Words Matter Edition

The opoid crisis kills thousands of Americans. Where did the idea that opoids weren’t addictive and could be freely prescribed come from? Let me show you. This is from the article from Slate Magazine: Bad Footnotes Can Be Deadly, A one-paragraph blurb helped cause the opioid crisis. That’s just the start of science’s citation woes. 

Read below –

Back in 1979, Boston University Medical Center researchers Jane Porter and Hershel Jick found that just a handful of the patients who’d been treated with narcotics at a set of six hospitals went on to develop drug dependencies. Their single-paragraph summary of this resultwould be published as a letter to the editor in the NEJM under the heading, “Addiction Rare in Patients Treated With Narcotics.”

According to the recent correspondence in NEJM, this single paragraph was cited hundreds of times in the 1990s and 2000s to support the claim that prescription painkillers weren’t that addictive. It was during this period that doctors started treating pain much more aggressively than they had before and handing out potent drugs with little circumspection.

A tiny article grew in influence by being cited hundreds of times to prove that narcotics weren’t addictive when in fact all it said that under hospital conditions, that is, careful and close monitoring, narcotic use seldom led to addiction.

The tens of thousands of Americans with a serious problem with prescription drugs would no doubt be delighted to hear that a study of hospital care had been extrapolated to prove that handing out narcotics like candy at Halloween wouldn’t cause any problems.

What fascinates me is the power of a handful of words. Here we have just a few words. The original paragraph is just 101 words long. And yet the effects were dramatic. They were magnified by poor use of citations and an apparent desire to see what everyone wanted to see, that the free use of narcotics wouldn’t cause any problems. And these few words with the assistance of wishful thinking and poor writing habits reshaped our world, our reality.

I was reflecting the other day that over the past eight years, I may have written as many as a million words in my blogging and other writing. Sometimes, it seems that these have had little effect but there are many who do read me and how can I tell what will be the import of my work? It may be indirect. It may be long term but if there is anything that is obvious from this little story  –  it is that words do have consequences.

James Pilant

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