Welcome to My Substack
The Conversation Begins
After more than four decades as a practicing pain physician, and researcher I’ve launched this Substack to cut through the noise surrounding pain, opioids, addiction, and the policies that shape how we treat them.
Here’s what you can look forward to:
Evidence-first policy analysis—Straightforward breakdowns of new laws, guidelines, and proposals and their real-world impact on people in pain and those with substance-use disorders. Too often, policy debates are driven by fear, sensational headlines, and political optics rather than rigorous data and real-world clinical outcomes. I intend to change that narrative.
Critical takes on dominant narratives—Examining where the data supports—or contradicts—today’s headlines and helping you separate signal from noise. Many public health stories harden into conventional wisdom before the evidence has been fully examined. Here, I will question assumptions, challenge oversimplified explanations, and ask whether the policies that follow from popular narratives are actually supported by data. The goal is not to reject every mainstream account, but to insist that consequential claims deserve careful scrutiny.
Clinical insight you won’t find elsewhere—Perspectives drawn from 350+ clinical trials, decades of patient care, and my own research on pain, analgesics, opioids, and addiction risk. Each post will examine the science, data, unintended consequences, and the human impact. Whether the topic is opioid prescribing rules, addiction-treatment policy, or emerging regulatory changes, I’ll bring the same standards I’ve applied in clinical trials and hundreds of peer-reviewed publications: facts first, context always, and ideology nowhere.
Thoughtful essays designed to inform and sharpen your critical thinking— My promise is simple: no clickbait and no fear-mongering—just straightforward, clinically grounded perspective from someone who has spent a career balancing effective pain relief with responsible risk management.
If you’re tired of simplistic slogans and ready for thoughtful, evidence-driven conversation about one of the most important—and most misunderstood—areas of American medicine, I invite you to join me.
Let’s roll up our shirtsleeves and get to work.