FACT: This claim is based almost entirely on the 2018 SPACE Trial, a small VA study of 240 patients that has been widely misrepresented by the media, policymakers, and expert witnesses.

The SPACE Trial compared very low-dose opioids (~22 MME/day) to an aggressive multi-drug non-opioid regimen for veterans with back or osteoarthritis pain. The opioid doses were far below therapeutic levels, while the non-opioid arm used maximum doses of multiple drugs, including duloxetine, gabapentin, and even tramadol, which is an opioid.

Despite this stacked design, the study found that:

• Both groups improved in pain and function.
• No significant difference existed between them.
• The opioid group had slightly better anxiety outcomes.
• There were no cases of addiction, misuse, diversion, or overdose.

The trial excluded nearly all chronic pain patients, anyone with fibromyalgia, neuropathic pain, prior opioid use, or mental illness, yet it was spun to claim that “opioids don’t work” for any chronic pain.

That distortion became the foundation for restrictive policies, forced tapers, and litigation narratives, often promoted by PROP-affiliated experts such as Anna Lembke and Roger Chou. Even the study’s lead author, Dr. Erin Krebs, admitted it was “too early for our findings to be incorporated into guidelines.”

The truth: The SPACE Trial showed that both opioid and non-opioid treatments can help some patients, but it never proved that opioids are ineffective. What it really demonstrated was how far the narrative can drift when science is twisted for politics and profit.

Read the full breakdown, data tables, and printable resources on our Patreon page