Nikki Sixx is a voice of reason on the opioid crisis?
January 12, 2018 11:53 AM Subscribe
From the things I didn't expect to read today file. Motley Crue bassist and primary songwriter Nikki Sixx speaking about the opioid crisis with intelligence and compassion.
Heroin Diaries is a pretty good read.
posted by Sphinx at 12:45 PM on January 12, 2018 [3 favorites]
posted by Sphinx at 12:45 PM on January 12, 2018 [3 favorites]
Nikki Sixx is sort of surprising if you don't know much about him. His Youtube video series was entertaining.
The rule is any famous person has at least a 75% chance of not being anything like what you think from their public persona.
posted by bongo_x at 2:20 PM on January 12, 2018 [4 favorites]
The rule is any famous person has at least a 75% chance of not being anything like what you think from their public persona.
posted by bongo_x at 2:20 PM on January 12, 2018 [4 favorites]
He does a radio program which runs most weeknights on my local alternative station, at a time when my other choices are Alice Cooper and Delilah. I tend to bounce back and forth among stations while on my way home from my night job, so I've heard him a fair bit there.
He's articulate and comes across as someone who may not be overly intellectual but who has been through a lot and has given his experiences a fair amount of thought, so that he has something to say which can range from straightforward to pretty insightful.
posted by Four Ds at 2:38 PM on January 12, 2018 [5 favorites]
He's articulate and comes across as someone who may not be overly intellectual but who has been through a lot and has given his experiences a fair amount of thought, so that he has something to say which can range from straightforward to pretty insightful.
posted by Four Ds at 2:38 PM on January 12, 2018 [5 favorites]
He does a radio program which runs most weeknights on my local alternative station
Not anymore, he ended that gig a few weeks ago.
posted by radwolf76 at 3:16 PM on January 12, 2018
Not anymore, he ended that gig a few weeks ago.
posted by radwolf76 at 3:16 PM on January 12, 2018
I don't see anything nuanced or compassionate about that. People in chronic pain, with debilitating diseases who have never abused their medications are losing their pain relief every day because people like Nikki Sixx are junkies. Sorry, but I have limited sympathy for him and all the sympathy in the world for the poor souls with ankylosing spondylitis and CRPS and spinal cord injuries who will never recover and have no oiptions other than painkillers who now can't get them.
A nuanced discussion of America's drug problem would look at unemployment, youth poverty and a profit driven medical community of fly-by-night solo practitioners who create many of the chronic pain patients people are incorrectly blaming for the drug problem. This is standard old-guy talk.
posted by fshgrl at 3:29 PM on January 12, 2018 [2 favorites]
A nuanced discussion of America's drug problem would look at unemployment, youth poverty and a profit driven medical community of fly-by-night solo practitioners who create many of the chronic pain patients people are incorrectly blaming for the drug problem. This is standard old-guy talk.
posted by fshgrl at 3:29 PM on January 12, 2018 [2 favorites]
His articulateness, given his profession, is a nice surprise.
But if I'm thinking "Who is out there who is an expert on drugs that can fuck you up beyond belief," really, a member of Motley Crue isn't a real stretch for that. Show me one of the Stranger Things kids waxing eloquently on the subject and then I'll be shocked.
posted by delfin at 3:48 PM on January 12, 2018
But if I'm thinking "Who is out there who is an expert on drugs that can fuck you up beyond belief," really, a member of Motley Crue isn't a real stretch for that. Show me one of the Stranger Things kids waxing eloquently on the subject and then I'll be shocked.
posted by delfin at 3:48 PM on January 12, 2018
People in chronic pain, with debilitating diseases who have never abused their medications are losing their pain relief every day because people like Nikki Sixx are junkies.
You know, it's not actually the junkies who decided that was the appropriate response...
posted by atoxyl at 3:55 PM on January 12, 2018 [28 favorites]
You know, it's not actually the junkies who decided that was the appropriate response...
posted by atoxyl at 3:55 PM on January 12, 2018 [28 favorites]
He explicitly calls out prescriptions, especially people in pain management getting regular and ongoing prescriptions as the problem. That is not the problem, those people are subject to a million hoops, drug testing and pill counts and registeries. The problem in terms of overdoses is synthetic opioids like fentanyl, from China, the numbers are clear on that.
Keep in mind, a lot of the alternate pain management techniques are pure quackery. Epidural injections are not FDA approved and have 40% complication rate in some studies, including spinal injury and guess what, life long incapacitating pain. Stem cells are a racket at this point. Devices like spinal cord stimulators are untested and only help 30-40% of patients while causing irreversible scarring and more trouble down the line in the form of, you guessed it, intractable pain. Nerve ablation has to be redone every few months. etc etc. Pain management has become the very worst kind of separating desperate people from their money with no safeguards at all. If you haven't had to help someone navigate it you have no idea what a clusterfuck it is. Patients know that and they refuse the alternate treatments and they lose their healthcare. It's kafka-esque.
posted by fshgrl at 3:59 PM on January 12, 2018 [11 favorites]
Keep in mind, a lot of the alternate pain management techniques are pure quackery. Epidural injections are not FDA approved and have 40% complication rate in some studies, including spinal injury and guess what, life long incapacitating pain. Stem cells are a racket at this point. Devices like spinal cord stimulators are untested and only help 30-40% of patients while causing irreversible scarring and more trouble down the line in the form of, you guessed it, intractable pain. Nerve ablation has to be redone every few months. etc etc. Pain management has become the very worst kind of separating desperate people from their money with no safeguards at all. If you haven't had to help someone navigate it you have no idea what a clusterfuck it is. Patients know that and they refuse the alternate treatments and they lose their healthcare. It's kafka-esque.
posted by fshgrl at 3:59 PM on January 12, 2018 [11 favorites]
Just because a "junkie" doesn't necessarily have a *physical* pain condition it doesn't mean they don't have chronic pain and that they're not worthy of sympathy.
posted by elsietheeel at 4:42 PM on January 12, 2018 [15 favorites]
posted by elsietheeel at 4:42 PM on January 12, 2018 [15 favorites]
I am also of the opinion that the crackdown on opioid prescriptions is likely to end up being excessive/misguided. But you were talking as if the public policy decisions can be blamed on the drug addicts who are in a different way themselves likely to end up victims of this crackdown as they turn to fentanyl-enhanced dope in lieu of increasingly scarce oxycodone etc.
He explicitly calls out prescriptions, especially people in pain management getting regular and ongoing prescriptions as the problem.
I think the exact relationship between prescription opioid use and addiction is a bit complicated but I don't think it's unfair to argue that for a while a lot of people were getting long-term opioid prescriptions unnecessarily, particularly as some recent studies have suggested that for many indications the effectiveness of opioids in the long term may be overrated anyway.
posted by atoxyl at 5:07 PM on January 12, 2018 [4 favorites]
He explicitly calls out prescriptions, especially people in pain management getting regular and ongoing prescriptions as the problem.
I think the exact relationship between prescription opioid use and addiction is a bit complicated but I don't think it's unfair to argue that for a while a lot of people were getting long-term opioid prescriptions unnecessarily, particularly as some recent studies have suggested that for many indications the effectiveness of opioids in the long term may be overrated anyway.
posted by atoxyl at 5:07 PM on January 12, 2018 [4 favorites]
I don't think it's fair to say that fentanyl from China is the sum total of the problem.
A lot of people got hooked on good ol' American prescription painkillers, in part thanks to the flooding of markets by drug wholesalers.
This isn't to say that pain management isn't important or that all opioids should be banned. It is to say that there was a corporate structure in place that flooded particular markets with pills and profited from doing so, and that it is absolutely related to the resulting health crisis.
posted by evidenceofabsence at 5:10 PM on January 12, 2018 [6 favorites]
A lot of people got hooked on good ol' American prescription painkillers, in part thanks to the flooding of markets by drug wholesalers.
This isn't to say that pain management isn't important or that all opioids should be banned. It is to say that there was a corporate structure in place that flooded particular markets with pills and profited from doing so, and that it is absolutely related to the resulting health crisis.
posted by evidenceofabsence at 5:10 PM on January 12, 2018 [6 favorites]
I'm with fshgrl on this one. It's both heartbreaking and infuriating to watch someone you love go through hell every minute of every day because they can no longer get the appropriate medication for their condition.
The last time I checked, there were plenty of people abusing alcohol to the point where it ruined their lives and those of other people. But I don't see anybody crusading to bring back Prohibition anytime soon.
posted by The Underpants Monster at 6:12 PM on January 12, 2018 [5 favorites]
The last time I checked, there were plenty of people abusing alcohol to the point where it ruined their lives and those of other people. But I don't see anybody crusading to bring back Prohibition anytime soon.
posted by The Underpants Monster at 6:12 PM on January 12, 2018 [5 favorites]
I lost one of my closest friends to an alternative pain management treatment - whether it was on purpose or accidental on her part isn't important - it was a long time coming and directly related to the failure of pain management in the medical/political arena. I blame the doctors and pharmacies and insurances and support for people in poverty directly. I am still interested in what people like Nikki Sixx has to say about it. These things aren't actually at odds with each other, the ruling class just convinces us they are.
posted by I'm Not Even Supposed To Be Here Today! at 8:10 PM on January 12, 2018 [3 favorites]
posted by I'm Not Even Supposed To Be Here Today! at 8:10 PM on January 12, 2018 [3 favorites]
The presciption problem was with pill mills that were explicitly set up and run to launder drugs, basically. Like the ones in West Virginia and Florida that saw 500 patients a day and they all needed the max dose of oxycontin.
Legitimate pain clinics should be left the fuck alone to treat very sick people as they see fit. No one should force a man or woman who was already crippled by a surgery or epidural gone wrong to undergo more and more and more and more "procedures" that have a low success rate, or no success rate in the case of epidurals. It's wrong. Half these people have medical PTSD as it is and most of the will NEVER get any better. Give them medication, use marijuana, use pain pumps maybe, look into novel anti-inflammatories but don't get them hooked on opiates then hold that over their head unless they agree to medical surgeries they don't want. It's inhuman.
I think that the US has such high rates of chronic pain because they have such high rates of reckless doctors and disconnected surgeons who patients have no recourse against. Did you know that up to 4% of epidurals given to women during childbirth can cause life long complications? I bet you didn't. Did you know that back surgery only helps approx 35% of people and even those studies only follow them for 5-10 years. You don't get your money back if it fails though, that's for sure.
I have sympathy for junkies but not to the same level, sorry. I do feel bad for the kids who grew up in these rural areas with shitty schools, shitty families and no job prospects and I understand they they become professional partiers but cutting off pain patients is not the solution to that.
posted by fshgrl at 8:22 PM on January 12, 2018 [2 favorites]
Legitimate pain clinics should be left the fuck alone to treat very sick people as they see fit. No one should force a man or woman who was already crippled by a surgery or epidural gone wrong to undergo more and more and more and more "procedures" that have a low success rate, or no success rate in the case of epidurals. It's wrong. Half these people have medical PTSD as it is and most of the will NEVER get any better. Give them medication, use marijuana, use pain pumps maybe, look into novel anti-inflammatories but don't get them hooked on opiates then hold that over their head unless they agree to medical surgeries they don't want. It's inhuman.
I think that the US has such high rates of chronic pain because they have such high rates of reckless doctors and disconnected surgeons who patients have no recourse against. Did you know that up to 4% of epidurals given to women during childbirth can cause life long complications? I bet you didn't. Did you know that back surgery only helps approx 35% of people and even those studies only follow them for 5-10 years. You don't get your money back if it fails though, that's for sure.
I have sympathy for junkies but not to the same level, sorry. I do feel bad for the kids who grew up in these rural areas with shitty schools, shitty families and no job prospects and I understand they they become professional partiers but cutting off pain patients is not the solution to that.
posted by fshgrl at 8:22 PM on January 12, 2018 [2 favorites]
Can we please stop referring to people with substance abuse disorders as "junkies". Please.
posted by colorblock sock at 8:38 PM on January 12, 2018 [22 favorites]
posted by colorblock sock at 8:38 PM on January 12, 2018 [22 favorites]
I can only imagine what it would be to watch someone I love suffer because they can't get the medication they deserve. But please remember that pitting folks with addiction against folks with chronic pain is not terribly helpful. It isn't even a dichotomy: folks become addicted when they try to treat their pain. Folks become addicted because they're trying to cope with a PTSD symptom.
And as a minor aside, children aren't becoming addicted because they're professional partiers. They're becoming addicted because they're emotionally beat up, don't have adequate access to mental health services, are increasingly poor and hungry, and have easy/cheap access to a virtually unlimited amount of pills. I think maybe humanizing addiction (just as we have a responsibility to humanize chronic pain) might go a long way to solving both parts of a wider problem.
posted by Avarith at 8:59 PM on January 12, 2018 [14 favorites]
And as a minor aside, children aren't becoming addicted because they're professional partiers. They're becoming addicted because they're emotionally beat up, don't have adequate access to mental health services, are increasingly poor and hungry, and have easy/cheap access to a virtually unlimited amount of pills. I think maybe humanizing addiction (just as we have a responsibility to humanize chronic pain) might go a long way to solving both parts of a wider problem.
posted by Avarith at 8:59 PM on January 12, 2018 [14 favorites]
But please remember that pitting folks with addiction against folks with chronic pain is not terribly helpful.
It's very helpful to pain patients who are NOT addicts and want to be treated as sick people with correct medication and not lumped in with or assumed to be drug addicts. You are conflating two populations in YOUR mind, I am not. Most pain patients would give everything they own to be able to stop taking opiods, gabapentin etc. They hate the side effects, the inability to work, the fuzzy thinking, heck gabapentin pretty much causes brain damage and is very hard to stop taking. The antidepressants that a lot of people are also prescribed are very hard to stop and pain clinics will literally threaten to stop prescribing it all unless people agree to have and pay for surgery they don't want. They have them over a barrel and they know it.
If you have no experience dealing with the pain industry in the US please don't try to tell me how it works. It's dehumanizing and horrible and its designed to bleed people dry and enrich doctors. Very few of them actually care about their patients at all.
posted by fshgrl at 9:05 PM on January 12, 2018 [2 favorites]
It's very helpful to pain patients who are NOT addicts and want to be treated as sick people with correct medication and not lumped in with or assumed to be drug addicts. You are conflating two populations in YOUR mind, I am not. Most pain patients would give everything they own to be able to stop taking opiods, gabapentin etc. They hate the side effects, the inability to work, the fuzzy thinking, heck gabapentin pretty much causes brain damage and is very hard to stop taking. The antidepressants that a lot of people are also prescribed are very hard to stop and pain clinics will literally threaten to stop prescribing it all unless people agree to have and pay for surgery they don't want. They have them over a barrel and they know it.
If you have no experience dealing with the pain industry in the US please don't try to tell me how it works. It's dehumanizing and horrible and its designed to bleed people dry and enrich doctors. Very few of them actually care about their patients at all.
posted by fshgrl at 9:05 PM on January 12, 2018 [2 favorites]
While Sixx has many things on his plate—photography, developing a musical based on "The Heroin Diaries",
*record scratch*
posted by petebest at 9:24 PM on January 12, 2018
*record scratch*
posted by petebest at 9:24 PM on January 12, 2018
I don't think anyone is conflating addicition with the need for pain management.
People are asking for compassion and consideration for people who suffer from addiction, rather than dehumanizing them and dismissing them as junkies who want to party.
posted by evidenceofabsence at 9:32 PM on January 12, 2018 [13 favorites]
People are asking for compassion and consideration for people who suffer from addiction, rather than dehumanizing them and dismissing them as junkies who want to party.
posted by evidenceofabsence at 9:32 PM on January 12, 2018 [13 favorites]
No one should force a man or woman who was already crippled by a surgery or epidural gone wrong to undergo more and more and more and more "procedures" that have a low success rate, or no success rate in the case of epidurals. It's wrong. Half these people have medical PTSD as it is and most of the will NEVER get any better.
As the caregiver to someone who's gone through exactly this for years now following the procedure that was supposed to fix the problem; who's got a case of medical PTSD they don't even know how to deal with that's damaging our relationship; who's endured all the degrading and inconvenient things one has to navigate nowadays to get a basic prescription for pain medication filled; who's endured the trip to the emergency room many, many times, only to get obnoxious questions from medical professionals that assume they somehow put themselves in this state through poor diet or too many or too few pain pills or drug-seeking behavior or whatever, while they're next to me barely able to speak, writhing from pain and nausea...I hear you on this. I'm angry about it too. My entire week was disrupted because of all of this, for the nth time—I couldn't actually tell you which time it is, 'cause I stopped counting hospital visits. I can't even get into all the ways our lives have been complicated because of this—with the medication being both the solution to and the problem behind so many things.
That doesn't mean I can't also see those with addiction as people deserving of my sincere sympathy and compassion. Addiction is a medical condition too, and perhaps paradoxically, it can cause real pain as well, and not just from withdrawal. I would think you might know something about this yourself, if you're dealing with a similar medical situation. The person I care for needs the pain medication to deal with real, unrelenting agony and nausea. Yet it's highly likely they're also becoming somewhat substance-dependent after several years of this. That's addiction too. That's just human physiology—you can't even draw a line there. Though I guess you can try.
But I mean, even if I grant your implication that the difference between the people we care for and the people you term "junkies" or "addicts" are that those with substance-abuse problems somehow did it to themselves, well, sometimes the person I care for could somehow be considered to have somehow done it to themselves, if by that you mean they bring pain upon themselves by not being a perfect medication-dispensing robot. Nor do we own anything such as a medication-dispensing robot that's also a robotic chef calibrated to make meals to meet their specific medical needs. We muddle through. They're human, and as I'm sure you know, it's hard to be a human and have to take up to a dozen medications every day, multiple times a day, while maintaining a modified diet that doesn't even make any sense due to how many conditions it's meant to address, and not choose incorrectly sometimes, not misjudge the severity of an oncoming attack on occasion, not take that pill exactly on time, not want to depart from the diet every so often for a celebration.
When we bought our house, we had a glass of champagne with the seller when they accepted our offer—and within 24 hours, we were back at the hospital. In retrospect, maybe we shouldn't have done that. But fuck. Even the "good" humans who take pain medication for serious chronic health conditions want to be human sometimes, or just make the wrong call, and pay for it dearly. There's no need to pile judgment on top of that as well. Arbitrarily dividing people with substance dependency into "good" and "bad" does our shared cause—wanting adequate medical care and pain management for people who really need it—no favors, because that line will always be blurry and humans tend to be judgmental and make mistakes. If you want your loved ones not to be preemptively judged and discriminated against, I'll just suggest it would behoove you to reserve your own judgement of those whose conditions you don't know and whose circumstances you haven't experienced.
I know, on a deep level, the pain of the type of circumstances you describe. It's taught me to have compassion and empathy beyond what I might have otherwise developed thus far in life. And so accordingly, my advice is to listen more and judge less.
posted by limeonaire at 10:20 PM on January 12, 2018 [16 favorites]
As the caregiver to someone who's gone through exactly this for years now following the procedure that was supposed to fix the problem; who's got a case of medical PTSD they don't even know how to deal with that's damaging our relationship; who's endured all the degrading and inconvenient things one has to navigate nowadays to get a basic prescription for pain medication filled; who's endured the trip to the emergency room many, many times, only to get obnoxious questions from medical professionals that assume they somehow put themselves in this state through poor diet or too many or too few pain pills or drug-seeking behavior or whatever, while they're next to me barely able to speak, writhing from pain and nausea...I hear you on this. I'm angry about it too. My entire week was disrupted because of all of this, for the nth time—I couldn't actually tell you which time it is, 'cause I stopped counting hospital visits. I can't even get into all the ways our lives have been complicated because of this—with the medication being both the solution to and the problem behind so many things.
That doesn't mean I can't also see those with addiction as people deserving of my sincere sympathy and compassion. Addiction is a medical condition too, and perhaps paradoxically, it can cause real pain as well, and not just from withdrawal. I would think you might know something about this yourself, if you're dealing with a similar medical situation. The person I care for needs the pain medication to deal with real, unrelenting agony and nausea. Yet it's highly likely they're also becoming somewhat substance-dependent after several years of this. That's addiction too. That's just human physiology—you can't even draw a line there. Though I guess you can try.
But I mean, even if I grant your implication that the difference between the people we care for and the people you term "junkies" or "addicts" are that those with substance-abuse problems somehow did it to themselves, well, sometimes the person I care for could somehow be considered to have somehow done it to themselves, if by that you mean they bring pain upon themselves by not being a perfect medication-dispensing robot. Nor do we own anything such as a medication-dispensing robot that's also a robotic chef calibrated to make meals to meet their specific medical needs. We muddle through. They're human, and as I'm sure you know, it's hard to be a human and have to take up to a dozen medications every day, multiple times a day, while maintaining a modified diet that doesn't even make any sense due to how many conditions it's meant to address, and not choose incorrectly sometimes, not misjudge the severity of an oncoming attack on occasion, not take that pill exactly on time, not want to depart from the diet every so often for a celebration.
When we bought our house, we had a glass of champagne with the seller when they accepted our offer—and within 24 hours, we were back at the hospital. In retrospect, maybe we shouldn't have done that. But fuck. Even the "good" humans who take pain medication for serious chronic health conditions want to be human sometimes, or just make the wrong call, and pay for it dearly. There's no need to pile judgment on top of that as well. Arbitrarily dividing people with substance dependency into "good" and "bad" does our shared cause—wanting adequate medical care and pain management for people who really need it—no favors, because that line will always be blurry and humans tend to be judgmental and make mistakes. If you want your loved ones not to be preemptively judged and discriminated against, I'll just suggest it would behoove you to reserve your own judgement of those whose conditions you don't know and whose circumstances you haven't experienced.
I know, on a deep level, the pain of the type of circumstances you describe. It's taught me to have compassion and empathy beyond what I might have otherwise developed thus far in life. And so accordingly, my advice is to listen more and judge less.
posted by limeonaire at 10:20 PM on January 12, 2018 [16 favorites]
Mod note: fshgrl, you’ve made your point. Let it lie. Thanks.
posted by restless_nomad (staff) at 10:24 PM on January 12, 2018 [3 favorites]
posted by restless_nomad (staff) at 10:24 PM on January 12, 2018 [3 favorites]
I did a little research a while back on chronic pain. One thing that came up is that many people who suffer from it are in no hurry to broadcast it for a variety of reasons (key among them the dissonance experienced when trying to communicate the reality of an "invisible" disability). Interesting then that one of the key symptoms to look for is rage, otherwise known as frustration's loud neighbor.
posted by philip-random at 11:25 AM on January 13, 2018 [3 favorites]
posted by philip-random at 11:25 AM on January 13, 2018 [3 favorites]
Treatment should absolutely be available for people who become addicted through recreational use, rather than punishment. But making medicine harder for everybody to get is most certainly not the answer.
posted by The Underpants Monster at 11:32 AM on January 13, 2018
posted by The Underpants Monster at 11:32 AM on January 13, 2018
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posted by I'm Not Even Supposed To Be Here Today! at 12:25 PM on January 12, 2018 [10 favorites]