Treating Pain Cost an Addiction Medicine Doctor Her Job

By Aneri Pattani, KFF Health News

Elyse Stevens had a reputation for taking on complex medical cases. People who’d been battling addiction for decades. Chronic-pain patients on high doses of opioids. Sex workers and people living on the street.

“Many of my patients are messy, the ones that don’t know if they want to stop using drugs or not,” said Stevens, a primary care and addiction medicine doctor.

While other doctors avoided these patients, Stevens — who was familiar with the city from her time in medical school at Tulane University — sought them out.

She regularly attended 6 a.m. breakfasts for homeless people, volunteered at a homeless shelter clinic on Saturdays, and on Monday evenings, visited an abandoned Family Dollar store where advocates distributed supplies to people who use drugs.

One such evening about four years ago, Charmyra Harrell arrived there limping, her right leg swollen and covered in sores. Emergency room doctors had repeatedly dismissed her, so she eased the pain with street drugs, Harrell said.

Stevens cleaned her sores on Mondays for months until finally persuading Harrell to visit the clinic at University Medical Center New Orleans. There, Stevens discovered Harrell had diabetes and cancer.

She agreed to prescribe Harrell pain medication — an option many doctors would automatically dismiss for fear that a patient with a history of addiction would misuse it.

ELYSE STEVENS

But Stevens was confident Harrell could hold up her end of the deal.

“She told me, ‘You cannot do drugs and do your pain meds,’” Harrell recounted on a Monday evening in October. So, “I’m no longer on cocaine.”

Stevens’ approach to patient care has won her awards and nominations in medicine, community service, and humanism. Instead of seeing patients in binaries — addicted or sober, with a positive or negative drug test — she measures progress on a spectrum. Are they showering daily, cooking with their families, using less fentanyl than the day before?

But not everyone agrees with this flexible approach that prioritizes working with patients on their goals, even if abstinence isn’t one of them. And it came to a head in the summer of 2024.

“The same things I was high-fived for thousands of times — suddenly that was bad,” Stevens said.

Flexible Care or Zero Tolerance?

More than 80% of Americans who need substance use treatment don’t receive it, national data shows. Barriers abound: high costs, lack of transportation, clinic hours that are incompatible with jobs, fear of being mistreated.

Some doctors had been trying to ease the process for years. Covid-19 accelerated that trend. Telehealth appointments, fewer urine drug tests, and medication refills that last longer became the norm.

The result?

“Patients did OK and we actually reached more people,” said Brian Hurley, immediate past president of the American Society of Addiction Medicine. The organization supports continuing flexible practices, such as helping patients avoid withdrawal symptoms by prescribing higher-than-traditional doses of addiction medication and focusing on recovery goals other than abstinence.

But some doctors prefer traditional approaches that range from zero tolerance for patients using illegal drugs to setting stiff consequences for those who don’t meet their doctors’ expectations. For example, a patient who tests positive for street drugs while getting outpatient care would be discharged and told to go to residential rehab.

Proponents of this method fear loosening restrictions could be a slippery slope that ultimately harms patients. They say continuing to prescribe painkillers, for example, to people using illicit substances long-term could normalize drug use and hamper the goal of getting people off illegal drugs.

Progress should be more than keeping patients in care, said Keith Humphreys, a Stanford psychologist, who has treated and researched addiction for decades and supports involuntary treatment.

“If you give addicted people lots of drugs, they like it, and they may come back,” he said. “But that doesn’t mean that that is promoting their health over time.”

Flexible practices also tend to align with harm reduction, a divisive approach that proponents say keeps people who use drugs safe and that critics — including the Trump administration — say enables illegal drug use.

The debate is not just philosophical. For Stevens and her patients, it came to bear on the streets of New Orleans.

‘Unconventional’ Prescribing

In the summer of 2024, supervisors started questioning Stevens’ approach.

In emails reviewed by KFF Health News, they expressed concerns about her prescribing too many pain pills, a mix of opioids and other controlled substances to the same patients, and high doses of buprenorphine, a medication considered the gold standard to treat opioid addiction.

Supervisors worried Stevens wasn’t doing enough urine drug tests and kept treating patients who used illicit drugs instead of referring them to higher levels of care.

“Her prescribing pattern appears unconventional compared to the local standard of care,” the hospital’s chief medical officer at the time wrote to Stevens’ supervisor, Benjamin Springgate. “Note that this is the only standard of care which would likely be considered should a legal concern arise.”

Springgate forwarded that email to Stevens and encouraged her to refer more patients to methadone clinics, intensive outpatient care, and inpatient rehab.

Stevens understood the general practice but couldn’t reconcile it with the reality her patients faced. How would someone living in a tent, fearful of losing their possessions, trek to a methadone clinic daily?

Stevens sent her supervisors dozens of research studies and national treatment guidelines backing her flexible approach. She explained that if she stopped prescribing the medications of concern, patients might leave the health system, but they wouldn’t disappear.

“They just wouldn’t be getting care and perhaps they’d be dead,” she said in an interview with KFF Health News.

Both University Medical Center and LSU Health New Orleans, which employs physicians at the hospital, declined repeated requests for interviews. They did not respond to detailed questions about addiction treatment or Stevens’ practices.

Instead, they provided a joint statement from Richard DiCarlo, dean of the LSU Health New Orleans School of Medicine, and Jeffrey Elder, chief medical officer of University Medical Center New Orleans.

“We are not at liberty to comment publicly on internal personnel issues,” they wrote.

“We recognize that addiction is a serious public health problem, and that addiction treatment is a challenge for the healthcare industry,” they said. “We remain dedicated to expanding access to treatment, while upholding the highest standard of care and safety for all patients.”

Not Black-and-White

KFF Health News shared the complaints against Stevens and the responses she’d written for supervisors with two addiction medicine doctors outside of Louisiana, who had no affiliation with Stevens. Both found her practices to be within the bounds of normal addiction care, especially for complex patients.

Stephen Loyd, an addiction medicine doctor and the president of Tennessee’s medical licensing board, said doctors running pill mills typically have sparse patient notes that list a chief complaint of pain. But Stevens’ notes detailed patients’ life circumstances and the intricate decisions she was making with them.

“To me, that’s the big difference,” Loyd said.

Some people think the “only good answer is no opioids,” such as oxycodone or hydrocodone, for any patients, said Cara Poland, an addiction medicine doctor and associate professor at Michigan State University. But patients may need them — sometimes for things like cancer pain — or require months to lower their doses safely, she said. “It’s not as black-and-white as people outside our field want it to be.”

Humphreys, the Stanford psychologist, had a different take. He did not review Stevens’ case but said, as a general practice, there are risks to prescribing painkillers long-term, especially for patients using today’s lethal street drugs too.

Overprescribing fueled the opioid crisis, he said. “It’s not going to go away if we do that again.”

‘The Thing That Kills People’

After months of tension, Stevens’ supervisors told her on March 10 to stop coming to work. The hospital was conducting a review of her practices, they said in an email viewed by KFF Health News.

Overnight, hundreds of her patients were moved to other providers.

Luka Bair had been seeing Stevens for three years and was stable on daily buprenorphine.

After Stevens’ departure, Bair was left without medication for three days. The withdrawal symptoms were severe — headache, nausea, muscle cramps.

“I was just in physical hell,” said Bair, who works for the National Harm Reduction Coalition and uses they/them pronouns.

Although Bair eventually got a refill, Springgate, Stevens’ supervisor, didn’t want to continue the regimen long-term. Instead, Springgate referred Bair to more intensive and residential programs, citing Bair’s intermittent use of other drugs, including benzodiazepines and cocaine, as markers of high risk. Bair “requires a higher level of care than our clinic reasonably can offer,” Springgate wrote in patient portal notes reviewed by KFF Health News.

But Bair said daily attendance at those programs was incompatible with their full-time job. They left the clinic, with 30 days to find a new doctor or run out of medication again.

“This is the thing that kills people,” said Bair, who eventually found another doctor willing to prescribe.

Springgate did not respond to repeated calls and emails requesting comment.

University Medical Center and LSU Health New Orleans did not answer questions about discharging Stevens’ patients.

‘Patients Will Die Without Her’

About a month after Stevens was told to stay home, Haley Beavers Khoury, a medical student who worked with her, had collected nearly 100 letters from other students, doctors, patients, and homelessness service providers calling for Stevens’ return.

One student wrote, “Make no mistake — some of her patients will die without her.” A nun from the Daughters of Charity, which ran the hospital’s previous incarnation, called Stevens a “lifeline” for vulnerable patients.

Beavers Khoury said she sent the letters to about 10 people in hospital and medical school leadership. Most did not respond.

In May, the hospital’s review committee determined Stevens’ practices fell “outside of the acceptable community standards” and constituted “reckless behavior,” according to a letter sent to Stevens.

The hospital did not answer KFF Health News’ questions about how it reached this conclusion or if it identified any patient harm.

Meanwhile, Stevens had secured a job at another New Orleans hospital. But because her resignation came amid the ongoing investigation, University Medical Center said it was required to inform the state’s medical licensing board.

The medical board began its own investigation — a development that eventually cost Stevens the other job offer.

In presenting her side to the medical board, Stevens repeated many arguments she’d made before. Yes, she was prescribing powerful medications. No, she wasn’t making clinical decisions based on urine drug tests. But national addiction organizations supported such practices and promoted tailoring care to patients’ circumstances, she said. Her response included a 10-page bibliography with 98 citations.

Abandoning People

The board’s investigation into Stevens is ongoing. Its website shows no action taken against her license as of late December.

The board declined to comment on both Stevens’ case and its definition of appropriate addiction treatment.

In October, Stevens moved to the Virgin Islands to work in internal medicine at a local hospital. She said she’s grateful for the welcoming locals and the financial stability to support herself and her parents.

But it hurts to think of her former patients in New Orleans.

Before leaving, Stevens packed away handwritten letters from several of them — one was 15 pages long, written in alternating green and purple marker — in which they shared childhood traumas and small successes they had while in treatment with her.

Stevens doesn’t know what happened to those patients after she left.

She believes the scrutiny of her practice centers on liability more than patient safety.

But, she said, “liability is in abandoning people too.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues

In More Pain? Blame the Weather – and Climate Change

By Crystal Lindell

On Wednesday, three people I know all had a migraine. My mom also told me that her hip joint was suddenly much more painful than normal. And the intercostal neuralgia in my ribs hurt so bad that I spent most of the day in bed.

The next day, the temperature here in northern Illinois suddenly spiked to 53 degrees Fahrenheit – an unusual occurrence for Januar. Then the rain started and never really stopped.

The random spike to 50 degree weather – when most people here still have their Christmas lights up – felt almost ominous. And it seems our bodies agreed.   

If we lived in the 1800s, all of us could have served as our town’s meteorologist, accurately predicting both temperature changes and precipitation.

But here in 2026, many people still don’t even connect their pain flares to weather changes. And I still hear doctors dismiss the idea that weather can impact pain.

As someone who lives with chronic pain, I think the connection is obvious. I can tell you almost down to the hour when it’s going to snow. I have learned to plan my rest days around rapid temperature changes in the forecast. And when it’s sunny and clear, I sometimes find myself wondering if I have somehow been cured – because I feel so little pain!

The thing is, the reason we had a 53 degree temperature spike in the middle of winter in northern Illinois is likely due to climate change. While the warm front may have come in regardless, just how warm it got was likely amplified by global warming.

In fact, the shifting global climate means we are all experiencing weather fluctuations and temperatures that had previously been considered rare.

And our bodies have noticed.

A recent story by Inside Climate News discusses the link.

"Global warming is bringing more heatwaves and an atmosphere that sucks up more moisture to feed storms. Those thermodynamic effects of climate change often have more clear ties to pain," wrote Chad Small, a PhD student in Atmospheric and Climate Science at the University of Washington. 

“For example, gout sufferers living in Arizona—which will continue to get hotter and dryer as global temperatures increase—will likely experience worse pain due to more frequent and severe instances of dehydration driven by the increasing temperatures and aridity. That’s on top of the exacerbation of the pain by the heat itself.” 

In 2023, The University of Pennsylvania published an article titled, "Why climate change might be affecting your headaches" in Penn Medicine News.

“Rising global average temperature and extreme weather events are likely to become more frequent or more intense,” they wrote. “Experts suggest that the stress of these events can trigger headaches.”

Society at large seems to still be in denial about all of this though, at least in my experience.

For example, when the weather changes, people who get migraines don’t get more sick days or easier access to government assistance.

And while weather changes are causing more pain flares, government regulators and health officials still limit access to opioid pain medication.

Not to mention the lack of social accommodation. Friends and family aren’t more understanding about the increase in pain because of climate change. In fact, most people aren’t even more forgiving of their own bodies in that situation.

The ableism at the root of our culture in the United States still expects people to push through the pain and show up anyway – and that social pressure only increases when someone’s pain flares get more frequent.

In other words, the more climate change increases pain, the less accepting people are of it. Perhaps that’s because many are still in denial that climate change even exists.

Unfortunately, all indications are that climate change is only going to continue getting worse, which means the pain it causes will do the same.

If we are going to endure it, we are going to have to offer grace to others and ourselves when that pain shows up in our bodies.

We can’t control the weather, but we can control how we endure it.  

Chronic Pain and Complications Common After Outpatient Surgery

By Pat Anson

Outpatient surgeries are often touted for their convenience and cost savings. The surgeries are often minimally invasive, less painful, reduce trauma and recovery time, and save patients (and insurers) thousands of dollars because they don’t have to spend a night or two in the hospital in post-op care. 

But two new studies in the UK – where outpatient procedures are called “day-case” surgeries – show the benefits of outpatient surgery are not universal and often make pre-existing pain conditions worse.

The studies, published here and here in the journal Anaesthesia, involved nearly 17,500 patients, and were conducted by a team of researchers at the NHS Foundation Trust and University Hospitals Plymouth. 

In the first study, researchers found that 1 in 8 patients (11.8%) who had day-case surgery did not go home the same day and were admitted to hospital for various complications. For some patients who had prostate procedures (including those for cancer and benign prostate growth), the hospital admission rate was higher than 50%.

In the second study, one in 14 patients (7.2%) developed chronic pain or had their pain worsen at the surgery site. Some procedures had higher rates of chronic pain after 3 months, including orthopaedic (13.4%) and breast (10%) surgeries. Patients with chronic post-surgical pain also had lower quality of life scores than they did before the surgeries.

To be fair, many of the patients in the studies had chronic pain before their surgeries. Pain was already present at the surgery site in 39% of patients and was moderately severe. Chronic pain elsewhere in the body was also common. About one in four patients had opioid prescriptions prior to their surgeries, and a little over one in 10 used opioids daily. 

These were the first studies of their kind in the UK, and fill an important gap in information about the outcomes of outpatient surgery. Because the UK’s National Health Service seeks to have 85% of eligible elective operations be done as day-case surgeries, researchers expect the outpatient workload to increase and the numbers of patients with chronic post-surgical pain to also grow..

“In summary, this large multicentre UK observational study on day-case surgery provides valuable new insights into a key patient group. We have shown that chronic pain is prevalent within this cohort, with a significantly higher burden than the general population,” the authors found.

“While most patients undergoing day-case surgery were discharged on the same day, the rate of unplanned inpatient admissions was unacceptably high, at twice the national target. This finding underscores a critical area for improvement, as reducing unplanned admissions would enhance the efficiency of day-case surgery and improve outcomes for patients. We highlight the complexity of day-case surgery, where even procedures that are generally seen as straightforward can still carry potential risks, especially for certain patient groups.”

Previous studies have found that female patients had higher rates of chronic post-surgical pain. The new studies found no difference in outcomes between males and females overall, but did show that gynaecological and breast surgeries (almost all female patients) had higher rates of chronic post-surgical pain. This suggests that medical specialties –  rather than being female –- were behind the increased risk.

The studies also found that wealthier patients were less likely to have chronic post-surgical pain compared to the poorest ones. Patients of Asian, Black and mixed ethnicity were also more likely to report chronic post-surgical pain, which may be due to healthcare inequities and cultural difference in pain perception.

The 5 Most Popular PNN Stories of 2025

By Crystal Lindell

Looking back at 2025, there was a lot of news to cover when it came to chronic pain and illness. Access to opioids was again a major concern for our readers, but there was also a lot of interest in the potentially harmful effects of gabapentin.

Below is a look at the top 5 most widely read articles that PNN published in 2025.

We truly appreciate every time you read, comment and share our articles. And we can’t wait to bring you more great coverage in 2026! 

1) Over 15 Million Americans Prescribed Gabapentin Despite Warnings

In September, we covered an analysis by CDC researchers that showed that the use of gabapentin (Neurontin) continued to soar in the United States — usually for chronic pain and other health conditions the drug is not approved to treat. 

Gabapentin is the fifth most prescribed drug in the United States, with prescriptions nearly tripling since 2010, according to findings published in the Annals of Internal Medicine. The number of patients prescribed gabapentin reached 15.5 million in 2024, up from 5.8 million in 2010.

Read the full article here.  

2) Cannabis Use by Older Adults Linked to ‘Younger Brains’ and Improved Cognition

In August, we covered a study that showed that cannabis use by older adults slowed the aging of their brains and may even improve cognitive function.  

An international research team analyzed health data on more than 25,000 adults in the UK, looking at the relationship between cannabis use, aging, and cognitive function. They found that cannabis users had brain characteristics “typically associated with younger brains” and “enhanced cognitive abilities.” 

Read the full article here. 

3) 6 Things to Try If Your Doctor Won’t Prescribe Opioid Pain Medication

A lot of pain patients find that their doctors are reluctant to prescribe opioids. So in February, I shared six things to try if your physician tells you to go home and take ibuprofen.

The first tip is not to give up. Tell your doctor what poorly treated pain is doing to your life – that you’re unable to work or that you may have to go to the emergency room. Tell the truth and don’t exaggerate, and you just might get them to change their mind.

Another option is to try kratom and/or cannabis. They don’t work for everyone, but many patients say they provide some level of pain relief.  

Read the full article here. 

4) DEA Plans Further Cuts in Oxycodone Supply

In November, we covered the DEA’s plan to cut the supply of oxycodone by more than 6% in 2026, along with marginal reductions in the supply of hydrocodone, morphine and other Schedule II opioids. 

From year-to-year, the cuts may not appear significant. But over the past decade, there has been an historic decline in the nation’s opioid supply. If its current plan is adopted, DEA will have cut the supply of hydrocodone and oxycodone by over 70% since 2014.

The DEA says the “medical usage” of prescription opioids is declining, when in fact the “medical need” for them is actually increasing.

Read the full article here. 

5) Study Links Gabapentin to Increased Dementia Risk 

In July, we covered how gabapentin (Neurontin) may significantly increase the risk of dementia and cognitive impairment, even for middle-aged patients who only took the nerve medication for six months.

That was according to research published in the Regional Anesthesia & Pain Medicine journal, which looked at health records for more than 26,000 U.S. patients with chronic low back pain.

Researchers found that patients with six months or more of gabapentin use had a 29% higher risk of developing dementia and an 85% higher risk of developing mild cognitive impairment 

Read the full article here.

We hope you enjoyed reading PNN in 2025 and that you found our stories informative and helpful. We look forward to continuing our coverage of chronic pain and other health issues in 2026. 

Unlike many other online news outlets, we don’t hide behind a paywall or charge for subscriptions. PNN depends on reader donations to continue publishing, so please consider making a donation today.

Happy New Year everyone!

Review Finds THC More Effective Than CBD for Chronic Pain

By Pat Anson

An updated systematic review found that cannabis products with relatively high levels of THC (tetrahydrocannabinol) may provide small improvements in chronic pain; while those containing high levels of CBD (cannabidiol) and little or no THC had minimal effect on pain.

Researchers at the Pacific Northwest Evidence-based Practice Center at Oregon Health & Science University reviewed 25 short-term cannabis studies involving over 2,300 patients with chronic pain. Their findings are published in the Annals of Internal Medicine. 

CBD-based gummies, tablets, oils and other products have long been marketed for various health issues, but researchers say they demonstrated almost no improvement in managing pain. 

“This may be surprising to people,” said lead author Roger Chou, MD, in a press release. “Conventional wisdom was that CBD was promising because it doesn’t have euphoric effects like THC and it was thought to have medicinal properties. But, at least in our analysis, it didn’t have an effect on pain.” 

Chou, who was lead author of the controversial 2016 CDC opioid guideline and its 2022 update, said the small improvement in pain was on the order of a half point to a point on the zero-to-10 pain scale. While providing modest pain relief, THC-based products also had a higher risk of side effects, such as dizziness, sedation and nausea.   

There are several caveats to the review which make it unhelpful, at best, in determining whether THC or CBD are effective pain relievers. 

One, many of the clinical trials were deemed to be biased or of low quality. They mostly involved patients with chronic neuropathic pain, which means they don’t necessarily apply to patients with other types of pain.

Second, most of the studies involved pharmaceutical-grade cannabis-based medicines, such as dronabinol and nabilone, which are approved for nausea, vomiting and as an appetite stimulant. None of them are approved for pain relief.  

Third, those pharmaceutical medicines are based on synthetic THC, not plant-derived THC or CBD. So basically, the researchers studied products that most cannabis consumers don’t use, which makes the overall findings misleading.

“This raises critical questions about generalizability: Can findings from standardized formulations inform real-world use of diverse, cannabis-derived, state-regulated products?” asks Ziva Cooper, PhD, from the UCLA Center for Cannabis and Cannabinoids, in an editorial also published in the Annals of Internal Medicine.   

Copper says the review demonstrates the need for better evidence and less reliance on clinical trials. The inclusion of observational studies and patient reviews of products obtained in dispensaries would better capture real-time evidence of current cannabis use and outcomes. 

“There are opportunities for novel approaches to understand cannabis-related health effects. Rigorous randomized controlled trials (RCTs) are the gold standard for determining the safety and efficacy of cannabis and cannabinoids for therapeutic end points,” Cooper wrote. 

“Yet, these studies are resource-intensive, challenging due to federal regulations, and slow to adapt to a rapidly evolving marketplace and patient behavior. Expanding the scope of study designs to consider complementary strategies is urgently needed.”

Chou says the wide variety of cannabis products on the market makes drawing conclusions about their effectiveness difficult.

“It’s complicated because cannabis products are complicated,” he said. “It’s not like taking a standardized dose of ibuprofen, for example. Cannabis is derived from a plant and has multiple chemicals in addition to THC and CBD that may have additional properties depending on where it’s grown, how it’s cultivated and ultimately prepared for sale.”  

Better cannabis research is one of the reasons the Trump Administration is moving to complete the process of reclassifying cannabis from a Schedule I controlled substance to a Schedule III drug with accepted medical uses.

Because cannabis has long been illegal under federal law, it has stifled research into its health benefits, leaving patients and doctors in the dark on its potential uses. This review does nothing to shine a light on the issue.  

‘Stop This Insanity’: Pain Patients Plead with DEA Not to Cut Opioid Supply Again

By Pat Anson

Thousands of people have left public comments in the Federal Register, most of them sharply critical of the Drug Enforcement Administration’s plan to reduce the supply of opioids and other Schedule II controlled substances in 2026.

If enacted without any changes, the DEA’s proposal would be the 10th consecutive year the agency has reduced aggregate production quotas (APQs) for manufacturers of opioid pain medication. 

The biggest cut next year would be in the supply of oxycodone – a reduction of 6.24% – a pain medication that is already in short supply, according to the American Society of Health-System Pharmacists.

“When cutting the production of this medication, you are harming millions of innocent victims, whose life has been taken from injury/illness and rely on pain medication daily to survive and have a quality of life,” wrote Charl Revelo. “We are not criminals. We are innocent pain patients.”

Revelo is one of over 5,000 people who left comments in the Federal Register – a hefty turnout, given that the DEA only allowed 15 days for public comments, about half the usual comment period for quota proposals. December 15 was the last day comments were accepted.

Over the past decade, DEA has reduced the supply of oxycodone and hydrocodone by over 70 percent –  citing a decline in “medical usage” and fewer requests from drug manufacturers. 

But “medical usage” does not reflect a decline in medical need. Chronic pain has actually risen in the U.S. and now affects about 60 million people, including 21 million with high-impact pain – pain strong enough to limit daily life and work activity, which is often treated with opioids.

Despite the increase in medical need, doctors are not writing as many prescriptions for opioids as they used to, in part because they fear investigations for “overprescribing” by the DEA and other law enforcement agencies. 

“Declining prescribing does not reflect declining need. It reflects restricted access, pharmacy shortages, and policies that have pushed patients off medically necessary treatment. These quota reductions will increase harm, not reduce it,” wrote a poster who preferred to be anonymous. 

“The current atmosphere of fear around prescribing of opioids is very likely to account for the apparent reduction in use. If doctors are afraid to prescribe these medications, that leads to a decrease in prescriptions,” wrote Jonathan Rogers. “This situation has led to chronic pain patients seeking other treatment, including kratom, methadone from clinics that are set up for addiction treatment and not pain management, and adulterated street opioids.”

“Please STOP reducing the amount of opioids. Pain patients are suffering & your actions - continuing to reduce opioid production year after year - is fueling the dangerous black market & putting Americans who are desperate for pain relief at great risk. It’s irresponsible & speaks to your motives,” wrote an anonymous poster.

“Do not reduce the production of opioids. They are a necessary medication to treat patients. The previous reductions, laws, lawsuits by anti-opioid persons, and incarcerations of medical providers is already causing so much suffering and death of pain patients,” said another anonymous poster. 

“This insanity with cutting back and ultimately doing away with opioids is criminal,” wrote Brooke Moon. “Please allow doctors to practice medicine and prescribe what they deem is necessary for the treatment of pain. The suffering of millions of innocent pain patients doesn't need to continue. Please stop this insanity!”

Missed Deadlines

Several posters pointed out the DEA has repeatedly missed a December 1 deadline in the Controlled Substances Act for setting annual production quotas. That puts a strain on drug manufacturers and contributes to shortages. 

“My mother recently died of cancer and was unable to get her pain medication and died in agony. That is on you,” wrote Peter Wilson, who suffers from chronic back pain.

“You need to get your annual quotas for medications before the deadlines expire. You need to do your job and make sure there are adequate quotas of legitimate pain medication for patients who desperately need it. Don't blame this on the pharmaceutical companies whose hands are tied by your inability to come up with reasonable quotas in the allotted time.”

Other posters support a proposal for the DEA to hire a Chief Pharmacy Officer (CPO) and put that person in charge of quota allotments. A CPO would be more familiar with the drug supply system and manufacturing deadlines.

“They should have a CPO because the DEA and DOJ can't seem to stay on track by themselves. They are allowed to miss the deadline, but in a normal person's world, you would be reprimanded for missing the deadline,” said an anonymous poster.

“The DEA definitely needs to hire a Chief Pharmacy Officer to take control of the quota disaster. DEA cites lack of staffing as one of the reasons it can not get the next year's quota in by December 1. Hiring a CPO would assure that the quotas are in by the deadline and that someone knowledgeable would make an informed, reasonable decision on the amounts,” wrote another anonymous poster. 

Even with a shortened public comment period, the production quotas for 2026 will likely not be finalized until after January 1. The last time production quotas were that late was in 2024, when the quotas were not published until January 3. Drug shortages spiked to record levels in the first few months of that year, including opioid pain medications covered under the quota system.

I See Doctors All the Time, But They Won’t Treat My Pain

By Neen Monty

I am in complete overwhelm right now. It has been far too much, for far too long.

As I write this, in the last ten days alone, I’ve had seven medical appointments or treatments:

• Two GP visits.

• One neurologist appointment. And the news wasn’t great.

• My fortnightly IVIG infusion.

• A consult with a new pain management doctor. It did not go great.

• The introductory session for the public pain clinic. The first step in a very long process to see the doctor I was referred to.

• A psychologist appointment.

That’s seven appointments in ten days.

This is what being seriously ill looks like. This is what living with a disabling, incurable disease looks like.

I don’t choose for my life to revolve around my disease. The disease chooses. The disease dictates my schedule, my energy, my mobility, my ability to work, and my ability to participate in life.

When you’re very unwell, with a serious, progressive and incurable disease, there is no choice. You don’t get to opt out. You don’t get to think happy thoughts, and everything magically gets better.

You don’t get to postpone or not feel up to it today. You don’t get to decide what you do with your four functional hours a day. Your illness becomes the architect of everything.

People say, “Why don’t you try harder?”

Try what, exactly? Try not being sick? Thanks, that’s really helpful advice.

Instead of empathy, I get blamed.

You should change your diet. You should exercise more. You should get out more. You should try grounding. You should try Bowen therapy. You should read this great book I just read, it’s sooooo motivational!

You should read up on stoicism, it would help you be tougher. You should stop taking all those medications. Pharma makes customers, not cures, you know. Never mind that if I stop taking just one of my medications, I will die.

They are all saying, “You should try being not sick.”

The truth is that they don’t want to hear about it. It’s boring. And you’re exaggerating. You’re malingering. You’re not strong enough. You’re not positive enough. You are not enough.

Not one of these people has taken a moment to even consider what my life is really like. What it’s like to wake up sick and in terrible pain, every single day. Usually at around 3am.

That’s when my day starts. That’s when I start battling the pain. It’s truly a very difficult existence.

But instead of empathy and support, I get belittled. Dismissed. Treated as if pain — the most defining and disabling part of my disease — is somehow optional, psychological, or a personal and moral failing.

Something that I chose. Something I did wrong. Or something I didn’t do right.

Because people like to believe that everything happens for a reason. Spoiler: It doesn’t.

And that bad things don’t happen to good people. Spoiler: They do.

Doctors will treat the disease. But they refuse to treat the pain the disease causes.

And honestly, what’s the point? If you’re not going to treat the pain, how can you call yourself a doctor? How can you pick and choose what you will and won’t treat? And who you will and won’t help?

Pain is not my only disabling symptom. I have significant muscle weakness that is noticeably progressing.

I try to exercise, even though it usually makes things worse before it makes anything better. I hope it’s going to make me stronger long term. I don’t know that, but it’s my best hope. So I take my dogs on a slow jog and walk, and hope for the best. Always looking on the bright side.

Pain? It’s getting worse. No question. That’s disease progression. And maybe opioid tolerance in play.

But every doctor says the same thing: “You cannot have a higher opioid dose. No matter how bad the pain is.”

This isn’t medicine. It’s barbarism. It’s cruelty.

This is politics dressed up as healthcare. Policy made by people who are not doctors or scientists, and not interested in the terrible pain they cause. Yet they call it “evidence-based” and “best practice.”

These are rules made by people who will never experience what they’re inflicting. Because we know when doctors and politicians are in the hospital, they get opioids.

Just not us normal folk. The little people. We don’t matter, apparently.

Every week I talk to medical professionals, trying to understand why it’s like this. I don’t want to argue, I want to learn. Is this clinician bias I am looking at? Or is this what they’re all being taught?

Answer: It’s systemic. Doctors are being taught myths based on lies. And they don’t have time to check the science. If they did, they would be horrified at the patient harm they have caused and the lack of evidence for their decisions. But they’ll never check, so…

They have literally been trained to believe that education is more effective than opioid pain medication. How can any intelligent person believe that? It blows my mind.

They are taught that pain is “psychological” or caused by a “hypersensitive nervous system.” It has nothing to do with tissue damage, inflammation, disease or pathology.

Which is 100% wrong in every case.

We have a generation of clinicians who see pain not as a serious medical symptom, but as a faulty thought pattern. A cognitive glitch. A mindset problem.

Do you know what that belief system does? It erases empathy. Because why feel compassion for someone who is “catastrophising?” Why help someone whose pain is “in the brain,” which they can change themselves?

Why treat the suffering of someone who just needs to understand pain better?

I can always tell the exact moment a clinician realizes my pain is pathological and that their program, book, or brain training technique won’t work on me.

It’s like a curtain drops. Their interest vanishes. Their warmth evaporates. They stop asking questions. They stop seeing me as anything other than a problem.

Only one person in the last fortnight showed actual empathy — the sort of basic human response that should be universal when you have a severe, progressive, incurable, and painful disease. Every human being should be able to say, at the very least, “I’m so sorry you’re dealing with that.”

But only one did. I spoke to two physical therapists and one GP on social media. Asking them questions, hoping to learn. I answered their questions, but they didn’t answer mine. And as soon as they realized I would be of no use to them, they ghosted me.

Only one took the time to say, “I’m so sorry this has happened to you.”

My story is terrible. I have been abandoned, ignored, demonized, stigmatized, misdiagnosed and refused the most basic care. Any normal human being should be horrified by my story and the reality of my life. Of the pain I am forced to endure.

But only one showed me any empathy at all.

Mostly what I get is coldness. Defensiveness. Blank stares. Silence.

Not my problem-ism.

These are the people we rely on. The people who decide whether we get treatment, whether we get relief, whether we get to have any quality of life at all.

My life is not my own. I am not choosing this. No one would.

I’m trying to survive a body that is failing me and a system that refuses to see what pain really is — a physical experience rooted in biology, pathology and disease, that is sometimes influenced by psychological and sociological factors.

Not a mindset. Not a belief. Not a psychological construct.

The hardest part of being sick isn’t the disease. It’s fighting for your life while the system fights against you.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. For more information on chronic pain, the science, the politics and the lived experience, got to Pain Patient Advocacy Australia. You can also subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

A Doctor’s Appointment Can Feel Like Criminal Court for Pain Patients

By Crystal Lindell

This week I had an appointment where I was worried that I would have to submit to a urine drug test. And if anything went wrong, it could ruin my life.

It wasn’t a criminal court date or a meeting with a probation officer. It was with my doctor.

Every six months, I have to see the doctor who prescribes my opioid pain medication for a check-in. I’m actually very lucky that I only have to see him twice a year, because many patients are required to go in much more frequently.

But those two appointments each year cause me so much stress that I have trouble functioning. There is always the fear that if something doesn’t go according to plan, my opioid prescriptions could be cut off. And when a doctor has that much power over you, it’s rational to worry about how things will go.

So, in the weeks leading up to the appointment, I stress about everything that could go wrong.

Chief among my worries is that I haven’t had health insurance since 2022, so now a lot of my previous medical bills are in collections. Mind you, even when I had insurance, a lot of my medical bills went to a collections agency because, between co-pays and deductibles, the bills were in the thousands of dollars.

I always worry that this be the visit when my doctor finally cuts me off from care because of unpaid bills. Or maybe it will be the front-desk receptionist who confronts me about the overdue bills. What do I do if they refuse to see me as a patient because I am late paying? While it’s a decision that would fully be within their rights, it would ruin my life.

I have good reason to fear this. In 2008, I got an HPV vaccine from a doctor, and the shot came with a $150 co-pay. I had just finished paying thousands of dollars in medical bills for my gall bladder removal surgery, so I was having trouble paying for the vaccine.

And then, out of the blue, I got a letter from that doctor’s office saying that they were cutting off my care because of the unpaid bill. And I was no longer allowed to get care at any of the doctors in that hospital system.

I was shocked and sad, and also thankful that I was moving out of the area soon. But the experience scared me and left me constantly worried that even small unpaid medical bills could result in a doctor abandoning me.

Money isn’t the only stress factor when it comes to these appointments. There is also the chance of a urine drug test going wrong. While my doctor has not ordered one in a while, it’s always a possibility.

Now, you might assume that since I take my medications as prescribed, there should be nothing to worry about when it comes to peeing in a cup. But if anything does go wrong, I could lose access to the medications that I need to function. Like if there’s a false result on the screening, which happens more often than you might think.

So, I stress.

A lot of people assume that drug tests only look for non-prescribed or illicit substances. That what they are really looking for is cocaine and heroin. But the tests go far beyond that, and they are constantly adding substances to check for. While they have never tested for kratom in the past, I have no idea if it will suddenly be added to the screening, and what would happen if I tested positive for it.

The real reason most doctors order drug tests is they want to make sure you are taking your opioid medication as prescribed. If the medication isn’t found in your urine, that means you might be selling or diverting it. 

Again, not a problem for me. But still, the act of being forced to pee in a cup for the sole purpose of policing my compliance with the doctor is always going to feel punitive.

All of these worries are rolling around in my brain when the day of the appointment arrives. I have to wake up earlier than normal to shower and make the drive to the doctor’s office. It’s almost two hours each way because he works at the closest university hospital, and my complex medical needs require more than a local primary care doctor can handle.

My body hates waking up early, and my chronic pain often flares up in rebellion if I don’t get enough sleep. So, I have to ease into functioning while waiting for my pain medication to kick in.

All of this stress is compounded by the fact that on the day of this particular appointment it was snowing, with a mix of rain and sleet hitting the ground in just the right way to make all the roads extremely icy.

I knew this was going to make driving difficult, but I also knew that if I canceled my appointment, I risked not being able to get my next pain medication refill. So I prepared myself for an extremely treacherous drive and planned to leave a full hour early

Before I was set to leave, my fiancé went to the local Casey’s gas station to fill up the car for me. When he came back he sounded like he had been to war: “You can’t drive to your appointment in this weather! People were literally spinning out in the Casey’s parking lot!”

Ugh. Fine. I decided to suck it up and call my doctor’s office to see what my options were because I knew the weather was too bad to drive.

I assumed that I would need to completely reschedule, because he’s usually booked out for months. But when I called, the receptionist said that in the notes my doctor had said that I could do the appointment virtually if needed.

I once heard that wearing different colored socks brings good luck, and thus I have done this many times throughout my life on stressful days. And this time, it actually worked!

I was able to do a very easy telehealth call, from the comfort of my own home! Everything went extremely well. He told me that he had seen the weather, and that I had made the right call to stay off the roads that day. I had spent all that time stressing for nothing. 

But it shouldn’t take a pair of mismatched socks to get compassionate care. Millions of chronic pain patients are constantly stuck navigating these types of appointments because of the war on opioids. Unfortunately, many of them end up living the things that I feared. 

Of course, in six months’ time, I will have to go to his office again, and I’m sure I’ll go through all the same stress before that appointment too. Hopefully by then I’ll have some sort of health insurance, and ideally it will be a clear summer day..

Until then, I’m just happy that my doctor decided to rule in my favor. In an ideal world, a doctor’s appointment shouldn’t feel like a verdict.

Mixed Findings on Effectiveness of Medical Cannabis

By Pat Anson

Some new studies are muddying the water even more on whether medical cannabis is an effective treatment for pain, anxiety, insomnia and other health conditions. 

The first study, a JAMA review of over 120 clinical trials, medical guidelines and meta-analyses (studies of studies), found that there is not enough scientific evidence to support most of the conditions that cannabis is commonly used to treat.

Over one in four (27%) adults in the United State and Canada have used cannabis for medical purposes. And over 10% of people in the U.S. have used products containing cannabidiol (CBD) for therapeutic purposes.

But researchers say that widespread use is driven more by perceptions, anecdotes and promotion than it is by scientific evidence.

"While many people turn to cannabis seeking relief, our review highlights significant gaps between public perception and scientific evidence regarding its effectiveness for most medical conditions," says lead author Michael Hsu, MD, a psychiatrist and health researcher at UCLA Health. “Patients deserve honest conversations about what the science does and doesn't tell us about medical cannabis.”

Hsu and his colleagues found that FDA-approved cannabis-based medications, such as dronabinol and nabilone, are effective for HIV/AIDS-related appetite loss, chemotherapy-induced nausea, and pediatric seizure disorders such as Dravet syndrome and Lennox-Gastaut syndrome.

But for most other conditions, the evidence remains either inconclusive or lacking. Over half of medical cannabis users take it for chronic pain, but current medical guidelines recommend against cannabis as a first-line treatment for either chronic or short-term acute pain.

The researchers also highlighted the potential health risks of cannabis. High-potency cannabis containing over 10% THC has been linked to higher rates of psychotic symptoms and anxiety disorder. Daily use of cannabis, particularly of inhaled or high-potency products, is also associated with higher rates of coronary heart disease, heart attack and stroke compared to non-daily use.

About 29% of people who use medical cannabis also met the criteria for cannabis use disorder.

The review emphasizes that doctors should screen patients for cardiovascular disease and psychotic disorders, and evaluate them for potential drug interactions, before recommending THC-containing products for medical purposes.

Medical Cannabis Reduces Opioid Use

But another study, published in JAMA Internal Medicine, suggests that medical cannabis is an effective treatment for chronic pain because it reduces the use of prescription opioids.

Researchers at Albert Einstein College of Medicine and Montefiore Health System evaluated 204 adults in New York State’s Medical Cannabis Program who were prescribed opioids for chronic pain between 2018 and 2023.  

At the start of the study, most participants reported high levels of pain (an average of 6.6 on the zero to 10 pain scale) and were taking an average daily dose of 73.3 morphine milligram equivalents (MME). By the end of the 18-month study, the average daily dose fell to 57 MME, a 22% reduction.

“Our findings indicate that medical cannabis, when dispensed through a pharmacist-supervised system, can relieve chronic pain while also meaningfully reducing patients’ reliance on prescription opioids,” said lead author Deepika Slawek, MD, an associate professor of medicine at Einstein, and an internal medicine and addiction medicine specialist at Montefiore. 

The reduced use of opioids suggests that chronic pain sufferers can be slowly weaned off opioids with medical cannabis. For example, participants who received a 30-day supply of medical cannabis reduced their opioid use by an average of 3.5 MME compared to non-users.

“Those changes may seem small, but gradual reductions in opioid use are safer and more sustainable for people managing chronic pain than stopping suddenly,” said Slawek.

Since the study occurred during a time period when opioid prescribing overall fell by nearly 50% in the United States, we asked Dr. Slawek if that could have influenced the findings. She said researchers adjusted their modeling data to account for that as best they could.

“The only way that we will be able to get definitive answers on whether medical cannabis reduces opioid use is to conduct randomized trials, which are very difficult to do in the U.S. specific to cannabis,” Slawek told PNN in an email. “We believe that by using causal inference modeling in this study, we were able to add the highest quality evidence possible that cannabis may reduce opioid use in patients with chronic pain.” 

The scientific data for medical cannabis is improving. According to an analysis by the National Organization for the Reform of Marijuana Laws (NORML), the number of cannabis research studies grew for the fifth consecutive year, with over 4,000 scientific papers involving cannabis published so far in 2025.

“Despite the perception that marijuana has yet to be subject to adequate scientific scrutiny, scientists’ interest in studying cannabis has increased exponentially in the past decade, as has our understanding of the plant, its active constituents, their mechanisms of action, and their effects on both the user and upon society,” said NORML Deputy Director Paul Armentano. 

“It is time for politicians and others to stop assessing cannabis through the lens of ‘what we don’t know’ and instead start engaging in evidence-based discussions about marijuana and marijuana reform policies that are indicative of all that we do know.”

According to NORML’s analysis, over 37,000 scientific papers about cannabis have been published since 2015. That means over 70% percent of all peer-reviewed scientific papers about cannabis have been published in the past ten years alone.    

The studies are growing and so is the anecdotal evidence. A recent survey of 1,669 medical cannabis users in the UK found that nearly 89% of those with chronic pain reported somewhat improved or significantly improved quality of life.

Feline Good: A Sense of Purpose Helps Me Manage Chronic Illness

By Crystal Lindell

Every morning, at around 5 a.m., my very fat orange cat Goose starts his daily routine: Screaming at the top of his lungs in an effort to wake up me and my partner.

He’s hungry and he doesn’t care if we’re asleep – it’s time for cat breakfast.

Trust me when I tell you that we have tried a number of workarounds to help avoid this daily cat alarm clock.

We have attempted to ignore his screams. We have tried feeding him a bigger meal later at night before bed. And we have left dry food out overnight.

We even gave him a late-night catnip snack in hopes that it would help him sleep later into the morning.

Goose doesn’t give a shit about any of that. He still gets up at 5 a.m. every single morning so that we can feed him.

Turns out, though, this daily ordeal may actually be helping me manage my chronic pain from Ehler-Danlos syndrome.

GOOSE AND CRYSTAL

New research from Cigna shows that having a strong sense of purpose can help offset the effects of chronic disease. And every single morning, Goose makes sure that I know that my purpose is to take care of him.

Cigna researchers found that while adults with chronic conditions usually have much lower vitality scores than those who are not sick, the same does not hold true when they also have a strong sense of purpose. 

Adults with chronic conditions and a strong sense of purpose actually have a significantly higher vitality score — nearly matching the scores of people without health issues. Cigna defines vitality as the ability to pursue life with health, strength and energy. 

People with a strong sense of purpose are significantly more likely to have vitality than those who do not (89% vs. 61%). They are also five times more likely to say they feel energized (63% vs. 13%) and nearly three times as likely to look forward to each new day (86% vs. 31%).

Notably, having a strong sense of purpose is linked to greater ownership of physical health — 84% of adults with strong purpose say they feel in control of their health vs. 55% of those without strong purpose. People with a strong purpose are also more likely to get regular exercise, sleep better, and to see their doctors for regular checkups. They also have less anxiety and depression.

“Having a sense of purpose gives people energy and helps them feel happier and healthier,” says Stuart Lustig, MD, National Medical Executive for Behavioral Health at Cigna. “When you know what matters to you, you’re more likely to bounce back from tough times, build strong friendships, and take care of yourself, which impacts your overall physical health.”

It can be easy to shrink into yourself when you’re dealing with chronic health problems, especially when it comes to chronic pain. And truth be told, one of the reasons I resisted my fiancé’s pleas to get a cat in the first place is that I was worried I wouldn’t be able to take care of the cat on bad pain days. 

But as fate would have it, having Goose actually helps me get through the bad pain days —  especially when he is waking me from a deep sleep by screaming for breakfast. In fact, Goose and his cat sisters give my life meaning and make me feel needed every morning, even on the days when I don’t feel like I have much to give.

Of course, you don’t have to get a cat to have a sense of purpose. You don’t even need to have a constant level of activity. Small, gentle acts of generosity can go a long way. 

There are many things in my own life beyond my cats that help me see the world outside of myself and my chronic pain. I also care for my elderly grandma, babysit my niece, volunteer at a local animal shelter, and cook for my family on a regular basis. I also write these columns, which gives me a very direct connection between my pain and my purpose. 

Finding purpose can happen in a million small ways, throughout the days and years. As the old saying goes, it’s better to give than to receive.  And ultimately, when you give, you do, in fact, receive.  

Study Shows Anger Makes Chronic Pain Worse

By Crystal Lindell

A new study claims that the angrier someone is about their chronic pain, the worse their pain will be. But to be honest, the whole thing kind of pisses me off.

All kidding aside, the research published in The Journal of Pain, looked at four distinct “multidimensional anger profiles” in pain sufferers.

Researchers followed 735 adult patients with different types of chronic pain, assessing how they experience, express and control anger, and how strongly they feel about being wronged by their situation. About a third of the participants completed follow-up assessments 5 months later.

They found that people with medium to high levels of anger and feelings of “perceived injustice” had some of the most severe pain. They reported greater pain intensity, more widespread pain, and higher levels of disability and emotional distress. 

In contrast, people who seemed to manage their anger more effectively and viewed their condition with less resentment tended to have less pain..

However, the researchers did not clarify which treatments the patients had access to or how being denied treatment impacted their pain. Instead, they encouraged doctors to make an “early assessment” of patients that emphasizes “the need for tailored, anger-focused, patient-specific interventions.”

One of the biggest issues I have with this study is that it sets up doctors to blame the patient’s demeanor and mood for their physical pain – something they are often already prone to do. 

I can hear the in-office conversations now.

“Have you tried being less angry?” the doctor asks, as though he’s offering an actual treatment option to the patient sitting on a cold exam table.

The question would rightly be infuriating, which would then just lead the doctor to type in their notes that the patient’s pain is partly caused by their inherent anger and sense of injustice.

Leaving the insulted patient in a state of untreated limbo. 

Yes, people whose pain is left untreated or poorly treated are more likely to be justifiably angry overall. And they are especially more likely to feel like their pain is unjust.

In fact, anger is a very appropriate response to such suffering. It inspires you to push those around you to help you find relief. And unfortunately, it’s often required to get real help from medical doctors. 

In the study's conclusion, the authors admit as much.

"Anger is not inherently harmful - when adaptive, it can be a strong motivator, helping individuals set boundaries and navigate challenges," wrote lead author Gadi Gilam, PhD, a psychologist and neuroscientist at the Hebrew University of Jerusalem. "Rather than eliminating anger, interventions should harness this adaptive potential while mitigating its harmfulness."

Perhaps they could also focus on interventions that actually treat physical pain? Especially since the most effective treatment for many types of pain – opioids – has been severely restricted over the last decade.

Anyone who tells you they’d be calm and accepting while dealing with chronic pain, while at the same time knowing there was an effective treatment they weren’t allowed to have, is lying to you.

It’s actually very normal to be angry in that situation and to feel a strong sense of injustice. The situation itself is not just. 

I have long said that lack of sleep will make you crazy so much faster than you expect, and a version of that applies to pain as well. Unrelenting pain will make you angry so much faster than you expect.

Rather than trying to treat the anger, doctors should focus on the source, and treat the pain itself. 

7 Gift Ideas for People with Chronic Illness

By Crystal Lindell

Black Friday marks the unofficial start of the holiday shopping season, and that means hunting for the perfect gifts for those we love.

Below are some gift ideas for loved ones with chronic pain and illness. It’s a gift list you can trust because it’s all based on my own experiences of living with daily pain myself for over a decade.

All of these items also make a great addition to your own holiday wish lists, if you have chronic condition yourself. 

1. Comfy Clothes

The #1 must-have fashion item for people with chronic pain is any clothes that are super comfortable. 

When you have chronic pain, clothing comfort just takes precedent over the latest trends. 

I personally have re-purchased these comfy pants more than 7 times over the last few years. I love how soft they are, and I love that they have pockets! 

But any comfy clothes, from sweat shirts to pajama pants, make a great gift for those with chronic pain. 

Find Women’s Jogger Pants on Amazon 

2. Heated Blanket

There’s nothing better than getting under a cozy heated blanket when you’re dealing with chronic pain. Even if someone already owns one, there’s always a need for one more! 

This heated blanket is my favorite and not only do I own two myself, I’ve also purchased it as a gift for loved ones over the years. And all of them always come back to tell me how much they love it! 

Find this Heated Blanket on Amazon

3. Reminders of Your Love

Little trinkets like a keychain can be a great way to give a constant reminder of your love for someone. Every time they see it, they can think of how much you care about them. 

This keychain features the phrase, “May you always have one more spoon.” It’s a reference to the Spoon Theory, which uses spoons to illustrate the limited energy that people with chronic pain and illness often have. 

It doesn’t have to be a key chain though. A special coffee mug or a bracelet can also make great gifts! 

Find the Spoon Theory keychain on Amazon 

4. Lego

Of course, it doesn’t have to be Lego specifically, but any sort of home-based hobby activities are great for people with chronic pain. 

I personally love this Lego Cat because I’m a huge cat person as well as a huge Lego fan. 

But you can also get your loved ones art supplies, crafting tools, or any other projects they can work on at home.

And bonus points if they can do it from the couch on bad pain days. 

Find the Lego Tuxedo Cat on Amazon 

5. A Good Book

Some days, a pain flare means I don’t have the energy to do anything other than read a book. So having good ones around that I know a loved one recommends is always welcome! 

I recently read The Frozen River by Arial Lawhon, and I really enjoyed the cozy winter setting and completely immersive 1700s plot. 

But you can really buy any book that you’d recommend to share as a gift with your loved ones. 

Also be sure to check out PNN’s holiday reading guide, which has books to help you better understand and treat many chronic pain conditions.  

Find The Frozen River on Amazon 

6. Bread Machine

While a bread machine may not seem like a gift typically associated with chronic pain, it’s actually perfect.

A good bread machine makes it super easy to whip up homemade bread, even when you’re also dealing with a pain flare. You just toss the ingredients in, hit start and presto! A perfect loaf of homemade bread!

It’s also great for anyone on a restrictive diet, since you can easily customize the ingredients. There’s even a setting for a gluten-free loaf! 

Find the Bread Machine on Amazon 

7. Gift Cards

Of course, when in doubt, it’s always a good idea to go with a gift card, especially if you’re shopping at the last minute — because the cards can be instantly delivered via text. 

That way your loved one is guaranteed to get the perfect holiday gift, because they pick it out themselves!

Happy shopping this holiday season!

Find Gift Cards on Amazon

We hope you have happy holidays, and many low pain days in the year ahead! 

PNN makes a small commission, at not additional cost to you, on items purchased through Amazon. 

Does Mindfulness Really Help with Chronic Pain?

By Neen Monty

“Mindfulness” is one of those words that’s been stretched so far it’s almost lost its meaning. We’re told it will calm our nerves, ease our pain, and maybe even transform our lives. 

But what is mindfulness, really? And what can it actually do for people living with chronic pain?

The popular definition goes something like this: Mindfulness is the practice of focusing your awareness on the present moment, without judgment.

Does that make sense to you? It didn’t make sense to me the first time I heard it. It sounds so simple… but it’s not so simple to do.

Most people think mindfulness is meditation. It’s not. Mindfulness is a state of awareness, a way of relating to your thoughts and sensations, while meditation is a tool that helps you develop that state. Meditation is how we practice mindfulness, the training ground for the skill of self-awareness.

Clear? As mud…

Okay, let me try again. At its core, mindfulness rests on two ideas:

1. Paying attention to the present moment.

2. Doing so without judgment.

That second part is the hardest. It can take a lot of practice. But in practical terms, living mindfully is living in the present moment. It’s not wasting time worrying about a future that may never happen, or dwelling on a past that can’t be changed.

The Difference Between Pain and Suffering

Let’s use pain as an example. Being mindful doesn’t mean ignoring pain or pretending it’s not there. It means noticing it: “I feel pain right now” and stopping there.

What we usually do next is the problem: “Oh no, it’s back. The pain is so bad! It’s going to get worse. I can’t take this anymore.”

Those thoughts are the suffering part. They layer emotion, fear, and meaning on top of the physical sensation of pain.

Mindfulness helps peel that layer away. Pain still hurts, but without the extra story, the extra worry, the panic, the hopelessness and the emotional response. It’s just pain.

Pain then becomes something we can observe, without emotion, rather than something that swallows us whole. This distinction isn’t just philosophical. Brain imaging studies show that mindfulness changes the way we process both thoughts and sensations.

Meditation strengthens brain regions that regulate attention and emotion, such as the prefrontal cortex and anterior cingulate cortex, while reducing reactivity in the amygdala, the brain’s alarm system. Other reviews confirm that meditation produces measurable neurobiological changes that are associated with greater emotional stability and self-regulation.

Over time, meditation helps the mind become less reactive. We learn to notice sensations, thoughts, and emotions without immediately trying to fight or fix them. 

Instead of launching into fight or flight, we remain calm and in control. Meditation, in that sense, is kind of the laboratory in which mindfulness is trained.

The Limits of Mindfulness

Does mindfulness cure pain? No. It does not.

Systematic reviews and meta-analyses find that mindfulness training has only small effects on pain intensity. What it does reduce is distress — the anxiety, fear, and emotional turmoil that often surrounds chronic pain.

That distinction matters. Mindfulness was originally designed as a treatment for stress and anxiety. And therefore, its benefits for pain are more indirect. It helps people who are fearful of pain or overwhelmed by it, to regulate their emotions and cope better.

But, if you’re already calm and accepted your pain without fear, mindfulness won’t make the pain go away. It won’t have much effect at all on your pain.

Most importantly, mindfulness is not a treatment for severe pain. You cannot be mindful and you cannot meditate, when you’re in severe pain. Mindfulness is not an intervention for 8 or 9/10 pain. That’s pure cruelty. I would even call that medical negligence.

Mindfulness is a treatment for fear and anxiety in the setting of chronic pain. In that sense, mindfulness may be helpful for someone in mild to moderate pain, where there is a lot of negative emotion surrounding that pain – such as fear, anxiety and catastrophising.

Mindfulness is a psychological tool, a treatment for fear and anxiety that’s been repurposed for pain. 

And often oversold as something it’s not.

Why Mindfulness Is Still Worth Trying

Even within those limits, I still believe mindful living is the best way for me to live. It doesn’t make my pain stop. My pain is caused by disease, pathology and biology, not by anxiety or fear.

Mindfulness does make my days quieter. It keeps me from being dragged into fear or frustration. I don’t worry about the future and don’t dwell on the past. Mindful living keeps me grounded. In the present moment. Because that’s where life is happening – the here and now.

That’s what mindfulness is, living in the present moment.

Mindfulness won’t fix what’s broken in the body. Mindfulness cannot fix pathology. But it can help restore what pain often breaks in the mind: calmness, control, and your sense of peace in the middle of chaos.

And sometimes, that’s enough.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. She has created a website for Pain Patient Advocacy Australia to show that prescription opioids can be safe and effective, even when taken long term. You can subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

5 Tips for Surviving the Holiday Season with Chronic Pain

By Crystal Lindell

The holiday season kicks off this week, but for people with chronic pain, this time of year can be difficult to navigate. 

Below are some tips for surviving the season while also dealing with chronic pain and illness. You can trust that they actually work, because all of them are gleaned from my own experiences of surviving the holidays while dealing with chronic pain myself.  

1. Check Your Pharmacy Schedule

A lot of pharmacies are closed on holidays or they close early, so if you have refills scheduled on those days, it’s best to plan ahead. Make sure you know when they are open so you can get your medications.

If you have a refill scheduled for a day when your pharmacy is closed, you may want to ask your doctor if they can send in any refill prescriptions the day before the holiday.

In my experience, a lot of doctors are surprisingly accommodating about this. Of course, if they refuse, you can ration out your medication a little so that you have enough to cover the holiday.  

2. Embrace Pre-Made Food

One of the most draining tasks over the holiday season is cooking. So, I highly recommend embracing pre-made food options.

Whether that means grabbing pre-made sides from the grocery store or ordering a fully prepared holiday feast from a local restaurant, outsourcing the labor of cooking can be a huge help if you have chronic pain.

Obviously though, buying pre-made food does usually cost more than cooking from scratch, but if you’re really in a pinch, I do have one more suggestion: Order takeout.

Fast food is usually inexpensive and quick, which means you’ll have more time and energy to actually enjoy the holiday season with loved ones.

Later, when you look back on those memories, it won’t matter if dinner was tacos or chicken wings, as long as you were all together. 

3. Include Rest Days in Your Holiday Plans

If you have multiple family functions to attend, try your best to plan days of rest into your schedule. 

Put “Rest” on your calendar as though it were any other required activity. And if it conflicts with other events, don’t be afraid to say that you just can’t make it. 

I know that saying “no” is easier to suggest than actually accomplish, especially when it comes to family. So if you do get pressured into doing multiple events in a row, just do your best to schedule an equal number of guilt-free rest days afterward. Emphasis on the “guilt-free.”

For example, if you have plans on Christmas Eve and Christmas Day, try to use Dec. 26 and Dec. 27 to recover. And I don’t mean, spend those days cleaning up, I mean actual rest.

When you’re dealing with chronic illness, providing your body with rest is just as important as providing food. 

4. Wear Compression Socks on Long Trips

Swollen feet and ankles are a common side effect of both chronic illness and many prescription medications.

So, if you’re traveling this holiday season — whether it’s a three-hour flight or a one-hour drive — I highly recommend wearing compression socks during your trip. Aside from preventing swelling, they can also help prevent dangerous blood clots.

5. Use Gift Bags

Wrapping gifts is a lot more time consuming than people usually like to admit, so do yourself a favor and just use gift bags instead. And save the ones you get, so you can reuse them next year.

Gift bags don’t have to be expensive either. If you head over to Dollar Tree, you can find a wide assortment of gift bags for just $1.25 each. 

The holiday season can easily turn into a series of stressors and pain triggers, but if you plan ahead and allow yourself some grace, you still can enjoy it — even with chronic pain. 

Winter Taught Me a Better Way to Cope with Chronic Pain

By Crystal Lindell

We’ve already had our first snowfall here in northern Illinois. Regardless of the official day winter begins next month, the first snow marks the start of winter for us.

And when you have chronic pain, the season brings with it cursed gifts, offering both a time of guilt-free rest and more days of ache.

During the summer, there’s a guilt that accompanies any days spent inside, even if you’re doing it because your pain is too intense to allow for anything else. Watching TV all day makes me feel like I am personally wasting the warm weather and sunshine.  

But that is not the case in winter. Instead, the long nights and cold days allow me to embrace the comfort of staying in, curled up under layers of blankets. 

I already have my Christmas tree up, and the warm glow makes being a couch potato seem almost magical.

And since the sky turns midnight blue at 5 pm, it suddenly feels almost natural to go to bed early. 

These are things my chronic pain-riddled body enjoys year-round. But in the winter, societal expectations allow me to indulge in the impulse to take full rest days or even rest weeks, without feeling the summertime angst about it.

The change in seasons also brings with it lots of changes in barometric pressure, which means all those cozy evenings come with a downside.

My body always knows when it’s about to snow, or sleet or both. It also feels every temperature change as it happens. Anytime it goes from -10 degrees to 40 and back again, my ribs feel it. 

The result is often multiple days spent with the type of excruciating pain that barely even responds to opioid pain medication.

Over the years, I have found that the only treatment that works for those pain flares is to accept them. I can’t stress myself out about it, because it only serves to escalate the pain. So I have to try to stay as calm as possible. My body can’t handle activity under those circumstances.

Which brings me back to those guilt-free rest days that winter supplies in ample amounts. And embracing things instead of trying to fight them.

Growing up in the Midwest, I was often taught that winter was a season to be fought and denied. Just a few months that we all had to endure until the “real” weather came back. Most people here spend the winter complaining, cursing, and just trying to survive.

A few years ago, I took a trip to Montreal, Canada in January, and witnessed an entirely different approach. Despite the fact that the holiday season was well behind us, the city was filled with winter festival activities, ice statues, colorful lights, and just a general sense that the dark and cold days were actually a good thing.

The experience has since shaped my own approach to the coldest months of the year. I do my best to appreciate the gifts that gray days and eternal nights bring. It’s a time for all of us to rest, refocus, and embrace the downtime the cold weather affords us.

Embracing pain has the same effect. When you learn to let it exist, it is paradoxically easier to keep it confined to smaller flare ups.

Weather forecasters predict many of us are in for a particularly harsh winter this year, with more snow and colder temperatures. 

But that doesn’t mean it has to be a slog.

When we take the winter season as it is, it can bear its gifts of rest and time. And who among us doesn't need more of both?