(this is a working draft)
You never hear about the laws and regulations that have been enacted. You never hear that pharmacies and Dr’s are constantly facing new regulations. The DEA is constantly visiting pharmacies that continue to make pain medications available to patients with prescriptions for narcotic pain medications due to legitimate medical necessities. CNN doesn’t ever show that the majority of pharmacies in this country have stopped carrying all opioid medications, period. They never interview the Dr’s who have been accused of running pill mills nor the patients who were seeing the Dr’s accused of being drug traffickers. Instead, you hear about someone’s son who had a back injury, was prescribed an opioid prescription and then, after the Dr stopped prescribing the medication, their son turned to the opioid most readily available on the street, heroin. Of course, they never talk about wether or not their child was actually still suffering from their injury or surgery. In fact, post surgical chronic pain is the leading cause of long term chronic pain. In fact, there is an overwhelming amount of medical research that proves treating a patient with opioid medications right after they have been injured or undergone surgery, actually, greatly reduces the chances of long term chronic pain. So, Dr’s generally do prescribe narcotics if you have been injured or undergone any kind of surgery.
Generally, people who are given pain medications along with a prescription for physical therapy, often do not follow through on the PT because it is too time consuming. They may go for a couple of sessions but then stop because they have a pain medication and can’t afford to take the time off of work to go to PT, they can’t afford it or they just don’t think it’s necessary. These people whose children have become addicts often mention that when their child’s Doctor stopped prescribing them the narcotic pain medication, the person was still suffering from pain and turned to the street to obtain more opioids. Then, it’s just a a matter of time that their family member overdosed from a lethal cocktail of drugs, including the opioid, heroin. Instead of being outraged that the Dr stopped treating their son’s pain effectively and safely, they are outraged at the Dr for treating their son’s pain with pain medication. Instead of being outraged that our healthcare system didn’t cover the financial burden of more expensive non opioid pain medications, or give better access to long term supplemental treatment options like Hyperbaric Oxygen, Hypnotherapy pre-surgery or post i jury to reduce stress and trauma, instead of Myofascial Therapy, Acupuncture and a whole host of other proven modalities, they blame the Medical Expert who did their job within the confines of our very inadequate healthcare system.
The way the media has covered the opioid epidemic is fundamentally biased and is totally based on false information provided by the DEA. The go to expert is almost always Dr. Kolodny, who does not even treat pain patients. Without any years of treating patients whose lives have been dramatically improved through high dose opioids, Dr. Kolodny always supports and re-enforces the lies, misinformation and bias. He is not alone. Many Dr’s lack the experience and expertise to treat patients with debilitating pain. This reality is diametrically opposed to the media’s coverage of the “Opioid Crisis” in which medical doctors give opioids out “like candy”.
The media coverage of the “Opioid Epidemic” never focuses on the 75-80% of legitimate pain patients who do not abuse their prescriptions. Instead, media coverage is relentlessly sensationalistic and spews out data provided by the DEA. It never addresses how this epidemic has actually affected legislature or how actual, real Doctors now treat post surgical needs, post trauma, post injury and even those with metastatic cancer and other complicated, life threatening medical pain conditions. Due to changes in opioid regulations, Dr’s have strict limitations on prescribing opioid prescriptions, pharmacies no longer stock opioids, hospitals have to juggle surgeries. In fact, even patients with metastatic cancer are faced with the inability to get the pain medications they need either in the hospital or at home.
Major news outlets never interview anyone who has benefited from prescription opioids because it dramatically improves their quality of life and/or gives them enough pain relief to continue to work. They never show real pain patients who do not abuse their prescriptions but because of the small percentage of people who do, they no longer have access to the medications that allow them to work. So many people are no longer able to work because they no longer have access to prescription opioids. Hundreds of thousands of people have significantly reduced quality of life because of new regulations and an overzealous DEA fueled by this administration’s latest war on drugs.
The media perpetuates lies and myths that help to fund and run the DEA’s opioid obliteration mission. Global watchdog groups have launched investigations into the very real human rights crisis of people no longer having access to their pain medications in the United States. The UN has declared it a violation of human rights, already. Yet, people continue to think that Dr’s give opioids out like candy! It is just wrong.
The media’s biased, poorly researches coverage, is contributing to skyrocketing overdose rates. Now, legitimate pain patients can no longer go to Dr to get their life saving medication, so they are forced to find it elsewhere. The streets are full of hat look like real pharmaceutical narcotic prescription pills but they are actually manufactured by the Cartels in Mexico and a huge number of manufacturers in China. There is a new threat, which is rarely ever brought up in the media coverage: drug dealers are increasingly cooking up Fentanyl in makeshift labs right in their homes. Yet, legitimate medical doctors are still being blamed for the opioids on the street.
When it comes to the war on drugs, the media is acting as a propaganda machine. Last year, 60 Minutes aired an episode featuring a retired DEA agent and they called him a “whistleblower”. He detailed information that was over a decade old. Much of what this former agent said was overblown and not factual. He accused lawmakers of getting kickbacks from big Pharmaceutical Companies for writing laws that contributed directly to pill mills and overprescribing. This is just not based in facts. The truth is, our federal lawmakers were protecting doctor’s ability to treat their patients as they thought medically necessary. Just as Insulin is a medication that lawmakers do not assume to know prescribing guidelines better than a patient’s personal physician, they were simply staying out of assuming medical protocols.
The laws changed over the years and pill mills were really a phenomena of the past. Yet, this was left totally out of the 60 Minutes segment. Instead, things that were once true over a decade ago were presented as current facts at the root of the opioid epidemic. Shortly after this episode aired, President Trump made a formal announcement that he would be increasing federal funding to combat the war on drugs. Before this episode aired, Trump had said the illegal opioids were coming from across our border and were being provided by drug dealers not doctors! Thus, the media is acting as propaganda and is directly connected to administration policies.
Now, synthetic opioids such as Fentanyl, are the leading cause of overdose deaths in the United States. Yet, the media coverage is STILL blaming this epidemic on doctors overprescribing medications. It has been impossible in almost every state for hundreds of thousands of patients to obtain a prescription for their pain medications anymore. Even for patients with metastatic cancer, obtaining a Fentanyl prescription, even though a hospital pharmacy, for Fentanyl is impossible. So, why is the media still blaming doctors for this epidemic?!?!
Sadly, legitimate pain management doctors are closing their medical practices at alarming rates. Because the media coverage is so biased and rooted in ignorance, public pressure to punish Dr’s is at an all time high. At the same time, millions and millions of dollars has been allocated to the DEA to go after Dr’s who overprescribe.
In 2016 a law was passed drastically limiting the amount of opioids legally allowed to be prescribed by General Practitioners, Family Doctors and Internists. The prescribing guidelines were based on the CDC’s recommendation for prescribing opioids. Even the CDC says these are guidelines NOT rules because only the treating doctor can adequately assess how much medication their patients need. Still, this 2016 law made it so that only Anasthesiologists and Board Certified Pain Medicine Specialists are legally permitted to write prescriptions for low or high dose opioids. In reality, access to these types of specialists is typically a luxury. The harsh truth is that access to Pain Medicine specialists and Anesthesiologists is extremely limited or totally impossible for hundreds of thousands of people living in rural communities and/or patients who are uninsured or who are on Medicaid programs to access.
Now, in 2018, even these Anasthesiologists and Board Certified Pain Medicine specialists are refusing to prescribe high dose opioids because the DEA has been using the recent influx of funding to relentlessly harass and pursue cases against ANY doctor who is prescribing opioids over the CDC guidelines. They are in fear of being criminally prosecuted for prescribing opioids to their patients.
Increasing lack access to actual prescriptions forces patients to medicate themselves using pills that are not dosed properly and are often cut with other substances that are lethal. Heroin is an opiate that is the real killer in this crisis. Yet, somehow heroin is never discussed as an opiate but the drug that a legitimate prescription is but it’s gateway drug. This epidemic is an addiction epidemic… mostly a heroin epidemic. But, because it is white people who are shooting up heroin and smoking crack, it is framed as an opioid epidemic that is blame on Dr’s not on street dealers. Yet, the truth of the matter is, almost 80% of addicts in the U.S. start out using drugs they bought on the street, not from a Dr’s whose office or ER they went to.
If, Dr’s were held legally responsible for all the patients who didn’t take their Insulin, Blood Pressure, Cholesterol, Depression, Bi Polar Disorder or Schizophrenia, people would be outraged. The CDC has guidelines fo each of these medical conditions and yet, it is understood that every case is unique and thus, these are simply guidelines NOT rules to be followed to the letter. If all the Dr’s who have over prescribed antibiotics were held legally responsible for being a criminal factor in the evolution of Super Bugs, which is also a current medical crisis, then I am sure people would be outraged by the amount of Dr’s who were forced to close their practices, stand trial and go to jail. The stigmas surrounding antibiotics would cause shame and fear to everyone who ever suffered from an infection and lived because they were able to get a prescription for it. This would not be tolerated and would be seen as severe governmental overreach. Yet, this is exactly what is happening with pain medications. Somehow, pain has been delegitimized as a valid health concern. Instead, pain is now talked framed as a “nuisance”, something that is annoying but not life threatening. Even if you have severely debilitating pain, you should be able to suck it up, take some Advil and then, get on with your day.