Use of opioids is a problem in the U.S. Patients ordinarily do not want to take pain medication unless they have pain, which presents an important and overlooked question: Why are so many patients having so much pain? Patients have too much pain, both physical and mental, because chronic infections are not being diagnosed; and patients are treated symptomatically.

Patients in pain often have undiagnosed or untreated chronic infection, gastrointestinal disease, and other complex medical problems. They often have mental health issues from the gut-brain connection, infection altering brain chemistry, and/or pathogens in the brain. Patients in chronic pain, who have more pain than understood, or who have an opioid addiction, should be evaluated for immortal infections and parasites.