DECONSTRUCTED: ORWELLIAN MEDIA FAILURE ENABLES MOUNTING DEATHS BY AMERICAN MEDICINE’S DISPENSING OF OPIOIDS FOR ITS OPIOID CRISIS

 

As elsewhere, Media in hard-hit Tennessee disseminate Medical establishment deceptions and useful fabrications as needed, for a pat on the head: failure is success; bad is good; down is up

by Clark Miller

Published February 25, 2022

From a previous post – 

New (2019) data from the Tennessee Department of Health  paints the same predictable picture as from other areas in Canada and the U.S. –  high-risk opioid use and overdose continue to worsen  in response to increasing provision of the medical model fix for the opioid crisis, inconsistent with and invalidating of opioid (methadone and buprenorphine) substitution treatment.

The new data from Tennessee factors out confounding effects of fentanyl and OD death-reversing naloxone by providing comparison of medical MAT “treatment” provision trends with trends in non-lethal heroin overdose incidence, a measure of high-risk opioid use.

Tennessee is a state hit early and hard by the opioid crisis.

The response described in the 2019 Tennessee Department of Health report has included significantly increased provision of the medical “treatment” for opioid use disorder – MAT (opioid substitution treatment OST) with buprenorphine or methadone –

CSMD data show an increase in the utilization of buprenorphine for medication-assisted treatment (MAT).

Prescriptions filled for buprenorphine for MAT increased from 164,800 prescriptions in the first quarter of 2014 to 232,300 in the last quarter of 2018.

This increase coincided with a 57.9% increase in the number of patients filling buprenorphine for MAT and a marked increase in the number of buprenorphine for MAT patients on long-term prescriptions (>270 days per year).

About 75% of TN counties experienced an increase in the rate of buprenorphine prescriptions filled.

 

If buprenorphine (Subutex, Suboxone) provision results in beneficial effects in reducing mortality and other costs related to opioid use, that occurs by the mechanism of bupe use reducing high-risk use of opioids, e.g. by injection, with illicit drugs, using street drugs like heroin that may have fentanyl added. Moderation of opioid-related overdose deaths is not a meaningful measure of effectiveness of MAT with bupe, because it’s established that naloxone, concurrently increasing in availability and use, is able to account directly for any apparent moderation.

It is also established that the recent (2014) emergence of highly-potent fentanyl in illicit economies of opioid abuse cannot explain away the consistent, invalidating increases in opioid overdoses and OD deaths as provision of the medical MAT “fix” has steadily and significantly increased over past decades.

The new data from Tennessee factors out confounding effects of fentanyl and OD death-reversing naloxone by providing comparison of medical MAT “treatment” provision trends with trends in non-lethal heroin overdose incidence, a measure of high-risk opioid use.

 

Non-fatal opioid excluding heroin overdoses are increasing, and heroin non-fatal overdoses are rapidly increasing based on hospital discharge data through 2017 (Morbidity data section, starting page: 46)

Prior to the ICD-9-CM to ICD-10-CM transition, outpatient visits for non-heroin opioid overdoses increased from 3.9 per 100,000 residents in Q1 2013 to 6.1 per 100,000 residents in Q3 2015. A shift was observed after Q3 2015, with an increase to 8.1 per 100,000 residents in Q4 2015, the increasing trend generally continued through end of 2017.

Prior to the ICD-9-CM to ICD-10-CM transition, non-heroin opioid inpatient stays showed small fluctuations both up and down, with 5.5 per 100,000 residents in both Q1 2013 and Q3 2015. After the transition, an upward shift was observed to 8.3 per 100,000 residents for non-heroin opioid overdoses stays in Q4 2015, similar to the rate of outpatient non-heroin opioid overdoses visits in the same quarter, but decreased to 6.7 per 100,000 residents in Q4 2017.

A large increase was observed for outpatient visits for heroin during 2013-2017 (0.8 per 100,000 residents in Q1 2013 to 11.8 per 100,000 residents in Q4 2017) with a gradual increase from Q4 2015 to Q4 2017 (3.4 to 11.8 per 100,000 residents).

 

These results from Tennessee, consistent with accumulating data from additional locales and nationally, appear to be unequivocally invalidating of presumed benefit for problem opioid use and the medically generated lethal opioid crisis from provision of substitute opioids without evidence-based treatment for compulsive opioid use. That was a predictable result, the presumed benefit – as in generation of the iatrogenic opioid crisis – driven by fabricated evidence in a collaboration of America’s top medical and research institutions, public health oversight, and media helpfully along for the ride.

As in generation of the lethal opioid crisis.

Tennessee officials addressing the opioid crisis

When a medication is developed that is, in fact, effective for a disease or condition, then made available for the affected population, things get better – symptoms are reduced, functioning and health regained, illness and death avoided, the benefited individuals wanting and choosing by use of the medication to, as humans tend to, avoid pain and illness, death. 

But use and increasing provision of an effective medication would not be tied to consistent worsening of epidemics of the disease state they are effective in treating. No, they wouldn’t, would they? As in American  Medicine’s increasingly lethal substance use epidemics.   

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

Here’s how that consistent pattern in America’s opioid epidemic – of increasing high risk use of opioids the more American Medicine’s cure is administered to diseased brains – was reported in Tennessee, with the necessary fabrications. 

Fentanyl!

Why is our opioid crisis getting worse?

“You can pretty much explain it with a one-word answer: fentanyl,” said Trevor Henderson, Nashville’s opioid response coordinator. 

We’ve seen that before, in fact consistently and universally as one of the necessary fabrications required to distract from the truth about what is worsening the lethal crisis. 

And it is predictably, coming from America’s trusted sources and top experts, a lie. 

That’s because the evidence establishes that fentanyl does not and cannot account for the worsening epidemic as described here, here, and here.

That’s evident because trends in “opioid prescriptions” are not represented in the graphic above, nor in any of the graphics or analyses or media reports you have been provided, that have been messaged to Americans trapped in lethal epidemics or with loved ones trapped. 

The figures, analyses, fabricated reporting, with rare exception, exclude certain types of prescribed opioids. Thye exclude the addictive, diverted, and misused opioids increasingly distributed by American Medicine to American’s trapped in American Medicine’s opioid crisis. 

The prescribed opioids increasingly misused, increasingly involved in overdose deaths, that served as currency for fentanyl and other illicit opioids, and that are increasingly found to be abused with fentanyl and in fentanyl-involved OD deaths. 

The prescribed opioids – methadone and buprenorphine (Suboxone and Subutex) dispensed increasingly by licensed medical professionals (LMP) as “medication assisted treatment”, or MAT, now as easily as by a phone call. 

Right. 

And there is this suggestion in the news report from Tennessee,

reflecting what is common knowledge, what goes without saying, information provided universally by America’s trusted experts and corporate media: that for a period, “states” implementing medical and treatment interventions for opioid dependence were making gains, “gaining ground” as evidenced by some decrease in overdose deaths. 

Those reports imply and message, as evidenced by a period of reduced opioid overdose deaths, that the lethal opioid crisis, at least for some periods and in some areas, was benefiting from public-healthcare-funded approaches including American Medicine’s MAT cure and “drug treatment” programs. 

That unfortunately is also a lie, a necessary fabrication, any and all decreases in OD deaths directly accountable for due to increased distribution and use of the emergency, death-reversing opioid antagonist naloxone (Narcan)

And it’s not just that the naloxone saves belie any fabricated, unwarranted claims – lies – attributing effectiveness of medical and traditional “treatment” approaches to the opioid crisis, but that the mounting use of Narcan for emergency saves points to, is evidence for a worsening crisis, to the failure of healthcare systems. 

Just as a trend of increased emergency use of AEDs to save cardiac arrest victims would point to a worsening, not effectively treated, epidemic of heart disease in America. 

The lies, deceptions, 

distractions, smokescreens and transparent fabrications are not unique to Tennessee and its compliant media, they are of a type, the same necessary fabrications messaged daily across  America’s opioid crime scene. Because they are from a single playbook. Because they are the fabrications accepted without question, absorbed passively and without reflection in the tepid, infectious, soothing bath of groupthink in which cowardice and need ensure that the necessary, created “truths” are messaged without distortion via mass media

Exactly as in creation of American Medicine’s avoidable, increasingly lethal opioid crisis out of pure fabrication

You were thinking that would have changed? On its own? 

Here’s some journalism

from no less a trusted source than National Public Radio. 

More than 130 people in the U.S. die of an opioid overdose every day. One of the most effective ways to save lives is to get those struggling with addiction treated with medication to stop their cravings. But a loophole in federal law might block at least one new opioid-addiction drug from coming to market for years.

“Cravings” are not a primary or significant factor identified in the research on the phenomenon of return to problem substance use after a period of no or non-problem use (“relapse”), never have been evidenced as such, as described here with explanation of the primary research

Many patients have to try several medications before finding one that works for them and that they can stick with.

Awesome! So, while most patients do well with the first or second medication for addiction they are prescribed, “many” others will need to try more medications before the medical cure works for them. Who wouldn’t ? To be cured of a life-threatening disease and freed from being trapped in America’s raging, increasingly lethal substance use epidemics? 

And despite consistent evidence of increasingly lethal drug epidemics, over decades of funding for and assurances of effectiveness of medications,  there is evidence of benefit, of course. 

Right? There would bave to be, right? 

There is, isn’t there? 

“It’s important to have multiple different treatment options for different patients, different circumstances,” says Carolyn Bogdon, a family nurse practitioner who oversees outpatient medication-assisted treatment programs at the Medical University of South Carolina in Charleston, S.C.

Some use methadone, which they get every day. Others use Vivitrol, which can be injected once a month. And many use buprenorphine, which comes in tablets and a dissolvable film that people take once or twice a day. Buprenorphine is an opiate, but it blocks the cravings associated with addiction without giving people the same high.

“There have been studies that show a reduction in mortality by 40% with buprenorphine,” Braeburn’s CEO says. “That keeps people alive. That gives people a chance to get back to their lives and recover fully.”

Another lie, unfortunately, a fiction, fabrication never supported by evidence

Despite the authoritative assertion otherwise in this piece of journalism from NPR, from the CEO of a pharmaceutical business.

We could continue, but there is really no point. This is the tedium, the banality of American institutional and cultural pathology and criminality, of America’s decay.  

The medical industry-generated opioid crisis is a development – the smoking guns increasingly described in accounts like Quinone’s Dreamland, Beth Macy’s Dopesick, and Chris McGreal’s American Overdose – that obligates journalists, engaging in journalism, to stop popularizing unsupported assumptions and medical/pharmaceutical industry distortions and deceptions that are linked to failed outcomes, rampant diversion and abuse of prescribed substitute opioids and perpetuation of problem opioid use – instead to question, investigate, expose, and take a lead role in a desperately needed critical discourse.

Media failure is the norm,

essentially every piece on the subject exemplifying abdication of questioning, investigation and analysis, in favor of reward for roles as popularizers of medical and addiction industry doxa. That’s not to say there are no incisive examples of truth-seeking, like the work of Quinones, Macy, and McGreal for example.

And there are examples like this, from the Dayton Daily News, reporting on discrepancies and problems in use of public Medicaid funds to address problem opioid use, following a celebratory piece in the NY Times that missed those problems and missed a return to increased overdose deaths in the Dayton area.

The strengths and public value in the accounts of observers like Macy, Quinones and McGreal are in describing, laying out, the events, connections, course, human foibles and cultural and institutional pathology in generation of the epidemic.

It’s when writers without capacity to understand, evaluate, contextualize in related sciences, and think critically about the related research and treatment issues offer interpretations and suggestions about the nature of problem substance use and its treatment that harm is predicted.

Writers, for example, popularizing opioid substitute therapy (OST) – buprenorphine prescribed in medication assisted treatment, MAT – engaged in the most basic of research interpretation errors, attributing cause-and-effect benefits in reduction of opioid-related overdose deaths to bupe based on longitudinal (“before-and-after”) observations, when in fact competing explanations unrelated to OST are supported and OST is not.

That’s a big deal, as OST continues to fail, overdose deaths mount, and succeeding political administrations collaborate with the medical/pharmaceutical industry and its popularizers to divert increasing public funds to the unsupported programs and away from evidence-based practices for substance use problems.

But chronic, day-to-day harm, a hijacking of American brains by misinformation, is generated pervasively, uniformly in diverse media outlets, from  city papers to the NY Times where the folklore and constructed mistruths comprising public understanding – mistruths invalidated by longstanding bodies of research and popularized not just in traditional news outlets and online sources but as well and extensively in entertainment and popular culture – are constructed, instilled by repetition, normalized, validated by authority, as if the fabrications were real and supported by evidence.

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.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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