Stanford Medicine Newsletter Updates For the Local Community


Stanford Medicine physicians shed light on the opioid epidemic

Anna Lembke


Overdose from prescription opioid painkillers and stimulant benzodiazepines represents the leading cause of injury deaths in the United States today, a surge that did not happen overnight.

Two Stanford Medicine researchers have written new books exploring the epidemic from distinctly different angles, with the goal of helping people understand the dangers of prescription painkillers and gain control over chronic pain.

Drug Dealer, MD
How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop

Stanford psychiatrist and addiction researcher Anna Lembke, MD, outlines how prescription drug overuse is largely a result of well-intended doctors trying to help patients with real pain and complex problems. Using anecdotes and personal stories from her clinical work with patients and families, Lembke weaves a powerful narrative of how the prescription drug epidemic came to be, and what can be done to address the systemic issues that contribute to it.

“This book is my attempt to understand how well-meaning doctors across America — most of whom became doctors in the first place to save lives and alleviate suffering — ended up prescribing pills that are killing their patients and how their patients, seeking treatment for illness and injury, ended up addicted to the very pills meant to save them,” said Lembke, assistant professor of psychiatry and behavioral sciences, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. This is Lembke’s first book, drawing from her more than 20 years of clinical experience working with patients who are misusing or addicted to prescription drugs. The book will be released Nov. 1.

Drug Dealer, MD uncovers the forces driving the epidemic using examples and statistics that health-care providers, policymakers, patients and families can understand. Lembke writes in a compassionate tone, yet her call to address the systemic issues in health care that lead to overprescribing harmful drugs is clear. She argues that the culprits behind the rise in prescription drug addiction are bureaucratic medical policies that prioritize short-term patient satisfaction over long-term well-being, financial ties between doctors and pharmaceutical companies, and a cultural narrative that rejects pain as a normal part of life. She believes that at the heart of the problem is a broken doctor-patient relationship, which can be restored only by rethinking how health care is delivered.

“The prescription drug epidemic is a canary in the coal mine,” Lembke said. “It’s a symptom of deeper systemic problems in all of health care, a sentinel warning that we have deep structural problems in the way medicine and pharma are embedded. It’s a clarion call for change—for all patients and for the doctors who treat them.”

Beth Darnall


The Opioid-Free Pain Relief Kit
10 Simple Steps to Ease Your Pain

Pain psychologist Beth Darnall, PhD, offers patients practical tools to reduce pain without prescription painkillers. Using her personal experience with chronic pain and more than 15 years of clinical experience, Darnall outlines ways patients can target the daily thoughts, emotions and actions that trigger pain. The book includes a CD designed to calm the nervous system.

“We know the best way to treat ongoing chronic pain is with a comprehensive approach,” said Darnall, clinical associate professor in the Division of Pain Medicine at Stanford Medicine. “Learning how to calm the nervous system is a critical aspect of pain management. This book gives patients the tools they need to reduce their pain by teaching them to control the factors that amplify and intensify pain.”

By examining and addressing factors that can drive pain, such as stress, fear and anxiety, poor sleep, lack of exercise and loneliness, the bookaims to help patients reduce pain and maximize pleasure in everyday life. Darnall’s research and work with patients demonstrate that even if opioids are prescribed, they should be part of an overall, comprehensive care plan that includes pain psychology, self-management, movement therapy or appropriate exercise, and other disciplines. Her book, which is now available, is written in simple language, making the information easy to access and understand.

“My goal was to make this book accessible to anyone who needs it,” Darnall said. “We have a pain epidemic in this country, and doctors and patients are looking for ways to treat pain without opioids. With the right choices, patients can train their brain away from pain and reduce their need for painkillers. The results are life-changing.”

Lembke will speak on Doctors and the Opioid Addiction Crisis at 7 pm on Thursday, Nov. 10, at Stanford Health Library, Hoover Pavilion, 211 Quarry Road, Palo Alto. The event is free, but seating is limited. Call 650-498-7826 to register.

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