In Pain

 The Washington Post is all over the scandalous opioid public and personal health emergency of late. See "The Opioid Files" series.

Recall my earlier review (scroll down in linked page) of Beth Macy's riveting book "Dopesick?"

My latest snailmail issue of Science Magazine just arrived. I always look right away to the book reviews for stuff of relevance and interest. Found this, "The ethics of opioids" (paywalled):

Summary
Imagine having your foot pinned between a moving van and a motorcycle and subsequently undergoing five surgeries to restore function to your mangled limb over a 1-month period. In order to endure the debilitating pain, you are prescribed high doses of opioid analgesics, only to discover that your care team has no exit strategy. Feeling abandoned by the medical establishment, you decide to subject yourself to a process of aggressive self-tapering and subsequently experience a gruesome withdrawal. Travis Rieder tells such a story—his story—in his new book, In Pain: A Bioethicist's Personal Struggle with Opioids. As an academic bioethicist, Rieder provides a philosophical lens to his lived experiences…

The Amazon blurb:

A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic.

Travis Rieder’s terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself.

Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system.

In Pain is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.

I've not (yet) bought it, being buried in several others at the moment and probing my usual overload of periodicals and 'net news. Amazon should be paying me to read all these books, given the hundreds I've cited, reviewed and linked on this blog.

I feel very lucky that I got through my open heart surgery last August with minimal need for and consumption of opioids.

Interesting, Travis is here, at Hopkins. Lotta talent in this town.

FEB. 2018 IN TAMPA

“This country prescribes too many opioids. People need to take some aspirin sometimes.” —former Trump Attorney General Jeff Sessions

Well, okeee-dokeee then...
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OTHER STUFF

Read an interesting piece in my New Yorker this morning.

Does Extinction Rebellion Have the Solution to the Climate Crisis?

...The campaign describes itself as a “self-organizing system,” but it is also the brainchild of a small group of experienced British radical activists. One of its founders is Roger Hallam, a fifty-three-year-old organic farmer from Wales, who is also a postgraduate student of theories of social change. Another is Gail Bradbrook, a longtime anti-fracking and tax-avoidance campaigner, who has a Ph.D. in molecular biophysics. Bradbrook and Hallam met in person for the first time in early 2017, not long after Bradbrook returned from a psychedelic retreat in Costa Rica, where she took ayahuasca, iboga, and kambo, in search of some clarity in her work. Bradbrook had been involved in the Occupy movement and campaigns around peak oil, but they failed to take off. “I was just sort of, like, fed up with failure,” she told me. “I was willing to just try anything, really.” Together, Bradbrook and Hallam sketched the outlines of Extinction Rebellion. In April, 2018, the strategy of conducting a peaceful, mass campaign of civil disobedience—Bradbrook and Hallam speak about converting a critical mass of 3.5 per cent of the British population, more than two million people—was formally approved at a meeting of about fifteen activists at Bradbrook’s house in Stroud, a market town in the Cotswolds with a strong ecological scene. Last summer, the first X.R. campaigners toured more than a hundred village halls and community centers, urging people to accept that the natural world is in a state of emergency. The group’s first demand—“Tell the truth”—is in many ways its greatest...

So, I keyword-searched around, and eventually found and watched this Gail Bradbrook YouTube.

About 50 minutes. Very interesting, very topically commendable--notwithstanding among one of the worst video presentations I've seen. An Anti-TED Talk.

Extinction Rebellion now has boots-on-the-ground chapters all around the world. They're here in Baltimore, and down the road in DC.

Count me in where it comes to the science of our Climate Emergency. See here as well for a recent local view. We also might usefully reflect on what POTUS thinks.

"Tell the truth."

A Frase "Quadrant IV" draws nigh.

ERRATUM

Saw this entire 2016 documentary on Maryland Public Television the other evening. This is the trailer for "Company Town" (SF Bay Area, that is).

Having covered the SF/Silicon Valley health infotech space for a number of years, and having lived in San Francisco in the late 1960's and in the East Bay from 2013 til we moved to Baltimore a few months back, I watched with rapt interest. Haven't yet been able to locate the full film.
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More to come...