I think Manal Fakhoury should be praised for her presentation about the opioid crisis regarding both its origin and its consequences. In doing so, she identifies a prominent ethical issue as well as a very important aspect of drug addiction recovery. The ethical issue that I am referring to is the notion of nonmaleficence. For those unaware, nonmaleficence is a principle of moral duty to do no harm or the least amount of harm that is possible. Doctors, upon entering the profession, swear an oath to uphold this principle. Manal hints that the opioid epidemic may be the result of a possible violation. Manal describes a paradigm shift in medicine towards pain treatment following publication of a journal article stating that the addictive properties of opioids may inhibited in the presence of pain. With pain as the “5th vital sign”, providers began to prescribe the narcotic medication without barrier. Manal saw its effects first hand, both as a pharmacist filling prescription for oxycontin and vicodin “like candy without any red flags” and a prison counselor witnessing the devastating consequences of addiction. It is here that we find the ethical dilemma. While the prescription of opioid medication for pain management may have had a positive intention, its consequences of addiction has plagued the United States contributing to the decreases in life expectancy for a second consecutive year, something that has not occurred in over five decades. Under the moral imperative of nonmaleficence, the medical care provider is obligated to do no harm, or at least do as little harm as possible. In this case, increases in opioid prescription and addiction may have led to an increase in overdoses from both the prescription drug and its illicit form found on the street. One can argue that the increased prescription of opioids for pain management without regulation resulted in consequences that vastly outstripped its benefits. Thus, the principle of nonmaleficence may have been breached. Manol suggests a new paradigm shift in treatment and argues that pain should not be treated with opioids but should instead be treated with social support and emotional connection. While I do believe that opioid medication has its place in medicine for management of severe intractable pain, I feel that Manol brings up a very important point regarding the treatment of pain and addiction. She highlights the importance of humanistic medicine that provides empathy in the absence of apathy; that provides community in the absence of stigmatism. It is this paradigm shift in medicine that in conjunction with pharmaceutical interventions such as Methadone programs and Naltrexone can provide the best means of combating the opioid epidemic. Again, medical care providers have the obligation to cause no harm or the least amount of harm possible. This idea nonmaleficence is ingrained in the medical profession, and I believe that Manol’s shift towards a more humanistic treatment approach provides a good starting point
First off, I love your transparency!! Thank you for your honesty, regarding when you admitted to being one of the people without empathy! (I also loved when you said you have been "hanging out in prisons." This definitely challenges the thinking of many of the viewers who have only preconceived notions about prisons & inmates from what they've seen in movies or read in books.) You have never been afraid to think outside of the box & do things that are unorthodox - at least since I've come to know you. And that's what makes you so well-rounded, so creative, so intelligent. As far as TEDx Talk, it hit home - HARD! Being an ex-inmates, & I one who has had several friends & family members who have struggled with drug addiction/abuse, I feel compelled to spread your message. Our families, our friends, our neighbors & the world at large need to hear this talk & grasp this message. I love your analogy & appreciate your proposal of a solution toward positive change & potential cure. You rock, Dr. Fakhoury!! Thank you!!!
Excellent message that definitely needs more air time. Thanks for stepping forward and sharing your expertise and experience. If anyone can facilitate change, it's you!
Manal, I'm so blessed to have crossed paths with someone that everyone on different levels of life can look up to. From inmates to professional speakers, we are all human and I'm glad you're highlighting this! Thank you for being a great leader for past, present and future generations. That's how to leave a legacy!
Manal Fakhoury, since hearing your talk on Oct. 14, 2017, it seems this epidemic of opioids have been in the news daily. I truly enjoyed your talk. Thanks!
OMIGOSH! Dr. Manal! You REALLY ROCKED IT, GODDESS!!!!! You touched my heart to the point of tears several times in this presentation, releasing SO MUCH PASSION in the truth you are declaring. I will listen again and again, to get this into my soul, to let you pull me into action! Thank you for doing this, for rising to the need, for modeling real Leadership as a Professional and a Human, especially a human face of the Sacred Life that makes us One. What a Universal, Divine Human you truly are!
This is a great way to fight against the people who need these medications and live in pain. Hope your proud of yourself. Addicts aren’t new. They won’t follow your rules. But people in pain will be the ones that suffer in there lives.
The opioid epidemic is a growing issue in today’s society. In the 1990’s pain became the fifth vital sign. This meant that physicians were now expected to resolve a patient’s pain along with other symptoms, which was believed to coincide with the principle of nonmaleficence in healthcare. For many, this meant reaching a pain goal of zero on a zero to ten scale. Physicians who did not fully resolve a patient’s pain were at risk of being viewed as negligent. Unfortunately, for many patients this goal is unreasonable, particularly following a multitude of surgeries and malignancies that have negatively impacted their overall health. As time progressed, an increasing number of patients were prescribed increasing doses of opioid pain medications to manage pain symptoms. Opioids work by inhibiting pain receptors, thereby decreasing pain. As the dose is increased, patients can begin to develop an increasing number of pain receptors, which leads to further increases in opioid dose to manage increased pain over time. I do agree that many members of society may require pain medications to achieve a near normal life due to the severity of their symptoms, however some patients have been prescribed very high doses of opioid pain medications over time, which may be disproportionate to true pain level. These patients are not inherently addicts, and they may not be drug seekers. On the other hand, physicians have over time continued to increase their opioid dose due to reported increases in pain, and they are now unable to wean off of the medication. Opioid usage is dangerous for the body at high doses over extended time periods. Indicating that addicts will never change is an example of a hasty generalization. These patients may be experiencing increased pain or other complications secondary to high-dose narcotic use, and they may experience difficulty weaning off of the medications even if they desire to do so due to withdrawal symptoms. In this case, these patients require support from a healthcare team in order to overcome the addictions they have acquired. Although patients cannot truly die from pain alone, shock secondary to extreme pain or severe withdrawal can be problematic. I do not propose that opioids be entirely removed from the healthcare system, and that is not the goal of many working against the opioid epidemic. There are, however, a multitude of other interventions that can be taken to reduce pain. For example, radiofrequency ablation procedures have been effective at reducing lumbar pain for many patients. Ultimately, promoting use of more interventional procedures and fewer opioids may reduce the rate of addiction while also improving pain for patients.
The Thinking💡Cap Channel supports this message. Thank you for providing a solution to this major problem in today's society!! Looking forward to sharing this thought-provoking, action-compelling talk!
Manal, thank you for bringing this important information to us. It was a great speech I thoroughly enjoyed. It certainly is an idea whose time has come.
And opiates are so good at what they do. They numb pain and give you the illusion that things are okay. We all want things to be okay....and they never are. Addicts are just people wanting to be happy like everyone else.
The real problem is not prescription opioids but illegal drugs. Less than 2% of chronic intractable pain patients are addicted. Only dependent on pain meds to live a near normal life. The war on opioids is hurting millions of responsible chronic pain med users. Media will soon be reporting on the large number of CPP's dying from unbearable pain. There is a need for helping addiction and for treating patients in intractable chronic pain.
I have chronic intractable pain and my body is addicted to the medications prescribed to me by my pain management doctor. I don't take more than prescribed only what they give me monthly. It takes the edge off and allows me to live my life. Unfortunately my body is addicted and it will take months to safely get off these pain medications. If I don't taper I will go into withdrawal. People die from that too.
I am so angry that Blacks were stigmatized and criminalized and were given no empathy during the crack epidemic. But now we have so much love and compassion and treatment for opioid addicts....I wonder why?
I’ve seen first hand police not take action against major pull dealers, but rather sit near their house and arrest the addicts once they turn the corner after a buy. The major dealer was tatted out many times, but the police just kept arresting addicts, sending them through the system, putting them in debt. Some addicts got clean, but other people just took their place. The dealer never got arrested. He finally retired and moved with his fortune of money. Guess it’s a cash cow. Rehabs, institutions, jails, prisons, counselors, research, medications to fight the addictions made by the same companies that make the opiate pills. The cycle continues.
This may be once side, but there is another side for those who suffer chronic pain and require prescription opioids. You have obviously never suffered from chronic pain and its not all emotional pain lady.
The opioid crisis needs all of us. Well done.
I think Manal Fakhoury should be praised for her presentation about the opioid crisis regarding both its origin and its consequences. In doing so, she identifies a prominent ethical issue as well as a very important aspect of drug addiction recovery. The ethical issue that I am referring to is the notion of nonmaleficence. For those unaware, nonmaleficence is a principle of moral duty to do no harm or the least amount of harm that is possible. Doctors, upon entering the profession, swear an oath to uphold this principle. Manal hints that the opioid epidemic may be the result of a possible violation. Manal describes a paradigm shift in medicine towards pain treatment following publication of a journal article stating that the addictive properties of opioids may inhibited in the presence of pain. With pain as the “5th vital sign”, providers began to prescribe the narcotic medication without barrier. Manal saw its effects first hand, both as a pharmacist filling prescription for oxycontin and vicodin “like candy without any red flags” and a prison counselor witnessing the devastating consequences of addiction. It is here that we find the ethical dilemma. While the prescription of opioid medication for pain management may have had a positive intention, its consequences of addiction has plagued the United States contributing to the decreases in life expectancy for a second consecutive year, something that has not occurred in over five decades. Under the moral imperative of nonmaleficence, the medical care provider is obligated to do no harm, or at least do as little harm as possible. In this case, increases in opioid prescription and addiction may have led to an increase in overdoses from both the prescription drug and its illicit form found on the street. One can argue that the increased prescription of opioids for pain management without regulation resulted in consequences that vastly outstripped its benefits. Thus, the principle of nonmaleficence may have been breached. Manol suggests a new paradigm shift in treatment and argues that pain should not be treated with opioids but should instead be treated with social support and emotional connection. While I do believe that opioid medication has its place in medicine for management of severe intractable pain, I feel that Manol brings up a very important point regarding the treatment of pain and addiction. She highlights the importance of humanistic medicine that provides empathy in the absence of apathy; that provides community in the absence of stigmatism. It is this paradigm shift in medicine that in conjunction with pharmaceutical interventions such as Methadone programs and Naltrexone can provide the best means of combating the opioid epidemic. Again, medical care providers have the obligation to cause no harm or the least amount of harm possible. This idea nonmaleficence is ingrained in the medical profession, and I believe that Manol’s shift towards a more humanistic treatment approach provides a good starting point
First off, I love your transparency!! Thank you for your honesty, regarding when you admitted to being one of the people without empathy! (I also loved when you said you have been "hanging out in prisons." This definitely challenges the thinking of many of the viewers who have only preconceived notions about prisons & inmates from what they've seen in movies or read in books.) You have never been afraid to think outside of the box & do things that are unorthodox - at least since I've come to know you. And that's what makes you so well-rounded, so creative, so intelligent.
As far as TEDx Talk, it hit home - HARD! Being an ex-inmates, & I one who has had several friends & family members who have struggled with drug addiction/abuse, I feel compelled to spread your message. Our families, our friends, our neighbors & the world at large need to hear this talk & grasp this message. I love your analogy & appreciate your proposal of a solution toward positive change & potential cure. You rock, Dr. Fakhoury!! Thank you!!!
Thank you for your courage to address pharmaceutical companies.
Amazing leader, speaker and community activist. This subject is so important right now.
Fantastic Talk! I love the clear action steps you gave us. Thank you for giving your powerful voice to this serious issue.
Excellent message that definitely needs more air time. Thanks for stepping forward and sharing your expertise and experience. If anyone can facilitate change, it's you!
Manal, I'm so blessed to have crossed paths with someone that everyone on different levels of life can look up to. From inmates to professional speakers, we are all human and I'm glad you're highlighting this! Thank you for being a great leader for past, present and future generations. That's how to leave a legacy!
Manal Fakhoury, since hearing your talk on Oct. 14, 2017, it seems this epidemic of opioids have been in the news daily. I truly enjoyed your talk. Thanks!
Thank you Brenda. All the best.
Free from drugs, turn to Jesus. No amount of substance can numb your guilt and shame, only His blood shed for us on the cross.
OMIGOSH! Dr. Manal! You REALLY ROCKED IT, GODDESS!!!!!
You touched my heart to the point of tears several times in this presentation, releasing SO MUCH PASSION in the truth you are declaring. I will listen again and again, to get this into my soul, to let you pull me into action!
Thank you for doing this, for rising to the need, for modeling real Leadership as a Professional and a Human, especially a human face of the Sacred Life that makes us One. What a Universal, Divine Human you truly are!
Thank you Di, you are an encourager.
I have watched your talk several times. Thank you.
This disease needs all of us, thank you for your message.
Well done! Great message delivered by a wonderful leader.
This is a great way to fight against the people who need these medications and live in pain. Hope your proud of yourself. Addicts aren’t new. They won’t follow your rules. But people in pain will be the ones that suffer in there lives.
The opioid epidemic is a growing issue in today’s society. In the 1990’s pain became the fifth vital sign. This meant that physicians were now expected to resolve a patient’s pain along with other symptoms, which was believed to coincide with the principle of nonmaleficence in healthcare. For many, this meant reaching a pain goal of zero on a zero to ten scale. Physicians who did not fully resolve a patient’s pain were at risk of being viewed as negligent. Unfortunately, for many patients this goal is unreasonable, particularly following a multitude of surgeries and malignancies that have negatively impacted their overall health. As time progressed, an increasing number of patients were prescribed increasing doses of opioid pain medications to manage pain symptoms. Opioids work by inhibiting pain receptors, thereby decreasing pain. As the dose is increased, patients can begin to develop an increasing number of pain receptors, which leads to further increases in opioid dose to manage increased pain over time. I do agree that many members of society may require pain medications to achieve a near normal life due to the severity of their symptoms, however some patients have been prescribed very high doses of opioid pain medications over time, which may be disproportionate to true pain level. These patients are not inherently addicts, and they may not be drug seekers. On the other hand, physicians have over time continued to increase their opioid dose due to reported increases in pain, and they are now unable to wean off of the medication. Opioid usage is dangerous for the body at high doses over extended time periods. Indicating that addicts will never change is an example of a hasty generalization. These patients may be experiencing increased pain or other complications secondary to high-dose narcotic use, and they may experience difficulty weaning off of the medications even if they desire to do so due to withdrawal symptoms. In this case, these patients require support from a healthcare team in order to overcome the addictions they have acquired. Although patients cannot truly die from pain alone, shock secondary to extreme pain or severe withdrawal can be problematic. I do not propose that opioids be entirely removed from the healthcare system, and that is not the goal of many working against the opioid epidemic. There are, however, a multitude of other interventions that can be taken to reduce pain. For example, radiofrequency ablation procedures have been effective at reducing lumbar pain for many patients. Ultimately, promoting use of more interventional procedures and fewer opioids may reduce the rate of addiction while also improving pain for patients.
The Thinking💡Cap Channel supports this message. Thank you for providing a solution to this major problem in today's society!! Looking forward to sharing this thought-provoking, action-compelling talk!
I loved your empathy and compassion.
Manal, thank you for bringing this important information to us. It was a great speech I thoroughly enjoyed. It certainly is an idea whose time has come.
Addiction is pain, it’s broken people, people who are looking for the ability to live with peace and happiness they can’t find anywhere else
And opiates are so good at what they do. They numb pain and give you the illusion that things are okay. We all want things to be okay....and they never are. Addicts are just people wanting to be happy like everyone else.
This is so true.
@@barb7124 Truth💪🏽
Amen
So true
Thank you for taking us through history.
A great speech Dr. Manal, thank you
Excellent talk. Needed to hear this.
Thank you to all my friends and colleagues that are sharing more information with me and others regarding the Opioid Crisis.
Amazing lady with an amazing message!!!
Great talk. Excellent message.
Very educational and compassionate.
Thank you for sharing the truth.
In withdrawal now. Thank you for your support 🙏
That was actually an excellent speech..... 👍
Thank you. Great message and well done.
On point. Thank you. I enjoyed this talk.
Great video Jason A played you and I had to hear more of you . Thank you
Thank you, I really enjoyed your talk.
The real problem is not prescription opioids but illegal drugs. Less than 2% of chronic intractable pain patients are addicted. Only dependent on pain meds to live a near normal life. The war on opioids is hurting millions of responsible chronic pain med users. Media will soon be reporting on the large number of CPP's dying from unbearable pain. There is a need for helping addiction and for treating patients in intractable chronic pain.
There are plenty of people who took legally prescribed medications for an acute use and then got addicted.
I have chronic intractable pain and my body is addicted to the medications prescribed to me by my pain management doctor. I don't take more than prescribed only what they give me monthly. It takes the edge off and allows me to live my life. Unfortunately my body is addicted and it will take months to safely get off these pain medications. If I don't taper I will go into withdrawal. People die from that too.
Very informative and great suggestions.
Thank you, I am sharing with my network.
This is AWESOME 👏🏽
Thank you for your helpful videos thank you
MERCI! love from france
I am so angry that Blacks were stigmatized and criminalized and were given no empathy during the crack epidemic. But now we have so much love and compassion and treatment for opioid addicts....I wonder why?
It was a different time
Beautiful
Thank you for your guidance.
Defining and Defeating the opioid crisis. Yes!
Addiction hurts so bad.
I’ve seen first hand police not take action against major pull dealers, but rather sit near their house and arrest the addicts once they turn the corner after a buy.
The major dealer was tatted out many times, but the police just kept arresting addicts, sending them through the system, putting them in debt. Some addicts got clean, but other people just took their place. The dealer never got arrested. He finally retired and moved with his fortune of money.
Guess it’s a cash cow. Rehabs, institutions, jails, prisons, counselors, research, medications to fight the addictions made by the same companies that make the opiate pills. The cycle continues.
This may be once side, but there is another side for those who suffer chronic pain and require prescription opioids. You have obviously never suffered from chronic pain and its not all emotional pain lady.
It’s pronounced OxyCONTIN not oxyCOTTON. How are you an expert on a drug you can’t pronounce ?
Is that all you got out of this? Rlly?
Yes, it's a brain illness. We need to work together.
This video doodoo
True
People are doing from street drugs, not prescriptions