that's what they were now taught. and then the v.a. and joint co-mission came in. and a vital sign. office you see a thing that says measure pain 1 through 10. it's cultural change. couldn't blame doctors. up until a year and a half ago. a year and a half ago, the cdc issued a set of 12 recommendations called the cdc prescribing guideline for opioids for chronic pain. in there it's guidelines. it's not telling doctors what you can or can't do. just follow these 12 steps and make your own decision. the issue that i have is, and most americans should have, starting a year and a half ago, now the information is out there. we have data that shows chronic use of opioids has no evidence of improving pain and function. and there is loads of evidence it's killing people. based on that, these 12 recommendations came out.