2. There is a "myth of two pains" -- physical vs mental -- that has plagued us for centuries and continues to adversely affect our treatment of patients suffering from chronic pain. The 19th-century view that pain was not legitimate unless it could be pointed to, probed and measured; otherwise it was 'hysteria,' 'neurasthenia,' or simply madness. Pain is not simply about altered neurochemistry. There may be psychosociospiritual contributors in a patient with pain. These should be acknoweldged without "blaming the victim" or dismissing the problem as "all in the head." Early life experiences of suffering, such as childhood traumas, may hardwire the our "pain thermostats" to be more sensitive to pain later in life.
3. Doctors have an irrational and unreasonable fear of using opioids to treat pain of all types. The historical context of opiophobia is coloured by the availability of these drugs and use (and abuse) over the centuries. Nonetheless, the current restrictive laws and regulations adversely affect how doctors prescribe opioids to treat pain today.