Last weekend I finally watched a film that has been sitting in my Netflix queue for some time. American Addict, produced by a physician, Gregory Smith, MD, is a well-made, informative and compelling documentary about America’s drug culture.
I don’t mean dope and crack and methamphetamine. I’m talking about the overuse and abuse of prescription drugs—pain pills, sleeping pills, antidepressants, antipsychotics, and stimulants.
It’s a public health crisis that is costing this country billions of dollars in health care costs, health insurance fraud, criminal activity, local and federal drug enforcement, loss of employment and loss of quality of life.
To be honest, American Addict is depressing. With any public health crisis—AIDS, homelessness, hunger, substance abuse—it’s difficult to watch people suffer. It’s even harder to understand how a cartel (as one journalist calls it) of commercial and political special interests could have created the problem and continue to support it.
But it’s an important film, nonetheless, and Dr. Smith is an eloquent speaker (watch the trailer below). He is board certified in both anesthesiology and integrative pain management. He runs a pain management and addiction clinic (those two often go hand-in-hand) and knows of what he speaks.
Who’s to blame?
American Addict points its finger at the cozy relationships between pharmaceutical industry lobbyists, politicians, and governmental regulatory organizations (I’m looking at you, FDA). Big Pharma wields as much cash and influence as Big Tobacco ever did.
The United States of America is addicted to narcotics. I do not mean the millions of individuals who are hooked. I mean the whole nation is jonesing for the stuff. I also do not mean the junk that slips into our nation in coffee cans or across midnight borders. I mean the billions of pills pouring off assembly lines.
It is time for doctors to say no to drugs.
I could blame the FDA for approving over 50 prescription narcotics when we only need a few. However, the mandate of the agency does not allow it to consider the health of the nation as a whole.
I would love to blame pharma. Why not — they are getting rich on the chaos. However, the drug industry is burdened with the bizarre philosophy that market forces and competition is the best path to a quality care, even if it leaves a few hundred thousand bodies lying around.
I cannot blame patients. They are the ones in fear. They are the ones who suffer. We cannot say to millions of cancer patients and others who experience levels of pain beyond the wildest Kafkaesque nightmare, that they should push back and refuse the “best and newest” pain-relieving solution.
Therefore, I blame doctors.
Doctors have always had the power of the medical order. Nothing happens in health care unless somewhere, directly or indirectly, a doctor orders it. Their failure to take a stand, to force medicine to be data-driven and view not only the patient on the table in front of them, but society as a whole, continues to lead us to disaster. The misuse of narcotics threatens not only those addicted and overdosed, but the rebound deprives suffering patients of desperately needed help.
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No easy answers
As American Addict points out, our health care, political and regulatory systems are full of conflicts of interest, which make change difficult.
It easy to blame the doctors that put pen to paper (or more likely use e-prescriptions), but more physicians feel they are being co-opted by corporate medicine to do what they are told, not what they think best.
A recent article I read spoke of a questionable new business opportunity. Because there has been a surge in the use and abuse of prescription painkillers in older Americans, more blood and urine tests are being done. Medicare paid $457 million in 2012 for drug analyses.
“In some parts of the country every doctor and his cousin is hanging out a shingle to do (addiction) treatment. There’s a tailor-made opportunity for ordering a profusion of tests instead of one,” said Bill Mahon, former executive director of the National Health Care Anti-Fraud Association.
“It’s like turning on a spigot of money,” he said.
We might be spending our retirement dollars and our tax dollars on drugs for the elderly, but the fastest growing segment of prescription drug abusers is the 12-17 year olds. That’s scary.
Anyone who has prescription pills in their homes needs to:
- question the necessity of the pills
- keep pills out of the reach of young children
- keep pills, especially any pain pills or sleeping pills or antidepressants, out of the reach of older children
- dispose of unused pills properly through a pharmacy
Poisonings due to prescription pills far outnumber those due to traditional street drugs.
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What became evident to me after watching American Addict, is that only we can look after our own best interests, and those of our family. No one cares about you as much as you do.