Big Pharma, doctors and the health care system, the growing inequality gap and shrinking social safety net, and the “War On Drugs.”
Yep, that’s right: our beloved Prince died because of a messed up “health care” system, the destructive government policies and laws on drug use, and the structure of our society, itself.
You might disagree and say that Prince was solely responsible because he’s the one that put the Fentanyl in his mouth.
I DO think Prince was responsible for jumping off risers on stage in high heels for too long and messing up his body, ending up in middle age with chronic pain, it seems. Given there’s no sign he was suicidal, he was also foolish to trust his crew to get him the pills.
Other than that, he was no different than so many of my patients who end up addicted to prescribed painkillers—particularly opioid medications—or other drugs they obtain illegally to manage their physical and/or emotional pain. Our whole culture in the USA seems designed to convince us that there are easy, drug-related solutions to the problems and stresses of life. And for good reason: there’s tons of money to be made by some very rich people.
At any rate, when it comes to prescription painkillers, we’ve all been sold a bill of goods. We’ve been told they’re effective in treating chronic pain. That’s not true.
Painkillers Don’t Work for Chronic Pain—They Make It Worse
First, a few facts:
- About 90 percent of people with chronic pain are prescribed opioids (and most still complain about their pain).
- Most people prescribed painkillers don’t misuse them: only 12.5 million out of 97 million Americans using prescription pain relievers were thought to have done so during 2015, for example.
- The US has only about 5 percent of the world’s population, but we consume around 80 to 90 percent of the opioids. Prescriptions for them went up 300 percent in the last 10 years.
- Overdoses on drugs kill more people than car accidents or shootings. About 45 people a day die from overdoses of drugs; for each death, 30 or more people end up in an emergency room.
- Drug overdoses often include a deadly cocktail of drugs, not just opioids (alcohol, cocaine, benzodiazepines, and now fentanyl etc.) 60 percent of long-term opioid users take risky combinations of drugs—especially the prescription benzodiazepines (Xanax, Valium, etc.). Experts now say that “opioid overdose” would be best termed “polydrug toxicity.”
- “Side effects” of opioids exacerbate the interference with daily activities that the pain was causing.
Hmmm….a bit complicated, no? Not exactly a black and white problem, as politicians like to tell us. Let’s take a deeper look:
How did we get into this mess?—A brief history
Of course, it’s not hard to see that the increasing stress on middle class, working class, and poor people in the USA is a major factor leading to people “checking out” with a variety of means: entertainment & sports, consumerism, and, of course, addictive/compulsive behaviors (alcohol, prescribed and illegal drugs, gambling, food, you-name-it). Wages have been stagnant since the 1960s for most people while the rich keep getting richer.
Not only has the 100 year old drug war been a colossal failure, the recent increase of heroin on the streets is a direct consequence of our country’s foreign policy: the attack on Afghanistan in 2001 and subsequent chaos led to a huge increase in opium production after years of suppression by the ruling Taliban.
Criminalization of drugs has always been tilted toward oppressed classes of people versus the use of alcohol and drugs by the well-to-do and white folks. For example, a good way to keep African-Americans in chronic chaos is to give them longer sentences for drug offenses than whites (crack vs. powder cocaine) and segregating blacks and other minorities into chaotic environments…not to mention using the CIA to import cocaine into urban LA in the 1980s, fostering the crack epidemic.
Big Pharma (shorthand for the “Pharmaceutical Research and Manufacturers of America”) is a major perpetrator of the problem. They spend millions of dollars every year advertising their wares as almost magic solutions to a host of medical (and non-medical, made-up or exaggerated) problems, including chronic pain. The money is also used for PR to convince us of the myth that the high prices they charge are due to the high cost of research and development of the drugs (actually, much of it is paid for by the public). Ironically, a recent poll showed that no private industry is held in lower esteem than the pharmaceutical industry.
Big Pharma began promoting prescription drugs for common stressors for the average person in the 1960s, not just for those with debilitating conditions. Soon came the rise of painkillers and “pain management.” Eventually, doctors spent less time with patients because prescribing drugs was relatively quick and it became so profitable the relationship between doctor and patient fundamentally changed.
In addition, Big Pharma has long promoted misleading and inaccurate research, especially when it comes to psychotropic drugs (for mental health conditions) and painkillers. They bribe doctors to promote their expensive drugs, help develop and sustain patient advocacy groups that emphasize access to dangerous drugs, and enjoy a revolving door between government officials and their industry.
So I suppose that it should be no surprise that, on March 29th, President Trump announced the establishment of the “President’s Commission on Combating Drug Addiction and the Opioid Crisis.” Here we go again—more drug war propaganda, you can be sure. It’s unlikely this commission’s recommendations will address legal, prescription drugs like the much-abused and deadly benzodiazepines. Given their recent statements, such as Attorney General, Jeff Sessions, who has endorsed the drug war approach and greater criminal prosecution and interdiction, it’s likely we will return to the “reefer madness” of the past and see attempts to roll back or at least slow down the legalization of cannabis and the legitimization of its use for medical problems. Big Pharma is deathly afraid of losing profits to this little, non-patentable herb. It’s clear putting politics and reactionary politicians in between doctors and patients is a very, very bad idea. When addiction occurs, it should be considered a public health problem and not a criminal problem.
As usual, prevention and education about legal and illegal drugs and their abuse is not promoted—it’s just not that profitable.
Health Care, Pain, and Alternatives to Treatment
Our health care system is good at addressing acute problems and emergencies, but terrible with long-term, chronic problems, the very conditions that consume most of health care dollars. Doctors are increasingly turning to painkillers to provide relief to patients for painful physical conditions, but also emotional, mental, and even social problems that overwhelmed patients present to their doctors (and mental health professionals). Depressed people and even addicted people are prescribed addictive painkillers such as opioids (not to mention a host of other toxic psychiatric drugs that I won’t say much about here). Furthermore, the people who need the painkillers are now being lumped into those who are addicted and misusing them, taking the attention off the sick health care system, Big Pharma, and the War On Drugs and putting even more pressure on doctors to get stingy with them, i.e., throwing the baby out with the bathwater.
It’s increasingly clear that opioids should only be prescribed for short-term relief of acute medical conditions (such as broken bones, pain after surgery, etc.) or to comfort people with terminal illnesses or life-threatening conditions.
Why? Because opioids are not effective for chronic pain. In fact, they raise the risk of injuries, addiction, and overdoses, not to mention:
The Double-Cross of Opioids: Hyperalgesia
The terrible trick is that opioids will eventually stop working and the patient will be left with their pain, a dependency on a drug, as well as the pain of withdrawal from the drug, if they choose to stop taking it. This pain can be worse than the original pain as it is often felt over the whole body; therefore, you have the original pain and a new, sometimes worse and more global pain! (This increased sensitivity to pain is termed “hyperalgesia.”) Doctors typically don’t know what to do when it’s clear a patient is addicted to medications, so the addiction goes untreated—except with more drugs.
In addition to other medical interventions such as over-the-counter medications, alternative treatments for chronic pain do exist and are effective. They include: physical therapy, massage, acupuncture, heat, exercise, yoga, tai chi, meditation, psychotherapy, relaxation and deep breathing exercises, and clinical hypnosis (see below). (Medical marijuana is also very effective, but, of course, not legal in all states.)
When alternatives don’t help enough, a patient may need to learn how to manage the pain–after all, health care professionals often have to assist patients who have other chronic illnesses learn to live with their health conditions.
The good news is that, if a person can stick it out and stay off the opioids long enough, the brain and body recalibrate and the pain goes back to the original level or even lower if they’ve been actively applying other methods.
The message must be loud and clear to everyone with chronic pain that they might have to curtail many activities that exacerbate the pain. Unfortunately, few doctors emphasize this and quickly prescribe painkillers instead; then many people just take a few more of them when engaging in activities that will cause several days of extra pain (similar to “weekend warriors” who go all-out and exercise on occasion, become too sore to keep exercising, and stop activity altogether, i.e., a good-intentioned practice that backfires). Doctors are often reluctant to tell patients that painkillers numb the ability for the body to tell us what our limits are and we can do more damage without realizing it until the drug wears off. (Was Prince given accurate information about painkillers? We’ll probably never know…)
The Underutilized Treatment: Clinical Hypnosis
I’m a psychologist who makes house calls to provide psychotherapy. As you might expect, many if not most of my clients have chronic medical conditions and this includes chronic pain. The two most effective approaches that I use with most of these clients are the 3-Stage Deep Breathing technique (which you can learn in the 4th episode of our podcast, The Mo’ Betta Life Show ) and clinical hypnosis. These methods assist clients in experiencing less pain in our session as well as learning how to manage their pain themselves over the long term.
Our nervous system normally returns us to a “baseline” state after episodes of high activation or arousal (joy, excitement, pain, anxiety, anger, etc.) as well as periods of calm. In other words, we’re destined to “regulate” and return to “homeostasis” or an in-between state that feels “normal.” Unfortunately, many people can no longer regulate normally, and this includes people with chronic pain.
Professionals trained in treating people with chronic pain with hypnosis carefully assess how a particular person has adjusted to the pain. For example, a person could be “dysregulated” either in an aroused state (anxious, angry, restless) or a subdued or depressed state. Assisting the client to attend to sensations and learn to regulate, reduce, or cope with pain must be done carefully. The process must be individualized for each client. Each person with chronic pain has ways to manage their pain that, although often counterproductive in the long term, must be respected. The retraining for pain management cannot simply be addressed using a “one-size-fits-all” approach or only one hypnotic technique. People can be very fearful of change or any suggestions to focus on their body or the pain.
For example, I’ve conducted sessions with individuals in pain that, on the first try, greatly reduced or even eliminated the pain while the person was in trance and for a period of time after the session. For others, it’s a gradual process: I work with the client to continually explore how to best use the power we all have to use trance states and suggestion to interrupt old patterns and create resourceful new ways of addressing chronic conditions.
Prince: the most visible victim of cultural, political, and economic bankruptcy
So, you see, people have the right to be foolish, but we also have a right to accurate information that impacts our well being when it’s available (never forget examples of corporate dishonesty and criminality such as being told that lead is a harmless addition to gasoline, convincing us that cigarettes don’t cause harm, and the fact that Exxon suppressed their own research on climate change, to name a few). We have the right to receive accurate information about how to avoid and treat health problems.
Well, at least I believe that. Our society apparently disagrees: the prevailing wisdom is that large corporations and the rich and powerful people who own and run them have the right to make a profit off of our misery, even if it makes us even more miserable.
And even if it kills us. Their right to make obscene profits at the expense of good health care for all is killing thousands and thousands every year.
And one year ago, the crimes of the ruling class, the politicians, and the corporations took one of the greatest musicians, songwriters, and performers of all time. And given that he’s from Minneapolis and I’m from across the river in St. Paul, that we’re both the same age, and that I’ve been diggin’ his music ever since me and my buddies listened to his first album the day it came out, I’m really frickin’ pissed!
Rest In Peace, my friend and brother, Prince Rogers Nelson—and thank you for all the great music and memories!
Me & my wife, Lynne, at Paisley Park on New Year’s Eve, 1987
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