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Whatever the underlying science or dynamics of "opioid dependance" we have to accept there is a core group of patients with chronic pain who attribute low dose opioid therapy for "survival and some quality of life". Chronic pain syndrome is a not so apparent evil that destroys the life of many who at some point were the hardest workers, putting in long hours, OT etc with hardly any sick leave and taxing the health care system the least and now find shunned by the same system as "opioid seekers". Not withstanding the research studies with an overflow of theories let us never forget Dr. Juurlink's opening sentence that "the relief of suffering is the fundamental objective of medical practice."