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Thread: With a 10-day supply of opioids, 1 in 5 become long-term users

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by JasperL View Post
    I acknowledge it's anecdotal and an n=2 in my case and for my mother in law, but there was no briefing, no counseling, no nothing. And for a provider to give opiates to a person who admits to being an alcoholic is bordering on malpractice.



    That's correct, but again, given what we KNOW are the risks and the well known opiate addiction crisis in this country, IMO, a 10-day prescription is irresponsible barring someone in extreme pain. IMO a default of 0 days, 0 pills is the correct one.

    The other problem with, say, 10 day supply when most patients actually NEED 2 or 3 is now you've got a bottle of opiates sitting in the drug cabinet and we know most non-medical users of opiates get them from family or a friend - e.g. steal them out of mom's cabinet. Sure, mom should flush them right away, but we know that doesn't happen and can't pretend that it does.



    But the problem with the drug companies is they have for years (from several reports I've read) purposely under reported the risks of prescribing opiates, and overstate the benefits of long term opiate use for chronic pain. And of those who are on the pills long term, something like 1 in 3 become addicts, or at least physically dependent on the drug, and if you've been around opiate addicts you know it's DAMN hard to kick that addiction - far tougher than alcohol. So doctors get patients on the opiate train and they can't get off it.

    Just one more thing - yes people are often to blame. But if the medical community KNOWS a large share of people who are put on long term opiate use become addicts, it doesn't MATTER who is at fault - the long term use of opiates will create a bunch of addicts and society has to deal with the fallout. The drugs just are easily and often abused, and handing them out like candy IMO a mistake.
    I agree about prescribing to an alcoholic...and dont get me wrong. I'm not saying there aren't irresponsible doctors. Pretty much every state has an online ethics board that you can review and prescription abuse is usually the top offense cited.

    Giving a 10 day supply prevents individuals from having to make another appointment and pay for another office visit. I would bet every police/fire station or hospital in the country has a drug amnesty box where people can take their unused eds. Sometimes we have to be responsible for our own actions...including properly disposing of unused medications.

    Opiate addiction is more and more treated on an outpatient basis. Unless there is a comorbid diagnosis (usually Major Depressive D/O) and an expressed risk of harm to self or others, day treatment and outpatient is becoming the standard. Extreme cases may require a 72 hour detox (whihc is approx the same for alcoholics). Its still nasty stuff...not minimizing it. And we can al agree...meds are over-prescribed. ALL meds. But I think its bigger than just pharm and lazy docs. Leaving out the corrupt pill peddlers that are a real problem, the best solution is maybe for patients and docs to work together on a treatment plan that minimizes opioid use.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by Hawkeye10 View Post
    What's with the tude, did we catch you on a bad day or are you always like this?

    Remedially: I am suggesting that we dont have enough information to know that regulating tools is the best way to get to a more healthy state, maybe this is a spiritual matter, which requires a different approach. Speak to that if you want my attention.
    Clinical depression has been demonstrated to have a CHEMICAL causation as does addiction so I am at a loss to explain your spiritual connection. Writing off addicts and suicides as the result of being a "loser" is not only incorrect it is lacking empathy.
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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by iguanaman View Post
    Clinical depression has been demonstrated to have a CHEMICAL causation as does addiction so I am at a loss to explain your spiritual connection. Writing off addicts and suicides as the result of being a "loser" is not only incorrect it is lacking empathy.
    Since when is someone seeking the best tool for the job writing off or lacking empathy for the job.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by JasperL View Post
    I don't really agree with that last point. I'm sure nearly everyone understands that there is a danger of taking opiods, but when your doctor hands you a scrip for 10 days, I'm quite positive the vast majority think they'll never be the exception, and doctors (at least in my experience and talking to others) are just about worthless as far as counseling patients on the risks. I'm sure they don't say, "Here's a 10-day Oxy prescription - you have about a 5-10% chance of becoming an opiate addict and ruining your life if you take them. Have fun, see you in two weeks!"

    Hell, I'm a sober alcoholic who makes a specific point to tell my doctors this and after my last minor surgery, what do you think I got? A prescription for narcotics with exactly NO counseling or questions. Nothing. And I know from my recovering buddies this is common. He might as well have handed me a bottle of booze for my pain. I take care of my 87 yo mother in law's medical stuff - she gets opiates handed to her like candy, no counseling, nothing. As I said earlier, we told the doc after her hip surgery she does poorly on them, and out the door we get a scrip for 45 pills! There are other options for pain than opiates but even given the risk the go-to is Oxy or hydrocodone.

    So, sure, it's a personal responsibility thing, but it's also a failure of the medical system that providers practically beg people to take drugs that just ARE causing massive misery and death in this country with, in my experience, ZERO real counseling about the risks. Even Mexico appears to handle this better than we do, or at least some hospitals. A friend got some elective surgery down there recently and was told before it - you'll get no narcotics here - none. Don't ask. You'll be in pretty bad pain for a day or so, but it's manageable, then it'll quickly subside, so no opiates. That ought to be the standard here - default is Advil, not Oxy.
    You don't agree with my last point but then prove it in your last statement.

    This is the reason why I don't want government to be involved in my personal health care. I shouldn't have to go through pain because other people are irresponsible, which is precisely what you and others are advocating.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    With a 10-day supply of opioids, 1 in 5 become long-term users
    that **** scares me enough that i went through a wisdom tooth extraction on advil. i got addicted to the fountain of old after two cigarettes, so i'm not enthusiastic about trying prescription pain pills unless i absolutely have to.

    i did kick those ****ing cancer sticks, though.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by SouthernDemocrat View Post
    In August I was our riding my road bike over lunch. While stopped at a stop light a woman who was looking at her cell phone plowed into me at 40 mph from behind. I work up in ICU a few hours later with a broken back, broken ribs, shattered scapula, a gash on my forehead exposing my skull, nerve damage, muscle damage throughout my body, even tire marks on the backs of my legs. They had me on IV dilaudid. I had them take me off of it after 24 hours. When I got out of the hospital they wrote me a prescription for 3 weeks of narcotics. I never filled it and instead would just take 2 Aleve every 12 hours. At first I was in so much pain I could not stand without assistance. I knew though that I would be in pain for while until I healed and there was nothing for it other than just to deal with it. I knew that I would be in pain for long enough that if I tried to mask it with narcotic pain killers, I would risk getting addicted to them. Moreover, I knew that narcotics dull your pain tolerance. So I dealt with it. I pushed myself, and according to the doctors I healed at a miraculous rate.

    Humanity has been around for over 200,000 a years. We have only had narcotics for the last 200 years or so. Before that we just dealt with the pain until we healed. I am not saying there is not a role for narcotics. For 2 or 3 days after severe trauma or a surgery, they can certainly make a big difference. However, they are not for chronic pain.
    I'm glad you've fairly well recovered.

    Actually, narcotics have been around much longer than 200 years. Opium has been around since the earliest days. A quick check says it goes back to about 4000BC. Having been administered morphine, I know it really works. Opiates, derived from opium, have been around a long time too.

    Opioids are substantially different, in that they are synthetic drugs that are chemically engineered to work with the human body. Very efficient as it turns out, but also very dangerous as we all know. In the short number of years that humans have been administered opioids, they have been a disaster for society, by any standard.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by JasperL View Post
    I don't really agree with that last point. I'm sure nearly everyone understands that there is a danger of taking opiods, but when your doctor hands you a scrip for 10 days, I'm quite positive the vast majority think they'll never be the exception, and doctors (at least in my experience and talking to others) are just about worthless as far as counseling patients on the risks. I'm sure they don't say, "Here's a 10-day Oxy prescription - you have about a 5-10% chance of becoming an opiate addict and ruining your life if you take them. Have fun, see you in two weeks!"

    Hell, I'm a sober alcoholic who makes a specific point to tell my doctors this and after my last minor surgery, what do you think I got? A prescription for narcotics with exactly NO counseling or questions. Nothing. And I know from my recovering buddies this is common. He might as well have handed me a bottle of booze for my pain. I take care of my 87 yo mother in law's medical stuff - she gets opiates handed to her like candy, no counseling, nothing. As I said earlier, we told the doc after her hip surgery she does poorly on them, and out the door we get a scrip for 45 pills! There are other options for pain than opiates but even given the risk the go-to is Oxy or hydrocodone.

    So, sure, it's a personal responsibility thing, but it's also a failure of the medical system that providers practically beg people to take drugs that just ARE causing massive misery and death in this country with, in my experience, ZERO real counseling about the risks. Even Mexico appears to handle this better than we do, or at least some hospitals. A friend got some elective surgery down there recently and was told before it - you'll get no narcotics here - none. Don't ask. You'll be in pretty bad pain for a day or so, but it's manageable, then it'll quickly subside, so no opiates. That ought to be the standard here - default is Advil, not Oxy.
    My bad, I got mixed up in the conversation and thought you were responding to a different post I had made.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by SouthernDemocrat View Post
    As I pointed out here I know what dealing with pain is like: https://www.debatepolitics.com/break...post1067004223 (With a 10-day supply of opioids, 1 in 5 become long-term users)


    But to repeat myself, as was pointed out elsewhere in the thread, narcotics are not meant or even particularly effective for chronic pain. No other nation prescribes them for chronic pain like we do. Anywhere else, you get them for short term severe pain after surgery or severe trauma, and that is it other than for terminal cancer patients. This is why we have 5% of the world's population, yet 80% of the narcotics prescriptions. Some 300 million narcotic prescriptions were written in 2015 alone. It is a 24 billion dollar industry for the pharmaceutical companies that make them.

    The majority of people that use narcotic pain killers regularly long term are addicted to them whether they know it or not. That pain they experience when coming off them is not the pain from their old injuries, its withdrawal symptoms. The majority of the people addicted to narcotics in this country are people getting them legally prescribed.

    Narcotics are for very short term pain after surgeries or severe trauma. They are not for treating chronic pain and that misuse of them is why we have such a opiate addiction epidemic in this country.
    The key word is "misuse". Other then that, I will agree with you that opioid meds are over prescribed. Like I pointed out earlier, I have thrown most of the opiod meds out after surgery. However after an automobile accident nearly 5 years ago, morphine was a must, at least for a few hours. And my brother once suffered a head injury that resulted in so much pain that he was given virtually every pain medication known to man including opioids. He never became addicted. I do not agree that opiods have no legitimate use for chronic pain. There is no prescription pain medication that does not carry an addiction risk. It is a risk versus benefit issue.
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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by ObamacareFail View Post
    The key word is "misuse". Other then that, I will agree with you that opioid meds are over prescribed. Like I pointed out earlier, I have thrown most of the opiod meds out after surgery. However after an automobile accident nearly 5 years ago, morphine was a must, at least for a few hours. And my brother once suffered a head injury that resulted in so much pain that he was given virtually every pain medication known to man including opioids. He never became addicted. I do not agree that opiods have no legitimate use for chronic pain. There is no prescription pain medication that does not carry an addiction risk. It is a risk versus benefit issue.
    There is actually very little evidence that narcotic pain meds are effective for chronic pain. We are the only nation that prescribes them for chronic pain. What they are good for is short term pain following surgeries, end stage cancer, or severe trauma.

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    Re: With a 10-day supply of opioids, 1 in 5 become long-term users

    Quote Originally Posted by iguanaman View Post
    Clinical depression has been demonstrated to have a CHEMICAL causation as does addiction so I am at a loss to explain your spiritual connection. Writing off addicts and suicides as the result of being a "loser" is not only incorrect it is lacking empathy.
    There is much theorizing on the chemical cause of depression...but Ive yet to meet the person that loves themselves, is in a powerful and positive loving relationship, had a strong supportive relationship with their family, did not experience trauma, loves their life today and is excited about their life tomorrow that still suffers from depression. Not saying that person doesnt exist...but that I've never met that person. Which is odd if depression is due to faulty brain chemistry because that should be the case in a significant number of patients. IF that is the cause.

    Depression is most often the bi-product of Crappy Life Syndrome. If yesterday sucked, and today sucks, and tomorrow looks a lot like yesterday and today...well...THATS depressing. People in that circumstance SHOULD be depressed. And yes...their brain chemistry would absolutely reflect state...but not cause.

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