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ADDICTION MEDICINE:

PATHOLOGICAL RECKLESSNESS, INCOMPETENCE, AND MALFEASANCE DRIVING AMERICA’S LETHAL EPIDEMICS

By Clark Miller

Published September 4, 2019

Updated April 9, 2021

 

But First:

 

FOR AMERICANS TRAPPED IN SUBSTANCE USE EPIDEMICS

– A CURE!

Attention all Americans struggling and at risk of a ruined life, illness, death,

loss of family and friends, destitution – or with a loved one who is – there are medical cures that successfully treat the brain condition causing addiction, and all that is needed is to see your doctor for the prescribed medications!

Doctor discussing prescribed medications with patients

It sounds too good to be true,

but our most trusted and knowledgeable authorities and institutions – the highly trained medical, research, public healthcare and media workforces entrusted to protect our health – have established that the medical cures work.

How do we know?

They keep telling us.

(Don’t wait much longer to get to your doctor’s office to start the medical cure, but until you get in, read on.)

Here’s how we know:

America, using public healthcare funds, has invested billions and billions of dollars over many decades in developing medical cures for the medical condition of addiction– established to be a chronic disease of the brain. That level of investment of public resources and medical science, of course, pretty much guarantees gains against any disease. 

This is America, after all. 

Nora Volkow

In definitive major media reports and features, like this award-winning HBO special on “Addiction” from 12 years ago, America’s top scientific and medical authorities provide assurances that the “right medicines”, based on our medical understanding of the disease of addiction, serve as effective treatments for the disease.

Twelve years ago.

Watch the introductory video segment with America’s top addictions authorities (beginning around the 2:36 mark) assuring America of their “understanding” of “a medical condition with real medical solutions”.

And imagine the progress that must have been made against substance use problems and their costs since then!

 

Those time-tested medical treatments sure weren’t cheap, requiring decades and diversion of essentially all public research, development, and institutional resources to the medical cures, – including public funding for an entire industry, “Addiction Medicine” – but what price is too much for the cures for America’s ages-old lethal problems with substances of abuse?

And without diversion of public resources to the pharmaceutical/medical industry cures, where would we be?

Without the universally recognized medical fix dispensed over past decades for America’s opioid crisis, that’s where. Using the anti-addiction medicines that have been developed, and used more and more over past decades, like methadone and buprenorphine. The ones used in France, too, to solve its opioid problem.

Medicines so effective for addiction that there has developed a separate economy – on the streets and in prisons – operating so that the medical cure gets shared and used as treatment for addiction by individuals who may not be directly prescribed by doctors.

 

As addiction and brain disease expert Nora Volkow of the prestigious NIDA (National Institute for Drug Abuse) explains to Beth Macy, writing in Dopesick:

As long as the person is not tapered off “bupe” too soon, the medical “treatment” is generally successful, and buprenorphine that is diverted and allegedly abused, in fact is used by persons in the process of successfully treating themselves for opioid use disorder, to avoid returning to problem opioid use (like heroin) during periods of withdrawal symptoms.

When a person is weaned too soon, his or her relapse feeds the perception that MAT is ineffective, reinforcing unfair and faulty notions about the treatment, said Nora Volkow, the NIDA official, “All studies – every single one of them – show superior outcomes when patients are treated” with maintenance medications such as buprenorphine or methadone, Volkow told me. She pointed out that most patients buying black-market Suboxone are really trying to avoid dopesickness – “and that is so much safer for them than going back to heroin” (from Dopesick, p 222).

As explained by the medical authorities consulted for this recent NPR report

Because of these attributes, few people use buprenorphine to get high. Instead, more people use it to prevent withdrawal and to stay away from other illegal drugs such as heroin and illicit fentanyl.

Some leading addiction experts argue that self-treatment with buprenorphine can save lives because it is used in place of more dangerous substances that are blamed for the continued rise in overdose deaths.

“It was not diverted buprenorphine that’s responsible for our current situation,” says Dr. Zev Schuman-Olivier, an addiction specialist and instructor at Harvard Medical School. “The majority of people are using it in a way that reduces their risk of overdose.”

So, rest assured

There are medicines, available from your doctor, to treat addiction to opioids, to alcohol, to tobacco, and soon, thanks to ongoing research, for cocaine, meth, other stimulants. It’s important to make an appointment and get started soon on an effective medical treatment, considering the grave risks of substance use.

How else do we know,

are able to trust, that there are medications from your doctor that treat the chronic brain disease of addiction?

Because it’s unimaginable, inconceivable, that vulnerable Americans – trapped in problem substance use and at risk of loss of health, livelihood, family, life – would be provided false information or misled by America’s most highly accomplished, authoritative, educated professional class and most trusted institutions.

Isn’t it?

Okay . . . wait.

Cancel that appointment. For just now.

Let’s reconsider.

Because . . . okay . . . that’s exactly what happened to create the opioid crisis – with at least half-a-million more predicted deaths – the opioid crisis that the U.S. medical/pharmaceutical industry is fixing with more addictive, diverted, abused opioids.

Except . . . okay . . . that fix isn’t working.  Not only not working for the lethal medically-caused epidemic it’s a fix for, but instead is generating more illness, death and risk from all evidence.

 

 

Okay . . . okay . . . what actually happened is that in an overtly criminal, malfeasant, pathologically incompetent collaboration of medical researchers, medical institutions and journals, psychiatrists, pharmaceutical manufacturers, prescribing doctors, and U.S. watchdog major media – the NY Times, Scientific American, Time magazine and others – created or ineptly, negligently enabled and supported deceptive lies to mislead vulnerable Americans into misuse of addictive opioid pain medications, no more effective that over-the-counter pain relievers, and against all lines of longstanding evidence, for the non-medical condition of common chronic pain.

Let’s reconsider that visit to your medical professional.

Oxymoron – from Greek oxumōros = “pointedly foolish”

It’s actually simple. Painfully, tragically simple.

There are no medications, no “Addiction Medicine” – despite decades of false promises and assurances and many $billions in public healthcare funds diverted away from longstanding evidence-based psychosocial treatments – that are supported by evidence (requiring bodies of replicated randomized controlled trials = RCTs) as effective in treating “addiction” = compulsive use of mood-altering substances creating problems. No such evidence. If there were, proponents of such medications could point to those bodies of evidence.

Science Daily No magic pill to cure alcohol dependence yet

There are no medications and never will be.

Because there is no disease, brain condition, or condition at all to treat with any medical intervention.

Because compulsive substance use is not remotely a medical condition – on any critical examination, the “evidence” for the fictional brain disease model dissolves, is invalidated by all longstanding lines of relevant evidence and reasoning.

The outcomes of the fabricated medical model and medical approach – just as for the runaway prescription of addictive opioid medications for common chronic pain, an entirely non-medical condition with no biomedical treatments – were predictable from the start –

The Hill Study: Opioids could kill nearly 500k Americans in the next decade
headline2-vox
headline2-npr
Vape header NPR composite
Meth NYT headercomp2

While there are no bodies of validating evidence (replicated randomized controlled trials, RCTs) to support clinically significant benefit from medications for compulsive substance use, common chronic pain, or depression, despite decades and billions of dollars of public healthcare resources successfully diverted, research is not required to invalidate the constructed fictions of medical treatments for the non-medical conditions.

Because the fictions are absurd on their face. Millions and millions of deaths, of lives impaired or ruined by substance use, by impairing depression, suicide, related physical illness and discomfort – those costs mounting, over decades of promises and assertions of medical treatments.

And all it would have taken, for the vulnerable Americans and their families, to avoid all that pain and loss, the impaired lives and lost lives, was to take a prescribed pill. From any doctor. Who wouldn’t? Why not? The medications are widely available, the economics are on the side of even the more expensive ones.

America’s collective brain has been dosed with these medical fixes for decades now, with the predictable result: no gains, no signs of benefit in epidemiological data, instead continuously worsening epidemics as higher and higher doses of the cures are enthusiastically provided by the manufacturers and dispensers.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.”

– Pierre Bourdieu  Outline of a Theory of Practice (1972)

In Bourdieu’s Theory of Practice, heterodoxy is dissent, challenge to what “goes without saying” – the accepted, constructed doxa, “knowledge”, reality, that goes without saying precisely because it “comes without saying”, without real scrutiny, untested, unquestioned. The function of doxa is not knowledge or truth or promotion of the collective good, but to protect and serve the interests of those with the power, the cultural capital, to create it.

The mass implementation of harm-predicting, entirely inappropriate medical/pharmacological “treatments” that are not treatments, because the condition being treated is not remotely a biomedical condition, is a GENERALIZED ERROR, A USEFUL CONSTRUCTED FICTION, Bourdieu’s DOXA, the runaway dispensing of opioids for common chronic pain just the most acute, the current, most egregious example, requiring construction of two fictions – that chronic non-cancer pain is a biomedical condition with medical treatments, and that addictive opioids were an effective and safe option for treatment.

It’s something we can evaluate. Just as chronic pain was successfully created – by lies – as a biomedical problem that could be treated with medications, decades of a similar collaboration of medical authorities, popularizers and media have created fictional portrayals of the problems of depression and problem substance use (“addiction”) as diseases or biomedical condition of the affected brains, to be treated with medications. Decades of institutional support and application of the medical cures, with billions of dollars in funded research and development of “treatment” infrastructure.

What are the results of that focus on medical approaches and investment with diversion of public health resources away from other approaches? An opioid crisis, worsening epidemic of depression, and worsening epidemics of problem use of substances including alcohol and methamphetamine.

The more public healthcare resources diverted and the more medical cures and fixes provided, the worse and more deadly the problems become.

 

graphs of increases in U.S. drug overdose deaths and provision of opioid substitute medications

There is no shutting down the desperate ingenuity of American capitalism and profit motive nor that of mood-altering chemical innovation in the evolution and use of ever more potent and creative means to meet as pressing a human need as escape from psychic pain, to gain relief, respite, from the inner distress, fears and pain driving compulsive substance use. No shutting down by prohibition or threat, or punishment, nor by shaming, nor by a fictional higher power or fictional medicinal cures, or the bizarre prescriptions of a religious subculture.

There are only the longstanding, evidence-based therapies established as effective

in moderating and providing relief from the causes, the drivers of those compulsive, driven behaviors – the unmet psychic needs, injuries, distress and distortions – therapies that have never been incorporated into the criminal scam comprising treatment as usual (TAU) – what Americans have been brainwashed to pay for and believe constitutes “treatment” – for the fabricated condition of “addiction”. Those longstanding psychotherapies and psychosocial supports that are evidence-based practices (EBP) have never been supported in any meaningful way by public healthcare policy and resources, our resources that are instead diverted away to unsupported medical fixes and harm-predicting  TAU fueling worsening epidemics.

While American Medicine’s fix for American Medicine’s generated opioid crisis – addictive, diverted and abused opioids substituted for other opioids – doesn’t work, and really doesn’t work with new opioids like fentanyl and carfentanil on the streets, it does function as integral currency and consumable in the addictive drug economies of abuse on the street and in prisons. Works partly to provide a euphoric/sedative effect or as a distress- and pain-moderating “bridge” between periods of use of a preferred injectable like heroin or fentanyl. And it’s appreciated as a drug of abuse in prisons, easy to get in and bringing attractive profits for dealers who know how to, after trading a preferred injectable like heroin for someone’s doctor-provided subs, funded by public healthcare resources. The economies of bupe abuse.

The trusted, authoritative, privileged and public-healthcare-funds-controlling medical industry (okay, yeah, the industry that gave us the opioid crisis and this  and this and this), operating under an absurd fictional “brain disease” model of compulsive substance use, operating entirely in ignorance and darkness, out of scope of competence required to understand the causes and nature of problem substance use that includes developmental psychology, behavioral psychology, ACE, trauma, underlying emotional and cognitive distress.

An industry, as established by its decades-long track record of worsening public health epidemics, that can only do harm, only help to fuel criminal economies of abuse – abuse of dangerous substances and of public healthcare resources.

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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