Impaired, compliant American reporting protects lethal systems fueling an uncontrolled opioid crisis

by Clark Miller

Published April 11

Every day in mass and social media in the U.S. and beyond, fabricated “knowledge” that is demonstrably false, unsupported by evidence, and lethally misleading is messaged to a public trusting in the explanations and recommendations of designated healthcare experts.

It was media-designated, trusted experts and compliant reporting that created the lies enabling the opioid crisis. And that falsely promote vaping as an effective way to stop use of regular cigarettes – a substance use problem whose mortality and healthcare costs eclipse those of opioids and all other drugs combined – with predictable epidemic effects and increases, not decreases, in cigarette smoking after decades of decline.

Nothing has changed, and there are no surprises, only the predictable. 

headline on 2020 opioid overdose deaths

America’s Medical/Media collusion yesterday: “Addictive, Schedule II opioids are safe and effective for all pain.” 

Medical/Media collusion today: “addictive, abused, diverted opioids are a safe and effective medical fix” for the opioid crisis they created yesterday.

Trending Useful Idiots: “Experts point to need for more $billions for medical treatments in battle against opioid crisis deaths caused by the Sackler family.”

From a previous post – 


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 the Trump administration collaborates 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.

The broader fabrications include all of the core useful fictions that comprise the public understanding of “addiction” and its treatment, that comprise doxa –

1) that compulsive substance use is a medical condition

2) a disease of the brain, caused by “hijacked brains”

3) for which there are medical treatments

4) that have provided gains in understanding and treatment outcomes

5) including effective treatment of opioid dependence with substitute opioids

6) and tobacco use with anti-craving medications and nicotine replacement therapy (NRT)

7) In “rehab” (residential) and outpatient addiction treatment programs, beneficial treatments are provided.

8) Relapse and continued use are caused by avoidance of withdrawal symptoms and cravings to use, both effects generated by “hijacked” brains.

9) Group therapy is a type of treatment that benefits individuals with compulsive substance use.

10) The 12-Steps of the Alcoholics Anonymous religious subculture and meetings of AA and Narcotics Anonymous (NA) provide benefit for problem substance use.

11) Addiction professionals working and providing group and individual counseling in programs are qualified and competent to provide treatments for the complex, life-threatening condition of compulsive substance use.

12) There exist professionals who are “peer supports” or “peer mentors” providing “peer support” that is beneficial to individuals with compulsive substance use.

Those are the accepted traditions, the truths, well-established knowledge, so well established that it “goes without saying” – that is, the useful constructed fabrications, the doxa – driving treatment approaches that have gotten us, over past decades, to where we are now – incompetently and blindly enabling the deaths and suffering of millions of Americans.

It may be worth asking,


What does the unreported research say? 


1) On any informed and competent review and consideration of the longstanding evidence, the behavioral symptom of compulsive substance use does not remotely constitute a medical condition.

2) let alone a disease of the brain or disease at all. Nor a psychiatric disorder or other biomedical condition.

3) There are no bodies of replicated RCTs (randomized, controlled trials, or experiments) that support clinically significant, durable benefit from any medication for substance use. Or are there? Please provide them. Research aside, that claim turns out to be absurd on its face. 

4) Disease models of compulsive substance use are invalidated by all lines of relevant, longstanding research and evidence; outcomes of those models and medical “treatments” are worsening lethal public health epidemics. 

5) The medical industry gold standard and fix for problem opioid use – prescribed substitute addictive opioids – is not and has never been supported as providing overall benefit, is invalidated by mounting evidence.

6) There are no bodies of replicated RCTs to support clinically significant benefit from medical-model smoking cessation interventions – medications or nicotine replacement. Recent invalidating evidence here

7) The core elements of “treatment” provided almost universally as addiction treatment in the U.S. are invalidated by longstanding bodies of evidence, instead predict harm.

8) Patterns of relapse to problem substance use predicted by and required to support any “hijacked brain” model of “addiction” are invalidated by available research.

9) With very limited exception, group “therapy” is not supported by research as a beneficial therapy.

10) The features and odd prescriptions of the religious subcultures AA and NA are established as harm-predicting by longstanding research.

11) The “addiction professionals” paid to provide “treatment” in U.S. addiction treatment programs are not competent, trained, or qualified to provide treatment.

12) “Peer support specialists” are even less qualified than addiction professionals to provide guidance and therapeutic interactions with persons trapped in complex, potentially lethal conditions of compulsive substance use.

That is, the entirety of what is “known” about “addiction” and its treatment – and provided to vulnerable Americans trapped in lethal epidemics and trusting, as they’ve been trained to, in medical professionals –  is at best folklore, more responsibly characterized as what it accurately is: the increasingly lethal expression of pathological levels of incompetence, avarice, deficits in integrity, in research literacy, and in capacity for critical thought. 

Lethal levels. 

Which is why those truths established by decades of evidence and research must so desperately be hidden, buried by the insipid, transparent fabrications of America’s Medical/Media collusion. Livelihoods, careers, institutions, and generous profits depend on those fabrications. 

Fabrications like the desperate distraction of fingering of a family and business as villians who are exemplars of American Capitalism, without that family or its employees having ever provided a single opioid pill to any American, unable to, requiring bought-off medical professionals taking clinical advice from pill salesmen to do that for them. 

Fabrications like the lie that fentanyl is responsible for continuously surging opioid deaths, its presence a complete surprise to users and on the streets, who were absolutely certain they were getting pure, known, recreational grade meth or heroin, or “subs” on the street. NOT that they would be seeking out fentanyl – the cheapest, most potent high around – or trading their medically provided bupe (Suboxone) for it.

No way could that be true

Fabrications like the never-supported-by-actual-evidence necessary stories about isolation, or lack of access to services, or elevated anxiety, or social isolation explaining COVID-period surges in opioid OD deaths. 

Because it definitely could not – must not – be explained by the established, supported-by-evidence  role of medically-dispensed MAT opioids in fueling the opioid crisis and tied to the increased OD deaths over the pandemic period, after safety protections for the addictive, diverted opioids were radically relaxed. 

Lethal fabrications like those compliantly reported here by popularizers of fictions – 

With drug overdose deaths continuing to rise, policymakers must help people with substance use disorders access evidence-based care and treatment, said leaders from the American Medical Association (AMA) and Manatt Health during a webinar on Monday.

In unveiling their “State Toolkit to End the Nation’s Drug Overdose Epidemic” — which includes proposals ranging from scrapping prior authorization requirements, to incentivizing positive behavior change, to enforcing parity laws — the groups highlighted that 28 states have witnessed a 30% increase in overdose deaths in 2020 over the year prior.

. . .

The groups’ document provides 24 recommendations across six major policy areas:

  1. Expanding access to evidence-based treatments
  2. Ensuring access to addiction medicine, psychiatry professionals, and other trained physicians
  3. Enforcing mental health and substance use disorder parity laws
  4. Increasing access to alternative options for patients with pain
  5. Broadening harm reduction efforts to reduce the number of overdose deaths and disease
  6. Monitoring and evaluating substance use disorder programs

But there are problems with those confident assertions and assurances for a trusting public from America’s top medical and public health authorities, assurances conveyed by mass messaging every day in mass and social media. 

There are no medical evidence-based treatments and has never been evidence for such treatments for the entirely non-medical condition of compulsive substance use. 

Addiction medicine” and psychiatric treatments for the behavioral symptom of compulsive substance use are increasingly lethal fictions

Increases in funding for existing lethal systems predicts more deaths. 

Decades into their lethal opioid crisis, American medical prescribers continued to misprescribe opioids while avoiding referrals to the established evidence based treatment for common chronic pain and while referring patients to “treatments” established as ineffective. 

American Medicine’s opioid substitution harm reduction (MAT) is fueling economies of high-risk opioid abuse, is increasing overdose deaths, and is tied to increased incidence of injection-related disease.

Substance use disorder and MAT programs under medical monitoring and management are tied to increasing detection of illicit fentanyl in drug screens with other opioids and increasing pandemic OD deaths.  The AMA and American Medical Industry have controlled public funds, media and other messaging, treatment, and funding over past decades without evidence for benefit, instead persistently worsening lethal epidemics

The problem is that they are lies that are lethal. 

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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