Big Pharma’s ability to manipulate our institutions goes beyond the medical profession and includes our political representatives in Washington DC. When the DEA wanted to go after Purdue, they called in their political markers and had the DEA stand down. Then when push came to shove, and the truth was being known, they convinced DOJ that the distributors and chain pharmacies were just as guilty as a manufactures. The DOJ gave the marching orders to the states attorneys around the country as to how to convince juries that the distributors and retailers were just as guilty. They created new case law that will cripple and bankrupt drug distributors and drug chains in the United States. It is a failure of the DEA and the FDA to stop Purdue, who was the originator of the concept and has secretly shipped the wealth of the Sackler family overseas according to some sources! astute drug marketing has trumped good medicine for years and certainly was on display with the medical drugs recommended for treating the Covid! As long as they can control the FDA and other federal agencies via political influence, I see nothing changing!
Good article. Lots of good information. I look forward to reading more. As an RN I remember telling patients not to worry, that if they are taking opiates for pain that they wouldn't get addicted. How naive of me. I do believe there is a genetic component to addiction as well. Why do some people become easily addicted, while others can stop cold turkey with no problem. I've seen it in people I know who drank alcohol like fish, and they just stopped cold turky, or the same with smoking. I'd be interested in seeing studies done about that too.
One problem today is the pendulum has swung too far the other way - against opioids. The DEA regulates the manufacture of legal opioids in the U.S. and gives quotas to each manufacturer. The quotas have been going down year after year. The manufactures cannot meed the demand. So that means legitimate chronic pain patients can't get the opioids they used to get and suffer with great pain. Some kill themselves. Others go on the risky black market to get fake opioids that are typically fentanyl. They overdose from that or get sick from who knows that else is in the fake opioids. Or they go on risky heroin because it's cheaper. Real opioid pills commands a very high price on the black market because they are know to be safe the dose is known.
Yes, chronic pain patients do get addicted to opioids. So what is so bad about that? If they are able to obtain legal opioids they will likely not overdose and die from getting them on the black market. They can live a normal life with pain relief. Should they be denied legal opioids? They are now, as many doctors are forced to cut them off after a time. Go back in American history before there were any modern opioids and many doctors worked out programs to give these types of pain relief drugs to patents without feeding addicts who just wanted to get high. With the pre-opioid drugs like morphine and heroin, people were able to function and have normal lives.
I had to get a minor surgery recently. The doctor gave me a list of prescriptions. I went to CVS and they had all the prescription drugs except the opioid, which was out of stock. I found out later it is alway out of stock at CVS. The doctor's staff found the opioid at a Walgreens so I could get it there. But that's only because my doctor called them first. Anybody going into that Walgreens without having a doctor call first would not get any, even if they had a legitimate prescriiption.
The only opioid the doctor could prescribe for me was a shitty hydrocodone. It only had 5mg of an opioid, The rest of the drug was made up of lousy Tylenol which I did not want. Years go I got prescriptions for hydrocodone with 10mg of opioid. Those worked a lot better. That is no longer the case - mostly not available now. No percocet - that's never in stock. No pure opiods ever in stock. No wonder people are turning to the black market for pain relief.
Yes, the pill mills in Florida called pain clinics fed addicts only looking to get high. Criminals took loads of people to the Florida pill mills and got big prescriptions filled and went to one pill mill after another on the same day. Then they took those drugs and sold them in the black market back where they came from. The pill mills had armed guards due to all the unpredictable addicts coming there. But this was eventually controlled with better laws and law enforcement.
The problem is pain cannot be measured by a doctor, it's internal. So you can't tell who is suffering pain and who just wants to get high. It is a difficult problem. But taking away opioids from legitimate pain patients only feeds organized crime, which now controls parts of Mexico and has infiltrated the U.S.
You want to prosecute somebody for opioids, the fault is mostly not in the manufacturers or the distributors. The problem is the doctors who write the prescriptions.
Addiction to drugs is the personal responsibility of the addict wanting to get high. The drug does not run their life. The drug does not make them buy more. Addicts only care for themeless, not others. Many addicts stop using, and that's done with will power. And some need help to do that, which should be given. Many people can use all kinds of drugs like opiods and heroin and not become addicted. They just stop when they realize they may be getting addicted.
Drug addiction is not a disease. Drug use is a choice for those that use to get high. Some choose drugs because they like the high and are willing to pay the price.
The rate of addiction has remained the same. It’s about 1, 2 percent who are prescribed opioids.
The pendulum has swung so far the opposite direction that patients are being regularly undertreated for pain or not treated at all for pain. Even postop. I’ve spoken to nurses who say they give IV Tylenol and gabapentin postop. Or Benadryl. (What?!!) And if the patient is a little too loud because the pain is uncontrolled and he’s crying, well, just give him haldol. I’ve heard at a webinar a “Dr” say to tell the patient he’s “getting the good stuff” and the patient gets haldol. Sounds like malpractice to me.
This has to stop. I think we cannot call ourselves a civilized country when most doctors want to eliminate the treatment of pain, no worries about the damage that causes. It’s gotten so bad that even people in hospice “care” are being denied opioid medication for the treatment of pain, or they’re desperate for proper pain relief because they’re being undertreated. And then to add insult to injury, they’re called drug seekers. Doctors who mistreat patients in this way have taken a noble profession and become torturers instead. And it seems to me that they’re enjoying it.
As a physician, your job is to relieve suffering. Your job is not to play at being a detective to try to decide magically who you think might become addicted.
Thanks for this. An excellent and thought-provoking summary of big pharma's deceptive and evil "information-laundering" tactics. My own specialty (psychiatry) is one of the most heavily affected by this scourge. I wrote about my own experiences back when I was a psychiatry resident, when the pharma-ghouls were trying to get their tentacles into me.
Fascinating, but very disturbing. The authors of the letter were affiliated to the Boston Collaborative Drug Surveillance Program which is still going strong. The Director is a Susan Jick but I expect this is merely a coincidence. (I'm assuming daughter of the H Jick who wrote the letter that was so heavily cited. Is there a better way to make it in academia than to be the offspring of someone who already made it?)
I don't mean to impugn either of them. It's the way that findings are weaponized, forgive the indelicate term, that is the crux of this. Kind of like Kanye West endorsing a sports shoe isn't it.
Big Pharma’s ability to manipulate our institutions goes beyond the medical profession and includes our political representatives in Washington DC. When the DEA wanted to go after Purdue, they called in their political markers and had the DEA stand down. Then when push came to shove, and the truth was being known, they convinced DOJ that the distributors and chain pharmacies were just as guilty as a manufactures. The DOJ gave the marching orders to the states attorneys around the country as to how to convince juries that the distributors and retailers were just as guilty. They created new case law that will cripple and bankrupt drug distributors and drug chains in the United States. It is a failure of the DEA and the FDA to stop Purdue, who was the originator of the concept and has secretly shipped the wealth of the Sackler family overseas according to some sources! astute drug marketing has trumped good medicine for years and certainly was on display with the medical drugs recommended for treating the Covid! As long as they can control the FDA and other federal agencies via political influence, I see nothing changing!
@Matt Bivens Why was the cautionary note above the Porter & Jick letter removed, if you know?
I don’t; I’m curious but don’t really have any idea.
see also https://www.wisnerbaum.com/toxic-tort-law/monsanto-roundup-lawsuit/monsanto-papers/ where Monsanto gamed the FDA test and ghostwrote publications for scientists to attach their names to.
Good article. Lots of good information. I look forward to reading more. As an RN I remember telling patients not to worry, that if they are taking opiates for pain that they wouldn't get addicted. How naive of me. I do believe there is a genetic component to addiction as well. Why do some people become easily addicted, while others can stop cold turkey with no problem. I've seen it in people I know who drank alcohol like fish, and they just stopped cold turky, or the same with smoking. I'd be interested in seeing studies done about that too.
One problem today is the pendulum has swung too far the other way - against opioids. The DEA regulates the manufacture of legal opioids in the U.S. and gives quotas to each manufacturer. The quotas have been going down year after year. The manufactures cannot meed the demand. So that means legitimate chronic pain patients can't get the opioids they used to get and suffer with great pain. Some kill themselves. Others go on the risky black market to get fake opioids that are typically fentanyl. They overdose from that or get sick from who knows that else is in the fake opioids. Or they go on risky heroin because it's cheaper. Real opioid pills commands a very high price on the black market because they are know to be safe the dose is known.
Yes, chronic pain patients do get addicted to opioids. So what is so bad about that? If they are able to obtain legal opioids they will likely not overdose and die from getting them on the black market. They can live a normal life with pain relief. Should they be denied legal opioids? They are now, as many doctors are forced to cut them off after a time. Go back in American history before there were any modern opioids and many doctors worked out programs to give these types of pain relief drugs to patents without feeding addicts who just wanted to get high. With the pre-opioid drugs like morphine and heroin, people were able to function and have normal lives.
I had to get a minor surgery recently. The doctor gave me a list of prescriptions. I went to CVS and they had all the prescription drugs except the opioid, which was out of stock. I found out later it is alway out of stock at CVS. The doctor's staff found the opioid at a Walgreens so I could get it there. But that's only because my doctor called them first. Anybody going into that Walgreens without having a doctor call first would not get any, even if they had a legitimate prescriiption.
The only opioid the doctor could prescribe for me was a shitty hydrocodone. It only had 5mg of an opioid, The rest of the drug was made up of lousy Tylenol which I did not want. Years go I got prescriptions for hydrocodone with 10mg of opioid. Those worked a lot better. That is no longer the case - mostly not available now. No percocet - that's never in stock. No pure opiods ever in stock. No wonder people are turning to the black market for pain relief.
Yes, the pill mills in Florida called pain clinics fed addicts only looking to get high. Criminals took loads of people to the Florida pill mills and got big prescriptions filled and went to one pill mill after another on the same day. Then they took those drugs and sold them in the black market back where they came from. The pill mills had armed guards due to all the unpredictable addicts coming there. But this was eventually controlled with better laws and law enforcement.
The problem is pain cannot be measured by a doctor, it's internal. So you can't tell who is suffering pain and who just wants to get high. It is a difficult problem. But taking away opioids from legitimate pain patients only feeds organized crime, which now controls parts of Mexico and has infiltrated the U.S.
You want to prosecute somebody for opioids, the fault is mostly not in the manufacturers or the distributors. The problem is the doctors who write the prescriptions.
Addiction to drugs is the personal responsibility of the addict wanting to get high. The drug does not run their life. The drug does not make them buy more. Addicts only care for themeless, not others. Many addicts stop using, and that's done with will power. And some need help to do that, which should be given. Many people can use all kinds of drugs like opiods and heroin and not become addicted. They just stop when they realize they may be getting addicted.
Drug addiction is not a disease. Drug use is a choice for those that use to get high. Some choose drugs because they like the high and are willing to pay the price.
The rate of addiction has remained the same. It’s about 1, 2 percent who are prescribed opioids.
The pendulum has swung so far the opposite direction that patients are being regularly undertreated for pain or not treated at all for pain. Even postop. I’ve spoken to nurses who say they give IV Tylenol and gabapentin postop. Or Benadryl. (What?!!) And if the patient is a little too loud because the pain is uncontrolled and he’s crying, well, just give him haldol. I’ve heard at a webinar a “Dr” say to tell the patient he’s “getting the good stuff” and the patient gets haldol. Sounds like malpractice to me.
This has to stop. I think we cannot call ourselves a civilized country when most doctors want to eliminate the treatment of pain, no worries about the damage that causes. It’s gotten so bad that even people in hospice “care” are being denied opioid medication for the treatment of pain, or they’re desperate for proper pain relief because they’re being undertreated. And then to add insult to injury, they’re called drug seekers. Doctors who mistreat patients in this way have taken a noble profession and become torturers instead. And it seems to me that they’re enjoying it.
As a physician, your job is to relieve suffering. Your job is not to play at being a detective to try to decide magically who you think might become addicted.
Thanks for this. An excellent and thought-provoking summary of big pharma's deceptive and evil "information-laundering" tactics. My own specialty (psychiatry) is one of the most heavily affected by this scourge. I wrote about my own experiences back when I was a psychiatry resident, when the pharma-ghouls were trying to get their tentacles into me.
https://pairodocs.substack.com/p/he-who-pays-the-piper-part-2
Such a unique perspective on the opioid crisis. Thanks for this.
Fascinating, but very disturbing. The authors of the letter were affiliated to the Boston Collaborative Drug Surveillance Program which is still going strong. The Director is a Susan Jick but I expect this is merely a coincidence. (I'm assuming daughter of the H Jick who wrote the letter that was so heavily cited. Is there a better way to make it in academia than to be the offspring of someone who already made it?)
I don't mean to impugn either of them. It's the way that findings are weaponized, forgive the indelicate term, that is the crux of this. Kind of like Kanye West endorsing a sports shoe isn't it.
c.f. Jeff Schmidt 'Disciplined Minds' - https://scholar.google.co.uk/scholar?cluster=9095961671764661549