With More People Killing Themselves – What to Do?

With More People Killing Themselves – What to Do?

By Geralyn Datz, Ph.D.

(Editor’s Note—The recent CDC report on suicide was alarming. Suicide rates have increased in nearly every state over the past two decades, and half of the states have seen suicide rates go up more than 30 percent. While the CDC didn’t release any data about what’s happening in the chronic pain community, most observers believe that the increased suicide rate is at least partially due to an increase in more chronic pain patients taking their own lives. We asked Dr. Geralyn Datz, a psychologist and former head of the Southern Pain Society to share a few thoughts.)

The topic of suicide itself has a huge taboo around it. The challenge in discussing suicide is always to acknowledge the vulnerability of the individuals that suffer from this type of thinking, as well as to address mischaracterizations of these individuals as weak, selfish, or simply “crazy”. In the life of a mental health professional, suicide is an occupational hazard that is haunting and challenging. While all suicides cannot be prevented, the number of them can be reduced through education.

Geralyn Datz, PhD

For people who suffer with pain, suicide may be viewed as an escape from the unsolvable problem that is chronic pain. Depression and anxiety also often co-occur with chronic pain, further adding to the mental obstacles in the life of pain patient, and making escape from reality, and suffering, all the more tempting. Finally, access to adequate pain treatments, including opioids, is very challenging, adding to the pressure and anguish that exists for pain patients today.

When applied to the problem of chronic pain, for a large subset of people with pain and suicidal thinking the issue is not that they want to die, it’s that they don’t want to feel pain and suffer any more. And suicide can unfortunately seem like a reasonable option.

One common myth that surrounding suicide is the thought that the person wants to die and can’t be helped.  One study that explored the desire to escape suffering vs the will to live is a famous study of individuals who jumped off the golden gate bridge in attempt to commit suicide. More than 3,000 people have leapt to their death from San Francisco’s Golden Gate Bridge, but out of the 26 people who survived the jump, all 26 reported that the moment they leapt from the bridge, they regretted their action and wanted to live.

Another myth is that asking about, or talking about suicidal thinking with the person experiencing it, increases the likelihood suicide will happen. The vast majority of suicide-related research—including a very well done study in 2014—suggests that open conversations about suicide are unlikely to increase suicidal ideation and may actually decrease it.

Sometimes suicidal thinking is the result of interactions of factors. Genetic factors, like a personal or family history of psychological diagnosis, or of attempted suicide or completed suicide, can influence a person who has come to the point of contemplating suicide. Childhood trauma, of any sort, physical, emotional, sexual, and parental neglect, can also affect the development of suicidal thinking.

However suicidal thinking has developed, and the circumstances that surround it, it must be confronted. The following are some recommendations for dealing proactively with suicidal thinking:

  1. Don’t isolate, reach out. Be it talking to a friend, family member, faith community member, medical provider or calling a therapist, break the silence and shame feelings that are often present with severe depression and anxiety.
  2. Call or text a crisis hotline. Suicide Prevention Lifeline (1-800-273-8255) or Crisis Text Line (text HOME to 741741).
  3. If you feel you are in immediate danger, call 911, go the ER or local 24-hour psychiatric facility for admission.
  4. Safety first. If you are feeling like a threat to yourself, remove any harmful means from your home, and ask someone to help you monitor or co-administer your prescription medications to reduce the likelihood of overdose.
  5. Develop a safety plan. Write out your plan for action in a crisis. Also, the My3 app is a safety planning and crisis intervention app that can help develop these supports and is stored conveniently on your smartphone for quick access. It is difficult to plan and think clearly when in crisis, and having a plan can give you support.
  6. Get help. Suicidal thinking is a sign of severe depression and also anxiety. Schedule a consult with a mental health provider, psychologist, psychiatrist, counselor or primary care doctor. If you are without insurance, find your community mental health center that offers low cost assessments. Consider psychotherapy to develop coping skills for navigating this difficult period in your life. Medications can also be helpful for addressing mood disturbances, sleep difficulty, and panic attacks that often accompany suicidal thinking.


Authored by: Geralyn Datz, Ph.D.

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I can relate to all of your comments, my fellow CPPs. I am almost at the end of my rope and then I HAVE TO go to fill my muscle relaxer at the same pharmacy I have been using for at least 7 years and the pharmacist yells to me out the window, as I am sitting in chairs, hunched over, with my cane, “you can’t fill this until 6/5!” “You keep filling your meds early and we can’t continue doing that.” My last refill date was 6/8. For some reason this person decided I deserved this treatment at that time, in front of everyone. We’re talking about 3 days. I was surrounded by about 7 other people staring right at me. Of course, in my mind after dealing with this I am feeling like they are all now judging me. Mind you I have never had an issue getting my script 2-3 days early so that I don’t run out because many time there are delays when I submit the refills so I’m forced to suffer which doesn’t bother them. These pharmacists are so cruel that they don’t even follow HIPPA regulations anymore. Again, this isn’t even the opioid meds I am on! These are the muscle relaxers script only. I ask, when did it become acceptable for pharmacists to Treat suffering patients like we are lower than dog crap? When did we become less than human?

I can’t be fixed. If you’ve ever been through multiple surgeries and treatments and medications only to constantly get the same answer from your physician- “I’m sorry, there’s nothing else I can do for you.” Apparently, nerve damage is a life sentence of excruciating pain and humiliation. Of course, there are so many other side affects and additional pain you get to endure that I won’t waste time listing here. Just trust me. The hell is absolutely never ending. And in addition to all this you go to seek treatment using medication that your doctor says is the ONLY thing that can help you with the pain. You go to fill this LAST RESORT and get treated less than human or drug seeking even though the doctor is reputable and you have a contract with the doctor that monitors everything you take. I have not only been given a life sentence of excruciating pain, but now I am forced to deal with complete humiliation and verbal abuse from the pharmacy I HAVE to fill the script at. And there is NO END TO ANY OF IT. This is it, folks. This is your existence for the rest of your life. Kind of makes you wonder why CPPs wouldn’t consider suicide! No one would want to live like this! ITs a never ending cycle of mental and physician pain. Forever.

Kim C

Most of my thoughts have been taken. I can tell you from a person who took 72 10/325 Percocet, that I was serious about dyng and at NO point did I regret my action.
I had been told to live in pain, that wasn’t liveable,and that was before my disease progressed to being bedridden. I had researched the drug and understood that three hours was generally the point of no return. I never lost consciousness to the point that when talked to, I would wake up and answer. My plan to get out into a far away field was disrupted in the student union when a friend stopped to talk to me for over 15 minutes, 10 minutes after having consumed the pills and walking across campus to use a pay phone to leave a message for my parents that I loved them. I would not give my name tellng them they will figure it out when they found me. So after 30 minutes passed from taking the pills, I left the union and barely got outside as the pills started taking effect. I then tried to slip among some trees. Unfortunately, people kept asking if I was okay. Eventually, someone called 911. I was angry then, as I had no reason to regret my actions.
The doctor and nurses kept asking what I took. Since I kept answering, they were afraid to try to stop anything having no idea. After more than three hours passed, I told the doctor what I ingested, thinking I was past the point of no return. The doctor replied, “You are lying as you would be dead by now if you took that.” So they waited for the toxicology report for at least another hour. At that point, the doctor came in apologizing and told me they were going to make the procedures as painless as possible since I had told the truth. They inserted a nasogastric tube for the charcoal and the rotten egg smelling meds they gave me around the clock to stop the acetaminophen from damaging my body. I, needlessly to say, survived.
The ONLY reason I did not regret surviving is that I was told, “You never need to try this again, as there will always be a doctor willing to give you the needed narcotics to stay out of pain.” Little did they know that 25 years later, when my incurable disease has progressed to being bedridden, that a group of idiotic doctors who think they know better than all other doctors, took a report that they helped draft as a recommendation for general doctors and ran to the media to blow it all out of proportion.
I have reached the character limits. So, I end saying that quality of life makes suicide a reasonable choice.


I know we all are still in shock over the suicide mandate. It should be noted that most of us probably all are not suicidal. We want to live. The fact is some of us have degenerative diseases that are decades old. Your article does not even mention that are medication is being taken away from us all the way down to 90 mme. A lot of us are not going to even be able to get down there. The Logical course, the only course is self destruction. No amount of yoga, exercise, psychology, acupuncture, tens treatment and all the rest will take the place of opiate therapy. Tell me I’m not in a bad dream. This is the plan? Starve the pain patient of there pain medication until they kill themselves? What other conclusion can anyone draw? Why can no one save us from this depopulation by genocide.

There’s a shortage of Dr.s where i live plus there is a long list of people needing a phycologist. There’s only one for the entire area which is huge. I actually tried to talk to the P.A.at the pain CLINIC about chronic pain patients commiting suicide and he sent a letter to my new primary dr.stating I said I was suicidal. I did not !! No I don’t want to die but,I am suffering in tremendous pain. Last winter I dropped a dr.that gave me something to help me sleep. It was NOT a sleep aid it was an anti-depressant. I hadn’t slept in months and that drug gave me suicidal IDEATIONS which scared the Crap out of me. I knew I wasn’t myself so I looked THAT DRUG UP and sure enough that was an anti-depressant which have never agreed with me personally. I’m really mad he said nothing about it giving people suicidal tendencies or IDEATIONS. He did say you can have night terrors. Oh that’s wonderful. No it’s not at all ok to try to give me an anti-depressant without telling me. These people at the pain CLINIC only care about their livelihood not patients at all period. They’ve made my back worse than ever. Gee thanks for nothing but,grief. Sad sack in the Willamette valley.

Alan Edwards

Being bullied or abused verbally, physically and emotionally makes many think of suicide. It exacerbates low mood, chronic pain or makes treatment less effective. I have often thought of dying and thought I would die when my pain level becomes unbearable.

Abuse is painful whether or not you are struck or berated and right now chronic, intractable pain patients and veterans are being abused by state medical boards,and powerful government acronyms. Some medical professionals, also.

Yesterday, was pharmacy day. I have to weigh the suffering I endure there, the good people, the bad, and the rude, to obtain needed meds.They now mostly dispense antidepressants, at huge profit, which do nothing for my pain or shyness. I was misdiagnosed with depression 28 years ago which was a disaster for my health and finances.. ALL antidepressants failed.

A good Samaritan, kind word and actions, and freedom from suffering will prevent suicide. At least 20 veterans a day now are dying supposedly by their own hand. So be kind, government acronyms and medical professionals. It is evident that now, you may be doing harm.


Patriot. Amen.

Suicide? I don’t think it’s the correct terminology. Genocide is the correct word by its very definition. Our gov. should be quite familiar with it since my native ancestors were the victims of that particular land grab policy. So do not go to thinking our gov. is above such actions.

William Dorn

This is to all in government that had a hand in this crime against chronic pain patients. In the UNITED STATES of AMERICA you do not kill one group of people to save another group of people. Leave pain patients alone and go after illegal drugs or is that to hard for you to handle.


Please give us back our rights to be treated by our Doctors Let them do their jobs helping those that are physically sick! This is supposed to be Greatest County to live and thrive in .
No one who hasn’t suffered like CPP or the Veterans or Cancer Paitents or first responders from 911 or any other painful illness .You know nothing about how we suffer .
Class Action ! Make them pay for all the Inhumane suffering and death at the hands of
Of the so called Lawmakers in Washington it’s an easy fix . Stop the needless suffering give us our Quailty of life back Now not in July August September or next year we are dying, we aren’t dying from Fake Opiate overdoses we are responsible sick people trying to live a normal Productive life.

Jim Moulton

Good article, there will be a lot more suicide attempts, now with the changing of pain meds. Alot of people will have a tough time dealing the xtra pain. Years ago my lawyer had bad back pain, he couldn’t cope with it, so he committed suicide.

Jessamyn Butler

Throw out all of the “old psych BS knowledge” in these cases. Most of us chronic pain patients DON’T want to die. We want to live–but not in pain. And living–not in pain–is a really easy thing to accomplish if “they” would just give us our medications!!! We would go back to our nice, semi-functional, semi-mobile, semi-productive (or even better) lives. But no, everyone would rather pander to the junkies who are one more OD away from death and the for-profit “treatment” centers (I say “treatment” lightly, because I don’t put much faith in them. One has to WANT to get better to get off drugs, not get “put” there to get better, or go there for a vacation to “get the heat off” for awhile like most do…). If the DEA really wants to impress anyone, they would get out on the streets and the borders and the ports and go after the Big Guys, the importers of the nasty drugs and mixtures that are coming in and getting distributed on the streets, causing the REAL opiate overdoses, not going after the poor doctors who are trying their best to treat the really tough, complex chronic pain cases. DEA is a bully. And CDC is something I can’t say on here, so I’ll say “wimp,” hiding behind their FAKED data, and putting out high-falutin’ guidelines, knowing what would happen…They all should be ashamed. They should have had the forethought, instead of listening to Kolodny and letting him run with the PROP ball. I’m disgusted to say I’m from this god-forsaken country anymore. Have you seen the new laws in British Columbia?? Now that’s a place that knows how to treat its chronic pain patients! Get a clue, before more people die unnecessarily, ‘Murrica..


Just wanted to share a quote with all of you.

Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies. Groucho Marx

How true it is!!!


I was going to write all the bellow opinions

Jennifer R

I agree with the 3 comments here so far, but this article doesn’t really discuss the increase of suicides by chronic pain patients as the Editor’s note states..& this is the exact data that is needed. I’m seeing more suicides on social media by chronic pain patients & as one who has completely lost my health & quality of life due to being a long term CPP, I understand why more patients are choosing to stop their suffering. I’m existing, not living. I have suffered unbelievable pain & permanent damage to my body, not only for being a CPP but for using my full name all over social media to fight our government agencies, Big Pharma & the “health” care system who’s more than aware that they are responsible for what I have been reduced to. I’m labeled as an addict from using my voice..so be it. My records show my diligence with my medication. Another very disturbing trend I’d like to see (or write) an article about, is how entire families are suddenly disowning their adult children who are at the end of their decades of fighting invisible diseases with no cure..the impact of this is enough to increase the desire to suicide. I am one who was told by email, that I am no longer their daughter..right before undergoing surgery for the aneurysm that is still in my brain stem. I’m one of very few still alive after this surgery & losing my entire family & extended family in one day, nearly killed me. This is a multi-tiered issue but it boils down to one thing: the CDC’s prescribing guidelines implemented using false data by the VA & FDA & now Medicare. We’re not crazy or selfish, we’re suffering. Everyone here knows that unfortunately.

David Cole

Has someone who’s been dealing with suicidal thoughts for the last two years of forced tapering, when I caught myself walking out the door to actually do it, I was calm and felt like a great burden has been lifted off my shoulders. I’m no longer suicidal but I certainly can see how people find them self committing suicide, it’s an easy thing to do once you reach that point. If it weren’t for whistleblowers the CDC would have never admitted to over counting RX opiate-related deaths by 50%. So given the fact that the CDC guidelines were written by addiction specialists, the evidence is clear the books have been fixed. So as far as I’m concerned some people need to go to jail. I can’t wait to see the FDA and HHS guidelines, they will reflect the true data. Bottom line is a lot of good people died for nothing, there never was an RX opioid pain medication epidemic.

Louise Silvern, Ph.D.

Thank you for the advice about supporting individuals who are considering suicide. I want to add that all available research about psychological trauma indicates that severe intractable pain creates post-traumatic reactions among some individuals (although researchers have so far not addressed that rather obvious issue). Like others who work with chronic pain patients, I have seen that occasionally ending ones life prematurely appear as the only reasonable option, even for pain patients who have struggled to find better alternatives. Such tragic outcomes appear increasingly frequent, probably because the senseless restrictions on opioid medications are forcing ever more patients into those tragic circumstances.

That observation raises an additional suggestion for individuals who consider ending their lives; taking action against traumatizing circumstances has been repeatedly found to be an important way of ameliorating post-traumatic reactions. Fighting the irrational restrictions on prescribing is important for patients as a group and individually.

Along those lines, it concerns me that advocates for pain patients describe it as “suicide” when patients come to the point of ending their lives. As a psychologist, I am accustomed to thinking about “suicide” as emerging from subjective or “internal” states and dilemmas. However, when governmental restrictions significantly contribute to that tragic end, an external cause, i.e., “governmental torture” is the better description and death is sometimes the outcome. It is not fair to use terms like “suicide”that indicate the problem resided in the deceased person.


I can guarantee that the suicide rate for chronic pain patients will definitely be going up. What people without chronic pain don’t realize is how absolutely draining and exhausting it is physically and mentally, it’s hard enough dealing with chronic pain when you have the required amount of medication let alone dealing with horrible chronic pain and not having enough meds. I’m not suicidal but there have been days I thought, “if I died right now from a heart attack, it wouldn’t be so bad”. But who knows, my pain meds have been cut pretty drastically recently, so how do I know some day when I’m having horrible pain that it won’t push me to my limit of what I can handle, then maybe suicide makes sense, at least for that moment in time. We all have to keep positive thoughts in our minds, concentrate on the people in our lives who love us and how devistating our deaths would be to them. We all have love to give and equally love to receive. So no matter what we’re going through, remember, we get one life and one life only, there’s no do overs. And you are loved.

Keep screwing with people’s medications. Throw them into opiod and Benzedine withdraws. You are going to see more than suicides.

Brilliant insights here from Dr Datz. The facts that we refuse to discuss, are the ones about which we learn nothing. Fear, anxiety, and anger all contribute to the idea of suicide. Discussing these emotions themselves, leads us to discuss the unique facts of our lives that are causing us to feel afraid, angry, or anxious. What truly terrifies many people in listening to someone who is experiencing these strong emotions, is the fear that the person may lash out violently and harm the listener. Complicating that, our culture sends various subtle hints that tolerate violent outbursts in certain contexts.

The net result is that people become too afraid to listen to others who need help sorting out their problems.

If we had a more-rational view of violence, for example, “never be first to use force”, or “only use force to stop someone who is already using force”, we’d be more certain that it is safe to listen to a friend who is angry and let that friend explain what’s creating their anger.

Successful people have constructive solutions for their problems, and they employ those constructive solutions, rather than get angry.

We need to teach the skill of innovating constructive solutions to problems. Any constructive solution to any problem, is better than lashing out violently to cause harm to oneself or to others.

Pain patients in this country observe this principle at work every minute of their lives. Any solution to the suicide problem would be better, than commanding people in pain to stop taking pain medicine and suffer (out of the fear that pain medicine will get abused by suicidal people or by people who accidentally die from unintended overdose). Yet the only solution professional politicians can come up with, is to make our pain worse and increase our likelihood of the very same suicidal acts, that those professional politicians insist they are trying to prevent.

Politics is a form of violence. It’s harmful by it’s very nature. It’s killing us, by teaching us to be violent, rather than solve problems.


Thank you for the timely article. I would add severe anger to your list on symptoms of depression and . Depression is a result of anger turned inward. In other words all hope is lost. long past is the time that we should have had this discussion. You say in your last step number 6 that suicidal thinking is a sign severe depression and anxiety. I would submit to you that the severe depression and anxiety that you speak of is a Direct result of the pain patient looking at the calendar and actually plotting out how long he can possibly continue with this torture. This life threatening mandate has been in the air for 5 years. As the medicine is decreased farther and farther down toward the 90 mme mandate they know that it’s just a matter of time before they cannot stand it any longer. Gone is the time that this thinking is some kind of theoretical guideline. Now The Chronic pain Suffer is faced with literal life or death. Severe depression and anxiety would be the normal result with any normal brain NOT a sick or wrong thinking one. We are not talking about suicide here. This is Murder By Any definition. Why do we have to excuse our government and call it anything else?

Sharon C.

A history lesson might be appropriate. Around March, 1963 the Buddhist monks were protesting the treatment of Buddhism by the Diem regime. Diem proclaimed that Roman Catholicism alone was the only religion that would be practiced in Viet Nam, the only flag allowed was the Roman Catholic flag. But the Buddhists had other plans. So the monks flew their flags and were punished by Diem. When the monks failed to make the regime stop the terrible persecution of their fellow monks, the monks decided on self- immolation. That got the attention of the world. That concludes today’s history lesson.


[edit], a bandaid for those predisposed towards suicide. Whether it be child good trauma, or family history. I predict a dramatic rise in suicide by neglect. That’s neglect of treating chronic pain patients who have no where to turn. Patients who have been leading SEMI normal lives with the aid of opoids or other pain medication.

I’m not talking about addicts who take non prescribed drugs to escape thier normal dysfunctional lives. I’m talking about the millions of patients trying to get by within the all regulated system tying doctors hands with threats. Should they try to ease the pain of actual people who respond to treatment with opoids.

I’m 64 years old with chronic pain. I’ve tried the other modalities of treatment. Now I’m expected to go back and start all over. When the opoids were allowing me to have a semi normal life. Now almost completely off ant pain medication, soon to be stopped. I have the next ten or twenty years to live in pain so bad I can barely describe it to someone never in pain.

Take two aspirin and call me in the morning if you don’t deal better. Never contemplated suicide, but the more you people want to talk about it. Seems like it’s what you want us to do. Deny till they die,

Kris Aaron

I have a few disagreements with this article.
First, most people living with severe chronic pain are at least partially physically disabled and unable to access places like the Golden Gate Bridge or the roof of a tall building, much less climb out on the edge. As a chronic pain patient myself, I doubt if “regret” would be my primary emotion in the last few seconds before my suffering ended.
Second, people who call suicide hotlines or go to crisis centers may be in for a horrible surprise. Many crisis centers do not allow the use of medication they haven’t prescribed, leaving the potential suicide victim unmedicated for hours or days. Some, sadly, are nothing more than 72-hour holding pens that provide only five minutes of “talk therapy” to justify their existence.
Recently, a friend threatened suicide; his terrified wife called a local help hotline which in turn called the police. They dragged him off IN HANDCUFFS to the afore-mentioned 72-hour holding pen! This is standard treatment when law enforcement is involved.
No suicide hotline is capable of helping chronic pain patients. They are not equipped to prescribe opiates or refer patients to physicians who do. We don’t need a sympathetic listener to tell us they “understand” (no, they don’t. only chronic pain patients understand, and they aren’t working at a suicide hotline). We really don’t need someone to ask us if we’ve tried accupuncture, massage therapy, talk therapy, colored lights, special diets or exercise.
We need opiates! We are IN PAIN!!
Our physicians have already told us we aren’t going to recover or regain our former functionality. The only thing they can do for us is prescribe opiates, something they’re now forbidden to do by the government. We are looking at years of endless suffering, our lives destroyed by our own bodies.
No suicide hotline can help us deal with this hard fact. Happy-face thinking won’t make our agonizing days and sleepless nights any easier. Only opiates will keep us alive.
When we are denied relief from endless pain, suicide is the rational alternative to a life of misery.
Don’t tell us not to commit suicide. It’s our government that is killing us. Tell them to stop!


“And suicide can unfortunately seem like a reasonable option.”

With every new government regulation that prevents those in pain from ever getting ANY relief, it becomes an even more reasonable option.

What does one say to a loved one who is considering suicide because they simply cannot stand the agonizing, excruciating torturous pain even one more day?

All I’ve got is “Don’t let the b*****ds win!”

Every day I pray it is enough.

Unfortunately we will see more suicide in the chronic pain community. It’s almost as if we are disposable people.
We are not and anyone needing support please reach out. We can change these bogus rules the CDC is trying to apply to everyone. One size does not fit all.
Keep fighting, we are strong and worthwhile!


This is only my perspective having lived more than half my life with chronic pain, anxiety and depression.

First the government needs to stop playing “We know what’s best for everyone”. All entities and for profit corporations including DEA, private prisons, Big Pharma etc, need total transparency if they are going to affect the lives of people to the degree they have today.

Too many pockets make huge profits based on their decisions which have ruined so many lives without fully understanding chronic pain or addiction.

First, if you at least decriminalize drugs as other countries have done many of the problems we face would go away.

You take away the very things that work for pain sufferers and what do they do? They don’t just “suck it up”, they look for something else.

A large number of over doses were from cocktails of other meds and/or alcohol but they don’t mention that.

Psychotropic drugs have been attached to way too many suicides and/or mass shooting etc. Why aren’t we digging further into this area?

The problem isn’t with the chronic pain sufferer, it goes deeper than that. Why aren’t we looking at government agencies, military, Big Pharma, prisons, police, for profit recovery etc.?

They have way too much money to lose if it weren’t legal to choose your choice of relief without needing permission.

On top of that add drug and alcohol education in our schools. Speaking of alcohol, why is this legal? How many deaths and broken lives are attributed to this substance?

One last thing. Many people are required to take drug tests. Tell me why politicians are not required to take random drug tests. More than any other job I can think of, being a politician affects the lives of everyone based on their mental capacities while making very important decisions.

Why are they not subject to random drug testing? My opinion? I see up to 3 reasons. 1) Drug/alcohol use, 2) Profit in one or more ways or 3) Combination of both.

Full transparency and required random drug testing for all politicians will save a lot of lives! PROVE ME WRONG please.