Ya Got Trouble !

11 drugs lik cocaine ladies

At the intersection of emotionally charged trains of thought, lies the potential for hyperbole, hysteria, and high drama. Nowhere is this more evident than in our nation’s debate over the utility of prescription pain drugs. Both sides offer sobering statistics. We cringe hearing that more people die from drug overdoses than from motor vehicle accidents. Then in the next breath we’re saddened by the news now one hundred million Americans suffer from chronic pain. This all may be true, yet still I’m reminded of what Mark Twain wrote, “There are three kinds of lies: lies, damned lies and statistics.” Unfortunately, efforts at finding truth can sometimes become sidetracked by blowhards with hidden agendas.

2 stay here  second one

Twain was a fan of satire, so in that spirit I would like to offer my concept of how The Music Man’s dashing huckster “Professor” Harold Hill might have taken on the pain debate. In the movie, this self-proclaimed music teacher/instrument salesman sounded the alarm over “the presence of a pool hall.” Here is what he might have said, had it been a pain clinic instead. Note, if you’ve never seen the musical, I recommend you watch the video clip first.

3 friend either you are

Friend, either you’re closing your eyes to a situation you do not wish to acknowledge, or you are not aware of the caliber of disaster indicated by the presence of a pain clinic in your community.

 Well… Ya got trouble, my friends, right here, 
I say, trouble right here in your city.

 Why sure I’m a pain physician, certainly mighty proud to say,  
I’m always mighty proud to say it.

I consider that the hours I spend, needle in my hand, are golden.
Helps you cultivate horse sense, and a cool head, and a keen eye.

 3 g a cool head
Did ya ever try to treat a herniated disk with an epidural steroid shot?

But just as I say it takes judgment, brains and maturity 
to place a needle in the spine,
I say that any boob can pull a pad from his pocket.

And I call that sloth, 
the first big step on the road to the depths of deg-ra-da–

I say first, medicinal mar-i-ju-ana, then pills from a bottle.

4 and the next thing you kow 
And the next thing ya know 
your pills are selling for money on a back street route.

And listed on some big out of town KASPER*
showing how they’ve been doctor shoppin’.

Not a wholesome caring place, no! 
But a place where they pay cash right on the spot!

 Like to see some screwed up druggie boy sittin’ in your office?
Make your blood boil? 
Well, I should say. Now friends, let me tell you what I mean.

You got nine – new – pain – regs – that – were passed by the board.**

Regulations that mark the difference between a specialist and a bum, 
with a capital “B” 
and that rhymes with “P” 
and that stands for PAIN!

And all day long that pain clinic bunch will be loitering around, 
I say those addicts will be loitering,
loitering around your up town, middle town, down town too!

 5 here him tell about
Get the pills in their pockets, 
never mind setting functional goals
or the records reviewed
or agreements signed.

Never mind taking too many 
so your patients are caught 
with the bottle empty
on a Saturday night,
and that’s trouble.

Yes you got lots and lots of trouble.
I’m thinkin’ of the pain pill partiers
old ones, young ones, 
caring not a bit about breaking all the rules.

6 and that stands for pool pointing with crowd 
Ya got trouble, folks! Right here in your city.
Trouble, with a capital “T”
and that rhymes with “P”
and that stands for PAIN!

 Now, I know all you docs have the right kinda patients. 

I’m gonna be perfectly frank.
Would ya like to know what kind of conversation goes on 
while they’re loafing around your halls?

They’ll be tryin’ out Oxy, tryin’ out morphine
tryin’ out fentanyl and Zohydro.

And braggin’ all about 
how they’re gonna cover up a bad drug screen with with Clorox.

 8 zyour son and your daughter
One fine night, they leave the clinic, 
headin’ for a chance at the pharmacy.
Desperate men, enabling women! 
Narcotic shameless craving
that’ll make your son and your daughter 
defy every decent societal instinct.


Friends, the stoner brain is the devil’s playground! Trouble!

Oh we got trouble. Right here in your city!
with a capital “T” 
that rhymes with “P” 
and that stands for PAIN!

We’ve surely got trouble! Right here in your city.
Gotta figure out a way to treat and not just go insane.

 7 caring not a bit about breakin all the rules

Doctors of this city, heed that warning before it’s too late! 
Watch for the telltale signs of addiction!

 The minute after your patient walks into your office,
does he claim to be paralyzed below the knee?

 10 below the knee
Is there a needle track mark on his index finger? 

A dime bag hidden in his butt pack?

Is he starting to visit web sites
like “How to Pass a Whiz test” dot com?

Are certain drugs showing up on urine drug screens
Drugs… like cocaine? And… heroin?

 14 the devils tool
Well, if so my friends, ya got trouble, right here in your city!
with a capital “T”
and that rhymes with “C” 
and that ain’t cool.

We’ve surely got trouble! Right here in your city! 
Remember that pain clinic doc is a willing fool!

Oh, we’ve got trouble! 
We’re in terrible, terrible trouble!
Those pills for the fifteen hundred cash is the devil’s tool.

Oh yes we got trouble, trouble, trouble! 
Oh yes we got trouble here, we got big big trouble!

With a “T”
Gotta rhyme it with “P”
And that stands for PAIN!

13 is a willing fool


*KASPER is the Kentucky All-Schedule Prescription Electronic Reporting system

**The Kentucky Board of Medical Licensure



Spoiler alert… Professor Harold Hill had nothing against the pool hall. He wasn’t even a music professor. He was a con artist with a hidden agenda. He wanted to make a big score selling band instruments then bolt out of town. In the end though, Harold Hill had a change of heart and found true love.

If we can cool down the hyperbole, hysteria and high drama; if we can look beyond the soaring rhetoric and eye-popping statistics; if we can engage in honest and respectful communication; perhaps we can find meaningful solutions to our nation’s pain medication crisis.

15 last one with statue

Remember my friends,
listen to me,
because I pass this way but once!

8 thoughts on “Ya Got Trouble !

    Our nation’s debate (pain medication)
    Deaths from drug overdoses
    100 million Americans with Chronic Pain
    There are three kinds of lies: lies, damned lies and statistics.
    IMDb site for “The Music Man” movie
    Robert Preston as Professor Harold Hill
    “Ya Got Trouble” video clip

    ASAM examines marijuana laws
    Doctor shoppers
    Pain clinic or pill mill?
    The Kentucky Board of Medical Licensure (Pain Regulations)
    What is a pain doctor?
    ABC’s of Pain
    First Do No Harm poster

    Click to access First_Do_No_Harm_Poster.pdf

    Treatment agreements
    “Pharm parties”
    Clorox and urine drug tests
    ASAM definition of addiction
    What’s a dime bag
    The “Whizzinator”
    Tumblin’ dice (urine drug screens)
    Street value of drugs

  2. One of the most creative and hopefully enlightening pieces of journalism, wisdom and truth I have seen in a long time. If anyone doubts this, you are welcome to join me on certain days when I see with my own eyes…and I hear with my own ears…as I go in and out of different pain clinics and other assorted medical offices in the Bluegrass State of Kentucky (rated number 1 in per capita prescription drug misuse/abuse in the USA) that I call home….trying to make a living…..trying also…to make the right difference by attempting to meet with (and help) providers who live and work in this crazy mixed up world (and have to be able to distinguish truth from deception) many of us know of but way too often, judgmentally take for granted.

    Mike Mankel
    Lexington KY

  3. For a limited time only… I am making available an audio version of “Ya Got Trouble” in my dropbox.

    This was set to music by the incomparable Phil Ward with help from bass player extraordinaire Cameron Murphy. Yours truly is on vocals.

    Enjoy the trouble…


  4. This tweet features Kentucky’s Drug Czar in a brief video snip from an outstanding television story about the rise of crime and heroin overdose deaths in Kentucky since the passage of the state’s “Pain Law” in 2012.

    In fairness to Mr. Ingram, his comments may be out of context due to editing by WHAS producers. The entire story can be viewed via this link: http://www.whas11.com/story/news/health/2014/11/06/heroin-addiction-rapidly-increasing-killing-in-louisville/18631329

    Regardless, for it to be said that “heroin is just another opioid” implies a serious lack of understanding as to this particular drug’s addictive potential. Heroin is highly addictive and universally illicit.


    Furthermore, this statement adds to the stigma and shame that “legitimate” pain sufferers must endure. It is damaging and harmful on many levels to imply that taking opioid pain medication is somehow the same as taking heroin.

    It is not.

    And Mr. Ingram is not a physician.

    He is a respected and influential law enforcement expert.


    Van Ingram is the Executive Director for the Kentucky Office of Drug Control Policy (ODCP). Mr. Ingram joined ODCP in November 2004, shortly after it was created with the mission of coordinating Kentucky’s substance abuse efforts in enforcement, treatment and prevention/education. He served with the Maysville (KY) Police Department for more than 23 years, the last six as Chief of Police. He is a former President of the Kentucky Association of Chiefs of Police and was named “Kentucky Chief of the Year” in 2001. Mr. Ingram is a former recipient of the Governor’s Award for Outstanding Contribution to Law Enforcement, as well as the Melvin Shein Award for distinguished service to Kentucky law enforcement. Mr. Ingram is a certified law enforcement instructor and has trained officers across the state on a variety of topics, including community-oriented policing, case management, and “Kentucky Substance Abuse Issues” for Chiefs, Sheriff’s and command staff. He is a frequent speaker on a variety of substance abuse issues both in Kentucky and nationally.

    • This the is very type of ignorance that hinders legitimate pain patients from receiving adequate pain relief. Not only is heroin NOT just another opioid/opiate, it’s NOT FDA approved, coming with instructions on how to take it, and you never know what you are getting when you buy.

      You might say, it in NO WAY resembles just another opiate. /Kim Miller NO ASSOCIATION with any page

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