NORMAN J CLEMENT RPH., DDS, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS

“the DOJ has adopted eugenics or Neo-Eugenics. As David SteinMD put it, they’ve resurrected and repackaged the old eugenic philosophy so that history doesn’t repeat itself, but it, sure enough, rhymes...”@marktwain

DOES NOT THE MAN BEHIND THE WHEEL SEEK FURTHER REVIEW

YOUAREWITHINTHENORMS.COM PODCAST ANALYSIS OF FACTS SUPPORTING THIS PRESENTATION BELOW: WAR ON PAIN DOCTORS

Kolodny’s Prescription Opioid Use Disorder and Gladwell’s Tipping Points Akin to Social Murder Observation

Lack of effective pain relief is harming millions of Americans and people in Canada. (The American Council on Science and Health)

This article attempts to bring forth the truth, by highlighting the science and facts and expose false and fraudulent narrative and the crucial role Physicians like Dr. Christopher Russo, MD an Interventional Anesthesiologist Pain Specialist play in the understanding and treatment of pain.

In a cleverly manipulated, ” perverse system” of Social Murder and Dehumanization of Chronically ill persons and Intractable Pain Patients, that allows law enforcement officials to keep the assets of suspected drug defendants for their own, local police departments.” (Libby Report 2005)

The concept of “social murder,” initially coined by Friedrich Engels to describe the systemic killing of workers through exploitative capitalism aligns summarily with the thinkings of both Kolodny and Gladwell; as this article expands this concept to encompass modern information warfare, where the manipulation of narratives and suppression of free speech cause a “moral and intellectual” death.

Examples include the denial of healthcare, particularly pain management, and the silencing of dissent such as seen with United States Drug Enforcement and United States Department of Justice “War and Intimidation of Physicians, Pharmacist Dentists, Nurse practitioners and specifically the action again Dr. Christopher R. Russo, MD., et al.

Pointing out in this discussion those controlling information and healthcare systems bear responsibility for this modern form of social murder, advocating for public policy action to address these issues. This parallels Engels’ critique, highlighting the enduring need to fight against systemic injustices that endanger lives and freedoms.

DR. ANDREW KOLODNY, MD., IDENTIFIED AS “AMERICA’S MOST DANGEROUS PSYCHIATRIST”

Is a Psychiatrist, Brandies University, have testified as paid witnesses for plaintiff law firms involved in opioid litigation, making as much as $725 an hour by misidentifying narcotic analgesic prescribing by equating there use as heroin pills.

Further Kolodny’s thinking fails to present an understanding that these medications and these medicinal products are not for recreational used and has shown pain patients are suffering badly resulting increased pain, reduced quality of life, contemplating suicide and even committing suicide and are buying drugs on the black market.  There is yet another request by American doctors to the CDC for them to withdraw their opioid prescribing guideline which has caused so much needless suffering. (The American Council on Science and Health)

The AMA pointed out that “CDC’s threshold recommendations continue to be used against patients with pain to deny care.

We know that this has harmed patients with cancer, sickle cell disease, and those in hospice.

The restrictive policies of medical dehumanization also fail patients who are stable on long-term opioid therapy.” (The American Council on Science and Health)

Thus resulting increased pain, reduced quality of life, contemplating suicide and even committing suicide and are buying drugs on the black market. 

KOLODNY’S MEDICAL LOBBY OPPOSITION TO HUMANITY

Opposed to this is the medical lobby Physicians for Responsible Opioid Prescribing (PROP) who were instrumental in having the guidelines passed and who also influenced the Canadian guidelines which followed in 2017.

At least four PROP board members, including founder Andrew Kolodny, MD, have testified as paid witnesses for plaintiff law firms involved in opioid litigation, making as much as $725 an hour. (The American Council on Science and Health)

ANDREW KOLODNY, MD., TOP U.S. GOVERNMENT EXPERT

Chronic Pain Care Patients, are being dehumanized a Social Murder thru forced tapered by their doctors treating them in degrading ways that results to many experiencing themselves as less than human, denying that they have mental states,

a) The Medical Profession conceiving of other people with addiction as less human than oneself, Pharmacists and,

b) The Practices of Pharmacy Profession conceiving of intractable pain sufferers as inanimate objects, and conceiving people who suffer the effects of Sickel Cell Diseases as subhuman animals.”

A RARE CASE OF GOVERNMENT PROMOTING EUGENICS??

Most importantly Racial Bias forms a critical part of Kolodny’s Anti Opioid (Narcotic Analgesic) Campaign is which he stated 2018 in the New York Times and titled, A Rare Case Where Racial Biases,’ Protected African-Americans. , “ racial bias in pain care protected AfricanAmericans” had concluded Dr. Andrew Kolodny, MD.

While the DOJ-DEA law enforcement has quietly adopted the philosophy of Eugenics in the use of Narcotics Analgesics in the treatment of Chronic and Acute pain. This thinking has surplanted clinical discretion and judgment of your healthcare provider with that of over prescribing and drug trafficking.  

Ironically, Dr. Kolodny’s was serving at the time as one of the U.S. Governments Top Expert during the Obama Administration receiving millions of dollars in funding.

“SOCIAL MURDER“

In the 19th century, Friedrich Engels introduced the term “social murder” in his seminal work, The Condition of the Working-Class in England, to describe the systemic exploitation leading to the premature death of workers.

According to the Eugenic Archives;

The term “dehumanization” was coined in the early 19th century and has acquired a wide range of meanings closely identical to how Engel’s defines of Social Murder that include treating certain people in degrading ways (for instance, merely as means to an end), referring to them as non-human animals or as inanimate objects, and denying that they possess distinctively human characteristics.

Constructions akin to Engels’ Social Murder Obsrvation and the War for Truth in the Age of 5^th Generation Information Warfare

Engels pointed out four core components of this concept: 

Exploitation: The relentless extraction of labor from the working class under capitalism.

Premature Death: The resultant health deterioration and early mortality due to harsh living and working conditions.

Awareness: The acknowledgment by the ruling class of these conditions yet choosing inaction.

Responsibility: The culpability of the bourgeoisie for these deaths, akin to murder due to their negligence.

Fast forward to contemporary times, the term “social murder” has seen a resurgence, (neo eugenics) particularly and the detrimental health outcomes of austerity measures illustrate this enduring problem. SCD which disproportionately impacts Black communities, with approximately 90% of diagnosed individuals being of non-Hispanic Black or African American descent.

These disparity highlights significant health inequities the “Social Murder” concepts of Kolodny’s pescription opioid use disorder (P-OUD) and Gladwellean Tipping Points both fail and need to be addressed.

The DEA’s aggressive investigative procedures poison the doctor-patient relationship from both sides and Law Enforcement Personnel issued in 2004 appeared to be consistent with these principles, so we were surprised when they were withdrawn.

The Interim Policy Statement, “Dispensing of Controlled Substances for the Treatment of Pain,” which was published in the Federal Register on November 16, 2004, emphasizes enforcement, and seems likely to have a chilling effect on physi- cians engaged in the legitimate practice of medicine.

As Attorneys General have worked to remove barriers to quality care for citizens of our states at the end of life, we have learned that adequate pain management is often difficult to obtain because many physicians fear investiga- tions and enforcement actions if they prescribe adequate levels of opioids or have many patients with prescriptions for pain medications.136 

Moreover, the concept extends beyond class to encompass profililig by pharmacists intrinsict Chronic Pain Sufferer systemic racism, in medical care treatments in Chronic Pain Diseases such Sickel Cell and risk factors.

Which, are the essence of prevention easing of Adhesive Arachnoiditis; Epstein Barr Virus reactive in stress, trauma, medical procedures, severe infection, and psychological stress that will activating ones bodies cortisones, (a Natural response) AB but also activates (auto-antibodies) infiltrates a persons tissues inflammation, scaring and pain.

Futher along with Cytochrome P450 abnormalities, intractable pain (genetic abnormality or dynamic normality specific to each patient), there are NO one size fits all.

The witholding of pain care treatment by Pharmacists in Sacardosis, or during a Sickel Cell Crisis where the devaluation of Black lives can be seen as a form of social murder, perpetuating through societal structures and attitudes. 

The American Medical Association (AMA) has pointed out that;

“CDC’s threshold recommendations continue to be used against patients with pain to deny care. We know that this has harmed patients with cancer, sickle cell disease, and those in hospice. The restrictive policies also fail patients who are stable on long-term opioid therapy.”

” The Monsters in our mist, every American citizen who is human and their families, their son’s daughter’s mother’s father’s Brothers Enemy Number One Andrew Kolodny, a Psychopathic psychiatrist and his tyrannical, barbaric hate group anti-pain relief and anti- unreplaceable pain medicine P R O P that’s hate group anti-poon relief anti- unreplaceable pain medicine hate group prop that by putting out there 2016 100% admitted genocidal death plan 100% propaganda, 100% total lies, 100% proven unscientific false data along with Thomas Friedman head of the CDC in 2016 bogus misinformation quotation guidelines, not laws!

Not one of these individuals having any Physical Medicine training or experience encroached upon a whole nation of Physical Medicine doctors and their American citizen patients suffering and horrible pain, perjuring themselves and duping the complete American public and all of our politicians false reclaiming they were physical Medical experts which is we will know was this far from the truth.” 

Red Flags and Lack of Medical Expertise: The DEA relies on “Red Flags” like high prescribing volume or cash payments to identify potential criminal behavior among physicians.

Critics argue these indicators are often consistent with legitimate pain management practices and that investigators lack the medical training to differentiate. (Libby Report 2005)

Asset Forfeiture: The DEA’s use of asset forfeiture, seizing assets from suspected physicians even before conviction, is criticized as a perverse incentive that allows law enforcement to profit from investigations. (Libby Report 2005)

Historical Parallels with the Harrison Act: The prosecution of physicians for prescribing opioids is compared to the persecution of doctors under the Harrison Act of 1914, which criminalized the prescription of narcotics to addicts, leading to mass arrests and the collapse of addiction treatment. (Libby Report 2005)

@bobsheerin.apdf

♬ original sound – Bob Sheerin

Chilling Effect on Pain Management: The fear of DEA scrutiny has created a chilling effect on pain management, with physicians hesitant to prescribe opioids even when medically necessary, resulting in undertreatment of chronic pain and suffering for patients. (Brief for Amicus Curiae National Pain Advocacy Center)

Misleading Narratives and Disinformation: Critics argue that the DEA and other agencies have promoted misleading narratives about the opioid crisis, conflating legitimate medical practice with illegal drug trafficking and fueling public fear. (McQuade’s warnings)

SHADOWING GLADWELLEANS OPIOID-AMYLOID HYPOTHESIS THE TIPPING POINT OF 25 YEARS OF MIS-INFORMATION

The DEA’s attempt to blame physicians for the drug’s street availability seems arbitrary, unjustified, and capricious.” However, the so called drug epidemic is increasingly attributed to US government regulations, particularly those implemented by the DEA. (Libby Report 2005)

Critics point to the agency’s control over the manufacturing and distribution of legal narcotics, arguing that the vast quantities of stolen or lost pharmaceuticals, rather than prescriptions written by doctors, are the root cause of the crisis.

This suggests that the focus should shift from targeting prescribers to addressing systemic failures in the pharmaceutical supply chain. (Libby Report 2005)

The provided text examines the controversial prosecution of pain doctors for opioid prescribing practices. 

The DOJ-DEA manufactures a standard for criminal liability that overly deters and may cause medical professionals to act against their best medical judgment due to fear of oversight. It has a chilling effect on their willingness to care for patients in pain.

It details the history of opioid use in pain management, highlighting the shift from treating only terminal cancer patients to including those with chronic pain.  (Brief for Amicus Curiae National Pain Advocacy Center)

“The aggressive targeting of medical professionals who prescribe pain medication has often been fueled by misleading narratives about the opioid crisis, conflating legitimate medical practice with illegal drug trafficking​.” (Commentary on McQuade’s warnings)

According to the DEA, the prosecution of any given doctor is based on whether there is a “legitimate medical purpose” for a prescription he has written or whether it is “beyond the bounds of medical practice.”

Doctors in practice by themselves and older doctors are often painted by investigators as rubes, easily duped by addicts, or unable to stop freely prescribing narcotics in the manner they did during more permissive times. (Libby Report 125)

Such reliance on subjective “red flags,” asset forfeiture practices, and the promotion of misleading narratives raise concerns about the agency’s overreach and lack of understanding of legitimate medical practice.

Thus, the text of this article addresses a re-evaluation of the DEA’s approach, particularly in the U.S. vs. Bothra et al., which is necessary to ensure that patients with legitimate pain needs have access to appropriate care without subjecting physicians to unwarranted prosecution. 

YOUAREWITHINTHENORMS.COM PODCAST ANALYSIS OF FACTS SUPPORTING THIS PRESENTATION BELOW: “Social Murder in the Digital Age”

FORCE TAPERING

The American Psychiatric Association reported on a study on the impact of tapering for chronic pain patients who have been getting high dose opioids. They concluded that;

“Among patients prescribed stable, long-term, higher-dose opioid therapy, tapering events were significantly associated with increased risk of overdose and mental health crisis”.

I’m struggling with 2nd forced taper I can’t eat, sleep, walk, sit; in emotionally & physically depleted !! I deserve quality of life !! Born with Hip dysplasia, tilted tibia, scar tissue, ankle rotated, spinal curve has caused so much damage to my body & soul.. I want to live.

OPIOIDS AN EPIDEMIC OF GLADWELLEAN GHOST OF STUPIDITY

YOUAREWITHINTHENORMS.COM PODCAST ANALYSIS OF FACTS SUPPORTING THIS PRESENTATION BELOW: “Social Murder in the Digital Age”

Russo’s story click below

DECEPTION BY OMISSION

AND

THE COMPLEXITY OF PAIN MANAGEMENT

WHO PRACTICES MEDICINE IN AMERICA, PROSECUTORS OR PHYSICIANS?

However, there is no single standard of care for treating pain, and views on opioid prescribing are in flux.

#MedTwitter – this is the backstory that you should hear about the opioid crisis.

It’s a doozy….https://t.co/6Tjfto3oR9

— Liza Lockwood (@DrLizaMD) August 3, 2024

Prosecutors concede that no specific guidelines or procedures exist to evaluate either of those standards.

At a Healthcare Fraud Prevention and Funds Recovery Summit in Washington, DC, in 2004, Greg Wood, a federal investigator for the U.S. attorney’s office in Virginia, said the government aims to produce probable cause that a doctor:

(a) intentionally wrote a narcotics prescription for patients without legitimate medical needs,

(b) knew the patients getting the prescriptions were addicts, or

(c) knew the patients getting the prescriptions were selling the drugs.126 Any of those is sufficient for an arrest. 

The DEA continues to lower its evidentiary standards, making it nearly impossible for many doctors to determine what is and isn’t permitted.

CLICK ON HERE: SEE VIDEO OF DR. MARK IBSEN, MD, ON THE CONSTRUCTS OF THE TIPPING POINTS OF GLADWELLEAN SOCIAL MURDER

Historical Parallels with the Harrison Act:

The prosecution of physicians for prescribing opioids is compared to the persecution of doctors under the Harrison Act of 1914, shown in the timeline listed criminalized the prescription of narcotics to addicts, leading to mass arrests and the collapse of addiction treatment. (Libby Report 2005)

1914:

The Harrison Narcotics Act is passed, criminalizing the non-medical use of opium, morphine, and cocaine. This law effectively criminalizes addiction and leads to the prosecution of many doctors for prescribing narcotics to addicted patients.

1914-1938:

Approximately 25,000 doctors are arrested under the Harrison Act, facing trials, loss of reputation, and financial ruin.

1980s

Physicians specializing in opioid treatment for terminal cancer pain begin advocating for the use of opioids to treat non-terminal chronic pain. This new approach sparks debate within the medical community.

1990s:

Sales of prescription pain medications surge due to the growing acceptance of opioid therapy for chronic pain.

2000-2001:

The Department of Justice criticizes the DEA for its lack of measurable success in reducing the illegal drug supply. The DEA is urged to find a new front in the War on Drugs with tangible results.

2002:

Glen A. Fine, Inspector General of the Department of Justice, questions why the DEA isn’t focusing more on prescription drug abuse, considering its scale.

DEA Commissioner Asa Hutchinson announces a shift in focus from illicit drugs in urban areas to prescription painkillers in rural areas, citing the “emerging opioid threat.”

Hutchinson compares OxyContin to illegal drugs like cocaine and heroin, generating public fear and linking a legal prescription drug with illicit substances.

2003:

At a training conference for drug diversion agents, Detective Dennis M. Luken encourages investigators to target physicians, emphasizing asset forfeiture as a key strategy.

2004:

At a Healthcare Fraud Prevention and Funds Recovery Summit, federal investigator Greg Wood outlines the government’s criteria for targeting doctors, focusing on illegitimate medical purposes, knowingly prescribing to addicts, and knowingly prescribing for drug diversion.

2005:

Ronald Libby publishes “Treating Doctors as Drug Dealers: The DEA’s War on Prescription Painkillers,” highlighting the DEA’s aggressive tactics and the chilling effect on pain management.

December 6, 2018:

Dr. Christopher Russo’s home is raided by the FBI, marking the beginning of a 3.5-year legal battle.

This is argued to be due to flawed investigations and an absence of a unified standard of care for pain treatment, resulting in unwarranted criminal charges and asset forfeiture.

The timeline ultimately supports the view that this approach is unjust and harms patients in the widely touted U.S. so-called “opioid crisis.”

!!PEOPLE ARE NOT TREATED WITH PREJUDICE AND INHUMANITY!!

The Drug Enforcement Administration’s (DEA) shift in focus from illicit drugs to prescription painkillers, particularly opioids, has created a climate of fear among physicians, leading to the undertreatment of chronic pain and potential harm to patients.

The DEA’s reliance on circumstantial evidence (“red flags”) and asset forfeiture practices in targeting physicians is criticized for being arbitrary and lacking medical expertise, leading to the prosecution of well-meaning doctors.

This aggressive approach echoes the historical persecution of physicians under the Harrison Act of 1914, raising concerns about the DEA acting as a “morality police” rather than a regulatory body.

The lack of clear guidelines and the ever-changing standards for opioid prescribing leave physicians vulnerable to prosecution, forcing them to prioritize self-protection over patient care.

As reported earlier by Andy Smith

On the rare occasions when pain patients do develop substance abuse, the primary factors that predict risk are related to identifiable mental health issues in patient records — not prescription opioids.

SICKEL CELL DISEASE PAIN DISCRIMINATION: A SUPPOSITION OF GLADWELLEAN STUPIDITY

A FALSE NARRATIVE OF DISINFORMATION IS DEPENDENT UPON THE IGNORANCE OF JOURNALISTS SUCH AS TRESA BALDAS AND ROBERT SNELL PROMOTING

However, the media’s embrace of disinformation and a gravitational ignorance of healthcare science and protocols are on trial and, most importantly, the denial of humanity.

To dominate the narrative media, such as Detroit News Reporter Robert Snell, by fascinating fools and enablers, those blinded by the journalistic shadows of this false cave narrative rejecting what they have been informed are the realities of medical science.

For example, in the case of Detroit Pain Center, Robert Snell, a reporter, reported that.

@robertsnellnews Armed security at a Metro Detroit healthcare facility is considered a “Red Flag.” On the other hand, It is evidence of “fraud” for which of the following?

A. Beaumont Hospital System

B. Henry Ford Health Systems

C. St. Johns Hospital

D. DMC Sinai-Grace

E. The Pain Center

BIOLOGY IS NOT CATEGORICAL

RED FLAGS, OVERPRESCRIBING, AND TIPPING POINTS ARE THE SHADOWS OF DECEPTION FROM THE CAVE WITHIN THE GLADWELLEAN STATE

RED FLAGS OF DECEPTION

The core argument centers on the claim that the Drug Enforcement Agency (DEA) and other agencies have misused “red flag” indicators to target and prosecute doctors, leading to a shortage of pain specialists and an increase in patient suffering. 

To target doctors, investigators look for “red flags” they believe indicate potentially criminal behavior. These red flags are generally circumstantial evidence found during standard criminal investigative procedures.

The problem with red flags is that what may appear to be evidence of criminal behavior to an investigator without medical training is often perfectly consistent with legitimate medical practice, particularly in a dynamic field like pain management.

Criminal investigators without medical training aren’t qualified to tell the difference.

Yet they routinely make such decisions, and such close judgment calls can cause the criminal prosecution of an otherwise legitimate physician. 

https://t.co/j5vAAibGXz

— Liza Lockwood (@DrLizaMD) August 31, 2024

Incidence of substance abuse or overdose in clinically managed pain patients treated with opioids in an ongoing doctor-patient relationship is almost certainly less than one in a thousand patients.  This incidence falls within the range of known confounds on the accuracy of diagnosis.

According to Dr. Thomas Kline, MD., lots of drugs are dangerous. What is different about narcotic opiates is they are only a problem in people with a genetic predisposition to become addicted to them. This is less than one; 99% will never be addicted to opiates because they don’t have the genetic pattern.

Pain ranges from acute to chronic and in etiology and severity; it may accompany or describe many conditions, including degenerative conditions like cancer, inflammatory or autoimmune conditions like lupus, or neurological conditions like multiple sclerosis.

Unbelievable and Absurd! Dr. Ibsen Highlights the Disregard for Expertise—Chronic Regional Pain Syndrome (CRPS) Is Now Questionably Characterized as Non-Painful. |

The Phenomenon of Cancel Culture Has Effectively Stifled Discourse on Pain. | It Is Essential to Acknowledge and Embrace the Uncertainties in Medical Understanding. | The Debate Surrounding the Fifth Vital Sign Requires Comprehensive Examination. |

JUSTICE POTTER STEWART AND THE MEDICINE OF LAW

PAIN IS A SYMPTOM OF A DISEASE

Is it not true that historically, most, if not all, of the great breakthroughs and advances in medical science have been made by people who did not follow the conventional way of doing things?

They followed a new way, their way, and most of the conventional physicians of their day would have disagreed with them because this is not how it has always been done.

The Significant Connection Between Viruses and Autoimmunity Necessitates Serious Investigation. | We Are Engaged in Collaborative Efforts Across 60 Different Countries, Uniting Our Activities Through Helene, Milton, and Pain Advocacy. |

YANA: The Truth Is Articulated and Demonstrated. | Alan C. | Dr. Norm Shares Insightful Observations from the Experiences of Medical Professionals at the University of Michigan.

DR. FOREST TENET:

“..AGGRESSIVE COMPETENT PHYSICIANS SEES OUTSIDE THE BOX..”

Pathological Pain Pathway

BOTH AN ABNORMAL OR DYNAMIC NORMALITY

Epstein Barr Virus kissing disease enters through the mouth or the throat.

Risk factors are the essence of prevention easing of Adhesive Arachnoiditis; Epstein Barr Virus reactive in stress, trauma, medical procedures, severe infection, and psychological stress that will activate your bodies cortisone, a Natural response AB but also activates (auto-antibodies) infiltrates your tissues inflammation, scaring and pain.

Cytochrome P450 abnormalities, intractable pain (genetic abnormality or dynamic normality specific to each patient), and other wards are NO one size fits all.

Acetazolamide(DIAMOX))??

!!WHEN LAW ENFORCEMENT PRACTICES MEDICINE!!

However, even those guidelines are subject to change without notice.(2005-Libby Report) “In his speech at the NADDI conference, Detective Luken likened pain specialists to illegal drug dealers and explained that pain doctors sell pain medication for money, sex, or to feed their drug habits or those of family members or girlfriends—just as standard drug pushers do. Key points fully supported in the paper include:

“..All of the realities above were known to the authors and approving officials of the US CDC and Veterans Administration 2022 opioid prescribing guidelines — BEFORE publication of their fatally flawed and politically-driven guidelines..”

BRIEF FOR AMICUS CURIAE  NATIONAL PAIN ADVOCACY CENTER IN SUPPORT OF PETITIONERS

An authorized prescription meets the requirement of being for “a legitimate medical purpose” prescribed “in the usual course” of a physician’s practice. A prescription that fails this criterion is unauthorized.

Douglas:

“..Find out just what people will submit to, and you will find out the exact amount of injustice and wrong which will be imposed upon them, and these will continue till they are resisted with either words or blows or with both. The limits of tyrants are prescribed by the endurance of those they oppress..”

The government has a legitimate interest in deterring the diversion and misuse of controlled substances, especially amid a drug overdose crisis.

However, a standard for criminal liability that overly deters may cause medical professionals to act against their best medical judgment due to fear of oversight. It has a chilling effect on their willingness to care for patients in pain.

The physician who writes an unauthorized prescription is only criminally liable if he does so “knowingly or intentionally,” as the statute provides. Judicial decisions that read “knowledge” or “intent” out of the statute defy this plain meaning and effectively eviscerate the scienter requirement.

However, unlike in the treatment of conditions such as sepsis or heart attack, for example, there is no unitary standard or broadly applicable protocol for treating pain because pain is so heterogeneous.12 

The better and more straightforward statutory reading holds the physician to the same culpability standard as anyone else, appropriately distinguishing criminally culpable from criminally nonculpable actors.

To protect a significant cohort of patients who may require medical use of controlled substances—including millions with severe pain—this Court should confirm that under the proper construction of the CSA, a medical provider may be held liable only when he knows or intends to prescribe without a legitimate medical purpose in the usual course of his professional practice.

And even encourage them to engage in self-protective practices that risk their safety and endanger the lives of those in their care. Each of these predictable adverse outcomes is occurring in pain care today.

Although there are a variety of available modalities to treat pain, prescribed opioids13 remain a mainstay in the management of many types of acute pain, pain from cancer or other serious diseases, and in end-of- life care.14 

All current guidelines—including those issued by the Centers for Disease Control and Prevention (CDC) in 2016—support the use of opioids in chronic pain that is not managed by other means.15 

Between eight million16 and 13 million17 Americans regularly rely on prescribed opioids to manage physical pain.

Recent attempts by public health agencies to articulate a standard of care for opioid prescribing have backfired, requiring the agencies to course correct.

The CDC, for example, stated publicly that key provisions in its 2016 Guideline for Prescribing Opioids for Chronic Pain had been misapplied as one-size-fits-all mandates by policy actors in ways that risk patient harm. (18)

we focused on the actual science, medicine, and care of the actual chronic pain patients and their symptomatology and pathology

” Brandon Helms claimed that the DOJ had “overwhelming evidence” Against me and the others. 

!!READY TO FIGHT!!

It’s just amazing, I thought; my Dad completed both neurosurgery residency and fellowship at the University of Michigan; my Mom a Dentist; all this education, all this training.

And all of this Knowledge, and this Government Misfitted, Mis-Guided, Slick Prosecutors used my (our) ability, my (our) skills to further their legal careers to define me and my colleague’s as drug dealers.

The prosecutors in Detroit could not even get our names right on the documents they were sending us, including the sentencing guidelines, the plea deal, the restitution, and all that other B.S. 

We intimidated McMillion and Helms: During the actual trial and testimony, we focused on the actual science, medicine, and care of the actual chronic pain patients and their symptomatology and pathology. 

We broke down the charts and explained our decision-making regarding a multi-modal approach to pain management. This included rational polypharmacy, including opioids and non-narcotic medications. DME, physical therapy, injections, urine drug screens, opioid agreements, pill counts, referrals to other specialists, including addiction medicine and surgical consultations.

I was pissed; we were all pissed and ready for a fight!!!

Conclusion:

The DEA’s aggressive tactics in targeting physicians for opioid prescribing have created a climate of fear and uncertainty within the medical community, hindering effective pain management and potentially causing harm to patients.

The agency’s reliance on subjective “red flags,” asset forfeiture practices, and promotion of misleading narratives raise concerns about its overreach and lack of understanding of legitimate medical practice.

A re-evaluation of the DEA’s approach is necessary to ensure that patients with legitimate pain needs have access to appropriate care without subjecting physicians to unwarranted prosecution.

_________________________________________________________/

U.S. Food & Drug Admin., A Guide to Safe Use of Pain Medications 3 (Feb. 23, 2009) (URL citation omitted)) (“[T]he U.S. Food and Drug Administration (“FDA”) has endorsed properly managed medical use of opioids (taken as prescribed) as safe, effective pain management, and rarely addictive.”).

https://www.acgme.org/about/overview

https://www.acgme.org/about/overview

15 Deborah Dowell et al., CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016, 65 MORBIDITY MORTALITY WKLY. REP. 1 (2016).

16 Kurt Kroenke et al., Challenges with Implementing the Centers for Disease Control and Prevention Opioid Guideline: A Consensus Panel Report, 20 PAIN MED. 724, 726 (2019).

17 Ramin Mojtabai, National trends in long-term use of prescription opioids, 27 PHARMACOEPIDEMIOLOGY & DRUG SAFETY 526(2018).

18 See Deborah Dowell et al., No Shortcuts to Safer Opioid Pre-scribing, 380 NEW ENG. J. MED. 2285, 2287 (2019) (highlighting

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references:

The DEA and the Opioid Crisis: A Critical Analysis

Briefing Document: Social Murder in the Age of Information Warfare

This briefing document analyzes the resurgence of the concept of “social murder” in the modern context, drawing from Friedrich Engels’ original framework and contemporary observations by [Presumably, a source referencing Logan is missing]. The document highlights the parallels between 19th-century exploitation and present-day information warfare, emphasizing the devastating consequences of both.

AMANPOUR AND FRIENDS

Ms. Jia Tolentino, joins Michel Martin to discuss the reaction to Thompson’s death.

Engels’ Social Murder:

• Core Components: Engels’ “The Condition of the Working-Class in England” identified four key elements of social murder: (1) Exploitation of the working class, (2) Premature deaths due to harsh conditions, (3) Awareness of these conditions by the ruling class, and (4) Culpability of the bourgeoisie for inaction.
• Key Quote: “[T]hese deaths are murder just as surely as the murder of a single individual; only it is not so easy to detect the murderer.”

Social Murder in the Information Age:

• Information as Exploitation: Paralleling Engels’ exploitation, information warfare utilizes technology to control narratives, shaping public perception and influencing policy. This manipulation is likened to a form of exploitation, where individuals’ understanding of reality is distorted for political or economic gain.
• Death of Truth and Freedom: The consequence is not physical death but the demise of intellectual and moral freedom. This metaphorical death stifles dissent, independent thought, and the ability to engage in meaningful discourse, thereby undermining democratic principles.
• Complicit Actors: Awareness of this manipulation exists among media, government, and tech giants, yet they fail to take significant action, mirroring the bourgeoisie’s negligence in Engels’ time.
• Responsibility and Censorship: Logan [Source Missing] criticizes media outlets, tech companies, and even non-profits and government agencies for their role in manipulating information, labeling it a betrayal of journalistic integrity and freedom. This “cancel culture” acts as a modern guillotine, silencing dissent and controlling the narrative.
• Key Quote: “[Quote about modern ‘cancel culture’ acting as a societal guillotine from the source]”

Social Murder and Healthcare Inequities:

• Applying the Concept: The document extends “social murder” beyond information warfare, applying it to healthcare inequalities. Specifically, it cites instances like pharmacists refusing to fill legitimate prescriptions for pain medication, particularly impacting chronic pain sufferers and those with conditions like Sickle Cell disease.
• Systemic Racism and Neglect: This withholding of treatment is likened to the devaluation of Black lives and the perpetuation of systemic racism within healthcare structures. The document draws parallels between this neglect and the suffering of the working class described by Engels.
• Key Quote: “The witholding of pain care treatment by Pharmacists…where the devaluation of Black lives can be seen as a form of social murder, perpetuating through societal structures and attitudes.”

Call to Action:

• Reclaiming Responsibility: Both Engels and Logan emphasize the need for collective action to dismantle structures that enable social murder, whether in the form of economic exploitation, information manipulation, or healthcare disparities.
• Defending Freedom: The document underscores the urgency of defending freedom of speech and thought as fundamental pillars of democracy, warning against the erosion of these freedoms in the face of information warfare and censorship.

Conclusion:

This briefing document presents a compelling case for the continued relevance of “social murder” as a concept, demonstrating its applicability to contemporary issues beyond the realm of economic inequality.

By highlighting the parallels between 19th-century exploitation and modern forms of manipulation and neglect, the document urges a critical examination of power structures and a renewed commitment to defending truth, freedom, and equitable access to essential resources.

Briefing Document: The DEA’s War on Prescription Painkillers and the Chilling Effect on Pain Management

Main Themes:

• The Drug Enforcement Administration’s (DEA) shift in focus from illicit drugs to prescription painkillers, particularly opioids, has created a climate of fear among physicians, leading to undertreatment of chronic pain and potential harm to patients.
• The DEA’s reliance on circumstantial evidence (“red flags”) and asset forfeiture practices in targeting physicians is criticized for being arbitrary and lacking medical expertise, leading to the prosecution of well-meaning doctors.
• This aggressive approach echoes the historical persecution of physicians under the Harrison Act of 1914, raising concerns about the DEA acting as a “morality police” rather than a regulatory body.
• The lack of clear guidelines and the ever-changing standards for opioid prescribing leave physicians vulnerable to prosecution, forcing them to prioritize self-protection over patient care.

Important Ideas/Facts:

• Shift in DEA Focus: The DEA, facing criticism for its inability to demonstrate success in curbing the illegal drug supply, shifted its focus to prescription painkillers, particularly OxyContin, framing it as a new front in the War on Drugs. (Libby Report 2005)
• Red Flags and Lack of Medical Expertise: The DEA relies on “red flags” like high prescribing volume or cash payments to identify potential criminal behavior among physicians. Critics argue these indicators are often consistent with legitimate pain management practices and that investigators lack the medical training to differentiate. (Libby Report 2005)
• Asset Forfeiture: The DEA’s use of asset forfeiture, seizing assets from suspected physicians even before conviction, is criticized as a perverse incentive that allows law enforcement to profit from investigations. (Libby Report 2005)
• Historical Parallels with the Harrison Act: The prosecution of physicians for prescribing opioids is compared to the persecution of doctors under the Harrison Act of 1914, which criminalized the prescription of narcotics to addicts, leading to mass arrests and the collapse of addiction treatment. (Libby Report 2005)
• Chilling Effect on Pain Management: The fear of DEA scrutiny has created a chilling effect on pain management, with physicians hesitant to prescribe opioids even when medically necessary, resulting in undertreatment of chronic pain and suffering for patients. (Brief for Amicus Curiae National Pain Advocacy Center)
• Misleading Narratives and Disinformation: Critics argue that the DEA and other agencies have promoted misleading narratives about the opioid crisis, conflating legitimate medical practice with illegal drug trafficking and fueling public fear. (McQuade’s warnings)

PAIN UNDER THE WATCHFUL EYE OF THE UNITED STATES JUSTICE DEPARTMENT

Key Quotes:

• “The DEA would need to find a new front for the War on Drugs, one that could produce tangible, measurable results.” (Libby Report 2005)
• “Criminal investigators without medical training simply aren’t qualified to tell the difference. Yet they routinely make such decisions, and such close judgment calls can cause the criminal prosecution of an otherwise legitimate physician.” (Libby Report 2005)
• “It is a perverse system that allows law enforcement officials to keep the assets of suspected drug defendants for their own, local police departments..” (Libby Report 2005)
• “The DEA’s attempt to blame physicians for the drug’s street availability seems arbitrary, unjustified, and capricious.” (Libby Report 2005)
• “A standard for criminal liability that overly deters may cause medical professionals to act against their best medical judgment due to fear of oversight. It has a chilling effect on their willingness to care for patients in pain.” (Brief for Amicus Curiae National Pain Advocacy Center)
• “The aggressive targeting of medical professionals who prescribe pain medication has often been fueled by misleading narratives about the opioid crisis, conflating legitimate medical practice with illegal drug trafficking​.” (Commentary on McQuade’s warnings)

Conclusion:

The DEA’s aggressive tactics in targeting physicians for opioid prescribing have created a climate of fear and uncertainty within the medical community, hindering effective pain management and potentially causing harm to patients. The reliance on subjective “red flags,” asset forfeiture practices, and the promotion of misleading narratives raise concerns about the agency’s overreach and lack of understanding of legitimate medical practice. A re-evaluation of the DEA’s approach is necessary to ensure that patients with legitimate pain needs have access to appropriate care without subjecting physicians to unwarranted.

Pain Management and the DEA: An 8-Question FAQ

1. What is the primary criticism of the DEA’s approach to prescription painkillers?

The DEA’s aggressive tactics, mirroring the War on Drugs, have created a chilling effect on legitimate pain management. They have been criticized for:

• Targeting physicians: Employing tactics like undercover investigations, asset forfeiture, and informants, creating an atmosphere of fear among doctors.
• Lack of medical expertise: Relying on “red flags” that may not be indicative of criminal behavior, leading to the prosecution of well-meaning physicians.
• Misleading narratives: Promoting a narrative that conflates legitimate medical practice with illegal drug trafficking, further demonizing pain management.

2. How has the DEA’s focus shifted in recent years?

Facing criticism for its inability to control the illicit drug supply, the DEA sought a new front with measurable results. This led to a shift towards prescription painkillers, particularly OxyContin, which they framed as a new drug epidemic. This focus on legal drugs allowed for easier monitoring and prosecution of physicians.

3. What are the concerns surrounding the DEA’s use of asset forfeiture?

The DEA’s asset forfeiture program, which allows them to seize assets from suspected drug offenders, has been criticized as a perverse incentive. It raises concerns about:

• Financial motivation: Encouraging law enforcement to prioritize asset seizures over public safety and due process.
• Lack of oversight: Operating with minimal congressional oversight, making it difficult to assess the program’s effectiveness and prevent abuse.
• Funding investigations: Using seized assets to finance further investigations, creating a self-perpetuating cycle that disproportionately targets physicians.

4. How does the Harrison Act of 1914 relate to the current situation?

The Harrison Act criminalized the non-medical use of narcotics, leading to the arrest and prosecution of thousands of physicians for prescribing to addicts. This historical precedent highlights the dangers of:

• Criminalizing medical practice: Turning legitimate medical care into a criminal offense, driving patients to the black market, and undermining the doctor-patient relationship.
• Morality policing: Using law enforcement to enforce social norms and medical practices, potentially sacrificing patient well-being for ideological goals.
• Repeating past mistakes: Ignoring historical lessons and repeating the same mistakes that led to the failures of the War on Drugs.

5. What is the controversy surrounding the “opioid crisis” narrative?

The dominant narrative surrounding the opioid crisis blames overprescribing physicians for creating addicts. However, this narrative is challenged by evidence suggesting:

• Misleading statistics: Conflating deaths from illegal fentanyl and heroin with prescription opioid use.
• Ignoring other factors: Overlooking contributing factors like mental health issues, socioeconomic disparities, and the lack of access to alternative pain management options.
• Undermining legitimate pain care: Creating a climate of fear that discourages physicians from prescribing opioids even when medically necessary, leading to undertreated pain and patient suffering.

6. What are the implications of the lack of standardized pain management protocols?

The absence of clear, universally accepted guidelines for pain management creates a vulnerable situation for physicians. It allows law enforcement agencies to:

• Interpret behavior subjectively: Apply vague standards like “legitimate medical purpose” and “beyond the bounds of medical practice” arbitrarily.
• Target physicians based on individual judgment: Prosecute doctors based on personal interpretations of medical practices rather than objective criteria.
• Discourage innovation and personalized care: Stifle the development of new pain management approaches and limit personalized treatment options for patients.

7. What are the potential consequences of the DEA’s actions for patients?

The DEA’s aggressive approach to pain management has significant negative consequences for patients, including:

• Reduced access to care: Fear of prosecution leads to physician shortages and reluctance to prescribe opioids, leaving patients with limited treatment options.
• Untreated pain: Patients suffering from chronic pain may be denied effective pain relief, leading to decreased quality of life and potential disability.
• Forced tapering: Patients may be forced to rapidly reduce their opioid dosage, causing severe withdrawal symptoms and potential health complications.

8. What are some proposed solutions to address the concerns surrounding pain management and the DEA?

Several potential solutions have been proposed to address the issues:

• Developing clear guidelines: Establishing clear, evidence-based guidelines for pain management that protect both patients and physicians.
• Increased medical expertise in investigations: Requiring law enforcement agencies to consult with medical professionals during investigations to ensure accurate assessments of medical practices.
• Shifting focus to harm reduction: Focusing on harm reduction strategies like expanding access to addiction treatment and addressing the root causes of the opioid crisis.
• Reforming asset forfeiture laws: Implementing stricter safeguards and oversight mechanisms to prevent abuse and ensure due process in asset forfeiture cases.

(Saved responses are view only) 

FAQ: Social Murder in the Age of Information Warfare

1. What is “social murder,” and how is it relevant today?

The term “social murder,” coined by Friedrich Engels in the 19th century, describes the systemic exploitation and negligence that leads to the premature death of vulnerable populations. While Engels focused on the working class, the concept remains relevant today. We see it manifested in events like the Grenfell Tower fire, the detrimental impact of austerity measures, and systemic racism that devalues Black lives.

2. How does information warfare contribute to modern “social murder”?

Information warfare, with its manipulation and control of narratives, is a new form of exploitation. This battle for truth takes place in the digital realm, where technology is used to shape public perception and policy, often at the expense of individual freedoms and democratic principles.

3. What is the “premature death” associated with information warfare?

Unlike Engels’ time, the death in the context of information warfare is not physical but moral and intellectual. The suppression of free speech, dissent, and independent thought through censorship and “cancel culture” leads to a metaphorical death of democratic values.

4. Who are the responsible parties in this modern form of “social murder”?

Those who control and influence the information ecosystem—media outlets, tech companies, governments, and even non-profits—bear responsibility for their role in manipulating information and suppressing truth. Their inaction in the face of these practices equates to the negligence of the bourgeoisie that Engels condemned.

5. How does the source connect “social murder” to healthcare, specifically pain management?

The source argues that the withholding of necessary pain management medication by pharmacists, especially for chronic pain sufferers and those with conditions like sickle cell disease, can be considered a form of social murder. This is particularly true when pharmacists provide no clear medical justification for their refusal, echoing the systemic negligence and disregard for vulnerable populations that define the concept.

6. Does the concept of “social murder” extend beyond class and race?

Yes, the concept extends beyond class and race to encompass any systemic issue where individuals are harmed or their rights are violated due to negligence, exploitation, or the suppression of truth. Information warfare, for example, impacts people across societal divisions.

7. What is the significance of the comparison between Engels’ time and the present?

The comparison highlights the enduring nature of systemic oppression and the need to recognize and challenge its evolving forms. While the tools and targets may change, the underlying principles of exploitation, negligence, and the suppression of truth remain constant.

8. What call to action does the source present?

The source calls for a collective effort to recognize and dismantle the structures that enable social murder, both in its traditional and modern forms. This involves holding those in power accountable, defending freedom of speech and thought, and promoting transparency and truth in all aspects of society.

Social Murder: Then and Now

Timeline of Events

This source does not provide a chronological timeline of events. Instead, it presents an argument about the concept of “social murder” and its application to both historical and contemporary issues.

Cast of Characters

1. Friedrich Engels (1820-1895):

• German philosopher, social scientist, and journalist.
• Co-founder of Marxist theory alongside Karl Marx.
• Introduced the concept of “social murder” in his 1845 book “The Condition of the Working Class in England,” arguing that the capitalist system led to the premature death of workers due to harsh living and working conditions.

1. (Implied) Contemporary Figures and Entities:

• The Bourgeoisie: The source uses Engels’ term to refer to the modern-day ruling class or those in power who benefit from the exploitation of others and perpetuate social murder through inaction.
• Media Outlets and Tech Companies: The source argues that these entities hold responsibility for perpetuating a modern form of social murder by controlling and manipulating the flow of information, suppressing dissent, and ultimately endangering democratic principles and personal freedoms.
• Pharmacists: The source highlights pharmacists who refuse to fill prescriptions for pain medication as engaging in a form of social murder, particularly impacting those suffering from chronic pain conditions and potentially reflecting racial disparities in healthcare.
• American Medical Association (AMA): The source cites the AMA’s criticism of restrictive policies that deny patients necessary pain care.

1. Raphael et al. (2021):

• Authors of an academic study (specific title not provided) examining the use of the term “social murder” in academic literature and its potential to spark public policy action on health inequalities.

1. Popay et al. (2010):

• Authors of a study (specific title not provided) cited by the source to support the argument that the adverse health effects of living and working conditions leading to health inequalities necessitate urgent action.

1. Jasper (2011):

• Author of a study (specific title not provided) that provides evidence for the role of emotions in driving social and political movements, supporting the potential of using emotionally charged terms like “social murder” to mobilize public action.

1. Logan:

• The source repeatedly refers to a “Logan” who critiques modern “cancel culture” and the manipulation of information by non-profits and government agencies. It is unclear from the provided text who this Logan is.

1. Sir Edward Grey:

• British Foreign Secretary (1905-1916).
• Famous quote mentioned in the source: “The lamps are going out all over Europe; we shall not see them lit again in our lifetime.” This quote is used to highlight the fragility of freedom and democracy in the face of threats like information warfare.