Drug Dealer, Not MD

02/23/2017

I have not read Anna Lembke’s book, but I know that blaming does not solve problems, and according to the review by Sally Satel, MD in the 12/8/2016 Wall Street Journal that would appear to be her primary strategy for addressing problems related to prescription drugs.

MDs (as well as DOs, dentists, and a variety of other medical professionals) prescribe so-called “controlled” substances. We do not sell them.

As far as I know none of these professionals asked for the role of gatekeeper for these drugs, many of which are readily available on the black market created by our government’s failed policy of prohibition. Alcohol and tobacco, both available over-the-counter with no prescription, kill many times more Americans than prescription drugs, and our “war” on drugs probably kills more innocent Mexicans than the number of Americans who die of overdose.

Prescribers regularly order pharmacists to dispense lethal amounts of opiate analgesics, but rarely does a lethal overdose occur when the person takes only the amount prescribed.

Punishing prescribers for adverse events related to use of controlled substances has made us suspicious -- if not hateful -- of patients, and has corrupted some otherwise competent professionals.

To minimize further harm we should downsize the very uncontrolled black market in these drugs and let pharmacists, rather than other healthcare providers, act as gatekeepers. These other providers would only advise. The physician shortage would disappear, and physician fees would drop enormously.

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