“The Opioid Crisis: The way I see it…”

      The other day as I was driving home after work, I recalled listening to a brief NPR report on the Opioid Crisis. For the rest of the day I couldn’t help myself to think how did we get into this awful mess in the first place. Specially now several years later after all the deadly costs associated with this ongoing public health calamity ravaging so many communities throughout the country with no end in sight.

           I think we must have to acknowledge that this mess did not arise form ignorance nor stupidity…or did it? But, at a closer look it arose, instead from corporate unethical behavior & deplorable corporate greed. Retrospectively, in essence, all the circumstances & factors seem to have been ripe for the back then perfect storm (the creation of the Opioid crisis in the US/world as we know it today).

         During that time JACOH came out with a call for the medical community of prescribers to take stock of their ineffective role of controlling pain across the boards. Hence, “Pain: The Six Vital Sign” campaign ensued furiously. Naturally Big Pharma  probably felt this was their “green light” and moral justification to flood the market with opioids, after all it was us-- the medical community-- who undertreated (knowingly) pain for decades. Did we get framed for material gain alone or for their wider and deeper corrupt ends? Or didn’t the apparent consequences appeared foreseeable to all 3 stakeholders?  

        Perhaps, civic altruism let us astray during esthat time as in so many witnessed cases throughout history. Or perhaps as some of us would quickly point out or say, nothing more than The Law of Unintended Consequences playing itself out at its best. Or did we forgot to seek scientific guidance or take moral stock of our practices.

 As all 3 stakeholders scrambled to lay the blame ( point fingers for this unimaginable fiasco ) it becomes clearer to this author that we the medical prescribing community have been by far the most vilified group directly or indirectly by the media when in reality equity apportionment is missing to this day in most articles, op eds, essays, etc. covering this controversial subject matter.

 At this fork in the road, we should all continue to strive and remain committed to the vigorous pursuit of the truth (wherever that may lead) and persistent attention to the purposes for which these truths may be put in service. Moreover, how our actions or transactional inactions may compromise reflections of our individual and collective ethical values. The way I see it, we felt impotent in mitigating the opioid crisis when we had an opportunity all because we abdicated our role of patient advocates. Initially we should have spoken the truth even when it would have been difficult to disagree with the industry prevailing point of view..

 The way I see it, we should have known better... even big Pharma.