Shaw's Eco-Logic

This HND piece puts the spotlight on lower back problems, which are not only the leading cause of disability, they have plagued mankind since we started walking upright. Unfortunately, our backs, knees, and feet—to name a few—would look a lot different if they were purpose-designed for us from the get-go. Instead, these structures have been modified from the original ape design, and trade-offs were definitely made.

Spondylolysis, a vertebral defect that can lead to small stress fractures, is found only in humans, and not apes. We describe research showing that the further from an ape-like vertebral structure humans get, the more likely they are to develop spondylolysis. Indeed, these people have vertebrae that seem to be over-adapted to bipedal life, and are of a different shape.

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This HND piece follows up a column we did back in 2017, which covered most of the basics. In this latest story, we focus on a report issued by the New Center, that takes a historical perspective on the crisis, details where we are at the moment, and offers a number of recommendations.

One important recommendation involves expanding Medication Assisted Treatment (MAT). The gold standard here is methadone, which must be dispensed in a highly regulated setting. Other MAT drugs exist, although they are not quite as effective. Still, it is most disturbing that there are still several states that prevent Medicaid from reimbursing for MAT.

Prescription drug monitoring programs can be helpful, but need to consider the legitimate needs of chronic pain patients. Drug courts that emphasize treatment over incarceration can also be beneficial.

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