The New Religion of Narcotics

I just finished reading Neil Gaiman’s fascinating novel, Gods of America.  Here’s a link to it on Amazon.  I first learned about his work by watching the movie Stardust, then reading the novel.

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 lose their followers and thus their power.  A war is arranged between the ‘old gods,’ and the new ones that Americans have instituted.  In the story, media, technology, entertainment and 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 5mg Vicodin, but I can take the 1omg Vicodin just fine!’

‘Somebody stole my Fentanyl patches and my Morphine pills, and all of my Oxycontin and all I have left is my Methodone, 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 ten 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 dialog 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 medication and anxiety medication.  Or maybe, they worship pain and anxiety, and the offer up the drugs to their deities.  Or perhaps they are slipping into amazing dream states, sleeping all the time, and having ephiphanies 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 a) truth is relative and defined by each person and b) to suggest that would be poor customer service, or discrimination or to be ‘judgmental.’   Furthermore, we reject anything that might suggest an individual take responsibility, or make good moral decisions because morality is relative and faith is irrelevant.

Thus, the internal discord and evil and even legititimate 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 a ‘pain’ and offer it a ‘pill.’

Well there you are, America.  We worship at the feet of pain and pills.  We offer our young and our old and our middle aged and vital 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.


9 thoughts on “The New Religion of Narcotics

  1. Hi Ed. Enjoyed your post! And I agree, as I see parents offering up their own children, spouses offering to sacrifice their marriages, workers ready to burn their jobs in the belly of Narcotic Baal. Entire families swallowed up and checked out. As an ER nurse and soon to be Practitioner carrying a Christian banner, I wish I could reach them all. Impossible. I do find,however; that on rare occassions there is that one willing to listen (at least until discharge)while you plant a seed that if allowed to grow would set them free. A pleasant fiction. Thanks.

  2. Wow, suddenly I have hope for physicians after reading your article. I dream that someday soon we take over medicine and do it right this time. Could it be that some of us are interested in not only taking care of people but also taking back our craft from the Godless machine of insurance and government? I was born and raised in East Tennessee and dream of going back one day to finish my career.
    thanks for putting your thoughts in words for us to read- now I have to find out what else you’ve written and go through it all.

  3. I am one of those you described. I was a Program Director until needing surgery for diverticulitis. Then an open partial colectectomy, with no pain meds. Bit My back and joints still hurt. Went to the doctors in my HMO and all said I was fine, just needed to exercise. I just found out I have severe osteoarthritis in my hip and need a new hip. AShould I get any pain relief fom that. I have never been a drug abuser but over 20 yeaqrs ago I was on SSDI. I manged to get off and had a good career. It was as if I never got off. Doctors just me and do not even listen. I used to call on behalf of clients and know I was treated with greater respect. If I had been treated with respect and quality care since going back on SSDI, Maybe I could have had the hip fixed and returned to work. I am in my sixties.

  4. That is a great tip especially to those new to the blogosphere. Short but very accurate info… Appreciate your sharing this one. A must read article!

  5. Edwin-

    A good commentary but most of the people you quoted (and I have no doubt that all of those were actually uttered by someone who must have imagined you were wearing your ‘Talk To Me Like I’m Stupid’ button that day)are not worshiping at the altar of Pain, just Pills. Almost no one is actually in pain, other than the pain of having to deal with reality unimpaired. And, sadly, society seems to be saying that this is OK.

  6. Frankly I think the new religion is data points. Hospitals are focusing on data points not patients and are firing doctors for not meeting data points such as LOS. These are docs who have fewer 72 hour returns, more compliments and less complaints -from anybody. New religion, data points.

  7. Edwin, Amen and thank you for writing so truthfully about this subject! We must all work in the same ED! P.S. We are not the instigators of this epidemic

  8. I actually had a patient tell me they were allergic to “Baby Vicodin.” Perplexed I asked what was baby vicodine and was promptly informed “I can only take the 10 mg.”

  9. Ed,

    I have shared your post with many. I have worked in emergency medicine for several years. One of the other trends I have noticed that just leaves me just perplexed, is the sense of entitlement many of these people have. The aggression they think they have a right to show. I have been threatened too many times to count, called every thing one could imagine, been hit, kicked, spit on, peed on as all of us have, but the other day one of these patients; whom is a very well known seeker (God forbid we peg anyone with that term anymore) cornered me when he found out he wasn’t going to get his requested drug and said “when I ask for something or tell you to do something I expect you to do it”. For the first time in 15 years I felt fear of harm at work and its all because I informed him we would not give him a prescription for his drug of choice.

    These people have caught on to this culture shift and know if they demand and or become aggressive we are going to give them what they want, as you said “we cannot not possibly suggest that anyone isn’t telling the truth…to suggest would be poor customer service, or discrimination, or to be ‘judgemental’.”

    It is time we take control back, when people truly need treatment they can get it. I have heard many of times we have to treat everyone the same, we want people to choose our hospital, we want them to leave here feeling they were listened to and cared for; we can achieve that and still not answer their every whim. Lets give what they need not what they want. Im sure that will have some saying “who am I to tell you what you need”, what I am saying is an emergency room is not a place to treat chronic pain. Have a pain management plan with your doctor, plan a head better, take responsibility for yourself and don’t get aggressive toward the ER nurse or physician because we give you one or two doses to treat you now and tell you to follow up with your primary care physician. Its not my fault you left your pain pills unsecured and they got “stolen”, your doctor wont give you anymore, etc. If someone comes into my driveway; drives away in my car because I left the keys in it, I wouldn’t go to the dealership demanding another one. I would be laughed off the lot. That way of thinking is absurd.

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