Stupid Is As Stupid Does

Forrest Gump 1994: “My mama always said life is like a box of chocolates. You never know what you’re gonna get”.

If we’re talking about politicians, aint that the truth!

After writing several blogs calling out Massachusetts Governor Duval Patrick, West Virginia Senator Joe Manchin, Vermont Governor Peter Shumlin, and now Delaware Secretary of State Jeffrey Bullock, it is indeed difficult to comprehend that all of them arrogantly assume the majority of their constituents are ignorant and naïve.

The Online Urban Dictionary defines the title phrase, “Stupid Is As Stupid Does” as “…an intelligent person who does stupid things is still stupid. You are what you do.”  I have to believe that on some level any politician that rises to the level of Governor, Senator, or in this case, Secretary of State has to have some semblance of intelligence.  Why then are Bullock’s quotes fraught with fallacy as outlined below?

Even persons and groups with the most staunch opposition to opioids with any sanity have to see the flaws in this rhetoric, and I’m hopeful they agree that universal precautions for opioid prescribing is vastly more important than singling out any one product.

Just how gullible are Americans? (Maybe that should be the title.) Or maybe, “False fears fraught with fallacy” or perhaps “Politics is like a box of chocolates”.

While some may believe that Abuse Deterrent Technology (ADT) is the answer to all opioid evil, our “leaders” are sauntering off the cliff as sheep, “followers” as they are, one politician after another is pinning a feather in their cap scheming their “get tough on drug campaign” with an assumption that we Americans are idiots.

Let’s take a closer look…

One June 23, 2014, The Cape Gazette ran a story, State restricts hydrocodone use which is pasted below in blue.  My comments follow in red…

The Delaware Secretary of State has placed emergency regulations on an extended-release drug because it is easy to abuse.
Newsflash:  All opioids are “easy to abuse”, but OxyContin® is currently the only opioid with FDA sanction to be LABELLED as an ADF.

Hydrocodone, which also goes by brand name Zohydro, can be chewed, crushed, cut, grated or ground;  it has no chemical barriers that prevent users from extracting the opioid by using common solvents such as water, said Delaware Secretary of State Jeffrey Bullock.
Really?  Did the Honorable Bullock test this in a lab?  If he did, he would know that the same is true of generic extended release oxymorphone (which by the way is 3x more potent than hydrocodone), hydromorphone (aka Dilauidid®, which by the way is 4x more potent than hydrocodone), morphine, oxycodone, codeine, dihydrocodeine, etc.

“The use of this new and dangerous narcotic painkiller known as Zohydro must be monitored closely because the abuse of it can be deadly,” Bullock said.
Really?  Abuse of ANY “narcotic painkiller” can be deadly.  It doesn’t matter if you overdose on methadone, hydromorphone, oxycodone, or hydrocodone – you can only die once.

Bullock said he adopted the emergency regulations because of the potential for accidental overdose or intentional abuse or diversion.
Hello?  Such policies should be collaboratively developed with healthcare providers and should not be limited to Zohydro but should apply to all opioids equally.  Do we restrict all explosives from airports or just restrict a select few from carry-on luggage?

Prior to prescribing an extended-release hydrocodone that has no abuse-deterrent formulation, Bullock said, medical practitioners should conduct and document a thorough examination of a patient.
For the love of God; I should hope that before ANY medications (opioids, non-opioids, antibiotics, anti-hypertensives, anti-diabetics, anti-cholesterol and others) are prescribed for any condition, that “medical practitioners should conduct and document a thorough examination of a patient”. 

I thought I saw it all with the “three stooges” from Massachusetts, Vermont, and West Virginia, but after reading the Cape Gazette, Mr. Bullock gets “Honorable” mention at the very least.

As François de la Rochefoucauld put it, “Passion makes idiots of the cleverest men, and makes the biggest idiots clever”.

Feel free to comment!

23 thoughts on “Stupid Is As Stupid Does

  1. Stupid is as stupid does, the best abuse deterrent technology is substance abuse treatment and 12 step fellowship support as in Meetings Meetings Meetings, work the steps or die, etc.Meeting Makers Make it, and lots of service work to keep you busy and out of your own head! We have more prisons with drug abusers in them than treatment centers. 95% of all crimes are commited under then influence of some such substance and one of the most dangerous to the user and others is booze cause it is actually legal and not well regulated and widely available. You can throw a rock randomly in most cities and hit a place that sells booze now, even the pharmacies are selling booze!!! How responsible is that? My one stop get loaded shopping store where I can pick up my pills and my booze at the same place and only be carded for one of those items!!! Cigarettes are more restricted than booze and pills now!!! WE need to stop persecuting sick people, stop building prisons and stop sending non violent drug abusers there and start building more treatment centers for addicts and alcoholics!

  2. Dr. Fudin,
    Thanks for another well written and informative letter! I, too, will forward the info and my story to my senator and congressman.
    You are a gem!

  3. Thank you Dr. Fudin. I have copied and pasted your blog to my two state senators and the President of the United States from the links I have for advocacy on my website. I place your name in front of your comments since it is in black and white.

    My introduction:
    Please read this blog by a well-respected pain doctor. Consider what it would be like to break your leg and end up with that same pain, pain that never ended. Think about the last toothache or earache you had and imagine that it never went away, through absolutely no fault of your own. Please educate yourself and show compassion to your constituents who live in chronic pain.

    My Salutation:
    Please think smart _____, save a life. Sincerely, Celeste Cooper

    1. Outstanding, Celeste! I am forwarding all to my Representatives and the President while sharing my Pain-Story in brief.

      Thank you for all that you do for all of us who live day in and day out in pain!

  4. Dr. Fudin is right about politicians are being stupid and with NO medical education, they are making ALL our choices for us.

    I agree that the politicians are trying to kill off those who are on disability because it’s straining the system because they can’t manage the national budget, plus the baby boomers are now drawing their SS. Without consulting medical professionals, politicians are calling all the shots. How can they? The politicians have made it sound like all pain meds are a death sentence, how untrue. How are we going to be able to live our lives with all this crap going on for much longer? Chronic pain patients are doomed unless somebody wakes up and helps us to bring understanding and education to Washington D.C. I guess, maybe the ADA is our only chance if they will listen.
    A decade of pain relief for the pain community and now nothing but suffering in the worst pain ever because of the DEA going nuts across the nation and our government is allowing it to happen to the weakest people and many have children and families to take care of. I’m seriously worried about patients lives. How much more stress and pain can the pain community suffer through? I know I can’t take much more. I think that is just what our government wants. Now what can be done about it so we can live a some what normal life with less pain? Who can get to them to listen? Siobahn Reynolds made her way into Congress to be heard, who else can do this and be taken seriously? We are being ignored and I know many other states are going through the same things. In my opinion, this needs to be handled all the way at the top, Washington D.C.! We keep talking about the issues everywhere but we aren’t getting very far at fixing anything because the government won’t listen. Any ideas on how to get this done? or are we all just doomed to return to the early 80’s or earlier where everyone just commits suicide when the pain is too great?
    I’m sorry, just so stressed about all this. I keep hoping for new ideas and something positive to happen but it doesn’t. Yeah, just a bunch of stupid idiots we have running our country. JMHO!

    1. Hi donna,
      I think of siobhan so often, and miss her so badly. The world could not afford to lose her when we did.
      I wonder if anyone can pick up where she left off with the fact that THE CONTROLLED SUBSTANCES ACT IS UNCONSTITUTIONAL. She told me she was on solid legal ground, she just needed a pile of money to take it into court(s) and get it done.

  5. Just an FYI…In attempting to find a primary care doctor in Massachusetts, I told the receptionist I was new to the area and had a disability. First question: Are you on narcotics? I told her yes but said I already knew the doctor wouldn’t write the script. I just needed a good doctor. She said he was forced to stop writing pain prescriptions a few months ago.

    There is no hospital or doctor that I know of who will write prescriptions for anything narcotic in MA and soon all of New England. I feel as if I am living in a state and country that want me to stay disabled in bed in pain. Why? Is it so I’ll vote for those who support “medicare”? Maybe they want me dead so those who are chronically ill don’t drain the system. It’s only going to get worse. Is it time to go to court under the ADA?

    If you are in a place where you are receiving care, don’t leave. I’ll be heading back to my old neurologist at about a $2000 cost as I can’t receive adequate care in Massachusetts. I will be so in debt I don’t know what to do. All the ramifications of these stringent regulations far exceed the benefit of stopping addicts. Thanks Dr.F for keeping us informed!

  6. PainDr… Once again-On the money… The bottom line is…when politicians play doctor, patients lose.

  7. I totally agree Dr Fudin, My Issues are incurable so that makes me chronic for life .Its been two years I suffered because of all this . I’ve been evaluated by a addiction specialist an her conclusion was that I was not an addict and I needed opiates to lead a somewhat normal life. Then answer me this why can’t I get the tamper proof oxycontin time release for my pain, I really don’t know how much longer I can take not being able to walk because of th e pain. Thank you so much for what you do.

  8. Jeff, I absolutely hate defending the statements of a politician who is practicing medicine, but just because the Secretary of State’s comments apply to most opioids in addition to hydrocodone do not in this case make those remarks about hydrocodone less accurate. The far more treacherous problem of late is that politicians are making medical decisions for the general population, apparently without a full understanding of the facts substantiated by high-quality evidence or in consultation with medical experts like you.

  9. Dr. Fudin ,
    Thanks’ for your update, speaking of updates seems we’ve heard nothing about this dangerous drug of mass destruction Zohydro ER cornering the market of all drug abusers and chronic pain sufferers. Maybe this has something to do with the price of the medication. I’m sure this new Zohydro ER is a excellent medication for those that cant tolerate acetaminophen.
    I wonder how many abusers have actually tried to abuse this terrible all consuming Massachusetts banned “Heroin in a Capsule”
    I’ve found no problems with any overdoses of Zohydro ER searching the internet but who knows, there has to be one person that tried abusing it sitting quietly in a room or basement of a house jonesen.
    Zodydro ER is a capsule not a tablet so abusers can put away their crushing device techniques, unless it has stealth beadlets inside, most likely not if its this scary non – abuse deterrent medication.

    So all that Media hype for nothing, seems our government appointed politicians need to spend more time on their job and issues at hand for which they where elected and leave this type situation to the FDA and doctors that treat chronic pain sufferers. But it seems all that suffer from chronic pain just don’t matter anymore. My feelings aren’t hurt, we must take care of our health and move forward putting this issue behind us.

    Mark S Barletta

    1. Paul: That’s an interesting question! What really gets me about that formulation is how Reckitt Benckiser “pulled a fast one” by combining naloxone with buprenorphine for “ADT”. It makes perfect sense for Talwin NX, since as you know, naloxone is poorly orally absorbed, but if crushed and injected, the naloxone has a higher affinity for opioid receptors than pentazocine. I pointed this out on Bupes, and Subs, and Surgery, Oh My. Where’s the science for combining buprenorphine with naloxone, when naloxone cannot physically reverse buprenorphine since buperenorphine has a higher receptor affinity? It’s just craziness how politics and poor science prevail in so many cases.

  10. I agree that Bullock is a moron, Jeff. However, I disagree with your assertion that OxyContin is the only opioid on the market that is an ADF. There are other opioids being sold with essentially identical ADF properties. Perhaps a more accurate statement would be that OxyContin is currently the only opioid with FDA sanction to be LABELLED as an ADF.

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