In this site, “medications” mean much more than they do in the general public. In this site, “medications” consist of any chemical that has physical effects on bodily functions, both in beneficial and negative ways. By taking the position that “chemicals that act on the body” are important for chronic non-cancer pain patients with 5+ pain, then  prescription medications, supplements, exercise, sleep, state of mind and, of course, eating right also constitute “medications.” In this site, individual or combinations of all chemicals acting on the body are critical in restoring optimal functioning across all systems.

The very limited range of prescription drugs that board certified pain management anesthesiologists used most often for moderate-to-severe chronic non-cancer pain in the program I directed on Scripps Memorial Hospital campus are the following:

Morphine Sulphate

Avinza ER


MS Contin


Fentanyl (transdermal, transmuscosal)

Actiq, Fentora




Vicodin, Zydone (hydrocodone and acetoaminophen)







Opana ER

The objective in this site, as is commonly recommended by specialists in the chronic non-cancer pain field worldwide, is to use prescription medications as a catalyst to the restoration of as normal functionality as possible, with the ultimate goal to turn over to the patient as much self-management of the conditions of their pain’s occurrence as possible. The objective is not to provide a never-ending feeding trough for providers who may have good intentions but no documentable competence or experience in the practice of chronic non-cancer pain. To the extent that the prescribed medication in any way interferes with or retards the restoration of functionality, by definition that medication must be deemed inappropriate for the individual. Any medication, therefore, is defined in terms of its ability to facilitate the restoration of functionality. No opioid, then, is ever used as an end in itself. The qualifications and the experience of the person prescribing one’s opioids, therefore, is absolutely critical for the patient to not only question but to reject as needed.

The effects of opioids are two-fold: by introducing them into the body, the aim is to modulate the production and availability to receptors of the analgesic effects of opiates. By introducing synthetic opioids, we automatically block production of our natural  opiates (endorphins). The objective is to reinstate production of our natural opiates by restoring as natural functionality as possible in order to reinstate production of natural opiates.

That is why the goal of long-term and natural management of pain is the goal here rather than being forever chemically dependent on synthetic opioids. By definition, the use of synthetic opioids is incompatible with long-term, natural, self-regulation of our own natural opiates. While chemical dependence is a natural consequence with the use of any chemical that is introduced into the body on a consistent basis, addiction is statistically very rare in legitimate chronic non-cancer patients if the management of opiates is competently managed. This is why pain management must be a decision process managed by someone who is thoroughly experienced in pain management and in effectively managing pain medications as we have suggested here in the treatment of chronic non-cancer pain. Done right, side effects from opioids are minimal, largely because they are the medications most similar to the natural chemical produced by our own body to manage pain and a multiplicity of other critical functions. Negative effects from opioids, again if done right, are usually less than the effects of other drugs used by physicians to treat a multiplicity of diseases.