Tab Clearing: Trump on Afghanistan; Opiates and Pain

In this op-ed, a knee surgery patient exhibits frustration at being treated like a potential drug abuser for using opiates for post-surgery pain. I'll cut to the chase, for those who feel lazy:

The thing is, there are millions of Americans who aren’t an addiction liability just because they want a narcotics prescription post-injury or post-surgery. Yes, the government says nearly 80 percent of heroin users first misused opioid prescriptions, but the research being cited refers to people who illegally obtained those prescription opioids. Not patients.

In conclusion, Orthopedic Surgeon (and all doctors, really), can you ease up on prohibiting medications that help patients in pain to relax a bit? They’re not terrible drugs. They’re terrible drugs in the wrong hands.

I am of an age that I know people who have had major orthopedic surgery and cancer. For orthopedics, there's not much worse than a knee replacement. An orthopedic surgeon told me that the knee is a far more complex joint than the hip, as the knee has several degrees of motion. Despite the glowing ads that some hospitals run for their joint replacement centers, the recovery from knee replacement can be long and brutal. Shoulder surgery has the reputation of having a recovery period that people put off having it.

Add in people dealing with spinal deformities and cancer and you have a large number of people who are dealing with prolonged and debilitating pain. Opiates help, not necessarily to make them pain-free, but to knock enough of the edge off that people can function.

So how are they treated? They're treated like drug abusers. Bring in the pills for a count. Take a piss test to ensure that the drugs are being used. If they try to taper off for a time, that effort is treated as if it's permanent, leaving them high and dry for a reoccurrence of pain. But the worst is the emotional impact of being told that although they are in pain, they're being looked at with a gimlet eye because they must be incipient druggies.

As a result, patients try to deal with pain on their own and they suffer. Nobody seems to care. Certainly not the politicians, who have jumped on the "all opiates are bad" bandwagon. The doctors have been given the message that if any badged-up DEA flunky thinks they may have overprescribed, at the very least, they'll take away the doctor's prescription pad and maybe go after their license. So they'll settle for having patients suffer.

The pendulum has swung too far.

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Now, on to Trump:

President Donald Trump paid a surprise Thanksgiving visit to Afghanistan ... During his visit, Trump announced that the U.S. and Taliban have been engaged in peace talks and insisted the Taliban want to make a deal after heavy U.S. fire in recent months.

The Taliban's leaders are not stupid. They can read a calendar as well as anyone else. They know, full well, that Trump is standing for re-election next year and that he started campaigning the day after he was sworn in. They know that Trump has promised to get out of Afghanistan. They know that the person who is most anxious for a deal is Trump.

In short, the party that is most eager to make a deal is Trump, not the Taliban. That gives them them the edge in any negotiations, and they know it. Trump may not, for he seems to have an ability to see his own version of reality, a world where there are kind-hearted Nazis, that the Mall in Washington was packed for his Inauguration and so on.

Don't be surprised if Trump gives away the store in exchange for a deal. We've seen this movie already.