What do pregnant women with high fevers and people with severe chronic pain have in common? Increasingly, both are being told to “tough it out.”

The recent Tylenol-autism scare has dominated headlines, casting doubt on the only medication long considered safe for pregnant women.

This comes as no news to people living with chronic pain; they’ve gradually seen their options shrink to nearly zero as opioids are restricted, Tylenol is ineffective and non-steroidal anti-inflammatory drugs (NSAIDs) often become unsafe with prolonged use.

In both cases, the message is the same: Relief is off the table.

Pregnant women in need of relief from fever or discomfort are asking themselves: “If Tylenol is harmful to my baby, and NSAIDs like ibuprofen are also off-limits, then what am I supposed to use when I’m sick?”

Rephrased, nearly the same question has been asked by people with chronic pain for more than a decade: “If I cannot take NSAIDs, Tylenol provides no meaningful relief and I can no longer obtain stronger medications such as opioids, then what can I use?”

Both groups are now confronting the same painful truth. Despite the triumphs of modern medicine, the science of pain control has barely advanced.

Aspirin and heroin were discovered in the 19th century. In the century since, pain treatment has made shockingly little progress.

Meanwhile, the Tylenol scare is built on shaky evidence but creates real fear, leaving women with almost no safe options.

For people living with chronic pain, the problem isn’t lack of research so much as a damaging fallacy: that opioids cannot be used safely, even for short periods of time, let alone long-term.

This belief ignores decades of experience showing that, for many people, properly used opioids were the only medications that provided meaningful relief and allowed them to function.

US government data indicates that the addiction rate to prescription opioids among adults 18 and older has consistently stayed below 1%. 

That fact is rarely acknowledged in public debate. Instead, policymakers and the media mistakenly conflate people who take opioids under medical supervision with those who misuse drugs obtained illicitly.

The truth is that the overdose crisis has not been driven by people with prescriptions but by a growing number of nonmedical users who buy drugs of uncertain dose and purity on the black market.

And the more the government cracks down on prescribing, the more people are pushed toward dangerous street drugs like fentanyl.

Yet this reality has done little to change the climate of stigma and restriction. Doctors who once had the flexibility to prescribe responsibly now fear scrutiny or punishment. 

Pharmacies limit supplies or refuse to fill them outright. Regulators have imposed one-size-fits-all rules that treat every person as a potential abuser.

The result is that people with severe pain — who once received effective care — are told to endure what medicine could manage but now refuses to provide.

And when even Tylenol, one of the last “safe” options, is dragged into controversy, it underscores how little progress we’ve made in confronting the real crisis: our reluctance to allow effective pain treatment at all.

The lesson of the Tylenol scare is that, even more broadly, our health system has been failing pregnant women or people living with chronic pain by leaving so few choices.

We need a new way of thinking about pain. That involves rejecting false stories about opioids and recognizing what the data truly shows.

It requires creating a balanced solution — one that tackles addiction without leaving behind those for whom opioids are the only effective treatment. 

It calls on regulators to open the way for innovation — not by launching new task forces or subsidies, but by getting out of the way.

The current climate treats potential pain therapies as guilty until proven innocent. Streamlining approval and reforming scheduling laws would do more to spur real innovation than any government initiative.

Until that happens, pregnant women trying to manage a fever and people dealing with constant, overwhelming pain will keep hearing the same message: tough it out.

That isn’t medicine. It’s cruelty.

Jeffrey A. Singer, MD,  is a senior fellow at the Cato Institute, the author of “Your Body, Your Health Care” (Cato Institute). Josh Bloom, PhD, is director of chemical and pharmaceutical science at the American Council on Science and Health.