Magazine | March 20, 2017, Issue

Letters

Needles and other drug paraphernalia in a park in Philadelphia, Pa., 2017. (Reuters photo: Charles Mostoller)

Pain and Punishment

Psychiatrist Sally Satel’s piece “Treating Opioid Addiction” (March 6) favors “benign paternalism” in public policy regarding what some have hysterically called an “epidemic” but Dr. Satel more soberly calls a “crisis.” What caused this crisis? According to Dr. Satel, it all started when “patient advocates” and “narcotics manufacturers” encouraged some physicians to “over-prescribe” medications for such minor ills as “toothaches.” However, having said so, Dr. Satel immediately acknowledges that “the average drug abuser is not a person being treated for pain” but someone who “obtains pills from friends, shady doctors, or street sellers.” Just so. But if the main cause of the problem is neither misbehavior by physicians nor misbehavior by patients, why has the main response by government been to discourage conscientious physicians from prescribing seriously needed pain medication to responsible patients?

Max Hocutt

Via e-mail

Sally Satel responds: Mr. Hocutt puts his finger on a major tension: how to deliver good pain treatment while curbing abuse of prescription painkillers. The justification behind practices such as prescribing smaller amounts of medication and using prescription-monitoring programs is not to disadvantage pain patients, but to keep painkillers such as Vicodin and OxyContin out of general circulation, where they are prone to abuse by others. Patients with chronic pain are understandably worried and upset about being caught in a dragnet not intended for them. Better education for clinicians in managing both pain and the prescribing of opioids is one answer, but it won’t happen overnight.

Command and Control

Kevin D. Williamson’s article “Progressivism in the Boardroom” (March 6) exposes the liberal-corporate-executive command-and-control mentality. “The boss is always right even when he’s wrong” is difficult to challenge. Williamson did not touch upon the group psychological manipulation taking place on school boards and in corporate board rooms. Several books explain the “how to” and “positive side” of group psychological manipulation. CEOs and superintendents see nothing ethically wrong with developing strategic-planning consensus in this fashion; indeed, they are supported by human-resource companies, some listed on the New York Stock Exchange. Board members and employees know something is wrong but can’t quite put their fingers on it. In 2002, Beverly K. Eakman wrote a book titled “How to Counter Group Manipulation Tactics” and subtitled “The Techniques of Unethical Consensus-Building Unmasked.” It should be required reading for anyone with a command-and-control boss.

George Hulshart

Myrtle Beach, S.C.

NR Editors includes members of the editorial staff of the National Review magazine and website.

In This Issue

Articles

Features

Books, Arts & Manners

City Desk

A City of Shopkeepers

The city is full of walk-in businesses — shops, stores, eateries, bars, banks, fix-it places. That means the streets are full of business names. Many belong to chains — Victoria’s ...

Sections

Politics & Policy

The Week

‐ We’re told the envelope given to Warren Beatty actually contained Nate Silver’s projection. ‐ To replace Michael Flynn as national-security adviser, Donald Trump selected someone uniquely suited for the position. ...
Politics & Policy

Poetry

GLOUCESTER Lizard-voiced, the seagull, esurient And flush with light, cuts through sapphire and salt Waves, to gratify pure appetite. Granite endures like graves. Briars bloom. On planks and shelves, books dock like sailing ships And wait ...
Politics & Policy

Letters

Pain and Punishment Psychiatrist Sally Satel’s piece “Treating Opioid Addiction” (March 6) favors “benign paternalism” in public policy regarding what some have hysterically called an “epidemic” but Dr. Satel more soberly ...

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