Written by Richard Rapaport   

(Let me know what you think, Best ~ Richard Rapaport This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

Pill Popping/Pill Shopping
A Proposal to Declare “Peace, Not War” On Opioid Addiction
By Richard Rapaport


“Terrific interview Jim, thank you very much.” CBS Evening News anchor Scott Pelley seems barely able to contain himself as he atta-boyed correspondent Jim Axelrod for a so-so interview with former Center for Disease Control boss, Dr. David Kessler.

The subject of the CBS News special report was the epidemic of overdoses and deaths caused by the super-opioides and various other painkillers that are the drug du jour throughout America’s rapidly de-industrialized rustbelt. The CBS story was a multi-part piece that ran last week tracing the progress, or lack thereof, of Jason Ameral, an unemployed, addicted 30-year old Massachussan who allowed CBS to follow him around for the 24-hour binge prior to checking into a local rehab. During the day, Jason hit up dealers throughout Suburban Boston for that final taste of the powerful Fentanil/Heroin cocktail that is today’s drug cocktail/combo of choice.

The CBS project strove mightily to present a no-holds-barred report with the gravitas, say, of Edward R. Murrow’s legendary 1959 CBS farm worker documentary, “Harvest of Shame.” Going for the brass ring, the report mordantly presented itself as being “In the Shadow of Death: Jason’s Journey.” It was dramatic stuff that did not lend itself to Scott Pelley’s incessant cheerleading.

There were other clues that CBS was investing its “Tiffany Network” prestige in the piece. Pelley, for example, conducted his anchoring while standing up at a podium rather than from his usual anchor chair. The report even featured an antsy President Obama adding his own cautious commentary on what CBS strove to characterize as possibly the most fraught crisis of modern American life.

The piece even attempted to enlist CDC’s Dr. David Kessler as a medical co-conspirator, but couldn’t make a dent in a man who may one of the smoothest Federal bureaucrats of all time. Kessler did go so far as to characterize the proliferation of painkillers as “one of the mistakes of modern American medicine.” Kessler did allow as how the underlying reason for the proliferation of pain medicine was actually a noble, if ultimately misguided, effort.

Why misguided? Because it turns out that America had passed this way before. All you had to do was go back to the early 1980s when Nancy Reagan was first collaborating on the Administration’s creepy new anti-drug slogan delivered alongside the ludicrous Mr. T: “Just Say no!” It turned out to be the face of the 80s burgeoning crack/cocaine epidemic. Then, the effect was galvanic and to a certain extent changed the way America regarded pain, drugs and addiction.

Before “Just Say No,” American physicians had largely operated under the rubric that pain was one of five Hippocratic “vital signs” that needed to be treated, according to David Kessler, “until the pain was alleviated.” This was in contrast to an even older medical principle suggesting that a little pain might even be somewhat salubrious for the soul.

Operating under this latter mindset, doctors historically expected their patients to suck it up. Over the years, however, America had heard enough of the horror stories of under-medication coupled with surgery. And, if it was going to be character versus morphia, the latter was going to win out every time. “Pill shopping” along with “pill popping” increasingly became the American way of oblivion.

The 1980’s Reagan-inspired “War on Drugs” was a social and penological disaster, and one that President Obama is still trying mightily to sort out. One part of his current plan includes paroling of the thousand of non-violent convicts many of whom had been caught up in the racially-tinged drug hysteria the early 80s. In both tone and content, today’s version of “Just Say No” also sounded spookily like a tryout for “War on Drugs II.” At the same time, news editors and reporters like CBS’s Pelley thought they had sussed out a great story and jumped in up to their ears. And as they had in 1986, the media and various legislatures were soon in the act of creating a new demonology that put many Black American men into the crosshairs for cocaine powder and crack offences and far too often locked them up for often-wildly disproportionate sentences.

And while reports like CBS’s made compelling television, the danger of yet another war, on drugs or on anything else, should give us all pause for thought. We need to stop, take a deep breath, and consider what it will mean to start and prosecute a war on drugs; one that will harness the power of the purse in tandem with the power of the press that could easily become a template for incarcerating a whole new class of citizens/felons/drug abusers.

Rather, as often is the case, the best War on Drugs will be no War on Drugs. Let us instead began to treat drug addiction as the medical/sociological problem it largely is. We also need to provide the services, treatments, jobs and a positive mind-set for kids in trouble. Remember, they are our kids in trouble. Treating, for example, an overdose is a relatively straightforward procedure. But hundreds have died lonely, unnecessarily and tragic deaths because they had no easy access to Narcan the opioid-antidote of choice. Here, we can take some solace from the fact that some of the more highly developed cities – including San Francisco -- are working especially hard to make Narcan more available on an over-the-counter basis.

It simply makes sense to provide access to the antidote that often makes the difference between life and death. Even more, we need to cancel the nascent “War On Drugs” that CBS and others seem to be trying to sell us. Most of all, we need to mobilize our human resources not to fight a war, but rather to prepare for a useful “peace” in which media and medical professionals lead in an effort to confront the root causes of opioid addiction and do so with a “declaration of peace and health” rather than any new “rumors of war.”

###