WASHINGTON — Activists on Friday delivered a parting gift to Scott Gottlieb, the outgoing Food and Drug Administration commissioner, at the entrance of a federal building here: an 800-pound, supersized heroin spoon stamped with the FDA’s logo.

The group urged FDA to stop approving “dangerous” opioids and to instead encourage the development of more drugs to treat addiction. Many protesters decried the November approval of Dsuvia, a mega-potent pain drug, and urged the Trump administration to nominate an FDA commissioner who would take a different tack than Gottlieb on opioid approvals.

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  • Since WHEN is it the governments responsibility to tell American Citizen’s how to live their lives? People actually still make their own decisions, be them good or bad. No one forced ANYONE to take these drugs. Now, people who are in dire need of pain medication for chronic, unrelenting pain (who actually take responsibility and DO NOT ABUSE the medication they are given) will SUFFER for the mistake made by someone WHO WASN’T SO RESPONSIBLE. Pain medications are NOT STREET HEROIN. Chronic pain patients are NOT ADDICTS and the general public does not comprehend the difference. If you need to BLAME SOMEONE, BLAME THE CARTEL’S AND PROTEST AGAINST THEM.

  • Your fight is not over, unless you accidently, got on it yourself. I hate this drug with a passion. Yet, I get used by heroine dregs so as to corner an olderly man in to being their servant of these opiates. This leads to holes in their arms, ect. America needs to fight back

  • Everything Susan said is correct. There is no room for compassion or humanity when greed is all encompassing. To the government we have outlived our usefulness, we cost too much, and are a negative on the balance sheet. This is our way out of the equation. Maybe after most of us have expired one way or another then the last remaining few may get a little bit of relief for the last of their days.

  • It is not medical patients or prescriptions that are the problem. Drug abuse and addiction of all kinds is a medical and psychological problem related to childhood trauma and a genetic predisposition that affects one percent of the population or about three million people or the total number of opioid addicts today in America. There are over 100 million chronic pain patients, 18 million require opioids as alternatives do not work for them. One percent of the population is affected with opioid addiction, whereas thirty three percent of our gigantic rapidly aging baby boomer population suffer from chronic pain. Eighteen million chronic pain patients require opioids in sufficient doses to treat their severe pain or they will either die slowly of heart attacks and strokes from the stress of living in severe pain, or who will commit suicide from under treated pain. Many of those with serious chronic pain are our returning veterans after seventeen years of war. It is outrageous that they are forced into committing suicide because the federal government has forcibly taken away their only pain relief, opioids, often with no taper, just yanked off all at once! This is cruel and completely unnecessary abuse of our vulnerable wounded veterans! Many pain patients are too ill and in too much pain to even advocate for themselves. It is the worst cruelty and most ignorant, prejudicial, hysterical, and counterproductive madness ever perpetrated against innocent suffering patients that I have ever seen in healthcare in my entire lifetime and it is absolutely outrageous! We cannot throw six or more times as many Americans under the bus and abandon them to suffer and die because of overblown concerns over the one percent of Americans who are overdosing themselves, and especially when these very same policies are harming even those that we say that we are trying to help. The overdoses are getting much worse and more deadly because addicts and abusers have been forced off of using much safer prescription opioids onto being forced to use illegal opioids like heroin, often containing dangerous unknown levels of fentanyl. Heroin laced with illicit fentanyl is twenty times more unsafe than prescription drugs ever were! No wonder that overdoses have gone up! And we told you that this would happen but you all refused to listen. How many people died needlessly because of this insanity? We may never know, but over 200 pain patients have died directly because of the CDC and laws restricting prescription opioids given to suffering patients. That is 200 dead people whose deaths were directly caused by Kolodney, PROP and the CDC and their deliberate lies! The restrictions on prescription opioids were an easy to implement but massively cruel and inhumane low cost solution, not requiring much government investment in any proper medical treatment for anyone. Implementing these overly restrictive opioid policies may have made politicians look good, but it has killed many innocent patients suffering with severe chronic pain and has even harmed patients dying of cancer, and these misguided policies will kill many more patients if they are not rescinded and stopped ASAP!

    Opioid abuse and addiction as well as chronic pain are both illnesses that cannot be solved by writing any laws or by any law enforcement. Imagine using only law to treat diabetes by limiting the doses of insulin allowed to be prescribed by doctors, or by trying to cure cancer by locking up patients with cancer in jail and criminalizing the doctors who dare to try to treat their cancer patients! This is exactly what we are doing to doctors trying to ease the severe suffering of their patients who suffer from chronic, painful, incurable medical conditions. Chronic pain is deadly, it can kill you slowly or lead to suicide. The stress of living in under treated or untreated chronic pain is the greatest stressor known to man. This is why pain is used as torture, and living in severe chronic pain IS torture for the rest of our lives, a fate that none of us deserves. It is NOT a minor inconvienience like a headache that we can just take two Tylenol and it will go away. If that were true then no one would commit suicide due to pain, they would just take Tylenol. People who do not suffer with severe chronic pain have absolutely no idea. They don’t feel any pain so they assume no one else does either, but they are very wrong. You able bodied pain free people get to enjoy your days off and holidays while we sit in recliners unable to move without pain, throbbing and aching while you enjoy yourselves. Why don’t you ever care even a whit about 18 million of us who cannot enjoy any holiday anymore while wesuffer in inhumane agony. Often we can’t even think straight or speak due to our severe pain. How can we even advocate for ourselves or fight back against this terrible and cruel abuse when many of us can no longer shower or get out of bed since our pain relief was cruelty taken away from us because of other people’s drug abuse problems?

    Pain and drug abuse and addiction are both serious medical and mental health issues that need medical, mental health and substance abuse treatment solutions, not jails, law enforcement, stigmatization, blame and shame, cruelty or abuse of patients or providers, or even the abuse and criminalization of the drug companies that make the life saving opioids that millions of patients need. Drug companies are not a fault because opioids, which have been used by medicine for over 3,000 years, are addictive for some people! Every doctor and person in America obviously knows that Everyone knows that opioids can be addictive for some people, or about one percent of the population, and that is about the same three million people who are presently addicted to opioids right now in America. This population hasn’t changed much over time, just the overdoses have increased. These people are mostly dying from poly pharmacy or the abuse of many drugs at the same time, and from heroin laced with fentanyl in unknown doses and with unknown contents and because twenty times safer prescription drugs are no longer available because of recent misguided governmental policies. The average number of drugs in the bodies of those who overdosed, according to the CDC’s own data, was six different drugs, many of them were illegal drugs, not prescription drugs at all! Many peoole who abuse prescription drugs did not get them by having a prescription from a doctor for themselves, but have obtained them in other ways. These overdoses were not primarily caused by prescription opioids at all! None of those who overdosed were following their doctor’s or pharmacists orders, all of them were deliberately misusing and abusing these drugs on purpose. Those of us under a doctor’s care for serious, painful, incurable medical conditions, all of whom are carefully monitored by our doctors and who follow all instructions carefully, and who are NOT overdosing ourselves and who obtain a great deal of relief and improved function from taking opioids should not be punished, forced to endure a lifetime of torture and premature death or be thrown under the bus just because of other people’s drug abuse and addiction problems. These are two entirely different populations at the extreme ends of the spectrum.

    We don’t refuse to treat diabetic patients over concern for cancer patients, so neither should we refuse to give proper pain treatment to older chronic pain patients who require adequate doses of opioids just to function or to be able to live due to our having very painful incurable diseases just because of concerns about mostly young people suffering from trauma, and mental and emotional illnesses who try to find solace in taking drugs like opioids and who have a genetic predisposition to opioid addiction. Each group of patients needs to be properly diagnosed and given the proper medical treatment for their corresponding medical and mental health conditions. Don’t take opioids away from patients in pain who desperately need these drugs, instead identify those with substance abuse and addiction problems and give them access to proper long term treatment for their addiction using MAT and counseling to help these addicts learn the skills to cope with life without drugs.

    We could do a lot more prevention also by teaching everyday mental health skills to young people, such as assertiveness training, meditation, dealing with trauma and difficult life situations, learning healthy coping skills for dealing with stress, having healthy interpersonal boundaries and healthy self esteem, and give our young people the important life skills and tools that they need to cope with life without using drugs or chemicals inappropriately. It helps to always tell your children and loved ones that you love them every day and make sure that they feel loved and supported, that goes a long way to prevent drug abuse. It has worked very well with my son who says that he will never smoke, drink, or use any drug. Also, never abuse or disrespect your children. Do not hit them, demean them or yell at them or abuse them in any way, and if you make a mistake then admit it and apologize, kids are very forgiving. Child abuse, bullying and trauma, especially sexual trauma can lead to drug abuse and addiction. I never abused my son and I never spanked him. I used other more effective methods and I am very glad that I did. We have a superior relationship and totally trust and know one another.

    The entire substance abuse community is mostly in complete denial of the contribution that child abuse, trauma and mental health issues have on drug abuse. They insist upon focusing on the drugs as being the only problem and just staying away from drugs will solve everything, but this is not true because it fails to address why people use and abuse drugs and that root cause must be addressed or people will relapse. Drug abuse is not primarily about drugs. It’s not the drugs that cause drug abuse, it is the abuse and misuse of drugs to cover up or to try to cope with an underlying problem that causes people to turn to drug abuse. There is also a strong genetic predisposition to drug and opioid abuse for those with this genetic weakness. If you want to stop abusing drugs then find out why you are using them inappropriately. What are you trying to cover up and what are you hiding from? What are you running away from? What is making it difficult or impossible for you to cope with life without using drugs and alcohol to escape? If we address the underlying root causes of drug abuse and addiction, then we can end addiction, one person at a time. There are also people with a strong genetic tendency to experience an overwhelming high feeling from taking opioids, about one percent of the population. Everyone else will usually not get this reaction, but will instead experience nausea, dizziness and constipation from using opioids to treat pain. Anyone who has pain and takes an opioid and then feels better than they have ever felt before should stop using the opioids and contact their doctor. If you get this reaction, do not take any more opioids, as you may have this genetic tendency and are likely to be high risk for addiction. This tendency often runs in families. Everyone else, as many as 99 to 98 percent of the rest of us, are not likely to have any serious long term problem with opioid abuse or addiction.

    Fear, lies, misinformation, false narratives, bad statistics, bad falsified, reversed engineered or biased research can never help us make proper treatment recommendations to solve these complex multifactorial problems. Those who make laws or public policies must be scrupulously honest and willing to admit it when they are wrong or whenever they make mistakes and correct these mistakes or else people will be seriously harmed. One such mistake was conflating opioid addiction and abuse with the legitimate, medically supervised medical use of opioids for serious pain. These are two different issues altogether! One is the appropriate medical use and the other is the inappropriate non medical use. One is health giving, the other is health destroying. Any substance taken to excess can kill. Too much oxygen can kill. Too much water drinking can kill. Too much food can kill. Taking too many blood pressure medications can kill. There are also no one hundred percent safe and effective medical treatments for every medical condition, Most effective medical treatments have serious risks and side effects, even death. Hundreds of thousands of patients die every year from medical mistakes but we are not calling that an epidemic. One hundred thousand children die every year from respiratory diseases due to coal fired power plants but we are not stoping this even when we have much cleaner better technology and can easily do so. Why are we so overfocused only on opioids when they were just a fraction of the drugs used in this overdose crisis? I smell an agenda here. It was all because of greedy fanatics from PROP who want to ban most of the medical use of opioids for many years. They are planning to make millions suing drug companies too and have a vested interest in using buprenorphine that costs $300 per month. We must not get hysterical or be manipulated by overzealous anti-opioid extremists and go overboard here!

    Medical patients who do not have any previous substance abuse or addiction problems do not as a rule become addicted to opioids due to medical use. Exposure to opioids does not often result in abuse or opioid addiction. Opioid exposure for most people is not a disease vector like being exposed to measles. It is only those with the genetic predisposition to opioid abuse who are most often seen by addiction specialists who can become addicted through a one time medical exposure. We can educate people and doctors to avoid taking opioids if they get you really high the first time that you take them for a medical condition or during experimental drug abuse. The high is never as good after that and this is why opioid abuse is often called chasing the dragon to try to get the high feeling that occurred with first time use. We cannot always prevent this exposure as people may eventually need surgery and need opioids for medical reasons at sometime in their lives. Only one out of one hundred people are affected by this problem, the rest of us are very unlikely to ever have an addiction problem with opioids as they are not that appealing to 98 percent of people. If my pain would end, I would never want to take any more opioids, believe me! Who needs it and all of the hassles and constipation and stuff if you don’t have any serious physical pain? Not me! I am not a wimp either! If I were a wimp, I’d be dead already!

    Neither doctors nor drug companies can ever forcibly get any patients deliberately “hooked” on opioids for profit against the will of the patient. This concept is outdated and does not align with current research. Physical dependence, or being “hooked” is not addiction. Addiction is when after a person is detoxed and is no longer physically dependent on opioids at all, and then they will still return to using opioids addictively against medical advice and despite harm and without having any underlying physical pain problem or any legitimate medical reason to do so. Patients who are not addicted may become physically dependent and will then need to be tapered off of opioids if their pain condition is cured and they no longer need any opioids for treating their pain, but they will not return to using opioids for nonmedical reasons after their pain has ended and they have been weaned off of opioids. If mere exposure to a weeks worth of opioids caused opioid addiction in every person, then America would now have over 250 million opioid addicts instead of the 3 million or one percent of the population that we have always had. The number of opioid addicts has not risen over the years, what has increased are the fatal overdoses. This is likely due to to the presence of massive amounts of illicit street fentanyl hitting the streets mixed with heroin and misidentified to customers as being prescription opioids and due to an increase in suicide attempts due to the economic despair caused by the 2008 mortgage crisis and pockets of severe poverty and entrenched unemployment such as occur in West Virginia, and in places like Detroit and Chicago. People who have permanently lost jobs and homes and who couldn’t get new ones were very upset and many turned to drug abuse to console themselves and then found out that they could make a living by selling prescription opioid drugs to others to support themselves and to support their drug habits. The pharmaceutical companies gave out deliveries to anyone with a valid DEA license with no restrictions on the amounts of pills they could dispense and no way to know how large a community that they were serving. There needs to be a computer database for drug companies to use to determine if the request for doses of scheduled drugs are excessive in the future and caps on the number of bottles that can be dispensed so as to prevent this in the future, but government is way too focused on just suing drug companies and mostly unjustly blaming them and getting money from them to use to provide addiction treatment, by treating opioid drug companies like they are tobacco companies when tobacco is not a medically necessary drug. This is actually very misguided. It will only increase medical costs for suffering patients with pain and who are dying of cancer who will be forced to pay for other people’s drug abuse problems once again. We should be working to improve the situation with drug companies instead of blaming them for an addiction problem that is innate to our human nature and over which drug companies have very little actual control. Who will make opioid medications if we put them all in jail and out of business as if they are drug cartels? We are acting very foolishly.

    America has the worst drug abuse problem of any other civilized country on earth. We are the only one without a single payer health care system and the only one who always uses incarceration to try to solve every single social problem that we have, like we do about our drug abuse problem. We are so purittanically focused on sex and drugs and on taking away anything that people might enjoy that we are irrational. We are doing alcohol Prohibition all over again only this time with opioids. We forget that we have no viable medical replacement at this time for opioids that works any better or is any safer, and that opioids are drugs that are essential medications in health care and cannot be eliminated. We are thinking that this is all only common sense when instead we are acting very irrationally and very irresponsibly, by overgeneralzing and using black and white one size fits all prejudicial thinking. Other countries have had tremendous success with the decriminalization of all drugs and with providing better treatment for both patients and drug abusers and by using harm reduction measures. See Portugal and the heroin treatment programs in Switzerland.

    We Americans need to all stop being so tremendously pig headed, because we keep on doing the very same things over and over and keep getting the same bad results, and then we just do more of the same, seemingly hoping that prohibition, law enforcement, jails and punishment will somehow eventually work if we only try doing it hard enough. We hide good research that we don’t want to believe and we keep ourselves in denial of any reality that law enforcement cannot and will never solve or properly address our drug abuse and addiction problems, because these are medical problems and are not crime problems at all. Drug abuse is a sickness problem that requires medical assistance, not a badness problem that requires incarceration, law enforcement or punishment. It’s time to get out of the Middle Ages and start facing the true facts about these issues and stop demonizing sick and suffering people. Neither group of people are criminals or bad people undeserving of our care and concern. On the contrary, we have an obligation as Christians and as fellow citizens and as neighbors and as decent moral human beings to care for both drug abusers and addicts AND those mostly older people who are very low risk of substance abuse who suffer from severe chronic and cancer pain, and who need adequate doses of opioids until better drugs or treatments are developed or else they will just suffer and die needlessly. We do not need to be so terribly cruel to help address drug abuse and overdoses. Cruelty only kills and harms people and does not save anyone. In fact this cruelty and our mean spirited attitudes about other peoole’s needs and problems and our selfishness are one of the root causes of drug abuse in the first place. Human abuse contributes to the pain that underlies drug abuse, and it’s long past time that these abusers are held to account for THEIR OWN part in contributing to the problem of opioid abuse! The problem isn’t with opioid supply or with the proper medical use of opioids to treat serious pain, the problem is with drug misuse and drug addiction and the lack of access to proper evidence based treatment for this addiction and drug abuse problem.

    When we first learned about this overdose crisis the very first thing that we should have done was that we should have taken measures to save lives by keeping drug abusers and addicts alive and away from twenty times more unsafe street drugs like heroin laced with illicit fentanyl long enough to get them into treatment, by offering them much safer prescription drugs for free under a doctor’s care where they could have been more safely monitored, and then funneled into proper treatment for addiction. Instead we did exactly what former governor LaPage wanted done which was to make opioid abuse and addiction twenty or more times more deadly, which is why so many people have died and are still dying of so many, often unnecessary drug overdoses. La Page wanted illegal drugs to be so unsafe that people wouldn’t use them, which is unlikely due to the nature of addiction and drug abuse, or so that it would just kill off all of those pesky drug abusers that might require that we raise taxes on wealthy men like La Page to provide for their care. Greed can be very cruel! It would have been MUCH safer to just have gotten all of the drug addicts and abusers back on to using twenty times or more safer prescription opioid drugs where they would then have had to come in and see a medical provider every month who could then offer them MAT or refer them to proper drug treatment and this would have helped these suffering addicts to get the real help that they need, and prevented more accidental overdoses. Of course we don’t ever want to do that now do we! We say that that would just increase drug abuse, but even though it seems counterintuitive, this is not actually true. We could have saved tens of thousands of young lives from overdose deaths and we absolutely refused to do so! This verges on or actually was serious criminal governmental malpractice! I knew that these misguided public policies and laws were all based on fear, lies, greed, extreme anti opioid bias, bad research, prejudice, hatred, and dislike of drug addicts, pain patients and the disabled, media hype, and political expediency, and that this would inevitably result in even more death and suffering for many millions of Americans, but no one would ever listen to me or to any of the other more rational voices of reason from out here in the wilderness. Far too many innocent people have died needlessly due to PROP, Kolodny and his outright lies, the CDC, and fear, predjudice, hysteria and bad laws and bad public policies. We needed to better understand the problem that we were facing better BEFORE we went on making drastic changes to our nation’s medical opioid treatment laws. We completely misdiagnosed the problem because we pig heatedly refused to listen and thought that we knew it all! Doctors, in consultation with their patients, and not politicians or the DEA or law enforcement, are the ones who are the best qualified to decide the proper way to treat serious medical pain and addiction problems. Extreme opinions are rarely the right choice of action when dealing with public policies that affect hundreds of millions of different people with different needs, careful study of the problem before doing anything drastic and moderation is the key.

    Pain treatment really does only rarely lead to opioid addiction in all but that one percent most vulnerable population. How about developing a genetic test to identify those who have this predisposition to opioid addiction? That way we could use non opioid therapy with those who would truly be harmed by exposure to opioids, much like those who have an allergy to penicillin. We don’t stop using antibiotics for all patients because a small number are allergic to some antibiotics. This antibiotic allergy can even kill a patient, but we still don’t deny treatment to all other patients because of this like we are trying to do with opioids. It is just purittanicalism and our oversized fears of addiction that are driving this hysteria. Kolodney is like a Fox News pundit falsely saying that immigrants are bringing in smallpox when smallpox was eradicated worldwide in 1977! They are lying and fomenting fear and hysteria for their own vested self interests. Kolodny, PROP and the media have sold us all an entirely false narrative, one deliberately designed to predjudice the jury pools in the drug company lawsuits that Kolodney is involved with.

    It may also make people, especially those who have lost family members to drug overdoses to feel better by scapegoating doctors, drug companies, and chronic pain patients as being the cause of the opioid abuse and addiction overdose problem, because dying of an opioid or other drug abuse overdose is highly stigmatized by our society. This stigma is very wrong. Family members want to take the onus off themselves, their families, and the deceased loved one who has died of a drug overdose and so blaming doctors or drug companies for their loss feels better to them, but it is not the truth and this narrative is killing and harming both drug abusers and patients with pain and the doctors who try to help them. Drug abuse is truly an illness just like diabetes or cancer is and so drug abuse, addiction or chronic pain should not ever be treated ANY differently or any less compassionately just because it involves drugs of abuse. Doctors must be left alone to practice medicine without law enforcement or government interfering with proper patient care by their attempting to practice medicine without a license. They are NOT qualified to do this. Imagine if doctors ever tried to dictate how law enforcement should investigate and prosecute murders! State Boards of Medicine, and not the DEA or law enforcement or the legislature, must be the ones to primarily regulate the practice of medicine. We must free up our doctors to use their best medical judgement to treat their patients without having to suffer from undue fears of loss of license, jail time, criminal convictions or any other unnecessary legal sanctions for only just doing their very best to try to help their suffering chronic pain patients who have extremely complex medical conditions, and these doctors often try to provide this care under very heroic and extremely difficult circumstances. They deserve medals of honor, not criminal convictions and public disapproval. We have lost thousands of our most experienced medical pain specialist experts at a time of unprecedented need due to a huge aging baby boomer population who have left the practice of medicine forever all due to these terrible, harmful and very unnecessary laws and undue restrictions on the medical use of opioids that does absolutely nothing whatsoever to address drug abuse. We have completely wasted our time and taxpayer money on criminalizing innocent doctors for the sometimes inappropriate behavior of some of their patients, or just because they care for extremely ill and suffering patients. Each person can only be responsible for their own behavior. Patients have to take better responsibility for themselves. If patients abuse or misuse their medications against medical advice, then their doctors should NOT ever be held liable for this.

    All medical procedures, drugs, surgeries etc., have risks and benefits, none are completely safe. Long term use of ibuprofen and Tylenol kills thousands of Americans every year due to organ failure, almost as many as die of prescription opioid abuse. Opioids do not damage the internal organs and are very safe with long term use if they are used as directed and monitored by a proper medical provider.

    The method that our governemnt and medical authorities chose to use to address the drug overdose problem that was primarily a poly drug overdose problem and was never really an opioid epidemic at all, was to criminalize and over regulate the use of much safer prescription opioids as if the mere medical exposure to any prescription opioids was simply a disease vector that would inevitably lead to addiction in every patient ever prescribed an opioid medication, leading to this so called epidemic of only prescription caused opioid overdoses while completely ignoring the fact that opioids were not the only drug involved. This was because the average number of drugs found in these overdose victims was six different drugs and alcohol! In a great many cases had only prescription opioids been used, then the person would not even have overdosed or died! They were calling a drug overdose consisting of one half gallon of alcohol, one bottle of benzodiazepines, and one Vicodin, an opioid overdose when it really was the alcohol and benzodiazepines that killed the person, as this is a known lethal combination, one that put the famous case of Karen Ann Quinlan in a coma for the rest of her life. And, since no one ever takes this particular combination of substances to get high, I suspect that this was actually an intentional suicide attempt, and was not an unintentional drug overdose at all, and it was certainly not an opioid overdose, despite the fact that the CDC dared to call it one.

    It has now been proven, and the CDC was forced to publically admit that they deliberately doubled the number of so called opioid overdoses to bring more sensationalistic attention to this supposed opioid overdose epidemic problem. However, there are several good articles that have proven that the actual number of real prescription opioid overdoses are much much lower than even what the CDC’s corrected numbers were and much lower than what the entire media has been falsely reporting for years. There are really actually more like only 5,000 overdoses caused by prescription opioids in America each year, more like the number of people who die each year from falls, and not the 50,000 or more that everyone is falsely reporting. The rest of these drug overdoses are from poly pharmacy, combinations of both prescription drugs and street drugs like heroin, cocaine, methamphetamine, and illicit fentanyl. Illicit fentanyl and carfentanyl are the drugs that are actually causing what is truly the most lethal illegal opioid drug overdose crisis in history, but these drugs are NOT prescription opioids that are used by ANY patients to treat pain they are drugs bought on the black market and are often used as counterfeits for prescription opioids or are added to street heroin. Despite these facts it has been legal much safer medically necessary prescription opioids which are still being prohibited in ever increasing amounts and which are being falsely blamed forbeing the entire cause of the drug overdose and addiction problems in America. Very few people will believe otherwise, no matter what the evidence is because they have already bought the entire PROP false narrative, hook line and sinker, and don’t want to admit getting conned. So we endlessly go on trying, over and over, always very unsuccessfully, to use prohibition, law enforcement and the War on Drugs mentality for over fifty years, trying to solve our drug abuse and addiction problems by using methods which in my opinion have made these drug abuse and addiction problems much worse, and we have wasted over $600 billion that could have been better used for treatment and prevention to save lives instead of to destroy lives, but there is always unlimited money for law enforcement, but not for medical treatment. I guess that prisons are just too profitable to resist. Perhaps we have a prison, law enforcement and criminalization addiction problem as well as our drug abuse problems. Now we have an entrenched DEA and a huge law enforcement and prison industrial complex industry with vested financial interests who all want to keep their profits and their cushy jobs with benefits, rather than to ever allow us to change our system into one that could ever be transformed into using more humane and more effective treatments and that would invest in better methods of prevention, an idea that we have NEVER even tried, even after failing for over fifty years! Is this whole hog headed or what!

    Let’s try something different like comprehensive universal health care in at least one state and see what happens. Oh I forgot, that would be some kind of evil socialism, wouldn’t it? I’ll bet that this would do much more to stop drug overdoses than law enforcement has ever done! Is that what they are all so afraid of? After all aren’t the states supposed to be the laboratories where public policies can be tested to see if they could work nationwide? Let’s have one state try universal health care with access to medical, mental health, and comprehensive substance abuse treatment for every person in the state. Let’s stop restricting medical opioids and MAT and allow doctors to prescribe both opioids for pain to their patients in any doses as needed for their well documented painful incurable medical conditions and allow unlimited doctor ability to prescribe adequate doses of methadone for addiction treatment or to slowly wean opioid addicts off of opioid drugs using oxycodone or other opioids, as it is easier to get off short acting opioids than it is to get off of methadone which is the hardest opioid to detox from. Let’s not use $300 per month buprenorphine because people who use Suboxone cannot have emergency anesthesia for any emergency surgery and this causes a serious problem and so Suboxone should be avoided unless methadone or weaning off all opioids cannot be used. Wean methadone patients off of methadone using oxycodone in an inpatient setting to avoid possible drug abuse while they are detoxing and caution patients not to return to drug abuse after detox as they may very easily overdose and die having lost their tolerance for opioids. We could easily write up a comprehensive inpatient and outpatient and support network structure to do this.

    NA needs to reform, or we could start an entirely new kind of less blame and shame based support network for drug rehab support like the 16 step program or better. Telling patients in NA meetings who are on MAT that they are using drugs is wrong and expecting all NA members to never take even a Tylenol or any prescribed drug for any reason, even blood pressure medication, by saying that this is a relapse is also wrong. Relapse is only relapse to drug abuse, not to properly prescribed drugs under medical supervision that are taken as directed. I realize that this is a fine line and perhaps is a slippery slope for some recovering addicts, but the emphasis must be on the normal and proper use of drugs as directed by a doctor, and away from the misuse of drugs against medical advice, not the total avoidance of any drug at all whatsoever for ANY reason! So unless the recovering addict is abusing drugs to get high or for inappropriate or non medical reasons they should not be considered to have relapsed. These misconceptions and overgeneralizations in NA must be addressed or else newer and much better and more wholesome support groups need to be created. Going overboard will not help anyone. If people always take ten pills if they are only supposed to take two, then have all pills locked up and have a trusted family member or friend dispense them. We must also not only address drug abuse as being the main problem, because the main problem with substance abuse and addiction is why people are using drugs to escape life. There is already a good model for this kind of treatment called Sanctuary, read the book, it is a real eye opener. I know these things myself from both personal and professional experience.

    I also know that Kolodny and PROP are being deliberatly dishonest because they truly must know that what they are saying, doing and advocating for is all false. I cannot believe that they are honestly mistaken. There is just far too much written in the literature about opioid abuse that contradicts their entire point of view and there is far too much good research out there that they have all chosen to completely ignore, and I have caught them creating fake reversed engineered research to try to justify false, extremely biased predetermined conclusions for me to believe that their motives are in any way honorable ones. Brandeis really ought to discipline Kolodney and fire him from teaching there. One of the biggest scandals in medical research is how much of our so called medical research is deliberately reversed engineered and phony, all made up to achieve a predetermined conclusion for someone’s financial or personal gain and that seriously causes harm to innocent patients. Much more needs to be done to address this very serious problem before we can ever have any real evidence based medicine here in America. We will never have evidence based medicine if much of the so called medical research evidence is all faked using phony reversed engineered research studies. Anyone can do this easily. Just decide what outcome you want design a study that looks legitimate and do the study, then take out most of the data that says what you don’t want it to say. It’s all too easy. It is outrageous that patients are being given medical treatments and medications, often very dangerous treatments and medications that are all based on falsified medical research information. This is how many patients are seriously harmed by our for profit medical system that puts profits before the needs and care of patients. It is truly extremely shameful! We cannot ever do proper patient care without telling the truth and using properly done honest research.

    We also must accept our human limitations and always admit it whenever we are honestly wrong. There should be no consequences for ever telling the truth or for admitting any honest mistakes, as this is the only way that we can ever learn to improve patient care and the practice of medicine and nursing. Doctors and nurses are fallible human beings and are not gods or superhumans, we must allow them to be human and to make honest human errors. The perfect truly is the enemy of the good here.

    The opioid and other drug abuse and addiction problem is mostly separate from the problem of legitimate medical pain, with some overlap. These two problems are different and so the proper diagnosis must be made. We can differentiate addiction from dependence first of all by saying that physical dependence happens to everyone who takes an opioid or other drug that causes dependence long term for either an appropriate medical reasons or an inappropriate non medical reasons so that they will experience withdrawal symptoms unless they are slowly tapered off of these drugs. Addiction, by contrast remains after detox, so that the addict will immediately return to drug abuse right after detox, even though there is no issue with any possible withdrawal symptoms and they are no longer physically dependent or physically “hooked” on these drugs. They do not then use drugs to avoid these withdrawal symptoms, but instead because of a psychological compulsion to want to return to drug abuse often to avoid unpleasant emotional or psychological symptoms of anxiety, PTSD, depression, despair, grief, or other mental or psychological symptoms or because of their inability to cope with life without using drugs or chemicals with which to try to cope. This is why so many addicts relapse after detox. Detox is not nearly adequate to address drug addiction. Detox would work if the person just had normal physical dependence and they no longer had any pain and just wanted to stop using opioids, and if they don’t have a true addiction, but if there is true addiction there must be further therapy to learn better coping skills to cope with life on life’s terms without resorting to drugs or alcohol to cope. Drugs are not the main problem with addiction, we are barking up the wrong tree. It is the compulsive use of drugs to try unsuccessfully to cope with life which is a maladaptive coping mechanism that causes the biggest problem in solving our addiction problem. America also is a very highly competitive, perfectionistic, winner take all, cruel and uncaring society where money, outward appearance and extreme talent are rewarded and ordinary people are seen as being losers if they are just average or below average by our extremely perfectionistic standards. This leads to our overuse of performance enhancing drugs like steroid use in athelites and the like, and the same also holds true for drug abuse and addiction. Men are supposed to be inhumanly tough and unemotional in America and so using opioids to mask the pain and anxiety that would perhaps be seen by some people as being unmanly is one way to put on a false facade of appearing to be always strong and above having any“weak” human feelings, that actually we all have. Our macho culture is killing our men. On the other hand the pressures on women and girls are also excessive, as beauty is valued above all else for women, and so what does a plain, average, or ugly girl do? There is way too much cruelty, too much trauma and too much child abuse in America, and this can lead to PTSD, and to substance abuse to cover up these symptoms, and to try to function or to numb out from the emotional pain and still appear to be above it all. Bullying can even lead to suicides in vulnerable teens. Men often choose guns or other violent means of suicide, but women will often use drug overdoses to commit suicide, and most suicides do not leave a suicide note, which makes telling accidental drug overdoses from intentional suicides very difficult. There are a substantial number of suicides that are falsely labeled as drug overdoses. As many as twenty percent of all drug overdoses are actually suicides. This makes data collection to determine the underlying cause of our drug overdose crisis even more difficult to determine. Much more must be done to help to ensure that every person with suicidal thoughts is referred to an appropriate mental health provider and that this mental health care is available and affordable for all Americans, or more people will die needlessly of preventable suicides. Hot lines should always ensure that any suicidal callers are referred to a mental health provider and are not just simply patronized. I have had repeated personal experience with this patronizing attitude and suffered severely from lack of access to proper help when I needed it, causing me long term damage.

    Therefore, we must stop spending our money on prisons and law enforcement and instead focus on helping each other rather than on criminalizing each other. If we refuse to help people in severe distress how can we justify our harsh treatment of them when they cannot cope? It will save money and save lives to focus on universal access to medical care, mental health and substance abuse treatment and perhaps even dental care, rather than on law enforcement. We can retrain the DEA agents to become substance abuse counselors or social workers, we can even continue their same pay scales and benefits so they don’t have to lose their livelihoods but only just refocus them to helping people rather than on prosecuting people. Doctors who may prescribe inappropriately need to be retrained, not thrown in jail or thrown out of medicine. Legitimate pain clinics are not pill mills. Pill mills are places where every patient gets lots of opioids for cash and where opioids are the only treatment offered. Legitimate pain clinics are board certified, offer a menu of different services and take insurance, not usually cash. Legitimate pain clinics may prescribe a lot of opioids, but that isn’t all that they do, and they only see patients with the worst pain so they must be given lots of leeway to prescribe and try different ways to help suffering people. Some guy in a wheelchair and a neck brace who can barely move is not a drug addict, and his doctor cannot therefore be a drug dealer. I am horrified that the DEA and law enforcement don’t know any better than this. We must stop the madness and think before we continue to over react and cause even more harm then we are doing right now. Millions of vulnerable innocent lives are at stake, we must act more cautiously and thoughtfully and not succumb to hysteria and false and sensationalistic narratives. The AMA has finally woken up to the serious harm that three years of these overly strict anti-opioid hysteria laws has caused to both patients and to drug abusers causing an increased loss of many lives. We know that prescription drugs are twenty times safer than the street fentanyl that is killing people, so first we must stop the dying from overdoses by getting addicts and abusers off of street drugs and onto much safer prescription opioids or MAT. Then we must get them into comprehensive detox or long term treatment with MAT and counseling to learn how to cope with life on life’s terms. We could use the Swiss model because it is has been proven to save lives. We must first do harm reduction by restoring chronic pain patients rights to adequate doses of opioids. Then we could have doctors carefully educate and screen any patient for substance abuse or mental health issues before ever using opioids on them. Perhaps all new patients could be screened upon admission to the practice and given an opioid risk for abuse or misuse score to guide practice. Then this status could be updated if opioids are ever being considered. Those long term patients who are now suffering from under treatment of their severe pain must have access to adequate doses of opioids restored ASAP before more pain patients commit suicide or turn to street drugs. The inhuman, cruel treatment of all patients in America who are suffering from life long severe pain must end. Patients will sign that they will hold doctors and governments harmless if this is wanted, but we should have the right to treatment with adequate doses of opioids if all other pain treatment modalities have failed to help us and we must never be thrown under the bus again!

    This terrible abuse of chronic pain patients must stop! It is cruel, inhuman, counterproductive, and likely illegal and unconstitutional. We are adults with severe pain that cannot be cured, and we should have a human right to pain treatment with adequate doses of opioids as long as we take our opioids only as directed, do not abuse other drugs or alcohol, are carefully monitored by our doctors and follow all of the rules of our pain contracts. We could be individually certified by the state if needed and present a case for review to prove our lack of risk for drug abuse and we will sign any waiver asked. We just want the severe pain to stop and to get some of our life back. Opioids cannot cure our underlying diseases, they can only mask some of the pain. Opioids will never take away all of our pain, and so implying that we are wimps or that we expect too much is just plain wrong and is terribly abusive to suffering patients. The fear, predjudice and abuse of chronic pain patients and those with drug abuse and addiction all of which are diseases and are medical illnesses must stop once and for all. This treatment is inhuman, cruel, counterproductive human abuse and it is a human rights abomination. We must stop the madness and get back to sanity before many more people suffer and die needlessly because of fear, lies, ignorance and a lack of basic humanity.

    I will keep fighting these horrors for as long as I can to restore proper care to these two very vulnerable patient populations and for my own needs as a suffering person with severe chronic pain. Those who do not suffer with severe chronic pain have no idea what we are forced to endure and ought to have much more compassion. Compassion must return to America soon or else we will all devolve into ravenous beasts that are worse than any animal ever was. I pray that we wake up before this occurs and it is too late. Jesus said that sinners and sick peoole needed a doctor and not a jailer, and so we Americans need to heed His words and do the same if we ever expect to live up to our Christian heritage.

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