Pain Management

When Doctors Refuse to Prescribe Pain Medication: Understanding the Real Problem

Living with chronic pain is exhausting enough — physically, emotionally, and financially. But for many patients, the hardest pain to manage isn’t the physical one; it’s the feeling of being dismissed, judged, or labeled “drug-seeking” when they ask for help.

The Fear Behind the Refusal

Since the opioid epidemic, many healthcare providers have become overly cautious — or even fearful — of prescribing legitimate pain medications. Strict regulations, DEA oversight, and the threat of license loss have caused some doctors to take an extreme “zero-opioid” stance, even when their patients are suffering.

While the intention is to prevent addiction and diversion, the result has often been undertreated or completely untreated pain, especially for patients with:

• Ehlers-Danlos syndrome (EDS)

• Fibromyalgia

• Neuropathic pain

• Autoimmune or inflammatory disorders

• Complex regional pain syndrome (CRPS)

• Post-surgical or palliative pain

These are legitimate, debilitating conditions — not signs of addiction.

The Harm of Labeling Patients “Drug-Seeking”

When a doctor uses terms like “drug-seeking” or “malingering,” it can follow a patient for years in their medical records. These labels are often based on bias, not evidence. Many patients labeled this way are actually desperately seeking relief, not drugs.

This kind of medical gaslighting — minimizing pain or assuming psychological causes — can lead to:

• Delayed diagnoses and worsening symptoms

• Anxiety, depression, and trauma from being disbelieved

• Avoidance of medical care out of fear of judgment

• Reduced trust between patient and provider
  
  

The Right to Compassionate, Evidence-Based Pain Care

Patients have the right to adequate pain management under federal and ethical standards. The CDC, FDA, and AMA have all clarified that pain management should be individualized — not one-size-fits-all. Blanket refusals to prescribe controlled substances, without assessing the patient’s full history, are unethical and contrary to patient-centered care.

Pain management is not just about opioids. It’s about options — medications, physical therapy, complementary treatments, compounded medications, and most importantly, respect.

How to Advocate for Yourself (or a Loved One)

If you’re being denied pain care or treated unfairly:

1. Request a copy of your medical records. Look for notes labeling you as “drug-seeking” or “non-compliant.” You have a legal right to request corrections or add a patient statement.

2. Document everything. Keep a pain diary, note medication trials and responses, and bring evidence to appointments.

3. Ask for a pain management referral. Some clinics specialize in chronic pain and understand the balance between safety and relief.

4. Use calm, factual language. Example:
   
   “I understand your concerns about prescribing controlled medications, but I’m asking for help managing pain that affects my ability to function. What options can we safely explore together?”

5. If denied entirely, file a complaint with your state’s medical board or patient rights department. Unwarranted refusal to treat pain can be considered patient abandonment.
   
   

Remember: Pain Is Real, and You Deserve Relief

Pain is not “all in your head.” It’s not weakness. It’s not addiction. It’s a physiological signal that something is wrong — and you deserve a provider who listens, investigates, and treats you with empathy.

At AKG Advocacy, we believe no one should have to suffer in silence or be shamed for needing relief. Compassionate care and safety can coexist — and patients deserve both.

Dealing with Difficult Providers

Scenario 1: When a Doctor Dismisses Pain Complaints

Doctor:
“I don’t see anything in your labs or imaging that explains this level of pain. Maybe it’s stress-related.”

Patient:
“I understand the tests look normal, but my pain is still very real and it’s affecting my daily function. Chronic pain doesn’t always show up on imaging, especially with connective tissue or nerve-related conditions. Could we talk about next steps for managing it safely and effectively?”

Why this works:
It avoids confrontation but reinforces that invisible pain is valid and demands management.

Scenario 2: When a Doctor Refuses to Prescribe Medication

Doctor:
“I don’t prescribe opioids anymore. Too many people have abused them.”

Patient:
“I understand your concern about safety — I share that concern. My goal isn’t to get opioids; it’s to get my pain under control enough to function. Can we review all possible options, including non-opioid and compounded treatments, and find what’s medically appropriate for me?”

Why this works:
It reframes the conversation around function and safety, not suspicion or addiction.

Scenario 3: When a Patient Is Labeled “Drug-Seeking”

Doctor:
“You’ve asked for pain medication a few times now. That’s concerning behavior.”

Patient:
“I hear what you’re saying, and I understand how that might look from your perspective. I want to assure you I’m not seeking drugs — I’m seeking relief so I can live a normal life. I’m open to any treatment plan that manages my pain responsibly and allows me to function.”

Why this works:
It addresses the stigma directly, keeps the tone calm, and invites partnership instead of defensiveness.

Scenario 4: When the Provider Ignores a Documented Diagnosis

Doctor:
“Ehlers-Danlos Syndrome can cause discomfort, but it doesn’t usually require strong pain medication.”

Patient:
“Actually, pain is one of the most common and disabling symptoms of Ehlers-Danlos Syndrome. I have documentation from specialists and physical therapy showing how it affects me daily. Would you like me to share those so we can develop a coordinated pain plan?”

Why this works:
It adds credibility, brings in evidence, and encourages collaborative care.

Scenario 5: When You Need to Ask for a Referral

Patient:
“I appreciate your honesty about what you’re comfortable prescribing. Since my pain is ongoing and complex, could you refer me to a pain management specialist or clinic that works with patients who have conditions like mine?”

Why this works:
It avoids confrontation and keeps the focus on continuity of care, not blame.

Scenario 6: For a Caregiver Advocating on a Loved One’s Behalf

Caregiver:
“My loved one has been in severe pain and unable to perform basic tasks. We’re not asking for long-term opioid therapy — we’re asking for a plan that includes compassionate, individualized care. Can we discuss what options are safest and most effective for their situation?”

Why this works:
It establishes the caregiver’s advocacy role and reinforces the goal of safety and relief.

Scenario 7: If You Feel Dismissed or Gaslit

Doctor:
“You just need to push through the pain and be more active.”

Patient:
“I’ve tried staying active, but without adequate pain management, it increases my symptoms. I’m asking for your help to find a balance between movement and pain control. I want to be proactive — I just need the right support to do that safely.”

Why this works:
It reasserts self-agency while calling out the false “just push through it” mentality respectfully.

Scenario 8: Ending the Appointment on Record

Patient:
“Before we finish, I’d like this refusal to be documented in my chart along with my continued request for pain management. I’d also like a copy of today’s visit summary for my records.”

Why this works:
It creates a paper trail of denial without confrontation — vital for appeals, complaints, or future care transitions.

Chronic Pain Management Statistics

Key Prevalence & Burden Figures

• In 2023, 24.3% of U.S. adults reported experiencing chronic pain (defined as pain “most days” or “every day” over the past 3 months). cdc.gov+1

• In that same year, 8.5% of U.S. adults had high-impact chronic pain (pain that frequently limits life or work activities). cdc.gov+1

• Back in 2021, an estimated 20.9% (≈ 51.6 million) of U.S. adults experienced chronic pain; and 6.9% (≈ 17.1 million) experienced high-impact chronic pain. cdc.gov+1

• Among older adults (age 65+), in 2020-2021: 12.8% filled at least one outpatient opioid prescription; 4.4% obtained four or more opioid fills in that year. meps.ahrq.gov

• The annual cost burden of chronic pain (including medical costs, lost productivity, etc.) has been estimated at $560 to $635 billion in the U.S. umaryland.edu

Treatment & Management Patterns

• In 2019, among U.S. adults with chronic pain, 22.1% reported using a prescription opioid in the past 3 months. cdc.gov+1

• Among U.S. adults with chronic pain, nearly a third had used prescription opioids in the prior year; among those with high-impact chronic pain, the figure was over 40%. pmc.ncbi.nlm.nih.gov

• Opioid dispensing rates have declined nationally: from ~46.8 opioid prescriptions per 100 persons in 2019 to ~37.5 per 100 persons in 2023. cdc.gov
  
  

Why These Matter for Advocacy

• With ~1 in 4 adults experiencing chronic pain (and ~1 in 12 experiencing high-impact chronic pain), the scale of need is large—meaning many are at risk of being under-treated or misunderstood.

• The cost burden shows pain is not just a personal health issue—it has major societal and economic consequences.

• The treatment data indicate a shift: opioid use is high among pain patients but also declining; this suggests both the risk of under-treatment (when providers over-restrict) and the need for balanced pain management approaches.

• Disparities: Prevalence is higher in certain demographic groups (older age, women, lower income, etc.)—important for targeted advocacy and equity focus. cdc.gov+1