The stigma and enigma of chronic non-malignant back pain (CNMBP) treated with long-term opioids (LTO)

Certain diseases and drugs, like chronic non-malignant back pain (CNMBP) and opioids, are maligned by society, resulting in sufferers and users experiencing discrimination within the health care system which has the effects of increasing, rather than alleviating their pain and suffering. Many patients with severe CNMBP suffer not because their pain is untreatable but because their pain and personhood have not been validated by doctors and nurses who are opioiphobic. Such ignorances fears, beliefs and biases not only deny some CNMBP patients adequate pain relief but also puts their lives at risk as it has long been recognised that chronic pain can lead to immunosuppression, affecting morbidity and mortality. Beyond the effects on patients, CNMBP treated with long term opioids (LTO) has a profound impact on families, whose pain and suffering is rarely addressed in practice. There is an urgent need to change current practice if CNMBP patients treated with LTO are to maximise their health potential and become responsible consumers of health care.