<p>Opioid moderatism and the imperative of rapprochement in pain medicine</p>

The Problem (and the Answer?) to the Limited Availability of Pain Psychologists: Can Clinical Social Workers Help?

“…Much of this failure has been related to the devolution of the "profession" of pain medicine to the "business" of pain medicine, 4 which has been due to numerous factors. These have included, but not necessarily been limited to, the malevolent dominance of the health insurance industry, 5,6 progressive corporatization, 7 fraudulent marketing, 8 industry's detrimental influence on medical education, 9,10 a lack of undergraduate medical education in pain management, 11 and, of course, the profound swing of the "opioid pendulum" from reckless opiophilia to its current zeitgeist of often cruel opiophobia, [12][13][14] and last but not least, the demise of interdisciplinary pain care. [15][16][17][18] Interdisciplinary pain care is based on the biopsychosocial model of pain management, rejecting a purely biomedical model.…”

Pain Management for Dental Medicine in 2021: Opioids, Coronavirus and Beyond

“…Many of the arguments made by both factions have been agenda-based and not particularly scientific, with considerable zealotry evident. In 2019, Schatman and colleagues 3 published a call for “opioid moderatism”, noting that while reverting to the clear patterns of overutilization of opioid analgesia that were evidenced during the first decade of this millennium would not be prudent, neither is the deepening climate of opiophobia and oligoanalgesia that has become progressively more prevalent in the United States over the past decade. A search for a “sane middle ground” in which opioids are prescribed judiciously as a last treatment option with prescribers responsible for exercising thorough and consistent risk mitigation was urged.…”

Chronic Pain Patient “Advocates” and Their Focus on Opiophilia: Barking Up the Wrong Tree?

“…Much has been written on how efforts to reduce the flow of prescription opioids have morphed into a war on chronic pain patients. [1][2][3] There have been numerous editorials and articles published expressing concerns regarding the unfortunate consequences of the resulting "opiophobia" and "oligoanalgesia", 3-5 and many other key opinion leaders have and continue to express similar concerns. [6][7][8][9] Efforts to counteract these tragic consequences have met with a degree of success, although much more needs to be done if chronic pain patients for whom there are frequently no other viable, accessible alternatives to opioid analgesia are to regain access to judiciously prescribed opioids.Unfortunately, advocacy for patients with pain, particularly on social media, has seemingly devolved into purely advocacy for access to opioids.…”