NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., IN THE SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NDJOU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
DON’T BLAME THE SACKLER’S OR YOUR DOCTOR
The moment I was indicted for prescribing opioids to an undercover agent posing with leg pain, I knew I had to plead guilty. The narrative around the opioid epidemic was too strong.
Thousands overdosing daily due to prescription opioids doled out recklessly by physicians. A narrative was broadcasted across media outlets over and over.
What we hear repeatedly, we perceive to be true. And when I was accused, I had to plead. In the opioid epidemic, the accusation is the basis for the conviction.
So when I saw various members of the Sackler family testify they are not personally liable for the opioid epidemic, I resonated with their resolute defiance.
I see part of me in them. I hear my story in their words.
The public sees the Sackler family’s defiance as delusion. Of course, the Sackler family deliberately peddled an addictive drug onto the market. Of course, they convinced physicians to prescribe it to their patients. This is the narrative — to deny it is unconscionable.
The funny thing about narratives is they simplify to the lowest common denominator. And in simplifying, they gloss over the details.
In my case, I was accused of excessively prescribing opioids, so the opioids I prescribed to the undercover agent presenting with pain must be criminal, since any physician who prescribes high quantities of opioids must also possess criminal intent.
Never mind the prescription forgeries from my employee, or the police report I filed against her. My prescription count was high, so I must be criminally culpable, despite clinical evidence showing little correlation between prescription count and opioid mortality.
Never mind the lower dose of and the limited number of opioids I prescribed the undercover agent. Any opioid presumed to be medically unnecessary is a crime, despite clinical evidence proving access to care and to prescription opioids reduces illicit opioid abuse.
The narrative about my practice told of a physician who prescribed excessive quantities of opioids and therefore is a criminal. It glossed over the awards received for the high quality of patient care, and the pioneering tele-psychiatry services provided to patients with substance use dependency.
Just like the narrative about the Sackler family simplified into a greedy pharmaceutical company that manipulated physicians into prescribing addictive opioids and coerced patients into becoming addicts to drive profits.
Narratives are powerful because they are simple. But the opioid epidemic is not simple. It is decidedly complex. And like most complex things, not defined by their component parts. No one physician is responsible for the epidemic. Just like no one company or medication is responsible.
THE PROBLEM IS COMPLEX AND SHOULD PLACE BLAME ON US GOVERNMENT LAW ENFORCEMENT FOREIGN POLICIES WHICH HELPS TO GROW HEROIN PRODUCTION (SIGAR REPORT)
WE BLAME INDIVIDUALS
To blame any one person, medication, or corporate entity for a fundamentally complex problem places the burden of responsibility upon select individuals for a problem that should be distributed across society.
We each contributed to the opioid epidemic — myself included. But bearing responsibility differs from being criminally culpable. The difference is nuanced, but complex systems require the study of nuance because this is where we find the solutions.
In trying to resolve this epidemic, we blamed individuals, we aggressively reduced the number of prescription opioids, and we stigmatized opioids into a drug of abuse. Yet the epidemic continues.
Instead, we must parse through the narratives, examine the glossed over details, study the nuances, and appreciate the complex nature of the opioid epidemic.
In doing so, we understand slowing reducing opioids is better than abruptly discontinuing. We understand access to care is better than restricting treatment.
We now need the law to catch up with the medicine
Instead of penalizing the targeted through settlement fees, reinforcing the narrative, we should use the lawsuits to adjust laws around the opioid epidemic, balancing the clinical principles of addiction medicine with the need for clinically sensible legal oversight.
It is a complex balance — medicine and law — but if we achieve this balance, then we can resolve the epidemic.
It is easy to dismiss my perspective and revert to the same well-worn narrative. Perhaps I share the same delusional defiance expressed by the Sackler family.
Or perhaps I reveal the nuanced complexities underlying the narrative.
THIS IS PRECISELY WHY THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION (DEA)NEEDS TO ABOLISH
FOR NOW, YOU ARE WITHIN
(1) Truth Out (2021) — https://truthout.org/articles/the-war-on-drugs-comes-to-the-doctors-office/
(2) NPR (2017) — https://www.npr.org/sections/health-shots/2017/11/24/565360136/telemedicine-for-addiction-treatment-picture-remains-fuzzy
Corroborating legal documents (as per post-conviction relief efforts):
(1) Request for exculpatory evidence on basis of falsified police report and perjured grand jury indictment — https://drive.google.com/file/d/1ApjthkKgnQtoTZkJoHVsyfkJdgEw3xIX/view?usp=sharing
(2) Request for prescriber information based upon actual number of opioids prescribed, as per 2017 Medicare Part D claims — https://drive.google.com/file/d/1G0P_5KQCsk_UrlcXQ8CSjB4mZo25xHJt/view?usp=sharing
(3) Request for clarification on factual basis of conviction given procedural due process violations — https://drive.google.com/file/d/1r22VoZCUbcTnzcM3lK8JERXcSEwCdpZn/view?usp=sharing