In 1996, Purdue Pharma introduced a drug it described as a breakthrough in pain management. OxyContin was marketed as modern, safe, and compassionate—a scientific solution to human suffering. What followed is now one of the worst public health disasters in history. More than a quarter million people in North America have died from prescription opioid overdoses.
Today, fentanyl is finishing what OxyContin started, claiming roughly 70,000 lives in the United States each year. The opioid epidemic did not begin in dark alleys—it began in bright exam rooms, with ordinary people asking their doctors for help with one of the most common medical complaints in the world: back pain.
How Back Pain Became the Gateway
Back pain is the single leading reason physicians prescribe opioids. According to the Centers for Disease Control and Prevention, more than half of all opioid prescriptions are written for musculoskeletal conditions, with low back pain at the top of the list.
The problem isn’t that doctors are indifferent, or that patients are reckless. It’s that both are working from the same mistaken premise: that persistent pain must mean physical injury. This assumption turns opioids into a deceptively rational response. If tissue damage causes pain, then suppressing the pain pharmacologically seems humane. The reality is more complicated—and far more dangerous.
“Opioids aren’t a treatment for pain—they’re a gateway to disability.”
— Franklin et al., 2008, Spine
What the Evidence Shows
The clinical data are unambiguous. A 2018 randomized controlled trial published in JAMA compared opioids with non-opioid medications for chronic back and joint pain. After 12 months, patients taking opioids reported no better pain relief—and significantly worse functioning—than those on alternatives.
(Krebs et al., 2018, JAMA.)
Other studies have found that early opioid prescriptions increase the likelihood of long-term pain disability rather than preventing it. Opioids dull the nervous system but do nothing to correct the psychological and neurobiological processes that maintain chronic pain.
A Personal Story
A close friend once told me about his mother, who was admitted to the hospital with severe back pain doctors couldn’t explain. They treated her with morphine to keep her comfortable. Within hours, her breathing slowed. She never woke up.
Only months earlier, she had lost her husband unexpectedly. Her daily life had collapsed—financially, emotionally, existentially. She wasn’t just in pain, she was grieving. Her body was expressing what her mind could not. The cause of her pain was invisible, but no less real.
Her death wasn’t an outlier. It was a symptom of a medical system that mistakes emotional suffering for structural failure, and treats both with the same chemistry.
When I heard that story in the fall of 2024, something changed for me. Until then, I had been helping people overcome chronic back pain one at a time through conversations and coaching. But this tragedy made it impossible to stay small. I realized that what we’re facing isn’t just a medical issue, but a national misunderstanding about the nature of pain itself.
That’s when I decided to take Makepeace beyond individual recovery and turn it into a movement.
Pain, Misunderstood
Pain is one of the brain’s most sophisticated warning systems. In acute situations, it protects us. But when the brain continues to produce pain signals long after tissues have healed, the pain becomes self-perpetuating—a neurological feedback loop sometimes called “neuroplastic pain.”
In these cases, the brain interprets emotional distress, fear, or repressed anger as physical danger and creates pain to force behavioral change. Opioids may interrupt this signal temporarily, but they also reinforce the underlying narrative that the pain is purely mechanical. The more a person relies on medication, the less opportunity the brain has to relearn safety.
A Better Explanation—and a Safer Way Forward
The emerging field of mind–body medicine offers a more complete model of chronic pain. By addressing the emotional and cognitive components of pain, patients can often achieve lasting relief without drugs, surgery, or even physical manipulation.
This doesn’t mean the pain is “all in your head.” It means the brain is the organ that interprets—and can also misinterpret—pain. Healing comes from retraining those neural pathways, not suppressing them.
The opioid crisis is, in one sense, a medical failure. But it’s also an epistemological one: a crisis in how we define pain and what we believe about the body. Until that belief changes, the prescriptions will continue—and so will the casualties.
That change has to begin where the crisis began: in the exam room. If physicians, nurses, and triage staff were trained to recognize when pain is likely psychological rather than structural, they could intervene early with reassurance, education, and simple cognitive tools—instead of defaulting to pharmacology.
That is the next frontier I intend to build: an evidence-based framework to help frontline medical workers distinguish between injury and neuroplastic pain, and to give them alternatives that heal rather than sedate.
When medicine sees pain more clearly, it won’t just heal individuals — it will help a nation in pain begin to heal itself.
References
Centers for Disease Control and Prevention. (2017). CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recommendations and Reports, 65(1), 1–49.
Franklin, G. M., Stover, B. D., Turner, J. A., Fulton-Kehoe, D., & Wickizer, T. M. (2008). Early opioid prescription and subsequent disability among workers with back injuries: The Disability Risk Identification Study Cohort. Spine, 33(2), 199–204.
Krebs, E. E., Gravely, A., Nugent, S., Jensen, A. C., DeRonne, B., Goldsmith, E. S., et al. (2018). Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: The SPACE randomized clinical trial. JAMA, 319(9), 872–882.
Volkow, N. D., McLellan, A. T., Cotto, J. H., Karithanom, M., & Weiss, S. R. (2011). Characteristics of opioid prescriptions in 2009. JAMA, 305(13), 1299–1301.
Keep learning
Take This 1-Minute Back Pain Self-Test
If your pain moves around, worsens with stress, or fades when you’re distracted, it may not be structural at all. This short self-test helps you recognize patterns that point to a nervous system stuck in ‘protect’ mode—and how to begin calming it down.
The Harder You Try to Fix It, The Worse It Gets
The endless search for fixes—new stretches, supplements, devices—often keeps the brain focused on danger. Real recovery begins when you stop trying to “fight” the pain and start teaching your brain that it’s safe to relax again.
Harvard Confirms Back Pain Is Usually Not Structural
Harvard researchers found that most spinal changes seen on MRI scans—disc bulges, degeneration —appear just as often in people without pain. These are normal signs of aging, not proof of damage. The true driver is often the brain’s over-protective alarm system.
Real people. Real relief.
These are real stories from people who were stuck in pain—until they tried the Makepeace Method. Now they're free.
One day, you bend down to pick up a sock—and your back goes out.
“Knowing what I know now, I regret having back surgery.”
“I feel so much better — and I’m grateful this exists.”
“This took my pain from a 9 or 10 down to a 1 or 2.”
“After doing the program, I got up from my desk one day and the pain and tingling were just gone.”
“I've had significant improvements in my pain levels. I now feel confident about managing my back health.”
“This method makes a complex idea easy to implement. Bottom line: I’m feeling much better.”
“I was bedridden for weeks. Now the pain is gone, and when it flares, I can shut it off.”
“I was a massage therapist for 30 years. Several weeks ago I started an excruciating ordeal with back pain. The Makepeace Method was life changing for me. My back has improved tremendously. Thank you a million times over.”
“I loved your course. It was a blessing listening to your videos. It has given me hope on my healing journey.”
“I had been truly suffering for months. Within a few days, I was moving freely again. Thank you.”
You've done your time in pain. Now take your life back.
You’ve fought hard and tried it all, but the burden was never yours to carry forever. Your brain is ready to reset, your body to feel safe again. Pain is not who you are - it’s time to reclaim your life.
