I am very concerned about the mislabeling of patients who suffer from pain that is being carried out in a wholesale fashion by some in the American medical community. This mislabeling is the result of the most dangerous combination in the world: good intentions and avarice. These two have recently combined to create distortions that are now to the point of wholesale fraud. Calling something what it is not can have devastating consequences, especially for such a politically charged diagnosis. The treatment of this affliction has always been problematic. Seen by some as a moral failing, justifying the death penalty in China and Arabia still today, it has always been imbued with a sense of shame. Starting with alcohol and progressing to opium, the few percent of our population that fall victim to this disease have never been treated humanely.

In today’s America, victims of these diseases die daily in our jails and prisons from completely preventable causes. Those addicted to opioids or alcohol die from the electrolyte imbalance of untreated vomiting and diarrhea or from the stress of their suffering through Takotsubo cardiomyopathy. These deaths are almost never investigated by the Justice Department’s Civil Rights Division despite the fact that only federal action could hope to change anything in state law enforcement. But the DOJ is too busy targeting doctors who treat pain and addiction to bother themselves with the deaths of a few thousand SUD patients. Even when a young type 1 diabetic woman is denied insulin and watched as she slowly dies, or a pregnant woman, also in her twenties, falls a dozen times and dies seizing in her own filth, they feel no need to intervene.

Hardly any politician and few doctors want to help anyone labeled as an addict, and law enforcement is rarely concerned if they die in custody. And that’s what terrifies me about a new paradigm shift in addiction medicine. This area of medicine is fairly new, being recognized only in 2016, and has struggled to gain prominence because of the prejudices related above. Then the opioid epidemic hit, and suddenly, these addiction medicine specialists had access to funding and support. With the epidemic also came an opportunity for law firms that had participated in the tobacco settlements to find a new deep-pocket target. Hardly any group of companies makes more money than those in the pharmaceutical industry, with profit margins that are the envy of the biggest oil companies.

These firms funded “grassroots” groups to advocate for what has essentially become opioid prohibition, demonizing an entire class of medications instead of the actions of a few unscrupulous companies. A few companies had indeed gone rogue, paying a few doctors to prescribe expensive opioid preparations, and some federal regulators to look the other way by offering speaking fees and other inducements to physicians and sweet, high-paying jobs to government employees in the DEA and FDA. Somehow, these actions were considered a federal crime for the doctors and perfectly fine for the regulators. But now the ball was rolling: Netflix made a sensationalized but pretty good movie called Dopesick, and then an insanely biased one called Pain Hustlers, where every doctor treating pain is willing to sacrifice everything they had worked decades for to get a vacation on a beach.

The seemingly almost powerless but dogged federal attorneys were painted as heroes, fighting to protect the poor patients from those greedy doctors. Compared to Reefer Madness, it was much more entertaining; who doesn’t love Captain America? But it was so over the top that even Glavlit would have blushed. And now, after billions have been paid to the law firms and states and thousands of physicians have been shut down or arrested, the ball is still rolling. Pain patients have never been easy to treat. They remind us daily that we are not yet masters of the human body. Despite our mastery of surgery and possession of new genetic tools, there are conditions we cannot cure. Even oncologists can have hope that a new chemotherapy agent will cure their patients, but only the most compassionate of physicians are willing to see and treat this suffering on a daily basis.

And these patients cost. Drug tests, imaging studies, and EMGs cost insurance companies, and state and federal medical systems. This is a problem for those who don’t support social safety nets, and they have found a solution. About 21 percent of the American population suffers from chronic pain, with 8 percent having high-impact chronic pain. What if we could relabel all of these patients as addicts? As crazy as it sounds, I can show you videos of lecturing physicians saying that chronic pain patients are all just faking it for that sweet disability payout, about $6,000 per year. Insisting that these people don’t need doctors, that they, like poor little Regan from The Exorcist, just need a priest. Yes, this physician was a psychiatrist, and she gets paid between $30,000 and $50,000 to give one of these speeches. Physician, heal thyself.

Another psychiatrist spoke at a recent addiction medicine conference and opined that, despite over a century’s evidence to the contrary, opioids don’t treat pain; they provide a psychological crutch. That anyone who had developed tolerance or withdrawals was indeed “addicted,” no matter what the DSM-5 said, and that all of them just needed the gentle embrace of buprenorphine. I think these speakers should be forced to wear NASCAR suits with the names of their sponsors so we can see who is paying for these opinions. One doctor there listed “no conflicts” despite having taken hundreds of thousands of dollars from opioid liability law firms and even more from the federal government to help incarcerate physicians who don’t share his opinions on opioid prohibition.

Why would insurance companies, law firms, and the federal government all want to push this agenda? If opioids are poison, then lawsuits will earn states and law firms billions. If pain patients are all addicts, then we don’t have to keep trying to cure them since “once an addict, always an addict” is now treated as holy writ. And we can only prescribe them methadone or buprenorphine. The former requires daily visits, and the latter replenishes the coffers of those same pharmaceutical companies so they can be ready for the next payoff. I may be jaded by what I have seen over the last five years as I devoted myself to the study of these issues, but I don’t think I’m wrong. I have heard addiction specialists say, on video, mind you, that even if an abandoned pain patient doesn’t have an addiction, say they do so you can treat them with buprenorphine.

I implore you, my colleagues, NOT to take this advice. Many addiction physicians and psychiatrists who treat anxiety and ADD have sat back and smugly cheered the destruction of their pain management colleagues, buying into the hype and disinformation, while a few stood by in terror, knowing that their time was coming. Do you think any federal agency ever goes to Congress and says, “We solved the problem; now defund us?” No. They redefine the crime so that they have new targets. When fentanyl poured over the border, killing thousands, the DEA understood it would be hard to solve that problem. So they redefined doctors treating pain as “drug dealers” and blamed prescription medications for the fentanyl poisoning deaths, causing the deaths of tens of thousands. Now, everyone is too scared to treat pain effectively, and the DEA is running out of easy targets.

So get ready for the next wave of propaganda to explain how treating patients through telemedicine is shady and that the recognition of adult ADD is a scam created to allow the white coat drug dealers to peddle their new poison, stimulants. Then, there will be a clampdown on addiction treatment centers, where they will be prosecuted for fraud, with those video self-confessions played in court as proof. The only solution is for physicians from every area of medicine to recognize that this is not just an attack on a few “bad” pain doctors. This is the start of a movement to give the federal government complete control over the practice of medicine in America. This is contrary to federal law, as I keep saying, but since no one has the power to enforce any law on federal agencies except Congress, we are on our own.

Doctors have three tools to stop this. One, every time a government-paid medical expert witness makes a false statement to a jury to secure a conviction and that big paycheck, doctors should write an amicus brief to the appellate court pointing out the false statements. If you want to become adept at this skill, there are classes offered by a doctor who has learned the process and filed in support of Dr. Xiulu Ruan. Second, make the same argument in the form of a complaint to the experts’ individual state medical boards. The AMA has an excellent policy to hold these doctors to account, stating that their testimony must conform to the following rules. The government is enforcing the extreme practice of medicine only because these physicians are willing to put greed over the good of all:

• Reflects current scientific thought and standards of care that have gained acceptance among peers in the relevant field.
• Appropriately characterizes the theory on which testimony is based if the theory is not widely accepted in the profession.
• Considers standards that prevailed at the time the event under review occurred when testifying about a standard of care.

Third, and probably the hardest, we must start working toward some type of legal insurance to protect doctors from politically based criminal charges. It has gotten to the point that any law enforcement agent or politician with a badge can target any physician prescribing any controlled medication to any patient for any reason. This must stop. Even though the risk to any individual physician is rare, the effect on the medical community is profound. When innocent doctors like Dr. William Bauer, Jay Joshi, and Terry Sasaki are thrown in prison to make a point, we all know that we practice at the pleasure of whatever aggrandizing politician or U.S. attorney happens to be in our area. This is destroying the very spirit of innovation and independence that has made America the center of medical advancement for the last hundred years.

To borrow from Franklin, we must, indeed, all hang together, or, most assuredly, we shall all hang separately.

L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues. 

He can be reached on LinkedIn and YouTube.