PROPaganda, Part 2 of 2

A 2018 documentary called, “Do No Harm: An Opioid Epidemic,” featuring Dr. Andrew Kolodny (to whom I recently wrote an open letter) and “working closely with Dr. Kolodny and PROP“, is a classic propaganda film that’s been influencing a lot of viewers and, therefore, a lot of lives. I viewed this film a few nights ago, and 90 minutes and 9 pages of handwritten notes later, I began writing this series of posts. View part 1 here.


Bad Science Leads to Bad Policies

One of the goals of the film is to blur the lines between legally prescribed medications, illegally obtained/used prescription medication, and heroin, along with abuse of medication and appropriate (responsible) use of medication. Dr. Kolodny wants all opioids (except his favorite, bupenorphine) eradicated, unless a person is actually dying or for immediate post-surgical pain.

Once again, however, the evidence and science do not line up with the film’s or Dr. Kolodny’s claims. For example, this landmark medical study, one of the largest to date concerning opioids by Porter and Jick from 1980, concerning narcotic addiction specifically, reviewed nearly 40,000 hospitalized medical patients. Although nearly 12,000 of those patients “received at least one narcotic preparation, there were only four cases of reasonably well documented addiction in patients had no history of addiction.” (my emphasis added)

Classic addiction study 'paragraph'
Although one can clearly see the footnotes in the text, the film’s screenshot makes the full study’s citation unable to be read at the bottom, and then the video pans in, effectively erasing that citation altogether.

In the film, this screenshot is shown, and the study dismissed out of hand as a “mere paragraph”, a “letter to the editor”, in the New England Journal of Medicine, asserting, “few bothered to check out the source of the study,” implying the NEJM is untrustworthy, even though less than 2 minutes later, the same Journal is cited for a different study the filmmakers do approve of. Going back to Porter and Jick’s study above, although one can clearly see the footnotes in the text, the screenshot makes the full study’s citation unable to be read at the bottom, and then the video pans in, effectively erasing that citation altogether. At the same time, the narrator tells viewers the doctors/research did not draw conclusions about addiction, when a quick scan of this “mere paragraph” shows they obviously did.

Oddly, the only other study or source cited in the entire film was another New England Journal of Medicine study (citation not given in film). The narrator allegedly quotes from this unnamed study saying, “76% of those seeking help for addiction, began by abusing prescription meds, primarily oxycontin.” That raises a lot of questions, most importantly, how many people is the study referring to? Why did they begin abusing prescription medication? How did they obtain that medication in the first place (legally or illegally)? How quickly did they transition from prescription medications to whatever they were now seeking freedom from? What were they now abusing? Does it matter what they started on, or is it more important to learn why they started?

Exploring the reasons for addiction and how it occurs is extremely important; some people begin their addiction journey by abusing paint fumes, alcohol, or other drugs/substances, but neither paint nor alcohol requires a prescription to purchase.

But this figure, claims the film, “draws a direct line between Purdue’s marketing of oxycontin and the heroin epidemic.” Yet even the film goes on to admit that once Purdue Pharma addressed the issue of oxycontin abuse via tampering by inventing a tamper-resistant pill, the rates of prescription drug abuse went down and heroin began to rise.


Curiouser and Curiouser…

Also repeated ad nauseum throughout the film, is the unsubstantiated belief that there is no difference between legally prescribed and responsibly used opioid medications and heroin. Prescription opioids like Vicodin (hydrocodone) are consistently and erroneously referred to as “heroin pills” and “synthesized heroin” throughout the film (and elsewhere by Dr. Kolodny). Hydrocodone IS NOWHERE NEAR as strong as heroin, and notice how much stronger bupenorphine is compared to heroin! These charts show the compared strength between common prescribed opioids, and commonly abused street drugs.

Opioid strength chartrelative strength of opioids from oral morphine to carafentanil


More Bad Science…

“Horrible statistics on teens taking opioids. I think a few years ago it was more than 10% of 12th graders.” – Chris Evans, PhD (emphasis added)

Again, this stat gives no source or context leaving out information that would make it less sensationalized. Like the fact many 12th graders undergo a common, painful, but short recovery surgery called “wisdom tooth extraction”, and if 10% are addicted (which neither the stat nor Evans actually states), that means 90% ARE NOT. *It should be noted that Chris Evans, PhD, claims neither to be a medical doctor, pharmacist, drug expert, educator, or any other related expert.

In the second-half of the film, the plight of heroin babies is addressed, and the tragedy of children in foster care due to the heroin epidemic is highlighted, but becomes mischaracterized during an interview with Julie Gaither PhD, MPH, RN, Yale School of Medicine and child abuse researcher, calls it a “prescription opioid epidemic.”

Further confusing the issue, the filmmakers include the drastic, unscientific claims of Joel Hay, PhD Professor of Pharmaceutical Economics and Policy at USC, who is not a medical doctor, clinician, ER doctor, chronic pain patient, or related expert in the field of pain management, yet declares in an interview:

“The damage that’s been done since then [referring to Purdue’s oxycontin marketing], in terms of the number of people taking not only oxycontin, but many types of opioids for conditions that really have–there’s no value for these drugs.” – Joel Hay, PhD Professor of Pharmaceutical Economics and Policy, USC

At one point, the film admits to the high recidivism rate within 1-2 years, of those they interviewed who struggle/struggled with addiction. Therefore, the key to stopping this “epidemic” is bizarrely revealed by Jeanmarrie Perrone, MD Perelman School of Medicine, University of Pennsylvania:

“We need to stop new cases from feeding into it…that’s what we did with Ebola.” (except this isn’t a biological agent spreading like Ebola)-my emphasis

To the filmmakers and Dr. Kolodny, that means preventing access to pain medication, even for legitimate pain.


Destructive Claims About Chronic Pain

Chronic pain is addressed in the film, though in subtle, confusing, and misleading ways. Near the beginning, a female investigative reporter claims, “People with real chronic pain finally got relief from oxycontin; got their lives back.” That should be something to celebrate, right? As the film progressed, 6 people who were originally featured in a Purdue Pharma ad for oxycontin were highlighted. Purdue even did a 2-year follow-up ad with the same people, showing they were neither addicted nor dead from overdose, neither did they feel differently about how their medication had helped them.

New Yorker Quote
“The Neuroscience of Pain,” by Nicola Twilley, New Yorker

When, “Do No Harm” was made, the filmmakers revealed that many years later, 3 of the original female patients still felt the same way about their medication, while 2 males had died of unrevealed causes. Though all of the patients were older, the film ominously (and potentially slanderously) stated they had died, “of reasons thought to be related to their opioid addiction.” Considering the film’s strict and unscientific stance that anyone who takes opioids for any reason is “addicted”, there is really no way to interpret the narrator’s vague statement. The last patient had been interviewed for a PROP (headed by Dr. Kolodny) commercial sometime prior to the film, and that clip was shown. Since her Purdue commercial debuts, she had lost her insurance and therefore her medication. She never denied having relief from the medication, and never admitted to addiction or feelings of euphoria, but still claimed she, “would probably be dead,” from oxycontin overdose by now, and described the medication as “synthetic heroin”, though it is not clear why she thought that. The narrator went on to describe her as, “one of the lucky survivors.” Her current pain, disability, and lifestyle were never addressed.


Helping Keep Grandma “Clean”?

Without providing evidence from even one pain specialist or any study, the film went on to claim that elderly patients will (not “can”) get addicted to their medication, describing one unnamed grandma who doctor-shopped for reasons unknown (though the film, of course, assumes this grandma was trying to get high), and another grandma named Linda, who had been struggling with apparent over-medication, although the film’s narrator describes Linda as having been “addicted” (neither Linda nor her doctors described her this way). Once a correction in dosing was made (never revealed in the film), Linda was able to have improved quality of life and seemed quite happy, yet the film characterized her story this way, “Linda lost years of quality of life by innocently trusting her doctors…”

Statistically, the elderly make up the majority of the roughly 100 million American chronic pain patients, suffering daily, hourly, from severely painful and debilitating conditions like arthritis, joint pain, hip pain, knee pain, back pain, and more. Many undergo major surgeries with very long recovery times, yet the filmmakers and Dr. Kolodny seem to feel it is imperative to allow elderly people to suffer in unbearable, crippling pain that is easily preventable, in order to “prevent addiction.”


Conflating Pain and Abuse

Yet, while there was no evidence of abuse in either of the elderly women featured, the film quickly switched to the stories of pain patients (all but one suffering from acute, short-term pain) who had started abusing their medications and had quickly progressed to heroin.

Although numerous medical studies (also here, here, here, here, and here) over the decades have shown that pain patients without a prior history of abuse are statistically unlikely to become addicted, the film did not make it clear whether any of these patients had a history of prior abuse or mental illness, and 2 of the 4 obtained their medications illegally from the start. In follow-up interviews it was revealed the one chronic pain patient (middle-aged) had remained clean from all narcotics for at least a year, but had been forced to leave his job due to disability and move in with his parents. He had lost his career, his independence, his finances, and his personal identity (as he describes it in the film), but hey, at least he wasn’t “addicted”.

The next interview (still in the section about chronic pain patients) featured an addiction specialist who stated:

“The most challenging are the opiate addiction patients, because when people are dependent on opiates and it’s controlling their life, you’re dealing with a monster the size of that wall…It changes their thinking.” He goes on to describe the dishonesty associated with addiction.

Another addiction specialist with no clinical experience regarding pain patients, claimed people in chronic pain and their doctors can’t tell the difference between withdrawal and the associated pain, and their chronic pain. It did not seem to occur to that specialist that withdrawal pain will subside in a matter of days, and chronic pain, is, well CHRONIC.

Finally, giant text on the screen reads around the 38 minute mark, “Women over 45 have highest incidence prescription drug overdose,” while the narrator craftily says, “Women over 45 have the highest rate of accidental death–we think it’s accidental–of use and overuse of prescription drugs.” Did you catch that? “Use and overuse of prescription drugs,” which may and may not include prescription opioids. It’s a dirty trick.

Women over 45 have the highest rate of prescription opioid use due to chronic pain, and they also, because of their age, have the highest rate of “prescription drug use”. It’s also true that women outlive men, making the “women over 45” population higher than other groups. It does not mean these women (or men) are addicted, and there is no evidence for that egregious claim!

Most chronic pain patients are trying to live, work, and play, not “get high” or escape their responsibilities. They have a proven track record for both their medical conditions and responsible use of their medication, and it is both discriminatory and defamatory to call them addicts because other people do not use the same medications responsibly or legally.

While the film promotes a zero-tolerance medication approach for chronic pain patients with legitimate, physical disabilities, most of whom are elderly, it also never promotes alternative therapies and legislating insurance coverage for those. It never champions pain research, or offers any real hope for pain patients at all. Chronic pain patients are used, instead, to conflate the false idea that all opioids lead to addiction, and are then left out in the cold, even though there is a large body of consistent evidence proving “less than 4% of those who abuse prescription opioids go on to develop heroin addiction.” Meanwhile, the film hypocritically calls for ongoing treatment of addiction using medication, and the number one and two MAT drugs are opioids!

“One of the problems we have with this epidemic is that people are not getting an acute illness that can be treated with surgery, or an antibiotic, or some short course of treatment. People have developed a chronic brain disease that needs management.” –Kelly Clark, MD, MBA, DFSAM, Addiction Medicine and Psychiatry Louisville, KY

I want to know why Dr. Kolodny and the filmmakers of “Do No Harm” feel that those with addiction deserve compassionate, ongoing treatment, including with medications that happen to be opoids (bupenorphine), but law-abiding, responsible chronic pain patients do not deserve the same.


Recap

What the film did not have:

  • It did not feature one pain specialist.
  • It did not feature more than 2 chronic pain patients;
    • 1 who had been over-medicated in the past and was doing well on a reduced dose (not revealed in the film).
    • 1 who was on no medication and had been forced to leave his job and move in with his parents in his 40s-50s due to his now-unmanaged pain.
  • It did not feature a pharmacist.
  • It did not feature a pharmacologist.
  • It did not feature representatives from the FDA, CDC, NIH, or any other government health agency.
  • It did not feature more than 1 study to back claims made throughout the film.
  • It did not feature accurate, verifiable statistics, but it did include a lot of “we think…” and “probably”.
  • It did not feature what might be termed “facts”.
  • It did not feature an unbiased approach.
  • It did not feature personal responsibility.
  • It did not explain why it is ok for addicts to have ongoing medication assisted therapy for their “chronic disease” of addiction, but not ok for law-abiding chronic pain patients to have ongoing medication assisted therapy for their chronic diseases.
  • It did not feature alternatives for chronic pain patients, no acknowledgement of their very real pain and disability from lack of treatment, no help at all. Meanwhile, the film strongly criticized hospitals, doctors, and other medical personnel for not finding alternative therapies for addiction patients, for not acknowledging their pain and disability from lack of treatment, from turning them out on the street with no help at all.
  • It did not show how the suicide rate has gone up an alarming 30% between 1999-2016, the exact years opioid prescribing was strictly reduced and began a downturn. Not only that, the rates have gone up among those age groups most likely to be chronic pain patients.*

What the film did have:

  • Giant text that read, “From 1999-2017, over 500,000 opioid related deaths.”
    • Except this stat is untrue. According to the CDC’s own data, the estimated number of deaths during that time frame was 123,560.
  • Claiming the opioid epidemic can be “traced back to Purdue’s oxycontin,” in 1996, as if the heroin epidemic of 1976 never happened, as if people never used opioids before 1996, and as if doctors haven’t known for literally all of recorded medicine (5000 years) the pros and cons of opioids.
  • It did feature highly emotive language and muckracking techniques.
  • Screaming babies.
  • Bias.
  • A dizzying back-and-forth and mash-up of arguments that made the film hard to keep up with.
  • It did feature inflammatory statements about doctors, the FDA, pharmacists, pharmaceutical companies (Purdue Pharma, especially), and the medical community in general. An interesting approach, since Kolodny was quite unhappy with my own “Open Letter…”
  • It did reiterate everything Kolodny himself has ever said on the subject.
  • It did manipulate grieving parents, lying to them, and harnessing their natural, good desire to make a positive change; to make their child’s death meaningful. As a parent who has lost a child (though not to heroin or drug overdose), that has made me more upset than anything else in the film, and shows just how low the anti-opioid crusade will go to make itself heard.

Sources Cited:

http://www.donoharmdocumentary.com/

https://ramblingsoapbox.com/2018/06/26/an-open-letter-to-dr-andrew-kolodny/

https://lptv.org/do-no-harm-the-opioid-epidemic-3/

https://www.addictioncenter.com/treatment/12-step-programs/

https://beittshuvah.org/treatment/residential-program/

https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain?mbid=contentmarketing_facebook_citizennet_paid_magazine_the-neuroscience-of-pain_2-4-visit

https://www.ncbi.nlm.nih.gov/pubmed/18489635

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711509/

https://www.ncbi.nlm.nih.gov/pubmed/15102251

https://www.ncbi.nlm.nih.gov/pubmed/2873550

https://www.ncbi.nlm.nih.gov/pubmed/18164924

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073133/#!po=13.0952

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940677/


Further Reading:

https://www.politico.com/magazine/story/2018/02/21/the-myth-of-the-roots-of-the-opioid-crisis-217034

http://ehealthmagz.com/2018/07/20/chronic-pain-patients-did-not-cause-opioid-epidemic/#comment-77

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15 thoughts on “PROPaganda, Part 2 of 2

  1. Also missing from this film and other PROP screeds is Dr Andrew Kolodny’s conflict of interest. He’s one of 2 Kolodny’s serving on the Board of Directors of Physicians Reciprocal Insurers, a malpractice-insurance company that obtained a waiver from New York legislators, allowing it not to issue a mandatory annual statement of it’s financial condition for 9 of the past 10 years. The single biggest claim lawyers make for their clients in malpractice cases, is for the “pain and suffering” that results when doctors botch a job of surgery or other treatment. Lobbyists for the malpractice insurance industry are trying to get a “pain-and-suffering” damages law passed, that caps damages at $300,000, no matter how much harm the patient actually suffers. By libelling and slandering every person with pain, Dr Kolodny’s insurance company helps win an argument for the $300k limit of patient’s rights. Was Kolodny’s insurance company already in financial trouble when it began lobbying for the damage cap? How much money did Kolodny’s insurance company spend on making this “documentary”? How much money does Kolodny’s insurance company donate to PROP, with which to pay Kolodny a full-time salary to work as PROP’s Executive Director? How many of Kolodny’s competitors decided to collude with him and are also paying PROP money? And how much money does Kolodny’s insurance company pay to media companies for political advertising of some sort? We can’t know the answers to those questions without a subpoena, because that reporting waiver granted by New York legislators, enables Kolodny’s insurance company to conceal all of these facts from the public.

    The CDC should have asked those questions before they let Kolodny advise them on opioid policy, a subject that’s outside their area of expertise. (CDC is a research unit of the Public Health Service specializing in communicable diseases. The research units of the Public Health service that specialize in addiction treatment are the National Institute of Mental Health and the National Institute of Drug Abuse. Curiously, PROP did not approach either group of subject-matter experts on opioids to ask them to craft a policy on opioid use…and instead, went to CDC where no experts who could question Kolodny, were at work. Addiction is not a communicable disease.).

    Congresswoman Mia Love of Utah has introduced a bill, the Write The Laws Act, that would require Congress to hold hearings on all new proposed federal regulations and vote whether or not to approve them. I think this Kolodny CDC disaster amply demonstrates the problem Rep Love is trying to fix: When bureaucratic agencies don’t even understand what their responsibilities actually are, and they begin pushing and shoving one another over authority to regulate something, real harm results to the public.

    Meanwhile, it’s time for the Justice Department to appoint a Special Prosecutor to look into this Kolodny mess.

    Liked by 1 person

    1. Do you happen to have a source? In my home state of Ohio, such malpractice cases have already been capped, and no lawyer wants to take one! Also, Kolodny first tried to approach the FDA with no luck, then turned to the CDC where he allegedly had a personal connection with Tom Friedan.

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      1. The Albany Times-Union has written a series of articles on this topic, dating from way back when everyone in Albany assumed that Hillary Clinton would become President and could orchestrate a federal bailout of the industry, to go with the damage caps. With the ongoing Trump scandals there’s nobody willing to stick their neck out any longer, and the Times-Union is now kinda bluntly pointing out that Kolodny’s company is quite likely in financial trouble, and the State of New York would have to force every insurer in the state to raise rates and pay for the bailout. Here’s the latest Times-Union coverage on the topic: https://www.timesunion.com/tuplus-local/article/Amid-scandal-and-fiscal-woes-insurance-mogul-10861319.php A year ago the Times-Union was much more circumspect than they are right now. What created the problem was the 2011 disaster at New England Compounding Center, who shipped a batch of unsterilized epidural anesthesia meds that gave 13,000 people fungal meningitis and arachnoiditis. New England Compounding was a cheap-end generic drug maker that didn’t own anything other pharma firms or Wall Street corporate raiders wanted to buy, so faced with damage claims from 13,000 seriously-sick people they went into Chapter 7 liquidation and the 13,000 seriously-sick people lawyered up and sued the anesthesia doctors who injected them with contaminated medicine, alleging malpractice. The malpractice laws generally cover accidental damage…no showing of intentional negligence is needed, merely harm, to prevail in a malpractice case. So 13,000 people sued their doctors and malpractice insurers had to pony up the money. PRI, if the Times-Union story is correct, is the company least able to pay it’s share of the damages. Curiously, way the bleep back in 2012 when the New England Compounding story was first breaking, Andrew Kolodny threw together this pressure group called PROP, and petitioned the FDA seeking an upper limit on pain meds dosing. Since arachnoiditis is the 2nd-most-painful disease known to science, (more painful than any known form of cancer), what speaks volumes is that the PROP petition to FDA tried to argue that opioids were to be used for Cancer Pain Only. And PROP invented the concept of a Milligram Morphine Equivalent (MMEQ), giving absolutely no indication of how that MMEQ number was to be calculated. Their petition was so full of factual errors that the opioid experts at the FDA rejected it and told Kolodny to correct the errors before they’d reconsider it. PROP sat on their butts for 3 years and did nothing. Effectively, PROP was masquerading as a charity while lobbying for PRI. PROP’s own website (Google it) announces that PROP’s budget is generously donated by the Steven Rummler Hope Network of Minnetonka, Minnesota. Who the bleep is the Steven Rummler Hope Network? If you Google them, you will read that Steven Rummler was a rich kid who died of an overdose and his parents incorporated a 501(c)(3) charity…and put Andrew Kolodny on as their Medical Adviser (later joined by other doctors local to the Minneapolic metro area). Effectively, money can pass from PRI and other malpractice insurers, drug companies, and any other corporation wanting to curry favor, directly to the Steven Rummler Hope Network, and be passed on to PROP. October of last year, the Rummler Network held a $5,000-a-plate fundraiser at the Westin Hotel in Minnetonka. Clearly there are people paying big bucks to curry these favors. Bottom line is that the money is laundered through the Rummler charity to PROP. As long as Kolodny had friends in high places who could eventually pay a Federal bailout, he really had no worries, and that’s what drove the competition to collude with him, I expect. After all, if it bailed out a company that was failing, it could make better-run malpractice insurers filthy rich! If you have Evernote, I can share with you about 300-500 articles I’ve clipped on this story over the past year…but you may need to do some searching to put all the pieces together. I’m still putting pieces together myself.

        The basic problem caused by the Trump scandals and their failure to actually dislodge Trump from the White House, is that now nobody can quietly finesse the money over to these companies, out of view of most taxpayers. Any move to give them money will be noisy and public. Too many Trump people are out to get something on the Special Prosecutor. That means nobody can approach the Special Prosector with any kind of a payoff, offering if he looks the other way, some way they can pay people off with money they steal from taxpayers.

        What Hillary Clinton originally intended to do was a Medicaid expansion, that would let people who weren’t completely 100% broke, collect Medicaid. And what Kolodny wanted to do to the 13,000 New England Compounding victims, is take away their pain meds, force them to lay in bed and be unemployed, and led Medicaid take over caring for them. That, basically, would allow doctors to pay lower malpractice premiums and would, in theory, make Affordable Care nearly affordable for some people.

        Without Hillary around to orchestrate the political moves, things are getting problematic. Like Dr Strangelove, the prosthetic arm that does the Nazi Party salute keeps flying out of control at the most inopportune moments.

        Of course, Trump’s ace-in-the-hole is the human trafficking business that’s been illegal since 1987 but flourishes. Since 1987 it’s been against the law for an employer to hire people, unless the workers present a photocopy of either a birth certificate, naturalization papers, or a valid US visa allowing them to work. To compute their liability to pay Social Security Tax, employers must know who is a citizen, who is a resident alien seeking citizenship, and who is a temporary visitor to the US, such as an actor or a college student…and the IRS insists that employers be able to document this when audited. There would not be millions of people slipping across the border illegally, if there were not millions of jobs they could do, for tax cheats who desire not to obey the Social Security Tax law. This is a major embarrassment for both Republicans and Democrats, for nobody since Barry Goldwater has campaigned on shutting down Social Security…and Social Security goes bankrupt a lot faster when millions of tax collections for it, go uncollected. There are tax cheats who align with both major political parties and try to pay off local politicians to avoid scrutiny of their activities. An awful lot of kids grew up in barrios, watched their parents suffer working for sweatshops run by crooks, understood the fear of deportation, turned 17, enlisted in the military, got out, and now have jobs working at the Homeland Security Department. Those folks get what’s actually been happening. A lot of them are oiling up the handcuffs, waiting for a chance to make a move.

        Bottom line is, we can’t have tax cheats making up the rules for how honest taxpayers are to be taxed. Affordable care won’t ever be affordable if tax cheats don’t pay taxes to fund the system.

        And the only reason the system could get that thoroughly corrupted, is that patients, the people in whose name all the healthcare money is spent, have zero say over how it is spent.

        That’s entirely due to the belief that some people will over-consume care, in the form of pain medicines that are supposedly addictive. If we simply left it up to people to say whether we are sick or not, and decide whether our treatments helped or not, patients could control this entire flow of money to the.healthcare system and we could do it cheaper than all the thousands of money-counters who hold up the movement of money in the system.

        Bottom line is: It’s an ugly mess, and cleaning it up is going to put all of the ugliness right out in public view. There’s no getting this toothpaste back in the tube.

        Like

        1. Whew! That was a lot of information! I tried looking up sources, including the article you linked to, but didn’t find anything about Kolodny having ties to PRI, or anything else. I’d be interested in seeing your other sources, if you’d like to send me an email.

          Like

  2. Excellent article, Loura. Well researched and competently organized. I would offer one minor correction and a point of additional emphasis, if I may.

    Published CDC statistics reveal that women have somewhat lower rates of opioid prescription than men. But this is almost certainly due to the fact that women have more pain than men but are under-treated for their pain. The disregarding of women’s reports of illness and writing off their medical complaints as “hysterical” is a well known bias of medicine. This bias is largely responsible for women’s higher mortality statistics during hospital ER visits for heart attacks.

    On the other side of the statistics, CDC also reveals that the mortality rates among people over age 50 due to opioid overdose related causes have been stable and low for the past 17 years. But it is precisely these people who have benefited most from liberalization of opioid prescribing under “Pain as the Fifth Vital Sign” in the 1990s and early 2000s. In 2016, seniors were 250% more likely to receive an opioid prescription than young people under age 30. But overdose rates in young people have continuously climbed over the past 17 years until reaching levels six times higher than in seniors. in 2016. These contradicting trends offer compelling evidence that exposure to medical opioids did not cause and is not sustaining America’s public health crisis with addiction and overdose deaths. Furthermore, the CDC knows of this contradiction and is stone walling efforts to force changes in opioid policy that it implies.

    Liked by 1 person

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