Changing the Way We Talk about Pain Medicine

OPIOID. A word packed with toxic rhetoric.

When you read or hear the word “OPIOID” you experience a bundle of feelings or thoughts, however subtle. Maybe the bundle is mainly positive, maybe negative. Either way, that bundle almost certainly includes an anxiety factor. That’s because the word “opioid”, while a technical medical term, has been turned into a rhetorical device.

Opioid death, opioid crisis, opioid epidemic. These terms are packed with power and emotion. They invoke images: white masks, bodies hunched over, ambulances, sirens, politicians shouting, people crying. There is no fair or objective way to use the word “opioid” anymore.


Now, I will tell you something personal. I will be using a gender neutral “they” pronoun.

I have a cousin who relies on pain medicine to be able to function.

If I had said, “I have a cousin who relies on opioids to be able to function”, entirely different thoughts and feelings may have come to mind; maybe concepts like “ADDICTION” and “ABUSE”. Maybe that classic trope that we’ve all seen on TV would come to mind; the one where a character gets hurt or injured, then has surgery, then ends up a strung-out, tragic figure doing anything to get the drugs they’re now hooked on.


I do actually have a cousin who relies on pain medicine to be able to function. They’ll go out to a picnic on a Saturday and have a great time and spend Sunday in bed recovering, trying not to move. They hold down a full-time job during the day, but come home and lay still for an hour doing breathing exercises, trying relax their moving parts. A typical evening of supper and TV might happen. Sometimes sleep happens, but sometimes pain prevents it. When it rains, or the barometric pressure falls their pain increases in relation to it. There is not an hour or minute in their life where pain is not present. But it is controlled.

Many Americans (an accurate number is under dispute) use PAIN MEDICINE that is an opioid in order to have some kind of a quality life. With pain medication, they can work, they can participate in family events, go for walks. Often times without those medications, they cannot work, or they suffer greatly after trying to take a walk – can’t dance, can’t go to a ball game.


I had a long conversation with a nurse recently about chronic pain management. She was talking about opioids with the language of the media: “addiction”, “danger”, “consequences”. It made my very aware of the impact of words and how there are accurate ones and misleading ones. A new language is needed if we are going to ever be able to talk about the legitimate needs of chronic pain patients without the specter of the opioid death/crisis/epidemic rearing up behind it.

  • “ADDICTION” VERSUS “DEPENDENCE”: As a rule, pain patients are not “ADDICTED” to pain medicine. They are however “DEPENDENT” on the pain reducing benefits of the medicine in order to function.
  • “ABUSE” VERSUS “RELIANCE”: To obtain the desired effects of these drugs, which may include periodic increases or break through dosing, they do not “ABUSE” the medicine, but they are “RELIANT” on it being flexible for a meaningful quality of life.
  • “OPIOID” VERSUS “PAIN MEDICINE”: While they may technically use an “OPIOID” drug, it is equally true that they use a “PAIN MEDICINE” – a term much more accurate to their need.

This might not be a big change, but I hope it will make conversations possible. I hope it begins to move us beyond the toxic rhetoric and sound bites of the opioid crisis to the need for thoughtful and compassionate pain management.

TELL US, what words do you think or wish could be changed?

Jim Sliney Jr. is a Registered Medical Assistant and a Columbia University trained Writer/Editor who creates education and advocacy materials for patient support groups. He has worked closely with several rare disease communities. Jim also coordinates the patient content for PatientsRising and collaborates with other writers to hone their craft. He’s a native New Yorker where he lives with his wife and all their cats. Connections:   Twitter   Quora    Emailjim sliney jr

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