Fear-Mongering and Stigmatizing Medications is Only Harming You and Your Community

Taylor Nichols, MD
7 min readMay 22, 2023

The current trend among the chronic pain community — unfortunately driven by some of their loudest advocates — is to stigmatize medications which can highly effective for many patients and for the right conditions. One of the main targets of this stigmatizing misinformation is buprenorphine. Why? Because buprenorphine is a partial-agonist opioid medication which is frequently used for the treatment of patients with substance use disorder, specifically opioid use disorder, for medication assisted recovery (MAR).

People within the chronic pain community understandably fear being stigmatized as patients with substance use disorder (PWSUD) and are pushing back strongly against the idea of buprenorphine — a partial-agonist opioid medication — being pushed on them to replace full-agonist opioid medications. I would be curious if the medication were used to treat a different and less stigmatized community, if folks would be stigmatizing a medication that can be used in their treatment the same way.

I say unfortunately, because — as I have mentioned before and will continue to mention at every chance I get — the stigma that harms the SUD community IS the stigma that harms the chronic pain community. That stigma against people who use drugs (PWUD) is weaponized against pain patients and contributes to pain patients receiving inadequate treatment.

So long as the same loud voices perpetuating stigma against PWUD or PWSUD or the medications that can be used for their treatment and recovery continue to be the leading voices advocating for the chronic pain community, the same narrative will continue to be pushed and therefore there will never be significant enough progress in the fight for the treatment that both communities deserve.

Venn Diagram of the overlap of the SUD and CPP communities

The patients within the chronic pain community who do not have substance use disorders SHOULD be the strongest allies for the SUD community. This is an example of intersectionality.

There is no question that both communities a marginalized and often receive inadequate care and both have deep medical trauma. However, your liberation is tied to theirs. Your ability to receive adequate treatment is tied to theirs. You both can use opioid medications to treat your chronic…

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Taylor Nichols, MD

Humanist. Emergency Medicine and AddictiEmergency + Addiction Medicine | Health policy and advocacy | Health tech and innovation