Hysteria against opioids won’t help anyone

The New Reefer Madness: Hysteria against opioids won’t help patients who suffer from chronic pain  – 03 Jun 2016 – by Lorraine Berry

It is this casual use of words such as “epidemic,” “addict,” and even “opioid” that is contributing to a common belief in the American public, which is that we are in the midst of a prescription pain medicine crisis of epic proportion, and that if we do not do something quickly, the sky is most definitely going to fall

One might have thought that the entire nation was in the grips of a public health disaster due to opioids, but the actual numbers vary.

One of the words that causes confusion is the word “epidemic.” For many, an epidemic connotes the idea that huge portions of the population are suffering.  

Yet, that’s not what epidemic means.  According to a medical dictionary, an epidemic is “the occurence of more cases of a disease than would be expected in a community or region during a given time period.”

Epidemics do mean that there has been an increase in cases of disease, but they do not, as the media seems to use the word, mean that nearly everyone is sick. 

One headline in a recent newspaper carried the headline, “Opioid-related deaths surge, pushing morgues to capacity.”

That headline implies the bodies stacked up like cordwood, and that there is mass death and destruction taking place because of opioids.

It is also crucial to note that heroin is not only considered an opioid, the figures for “prescription opioid overdose” included heroin deaths

The numbers are not easy to interpret.

For example, the Centers for Disease Control (CDC) says that 43,982 people died from drug poisoning in 2013.

But, the number of deaths from opioid medicine was 16,235 and the number of deaths from heroin overdose was 8,257.

If you add those two last numbers together, you see that there are thousands of drug poisoning deaths that are not accounted for through opioids or heroin.

It’s why you can read in some articles that there are 28,000 opioid-related deaths per year in one place, 16,00 in another, or that there were 44,000 drug deaths.

The media has not been as careful as it needs to be in distinguishing heroin deaths from opioid deaths, nor even talking about what causes the other drug deaths

In a document put out by the CDC, the number of deaths caused by opioids and heroin is emphasized, although at one point, after continually referring to the “drug overdose deaths of 47,055” in 2014, someone would have to read further to see that the percentage of these deaths caused by opioids and heroin is 61 percent, leaving 39 percent unaccounted for.

Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as “prescription” opioid overdoses.

The CDC counts heroin as a “prescription opioid.”

The study also documents that it is near impossible to distinguish “legitimate” and “illicit” Fentanyl.

So, again, while it is common to lump everything together under the term “prescription opioid,” those numbers also include street drugs that were never issued through a prescription pad.

It is also important to look at the figures in context.

28,000 deaths is significant. The number most often cited is 44 people per day.

But compare that number to deaths from cancer, and you see that the annual death rate from cancer is 480,000 or 1200 per day.

There is a huge difference between 44 per day and 1200 per day. And, consider that alcohol is responsible for 88,000 deaths per year, and one-third of traffic fatalities involve drunk drivers. Alcohol is not banned

And, to further complicate matters, the CDC admits that someone who died from a combination of heroin and prescription opioids in their system would go into both sets of statistics, thus making the “heroin” deaths and “opioid” deaths numbers confusing as some people appear to be counted twice.

In the past decade, however, 90 percent of those beginning heroin are white.

In other words, new heroin users are primarily white and primarily living in the suburbs.

It bears asking whether the constant emphasis in the press being in crisis and an out-of-control epidemic has more to do with WHO is being affected rather than the number of people affected.

 

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3 thoughts on “Hysteria against opioids won’t help anyone

  1. david becker

    Statement by David Becker

    Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has. so said. Margaret Mead We committed citizens from rallyagainstpain must create a new world a far better world of eternal dignity, as President Truman wrote, and bring new hope and restore humanity and sanity for all people in pain. We must create this new world of pain care for there has been not only a continuous escalation of market and regulatory failure in pain care but increasing cruelty and a great diminishment of natural rights and sanity in pain care, as well. Pain care in America has degenerated into theatre of the absurd and theatre of cruelty. It is an evil that only belongs In books like Brave New World or like Kafka’s The Trial or An Artaud play. Pain care In America today has no place in the civilized world.

    It is one thing for an administration to be frozen in the ice of indifferentism and to not live in the spirit of charity, as FDR wrote, but no other President in American history has done more to destroy the hopes, lives, and natural rights of people in pain then President Obama and his administration. No other President has acted in bad faith when creating a National Pain Strategy which his own staff- Wanda Jones called just a beginning, by refusing to fund such. Americans deserve much more than just a beginning for the 170 million Americans who suffer pain every year and the ruinous consequences it can have on their marriages, their careers, their children, their quality of life and their mental health. And in response to letters from Senator Hatch, members of Congress and dozens of interest groups Obama’s staff Dr Novotny showed his jaunty disdain to people in pain by laughing about the prospects for the national pain strategy.

    Hey did you hear about the Surgeon General’s new warning that seeking pain care is dangerous to your health and makes the country addicted. Like many key decision makers in DHHS the Surgeon General lacks knowledge, sincerity, and empathy for people in pain. He is too far removed from their lives and if he or anyone in the Obama administration believes that debate on pain care should be uninhibited robust and wide open- name the time and the place for such debate-and ill be there. But I know that none of them believe in deliberative democtracy or agonistic democracy. Its there way or the highway. We are free to think what we wont- theyre only interested in us obeying them.

    When NIH Director Collins first came to office I asked policy staff at DHHS about him and pain and was told they had to have several talks with Dr Collins to convince him that pain is important. But we know he has failed the folks at meaction and continues to treat pain as unimportant as evidenced by the stingy budget for pain research.

    Helen Keller wrote: it’s a terrible thing to see and have no vision- how bout the members of the NIH pain consortium and IPRCC- they are visionless and lack the motivational intensity to make pain care much different or better then it is today. And as the Bible suggests people in pain are perishing due to the visionless experts throughout DHHS and the Obama administration. People in pain need an administration that is capable of much greater dedication than the inward focused and self referential and self interested staff at DHHS. They should not be allowed to chart their own course but instead should reflect the collective will of the American public including the 175 million in pain. But which one of them can claim they have made a real effort to hear no less consider what Americans in pain want? I can certainly name several that have ignored my free speech right but I can’t name a single one that made it clear they care to hear my opinion- despite the fact that I have gotten 3 pieces of legislation in NYS requiring education in pain care and despite my influence on my Congressman Engel to introduce the palliative care education bill in Congress.

    Lets not forget CDC Director Mr Frieden. He was commissioner of NYC when NYC Hospitals were rated the worst in the Nation. President Johnson wrote the important thing to consider about any policy is not the good it may do but the potential harms of the policy. And instead of empathy for the plight of millions of Americans in pain Freiden has added greatly to the suffering and perfect misery by cruelly and carelessly creating guidelines for opioids without regard to their effects on the lives of people in pain. You will hear today how his efforts have added greatly to the adjustment burden, the symptom burden, the treatment burden and the financial burden of pain for millions of Americans. But, of course, Mr Frieden won’t accept responsibility for that. His actions cannot be squared with any theory of health justice or morality. He, like the rest of Obama’s administrative authoritarians suffer from hubris syndrome and make clever use of what’s known in criminology as the neutralization effect. He claims there are no harms to his opioid guidelines, that the high cost of unreliable urine drug tests that can cost people their jobs and livelihoods or pain relief are not his problem and that the CDC is not responsible for any harm to people in pain by doctors refusing to give any opioids or closing their practices and after all the important thing is not people in pain- the important thing is to prevent addiction at any cost to people in pain. And lastly, they deride us with their discursive imperialism and eliminative materialism as not being one of them- we are “others” that can think what they want as long as we obey the morally disengaged and disempathic designs of the Obama administration. After all, the Obama administration regards people in pain as drug-seeking, malingering, catastrophizing, menopausal, peasants and serfs with no rights. To him people in pain are problems and not people.

    Obama’s DEA has gone after people in states where marijuana is legal and he has tried to prevent pain relief from Kratom. No other President in U.S. history has been crueler to people in pain then Obama. Whether its marijuana, opioids, kratom- whatever helps people in pain Obama feels he has the right to take away anything that helps people in pain for any reason or no reason at all.

    Instead of creating a more perfect Union with his policies and practices- here we are today- a disenchanted faction of Americans caused by the cruelty of the Obama administration. Instead of serving the happiness of people As Jefferson said should be the goal of government, Obama has made people in pain miserable, scared,helpless and hopeless.Instead of deliberative democracy, Obama’s right wing authoritarianism has denied all recognition of free speech and democracy in pain care. He has cherry picked industry representatives to advisory committees and their social darwinism is to pursue their organizational interests and occupational interests and ignore the voice and concerns of people in pain. Their claim is that people in pain are not qualified to have an opinion about their care- and we’ve heard very similar from the AMAs Patrice Harris with regard to people in pain being heard in regard to outpatient surveys. Instead of a fair chance to be heard by doctors and by the CDC,CMS, FDA, DEA he has acted like judge jury and executioner by assuming all people in pain are guilty of addiction until proven innocent and has denied, and has no regard for the free speech rights of those he believes are addicts.

    Obama has long since forgotten the memory of freedom that our founders and Veterans fought to obtain and maintain and he has locked people in pain in an iron cage of poor pain care that lacks vision, empathy, humility or any virtue for that matter. He brooks no doubt that he stands in the light of nature and regards all others- including people in pain as being stuck inside Plato’s cave. His administration has done with people in pain the same thing that Edward the VIth did with the rights of his people- given them to a few powerful individuals to do as they please with the lives and rights of people for pain. For the sake of oligarchs power, profits and prestige. And now millions of people in pain not nly suffer from cruel pain care but ar relegated to moral and civil vagabondage.

    We’ve learned too many times that doctors have used CDC guidelines to stop opioid prescribing even with patients they’ve had for years that have had no problems with opioids. Often these doctors offer either no treatment at all or ineffective treatments or treatments that insurers don’t cover. In their comments to the National Pain Strategy, no medical professional called for lowering the prevalence of pain and no medical organization has an inspiring vision or energetic plan to make pain much different or better than it is. They move at a petty pace because they can and they don’t wish to be held to a higher standard and don’t care much about pain or people in pain. They understand that people in pain are like a conquered nation and they feel free to treat people in pain any way they wish. They dont have the right stuff, they, too, lack the commitment, the motivational intensity, the vision, the humility, the caring, the empathy to do what is best for people in pain. Pain care in America is not dying with a bang- it’s dying with a whimper from a whimpering and whiny medical profession that to this day refuses to see that all doctors have education in pain care- despite pain being the most common reason that people seek medical care.

    Nora Volkow in the Pain Consortium has written of the great risk of suicidality of people in pain and that veterinarians receive 75 hours of pain education and doctors only ten. And while some of the most advanced treatment for pain is too costly for most Americans- it is readily available for pets and animals. Go figure. Animals get a moonshot for pain- people in pain get moonshine in the form of treatments based on unreliable research and a one size fits all approach that doesn’t consider the preferences, experience, ideas, values, of people in pain. And If it’s not their way it’s the highway. Their way is often riddled with misdiagnoses, undertreatment, treatment that is prejudiced toward Blacks, Hispanics women and children. If you have fibromyalgia, chronic lyme disease you’re likely to be mistreated and disrespected by doctors.

    Evil can only exist when good people do nothing. It is clear due to the evil cruelty and longstanding neglect and failure of our markets and government that we- the people- must now act to restore humanity and sanity and the natural right to life, liberty, and pursuit of happiness to people in pain including the right to pain care of our choosing.Our government and marketplace have become angry extremists and hysterical mobs with regard to opioids and they never had much respect or humanity for people in pain. And we come here with the same resolve that JFK had when he wrote-Let every nation know, whether it wishes us well or ill, that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe to assure the survival and the success of liberty. We will create the symbols of a new day for people in pain and a new world of dignity for people in pain. We can do no other.

    Liked by 1 person

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    1. Zyp Czyk Post author

      It too me quite a while to read it, but this is a great statement – and it works well as a speech.

      I like how you’ve tied our pain care to the rights of all Americans and interwoven your statement with the main points of so many other famous presidential speeches. This way, you’ve made our cause more universal and about more than just specific pain protocols. When I read it, I feel it could apply to all kinds of other sidelined groups.

      This must have taken an incredible amount of work and I appreciate that you took the time to fix spelling and grammar to make it more smooth and clear. Thank you for making such a huge effort for our cause.

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      Reply
  2. david becker

    Thanks for the kind words. I knew, that others would focus on the legitimacy of the cdc opioid guidelines and wanted to put the guidelines in a larger perspective. I new I had to be presidential with regard to the issues and contrast the visionless and whimpy efforts of the Obama administration with the visions and determination of former presidents.
    But ultimately, if nothing else, I want people in pain to consider my claim that we can no longer rely on government or the market to do what is right for us. We have been Balkanized and disenfranchized and tortured with others designs. If we dont fix pain care- no one else will.

    Liked by 1 person

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