This really isn't true. (Source: I'm a psychiatrist who treats some forms of chronic pain, while also treating people with opioid use disorder who started with

This really isn't true. (Source: I'm a psychiatrist who treats some forms of chronic pain, while also treating people with opioid use disorder who started with prescription pills). Good psychotherapy for chronic pain explicitly acknowledges that pain is real and not just in the patient's head. Chronic pain is thought (at a grossly oversimplified level) to be due to nerve sensitization rather than acute trauma, but experience, co-morbid health problems, and life stressors all interact to influence this. Psychotherapy for chronic pain helps people identify maladaptive behaviors that could be worsening chronic pain, and then help to set goals and learn skills to improve their overall function. On average, it's only modestly effective, but it's better than many alternatives. Some people might say that opioids are a placebo. A more nuanced statement would be that most trials can't distinguish between opioids and placebo for chronic pain. That doesn't necessarily mean they don't work for an individual, it just means that it's an intervention based upon low-quality evidence. On the other hand, opioids come with significant (and occasionally catastrophic) risks, and so the decision to pursue a high-risk/low-benefit treatment is discouraged. There are always exceptions, but I've been really pleased with the results I've seen as we've moved further away from opioids for chronic non-cancer pain.