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 ...

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Trump recently declared a national public health emergency. In this statement he was not talking about HIV or hepatitis C nor was he referring to the increased incidence of gun violence in the country. The president’s statements focused on a very different public health problem; he was talking about America’s high incidence of opioid-related deaths mostly from overdose. This declaration has been met with various pronouncements ...

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Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. ...

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Prescription opioid abuse is one of the United States’ greatest public health challenges. Approximately 97.5 million Americans consume opioids annually, and around 90 people die every day from opioid overuse. The last time in recent history a health care crisis garnered this much public attention was following the release of the 1964 “Surgeon General's Report on Smoking and Health” correlating smoking to heart disease ...

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No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice. I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in ...

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Drug overdose deaths, once rare, are now the leading cause of accidental death in the U.S., surpassing peak annual deaths caused by motor vehicle accidents, guns and HIV infection. As a former public health official, clinician, and researcher, I’ve been engaged in efforts to control the opioid addiction epidemic for the past 15 years. The data show that the situation is dire and getting worse. Until opioids are prescribed ...

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Future generations will look back on the opioid epidemic as the greatest tragedy of modern medicine. The recent 60 Minutes special about drug distributors really highlights that manufacturing and prescribing opiates was never about the best interest of patients. The pharma companies saw a business opportunity that could be exploited by offering patients a little pill to take their pain away. What person, given the chance, would ...

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“Do not get caught” seems to be the real rule of the law in South Florida, where I live. I was trained to limit the use of controlled substances, narcotics, hypnotics and sedatives. Their use can affect consciousness, ability to drive a car and work.  More severe consequences include respiratory depression and overdose from too high of a dosage or mixing too many medications and over the counter items. The Joint Commission, ...

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How can we combat the opioid epidemic? One of the government’s most recent suggestions is to take Opana ER, an opioid indicated for very severe pain, off the market. The request, filed by the U.S. Food and Drug Administration in June, was linked to concerns of abuse-related HIV and hepatitis C outbreaks. But removing access to opioids altogether isn’t the solution. There are individuals suffering from ...

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In order to fully understand the issues surrounding opioid prescribing practices, it is important to review a brief history of how these drugs came to market. Opium was the first opioid, derived from the sap of opium poppies whose growth and cultivation dates back to 3,400 BC. In the 18th century, physicians in the U.S. used opium for multiple ailments. Towards the end of the 18th century, the addictive qualities of ...

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