1) This morning, as I listened to Chapter 10 (America’s Three Opioid Epidemics) of Dr. Travis Rieder’s book, “In Pain: A Bioethicist’s Personal Struggle with Opioids,” I could not control the outpouring of tears that rushed down my cheeks.

#MedTwitter #NurseTwitter #OpioidCrisis

2) I was overcome with sadness and “righteous” anger as I came to grips with the observations that many minorities had long seen, but the country is now witnessing.

#Race #Equity #Access

3) Specifically, on the bottom of page 231, the Dr. Rieder recalls a question that he got after one of his early talks on the opioid epidemic:

4) “I don’t remember which venue it was, but I remember who asked it: she was a black woman—middle-aged and petite, with kind eyes and a disarming demeanor—and she stood quietly for what seemed like a long time before she finally asked her question.

5) “Why do you think we’re just now talking about opioids so much? I mean: all of a sudden, it’s everywhere; you’d think we just discovered drugs in this country.”

6) The author gave an academic answer referencing the role of pharmaceutical companies, the rise of the fifth vital sign, etc. However, in hindsight he realized that he misunderstood her question.

7) After he finished, the woman responded, “That all may be true, but I want to suggest something else that you might want to think about a bit… It’s because white kids started dying…

8) You see, I’ve had an opioid epidemic in my community for as long as I can remember, but we don’t talk about that one. It’s a crisis now that white kids in West Virginia die from OxyContin instead of black kids in the city dying from heroin.”

9) There is no doubt that race and demographics have influenced how American society tackled the opioid epidemic. Back then, it was the “War on drugs” and it affected poor Black communities—particularly Black men, who were then arrested and sent to prison, or even killed.

10) Some of them are still in prison today. Now it’s the “Opioid Epidemic” affecting suburban/rural white kids who get access to needle exchange programs, access to safe injection sites, and access to addiction/rehabilitation services—instead of being thrown into prison.

11) The former problem—“The War on Drugs”—was handled via the Criminal Justice System and Americans morally judged Black Americans. The latter problem—“The Opioid Epidemic”—is being handled as a health care issue.

12) Ultimately, both problems are health care issues, and I’m glad that we are now starting to address it as such.

However, must the U.S. always wait to address our societal problems when it affects white Americans or the family members of politicians and celebrities?

13) It seems like Tupac was right all along, “They Don’t Give a F*** About Us.” Tupac further elaborates in his song “Letter to the President” and “Changes.”

14) Back in the 1990s, Black artists shared their stories via music and pleaded for the country to see/understand the problems afflicting minority communities.

15) Despite my previous efforts to not allow racism or micro-aggressions to outwardly affect me (because I thought it would not help me be an effective leader), I’m realizing that is does affect me: racism is a chronic stressor—even when I am not thinking about it.

16) Perhaps this is one of many reasons why Black Americans—not Black people living in other countries—have worse outcomes with several diseases.

17) I am tired of always having to prove myself—just to be included.
I am tired of the undue stress of “representing” the rest of the Black community—we are NOT a monolith.
I am tired of proving that ALL people—including Black people have value and bring new insight to the table.

18) America, open your eyes!
Appreciate the value that diversity has to offer.

When I think about the Civil Right’s movement, the beneficiaries are not just Black Americans, but also other minorities/immigrants, women—in short, everyone living in the United States of America.

19) As we tackle this Opioid Epidemic, let’s remember to have empathy for ALL victims of this crisis—regardless of race, gender, sex, socioeconomic status, religion, or creed.

20) Let us ensure that our actions/responses are not selective—i.e., let us make sure that the appropriate treatment is available to ALL victims.

21) Thank you Dr. Jody Leng ( @jodyleng) for including this book as part of our Regional Anesthesiology & Acute Pain Medicine Fellowship curriculum.

22) Thank you Dr. Travis Rieder ( @TNREthx) for being vulnerable by sharing your story and providing the reader with insight about pain, the Opioid Epidemic, and the flaws in our health care system.

23) Thank you Dr. Travis Rieder ( @TNREthx) for also acknowledging your privilege and using it to give that Black woman a voice.

24) I strongly encourage everyone to read this book (or listen to it as I did with my daily walks) especially anyone involved in the following fields:

25) Health Care: physicians, nurses, medical students, physical therapists, allied health professionals, hospital administrators, hospital executives, pharmaceutical companies, etc.

26) Public Service: Politicians (especially members of Congress, senators, governors, judges), police officers, teachers, state and federal agents, etc.

· Science, Technology, Engineering, and Mathematics

The book is available here: https://www.amazon.com/Pain-Bioethicists-Personal-Struggle-Opioids-ebook/dp/B07JZBPPL1

27) The audio book is available here (It’s free if it’s your first time accepting a book from a friend): https://www.audible.com/search?keywords=in+pain%3A+a+bioethicist&ref=a_ep_freetr_t1_header_search

@Stanford_RAAPM @StanfordPain @IASPpain @AmerMedicalAssn @ASALifeline @POTUS #OpioidCrisis @KamalaHarris @CDCgov @AP #BlackLivesMatter #BlackTwitter