| HN Mirror

>True the recent shift is itself reactionary and with its own problems, but this one isn’t because of Nancy Reagan. >American Puritanism would also not explain having the highest rates of opioid prescriptions of peer GDP/capita nations in the world.

I would argue that a non-puritan society would look at concerning rates of recreational opioid use and abuse and try to solve the underlying problems that are driving people into that instead of treating them as criminals for their choice of dug to abuse and putting policies and laws in place that make legal medical access to opioids increasingly ridiculously convoluted and scaring doctors away from prescribing them. That puritan streak is what underlies the societal revulsion to "drug addicts" and reacts with an attitude of "cut them off". It's what makes society view addiction as a moral failing on the addicts part, and it contributes to a lack of resources and help for people looking to escape that addiction. Sure if you're extra wealthy you could check yourself into a hollywood rehab center, but for the rest of us lowly schmucks, your average local rehab centers are cold places that will do the bare minimum to make sure you don't die, and then throw you back out into the world with no more resources or support than you had before, to face the same problems that drove you to your addictions again.

Or one could also look at the media and public reaction to Perdue's support for the concept of "pseudo-addiction". While the media and public mock this as laughable at best and dangerous overpromotion of drugs at worst, there's nothing unreasonable about the concept at all. The idea is really simple, that perhaps some people who exhibit addiction behaviors like "taking more pain medications than prescribed", "focus on when they can take their next dose", "moaning or vocalizing in pain", "demanding specific medications", "seeking to keep a extra supply" might not be addicts but might actually be - you know - in pain (due to an inadequate treatment regimen). And that seems obvious right? Like if you had someone who was being given say, 200 mg of ibuprofen every 6 hours for a broken leg, you might expect them to do some or all of those things right? I know I certainly would. And yet, switch from ibuprofen to opioids and all of a sudden people think this is ridiculous.

> 1. Not true

Fair enough, I should have say there isn't "much", and the things there are can have plenty of their own bad side effects even if they aren't "addictive". Steroids would be an option. Long term use of which can among other things raise your blood sugar contributing to diabetes, increase your chances of getting infections, increase osteoporosis, increase bruising and slow healing in general. Anti-epileptics can help if your pain is specifically nerve pain, and anti-depressants can help in some cases too, though again with their own non-insubstantial risks.

> Yes, we do. If your oncologist doesn’t prescribe you appropriate analgesia or refer you to a palliative care practitioner then find a new one.

Anyone with a chronic and disabling medical condition could probably give you a book worth of experiences where doctors, co-workers, family and friends became increasingly exasperated or frustrated by the fact that they do not in fact get better and continue to require accommodations. I'd also point out there are other conditions that cause high levels of chronic pain that aren't cancer and aren't terminal. Getting palliative care (or even someone to understand that you need palliative care that isn't also end of life care) in those circumstances is an uphill battle to say the least.

> The vast majority of non surgical medicine is about chronic disease management. Medical cures are the exception.

And one need only participate in any discussion about modern medicine and care to see how much people are against the idea of lifetime medications and treatment. See also recent sturm und drang over Wegovy for treating obesity. Perhaps a better way of phrasing it would be "if you don't have a specific set of well recognized 'incurable' conditions, our society and medical system is set up to assume you will get better". It's especially bad if you have slow and largely "invisible" disabilities. My family member that had to deal with the pill mill doctor was in that situation because they were being passed from doctor to doctor to doctor all of them wanting something that some other could treat to "get better" first before they wanted to do anything. And the pill mill doctor was no different, kept throwing more pills at them until "your condition improves and then we can look at other options". It took us nearly 6 years to finally put together an actual team of doctors that were interested in coordinating and understood that this wasn't ever going to go away and that treatment was going to mean sometimes one thing or another would get worse while the other aspect was treated.

>The sad reality is that the medical industry was complicit in causing unnecessary suffering due to the legitimized medicalized misuse of opioids and this is the aftermath.

And how many thousands or millions of others will be put through more unnecessary suffering in our reactionary spasms of guilt in this aftermath? How many lives will we lose to suicide because the alternative is facing a life of poorly managed pain and being treated like a criminal for trying to get treatment? How many people will be drive to ever increasingly desperate measures to obtain illegal pain medications as their options for legal paths are closed or made more and more unworkable? How many people will we leave in pain because they "might get addicted" as if being addicted to a tolerated but effective medication is the worse then being in disabling levels of pain? How many innocent people will we allow to suffer, because we are unable or unwilling to punish only the guilty?