Though the author is writing about the witch hunt and punishment of doctors suspected of drug abuse, this article is equally pertinent to pain patients who are always suspected (if not downright accused) of drug abuse.
Sociologist Stanley Cohen used the term ”moral panic” to characterize the amplification of deviance by the media, the public, and agents of social control.
Labeled as being outside the central core values of consensual society, the deviants in the designated group are perceived as posing a threat to both the values of society and society itself. Belief in the seriousness of the situation justifies intolerance and unfair treatment of the accused. The evidentiary standard is lowered.
Howard Becker describes the role of “moral entrepreneurs,” who crusade for making and enforcing rules that benefit their own interests by bringing them to the attention of the public and those in positions of power and authority under the guise of righting a society evil. 2
And according to cultural theorist Stuart Hall, the media obtain their information from the primary definers of social reality in authoritative positions and amplify the perceived threat to the existing social order.
The authorities then act to eliminate the threat.3 The dominant ideas or ideologies are reproduced by relying on the opinions of the defining authority and then spread through the media. The communal good has been assailed.
This describes exactly what PROP and it’s defining authority, Andrew Kolodny, has done.
As a society governed by organizations, associations, institutions and regulatory bodies, the medical profession is not immune to “moral panics.”
A threat to patient care or the values of the profession can be identified and amplified. A buildup of public concern fueled by media attention ensues creating a need for governing bodies to act. Medical Professionalism and the Public Health has been assailed.
Unbeknownst to the general public and most members of the medical profession at large, certain groups have gained tremendous sway within medical society.
Through moral entrepreneurship they have gained authority and become the primary definers of the governance of the medical profession and the social control of doctors.
To benefit their own interests they have fostered and fueled “moral panics” and “moral crusades.”
Exhorting authorities to fight these threats by any means necessary they have successfully made and enforced rules and regulations and introduced new definitions and tools with no meaningful resistance or opposition.
Addiction Medicine Monopoly, False Authority and Conflicts of Interest
The “impaired physicians movement” can be defined as a group of physicians with alcohol and substance abuse problems who, having found sobriety through 12-step spirituality, banded together to promote the ideology behind their personal “recovery” to other doctors and the medical community at large.
In the 1980s the movement gained momentum and as their numbers grew began calling themselves specialists in “addiction medicine.”
The American Society of Addiction Medicine (ASAM)
is not a true specialty,
but a Self-Designated-Practice-Specialty,
which simply means that is what they are calling themselves.
It reflects neither knowledge nor expertise.
“Board certification” by the American Board of Addiction Medicine (ABAM) is not recognized by the American Board of Medical Specialties (ABMS).
Addiction Psychiatry, a subspecialty of psychiatry under the American Board of Neurology and Psychiatry is the only specialty recognized by the ABMS. and their specialty society is the American Academy of Addiction Psychiatry.
The ASAM is schooled in just one one uncompromising model of addiction with the majority attributing their very own sobriety to that model–the chronic relapsing “brain disease” with lifelong abstinence and 12-step spiritual recovery model.
As the “voice of addiction medicine,” the ASAM has nevertheless defined the dominant treatment paradigm in the United States.
ASAM doctors outnumber addiction psychiatrists by 4:1 and the movement is well funded.
Because addiction is defined as a “disease”, addicts must be “treated” (more often coercive than voluntary), and “cured” (defined as abstinent).
The billion dollar assessment and treatment industry and the drug and alcohol testing industry lucratively profits from this model which has grown to monopolize addiction treatment in the United States. [see Inside The $35 Billion Addiction Treatment Industry]
The goal of the ABAM Foundation is to “gain recognition of Addiction Medicine as a medical specialty by the American Board of Medical Specialties (ABMS).”
A monopoly defined by self-appointed experts without recognized specialty training will soon likely Robber baron their way to being accepted as a true specialty.
Moral Panics and Moral Crusades
By introducing and fueling moral panics the ASAM/FSPHP political apparatus has been able to expand in both scope and power.
The Medscape article “Drug Abuse Among Doctors: Easy, Tempting, and Not Uncommon”published in the “Business of Medicine” section in January 2014 is characteristic example of the authoritative opinion, propaganda, and misinformation spun to maintain a pervasive climate of fear.
Proof by anecdote.
Physicians are “5 times as likely as the general public to misuse prescription drugs” according to Lisa Merlo, PhD. “Given the epidemic of prescription addiction sweeping the nation, that’s a grim statistic.”