Update Opioid Crisis –

No, Substitute Opioids are not Fixing America’s Lethal Opioid Epidemic

by Clark Miller

May 17, 2019

A few decades ago, when vested interests were constructing the transparent fabrications required to sell prescription opioids to Americans who did not need them, would be harmed and killed by them in increasing numbers, U.S. media, as exposed by Sam Quinones in Dreamland, were along for the ride. Abdicating investigative and watchdog roles and deferring to medical “experts” – individual, institutional, research, governmental, academic experts whose pathologically negligent and incompetent misuse of information constructed the lies that would fuel the opioid crisis – media dutifully published the deceptions that would cause and require a lethal epidemic to trigger any accounting, too late.

Dreamland cover 2

Nothing has changed. Most ominous and predictive of continued harm and deaths, nothing has changed to help a vulnerable population including Americans trapped in lethal substance use or depression epidemics to understand the cultural and institutional roots of the problem and the predictable outcomes – that those experts relied on by media are unable to do other than provide inappropriate and predictably harmful guidance and practices for those problems, because they lack training and understanding related to the non-medical problems of chronic pain, depression and the behavioral symptom of compulsive use of substances – phenomena that are entirely psychological, behavioral, psychosocial in nature. Not biomedical.

Medical Fixes

SAMSHA bupe client trends2

For non-medical problems, with predictable outcomes

Overdose deaths US trend The Guardian

(from The Guardian – November 29, 2018)

There is no mystery here – no mystery to the ominously mounting death toll as more and more doses of medical “fixes” are applied to non-medical problems. No mystery that substance use, depression, suicide epidemics are continuously worsening over decades and $billions of public healthcare resources diverted to entirely inappropriate medical approaches for non-medical problems.

No more than we should be mystified by worsening outcomes if cultural understanding, healthcare funding, and treatment practices for HIV or diabetes or cancer were determined by mass media constructing, say, physical therapists as the competent and authoritative experts for those problems and constructing their recommendations for public health and treatment policy as credible and based on capacity to understand the relevant research and evidence.

No mystery, just predictably mounting illness and deaths.

Because the constructed distortion, the fabricated expertise, is so fundamental, unquestioned, “goes without saying” – pervasive, anastomosing through media, culture, popular culture, as knowledge. Present as assumed and established knowledge underlying all accounts, all messaging to consumers from interests with the cultural capital to control that messaging.

Like here, in a recent Associated Press (AP) report summarizing U.S. healthcare efforts to manage the opioid crisis created by that media/medical collaboration.

Now, States are spending grant money on treatment, overdose antidote kits, recovery support services, training for doctors and public awareness campaigns. The goal is to get more people treated with medications for opioid addiction such as buprenorphine and methadone. There’s solid evidence backing these medications, when they’re used alongside counseling and ongoing support.

Of course there must be solid evidence, wouldn’t there be? With $ billions in public healthcare funds diverted to that medical fix? Evidence to support the medical use of addictive, diverted opioids prescribed to “treat” the runaway opioid crisis generated based on yesterday’s medical expert assurances of evidence for universal use of opioids for the non-medical condition of chronic pain?

STAT opioid deaths

Turns out there isn’t such evidence, never was. Predictably, for a non-medical problem “treated” with medical fixes.

As outlined and discussed here at A Critical Discourse in a series of posts on the opioid epidemic and its causes, the false promise of medication assisted treatment (MAT) as implemented is increasingly exposed by critical evaluation of diverse lines of evidence and research from U.S. MAT outcomes and from France’s decades-long, least restrictive, most intensive opioid substitute treatment (OST) campaign in the world, held out as the model for a U.S. medical “fix” with substitute opioids.

As established for the lethal iatrogenic opioid crisis the fix is a response to, the research “evidence” was never credibly supportive and predictive of benefit, instead predictive of a mounting body of evidence of failed outcomes and steadily worsening lethal public health epidemics associated with population “dose” of the medical cure increasing substantially and steadily in the U.S. and model country France. That research – vetted by the same expert professional class responsible for ensuring a research evidence base for the medically appropriate, safe, effective use of addictive opioids for the non-medical condition of common chronic pain – was never subjected to competent critical analysis of research design, interpretation and validity, never subjected to a critical discourse, instead successfully endorsed by popularizing writers in mass media.

That mounting evidence has included –

Retention rates (patients staying in and successfully completing MAT treatment programs) low and trending to zero in natural community treatment settings, with concurrent misuse of other opioids, other drugs – described in this post:

Doxa Deconstructed: Another Medical Fix Not Supported by Evidence – Suboxone for the Opioid Crisis

Evidence in the anomalous case of a Plumas County, California reversing opioid-related OD deaths pointing to Naloxone as the effective protective factor and against OST – described in this post:

In a California county hard-hit by opioid abuse, reduced death rate points to OD reversal drug naloxone, not opioid substitute Suboxone

Consistent evidence – as the national “dose” of substitute opioid medical “fix” and “anti-addiction drug” buprenorphine has steadily and substantially increased – of a concurrently worsening, lethal epidemic – outlined in this post:

More Signs U.S. Medical Industry Magic Pill Approach to Opioid Crisis on Same Track as Decades-Old Failed French Experiment of Unrestricted Buprenorphine Prescriptions in Primary Care

Rampant, runaway diversion and abuse of the prescribed, addictive substitute opioids in France and the U.S., enough in France to fuel buprenorphine abuse epidemics in another country – described in this post:

The French Connection France’s Decades-Long Unrestricted Buprenorphine (Substitute Opioid) Campaign – Promoted as the “Fix” for U.S. Opioid Crisis – is Fueling Widespread Prescribed Opioid Diversion, Trade and Abuse

Lack of evidence to support the claim of efficacy for MAT/OST in reducing OD deaths or for other benefit, instead evidence for diverse harms – described in this post:

The Science: Following French Failure, Americans Get a Substitute Addictive Opioid as “Fix” for the Opioid Crisis, Marketed as Reducing Overdose Deaths Does It?

OST falsely constructed, branded as “treatment” thereby diverting public resources, attention, and policy away from existing evidence-based treatments for problem substance use including opioid use – described in this upcoming post:

Upcoming Post Opioid Epidemic: For Worsening Crisis French and U.S. Medical Systems Dispense Ongoing Addictive, Abused Substitute Opioids With No Evidence-Based Treatments, Predictable Outcomes
and these posts at A Critical Discourse:

Why Addiction Treatment Doesn’t Work

Why There is No Such Thing as “Addiction” – A Fabrication that Diverts Healthcare Resources to the Criminal Treatment Scams Driving Lethal Public Health Epidemics

Effective Substance Use Treatment Requires Ending All Funding and Treatment for “Addiction” – A Fabrication that Diverts Healthcare Resources to the Criminal Treatment Scams Driving Lethal Public Health Epidemics

Evidence falsifying and dismantling claims by the medical/harm-reduction industry that diverted substitute opioids are primarily or largely used in self-treatment by individuals motivated to stop high-risk opioid use, instead affirming misuse and abuse of diverted prescription opioids – described in this upcoming post:

Update, Opioid Crisis – Word from the Street: The Bupe Economy is About Abuse not Self-Treatment

More from the AP –

States have started reporting back to the federal government that thousands of people have entered treatment as a result of grant money, including hundreds of pregnant women. Pennsylvania, for example, says it treated 11,423 people in FY2017, including 86 pregnant women. Michigan says it treated 2,974, including 30 pregnant women. Tennessee: 3,075, including 55 pregnant women.

Lots of vulnerable Americans getting into treatment, that has to be good doesn’t it? Of course, that treatment being paid for with public healthcare funds must be beneficial, with America’s trusted public healthcare policy authorities and experts overseeing it?

In fact, that “treatment” that vulnerable Americans trapped in opioid and other substance use epidemics are provided is standard “addiction treatment” – essentially the only form of treatment available – and it excludes the types of therapies established by longstanding evidence as effective, instead functions as a multi-billion dollar entitlement system providing “services” that predict at best no benefit, more likely harm.

Functions as a criminal scam –

In some ways the opioid epidemic is only the latest manifestation of drug problems deeply rooted in American history. Public health experts say one major difference today is that addiction is increasingly recognized by experts and lay people alike as a disease of the brain, not a moral failing. That could open the way for building an infrastructure for what’s called the “continuum of care” — prevention, treatment and recovery.

A disease of the brain? Interesting. Are there other diseases of the brain that Modern Medicine has identified, controlling public healthcare funding for research and treatment approaches over decades and without gains or benefit? Instead resulting in worsening epidemics and mounting deaths over those decades of promises of medical cures?

The longstanding evidence – all lines of relevant evidence and research – is clear. There is not and never has been support for the behavioral symptom of compulsive substance use constituting a disease, or medical condition, or psychiatric disorder, not remotely.

There are no mysteries here, and no intractable, chronic diseases with medical understanding or treatments, but there is pathology.

Pathological levels of diminished capacity for integrity, for obligation to avoid harm, for research literacy, for critical thought, critical discourse.

A lethal condition. American media, again, along for the ride.