American Medicine is progressing toward eliminating symptoms and signs of disorders of economic and social distress, desperation, abuse and victimization

By Clark Miller

Published February 6, 2022

As more and more public funds are diverted to “treatments” established as ineffective at best – “treatments” that are worsening lethal crises – and harming vulnerable Americans by displacing longstanding evidence based behavioral health therapies for the compulsive behavior of problem substance use, deaths and public health costs mount in uncontrolled substance use epidemics.

Precisely as in the pathological collaboration to fabricate and publicize medical deceptions needed to rationalize runaway medical dispensing of addictive opioids against all lines of longstanding relevant evidence and for the non-medical condition of common chronic pain, unmanaged evidence is the enemy. The expected competent, investigative, critical evaluation of evidence that would have averted an increasingly lethal, iatrogenic opioid crisis is disruptive threat to the status, control, and business of American Medicine and Healthcare. That’s why those discarded ideals of democracy and a free press are no more instrumental and protective now than in the collaborative generation of the avoidable crisis. 

In that collaboration – of America’s top medical institutions, journals, universities, authorities, in cooperation with the pharmaceutical industry and American corporate media – facts, knowledge, research evidence, truth had and have no roles in driving understanding, policy and resources to protect public health, to protect Americans from harm.

Instead, facts, evidence and critical thought about evidence pose potential barriers to the free operation of manufactured fact and fabricated knowledge driving healthcare funding streams – streams that confer status and privilege and require protection of the cultural capital and mass media compliance they depend on.

No one seems to be catching on. So it’s working,

the collaboration, a triumphant and increasingly lethal collusion to continue diversion of public resources to the trusted healthcare industries and authorities that lied and fabricated to generate the lethal opioid epidemic.

Longstanding research paints a clear picture: the compulsive behavior of problem use of mood-altering substances as well as most chronic pain (centralized, non-cancer chronic pain) are psychogenic (driven by distressing and unbalanced inner states including thinking and feeling) and psychosocial (driven by outside stressors and effects of past disturbing events) in nature, not biomedical (physical); the indicated treatments are longstanding evidence-based effective psychotherapies like cognitive behavioral therapy (CBT) and psychodynamic therapy to address the emotional, environmental and cognitive deficits and disturbances underlying the stressors driving compulsive use of mood-altering substances, with no effective medical treatments supported by evidence.

Dr. Nora Volkow
image from the movie A Clockwork Orange

The Medical-Media collusion functioning to protect dominant entitlement systems is oblivious to that research and increasing lethality of those systems.

Instead, reductionist, mechanistic medical approaches are heralded as promising for managing human behaviors by blocking urges and associated mental states. One approach uses implanted devices to interfere with neurological processes to block expression of electrochemical signals as signs and symptoms experienced as urges, sadness, anxiety or other mood states. The concept has taken a new twist with use of electrodes meant to stop compulsive substance use by shutting down the mental/emotional experiences driving that compulsive use. An implanted, electromechanical lobotomy. 

Researchers at the West Virginia University Rockefeller Neuroscience Institute (RNI) and West Virginia University Medicine are conducting the first clinical trial in the US that uses deep brain stimulation to treat opioid addiction. The procedure is meant for those who have exhausted all other forms of treatment but still suffer from opioid use disorder. The first patient, a 33-year-old man, has a decade-long history of opioid and benzo abuse, overdoses and relapses.

Deep brain stimulation, or DBS, is a form of surgery that places electrodes inside the patient’s brain — in this case, in the self-control and pleasure centers. An external device sends electrical pulses to interrupt the patient’s typical brain behavior, such as an addict’s craving a drug or an obsessive compulsive disorder patient’s feeling an urge to perform a ritual. In the case of opioid addiction treatment, the impulses will presumably train the patient’s brain to no longer crave the drugs. “Addiction is a brain disease involving the reward centers in the brain, and we need to explore new technologies, such as the use of DBS, to help those severely impacted by opioid use disorder,” says Ali Rezai, M.D., principal investigator and executive chair of the RNI.

Compulsive problem use of substances is an expression of complex developmental, psychological and psychosocial forces,

a behavioral symptom of inner psychological and mental distress, is not now nor has ever been evidenced as a “brain disease” or other type of medical condition, a necessary fabrication that on examination is absurd on its face.

Vulnerable Americans trapped in opioid, substance use, and depression epidemics have been effectively domesticated as reliable consumers for decades by learned internalization of the long-invalidated fabrications that those conditions are medical, with medical treatments, discouraging their use of and diverting them and public health investment away from the evidence-based treatments. The consistently worsening epidemics and public health costs over decades and billions diverted to medical approaches point to the harms imposed by medical approaches for the non-medical conditions.

The massive, expensive entitlement systems and criminal scams including “addiction medicine”, “rehab”, and “addiction treatment” that are failing to provide effective treatments for Americans trapped in compulsive substance use – instead fueling worsening lethal epidemics – require constructed fictions to maintain status and control of public healthcare resources. The most undermining and damaging fabrication is that there is a medical condition, “addiction” with medical treatments: pills for cravings and prescribed addictive substances as substitutes, that are supported by research as effective for treating substance dependence.

But explained here and in related posts, research tells a different story

Research that has had to be distorted, ignored, and spun by those industries and media popularizers to support necessary fictions – just as for the fabrications that created the worsening opioid crisis.  As explained in this post with links to primary research, relapse (return to a harmful pattern of compulsive substance use after a period of having stopped) is not caused by cravings per se instead by other factors, including belief in the instumental “disease model” of addiction, and caused by lack of sense of self-efficacy – a sense of self-confidence and associated motivation for change that is built over extended periods in psychotherapy relationships with reflected-on experience of successes and reworking of associated beliefs and moods by use of evidence-based psychotherapies.

Self-efficacy: the opposite of helplessness and powerlessness

The central therapeutic factor strongly supported by extensive research as protective against relapse and required generally for change is self-efficacy, or sense of confidence in one’s own choices, abilities, and effectiveness to make the changes needed to resolve a problem or regain health and safety. This is one of numerous reasons why exposure of substance users to the prescriptions of the religious subculture Alcoholics (or Narcotics) Anonymous causes harm (an 85 to 95 percent failure rate), by instilling a sense of powerlessness and required dependence on a magical outside power. Like a magic pill. 

Self-efficacy is developed, reinforced, experienced and strengthened in a process of interaction with skilled therapists over which experiences that include active changes (as distinct from passive changes like taking a pill or having a brain device implanted) are experienced as effecting positive changes in the patient’s life and resolution of problems.

That is, a key factor solidly established by research as required to stop and protect against return to problem substance use requires work in therapy over time in order for patients to internalize, own, and self-affirm personal agency and effectiveness and control, in behavioral and other changes that protect against problem substance use.

Working against, countering and diverting substance users from that required engagement in personal change and process of evidence-based psychotherapies: every visit to a medical setting for the entirely non-medical condition of compulsive substance use causes harm – instills belief in lack of control and personal ineffectiveness against a “disease of the brain” that requires medical treatments, and instills passive dependence on those cures – pills and substitute addictive substances – that have no research base for effectiveness and are associated with epidemics that have worsened over decades of increasing dose provided. Every medical visit helps hijack trusting brains, helps fuel worsening epidemics.

medical clinic setting

Medical visits and the sham “treatments” are a barrier to self-efficacy,

that is a barrier to healing and wellness. That process is subverted when vulnerable patients are reinforced, by medical visits for a non-medical problem – in the false belief of a passive fix for substance use, a pill.

The trained belief in a non-existent condition “addiction” as a medical condition with medical treatments was predicted, all along, to generate illness, “treatment” failures, ultimately lethal epidemics.

Every visit to a medical office or provider for a substance use problem causes harm by instilling and reinforcing false belief in a passive, ineffective medication, a pill for a complex, individualized inner reality of potent early experiences, psychological injury, distress, distorted beliefs and associated mood states – an individualized inner reality with only collaborative, extended work in psychotherapies as indicated treatments – disincentivizing patients engaged in a potentially lethal compulsive behavior (the symptom of that inner reality) away from engaging in the more intensive, active work of counseling and behavioral changes. Predicting continued distress, illness and harm.

Americans have been trained by deceptions over decades, provided drugs for which there is no evidence base (no body of adequately designed random controlled trials (RCTs) supporting effectiveness), deceived about the meanings of the outcomes research, assured of benefit by their medical providers to whom they entrust their wellness – professionals lacking the training, competence, and capacity to evaluate and think critically about research, research claims, and practices required to evaluate effectiveness of treatments and avoid harm.

man holding pill

The distorted, misused research and predictably harmful outcomes are documented and explained, with links to primary research and other materials in multiple posts, as here .

That false, ingrained, trained belief leading vulnerable Americans to access medical visits for those non-medical problems is associated with immeasurable public health costs and harms. The Opioid Crisis is only the most visible and attention-grabbing example. Costs include the enormous waste of public and private resources for biomedical “treatments” with no benefit nor predicted benefit supported by research, for example: $ 90 billion annually for ineffective, inappropriate biomedical interventions for lower back pain.

More fundamentally and pervasively – because those beliefs drive emotional states and behavior, thereby choices – the deceptions, wildly lucrative and beneficial to medical, pharmaceutical, and “harm-reduction” industries, are effective psychological barriers between trusting, vulnerable Americans and real, effective evidence-based treatments for those non-medical conditions.

Instilling belief in a fictional medical condition to explain relapse is a deception critically important to validate and enrich entitlement systems like “addiction medicine” and “harm reduction” that divert public healthcare funds away from evidence-based treatments. As such it has been ingrained, trained into trusting, vulnerable Americans for decades, every single visit to a medical provider or office to address smoking or any other substance use problem further reinforcing the lethal deception that there is a pill or medical treatment, a passive easy fix, that can replace the work of therapy and change and serve as treatment for a compulsive behavior driven by inner emotional distress and distorted beliefs.

As the population dose over past decades of the medical fix

for the non-medical condition of compulsive substance use increases, lethal epidemics worsen.

As billions and billions of public healthcare dollars are diverted away from longstanding evidence-based psychotherapies for the behavioral symptom of compulsive substance use, diverted to constructed fictional, failed medical approaches, deaths mount. Billions that could have been allocated to real evidence-based psychotherapies and supports that treat the compulsive behavior of substance use.

And allocated to prevention of the avoidable childhood emotional and psychic injuries established as generating risk of problem substance use. That potential investment – in preventing the harms to children that set them up for problem substance use later in life – is losing out, outcompeted by the medical and pharmaceutical industry lock on use of the public funds to instead market chemical and electromechanical interventions to alter their brains to not care they were ever harmed, an approach stunning in it’s convenience, acceptance and social pathology. 

Brain implant, magical higher power, pill:

each robbing someone vulnerable, at-risk of harm and death, of the key factor, the real cure, required for recovery and wellness – belief in self, forged through experience and reflection, belief in one’s own power and capacity to make effective changes that are healing, protective, self-transformative. And each sham treatment empowering and rewarding pathological systems with status, control of cultural capital and social resources, validated and celebrated by impaired media. 

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.

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.

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