Any distraction to hide the evident truth: of surging infectious endocarditis, other injection-related diseases increasingly caused by high-risk opioid use – over decades of increased provision of  “proven” medical cures for the high-risk use

by Clark Miller

Published February 12, 2023

As with other aspects of America’s increasingly lethal public health crises, a decades-long trend is worsening. 

It’s of course an important angle and issue to cover, that “Hospitals are struggling to respond”. Health systems have been struggling to respond to a lot of public health assaults. 

But not as important actually, ultimately, as the human and public health toll of that spike (which is actually a decades-long surge) or as important as understanding and beginning to address the real causes – as distinct from the cause constructed absurdly in the headline as “The addiction crisis”. 


As in, “The addiction crisis is causing a spike in opioid overdose deaths”.

See? Something got off there in the thought process, didn’t it, some capacity for something, diminished. 

But let’s give the writer and editors some credit, for this – 

Increased injection drug use has led to a spike in cases of the life-threatening heart condition endocarditis, with cases rapidly accelerating since the onset of Covid-19.

Now we’re on the right track, identifying “increased injection drug use” especially of opioids – that is, increased prevalence of high-risk opioid use – as the explanation.

Sort of. Because – oops! – now we’re off-track again, derailed somehow, for some reason.

Cases did not, in fact, “rapidly accelerate since the onset” of the pandemic, instead stalled, then did precipitously increase in 2021 and 2022, as explained in this recent post.  

Off track. Off task. 


With drug deaths hovering at an all-time high and endocarditis cases among drug users up nearly tenfold in the last decade, physicians, researchers, and health officials have begun to confront the problem with more urgency. In particular, doctors are coming to terms with a basic reality: Their hospitals often have few protocols for treating endocarditis patients who use opioids and the withdrawal they’ll likely experience upon admission.


The focus, the problem here is in managing the king tide of infectious, injection-related disease sweeping in.

Not facing the cause of the surge, instead “the problem” that America’s top “physicians, researchers, and health officials have begun to confront” is providing damage control for the high-risk opioid use that’s been consistently, persistently surging over decades and decades – pre-pandemic, pandemic, now post-pandemic – over the same decades and $billions in public health funds diverted to steadily increasing provision of American Medicine’s anti-addiction fix that specifically works by eliminating high-risk use, by rebalancing diseased brains to avoid high-risk use. 

Provision of the proven cure attested to by uniform consensus of those same  expert “physicians, researchers, and health officials”, for the non-medical condition of compulsive problem substance use. 

Opioid withdrawal? Those protocols have been around and in full use for decades, in fact form the therapeutic, proven, anti-addiction effects that comprise the established benefit of the prescribed MAT opioids buprenorphine and methadone. Decades ago and before their widespread use, and continuing, other medications were and are in standard use for managing opioid withdrawal. 

The MAT opioids are so safe and effective that they can be provided with a phone call, safety controls are being removed, and we need to be getting more kids on them. 

But . . . but . . . but . . . 

The hospitals don’t’ have the addiction medicine specialists required to dispense the proven anti-addiction medical cures that are established as preventing potential withdrawal symptoms, eliminating high-risk use, and predicting management of the disease of opioid use disorder (OUD). 

“Most hospitals don’t have addiction consult services,” Thakrar said. “Most hospitals are not going to have access to addiction expertise, and in part that’s because hospitals haven’t paid for it. It hasn’t been a priority. … A lot of hospitals don’t have specialty services, so a lot of providers and cardiologists might be left without anyone to call.”

The resulting void forces other doctors — in this case, cardiologists or infectious disease specialists — to treat their patients’ addiction, which they’re sometimes ill-equipped to do.

DeSimone, the infectious disease specialist who was the lead author for the AHA’s new recommendations, acknowledged those doctors may be uncomfortable providing addiction medications, like writing a prescription for buprenorphine or connecting their patients with a methadone clinic.


Now that, unfortunately, is more than getting off track, more than intentional diversion, excuse-making, symptom of diminished capacity. 

It’s a deception, in effect a lie. 

Because as well publicized recently, “The X Waiver is Officially Dead” – 

While the administration has incrementally loosenedopens in a new tab or window the requirementsopens in a new tab or window for providers to obtain an X waiver in recent years, the provision included in December’s omnibus bill eliminates the certification entirely. The abolishment of the X waiver is included in the bipartisan Mainstreaming Addiction Treatment (MAT) Actopens in a new tab or window.

. . . “So not only does the elimination of the X waiver create the regulatory pathway” for clinicians to prescribe buprenorphine without a separate certification, Hurley said. “It also removes the impression that the treatment of opioid use disorder with buprenorphine is a highly specialized, complex, or dangerous activity.”

The proven medicines, increasingly dispensed over decades and decades, curing opioid withdrawal symptoms, craving and addiction, are, it seems, established now as so safe and effective that any licensed medical provider is qualified – without specialized training of any sort – to provide them. Encouraged to. 

That’s from the same consensus of top American medical, public health, and research experts who are now, in this very helpful STAT piece, tying themselves into knots with disingenuous excuses for why we can predict that with or without their proven medical fix, these patients will return to hospital with opioid injection-related infectious disease. 

Due to high-risk opioid use. 

We know why

the embarrassing excuse-making, the distraction, the deception, the lying are necessary. 

To divert attention from and avoid facing what is established. 

Established partly by deconstruction of the concerted media/institutional/medical/research collusion of a campaign of lies to cover the causes of a persistently worsening, increasingly lethal opioid crisis pre-pandemic, through pandemic, then post-pandemic, following dissipation of fabricated pandemic stressors as distracting, bogus explanations. 

COVID pandemic was a natural experiment

One of multiple, independent invalidations of the necessary fabrications is a natural experiment. COVID pandemic restrictions and social effects that were presumed to be causally linked to pandemic surges in high-risk opioid use, overdose, and deaths have dissipated, beginning nearly a year ago. And predictably – because it is established that medical approach (MAT) and traditional substance use treatments not just fail but fuel and worsen problem opioid use – with those factors removed America’s opioid crisis continues to worsen. That’s established now

It was all predictable.

Partly because the rationalizations – fabricated by consensus, mass messaging, and groupthink – never made sense, not from the beginning – explained here. And here, for example, for the “social isolation effect”. 

Treatment access effects? Imposed by pandemic conditions? More necessary lies. As America’s medical treatment experts assure us, their substitute opioid proven cure is, as a standalone treatment, effective in drastically cutting opioid deaths. Even when diverted, obtained and used on the street, despite all appearances of being abused, is actually being used to cure opioid use disorder, to avoid high-risk use, we have that on the word of America’s top addiction expert. Suboxone, “subs” is everywhere on the street, for anyone at any time, so that must be why we are seeing such rapid success in treating . . . right. 

Do you see? 

Right. Becuase . . . 1) there’s never been evidence for any of that (it was naloxone), 2) those medical cures increased in availability and use over pandemic years while deaths surged instead of decreased, and 3) now post-pandemic, with fabricated, bogus pandemic stressors dissipated, and with MAT opioid provision increasing – high-risk use and deaths continue to surge. Fabrication-invalidating points 2 and 3 are established for Delaware, for St. Louis, also for Maine, and in W. Virginia where injection-related HIV is increasing too. 

We know why

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.

Latest Stories

Sign Up For A Critical Discourse Newsletter

You'll receive email alerts of new or upcoming posts.

A Critical Discourse

Fog Image