Category Archives: Health

The Disease of War

I recently read a disintegrating little paperback on my bookshelves.  It probably belonged to my father, who was a public health doctor, with a masters in public health from Columbia University.  The book, Eleven Blue Men, consists of twelve stories about mysterious cases of sickness and death that came under the New York City Public Health Department’s purview in the mid-1940s.  The stories were originally serialized in The New Yorker magazine.  My edition of the book, by Berton Roueche, was published in 1955.

The stories involve cases of superlative medical detection, and they describe the extensive efforts exerted by epidemiologists and other investigators to identify and contain the culprits.  Cases of botulism, tetanus, smallpox, psittacosis, leprosy, typhoid fever, and others are described in detail.  There is a chapter on antibiotics, including the discovery of penicillin from mold, and the methods by which it was mass produced during World War II.

The outbreak of smallpox in New York City in 1947, a most contagious and deadly disease, led to the most massive emergency vaccination program in history, with 6,350,000 people being vaccinated, including the mayor of New York, within 28 days.

A new disease, which came to be named ricksettialpox, began striking inhabitants of a specific apartment complex in the borough of Queens in 1946.  It took significant sleuthing and the inspiration of an exterminator to discover the vector, a mite that fed on mice.

In the case of leprosy, the author goes into the historical discrimination and cruel torture of lepers, and the Bible-based fear of the disease, even though it is extremely sluggish and only marginally contagious.

While the stories are dated, and many of the diseases now rare in the US because of better sanitation, nutrition, and vaccinations, the afflictions themselves still exist and crop up from time to time.  The World Health Organization officially declared smallpox eradicated worldwide in 1980.  Other killer diseases like polio or tetanus now are virtually absent from the US and other developed countries.  Antibiotics like penicillin have completely changed the face of bacterial diseases and their treatments.

Medicine has made extraordinary strides in the past century, but I wonder about diminishing returns.  I read in newspapers about the starving children in Yemen and Ebola in the Congo, where there are also ongoing armed conflicts.  I think about microbiologist Hans Zinsser’s 1934 book Rats, Lice, and History, in which the author claims the bacteria win every war.  Zinsser was the original author of the microbiology text still used in medical schools today.

So, while medicine may have advanced, the social disease known as war has not, and it’s as deadly as ever, if not more so.  The starving children in Yemen are civilian victims caught in the proxy war between Saudi Arabia and Iran, with the US assisting the Saudis through arms sales and military cooperation.  There’s no medicine that cures starvation or unsanitary conditions.  Malnutrition, impure water, and stressful living conditions are breeding grounds for diseases like cholera, which, like Ebola, is transmitted through contaminated bodily fluids.

Eleven Blue Men softened my views on vaccines.  I can’t argue with vaccines for polio, smallpox, or tetanus, but I wonder about the proliferation of vaccines for an array of milder diseases, like influenza, which are generally self-limiting.  Vaccines themselves cause risks.  American children receive some 70 vaccines before they are 18 years old.

The medical clinics in Yemen are full to overflowing, but there’s little they can do for starvation.  Clinics in war-torn or infection-ridden areas may have vaccines or medicines, too, but they can’t provide the food, sanitation and clean water that do a longer-lasting and more effective job of preventing and healing disease.

When it comes to public health, the simplest measures are usually the best.  They have to do with sanitation, nutrition, and clean water.  In the case of civilian victims of war, the “collateral damage”–as the military likes to rationalize it–most of the trauma comes not from the bombs and bullets, but from the diseases that meet no resistance in debilitated populations.  It’s no wonder that the Spanish flu epidemic of 1918, at the heels of World War I, was the deadliest epidemic in history, killing more people in one year than the bubonic plague killed in the four years of the Black Death.  The flu epidemic killed ten times more people than the war itself.  The flu has not been that deadly since, but neither have the people been so lacking in resistance.

We don’t think of war as a disease, but maybe we should.  It’s a social disease, and no one is immune.

 

 

 

 

 

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To Vax or Not to Vax?

Flu season is upon us.  The “health care industry,” which includes the government and its agents, like the CDC and New York Times, not to mention the pharmaceutical and insurance industries, want to make sure the public, otherwise known as the “sheeple,” are well informed and well protected against this horrendous but self-limiting disease that mutates every year.  The influenza virus, in fact, mutates so fast that the vaccine is often unavailable until flu season is almost over.

On October 9, 2018 the Savannah Morning News reported that a health insurer focusing on Medicare, Clover Health, polled residents in its Savannah market to determine who planned to get the flu vaccine this year.  Only 70 percent of elderly plan to get it, but this is higher than the national average of 63%.  The article also said last year’s vaccine was only 40% effective, and that last year’s flu season was the deadliest in decades, accounting for 80,000 deaths.  The Center for Disease Control (CDC) expects this year’s strain to be milder.

Well, digging a little deeper into the flu story uncovers a few other pertinent facts.  First, the CDC reported last year’s vaccine was only 17% effective, and while the reported deaths are high (56,000), the CDC admits it does not specifically track deaths directly attributed to flu.  In fact, many deaths ascribed to flu were not proven cases, and/or were more directly caused by pneumonia or circulatory problems.

Digging even deeper reveals the flu vaccine industry is a $1.6 billion enterprise, only a small portion of the vast and growing vaccine industry.  Sources vary, but the vaccine market is reputed to have brought from $24 to $32 billion in profits to pharmaceutical companies in 2014.  That number is growing, due to “significant expansion of current product offerings” and expected to reach $61 billion in profits by 2020.

Concurrent with the push for flu vaccines, there is a rising chorus of voices claiming an “epidemic” of measles in Europe, blamed on a decline in vaccinations there in recent years.  Deaths have been reported, sort of, although evidence of this is sketchy.    In its September 22, 2018 issue, the New York Times reported “anti-vaxxers” in Italy are protesting mandated childhood vaccines.  In Italy, the vaccine issue has become politicized, and the NYT makes no secret of its contempt for the “anti-vaxxers” who it implies are also anti-science.  It dismisses the common notion that vaccines can cause autism and doesn’t mention the other risks associated with vaccines.

In fact, vaccines carry some very real risks, but in the US vaccines are the only products protected from liability.  In 1986, producers of the DPT (Diptheria, Pertussis, Tetanus) vaccine were being sued for cases of brain injury and death associated with the vaccine. They threatened to withdraw the DPT, the MMR (Measles, Mumps, Rubella) and oral polio vaccines from the market unless the lawsuits were withdrawn.  They claimed vaccines were “unavoidably unsafe,” so the federal government established the Vaccine Injury Compensation Program (VICP) to protect manufacturers from lawsuits claiming injuries from their vaccines.  Thus, every mandated vaccine carries a 75-cent surcharge to fund the federal program that protects the pharmaceutical industry.  The United States gives more vaccines than any country in the world.  It recommends twice as many vaccines as other developed countries for babies less than one-year old.  It also has the highest infant mortality rate.  Of the states, Mississippi requires the most vaccines for young children and also has the highest infant mortality rate.  As expected, the US is the largest revenue contributor to vaccine manufacturers.  While the federal health officials may recommend vaccines, various state health officials mandate them.

While autism is the most cited risk associated with vaccines, it’s hard to prove causality, partly because autism is such a vaguely defined disorder.  More specific risks are anaphylactic shock, fainting, dystonia, or seizure.  Vaccines can also cause encephalitis, encephalopathy, or interstitial lung disease.  A reversible paralysis called Guillain-Barre Syndrome, which can be severe and fatal if it affects respiration, has been attributed to the HPV (Human Papillomavirus) vaccine, Gardasil, as well as to the flu and other vaccines.

A recent book by a practicing physician, Thomas Cowan, Vaccines, Autoimmunity, and the Changing Nature of Childhood Illness (2018) explains the body’s two branches of the immune response.  The body’s first line of defense against infection is the cell-mediated response, he says.  In this stage, white blood and other cells destroy the pathogen.  The second line of defense, the humoral response, is the adaptive adjustment that employs antibodies to fight future episodes of exposure. He says vaccines distort this response, because they rely on the second, more transient, stage in the body’s defense cascade.  The resultant confusion in the body’s infection-fighting apparatus leads to dysfunction in the immune system and can increase the risk of allergies, autoimmune diseases, and even cancer.   He says that in the United States, people receive up to 70 vaccines before they are 18 years old.

I have not read Dr. Cowan’s book, but his theory makes sense.  When the body is exposed to so many potential threats, it becomes difficult to distinguish between friend and foe.

At one time influenza was indeed a deadly threat, but its virulence has decreased over time.  In 1918, the so-called Spanish flu (which was said to come from China) was supposedly the deadliest in history, with 500 million people affected.  Twenty to fifty million people died, with more dying in one year than in the four years of the Black Death (bubonic plague) of 1347-1352.  It killed ten times more people than World War I, with half of US soldiers in Europe falling to flu rather than the enemy.

Because the flu virus mutates so fast, it is possible to get the flu repeatedly.  However, recovery from a disease like the measles confers lifelong immunity, which may not be true for vaccine-induced immunity.  Also, it is possible that a vaccinated person can still carry the disease virus and be contagious to others.

To avoid the flu this year, and every year, the safest methods involve common sense.  With or without the vaccine, health ultimately depends on high resistance, which includes good nutrition, rest, exercise, fresh air, and avoiding crowded, unhealthy places like hospitals, doctor’s offices, and shopping centers.

 

 

Masochists, Martyrs, and Victims

I’ve been going through old files of articles and clippings, trying to simplify my life.  While younger people talk about productivity and greed, I look at the yellowed and dusty results of having produced and saved too much that has nowhere to go, except the trash.  The exercise is gratifying and humbling, because I used to know and care about many more things than I do now.  There are remnants of lost causes, one of which was my career.

I re-read ‘The Masochistic Personality,” by Stuart S. Asch, a psychiatrist who claims a difference between the sexual masochist and the personality type.  The former gets his kicks by being dominated and abused by a certain type of person.  The personality type is not specifically sexual but courts disappointment or humiliation.  The term is derived from Leopold von Sacher-Masoch, a 19th century Austrian novelist who wrote about sexual gratification from self-inflicted pain.  Some psychiatrists believe self-mutilation is also one of the traits.

The article focuses on the personality type, which has been dropped from the official list of psychiatric diagnoses, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), although the term retains historical and descriptive usefulness.  Asch says masochists desperately seek approval and love.  The masochist is strongly self-critical, having introjected an abusing authority figure who approves of self-punishment for forbidden sexual or aggressive thoughts or behavior.  Masochists will abase themselves repeatedly or in ever more humiliating gestures to obtain the approval or extract guilt from the unloving, rejecting love object.  They tend to blame fate for their repeated failures.

Asch mentions animals, who apparently develop more intense bonds to an adult that inflicts pain in early life.  Indeed, in human beings, there seems to be a pattern of stronger attachment to an abusing parent.  Genetic theories have contributed.

Asch doesn’t discuss sadism, with that term ascribed to the Marquis de Sade, who wrote in the 18th century about people who experienced sexual pleasure by inflicting pain on others.  Sigmund Freud attributed this to fear of castration, which leads the sadist to act out his fear on others.  In my view, masochists and sadists need each other, and each carries traits of the other, like two sides of a coin.  The metal that binds them together is blame.

The coin of blame buys religions, lawyers, governments, soldiers and toys. Everything from religion to law to parenting holds self-sacrifice as a noble standard, in the name of loyalty, duty, or spiritual progress.  Society at large reinforces the sado-masochistic power struggles that have become the “norm” for Western beliefs.  To falter brings guilt and, often, punishment. The ominous “they” are blamed for universal problems that “we” feed into without acknowledging “our” contributions.

I read with the distance of time and recuperation from the world of medicine.  There is such rigid judgmentalism built into the discipline that patients become guilty just by being patients.  I can already hear the screams of protest from my former “colleagues,” who are masochists for putting up with this arbitrary system of classification known as the DSM-V  and who collude with such an inhumane approach in the name of scientific objectivity.

Moreover, psychiatry as a discipline errs by not addressing the generalized ills built into the national psyche.  For psychiatrists as a group to diagnose and presume to treat the individual effects of PTSD (Post-Traumatic Stress Disorder), for instance, without addressing the causes of PTSD—primarily war–is abhorrent.  To attempt or pretend to treat symptoms of substance abuse or attention-deficit hyperactivity disorder (ADHD), or even depression, without delving into society’s contribution to the problems is, to me, an abdication of responsibility that puts the profession to shame.

What does this have to do with masochism?  Maybe nothing, except that by taking such a narrow view, the institution of medicine begs to be punished, as though it knows it’s wrong but will continue unchecked until something or someone puts a stop to it.

The victim role is the hardest to give up.  It’s easy to blame someone else when things don’t work out.  The masochist holds grudges and denies his role in his own trajectory.  He will find or create a controlling sadist to manage his life for him.  Power struggles ensue, with each blaming the other when things go wrong. Unfortunately, healthier choices are overlooked in this struggle, one that erodes self-respect and mutual trust.

Drug use going up?  Suicide rates rising?  All manner of psychiatric and physical illnesses swelling like a pregnancy?  Violence increasing?  Fear and anger seeking catalysts to ignite them into something cataclysmic and definitive?  Look for someone and possibly many people or groups to blame.

A retrospective analysis of “The Masochistic Personality” reveals more about psychiatry’s limitations than its strengths in understanding human nature.  Perhaps psychiatry’s move from early, descriptive interpretations to the codified DSM, its increasing reliance on medications, technology, and “scientific,” measurable results, under the pretext of objectivity, renders it less human and compassionate, and thus less relevant to real life.

From the beginning of my studies, I noted the preoccupation with pathology.  What a difference from astrology, which shows the dynamic interplay of strengths, weaknesses, and how perception often determines the difference.  Oriental belief in qi gives a similar picture of dynamic patterns, with a concentration on health maintenance.

In contrast, the Western love affair with trouble, under the guise of reason, logic, sequential, and binary thinking, that shows in its approach to medicine, is like putting blinders on to see only a narrow range of information and to deny everything outside the limited field.

No one else attempts to diagnose society at large, but I see unsettling correlations between Freud’s anal stage of psychosexual development and the current sado-masochistic world we live in.  Have Americans been unable to mature beyond the “terrible twos,” the age at which Freud claimed toddlers learn sphincter control and appropriate use of power?  Successful negotiation of this stage leads to good boundaries, healthy respect for self and others, and the ability to tolerate a degree of frustration. Shame and doubt mark those who fail at this task.  They are prone to power struggles with internal and external authority figures throughout life.

A culture carries its own karma.  I don’t understand the blame game.  I don’t blame anyone or anything for what we have created, because blame only perpetuates the problem, at the expense of solving the problem.  Not to avoid the problem but to understand that anyone could have created it, and everyone can learn from it – this is the challenge.

 

 

Placebo and Qi

An article in the September 3-9, 2018 issue of Time magazine, “Placebo’s New Power,” describes instances of people knowingly taking placebos and getting relief.  These “honest placebos” were administered in a study of irritable bowel syndrome (IBS) patients.  One patient, whose IBS symptoms improved dramatically during the study, later found her symptoms recurred.  She decided to continue the placebo treatments at the researcher’s private clinic and achieved remission again.

Overall, results were so encouraging in this Beth Israel Deaconess Medical Center study that the National Institute of Health has awarded the research team a $2.5 million grant to replicate the study.

Placebos have been around since time immemorial, used to advantage in numerous conditions.  Their use is predicated on the belief that a patient’s faith in the treatment has a healing effect.  Formal pharmaceutical studies in Western medicine measure a presumed new drug’s effects against placebo to determine whether it will work on a large scale.  In Western medicine, generally, the “placebo effect” is disparaged, as though there is something “un-scientific” about it.

The Time article speculates about why people who know they are taking fake pills get better.  It notes patients appreciate doctors who validate their suffering.  They fare better with doctors they perceive as warm and competent.  We are told that confidence in “medical industry leaders” in the US has plunged to 34%, from 73% in 1966.

To me, this is another example of Western medicine taking credit for applying common sense.  Not once does the article mention such old-fashioned terms as “bedside manner,” which cannot be measured or billed for in the codified, prioritized list of “evidence-based” protocols that wants to squeeze patients into convenient, binary-based boxes.

In Western medicine, the patient is seen as a relatively passive recipient of medical care.  The doctor, treatments, and pills act upon the patient, with the external agent believed to effect the healing.

In contrast, Oriental medicine perceives the body is its own healing agent, with its own homeostatic wisdom, presumed to want healing, with the practitioner a partner and participant in the process.  Belief in the treatment, and in the practitioner’s competence, are valuable and acknowledged aids in the healing process.  Far from being “placebo,” the partnership between patient and clinician becomes an integral component of the treatment goal.

A fundamental difference between Oriental and Western medicine involves “qi,” (also spelled “chi”) or “life force.” In Oriental philosophy and medicine, “qi” pervades all things, and is crucial to life. When the body’s “qi” is depleted, restricted, or out of balance, it leads to trouble.  Disharmonies begin on a spiritual level, then become increasingly “dense,” manifesting as intellectual, emotional, and finally physical levels.  Practices like acupuncture rely on stimulating or balancing qi along specific energy channels called “meridians.”

There’s a mistaken belief in the West that we know more than we do about the body.  While we point to specific brain chemicals, such as neurotransmitters serotonin or acetylcholine, these are only two of perhaps thousands of brain messengers that interact in a constant dynamic.  The brain is only one organ in an equally complex body, with signals going back and forth at lightning-fast speed.  Western science presumes the body is like a machine, but the mechanical construct of Western medicine gives no credit to life.

For me to say Western medicine is backwards, that the practice of dehumanizing patients under mechanical models works against health, may sound extreme.  Certainly the most expensive “health care industry” in the world deserves more respect, more funding, and more of our life blood.  But I suspect the opposite, that the commercialization and institutionalization of the “health care industry” has devitalized the system in the name of high-tech, low-yield placebos that only help if you believe they work, and often not even then.

 

Drugs, Drugs, and More Drugs

The pharmaceutical industry in the United States has hoodwinked the public into believing its snake oils are worth the money you pay.  The government, “health care industry,” and insurance companies are happy to comply, and maybe some of them even believe their hype.

This does not stop them from jacking up the prices of necessary medications, like insulin for diabetes.  According to the New York Times, Martin Shkreli set a new record for Wall Street greed when he acquired the rights to Daraprim, a life-saving anti-parasitic drug, in 2015 and hiked the price from $13.50 to $750 a pill overnight.

The NYT says the Trump administration “went ballistic” when Pfizer increased prices a few weeks ago.  This has deterred Pfizer, along with Merck, Roche, and Novartis from raising prices, for now.

But not to worry, if you have stock in a pharmaceutical company, because the FDA and its sympathizers are on your side.  Only worry if your insurance company doesn’t cover the cost of your medications.

You might profit from buying stock in the companies whose drugs the FDA, the “health care industry,” and the insurance companies are pushing, such as the over-the-counter naloxone that is one of four medications promoted for “opioid use disorder.”  In terms of reputation, this “opioid crisis” has spread far and wide, to the highest government offices, academia, psychiatry, newspapers, magazines, television, the internet, the courts, and dinner-table talk.  Its funding has been greatly enhanced by the promoters of public disinformation, yet relevant facts are few.  All the stories have the monotonous flavor of canned worms, opened, sampled and regurgitated for yet another meal.

We are told about opioid-related deaths, the evil drug company that promoted its opioid drug as non-addictive, the lazy or greedy doctors who over-prescribe narcotics, and the glories of “medication-assisted treatment,” or MAT.  Somehow, heroin comes up in all these stories, yet most people should know heroin is nowhere legal in the United States, not even by prescription.  We are rarely told that this magical MAT consists of four drugs, two of which are opiates themselves, or that the federal government has added special training and licensing requirements for administration of its approved protocol. We are not told that “treatment” does not mean “cure.”  No, “cure” would imply eventual freedom from all drugs, a notion that doesn’t serve Wall Street profits.

So let me give you one example of how this scam works.  I hesitate to call it a “conspiracy” (wink, wink), because of the paranoia such a word implies.  I’d rather call it a “consortium” of interrelated interests, all of which stand to profit by exaggerating the problem and presenting expensive but ineffective solutions.

We are told opioid-related deaths have skyrocketed this century, and Oxycontin (oxycodone) is the precipitating culprit.  OxyContin is produced by Purdue Pharma, which indeed does have a shady background.  In 1952, three brothers—Arthur, Raymond, and Mortimer Sackler–all psychiatrists from Queens, New York, purchased Purdue Frederick Company.  Arthur was reputed to be brilliant in psychiatric research and pharmaceutical advertising.  Working for Roche, he found enough uses for Valium (diazepam) to make it the first drug to hit the $100 million mark in revenue.  He also “positioned” Librium (chlordiazepoxide) for Roche.  Valium and Librium are members of the “benzodiazepine” class of drugs, a class that includes Xanax (alprazolam), Ativan (lorazepam), Klonopin (clonazepam), and others.  Alternatively, oxycodone is a semi-synthetic opioid from thebaine, an opioid alkaloid in the Persian poppy.  It was developed in 1919 in Germany.

In December, 1995 the US Food and Drug Administration (FDA) approved Purdue’s OxyContin (oxycodone), to treat pain.  It hit the market in 1996. Direct-to-consumer (DTC) advertising of drugs was approved by the FDA in 1997.  Purdue marketed the drug to doctors and the public as a non-addictive treatment for pain.  It reached $45 million in sales the first year, and $1.1 billion by 2000.  By 2000, it was becoming evident that OxyContin was, indeed, addictive, but the FDA still approved a larger, 160-milligram pill for those with high tolerance.

In 2007, in US vs. Purdue Frederick Company, Inc., Purdue pleaded guilty to intent to mislead doctors and patients about the addictive properties of OxyContin.  It paid $600 million in fines, among the largest settlements for pharmaceutical companies in US history.

By 2010, revenues had hit $3.1 billion, or 30 percent of the painkiller market.  Purdue remains a privately held company, in the hands of the Sackler descendants.  It is being served with multiple lawsuits from different states for its role in contributing to the “opioid epidemic.”  According to The Week, Kentucky is one of the worst-hit states.  It has filed twelve claims against Purdue, for false advertising, Medicaid fraud, unjust enrichment, and punitive damages, among others.  The Week also says there was a four-fold increase in prescription painkillers supplied to pharmacies and MD offices between 1999 and 2010.

Meanwhile, The Guardian reported in 2017 that the US constitutes 80 percent of opioid pill production but has only five percent of the world’s population.  It claims the pharmaceutical companies made false claims of an “epidemic of pain,” in the 1990s, and the federal agencies went along.  Pharmaceutical lobbyists got Congress to loosen restraints, and doctors were often reprimanded for not supplying enough.  “Regulators became facilitators,” as the FDA approved one opioid pill after another.

How does this relate to heroin, a known street drug, one might ask.  It’s a good question, for which there are no easy answers.  The idea that prescription painkiller pills are “gateway” drugs to heroin use has been mentioned.  One source notes that heroin is less expensive on the street than OxyContin, which can cost $1/milligram, or $80 for an 80-mg pill.  A more significant problem with heroin, we are told, is that it is increasingly laced with fentanyl, another opiate that is up to 5000 times stronger than heroin.  Synthetic fentanyl is being smuggled in from China.  Heroin is coming from Mexico, some say.  Fact is, there are few facts available in this gigantic obfuscation of facts that characterizes sensationalism.

So we don’t exactly know how prescription pain-killers are related to heroin/fentanyl deaths.

Death from opioids usually comes from respiratory depression.  In other words, people who overdose pass out and stop breathing.  Many other drugs cause respiratory depression, too, and a mixture can have cumulative effects.  It is common for people with chronic pain to take both a narcotic (opioid) and a muscle relaxant/sedative of the benzodiazepine class mentioned above.  The benzodiazepines also cause respiratory depression, as does alcohol.   Too, it’s not clear how many of these opioid-related deaths are complicated by other substances.  One psychiatric journal mentioned that a third of opioid deaths were complicated by benzodiazepines.  It’s probably safe to say that hard-core street addicts could be taking many drugs at any given time.

But our “medication-assisted treatment” bypasses all these inconvenient details.  It does include a drug, naloxone, which reverses the effects of opioids and can save lives in a primary opioid emergency.  It has been around over 45 years and is well known in emergency rooms for its life-saving effects.  Since this crisis began, police and ambulance drivers have had to use it on numerous occasions.  Now, the US Surgeon General Jerome Adams, MD, MPH, has encouraged over-the-counter preparations of naloxone for those with opioid use disorder and their loved ones.  FDA head Scott Gottlieb is also advocating expanded access to treatment, Medicaid funding, and other systemic changes to pay for the problem.

Manufacturers of OTC naloxone have jumped to increase prices accordingly.  Narcan intranasal (Adapt Pharma Inc.) retails for $135/dose, more than double its price a few years ago.  Kaleo’s Evzio auto-injector now retails for $4,500, more than 6.5 times its $690 average price in 2014.

What’s not clear about this scenario is how a passed-out opioid over-doser who has stopped breathing will be able to administer the naloxone.  Irreversible brain damage occurs mere minutes after a person stops breathing.  The life-saving medication requires someone alert, quick to recognize the problem, and to administer the antidote.

With all the calls for funding, research, and treatment, no one is admitting that substance use treatment is notoriously ineffective.  FDA head Gottlieb and others are begrudgingly accepting the idea that cure may not be practical, and long-term maintenance must be considered.  So the magic bullet, the aforementioned MAT, or “medication-assisted treatment,” is not a cure.  It is designed to convert illegal opioid use to legal opioid use for perhaps a lifetime.  Of course this will require funding for treatment, for the treating facilities, support staff, the researchers, and for the prescriptions.

Who benefits from this crisis?  Well, the National Institute of Health has earmarked $1.1 billion to develop “scientific solutions,” backed by a $1.3 trillion omnibus package passed by Congress, according to Psychiatric News.

US President Donald Trump has declared the “opioid crisis” a public health emergency.  We have the White House Opioid Commission looking for ways to fund and treat the problem, including such issues as insurance coverage.  It recommends funding for no less than eight professional organizations.

The four approved medications in MAT are naloxone, mentioned above, naltrexone, and opioids buprenorphine and methadone, in case you want to buy stock in the companies.  Insurance company stock will most likely benefit, too.

The common denominator in this “emergency” is the use of more drugs to treat the drug problem in the drug-crazed culture we have created.

How Do You Define Crazy?

What is “addiction”?  What causes it?  There’s a lot of attention given, lately, to various forms of “addiction,” but definitions of it and its clues about its causes are rare.  The American Psychiatric Association (APA), the primary lobbying organization for the professional mental disorder labelers, claims it is a “brain disease” that is “complex” and characterized by “compulsive substance use despite harmful consequences.”  The official platform, published on line, says there are a number of effective treatments, and that people can recover.

The APA also asserts there are “changes in brain wiring” as a result of addiction, and that “brain imaging studies show alterations in judgment, decision making, learning, memory, and behavioral control.”

The psychiatric establishment, including the National Institute for Drug Abuse, states brain changes in the brain stem, cerebral cortex and limbic system cause addiction.

So that’s our answer, in a nutshell.  Satisfied?

I’m not.  In fact, it’s embarrassing to admit I’m associated with such pretenders, because this propaganda campaign is nothing more than pandering to a group of people who probably know more about addiction than the “experts” do.  First, “addiction” per se is not listed among the growing list of “mental disorders” in the latest bible of psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, version V.  (DSM-V).  We have “substance use disorder,” and specific diagnoses related to the type of substance (mis)used, such as “opiate use disorder.”  We do have “internet addiction,” a new, DSM-V, excuse to seek funding for treatment.  But my rant here is not about addiction or the “opioid epidemic,” or even the marketing blitz that characterizes modern strategy for creating and perpetuating insanity.  It’s about terminology and the ocean of irrelevance that is pawned off as information to an under-informed, misinformed, and gullible public.

I first heard the term “brain disease” from members of the National Alliance for the Mentally Ill (NAMI), a lobbying group that prides itself on its family-associated organization, lobbying efforts for “mental health parity,” and its disassociation from mental health professionals.  NAMI has especially wanted to “de-stigmatize” mental illness by insisting it’s a “brain disease,” caused by a “chemical imbalance” in the brain, thus equivalent to physical diseases, even though there is little physical evidence for such conditions.

The psychiatric establishment, assisted by the pharmaceutical companies, the government, and to some extent, the insurance companies, has jumped on this opportunity to legitimize (and fund) research and treatment for a variety of mental disorders, and the list keeps growing.  Since the first DSM was published in 1952, the number of official mental disorders has steadily expanded, apparently to accommodate the tide of new medications flooding the market.  Homosexuality, formerly listed, has been expunged since 1987, but we have added problems you didn’t know were disorders, such as ‘social anxiety,” “adult attention-deficit hyperactivity disorder,” and “hypoactive sexual desire disorder.”  Insomnia is now an official psychiatric disorder, maybe thanks to the efforts of researchers and pharmaceutical companies that want to study and profit from it.

Lately, we are told the national suicide rate has gone up.  Army suicides are up, and there’s a question about whether some of the opioid-related deaths were intentional suicides.  We have the controversy over what used to be called “physician-assisted suicide,” which is no longer a politically or socially correct term, because it stigmatizes those who get a physician to help them die.  This is now called “medical aid in dying.”  Who remembers when Jack Kevorkian, a pathologist, went to prison in 1999 for helping patients die, convicted of second-degree murder?

Psychiatric terminology is tossed around with the same carelessness of standard epithets but carries the unsubstantiated veneer of insider knowledge.  Who hasn’t heard the president called a “narcissist?”  Look in the DSM-V to find out that “narcissistic personality disorder” could probably fit many people, depending on how one interprets the list of vague criteria, such as grandiosity or lack of empathy.  There are no “brain imaging studies” that prove it, and there’s no treatment.

To say the APA is misrepresenting itself, psychiatry, the mentally ill, and is flooding the public with irrelevance seems like a drastic claim, but here are the “facts.”  In its bid to align itself with “medical science,” such as it is, psychiatry likes to talk about “evidence-based” findings, but the evidence for most of its claims is based on subjective screening tools, such as Beck’s or Hamilton’s Depression scales, which depend on the patient or observer to assess symptoms or signs believed to contribute to clinical depression.

Also, the APA’s claim that “brain imaging studies” have identified specific areas of malfunction related to various mental disorders, is simply not true, but they keep trying, and the “psychiatric industry” is hot to obtain more funding for more research into the various potentialities of such tools as functional MRI and PET scans.

It is true that people under the influence of certain drugs and alcohol show more or less activity in certain brain areas, and autopsies of those with significant alcoholism, for instance, have brain changes consistent with long-term damage.

A great deal has been made over neurotransmitters, in order to justify the “chemical imbalance” hypothesis.  The class of antidepressants termed “serotonin-selective reuptake inhibitors” or “SSRIs”, led by the introduction of Prozac (fluoxetine) in 1989, quickly followed by copycats Zoloft (sertraline), Paxil (paroxetine), and others, spawned a new wave of psychiatric drugs that targeted specific brain chemicals (neurotransmitters).  Do they work?  There is increasing evidence that they don’t work for long, especially in children, and they may do more harm than good.  Approval by the FDA of direct-to-consumer (DTC) advertising in 1997 may have contributed to the upsurge in use of psychiatric as well as a host of other medications, and to the misperception that there’s a pill for every ill.

The “opioid epidemic,” deserves particular note, because it has been deemed by the Powers-That-Be as a “public health crisis,” deserving of broad-scale funding, research, special treatment protocols, legislation, and lawsuits against the pharmaceutical companies deemed most responsible for creating the problem.

Here, the psychiatric establishment–along with the government and media–has gone out of its way to misrepresent and inflate the problem, as well as its preferred solution, which is to hook people forever on different opiates.  The Need-To-Be-Needed crowd indirectly admits it has no cure, yet, but more funding will provide for better access to “care,” and for more research, such that maybe someday we will know enough to cut people loose from their psychiatric problems.

 

 

 

 

 

Gotcha!

The “health care industry” owns you, body and soul.  The irrefutable fact that health care insurance is mandatory in the United States proves the “industry” owns your body.  The idea that it owns your soul, too, requires a deeper look.

The “soul” is hard to define, and there are those who claim it doesn’t exist.  Various religions have their own conceptions of what the “soul” is.  For the purposes of this article, I will keep things simple by claiming the soul in this physical life is affiliated with mind, the ineffable generator and receiver of thoughts and ideas, the vast processing unit some people assume is in the brain.

The health care industry’s claim on your mind, and the mass mind, can be evidenced in multiple ways, most specifically in the mass belief that health care on a grand scale is necessary.  Television, with its ability to influence millions through covert and overt mental manipulation, works to consolidate and perpetuate the belief that you need doctors to look for and treat problems you didn’t know you had, to “educate” you about warning signs of potentially life-threatening conditions.  Media warns about “bad” foods, and signs of cancer and other terrifying diseases, all broadcast with the stated intent of helping you live a healthier life.  It promotes a philosophy that the “health care industry” works to serve you, when, in fact, the “health care industry” works to manufacture and promote disease by undermining your confidence in yourself and your body’s natural tendency toward healthy homeostasis.  It sells health care the way it sells cosmetics, by leading you to doubt your own beauty and your own body, enough to buy the product that will make you feel better about yourself.

The new “normal” for blood pressure has dropped from 120/80.  The new normal for cholesterol has dropped from 200.  No one mentions these are only numbers, and blood pressure fluctuates naturally during the course of the day, depending on activity and stress.  More people are depressed, we are told, and better pills for dealing with uncomfortable emotions are coming down the pike every day.  Never mind that TV itself is depressing and probably raises blood pressure.

Fact is, the body, which is well adapted for handling specific threats, is confused by more generalized, non-immediate, ones, like those generated by the mind, its imaginings, and the information the mind feeds to the body.  Worry is a bad habit that creates constant stress, keeping the body on the alert for ill defined dangers.  A perpetual state of hyper-arousal takes its toll on the body.  Worry is only one manifestation of fear, a chronic condition in our society, not only perpetuated through media but alive and pulsating on the streets, in traffic, in grocery stores and shopping centers.  People have short tempers, are quick on the trigger, and always afraid the other guy with a short fuse has a real gun that can do real damage in real life.  We live in a violent world.  Just watch TV to learn that version of the truth.  We have real reasons to be afraid, and we tell our bodies that, despite the lack of immediate danger.

So what does this have to do with the health care industry owning our minds?  Well, the idea that we absorb all this crap as if it were gospel, without the exposure to alternatives to determine how much is true and how much is propaganda, for the purpose of selling “health care.”  The illusion that there is “care” in the “health care industry” ultimately leads to a sense of having been betrayed, because the “care” was siphoned off a long time ago.  The system itself is greedily vampiristic, the parasites feeding off the host, bleeding and treating them ultimately to death, one life at a time.

Of course there are exceptions, and there are the medical heroes, those who have not lost the ability to care.  These are the doctors, nurses, and other “providers” patients are lucky to have.  But even the best of them are stretched thin and on the verge of burnout with the excessive demands of the system itself.

There are alternatives to the one-size-fits-none proposition offered by the “health care industry,” but you won’t hear about them on television.  You might hear from those who have personally benefited from alternatives like acupuncture, massage, chiropractic, herbal therapies, or folk remedies, just to name a few.  Ayurvedic medicine, but these are not likely covered by your mandatory insurance, so you would have to pay out-of-pocket.

But hey, it’s the price you pay for freedom.