By Clark Miller

Published September 25, 2019

Updated April 14, 2021



“It literally is miraculous.”

Those are the words Dr. Shmuel Mandelbaum, a physiatrist specializing in behavioral health at Holy Family Memorial in Manitowoc, used to describe Suboxone, a drug used to treat those with an opioid addiction. In most cases, Suboxone is a film that patients put under their tongue.


“I typically will encourage people to take it for longer than what they come in thinking,” Mandelbaum said. “They may come in thinking they’ll use it for a few months and then wean off of it. But if people are really addicted to opiates, you’re probably going to have to stay on (Suboxone) for a year before you consider moving on.”
Mandelbaum said there is no risk in chronic treatment using Suboxone. Coming off too early, however, can lead to relapse.

That seems encouraging and entirely consistent with the media/medical manufactured consensus

and narrative that emerged over past decades to establish medication assisted treatment (MAT) or “opioid substitution therapy” (OST), as the unquestioned “gold standard” “fix” for compulsive high risk opioid use driving the lethal epidemic, and certainly would have helped fuel runaway medical dispensing of substitute opioids and expanding use of public healthcare funds for the medical “treatment”.

But media featured anecdote and witness of miracles aside, what does the evidence say about effectiveness of Suboxone as a substitute opioid treatment for compulsive opioid use driving America’s lethal epidemic ? How are things going in Wisconsin, where the medical fix for the non-medical condition of compulsive substance use and for the medically-generated lethal crisis is reported in major mass media to be working miracles?

About the same, it appears, as in the rest of the US and world.

Because he’s been prescribing Suboxone for such a short time, Mandelbaum said he doesn’t have any hard data regarding success rates.

We do – and the new evidence from Wisconsin

is part of a consistent, invalidating, predictable pattern that disconfirms benefit attributable to OST. That expanding pattern is described in detail in multiple posts at A Critical Discourse for locales within and outside the U.S.


Dayton, Ohio

Plumas County, California

Franklin County (Columbus) Ohio

Cincinnati, Ohio






Rowan County, North Carolina

Bethlehem, Pennsylvania

Ontario, Canada

United States

Victoria, B.C. Canada



and in Wisconsin


“Hospital emergency room visits for opioid-related overdoses in Wisconsin increased from 2014 to 2018 by 64%.”

Over the same period opioid-related overdose deaths climbed steadily including those attributed to heroin.



As in other locales consistently, over that same period of increasing high-risk use of opioids with associated mortality and other costs, medical provision of the “gold standard” medical “treatment” for high-risk opioid risk was significantly increasing.

“Statewide, 10,626 patients were treated at the 18 methadone clinics in operation last year, up from 6,319 in 2013.”

Figures in the table represent medical provision of both methadone and buprenorphine.

Wisconsin MAT provision trend1

For the most recent recording period – 2018 compared to 2017 – opioid related OD deaths decreased by about 10 percent. As in other locales consistently, any apparent moderation in increasing trend of opioid-induced OD deaths can be attributed to the directly acting and observed life-saving effects of increasing distribution and use of naloxone (Narcan).

Increased emergency use of the overdose death preventing antagonist naloxone, of course, represents continuation or worsening of prevalence of high-risk opioid use and worsening of the iatrogenic and lethal opioid crisis.

That is, as is consistently evidenced in other locales, emergency responders are saving lives, often repeatedly, by reversing opioid overdoses, accounting for all moderation in lethality trends, leaving none to attribute to OST, while the invalidated medical “treatment” continues to fuel street economies of high-risk opioid use.

The mounting, consistently invalidating pattern was predictable, all along, because there has never been credible evidence to support effectiveness for OST, instead all lines of evidence disconfirm effectiveness and point to increasing harm.

The more gold standard medical treatment provided to the diseased brains, the more deaths mount.


The medical model substitute opioid cure for the medically generated worsening lethal opioid crisis has failed, predictably. It was manufactured, branded and promoted on fabricated evidence for effectiveness just as generation of the crisis was, its failure not explained away by the emergence of fentanyl and constituting a fraudulent diversion of public healthcare funds away from longstanding evidence-based therapies for the non-medical condition of compulsive substance use.

Suboxone package on a sidewalk

The evidence, critically and competently examined, establishes that the medical “fix” provides no benefit for high-risk opioid use or overdose rates, instead worsening lethal epidemics, and the “evidence” for reduced OD deaths attributable to OST (MAT) used to market the “treatment” doesn’t hold up, never has, instead points to Naloxone as the effective factor in moderating OD deaths. Meanwhile diversion and abuse fueled by a runaway national “dose” of substitute addictive opioids – as in generation of the crisis – is integral to national high-risk opioid use economies – diversion and abuse of addictive opioids driving a street and prison economy; diversion and abuse of public healthcare funds driving a professional supplier economy constructed as “medical treatment”.

Just as in creation of the opioid crisis, American Media have been along for the ride, uncritically swallowing whole and promoting distorted research and constructing the fake medical news required to protect control of healthcare funding by Big Pharma and Big Medicine.

As established in multiple posts with links to primary research and to invalidating data from an expanding array of locales, critical analysis of the relevant research establishes mounting harm caused by medical “treatment” of the medically generated opioid crisis.

That’s not how media have been reporting it

as, for example, in the USA TODAY NETWORK promotional piece advertising “miraculous” outcomes attributable to dispensing of the widely diverted and abused substitute opioid buprenorphine (Suboxone).

Just as in the media/medical collusion that manufactured “evidence” out of nothing to fuel the runaway medical dispensing of opioid drugs for the non-medical condition of common chronic pain and fueling a lethal epidemic, that same mutualistic collaboration abjectly distorted research results to promote harm-predicting medical smoking cessation fixes to a vulnerable public and has, predictably, fabricated fake medical news that fuels the lethal street and lucrative medical industry economies of substitute opioid distribution.

Just as for use of opioids for common chronic pain, for all pain, the fabricated medical substitute opioid fix is a “gold standard”, unquestionably established as such by America’s top medical institutions and authorities, vetted by America’s watchdog press.


It goes without saying that it is.

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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