15 ms·

The news industry was complicit in the opioid crisis

166 points by danso 7y ago

BucketSort 7y ago
Let's be honest, what aren't they complicit in?
- happytoexplain 7y ago
  Broad condemnation of a broad group of a people is a dangerous path.
  - BucketSort 7y ago
    Right, corporations are people I forgot.
    - cameronbrown 7y ago
      They're made of people? Last time I checked the machines haven't taken over yet.
      - mieseratte 7y ago
        Companies employ people, but who do they work in service of?
      - w56rjrtyu6ru 7y ago
        A machine made of people is still a machine.
  - Clubber 7y ago
    Yes, but you have to admit, the news doesn't really serve its intended purpose of speaking out against power. It seems more like a conduit that's pretending it's not.
    - deleted 7y ago
      [deleted]
    - inetknght 7y ago
      News' intended purpose isn't just about speaking out against power. It's about providing a means for people to obtain information about current events -- political, medical, whatever. It's supposed to help augment your education. You know, the same education which is thoroughly gutted in America.
    - deleted 7y ago
      [deleted]
- duxup 7y ago
  What counts as complicit? Reporting accurately on what the medical community thought the answer was?
deleted 7y ago
[deleted]
ineedasername 7y ago
I think complicit is too strong of a word. They were reporting on the established (at the time) medical opinion. If the news industry hyped these drugs beyond what the medical establishment held to be accurate, then I would agree, but this article doesn't really indicate that.
- mieseratte 7y ago
  Perhaps news agencies should include some measure of due-diligence and skepticism, rather than parroting.
  - yifanl 7y ago
    Certainly, but skepticism doesn't mean reporting "nothing is true". When the vast majority of medical sources claimed opioids were safe, most media understandably wanted to avoid looking as conspiracy theorists.
  - ineedasername 7y ago
    You assume they didn't due any due diligence. Maybe they didn't, but maybe they did too. Either way, what would have sufficed beyond verifying that it was indeed the prevalent medical opinion of the time and that it wasn't contradicted in any significant way? It's not the role of news media to verify scientific research further than that-- it's the role of the research establishment which, yes, failed at that task until it was too late to avoid a crisis. If there had been significant opposition to this at the time, I would agree that news media failed. But I just searched through ProQuest and Google Scholar for research journals during 1990-2000 and I didn't find much at all that points towards significant risks of increased prescribing of these drugs. Quite the opposite, they pointed towards them being underutilized and leaving patients in significant pain despite low risk of addiction. As it turns out, doctors were wrong. But it's only in the last few years that the scope of the issue has really come to light. I can't fault the media for not knowing 25 years ago what the medical establishment has only recently come to accept.
    - mieseratte 7y ago
pjc50 7y ago
"Chronic pain is widespread and under-treated" may well still be true. It's just that opioids do carry a risk of addiction. This is partly why so many states have started legalizing marijuana, medical or otherwise. I don't really like this article's tone of press-blaming: ultimately the medical profession has to take responsibility for its treatment, both under- or over-treatment, and has its own responsbility to find out the facts and disseminate them through professional channels.
- codeddesign 7y ago
  Yes, but controversy sells papers. Ultimately the blame is on the pharmaceutical industries, the doctors, and yes the patients.
- bilbo0s 7y ago
  People are looking for anyone to blame. Drug reps. Doctors. Pharmaceutical firms. Now we've entered the "politicians/the media is to blame" stage. When something goes wrong in this spectacular a fashion, you can bet people will try to lay blame wherever they can. But probably the truth is that this was on all of us. Doctors for prescribing without disseminating incredibly pertinent information, Parmas for creating "medicinal" opioids in the first place, politicians for not admitting the need for stronger regulation earlier, media for not covering the story better earlier, the people for being in denial about the obvious signs of addiction in their friends and loved ones. I mean the list probably goes on and on.
  - Loughla 7y ago
    I'm with you on this. It's like conspiracy theories - people WANT someone to point to and say, "that is the person in charge, they're the reason this has happened." When in most cases, a really, truly shitty situation like this one does rely on the action of a few, powerful, bad actors, but mostly it's daily choices to simply not think made by all of us.
    - walshemj 7y ago
      Instead of banning any advertising of prescription meds to the general public.
nprz 7y ago
>A 2001 US News and World Report story described OxyContin as a “safe, effective medication with few side effects,” and put the chances of addiction at one percent >we now know that between eight and 12 percent of patients prescribed opioids for chronic pain develop an addiction I wonder how the state of the economy influences rate of addiction?
- codeddesign 7y ago
  I would imagine that the rate directly correlates with other additions such as alcohol. While addition happens to all classes of society, those in impoverished areas tend to have a greater concentration of addition (at least reported).
accounn 7y ago
world is run by scam business.
_iyig 7y ago
Seems like a good place to link Paul Graham’s essay on PR firms, and their relation with news media outlets: http://www.paulgraham.com/submarine.html http://www.paulgraham.com/submarine.html
deleted 7y ago
[deleted]
same_as_today 7y ago
Today the same media is praising Cannabis and CBD, and says that marijuana is the miracle cure for depression, ... Of course, you can't question that, especially on HN where every anti-cannabis opinion is downvoted.
- kibwen 7y ago
  This is a sweeping statement, can I ask for at least one sourced example? I've seen no source attempting to claim that marijuana is a miracle cure for depression, or that CBD is anything other than a fad propped up by a regulatory fluke. At most, I have seen articles regarding the potentially beneficial painkilling effects of marijuana for terminal cancer patients.
  - same_as_today 7y ago
    All of these articles from very reputable sources say that many view marijuana as a miracle cure. Of course, they are balanced and also question this narrative, but why do they say this view is widespread? > How one molecule from the cannabis plant came to be seen as a therapeutic cure-all: https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-cannabis-cure.html https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-... > More Australians are using medicinal cannabis to treat a host of health problems as reports of its supposed healing powers flood the media: https://www.theguardian.com/society/2019/aug/11/medicinal-cannabis-the-hype-is-strong-but-the-evidence-is-weak https://www.theguardian.com/society/2019/aug/11/medicinal-ca... https://www.theguardian.com/society/2019/may/05/cbd-a-marijuana-miracle-or-another-health-fad-cannabidiol-anxiety-epilepsy https://www.theguardian.com/society/2019/may/05/cbd-a-mariju... https://eu.usatoday.com/story/news/world/2017/04/25/marijuana-pot-treatment-children-autism-cannabis-oil/100381156/ https://eu.usatoday.com/story/news/world/2017/04/25/marijuan...
- saiya-jin 7y ago
  That's an extreme view, don't know where you are getting positive-only information feed. Like any mind-altering substance, it has its positives and drawbacks which are different from person to person. For me personally, the benefits far outweigh drawbacks. In society where things like alcohol and cigarettes/tobacco are perfectly fine although they provably destroy endless stream of families, lives and bring one of the worst possible (and costly to society) ways to die, having cannabis illegal is unfair and illogical. US prisons full of small time weed offenders, an event that effectively ruins one's professional life. Read a bit about history and why it was banned in US, which then pushed it to the rest of the world. Even to places like India where its used as religious plant for millennia. I strongly welcome legalization and hope the movement comes to Europe, and rest of the world soon. Society is better off if it is legalized (and regulated for things like access to minors/psychiatric patients, strength, purity etc). Now to advise it as panacea for mental issues is plain stupid. Go see an expert, that's why we have them. Same would go for stuff like LSD.
ademup 7y ago
I wish I could use the fallacious "No TRUE doctor would use The Times to inform medical decisions." Because it seems like it should be universally true. On the one hand I am glad this one is telling their truth, now I feel more informed. On the other, I am appalled and terrified that this may apply to a significant percentage of "true" doctors.
bigYahnz 7y ago
The "news" industry is complicit in just about every shit thing happening in this country.
caconym_ 7y ago
These days I don't think you can blame the media for anything without blaming the advertising industry as the upstream cause. We distribute unbundled nuggets of content that are optimized to get clicks (and to drive click rate, meaning you have to make your impact and turn the consumer around as quickly as you can), because that's what's incentivized by advertising-based revenue streams. Those optimizations are not compatible with accurate and balanced coverage of nuanced issues. I assume something similar was true in the 90s, or starting to be true, but I don't have as good an understanding of how it all worked back then.
- gundmc 7y ago
  It's pretty absurd to shift the blame to advertising. This wasn't the age of clickbait and adtech, this was over 20 years ago. 24 hour news channels like Fox News and MSNBC were in their infancy. Isn't there some responsibility to be had to uphold journalistic integrity? If anything, this article shows the danger of pop science and journalists writing authoritatively about things they don't understand well.
  - caconym_ 7y ago
    Maybe you missed the first two words of my comment: "these days". I did not restrict my context to 20 years ago, because neither does the linked article.
bpaddock 7y ago
My wife killed herself because of Chronic Pain. Her saga is required reading at Duke Medical School and has become part of the documentary Pain Warriors, to be released soon. The documentary covers the lives of those miss treated by the Medial Establishment, including doctors that treat Chronic Pain. Those with Chronic Pain are being left to suffer because of abusers. In April of 2019 the CDC stated that their "guidelines" are being miss applied. Sadly the damage is already done. https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html https://www.cdc.gov/media/releases/2019/s0424-advises-misapp... "CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations. In a new commentary in the New England Journal of Medicine (NEJM), authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) advise against misapplication of the Guideline that can risk patient health and safety. CDC commends efforts by healthcare providers and systems, quality improvement organizations, payers, and states to improve opioid prescribing and reduce opioid misuse and overdose. However, some policies and practices that cite the Guideline are inconsistent with, and go beyond, its recommendations. In the NEJM commentary, the authors outline examples of misapplication of the Guideline, and highlight advice from the Guideline that is sometimes overlooked but is critical for safe and effective implementation of the recommendations. CDC is raising awareness about the following issues that could put patients at risk:..."
- bpaddock 7y ago
  Dr Myles Gart wrote a piece entitled “Pain is not the fifth vital sign” Medical Economics on May 20th, 2017. http://medicaleconomics.modernmedicine.com/medical-economics/news/pain-not-fifth-vital-sign http://medicaleconomics.modernmedicine.com/medical-economics... This is my reply to Dr Gart's editorial, edited to fit the format here the best I can. “… First and foremost, we must bury the claim of pain being the fifth vital sign and replace it with a 21st Century pain assessment tool that incorporates objective evidence and measures of pain. …” Dr Gart, at this moment are you hungry? In your lifetime have you ever been hungry? Hunger is a type of pain. Did you treat that pain by consuming a substance? Please correct me if I am wrong. To my knowledge there is no objective test, no simple Pain Meter, that will show me that you are hungry. Yes we could look at enzymes and such. Will that truly tell me just how hungry you are objectively? If there is no objective test for a pain as simple as hunger, that each of us experience most every day, what hope does a person in Chronic Pain have? In Ohio the Governor is now practicing medicine by decreeing that there can be no more than seven days of opiate pain medication. Perhaps he should discuss that with the person that was hit by a train and survived with most every bone broken. My wife Karen died of suicide to stop the pain she experienced for over over 20 years, due to the failure of the Medical Establishment as a whole. THIS IS THE REALITY OF Chronic Pain. "Karen's Journal of CSF Leak Headaches and Chronic Pain: How Intracranial Hypotension and Levaquin (Levofloxacin) Killed Me" is now required reading at Duke School of Medicine to educate future Neurologists about the realities of Chronic Pain. A local reporter wrote in a Cover Story: "Karen's first-hand account of her illness gave an honest, heart-wrenching depiction of what it is like to live with debilitating pain day-to-day." – http://www.kpaddock.org http://www.kpaddock.org May I humbly suggest you read it. See for FDA links on the antibiotic issue [at http://www.kpaddock.com/fq http://www.kpaddock.com/fq ]. In book form it has been edited by a medical doctor that has the same condition has Karen had. When bought through the Spinal CSF Leak Foundation 100% of the royalties go to them, to support them, just in case anyone thinks I'm posting this to promote the book for profit myself. The book can be read for free at http://mystory.kpaddock.com http://mystory.kpaddock.com for free. I do not know what motivated you to write your article. I do know from it that far more time needs to be spent with people in Chronic Pain, to understand the realities of their life. When a person in Chronic Pain that has been taking opiate pain medication under a competent doctors supervision for ten years, is able to function, take care of their family, hold a job, is without warning told then can not have it any more, “tough luck”. What are they to do? They resort to street drugs and become the very victims this currently policy is trying to prevent. People in Chronic Pain have typically already tried multiple rounds of physical therapy, bio-feedback, meditation, exercise and the list goes on, with no relief from the pain. What are they to do? Not having Chronic Pain myself, I will never claim to understand it. I did watch my wife suffer with it for 20+ years. What exactly is the agenda here? None of us such as Advocates like myself nor the sufferers have figured this out yet. Can anyone please explain? To us it appears as an attack on the most vulnerable. This is one of the many comments I received about your article: “…Chronic problems frustrate doctors and they blame the patient rather than look at themselves. …” or support research to find real solutions to Chronic Pain. No one chooses to live with Chronic Pain each and every moment of their lives.
DrScientist 7y ago
There is general lack of basic scientific knowledge for those working in the media and too much cut & paste. However, Doctors should have known better - opioids are not some new fangled treatment for goodness sake[1] Doctors are highly trained, highly paid and their failure is central to the opioid crisis. [1] In fact they are one of the first modern medicines - a wonder drug - then people realized the downsides. That was over 100 years ago.... https://en.wikipedia.org/wiki/Laudanum#History https://en.wikipedia.org/wiki/Laudanum#History https://www.historic-uk.com/HistoryUK/HistoryofBritain/Opium-in-Victorian-Britain/ https://www.historic-uk.com/HistoryUK/HistoryofBritain/Opium...
scarface74 7y ago
Why is it that when “rural America” and the suburbs got caught up in a drug epidemic people blame the media, corporations, the lack of opportunity, and call it an illness, but when it was happening in the “inner city” it was all about “the culture”, “moral failings”, “getting tough on crime”, and “the war on drugs”. I wonder what could the difference possibly be....
- TeMPOraL 7y ago
  That in the former case, the drugs in question are given to you by your country's medical system, while in the latter case, you have to procure them yourself on a black market?
  - scarface74 7y ago
    I’m not saying that chronic pain isn’t real or shouldn’t be treated, but many of the abusers are “drug seeking” patients who go to different doctors to get prescriptions and many of the doctors are illegally prescribing the drugs. Opioids also end up on the black market and definitely they all aren’t bought legally. Also, it is public knowledge that the government looked the other way and protected drug growers in South America in the 80s because it was more concerned with the Cold War.
  - Nasrudith 7y ago
    The thing is while a worryingly large minority of addicts used their prescribed medication first (including not taking as directed) the majority still used it illicitly either through street sources or stealing from those with legitimate needs. There is still an obvious empathy gap and double standard.
    - mieseratte 7y ago
      > There is still an obvious empathy gap and double standard. Well, no, there isn't obviously one. You seem to be alluding the the crack epidemic and the Just Say No / DARE types. No one was getting hooked on crack after being prescribed medicinal cocaine by their doctor. It is an apples-to-oranges comparison. A more apt one would be the methamphetamine epidemic that preceded the opi(ate|oid) epidemic. Plenty of moral panic in the news, precious few folks gave a damn about the redneck tweakers.
duxup 7y ago
I don't buy this line of argument. If the news reflects the medical community's POV and the medical community is wrong, that makes them "complicit"? >Piece after piece told readers, including young doctors and medical students like me, that pain was under-treated and opioids were safe. Outlets championed a paradigm shift in the way we thought about pain relief. Pain joined body temperature, blood pressure, heart rate, and breathing rate as the fifth vital sign. Was that untrue? I remember those stories, lots of doctors were advocating for a change on how pain was treated. The article straight up says that the medical community thought opioids were the answer. Should the news media have rejected the medical community's position and suggested people use something else? Essential oils? Some sort of anti vax message? The medical community might want to think twice about telling the news media or anyone else that they should have disregarded their expertise in the past as I'm not sure they'd like it if that happened today...
- dsfyu404ed 7y ago
  > that makes them "complicit"? By 2019 standards the news, the politicians, the doctors, are all "complicit in the opioid crisis" because they didn't predict the present state of affairs back in 1999 (or thereabouts) and work against it. If everybody is complicit then nobody is. It makes for eyeball grabbing titles though.
- macspoofing 7y ago
  >If the news reflects the medical community's POV and the medical community is wrong, that makes them "complicit"? The expectation is that news are independent and practice journalism and they don't just take anyone at their word.
  - duxup 7y ago
    >they don't just take anyone at their word. How does that work exactly? Doctor's say they're not treating pain properly and they feel opioids are a good option to do that. What exactly should a journalist do then? Not report it? Do some science?
    - 7y ago
CrankyBear 7y ago
Complicit? Reporters aren't medical experts. They reported what the medical pros of the 90s said. And, the doctors at the time all nodded their heads and said it was great stuff.
- base698 7y ago
  Yup, and the literature misquoted said the same 16 years ago, appears some of the media was into it then: Drug companies amplified that theme in materials sent to doctors and pharmacists. For example, Janssen Pharmaceutica, the producer of Duragesic, called the risk of addiction ''relatively rare'' in a package insert with the drug. Endo termed the risk ''very rare'' in presentations to hospital pharmacists. Purdue Pharma, the manufacturer of the powerful narcotic OxyContin, distributed a brochure to chronic pain patients called ''From One Pain Patient to Another,'' contending that it and similar drugs posed minimal risks. ''Some patients may be afraid of taking opioids because they are perceived as too strong or addictive,'' the brochure stated. ''But that is far from actual fact. Less than 1 percent of patients taking opioids actually become addicted.'' The trouble, however, was that studies that looked at the experience of pain patients who used long-acting narcotics for extended periods of time did not exist. So narcotics advocates like Dr. Portenoy and drug companies like Purdue Pharma had looked elsewhere, at surveys of patients whose use of narcotics was limited. And those reports were not always put into proper context. https://www.nytimes.com/2003/11/25/science/the-delicate-balance-of-pain-and-addiction.html https://www.nytimes.com/2003/11/25/science/the-delicate-bala...
PaulHoule 7y ago
Lately Google and Bing have been pushing searches for medical terms away from Wikipedia and towards WebMD, but that article says WebMD is funded by drug companies, and is itself suspect. Wikipedia has remarkably fair treatment of controversial topics such as rBST.
vertoc 7y ago
Related good read: https://slatestarcodex.com/2019/09/16/against-against-pseudoaddiction/ https://slatestarcodex.com/2019/09/16/against-against-pseudo...
epmaybe 7y ago
Looking at my own experience with doctors who were practicing throughout this scandal, I always try to think: what will our generation's scandal in the medical community be? The loss of the doctor-patient relationship could be one. Our trust and financial relationship with the pharmaceutical/insurance industries, or maybe our salaries in general?
1121redblackgo 7y ago
If there are any of chronic pain sufferers in here that have not yet explored the connection between emotions and pain, if you see this then now may be your lucky day. There is no correlation between structural changes in your body and the level of pain you have to endure, and you can be fully cured from your chronic pain within months. It is hard work, and you will have to deeply examine your life, but if you are ready I encourage you to check out Dr. Sarno and fall down the Healing Back Pain rabbit hole. Nicole Sachs has some excellent youtube videos that I recommend. As well there is Steve Ozanich's incredible book. I suffered for a decade with debilitating back pain, arm pain, neck pain, headaches, arthritis, knee pain, jaw pain, tendinitis, all of it, every day, all day, my entire life was my pain for a decade. And like thousands and thousands of others before me, once I discovered the real source of my pain I could actually work on healing it, and within months I was fully cured, and now have a toolset to interface with stress and pain in a healthy way that will last me forever. You don't have to suffer, but you will need to work at this.
- 1121redblackgo 7y ago
  A small addendum. This comment was downvoted '-1' pretty quickly. Like Eric Weinstein and the IDW suggest, we need the voices that were cast aside and disregarded if we are going to move forward in a new paradigm. I'm not lying or selling anything here. I am healed. So can you be. Your choice.
lambersley 7y ago
Though I can accept that news industry may have had a role to play in the influencing the thoughts and opinions of inexperienced medical professionals, I cannot accept that they are 'complicit' in the opioid crisis. Its hard to accept that the medical practice in the Americas is comprised of mostly "young doctors and students." In 2018, ~69% [1] of physicians in America were over 46 years old. I am more inclined to believe that bad actors, lobbying and general incompetence is to be blamed. This topic reminded me of "The $100 billion per year back pain industry is mostly a hoax"[2] piece which highlighted drug companies who spent millions on marketing, borrowing a page from Big-Tobacco, doctors who over-prescribed and frustrated patients who too matters into their own hands. [1] https://www.statista.com/statistics/415961/share-of-age-among-us-physicians/ https://www.statista.com/statistics/415961/share-of-age-amon... [2] https://qz.com/1010259/the-100-billion-per-year-back-pain-industry-is-mostly-a-hoax/ https://qz.com/1010259/the-100-billion-per-year-back-pain-in...
simplecomplex 7y ago
The war on drugs doesn’t work. the government should not have the authority to interfere with what people put inside their body. Stop blaming drug addiction on everybody but the drug addicts.
ashelmire 7y ago
I think it's interesting that out of 120+ comments on opioids, nobody mentions the elephant in the room: Some studies find NSAIDs are as effective in the treatment of pain [1]. You can find several other studies with a quick search, though most of the ones I've found were short-term. An additional issue is that opioids are not a treatment for the causes of pain. Pain is generally a symptom, not the underlying pathology. Physical therapy and other reliefs (nonsurgical) can treat the causes of pain and eliminate the need for any pain treatments. And as for an anecdote - my stepfather went from large doses of opioids after back surgery and severe pain (for an issue they wouldn't recommend surgery for anymore, but would instead recommend physical therapy) for years, to a reasonable level of prescribed marijuana consumption. Just some things to think about, since most of voices in the room seem to be pro-opioid. 1. https://jamanetwork.com/journals/jama/article-abstract/2673971 https://jamanetwork.com/journals/jama/article-abstract/26739...

166 points by danso 7y ago

BucketSort 7y ago

Let's be honest, what aren't they complicit in?

happytoexplain 7y ago
Broad condemnation of a broad group of a people is a dangerous path.
- BucketSort 7y ago
  Right, corporations are people I forgot.
  - cameronbrown 7y ago
    They're made of people? Last time I checked the machines haven't taken over yet.
    - mieseratte 7y ago
      Companies employ people, but who do they work in service of?
    - w56rjrtyu6ru 7y ago
      A machine made of people is still a machine.
- Clubber 7y ago
  Yes, but you have to admit, the news doesn't really serve its intended purpose of speaking out against power. It seems more like a conduit that's pretending it's not.
  - deleted 7y ago
    [deleted]
  - inetknght 7y ago
    News' intended purpose isn't just about speaking out against power. It's about providing a means for people to obtain information about current events -- political, medical, whatever. It's supposed to help augment your education. You know, the same education which is thoroughly gutted in America.
  - deleted 7y ago
    [deleted]
duxup 7y ago
What counts as complicit? Reporting accurately on what the medical community thought the answer was?

deleted 7y ago

[deleted]

ineedasername 7y ago

I think complicit is too strong of a word. They were reporting on the established (at the time) medical opinion. If the news industry hyped these drugs beyond what the medical establishment held to be accurate, then I would agree, but this article doesn't really indicate that.

mieseratte 7y ago
Perhaps news agencies should include some measure of due-diligence and skepticism, rather than parroting.
- yifanl 7y ago
  Certainly, but skepticism doesn't mean reporting "nothing is true". When the vast majority of medical sources claimed opioids were safe, most media understandably wanted to avoid looking as conspiracy theorists.
- ineedasername 7y ago
  You assume they didn't due any due diligence. Maybe they didn't, but maybe they did too. Either way, what would have sufficed beyond verifying that it was indeed the prevalent medical opinion of the time and that it wasn't contradicted in any significant way? It's not the role of news media to verify scientific research further than that-- it's the role of the research establishment which, yes, failed at that task until it was too late to avoid a crisis. If there had been significant opposition to this at the time, I would agree that news media failed. But I just searched through ProQuest and Google Scholar for research journals during 1990-2000 and I didn't find much at all that points towards significant risks of increased prescribing of these drugs. Quite the opposite, they pointed towards them being underutilized and leaving patients in significant pain despite low risk of addiction. As it turns out, doctors were wrong. But it's only in the last few years that the scope of the issue has really come to light. I can't fault the media for not knowing 25 years ago what the medical establishment has only recently come to accept.
  - mieseratte 7y ago

pjc50 7y ago

"Chronic pain is widespread and under-treated" may well still be true. It's just that opioids do carry a risk of addiction. This is partly why so many states have started legalizing marijuana, medical or otherwise. I don't really like this article's tone of press-blaming: ultimately the medical profession has to take responsibility for its treatment, both under- or over-treatment, and has its own responsbility to find out the facts and disseminate them through professional channels.

codeddesign 7y ago
Yes, but controversy sells papers. Ultimately the blame is on the pharmaceutical industries, the doctors, and yes the patients.
bilbo0s 7y ago
People are looking for anyone to blame. Drug reps. Doctors. Pharmaceutical firms. Now we've entered the "politicians/the media is to blame" stage. When something goes wrong in this spectacular a fashion, you can bet people will try to lay blame wherever they can. But probably the truth is that this was on all of us. Doctors for prescribing without disseminating incredibly pertinent information, Parmas for creating "medicinal" opioids in the first place, politicians for not admitting the need for stronger regulation earlier, media for not covering the story better earlier, the people for being in denial about the obvious signs of addiction in their friends and loved ones. I mean the list probably goes on and on.
- Loughla 7y ago
  I'm with you on this. It's like conspiracy theories - people WANT someone to point to and say, "that is the person in charge, they're the reason this has happened." When in most cases, a really, truly shitty situation like this one does rely on the action of a few, powerful, bad actors, but mostly it's daily choices to simply not think made by all of us.
  - walshemj 7y ago
    Instead of banning any advertising of prescription meds to the general public.

nprz 7y ago

>A 2001 US News and World Report story described OxyContin as a “safe, effective medication with few side effects,” and put the chances of addiction at one percent >we now know that between eight and 12 percent of patients prescribed opioids for chronic pain develop an addiction I wonder how the state of the economy influences rate of addiction?

codeddesign 7y ago
I would imagine that the rate directly correlates with other additions such as alcohol. While addition happens to all classes of society, those in impoverished areas tend to have a greater concentration of addition (at least reported).

accounn 7y ago

world is run by scam business.

_iyig 7y ago

Seems like a good place to link Paul Graham’s essay on PR firms, and their relation with news media outlets: http://www.paulgraham.com/submarine.html http://www.paulgraham.com/submarine.html

deleted 7y ago

[deleted]

same_as_today 7y ago

Today the same media is praising Cannabis and CBD, and says that marijuana is the miracle cure for depression, ... Of course, you can't question that, especially on HN where every anti-cannabis opinion is downvoted.

kibwen 7y ago
This is a sweeping statement, can I ask for at least one sourced example? I've seen no source attempting to claim that marijuana is a miracle cure for depression, or that CBD is anything other than a fad propped up by a regulatory fluke. At most, I have seen articles regarding the potentially beneficial painkilling effects of marijuana for terminal cancer patients.
- same_as_today 7y ago
  All of these articles from very reputable sources say that many view marijuana as a miracle cure. Of course, they are balanced and also question this narrative, but why do they say this view is widespread? > How one molecule from the cannabis plant came to be seen as a therapeutic cure-all: https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-cannabis-cure.html https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-... > More Australians are using medicinal cannabis to treat a host of health problems as reports of its supposed healing powers flood the media: https://www.theguardian.com/society/2019/aug/11/medicinal-cannabis-the-hype-is-strong-but-the-evidence-is-weak https://www.theguardian.com/society/2019/aug/11/medicinal-ca... https://www.theguardian.com/society/2019/may/05/cbd-a-marijuana-miracle-or-another-health-fad-cannabidiol-anxiety-epilepsy https://www.theguardian.com/society/2019/may/05/cbd-a-mariju... https://eu.usatoday.com/story/news/world/2017/04/25/marijuana-pot-treatment-children-autism-cannabis-oil/100381156/ https://eu.usatoday.com/story/news/world/2017/04/25/marijuan...
saiya-jin 7y ago
That's an extreme view, don't know where you are getting positive-only information feed. Like any mind-altering substance, it has its positives and drawbacks which are different from person to person. For me personally, the benefits far outweigh drawbacks. In society where things like alcohol and cigarettes/tobacco are perfectly fine although they provably destroy endless stream of families, lives and bring one of the worst possible (and costly to society) ways to die, having cannabis illegal is unfair and illogical. US prisons full of small time weed offenders, an event that effectively ruins one's professional life. Read a bit about history and why it was banned in US, which then pushed it to the rest of the world. Even to places like India where its used as religious plant for millennia. I strongly welcome legalization and hope the movement comes to Europe, and rest of the world soon. Society is better off if it is legalized (and regulated for things like access to minors/psychiatric patients, strength, purity etc). Now to advise it as panacea for mental issues is plain stupid. Go see an expert, that's why we have them. Same would go for stuff like LSD.

ademup 7y ago

I wish I could use the fallacious "No TRUE doctor would use The Times to inform medical decisions." Because it seems like it should be universally true. On the one hand I am glad this one is telling their truth, now I feel more informed. On the other, I am appalled and terrified that this may apply to a significant percentage of "true" doctors.

bigYahnz 7y ago

The "news" industry is complicit in just about every shit thing happening in this country.

caconym_ 7y ago

These days I don't think you can blame the media for anything without blaming the advertising industry as the upstream cause. We distribute unbundled nuggets of content that are optimized to get clicks (and to drive click rate, meaning you have to make your impact and turn the consumer around as quickly as you can), because that's what's incentivized by advertising-based revenue streams. Those optimizations are not compatible with accurate and balanced coverage of nuanced issues. I assume something similar was true in the 90s, or starting to be true, but I don't have as good an understanding of how it all worked back then.

gundmc 7y ago
It's pretty absurd to shift the blame to advertising. This wasn't the age of clickbait and adtech, this was over 20 years ago. 24 hour news channels like Fox News and MSNBC were in their infancy. Isn't there some responsibility to be had to uphold journalistic integrity? If anything, this article shows the danger of pop science and journalists writing authoritatively about things they don't understand well.
- caconym_ 7y ago
  Maybe you missed the first two words of my comment: "these days". I did not restrict my context to 20 years ago, because neither does the linked article.

bpaddock 7y ago

My wife killed herself because of Chronic Pain. Her saga is required reading at Duke Medical School and has become part of the documentary Pain Warriors, to be released soon. The documentary covers the lives of those miss treated by the Medial Establishment, including doctors that treat Chronic Pain. Those with Chronic Pain are being left to suffer because of abusers. In April of 2019 the CDC stated that their "guidelines" are being miss applied. Sadly the damage is already done. https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html https://www.cdc.gov/media/releases/2019/s0424-advises-misapp... "CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations. In a new commentary in the New England Journal of Medicine (NEJM), authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) advise against misapplication of the Guideline that can risk patient health and safety. CDC commends efforts by healthcare providers and systems, quality improvement organizations, payers, and states to improve opioid prescribing and reduce opioid misuse and overdose. However, some policies and practices that cite the Guideline are inconsistent with, and go beyond, its recommendations. In the NEJM commentary, the authors outline examples of misapplication of the Guideline, and highlight advice from the Guideline that is sometimes overlooked but is critical for safe and effective implementation of the recommendations. CDC is raising awareness about the following issues that could put patients at risk:..."

bpaddock 7y ago
Dr Myles Gart wrote a piece entitled “Pain is not the fifth vital sign” Medical Economics on May 20th, 2017. http://medicaleconomics.modernmedicine.com/medical-economics/news/pain-not-fifth-vital-sign http://medicaleconomics.modernmedicine.com/medical-economics... This is my reply to Dr Gart's editorial, edited to fit the format here the best I can. “… First and foremost, we must bury the claim of pain being the fifth vital sign and replace it with a 21st Century pain assessment tool that incorporates objective evidence and measures of pain. …” Dr Gart, at this moment are you hungry? In your lifetime have you ever been hungry? Hunger is a type of pain. Did you treat that pain by consuming a substance? Please correct me if I am wrong. To my knowledge there is no objective test, no simple Pain Meter, that will show me that you are hungry. Yes we could look at enzymes and such. Will that truly tell me just how hungry you are objectively? If there is no objective test for a pain as simple as hunger, that each of us experience most every day, what hope does a person in Chronic Pain have? In Ohio the Governor is now practicing medicine by decreeing that there can be no more than seven days of opiate pain medication. Perhaps he should discuss that with the person that was hit by a train and survived with most every bone broken. My wife Karen died of suicide to stop the pain she experienced for over over 20 years, due to the failure of the Medical Establishment as a whole. THIS IS THE REALITY OF Chronic Pain. "Karen's Journal of CSF Leak Headaches and Chronic Pain: How Intracranial Hypotension and Levaquin (Levofloxacin) Killed Me" is now required reading at Duke School of Medicine to educate future Neurologists about the realities of Chronic Pain. A local reporter wrote in a Cover Story: "Karen's first-hand account of her illness gave an honest, heart-wrenching depiction of what it is like to live with debilitating pain day-to-day." – http://www.kpaddock.org http://www.kpaddock.org May I humbly suggest you read it. See for FDA links on the antibiotic issue [at http://www.kpaddock.com/fq http://www.kpaddock.com/fq ]. In book form it has been edited by a medical doctor that has the same condition has Karen had. When bought through the Spinal CSF Leak Foundation 100% of the royalties go to them, to support them, just in case anyone thinks I'm posting this to promote the book for profit myself. The book can be read for free at http://mystory.kpaddock.com http://mystory.kpaddock.com for free. I do not know what motivated you to write your article. I do know from it that far more time needs to be spent with people in Chronic Pain, to understand the realities of their life. When a person in Chronic Pain that has been taking opiate pain medication under a competent doctors supervision for ten years, is able to function, take care of their family, hold a job, is without warning told then can not have it any more, “tough luck”. What are they to do? They resort to street drugs and become the very victims this currently policy is trying to prevent. People in Chronic Pain have typically already tried multiple rounds of physical therapy, bio-feedback, meditation, exercise and the list goes on, with no relief from the pain. What are they to do? Not having Chronic Pain myself, I will never claim to understand it. I did watch my wife suffer with it for 20+ years. What exactly is the agenda here? None of us such as Advocates like myself nor the sufferers have figured this out yet. Can anyone please explain? To us it appears as an attack on the most vulnerable. This is one of the many comments I received about your article: “…Chronic problems frustrate doctors and they blame the patient rather than look at themselves. …” or support research to find real solutions to Chronic Pain. No one chooses to live with Chronic Pain each and every moment of their lives.

DrScientist 7y ago

There is general lack of basic scientific knowledge for those working in the media and too much cut & paste. However, Doctors should have known better - opioids are not some new fangled treatment for goodness sake[1] Doctors are highly trained, highly paid and their failure is central to the opioid crisis. [1] In fact they are one of the first modern medicines - a wonder drug - then people realized the downsides. That was over 100 years ago.... https://en.wikipedia.org/wiki/Laudanum#History https://en.wikipedia.org/wiki/Laudanum#History https://www.historic-uk.com/HistoryUK/HistoryofBritain/Opium-in-Victorian-Britain/ https://www.historic-uk.com/HistoryUK/HistoryofBritain/Opium...

scarface74 7y ago

Why is it that when “rural America” and the suburbs got caught up in a drug epidemic people blame the media, corporations, the lack of opportunity, and call it an illness, but when it was happening in the “inner city” it was all about “the culture”, “moral failings”, “getting tough on crime”, and “the war on drugs”. I wonder what could the difference possibly be....

TeMPOraL 7y ago
That in the former case, the drugs in question are given to you by your country's medical system, while in the latter case, you have to procure them yourself on a black market?
- scarface74 7y ago
  I’m not saying that chronic pain isn’t real or shouldn’t be treated, but many of the abusers are “drug seeking” patients who go to different doctors to get prescriptions and many of the doctors are illegally prescribing the drugs. Opioids also end up on the black market and definitely they all aren’t bought legally. Also, it is public knowledge that the government looked the other way and protected drug growers in South America in the 80s because it was more concerned with the Cold War.
- Nasrudith 7y ago
  The thing is while a worryingly large minority of addicts used their prescribed medication first (including not taking as directed) the majority still used it illicitly either through street sources or stealing from those with legitimate needs. There is still an obvious empathy gap and double standard.
  - mieseratte 7y ago
    > There is still an obvious empathy gap and double standard. Well, no, there isn't obviously one. You seem to be alluding the the crack epidemic and the Just Say No / DARE types. No one was getting hooked on crack after being prescribed medicinal cocaine by their doctor. It is an apples-to-oranges comparison. A more apt one would be the methamphetamine epidemic that preceded the opi(ate|oid) epidemic. Plenty of moral panic in the news, precious few folks gave a damn about the redneck tweakers.

duxup 7y ago

I don't buy this line of argument. If the news reflects the medical community's POV and the medical community is wrong, that makes them "complicit"? >Piece after piece told readers, including young doctors and medical students like me, that pain was under-treated and opioids were safe. Outlets championed a paradigm shift in the way we thought about pain relief. Pain joined body temperature, blood pressure, heart rate, and breathing rate as the fifth vital sign. Was that untrue? I remember those stories, lots of doctors were advocating for a change on how pain was treated. The article straight up says that the medical community thought opioids were the answer. Should the news media have rejected the medical community's position and suggested people use something else? Essential oils? Some sort of anti vax message? The medical community might want to think twice about telling the news media or anyone else that they should have disregarded their expertise in the past as I'm not sure they'd like it if that happened today...

dsfyu404ed 7y ago
> that makes them "complicit"? By 2019 standards the news, the politicians, the doctors, are all "complicit in the opioid crisis" because they didn't predict the present state of affairs back in 1999 (or thereabouts) and work against it. If everybody is complicit then nobody is. It makes for eyeball grabbing titles though.
macspoofing 7y ago
>If the news reflects the medical community's POV and the medical community is wrong, that makes them "complicit"? The expectation is that news are independent and practice journalism and they don't just take anyone at their word.
- duxup 7y ago
  >they don't just take anyone at their word. How does that work exactly? Doctor's say they're not treating pain properly and they feel opioids are a good option to do that. What exactly should a journalist do then? Not report it? Do some science?
  - 7y ago

CrankyBear 7y ago

Complicit? Reporters aren't medical experts. They reported what the medical pros of the 90s said. And, the doctors at the time all nodded their heads and said it was great stuff.

base698 7y ago
Yup, and the literature misquoted said the same 16 years ago, appears some of the media was into it then: Drug companies amplified that theme in materials sent to doctors and pharmacists. For example, Janssen Pharmaceutica, the producer of Duragesic, called the risk of addiction ''relatively rare'' in a package insert with the drug. Endo termed the risk ''very rare'' in presentations to hospital pharmacists. Purdue Pharma, the manufacturer of the powerful narcotic OxyContin, distributed a brochure to chronic pain patients called ''From One Pain Patient to Another,'' contending that it and similar drugs posed minimal risks. ''Some patients may be afraid of taking opioids because they are perceived as too strong or addictive,'' the brochure stated. ''But that is far from actual fact. Less than 1 percent of patients taking opioids actually become addicted.'' The trouble, however, was that studies that looked at the experience of pain patients who used long-acting narcotics for extended periods of time did not exist. So narcotics advocates like Dr. Portenoy and drug companies like Purdue Pharma had looked elsewhere, at surveys of patients whose use of narcotics was limited. And those reports were not always put into proper context. https://www.nytimes.com/2003/11/25/science/the-delicate-balance-of-pain-and-addiction.html https://www.nytimes.com/2003/11/25/science/the-delicate-bala...

PaulHoule 7y ago

Lately Google and Bing have been pushing searches for medical terms away from Wikipedia and towards WebMD, but that article says WebMD is funded by drug companies, and is itself suspect. Wikipedia has remarkably fair treatment of controversial topics such as rBST.

vertoc 7y ago

Related good read: https://slatestarcodex.com/2019/09/16/against-against-pseudoaddiction/ https://slatestarcodex.com/2019/09/16/against-against-pseudo...

epmaybe 7y ago

Looking at my own experience with doctors who were practicing throughout this scandal, I always try to think: what will our generation's scandal in the medical community be? The loss of the doctor-patient relationship could be one. Our trust and financial relationship with the pharmaceutical/insurance industries, or maybe our salaries in general?

1121redblackgo 7y ago

If there are any of chronic pain sufferers in here that have not yet explored the connection between emotions and pain, if you see this then now may be your lucky day. There is no correlation between structural changes in your body and the level of pain you have to endure, and you can be fully cured from your chronic pain within months. It is hard work, and you will have to deeply examine your life, but if you are ready I encourage you to check out Dr. Sarno and fall down the Healing Back Pain rabbit hole. Nicole Sachs has some excellent youtube videos that I recommend. As well there is Steve Ozanich's incredible book. I suffered for a decade with debilitating back pain, arm pain, neck pain, headaches, arthritis, knee pain, jaw pain, tendinitis, all of it, every day, all day, my entire life was my pain for a decade. And like thousands and thousands of others before me, once I discovered the real source of my pain I could actually work on healing it, and within months I was fully cured, and now have a toolset to interface with stress and pain in a healthy way that will last me forever. You don't have to suffer, but you will need to work at this.

1121redblackgo 7y ago
A small addendum. This comment was downvoted '-1' pretty quickly. Like Eric Weinstein and the IDW suggest, we need the voices that were cast aside and disregarded if we are going to move forward in a new paradigm. I'm not lying or selling anything here. I am healed. So can you be. Your choice.

lambersley 7y ago

Though I can accept that news industry may have had a role to play in the influencing the thoughts and opinions of inexperienced medical professionals, I cannot accept that they are 'complicit' in the opioid crisis. Its hard to accept that the medical practice in the Americas is comprised of mostly "young doctors and students." In 2018, ~69% [1] of physicians in America were over 46 years old. I am more inclined to believe that bad actors, lobbying and general incompetence is to be blamed. This topic reminded me of "The $100 billion per year back pain industry is mostly a hoax"[2] piece which highlighted drug companies who spent millions on marketing, borrowing a page from Big-Tobacco, doctors who over-prescribed and frustrated patients who too matters into their own hands. [1] https://www.statista.com/statistics/415961/share-of-age-among-us-physicians/ https://www.statista.com/statistics/415961/share-of-age-amon... [2] https://qz.com/1010259/the-100-billion-per-year-back-pain-industry-is-mostly-a-hoax/ https://qz.com/1010259/the-100-billion-per-year-back-pain-in...

simplecomplex 7y ago

The war on drugs doesn’t work. the government should not have the authority to interfere with what people put inside their body. Stop blaming drug addiction on everybody but the drug addicts.

ashelmire 7y ago

I think it's interesting that out of 120+ comments on opioids, nobody mentions the elephant in the room: Some studies find NSAIDs are as effective in the treatment of pain [1]. You can find several other studies with a quick search, though most of the ones I've found were short-term. An additional issue is that opioids are not a treatment for the causes of pain. Pain is generally a symptom, not the underlying pathology. Physical therapy and other reliefs (nonsurgical) can treat the causes of pain and eliminate the need for any pain treatments. And as for an anecdote - my stepfather went from large doses of opioids after back surgery and severe pain (for an issue they wouldn't recommend surgery for anymore, but would instead recommend physical therapy) for years, to a reasonable level of prescribed marijuana consumption. Just some things to think about, since most of voices in the room seem to be pro-opioid. 1. https://jamanetwork.com/journals/jama/article-abstract/2673971 https://jamanetwork.com/journals/jama/article-abstract/26739...