Third Wave Dope-ism

It was looking like a slow week – then it wasn’t…

  • It looks like the young are drinking themselves to death at rates not seen in a long time.  Naming generations and critiquing the young isn’t something I aspire to be associated with, so I will avoid commenting specifically about the modern 20 & 30-somethings.  Instead, I will pull this subject matter back to my usual topic:  The Opiate Crisis.  Are we going to heap further restrictions upon alcohol because of a spike in booze-related deaths?  Likely not.  And why not?  Because Prohibition is pretty much off the table for booze in this society.  It is off the table – and will likely stay so because the stink of failure is still all over alcohol prohibition.  What options remain for us as a society to address these things?  I believe the fact that prohibition isn’t a real option here increases the chances that people will want to discuss the demand side of this problem to a degree that they never would with illegal drugs.  I believe people will be more inclined to ask why people would want to drink themselves to death?  This is infinitely less likely around opiate-related deaths.  This difference – in my opinion – is literally killing us by the bushel.  It reflects a moral cowardice at minimum, and more to the point, it reflects a genuine disinterest in the pain of others.  We are getting what we ask for.
  • I am amazed that people see this as a matter of conscience.  Is there anyone in the world who works who isn’t faced with a matter of conscience at some point?  What makes pharmacist’s special?  If you agree to the job, and you take the pay, and then don’t do the job, how is it you still deserve to be paid?  I don’t think any one in any job should  be paid when they don’t do the work they agree to – but LEAST of all when someone is in the position that the pharmacist is in.  The drugs I get – and reasons I get them –  are a matter of privacy between me and my doctor.  I don’t owe ANY motherfucker ANY explanation of what I need and why they’re needed if I am following my doctor’s orders (I might also go further and say, if I am seeking treatment – particularly the relief of pain – that is really only MY business.)  Any entity who seeks to interfere in a doctor-patient relationship should take their teeth out and gum a bag of rancid dicks.  I might be able to see some wiggle room in this if you OWN the pharmacy, but perhaps not even then – especially if you agree to take the script.  CVS is really the responsible party.  They shouldn’t hire nuts like this.  At the end of the day, CVS needs to get this shit right.  They also need to be way more forthcoming about their policies than they appeared to be in this case.  Few things are more maddening than being fucked with at the pharmacy.
  • I have some experience with folks with PTSD.  It is literally said to be a re-wiring of the brain.  If MDMA helps to wire it back the right way, then it is a miracle drug.  Of course, it is highly predictable that if MDMA does prove to be such a miracle, all users of it will be treated with suspicion or worse.  I guarantee there will be institutions and pundits who will be more concerned with seeking to mitigate any pleasure MDMA might create that isn’t necessary for the drug to treat the patient.  The national illness – Puritanism – which causes people to even THINK of such things is so deeply ingrained in our culture it goes entirely without discussion or scrutiny.  It shows up as a filter in any forward-moving flow.  I pity those with PTSD for many reasons; but adding the stigma of them being junkies or dope fiends or any of the other usual appellations put on those who use medication with euphoria as an effect is cruel.  Fear of that stigma will keep some from the treatment – I guarantee it.  That many with PTSD are those who served the country makes it twice as sick.  That many with PTSD are victims of other types of violence makes it infinitely so.  I simply don’t believe euphoria is our enemy.  I think fear of it betrays some dark shit about those who display it.  They need help, and I want to sympathize – and perhaps one day I will – but for now I can’t.  The damage they create is too great.
  • Fentanyl madness is about to kick into high gear.   There is some data which suggests there is now a spike in Fentanyl compounds much more potent than even the regular stuff.  To read about it is frightening.  If this is true, legalization is the only defense.  The synthetic opiates are so potent they are literally too physically small to interdict.  It would be infinitely better to make heroin available in standardized doses than to allow even a small amount of this shit to be out there.  As I understand it, many would die in they ingested a small grain or two of Fentanyl.  I can only imagine if a car carrying a more potent analog got in a car accident!   Every first responder who breathes around it would be at immediate risk!  The War on Drugs is over – THE DRUGS WON.   It is time to sue for peace.  That peace can’t be worse.
  • Were I to win the lotto, I think I would start a book on the topic of the power dynamics between doctors and patients, particularly for pain patients.  The patient has literally no power.  They have nothing with which to bargain.  They risk sanction and loss of freedom (literally) for shopping for a doctor they like.  If they can’t get what they want by the doctor organically agreeing with them, it is almost impossible to expect they will give it to you for the asking.  You have no power.  You have no voice.  It is like getting in a taxi and hoping they know where you are going, but also, that you can have your life completely destroyed if they don’t.  This study suggests that you basically have 11 seconds to make your case before the doctor tunes out.  These days, those 11 seconds are usually the end of a much longer process of days, weeks, and months of trying to even get the appointment (and once you get it, making sure absolutely nothing will interfere with you making it there because there are no do-overs!)  If you are a new patient, there could be months or years of waiting for this moment.  Our lives have nuance.  Our pain has nuance.  11 seconds is no venue for nuance.  Just sitting here typing this, I would love to open a non-profit that teaches people how to talk to doctors.  To get them to see you – you the actual person.  I think I thought of that because the thought crossed my mind “How does one make that 11 seconds count!?”  What a sad statement.  I guess one doesn’t need a whole non-profit for just this; perhaps a YouTube series would suffice.  Perhaps a video series or a book to let you know what being in pain will mean in terms of treatment.  To train those in pain to have the greatest chance of actually getting relief.  It is something I will have to think about.  I realize I am leaving this kind of open ended and not getting a real narrative built here, but I need to think about it a bit more.  There is really nothing more important than the power dynamic between pain patient and the treatment industry.  There is much more to it than I can cover here.  More to come.  Much to ponder.  The 11-second thing is really disturbing.
  • The only real weapon I can think of to change minds about the hysteria around pain medication is to personalize it.  To ask what people will do when these drugs aren’t available for them when they need them.  I pray no one needs such drugs, but once you need them, the argument is purely academic.  When you are in pain, relief is all you can think of, and barring such pain, that need for relief is almost impossible to imagine.  We are now in experiencing a shortage of pain meds in hospitals.  This is a complete and total disaster.  It is a disaster because the hysteria around opiates seems to have its fingerprints all over this.  What company will now jump in to meet this need knowing they will be sued by people who claim to not understand the known addictive elements of opiates?  The answer is “none”.  It is a failing of us as a species that we need to see self-interest in things before we can be moved to act, but one can hope the thought of experiencing pain of a type we don’t permit pets to experience might motivate some.  What makes this so much worse than other problems is that is almost entirely ginned up as click bait.  Our discussions of it are so over-simplified and backward that no honest motive can be assigned to them.  It is only those who have experienced both the pain of injury and the indignity of suffering who I think understand where this leads.  This is why it is important to fight.  This is why it is essential to be unconcerned with how those without such experience will react to that fight.  The fight is for all even when it feels like it is against all.