We’ve all heard about the out-of-control Opioid Epidemic; 42,000 died of opioid overdoses in 2016. It’s gotten so out-of-control that people are being told to carry Narcan with them in case they come across someone who has OD’ed on opioids! But what do we really know about this crisis and how did it get so bad?
I knew before I went to med school that allopathic medicine had a bad track record with pain. That’s why I wanted to do an acupuncture elective in my second year. There were only 2 acupuncturists in the whole city of Halifax at the time. I chose the Chinese anesthesiologist, who did allopathic medicine by day and practiced acupuncture on his off hours. I was teased and taunted by my classmates but I suppose I asked for it because I would practice my needling technique between classes by puncturing a defenseless apple. The resistance of the apple skin presumably matches that of a human!
In my Naturopathic training I learned about homeopathic remedies for pain. The most famous of which is Arnica – for pain, shock, swelling, bruising, and bleeding. Many cosmetic surgeons use Arnica for better cosmetic results. Since many of my fellow students in Naturopathic classes were chiropractors, I developed an appreciation of that art. That appreciation over the years extended to massage, myofascial release, Egoscue alignment, the Alexander Technique, the Mitzfah Technique. I also learned about Therapeutic Touch, EFT (emotional freedom technique), and the work of Dr. John Sarno a Rehabilitation Professor, who helped patients identify the emotional component of pain and release that emotion along with the pain.
And, of course, there is magnesium. Epsom salts baths, oral ReMag, transdermal ReMag lotion are all incredibly effective to help pain and inflammation. A new addition to my pain management repertoire is Pico Silver Solution. So many people have commented that a sinus, tooth, ear or joint pain went away with Pico Silver that I realized how much subclinical inflammation and infection people harbor. I recalled in my Chinese Medicine herbal and acupuncture training in New York that the body will defend the internal organs against infection by diverting the organisms to the outer body, especially the joints.
Instead of the wealth of knowledge that could be learned from chiropractors, masseuses, Chinese Medicine, and other healers, allopathic medicine put all its attention on drugs to suppress pain. Unfortunately too many doctors became drug pushers with revolving door practices. Since opioids are controlled substances, doctors were directed to give out scripts on a short term basis. However, doctors could use the weekly script writing as a way to earn their Medicare payment and only have to spend a few seconds with each patient. You can imagine that word got around. I’m sure it was lucrative and very tempting for some doctors and led to a pattern of abuse, addiction and overdose.
Besides racking up patient fees, a recent Medscape article titled “Opioid Makers, Blamed for Overdose Epidemic, Cut Back on Marketing Payments to Doctors” alerted me to the fact of opioid kickbacks. It was a bit of a shock since I thought that kickbacks to doctors had been outlawed years ago. I wrote about this in Death by Modern Medicine. However, according to a 2014 report by CBS about the ties between doctors and Big Pharma “It’s illegal to give kickbacks to a doctor to prescribe drugs, but it is legal to give money to doctors to help promote your drug. Some doctors make tens of thousands or hundreds of thousands of dollars a year beyond their normal practice just for working with the industry.”
Supposedly the payouts are decreasing. In 2016, drug makers spent $15.8 million to pay doctors for speaking, consulting, meals and travel related to opioid drugs. That was down 33 percent from $23.7 million in 2015 and is 21 percent less than the $19.9 million in spent in 2014. But I’m sure they will find another way to compensate their best performing doctors because the overall payout is incredible. There has been more than $9 billion in payments since 2013 to more than 900,000 doctors.
The Medscape article talked about Purdue Pharma, the maker of OxyContin, of aggressively marketing the powerful narcotic even after it knew the drug was being misused. Charges have been laid against Insys Therapeutics for allegedly bribing doctors to use its fentanyl spray for unapproved uses. You can read about how the DOJ got into the act on June 28, 2018 in the following press release “National Healthcare Fraud Takedown Results In Charges Against 601 Individuals Responsible For Over $2 Billion In Fraud Losses.” The byline read “Largest Health Care Fraud Enforcement Action in Department of Justice History Resulted in 76 Doctors Charged and 84 Opioid Cases Involving More Than 13 Million Illegal Doses of Opioids.”
We can only hope that people who require legitimate pain control will get the opioid they need but also be offered alternatives as they wean off a short course of the addictive drugs. Maybe that’s where you, the reader, comes in to remind people that there are alternatives that put them back in control.
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Carolyn Dean MD ND
The Doctor of the Future®
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