Articles by JCS

Dr. Frankenstein

                                                                                                  

Word count: 3403

New Dr. Frankenstein

Everyone is familiar with novelist Mary Shelley’s horror story about Dr. Frankenstein, a scientist who created life from the dead but was horrified by the creature he had made when it turned into a deadly monster.

Although this classic science-fiction story has had many revisions since its inception in 1816 (Young Frankenstein by Mel Brooks is my favorite), today we see a new type of Dr. Frankenstein who creates not one, but many monsters from people in pain. Instead of a shock from a lightning bolt used by the original Dr. Frankenstein to create his “Creature”, today patients are shocked by the new Dr. Frankenstein with prescription painkillers laced with heroin.

The enormity of Dr. Frankenstein’s experiment is mind-boggling; instead of creating just one, today there are millions of creatures of OxyContin, Percocet, Hydrocodone, or Vicodin doled out by thousands of Dr. Frankensteins across the country. A 2014 study by the Centers for Disease Control (CDC), “Opioid Painkiller Prescribing,” found MDs prescribed 259 million prescriptions for opioids, equivalent to one for every American adult.[1]

This tsunami of opioid abuse also varies by regions according to the CDC. For example, in Virginia, physicians write 78 opioid prescriptions for every 100 persons per year. That number almost doubles to 138 prescriptions per 100 people in West Virginia; hence, the term Hillbilly Heroin epidemic.[2] Each day, 46 people die from prescription painkillers in the U.S.[3]

Big Pharma has flooded society with narcotic painkillers to the point that Thomas Frieden, MD, Director of the CDC, admitted that physicians had essentially supplanted street corner drug pushers as the most important suppliers of illicit narcotics.[4] Indeed, Marcus Welby, MD, has gone bad, very bad.

Just as the original Frankenstein laboratory was a far cry from a normal doctor’s office, so are today’s ‘pill mills’ that look more like busy bus stations where doctors prescribe these drugs with impunity, physicians take no medical history, give no serious examination, nor is any type of actual therapy rendered—it is solely a ‘cash and carry’ transaction.  In other words, give the ‘pill mill’ doctor the cash and you can carry out the drug of your choice, no questions asked.[5]

This new Dr. Frankenstein bills his practice as “pain management”, “pain relief”, or “bone and joint” clinics, and he may call himself a “spine interventionalist” or “chronic pain care provider,” but, in reality, these pain docs have become legal drug dealers. Their methods are similar using strong euphoric, addictive, and often dangerous drugs to treat gullible patients, most of who suffer from acute or chronic low back and neck pain, including many suffering from failed back surgery.

For millions of people, this is a medical merry-go-round that never ends. Indeed, it’s better than a day at Disney World where everything is magical because everyone is high!

Plus, it’s totally legal and covered by insurance! Don’t you wish all your recreational drugs were so easy?

Weapons of Mass Destruction

Just as the original Dr. Frankenstein’s handiwork created one monster that terrorized local citizens in Mary Shelley’s novel, today’s inept medical spine care—opioids, epidurals, fusions—must be considered new types of weapons of mass destruction. Instead of bombs or bullets, Dr. Frankenstein uses drugs, shots, and surgery to terrorize Americans.

The new Dr. Frankenstein knows he’s scamming the public. He is perfectly aware his opiates are addictive, dangerous, and often deadly. He knows his expensive epidural shots are unproven, dangerous, and temporal at best. He knows perfectly well the ‘bad disc’ justification for spine fusion is a disproven diagnosis as the Mayo Clinic’s systematic review of 33 worldwide studies confirmed once again last November.[6]

Dr. Frankenstein knows none of his experiments correct the underlying mechanical causes of most back and neck pain cases. He simply ignores the guidelines to use conservative care first, masks the pain, and continues making tons of money and millions of monsters with his chemical concoctions and ineffective spine surgeries leaving a trail of both disability and substance abuse.

A new report by the Global Burden of Disease released in The Lancet found that, “in 2013, musculoskeletal disorders (i.e., mainly low back pain, neck pain, and arthritis) and mental and substance abuse disorders (predominantly depression, anxiety, and drug and alcohol use disorders) accounted for almost half of all health loss worldwide.”[7]

If chiropractic care accounted for almost half of all health loss worldwide, we would be shamed! However, if chiropractors were the primary spine care providers, we would not see this high rate of musculoskeletal disorders or substance abuse as a non-surgical and non-drug spine care profession that gets better results with more patients than anything the medical spine world has to offer.

The back pain epidemic has been so mismanaged by the medical profession and patients are so ill-informed by the media that Mark Schoene, associate editor of TheBACKLETTER, an international medical research journal, clearly warns, “such an important area of medicine has fallen to this level of dysfunction should be a national scandal. In fact, this situation is bringing the United States disrespect internationally.”[8] And it is creating millions of disabled monsters.

Join the Band

Although Dr. Frankenstein has been on the loose for over twenty years and virtually ignored by the medical media, this epidemic has recently gotten more media attention.

New players on this anti-opioid bandwagon include Time magazine with its June 15, 2015, cover story by Massimo Clabresi, “The Price of Relief”, highlighting the depths of this Hillbilly Heroin epidemic in mainstream American towns.

The Time cover appropriately pictured Dr. Frankenstein’s fishhook baited with a prescription opioid pill touting, “They’re the most powerful painkillers ever invented. And they’re creating the worst addiction crisis America has ever seen.”

This eye-opening article is a tragic account of the massive drugging and addiction of millions of Americans by the medical industrial complex—the medical society, Big Pharma, the FDA—empowered by a complicit medical media that has heretofore ignored this problem because, of course, medical reporters are sponsored by Big Pharma. And one thing is true in the commercial media—you don’t bite the hand of Big Pharma that feeds you—even when it’s feeding people dangerous drugs as readily as hot dogs on the 4th of July.

The Time writer offered a poignant summary of the enormity of this bleak situation:

“It took a tragic combination of good intentions, criminal deception and feckless oversight to turn America’s desire to relieve its pain into such widespread suffering. Most everyone has played a role. Weak research opened the door to overuse of opioids. The Food and Drug Administration (FDA) approved ever more powerful drugs for long-term use based only on evidence of their short-term safety and efficacy. Two pharmaceutical companies pleaded guilty to criminal charges that they misleadingly marketed the drugs as safe. Too many doctors embraced the easy solution of treating pain by writing a prescription.” [9]

        He also doubted the AMA will take any responsibility and suggests the federal government is clueless:

“The same medical associations that once pressured doctors to hand out opioids liberally now issue conflicting advice over how to combat the problem they helped create. Government scientists admit they have no idea when and whether it’s safe to use opioids to treat long-term pain.”[10]

Is this not the blind leading the blind or what? Ironically, they purport to be the ‘guardians’ of Americans’ health!

Military Misery

This shocking news of opioid painkiller addiction surfaced briefly in 2014 with articles about the growing narcotic painkiller addiction among active military and veterans.

On June 30, 2014, the LA Times reported, “Pain, Opioid Use Surprisingly High in Soldiers Returning from War.” A similar two-part report aired on NPR’s All Things Considered, “A Growing Number of Veterans Struggles to Quit Powerful Painkillers” on July 10, 2014, and the second part, “Veterans Kick the Prescription Pill Habit against Doctors' Orders,” on July 11, 2014. 

One NPR segment on opioid abuse in the military cited Dr. Richard Friedman, director of the Psychopharmacology Clinic at Weill Cornell Medical College, who spoke of this prescription painkiller abuse among the active military:

“It's like giving a football player painkillers so he can finish the game. It gets him back on the field, but might hurt him worse in the long term.”[11]

Strangely missing in these reports on this anti-opiate bandwagon was any mention of the chiropractic profession in the military. Considering musculoskeletal disorders (MSDs), principally back pain, is the number one condition for the use of opioids, we should have expected NPR to be tooting our horn the loudest as the leading non-drug health profession that primarily treats MSDs.

Smack Epidemic

Even our sports heroes are victims of this opioid abuse. On July 12, 2014, journalist Michael O’Keeffe of The New York Daily News revealed this ‘pill mill’ painkiller problem in his exposé, “EXCLUSIVE: Feds Quietly Investigating Prescription Drug Abuse In NFL Locker Rooms, Sources Say”:  

The Drug Enforcement Administration’s probe began after attorneys representing about 1,300 NFL retirees filed a lawsuit accusing the league of illegally handing out painkillers, sleeping pills, and other drugs without informing players of the risks of health problems and addiction. 

Former Chicago Bears quarterback Jim McMahon and other plaintiffs accuse the NFL of illegally providing prescription drugs without telling players about the risks. McMahon says he became hooked on pain pills, at one point gulping down more than 100 Percocets each month.[12]

Just like their fans, little do these NFL players realize the long-term risks far outweigh the short-term high of opioids that actually remain unproven for treatment of chronic pain since they do not correct the underlying problems as the 2014 Cochrane Review admits, Opioids Compared with Placebo or Other Treatments for Chronic Low Back Pain.[13]

Another national sports magazine has joined the anti-opioid bandwagon. Just a week after the Time article, Sports Illustrated (June 22, 2015), did an exposé by L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic,” on the sordid situation in high school sports where opioids are killing young athletes.

“Anyone who is giving a kid an opioid prescription without serious oversight and supervision is out of their mind,” says Joe Schrank, a New York City–based drug counselor and former USC offensive lineman. “That stuff is like kryptonite.”[14]

Once the kryptonite ends, these victims turn to the street for cheaper heroin. The SI writers report while opioid painkillers cost up to $30 per pill on the black market, heroin cost $5 a bag and gives a more potent high. Jack Riley, the DEA’s chief of operations, recognized that high school athletes were becoming “unwitting customers of the cartels,” which target people susceptible to prescription-drug abuse. “In the athletic arena, if anything can be likened to a weapon of mass destruction, it’s heroin,” Riley says. “It is that pervasive now.”[15]

Families consistently said that they received no warning from physicians about the addictive power of the opioid painkillers they prescribed…one physician who prescribed Roxy (Roxicodone) for an athlete jokingly said, “You got the good stuff.” Sadly, Dr. Frankenstein finds humor in the darkest places.

“You know what really breaks my heart?” said JoAnn Montanos, mother of Roman, a multi-sport high school star who died of an overdose. “My son knew he was meant to be an athlete. Sports was his first addiction. He just ran into another addiction that was so much more powerful.”[16]

Indeed, this new Dr. Frankenstein must be stopped!

Big Pharma’s Gravy Train

Generally when the public thinks of drug lords, they think of drug cartels from Mexico or Columbia. While that may still be true, the biggest drug lord in America is Big Pharma and it’s perfectly legal.

Prescription opioid painkillers for back pain brought in $17.8 billion, and OxyContin alone made $3 billion in 2010.[17] Considering 259 million legal prescriptions for opioids were written to 127.86 million people, this equates to $68 per prescription or $139.21 per person.[18] Not bad for getting people hooked on worthless drugs.

According to renowned spine researcher, Richard Deyo, MD, MPH, “More people are interested in getting on the gravy train than on stopping the gravy train.”[19] Quite a sobering admission, but painfully true considering the AMA has said little about the tsunami of opiates, epidurals, and spine fusions, the biggest tickets on this gravy train.

Indeed, like any drug dealer, a lot of money fuels Dr. Frankenstein and his supplier, Big Pharma, on this gravy train running out of control, and there’s no way these dealers will warn the victims they may be in danger—there’s simply too much money at stake to be truthful.

The Sports Illustrated article discovered this dishonesty when “Families said they received no warning from physicians about the addictive power of painkillers.”[20] I can attest the majority of my patients who had previously taken the medical gravy train for their back problems were never told the prescribed “painkillers” were medicinal heroin. They simply bought a ticket not knowing where they were being taken by Dr. Frankenstein’s magical ride.

The dilemma of this opioid drug addiction is more prevalent and confusing than people realize according to a 2013 article in Medscape.com, “Many Docs Still Don't Understand Opioid Dependence.” In fact, opioid addiction is now more pervasive than patients suffering from diabetes and cancer:

“Results showed that 12 percent of the adults reported personally struggling with opioid dependence, which the surveyors point out is more than those who struggle with diabetes (7 percent) or cancer (3 percent).”[21]

This survey of opioid addiction found it was compounded by shame, embarrassment, fear, and the delusion that patients and doctors alike think they can get off these drugs and stop their addiction on their own:

“The survey also found that 77 percent of the adult participants and 93 percent of the clinicians said that shame, embarrassment, or fear that others would find out are among the main reasons why those with the addiction might not seek treatment.

“Although 71 percent of the adults and 85 percent of the clinicians said that many of these people think they can stop their addiction on their own, 83 percent and 92 percent agreed that a long-term combination of medication and behavioral changes is needed for successful treatment.”

Finally in 2014, the federal government stepped in to slow this gravy train considering the medical society and Big Pharma weren’t interested in regulating themselves. An article in The New York Times, In Move to Curb Drug Abuse, D.E.A. Tightens Rule on Widely Prescribed Painkiller,” emphasizes the dangers of this out of control medical terrorism:

Abuse of painkillers now claims the lives of more Americans than heroin and cocaine combined, according to federal data, and the number of Americans who die from prescription drug overdoses has more than tripled since the late 1990s. Prescription drugs account for the majority of all drug overdose deaths in the United States. In all, drug-induced deaths have outstripped those from traffic accidents.”[22]

Despite the increasing DEA push-back and tragedy of this horror story in the news, Dr. Frankenstein marches on empowered by bribes by Big Pharma and kickbacks from device manufacturers, MRI centers, and hospitals—the hallmarks of influence as I mentioned in my award-winning article, Medical Payola.

Undoubtedly Dr. Frankenstein will not stop this gravy train because the money is just too good for doing so little work giving epidural shots and dispensing narcotic pills like Halloween candy. The reported median salary for pain management doctors who do not practice anesthesiology is $340,506, and those who practice pain medicine with anesthesiology report an average of $502,024 per year.[23]

Not bad pay for giving placebo, addictive, and often deadly treatments to a gullible public trained by Big Pharma’s incessant direct-to-consumer TV ads to swallow a pill for every ill, especially when it’s laced with heroin.

Instead of writing prescriptions for addictive opioids, Dr. Frankenstein should be writing referrals for many of his patients to chiropractors. However, with the prevailing chirophobia, that is as likely to happen as Jackie Robinson being greeted with open arms as a rookie in MLB.

Dr. Frankenstein’s Packing

With this easy money on the gravy train also comes trouble. This legal access to medicinal heroin has become a nightmare for both patients and physicians. Today, Dr. Frankenstein not only wreaks havoc and death in patients’ lives, now a new study found Dr. Frankenstein often becomes the target of his monsters’ wrath, too.

When the new DEA federal regulations passed to combat opioid abuse making it more difficult to get prescription renewals, many unhappy patients who were cut off from their pipeline of legal ‘smack’ often created a violent situation for Dr. Frankenstein. Just as the creature turned on the original Dr. Frankenstein, patients today become monsters demanding their fix often using violence.

A June, 2015, survey published in Pain Medicine revealed the dangers Dr. Frankenstein faces in his own office.[24] In fact, the highest situation for violence involved opioids (89.9 percent). The survey found over 8 percent of chronic pain care providers (CPCPs) now carry a gun for protection. The researchers found that 64 percent of CPCPs have called security and 51 percent had received threats. Discharging a patient was the most common risk (85 percent). Apparently once a patient gets hooked on opioid painkillers, they resent being denied access to more drugs.

Once the prescription painkillers are depleted, it creates a ‘gateway’ situation where addicted patients turn to the street for more creating a whole new set of problems. According to the National Institute of Drug Abuse, 80 percent of all heroin users begin after using opioid painkillers. [25]

Dr. Frankenstein’s Stoned, Too

This chaotic situation becomes more alarming considering that 69 percent of the physicians had misused prescription drugs sometime in the past,” according to an article in Medscape, “Why MDs Abuse Prescription Drugs.” Apparently Dr. Frankenstein can’t keep his own hands out of the cookie jar of opiates.

Ironically, the reason given why MDs abuse prescription drugs sounds painfully similar to what most patients might say:

Several of the physicians who said that they misused drugs reported that it was because they had trouble trusting the recommendations from their treating provider.”[26]

This mistrust should not come as a surprise considering a 2014 Harvard study reported on data from an international health care survey that the United States is near the bottom of the list when it comes to public trust in the medical establishment in general than people in many other countries.[27]

Perhaps their mistrust is due to the possibility that their treating medical provider may also be a former or current abuser. Indeed, would you trust your MD knowing there is an 8 percent chance he is packing a gun, a 69 percent chance he has abused drugs, or a 60 percent chance he is an atheist as Francis R. Collins, MD, Director the NIH, revealed from his personal experience?[28] 

All in all, this is a bad formula for trust and good outcomes. Throw into this mix another issue that Dr. Frankenstein most likely suffers from—chirophobia, the irrational bias against chiropractors—so his patients are denied the best form of care for their chronic back pain. Indeed, this gravy train has become a sickening ride for many patients.

Let me suggest the medical mismanagement of back pain is a prime example why the public distrusts their MD, especially for those who have taken a wild ride on the medical gravy train from drugs, shots, to disc fusions and later found relief in a chiropractor’s office.

As I say to those patients misdiagnosed with a ‘bad disc’ and subjected to opioids, epidural shots, and fusions, “if you can’t trust your MDs about back pain, what else can you not trust them to do?”

Sadly, this ride never ends for some patients who have repeated surgeries and continue to live on opiates for the rest of their lives, never knowing chiropractic care could have prevented this bad trip.

Indeed, we should be the drum major leading this anti-opioid bandwagon!

We could not have asked for a better opening act with the cover story in Time magazine and Sports Illustrated as well as the many other recent articles on the opioid pandemic.

If the chiropractic associations and their PR specialists at F4CP do not jump on this anti-opioid bandwagon, they should be held derelict in their duty to position chiropractic as a non-drug and non-surgical solution to this pandemic of opioid abuse.

Millions of monsters need our help to destroy Dr. Frankenstein.

 

 



[1] National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, www.cdc.gov/vitalsigns/, July 2014.

[2] Opioid painkiller prescribing: where you live makes a difference. CDC Vital Signs. July 2014. http://www.cdc.gov/vitalsigns/pdf/2014-07-vitalsigns.pdf Accessed March 4, 2015.

[4] Centers for Disease Control and Prevention Press Release, CDC Vital Signs: Overdose of Prescription Opioid Pain Relievers—United States, 1999-2008; 2011: www.cdc.gov/media/releases/2011/t1101_presecription_pain_relievers.html.

[5] Marianne Skolek, Walgreens, OxyContin Profits, Ethical Responsibility and the DEA, Salem-News.com, Sep-23-2012

[6] Brinjikji W, et al., Systematic literature review of imaging features of spinal degeneration in asymptomatic populations, American Journal of Neuroradiology, 2014, prepub ahead of print; www.ajnr.org/content/early/2014/11/27/ajnr.A4173.long.

[7] Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 2015 DOI: 10.1016/S0140-6736(15)60692-4

[8] U.S. Spine Care System in a State of Continuing Decline?, The BACKLetter, vol. 28, #10, 2012, pp.1

[9] Massimo Calabresi, The Price We Pay For Relief: Why America Can’t Kick Its Painkiller Problem, Time, June 4, 2015

[10] Massimo Calabresi, The Price We Pay For Relief: Why America Can’t Kick Its Painkiller Problem, Time, June 4, 2015

[11] Veterans Kick The Prescription Pill Habit, Against Doctors' Orders, by Quil Lawrence, All Things Considered,  NPR, July 11, 2014

[12] Michael O’keeffe, EXCLUSIVE: Feds quietly investigating prescription drug abuse in NFL locker rooms, sources say, NEW YORK DAILY NEWS, Saturday, July 12, 2014

[13] Luis Enrique Chaparro, MD, Andrea D. Furlan, MD, PhD, Amol Deshpande, MD, Angela Mailis-Gagnon, MD, MSc, FRCPC, Steven Atlas, MD, Dennis C. Turk, PhD, Opioids Compared With Placebo or Other Treatments for Chronic Low Back Pain, An Update of the Cochrane Review, Spine. 2014;39(7):556-563

[14] L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic,” Sports Illustrated, June 22, 2015.

[15] L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic,” Sports Illustrated, June 22, 2015.

[16] L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic,” Sports Illustrated, June 22, 2015.

[17] Rafia S. Rasu, BPharm, MPharm, MBA, PhD; Kiengkham Vouthy, PharmD; Ashley N. Crowl, PharmD; Anne E. Stegeman, PharmD; Bithia Fikru, PharmD, MPA; Walter Agbor Bawa, MS, PharmD; and Maureen E. Knell, PharmD, BCACP, “Cost of Pain Medication to Treat Adult Patients with Nonmalignant Chronic Pain in the United States,” Vol. 20, No. 9 September 2014 JMCP Journal of Managed Care & Specialty Pharmacy

[18] Louise Radnofsky and Joseph Walker, Clampdown on Popular Painkillers, The Wall Street Journal, 8/22/2014.

Chapter Five: Dr. Toad’s Wild Ride

[19] Reed Abelson, Financial Ties Are Cited as Issue in Spine Study, NY Times, January 30, 2008

[20] L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic,” Sports Illustrated, June 22, 2015.

20 Deborah Brauser, Deborah Brauser, Many Docs Still Don't Understand Opioid Dependence,

www.medscape.com Jun 14, 2013

[23] Pain Medicine Physician Salary, http://mdsalaries.com/2012/09/17/pain-medicine-physician-salary/

[24] Kim David, MD, Daftari Anuj, and Sibai Nabil, Violence toward chronic pain care providers: A national survey, Pain Medicine, 2 JUN 2015.

[25] OxyContin a gateway to heroin for upper-income addicts by  Donna Leinwand Leger, USA TODAY, June 28, 2013

[26] Veterans Kick The Prescription Pill Habit, Against Doctors' Orders, by Quil Lawrence, All Things Considered,  NPR, July 11, 2014

[27] Amy Norton, Americans Show Distrust of Medical Profession in Survey, HealthDay, Oct. 22, 2014

[28] Interviewed by David Hirschman, Recorded September 13, 2010, BigThink.com


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