Episode 47 - painKiller

The final part of our American healthcare series, painKiller brings together everything we've learned the past two weeks and beyond in Ashes Ashes to explore how the opioid crisis was created and how it is perpetuated to fulfill a single ultimate goal: profit. Pharmaceutical companies, the insurance industry, hospitals, doctors, and politicians - all which ostensibly exist to serve the public have instead mostly contributed to our modern day hellscape of pain, addiction, and increasingly death.

This isn't a show about how the end of the world is looming, this is a look at the ugly truth of collapse affecting people all around us right now.

full transcript available

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This is part three of a three part series on the American healthcare system:

  1. Episode 45 - Bill of Health
  2. Episode 46 - Pill of Sale
  3. Episode 47 - painKiller

Chapters

  • 4:40 Pharma companies create misuse
  • 11:25 Pill Mills
  • 13:42 The modern day problem
  • 19:09 Chronic pain
  • 24:18 Physician frustration
  • 30:16 Making sense of it all
  • 43:21 What can we do?

Sources

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@misc{Anjeanette Damon_2018, title={Denied medical care while detoxing, Texas woman died in a rural Nevada jail}, url={https://www.rgj.com/story/news/2018/08/31/kelly-coltrain-death-nevada-mineral-county-jail-denied-treatment/1145643002/}, journal={Reno Gazette Journal}, author={Anjeanette Damon}, year={2018}, month={Aug} }

@misc{Beall_2018a, title={The history of heroin: From King Tut to cough remedy}, url={https://heroin.palmbeachpost.com/history-of-heroin/}, journal={Igniting an Epidemic}, author={Beall, Pat}, year={2018}, month={Jun} }

@misc{Beall_2018b, title={Purdue Pharma plants seeds of the opioid epidemic in a tiny Virginia town}, url={https://heroin.palmbeachpost.com/purdue-pharma-plants-seeds-of-opioid-epidemic/}, journal={Igniting an Epidemic}, author={Beall, Pat}, year={2018}, month={Jun} }

@misc{Beall_2018c, title={How Florida spread oxycodone across America}, url={https://heroin.palmbeachpost.com/how-florida-spread-oxycodone-across-america/}, journal={Igniting an Epidemic}, author={Beall, Pat}, year={2018}, month={Jul} }

@article{Bennett_2011, title={Methadone Maintenance Treatment: Disciplining the ‘Addict’}, volume={13}, ISSN={1442-1771}, DOI={10.5401/healthhist.13.2.0130}, number={2}, journal={Health and History}, author={Bennett, Cary}, year={2011}, pages={130–157} }

@misc{Bruce Alexander_2010, title={Addiction: The View from Rat Park}, url={http://www.brucekalexander.com/articles-speeches/rat-park/148-addiction-the-view-from-rat-park}, journal={Bruce Alexander}, author={Bruce Alexander}, year={2010}, month={Mar} }

@misc{Carlton_2018, title={Martinsville gets federal funds to help with opioids issue}, url={https://www.martinsvillebulletin.com/news/martinsville-gets-federal-funds-to-help-with-opioids-issue/article_289abb1e-c063-11e8-952a-635fd7d65a6c.html}, journal={Martinsville Bulletin}, author={Carlton, Brian}, year={2018}, month={Sep} }

@article{Chou_Turner_Devine_Hansen_Sullivan_Blazina_Dana_Bougatsos_Deyo_2015, title={The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop}, volume={162}, ISSN={1539-3704}, DOI={10.7326/M14-2559}, number={4}, journal={Annals of Internal Medicine}, author={Chou, Roger and Turner, Judith A. and Devine, Emily B. and Hansen, Ryan N. and Sullivan, Sean D. and Blazina, Ian and Dana, Tracy and Bougatsos, Christina and Deyo, Richard A.}, year={2015}, month={Feb}, pages={276–286} }

@misc{Clinical Pain Advisor_2018, title={Lower Socioeconomic Indicators Linked to Increase in Opioid Prescriptions}, url={https://www.clinicalpainadvisor.com/opioid-addiction/opioids-socioeconomic-factors-increases-prescription-amount/article/735342/}, journal={Clinical Pain Advisor}, author={Clinical Pain Advisor}, year={2018}, month={Jan} }

@article{Dahlhamer_Lucas_Zelaya_Nahin_2018, title={Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults}, volume={67}, ISSN={0149-21951545-861X}, url={https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm}, DOI={10.15585/mmwr.mm6736a2}, journal={MMWR. Morbidity and Mortality Weekly Report}, author={Dahlhamer, James and Lucas, Jacqueline and Zelaya, Carla and Nahin, Richard}, year={2018}, month={Sep} }

@article{Deborah Dowell_Tamara Haegerich_Roger Chou_2016, title={CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016}, volume={65}, ISSN={1057-59871545-8601}, url={https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm}, DOI={10.15585/mmwr.rr6501e1er}, journal={MMWR. Recommendations and Reports}, author={Deborah Dowell and Tamara Haegerich and Roger Chou}, year={2016}, month={Mar} }

@misc{Doward_2018, title={Cost of lifesaving heroin withdrawal drug soars by 700%}, url={https://www.theguardian.com/politics/2018/sep/29/heroin-withdrawal-generic-drug-price-hike}, journal={The Observer}, author={Doward, Jamie}, year={2018}, month={Sep} }

@book{Hari_2015, title={Chasing the Scream: The First and Last Days of the War on Drugs}, ISBN={978-1-62040-892-6}, note={Google-Books-ID: DxAbBQAAQBAJ}, publisher={Bloomsbury Publishing USA}, author={Hari, Johann}, year={2015}, month={Jan} }

@misc{Iqbal Pittalwala_2018, title={Three Factors Could Explain Physician Burnout}, url={https://ucrtoday.ucr.edu/53530}, journal={UCR Today}, author={Iqbal Pittalwala}, year={2018}, month={Aug} }

@misc{Karen Bouffard_2018, title={Opioid-related overdose deaths hit new high in Mich.}, url={https://www.detroitnews.com/story/news/local/michigan/2018/10/04/opioid-related-overdose-deaths-high-michigan/1520040002/}, journal={Detroit News}, author={Karen Bouffard}, year={2018}, month={Oct} }

@misc{Kathleen McKiernan_2018, title={Dangerous jobs face heightened opioid use}, url={http://www.bostonherald.com/news/local_coverage/2018/08/dangerous_jobs_face_heightened_opioid_use}, journal={Boston Herald}, author={Kathleen McKiernan}, year={2018}, month={Aug} }

@misc{Levitz_2018, title={OxyContin Billionaire Patents New Drug for Opioid Treatment}, url={http://nymag.com/intelligencer/2018/09/richard-sackler-oxycontin-billionaire-patent-opioid-addiction-treatment-buprenorphine.html}, journal={Intelligencer}, author={Levitz, Eric}, year={2018}, month={Sep} }

@misc{Lindsey Bever_2018, title={The man who made billions of dollars from OxyContin is pushing a drug to wean addicts off opioids}, url={https://www.washingtonpost.com/news/business/wp/2018/09/08/the-man-who-made-billions-of-dollars-from-oxycontin-is-pushing-a-drug-to-wean-addicts-off-opioids/}, journal={Washington Post}, author={Lindsey Bever}, year={2018}, month={Sep} }

@misc{Lopez_2017a, title={The growing number of lawsuits against opioid companies, explained}, url={https://www.vox.com/policy-and-politics/2017/6/7/15724054/opioid-epidemic-lawsuits-purdue-oxycontin}, journal={Vox}, author={Lopez, German}, year={2017}, month={Jun} }

@misc{Lopez_2017b, title={The opioid epidemic, explained}, url={https://www.vox.com/science-and-health/2017/8/3/16079772/opioid-epidemic-drug-overdoses}, journal={Vox}, author={Lopez, German}, year={2017}, month={Aug} }

@misc{Mariana van Zeller_2009, title={The Oxycontin Express}, url={https://www.youtube.com/watch?v=wGZEvXNqzkM}, number={3–1}, journal={Vanguard}, author={Mariana van Zeller}, year={2009}, month={Oct} }

@misc{Megan Thielking_2017, title={Senator: when people die of overdoses that “just removes them from the gene pool.”}, url={https://www.statnews.com/2017/03/07/missouri-prescription-drug-database/}, journal={STAT}, author={Megan Thielking}, year={2017}, month={Mar} }

@misc{Miya Tokumitsu_2018, title={Tell Me It’s Going to be OK}, url={https://thebaffler.com/salvos/tell-me-its-going-to-be-ok-tokumitsu}, journal={The Baffler}, author={Miya Tokumitsu}, year={2018}, month={Sep} }

@article{Morone_Weiner_2013, title={PAIN AS THE 5TH VITAL SIGN: EXPOSING THE VITAL NEED FOR PAIN EDUCATION}, volume={35}, ISSN={0149-2918}, DOI={10.1016/j.clinthera.2013.10.001}, number={11}, journal={Clinical therapeutics}, author={Morone, Natalia E. and Weiner, Debra K.}, year={2013}, month={Oct}, pages={1728–1732} }

@misc{Raymond_2018, title={Rate of Babies Born to Opioid Addicted Mothers Quadruples}, url={http://nymag.com/intelligencer/2018/08/rate-of-babies-born-to-opioid-addicted-mothers-quadruples.html}, journal={Intelligencer}, author={Raymond, Adam K.}, year={2018}, month={Aug} }

@misc{Samsha_2015, title={Buprenorphine}, url={https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine}, journal={Samsha}, author={Samsha}, year={2015}, month={Jun} }

@misc{Sanger-Katz_2018, title={Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017}, url={https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html}, journal={The New York Times}, author={Sanger-Katz, Margot}, year={2018}, month={Aug} }

@misc{US China Economic and Security Review Commission_2017, title={Fentanyl: China’s Deadly Export to the United States}, url={https://www.uscc.gov/Research/fentanyl-china%E2%80%99s-deadly-export-united-states}, author={US China Economic and Security Review Commission}, year={2017}, month={Feb} }

@misc{Wilber_2018, title={Fentanyl smuggled from China is killing thousands of Americans}, url={http://www.latimes.com/politics/la-na-pol-china-fentanyl-20181019-story.html}, journal={latimes.com}, author={Wilber, Del Quentin}, year={2018}, month={Oct} }

@article{Zhou_Yu_Losby_2018, title={The Association Between Local Economic Conditions and Opioid Prescriptions Among Disabled Medicare Beneficiaries}, volume={56}, ISSN={0025-7079}, DOI={10.1097/MLR.0000000000000841}, number={1}, journal={Medical Care}, author={Zhou, Chao and Yu, Ning Neil and Losby, Jan L.}, year={2018}, month={Jan}, pages={62} }

See the specific page numbers for the sources below:

Chasing the Scream, by Johann Hari: pages 170-172

Published 25-10-2018 00:12