To stop the opioid crisis, the war on physicians must end


The present state of our nation can be traced back over the past five decades to the concerted efforts of specific entities, their goals based on profit and power, who set specific plans in place to maximize their control of same. Over the past 40 years, two such plans were woven together as they brought us to our present war on physicians and patients.

One plan was created by increasing private prisons during the Nixon administration for the expressed purpose of incarcerating minorities charged with drug abuses and calling it a “war on drugs.” Nixon’s intended outcome — that of getting minorities off the streets and severely impacting their ability to live normal lives outside of prison — also suited the plans of other groups seeking political and economic control.

Despite this “war,” drugs continued to take over our nation as the greed for profit and power grew exponentially. Some groups saw the established financial success of physicians as a major threat to their own self-serving plans. They deduced that chronic pain patients, now finally receiving acknowledgment and treatment for their pain, could be both blamed as a source of street drugs and used to help bring down honest physicians. We were shown “statistical reports” that “prescription drugs” were the cause of overdose deaths in specific regions of our country. But when the deaths began to occur in white middle-class families, public outcry to increase the efforts of the war on drugs became deafening. There had to appear to be some effort to control the drugs, so draconian measures were set — in some states by law, in others by regulation — that targeted the legitimate physicians who prescribed for pain patients.

Ultimately, patients were often cut off without warning from their pain treatment. For pain patients, it is a return to the terrors of intractable pain, inability to function productively in society and a potentially horrible death.

Despite the efforts of those who speak against punishing patients and physicians and the evidence showing the futility of this approach to the war on drugs, this situation continues to threaten the lives of both patients and their physicians.

Despite scientific proof that substance abuse disorder is an illness of the brain and can usually be well managed by an addiction specialist, legislators and law enforcement officials alike still only see “drunks and addicts” and still, after decades of failure, claim that incarceration/punishment is the only way to fight the war on drugs.

Despite, also, the logic that if you are fighting a war against a crime, you go after the source of the crime, rather than innocent bystanders. Without getting rid of the sources of the drugs, how much good is it going to do to punish the people who use them? We know that heroin and fentanyl are the greater causes of overdose deaths, yet we still hear and see propaganda about prescription drugs being the cause, in efforts to justify continuing the incarceration/punishment solution to the problem. Legitimate physicians are still blamed for the proliferation of death-dealing drugs.

The results? Consider the facts that every year more than 400 physicians commit suicide, that thousands of chronic pain patients suddenly deprived of their medication have either committed suicide or gone to the streets to get their medication, and many of these patients have also suffered unintended overdose deaths.

The over-reaching legal restrictions on prescriptions and the law enforcement mentality that believes physicians are guilty until proven innocent, are not the only reasons physicians are either opting out of practicing medicine or opting out of life altogether. If you are a physician, who has spent at least half the normal human lifespan studying and preparing to make life better for those who suffer, life may be becoming a nightmare.

Insurance companies dictate what treatments are allowable, as well as how often, and how long such treatments will be permitted. They do not refer to medical societies for their information. They refer to bottom-line profit indexes. Legislators who pass laws (when medical board regulations would more properly suffice) that limit what physicians can prescribe, and how often — arrange that selected physician’s offices and lives will be disrupted, the physicians in question treated as guilty of crimes before having a chance to be proven innocent. Those who are erroneously charged with the felonies that have been put in place as a weapon in the war on drugs never quite regain their previous public status of “innocent,” even when proven so.

Does it matter that these laws have only created chaos and confusion, betrayal and mistrust? Does it matter that physicians were already reeling from finding themselves backed into corners where they had to “sign on” to corporate health care entities that are run by non-medical administrators who decree when and how often they work, how many patients they will see for how long and paychecks determined based on computer-run quotas and outcomes? And finally, adding to the fears of losing their practices, their licenses and meaning attached to their life’s work, physicians in increasing numbers are being attacked and/or killed by frustrated, angry patients or their relatives.

Why is this ethically, morally and even logically erroneous approach to our drug crisis — which must be separated in our minds from medical care for chronic pain patients — continuing to exist as a modus operandi? Why are physicians who serve our communities targeted as criminals at worst and problem employees who must be managed at best? Sociologically, physicians have historically belonged to one of the highest prestige vocations in America. Their demotion to the present state is not through the fault of their own but through others’ sociopathic need for profit and power.

It is in our best interests to respect and protect the lives and vocations of our physicians. We must insist on humane treatment of chronic pain patients and their physicians. And we must fight the war on drugs on its proper battlefield.

Marylee M. James is a sociology professor and a former nurse.  She can be reached at Says Who?? Verstehen, through shared perspectives.

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