{"id":1083,"date":"2019-08-15T07:48:11","date_gmt":"2019-08-15T14:48:11","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=1083"},"modified":"2019-08-15T07:48:11","modified_gmt":"2019-08-15T14:48:11","slug":"skeptics-can-learn","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=1083","title":{"rendered":"Skeptics can Learn"},"content":{"rendered":"\n
\"\"
Pyrrhon, Greek Skeptic<\/figcaption><\/figure>\n\n\n\n

I was skeptical when the well-dressed drug salesmen told us\nin the 1990\u2019s the new long acting narcotics (Oxycontin) wouldn\u2019t lead to\naddiction. I remembered the processes taught to me long ago in medical school\nhow our bodies change the number of neuro-receptors we have, so we can develop\ntolerance to drugs over time. Our bodies understand just how important the sensation\nof pain is to our survival. <\/p>\n\n\n\n

As a physician skeptic, I rarely prescribe the new drugs as\nthey first come out. Call me conservative. <\/p>\n\n\n\n

I was also skeptical when I started reading about the new\nnarcotics developed to treat narcotic addiction. <\/p>\n\n\n\n

Maybe it was because I knew the history of humans and\nnarcotics. Opium extracted from poppies has been used from ancient times. The\ndark paste could be smoked or eaten. It offered some benefits but addiction was\na problem for many. Hundreds of years ago it was discovered that a mild acid\nextraction of raw opium produced morphine. This new drug was used for pain, but\nalso to treat opium addicts. <\/p>\n\n\n\n

Then, after the Civil War, a stronger acid extraction of\nmorphine produced heroin. Many horribly wounded veterans had become addicted to\nmorphine, and heroin was at first considered a treatment for this addiction.\nHeroin was effective for acute pain, but its faster action produced a euphoria,\nand addiction again became an even greater issue. <\/p>\n\n\n\n

Methadone was another new narcotic 40 years ago developed\nspecifically to deal with heroin addiction. It has migrated to be used for\nchronic pain, but it has a very narrow window of pain relief before it\nsuppresses the drive to breathe; fatal overdose is a significant threat.\nFederally licensed methadone treatment programs are available for patients with\nnarcotic addiction, but patients may be required to come in every day and be\nobserved taking their dose. It makes holding a job or travel a real problem.\nAnd there are only a few treatment centers in Idaho and they are in urban\nareas.<\/p>\n\n\n\n

So, when another \u201cnew\u201d narcotic drug was suggested for the\ntreatment of opioid addiction I was skeptical. But I read the studies and the\nreports. <\/p>\n\n\n\n

This new synthetic narcotic buprenorphine, binds to the\nnarcotic receptors on our nerve cells very strongly, but it doesn\u2019t fully\nstimulate the nerves. It is effective at reducing cravings but doesn\u2019t produce\na \u201chigh\u201d feeling. It has been used in Europe for 20 years, but only for a\ndecade here in the US. <\/p>\n\n\n\n

I understand the Drug Enforcement Agency being reluctant to\nauthorize the use of another narcotic to treat narcotic addiction. I\u2019ve just\ndescribed for you the tawdry history of such attempts. So, the DEA requires any\nphysician prescribing this drug to get extra training and limits the number of\npatients they can treat. <\/p>\n\n\n\n

I had little reason to prescribe this drug until recently.\nNow I work in a clinic with a program for the treatment of patients with\nsubstance abuse disorders. My skepticism is being challenged daily. <\/p>\n\n\n\n

I took the extra training and got the DEA certification. I\nlearned the pharmacology of the drug, its side effects and drawbacks. It is no\nmiracle drug, but for some folks it can provide a real benefit. And that\u2019s the\ngoal, isn\u2019t it? Get people healthy.<\/p>\n\n\n\n

Patients must see a counsellor as part of our program. We\ntest urine specimens for any illicit substances. We call patients in to count\ntheir pills to make sure they aren\u2019t selling them. And believe me, there is a\nmarket for these pills too. Almost every patient we have enrolled on our program\nadmits they have tried the drug \u201cfrom a friend\u201d. <\/p>\n\n\n\n

In our program I\u2019ve seen patients who haven\u2019t used illicit\ndrugs for years now, on a low maintenance dose. They are in stable\nrelationships, working regular jobs. Most expect to be off the medicine someday.\n<\/p>\n\n\n\n

I hope so too.<\/p>\n\n\n\n

Many physicians I have spoken with are very skeptical about\nthe value of such treatment. I know their skepticism. I wonder why they weren\u2019t\nso skeptical when the fancy suit drug salesman came knocking with Oxycontin\ncoffee cups 25 years ago.<\/p>\n","protected":false},"excerpt":{"rendered":"

I was skeptical when the well-dressed drug salesmen told us in the 1990\u2019s the new long acting narcotics (Oxycontin) wouldn\u2019t lead to addiction. I remembered the processes taught to me long ago in medical school how our bodies change the … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1083"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1083"}],"version-history":[{"count":1,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1083\/revisions"}],"predecessor-version":[{"id":1085,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1083\/revisions\/1085"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1083"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1083"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1083"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}