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The Opioid Epidemic

 

Recently, the media has been filled with glee around the guilt of the Sackler family (Purdue Pharma) in the origins of the Opioid Epidemic. I have no interest in arguing on their behalf, because the avarice and lack of compassion in their decisions is obvious and really not up for debate. But it interested me that they were singled out, and that the media was willing to simplify the whole epidemic down to the choices of one, rich, Jewish family. I am sensitive to the specter of anti-Semitism, because of the endless role it has played in history, and this struck me as worth examining.

E pre groom

“Are you sure we need to discuss this?”

The Sackler family is responsible for OxyContin, one of the opiates that flooded the market in the nineties, and they attempted to downplay the risks of addiction in their marketing campaigns and ignored misuses of their drugs in favor of making an enormous amount of money, but they could have accomplished none of this on their own. Doctors, who knew that opiates were addictive (Morphine has been around for a long time, Opium for much longer), over-prescribed these medications, and some even made an illegal business out of the underground market for opiates (though most did not). Pharmacies and distributors bought larger amounts of opiates than could ever be used responsibly, knowing they were feeding addiction and illegal markets and doing it anyway. We, as a society, defunded and underfunded addiction treatment, ignoring and demonizing substance abusers so that they could not find a way out, even if they’d wanted to. Families ignored, friends ignored, schools ignored, government ignored, and the FDA approved more and more variations of opiates for the marketplace.

It’s also important to recognize that the Opioid Epidemic has become national and world news in the last few years largely because of the rise of Fentanyl, and then Carfentanyl, both of which are more lethal than Heroin, and have led to many overdose deaths. And Fentanyl has nothing to do with the Sacklers. It’s also important to see that when people of color were losing the war against drugs we didn’t call it an epidemic, instead we blamed the addicts themselves for their problems. This time it is young white people who have been dying, and that seems to have made a difference in the coverage.

Another big difference for the current epidemic is the growth of social media, and technology in general. In the past, a teenager might have had to drive forty minutes to the bad side of town to buy drugs. Now, with a text, you can have anything brought to you in ten minutes. Anything. You don’t have to go to the bad part of town, or spend a lot of money; sometimes all you have to do is open the medicine cabinet in your friend’s house. If we are having an opioid epidemic, then we are having a Benzodiazepine and Marijuana Tsunami, with an alcohol chaser. Vapes, which are everywhere now, can easily be adapted for use with all kinds of different, hard, drugs, and used out in the open. In middle school.

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“You can’t take my Benzos!”

The question is, why did this happen? Why were we so eager to believe the lie that opiates could be made non-addictive? Or that addiction is a small price to pay for pain relief? Or that the market can be trusted to make moral decisions?

This is our culture. American culture. The Sacklers were certainly not acting on Jewish law and morality in their decision making; they were, actually, following the prevailing American value that money is good, and drugs are good, and let’s not think too hard about the downsides, or address the complexities, or look at the people who are struggling, because, really, it’s their own fault if they can’t pull themselves up by their bootstraps.

There are reasons other than Anti-Semitism to explain the hatred and blame of the Sackler family in particular. One, there was a recent document release from their trial, and the information in it was really juicy and obnoxious and therefore caught people’s attention. Even more important, a lot of Americans recognized in the Sacklers a stand-in for the Trumps, and there is great satisfaction in seeing a similarly rich, and corrupt, family being brought down.

But their Jewishness made me nervous. It’s always scary for me to see a Jewish person in the news for criminal, immoral, or unjust behavior – not just because what they did is upsetting, but also because of my fear that their crimes will be used against the whole of the Jewish people. The Holocaust is not as far in the past as some people would like to believe, and we’re seeing an upsurge in anti-Semitism everywhere.

I still don’t know if anti-Semitism played any role in the coverage of this. The origins of the Opioid Epidemic are complex and interwoven and need to be addressed from multiple directions. Simplifying it all down to the greed of one company, and one family, felt good for a moment, because it made us feel like we finally had a handle on what happened. But the epidemic is still happening. We still have a lot of work ahead of us to change our laws and policies and culture, in order to prevent more overdose deaths and lives lost to addiction in all kinds of ways. We want to blame someone, like the Sacklers, or Central American migrants, or corrupt doctors, because we want it to be someone else’s fault, and therefore someone else’s responsibility to fix. But that won’t work. This is our problem, and it belongs to all of us.

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“Is she serious, Ellie? This is so not my fault.”

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“Just pretend to be sleeping, Cricket. It always works for me.”

If you haven’t had a chance yet, please check out my Amazon page and consider ordering the Kindle or Paperback version (or both!) of Yeshiva Girl. And if you feel called to write a review of the book on Amazon, or anywhere else, I’d be honored.

Yeshiva Girl is about a Jewish girl on Long Island named Izzy. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes is true. Izzy’s father decides to send her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, as if she’s the one who needs to be fixed. Izzy, in pain and looking for people she can trust, finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?

About rachelmankowitz

I am a fiction writer, a writing coach, and an obsessive chronicler of my dogs' lives.

78 responses »

  1. Thanks for the insight. In Australia, we’re aware of the overprescribing and overuse of opioid medications and similarly addictive medications. I didn’t realise in the USA, one family had been singled out for blame.

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  2. Was not aware Sacklers were Jewish. You might add in the marketing of oxycontin. I received sales people pushing this drug who claimed a lack of addition potential. Never believed them nor did I ever prescribe more than a brief course (7-10 days).

    Much later in life I blew a lumbar disc and was in exqusite pain for weeks at a time. When all else failed, I took oxycontin. I also had substantial withdrawal symptoms. Some really crazy stuff. I’ll personally testify to the negative aspects of this drug. Back surgery solved the problem for me.
    Way to go Rachel. A nice piece. Thanks

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    • I’m very lucky because I get sick from opioids, so I’ve never had to deal with the addiction symptoms. But I’ve seen them and they are awful.

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    • I’m so glad to hear this. I have only been on opioids after open heart and cancer surgery, when the pain was severe. And only for a very brief period. I also couldn’t wait to get off them, after Oxycontin gave me a horrible panic attack. So, I took Tylenol. Now I have spinal degeneration and disc damage. Which causes extreme pain, whenever I walk for more than five minutes. Surgery isn’t an option, due to my age and complex medical conditions. But, I still refuse opioids and will try Tylenol and a back brace. I’m so grateful for doctors who refuse to be a part of this epidemic. Seniors are also an over medicated group. Especially with Adavan. So I also tell members of the medical community that my drug of choice is chocolate. Maybe, the Pharma geniuses could come up with chocolate covered Tylenol. But, seriously, we’re in over our heads with this epidemic, and I’m very grateful for people like yourself, and Rachel, who have the courage to speak out. Please excuse any typos… mild cataracts. Mary

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  3. “Their Jewishness made me nervous,” you said, and I know just what you mean. I’m not Jewish, I’m Catholic, and that’s another group people love to hate. When I see Catholics unfavorably in the news, I worry that people see it as an opportunity to attack a whole church for the actions of a few. I know from experience that anti-Catholicism is alive and well, although often more subtle than in the past. For some people, it doesn’t take much to cultivate and validate their bigotry.

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  4. For a very thoughtful article about this see The Sun from March 2019 called “Filling the Void.” I think you can access this for free. At least another blogger was able too. It addresses most of your concerns, though not anti-Semitism. I had never picked up that from any news accounts and I am pretty sensitive to such implications.

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  5. I wish I could brush off your concern and say, “Surely, people have changed. We are wiser, now, and will not make one group a scapegoat for a national crisis.” But, if I have learned anything in the last few years, the desire not to worry about the possible existence and strength of baser human inclinations is dangerous to indulge.

    I hope people are wise. I, too, will be vigilant and watch for signs that they may not be.

    It is also sad when we take a few individuals as representative of a whole–and that the whole has to worry about the few individuals whose actions may endanger the rest.

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    • I think we’ve been doing a lot of this the past few years, around different issues with different groups. Lots of knee jerk reactions that cause real damage to people who don’t deserve it. I wish we could stop.

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  6. I agree, it does belong to all of us, but I beg to differ where greed is concerned. Whether it’s Sackler, or Morgan, or Ponzi or whomever. America has been blessed with prosperity but greed knows no ethnicity or color or religion. It is a human condition, wherever one lives. If we continue to pervert our blessings believe me, we will lose them. And no government can regulate it. Government itself can be the problem.

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  7. Thank you for addressing this critical issue. Anti-Semitism? Jesus, Salk, Maimonides, Gershwin, Mendelssohn, Ricard Rogers and a host of Nobel prize winning, medical scientists were Jewish. They enhanced humanity.

    The Hebrew Bible has a moral code that has strongly influenced much of the civilized world for the good. The Christians have spread the Hebrew Bible’s goodness all over the world.

    The fact tbat the Sacklers are Jewish simply demonstrates that all peoples have individuals with excessive greed. I don’t even like the term millenials because it stereotypes an entire population.

    We are all a part of humanity and are in the same boat for better or for worse. Try to remember that evil against the Jews and humanity in the 30s and 40 s caused the death of six million Jews, two million of which were CHILDREN. God bless us everyone.

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  8. Another awesome post, Rachel. Not only about the opioid epidemic. But, also the dangers of anti-semitism. I grew up in New York, in a Jewish/ Catholic neighborhood. Our neighbors, and close friends had a cousin who was a Holocaust survivor, and shared, with us, the evils of what was done to her. Along with the knowledge that she was still affected over twenty years later. I was about fourteen (1966), and, if I live to be 100, will never forget the day that I saw the number from the death camp, Buchenwald, on her arm. My thoughts then, and now, were how the inhumanity of one group of people could reduce someone to the level of a number. Stripping them of all freedom and dignity. Including, the right to life, itself. Anti-semitism is very real, and, along with being very dangerous. Mary ❤

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  9. I agree. There are many contributing causes to this “epidemic.” Demonizing one family is a short-sighted view.

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  10. Thank you Rachel for your excellent post about this horrible epidemic. I have done a great deal of thinking, reading, and reflecting on this issue and I agree with your comments on the “color” issue as it relates to this topic. When drugs were only found in cities and people of color were the hardest hit, littleh was done except to incarcerate “junkies.” Now that it’s hit the white suburbs and is effecting everyone and anyone— we are starting to look for different answers. That’s a good thing, but it’s just another example of white privilege. Sad.
    Quite honestly, I never knew the Sacklers were Jewish. What they did was wrong and they need to be accountable. Knowing that OxyContin was extremely addictive and downplaying it and encouraging overprescribing is immoral for anyone regardless of ethnicity. But there’s so much blame to go around as you explained so well in your article.

    Today marks the second month anniversary of my daughter’s death by suicide while incarcerated for drug related crimes she committed. Her mental health issues led her to self medicate by taking a left-over OxyContin from her husband’s major surgery. By the time those few pills were gone, she was addicted and she had to find a new source. Being a med-surge nurse in a major hospital, she began giving herself morphine drips on the job. Long story short, that led to heroin, which destroyed her life as it had been. It ruined her marriage, broke up her family, took away her job and led to a life of crime. What was once a suburban wife and mother of 3, with a good-paying job and a nice house became a prostitute living in a flophouse with Hep C, a DUI and shoplifting record, and so thin that when arrested and handcuffed, the cuffs fell off her hands.
    Her shame for the pain she had caused her children and parents was too much to bear without the drugs to dull the pain. She hung herself, alone in a cold jail cell and now her remains sit in a jar on my bookshelf.
    We must begin to do things differently—laws and attitudes need to be changed in the treatment of people with addiction disease, most who have an underlying mental illness. Thanks again for addressing this crisis.

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    • One of the most obvious lessons of social work is that we need much better care for mental health, including addiction. If you need inpatient care, thirty days is not enough, and yet most people don’t even get that much. There is so much more we can do, as a society, to support recovery. But we aren’t doing it. I’m so sorry for your loss, and I hope you and your grandchildren are getting the help you need to find a way forward.

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  11. I’m a retired Registered Nurse, and I will be the first to tell you that healthcare priorities are all wrong, and have been for years.

    I found out many, many years ago that opiates make me violently ill, so I never take them, but that still doesn’t stop the medical professionals I go to from trying to prescribe them for me, because of my intractable chronic pain (which has many causes). A few weeks ago, I got so fed up with one practitioner who asked me AGAIN if I wouldn’t “reconsider taking something,” that I yelled that I DON’T take opiates, they are NOT for me, and I was TIRED of having people SHOVE THEM AT ME! She back-pedaled with, “Okay! Okay! I won’t mention it again!” All I went to that practice for was to get a valid prescription and treatment notes that will qualify me for getting insurance to help cover the cost of a hospital bed, which I desperately need but cannot afford out-of-pocket. My first visit to the practice was about 6 months ago. The medical equipment company tells me that the practice STILL hasn’t sent them the necessary documentation for them to process for insurance coverage for a bed. This is the third medical practice I have appealed to for help getting a hospital bed (not for addictive drugs!), but to no avail.

    Thanks for posting this story, and for offering commentary space.

    I noticed that you told another person that you get sick from opiates, too, which helps me feel less alone with my pain. Sometimes I think I must be the only stone-cold sober person in America (if not in the world at large).

    And we also seem to share a similar appreciation for chocolate! 🙂

    Reply
    • I rely heavily on NSAIDs, which have their own problems. Doctors haven’t been pushing opiates with me, thank God, but they do harp on the benzodiazepines (another drug I don’t react well to), and one wants me to try marijuana. I definitely prefer chocolate!

      Reply
  12. Like your first commentator, i had not heard of this. It apparently hasn’t made the Australian news.

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  13. This is a great post Rachel and I agree with you that there other addictive substances out there. The flip side of this is physicians are slower and more reluctant to prescribe narcotic pain medications for those who truly need them, such as people in the last weeks and months of their life.

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  14. An intense and thought provoking post Rachel. In my day, you smoked your own cigarette rather than share as you could never be sure what was in it. It’s worrying that so much is available so easily.

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  15. I think you sum it up well with just two words, Rachel. ‘American culture’.
    Best wishes, Pete.

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  16. Interesting article. I didn’t know that the Sackler’s were Jewish. Was it something everyone was supposed to know? Anyhow – when my twins were born and I had a cesarian, they gave me darvon, a synthetic opiod, to kill the pain. I was hooked after one day. Can you imagine? I would lie in bed and look at the clock, waiting for my next shot. I was more interested in the darvon than in my twins. When they discharged me, thank goodness I didn’t fill my perscription. When my daughter was born in France (8 years later!) I was hoping they’d give me darvon. They gave me plain paracatemol and I was disappointed. I was been able to stop smoking after smoking for 15 years – I was never a drinker – but synthetic opiods are absolutely lethal. I can understand and sympathize with every person who’s ever been addicted.

    Reply
    • Nicotine is one of the most addictive substances, so you should be very proud of yourself for being able to stop smoking. Addiction is brutal and some bodies are much more vulnerable to it than others. We forget that and assume we’re all fighting the same fight. We’re not.

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  17. One of my close friends is a recovering heroin addict, so your writing today was especially meaningful. My pal has always placed the blame for his addiction squarely upon his own shoulders.

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    • I’ve met a few heroin addicts and it’s a very tough journey, even years later, because of the damage the drugs leave behind. Having good friends with you for support and understanding can make all the difference.

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  18. Hmm I had no idea the family was Jewish – thank you for your insights.

    I only have one bone to pick: you say that people used to have to go to the “bad side of town” for drugs. This is not true and never has been true, it is a lie that perpetuates racist stereotypes. People in suburbs and in fancy houses have always used (and bought and sold) drugs as well. Implying that drugs are more rampant among lower classes is another way of blaming poor black people for drug addiction, which you mention is not right.

    From a healthcare point of view, there *is* a time and a place for the use of opioid painkillers, but in most cases, that should be for *short term* relief only. Unfortunately, people have started to see healthcare as a commodity, and with this they start to expect a “good experience” and not just good care, so there has been more and more pressure to eliminate or control pain to make people happy, rather than focusing on accepting and working through pain (some of which is inevitable.) I have met people who are furious that they were not given *more* pain medication in order to stay completely comfortable after surgeries. Unfortunately, certain procedures or conditions will always come with pain, and complete comfort is not always something that can be provided.

    I do think enough doctors do not utilize pain specialists enough, who know how to help people manage and work through pain instead of squashing it with meds. It takes more appointments, more effort on the part of the patient, more paperwork with the insurance company, and more time to start seeing benefits. Perhaps some doctors don’t want to go through that, perhaps some don’t think their patients will participate or believe that it will help enough. Whatever the reason(s), we have a lot to work on!

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  19. I think we need to ask the basic question: why are people in our culture so susceptible? Opioids are, as you point out, an equal opportunity addicter. I wrestle with this question: how we can prepare children, from their very first knowing, to be strong and whole and not need whatever an opioid high provides?

    What if we looked at each child and helped them find their strengths and passion?

    And then there is the genetic, physical fact of addiction…could we identify that danger gene?

    Reply
    • Both wonderful ideas! I think we’re more likely to get the genetics figured first, but truly supporting children in their journey to adulthood would make all the difference.

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  20. Excellent article. It addresses two BIG problems…discrimination and the prevailing culture of fix everything with a pill. I used to work for a physician who said that what people really want is a drive-through window where the physician reaches out a hand and says “heal.” As a nurse I see both too many pills and now not enough for real need. We also fail to see the use of drugs throughout the centuries long before they were manufactured when they were readily available.

    The stress of our fast paced lives and little use of silence and contemplation have added to the problem.

    You article is right on target!

    Reply
    • Thank you! I’ve definitely found myself wishing for a pill to fix everything, because it’s so hard to be patient and tolerate pain and confusion. And there are some medications that really do help, it’s just that it takes time and care to find the right answers for each individual and we want things to be much simpler than that.

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  21. Pingback: The Opioid Epidemic — rachelmankowitz – worry-less-journey

  22. Oddly I wrote a post regarding racism just yesterday. These things tend to cluster, don’t they? I’m grateful that pain killers (mostly opioids) are toxic to my system. I could have been one of the victims of them else wise. I asked someone I knew once (who was an addict of such stuff) why they did them…all the ‘benefit’ I could see was the more excellent sleep that was gained. They said those drugs were a cheap ‘high’ and they could zone out and get away from the world for a while. Of course I doubt they knew that you have to take more and more to get the same effect over time, because one’s body adapts to the drug and it’s not as effective.

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    • I still get jealous of people who get real benefit from these drugs, but I have to remind myself that I’m lucky I don’t, because then I don’t have to deal with the downsides.

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  23. Thank you for sharing.

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  24. I get your point that anti-Semitism is a big deal, but I’ve been writing (as a journalist) about OxyContin since the beginning of the overdose epidemic and it never crossed my mind that the Sacklers are Jewish until reading your post.

    They are certainly not alone as wrongdoers in this created epidemic (hospitals, doctors, pharmaceutical suppliers, heroin traffickers etc. share plenty of the blame). But, the Sacklers and Purdue Pharma have acted (and continue to act in new marketing campaigns for opioids in developing nations) in truly evil ways. The courts may never hold them accountable, but they are and it has nothing to do with who they are. It’s purely what they’ve done.

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  25. My hope that, no matter what the reason this family was singled out, that it is just the beginning of holding people/companies accountable for what has happened.

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  26. This is such a thoughtful piece, Rachel. There is so much here. You’ve touched on so many important parts of the problem that a lot of people ignore. And as an African-American I understand your feelings about the anti-Semitism aspect. Just as with racism, we’re told too many times that we’re over-emphasizing or imagining anti-Semitism.

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    • Thank you so much! I really needed to hear this, because with all of the responses saying that people didn’t know that the Sacklers were Jewish, I was starting to feel a little crazy. I remember the relief I felt learning about microagressions, that they were real and even had a name! It doesn’t have to be intentional, or even conscious, to cause pain. The fact is, I really don’t know if there was any anti-semitism in the coverage of the Sacklers, but I wanted to write about how it felt to think there might be.

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  27. Rachel, I love the complexity of this piece, Rachel.

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  28. This is a very interesting post, thank you for raising our awareness and making us think about the rush to demonize this particular family when the problem does permeate every level of society.

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  29. Great piece Rachel and very though provoking. You are right there is so much more work to be done here and we have to hold many more accountable, this issues spreads far and wide but we have made a good start. I never thought about the Sackler’s religion in this whole mess, but what they did is truly reprehensible and disgusting.

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  30. Ich bedanke mich für Deine BESUCHE bei mir im Blog. L.G. Wolfgang

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  31. The media always want an easy answer and a scapegoat. Problems are usually more complicated than portrayed.

    I’m worried by what seems to be a growth in hatred and fear in the mainstream. The far right seems to be on the rise everywhere and causing problems. The media, at least on this side of the pond, are playing a big part in this.

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  32. Thank you for your spotlight on the crisis. As a nurse in Seattle, I see many addicts on the street daily. We have a task force at the hospital to try and deal with the issue, mainly through education and opportunities for people to return unused drugs safely. Physicians also need education, and I hope the tide will turn soon. I love your writing, and your dogs!!

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  33. Rachel, you are a very powerful writer. I applaud you!

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  34. Food for thought, it’s so easy to oversimplify a complicated issue. Thank you.

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  36. The Sackler family have donated huge amounts of money to universities and the arts. The room that one of my son’s stayed in at Oxford was named after them. The drug epidemic is part of a culture that also involves over use of antibiotics, plastics, fuel, porn and all. This is a “I should not have to suffer this” mentality. Doctors are sitting ducks for litigation. They have been told that it is unprofessional to make personal judgements about a patient’s pain (which is a subjective thing) and prescribe because that is what is expected. So they do. Now a few years down the line they are being told that they shouldn’t have done it. Well, it isn’t doctors forcing drugs down patient’s necks.

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  37. I just saw this, and apparently I’ve been really out of the loop because I haven’t heard of this family ~~ rushes off to google this for more information. I read an interesting article recently about how doctors switched their focus from treating illnesses to treating symptoms – “Oh, your knee hurts? Here, take a pain pill! We have no idea why your knee hurts, but this will make it all better.” When patients started to become addicted to said pain killers, they started limiting them, so the people had nowhere to go but the “bad side” of town. It’s a vicious cycle. I don’t know the answers, but this rang true to me – I have aches and pains that are most likely from being hauled around too much by a 100 lb dog, but no one has ever thought to actually diagnose them, I just get handed ibuprofen.

    Reply

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