off opioids as though I were some junkie and had no real reason to be taking them is NOT what I’d come to the clinic for.
I was looking for better ways to manage my pain so I wouldn’t have to rely on opioids so much, but it was becoming clear they wanted to treat me for a presumed addiction, not for the pain that was crippling my life.
When they told me that the opioids that had been providing me pain relief for over 15 years “weren’t effective”, I began to have serious doubts about this “pain clinic”. They didn’t seem to believe that any level of chronic pain could be effectively addressed with opioids, yet that’s exactly what I’d been doing successfully for years.
Of all medications, only opioids encounter such intense opposition to the very idea that they might be effective and aren’t terribly harmful to most patients. Even beyond arguments for or against their use, the notion of their “terrible harm” is so deeply embedded in our health care system that any alternate suggestion has become, quite literally, unthinkable.
The opioids I’d been prescribed had been my last resort and the only method of pain relief effective for me. I had expected to be taught other methods of pain control so that I could taper down the opioids, but I had not imagined they would be taken away *before* providing an alternative.
Forcing patients to suffer the pain that had been relieved by medication seems like unwarranted cruelty to me, but the doctors at the Stanford pain clinic seemed stuck in the rigid prejudice that “opioids are bad” under any circumstances.
My long-term effective pain relief from opioids isn’t backed up by research or studies because only studies looking for problems with opioids are being funded and that any showing a potential benefit of opioids are ignored.
They didn’t seem to accept any input from me that didn’t agree with their predetermined ideas. This made me afraid that if I placed myself into their care and under their control, they wouldn’t listen to me even if I became desperate for pain relief.
During my interaction with the medical doctor, who was clearly the highest ranked professional I met, I saw that they would follow their own assumptions and not respond to contrary feedback. I’ve found that doctors with such a narrow focus and predetermined agenda are a hazard to my well-being, so I decided not to enter the program after all.
At such a highly regarded medical center, I had expected to meet thoughtful, knowledgeable, and compassionate individuals. Instead, I was confronted with rigid, uncompromising, and impersonal policies.
I was dismayed how quickly they tossed aside my long and carefully documented history of pain relieved by opioids just because it didn’t match their expectations.
This so-called “pain clinic” was focused more on taking away opioids and treat an imagined addiction than on effectively treating pain.
NOTE: My experience at Stanford was in 2010 and, from what I’ve heard, the program has changed considerably since then. But the prejudice against opioids continues; these days Stanford seems enamored with the idea that supposed “catastrophizing” by patients is a powerful determinant of chronic pain.
I’m convinced they have it backward, and anyone who has chronic pain eventually learns the sad truth:
Chronic pain truly IS a catastrophe
in today’s medical, financial, and social systems.