Nowhere in your paper do you mention they opiods have very legitimate medical uses. What else do you propose for severe post-open pain, or metastatic cancer?
When I was an intern in Paris, the Establishment was afraid to give morphine to elderly patient suffering severe oncological pain, or god forbid - post-op, it was oral paracetamol... Or IV if you shouted loud enough.
Now, proper analgesia on demands with numerical pain rating scores are the rule, not the exception - and yet I am unaware of any opiate crisis chez nous, at least outside of the ghettos
I agree. This article is pure hyperbole, mixing arguments about legal medications with illegal drugs and even somehow tying in Prohibition. My wife had two back surgeries for a shattered spine and suffered excruciating pain and sleepless nights for years, leading to two serious car accidents. Only a small dose of Oxycontin at night provided relief and she now lives a good life except that blanket bans on opioids make it much more difficult to fill her prescriptions. We need a more nuanced, rational response to painkillers than this sky-is-falling indiscriminate reaction.
Thanks Matt, very well written. I was going to say it's amazing this issue doesn't get more coverage, but I forgot who is actually profiting, and their ties to the MSM. I don't normally use the evil word, but I think the big pharma folks who understand what they are doing, Sacklers, et al, are truly demonic. They are guilty of murder.
Let's not forget the role that patient-satisfaction linked reimbursement and pain as the 5th vital sign played in all of this. Yes, big pharma are villains, but government, private equity and the medical organizations also all have blood on their hands.
Writing as a physician, the above point cannot be overstated. Especially the government's role and its requirements, predicating payment based on persons demanding narcotics being sure to give positive reviews on physician and hospital surveys.
Johann Hari's "Chasing the Scream," a fine book though flawed, somehow omitted most of the history lesson here, and not only because it was published back in 2015. In memory of my son Axel, I'll be sharing this article with many people who care.
Humans are just elemental parcels whereupon are sown inert corporate crops. Financiers and their industrial armies plant their aims in us, then harvest, produce, and package us. Then they sell us back to ourselves. I covered medicine for decades and nothing corporate-run ever ends up doing any good. Never. It might look like it does at first, but keep observing, and in time you will always see the puff of black smoke, smell the odor of sulphur. I am so glad you have brought your journalistic curiosity into the world of medicine. Watch out House of Medicine.
“nothing corporate-run ever ends up doing any good”? Corporations (Big Food, Big Pharma, now Big Higher Ed) have done an exceptionally good job of making us “elemental parcels” fat, depressed, addicted, & dumb. . all of which, to their bottom lines, spells success. Gotta give them that.
There was a great show on about 8-9 yrs ago called The Knick. Unfortunately it only lasted 1 season, but it follows a surgeon in the early 1900’s in NYC. He becomes addicted to cocaine and in one of the last episodes they send him to rehab to receive a new medication heralded by the Bayer Company , and as the scene fades it focus’ on a bottle, heroin. It’s truly amazing that we allow this to happen again and again. Great article Matt!
I watched the series as well. I was disappointed it got cancelled. IIRC, the surgeon played by Clive Owen was loosely based on the real surgeon, William Halsted who was a pioneer in surgery and medicine, and also addicted to cocaine as they were experimenting with the local anesthesia usefulness of it and later morphine. .
Beware, though. We clamped down so heavily on opioid prescribing -- no question, meds were promiscuously prescribed and a corrective was sorely needed -- that now chronic pain patients are in sustained agony, begging for a doctor who will treat them with opioids. These are essential pain relievers for a subset. There needs to be a middle ground. Better integrated pain management and more physician knowledge about prescribing opioids where needed.
I live in Canada where we have a severe doctor shortage. I just had bilateral total hip replacement and suffer from severe osteoarthritis of the spine. Without a doctor I cannot get a prescription for Tylenol3. I have never abused the use of Tylenol3 and have restricted my use to 1 -3 tablets for the last 6 years. Without this drug I am unable to sleep or walk and that results and even more pain and health deterioration. No urgent care centre or online medical service is allowed to prescribe any opioid including Tylenol3. I am unable to wait in line for 10 hours at the hospital emergency room to get this drug. This overreaction by the government and medical authorities, to even prescribing the lowest level opioids for pain, is cruel and inhumane.
Nice work, Matt. I’m the wife of a doctor and have been waiting decades for this line of thinking, writing, & research. As a patient, I’m a huge disappointment to Big Pharma & its bedfellow House of Medicine since I have no chronic condition nor do I rely on any prescription drug. And they claim to care about preventive health? Ha! Good health is too damn costly for them.
Perhaps the most effective tool House of Medicine has for keeping docs cowed and generally ignorant to its wiles is incentivized “productivity”. Today’s doctors rarely come up for air. Hard to get any clear view from 10,000 feet when you’re beleaguered, bleary-eyed, sleep-deprived, weary, and entrenched. It’s not a coincidence these same descriptors apply to war & torture tactics.
As a heroin addict in recovery I can tell you CAN get high on Suboxone, it just takes a little more to “punch” through as we used to say, sublocade too…. It’s sad that we’re looked down upon and not offered anything but more drugs to get off of the drugs most of us were willing prescribed and then they didn’t work so turned to heroin…. Thank you for the article!!! 🫶🏻
I know it's a waste of time but I'm going to forward this great article to everyone that I know. We used to have a government that cared about its citizens but that ended with Teddy Roosevelt and the so-called "Progressive Movement."
Just keep bringing it. Just keep educating us. My daughter is a front-line licensed social worker and clinician. I send her all that I read on here and she is grateful. She also teaches at the local university and supervises students in their practicum. She uses a lot of what I find on here to teach them.
The prevolent unseemly practice of focusing on the treatment of symptoms in place of any effort to diagnos and affect a viable cure seems to aggravate the tragic corruptive practices of "big pharma" and their corporate "fellow travelers".
This is probably the best article I've read on the opioid crisis.
Nowhere in your paper do you mention they opiods have very legitimate medical uses. What else do you propose for severe post-open pain, or metastatic cancer?
When I was an intern in Paris, the Establishment was afraid to give morphine to elderly patient suffering severe oncological pain, or god forbid - post-op, it was oral paracetamol... Or IV if you shouted loud enough.
Now, proper analgesia on demands with numerical pain rating scores are the rule, not the exception - and yet I am unaware of any opiate crisis chez nous, at least outside of the ghettos
I agree. This article is pure hyperbole, mixing arguments about legal medications with illegal drugs and even somehow tying in Prohibition. My wife had two back surgeries for a shattered spine and suffered excruciating pain and sleepless nights for years, leading to two serious car accidents. Only a small dose of Oxycontin at night provided relief and she now lives a good life except that blanket bans on opioids make it much more difficult to fill her prescriptions. We need a more nuanced, rational response to painkillers than this sky-is-falling indiscriminate reaction.
Thanks Matt, very well written. I was going to say it's amazing this issue doesn't get more coverage, but I forgot who is actually profiting, and their ties to the MSM. I don't normally use the evil word, but I think the big pharma folks who understand what they are doing, Sacklers, et al, are truly demonic. They are guilty of murder.
Thank you for this. I lost my son.
I am sorry Nancy. I lost my son too.
Let's not forget the role that patient-satisfaction linked reimbursement and pain as the 5th vital sign played in all of this. Yes, big pharma are villains, but government, private equity and the medical organizations also all have blood on their hands.
Writing as a physician, the above point cannot be overstated. Especially the government's role and its requirements, predicating payment based on persons demanding narcotics being sure to give positive reviews on physician and hospital surveys.
Johann Hari's "Chasing the Scream," a fine book though flawed, somehow omitted most of the history lesson here, and not only because it was published back in 2015. In memory of my son Axel, I'll be sharing this article with many people who care.
Humans are just elemental parcels whereupon are sown inert corporate crops. Financiers and their industrial armies plant their aims in us, then harvest, produce, and package us. Then they sell us back to ourselves. I covered medicine for decades and nothing corporate-run ever ends up doing any good. Never. It might look like it does at first, but keep observing, and in time you will always see the puff of black smoke, smell the odor of sulphur. I am so glad you have brought your journalistic curiosity into the world of medicine. Watch out House of Medicine.
“nothing corporate-run ever ends up doing any good”? Corporations (Big Food, Big Pharma, now Big Higher Ed) have done an exceptionally good job of making us “elemental parcels” fat, depressed, addicted, & dumb. . all of which, to their bottom lines, spells success. Gotta give them that.
💯
There was a great show on about 8-9 yrs ago called The Knick. Unfortunately it only lasted 1 season, but it follows a surgeon in the early 1900’s in NYC. He becomes addicted to cocaine and in one of the last episodes they send him to rehab to receive a new medication heralded by the Bayer Company , and as the scene fades it focus’ on a bottle, heroin. It’s truly amazing that we allow this to happen again and again. Great article Matt!
I watched the series as well. I was disappointed it got cancelled. IIRC, the surgeon played by Clive Owen was loosely based on the real surgeon, William Halsted who was a pioneer in surgery and medicine, and also addicted to cocaine as they were experimenting with the local anesthesia usefulness of it and later morphine. .
Two seasons and it's available in dvd/bluray. It is excellent, with a genuine electric ambulance.
Beware, though. We clamped down so heavily on opioid prescribing -- no question, meds were promiscuously prescribed and a corrective was sorely needed -- that now chronic pain patients are in sustained agony, begging for a doctor who will treat them with opioids. These are essential pain relievers for a subset. There needs to be a middle ground. Better integrated pain management and more physician knowledge about prescribing opioids where needed.
I live in Canada where we have a severe doctor shortage. I just had bilateral total hip replacement and suffer from severe osteoarthritis of the spine. Without a doctor I cannot get a prescription for Tylenol3. I have never abused the use of Tylenol3 and have restricted my use to 1 -3 tablets for the last 6 years. Without this drug I am unable to sleep or walk and that results and even more pain and health deterioration. No urgent care centre or online medical service is allowed to prescribe any opioid including Tylenol3. I am unable to wait in line for 10 hours at the hospital emergency room to get this drug. This overreaction by the government and medical authorities, to even prescribing the lowest level opioids for pain, is cruel and inhumane.
Just tragic and totaly avoidable
Nice work, Matt. I’m the wife of a doctor and have been waiting decades for this line of thinking, writing, & research. As a patient, I’m a huge disappointment to Big Pharma & its bedfellow House of Medicine since I have no chronic condition nor do I rely on any prescription drug. And they claim to care about preventive health? Ha! Good health is too damn costly for them.
Perhaps the most effective tool House of Medicine has for keeping docs cowed and generally ignorant to its wiles is incentivized “productivity”. Today’s doctors rarely come up for air. Hard to get any clear view from 10,000 feet when you’re beleaguered, bleary-eyed, sleep-deprived, weary, and entrenched. It’s not a coincidence these same descriptors apply to war & torture tactics.
Matt,
Great article and I will be reading each and everyone following it regarding this subject.
As a heroin addict in recovery I can tell you CAN get high on Suboxone, it just takes a little more to “punch” through as we used to say, sublocade too…. It’s sad that we’re looked down upon and not offered anything but more drugs to get off of the drugs most of us were willing prescribed and then they didn’t work so turned to heroin…. Thank you for the article!!! 🫶🏻
I know it's a waste of time but I'm going to forward this great article to everyone that I know. We used to have a government that cared about its citizens but that ended with Teddy Roosevelt and the so-called "Progressive Movement."
Just keep bringing it. Just keep educating us. My daughter is a front-line licensed social worker and clinician. I send her all that I read on here and she is grateful. She also teaches at the local university and supervises students in their practicum. She uses a lot of what I find on here to teach them.
Greed seems to be the bottom line underlying issue with this and most of societies intractable problems
Thank you for your candor and concerns!
The prevolent unseemly practice of focusing on the treatment of symptoms in place of any effort to diagnos and affect a viable cure seems to aggravate the tragic corruptive practices of "big pharma" and their corporate "fellow travelers".
As Usual,
EA