In the wake of the opioid crisis, medical professionals’ fears about prescribing opioid painkillers have risen — to the extent that some doctors have turned to “pain acceptance” as a treatment philosophy. But chronic pain patients are speaking out about how dangerous that could be for their quality of life.
In November, Vox published a podcast detailing how “pain acceptance” is “gaining traction” among American doctors as a response to the opioid epidemic. The movement is “kind of just what it sounds like,” said narrator Sarah Kliff, who lives with chronic pain herself. “It means asking patients to live with a certain level of pain — for months, years, or even for the rest of their lives.”
The podcast features Jane Ballantyne, a controversial doctor who champions pain acceptance. Kliff said that as Ballantyne watched problems from opioids, like the side effects and risk of addiction and dependence, grow, she started questioning the “assumption” in pain treatment that doctors should get their patients to zero pain, which is why they were prescribing opioids. Ballantyne wondered, what if we stopped aiming for zero?
“There are approaches that involve not becoming too focused on the pain, thinking of living with the pain rather than thinking you can’t live with the pain,” Ballantyne said.
Ballantyne acknowledged that she has been criticized for her philosophy, which she first wrote about in 2015.
“[The response] was so personally aggressive and showed such lack of understanding of what we were actually saying. It was interpreted as cruel and unsympathetic and you don’t understand what people are going through,” she said.
The podcast concluded with the stories of two chronic pain patients — one who had tried “pain acceptance” and experienced some success, and another who remained skeptical about the philosophy.
The podcast prompted a backlash from people with chronic pain, who argued that saying a level of chronic pain is “acceptable” essentially abandons chronic pain patients. Rather than tell them they need to accept their pain, they need more pain relief options, doctors who are willing to fight for them, and less stigma against using opioids responsibly.
Many pointed out that they’ve actually already accepted and learned to live with their pain (and even done the techniques Ballantyne suggests, like meditation and physical therapy), but that doesn’t mean they don’t still deserve help reducing their pain.
I've "accepted" my pain. That doesn't mean it doesn't affect me. Acceptance doesn't mean I'm suddenly not disabled. That doesn't mean I don't need mobility aids, or pain medication, or accommodations. Acceptance alone does nothing for me.
— 🔮Evil Ghoul🎃 (@sleepyjuniper) November 15, 2017
Untreated pain often leads to depression and suicide. Any doctor that thinks that's preferable to a low risk of addiction is breaking the hippocratic oath.
— Scarily tired Brian (@TheBrianest) November 15, 2017
Managing pain is multi-modal. The goal for me is the highest quality of life with the minimum medication. I like being clear-headed AND I like to be functional. It's a daily balancing act of which medications are one component.
— Andi Cougevan (@AndiCougevan) November 14, 2017
If pain acceptance worked why would I even go to the doctor? Like period? I learned all the coping skills they push a decade before asking for help, I only asked once I became unable to work, go to school, sleep or eat.
— Jat (@KatastrophicImp) November 15, 2017
If you've never had chronic pain, this is truly a highhanded and rather evil thing to even contemplate.
— Sue Stone (@knittingknots) November 15, 2017
Chronic pain isn’t a one size fits all… I’ve accepted my autoimmune diseases and chronic pain, I accept that this is my life and I will keep fighting. I will not accept not having treatment because I need a quality of life, so I can run, so I can have a life.
— Mel 🇨🇦🇺🇸 (@Meljanx) November 15, 2017
absurd on pain meds I work 37hr/wk, take care of my daughter & myself alone & study part time. Off meds I'm bed bound & dependent
— Tanith (@TweetingEDS) November 15, 2017
I try to accept my pain so that, as my therapist would say, I don't have an additional layer of suffering, i.e., psychological suffering. That doesn't mean that the physical pain and suffering shouldn't still be treated. Right now, the latter isn't for me.
— Beth Morton, PhD (@beth_morton) November 15, 2017
Meditation is one tool people should have access to. So are pain meds.
— hope (@hoperhenderson) November 15, 2017
Though politicians and medical professionals often suggest cutting opioid prescriptions as a solution to the crisis, studies show the majority of people prescribed opioids for chronic pain use them responsibly and do not become addicted and report a lower quality of life and worsening pain with opioid restrictions.