Published by Vox

When you ask Stanford pain specialist Sean Mackey how he deals with chronic pain patients in the middle of the opioid epidemic, he has a consistent answer: “It’s complicated.”

Mackey, who describes himself as “a centrist on opioids,” says that’s how doctors should approach the decision to prescribe opioid painkillers to chronic pain patients. That many doctors didn’t approach their initial prescriptions in a more nuanced way in the 1990s, he argues, is one of the factors behind the current drug crisis. But he also says many doctors now take a too simplistic view against opioids, causing what he characterizes as “a public health crisis in pain.”