The chronic pain community cannot afford a hierarchy of suffering. Some patients manage their pain without prescription opioids. Others rely on non-opioid medications, procedures, physical therapy, or a combination of treatments. And some of us depend on full agonist opioid therapy to maintain a meaningful quality of life. I will never apologize for defending access to full agonist opioids when they are medically appropriate. But here’s what I won’t do: diminish another patient’s treatment to defend my own. We do not need to agree on treatment to stand together on patient autonomy. The enemy isn’t the patient who chooses a different path. It’s the stigma, the blanket policies, the fear-driven decision-making, and the erosion of individualized pain care. We have enough people questioning our suffering without doing it to each other. Your relief does not invalidate mine. My medication does not threaten your recovery. And none of us should have to prove that our way of surviving is morally superior. Different treatments. Different bodies. One community. That’s how we fight for all of us.

I will always defend patients who benefit from opioids for chronic pain. I wouldn't be here if I hadn't had access to them in the past. I likely would have taken my life by now. This isn't a competition. Use what works best for you.