Just thought it should be known that I copied and pasted the Commnetary article into ChatGPT to be read aloud and got in trouble because the article goes against their TOS. Of course it does. (To be fair, I input certain article so the AI can learn truth)
I don't think she and many others are against that, but more against DEI, which is neither diverse, equitable nor inclusive--mostly of white and/or male perspectives, and ideological diversity is absolutely verboten.
I imagine a merit-based system is absolutely terrifying to those mediocre 'talents' who've got nothing more than biology and largely fake 'marginalization'.
The problem with designating DEI an enemy is that at least 2/3 of it are wonderful, and have been producing great results for decades. I spent a career in Human Resources with two large corporations in different industries. Far too many studies have demonstrated the financial value to a company of having a diverse organization where inclusion--all ideas welcome--is a focus. In the 90s and early 00s, companies felt they had to prove "the business case" for diversity and inclusion. It was proven long ago, and noticeably, companies don't talk about it anymore, they just enjoy its results. The two very successful companies I worked for, one in consumer products and one in health care, were among them.
Somewhere along the line, someone decided to put an E in D&I. No one can even tell me for sure if it stands for Equality or Equity. Not a good idea, and not necessary. If an organization is successful at D&I, the rest takes care of itself, as a result of the kind of merit-based system you mention.
The problem with the discussion is that most people don't understand D&I, and imagine it to be even worse than Affirmative Action. Oh, we have to hire a woman for this job. Oh, we have to hire a person of color for this job. That kind of deliberate discrimination is as bad as white guys only hiring white guys. Good organizations don't do it. They expand their search to find sufficient quantities of qualified candidates for jobs, and hire good people, and voila!, they have success.
Are there women and people of color who are not very good at their jobs? Of course, and there are a lot of white men who are not very good at their jobs, yet seem to do fine. Those are crappy employee problems, not diversity-induced problems.
So much of the DEI hysteria has been stoked deliberately by journalists such as Bari Weiss. She knows its disingenuous, because she's smart enough to understand the difference. Yet she and others do it anyway. And when someone knows what they are writing is bullshit, and write it anyway, they lose me quick.
I’m not sure about the 2/3rds. I think it’s an idea whose time has come to go. The so-called ‘marginalized’ aren’t nearly as marginalized as they fancy themselves and I’m ready to designate the LGBTQ as the new Apex Privileged (which means, of course, immediate new Whiteness). I mean, they’re getting laws passed successfully to force everyone to bend to their genderwoo, so, AFAIC, they are no longer in need of protection, esp since so many transactivists attack women with impunity at protests and events, or get them cancelled. (Most of them are men underneath the gender appropriation, so la plus ca change). And diversity of opinion is absolutely verboten now. I think it’s time to go back to merit-based hiring et al. I wrote about it a few years back, if you don’t want to read the whole article just scroll down to the part subtitled, “What would a truly merit-based Supreme Court pick system look like?”
I’d be interested in hearing more about the 2/3rds you thought worked well. Would that be, like, the first two-thirds of the DEI project?
The two of three are diversity and inclusion. I think you're conflating potential overreach in legislation with the real value of different perspectives, and the value of ensuring they are included for consideration. D&I continue to be considered extremely valuable in damn near every corporation around, because efforts have been successful for shareholders.
Some in power may wish to forbid diversity of opinion, but they sure as hell haven't yet. There's not a whole lot of it published here at TFP, but among many others, Matt Taibbi and Glenn Greenwald are leaders in that area.
Now, please bear in mind that I am not directing this next thought toward you, as it doesn't seem to fit your perspective. But all the woe-is-me bullshit out there about inept black trans immigrant women getting every job in America that should have gone to a more qualified white guy is cover for those who were never OK in the first place with women in their workplaces (much less as their bosses), and those feelings exist for every other nondominant group they have seen enter American workplaces and society. But guess what? White men are still in charge! The vast, vast majority of white men who are rejected for a job in favor of a woman, Asian, etc. are also rejected when compared to other white men. White men run the government, banks, corporations. And that's where all the power is. But there are plenty of unsuccessful white men who want to blame their lack of success on someone else.
Oliver, the current frenzy over the Supreme Court started with Clarence Thomas taking $2-3 million in gifts from billionaires over 10 years. Alito's dipshit wife's flags are just noise.
Cliff Asness is just another Wall Street whatever, one who loudly opposed even the little bit of regulation Dodd-Frank had to offer. Who gives a shit what he thinks about campus protesters?
Oh, wait. He's Jewish. And if you are a Jewish person, especially if you are a Jewish person with a shitload of money, you can get a shout-out from Bari & friends.
#1- Billy Joel, Paul Simon, Simon and Garfunkle, early Elton John. What more do you need?
#2- All of these anti-capitalists must know that their standard of living far exceeds that of any socialist country. Personally, i think that most are failures who want to drag the rest of us down to their pitiful levels.
#3- Are you joshing me? There is a professional woman's Basketball league? This is the first that I've heard of it.
I would hazard a total guess and say that 90+% of Americans have "never spoken to a journalist before." The only reason I have is that I wrote for the campus paper for a semester in college, and therefore spoke to at least a few wannabe journalists.
Only someone from Boston, New York, Washington, DC, LA, or the Bay Area would think that everyone else talks to reporters all the time. It's not only condescending, it's pretty dense, to use my mom's word for when my brain resisted logic.
The WNBA All-Star game. If anyone watches that, it will only be because Clark presumably is there.
The folks who run women's basketball are brain dead. Professional basketball is entertainment. Their most popular asset should be at every major event even though Clark is clearly not one of the best 12 or whatever number of players are on the Olympic team.
I would really like to see The Free Press explore the pain patient's perspective in the current era of anti-opioid hysteria.
As I have written elsewhere, it is frustrating to see almost nothing in the media but anti-opioid zealotry and half-truths. Medical opioid prescribing has plummeted since 2010; opioid overdoses have doubled over the same period.
Does anyone in the mainstream media see what's happening now to legitimate pain patients and ordinary people going in for surgeries? Do they even care? People are having amputations, hysterectomies, C-sections, joint replacements, and even by-passes -- and being denied effective or even adequate pain control even WHILE STILL IN THE HOSPITAL. People undergoing double-amputations have been given Tylenol. People with sickle-cell anemia. People passing kidney stones. People with terminal cancer.
Ordinary people -- non-addicts who have never refilled pain prescriptions early, never sold or given away their meds, never given anyone any reason to believe they are anything but responsible with their medications -- are now being cut off, force-tapered, prescribed alternative drugs that are ineffective and/or harmful (including suboxone and gabapentin), forced into harmful "interventional pain" procedures actually banned in other countries, and treated like criminals. They are forced to sign humiliating one-sided "pain contracts." To show up on a moment's notice for urine tests or pill counts. Not allowed to change doctors. Not allowed to change pharmacies. Not allowed to be treated for pain in an ER for any reason without permission. Not allowed to travel (lest they be unable to show up promptly for an unexpected-but-demanded urine test at the doctor's office; no other doctor's office will do). And medically abandoned, instantly and irrevocably, for the slightest of reasons.
Legitimate chronic pain patients who were, prior to the anti-opioid hysteria, able to live pretty normal, quality lives, thanks to their meds -- including working, parenting, and enjoying hobbies -- are now bedridden, racked with pain. Many are dying --- some, because they kill themselves when they decide they can't bear their untreated or undertreated pain anymore; some, because untreated pain itself kills (e.g., stroke, heart attacks, uncontrollable blood pressure); and some because they overdose after turning in desperation to the street and its unregulated drug supply after their safe and regulated medications are abruptly withdrawn.
Even those lucky few who still have doctors willing to take the risk of prescribing what they need are finding, more and more, that their pharmacy can't -- or simply won't -- fill their prescriptions. Each year, the FDA and DEA limit ever further the number of pain medications that can be manufactured. Desperate and frightened patients at the end of their previous fills are calling and calling pharmacies looking for any that will admit it has the medication in stock.
And the backdrop of all of this torture -- to the ignoring of legitimate pain and the abandonment of legitimate patients, with every one of us now staring down the likelihood that our own next illness, injury, or need for surgery will come with treatable-but-untreated intense pain -- is that all of this suffering is accomplishing nothing. Or, more accurately, it is having exactly the opposite of the intended impact: Overdose deaths continue to go up and up and up. Because prescribed pain meds are not now the real problem -- and were never more than a fraction of the real problem. The iron law of prohibition is in full swing. Opioid deaths continue to go up and up. Why? Fentanyl. We are literally torturing and killing real people in real pain for NO BENEFIT.
You'll see endless stories of hospitals (including VA hospitals) who have massively cut opioid administration in hospital. The stories are always upbeat and heavy on virtue-signaling. You'll notice, however, that actual patients are not asked or surveyed about their experiences, or about how many would have strongly preferred to have had their pain effectively managed in the hospital.
Even the CDC recognizes that its initial clinical practice guidelines/report -- the one used by states, by the DEA, and by hospitals and insurers to massively cut the opioid medications people need -- was widely misapplied, to the direct harm of tens of thousands of legitimate patients, and has tried to scale back the damage. But it seems to be having little effect in rolling back the devastating FDA and DEA overreach. As long as doctors fear losing their livelihoods and their liberty for prescribing, they will not.
Anyone who has experienced a surgery or injury and enjoyed the benefit of effective pain medication in the hospital should be terrified of the new reality. I know I am. I've never taken pain meds more than 5 to 7 days following a surgical procedure (2 in my 56 years) or bone break (2 in 56 years), but I was very glad to have them then. Thanks to the DEA terrorizing doctors and inserting themselves between doctor and patient -- thanks to health "care" insurance companies now literally paying doctors not to prescribe the meds we need -- we can now all look forward to being treated inhumanely when we are next in pain, or to watching a loved one be treated inhumanely while we are powerless to push back.
For anyone interested in getting a bigger picture, here is a collection of patient stories from the National Pain Council collected last year:
Or just go to X and search for "opioid hysteria." Read stories from people whose loved ones died in agony. Read stories from nurses who are on the front lines and seeing every day what withholding pain medication from hospital patients looks like. Read stories from doctors who are afraid to treat their patients as they want to.
Pain contracts are not for your "ordinary people" but for those patients whose over usage, such as seeing multiple prescribers, has raised concerns and require some outside control.
That is simply not true. It may have been true back in the 80s, when "narcotic contracts" were required only for suspected addicts. But today, pain contracts (or "pain agreements") have become standard of care for patients at pain management clinics -- and pain management clinics have become the only provider available for most long-term pain patients. Such agreements are "voluntary" only in that you are free to be denied care if you refuse to sign one.
The way this usually happens now is that chronic pain patients whose long-term pain has been appropriately managed with opioids by a primary provider for many years are dropped by the provider when he or she decides it is too risky in the current environment (with the DEA) to keep prescribing. Other times, the patient is abandoned when the provider retires. The patient searches for a new provider who will manage pain, and finds that most providers will not now take a new patient on long-term opioid medication (even if there is no indication or reason to suspect the patient has ever abused his or her prescription).
Such patients are typically shuttled to a "pain management" clinic -- where they are required to sign coercive, abusive and stigmatizing "agreements" that typically include agreeing to spur-of-the-moment drug testing and to refuse any pain treatment from any other provider under any circumstances -- even at the dentist or in the emergency room. I have read desperate posts from pain patients who have been dropped by their management clinic for receiving pain management at an emergency room after sustaining a serious injury. Being dropped by a pain management clinic makes it almost impossible to be taken on as a new patient at a different pain management clinic.
Patients are also told they can only fill prescriptions with one pharmacy. This would be fine, except that thanks to the FDA and DEA annually cutting the available supply of opioids, it is increasingly common for a patient's usual pharmacy to be out of the prescribed medication. The patient is not allowed to try to prevent a treatment gap by filling the prescription early, and when the day comes to fill, the pharmacy says it does not have it in stock, there's a shortage, and it can't get the medication for days or weeks.
At many so-called pain management clinics, chronic pain patients are told they are required to undergo questionable, expensive, ineffective, and painful "interventional" treatments (like nerve ablation) before the provider will even consider prescribing the narcotics that have effectively managed the patient's pain for years. (And there is no guarantee that even if the patient jumps through these hoops, he or she will be prescribed the needed medication.)
For the record: I am not myself a chronic pain patient. But I have read many accounts by chronic pain patients, and I have a friend who is going through this hell now in Washington state (her long-time primary provider retired last year). She has an inoperable spinal tumor, disintegrating discs, and Bechet's Disease, with regular extremely painful flare-ups (it causes weeping lesions in her mouth, her eyelids, her vagina, lesions on her skin, severe gastrointestinal problems, cardiac involvement, and severe joint and blood vessel inflammation). During a severe flare-up, she has to be admitted to the hospital for days on a Dilaudid drip. She has never abused her prescribed pain medication -- to the contrary, I remember her primary provider used to be exasperated with her for filling it every 3 months instead of every month. But she's on so much gastro-interfering medication (biologics) for her immuno issues that the additional constipation caused by the pain medication has always been a barrier to use for her. Now, though, her underlying problems are getting progressively worse, and so is the pain. She searched for a new provider after the old one retired, but has been told she has to go to a pain management clinic for the hydrocodone. Every one she's contacted wants her to sign one of these abusive contracts. She's afraid that she'll be called for a drug-test on a day when she is too disabled to drive (these are increasingly frequent for her now), or when she has to be at another medical appointment. This is a person with zero history of drug abuse and a long track record of under-using her legitimate narcotic prescription.
Another friend (a tenant of mine in another state) died from esophageal cancer last spring in Oregon. Her final 6 months were agonizing for her. Not even end-of-life cancer patients can rely on getting effective pain management any more. The doctors would not give her anything stronger than Tramadol (which is not nearly as effective as the opioids most won't prescribe anymore). Again, this is a person with no history of drug abuse, and with an obviously legitimate need for effective pain management. The web is full of accounts by people who are traumatized and grieving over the agony they watched loved ones experience in dying with insufficient pain management.
Too damn many lawyers slobbering at the mouth to sue the living hell out of anyone or anything for anything other than a perfect outcome. Pain killers? People get hooked pretty easily and when their lives fall apart the lawyers show up. The doctors and hospitals are stuck with long expensive trials or just settle for millions. So what do they do? They limit pain meds so they can have a fighting chance to avoid the lawsuits and 7 figure settlements. Just look at what happened to JNJ over baby powder.
Opioids = baby powder? That's a good one. Are you familiar with the J&J case? They were sued by almost every state in the country because they continued selling a product after it was known to be tied to heightened risk of cancer. With no warning. They're lucky they got away with settling.
But thanks for reiterating my point. Yes, JNJ got sued by everyone and their brother. And wasn't that my point?
Take a class in statistics. You will find that correlation does not equate to causation. But most jurors can't understand that so on we go with frivolous lawsuit after frivolous lawsuit that in the end cause all of us to pay more for everything.
No, your point was that "Too damn many lawyers slobbering at the mouth to sue the living hell out of anyone or anything for anything..."
J&J was sued by 40+ State Attorneys General. State Attorneys General are not the typical type to have bus stop bench ads. You are badly mistaking publicly elected officials for Saul Goodman.
Tell us something--were all the State AGs ambulance chasers when they sued the tobacco companies? How about when a couple of them sued the Biden administration for First Amendment violations?
I will believe Attorneys General loooooooooooooong before I trust a large pharmaceutical corporation.
I know you're trying to bag on lawyers, but it comes off as defending J&J. Perhaps if J&J had a few of their own lawyers weigh in, they might not have continued to sell a cancer-adjacent product.
Gabapentin is an anti-seizure medication that is approved only for refractory focal epilepsy and neuropathic pain (for example, shingles, fibromyalgia, diabetes). The problem is that it, like pregabalin, is now being prescribed for both human beings and pets for every imaginable kind of pain (including non-neuropathic pain syndromes, like back pain, sciatica, spinal stenosis, episodic migraine, and post-op pain). Its mechanism of action is simply not effective for non-neuropathic pain. It is especially useless for acute pain, and is now the most-prescribed medication for "off-label" purposes in the U.S. In spite of this, doctors and vets prescribe it now as a general pain reliever because they are afraid to prescribe actual pain relievers.
Gabapentin IS a therapeutic and appropriate medication for specific conditions. But when it is prescribed as a "pain reliever" for non-neuropathic pain, where it will not be effective (instead of opioids, which are), the significant side effects far outweigh the non-existent benefits. It is linked to memory loss, dementia, significant weight gain, dental decay/tooth loss, vision changes/vision loss, and hair loss.
XR: last week I showed up to watch the old hardware store in my neighborhood get torn down. Yes…it was structurally compromised. Yes…people were sad.
I said to the owner of the dry cleaner, a small Asian woman, that perhaps when a few more people showed up we could lie down in front of the bulldozer.
Then I had to explain that it was a time honored American way of protesting, but no…I said it in jest.
Also, I love how Chris Murphy, in his NYT article only talks about unhoused people and shelter. Here are some cold, hard facts.
Adjusted for state population, Mississippi (0.33), Alabama (0.65) and Louisiana (0.69) had the lowest rates of homelessness.https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.usnews.com/news/best-states/articles/states-with-the-most-homeless-people%23:~:text%3DAdjusted%2520for%2520state%2520population%252C%2520Mississippi,the%2520lowest%2520rates%2520of%2520homelessness.&ved=2ahUKEwiP_bbEhOiGAxVy4MkDHf2ECDEQFnoECBQQBQ&usg=AOvVaw21x9eAO_fiumQGnGwO_DCs
Alexandr Wang for President.
Just thought it should be known that I copied and pasted the Commnetary article into ChatGPT to be read aloud and got in trouble because the article goes against their TOS. Of course it does. (To be fair, I input certain article so the AI can learn truth)
Liberal used to be for liberty of the individual (liberal.) It now means group membership bully, or mob authoritarian.
Is trashing diversity and inclusion required by Bari, or just strongly suggested?
I don't think she and many others are against that, but more against DEI, which is neither diverse, equitable nor inclusive--mostly of white and/or male perspectives, and ideological diversity is absolutely verboten.
I imagine a merit-based system is absolutely terrifying to those mediocre 'talents' who've got nothing more than biology and largely fake 'marginalization'.
The problem with designating DEI an enemy is that at least 2/3 of it are wonderful, and have been producing great results for decades. I spent a career in Human Resources with two large corporations in different industries. Far too many studies have demonstrated the financial value to a company of having a diverse organization where inclusion--all ideas welcome--is a focus. In the 90s and early 00s, companies felt they had to prove "the business case" for diversity and inclusion. It was proven long ago, and noticeably, companies don't talk about it anymore, they just enjoy its results. The two very successful companies I worked for, one in consumer products and one in health care, were among them.
Somewhere along the line, someone decided to put an E in D&I. No one can even tell me for sure if it stands for Equality or Equity. Not a good idea, and not necessary. If an organization is successful at D&I, the rest takes care of itself, as a result of the kind of merit-based system you mention.
The problem with the discussion is that most people don't understand D&I, and imagine it to be even worse than Affirmative Action. Oh, we have to hire a woman for this job. Oh, we have to hire a person of color for this job. That kind of deliberate discrimination is as bad as white guys only hiring white guys. Good organizations don't do it. They expand their search to find sufficient quantities of qualified candidates for jobs, and hire good people, and voila!, they have success.
Are there women and people of color who are not very good at their jobs? Of course, and there are a lot of white men who are not very good at their jobs, yet seem to do fine. Those are crappy employee problems, not diversity-induced problems.
So much of the DEI hysteria has been stoked deliberately by journalists such as Bari Weiss. She knows its disingenuous, because she's smart enough to understand the difference. Yet she and others do it anyway. And when someone knows what they are writing is bullshit, and write it anyway, they lose me quick.
I’m not sure about the 2/3rds. I think it’s an idea whose time has come to go. The so-called ‘marginalized’ aren’t nearly as marginalized as they fancy themselves and I’m ready to designate the LGBTQ as the new Apex Privileged (which means, of course, immediate new Whiteness). I mean, they’re getting laws passed successfully to force everyone to bend to their genderwoo, so, AFAIC, they are no longer in need of protection, esp since so many transactivists attack women with impunity at protests and events, or get them cancelled. (Most of them are men underneath the gender appropriation, so la plus ca change). And diversity of opinion is absolutely verboten now. I think it’s time to go back to merit-based hiring et al. I wrote about it a few years back, if you don’t want to read the whole article just scroll down to the part subtitled, “What would a truly merit-based Supreme Court pick system look like?”
I’d be interested in hearing more about the 2/3rds you thought worked well. Would that be, like, the first two-thirds of the DEI project?
https://growsomelabia.substack.com/p/what-would-a-truly-merit-based-supreme
The two of three are diversity and inclusion. I think you're conflating potential overreach in legislation with the real value of different perspectives, and the value of ensuring they are included for consideration. D&I continue to be considered extremely valuable in damn near every corporation around, because efforts have been successful for shareholders.
Some in power may wish to forbid diversity of opinion, but they sure as hell haven't yet. There's not a whole lot of it published here at TFP, but among many others, Matt Taibbi and Glenn Greenwald are leaders in that area.
Now, please bear in mind that I am not directing this next thought toward you, as it doesn't seem to fit your perspective. But all the woe-is-me bullshit out there about inept black trans immigrant women getting every job in America that should have gone to a more qualified white guy is cover for those who were never OK in the first place with women in their workplaces (much less as their bosses), and those feelings exist for every other nondominant group they have seen enter American workplaces and society. But guess what? White men are still in charge! The vast, vast majority of white men who are rejected for a job in favor of a woman, Asian, etc. are also rejected when compared to other white men. White men run the government, banks, corporations. And that's where all the power is. But there are plenty of unsuccessful white men who want to blame their lack of success on someone else.
Oliver, the current frenzy over the Supreme Court started with Clarence Thomas taking $2-3 million in gifts from billionaires over 10 years. Alito's dipshit wife's flags are just noise.
Cliff Asness is just another Wall Street whatever, one who loudly opposed even the little bit of regulation Dodd-Frank had to offer. Who gives a shit what he thinks about campus protesters?
Oh, wait. He's Jewish. And if you are a Jewish person, especially if you are a Jewish person with a shitload of money, you can get a shout-out from Bari & friends.
#1- Billy Joel, Paul Simon, Simon and Garfunkle, early Elton John. What more do you need?
#2- All of these anti-capitalists must know that their standard of living far exceeds that of any socialist country. Personally, i think that most are failures who want to drag the rest of us down to their pitiful levels.
#3- Are you joshing me? There is a professional woman's Basketball league? This is the first that I've heard of it.
On a lighter note- I would much rather see Garfield or Big Foot than the woke garbage currently put out by the Hollywood elite.
Garfield is cute and likes lasagna. What more do I need?
I know! Even that Maverick sequel was a little wokey, pretending that wasn't Iran we were bombing.
The 'never spoken to a journalist before' is condescending and treats the decent people of West Virginia like a circus attraction.
I would hazard a total guess and say that 90+% of Americans have "never spoken to a journalist before." The only reason I have is that I wrote for the campus paper for a semester in college, and therefore spoke to at least a few wannabe journalists.
Only someone from Boston, New York, Washington, DC, LA, or the Bay Area would think that everyone else talks to reporters all the time. It's not only condescending, it's pretty dense, to use my mom's word for when my brain resisted logic.
The WNBA All-Star game. If anyone watches that, it will only be because Clark presumably is there.
The folks who run women's basketball are brain dead. Professional basketball is entertainment. Their most popular asset should be at every major event even though Clark is clearly not one of the best 12 or whatever number of players are on the Olympic team.
Hmmm.....internal IDF memos re: pre- Oct 7th?
https://share.newsbreak.com/7csrcr4l
I appreciate the recommendation for "Blinded By The Light." I hadn't heard of it before, but based on the preview and reviews it looks worth watching.
I would really like to see The Free Press explore the pain patient's perspective in the current era of anti-opioid hysteria.
As I have written elsewhere, it is frustrating to see almost nothing in the media but anti-opioid zealotry and half-truths. Medical opioid prescribing has plummeted since 2010; opioid overdoses have doubled over the same period.
Does anyone in the mainstream media see what's happening now to legitimate pain patients and ordinary people going in for surgeries? Do they even care? People are having amputations, hysterectomies, C-sections, joint replacements, and even by-passes -- and being denied effective or even adequate pain control even WHILE STILL IN THE HOSPITAL. People undergoing double-amputations have been given Tylenol. People with sickle-cell anemia. People passing kidney stones. People with terminal cancer.
Ordinary people -- non-addicts who have never refilled pain prescriptions early, never sold or given away their meds, never given anyone any reason to believe they are anything but responsible with their medications -- are now being cut off, force-tapered, prescribed alternative drugs that are ineffective and/or harmful (including suboxone and gabapentin), forced into harmful "interventional pain" procedures actually banned in other countries, and treated like criminals. They are forced to sign humiliating one-sided "pain contracts." To show up on a moment's notice for urine tests or pill counts. Not allowed to change doctors. Not allowed to change pharmacies. Not allowed to be treated for pain in an ER for any reason without permission. Not allowed to travel (lest they be unable to show up promptly for an unexpected-but-demanded urine test at the doctor's office; no other doctor's office will do). And medically abandoned, instantly and irrevocably, for the slightest of reasons.
Legitimate chronic pain patients who were, prior to the anti-opioid hysteria, able to live pretty normal, quality lives, thanks to their meds -- including working, parenting, and enjoying hobbies -- are now bedridden, racked with pain. Many are dying --- some, because they kill themselves when they decide they can't bear their untreated or undertreated pain anymore; some, because untreated pain itself kills (e.g., stroke, heart attacks, uncontrollable blood pressure); and some because they overdose after turning in desperation to the street and its unregulated drug supply after their safe and regulated medications are abruptly withdrawn.
Even those lucky few who still have doctors willing to take the risk of prescribing what they need are finding, more and more, that their pharmacy can't -- or simply won't -- fill their prescriptions. Each year, the FDA and DEA limit ever further the number of pain medications that can be manufactured. Desperate and frightened patients at the end of their previous fills are calling and calling pharmacies looking for any that will admit it has the medication in stock.
And the backdrop of all of this torture -- to the ignoring of legitimate pain and the abandonment of legitimate patients, with every one of us now staring down the likelihood that our own next illness, injury, or need for surgery will come with treatable-but-untreated intense pain -- is that all of this suffering is accomplishing nothing. Or, more accurately, it is having exactly the opposite of the intended impact: Overdose deaths continue to go up and up and up. Because prescribed pain meds are not now the real problem -- and were never more than a fraction of the real problem. The iron law of prohibition is in full swing. Opioid deaths continue to go up and up. Why? Fentanyl. We are literally torturing and killing real people in real pain for NO BENEFIT.
You'll see endless stories of hospitals (including VA hospitals) who have massively cut opioid administration in hospital. The stories are always upbeat and heavy on virtue-signaling. You'll notice, however, that actual patients are not asked or surveyed about their experiences, or about how many would have strongly preferred to have had their pain effectively managed in the hospital.
Even the CDC recognizes that its initial clinical practice guidelines/report -- the one used by states, by the DEA, and by hospitals and insurers to massively cut the opioid medications people need -- was widely misapplied, to the direct harm of tens of thousands of legitimate patients, and has tried to scale back the damage. But it seems to be having little effect in rolling back the devastating FDA and DEA overreach. As long as doctors fear losing their livelihoods and their liberty for prescribing, they will not.
Anyone who has experienced a surgery or injury and enjoyed the benefit of effective pain medication in the hospital should be terrified of the new reality. I know I am. I've never taken pain meds more than 5 to 7 days following a surgical procedure (2 in my 56 years) or bone break (2 in 56 years), but I was very glad to have them then. Thanks to the DEA terrorizing doctors and inserting themselves between doctor and patient -- thanks to health "care" insurance companies now literally paying doctors not to prescribe the meds we need -- we can now all look forward to being treated inhumanely when we are next in pain, or to watching a loved one be treated inhumanely while we are powerless to push back.
For anyone interested in getting a bigger picture, here is a collection of patient stories from the National Pain Council collected last year:
https://704935b5-03fb-4b17-beea-2ec9b6b07625.usrfiles.com/ugd/704935_86e0e747117a40ed87b10716ccac50b1.pdf
Or just go to X and search for "opioid hysteria." Read stories from people whose loved ones died in agony. Read stories from nurses who are on the front lines and seeing every day what withholding pain medication from hospital patients looks like. Read stories from doctors who are afraid to treat their patients as they want to.
It's appalling.
Pain contracts are not for your "ordinary people" but for those patients whose over usage, such as seeing multiple prescribers, has raised concerns and require some outside control.
That is simply not true. It may have been true back in the 80s, when "narcotic contracts" were required only for suspected addicts. But today, pain contracts (or "pain agreements") have become standard of care for patients at pain management clinics -- and pain management clinics have become the only provider available for most long-term pain patients. Such agreements are "voluntary" only in that you are free to be denied care if you refuse to sign one.
The way this usually happens now is that chronic pain patients whose long-term pain has been appropriately managed with opioids by a primary provider for many years are dropped by the provider when he or she decides it is too risky in the current environment (with the DEA) to keep prescribing. Other times, the patient is abandoned when the provider retires. The patient searches for a new provider who will manage pain, and finds that most providers will not now take a new patient on long-term opioid medication (even if there is no indication or reason to suspect the patient has ever abused his or her prescription).
Such patients are typically shuttled to a "pain management" clinic -- where they are required to sign coercive, abusive and stigmatizing "agreements" that typically include agreeing to spur-of-the-moment drug testing and to refuse any pain treatment from any other provider under any circumstances -- even at the dentist or in the emergency room. I have read desperate posts from pain patients who have been dropped by their management clinic for receiving pain management at an emergency room after sustaining a serious injury. Being dropped by a pain management clinic makes it almost impossible to be taken on as a new patient at a different pain management clinic.
Patients are also told they can only fill prescriptions with one pharmacy. This would be fine, except that thanks to the FDA and DEA annually cutting the available supply of opioids, it is increasingly common for a patient's usual pharmacy to be out of the prescribed medication. The patient is not allowed to try to prevent a treatment gap by filling the prescription early, and when the day comes to fill, the pharmacy says it does not have it in stock, there's a shortage, and it can't get the medication for days or weeks.
At many so-called pain management clinics, chronic pain patients are told they are required to undergo questionable, expensive, ineffective, and painful "interventional" treatments (like nerve ablation) before the provider will even consider prescribing the narcotics that have effectively managed the patient's pain for years. (And there is no guarantee that even if the patient jumps through these hoops, he or she will be prescribed the needed medication.)
For the record: I am not myself a chronic pain patient. But I have read many accounts by chronic pain patients, and I have a friend who is going through this hell now in Washington state (her long-time primary provider retired last year). She has an inoperable spinal tumor, disintegrating discs, and Bechet's Disease, with regular extremely painful flare-ups (it causes weeping lesions in her mouth, her eyelids, her vagina, lesions on her skin, severe gastrointestinal problems, cardiac involvement, and severe joint and blood vessel inflammation). During a severe flare-up, she has to be admitted to the hospital for days on a Dilaudid drip. She has never abused her prescribed pain medication -- to the contrary, I remember her primary provider used to be exasperated with her for filling it every 3 months instead of every month. But she's on so much gastro-interfering medication (biologics) for her immuno issues that the additional constipation caused by the pain medication has always been a barrier to use for her. Now, though, her underlying problems are getting progressively worse, and so is the pain. She searched for a new provider after the old one retired, but has been told she has to go to a pain management clinic for the hydrocodone. Every one she's contacted wants her to sign one of these abusive contracts. She's afraid that she'll be called for a drug-test on a day when she is too disabled to drive (these are increasingly frequent for her now), or when she has to be at another medical appointment. This is a person with zero history of drug abuse and a long track record of under-using her legitimate narcotic prescription.
Another friend (a tenant of mine in another state) died from esophageal cancer last spring in Oregon. Her final 6 months were agonizing for her. Not even end-of-life cancer patients can rely on getting effective pain management any more. The doctors would not give her anything stronger than Tramadol (which is not nearly as effective as the opioids most won't prescribe anymore). Again, this is a person with no history of drug abuse, and with an obviously legitimate need for effective pain management. The web is full of accounts by people who are traumatized and grieving over the agony they watched loved ones experience in dying with insufficient pain management.
Too damn many lawyers slobbering at the mouth to sue the living hell out of anyone or anything for anything other than a perfect outcome. Pain killers? People get hooked pretty easily and when their lives fall apart the lawyers show up. The doctors and hospitals are stuck with long expensive trials or just settle for millions. So what do they do? They limit pain meds so they can have a fighting chance to avoid the lawsuits and 7 figure settlements. Just look at what happened to JNJ over baby powder.
Opioids = baby powder? That's a good one. Are you familiar with the J&J case? They were sued by almost every state in the country because they continued selling a product after it was known to be tied to heightened risk of cancer. With no warning. They're lucky they got away with settling.
No, Lawsuits = lawsuits. Get it now?
But thanks for reiterating my point. Yes, JNJ got sued by everyone and their brother. And wasn't that my point?
Take a class in statistics. You will find that correlation does not equate to causation. But most jurors can't understand that so on we go with frivolous lawsuit after frivolous lawsuit that in the end cause all of us to pay more for everything.
No, your point was that "Too damn many lawyers slobbering at the mouth to sue the living hell out of anyone or anything for anything..."
J&J was sued by 40+ State Attorneys General. State Attorneys General are not the typical type to have bus stop bench ads. You are badly mistaking publicly elected officials for Saul Goodman.
Tell us something--were all the State AGs ambulance chasers when they sued the tobacco companies? How about when a couple of them sued the Biden administration for First Amendment violations?
43 states have an elected attorney general. So, what does that make them? Politicians.
And your case is that a bunch of lawyer politicians are just and fair? Just like Joe Biden?
I will believe Attorneys General loooooooooooooong before I trust a large pharmaceutical corporation.
I know you're trying to bag on lawyers, but it comes off as defending J&J. Perhaps if J&J had a few of their own lawyers weigh in, they might not have continued to sell a cancer-adjacent product.
Gabapentin is an anti-seizure medication that is approved only for refractory focal epilepsy and neuropathic pain (for example, shingles, fibromyalgia, diabetes). The problem is that it, like pregabalin, is now being prescribed for both human beings and pets for every imaginable kind of pain (including non-neuropathic pain syndromes, like back pain, sciatica, spinal stenosis, episodic migraine, and post-op pain). Its mechanism of action is simply not effective for non-neuropathic pain. It is especially useless for acute pain, and is now the most-prescribed medication for "off-label" purposes in the U.S. In spite of this, doctors and vets prescribe it now as a general pain reliever because they are afraid to prescribe actual pain relievers.
Gabapentin IS a therapeutic and appropriate medication for specific conditions. But when it is prescribed as a "pain reliever" for non-neuropathic pain, where it will not be effective (instead of opioids, which are), the significant side effects far outweigh the non-existent benefits. It is linked to memory loss, dementia, significant weight gain, dental decay/tooth loss, vision changes/vision loss, and hair loss.
https://web.archive.org/web/20190621063105/https://www.nytimes.com/2019/05/20/well/live/millions-take-gabapentin-for-pain-but-theres-scant-evidence-it-works.html
I think ruining priceless art is a crime against humanity.
"Abortion Saves Lives" is quite a mantra, considering that every abortion results -- or is supposed to result -- in at least one death.
You will never get the media to say that.
XR: last week I showed up to watch the old hardware store in my neighborhood get torn down. Yes…it was structurally compromised. Yes…people were sad.
I said to the owner of the dry cleaner, a small Asian woman, that perhaps when a few more people showed up we could lie down in front of the bulldozer.
Then I had to explain that it was a time honored American way of protesting, but no…I said it in jest.
XR and their ilk sicken me.