Back by popular demand is Guest Blogger Mortimer Fein to tell us what MEAT and MORPHINE have in common!
Here’s what Morty has to say…
The World Health Organization (WHO) used to create graphs depicting the per capita morphine consumption in countries around the world. Per capita consumption of morphine equivalents is highest in the United States/North America and Australia and lowest in Myanmar, Afghanistan, Zambia and Madagascar. And I ask – where would YOU rather have low back pain, arthritis or cancer? Nothing against these places I am sure they are quite lovely in many ways, but I bet sufferers there would brave the high seas to come here for pain treatment if they had the choice. These WHO data used to imply civility – taken as a sign of how a society cares for its sick and its hurting. It is a testament to the power of perception that in just a few short years these data are now taken to represent the decline of western civilization. America’s consumption of opioids is a sign of its weakness, its softness, its pill popping wimpy-ness. We are no longer civilized and ahead of the rest of the world, we are now little more than a society of junkies, to hear some tell it.
“The US consumes (fill in the blank with whatever percentage you like) % of the world’s opioids,” they exclaim! Never mind that people often include in this rant opioids that aren’t even sold in other countries. It’s like saying 90% of the world’s Japanese food is eaten in Japan. America’s conspicuous consumption is infamous. We may consume 80% of the world’s opioids but we also consume 50 billion burgers per year. Three burgers per week for every single American. I would guess that’s about 80% of the patties if not more. Is anyone proposing bun limits? Time constraints for one’s ability to consume as many burgers in a week as one wants? Anyone monitoring how many times you went to Wendy’s, McDonalds, or Burger King in a month? ”Don’t fill that order, this man just bought a burger yesterday at a burger joint in Michigan. And before I give you this juicy baby let me see check your cholesterol (or your adherence to your statin regimen). The perception of this carnivorous consumption – Americans are fun-loving, carefree folks who love their lipids. Others though would see in these numbers the downfall of western civilization – a sign of America’s weakness, its softness, its fast food popping Wimpie-ness. (sorry).
People will vehemently argue both sides of these issues because, as we all know, perception is reality. The truth, of course, lies somewhere in between these overly rosy or sky-is-falling views. People with chronic pain meanwhile are losing the battle to define themselves and instead are being defined by hostile parties not above distorting data and selective use of evidence. For example, people with pain are not seen as the fun loving, sexy and trim models in the Hardee’s commercials (allegedly) about to consume more calories in one burger than they did all last week, they are seen as the compulsive overeaters buying a bag full of cheeseburgers, stealthily binging on them in their car.
Dan Brookoff, may he rest in peace, used to say, that “if you want to read a book about pain, read the Book of Job.” Job was ruined financially and physically, his family was destroyed, but Job was blameless, a man of integrity. He was made to suffer, yet he remained the perfect person. Can the world not see past the pain sufferer’s physical, fiscal, familial ruin and our own biases and not judge them or their treatments so harshly? If we can get past our biases and perceptions it just might be a sign of our civility.
As always, comments are encouraged and welcomed with enthusiasm.
Dear Dr. Atkinson and Dr. Fudin, This is great information about how the figures are being twisted to make us look like a nation of drug abusers. I hope this gets out into the media, for this is a very important part of the story that isn’t being told. The truth needs to get out about how the figures are being used! Everything you read lately, or hear on the news uses this rhetoric. Especially unfortunate are all the government policy hearings (and policies being written) that use this story about our “extreme consumption” as a main talking point when it isn’t even true! Why all this dishonesty ?? It will just hurt those who are truly suffering. Enough twisting the truth to fit agendas. Problems were there are none. Enough already.
Great article! Very important perspective. The WHO’s UNODC compiles a report each year on opium consumption worldwide including breakdown of prescription opioids, heroin, and raw opium consumption. Most of the statistics about usage by country are sourced from that report. The small print, however, makes it clear that the only first world countries that report prescription data are the US and Australia which explains why it appears we use more than everyone else. It’s more than a little dishonest, however, to make broad conclusions and label the US as drug abusers when we are the only ones honestly reporting use.
Dr. Atkinson, Thank you for your comments. This perspective provides key information that the media selectively ignores and that most likely, politicians don’t even know.
Our country CAN treat pain, including with opioids, we have the resources. It is a reflection of prosperity and humane medical care. The meme going around that it’s BAD that we do this is totally regressive thinking! Shame on us for having progress that relieves suffering…What??? Seems the rule of the day…So many would be happy to hurtle us back to the dark ages if given a chance! Many countries can’t even supply clean drinking water to their citizen’s much less ANY kind of medicines. We have been forward thinking AND HUMANE enough to provide end of life pain care for cancer patients , and for those in chronic pain. Hopefully we will continue to provide HUMANE care for our citizens who have tried all other options , including alternative medicine and still have painful, disabling conditions and respond well to opioids. Even so, many in our country continue to suffer and are denied even this compassionate care, including our veterans.
Hopefully all other nations will be able to provide good medical care for their citizens. This is a worthy cause. Progress toward compassionate care of people should be held up as an example, not demonized by data turned on it”s head. Hopefully we can turn around the regressive policies that are coming down the pike here, so we can again be an example to the world of compassionate caring of our citizens.
Thank you for your wonderful articles and compassion for those of us suffering. It’s such a shame that we are being treated this way. I’m a chronic pain patient married to a surgeon and he feels this war on opiates is ridiculous. He refuses to not prescribe due to the DEA. Of course he only has to deal with acute pain most of the time, but he does have chronic pain patients at times as well. He feels quality of life is the most important for patients. Of course, he’s been in practice for 30 years, so he’s got the old school mindset of medicine. Not the crap that goes on today.
There is never a doubt in my mind, when I read these ridiculous stats, that the agenda is NOT biased toward the sick, disabled, suffering, human. We don’t allow out beloved pets to suffer endlessly & needlessly, and unless you have felt true physical suffering (where there is nothing else), or watched someone you love be in endless agony, you simply do not understand. Unless, of course, you’re highly educated, know what “conflicts of interest” are, and believe in science and humanity! Thank you Dr. Fudin, and M. Fein! You give people hope.
Very well spoken! When did it become okay for any government agency to come between a physician and the patient? It’s time to stop this travesty! Chronic pain patients number 100 million & are not being heard. It’s time to take control of this and let them know Loud & Clear, that while opioids do not take away all of people’s pain, they do help a lot of pain patients remain productive and provide for an improved Quality of Life
Tears welling, I don’t know when I’ve ever read such a compassionate article on pain n opiates. We become physically addicted which is a mute point sense we will most likely need them for the remainder of our lives. Quality of life n how to best achieve it really the only thing topic that should be on the table. Thank you for your article.
Lynn, I love your comment. And I think you mean “physically dependent” as opposed to “physically addicted.” Addiction is an entirely different diagnosis. In fact, it may surprise you (and should please you) that Psychiatry’s DSM-V does not include “physical dependence” in the diagnosis of Substance Use Disorders when the opioid is prescribed for a medical reason, i.e. PAIN.
We are making progress!