Skip to main content

Healer or Dealer?? A Doctor shares his view...


Healer or Dealer – a doctor shares his own story to illustrate the challenges of treating addiction

“A disturbing dance of deception with an opioid-addicted patient”, an intriguing title for an article written by Siddhartha Mukherjee in 1/4/2018 issue of The New York Times Magazine.  The author uses his own experience with the insistent demands of a patient in what he calls the “opioid pre-epidemic” to highlight the challenges faced by doctors in the early wave of addiction:  not only a lack of adequate training and false information but also a dramatic change in the traditional doctor-patient role.  

As Dr. Mukherjee so skillfully expresses it:  “The doctor shifts from healer to dealer….  The doctor is, at first, the enabler and the supplier, and then the tormentor, the withholder, the liar, the enemy.”  Rather than “fix” the patient, a doctor is urged to provide “a fix”.  The result is a doctor-patient relationship characterized by suspicion.  Doctors today have increased knowledge and understanding of opioid addiction, but is this enough to establish a relationship with a client based on trust or are they doomed to persist in the role of drug dealer?

Though Dr. Mukherjee does not answer that question, he provides the reader with a new understanding of the predicaments doctors face and challenges the ideas that doctors are the enemies in the opioid crisis; in some case they are the victims too.


Comments

Post a Comment

Popular posts from this blog

The Language of Addiction ... A Family Disease? Think again!

In his play Romeo and Juliet , Shakespeare poses the question:  "What's in a name?"  He muses on the question by saying,  " That which we call a rose, by any other name would smell as sweet. " Well, I get the point... sort of, but I'm not sure I agree .   I bet if we called a rose a "stink blossom", or a "wailing tooth ache bud", it may not smell quite as sweet.  Why?  Because words have connotations as well as meanings and those connotations are what shape our perceptions. This is not a novel idea.  People change the name of things to change the perception of things.  We've seen it happen time and time again.  Janitors became custodians, garbage men became sanitation workers, stewardesses became flight attendants and store clerks became associates.  What was behind all these name changes?  An attempt to provide dignity to positions, to wipe away old associations and start anew. And so it is with the language used to describe a

48.3 miillion dollars buys a whole lot of margaritas: Canada takes on Purdue

Canada reported 4,00o fatal opiate overdoses last year and movement is underway to seek settlement from companies who not only under-reported the addictive effects of opiods, but also promoted their product to physicians through "perks" such as lavish vacations. According to Andrea Woo of  The Globe and Mail (Vancouver): "Ten of Canada’s largest pharmaceutical companies have voluntarily disclosed that they spent at least $48.3-million collectively on payments to physicians and health-care organizations in 2016, but critics say the figures are incomplete and fall well short of genuine transparency." $48.3 million?  Even if it is under-reported, it sure sounds like a whole lot of wining and dining and fancy hotel rooms to me.    Perdue Pharma LD has already paid out hundreds of millions of dollars in civil and criminal proceedings in the US in settlements related to their misleading information regarding OxyConton.  Although Perdue has not made a submission of g

Authentic help..a ride to treatment!

     I just love stories like this...    Uber has teamed up with Goodwill in a pilot program to provide free transportation for Virginians trying to get to treatment services for opiate addiction.  If you have read my book, The Weight of a Feather: A Mother's Journey through the Opiate Addiction Crisis , you know I am a real fan of real help, not talk about help, not referral for help but genuine help, when you need it .     Transportation is formidable obstacle in the way of treatment.  Transportation takes money and worse yet, when you live in an area without public transportation and you don't have access to a car, lack of transportation may be the bullet that kills any opportunity for treatment.  Sue Medeiros from the Chesterfield County Mental Health Support Services Department seems to have nailed it with her comment: "There's often a very small window when the individual is open to treatment--so we have to be ready with whatever we have."  Amen.