Dear Dr. Bonakdar

Robert Bonakdar, MD, is Director of Pain Management at the Scripps Center for Integrative Medicine, immediate past president of the Academy of Integrative Pain Management and co-author of the 2016 book Integrative Pain Management. Follow him on Twitter @DrB_Well.

While I wait for things to change, I will go back to the office, sign Dr. Murthy’s pledge, and wait for the day that the sales reps come to detail me on the benefits of group exercise for pain, and the denial letters I keep getting start using more truthful language: “We regret to inform you that this therapy is being denied because we simply don’t want to deal with the real issue. Pain, as you know, is a real bummer…”

My comment:

So many of you “experts” are pushing alternative therapies, as if most chronic pain patients haven’t already tried (and paid for out-of-pocket) most of these treatments (and more). When these alternative treatments only have a success rate equal to a strong placebo effect. What do you propose for the majority of pain patients who don’t respond to all of these alternative treatments? Just suffer, right?

Sure, let’s go backwards in the treatment of pain, like back to the 1980s, when doctors would only prescribe antidepressants for chronic pain — antidepressants, now prescribed like candy, even though sugar is probably a better drug.

“…opioids for pain care has not created any significant improvement in pain and disability…”

Opioids are not miracle drugs. Their purpose is not to cure, but to manage. Have antidepressants created any significant improvement in depression (or made it worse)? Have anti-addiction drugs cured drug addicts, or do some patients have to take them for the rest of their lives? Does insulin cure diabetes? Why are doctors requiring opioids to do more than any other drug?

The most successful treatment for pain is opioids. That’s a fact. The treatment that’s being denied to many chronic pain patients — and cancer and terminal patients — is opioids. Stop acting like most pain patients haven’t already tried all of these alternative treatments (and then been forced into poverty). Stop acting as if these alternative treatments can replace opioids, when all they can really do is help reduce their use (but only in a small percentage of patients).

It’s not chronic pain patients who are abusing their medications, it’s mostly those who suffer from addiction. The opioid war isn’t about the treatment of pain, it’s about the treatment of addiction.

Living with constant pain isn’t a “real bummer.” Donald Trump running for president is a real bummer. Suffering from intractable and incurable pain makes a person wish for death. Because death is preferable to living with constant pain without any hope of relief.

While all of you “experts” are living in a fantasy world, those who suffer from intractable pain are living in the real world. Why don’t ya’ll join us down here in hell?

8 thoughts on “Dear Dr. Bonakdar

      • I liked that it spoke to the insanity of the way pain patients are treated. We’ve all tried, at great expense, the alternatives. We know that opioids don’t cure us but we also know that they can make some functioning possible.
        I’ve said the same things. The war on drugs is a war on pain patients. The government has tied the hands of doctors so they can’t adequately treat us because of fear of investigation, loss of their licenses, or even jail time.
        I didn’t expect a solution but reading the article reminded me I’m not alone in my frustration and anger.

        Liked by 1 person

        • Maybe we’re talking about two different things. The article found at the link was about how we should be trying all these alternative therapies — again, I guess — whenever insurance decides to cover them.

          You’re not alone. There are tens of millions of pain patients who are affected by the new regulations by the CDC. I was abandoned by my doctor about 5 years ago, so I’ve been living this hell for longer than most pain patients.


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