Pain, though undeniably unpleasant, is not actually harmful in and of itself. While it often accompanies conditions and processes that are harmful to the body, for which it serves as a useful warning, simply relieving the pain involved does not actually stop or heal the harm which underlies it, and there are plenty of cases where pain exists with no harm underlying it. This poses the theoretical question of whether providing any type of pain relief is ever truly necessary in any condition, assuming one’s goal is to heal disease. Whether it is conventional or natural pain relief, returning a person to health would never strictly require relieving pain, by any means other than addressing the root cause, something pain relievers don’t typically do. This is not to say there is no benefit to providing pain relief, but it is strictly a quality of life consideration. If the body is likely to heal on its own, pain relief can make someone more comfortable throughout the process, and if the person cannot heal, then relieving chronic pain significantly enhances quality of life. But if pain is meant to serve as a warning signal for harm, there seems no reason for so many people to be in so much chronic pain.
Most practitioners do not enjoy treating chronic pain, especially in conventional medicine where options are few and treatment usually involves prescribing dangerous, addictive opioids. The harm opioids have caused our society makes it seem completely irredeemable to prescribe them at all, especially given that pain relief is at best a quality of life consideration and never medically necessary. It would seem unjustifiable unless there was truly no better alternative, but what if there was? It’s intriguing to use opioid addiction as a lens through which to understand pain, because while some people do become addicted to these narcotics as a consequence of using them to relieve physical pain, there are plenty of heroin addicts who did not turn to these drugs for that reason. Many people use heroin to cope with emotional pain, especially loneliness. The fact that heroin users will sometimes resort to prescription opioids, while people prescribed opioids may turn to heroin when they can no longer access their prescriptions, illustrates how blurry the line is between physical and emotional suffering on a biochemical level.
The typical heroin addict is someone who has been in an abusive or traumatic situation, and additionally has no real support network in terms of people they perceive might love and care for them enough to help. It’s actually quite a privilege for most people to know that if they were to hit rock bottom or find themselves trapped in an abusive situation, there is probably someone in their life who would take them in and offer support until they could get back on their feet. To live without this belief, even as a hypothetical safety net, can cause a level of anxiety most people are fortunate enough never to experience. The belief in a loving support network can almost be considered a human need, without which it becomes difficult to function normally, and many people who abuse heroin describe it exactly as this, a loving friend or presence that helps them cope with fear, loneliness or pain. As a drug of abuse, opioids seem to function as a chemical replacement for human affection, which is why people who have suffered abuse, feel unloved, and have no support network are so vulnerable to becoming dependent on them.
That people in physical pain, especially chronic physical pain, have the same vulnerability is a strong argument that what normally keeps us pain-free is in fact regular doses of human affection. There is abundant anecdotal evidence that human contact, especially loving contact, can very quickly and effectively reduce pain. Anyone who has seen an injured child run to its mother and be quickly soothed can appreciate this fact. In young children, pain of any kind (including emotional pain) almost serves as a trigger to reunite the child with his or her caregiver, and it’s unlikely that adults fully grow out of this, which has profound implications for the way we treat ourselves in modern society and the way we treat chronic pain. In terms of scientific evidence, it is well known that oxytocin, released in response to cuddling and other forms of affection, is a natural pain reliever. It has been shown to work especially on deep tissue pain, migraines, and back pain… and it is also well-known that most complex pain syndromes afflict people who are dealing psychosocial stress, especially loneliness, relationship abuse, workplace abuse, and estrangement from family members. Historically, the importance of nursing to the medical profession likely involved the real physiological benefits of receiving care from a warm, sympathetic human. The medical profession’s dependence on synthetic opioids seems to parallel the rise of a scientific paradigm which would minimize this, as well as the degradation of nurses from true caregivers to essentially underpaid and overworked doctors, performing the same routine medical tasks to make hospitals more efficient and profitable.
Besides relieving pain, another remarkable commonality between oxytocin and opioids is their ability to allay fear. While opioids are less famous for doing this, it is nonetheless true and may illuminate the legitimate value which has made them a part of medicine for almost its entire history. The use of opioids in medicine is quite ancient, going back to the herbal use of opium itself, Papaver somniferum. Not only does the herb block pain signals in the body to a wondrous extent, it also increases courage, and was used by an ancient order of warriors called hashishins to make them fearless in battle (the origin of the word assassin). It was also widely employed for this purpose by American soldiers in the Vietnam War, as an illicit aid to deal with the daily reality of obeying orders thrusting them into harrowing life-and-death scenarios. The consequence of this use, of course, was addiction and post-traumatic stress disorder, but interestingly this effect illustrates one of the most remarkable healing properties of opiate drugs.
A study on combat veterans in the Iraq war, published in the New England Journal of Medicine, found that wounded soldiers who received morphine for their injuries were less likely to develop PTSD than soldiers with similar injuries who did not1. Morphine is of course a synthetic derivative of opium and believed to be its active constituent, and this study suggests astoundingly that in certain situations, like acute trauma care, the use of opioids is psychologically protective and helps to prevent serious conditions like PTSD. This illustrates the homeopathic principle of like-cures-like, in that the timely use of a medicine in the right dose can relieve the very conditions it might cause or worsen when taken excessively. Opium is indeed used as a homeopathic remedy in extremely dilute form, and is useful to minimize symptoms like constipation, numbness, and the effects of fright.
That opioids can block fear as well as pain has important implications for the understanding of chronic pain. In the brain, fear and pain are processed so similarly that they can almost be considered the same thing; the brain regions that process fear and anxiety are the same as interpreting whether a given sensation is painful, and numerous experiments have shown that emotional fear enhances the sensation of pain and vice-versa. While research into the exact mechanisms is ongoing, including the increasingly recognized link between anxiety and chronic pain, plenty of anecdotal evidence attests to this. Poking an unaware person in the arm with a syringe causes so little pain that it almost goes unnoticed, whereas the dread of anticipating a required shot can easily magnify the same sharp sensation into a harrowing ordeal. While there definitely exist situations where it would be humane, appropriate, and beneficial to give painkillers, whether natural or pharmaceutical, given how much of pain exists in the brain, it is important to weigh the costs of any painkiller against its benefits and explore other approaches when these are possible. This would in fact seem obvious to most people, which makes it so strange how insistently conventional medicine continues to prescribe opiates. Many people can attest to their doctors insisting they take recommended painkillers following a procedure, even resorting to fear tactics when stoic people politely decline these prescriptions and insist they will not need them.
The physician William Osler famously referred to opium as “God’s own medicine,” and controversy has raged for centuries over whether opiates are unfairly maligned, depriving many patients of their legitimate benefits, or so addictive that they should be avoided entirely, the cause of multiple wars and one of the worst epidemics in history. Before the modern opioid crisis originating in the 1990s, opium was widely used and abused as “tincture of laudanum” much the same way as opioids and benzodiazepines are prescribed today, as a sleep aid, to treat anxiety, and relieve chronic pain in individuals dealing with profound psychosocial stress. Its unsuitableness for these purposes and addictive nature was disparaged then as it continues to be now, despite conventional medicine continuing to rely on it. Harrison’s Principles of Internal Medicine, a foundational textbook considered to be the authoritative source on conventional diagnosis and treatment over the last 70 years (Anthony Fauci is among its recent editors), had a preface in the 1990s insisting that one of a physician’s most important duties is to relieve pain, and shaming doctors who chose to withhold painkillers from their suffering patients.
I know this for a fact because I own a copy of the book in question, and the fact that they would say this on page one is blatant proof that the pharmaceutical industry funds most medical education. In fact, there is never a strict medical necessity to relieve pain: painkillers do nothing to promote the healing process, pain itself does nothing to obstruct the healing process, and no one ever died from being in pain. This is not to say that a physician should not relieve pain, which can be done by other, less-addictive means, it simply reflects the warped priorities being thrust upon medical students from their first day of training. The 1990s is considered the beginning of the modern opioid epidemic, when the new opioid pain reliever OxyContin was marketed to doctors specifically on the basis of its non-addictive properties. It turns out this was not true, and it was very addictive, ruining hundreds of thousands of lives. Eventually, doctors stopped prescribing OxyContin and became so wary of anyone seeking it that addicted patients turned to their only obtainable alternative, heroin. This precipitated the second wave of the opioid crisis, the third wave beginning when illegal heroin started to be replaced with illegal fentanyl, an FDA-approved prescription opioid about 50 times more potent than heroin.
In a perfect world, no one would require pain relief beyond gentle comfort and reassurance, but in reality psychosocial stress and our own cognitive limitations leave us all vulnerable at times to senseless pain. Natural remedies can often provide this as effectively as prescription medications with fewer side effects and less addictive potential, though even with natural therapies there is always the danger of simply masking symptoms at the expense of addressing a root cause. Even herbs have the potential to create dependency, with opium itself being a classical example, so when treating pain it is always useful to give heed to underlying emotional causes, such as fear, anger, loneliness, and grief, alongside soothing remedies for pain relief.
- Holbrook TL, Galarneau MR, Dye JL, Quinn K, Dougherty AL. Morphine use after combat injury in Iraq and post-traumatic stress disorder. N Engl J Med. 2010 Jan 14;362(2):110-7. doi: 10.1056/NEJMoa0903326. PMID: 20071700. ↩︎
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