Unmasking The Truth: The Shocking Reality Of The Opioid Epidemic And Who’s Really To Blame


By Jay K. Joshi, MD

Glide your hand over a piece of velvet and you notice the smoothness. You feel its aggregated smoothness, not the individualized roughness of each fiber. Each fleeting fiber, a prick of truth, is nullified, synthesized, and then magnified into the silky fluency of general perception—propaganda containing within it a concoction of ambiguities and assumptions, cooked with a splash of outright lies and a dash of truth. This is to ensure the intrigue rises to a level that is just right, just unbelievably believable. I experienced this dish, served in all its varieties with all the flair and pomp, until I could eat no more. And then the dish forced its way down my throat.

My first taste came during my last days of seeing patients. On a Friday, I received a call that indicated I was to be indicted. I had to first search the term to verify its definition, and even then, I did not grasp its immense implications. I was not yet able to process that I was being accused of a crime. I continued seeing patients the next day, Saturday—a physician until the very end. I reported to the federal courthouse in Hammond, Indiana, on Monday.

The courthouse is a truly impressive building in an otherwise dilapidated neighborhood. I suppose there is symbolism in that contrast, but I was too consumed with my own symbolism to pay that contrast any mind. The legal proceedings were brief, surprisingly polite, and more ceremonial than judicial, with none of the fanfare one might expect in what was—or perceived to be, at least—a high-profile criminal case. That soon contrasted with the virulent propaganda in which I was immersed—article by article, drop by drop.

The first news article, a harmless drop in an otherwise empty bucket, made its presence known through a transient splash … followed by a moment of silence. And the moment was over, disrupted by another drop and then a rapid series of drops, until they were no longer drops, but a stream. A rumbling, noisy stream of news and hearsay overflowed from the bucket, spreading out with accelerating aggression to permeate the minds of readers, gossips, and rumormongers. Then the stream turned into a flood, a deluge of destruction, ensuring its presence was felt and its impact known.

News reports claimed I gave pills to relatives and acquaintances of federal agents and coordinated a multistate drug operation. Those who followed the flood as closely as I floated in it likely learned what was written about me at the same time I did. We learned I was the top prescriber of opioids in the area I practiced, and one of the top opioid prescribers in the state of Indiana. We even heard I was impersonating another physician.

The articles grew to be so numerous they competed for attention with one another. The crafting of each article became a coordinated dance, a bid for attention between reader and writer. These writers used scandal to attract readers, twisting key facts, deliberately introducing ambiguities to create an air of suspense in an evolutionary process of journalistic adaptation—attention being the competitive prize.

The outright dishonest articles soon went extinct, leaving articles more successfully fit—in the most Darwinian sense—for navigating the ever-blurring distinction between truth and fabrication. Each article’s competitive advantage came from the selective use of sensationalistic terms or buzzwords and phrases appearing regularly as to warrant the familiarity of trust but unique enough to captivate with the thrill of novelty.

Soon the words danced from article to article, displaying different styles and techniques, sometimes subtle, sometimes crude. The dance became as enticing to the reader as the underlying content. In such a dance, some readers create their own perceptions as much as they respond to what they read. The coordination of perception and reaction continued, increasing in fervor, inside the minds of my colleagues, friends, and family—manifesting the most acute responses with utmost subtlety.

I noticed them all: the double looks, the unnatural pauses, the off-kilter body movements, the side-to-side eye sprints, and my favorite—the tight-lipped, blank-faced stare of someone trying but failing to hide emotions, as though by forcing silence, that person can avoid an unwanted conversation. The articles written were rarely discussed aloud; most people maintained a muted silence. But I could feel every word they’d read, line by line, from the looks on their faces.

While most simply avoided discussing the situation, not knowing what to say, some reveled in it, taking liberty to lash out with biting remarks, taunts, and jeers. Others saw opportunity at every twist and self-promotion at every turn.

Many physicians, some within my referral network, turned on me to designate my practice as the epitome of the opioid epidemic in health care gone awry, conveniently substituting allegations for facts and suppositions for hard data. They printed inflammatory materials and wrote scathing articles in local newspapers and on their personal blogs discussing my case, while keenly promoting their clinical practices, hoping their efforts toward social justice would net a pretty penny in the process—holding true to the saying, “Never let a good crisis go to waste.”

One pain specialist I had referred patients to self-published a scathing editorial, contrasting my indictment with the experiences of physicians who had suffered physical attacks from patients for refusing to prescribe controlled substances. Though these attempts at self-righteousness were thinly veiled self-promotions, they still hurt, and the closer the previous relationship, the more personal the wound.

Hysteria emanating from the opioid epidemic affects how we discuss and understand it and causes extreme responses. The more we simplify the conversation about how the epidemic grew to what it is now, the more we gravitate toward extreme, sensationalized interpretations around its beginnings and who is to blame. By now the terms “irrationality” and “misinformation” define the epidemic as much as the words “addiction” and “fentanyl.” When hysteria overtakes rational examination of the epidemic, the conversation is reduced to a never-ending array of accusations.

Jay K. Joshi is a family physician and author of Burden of Pain: A Physician’s Journey through the Opioid Epidemic.



  • Dismantle the current CDC board of directors. Replace members with actual doctors. The CDC, center for disease control. Should be doing their jobs, as we now see malaria in the US, along with other diseases, we thought we had already dealt with. It only makes good sense to replace these so-called doctors, really rehab, clinic owners, or investors. And replace them with Doctors that are controlled by the AMA. The CDC reports to the FDA, the FDA had nothing to do with the guidelines. Government overreach. There are so many sick, hurting, miserable people, that we’re not that way prior to 2016. You have taken away quality of life from millions. You have allowed Americans to be tortured by the CDC. Many have already chosen suicide, and there are many more that are planning an exit strategy. When you took away the peoples right to a quality of life, you took life away from them. We are isolated, because we can no longer go for a walk in the park, go for a drive in the car, never mind ever taking another vacation. We have had a right to dream of something better taken away from us. Because what good is it to dream? Do you want to move? Or to even want to go on a vacation? No, there is no more dreaming, of the things will do. With our family and friends. Isolation is probably the worst thing you have done to people. We become isolated as our friends, stop calling, and stop coming by, we’re not invited to get togethers. No one wants to be around someone in pain. Now, here, in the state of Georgia, which I come from South Carolina to see my doctors there. I have an internal medicine doctor, that I see every eight weeks, and now, according to the latest letters sent out from the DEA, the pain management doctor that I see, has to see me every 4 to 6 weeks. I’m actually wanting to cry as I’m writing this. 2016, I took my last two month vacation. I traveled through Minnesota Wyomi, North Dakota, South Dakota, and made our way to Colorado. I saw Mount Rushmore. That was all I could do as even then, my pain was still not completely Gone, and never will be. But I was at least able to do things. I saw the famous corn maze building that is put up on the outside of a building every year. It was amazing. I saw the badlands and visited Mount Moriah. I left a cigarette for wild Bill Hickok. I also saw Devils Tower, and was able to walk up to its base, get up on a rock, and with my hands spread up above my head, laughing. I sell so much more but I think you get the point. The next year my medicine was cut to a quarter of what I had been taking. So there went my grandkids coming to spend a week with their Naff, because I could no longer lift my baby Grandchildren. I don’t blame my child for not letting the grandkids come spend time with me. She sees how much pain I am in, and as a concerned, parent, she worries about my health, especially if the children are there, so that was also the year I lost my family. I still have faith that there are good people out there. I believe that one all Americans have come up against their own pain experience, you will hear more voices. Of course the CDC will spinet and create the narrative they want but people are not stupid. And they’re going to wake up, and they’re going to demand new leader ship. A

  • The medical community needs to stand with and support a doctor and their patients.

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