Monday, October 1, 2018

who's to blame

I get some of my blog ideas from reading others posts and sometimes I even get suggestions. I don't always wake up with these thoughts floating around in my head, although that is when I write them down the best I think. I do like to get them written before I have to interact with people. People can just ruin our thoughts! LOl, but I do think a bit clearer before my brain gets all clogged up with the minutia of the day. As I sat down this morning I checked the notifications I had received on Facebook last evening. In there was a suggestion. What did I think was the cause of the opioid epidemic in America? And so I began to think about that. I admit I don't know a whole lot about that subject, only stuff I hear in the news. I do know those opioids are mostly painkillers. It is reported a number of people become addicted to them after being prescribed the same by a doctor. I think that is especially so when being used for long term pain management. The abuse of these opioids is at the forefront only because of the number of deaths associated with there misuse. That is the bottom line as far as I see it. People have abused just about everything you can think of. The ones that start causing deaths are the ones that get the most attention. That should come as no surprise. We humans do take our pleasures to excess!
 The question I was asked was, who is to blame? Is it the Doctors? I really wish I could answer that. If I had the answer I would have the " prevention. " I do think if there is blame to be placed it is on the American psyche. We have been bombarded with the message that better living can be achieved through chemistry. It began with the " snake oil " salesman. I believe some form of that has been around as long as man has been around. Whether it was the local shaman or the largest drug manufacturers the message is the same, chemistry can cure anything. The message has also been, if we can't cure it, we can hide it. In the movie the shootist John Wayne has terminal cancer. The doctor tells him that and describes how painful a death it will be. With that he prescribes laudlum. What is laudlum? Alcohol and opium. You won't feel a thing. That's the best chemistry could offer. And yes it was an opioid. It was known to be highly addictive a hundred years ago and I'm thinking a lot more than that. China was famous for its' opium dens, and they were all addicts. And what were they trying to cure? Life, is the answer. Not much different than drinking, the idea is to escape reality. Whether that reality is physical pain or mental anguish, the purpose is escape. Opioids do not cure a thing! But the question was, who's to blame?
 I do think at least a portion of the blame has to be placed on the individual using those opioids. If you are prescribed them and do not follow the instructions how can you blame the physician? Once you start altering the dose and frequency you have entered the world of self medication. That is a place you really shouldn't go. It's the same place an alcoholic goes. It's the same place an obsessive person goes in pursuit of escape. I don't want to deal with reality and so I try to escape that reality if only for a little while.
 I also think a portion of the blame has to be placed squarely on what we are teaching our children. Are we teaching temperance? Temperance is generally thought to mean abstinence from drinking alcohol. Temperance also means moderation. Other synonyms include restraint or self control. Say temperance to most people today and they will think of the temperance movement, the banning of alcohol in the United States. At the time of that movement, spearheaded by women, alcohol was an epidemic! It was as far as those women were concerned. There response is not unlike the anti-gun people we have today. Given their way the second amendment gets repealed! Those ladies did manage to get the 18th amendment ratified. The 21st amendment repealed it why? The reason is the same one being used to " approve " certain choices and behaviors today, people are doing it anyway. The other, more driving force behind all of that? Revenue is the answer, there is money to made. Oh there was a string of other reasons, increased crime among them, that was tying up law enforcement officers dealing with the bootleggers and those manufacturing the product. They had to watch the borders as well for illegal importation. But, there was money to be made. Temperance was a failure then, temperance will be a failure today. That is why I offer no answer.
 We have the introduction of drugs like Narcan, being hailed as a lifesaver. Yes that drug does save lives no denying that, better living through chemistry. The truth is, life through chemistry. Is that the answer though? For some it is. It is the removal of some consequence. I don't believe anyone using opioids will make a conscious decision to overdose simply because Narcan is available. That's why it is called " accidental " although I would say it is no accident if you use them without medical supervision. To me, that's a bit of a misnomer. So, I do think we need to change this mindset that if I abuse a drug and kill myself, it is an accident. It goes to what I was saying yesterday, it's a consequence. We need to teach our children about consequences. Narcan is just another way to avoid those consequences.
 Who's to blame? The answer isn't an easy one. It isn't the one anybody wants to hear. According to some studies about 22% of the people that get addicted to opioids started with a prescription from their doctor. The other 78% gained them through illicit means. Does that mean that 78% of the time it is the fault of the user? That would be the obvious conclusion. For me, the truth is, it is 100% of the people addicted. It doesn't really make any difference how it began, what is important is the end result. Those using prescribed drugs are not any more or less likely to abuse them. To those using them prescribed the risk is exactly the same. We say they are " abusing " the drug because a doctor hasn't said they would be of benefit to them. Do you need a doctor to tell you how or what you feel? No, you need the doctor, the expert to determine the dosage required to obtain a certain effect. If that dosage doesn't yield the desired result who's fault is that? Is it the fault of the doctor or the medication? Or is it the fault of the patients constitution? And there is an answer no one wants to hear. Who's to blame?           

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