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Second Opinion: The New Religion of Narcotics

Leap, Edwin MD

doi: 10.1097/01.EEM.0000429673.63575.29
Second Opinion

Dr. Leapis a member of Blue Ridge Emergency Physicians, an emergency physician at Oconee Memorial Hospital in Seneca, SC, a member of the board of directors for the South Carolina College of Emergency Physicians, and an op-ed columnist for the Greenville News. He is also the author of three books, Working Knights, Cats Don't Hike, and The Practice Test, and of his own blog, all available Read his past columns at, and follow him on Twitter at @edwinleap.



I just finished reading Neil Gaiman's fascinating novel, Gods of America. I first learned about his work by watching the movie Stardust.

One of the themes of Gods of America is that the deities of the old world came to America in the hearts of their followers, but over time lost their followers and their power. A war is arranged between the “old gods,” and the new ones that Americans instituted. Media, technology, and entertainment, among others, are the new deities for a new age.

I thought about it as I considered my work. It seems that every day of my life is an endless discussion about narcotics in the emergency department. Or is it a kind of liturgy to another new god?

“Can't I get no Lortabs?”

“I can't take Percocet, all I can take is Dilau, Dilaud…. What is it called? Dilaudid? I don't know anything about those drugs, you know!”

“I'm allergic to the 5 mg Vicodin, but I can take the 10 mg Vicodin just fine!”

“Somebody stole my Fentanyl patches and my morphine pills and all of my Oxycontin, and all I have left is my methadone, and I only have a few, but I don't see the pain doctor for another month. Now what am I supposed to do, doctor? Just suffer?”

“My nerves are torn up. I'm out of Xanaxes, and my brother's friends came over and stole all of my Klonopin and Valium! Sure, I still got some Ativan, but look at how I'm shaking! Oh, and I'm out of Suboxone.”

“See, doctor, I have the degenerating disc disease. I guess I've had chronic back pain since I was, oh, 14. That's 10 years I've suffered! Nobody will do anything for me, so I just take pain pills wherever I can get them. Can I get some Percocet?”

I could go on. It's dialogue in a bad novel. It's a sonnet to somnolence. It's an endless homage to anesthesia. It's all but worship.

So it must be a religion. The people I see are worshippers of pain and anxiety medications. Or maybe, they worship pain and anxiety, and they offer up the drugs to their deities. Or perhaps they are slipping into amazing dream states, sleeping all the time, and having epiphanies of wonder and delight. Scratch that. They're dreaming of television and snack food. Of reality shows and disability payments.



And the object or objects of their worship are taking a terrible toll in lives lost, as epidemic prescription drug abuse sweeps across the land. ( It's enabled by a culture that in its own way worships disability and victimization, incapacity and the medicalization of all things.

It makes sense, really. We cannot possibly suggest that anyone isn't telling the truth because truth is relative and defined by each person and to suggest that would be poor customer service, discrimination, or judgmental. We reject anything that might suggest an individual take responsibility or make good moral decisions because morality is relative and faith is irrelevant.

The internal discord and evil and even legitimate suffering of the human heart must be medical, must be made somatic and mechanistic so that it can be treated mechanistically, and so that no one need concern themselves with uncovering the layers of difficulty and untruth in the human heart, no one need ask hard questions or suggest that one may have guilt or fear for good reasons. All we want to do is call it pain and offer it a pill.

There you are, America. We worship at the feet of pain and pills. We offer our young and our old and our middle-aged to the sleepy gods who accomplish so little and cost so much and offer only restless dreams and ultimately breathless deaths.

I will not worship them. I hate them, but I acknowledge their power.

This article first appeared in Dr. Leap's blog at Comments about this article? Write to EMN

© 2013 Lippincott Williams & Wilkins, Inc.