JAIME SANCHEZ: “THE SILENT EPIDEMIC OF ABANDONMENT” AND THE RISE OF THE ORGANIC INTELECTUAL

“THE SILENT EPIDEMIC OF ABANDONMENT“

from youarewithinthenorms.com

NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC., 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., M.B.A., 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

“..Another thing that happened during that time is 911, and our attack on Afghanistan. Heroin went from impossible to find to abundant because our soldiers regarding their fields..”

Criminalizing Compassion in Pain Care THE SILENT EPIDEMIC OF ABANDONMENT

This document analyzes the provided excerpts which present a critical perspective on the current state of pain management and the perceived overreach of government agencies, particularly the DEA, DOJ, and CDC, in regulating opioid prescriptions. The core themes emerging from these sources are:

• The Criminalization of Compassionate Physicians: The sources argue that physicians who compassionately treat chronic pain patients using FDA-approved opioid medications are being unjustly targeted, investigated, and prosecuted by government agencies.
• Quote: “..COMPASSIONATE PHYSICIANS OR DRUG DEALERS IN WHITE COATS..”
• Quote: “ALL OF THESE PHYSICIANS SEEN IN THIS PHOTO HAVE BEEN TARGETED CRIMINALLY FOR PRESCRIBING F.D.A APPROVED NARCOTIC ANALGESIC MEDICATIONS”
• The Abandonment and Suffering of Pain Patients: A direct consequence of increased scrutiny and fear among physicians is the abandonment of chronic pain patients who are then left in agony, with some resorting to suicide or seeking treatment in unregulated markets.
• Quote: “The consequenceS-ARE multiple-millions-of pain-patients-are ABANDON AND LEFT TO COMMITT SUICIDE”
• Quote: “Now the consequence is multiple millions of pain. Patients are abandoned from their palliative care and have either gone to bed, kill themselves or gone to the other market. I don’t think we can call it a black market anymore because I think it’s the only market that exists.”
• Misunderstanding the Difference Between Dependence and Addiction: The sources emphasize that chronic pain patients who require opioid medication for functional pain management are often dependent, not addicted. This crucial distinction is being ignored in the current regulatory climate.
• Quote: “At any rate, there’s a silent epidemic of abandonment going on with patients who require pain medication and are dependent on them. They are not addicted. They are dependent and there is a clear difference.”
• The sources provide a clear distinction: Addiction is characterized by an unmanageable life centered around obtaining illicit drugs, while dependence in pain patients allows for improved function and maintaining a normal life.

The provided excerpts paint a picture of a healthcare system where efforts to combat opioid addiction have inadvertently led to the severe suffering and abandonment of legitimate chronic pain patients. The contributors argue that government agencies have overstepped their authority, creating a climate of fear that discourages compassionate care and forces patients into dangerous alternatives.

The sources emphasize the importance of distinguishing between dependence and addiction and advocate for a more nuanced approach to pain management that prioritizes patient well-being.

The personal narratives, particularly that of Dr. Mark Ibsen, underscore the significant personal and professional risks physicians face when attempting to treat chronic pain.

UNDERSTANDING OF THE ORGANIC INTELLECTUAL

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REFERENCES:

The Criminalization of Compassionate Pain Care: A Study Guide

Quiz

1. According to the source material, what event coincided with an increased availability of heroin in America?
2. What concept, introduced in the late 1990s, aimed to improve pain treatment but is described as problematic due to pain’s subjective nature?
3. The source material argues that the heroin epidemic’s cause was misdirected; instead of focusing on heroin’s abundance, where did the blame shift?
4. What is the critical difference highlighted in the text between a pain patient dependent on medication and an addict using illicit drugs?
5. What alternative treatment did Dr. Ibsen utilize successfully for a significant percentage of his pain patients in 2011?
6. Despite the DEA choosing not to pursue Dr. Ibsen in 2011, which regulatory body did investigate him and attempt to suspend his license?
7. According to Dr. Ibsen, what was the finding of the administrative law judge regarding his treatment of pain patients inherited from other doctors?
8. What happened to many of Dr. David Bockoff’s pain patients after his DEA license was suspended in 2022?
9. The source mentions a genetic condition that can require very high doses of opiates in some patients. What is this condition called?
10. What specific federal agency is criticized in the source for expanding its mission into issuing guidelines on opiate addiction, which the author argues is outside its typical purview?

Quiz Answer Key

1. The 9/11 attacks and the subsequent attack on Afghanistan are cited as coinciding with an increased abundance of heroin.
2. Treating “the fifth vital sign” was the concept introduced to improve pain care, but the source notes the subjectivity of pain as a problem with this approach.
3. The blame for the heroin epidemic shifted to doctors, accusing them of overprescribing opiates in response to the campaign to support treating pain as a fifth vital sign.
4. A pain patient dependent on medication has improved function, keeps their job, and supports their family, whereas an addict using illicit drugs has a life that becomes unmanageable, potentially leading to homelessness and stealing.
5. Dr. Ibsen used cannabis and other alternative medications to help 80% of his pain patients taper off opiates.
6. The Montana Board of Medicine investigated Dr. Ibsen in 2011 and attempted to suspend his license.
7. The administrative law judge found that Dr. Ibsen was justified in treating the pain patients he had inherited from other doctors.
8. Many of Dr. Bockoff’s pain patients became “pain refugees” who struggled to find continued care, and the source states that four died after he was taken out of practice.
9. This condition is called CYP 450 genetic pleomorphism.
10. The CDC is criticized for expanding its mission to issue guidelines on opiate addiction, which the source argues operates differently than infectious diseases, the CDC’s typical area of focus.

Essay Questions

1. Analyze the author’s central argument regarding the “criminalization of compassionate pain care.” What are the key pieces of evidence or anecdotes presented to support this claim?
2. Discuss the interplay between the events of 9/11, the subsequent increase in heroin availability, and the changing landscape of pain management as described in the source material.
3. Explore the distinction the author makes between “dependence” and “addiction” in the context of pain patients and medication. How does this distinction inform the author’s perspective on current pain care policies?
4. Evaluate the criticisms leveled against the CDC and the Montana Board of Medicine in the source material. What are the specific actions or policies of these organizations that the author takes issue with?
5. Consider the implications of the “silent epidemic of abandonment” of pain patients as described in the text. What are the alleged consequences of this abandonment on individuals and potentially on society?

Glossary of Key Terms

DOJ: Department of Justice. A cabinet-level department of the U.S. federal government concerned with the administration of justice.

DEA: Drug Enforcement Administration. A U.S. federal law enforcement agency under the Department of Justice tasked with combating drug trafficking and distribution within the United States.

CDC: Centers for Disease Control and Prevention. The national public health agency of the United States.

PROP: Physicians for Responsible Opioid Prescribing. An organization that advocates for cautious opioid prescribing. (Note: The source encourages curiosity about this organization.)

Fifth Vital Sign: A concept introduced to encourage healthcare providers to treat pain as seriously as other vital signs like temperature, pulse, respiration rate, and blood pressure.

Palliative Care: Medical care focused on providing relief from the symptoms and stress of a serious illness to improve quality of life for both the patient and the family. In the context of the source, it refers to ongoing pain management for chronic conditions.

Pain Refugees: A term used in the source to describe pain patients who have been abandoned or cut off from their previous doctors and are seeking new providers for pain management.

CYP 450 genetic pleomorphism: A complicated way of referring to genetic variations in the Cytochrome P450 enzymes, which play a significant role in the metabolism of many medications, including opiates. Genetic variations can lead to individuals requiring significantly different doses of certain drugs.

Dependence: In the context of pain medication, it refers to the body’s adaptation to a drug, resulting in withdrawal symptoms if the drug is stopped or the dose is reduced. This is distinct from addiction.

Addiction: A chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.

Hypocritical Oath: A likely typo or play on “Hippocratic Oath,” an ethical code historically taken by physicians. The author uses it to refer to the principle of “do no harm.”

Administrative Law Judge: An official appointed by an administrative agency to preside over hearings and make recommendations or decisions in administrative law cases.

Cato Institute: An American libertarian think tank. The author mentions participating in a panel with them.

SNOWPIERCER AND THE COMPLEX UNDERSTANDING OF Antonio Gramsci‘S CONCEPT OF THE ORGANIC INTELLECTUAL