What helped for people in severe pain.. and what didn't

Unfortunately, the situation for pain isn’t great. It’s starting to look like gabapentin causes more harm than good (on average).

Some treatments commonly used for pain relief are highlighted in yellow. Some patients have reported flaring of their pain following over-exertion, so pacing strategies (e.g. spoon theory) are highlighted.

Those in severe pain reported positive experiences with opiates. However:

  • The sample size was slightly small. For the lower pain group, only 8 people reported results for opiates (this is really low).
  • These drugs have withdrawal effects when you try to get off them. The survey would not capture this if people haven’t tried to get off them yet.
  • ‘Recreational drugs’ tended to rank highly on this survey. It’s possible that the survey is measuring some of their ‘fun value’ rather than their medical usefulness.
  • Many have argued that there is an opioid crisis/epidemic going on.

Non-opiate pain relievers (prescription), e.g. gabapentin

“Other pain relievers” refers to prescription pain drugs that aren’t opiate pain medications.


Interestingly enough, other pain relievers did really poorly on the survey. Patients didn’t report a lot of positive experiences with them.

Gabapentin and suicide risk

Scientific paper: Gabapentin-related suicide: Myth or fact?

it is crucial to raise awareness of gabapentin as a potential cause of depression, aggressive behavior, and suicidal ideation

There’s also data from safety reporting databases which suggests that gabapentin has suicide risk.

VIGIAccess data for gabapentin:

VIGIAccess data for COVID-19 vaccines shows that completed suicide isn’t among the top psychiatric side effects:

Access to opiates

Let’s just say that it’s possible to buy kratom and O-DSMT without a prescription. However, you should treat these drugs like prescription drugs.

  • Kratom users report unpleasant withdrawal effects just like with opiates.
  • O-DSMT is the metabolite of Tramadol, a prescription drug.

DISCLAIMER: Opiates may be a bad idea

Some doctors will prescribe a lot of opiates because manufacturers pay a lot of money to market their drugs, sometimes in unethical ways (e.g. paying kickbacks to doctors and tainting the medical literature with misinformation). Your doctor may not necessarily be ethical or properly educated about opiates.