I get a lot of my bed from YouTube and progressive shows seem to be very anti-opioid, so I had to come up with a canned response. Feel free to use it yourself.
My wife and I have felt so depressed lately because of the outright bigotry of and assault on chronic pain patients' right to pain control. Every news outlet (especially progressive ones like TYT, The David Pakman Show, Ring of Fire, The Humanist Report, and countless others) have done hit job after hit job in opioids. Most don't even mention that pain patients need them, but almost no one talks about the harms of the illegal CDC guidelines on our community (those guidelines are a facsimile of the PROP petition to the FDA; that petition was denied because it lacked scientific backing and the evidence was on our side). We have made some progress with Kyle Kulinski of Secular Talk, but his appearance on TYT was really disappointing and I was ready to give up on educating people. This story is really what I needed to hear.
Some of the things that I constantly have to correct:
1) Doctors don't get people addicted and they doubt shove pills down your throat. Every person who claims this has done one of the following:
1a) they lied to their doctor (Even in alleged "pill mills"
1b) they took more than prescribed or in a different way than prescribed- they didn't follow directions
1c) they took it for something other than pain
2) State monitoring programs hurt more people that they help and they violate our privacy rights.
3) Drug testing, pill counts, and contacts were meant for addicts, but spread to the pain community. We complied and what did wet getin return? We got treated even worse. Morphine is no different than exogenous insulin and the restrictions on patients should be similar. Just like your body makes insulin, it makes endorphin (ENDOgenous mORPHINe- morphine used to be spelled morphin). If you take too much insulin, you can die from that overdose too. They're both physically dependent and require a taper to safely discontinue.
4) long-term pain patients have a 0.04-0.2% per annum chance of becoming addicted- lower than the general population
5) The decision of the appropriateness of opioids in any given patient should be made on an individual basis by doctors and the patients (and NO ONE else). We patients have to live with the consequences of undermedication and we would have to live with the consequences of over-medication
6) Addiction is a disease of dopamine (what cocaine and methamphetamine directly release) and a certain ninety of people are going to become addicts, maybe their drug of choice will be cocaine, maybe heroin, but addicts don't get made, their born
7) socially factors play a significant role in addiction
8) heroin isn't spiked with fentanyl, it's spiked with an illicit fentanyl analogue with unknown potency. 9) Pharmaceutical fentanyl is a great pain reliever with few side effects and almost no euphoria when abused. Although, is does have a higher than average risk of respiratory depression in opioidnaive patients
9) The crack down on doctors is killing people because they went from oxycodone pills with known dose and potency and moderately high euphoria when abused and a low risk of respiratory depression to heroin and fentanyl analogues with unknown potency and less euphoria. That's why people overdose
10) cannabis is not a replacement for opioids. Although it helps some people with some kinds of pain, it is mostly a good adjunct medication to enable opioids sparing.
11) There is no ceiling with opioids, they are safe at any dose if properly titrated.
12) Opioid overdose is extremely rare. Without mixed drug toxicity, people get sick before they overdose. "opioid related deaths" are any death that the patient had any opioid in their system when they died (they do the same hit job with Kratom). Usually, the real cause of death is combining alcohol with barbiturates and/or benzodiazepines
The answer to the opioid "crisis":
1) acknowledge that it is minor compared to the chronic pain crisis
2) full legalization where you can buy an opioid of a known potency and dose (methadone would be a good candidate to start with) at a pharmacy. You should have to meet withthe pharmacist and they should have to council you on the risks, offer information on treatment options if they believe you're addicted (or hearing that way), and sign an informed consent form.
3) They shouldn't be allowed to deny sale to any mentally competent adult
4) We also need to enhance the social safety net and make therapy and voluntary rehab free and readily available.
5) Stop making people "detox" when they go to rehab and immediately start them on methadone (big barrier to treatment)
We need to stop thinking that we can get everyone to stop taking drugs. We need to focus on making every addict a functional addict and making sure people who are ready to stop have help.
Pain patients need to stop being treated like addicts and we can't accept pill counts and urine testing (intended for dual diagnosis; chronic pain and addiction). It's no wonder the medical community thinks they can treat us like addicts, we've let them treat us like addicts for a decade. Doctors need to build a relationship with their patients, not blackmail them into one sided contracts that protect the doctor and strip away our rights while blackmailing is into high reimbursement, low success rate procedures, like steroid injections