HIJACKED BRAIN THEORY OF ADDICTION CONFIRMED BY OPIOID CRISIS POLL
Poll provides conclusive evidence that compulsive use of and addictive effects of emotionally soothing substances/experiences – including media disinformation – hijack and impair brain functioning
by Clark Miller
Published June 14, 2024
The opioid crisis
is everywhere, everyday, on social media, on major media, a persistent feature saturating day-to-day experience.
And yet, remarkably, it is essentially uniform, homogeneous, pure in its content, in message, in known truths.
Truths so well established by consensus and messaging that they go without saying.
The established truth, for example, that profit-driven pharmaceutical companies and the amoral families who own them share – or by most accunts have – primary responsibility for so many Americans becoming dependent on opioids, sliding into unmanageable lives and illness, increasingly death.
Here’s one of thousands – of zillions – of versions, copies, of the same established truths, repeatedly mass messaged, broadcast, reinforced, almost as if . . . as if the constant reminding, reassuring was necessary, needed.
By Ian Donnis
STORY OF THE WEEK: For most people, the opioid epidemic is probably out of sight, out of mind. But Rhode Island is still reaping the whirlwind from the epidemic, as those who struggle with addiction and their friends and family members know. Just last week, the state Department of Health put out an alert warning of heightened opioid overdoses in Charlestown, North Kingstown, South Kingstown, Westerly and Block Island.
In many ways, the roots of the crisis can be traced to Purdue Pharma’s introduction of Oxycontin in the mid-1990s, and how it was aggressively marketed as a non-addictive remedy for a variety of pain-related ailments. (Some of the company’s drugs were manufactured by subsidiaries in Coventry.)
The reckoning took years to develop, triggering an eventual wave of litigation against Purdue Pharma and the family that owned it, the Sacklers. Still, as Patrick Radden Keefe recounts in his authoritative history “Empire of Pain: The Secret History of the Sackler Family,” Purdue’s super-wealthy owners were able to have their way for years with such putative regulators as the U.S. Food and Drug Administration.
. . . Still, if this money is coming to the state and Rhode Island is still bearing the brunt of opioid addiction, what will it take to curb the epidemic? [Attorney General] Neronha said the Purdue money, combined with more recent settlement funds from the Big Three pharmacy chains (“all-in almost $250 million in cash alone”), is starting to flow into the state and will expand treatment efforts.
“So that’s going to make an impact,” Neronha said. “There’s no doubt in my mind. Look, it’s not going to be cured overnight. It’s not going to be solved overnight. But these resources are going to go a long way to helping people get into recovery, and successfully completed, I hope.”
Oxycontin and other opioids were “aggressively marketed”, in effect forced on American patients visiting their doctors, by the aggressive marketing.
The owners of large pharmaceutical companies have been so adept, so effective at developing marketing and sales strategies, that their sales forces were able to control the desired clinical results – runaway prescribing inundating patients with opioids dispensed by their doctors and generating the opioid crisis, in spite of those substances being Schedule II controlled substances and with known addictive potential.
So it only makes sense – everyone agrees – to hold the villains accountable and to exact payments, fines from them through legal action, providing funds that can be used to undo some of the harm, to provide the needed funding to expand America’s proven, life-saving, anti-addiction treatments, by “helping people get into recovery”.
And to make the exposed billionaires pay for what they did – for justice.
Many instances of remarkable journalism made it clear to Americans exactly who is to blame, who the real villains are.
This Wall Street Journal piece lists all the “villains”, all those culpable and with some share of responsibility . . . except for one group, the only group acting as gatekeepers, or with the ability to act as gate keepers between the supply of manufactured opioids and the consumer, those vulnerable, trusting patients who would become dependent, or allow excess pills to get to others who would, would develop devastating habits, would die by overdose. Except for the only group who could decide whether those patients would receive the opioids or not – America’s physicians and other licensed medical providers writing the prescriptions. They weren’t mentioned.
It’s a success story, from the industry’s point of view. It’s also a story of villainy, with a catalog of villains—not just the Sackler family of Purdue Pharma, but their sales representatives; the U.S. congressmen to whom they made outsize donations (Christopher Dodd, the former senator from Purdue Pharma’s home state of Connecticut, is spotlighted); the former prosecutors hired as lobbyists (Mary Jo White and, somehow inevitably, Rudolph Giuliani); and officials of the Justice Department and the Food and Drug Administration—where Curtis Wright, a physician and deputy director, collaborated with Purdue Pharma executives in drafting the review of OxyContin that helped open the way to its 1996 entry into the marketplace.
The rest, as might be said, is drug-epidemic history, although “Crime of the Century,” produced in association with the Washington Post, begins with a sprint through a much lengthier history, of both the opium poppy and the drug trade . . .
Everyone Knows it Now
Those are remarkable words – part of a headline, beyond any specific description of content of the piece, asserting, a slip in the Freudian sense, to message:
We’ve Instilled that Belief in All of You Now
How could there be any doubt about the truth? When top, trusted American institutions and authorities including medical, political, justice system, mass media, entertainment, and healthcare are in consensus? How could that type of authoritative consensus be off, disserve or endanger the public?
As the hundreds of $millions in lawsuit funds begin to be dispersed to America’s established treatment systems – proven effective over decades of funding and provision of treatment – the tide will turn on the lethal crises caused by the pharmaceutical companies and by pharmacies, filling doctors’ prescriptions for the opioids.
It’s been effective!
This Fox News poll illustrates that Americans have learned from the truths conveyed to them, identify pharmaceutical companies as primarily to blame for the opioid crisis, along with illicit suppliers, and that doctors, healthcare systems, media, and treatment systems have not had significant roles.
There is, however, a problem with all of this.
It’s that it’s all a lie –
a mass delusional structure constructed and installed by America’s triumphant medical/corporate/media collusion to protect the true actors and forces that generated and perpetuate lethal crises.
The lies are stupid, transparently stupid, and cowardly.
The mass delusion distracts from the real cultural and institutional forces driving problem substance use and lethal epidemics, protecting those systems while blocking changes that would begin to protect public health and provide effective prevention and treatment systems.
The Sacklers did not, could not, open a chain of retail outlets Americans could walk into and buy opioids off the shelves. No. Not a single opioid pill provided to living or dead Americans came to them from the Sackler family, from Purdue Pharmaceuticals, from any employee of a pharmaceutical or opioid manufacturing company. The only originating suppliers were licensed medical professionals meeting with patients in exam rooms, providing medical services to them, then writing prescriptions that supplied them with the opioids. Without their signatures, no opioids were dispensed.
Instead, what the evil Sackler family did was pay pharmaceutical reps – pill salesmen – to visit doctors (medical prescribers) in their offices during and between visits with patients and hold guns to the prescribers heads to force them to prescribe the opioids. And the reps forged their signatures on prescriptions, and they threatened harm or death to the families of licensed medical professionals if they refused to prescribe the opioids.
Ha! Funny. Of course they didn’t.
They didn’t need to. Instead, the pill salesmen – with exactly the level of qualification to understand and evaluate medical need and the research bearing on safety of the opioids as you would guess, that is, none – explained to the doctors that, against all longstanding evidence, these opioids are effective and safe for all forms of pain. And? Those helpful pill salesmen, conveying clinical understanding of opioid safety and use to America’s medical professionals, took them out to nice dinners, and lined their pockets with cash gifts including speaking junkets, where the newly educated doctors would explain to their colleagues the safety and need for the opioids, based on what they had learned, from salesmen.
Those physicians relied, with the health and safety of their patients at stake as with any medication and certainly for controlled substances, on the information provided them by those pill salesmen. Salesmen, not healthcare professionals or researchers.
The Sacklers weren’t the gatekeepers. No matter how nice the meals and generous the bribes, any competent medical professional using clinical and ethical judgement could have declined to prescribe, based on the evidence that was available to anyone interested in verifying Purdue’s claims, evidence they would almost have to have been exposed to in medical school.
This evidence
There has never existed, not at any time, a body of research evidence to provide even preliminary support for the safe practice of prescribing opioid medications for chronic pain, or with the expectation of durable benefit for chronic pain.
See, for example:
Chou, R et al. 2015. The Effectiveness and Risks of Long-Term Opioid Therapy for Chronic Pain: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 162:276–286.
From the beginning, well prior to explosion of runaway, widespread use of prescription opioids for centralized chronic pain, all lines of evidence pointed against and contraindicated their use. There was never support for their safe, effective use due to longstanding:
I) lack of research evidence for effectiveness long-term
II) evidence for the potential for hyperalgesia
Hyperalgesia – increased sensitivity to pain – induced by use of opioids (OIH) is known and described extensively, beginning late 19th century.
See, for example:
Lee, Marion et al. 2011. A Comprehensive Review of Opioid-Induced Hyperalgesia Pain. Physician 14:145-161
III) established addictive potential of opioids
The high abuse and addictive potential of opioids including those prescribed for chronic pain is long-established (1), generating a history of statutory control (2) e.g. Harrison Act (1914); Boggs Act (1951) and others.
The 1970 Controlled Substances Act (3) lists opioid drugs commonly prescribed for chronic pain as Schedule II Substances (4), highly controlled as “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence”
IV) understanding of the psychogenic nature of centralized chronic pain
Chronic pain (5) – long-lasting pain that is non-cancer, not caused by acute tissue damage or inflammation – is established by decades and multiple lines of evidence and research as psychogenic (generated by mental/emotional states) in nature and with indicated treatments that are psychological (behavioral health therapies), not biomedical.
See, for example:
Dersh, Jeffery et al. 2002. Chronic Pain and Psychopathology: Research Findings and Theoretical Considerations. Psychosomatic Medicine: 64: 773-786
[Numbers 1 – 6 in parentheses in boxes link to online sources listed at bottom of post.]
V) evidence for cognitive behavioral therapies (CBT) as the indicated treatment for chronic pain
Extensive and longstanding research (6) establishes that effective and durable CBT treatments for centralized chronic pain (long-lasting pain that is non-cancer, not due to acute tissue damage or inflammation) are psychological (behavioral health therapies), not biomedical, fundamentally targeting underlying beliefs and mood states associated with pain.
See, for example:
Cherkin, DC et al. 2017. Two-Year Follow-up of a Randomized Clinical Trial of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care for Chronic Low Back Pain. JAMA. 317(6):642–644. doi:10.1001/jama.2016.17814
For a critical review of the current evidence: Doxa Deconstructed: Chronic Pain is Not What You Think
All relevant lines of evidence existed decades prior to emergence of runaway misuse of opioids and the current crisis.
Nor was the FDA the gatekeeper, the supplier who could have said “No” to protect Americans. The FDA could have authoritatively asserted that opioids are no more a risk than baby aspirin, or vitamin C, and it would have remained the ethical and clinical mandate of every medical prescriber to use their training and the longstanding evidence available to make the medically sound choice.
Some did, as described by Chris McGreal in American Overdose
As McGreal describes it, the clinical environment in medical practice settings became coercive and toxic – a collusion of patients trained by decades of programming to seek a pill for every distress including opioids, supported by the medical/hospital/insurance industrial complex to report doctors who would resist providing opioids inappropriately and threaten them with complaints and action by professional and licensing boards.
McGreal talked to Dr. Charles Lucas, a surgeon in Detroit who resisted growing pressure to overprescribe opioids, ended up being subject to a complaint and summoned before a hospital ethics committee for failure to provide adequate pain treatment.
(from American Overdose pp 88 – 89)
The case was dropped, but it was not an isolated incident. Luca has worked closely with another surgeon, Anna Ledgerwood, since 1972. She too was hauled before the ethics committee on more than one occasion on the same charge. One of the investigations, for alleged inadequate pain management after a hernia operation, went all the way up to the state medical board. It cleared Ledgerwood, but Lucas said more junior surgeons buckled to the pressure to administer opioids just to stay out of trouble. “If they will give me a hard time, then they will surely give a young resident a harder time,” he said. “I tend to be a fighter. That’s my nature. But somebody who just wants to take care of patients, they want to be a professional physician, they don’t want to put up with all this crap; they’re intimidated. They’re also frustrated by it. The medical community knows that too many pain medicines are being written. Doctors talk about it among themselves. They’re not in a position to challenge the system. But they know.”
Lucas regarded the new pain orthodoxy as a growing tyranny, and he thought it was killing patients.
Of course they knew. Or should have, or should not be practicing medicine.
But the forces driving runaway, medically inappropriate dispensing of opioids were not knowledge, competence, integrity or professional courage. There were other forces at play.
Numbered links to sources
1 – The high abuse and addictive potential of opioids including those prescribed for chronic pain is long-established
2 – generating a history of statutory control
3 – The 1970 Controlled Substances Act lists opioid drugs commonly prescribed
4 – Schedule II Substances are highly controlled as “drugs with a high potential for abuse”
5 – Common chronic pain is established by the evidence as psychogenic, not physical
6 – Extensive research establishes cognitive behavioral therapy (CBT) as the indicated treatment for chronic pain
American Media useful scapegoating of Big Pharma and the fentanyl fabrication are successful – protected, empowered medical prescribers continue recklessly prescribing opioids
The overprescription and misprescribing of opioids has continued over the years and decades of an increasingly lethal epidemic, described here,
here,
here,
and here.
While continuing to misprescribe, decades into an increasingly lethal opioid crisis, America’s medical professionals only began protecting patient rights and health after forced to at risk of legal violation for failure to meet longstanding, established ethical requirements for any medical intervention – by providing informed consent.
The extent to which we tolerate and enable the pretense of Big Pharma causing the neglectful over prescription of controlled substances to patients is absurd and pathological. It is terminal group think, literally, because the fearful failure to state and face what is obvious empowers continuing over-prescription and predictable diversion, abuse and dependence.
To repeat: not a single opioid pill provided to living or dead Americans came to them from the Sackler family, from Purdue Pharmaceuticals, from any employee of a pharmaceutical or opioid manufacturing company. The only originating suppliers were licensed medical professionals meeting with patients in exam rooms, providing medical services to them, then writing prescriptions that supplied them with the opioids. Without their signatures, no opioids were dispensed.
And they wrote those prescriptions against all lines of longstanding relevant evidence.
Let’s try it more concretely:
Imagine a conversation between a treating medical specialist and a trusting yet anxious parent whose child is diagnosed with a life-threatening illness.
Parent: I really want to believe this medication can work and from everything you’ve said it’s what he needs. I’m just scared, with everything you read about side effects and dangers.
Doctor: Of course, but I do want to assure you that these medications are not only safe but effective as well.
Parent: It’s so confusing. My husband isn’t a doctor, but he Googled the medication and says it’s a controlled substance due to risk of serious effects, and no more effective than safer treatments, and can make the condition worse, and there are other effective treatments. He found that those things have been known for a long time.
Doctor: I would never recommend for someone who is not, like I am, medically trained, to attempt to gain information on something this important. I have years of training.
Parent: Thank you, thank you. I know you medical professionals must keep up with and review all the relevant information, especially about powerful medicines. You looked at the research thoroughly and talked to colleagues, other specialists, I’m sure.
Doctor: Actually, I learned over several dinner engagements about the medications and how safe they are from a pharmaceutical expert.
Parent: Oh. So . . . he or she was a researcher sharing the research with you? A pharmacist, or expert on drugs or medicine?
Doctor: Well, not exactly. He was a pill salesman with no training in any of those areas. The dinners were lovely, and I’ve been compensated generously for sharing the information with other doctors.
Parent: You are joking of course?
See how that was done? It was easy. To out the absurdity, the lethal malfeasance? Anyone can. All it takes is a willingness to state the obvious, an absence of the cowardice that would otherwise prevent stating the obvious.
Then it all falls apart, the façade that shields from view those more directly responsible. The truth becomes increasingly difficult to hide, to lie about.
Then, America may be forced to face the real causes and forces perpetuating the lethal crises.
Without the distracting, soothing lies like those of Hulu’s “Dopesick”, without America’s new heroin and the Medical/Media consensus it’s embedded in, Americans could be at risk, susceptible to very dangerous truths (“disinformation”) and impressions about the increasingly lethal epidemics.
Americans could come face-to-face with, to see, accurately, that –
The real villains are the American expert class and institutions including media – described in Sam Quinones’ “Dreamland” – who collaborated to fabricate lies about the safety and effectiveness of opioids for all pain, enabling runaway opioid overprescribing.
The actual forces hijacking the brains of young Americans – sources of lasting emotional pain and psychological deficits that set up vulnerability to and prediction of problem substance use later in life – are dysfunctional American parents and families inflicting on their children harm, “adverse childhood experiences” (ACE), not the drugs.
The real, ultimate gatekeepers, the professionals trained, entrusted, and responsible for understanding risk, need, safety, the relevant research, and appropriate use of all medications, to avoid harm to their patients, to inform their patients of those risks, are American medical professionals.
Members of America’s Media, entrusted under democratic principles of a free, corrective, watchdog press with the task and responsibility to courageously challenge information and expose untruth to protect Americans, instead protect their corporate owners and masters, trading away those responsibilities for careers.
No wonder America needs its scapegoats and cover stories, its pain relief – facing those established truths would come much too close to home, would be an indictment of America itself, the greatest nation in the world, its research, medical, academic institutions setting the worldwide example for use of opioid pain medications, for medical-model treatment of depression with doses of chemicals, for response to the COVID epidemic.
That goes without saying.
And an indictment of American culture itself, and the American family.
There is a way out
of America’s persistently worsening, lethal, iatrogenic public health crises, requiring focus on prevention to reduce incidence of ACE, adverse childhood experiences, that are established – by neurobiological, developmental, and epidemiological evidence, most saliently by reports of problem substance users in psychotherapy settings – as tied to and predicting development of multiple illness types including physical illness, mental health problems, and compulsive use of substances.
In a culture of untreated substance use epidemic fueled by harm-predicting sham treatment systems, ACE is transgenerational and self-intensifying. Children exposed to the psychologically and emotionally injurious experiences become vulnerable due to underdeveloped capacity for emotional self-regulation tied to increased risk of dependence on mood-altering substances that, as adults, sets them up to repeat exposure of their children to the neglect, abuse, and other ACEs that perpetuate and multiply effects.
That is to say, problem substance use and associated social and public health problems including lethal epidemic will not be lessened until the cultural and psychosocial drivers of ACE are recognized and prioritized as high-risk and high-needs public health areas.
From a previous post –
Turnbull’s programs engage in forms of “harm reduction” – including use of overdose death reversing Naloxone, safe injection sites, other measures to slow rate of deaths due to high-risk opioid use.
They are right, and they are describing what has been known,
established by research to be the evidence-based understanding of compulsive substance use (“addiction”) for decades. That established understanding explains, has predicted, why never-supported medical “treatments” for a non-medical problem has led to and worsened substance use epidemics. The longstanding evidence-based treatments for chronic effects of trauma, ACE, and other stressors – those complex, individualized states of inner distress driving compulsive use of a mood-altering substance – are all psychological, behavioral, psychosocial therapies and supports that address those individual experiences of pain, inner distress, and distorted beliefs, and more importantly help parents manage inner distress to better control their behaviors, prevent exposure of their children to ACE, and break the amplifying generational chain of emotional harm and substance use.
The lethal, empirically invalidated, and never-held-to-account folklore of addiction and its sham treatment is constructed and disseminated as true, as necessary to protect massive, lethal entitlement systems (including “addiction treatment”, “rehab”, “addiction medicine”) and their funding. It is fabricated, false knowledge, “doxa”, that goes without saying because it comes without saying, without competent, open examination of its grounding in evidence or of its or truthfulness or of health benefit, because public health benefit is not the purpose the “knowledge” serves. In that folklore, the compulsive use of substances – opioids, methamphetamine, alcohol, tobacco, food – is a disease of the brain, requiring medical treatments that have never provided relief and are established as invalidated, their use indicated against, while they fuel continuously worsening epidemics.
There seems no cure for the pathological drives that persistently defend, promote, and protect continued provision of invalidated, lethal medical “treatments” to vulnerable Americans, even as deaths mount the more medical fix is applied to diseased brains.
The evidence is clear.
Yet the numbers climb.
Back to our current post –
The necessary pretense of big pharma as responsible for an epidemic of lethal high-risk opioid use has become more desperate as their roles have been controlled and increasingly inhibited by media, political, and legal virtual-signaling and scapegoating feeding frenzies, while lethality of the crisis persistently mounts, demanding continued distraction from and rationalizations for failed expert approaches and root causes.
So desperate that a recent Yale study went to surreal lengths to absurdly use language to attempt to hide the necessary, key, causal role of medical prescribers in the overprescription of oxycontin and other opioids in generation of the crisis. Apparently unselfconsciously and without conscience the researchers spun, i.e., lied about, how prescribed opioids could only have been obtained by patients – by prescriptions written by doctors – by identifying that instead it was the “marketing” by Purdue pharma and others that caused the runaway, reckless overprescription of opioids fueling the crisis, because – don’t you see? – the doctors were victimized and unable to use their clinical training and judgment, overwhelmed, convinced, by the qualifications, clinical competence, and command of clinical, research, and pharmacological expertise of pill salesmen. Pill salesmen. And their marketing.
The remarkably absurd, desperately needed fabrication of America’s medically trained licensed prescribers victimized by pill salesmen – against the direct admissions and reports noted above that they of course knew and chose to protect their careers and avoid the discomfort of assertive competent clinical and ethical practice over the safety and wellbeing of their patients – has stuck.
Here, from a segment about 3 months ago on The Hill’s Rising broadcast is Amber Duke expressing indignation that the Sackler family and others have so far escaped criminal prosecution and criminal sentencing for their control of what America’s licensed medical professionals wrote on their prescription pads, victimizing the doctors with that control.
“And then there’s the Sackler family, right with the opioid epidemic, and how they managed to convince all of these doctors to prescribe pills that they claimed weren’t addictive, paid doctors all kinds of money in order, in kickbacks if they prescribed the pills and they faced no jail time they basically just had to pay some fines and haven’t really had to even admit any wrongdoing. It’s, it’s such a miscarriage of justice, and I applaud Florida governor Ron DeSantis for taking one step in the right direction of trying to get the American people, the information that they deserve”
What if we applied Ms. Duke’s logic and sense of justice to other substance use epidemics that threaten and portend grave public health costs? For example the latent juvenile obesity and diabetes epidemics predicted to explode over coming years. Obesity is driven by compulsive use of food that is no different clinically and in diagnostic criteria than any other “addiction“. The compulsive use of high-sugar, fat and calorie foods by kids as well as adults driven by anxiety and other forms of inner distress that use of those foods soothes is no different than for any other addictive substance.
So, we need to focus on the manufacturers and their marketing strategists who concoct in labs and skillfully advertise “junk” food to America’s kids and parents, along with large retail chain marketers who strategically place the unhealthy, addictive, legal crack cocaine for inescapable visual exposure by kids and adults going through check-out lanes. And the evil families who are primary owners of the companies making these decisions to promote foods that are drugs and are generating juvenile and adult obesity epidemics whose mortality, morbidity, and related social costs eclipse those of all other substance use problems combined. If anyone needs to be criminally prosecuted, it’s the individuals behind the marketing and promotion of cookies, candies, fast food, and the rest.
As obesity, diabetes and other related health costs explode, scapegoating the brilliant capitalists and entrepreneurs, dear to Ms. Duke’s heart, will become the desperately necessary distraction from the real causes of juvenile addictive use of junk food: parents and other adults who modeled the same addictive behaviors, who inflicted the ACEs on children generating inner distress the addictive use of food is soothing, and who – functioning exactly as medical professionals have in the opioid crisis – are the gatekeepers, who control whether their kids have access to addictive junk foods or manage their dietary health with alternatives.
As in the opioid crisis, those responsible for the generation of addictive use of food by children will be protected, shielded from scrutiny, by cover of media scapegoating frenzies, that protection gained at the price of a public health crisis to eclipse all others , the entertaining, hugely relieving, and satisfying drama of punishing the villains diverting attention and public health resources – soothingly – away from the real causes of illness and deaths, perpetuating them.
That’s how it works.
Back to reality
As an evidence-based model for understanding and providing prevention and treatment for compulsive problem substance use, the hijacked brain story never made sense, is established as absurd on its face, invaludated by all lines of relevant evidence. The title of this post is of course satirical.
And yet brains have been hijacked, willingly, soothingly – by an effective collusion of big medicine, corporate media, and especially by entertainment – to allow Americans to find escape in mass delusional structrues that allow them to avoid the profound discomfort of truth. At any cost.
Let’s look again at the Fox News poll –
Medical professionals – the only source of misprescribed opioids that generated the opioid crisis and continue to fuel it – are disconted as insignificant in the problem.
That’s understandable. In perverse and lethal ways, driven by the most fundamental needs of Americans whose brains have been hijacked for decades to believe that chemicals prescribed to them by their medical providers are the answer to all forms of their distress, physical, mental and emotional pain, including the entirely non-medical conditions of depressed mood and anxiety, compulsive substance use, and common chronic pain.
America:
“The doctors? With all that training? And competence?
They’re doing what’s right and exactly what their patients need! They don’t need to be controlled or restricted.
Where would I get the antidepressant, that SSRI that treats the depression I still have, that I’ve been on the last 20 years, if it wasn’t for my doctor?
And the pain medication for my lower back? They won’t pay for surgery, all the specialists keep saying there’s nothing wrong. God bless my doctor for the pain pills.
And where do you think I get my gabapentin for my fibromyalgia?
And my Seroquel for sleep? It sure knocks me out! Thanks doc.
I don’t know what I’d do without the speed – I mean Adderall – I need for my Adult ADHD. That’s a real thing ya know, adult ADHD. My doctor diagnosed me on the spot, just like that, so now I finally got something to take for it.
Everybody knows now, it’s big pharma causing the problem with opioids – that’s everywhere, it’s on TV, it’s what the experts say. How can anybody doubt that? And somebody poisoning everybody with fentanyl, like the Chinese or Putin? That’s what it is.
Leave the doctors out of it. They give us exactly what we need.”
And nowhere on the poll is to be found the psychosocial, developmental forces established as generating in childhood the psychological vulnerabilities that predict high risk of compulsive problem use of substances.
That’s understandable too. And lethal.
American parent:
“Adverse what? Who didn’t have a rough childhood? My drinking and the abuse and neglect? I got in a spiritual program and gave all that over to my Higher Power. And I made amends. So that wasn’t it. Where do you think that car he was driving came from, before my kid overdosed?
If he just woulda done what works and go to his meetings, but he couldn’t accept his lifelong disease and work the steps. He hated his disease.
Anyway, it was the Sacklers that made him an opioid addict, everybody knows that now. It’s on TV, everywhere.
It was that bad family.
They need to pay. Then this opioid problem can stop.”
“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.
At Twitter @jclarkmiller
