His confirmation appointment "hearing" has not even been scheduled yet - though the ones so far have been little more than senator grandstanding (R >> D).
The rest of your blurb sounds about right, though too gentle
Sticking just to the addiction issue: of we need more care, better care, accessible care, and treatment that actually works for more people. I worry that when one person who has found an answer for themselves, they become a proponent of that answer as the answer for everyone, and so may it be with RFK,JR and 12 step programs -- they work when they work, but for the majority they do not. His thinking can be simplistic -- one can live a healthy lifestyle, but it will not change the fact that people with healthy life styles still get sick -- the answer to the childhood obesity problem is likely not just a healthier school lunch. It's a starting point, it has worked for him, but his focus for the secretary of HHS needs to be broader, evidence-based, and to include treatment, not just prevention. If the safety data is there for obesity, you can ask people to eat healthy food and exercise and also provide medications for those who need them--be it methadone or semaglutide. He and Dr. Oz may well prove to be too busy quelling the polio and measles outbreaks they inspire...
Great piece. I think RFK jr is a mixed bag. “Promoting healthier lifestyle”? Fly at’er.
I think his willingness to deviate from conventional wisdom on some things will be a welcome breath of fresh air. I also think his skepticism could be put to good use.
But as you note, otoh, is the downside of the vaccine quackery business on some very established agents with very long track records.
And that’s been the issue all along. Will he be a net positive? I’m not sure.
Thank you for this paper. I share your approach to addiction and rehabilitation. In my earlier life as a Paramedic, I saw the “failures” when patients overdosed and I was called to administer naloxone and airway care. Frustrating was taking them to the ER where they would sit alone for hours, sometimes restrained, while waiting for the psych resident on call to visit them. I recall continuing conversations begun in the ambulance and often made some good connections. There just was no system for their care that showed any signs of hope. I would often meet them again with an opiate overdose. That was in the ‘70’s to the ‘90’s. Now these years later as a Pastor….well I don’t see these folks any longer. I pray that some consistent treatment can be devised and funded to provide hope. I am thankful I was in the field long before the fentanyl crises came into being. Heroin seems so mild in comparison…buy stock in the manufacturers of naloxone is what I should have done. God bless you all as you care for these folks who need a loving patch forward.
Although I agree with you on the Wellness Farms, there is one gigantic hole in your reasoning. Methadone is pure cruelty and insanity. It is 10x as addictive as heroin and takes 10x the length of time to get off of in. In fact, without some really creative use of medical interventions, one can not quit methadone. I have cold turkeyed that drug twice in my life and it is the most hellish experience imaginable. You can't intake water, you can not sleep, you can not ear, you can not think, all you can do is suffer for upwards of 35 days, which is why people that use it to quite heroin, literally a 3-5 day withdrawal experience that can be suffered by most anyone, never get off of methadone. They merely remain in a chemically shackled existence, enslaved to a dispensing counter until they die.
At least the US military has the decency to put methadone addicts into 2 month induced coma to get off of it. That method works, but aside from myself, I know of no one who has ever gotten themselves off of methadone.
To suggest methadone as a sane or rational mitigation for opiate addiction is practically unbelievable and it is even more suspect to do so in a world that has Kratom. The US government was not trying to help anyone in need, when they created methadone. They were merely creating a research arm for some of their darker practices.
Thank you for sharing your own story, Andi! I agree with you wholeheartedly. I've been an addiction therapist for more than 12 years and patients I have treated over the years say with both methadone and suboxone: I should have just stayed on heroin.
One thing I hear so rarely in MAT discussions is naltrexone. Why isn't that being pushed more and/or becoming more available? I've seen wonders with the use of that drug...and it's not an opioid!
Honestly, I was unaware of naltrexone until just now. My own insight comes from personal addiction and then the seemingly infinite opportunities to help get others through the recovery.
Once i learned about kraton i pretty much stopped researching additional tools. Kraton tinctures work fast, provide immense reluef and have negligible withdrawal symptoms once the opiates are completely out of the system. I did not know about kraton during my 2 seasons in hell, but it is incredibly effective and ive seen it work over 100x now. That's probably why there is s push to criminalize it.
Why people (MD's..) do not post articles written by people who lost many family members, ALL DUE TO 'modern med-I-CIN-e', in particular in 'covid' times??? RFKennedy't team documentary 'AUthorize to KILL' will show you some details, how hospitals 'accidentally' (NO, it was all covid 'protocolls') were killing the UN-vaccinated. It literally looks like for not only profit but to achieve the 'DEATH covid statistics' in order to go with their agenda. Let's not star talking Gene Therapies on clueless citizens, all under a pretext with a old falsified name of 'vaccines'...
SUbstack is censoring certain words, like ssam, redrum, backwards please..
I appreciate Sally’s article here. I also appreciate her views on being careful balancing medications used to help, especially with opiates. That being said, pharma will never stand for balance; they want lifetime patients. When I was working in chronic non cancer pain and addiction, I forbade any pharma reps from the unit and program. Shitty drug treatments came and went, and when suboxone came out in 2002 as a “miracle drug” I knew what that meant. The drug has value, helps many, but pharma only sees value and markets as such. That is not a stretch given history. That being said, medications can be useful but should rarely be permanent, just like with chronic non cancer pain.
RFK Jr doesn't object to vaccines. He objects to mandated vaccines with sometimes falsified studies that parents aren't able to give informed consent to because they're either coerced by doctors and the medical system or by state mandates (which were passed with heavy lobbying by the Phamaceutical companies), and which the companies have no liability for because of the 1986 National Vaccine Injury Act.
Why would you ever want a product forced on you that a company is unwilling to take liability for?
You can't have safe and effective vaccines if the companies aren't held responsible for them and have FDA and CDC officials bowing to approve so they can get lucrative jobs as lobbyists after their sting at the FDA/CDC.
Wow...he's not objecting to vaccines....why do you think that?...oh wait I know...its because NONE of you on the Sensible Medicine team have EVER bothered to sit down and have an actual face to face discussion with anyone noteworthy OUTSIDE your tribe of thought. I'm especially disappointed in Dr Prasad.....dude is on point on just about everything...however...its becoming difficult to continue to hold him in esteem as an advocate of science integrity when he won't do the hardest but most essential thing that needs doing in the fight for integrity...is have conversations with those who disagree with you. he talks about it a lot but never does it. I'm hopeful he will find that next gear and punch it. This reminds me of a video I watched once from Dan Wilson "debunk the funk" (who, by the way, works for an mRna company) dissing Dr. Ryan Cole for wanting people to come visit him in his lab....Mr. Wilson said that's stupid, why doesn't he just publish a paper on it..if he can" ....see THATS THE WHOLE PROBLEM WITH YOU ACADEMICS...( and I think this is where Prasad is stuck as well) you want so badly for the weapons or bullets in this debate/war to remain about the "papers" ....so no Danny boy....Dr. Cole wants people in his lab, so they can talk face to face and discuss what they can see and touch in real time. I encourage Sensible Medicine to pivot to this. Seek people from "that tribe" you know who I'm talking about....and start publicly interacting with them.
Re: "objecting to vaccines". One has to listen to what RFK, Jr says in order to understand his stance. One might have to use other platforms to find his speeches/long form interviews as YT likes to ban/censor. Due to his spasmodic dysphonia (began in his 40's, maybe from a flu shot - NO! flu shots are safe & effective!), his voice can be challenging to listen to but it is worth the effort. People should listen and consider what he has to say before piling on with smearing and repeating "misinformation". Maybe some minds will be opened. His story of how he got dragged into the vaccine controversy is eye-opening.
Nope. Most want NYT, WAPO, MSNBC, trusted govt agencies (and pharma CEOs) to tell them what to think (via propaganda) regarding RFK, Jr. Do your own research, consider other viewpoints? The horror! Is it OK to ask questions re: the pediatric vaccine schedule? Is it OK to ask why someone needing TKR was forced to receive mRNA shots prior to surgery? It is OK to ask if it's safe to receive 3 "vaccines" at the same time when in heart failure pending cardiac transplant? The patient decompensated but, oh well. No, it is not OK. Trust the experts. Roll up your sleeves and submit.
The novel mRNA delivery platform? A lot of us plebes object to these products. “Vaccines" via the updated 2021 definition no longer stop infection or transmission of a pathogen. Whatever, let’s compare a mutating respiratory virus to polio and smallpox. Shut up, mRNA shots are SAFE & EFFECTIVE. Got it?
The entire planet was coerced via a relentless media fear campaign to submit to modified mRNA injections called “vaccines” or else DIE regardless of age or comorbidities. The "unvaccinated" were selfish murderers, lost jobs/livelihoods, banned from public spaces, families/friendships broken up, M.D.'s threatened with loss of license if provided anything deemed "misinformation" re: the novel "vaccines", every human deemed a threat if not “vaccinated”. But wait, the...breakthrough…infections and…what about...natural immunity. Hmmm. No. Never mind. Oh yeah, that one guy - the highest paid govt. employee, the venerable Dr. F. - declared who got to NOT congregate together on holidays in private homes. "No one should be walking around wearing a mask" he said, then we were all wearing bandanas pulled up around our noses outside in the winter because it's so easy to get this scary virus OUTSIDE. Blue surgical masks? Never meant to stop viral transmission. Yes, that happened. Countless injuries as a result of experimental mRNA injections. Gain of function research? Whatt? A bat kissed a pangolin, dummy! But let's not talk about that, let's move on!
THIS: our trusted experts at CDC are - today - recommending infants receive THREE mRNA Covid-19 injections by 9 months of age....but that's a big nothing burger, right?
From the perspective of a judge who runs a drug court in California, this article is spot-on and it appears RFK has much to offer, at least in the realm of treating addiction.
I am skeptical of these claims that opiate replacement drugs reduce deaths by 50%. The study you cite is behind a paywall so unfortunately, I couldn’t read it. I suspect there are some serious confounding issues with these studies.
I knew someone who was on a methadone program, so I have some ideal as to how they work. She had to go in every day for the drug and underwent random tests to determine if she was using other opiates. The penalty for using was termination from the problem.
When people leave a methadone program, it could be because they were kicked out, or perhaps they just want to go back to using heroin. Of course, the OD rate will rise. Advocates of methadone like to make it sound like people left to go to AA, where the AA’ers then forced them off the drug, after which they OD’d and died. I suspect that never happens. There is a real anti-AA sentiment in the medical community. AA and similar programs seem to be the only thing that works long term.
I don’t see how methadone solves anything. It just delays the withdrawal date. Staying on it for life incurs awful side effects. Yes, I get the just so story, give them “therapy” until they are ready to taper. Let’s see some RCTs for that. The difficulty with opiate addition is not the 2-3 weeklong withdrawal discomfort, but removing the desire to feel the pleasure of the drug. Same with alcohol. AA/NA provides the free, intense 24 hour support system that recovering addicts need.
Disappointed to see Satel be so myopic. RFK jr is friends with long time addiction specialist and radio host Drew Pinsky MD. I think she is mistaken about RFK jr perspective and influences.
The post speaks to an important limitation in Medicaid coverage for residential treatment. What is missing on the Medicaid topic is the impact that proposed elimination of Medicaid expansion would mean for being able to pay for any treatment for many low income people with addiction. Addiction is not a qualifying condition for disability under Medicaid and thus it wasn't until Medicaid expansion that adults without dependent children who were addicted could qualify for Medicaid coverage. Many Medicaid reform recommendations call for either eliminating Medicaid expansion entirely or eliminating its enhanced match which would likely results in most states ending their Medicaid expansion program. This elimination could undermine state drug treatment diversion programs mentioned as a positive effort in this post
Excellent!
Kennedy was confirmed, and it is certainly a "new beginning," but of what?
RFK, Jr. introduced himself as a red-herring salesman with a strong affinity to limited hangouts:
https://rayhorvaththesource.substack.com/p/can-the-us-defund-the-who-the-wef
He contradicted himself several times:
https://rayhorvaththesource.substack.com/p/rfk-jr-contradicts-himself
He is selling hope for the disempowered and the desperate:
https://rayhorvaththesource.substack.com/p/this-is-not-about-rfk-jr
Bait-and-switch nearly always works, because people are so late at finding out details of just about anything:
https://rayhorvaththesource.substack.com/p/bait-and-switch-for-the-masses
His confirmation appointment "hearing" has not even been scheduled yet - though the ones so far have been little more than senator grandstanding (R >> D).
The rest of your blurb sounds about right, though too gentle
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Sticking just to the addiction issue: of we need more care, better care, accessible care, and treatment that actually works for more people. I worry that when one person who has found an answer for themselves, they become a proponent of that answer as the answer for everyone, and so may it be with RFK,JR and 12 step programs -- they work when they work, but for the majority they do not. His thinking can be simplistic -- one can live a healthy lifestyle, but it will not change the fact that people with healthy life styles still get sick -- the answer to the childhood obesity problem is likely not just a healthier school lunch. It's a starting point, it has worked for him, but his focus for the secretary of HHS needs to be broader, evidence-based, and to include treatment, not just prevention. If the safety data is there for obesity, you can ask people to eat healthy food and exercise and also provide medications for those who need them--be it methadone or semaglutide. He and Dr. Oz may well prove to be too busy quelling the polio and measles outbreaks they inspire...
Great piece. I think RFK jr is a mixed bag. “Promoting healthier lifestyle”? Fly at’er.
I think his willingness to deviate from conventional wisdom on some things will be a welcome breath of fresh air. I also think his skepticism could be put to good use.
But as you note, otoh, is the downside of the vaccine quackery business on some very established agents with very long track records.
And that’s been the issue all along. Will he be a net positive? I’m not sure.
Thank you for this paper. I share your approach to addiction and rehabilitation. In my earlier life as a Paramedic, I saw the “failures” when patients overdosed and I was called to administer naloxone and airway care. Frustrating was taking them to the ER where they would sit alone for hours, sometimes restrained, while waiting for the psych resident on call to visit them. I recall continuing conversations begun in the ambulance and often made some good connections. There just was no system for their care that showed any signs of hope. I would often meet them again with an opiate overdose. That was in the ‘70’s to the ‘90’s. Now these years later as a Pastor….well I don’t see these folks any longer. I pray that some consistent treatment can be devised and funded to provide hope. I am thankful I was in the field long before the fentanyl crises came into being. Heroin seems so mild in comparison…buy stock in the manufacturers of naloxone is what I should have done. God bless you all as you care for these folks who need a loving patch forward.
Although I agree with you on the Wellness Farms, there is one gigantic hole in your reasoning. Methadone is pure cruelty and insanity. It is 10x as addictive as heroin and takes 10x the length of time to get off of in. In fact, without some really creative use of medical interventions, one can not quit methadone. I have cold turkeyed that drug twice in my life and it is the most hellish experience imaginable. You can't intake water, you can not sleep, you can not ear, you can not think, all you can do is suffer for upwards of 35 days, which is why people that use it to quite heroin, literally a 3-5 day withdrawal experience that can be suffered by most anyone, never get off of methadone. They merely remain in a chemically shackled existence, enslaved to a dispensing counter until they die.
At least the US military has the decency to put methadone addicts into 2 month induced coma to get off of it. That method works, but aside from myself, I know of no one who has ever gotten themselves off of methadone.
To suggest methadone as a sane or rational mitigation for opiate addiction is practically unbelievable and it is even more suspect to do so in a world that has Kratom. The US government was not trying to help anyone in need, when they created methadone. They were merely creating a research arm for some of their darker practices.
Thank you for sharing your own story, Andi! I agree with you wholeheartedly. I've been an addiction therapist for more than 12 years and patients I have treated over the years say with both methadone and suboxone: I should have just stayed on heroin.
One thing I hear so rarely in MAT discussions is naltrexone. Why isn't that being pushed more and/or becoming more available? I've seen wonders with the use of that drug...and it's not an opioid!
Honestly, I was unaware of naltrexone until just now. My own insight comes from personal addiction and then the seemingly infinite opportunities to help get others through the recovery.
Once i learned about kraton i pretty much stopped researching additional tools. Kraton tinctures work fast, provide immense reluef and have negligible withdrawal symptoms once the opiates are completely out of the system. I did not know about kraton during my 2 seasons in hell, but it is incredibly effective and ive seen it work over 100x now. That's probably why there is s push to criminalize it.
Why people (MD's..) do not post articles written by people who lost many family members, ALL DUE TO 'modern med-I-CIN-e', in particular in 'covid' times??? RFKennedy't team documentary 'AUthorize to KILL' will show you some details, how hospitals 'accidentally' (NO, it was all covid 'protocolls') were killing the UN-vaccinated. It literally looks like for not only profit but to achieve the 'DEATH covid statistics' in order to go with their agenda. Let's not star talking Gene Therapies on clueless citizens, all under a pretext with a old falsified name of 'vaccines'...
SUbstack is censoring certain words, like ssam, redrum, backwards please..
I appreciate Sally’s article here. I also appreciate her views on being careful balancing medications used to help, especially with opiates. That being said, pharma will never stand for balance; they want lifetime patients. When I was working in chronic non cancer pain and addiction, I forbade any pharma reps from the unit and program. Shitty drug treatments came and went, and when suboxone came out in 2002 as a “miracle drug” I knew what that meant. The drug has value, helps many, but pharma only sees value and markets as such. That is not a stretch given history. That being said, medications can be useful but should rarely be permanent, just like with chronic non cancer pain.
RFK Jr doesn't object to vaccines. He objects to mandated vaccines with sometimes falsified studies that parents aren't able to give informed consent to because they're either coerced by doctors and the medical system or by state mandates (which were passed with heavy lobbying by the Phamaceutical companies), and which the companies have no liability for because of the 1986 National Vaccine Injury Act.
Why would you ever want a product forced on you that a company is unwilling to take liability for?
You can't have safe and effective vaccines if the companies aren't held responsible for them and have FDA and CDC officials bowing to approve so they can get lucrative jobs as lobbyists after their sting at the FDA/CDC.
Wow...he's not objecting to vaccines....why do you think that?...oh wait I know...its because NONE of you on the Sensible Medicine team have EVER bothered to sit down and have an actual face to face discussion with anyone noteworthy OUTSIDE your tribe of thought. I'm especially disappointed in Dr Prasad.....dude is on point on just about everything...however...its becoming difficult to continue to hold him in esteem as an advocate of science integrity when he won't do the hardest but most essential thing that needs doing in the fight for integrity...is have conversations with those who disagree with you. he talks about it a lot but never does it. I'm hopeful he will find that next gear and punch it. This reminds me of a video I watched once from Dan Wilson "debunk the funk" (who, by the way, works for an mRna company) dissing Dr. Ryan Cole for wanting people to come visit him in his lab....Mr. Wilson said that's stupid, why doesn't he just publish a paper on it..if he can" ....see THATS THE WHOLE PROBLEM WITH YOU ACADEMICS...( and I think this is where Prasad is stuck as well) you want so badly for the weapons or bullets in this debate/war to remain about the "papers" ....so no Danny boy....Dr. Cole wants people in his lab, so they can talk face to face and discuss what they can see and touch in real time. I encourage Sensible Medicine to pivot to this. Seek people from "that tribe" you know who I'm talking about....and start publicly interacting with them.
Re: "objecting to vaccines". One has to listen to what RFK, Jr says in order to understand his stance. One might have to use other platforms to find his speeches/long form interviews as YT likes to ban/censor. Due to his spasmodic dysphonia (began in his 40's, maybe from a flu shot - NO! flu shots are safe & effective!), his voice can be challenging to listen to but it is worth the effort. People should listen and consider what he has to say before piling on with smearing and repeating "misinformation". Maybe some minds will be opened. His story of how he got dragged into the vaccine controversy is eye-opening.
Nope. Most want NYT, WAPO, MSNBC, trusted govt agencies (and pharma CEOs) to tell them what to think (via propaganda) regarding RFK, Jr. Do your own research, consider other viewpoints? The horror! Is it OK to ask questions re: the pediatric vaccine schedule? Is it OK to ask why someone needing TKR was forced to receive mRNA shots prior to surgery? It is OK to ask if it's safe to receive 3 "vaccines" at the same time when in heart failure pending cardiac transplant? The patient decompensated but, oh well. No, it is not OK. Trust the experts. Roll up your sleeves and submit.
The novel mRNA delivery platform? A lot of us plebes object to these products. “Vaccines" via the updated 2021 definition no longer stop infection or transmission of a pathogen. Whatever, let’s compare a mutating respiratory virus to polio and smallpox. Shut up, mRNA shots are SAFE & EFFECTIVE. Got it?
The entire planet was coerced via a relentless media fear campaign to submit to modified mRNA injections called “vaccines” or else DIE regardless of age or comorbidities. The "unvaccinated" were selfish murderers, lost jobs/livelihoods, banned from public spaces, families/friendships broken up, M.D.'s threatened with loss of license if provided anything deemed "misinformation" re: the novel "vaccines", every human deemed a threat if not “vaccinated”. But wait, the...breakthrough…infections and…what about...natural immunity. Hmmm. No. Never mind. Oh yeah, that one guy - the highest paid govt. employee, the venerable Dr. F. - declared who got to NOT congregate together on holidays in private homes. "No one should be walking around wearing a mask" he said, then we were all wearing bandanas pulled up around our noses outside in the winter because it's so easy to get this scary virus OUTSIDE. Blue surgical masks? Never meant to stop viral transmission. Yes, that happened. Countless injuries as a result of experimental mRNA injections. Gain of function research? Whatt? A bat kissed a pangolin, dummy! But let's not talk about that, let's move on!
THIS: our trusted experts at CDC are - today - recommending infants receive THREE mRNA Covid-19 injections by 9 months of age....but that's a big nothing burger, right?
From the perspective of a judge who runs a drug court in California, this article is spot-on and it appears RFK has much to offer, at least in the realm of treating addiction.
I am skeptical of these claims that opiate replacement drugs reduce deaths by 50%. The study you cite is behind a paywall so unfortunately, I couldn’t read it. I suspect there are some serious confounding issues with these studies.
I knew someone who was on a methadone program, so I have some ideal as to how they work. She had to go in every day for the drug and underwent random tests to determine if she was using other opiates. The penalty for using was termination from the problem.
When people leave a methadone program, it could be because they were kicked out, or perhaps they just want to go back to using heroin. Of course, the OD rate will rise. Advocates of methadone like to make it sound like people left to go to AA, where the AA’ers then forced them off the drug, after which they OD’d and died. I suspect that never happens. There is a real anti-AA sentiment in the medical community. AA and similar programs seem to be the only thing that works long term.
I don’t see how methadone solves anything. It just delays the withdrawal date. Staying on it for life incurs awful side effects. Yes, I get the just so story, give them “therapy” until they are ready to taper. Let’s see some RCTs for that. The difficulty with opiate addition is not the 2-3 weeklong withdrawal discomfort, but removing the desire to feel the pleasure of the drug. Same with alcohol. AA/NA provides the free, intense 24 hour support system that recovering addicts need.
Disappointed to see Satel be so myopic. RFK jr is friends with long time addiction specialist and radio host Drew Pinsky MD. I think she is mistaken about RFK jr perspective and influences.
The post speaks to an important limitation in Medicaid coverage for residential treatment. What is missing on the Medicaid topic is the impact that proposed elimination of Medicaid expansion would mean for being able to pay for any treatment for many low income people with addiction. Addiction is not a qualifying condition for disability under Medicaid and thus it wasn't until Medicaid expansion that adults without dependent children who were addicted could qualify for Medicaid coverage. Many Medicaid reform recommendations call for either eliminating Medicaid expansion entirely or eliminating its enhanced match which would likely results in most states ending their Medicaid expansion program. This elimination could undermine state drug treatment diversion programs mentioned as a positive effort in this post