New Dr. Frankenstein
PERSPECTIVE
JC Smith
Everyone is familiar with novelist Mary Shelley’s horror story about Dr. Victor 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 aie shocked by the new Dr. Frankenstein with prescription painkillers laced with heroin.
The enormity of Dr. Frankenstein’s experiment is mindboggling; instead of creating just one, today there ai e millions of creatures on OxyContin, Percocet, or Vicodin that has been doled out by thousands of Dr. Frankensteins across the country. A 2014 study by the Centers for Disease Control (CDC) titled “Opioid Painkiller Prescribing” found that 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 patients per year. That number ahnost doubles to 138 prescriptions per 100 patients in West Virginia, hence the term “hillbilly heroin” epidemic.2 Each day, 46 people die from prescription painkillers in the United States.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-comer drag pushers as the most important suppliers of illicit narcotics.4 Indeed, Marcus Welby, MD, has gone bad, very bad.
Just as the original Dr. Frankenstein’s laboratory was a far cry from a normal doctor’s office, so aie today’s “pill mills” that look more like busy bus stations where doctors prescribe these drags with impunity; physicians take no medical history and give no serious examination, nor is there 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 drag 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 drag dealers. Their methods aie similar using strong, euphoric,
addictive, and often dangerous drags to treat gullible patients, most suffering from acute or chronic low back and neck pain, including many suffering from failed back surgeries.
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 legal and covered by insurance! Don’t you wish all recreational drags were so easy?
Weapons of Mass Destruction
Just as the original Dr. Frankenstein’s handiwork created one monster who 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, today’s Dr. Frankenstein uses drags, shots, and surgery to terrorize Americans.
The new Dr. Frankenstein knows he’s scamming the public. He is perfectly aware his opiates ai e addictive, dangerous, and often deadly. He knows his expensive epidural shots aie unproven, dangerous, and temporal at best. He knows perfectly well the “bad disc” justification for spine fusion is a disproven diagnosis that the Mayo Clinic’s systematic review of 33 worldwide studies confirmed once again last November.6
Dr. Frankenstein knows none of his experiments will 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 nonsurgical and nondrug 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 ai e so ill-informed by the media that Mark Schoene, associate editor of the international medical research journal The Back Letter, clearly warns that “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 more than twenty years and virtually ignored by the medical media, this epidemic has recently received more media attention. New players on this anti-opioid bandwagon include Time magazine with its June 15, 2015 cover story by Massimo Calabresi, “The Price of Relief” which highlights 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 hi vented. And they’re creating the worst addiction crisis America has ever seen.”
This eye-opening article is a tragic account of the massive dragging 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 aie sponsored by Big Pharma. And one thing is trae in the commercial media: you don’t bite the hand of the Big Pharma that feeds you, even when it’s feeding people dangerous drags as readily as hot dogs on the Fourth 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 overa se of opioids. The Food and Drag Administration (FDA) approved ever more powerful drags 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 drags 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 Los Angeles Times published the article, “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 paid, “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 about this anti-opiate bandwagon was any mention of the chiropractic profession in the military. Considering musculoskeletal disorders (MSDs), principally back pain, are the number one condition for the use of opioids, we should have expected NPR to be tooting our horn the loudest as the leading nondrug health profession that primarily treats MSDs.
Smack Epidemic
Even our sports heroes aie 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 drags 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 conect the underlying problems, as the 2014 Cochrane Review admits with, “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), published an exposé by L. Jon Wertheim and Ken Rodriguez titled, “Smack Epidemic.” about 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 sheet for cheaper heroin. The Sports Illustrated writers report that 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 drag lords, they think of drag cartels from Mexico or Colombia. While that may still be true, the biggest drag 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 2 010.17 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 drags.
According to renowned spine researcher Richard Deyo, MD, MPH, “More people aie 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 drag 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 it reported, “Families said they received no warning from physicians about the addictive power of painkillers.”20 I can attest that 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 on 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 straggle 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 drags 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 aie 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 drag overdose deaths in the United States. In all, drag-induced deaths have outstripped those from traffic accidents.”22
Despite the increasing DEA push-back and tragedy of this honor story in the news, Dr. Frankenstein marches on, empowered by bribes from Big Phanna 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 ditftcult 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 by 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%). The survey found more than 8% of chr onic pain care providers (CPCPs) now carry a gun for protection. The researchers found that 64% of CPCPs have called security and 51% had received threats. Discharging a patient was the most common risk (85%). Apparently, once a patient gets hooked on opioid painkillers, they resent being denied access to more drags.
Once the prescription painkillers aie depleted, it creates a “gateway” situation where addicted patients turn to the street for more, creating a new set of problems. According to the National Institute of Drag Abuse, 80% of all heroin users begin using the drag after they have used opioid painkillers.25
Dr. Frankenstein’s Stoned Too
This chaotic situation becomes more alarming considering that “69 percent of the physicians had misused prescription drags sometime in the past,” according to the article on Medscape, “Why MDs Abuse Prescription Drags.” Apparently, Dr. Frankenstein can’t keep his own hands out of the cookie jar of opiates.
Ironically, the reason given for why MDs abuse prescription drags sounds painfully similar to what most patients might say:
“Several of the physicians who said that they misused drags 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 healthcare survey that the United States is near the bottom of the list when it comes to public trast in the medical establishment in general, compared to people in many other countries.27
Perhaps their mistrust is due to the possibility that theft treating medical provider may also be a former or current abuser. Indeed, would you trust your MD knowing there is an 8% chance he or she is packing a gun, a 69% chance he or she has abused drags, or a 60% chance he or she is an atheist, as Francis R. Collins, MD, director the National Institutes of Health (NIH), revealed from his personal experience?28
All in all, this is a bad formula for trast and good outcomes. Add into this mix another issue that Dr. Frankenstein most likely suffers from—chirophobia, the irrational bias against chiropractors—so his patients ai e denied the best form of care for then chronic back pain, and yes, this gravy train has become a sickening ride for many patients. Let me suggest that the medical mismanagement of back pain is a prime example of why the public distrusts their MDs, especially for those who have taken a wild ride on the medical gravy train with drags, shots, or 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 frisions, “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 about the opioid epidemic in the United States. If the chiropractic associations and their PR specialists at the Foundation for Chiropractic Progress (F4CP) do not jump on this anti-opioid bandwagon, they should be held derelict in their duty to position chiropractic as a nondrag, nonsurgical solution for this epidemic of opioid abuse.
Millions of monsters need our help to destroy Dr. Frankenstein.
References:
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.
3. CDC Vital Signs, http://www.cdc.gov/vitalsigns/pdf/2014-07-vitalsigns.pdf
4. Centers for Disease Control and Prevention Press Release, “CDC Vital Signs: Overdose of Prescription Opioid Pain Relievers—United States, 19992008” 2011: www.cdc.gov/media/releases/2011/ til 01 fpresecription_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/2014/11/2 7/ajnrA4173. 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 DOL 10.1016/S0140-6736(15)60692-4
8. “U.S. Spine Care System in a State of Continuing Decline?”, The Back Letter, vol. 28, #10, 2012, pp.l
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. Ouil Lawrence, “Veterans Kick the Prescription Pill Habit, Against Doctor ’ Orders, ” 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, AID, Andrea D. Furlan, AID, PhD, Amol Deshpande, AID, Angela AlailisGagnon, AID, AISc, FRCPC, Steven Atlas, AID, 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, AlPharm, A1BA, PhD; Kiengkham Vouthy, PharmD; Ashley N. Crowl, PharmD; Anne E. Stegeman, PharmD; BithiaFikru, PharmD, MPA; WalterAgborBawa, 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 JAICP Journal of Alanaged Care & Specialty Pharmacy
18. Louise Radnofsky and Joseph Walker, “Clampdown on Popular Painkillers, ” Wall Street Journal, 8/22/2014. Chapter Five: Dr. Toad’s Wild Ride
19. ReedAbelson, “Financial Ties Are Cited as Issue in Spine Study, "New York Times, January 30, 2008
20. L. Jon Wertheim and Ken Rodriguez, “Smack Epidemic, ” Sports Illustrated, June 22, 2015
21. Deborah Brauser, “Many Docs Still Don't Understand Opioid Dependence, ” Aledscape, www. medscape.com, Jun 14, 2013
22. Sabrina Tavernise, “In Move to Curb Drug Abuse, D.E.A. Tightens Ride on Widely Prescribed Painkiller, " NY Times, AUG. 21, 2014
23. Pain Medicine Physician Salary, http.V/mdsalaries. com/2012/09/17/pain-medicine-physician-salary/
24. Kim David, AID, Daftari Anuj, and Sibai Nabil, “Violence Toward Chronic Pain Care Providers: A national survey, ” Pain Medicine, June 2, 2015.
25. Donna Leinwand Leger, “OxyContin a Gateway to Heroin for Upper-Income Addicts, ” USA TODAY, June 28, 2013
26. Quit Lawrence, “Veterans Kick the Prescription Pill Habit, Against Doctors ’ Orders, ” All Things Considered, NPR, July 11, 2014
27. Amy Norton, “Americans Show Distrust of Aledical Profession in Survey, ” HealthDay, Oct. 22, 2014
28. Interviewed by David Hirschman, Recorded September 13, 2010, BigThink.com
year practicing author Smith, of The MA, chiropractor, Medical DC, is a War 35Against Chiropractors, and he maintains a website, Chiropractors for Fair Journalism.
