I am going to delete some words to shorten this passage, taken from the essays Death: The Unintended Consequences of the War on Opioids, by Jeffrey A. Singer, and Drugs: The Systematic Prohibition of U.S. Drug Science, by Trevor Burrus, printed in the book Scienttocracy (page 125 et seq), edited by Patrick J. Michaels and Terrence Kealey. Stanley is a research fellow at the Cato Institute. He received his from Brooklyn College (CUNY) and his MD from New York Medical College. Burrus is also a research fellow, working in the Cato Institute’s Robert A. Levy Center for Constitutional Studies. He holds a BA in philosophy from the University of Colorado at Boulder and a JD from the University of Denver Sturm College of Law. All that follows until you run into the word “OK” is from Stanley and Burrus, thereafter from me.
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“Diacetylmorphine, or dieamorphine, was first synthesized in 1874. It became popular only after re-synthesized by the Bayer pharmaceutical company in Germany in 1895. Bayer originally marketed it over-the-counter as what was thought to be a nonaddictive substitute for morphine, primarily for use as a cough suppressant. Its potency is 2 ½ times that of morphine. For this reason Bayer gave it the brand name Heroin, from the German word heroish, meaning “strong, heroic.”
Of the opioids commonly used today, methadone (Dolophine) also has 2 ½ times the potency of morphine. Hydromorphone (Dilaudid) is twice as potent as heroin and 6.6 times as potent as morphine. Fentanyl (Sublimaze, Duragesic) has 50 times the potency of morphine. Among the commonly prescribed oral opioids, hydrocodone (Vicodin) is roughly equivalent in potency to oral morphine, and oxycodone is roughly twice as potent. Oral codene has about 1/6 the potency of oral morphine.
The term “opiate” is used to describe alkaloids derived directly from the opium plant, such as morphine. Opioid refers to semi synthetic and synthetic opiates, such as oxycodone (invented in Germany in 1917), hydrocodone (invented in Germany in 1920), and fentanyl (invented in Belgium in the 1960s), as well as antagonist drugs such as naloxone, and Indo genus compounds such as endorphins.
Opiates combined with opiate receptor sites in the central nervous system to produce the effects of euphoria, analgesia, narcosis, and respiratory depression. 17 known receptors have been reported, but the principal ones are the mu, kappa, and delta receptors. They have subtypes, three of which are the mu receptors mu1, mu2, and mu3. Subtypes one and three produce analgesia, euphoria, vasodilation, and physical dependence. Subtype two produces respiratory depression and physical dependence, but no analgesia. The mu2 receptor is the only receptor that produces respiratory depression. All of the known receptors produce physical dependence – that is, chronic use requires larger doses to produce the desired effect, and abrupt withdrawal causes unpleasant symptoms. Opioid tolerance is associated with decreases in receptor sensitivity. The mu1 receptor develops tolerance more rapidly than the mu2 receptor. This likely explains why some physically dependent opioid users resort to higher and higher doses to achieve the desired effect and gradually succumb to asphyxiation from respiratory depression.
A January 2018 study from researchers at Harvard and Johns Hopkins universities reviewed over 568,000 patients in the Aetna Health Insurance database who received prescription opioids for acute postoperative pain between 2008 and 2016 and noted a total misuse rate using the range of misuse diagnostic codes of 0.6%.
Despite the hyperbolic press coverage surrounding the rising national opioid overdose rate, the evidence shows that opioids are safe and effective choice for severe and chronic pain, carrying little risk of physical harm, and a low risk for abuse, dependence, and overdose.”
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Page 153:
First synthesized in 1912 and patented by Merck, 3, 4-Methylenedioxymethamphetamine, better known as MDMA or ecstasy, was a relatively obscure drug for much of its history. In the 1950s, the CIA dabbled in researching the drug for possible chemical warfare purposes. It wasn’t until the 1970s, however, when a group of psychiatrists began to use the drug to facilitate psychotherapy, that recreational use began to grow. Eventually, the drug showed up on the streets. Frightened of a new, unknown Street drug with the sexualized name of “ecstasy” that could be used by children, the DEA issued a notice of proposed rule making in July 1984, announcing the intent to classify MDMA as a Schedule I controlled substance.
In response to the DEA’s proposal, a group of physicians, researchers, and therapists hired DC attorney Richard Cotton to draft a letter to the DEA administrator requesting a hearing on whether and how MDMA should be scheduled. This letter seems to have surprised the DEA, which, according to the one DEA pharmacologist, “had no idea that psychiatrists were using it.” In fact, MDMA, initially called “Adam” within the therapeutic community (possibly either as a reference to Adam and Eve or as a pseudo-anagram of the letters MDMA), had flown under the radar of the DEA for years. Given that use was usually therapeutic, and that MDMA rarely causes an adverse reaction requiring either medical treatment or law enforcement assistance, it seemed that MDMA could have flown under the radar for years more had not hit the streets, been renamed ecstasy, and landed in the hands of teenagers. One distributor reveled in the DEA ignorance:
“One of the wonderful things is MDMA has been known as Adam and used therapeutically in thousands, tens of thousands of sessions for 10 years, since the early 1970s, when the DEA moved to make it illegal, they had never even heard the name Adam. It wasn’t listed at all. It was people who had learned of it from of therapeutic community, some of whom had gone on to mass market under the name of Ecstasy.” …
…
The DEA, fully ensconced in the drug warrior mentality of the 1980s, didn’t seem to care. In fact, the agency didn’t care that it couldn’t offer much evidence that MDMA was harmful or that it was being abused. Instead, the agency argued that actual harm need not be shown, just the potential for harm.
Even though board certified psychiatrist explained that MDMA had an “accepted medical use” in practices, the DEA insisted that the FDA should decide what belongs in that category. They argued that the agency “need only ask the FDA whether the drug or substance in question has received FDA approval under the FDCA [Food, Drug, and Cosmetic Act of 1938] in order to ascertain the existence, vel non, of ‘accepted medical use.’
In a carefully reasoned 90-page opinion, Judge [Francis I.] Young concluded that MDMA should be placed on Schedule III, not Schedule I. Young disposed of the DEA’s argument that “accepted medical use” was synonymous with FDA approval. “Congress could easily have linked the phrase ‘accepted medical use in treatment’ in the CSA to some provision of the FDCA, and FDA’s authority thereunder, had it desired to do so. It did not do so.” Rather than being determined by the FDA, accepted medical use is determined by “what is actually going on within the healthcare community.
Young reviewed “testimony in this record from reputable physicians, i.e., responsible medical authorities who constitute a respectable minority, that the use of MDMA is acceptable in the treatment of certain kinds of patients.” Furthermore, the drug, although it can be abuse, does not have a high potential for abuse. Finally, reasoned young, there are accepted safety standards for use under medical supervision, therefore, MDMA should be a Schedule III drug. …
[Note: The DEA arbitrarily classified it as Class I.]
… In the limited research that has been done, however, MDMA has continually surprised researchers with its efficacy to treat certain psychological problems, particularly PTSD. In one small study of those with treatment-resistant PTSD, 80% of MDMA-treated patients reported benefits from the treatment; only 20% of the placebo group did so. The one year later, the majority of those treated with MDMA reported continual beneficial effects, whereas none of the placebo group did. In another small study of those suffering chronic PTSD, 10/12 subjects were determined to be cured after two MDMA -assisted psychotherapy sessions. …
… If we wanted to invent a drug especially designed to help enhance trauma-focused therapies, it would have the following qualities:
- Be short-acting enough for a single session of therapy.
- Have no significant dependency issues.
- Be non-toxic at therapeutic doses.
- Reduce feelings of depression that accompany PTSD.
- Increase feelings of closeness between the patient and the therapist.
- Raise arousal to enhance motivation for therapy.
- Paradoxically, increase relaxation and reduce hypervigilance.
- Stimulate new ways of thinking to explore entrenched problems.
Ecstasy has all these qualities when used in a clinical setting and is extremely effective. (David Nutt, British pharmacologist.) …
…
The growing acceptance of research into MDMA has also helped resuscitate research into other psychedelics that were hastily banned and given a bad reputation before any meaningful scientific research could be done, particularly LSD and psilocybin. Psilocybin has been used to combat smoking addiction in small, FDA-approved studies with shocking results. In a study with 15 participants, “12 subjects, all of whom had tried to quit multiple times, using various methods, were verified as abstinent six months after treatment, the success rate of 80%.” Before it was stamped with the label “hippie drug” and associated with anecdotal stories of “bad trips,” LSD was used to successfully treat alcoholics. But getting into the story behind psilocybin and LSD is beyond the scope of this essay. Suffice it to say that the story is largely the same for MDMA, a fearful government, goaded on by hyperbolic media reports and frightened parents, and something before we knew much about it. As a result, science was retarded, and those who could have benefited were forced to languish with her possibly curable disorders.
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OK, virtually everything above is taken from the Burrus texts, and the brief passages below are mine. I watch more TV than I would admit to without embarrassment. Some shows, like Bosch Legacy, starring Titus Welliver, I find compelling. Author Michael Connolly supplies both riveting plot and complex characters. Another series, Ozark, features Jason Bateman, and while I watched the first season, I lost interest and have not returned to it. It was not believable.
Despite my willing suspension of disbelief with Bosch Legacy, it gnaws at me that he is fighting the Russian Mafia. With Ozark, the US government is fighting Mexican drug Cartels. I don’t think either exist, but these series and many others push this mythology. This has always bugged, me, and then to come across a straightforward treatment of opioid abuse as set out above suggests to me that screen writers are given certain subject and told that they have to include them in the shows. Of the scores of things they use to control us, fear of Russians (going way back) and fear of Mexican drug lords (and the associated fear of addiction to narcotics) are near the top, maybe just below viruses and Greta Thunberg and Climate Change.
Another series we are watching is called Lincoln Lawyer, starring Manuel Garcia-Rulfo, who replaced Michael McConaughey, the one who starred in the movies. It’s a Michael Connally piece too. In this plot line we learn that Mickey Haller had a surfing accident, and during his long recovery became addicted to opioids. That’s a different twist on the same plot line.
I’ve had two surgeries in past months, and as a result was prescribed opioids. We still have them. One morning I took a pill before going to the gym, as my operated hand hurt. I then drove the seven miles and noticed that I was a little bit high, and so had to be very careful. That effect wore off quickly, but it did help with the pain. I had no desire to take another pill, as the minor high I experienced was not pleasant. Only the pain relief was, and I was able to manage the pain without drugs thereafter. It lingers to this day.
The chances of my becoming addicted to opioids was practically nil, .6% if you read Burrus above. But they push that so hard. PTSD was a very big deal during the Iraqi and Afghanistan attacks, and if these young men and women could be helped by taking ecstasy, then do it! It seems that the people at the top are reminiscent of the 1936 movie Reefer Madness, which demonized marijuana. I don’t claim that it makes us smarter or more ambitious. (I don’t use it myself, but did once or twice in the past. I did not find the high to be a pleasant thing.) Marijuana is doing little more than pacifying people who should be more on top of things. I suspect in the beginning they needed a reason to throw Mexicans in US jails, which is what led to prohibition. When it came into widespread use in the white population, it became legal.
Enough of being afraid all the time of every damned thing they throw our way! Opioids are not the vast menace they claim them to be. Ecstasy and LSD have legitimate medical uses.
Piece of Mindful 
Wow. I gotta say, Mark, after all the Covid chicanery, it’s a bit surprising to read a post where you defend the pharmaceutical and medical industries.
John Rappaport offered a very different perspective on this issue in his blog earlier this month: https://blog.nomorefakenews.com/2022/05/17/opioids-obama-congress-guilt-free-criminals/
He quotes direct sources who verify that pharmaceutical companies knowingly produce opioids not only for medical use, but for small pharmacies to sell to street dealers in their communities. It’s part of the business plan, according to Rappaport.
Your experience with post-op opioids for pain management may not be atypical. Maybe the media has, as Burrus argues, blown the problem of opioid addiction out of proportion. If so, why? I mean, we know the media conglomerates and the pharma conglomerates are all controlled by four or five institutions, right? (Vanguard, Blackrock, State Street Corporation, etc.) If the media corporations are telling us to be VERY, VERY AFRAID of opioids, do you think they’re doing so in defiance of the will of their pharmaceutical corporation siblings? Did the media CEOs sit down with the pharma CEOs and say, “Okay, okay, we’ll say the vaccines are ‘safe and effective’ over and over until people believe it, but in return, you have to help us save them from the evil of opioids!” Do you think the opioid hype is any less of a con than any other incessantly-repeated hype?
Your experience with opioids may have been beneficial, but you’re a healthy man who hikes and goes to the gym and stays in shape. By contrast, whenever I visit my mother, it seems she’s deteriorating more and more, because she continues to take prescribed meds to help ease the side effects of other prescribed meds that were prescribed because of the long-term effects of yet other prescribed meds…. She isn’t an opioid addict, but she is completely dependent on pharmaceutical drugs that have eroded her body and crushed her spirit. Also, I know far too many young people who are dependent on meds for bullshit disorders like ADHD or “chronic anxiety” (both of which, as far as I’m concerned, are simply the natural results of growing up in a digital age that encourages short attention spans and constant fear).
I’d be interested to know if you, or anyone else, has thoughts on why our incessantly lying media has demonized opioids. It’s an interesting question.
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Indeed interesting, the point of my post, and maybe by the time we get through comments, I will understand it better. But for now, Burrus matches my real life situation and that of the Harvard Johns Hopkins studies, and that of returning Vietnam vets, that addiction is rare. Regarding vaccines and statins all the other stuff they prescribe, people do not get addicted, they merely become habituated, assuming the medicines are doing good. They trust doctors, huge mistake. When they die, it is is iatrogenic.
I can walk and chew gum. There is something going on with mainstream media and opioids. Something I do not understand.
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Thanks for clarifying. I knew we weren’t in disagreement on any of my points, so I was mystified. But your and Stephers’ ability to mystify me is what keeps me coming back. So many so-called truth seekers are just hollering in confirmation-bias echo chambers. I’m looking forward to the evolution of this comments section, too.
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The mainstream is pushing Psilocybin and Pot none stop. I suppose they want it decriminalized on the Federal level, and probably soon it’ll be at gas stations on the shelf with the tobacco and kratem. Heroin was big in my area around 2015-1017. I know a few people that overdosed. Meth is still a big thing around these parts. Booze seems to be doing a great job at screwing people’s lives up, just check your State’s annual DUI arrest record. Some people can use the hard drugs for a long time without consequences and others get taught a lesson early on. I do know that these drugs are brought into the area by higer level people, usually military and then givin to street and biker gangs to distribute. It’s always the lower rung drug dealers that get arrested. They never question where these guys get these drugs. Can’t get a job at Mcdonalds or do basice math, but they can bring in opium from Afghanistan?
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Meth and cocaine are different animals, crack cocaine deliberately brought into the black neighborhoods of Los Angeles in the 1980s. Better living through chemistry. Breaking Bad sold that idea pretty hard, and I do not know how much underlying truth is there. It was, after all, just TV drama. Wealthier people seem to be able to use cocaine without addiction, just for the sheer fun of it. (Robin Williams: “Cocaine is God’s way of telling you that you’ve got too much money.”) Alcohol is a constant – a lightly populated area like the one we live in has four heavily trafficked liquor stores. There’s an 80-20 rule at work there, as in all of life.
This post was about prescribed opiates and the running theme on TV news and drama that people cannot take these drugs without getting addicted. The most egregious TV show in this regard was Dopesick (Michael Keaton), blatant propaganda. It’s a meme, an idea being sold without underlying substance. I want to know why. Please stay on topic. Prescribed opiates for pain are widely used, effective, and people do not get addicted. Refer to the post and the Harvard/Johns Hopkins study of Aetna clientele.
Burrus writes about use of ecstasy and LSD in clinical settings where small studies showed them to be remarkably effective. (Large studies have not been done due to bugaboos that follow prohibition). Therapists (not psychiatrists who prescribe without therapy) found them very effective in treating PTSD and alcoholism. He was not writing about street use, and he noted ten years of use of ecstasy in clinical settings with remarkable success. I do wish people would read and then comment rather than just doing drive by’s.
I had three older brothers who all rode out of this mortal coil in a morphine haze. I have no problem with that as they were in intense pain.
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I read the article, wasn’t a drive by. People who I knew(some dead, others in prison) that used heroin started out with the prescribed pain killers and could no longer get access to those, so at that point in time no it’s not addiction, but it is the “starting point” where they feel that first rushful high that stops their pain and makes them want more. No health insurance, no prescriptions, and over the counter drugs are not powerful enough, so they turned to the street or club scene and then become dependant or addicted to those drugs. Then when that supply runs out in the area, they have to goto rehab where they are given other drugs to overcome withdrawal sypmtoms. So yes some people do eventually get addicted(without incurring adverse effects). Health care workers get fired for stealing them too. The legal consequences are extensive, people get prison time for a small amount of drugs, not county jail time, the state pen. And it all started with prescribed opioids.
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Your comment is anecdotal. The Johns Hopkins/Aetna/Harvard study placed problems with opiate abuse post-surgically at .6%.
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Lol, why would you believe the study? I know multiple people addicted to opiods, multiple people who have died from them too.
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Again, anecdotal, which is why they do studies, to qualify and quantify data.
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I hear you, those sane studies tell us climate change is real.
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That’s a nice bit of black/white thinking. We have more alternatives than because climate change is a hoax, all scientific studies are hoaxes.
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Based on my experience of 20 years in nursing, seeing & regularly giving, many people prescribed opioids for analgesia –
Opioids aren’t addictive if you need them, ie for pain control, in which case your body uses them straight away for the purpose in hand. When a person takes them for kicks it’s a different story. The opioids don’t get metabolised in the same way, more & more is needed for the same level of ‘high’, that’s where the addiction comes in. That’s where the power play around drugs centres, in my opinion.
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Burrus covers this in detail, including the passages I cite, the mu1,2 and 3 receptors. No one claims that opiates are not addictive, only that hardly anyone gets addicted. Soldiers in Vietnam were often addicted to various drugs, the reasons having to do with boredom and time on their hands … on returning stateside, most straightened out.
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The propagandists have been so aggressively assaulting us with bullshit on all fronts that it never occurred to me to question the opioid scare and possible reasons behind it, which is, I guess, why this post was so jarring. My own life experience has prompted me to categorically reject all pharmaceutical products… though, knock on wood, I haven’t suffered severe pain that would be relieved by opioid.
Since it seems clear that our reality-makers want us more dependent on drugs, I can only assume the opioid alarmism serves to create the usual false dichotomies and problem-reaction-solution scenarios. Opioids are bad because they’re addictive, therefore, pump yourself up with THESE drugs which aren’t as addictive but that you must become dependent on in order to benefit from them. With the continued push for “boosters” and the latest useless flu “vaccines,” it is clear we are meant to accept pharmaceutical “updates” to our bodies the same way we accept them for our computers. Demonizing one class of drugs in order to make others look “safe and effective” by comparison makes sense. And if universal dependence on drugs is the goal, I suppose it also makes sense to demonize drugs that are only beneficial when used in moderation for a very limited period of time.
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“Demonizing one class of drugs . . .” This is the same sense I get from phony drug war and accompanying propaganda. There is plenty of evidence to show this goes way back, not just with cannabis. Other examples would be demonized substances that were common among the natives/early settlers, like sassafras. This was a common addition to root beer, but was then banned. Safrole, the ‘active ingredient’ was supposedly toxic (after very dubious studies where it was force-fed to mice until they died of ‘cancer’) and now it is a ‘street drug’ produced in countries like Thailand, and sold as “Sass” in the ecstasy department. Also the very common ‘poke weed’ while not as a mind-altering substance, was early on attributed to the virility and impressive strength of the young men of Appalachia during some war, I think the Civil War, and suddenly it’s pronounced poisonous and there’s a massive campaign against it (though it was never outlawed). Still folks thinks this is a dangerous and toxic food though it fed our ancestors for many generations. (I believe this is where the Popeye cartoon got famous, replacing spinach for this green in a tea-like marketing campaign, which is not a native plant here and probably of inferior health potency). Like tea, then we start importing.
Find the potential market, claim it, exploit it, rinse and repeat.
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From Johns Hopkins Bloomberg School of Public Health:
“A Blockchain Solution to the Opioid Crisis” (August 2018)
https://globalhealthnow.org/2018-08/blockchain-solution-opioid-crisis
In the urgent search for multipronged, coordinated solutions to the opioid epidemic ravaging the U.S., blockchain might be just the powerful weapon we need.
In ‘redesigning’ the lifecycle of prescription drugs, we propose tracking the prescriptions sent from providers to the pharmacy and the quantity being prescribed.
Instead of paper prescriptions, e-prescriptions securely stored on the blockchain can restore trust to an outdated system with a layer of monitoring for misuse.
Some blockchain startups have plunged into solving these thorny issues, including BlockMedx, which is building a blockchain-based prescription platform to bring transparency and accountability to the misuse of opioids. Its solutions include other emerging technologies such as machine learning to predict the likelihood of drug misuse and abuse. And a blockchain-based identity management solution gives patients control of their data.
Though blockchain technology is still in early stages, the opioids emergency is already here and will persist until we intervene. It’s imperative we deploy innovative, multipronged solutions to this coordination problem—and blockchain could prove to be key.
On BlockMedx . . .
https://www.crunchbase.com/organization/blockmedx
BlockMedx is the world’s first and only completely secure, HIPAA-compliant, end-to-end solution for transmitting DEA Controlled Drug prescriptions such as prescription opioid pain relievers and others, from physicians to pharmacies using the Ethereum blockchain.
https://blockmedx.com
We offer a next-generation smart e-prescribing and analytics software. It can be used anywhere in the world to send and receive electronic prescriptions, track prescriptions, and predict patient risk behaviors.
Our software provides continuity in patient care across various doctors and facilities, a real-time data stream for improved business outcomes across all medical stakeholders, and data security native to blockchain.
PROBLEM-REACTION-SOLUTION
The central planners play the long game. The opioid situation is all about framing/narrative. I suspect the “epidemic”/”crisis”/”emergency” narrative is inaccurate (potentially grossly mis-represented), and intentionally so; and that it was rolled out once the advanced software/emerging AI was commensurate.
I say this, despite the fact that for all of my life (since as young as I can recall), my mom was addicted to her daily codeine hit, and eventually committed suicide (after several failed attempts). Further, my dad and his wife, both in their mid-70s, admit to being addicted to oxycodone and hydrocodone, respectively. My dad explained to me today that both he and his wife no longer (after 6 years of chronic, daily use) receive pain amelioration from the opioids (they need to supplement with medical marijuana, and that is also not sufficient); but they take them to manage their sleep/wake cycle (in addition to Benadryl at night) – which essentially takes their mind off of the pain, but does not reduce it directly (according to him). They like the energy it provides them during the day (including the moments of the “high” they get), and it sometimes helps to make them tired at night (but my Dad said he now needs the Benadryl). Because the pain meds are prescribed by a pain specialist, they are not limited as much in quantity (in terms of access), as most other opioid-prescribed patients are (that is, if prescribed by a general physician). Even so, my dad said he is required to get a urinalysis every other month (in order to monitor the opioid levels – as in, monitoring him for potential “abuse”), and the drugs are only prescribed electronically (AKA e-prescribing, as linked above); thus, providing data streams, risk profiling (predictive profiling), behavior nudging, and an impact node, on which stakeholders can hedge their bets on his compliance/lack of compliance, etc.
The system does not want its citizens to stop taking opioids, it simply wants to manage their consumption/use – yes, on the blockchain. It is a key impact market: https://wrenchinthegears.com/2019/10/20/pay-for-success-the-opioid-crisis-poor-peoples-economic-human-rights-campaign-radical-social-work-breakfast-presentation/.
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Well now, that makes sense. They are hyping a crisis for hidden reasons. This explains the Keaton movie Dopesick, pure propaganda.
Your parents, Dad and stepmom, sound like they are in chronic pain. I feel for them.
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MT,
Thank you for your sentiments, Mark. I am very close with my dad, and I want nothing more than for him to be free from his chronic pain and associated ailments. It is a struggle; and I am grateful he is willing to discuss it with me, even if he is not in a position to heed my cautionary advisement and holistic guidance.
While I think it may be an oversimplification (?), I concur that “Dopesick” reflects agit prop with ulterior motives.
Ironically, if you recall, I was actually the one who recommended you watch “Dopesick,” even though I had not seen it. I lost interest after a few minutes. But my daughter watched it in its entirety, and it was one noteworthy clip that she showed me which was the impetus for me to suggest you watch it – having to do with “breakthrough pain” (which seemed to parallel the notion of “breakthrough infection” with the COVID scam: https://www.bitchute.com/video/1eAa3UiFkyvQ/ (very short clip – less than two minutes).
Admittedly, this topic is a sensitive one for me, for numerous reasons (a couple of which I alluded to above). At the time of your hand surgery, privately, we discussed that I was concerned about you using prescribed opioids, and I suggested natural alternatives. Fortunately, you were very confident that you would most likely only take it once (if ever), and that it would not be an issue – which alleviated my concerns. It seems clear to me that you are incredibly disciplined, and have a lot of inherent willpower – admirable traits that, unfortunately, I do not naturally exhibit. Hence, I was most likely projecting my worries (arising from within myself, and my experience with my parents) on to you. It did not actually arise from any notion of a reported epidemic of opioid abuse (whether founded or unfounded – TBD). It was purely anecdotally driven.
While I voice these types of concerns to people I care about (in this respect, I include you in my circle), I am not militant about others who utilize the allopathic medical system. Clearly, it has its place, in certain instances. On the contrary, I am militant (for lack of a better word) about declining it for myself. To be completely transparent and vulnerable . . . I consider myself to be prone to having addictive traits (AKA an addictive personality – although I do not like that phrase, as I think it lacks a comprehensive understanding of what addiction truly means). Accordingly – and I can only speak for myself due to my family history and keen self-observation – I avoid not only opioids, but all pharmaceuticals (which I consider many, if not most, to be potentially addictive due to their interfacing with brain receptors – not to mention highly toxic), as well as recreational drugs, alcohol, nicotine, coffee, and sugar. My one vice is organic, unsweetened chocolate – and given the indulgent way I consume it from time to time, I have no choice but to concede that I lean into addiction (!). I am not aware of the reported statistics on how many adults have naturally occurring addictive traits (nor precisely how this mechanism operates); but, regardless, I sense it may be a pivotal factor in determining who would be more susceptible to falling into a cycle of opioid misuse/abuse – which I believe is a very real phenomenon (even if hyped/overblown – or at the very least, exploited – by the system for hidden reasons, as I theorized above).
I reviewed the 2018 study referenced in Scientocracy (footnoted in Chapter 4 by Dr. Jeffrey Singer, p. 129 of the Kindle version):
“Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769574/
Technically, it seems this was a retrospective data review that curiously seemed to use Rx refills as its metric for “misuse” (AKA drug dependence) – possibly revealing little, if anything, about opioid dependence, as no patients were involved in the “study.” I also get the sense that Singer may have cherry picked his assessment (or even worse, mis-reported); but I could be misunderstanding . . . I have copied/pasted several excerpts, as I think they are worth reviewing (my emphasis) . . .
From the Brat et al. 2018 paper (linked above):
568 612 (56.0%) patients received postoperative opioids, and a code for abuse was identified for 5906 patients (0.6%, 183 per 100 000 person years). Total duration of opioid use was the strongest predictor of misuse, with each refill and additional week of opioid use associated with an adjusted increase in the rate of misuse of 44.0% (95% confidence interval 40.8% to 47.2%, P<0.001), and 19.9% increase in hazard (18.5% to 21.4%, P<0.001), respectively.
Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients. The data from this study suggest that duration of the prescription rather than dosage is more strongly associated with ultimate misuse in the early postsurgical period.
The number of post-discharge prescriptions best predicted eventual misuse. Overall rates of misuse were low, but rates grew rapidly with increasing opioid use. The rate of misuse more than doubled among those with one refill (86 654 (15.2%); 293 cases per 100 000 person years) versus those with no refills (434 273 (76.2%); 145 cases per 100 000 person years). In total, each additional refill increased the rate of misuse by 70.7% (95% confidence interval 54.6% to 88.4%) before adjustment and increased the hazard of misuse by 44.0% (40.8% to 47.2%, P<0.001) after adjusting for covariates.
Each additional week of opioid use was associated with an average increase in the rate of misuse of 34.2% (26.4% to 42.6%, P<0.001, see fig 3A). Adjusting for covariates, each additional week of opioid use was associated with a 19.9% increase in hazard (95% confidence interval 18.5% to 21.4%, P<0.001).
We focused on typical surgical patients without a history of misuse or ongoing opioid use and estimated an adjusted 44% increase in misuse for every refill fulfilled, or 20% increase for every week of prescription.
Patients who received even one post-discharge prescription were three times more likely to be taking opioids at one year.
This finding extended across specialties, where surgical and non-surgical patients had similar rates of opioid refills. Several studies in surgical patients have also shown that administering opioids early after surgery is associated with subsequent long term usage. Irrespective of the direction of causality, our data suggest that patients who require subsequent refills of opioid drugs are statistically more likely to have an episode of misuse, even years after the index surgery.
Our findings suggest that opioid naive patients who receive low to moderately high doses of analgesics for short durations have small associated increases in overall rates of misuse.
Higher doses within standards of moderation may better saturate μ receptors, whereas under-treatment of acute pain increases the risk of pseudoaddiction, chronic pain, and, potentially, overdose. These findings suggest a more nuanced understanding of the relation between duration and dosage, with a focus on early appropriate treatment of pain (including higher doses) for a limited time. Such findings imply that optimal postoperative prescribing, which maximizes analgesia and minimizes the risk of misuse, may be achieved with moderate to high opioid dosages at shorter durations…
In the presence of uncontrolled confounding, we cannot be certain of the magnitude of the effect we observed.
The study concluded the following:
In this study, we quantified the strong association between short term postsurgical refills and misuse. A single refill increased the potential of misuse by more than 40%, and the duration of use appeared to be the most prominent predictor of misuse…The duration of a prescription rather than opioid dosage was more strongly associated with ultimate misuse in the early postsurgical period.
^ ^ ^ ^ ^
In parallel to the reported findings of this paper – anecdotally speaking, my dad – who was “opioid naive” pre-surgery – was prescribed OxyContin following back surgery, and then he asked for a refill one month post-surgery . . . then asked for a refill the next month . . . then the following month, and here he is 6 years post-op – still asking for a refill every month. He said he feels that until about a year ago (5 years post-op) – despite having to continually increase the dosage – the Oxy was ameliorating his pain. It is only in the past year or so, that he thinks it became less effective for addressing pain.
Sorry, MT, that may be a lot to absorb in one reply. Please understand where I am coming from in terms of my frame of reference. With all that I put forth, I think to say that this topic is so vast and deep – and highly nuanced – would be an understatement. I do not wish to trigger you, or anyone, or make any bold assertive claims. I am very open to learning more, as new information drops in my lap. This is the first time I have spent any time digging into this – academically speaking – and I am not a gung ho fan of the “studies” that these universities (esp. Johns Hopkins) proffer (reminiscent of all of the “COVID” studies I have perused!). I think I need more to go on before I would even venture into any potential debate. I am still in exploratory mode . . .
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While seemingly innocuous – and presumably beneficial – following is a digital gaming intervention applied to opioid addiction/abuse: https://survivingopioids.com/about.php (see the launch date – 11/22/22). The virtual role-playing game designer (Patrick Gervais of Sudbury, Ontario) works in mining (https://www.ontario.ca/page/ministry-northern-development-mines-natural-resources-forestry). I frequently come across this (overlapping fields of physical resource mining and data/digital mining) in my exploration of individuals who cross over into cybernetics/gaming: https://www.cbc.ca/news/canada/sudbury/opioid-addiction-video-game-1.6397450.
Similar gaming programs, like this NIH-funded initiative (albeit non-virtual), are being implemented for smoking cessation: https://www.hhrinstitute.org/hennepin-healthcare-investigators-study-game-to-help-people-quit-smoking/ (May 27, 2022).
^ ^ ^ ^ ^
I forgot to mention that the opioid abuse narrative/paradigm also fuels the graphene (nanotech) market:
“Biosensor combines graphene and mu-opioid receptor”
https://www.advancedsciencenews.com/biosensor-combines-graphene-and-mu-opioid-receptor/
“Catching opioids on the GO: graphene oxide sensors to detect morphine in urine”
https://graphene-flagship.eu/graphene/news/graphene-oxide-sensors-detect-heroin-abuse/
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I was aware of Johns Hopkins’ complicity in the Covid hoax even as I cited the study. It’s a large organization, and corruption comes from many places and forces. The Covid hoax was massive and required people in the upper tiers of management of JH to be co-opted, perhaps even placed in advance. As with NASA and the moon hoax, most participants are believers, only a few at the top are corrupt. That in mind, it is possible to glean good and honest work out of an otherwise corrupt organization. (Remember that Harvard Pilgrim devised a plan to fix the VAERS mess, only to be stifled by CDC.)
Here’s what Burrus wrote, which I cited directly:
Does that not state exactly what your citations emphasize? I took it to mean that within the .6% we see the tendency for opiate abuse, and it is detected by the number of refills. You are Burrus are in agreement.
I tend to value a clear head, which is why marijuana never appealed to me. In fact, I’ve never done any kind of drug, and like you am not on any prescriptions, and plan to avoid them for the balance of my life until perhaps it is time to leave this place in a morphine haze, as my brothers did. They were in severe pain. The drugs I fear most are things like statins and steroids, and drugs used to combat hypertension. These drugs have negative (“side”) effects that require still more drugs to combat them. Consequently, a typical senior citizen will produce a long list of drugs when queried during a doctor’s appointment. When filling out that damned questionnaire if I see a doctor I am happy to report no scrips, and for the long list of ailments simply to draw a long line down the “no” side. I don’t suffer any ailments knock on effing wood. I exercise vigorously, keep alive intellectually by means to this blog and interactions with people like you. So far, so good, says the 72-year old.
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As a matter of clarification . . .
1) I think you may be on to something revealing in this post, and you are ahead of me in this regard.
2) My exploration of this matter (as you have framed it) began yesterday, and I have a ways to go before coming to any speculative conclusions.
3) Despite my apparent biases (I have been forthcoming about this), I am very open to learning more, and gaining a coherent grasp on this topic.
4) While admittedly nit picking (although it may ultimately be very relevant) – the excerpt from Scientocracy that you provided above appears in my Kindle version (which can sometimes be different than its initial hard/soft copy edition) on p. 127 in Chapter 4 (“DEATH: The Unintended Consequences of the War on Opioids”), and is penned by Jeffrey A. Singer (whom I suggest is worthy of intense scrutiny: https://www.cato.org/people/jeffrey-singer – particularly as a Board member of ACSH: https://www.sourcewatch.org/index.php/American_Council_on_Science_and_Health – notable for spinning their downplaying of “fear mongering,” which translates into defense of Big Ag – DDT, GMOs; Big Pharma – vaccines; Big Biotech – CRISPR; Big Oil, Big Banks – Carnegie, Mellon; and additional industry sectors “Big” a là the brothers Koch). https://www.acsh.org/about-acsh-0 (industry apologists at their core)
In reviewing the excerpt above (which you attribute to Burrus – another individual deserving of examination: https://www.cato.org/people/trevor-burrus, particularly given his close connection to the Institute for Humane Studies https://www.sourcewatch.org/index.php?title=Institute_for_Humane_Studies, with Mellon banking ties https://www.sourcewatch.org/index.php?title=Sarah_Scaife_Foundation) – in relation to reviewing the JH study you linked (referenced in Scientocracy) – I am not perceiving a direct correlation.
The JH study declared the following:
What is already known on this topic
Opioid misuse is increasing rapidly in the US and internationally
Surgical patients are four times more likely to get opioids at discharge than their non-surgical counterparts
It is unknown how opioid prescribing habits by clinicians are related to rates of misuse
What this study adds
Each refill and additional week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients
The duration of a prescription rather than opioid dosage was more strongly associated with ultimate misuse in the early postsurgical period
The JH study makes no reference at all (that I can detect) to the mechanism of physical dependence, tolerance, or receptor sensitivity. It cannot imply any inferences as such, as it was solely a data cohort review comprising number of Rx refills, with an emphasis on duration of prescribing (involving no experimentation/study of the human subjects from which the data points were extracted). Prescription refill metrics – while seemingly reflective of opioid consumption – do not offer a direct, distinctive measure determining if the patients even took the pills once they received their prescription (there are a plethora of variables that would have to be taken into consideration – some more valid than others).
The study stated, “we quantified the strong association between short term postsurgical refills and misuse.” Again, it did not focus on the notion of larger doses (potential indicators of tolerance/receptor sensitivity – as noted in your pulled excerpt above) being associated with chronic use, but, rather on duration as being a key determinant.
I am still unclear on the .6% data point – which was determined initially by ICD-9 coding for misuse (see the Methods section; Results section; and the Supplementary Materials related to the ICD-9 codes and cohort derivation: brag040635.ww1.pdf). I want to emphasize that this study makes NO mention of the potential of fraudulent medical coding: https://www.cco.us/medical-coding-fraud/.
The researchers note the potential limitations of ICD-9 coding and the studied cohort (the .6% labeled as misusing opioids – which excluded all injected forms of opioids, and only comprised fully insured adults – not on Medicare/Medicaid – who had surgery and presumably had no use of opioids prior to surgery):
We recognize that administrative data have inherent biases that may have affected our results. First, the dataset does not exclude patients with undocumented presurgical misuse or opioid usage. Similarly, postoperative misuse might not have been detected in members who left the cohort because of lost or changed coverage. Miscoded claims are possible but less likely as coding of opioid abuse has been found to be accurate 85% of the time. Alternatively, increased recognition of the problem of opioid misuse may lead to overcoding in later years or undercoding in earlier years. Overcoding could explain the increasing rates of misuse observed in later years, but recent national studies by other authors have also shown similar trends. Finally, measurement of opioid use is complicated by the possibility that patients might fill a prescription and modify the course or dosing of the drug. We used the cabinet supply method for measuring use in an attempt to conservatively overestimate usage.
As for the problem of confounding, although we controlled for disease burden by adjusting for surgery type and examined the full spectrum of presurgical diagnosis codes, these are, at best, partial measures of disease state at the time of surgery. Notably, we were unable to control for the extent of pain or the individual features of surgical techniques. In the presence of uncontrolled confounding, we cannot be certain of the magnitude of the effect we observed. Those patients with a higher likelihood of developing misuse might request augmented treatment. The consistency of our findings, despite extensive sensitivity analyses, suggests there may yet be a causal component to our analysis. This is further supported by evidence linking most patients who present to addiction centers to an initial prescribed opioid for pain.
Finally, the generalizability of this study is limited to insured adults in the US, as several studies have shown increased rates of misuse in Medicaid, Medicare, and veteran populations. (my emphasis)
*Additional note: On the reported increased rates of opioid misuse among Medicare and/or veteran populations . . . Anecdotally speaking, my dad’s story does reflect this. He is on Medicare, and is a veteran (served at home in the National Guard during the Vietnam War). That said, he told me that he chooses to not get his opioids prescribed by his VA doctor, as the prescribing process is much stricter (more highly regulated) than that of his pain specialist (outside of the VA network).
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You are right about the authorship, which I corrected. I was not working with the book but rather from my transcribed notes, which allow me to copy and paste. I missed the line about Singer, and attributed both essays to Burrus. Oops.
And yes, the JH/Harvard study was with Aetna clients, but you do know that Aetna runs a Medicare Advantage program, so we do not know the makeup of the people who were prescribed opioids. Medical care, especially surgical medical care, is heavily skewed towards senior citizens. I guess I am case in point.
You should note that Burrus [and Stanley] work for Cato, as does Michaels, to my knowledge. You are going to find many links to conservative groups, which do not trouble me. I tend to enjoy the work of conservatives, as opposed surely to liberals, but also to journalists, who are capable of missing just about everything in their quest for “objectivity”. Subjects like this require passion and the ability to head down a rabbit hole, and journalists don’t have it or do that.
As to the JH/Harvard/Aetna study, you dance with who brung you. Dr. Kaufman made the point addressing one topic or another that often times we do not know enough about some topics because those topics are not studied. The studies follow the funding, and many topics are not in vogue and so are not studied. The Spanish Flu is a case in point. We still don’t know what’s up with that.
So at this point I am going to take all alarmism regarding opioid abuse with a grain of salt. I do think that there is something to be said for the tendency to abuse to be triggered by longer dosing. I do think that the vast majority of people are like me, able to take it or leave it, and even sentient enough to know that the pills in our medicine cabinet must be used with caution and good sense.
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After reading the post and all the comments, including Stephers’ in-depth yet still preliminary analysis, the alarmism about opioid addiction is reminding me about alarmism over Covid deaths. Mainstream media simultaneously had the public believe death would be rare and likely to happen only to the extremely elderly with comorbidities AND that people of all ages were dropping dead in the streets. The more muddled and confusing the narrative, the more inclined the majority is to give up trying to make sense of it and just let “experts” solve whatever the problem is.
Mark, when you say “the vast majority of people” are like you regarding caution about opioid… well, maybe the vast majority of older, educated, healthy, financially secure people are. If there’s a serious problem, it’s likely to be found in more disadvantaged populations, like Medicare recipients. These are the folks the media and our leaders care least about. When they make a big huge deal about how we need to SAVE THEM!!!!!!, it’s a sure sign that there’s a con behind it.
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I will repeat my message here – the study cited is Johns Hopkins/Harvard concerning Aetna clients. Nationwide, 42% of all Medicare recipients are in Medicare Advantage programs, one of which is run by Aetna. Therefore, it is safe to say that a very large percentage of the 568,000 people in the study are Medicare recipients. It would certainly be more than 42%, as surgical procedures skew heavily to seniors.
Medicare (not so much Advantage) is a godsend for all seniors, poor and wealthier alike. It is because of Medicare that seniors are not dropping dead in the streets.
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Also, a note about drug-seeking behavior: People predisposed or already addicted may go to great lengths to obtain prescriptions. I don’t think such people are (or should be) included in a study designed to measure the rate of addiction on post-surgical patients, who would not undergo surgery just to obtain drugs. There are street drugs and users out there, but this post was not about them.
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Stephers: since you are still exploring, but also because you may already have some knowledge in the area.
Like Mark, I have had several surgeries in sensitive active areas (and I am active) – a handful of finger procedures (one reconstruction (worse than Dupuytren’s fix)) a hand, and five spinal fixes, among others. It didn’t bother me, but yes, all the orthopedic surgeons strongly suggested that I [fill the script and] take the post-op meds – mostly codeine. Of all these procedures, I used just one pill necessarily, and just once: after a corrective (finger surgery). It hurt enough to prevent any sleep.
Given my array of orthopedic injuries and surgical repairs, I have had more than my share of [lengthy] re-hab and the associated staff. That shit hurts (I’m sure that Mark just loved his hand re-hab). Anyway, I have been told by more than a few that I “have a high tolerance for pain.” More likely that I have shit to do, and the pain is ignored as simply in the way.
Is that a real quantifiable attribute?
Might that be a factor in the initiation of habitual [drug] use?
I am a very unsympathetic guy; I exercise and eat properly… those that [choose] not to, deserve what they get. Admittedly, I may have gone too far a few times.
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DSK,
For one, I am so sorry that you have endured all of this – just plain old sucks to have to go through it.
Second, I, too, have been told by doctors, holistic practitioners, friends, family, etc. that I have a high tolerance for pain. I would have to concur; although, like you, I have a strong tendency to ignore my pain, as I have a very busy mom schedule – with very little room for any down time/recuperation time. The show must go on, right?
To attempt to answer your questions . . . I want to set up the framing a bit, and clarify that it seems we are addressing the issue of pain tolerance, NOT the issue of pain sensation in general. I believe – without referring to any specific studies – that some people do not actually receive the sensation of pain as much as others do, and vice versa, of course. But that is not particularly relevant here. I can’t say I have done much research in that respect. Accordingly, I do not think you are inquiring about how humans feel pain (as in, the mechanism and variability therein), but, rather, how we deal with pain (even if, theoretically, it was measured to be the equivalent amount of pain across persons of interest) . . . Essentially, 1) what is our individual threshold (presuming it can be measured/detected); and 2) can it a determinant to being pre-disposed to drug habituation/addiction?
Following is a mainstream, allopathic response which you can peruse: “What’s Your Pain Tolerance?” https://www.webmd.com/pain-management/features/whats-your-pain-tolerance. I think it offers some superficial answers, which I do not necessarily consider to be inaccurate, but perhaps incomplete. That said, what I find fascinating is that not only may gender be a factor in pain tolerance and pain management, but also hair color, eye color, and hand dominance, among other factors. (Interestingly, this information intersects with my research into melanin, which may be highly interconnected with pain tolerance/perception, and possibly even occulted and crossing over into esotericism. Perhaps I will write about this in the future, but this resource is a start: https://newhighmedia.wordpress.com/2020/01/31/red-hair-genes-melanin/.)
While I cannot verify precisely how quantifiable pain tolerance is, it does seem there are a plethora of studies to this end. I think it is outside the scope of this reply (and my current knowledge) to vouch for the validity of any related studies. Nonetheless, pain tolerance is considered to be both quantifiable and variable among individuals depending on their genetic profile, as well as their psychological and emotional profile, and beyond that.
So, without looking into specific studies, I would have to speculate that one’s tolerance for pain would most definitely be a factor in whether one is pre-disposed to not only initiating pain amelioration via pain meds, but also one’s continued or prolonged use of pain meds, and perhaps eventually leading into pain med addiction/habituation.
In speaking for myself . . . Since I am not opposed to feeling a moderate amount of pain (an amount that most other people around me would consider uncomfortable enough that they would seek meds or herbs for alleviation), I just go on my way feeling the pain, but simply dealing with it. It seems you do the same. I think this is unusual in our culture, though.
As a mom, when either of my children have been injured or adversely affected in pain in some way (regardless of the cause), my first question to them has always been to rate their pain on a scale of 1-10 (with 10 being excruciating/unbearable), so that it can help provide a gauge for them – and for me – to determine the best route of action. Thus far, my children have yet to measure personal physical pain above a 6. So that has helped me to help them (especially as they have grown older and can choose remediation for themselves) choose a proportionate/measured response to their pain. Hence, they have never voluntarily taken or received herbs or meds for pain cessation. Alternatively, when their pain has been between a 4 and a 6, they have treated it (or been treated when younger, such as when they were teething or following a tooth extraction) with homeopathy – both internally and topically (arnica, etc).
With all that said, I perceive physical pain as a form of signals intelligence in the body. I need it to indicate to me what is going on inside, because I cannot see inside myself (to my organs, nervous system, etc). That goes without saying. So I choose not to suppress pain, because I need it to communicate with me, so that I can determine the proper course of action in healing – which is not to address the pain, but, rather to address the root cause/source of the pain. That is central, and what most often gets neglected when we opt first to reach into a medicine cabinet for an Advil or Tylenol. If I have a headache – even if it is a splitting headache – I want to know what is causing that headache. On the contrary, if I have had surgery – for example, when I underwent wisdom teeth extraction at age 23 – then I already know the cause of the pain, and therefore, I am more inclined to treat the pain symptoms. However, even when I had my wisdom teeth out, I did not take pain meds, and I noticed the pain was not subsiding over a few days. Sure enough, I had a significant hematoma (resulting from the surgery) that was causing the pain, and I had to go back to the oral surgeon for treatment of the hematoma. Had I not been attuned to the pain (if taking meds), then I may not have caught the complication in time, and the result could potentially have been much worse.
I know . . . TMI. Sorry for the ramble. I am not even sure I sufficiently addressed your inquiry. As I have implied, I have a very personal relationship with pain (both acute and chronic), and I think the body is designed very intelligently to communicate to us via pain signaling/perception/sensation, so I do my best not to get in the way of that bidirectional interfacing.
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Stephers:
First off: thank you for the informative reply.
Secondly: WebMD… pffft – breezed through that one already. The other link is blocked here at my employer, I’ll have to check it out later at home – THAT one seems interesting (as is your investigation into melanin).
Thirdly: Indeed it does seem that we are similar as far as personal pain management goes. One Chiro went as far as to tell me that “you have trained your musculoskeletal system nicely to protect the [severely] damaged areas.” Sure, sure… doesn’t everyone do that?
Finally: TMI? Ramble? No way. Oh what I could of done with a real mom like you – wow.
Thanks again,
Dave
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I see over-prescribing as the crux of the issue. I have known many addicts in my life, and many who have gone through rehab and some ending in premature death. None of these were about prescription abuse, the street drugs in the Midwest in the 80s and 90s meant no one needed a prescription for anything. Ecstasy was very common and a substance I used fairly regularly while at uni. I think today the illegal/legal markets have become intertwined for many reasons and flooding the streets with illegal drugs was the precursor. Get them used to taking drugs, make them easy to get and cheap, then we can steer them into our markets in the future.
But, as much as I am not against altered states of consciousness, I have been prescribed opiates on several occasions, by the dentists and by doctors in the past (when I still believed in the medical establishment). There was no real need for these prescriptions, yet they gave them to me anyway. I tried those pharmaceuticals given to me for pain and they made me ill, couldn’t take them. One doctor gave samples to me for ‘depression’ (which I did not have) because I complained of PMS, once, when I was in my 20s. That’s all it takes to get on their prescription rosters, a sore tooth or a monthly mood swing.
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The narrow scope of this post (though ecstasy was mentioned as a treatment for PTSD) is the likelihood that surgical patients who are prescribed opioids would eventually become addicted to them. The answer, according to a Johns Hopkins/Harvard/Aetna study, was .6%. I cannot speak to street drugs and people who seek drugs without surgical trauma. I just want it to be clear that this post is about one thing, not everything.
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Then why talk about all those other things in your post? Why not just keep it to one paragraph along the lines of, ‘what do you think of this study’? Then we can all be very clear of your parameters.
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I had a lot of data I’d collected that I found interesting and wanted to share. But then the comments rolled in, and I was being anecdotally immersed in opioid crisis! opioid crisis! I wanted to put the kibosh on that, and so repeated ad nauseum to each scary comment that the only data available in the post said that there is no opioid crisis. I’ve attempted to s5ay that course since, keeping that to be the message. You must think I know how to plan.
We are being bombarded with scary talk about a national emergency with opioid addiction. Data says not. My question: Why the bombardment? Stephers implied a hidden agenda with block-chaining people and their prescriptions, either making sure they take their drugs or punishing t(em for not. I do not follow that line of reasoning unless the object is to really get people addicted to opioids. I guess it would not surprise me.
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Fair enough. I’m sure it’s a real challenge to keep comments on topic.
So, why the bombardment? IMO, same as it always is, create a market then exploit it. But you don’t create a market out of nothing, you go to where there is potential. The potential here is, loads of folks are getting addicted to drugs, seriously addicted, and it is a visible crisis that other folks are looking for an answer to. So provide them the answer, and then the solution. There really is a serious drug problem in this country (among others). Many of us have many ideas why it is occurring, but those ideas don’t make markets. They give it a name and a cause and sell all the associated propaganda.
They you get those who know there is a drug problem to finger point to a few dozen different causes, and rarely, if ever, at the root of the problem.
Hope that was on-topic enough. Sorry I don’t have any links to back up my opinions, but it is a topic I spend a good deal of research on. I just don’t believe any of their studies or solutions. Ever.
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MT,
We could potentially remain in unending circles of debate about the possible causes/correlations of acute pain, chronic pain, and opioid tolerance; and the extent of opioid use/misuse/abuse in this country (it is not reported to be a prominent/prevalent issue in some other developed countries, which is only hinted at in this MSM article: https://www.nbcnews.com/health/health-news/how-germany-averted-opioid-crisis-n1068286) . . .
I am compelled to cut through the noise – and, yes, I do consider that the Cato Institute contributes (knowingly or unknowingly) to the cacophony – as think tanks (left or right of center) most often do. Both sides gate keep and obscure, and have significant blind spots. Even though I have libertarian leanings (I used to follow Cato’s material years ago), I have yet to see any representatives from Cato get to the crux of any matter.
Returning to the 2018 JH/Harvard/Aetna study . . . I wanted to also return to my point about the long game . . .
One of the co-authors of the study you featured has been on my radar for the past two years – Isaac Kohane (and why I sense that this all relates directly to blockchain, machine learning/AI, e-prescribing, biometrics, bioinformatics, precision medicine, digitalized medications, Internet of Bodies, Internet of Bio-Nano Things, graphene/frontier nanomaterials, bio-digital convergence, etc. etc. etc. – essentially, ALL of the things I talk about here at POM):
https://dbmi.hms.harvard.edu/people/isaac-kohane
https://scholar.harvard.edu/kohane/home
https://aiforgood.itu.int/speaker/isaac-kohane/
https://pubmed.ncbi.nlm.nih.gov/?term=Kohane+IS&cauthor_id=31015651
When it comes to faux emergencies, AI for Good (which I have previously referenced here at POM – of which Kohane is intimately involved, as linked above) is a poster child:
We have less than 10 years to solve the United Nations’ Sustainable Development Goals (SDGs). AI holds great promise by capitalizing on the unprecedented quantities of data now being generated on sentiment behaviour, human health, commerce, communications, migration and more.
The goal of AI for Good is to identify practical applications of AI to advance the United Nations Sustainable Development Goals and scale those solutions for global impact. It’s the leading action-oriented, global & inclusive United Nations platform on AI.
AI for Good is organized by ITU in partnership with 40 UN Sister Agencies and co-convened with Switzerland.
https://www.getyarn.io/yarn-clip/48252c93-00ac-4fce-98c4-63af0ec73482
^ ^ ^ ^ ^
Kohane and his cohorts have plans. They have had these plans for decades. Whether or not opioid addiction is a little problem (a pebble) or a huge problem (a boulder) may not really matter. I do not think it really matters to the controllers – who consider us not only managed livestock, but now digitized assets to track and trace (even on the nanoscale), and on which to hedge their bets in terms of our medical compliance (nearly always within the allopathic medical model – a sick system, not a wellness system). They only have a hammer (toxic pharmaceuticals, and other presumably less toxic pharmaceuticals to treat excess use of the former – with little regard or acknowledgment of natural alternatives); and thus, they only see a nail.
My position on the media bombardment and the accompanying demonization (gaslighting!) of opioid-prescribing physicians and opioid-prescribed patients (technically, they are not demonizing the opioids, per se) – which I will attempt to re-state – is that the System needs the citizens to lack trust in themselves and their physicians (as “caretakers,” so to speak), so that they will be begging for a trustworthy system to care for them (to manage their behaviors, actually – and via Big Pharma/Big Biotech/Big Data) —> the AI-directed medical system. It all starts to make sense once you know where they want to go.
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That last paragraph really sounds plausible to me. And this – “the System needs the citizens to lack trust in themselves and their physicians” – ties in to what I seem to recall hearing (though I haven’t paid close attention to the opioid narrative), that everything was designed to incentivize prescribing opioids. Before the crisis or (“crisis.”) So I wonder if they were setting up the docs all along to take a fall, priming the pump, and then doing a rug pull.
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MT,
In digging further – in my attempt to perceive this topic from various angles – I came upon this article, which (despite promoting the allopathic paradigm, which I do not espouse) seems (somewhat) pertinent to your post (I think?), and is quite measured in its analysis: “Why Opioids Cannot Fix Chronic Pain” https://neurosciencenews.com/opioid-chronic-emotion-pain-17507/ (December 2020).
My main takeaway (which is why I sought out this article) is that (again, within the pharmaceutical realm) opioids may make patients feel better in the short-term (ie – post-op for a week or two/up to one month); but over the long term, there is evidence that these drugs may cause havoc on the physical, emotional, and mental well-being of the patient.
“Rather than helping the pain for which the opioid was originally sought, persistent opioid use may be chasing the pain in a circular manner, diminishing natural rewards from normal sources of pleasure, and increasing social isolation,” they wrote.
“Long-term opioid therapy that lasts months and perhaps years should be a rare occurrence because it does not treat chronic pain well, it impairs human social and emotional function, and can lead to opioid dependence or addiction,” they wrote.
[The authors posited that responsible, short-term use for acute pain is warranted.] https://www.annfammed.org/content/19/1/79
This precisely echoes the experience of both of my parents – both long-term opioid users who suffer(ed) from severe depression, with my mom finding no way out but to take her own life.
It seems the evidence (including the study you linked) demonstrates that short-term opioid use can be effective and (relatively) safe (and non-addictive), while long-term opioid consumption seems not only inappropriate (as alternatives – both conventional and holistic – do exist), but harmful on many levels, as well as increasingly addictive as the duration of use increases.
https://pubmed.ncbi.nlm.nih.gov/34855645/
https://pubmed.ncbi.nlm.nih.gov/11444716/
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I agree in total. Singer made it clear in his description of mu1, 2 and 3 that long-term opioid use would lead to need for larger and larger doses.He does not mention depression, but it is clear that depression is a natural outcome.
The kicker is the pain, how to treat it. We agree that short term use of opioids is effective, and most people who use them do so and then get off them. But if the pain persists and the opioids are not effective, what then? This is your father’s dilemma, and step mother’s I take it. I can see why you are deeply troubled. The only things that come to mind are meditation, hypnosis, acupuncture, and you can see I got not much to offer. I do not envy your position and understand your heartache.
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It does appear that the AI/Blockchain/pharma nexus is an attempt to create a system of doping that is “optimal” – as many people taking as much medication as they can handle and still function. It also cuts out the black market like Stub Hub and the other ticket resellers have done to ticket scalping.
Of course that will lead to everyone being given their prescriptions based on statistics and not choice, evening out the current inefficiencies.
I’m not sure this is all being consciously planned from the top down. It’s the logical outcome of the Frankenstein corporate system.
AI isn’t mimicking the human brain as much as human brains are a form of AI, until conscious awareness arises in individuals enough to override it. As corporations grow in size and power they are virtually unstoppable – until their inherent contradictions catch up to them. We are already seeing that.
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I think it started in the 50-s or 60-s with the promotion of drugs as mind enhancements. All this effects are not enhancements but brain or nerve damages. It’s poison. A healthy life without medicine will not cause you any sickness or unnecessary pain. There may be some exceptions like disabling the pain for some surgeries or tooth removals but even those can be minimized if you live a healthy life. When you age, which probably is Marks concern now, you ability to feel pain changes. Small accidents won’t hurt you like they did when you were younger. And bigger accidents can be avoided, right? I’m trying to say, it’s good to know, we can make the pain go away but we should avoid doing it. When you’re “sick”, it’s usually due to previous drugs you’ve taken. Then it is best to become clean first, get detoxed, get rid of the addiction. I know it’s easy to say but if you don’t things won’t get better. Any chemical substance you’re consuming is a poison and a burden to your body. You can get used to some of them, when your body learns how to produce the enzymes, but some of the poison will accumulate in your body and lead to organ failures and such. Whatever health problem you may have the best thing will always be to get rid of the poison first. And if it hurts, it’s your fault and it will teach your a lesson.
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Good points … my two minor surgeries … inguinal hernia and Dupuytren’s Contraction, I was not suffering terribly after and did not take anything except for once, when my hand hurt a few days after DC, and I was more curious than anything in doing that. It did seem to relieve that pain. Several years ago I had a tooth extraction and was in pain for a couple of weeks and took Advil, and it made a difference, that is, I felt uncomfortable pain and it took that pain away. It was later suggested to me that because I never took it before that was why it worked so well, that the body adapts. Anyway, I am drug free.
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I was given powerful drugs for anesthesia … I wonder how long it takes for those to wear off in total?
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MT,
As a self-trained, lay homeopath for nearly 25 years, my first go-to modality to treat post-op nausea, pain, scarring, etc is homeopathy. The following remedy is what I use for myself, my children, and my animals following any operation/dental procedure (fortunately, there have been very few instances – essentially, tooth extractions/fillings): https://www.clinicalnutritioncenters.com/anesthetic-detox-by-professional-complimentary-health-formulas-pchf-2-fl-oz-59-ml/. Here is a related resource from a trained homeopath: “HOMEOPATHIC REMEDIES FOR ANESTHESIA DETOX” https://www.villacortahomeopath.com/blog/homeopathy-for-surgery, as well as some helpful information here on myths surrounding the treatment of acute/chronic symptoms via a “non-classical” homeopathic approach: https://www.villacortahomeopath.com/blog/the-banerji-protocols.
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I’m showing symptoms of inguinal hernia. Do you have any wisdom to share re: belts, exercises, strategies for fending-off surgery, etc.? It would be much appreciated.
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I ran from it, hid from it. But the certainty is that an inguinal hernia is debilitating. You can do normal things, but if you try to do anything requiring extra strength, you risk making it worse. With my first hernia, other side, I was in a basketball game and tore it wide open rebounding. A truss will help. There are some remedies out there that do not work, as it is a tear and will not fix itself.
The question in this country is do you have insurance? Obamacare fixed nothing, so even if “covered” you’ll have to pay high deductibles. I am on Medicare, which knocks down the surgical costs and then requires that I pay 20%, which I can do. If you are on normal insurance, you’ll have to pay for most of it yourself. Thanks, Barack. Because of the structure of our health care system, wild overcharging goes on, the idea being that to get the money they want they have to do that. Sometimes people get stuck with those wild overcharged bills, and hospitals and doctors make it stick.
Do your research, ask questions, make phone calls (emails are useless), understand your financial position first and foremost. For the medical part, the surgery is simple and effective. You will not regret it.
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Thank you, Mark! And great “health care system” mini-analysis.
I hadn’t yet started looking into this, and I was very surprised by the serendipitous coincidence of you mentioning it.
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A.D.,
If you feel you are still in a position to fend off surgery (as it seems you may be attempting to avoid it), I suggest reviewing the following video and accompanying website:
https://www.youtube.com/watch?v=wRVYHl_eRsk (George demonstrates the ab vacuum in detail; and the comments thread is extensive and helpful)
https://mynaturalherniacure.com (George specifically addresses exercises and various belts here)
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Thank you, Stephers!
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A.D. you may not believe it now but why don’t you just try fasting and i mean hard core, not eating anything for a few days no juice, just water. And then eat very little for a week or so. I got rid of some chronic pains that way and they are still gone. In my experience only the first day is hard because your stomach will try to force you to eat. Go to bed early and the next day you wont be hungry anymore. It can’t do any harm to try, right? And it is for free too.
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Thank you, Barb! Are you theorizing that fasting can not only tackle pain but can also induce tissue repairs?
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Barb,
I find the phenomenon of pain to be fascinating, and highly mis-understood (as well as stigmatized and mistreated) in our western, industrialized culture. While being very far from a masochist, my experience of dealing with pain seems vastly different than most other people I know, in the sense that I have developed an intimate relationship with pain – almost embracing it. Of course, this can come off sounding very wrong and even insensitive (or downright callous) to others’ notion and experience with pain.
When giving birth to my two daughters at home – my relationship with physical pain (albeit acute – which is very different than chronic) was dramatically altered. I felt what it was like to be very primal; and hence, the pain I felt (both with the labor and the actual birth) was archetypal in nature. I kind of dug into it, and used it. Man, it was powerful. I can recall it now, as I did not attempt to suppress it. It was something inherent in the birthing process that I felt was necessary (for me, that is) to fully engage with the act of birthing new life.
I do have a backstory, though, that brought me to where I am (and was at age 30 with my first birth) . . .
At the age of 16, I was in a fairly severe car accident – suffering a muscle tear in my throat, body lacerations from the seat belt (first time I had ever worn one – saving my life!), severe whiplash, etc. etc. etc. My family was very mainstream (as I previously commented, my mom took codeine every day – and by age 8, I knew what Percocet was, as she popped Percocet pills every day too, including overdosing on them); so I was immediately given muscle relaxants (Soma from our medicine cabinet), and subsequently treated in the hospital for a couple days.
Following the initial stages of acute pain from the car accident, I experienced chronic pain as a result – which lasted for nearly 10 years, before I got a handle on how to treat my chronic pain naturally with an individualized, holistic regimen (mostly self-designed and self-administered, but also with the support of mentors and holistic practitioners in various modalities). During the first few years of chronic pain following the car accident (again, I was immersed in a mainstream family who embraced the medical model), I was regularly medicated (not only for months, but years) with all sorts of pain meds – the two I recall most were Flexeril and Voltaren. Consequently, I was misdiagnosed as having ankylosing spondylitis, followed by all sorts of “diagnoses” like fibromyalgia, chronic fatigue, etc. etc. etc. My body was a mess. I was a teenager, but it was like living in an elderly body.
Fast forward to my early 20s, when I began to seek alternative options. The impetus for this was being a nanny for a chiropractor’s family (when I was 21). I will never forget opening their medicine cabinet, to find NO pharmaceuticals (Rx or OTC) whatsoever – only homeopathic remedies, which were completely unfamiliar to me. Their family was essentially a picture of wellness/health – something very foreign to me. That experience set me on a new trajectory, and I never looked back.
Given that I had years of “poison” in my body (I would add mind and spirit to this as well), I did not heal from chronic pain in short order. It was a process of clearing out/detox (from the meds and the mental/physical trauma) that took a few years. I still experience triggers (physical, mental, emotional) every now and then; but I have the holistic tools to nip it in the bud.
As a wellness practitioner, it is not my desire to free others from pain (physical, mental, emotional) per se. Rather, my aim is to help others find meaning in their pain (without blame and shame) – to extract from it the individualized message. It is different for everyone. I do not judge others for their choices to consume drugs or chemicals, as I perceive a much, much deeper (existential, really) pain that resides in the human being that wants to be suppressed. It is a fight, really, until one is willing to dig in the muck and be willing to bring it all out into the daylight – like a blooming lotus. Metaphorically, there is much to be learned from a lotus flower, and it is why I chose to use lotus imagery on my very first business card – when I was 28 or so. I have since used other imagery, such as the teasel root, as it was my relationship with teasel (ingesting the root) that got me over my final hump of chronic pain (ostensibly healing from what is termed “Lyme disease” in our culture).
When it comes to my mom, she considered me a “zealot” (her words), when it comes to healing and wellness – and my perspective on pain. She took her life before she could ever change her mind on that one. My dad and his wife – while more open to hearing my thoughts and suggestions – are captured by the sick system. They were captured years ago, and they see no way out. Being on Medicare, and having little financial resources (and too much pride to take all of our hand-outs), they take only what is offered/promoted (pimped?) by the allopathic system.
It is not their physical pain per se that upsets me, it is primarily the emotional anguish that accompanies it. I know firsthand what it is like to live with chronic pain. I do not wish it on anyone. That said, chronic pain is a whole different animal than acute pain resulting from a physical insult – accident or surgery, or otherwise. There is meaning in it, and one needs to be willing to get to the root of it, without piling on a “wet blanket” of opioids or any other medication, or even herbs. I feel there is much more to it. In my personal journey healing from chronic pain, I discovered (again, for myself) that there was no magic herb (like kava, valerian, boswellia, or curcumin), or acupuncture session, or even hypnosis session – I have done all of these and much more – that could cure my pain. It was examining my core thoughts and feelings surrounding all types of pain (physical, mental, emotional – and finally, spiritual/energetic) that actually catapulted me to a whole new mindset. My shamanic work was pivotal in this, as I came to realize that I was holding on to the pain of my parents, and their parents, and their parents, and so on. For me, ancestral pain is very real. When I see my dad and his pain (mostly physical, but also mental/emotional/spiritual), it is apparent to me that he carries a huge burden of ancestral wounds, because I know the story of my extended family on his side, going back a few generations. It is not a pretty one. My mom, too, held horrendous trauma in her body, mind, and spirit, from the insults she experienced and acquired (via osmosis) from family members.
We are SO much more than our physical pain, and our modernized culture has NO way of dealing with, nor healing it. The system teaches us only to suppress and bury it. As usual, we are on our own to mend our broken bodies, minds, and spirits – but it is possible. I am a living testament, and I model this every day to my children; and I offer my wellness consulting services for free (I do not charge anyone – although I do love to barter!). I am far from perfect, and from being “healed.” I still experience physical, emotional, and mental pain; but I now have more tools in my tool belt, and I do not look for the quick fix.
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I am going in for acupuncture in two days, a sprained ankle that simply will not heal. I’d be interested in your take on acupuncture.
I am sitting here looking out our window over the deck and into the woods realizing I’ve lived a sheltered life. Even early on growing up in a dysfunctional family, I didn’t have problems beyond coming into self awareness and self acceptance. I went to my 50th class reunion and looked back on those days of so badly wanting to be accepted and liked, and realized that 50 years later no one’s perception of me changed, but I found my perceptions immensely different – save for one gal (who was probably the prettiest girl in the class and who was very popular) who was engaging and friendly and warm, I found myself not much interested in any of them. What a waste of gasoline that reunion was! I came away thinking that I had progressed into a caring and intelligent thinking adult, while they had changed very little.
So sitting here in my pain free stress free world, I thank my lucky stars that in 1992 or so, feeling an emotional wreck, I went to see a psychotherapist, one who did not prescribe drugs. Chemadreau was his name. After several weeks he finally gave me the bottom line: “You need to grow a backbone.” I took control of my household, ignored my wife’s manipulations and gaslighting, and in early 1993 she came to my office one night wanting a divorce. I had indeed changed, and it was more than she bargained for when we married. I left that marriage so much happier than I’d ever been before, and made new friends and met new women, and leading a hike one day in the Castle Mountains, met my life partner. It has only gotten better 27 years later.
Thank you, Doc Chemadreau, god rest your old chain smoking cranky Jewish soul, for spelling it out for me. From him I learned to get a mirror and learn how to use it.
Anyway, Stephers, my life compared to yours has been a cakewalk.
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MT,
On the ankle sprain and acupuncture . . . I am supportive of acupuncture for this purpose; and generally speaking, insurance does pay for it – if you get a diagnosis code for pain.
Alternatively (or concomitantly), you can also take a stab (pun intended) at doing self-applied acupressure.
See here the Xiaojie (pronounced she-ow-jay – “she-ow” as in rhyming with “trowel”) point on the hand for ankle sprains: https://www.mastertungacupuncture.org/acupuncture/tung/points/xiaojie-t-2213. If you watch this one-minute video, you can see the Xiaojie point https://www.youtube.com/watch?v=INwy8JYAuK4. In terms of acupressure (again, uses the same point used in acupuncture), you can stimulate the Xiaojie acupressure point by gently pressing this point on the base of the thumb joint (again, it may help to see it on the video I linked, but the photo may be just as helpful): right thumb if it’s your left ankle, left thumb if it’s your right ankle. You can gently activate the Xiaojie point for a few minutes at a time, a few times a day.
Hope this makes sense. Please keep me posted. I have other potential tools in my tool belt.
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It took me a while to grasp – Xiaojie 22-13 is the pressure point for ankle sprain? I do not understand acupuncture at all. I was left with the impression (probably due to my misunderstanding) that the PT I am seeing on Wednesday would be inserting needles in my calf.
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MT,
Xiaojie is the main point for ankle sprain (yes, located on the thumb joint), but there are others that the PT may use in conjunction (possibly also on your leg and/or foot). Keep in mind, acupuncture and acupressure are based on a meridian system – so imagine circuits of energy flowing from your hand down to your foot, for example). This 3-minute video (albeit superficial) may be helpful: https://www.youtube.com/watch?v=E1c_k_a0GjU.
Other simple, inexpensive DIY self-treatments (to complement acupuncture/acupressure):
1) Cabbage leaves wrap (can use even if swelling has dissipated) https://www.youtube.com/watch?v=1y2MrYv3ZNA
2) Castor oil (from local pharmacy) – gently massage ankle with it (apply/massage a few times a day)
3) Epsom salt (from local pharmacy) – soak ankle in bathtub/deep bowl (enough to fully submerge) of lukewarm or hot water with dissolved Epsom salt (be generous with the amount, as it is not expensive, and it should be fairly concentrated)
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MT,
22.13 (Xiaojie or Xiao Jie) is on the LU (lung) channel: https://www.catstcmnotes.com/post/xiao-jie.
Read more here about the Lung meridian: https://www.acupuncture-points.org/lung-meridian-points.html (only if interested, of course).
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Neither link mentions skeletal, nothing about ankles or sprains. I’ll report back after Wednesday to tell you what she did.
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MT,
Okay, okay (light, friendly chuckle). My links were seemingly irrelevant. Let’s keep it simple and more direct for now:
“Acupuncture for Sprains”
https://acupuncturetwincities.com/2010/11/acupuncture-for-sprains/
In Chinese medicine, this kind of injury is considered a blockage of energy and blood. Essentially, nothing is moving through the injured area, and you can see the stagnation in the swelling and purple bruising around the joint.
The first order of business in Chinese medicine is to get the energy and blood moving, relieve the pain, and soothe the injured tissues, so they can heal. If a sprain doesn’t heal properly, over time wind, cold, and dampness can move into the joint.
Your body works like a hologram in that there is a map of your entire body in each individual part.
Your acupuncturist may also perform ear acupuncture to help heal a sprain. Like foot reflexology, your ears also contain a map of your entire body, and are easier and less painful to needle than the bottoms of your feet.
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I have tried 2) and 3) and it is pleasing. However been using MSM lately and it seems to help reduce sore muscles and speed up recovery time although it gives me nonstop gass if I take too much.
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