I am a stage-four cancer survivor. No, that's wrong. I'm not a survivor. I beat cancer's ass into the ground, dusted myself off, and proceeded on with life. I don't consider myself, or the millions of other people who deal with life-threatening or chronic conditions, a victim. We are not. But surely, patients have enough to manage already without the idiocy rattling through Attorney General Jeff Sessions' teeth every time he opines on opioids, cannabis, and pain management.
That's right, I said it. Someone had to. Jeff Sessions is an idiot. The problem is plain for anyone who has had an experience like mine to see: Our top federal law enforcement officer has no idea what real pain is really like, or what doctors do to manage it.
Sessions recently told the surely apocryphal story about current White House Chief of Staff, and former four-star general, John Kelly refusing pain killers during hand surgery. I have no doubt that the general is one bad ass individual. But really? Did he wash the wound with tequila before the first incision, while grinding his teeth on a stick?
Watch Sessions tell the story here. It is itself quite painful. It's like your crazy great uncle's circa-1950s-liquor-fueled rants you are subjected to once every year at Thanksgiving dinner. The difference is that your crazy great uncle is kind of endearing when he's drunk, and his opinions are harmless. This crazy uncle is the Attorney General of the United States, and he has all the power to act on his feelings, and he clearly intends to do so.
"The plain fact, I believe, and I am operating on the assumption that this country prescribes too many opioids," Sessions told a gathering in Tampa a few weeks ago. "I mean, people need to take some, uh, aspirin sometimes, and tough it out a little."
"Believe." "Assumption." "Too many." Forget the fact he doesn't have the slightest notion of the difference between acute pain, like when a surgical scalpel cuts into your flesh, and chronic pain, that can last indefinitely. And I wonder what exactly "Dr." Sessions means by too many? Which patients, with what conditions, under what circumstances will be determined by the federal government to be deserving of pain relief? And who, exactly, is just going to have to "tough it out a little bit?"
The Attorney General probably doesn't have any specific patient in mind. He doesn't exactly appear to be focused on individual patients. He just wants to make sure that fewer patients are prescribed opioids to manage their pain—and he is weaponizing the federal government in order to accomplish this goal.
The Associate Press reported last month that, according to Sessions, "the Drug Enforcement Agency is now asking medical practitioners whether they have received continuing medical education on prescribing or dispensing opioids when they apply for a license or renew."
Sessions is forcing doctors to make an ugly choice: Either do best by their patients and adhere to their Hippocratic Oath—or suffer the bureaucratic harassment from the powerful Drug Enforcement Agency, and risk the loss of their license to practice medicine. If incentives matter, and they do, expect doctors to start making bad choices for their patients.
I remember a time, not too long ago, when Republicans and conservatives proclaimed loudly and often that health care choices should be between patients and doctors, and the federal government should keep its nose out. But those well-worn talking points have been shelved, replaced with a new form of medical authoritarianism.
For me, it's personal. I was diagnosed with cancer in 2001. I have been injected with aggressive chemotherapy cocktails that leave you feeling like you have the worst hangover ever, except that it goes on for months. And there's extensive nerve damage. If you are a masochist, you can read more gory details here.
I have undergone multiple surgeries that sliced me open from stem to stern, each time leaving dozens of surgical staples in my belly, making my torso look like I big zipper. Years later, I still deal with collateral damage from the battle, including scar tissue in my abdomen that can generate significant pain. With all due respect to tough guy John Kelly, I doubt he has felt real pain, the kind that makes you wish you were dead, until scar tissue from past surgeries manages to strangle your intestines closed.
And, yes, it irritates me to retell these stories. I'm not nearly old enough yet to be spending my waning days on the porch, telling my octogenarian friends about all the parts of my body that are broken. I was hoping to save the good stuff for when my wife finally sends me away to a geezer farm in the country.
Of course opioid addiction is a real problem, and opioid abuse is indeed dangerous. I have friends who have told their stories about managing pain, and addiction. They all sought other forms of treatment, settling on medical cannabis as a safer, more effective treatment for debilitating pain, and other chronic conditions.
I can recount countless stories of patients using cannabis to get off of opioids. But here comes the idiocy again. Jeff Sessions has said that "good people don't smoke marijuana," and that he believes that cannabis is the gateway drug that leads to opioid abuse. "We think a lot of this is starting with marijuana," he says at that same piece of performance art in Tampa. The research, of course, says the opposite.
So with traditional pharmaceuticals and cannabis off the table, I guess I really will have to "tough it out a bit."
When I sat down to write this piece, I debated using the word idiot. It's intemperate, you might say. So I Googled it. "Idiot: A stupid person. Synonyms: fool, jackass, knucklehead, numbskull, nitwit, asshat." It might as well have just said "Jeff Sessions."