Richard A. Lawhern is a nationally recognized health care educator and patient advocate who has spent nearly three decades researching pain management and addiction policy. His extensive body of work, including over 300 published papers and interviews, reflects a deep critique of U.S. health care agencies and their approaches to chronic pain treatment. Now retired from formal academic and hospital affiliations, Richard continues to engage with professional and public audiences through platforms such as LinkedIn, Facebook, and his contributions to KevinMD. His advocacy extends to online communities like Protect People in Pain, where he works to elevate the voices of patients navigating restrictive opioid policies. Among his many publications is a guideline on opioid use for chronic non-cancer pain, reflecting his commitment to evidence-based reform in pain medicine.
As much as I have written about pain and addiction care over the past three decades, daily life for most of my readers is about even larger values. This current conversation is about values that may change and shape our lives.
I grew up in an age before computers, much less electronic books or Kindle or the internet. I am a dinosaur when it comes to remembering too many darned passwords …
Books that shape life values: a lifelong reading list
My wife is dying.
The day has yet to be determined, but the causes are certain. Stage 4 metastatic pancreatic and liver cancers will allow her a few weeks more in which to say goodbye to a large circle of family and friends. She has decided not to undergo chemotherapy or radiation that at best might extend her life by a few weeks, at the cost of the quality of whatever …
Lessons from 47 years: long-term marriage and palliative care
When I was a teenager, practical computers did not yet exist. In 1966, my first exposure to a computer in engineering school was a room-sized mainframe whose fast memory consisted of a foot-tall rotating magnetic disc that could store 8,000 “bytes” (each byte containing eight “bits,” which allow for 256 possible values representing alphabetic letters or numbers).
At the time, we could forget about storing the full text of the King …
Understanding Moore’s Law and the exponential growth of technology
It is said that we live in difficult times, and that reality is unavoidable for anyone who does not live as a hermit in a cave somewhere. For patients and their doctors, the signs of impending failure are equally unavoidable.
Health care consumes 18 percent of U.S. gross domestic product and continues to rise faster than the rate of inflation. Consumer confidence in the goodwill and scientific integrity of U.S. health …
Military leadership lessons for the U.S. health care crisis
My wife underwent major surgery in December 2025. She remained 10 days in a Charlotte, NC, hospital and was then for several weeks supported at home by visiting nurses, a physical therapist, and a dietician. We just saw the bill: The hospital and participating doctors submitted bills of $120,000 to Medicare and to Tricare (family health insurance for military service veterans like me).
The 21 years that I served as a …
Medical bankruptcy: the hidden cost of U.S. health care
As health care writers and patient advocates, the authors are engaged in multiple projects intended to encourage major policy changes by highly resistant U.S. and state public health agencies. Misdirected policies and disinformation from these agencies are literally killing patients every day by denying them safe and effective management of agonizing pain, destroying the field of pain medicine, and criminalizing its practitioners.
This is institutionalized madness. It needs to stop. Now, …
My wife’s story: How DEA and CDC guidelines destroyed our golden years
Based on our combined experience of over 70 years in patient advocacy, pain management, and behavioral neurology, we are convinced that U.S. public perception and public policy on treatment of pain have been driven almost entirely by sociopolitical and legal factors. Seldom in recent years has policy been significantly influenced by science.
The U.S. enjoyed a brief period of scientifically enlightened policy in the late 1990s through 2008. A large number …
U.S. opioid policy history: How politics replaced science in pain care
As a longtime writer and health care educator, I am sometimes approached by media reporters to discuss multiple fields. Despite the breadth of my publications in U.S. and Canadian health care, my original academic degrees (45 years ago) were in engineering subjects. Among my other hobbies, I have at times contributed as a peer reviewer in advanced science and technology journals.
Thus, it came as no surprise when I received the …
Why almost nobody needs a PhD anymore: an educator’s perspective
Most of us have heard the ancient Indian and Buddhist parable “the blind men and the elephant.” Regardless of source, the parable usually contains these elements:
A ruler assembles several blind men and brings an elephant before them. One feels the head and says the elephant is like a pot; another the ear and says it is like a fan; another the leg and says it is like a pillar; another …
The blind men and the elephant: a parable for modern pain management
Two years ago, I asked, “Doctors diagnosing addiction: Are the blind leading the blind?”
The estimated rates of substance use disorder among clinical patients treated for pain vary greatly, depending on whom one believes. Studies also suffer from a widespread failure to address genetically mediated variability in minimum effective opioid dose between individuals. Thus, I have many times respectfully suggested that the entire body of literature on opioid …
Modified DSM-5 opioid use disorder criteria for pain patients
My primary focus is on U.S. and international public health policy for treatment of severe chronic pain. I have been active for over 28 years as a health care writer and educator, with over 300 papers authored or co-authored in a mix of peer-reviewed journals and mass media.
I am a particular critic of what I believe to be the proven misdirection (a.k.a. “fraud“) committed by Federal and State …
Opioid prescribing guidelines ignore metabolism
At age 81, I speak and write voluminously as a health care educator specializing in public health policy and practice for the treatment of pain and addiction. My wife and I are also careful about getting our periodic vaccinations for flu and COVID-19. A few days ago we responded to an invitation from our pharmacy to drop in for our shots on a walk-in basis. The process turned out to …
The frustrating bureaucracy of getting a vaccine
We are informed by the Spanish-American philosopher, essayist, and poet George Santayana, that “those who cannot remember the past are condemned to repeat it.”
That has never been my problem.
I grew up immersed in family stories from both parents — some of them true, and some not so accurately remembered. Starting at about age three with Little Golden Books that my mom bought for a nickel each at local thrift stores, …
From Civil War tales to iPhones: a family history in contrast
At age 81, I am one of “the old guys” who writes in online chronic pain support groups. I get a lot of emails from people in pain. One recent inquiry was from a lady named Marisa, who asked questions that are combined in the title of this article. The following is my response to Marisa and others.
My wife is a chronic pain patient who has multiple medical issues. I …
Why chronic pain patients and doctors are both under attack
Among Americans and Europeans, overweight and obesity are endemic. Excess weight is also a primary or contributing cause and a significant risk factor for many chronic diseases, including diabetes, heart disease, stroke, several cancers, liver and kidney diseases, respiratory and musculoskeletal disorders, and mental health problems.
That being said, one can read any amount of advice we can make time for, concerning dieting or exercise. But a harsh reality persists: Fat …
The hidden battle of weight loss: Why dieting alone isn’t enough
As a health care writer and data analyst, I hear frequently from patients who are being denied safe and effective pain care due to unscientific bias on the part of U.S. health care agencies—and sometimes on the part of otherwise once-reputable medical journals. These are among millions of U.S. citizens who are now being deserted by the medical profession.
Thousands, overcome by their pain and depression, have already …
The hidden bias in how we treat chronic pain
As I have written elsewhere, the United States is now embroiled in a highly contentious debate concerning the causes of the so-called “opioid crisis.” Prescribing guidelines updated in 2022 by the Centers for Disease Control and Prevention (CDC) and Veterans Administration (VA) have become the basis for continuing scientifically unsupported restrictions on patient access to long-term prescription opioid therapy. Doctors …
As a health care writer and patient advocate for over 27 years, I have interacted with thousands of patients who experience chronic severe pain, caregivers who support struggling family members, and clinicians who treat painful conditions. Depression and anxiety are very common in these patients and may significantly complicate treatment. Untreated depression – or under-treated pain – can cause increases in healing times, suicidal ideation, and Read more…
How a systems approach can revolutionize pain and depression treatment
At age 80, I’m an “old guy.” I’ve been an avid reader and writer on multiple subjects all of my life. Though I write primarily about U.S. health care, I maintain a lively interest in politics generally. Since election day, I’ve been hearing stories that express a profound sense of trauma in millions of us. Many feel themselves to be in mourning for their beloved country. Others feel vindicated and …
America’s democracy is on the brink: Will leaders act before it’s too late?
On May 9-10, 2017, the U.S. Food and Drug Administration (FDA) held a workshop titled “Training health care providers on pain management and safe use of opioid analgesics — exploring the path forward.” I attended the workshop in person to offer comments on behalf of chronic pain patients. A summary of my observations at the time was published by the now-defunct Pain News Network. The following extended extract is from …
The U.S. Food and Drug Administration is talking when they should be listening
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