The CDC is trying, desperately, it seems, to pound a square peg into a round hole, blaming COVID-19 for a surge in alcohol use and ignoring a glaring problem with the evidence. That’s not something you generally expect from scientists. However, I would argue the CDC is no longer controlled by scientists. While dedicated scientists still work there, the CDC is now controlled by politics. Founded as the Communicable Disease Center in 1946 to control malaria, it was expanded with an epidemic intelligence service in 1951.

Probably not the best name, as “intelligence service” brings up shades of the CIA. Perhaps “information service” would have been better, but that ship has sailed. By 1957, it expanded from its malaria focus to include STDs and later tuberculosis, becoming the National Communicable Disease Center in 1967, and finally, the Center for Disease Control in 1970, becoming the principal operations agency of the Public Health Service. It became plural, “Centers for Disease Control,” in 1980, absorbing first the Centers for Infectious Diseases, Chronic Disease Prevention and Health Promotion, and Environmental Health and Injury Control, then later adding Prevention Services, Occupational Safety and Health, and Health Statistics. “And Prevention” was added in 1992, but the name was not changed.

The first real controversy came in 1994 when the CDC was criticized for having sent samples of plague, Dengue fever, botulinum toxin, and West Nile virus to Iraq from 1984 to 1989. This was a completely unfair complaint, in my opinion. The U.S. was buddies with Iraq at that time. In fact, America had sent chemical weapons technology and provided weather reports so that thirty Iranian targets could be hit with chemical agents by Iraq from 1981 to 1988. So, Congress complaining about a few germs available from other sources worldwide is a bit rich.

The next problem arose in 2014 when Dr. Kent Brantly became the first person known to have Ebola transported to the U.S. The CDC recommended that he be flown from Liberia, where he was doing medical missionary work, to Emory University in Atlanta, Georgia. The CDC was criticized for recommending this, but they saw it as an opportunity to engage their protocols and protections and save a humanitarian physician. Dr. Brantly recovered and is alive today. But things didn’t end there. Mr. Thomas Duncan had flown from Liberia to Dallas with no symptoms but became ill and went to Presbyterian Hospital in Dallas. There, he was treated in the isolation unit, but a nurse became infected. The first known transmission of Ebola within the United States, and the U.S. media did not take it well, drawing parallels with Stephen King’s The Stand and doing their best to panic the American public.

The CDC magnificently stuck to evidence-based medicine, argued the facts, and handled the situation. Nurse Nina Pham survived the illness, and it did not spread. The next controversy is more relevant to our discussion. For a long time, the U.S. Justice Department had begged federal health agencies for a standard they could hold physicians to regarding the prescribing of opiates. They were not happy with what was commonly understood in the medical community, that although you can say what the average patient has needed in the past regarding opiate treatment dosing, that has almost no bearing at all on what the individual sitting in front of a physician needs.

For reasons I’ve discussed before, individual opiate dosing is extraordinarily variable. In the past, federal agencies like the CDC would point out that they were specifically forbidden by law from trying to influence the practice of medicine in the United States, but things had changed. Political pressure, spurred by pharmaceutical industry companies touting opiate alternatives, became extreme, and the CDC bowed, giving us the 2016 CDC “guidelines.” This rapidly had the desired effect. Doctors all over the United States, most never having heard of a morphine milligram equivalent until that time, opted out of treating pain as it was getting too complicated and was being vilified. A wise choice in retrospect for the individual physician but devastating for patient care and American medicine as a whole.

As doctors gave up trying to treat pain under much more complicated conditions, some abrogated their duty to care for their patients, finding excuses to “fire” them. This is patient abandonment by any other name, but it is now spoken of gleefully by medical boards as proof that a doctor is on their game. We had a large, by rural state standards, general clinical practice, with me traveling to study pain management and addiction through Harvard, and another ER and general surgery experienced physician of impeccable character and skill handling urgent care and minor surgeries. We also had two ANPs and two counselors. As our practice grew, a disgruntled employee pretended to be a patient and complained about our clinic to an insurance company, claiming patients had died under my care. The company investigated, finding my medical actions reasonable, even identifying the employee’s deception, but still felt the need to notify the board. I will place here a quote from a letter I wrote to my state’s medical board when they asked for me to address the issue.

“It is noted that of the thousands of patients treated at my practice, eight of these were 65 years old or younger at the time of their death, and six of those had received prescriptions for pain. I am aware of these patients; many of them were suffering from cancer or other debilitating illnesses. There are several oncologists who have referred patients to my practice. I do not exclude patients who might die from my practice. I do not understand the relevance of the rankings listed by the amount earned or where I am compared to other general practice physicians. As most of these doctors choose to exclude the treatment of pain from their practice, the burden shifts to those who do not. Also, the identical patient does not walk through every doctor’s door. If oncologists rely on me to ease the suffering of their patients, then, of course, I will stand out. The letter also reports payments made and references the number of patients seen. I hope most of the patients I see will continue under my care. To ease the suffering of those who cannot be cured, I see as one of the most sacred duties of a physician.”

The DEA saw things otherwise. The CDC had granted them a number, a metric, and they would now hold that up to all physicians and lop off the outliers, using state PMPs and pharmacy records to brand physicians over the guidelines as “pill mills” and kick in their clinic doors. This was very effective, and patients were sent to the street in droves. The year this started was 2016, and this coincides with the CDC’s noted increase in alcohol abuse. Why is this possibly their fault? Human beings do not tolerate severe pain for long and will do almost anything to escape it. They will also be naturally drawn to any experience or substance that gives them any small measure of relief. I have had more than one patient tell me that they started drinking heavily to blunt their pain when they could not find a doctor. Using alcohol to treat pain is not unusual. About 28 percent of chronic pain sufferers use alcohol for this purpose. For these patients, the agreement was that they had to go off the alcohol to be treated, blowing negative on a breathalyzer I purchased for our clinic; liver enzymes and alcohol metabolites were also tracked.

This proved very effective, and I was able to get these patients onto a safer treatment for their pain, at least until they kicked my door in. The CDC has apparently not considered its own actions as a prime driver for the increase; instead, it blames it all on COVID-19. I would remind the astute researchers at the renowned CDC that the 19 after the “COVID” stands for the year the pandemic started. Annual deaths from excessive alcohol averaged 137,927 per year for the period 2016-2017, jumping to 145,253 in 2018-2019, an increase of 5.3 percent. Then, pain doctor prosecutions started. And panicked physicians cut tens of thousands of patients off of opiate treatment. During that period, the alcohol-related death rate jumped an incredible 22.8 percent over 2020-2021, averaging 178,307 for those years. Some of this can, of course, be attributed to COVID-related drinking, as lack of work and social contact would have worsened depression, etc., but how much was not? How much was related to people in pain?

We may never be able to know exactly, and I couldn’t find data for alcohol-related deaths from 2022-2023. But according to the CDC, again, alcohol-induced deaths, a stricter criterion, went from 39,000 in 2019 to 49,000 in 2020. An increase of 25 percent. 2021 should then, if COVID-19 lockdowns are the cause, have dropped. But it did not. Provisional data from 2021 shows a jump to 52,000, an even greater increase of 26 percent. That would mean the alcohol-related death tsunami continues unabated. As does the war on Americans who suffer from pain and the physicians who dare to treat them.