After listening to NPRs new podcast episode with kolodny and others on How to fight the opioid epidemic I came across many things that were problematic but the two issues that stuck out to me I will highlight below...

The 1st issue I had was kolodny’s narrow view of addiction.. Throughout the episode we heard tragic stories of people succumbing to addiction and dying of overdose.. In these stories we heard how they suffered with substance abuse issues, psychiatric issues, also people with

Socioeconomic issues as well.. Instead of discussing all these factors and how they can attribute to why someone can succumb to addiction kolodny wanted to focus on 1 thing being the main catalyst: Prescription opioids.. Dr. Carl Hart who is a neuroscientist has been doing some

great work in regards to studying drug exposure and addiction.. He mentions how the majority of people who take legal and illict drugs don’t end up becoming addicted.. He mentions how we have to talk about other factors as I have listed above instead of focusing simply

on drug exposure.. I agree with him ... to focus only on drug exposure is to miss out potentially on different things we could be helping the patient with (mental health, socioeconomic status etc).. The 2nd main issue that shocked me the most was his conflation of those who

have chronic pain issues vs those who succumb to substance abuse.. (caveat there are those who both have chronic pain and substance abuse issues as well).. At one point there was a caller who suffered with pain, and he made a comment about how he needed access to

Opioids for his painful condition and he was having a hard time getting it and he was being treated like a criminal for needing pain meds for his severe condition.. Kolodny’s response to this pain patient is below not the full quote but a partial quote

“Patients with pain have been disproportionately harmed by aggressive overprescribing of opioids, millions have become addicted, thousands have lost their lives. It’s not as if we HAVE THESE 2 DISTINCT GROUPS (emphasis mine). So I do feel we can do a better job of treating pain

but that doesn’t mean that opioids are the answer”.. when I heard him say that I was pretty shocked.. Instead of addressing this pain patient about their pain he lumped him in with those who become addicted and end up losing their life.. He stated there are no 2 distinct groups

This really flys in the face of millions of chronic pain patients who have no prior psychiatric issues, or issues with abuse who rely on opioids for relief (sickle cell, EDS,AA etc).. I think it’s really dangerous to not make a difference between these groups of

Patients and lump them all together in my opinion. I thought these were the 2 major issues I had with it. It’s sad Mr. Kolodny is controlling this narrative with his narrow minded views but hopefully some real change can come one day in regards to changing the narrative #TwitteRx