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By Clark Miller

Published July 22, 2020

Updated April 14, 2021

The predictable happened:

Opioids were called safe and effective for all pain by America’s top medical and public health authorities and institutions. What happened?


The predictable happened:


In a collusion of American media and public health institutions and driven by abdication of professional and ethical responsibility by  medical industries and practitioners, inappropriate runaway provision of medical treatments (opioid pain killers that are no more effective than over-the-counter medications) for the non-medical condition of common chronic painagainst all relevant, longstanding lines of evidence – predicted and generated the worsening opioid crisis.

Medications were called effective cures for compulsive substance use, assured by America’s top medical authorities to be established as a medically treatable chronic brain disease. What happened?


The predictable happened:

Science Daily No magic pill to cure alcohol dependence yet
Meth NYT headercomp2

Medical dispensing of substitute addictive opioids was called a safe “gold standard” effective “treatment” for opioid dependence and the lethal opioid epidemic. What happened?


The predictable happened:


The same American mass media/medical collusion that fabricated evidence generating the lethal opioid epidemic now distorts research to fabricate evidence for another invalidated medical/pharmacological fix for a non-medical problem, the use of substitute opioids worsening instead of treating the public health epidemic.

As more and more of the medical cures are dispensed, the epidemics worsen and worsen – a pattern apparently insufficient to instill the insight that the cures aren’t working. While America gets sicker and sicker.

(from The Guardian – November 29, 2018)

It’s an established pattern established unequivocally by all lines of relevant evidence and that – despite efforts of popularizers of the failed medical OST “treatment” – is not explained away by intentional  abuse with known risks of fentanyl, established here and here


Antidepressants were called safe and effective for depressed mood. What happened?


The predictable happened:

Administration of nicotine by vaporizing (vaping) and inhaling was called effective for cessation of tobacco smoking, endorsed as “innovative” in the nation’s top medical journal. What happened?


Late in 2017 the nation’s top medical journal – Journal of the American Medical Association, JAMA – featured endorsement of an “innovative” plan by the U.S. Food and Drug Administration (FDA) for use of electronic cigarettes, “vaping”, to substitute for that of tobacco cigarettes as a form of medical harm reduction. The message was clear and came from one of the America’s most trusted and authoritative medical institutions: vaping is a much safer alternative to smoking. That message targeted, through mass media dissemination, a vulnerable and trusting public trapped in arguably this culture’s most costly and lethal compulsive substance use problem, the annual half-million deaths due to tobacco use eclipsing those related to alcohol, opioids, and other street drugs combined.

The message would also have been taken as authoritative by America’s medical professionals,

who encounter smokers routinely in primary care and other settings and advise them on interventions to help stop smoking. Institutions including top medical journals, medical regulatory agencies, and media have powerful influence on American medical practice, their cultural fabrication of a new medical gold standard  for treatment of chronic pain, for example, substituted for clinical and ethical judgment and responsibility and resulted in runaway, medically inappropriate dispensing of Schedule II opioids for the established non-medical condition of common chronic pain generating a lethal public opioid crisis. But that’s another story.

That JAMA-endorsed medical harm reduction flipped within months, predictably,  to a child nicotine abuse and dependence problem, now widely recognized as another public health epidemic.

The public disinformation campaign worked, providing for booming sales and use of vape products. Worked, that is, apart from the worsening child nicotine dependence epidemic.

And apart from the emerging adult vaping illness epidemic.

But it’s not just advertising at work, when e-cigarette use is endorsed as an innovative harm reduction approach in the nation’s leading medical journal, and the same journal endorses a research report – disseminated to American medical practitioners – with claims that vaping is an effective method for stopping cigarette use, repeated in authoritative media outlets.

As reported in JAMA and published in another leading medical research journal, the New England Journal of Medicine (NEJM) the landmark study, a “seminal study” according to medical authorities, establishes that vaping of nicotine is effective for stopping use of tobacco by smoking, affirming vaping as a new medical gold standard for smoking cessation. It’s even more effective than nicotine replacement treatment (NRT), based on critical evaluation of the research study by medical professionals, leading authorities, and major mass media. (Coincidentally, NEJM is the top medical research journal that published another seminal study not long ago – the study establishing that Schedule II opioids were safe and effective to use for all pain, including chronic pain.)

What happened?

It’s just that – the study in question establishing vaping as a new medical gold standard actually provides no evidence at all of benefit for smoking cessation from either NRT or e-cigarette use, instead points to no benefit.

It’s also that the demonstrably false, unvalidated claims of benefit (of about 10 percent and 20 percent cessation success rates for NRT and vaping, respectively), were based on errors in experimental design and interpretation of the most elementary and demonstrable types.

That’s what happened, predictably.

As in the runaway provision of addictive opioids for the non-medical condition of common chronic pain, indicated against by all lines of relevant evidence from the start; as in a worsening depression epidemic; worsening alcohol and methamphetamine pubic health threats; provision of false, harm-predicting information to a vulnerable public on effective treatments for smoking cessation; as for the invalidated, lethal medical substitute opioid “fix” for the medically-generated opioid crisis,

the predictable happened –

Medical “experts” and authorities entirely out of scope of competence to understand, formulate and provide treatments for the non-medical problems of common chronic pain, depressed mood, and compulsive substance use were funded and entrusted to protect public health with fabricated “treatments” that – exactly as in the media-medical collaboration to fabricate “evidence” to fuel the lethal opioid crisis – were never credibly supported by evidence for effectiveness let alone avoidance of harm.

That’s what happened, predictably –

self-protective and self-rewarding behaviors of the same pathologically compromised, incompetent and negligent collusion of American Medicine and Media that generated the opioid crisis, fuels a depression epidemic, lies to Americans about smoking cessation treatment, and is protecting a Big Pharma/Big Medicine opioid substitution (MAT, OAT, OST) “treatment” scam that is worsening the lethal epidemic they created.

Gross incompetence and medical malpractice happen.

Media cowardice, incompetence, and abdication of public responsibility happen.

Fabrication of useful evidence happens.

Preventable lethal epidemics happen.

Public healthcare funds diverted to fund harmful sham treatments happens.

Continued predictable and preventable deaths of vulnerable Americans happens.

If allowed to.

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.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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