Author of The Painful Truth
When a publication of Harvard Business Review’s caliber prints something, it stands as fact unless an authoritative voice corrects it. Therefore, I feel obligated to comment on Christopher Bowe’s recent HBR article, “Fixing Pharma’s Incentives Problem in the Wake of the U.S. Opioid Crisis.”
I’m disappointed in (although hardly surprised by) the misleading content of the HBR article. If we’re going to solve the opioid crisis, then we have to get our facts straight. So let’s begin.
When I saw NPR’s headline, Investors See Big Opportunities In Opioid Addiction Treatment, I wasn’t sure whether I should feel angry or simply disbelieving. Are investors really earning money on the backs of people suffering from addiction?
So many of us see addiction as a thief who steals our ability to think and function — and maybe even to live. Is it really possible there are people who see addiction as a major business opportunity?
According to “All Things Considered,” the answer is yes. Investors are buying up addiction treatment centers as hot commodities.
State Senator Gene Yaw means well when he suggests teaching all doctors the pros and cons of opioids. In theory, I appreciate what he’s saying and am pleased to see his support for broader education about opioids and pain management.
I often lament the fact that medical students get only about an hour of education in pain management (inclusive of opioid therapy training) before they become doctors. Veterinarians get more training in how to treat pain than medical students. The failure to teach medical students about treating pain has to be corrected before we can solve the opioids crisis.
We don’t yet know why Prince died. The facts aren’t in, and I don’t want to draw conclusions until I have more information.
That said, some entertainment media outlets (TMZ, Variety, and more) are reporting that Prince was treated with naloxone, which is the antidote for opioids including heroin, in the days before his death.
If that were true, it would mean that Prince was taking too much of a substance, whether it was prescribed or not.
But, if that turns out to be the case, it won’t change the fact that he was a musical icon, and it won’t change the fact that the world has lost an irreplaceable voice.
Mindfulness is not a foreign religion or threat to anyone’s religion, despite what some people may assume. We should remember that Walking the Labyrinth is a traditional process by which believers in Christianity can meditate.
All religions have recognized the healing properties of meditation or mindfulness.
Each religion may use its own symbols or mannerisms to practice its style of meditation, but they all come from the same place and serve the same purpose. It is to merge the mind with the body and to provide insight and peace for the purpose of becoming centered.
The death of the New York Times journalist, Sarah Kershaw, reminds me painfully of too many conversations I had with my patients during the course of my career as a pain doctor, about whether or not they wanted to live.
During the 30 years of my practice, countless patients told me they had no hope for a life without severe disabling pain and would, therefore, prefer to die. I believed them.
The CDC reports there are 44 deaths per day that involve opioids, but there are more than 105 deaths per day from suicide. An undoubtedly significant (but uncertain) number of those suicides can be attributed to people with severe pain.
Alec Ross, author of a book called Industries of the Future, writes that, in 20 years, cancer may be curable. We might just be able to “melt it away.”
Frequently, I compare pain to cancer. Believe it or not, pain is far more complex than cancer.
Cancer usually starts from a single DNA mutation. On the other hand, pain may involve multiple mutations that can influence each other and evolve depending on environmental factors.
Cancer involves a physiological process that has been disturbed. Pain involves multiple disturbed processes including cognition, emotions, social interactions, memories and physical stimulus. Genetic mutations that affect the expression and function of each of these areas can affect the dynamic experience of pain.
“There are worse things than dying.” I can’t tell you how many times I heard one of my patients tell me this during my 30 years of practice. The torture of severe pain robs a person of life’s pleasure and for some the only way out is death. In my book, The Painful Truth, I describe an old man I met as an intern. He was a veteran without a family and experiencing terminal, non cancer pain. He begged me to help him die. His words and face continue to haunt me.