I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it.
The entire drug regulation system is predicated on the idea that you have certain providers, namely physicians, who are competent to make decisions, and shifting that decision-making power to those providers protects us from harm.
The opioid crisis has demonstrated that whole paradigm is faulty.
The problem is that no one profession should be entrusted with that level of power or command over decisions.
Imagine, instead, a system where there was no drug regulation. Rather than assuming that physicians were making the best decisions about opioid use and sweeping the problem under the rug, such use would be constantly scrutinized.
We need more competition, and fewer gatekeepers. Gatekeeping means there's only one thing that needs to be breached.
Going outside recommended guidelines can be very very expensive for a physician.
The understanding of opioid use has clinically changed drastically in the last 40 years, similar to SSRIs in the last 70 years.
Not that I do not agree with your premise, but the issue seems to be much more institutional and related to human, research, and implementation error than a bunch of individual bad actors.
I understand (though disagree with) the libertarian philosophy that you should be free to take anything you please, but I fail to see how such a situation would lead to decreased use.
This is about doctors putting their patients at risk in the process of treating them for routine problems which did not result in opioid addiction rates as recently as 25 years ago, and certainly were not prescribed with any other side benefit as far as I've heard.
She has not tried, and is not interested in trying opioids for them, though.
I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equanimity...distancing myself from the pain and just observing it rather than feeling it, it all but goes away.
I have more chronic pain than I've ever had and, yet, I haven't taken a single pain killer in the past 3 years. I want to believe that somehow my pain is less than everyone who's getting caught in the net of opioids and that they do really need pharmaceutical help to deal with their pain, but my experience leads me to believe otherwise...that much of their need for drug help comes from their mental state and the unproductive way they accept pain into their lives. I also can't help but wonder whether today's increasingly disconnected society leads people to seek connection with a substance rather than other people. Would we still have an opioid epidemic if people spent more time having in-person conversations and less time liking things on Facebook?
Exercise is good for virtually everyone, and that's common knowledge. Yet relatively few go through the trouble.
Pain science is a very well-researched field that gets plenty of funding and is worked on by some of the best scientists and doctors in the world who have no corrupt agenda.
There is no conspiracy. Just doctors over-prescribing opioids, patients lying to get them, and a few very corrupt "pain management" shops - primarily in Florida - handing them out like candy.
I would say the root problem goes far deeper. Big pharma make big politic donations which buys the ability to do this. Big pharma heavily pushed these onto Drs. Big pharma lied about the addiction potential. Big pharma fudged the facts.
I am not 100% sure of the governmental process to get moving, but their is political oversight and they have been negligent for decades, but as government bodies > big corporations seem to have a personnel revolving door, no one wants to rock the boat and lose the chance of landing a high paying job later down the line.
That is a reality you did not include.
Perhaps, but there is a fundamental problem with a purely scientific approach to a problem like this.
Science has a measurement problem when it comes to pain. You can take an entirely disciplined approach to studying the problem but there is no way to measure pain that isn't subjective on the part of the patient. There's no way to separate actual pain from psychosomatic pain, no matter how good the scientists and doctors are or how non-corrupted their agendas. It's only when you start to realize that pain is primarily a mental illness, not a physical one, that can even begin to understand it. And that's a conclusion that is very difficult to reach from a purely scientific perspective, especially since you can cause pain so easily through physiological means. I've only been able to arrive at that point through my own subjective experience in seeing just how effective an approach based on disciplined thought can be.
You know what's also a very well-researched field that gets plenty of funding and is worked on by some of the best scientists and doctors in the world? Depression. And, like pain, depression is a condition that can only be measured subjectively by the patient. Scientists can (and have) deluded themselves into thinking they're measuring it more accurately, with fMRI scans and other non-subjective physiological responses, but it's just as likely they're measuring second-order responses in the brain rather than the primary symptoms.
And, like pain killers, those doctors and scientists largely favored an approach using medication, since that approach is most amenable to being studied scientifically. But what's been realized in the past decade is that medication is no more effective than mindfulness practice, despite having significantly more side effects. And, even more recently, there's now pretty good evidence that depression may not even be a problem of the mind and, instead, may be primarily a problem in a patient's gut bacteria. Scientists, in their belief that everything mental originates in the brain, have very possibly misunderstood for decades the basic nature of the problem they were studying.
Science isn't magic. It's a way of refining our thinking on a subject, but it doesn't automatically arrive at correct conclusions when those conclusions are difficult to conceive. My personal experience with pain leads me to believe this is one of these situations. It's no knock against scientists, but given the damage that we're seeing from the side effects of pain medications, I do believe it's long past time to expand the scope of the problem they're studying.
Chronic / serious pain yes. I read that 1/3 of people in the US are on (or perhaps have taken?) an opiod prescribed pain killer. If true, that is insane! That is not chronic pain.
* Drs have over prescribed opiate based painkillers. Fact. * Big Pharma corporations have pushed opiate painkillers recklessly. Fact * Profits became more important than the health of the customers/(patients). Fact
This has caused the death of 1000s. Yet no one actually responsible will be held accountable. Sure some Drs will lose their license, but the real guilty parties are further up the tree and will be untouchable.
Unfortunately, that seems to be the American way.
If you are a drug addict,there is a pill for that.
If there are side-effects to the pill you are taking to get you off addiction,there is a pill for that.
And if you take too much pills,there is a pill for that one too.
I think this made fertile ground for huge swing back that pharma got from prescribing it. The situation of such massive underprescribing allowed massive overprescribing, in a way.
Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in agony. For people with chronic pain, or those coming out of surgery, perceived recovery time can be a big thing for people.
Additionally, the article didn't address the fact that it could very well be that doctors were being paid off to prescribe a particular brand of opioid rather than just opioids in general, something that is relatively common when there are a large number of drugs that can equally help treat a given ailment.