An affordable price is probably the major benefit persuading people to buy drugs at The cost of medications in Canadian drugstores is considerably lower than anywhere else simply because the medications here are oriented on international customers. In many cases, you will be able to cut your costs to a great extent and probably even save up a big fortune on your prescription drugs. What's more, pharmacies of Canada offer free-of-charge shipping, which is a convenient addition to all other benefits on offer. Cheap price is especially appealing to those users who are tight on a budget
Service Quality and Reputation Although some believe that buying online is buying a pig in the poke, it is not. Canadian online pharmacies are excellent sources of information and are open for discussions. There one can read tons of users' feedback, where they share their experience of using a particular pharmacy, say what they like or do not like about the drugs and/or service. Reputable online pharmacy take this feedback into consideration and rely on it as a kind of expert advice, which helps them constantly improve they service and ensure that their clients buy safe and effective drugs. Last, but not least is their striving to attract professional doctors. As a result, users can directly contact a qualified doctor and ask whatever questions they have about a particular drug. Most likely, a doctor will ask several questions about the condition, for which the drug is going to be used. Based on this information, he or she will advise to use or not to use this medication.

3 Corporations Take on Obamacare, Pelosi Mute

Maybe between Amazon, a tech company, JP Morgan, an investment company and Berkshire Hathaway, a financial think tank and provider could solve the corruption within government healthcare first…Just last year:

The Justice Department charged more than 400 people across the country in a major crackdown on health care fraud, officials said Thursday. The accused individuals cost the federal government $1.3 billion in false Medicare and Medicaid billings, according to authorities

The investigation focused on opioid-related crimes as the government continues to try to address the public health crisis that has been sweeping the country. Many of the health care providers charged had billed Medicaid and Medicare for drugs that were never purchased, while others took advantage of addicts by giving out unnecessary opioid prescriptions for cash or charging for false treatments, according to the Justice Department. More here.

It is pathetic that the FBI has an exclusive division to investigate and prosecute healthcare/government fraud.

The FBI is the primary agency for exposing and investigating health care fraud, with jurisdiction over both federal and private insurance programs. Health care fraud investigations are considered a high priority within the Complex Financial Crime Program, and each of the FBI’s 56 field offices has personnel assigned specifically to investigate health care fraud matters. Our field offices proactively target fraud through coordinated initiatives, task forces and strike teams, and undercover operations.

The Bureau seeks to identify and pursue investigations against the most egregious offenders involved in health care fraud through investigative partnerships with other federal agencies, such as Health and Human Services-Office of Inspector General (HHS-OIG), Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), Defense Criminal Investigative Service (DCIS), Office of Personnel Management-Office of Inspector General (OPM-OIG), and Internal Revenue Service-Criminal Investigation (IRS-CI), along with various state Medicaid Fraud Control Units and other state and local agencies. On the private side, the FBI is actively involved in the Healthcare Fraud Prevention Partnership, an effort to exchange facts and information between the public and private sectors in order to reduce the prevalence of health care fraud. The Bureau also maintains significant liaison with private insurance national groups, such as the National Health Care Anti-Fraud Association, the National Insurance Crime Bureau, and private insurance investigative units. More here.

Another pathetic item is during 2017, when the House repealed Obamacare and the Senate failed to do so….no one spoke to the whole fraud component which is in fact costing the taxpayers billions…..BILLIONS.

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So, will these companies come to the rescue for their own employees or perhaps lay the groundwork for total repeal?


“The ballooning costs of health care act as a hungry tapeworm on the American economy,” Berkshire Hathaway (brk-b) chairman and CEO Warren Buffett said in a statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”

Amazon, Berkshire Hathaway, and J.P. Morgan Chase are forming a not-for-profit health care venture to lower health care costs for their U.S. employees, the companies announced Tuesday morning, sparking a slide in the shares of a host of health care-related companies. The initial focus of the independent company will be on technology that will provide their U.S. employees and their families with simplified and high-quality health care at accessible costs, the companies said.

Drug distributors Cardinal Health(cah, -2.80%), AmerisourceBergen(abc, -2.73%) and McKesson(mck, -1.64%) were all down nearly 3%. Health insurers also fell, with the 6.2% drop in UnitedHealth(unh, +0.06%) the steepest.

The move comes amid growing speculation that Amazon is likely to enter the prescription drug business and that has sent tremors through the pharmaceutical supply chain.

“The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Jeff Bezos, Amazon (amzn, +0.69%) founder and CEO, said in the statement. “Success is going to require talented experts, a beginner’s mind, and a long-term orientation.”

The effort is in its early planning stages, the companies said, and the initial formation of the company would be led by Todd Combs, an investment officer of Berkshire Hathaway; Marvelle Sullivan Berchtold, a managing director of J.P. Morgan Chase; and Beth Galetti, a senior vice president at Amazon.

“Our people want transparency, knowledge and control when it comes to managing their health care,” said Jamie Dimon, chairman and CEO of J.P. Morgan Chase(jpm, +0.48%). “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”

“The ballooning costs of health care act as a hungry tapeworm on the American economy,” Berkshire Hathaway (brk-b) chairman and CEO Warren Buffett said in a statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”  Drugstore operators CVS Health(cvs, -1.85%) and Walgreen Boots Alliance (wba, -1.10%) as well as pharmacy benefits manager Express Scripts Holding(esrx, -0.13%) dropped between 4.5% to 6% in premarket trading. Hat-tip Forbes.

Maybe Obama, Pelosi and the rest of the Democrats should have consulted with Watson…

Watson Health value-based care offerings deliver innovation designed to help drive value for providers and health care organizations as those providers and organizations work to manage population health, deliver more efficient care, engage patients and consumers, and optimize business performance – through the power of data-driven insights.

Is IBM part of the problem or the solution?

Watson Health offers end-to-end solutions for providers and organizations pursuing greater value in healthcare by offering solutions such as the following.

  • Providers
    Robust data integration and aggregation, risk-stratified analytics, performance measurement reporting, care management and patient engagement tools.
  • Health plans
    Analytics utilized by health plans to: identify consumer insights and support acquisition marketing, support care management, empower consumers for more informed decisions, and execute risk score optimization and compliance reporting.
  • Employers
    Flexible delivery of tools to help employers increase value of benefits and programs and provide employees with personalized, relevant information to help them understand their benefits.
  • Pharmaceutical and bio-tech
    Studies based on real-world evidence to help pharmaceutical and bio-tech companies understand the market landscape. Health economics and outcomes research combined with stakeholder research and engagement and management tools.

In today’s value-based healthcare environments, costs and revenues often depend on how fast and how effectively you can identify and engage at-risk patients, members and employees. Our solutions help you gain insight from your data to stratify your populations, design targeted programs, close care gaps and align with quality measures and initiatives.

  • Outcomes: Leverage insights, outcomes and economics through solutions, expertise and partnerships.
  • Essential connections: Vastly improve your understanding of your members, stakeholders, patients or employees, to gain essential knowledge and data to breakdown silos.
  • Confidence: Provide greater evidence and clarity to help you make informed decisions.


Top Progressives/Dark Money Meeting at Cali Resort

Beyond Resistance it is called….watch that hashtag through 2020. Meanwhile, if Kamala Harris is there with Van Jones and George Soros with Nancy Pelosi, you know the agenda is being crafted.

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Resistance Royalty: Pelosi, Soros Headline Left’s Biggest Dark Money Conference

Private memo gives inside look at Democracy Alliance’s latest secret donor meeting

CARLSBAD, Calif.—A secretive three-day conference where big money liberal donors are plotting the next steps of the “resistance” will be headlined by Friday speeches by billionaire George Soros and Democratic House Minority Leader Nancy Pelosi, according to internal documents obtained by the Washington Free Beacon.

The Democracy Alliance, a donor club of deep-pocketed liberal donors that each pledge to direct hundreds of thousands of dollars in funding to approved left-wing groups, descended on California’s posh La Costa Resort on Wednesday morning for its fall donor summit. The group continued its tradition of secrecy, promising all members and guests of the summit their participation would “remain confidential.”

The 38 page conference program is found here.

The first page of the conference agenda, which was obtained by the Washington Free Beacon and can be viewed in its entirety below, lays out “participation guidelines,” explaining that the Democracy Alliance is a “safe place” for donors and activists to meet. Guests are instructed not to share members’ names with the press and not to post to any social media sites, to contact Democracy Alliance if “the media or a blogger” contacts them, and to “refrain from leaving sensitive materials out where others may find them.”

This latter directive was ignored.

The agenda for the meeting, titled “Beyond #Resistance: Reclaiming our Progressive Future,” lays out three full days of events culminating in a Friday night dinner headlined by Pelosi.

A few hours earlier guests can attend “A Talk with George Soros,” who will be introduced with a “special videotaped message” by Democratic senator Kamala Harris (Calif.).

All of the events are scheduled to take place at the La Costa Resort, which features 17 tennis courts of both clay and hard surfaces including one with 1,000 seats for spectators, 36 holes of golf on the Legends Course and the Champions Course, an array of pools including three hot tubs that overlook said golf courses, a spa building, and the Deepak Chopra Center, where guests can do yoga or receive mind-body medical consultations.

Pelosi and Harris are not the only two politicians to have a presence at the swanky conference—Pennsylvania governor Tom Wolf (D.) held a Thursday event on his reelection efforts, Sen. Amy Klobuchar (D., Minn.) will speak on Friday about “Russian interference in the 2016 election,” and Rep. Ben Ray Lujan (D., Minn.), who chairs the DCCC, will attend a “festive brunch” on Saturday morning. Also making a “special appearance” on Friday will be Virginia’s governor-elect Ralph Northam.

The agenda also lists “special guests” at the conference, some more famous than others. Attendees showcased in the agenda range from failed California politician Sandra Fluke to liberal CNN contributor Van Jones to Center for American Progress CEO Neera Tanden.

Jones was headlining a Thursday dinner on “going outside the bubble” and learning from Trump voters.

Not all events and prominent guests are listed in the conference agenda.

Not listed, for example, was a Thursday night happy hour hosted by Planned Parenthood president Cecile Richards, who was spotted in attendance.

Also not listed as a special guest at the conference was David Brock, who checked in early Wednesday afternoon and has made himself highly visible at La Costa—slowly strolling around the sprawling property and staying up at the hotel bar till past midnight.

Brock is not a “partner” of Democracy Alliance—in fact, he has worked to create his own liberal donor network—but groups he controls, such as Media Matters for America, are among the many groups Democracy Alliance directs funding to.

Not listed in the agenda or spotted at the resort has been billionaire Tom Steyer, one of Democracy Alliance’s most prominent members in the past. Pelosi publicly reprimanded Steyer earlier this month for running a $10 million ad calling for President Trump’s impeachment.

Also not listed in the Democracy Alliance program was a meeting held by Patriotic Millionaires, who gave a Thursday morning briefing on the “tax fight” and “what is at stake.” The briefing was delivered by Larry Mishel of Americans for Tax Fairness, Thea Lee of Economic Policy Institute, and Jacob Leibenluft, a member of the Obama administration’s National Economic Council who is now with the Centeron Budget and Policy Priorities.

Not all meetings at the conference are open to all guests. Some meetings are “by invitation only,” “for prospective partners only,” or for “partners only.”

Right before Pelosi’s speech, for example, will be a “Partners only” forum dedicated to “committing resources.” The Democracy Alliance has never made its commitment decisions available to the public.

Democracy Alliance president Gara LaMarche wrote in a letter to attendees included in the agenda that President Trump’s November victory was “the most cataclysmic election of modern history.”

They are show a film by Heather Booth….the founding director of Midwest Academy. Just a few minutes into this video, you can see that child care is a social issue….other people need to pay for it…setting the table as child care turned into political power.

The Midwest Academy has been the go-to training school for turning social justice organizing into practical lessons for social justice organizers. Trainers from the Academy will join CTCP-funded staff for a three-day training that will cover the essentials of community organizing and developing strategies to build organizational power.

In the 1980s, MA was indirectly responsible for funding Barack Obama’s early organizing work, which began in June of 1985 in Chicago. At the time, Obama received key support from the Catholic Campaign for Human Development (CCHD) and the Woods Fund of Chicago. In both cases, Ken Rolling — who was a high official with the Midwest Academy, a Woods Fund board member, and a longtime member of CCHD’s national committee — likely played a major role in dispensing this money.

To this day, MA continues to indoctrinate its students in “us-versus-them” ideology, thereby producing an ever-growing cadre of radicalized activists. One prominent MA graduate is Service Employees International Union (SEIU) president Andrew Stern.

MA’s training sessions — titled “Organizing for Social Change” — are typically five days long. They teach techniques of “direct-action organizing,” whereby people are made “aware of their own power” to “take collective action on their own behalf” and address such societal issues as “rising inequalty in income and wealth.” MA’s openly confrontational modus operandi is reflected in a quote, attributed to Frederick Douglass, which appeared on the Academy website’s homepage as of January 2011: “Power concedes nothing without a demand. It never did and never will.” The chief objectives of MA’s tactics are interrelated: “electing our people to office” and “changing laws and regulations.”

MA training sessions cover such topics as “choosing problems and issues” on which to focus, “understanding preconditions for social change movements,” and obtaining “good media coverage.” Role-play techniques are used in order to help students determine what tactics work best in various situations: e.g., “stand or sit, shout or remain calm, make threats or try to reach consensus.”

An inviolable core principle undergirding all of MA’s tactics is that in every case, activists must “target” a “decision maker”; i.e., a “person or persons” who can be “forced” to “give you what you want.” Observing a central tenet of Saul Alinsky’s community-organizing doctrines, MA emphasizes: “The decision maker is always a person, never as institution.” (Alinsky taught that the people’s discontent must be directed, without exception, at an identifiable face — “a personification, not something general and abstract like a corporation or City Hall.”)

Toward this end, MA activists commonly employ a technique known as the “accountability session,” whereby they target a specific person — e.g., a government official or corporate CEO who possesses the authority necessary to make a decision vis a vis a matter of concern to MA. The activists arrange to meet with this person, telling him or her that they merely wish to have a certain existing policy or plan explained to them. At the meeting, however, the official is confronted by a large number of angry protesters; their activities are directed by an experienced organizer who has analyzed the official’s personal and family life, political connections, and career to find vulnerabilities where pressure can be applied.

To provide an overall structure for its training programs, MA has produced a 425-page manual titled Organizing for Social Change, co-authored by former MA trainer Kim Bobo, MA co-founder Steve Max, and current MA executive director Jackie Kendall. This publication is widely used by radicals and community organizations around the world as a textbook on how to conduct direct-action organizing. Such groups as the Children’s Defense Fund, NARAL, the Sierra Club, and the United States Student Organization have used the manual for training purposes. The AFL-CIO has incorporated the manual’s teachings into its “Union Summer” training camp for labor organizers. Former AFL-CIO president John Sweeney and the Rev. Jesse Jackson have highly encouraged their supporters to read it.

In December 2005, MA announced its establishment of an annual “Heather Award,” in honor of Heather Booth’s decades of work as an activist leader.
To view a list of this award’s past recipients, click here.

In 2008, MA executive director Jackie Kendall served on the team that developed the first volunteer-training program for “Camp Obama,” a two-to-four day intensive course — run in conjunction with Barack Obama’s presidential campaign — designed to cultivate political activists who could help the Illinois senator win the White House.

MA endorsed the October 2, 2010 “March on Washington” organized by One Nation Working Together, an event whose purpose was to inspire “an intensive voter-mobilization program for Election Day 2010.”
For a list of other notable endorsers, click here.

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Trump’s EO Halting Insurance Subsidies Comes from Boehner


CNBC: The Trump administration will immediately stop making critically important payments to insurers who sell Obamacare health plans, a bombshell move that is expected to spike premium prices and potentially lead many insurers to exit the marketplace.

The decision to end the billions of dollars worth of so-called cost-sharing reduction (CSR) payments came after months of threats by President Donald Trump to do just that. The news came only hours after Trump signed an executive order that Obamacare advocates said could badly harm the individual insurance marketplaces.

Advocates, along with insurers, health-care provider groups, patient groups and officials in many states, have expressed concerns for months that the cost-sharing reimbursements would be cut off by Trump.

Senate Minority Leader Chuck Schumer, D-N.Y., sharply criticized Trump in a series of Twitter posts late Thursday.

Two months ago, the Congressional Budget Office estimated that individual health plan premiums would be 20 percent higher than originally projected if the payments ceased. It also projected that premiums would be 25 percent higher than they otherwise would be by 2020, and that the federal deficit would be increased by almost $200 billion if the subsidies ended.

The payments, worth $7 billion or so to insurers this year and up to $10 billion or more next year, reimburse insurers for discounts in out-of-pocket health costs they give to low-income Obamacare customers. The discounts must be offered by law.

However, congressional Republicans successfully challenged in a lawsuit the Obama administration’s decision to make the reimbursement payments to insurers without getting the express budgetary authorization from Congress.

Now, both California Attorney General Xavier Becerra and New York State Attorney General Eric Schneiderman said they would file lawsuits seeking to prevent Trump from ending the subsidies.

The two were part of a group of 18 state attorneys general who were given permission this year to intervene in the pending appeal of the federal court decision that had ruled the payments were illegal given their lack of congressional authorization.

*** While the democrats are crying sabotage, they refuse to tell you that there is a legal ruling that says this funding is illegal. The Obama administration via the Treasury Department essentially stole money from various government agencies to subsidize insurance providers since Congress did not appropriate the funds.

In part it played out this way:

When House Republicans first came up with the idea to take the president to court nearly two years ago, they planned to sue the administration over a completely different part of Obamacare. Then-Speaker John Boehner was, as usual, facing pressure from conservatives who were frustrated at Obama’s liberal use of executive authority and their inability to derail the hated health-care law. So he and his leadership team hatched a plan to file a lawsuit accusing the president and his administration of exceeding their authority by unilaterally delaying the implementation of the employer mandate in Obamacare. The requirement that businesses with more than 50 employees provide insurance to their workers had long been a big target for Republicans and one of the more contentious policies in the law. It was the middle of the mid-term congressional campaigns, and Republicans suspected the administration was delaying the mandate to put off the political pain of compliance until after the election.

“The president changed the health-care law without a vote of Congress, effectively creating his own law by literally waiving the employer mandate and the penalties for failing to comply with it,” Boehner said in a statement at the time. “That’s not the way our system of government was designed to work. No president should have the power to make laws on his or her own.” The irony was that House Republicans had repeatedly assailed the employer mandate as a jobs killer, and yet here they were suing to force the administration to implement it faster. Read more here.

Charlie’s Parents End the Fight for his Life

Charlie Gard case: Parents withdraw application to bring sick baby to US

FNC: With tears streaming down their faces, the parents of terminally ill baby Charlie Gard on Monday withdrew their application seeking to take the child to the United States for an experimental medical treatment, with the couple’s lawyer announcing “the window of opportunity has been lost.”

Attorney Grant Armstrong said at London’s High Court it was too late for the 11-month-old child to receive treatment. Recent medical tests revealed Charlie has irreversible muscular damage.

“It’s too late for Charlie,” Armstrong said. “The damage has been done.”

Charlie’s parents, Chris Gard and Connie Yates, cried in the courtroom as the lawyer announced the news — their last bid to seek permission to take their child to the U.S. for treatment.

“As Charlie’s devoted and loving parents we have decided that it’s no longer in Charlie’s best interests to pursue treatment and we will let our son go and be with the angels,” Yates said in court.

The couple was expected to present new evidence in court on Monday, but they arrived in court to say the dragged out case has wasted “time. A whole lot of wasted time.”

“Had Charlie been given the treatment sooner he would have had the potential to be a normal, healthy little boy,” Yates said, referencing the recent medical test that ultimately led to the couple’s decision to withdraw.

“I only wanted to give him a chance at life,” Yates said. “We will always know in our hearts that we did the very best for Charlie and I hope that he is proud of us for fighting in his corner.”

Charlie, who was born on Aug. 4, 2016, suffers from a rare genetic condition, Mitochondrial DNA depletion syndrome. He has brain damage and is unable to breathe on his own. Doctors at Great Ormond Street Hospital, where Charlie has been treated since last October, have been locked in a prolong court battle, claiming more treatment would only cause pain to the child. They have argued to switch off Charlie’s life support to allow him to die peacefully.

But Charlie’s parents dispute the claim and have argued that their child should receive every possible treatment until his death.

Opioid Crisis Then and Now

The Opioid Crisis Is Dire. Why We Need a National Conversation About It Separate From Obamacare.

Let’s be honest—the opioid crisis in America is huge, it is severe, and it is devastating. But this partisan-fought legislation just isn’t the place to put that funding. And it would likely do little to help stem and reverse the opioid crisis.

First, it’s not as though funding for opioid treatment and recovery has been absent from the federal budget. As recently as last month, Sen. Susan Collins, R-Maine, was touting signed legislation that spent more than $1 billion to fund recovery programs.

This money was authorized separately from the debate over Obamacare in two pieces of legislation known as the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act.

We know that prevention programs have worked in the past, whether they pertain to forest fires or drunk driving or, for that matter, the massive reduction in drug use we witnessed in the late 1980s and early 1990s.

Such a prevention program for the opioid crisis must start with leadership from the White House in leading these conversations and highlighting the devastation of substance abuse initiation.

It requires detailing what is driving the opioid epidemic—namely, illegal fentanyl, heroin, and other illegal drug use and diversion. It requires more law enforcement—from border and customs policies and cracking down on cartels to international initiatives. And it requires messaging to our youth. More here.


This Isn’t the First U.S. Opiate-Addiction Crisis

Doctors overprescribed painkillers in the 19th century. Eventually, they stopped.

Problem and solution. Source: Museum of Science and Industry, Chicago/Getty Images

Bloomberg: The U.S. is in the throes of an “unprecedented opioid epidemic,” reports the Centers for Disease Control. The crisis has spurred calls for action to halt the rising death toll, which has devastated many rural communities.

It’s true that there’s an opioid epidemic, a public health disaster. It’s not true that it’s unprecedented. A remarkably similar epidemic beset the U.S. some 150 years ago. The story of that earlier catastrophe offers some sobering lessons as to how to address the problem.

Opioids are a broad class of drugs that relieve pain by acting directly on the central nervous system. They include substances such as morphine and its close cousin, heroin, both derived from the opium poppy. There are also synthetic versions, such as fentanyl, and medications that are derived from a mix of natural and synthetic sources, such as oxycodone.

Opioid addiction can take many forms, but the current crisis began with the use and abuse of legal painkillers in the 1990s, and has since metastasized into a larger epidemic, with heroin playing an especially outsized role.

All of this is depressingly familiar. The first great U.S. opiate-addiction epidemic began much the same way, with medications handed out by well-meaning doctors who embraced a wondrous new class of drugs as the answer to a wide range of aches and pains.

The pharmacologist Nathaniel Chapman, writing in 1817, held up opium as the most useful drug in the physician’s arsenal, arguing that there was “scarcely one morbid affection or disordered condition” that would fail to respond to its wonder-working powers. That same year, chemists devised a process for isolating a key alkaloid compound from raw opium: morphine.

Though there’s some evidence that opiate dependency had become a problem as early as the 1840s, it wasn’t until the 1860s and 1870s that addiction became a widespread phenomenon. The key, according to historian David Courtwright, was the widespread adoption of the hypodermic needle in the 1870s.

Prior to this innovation, physicians administered opiates orally. During the Civil War, for example, doctors on the Union side administered 10 million opium pills and nearly three million ounces of opium powders and tinctures. Though some soldiers undoubtedly became junkies in the process, oral administration had all manner of unpleasant gastric side effects, limiting the appeal to potential addicts.

Hypodermic needles by contrast, delivered morphine directly into a patient’s veins with no side effects, yielding immediate results. As Courtwright notes: “For the first time in the entire history of medicine near-instantaneous, symptomatic relief for a wide range of diseases was possible. A syringe of morphine was, in a very real sense, a magic wand.”

An enthusiastic medical profession began injecting morphine on a vast scale for all manner of aches and pains, much the way that a more recent generation of doctors began prescribing Oxycontin and other legal drugs in a reaction against widespread undertreatment of pain. Wounded veterans became addicts, but so, too, did people suffering from arthritis. Women also became addicts en masse, thanks to the practice of treating menstrual cramps – or for that matter, any female complaint of pain – with injections of morphine.

Skeptics in the medical profession warned about the dangers of administering too much morphine. Yet these warnings generally fell on deaf ears. Some of the problem lay with the doctors themselves. One well-regarded doctor put it this way: “Opium is often the lazy physician’s remedy.”

But distance played a role, too. Doctors traveling dirt roads on horseback couldn’t always follow up with patients in pain, and so they left their charges with vials of morphine. Well-meaning doctors who might otherwise resist administering morphine also faced pressure from patients and families to do so. If they refused, it was easy to find a doctor who would comply.

In the end, though, the medical profession largely solved the problem on its own. As awareness of physicians’ role in fostering addiction spread, medical schools taught aspiring doctors to avoid prescribing morphine except under carefully controlled circumstances. The growing availability of milder analgesics – salicylates like aspirin – made the job easier, offering a less powerful, but far safer, alternative to morphine.

While the younger generation of doctors stigmatized morphine, the problem was increasingly linked to older, poorly trained doctors who had come of age in an era when the hypodermic needle was touted as a cure-all. A study in 1919, for example, found that 90 percent of opiate prescriptions in Pennsylvania came from only a third of the state’s doctors, most of whom were over 50 years old.

As the medical profession started to police its ranks, shaming those who enabled addiction, the epidemic began to burn itself out. “Old addicts died off faster than new ones were created,” writes Courtwright. The smaller group of addicts who became the face of opiate addition tended to be poorer “pleasure users” who picked up the habit in the criminal underworld.

Today’s opioid epidemic is similar to the one that came and went over a century ago. While there is plenty of room for government assistance in funding treatment for addicts, never mind regulation of drugs, history suggests that the medical profession will ultimately play the most important role.

There are some promising signs. The number of opioid prescriptions written by doctors has dropped by small amounts over the past few years, though some of the evidence suggests that the decline has more to do with patients anxious about the potential for addiction.

Still, it took decades during the 19th century for doctors to shy away from injecting patients with morphine for the slightest complaint. It may take just as long before doctors kick the habit of prescribing powerful pain pills.