Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop 1st Edition

I was educated and engaged as I read about the world of prescribed drug abuse in Dr. Anna Lembke’s book, Drug Dealer, MD.The book helped me to identify common drug acceptance behaviors. One assumes drugs are needed when pin is present and they are administered by a physician. It was helpful to learn about the history of treating pain to see these experiences from a new perspective.Lembke describes the diverse agencies responsible for relaxed attitudes toward prescribing addictive drugs with courage and the narrative captivates the reader like the unraveling of a suspense novel.I am grateful to have a better understanding of federal drug schedules according to addiction potential and I am appalled that states have legalized recreational and medicinal marijuana, despite its federal classification as a schedule 1 drug. Why has the public not been educated regarding marijuana having no medical benefit and being so highly addictive that it should not be prescribed according to the Federal Drug Administration?Lembke has a powerful and compassionate voice to make a positive difference in the perspectives and lives of many readers.I have discussed this book at length with family and friends around me. Now that I am more aware of the opioid epidemic, I hear about it from sources around me and I am grateful I am no longer ignorant.

Drug Dealer, MD is an excellent book that is both accessible and useful to patients and their families, but it is also a must read for health care providers and, more importantly, those who control the levers of power in Washington- because, although they might not have meant to, they share some responsibility for the current opioid epidemic. Dr. Lembke spreads the blame for this crisis beyond the usual suspects (patients, doctors, insurance companies and Big Pharma) to groups not traditionally thought of as playing a role in the creation of this problem: the Joint Commission that accredits hospitals, the Centers for Medicare and Medicaid Services, and Congress. The real strength of this book is it holistic approach which ends up demonstrating the impact of the unintended consequences of well meaning health care policy. So, this is not just a story of pills, but of the role patient satisfaction surveys, electronic medical records, and the move toward integrated health care systems have played in the creation of this crisis. That is a story not usually told- which is why this is such an important book.

I did enjoy mainly the personal stories in this book. This has always been a topic that I find myself fascinated by. The book got a little repetitive and wordy at times but it was a good read overall.

I applaud Dr. Lempke for having the courage to write this book. This is must read for anyone hoping to understand the prescription - & illicit - drug epidemic that is currently plaguing the US. Especially hospital/medical group administrators and risk management departments. Like Dr. Lempke, I view high dose opioid treatment for chronic non-cancer pain in working-aged adults as office based medically assisted treatment (MAT) of addiction. Big Pharma discovered in the 1990s that chronic withdrawal is a good business model. The ‘lost generation’ described by Dr. Ballantyne and Angus Deaton are iatrogenically addicted to their opioids, and we - the medical profession - are responsible.Times are very tough out there for a large swath of Americans and we see this upclose and personally in pain and addiction clinics. In the words of Deaton: “However, addictions are hard to treat and pain is hard to control, so those currently in midlife may be a “lost generation” whose future is less bright than those who preceded them." As the recent election has revealed, the prevention of ‘terribly sad lives’ is an important topic for our time. I’ll leave this review with a quote from Mark Sullivan:“Although opioids are beneficial when taken for less than three months, studies of long-term use show that the drugs, while they may relieve pain, do little to improve function. Those who take the drugs for the longest periods of time, and in the heaviest doses, tend to be patients with psychiatric and substance-abuse disorders—a phenomenon that Mark Sullivan, a professor of psychiatry at the University of Washington, has called “adverse selection.” Sullivan told me that in poor, rural regions doctors are using opioids to treat a “complex mixture of physical and emotional distress.” He said, “It’s much more convenient for both patient and physician to speak in the language of physical pain, which is less stigmatized than psychological pain.” Some of these patients could be said to be suffering from what his colleague calls “terribly-sad-life syndrome.” “These patients are at a dead end, life has stymied them, they are hurting,” he said. “They want to be numb.” He believes that doctors are inappropriately adopting a “palliative-care mentality” to “relieve the suffering of people who have had very tough lives.”

I loved this book. She goes into great detail about big pharma, health insurance companies, hospitals, doctors, patients, medications, addictions, etc. I think we all have an idea what's going on but this really opens your eyes. It's truly sad how our health care system is set up and so many Americans are struggling with no/little help. Highly recommend picking this up and I couldn't put it down.