For years, pain patients were told to fight for harm reduction.
We did.
We
defended it publicly.
We were told it helped us too.
We were
told, “We’re in this together.”
When we say “abandoned pain patients,” we are talking about people with severe chronic illness and disability cancer survivors, neurological disease, connective tissue disorders, spinal injuries, degenerative conditions, and rare diseases who were stable on opioid therapy and then cut off.
Now let’s talk reality.
Workforce:
Harm
reduction workforce (very rough estimate):
Between 75,000
and 250,000 paid workers nationwide.
That includes:
State and local Departments of Health
CDC-funded programs and centers
University-based harm-reduction initiatives
SAMHSA grant recipients
Nonprofits, outreach teams, peers, administrators
That is a massive, funded workforce with salaries, platforms, and access to legislators.
Pain
patients abandoned from opioid care:
Zero
funded workers.
No
federal or state workforce assigned to them.
No program
offices.
No case managers.
No rapid response teams.
Funding:
Harm reduction funding:
Hundreds of millions of dollars per year in direct federal harm-reduction and overdose-prevention funding
$1–2+ billion annually in federal opioid response and grant funding that states can use for harm-reduction activities
This money pays salaries, builds programs, funds research, supports advocacy, and sustains institutions.
Funding
for abandoned pain patients who lost access to opioids:
$0.
No
federal grants.
No state grants.
No dedicated funding streams.
Not
“very little.”
Not “hard to track.”
Just Zero.
$0. Nada. Nothing.
The one program that was supposed to help:
There is exactly one federal program that was supposed to respond when opioid policy causes harm and when clinics close: the Opioid Rapid Response Program (ORRP).
ORRP is run through the CDC, with involvement from federal agencies including the Office of Inspector General and the DEA.
What did ORRP do?
Excluded pain patients from public meetings
Banned DPF, the only national organization documenting pain-patient abandonment
Dismissed and mocked pain patients who called begging for help
Lied about DPF, having us blacklisted from public meetings both through ORRP, Project Echo, and ASTHO. (Yes, we have the receipts in FOIA responses)
So
let’s be clear.
This problem was assigned to one office.
That
office chose not to act other than shuffling pain patients into
addiction clinics. That office called DPF and left what felt like a
threatening message. We have the FOIA response to prove they lied
about DPF and had us blacklisted.
Scale of the populations:
Estimated
people with opioid use disorder: ~2–3
million
Tracked.
Counted. Funded. Surveyed annually.
Estimated people still on daily opioids for pain: ~8–11 million
How
many pain patients are currently medically abandoned?
How many
will lose care next year?
We do not know.
Because no one even bothers to count them.
More hypocrisy:
An Office of Inspector General report flagged it as unacceptable if a Suboxone clinic was more than five miles from a patient.
Five miles.
Pain patients today are:
Driving hundreds of miles
Flying across the country
Bedbound and unable to travel at all
Plus, further than 50 miles is considered a red flag, which leads to more medical abandonment.
So, I am still waiting to hear how harm reduction is helping abandoned pain patients.
The truth:
I can name the harm-reduction workers who actively include abandoned pain patients in their work on one hand.
One hand.
I am deeply grateful for every one of them.
But when there are tens or hundreds of thousands of harm-reduction workers nationwide, that silence is not accidental.
We fought for harm reduction.
You
have the workforce.
You have the funding.
You have the
platforms.
You have the access.
You could fight for abandoned pain patients.
You choose not to.
And every single day, I receive messages like this one that came in today:
“My partner was stable on opioids for years. Her doctor of 15 years closed abruptly. No one will help her. She is in constant pain, vomiting, going unconscious, and has had seizures from withdrawal. She is bedbound. I don’t think she will last much longer. What can I do?”
Yes, I’m angry. Anyone who reads the hundreds of messages we receive every day like this one would be angry. Anger is the appropriate response to this level of suffering.
This is what your silence looks like.
So don’t tell pain patients we’re “in this together.”
Show us.
Until then, stop asking the people with no funding, no workforce, and no safety net to carry the moral burden for a system that refuses to carry ours.
To pain patients reading this: We see you.
We are here for you. We will never stop fighting. We will keep collecting your stories, documenting what is happening, and fighting for change. Your suffering will not be erased, minimized, or reframed to make others more comfortable.
You
are not invisible here.
And you are not alone.
