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Opioid epidemic emergency... ok, so now what?

iliveonramen said:
Ultimately we'll see. Purdue Pharma is under investigation by the DOJ. Purdue is the maker of OxyContin. They are also facing civil legislation by the state of Kentucky (among others).

A lot of the claims are that Purdue active peddled the drug to people that didn't need it and shouldn't be prescribed it. That the company failed to report suspicious practices by doctors.

I want to point out....drug companies are required to report suspicious activity when it comes doctors. It's never really enforced and they don't really do it, but that's something that should be taking place.

Drug companies in general having direct access to marketing to doctors and to consumers has pretty much created a host of issues with no benefit to anyone but their bottom line.
Click to expand...

In Guilty Plea, OxyContin Maker to Pay $600 Million - The New York Times

perdue already got busted and paid a settlement.

ABINGDON, Va., May 10 — The company that makes the narcotic painkiller OxyContin and three current and former executives pleaded guilty today in federal court here to criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused.

To resolve criminal and civil charges related to the drug’s “misbranding,” the parent of Purdue Pharma, the company that markets OxyContin, agreed to pay some $600 million in fines and other payments, one of the largest amounts ever paid by a drug company in such a case.

Also, in a rare move, three executives of Purdue Pharma, including its president and its top lawyer, pleaded guilty today as individuals to misbranding, a criminal violation. They agreed to pay a total of $34.5 million in fines.
Click to expand...

If you want the full story, well, up to a few years ago, read the book Dreamland.
 
Goshin said:
What are we realistically going to do about it?


The rules are already so strict that people in real need of pain management have trouble getting what they need.


Tightening down on that is mainly going to make it harder for people with real needs... causing people in pain to suffer more for the sake of trying to stop people from getting high, which has proven over and over to be ****ing futile.



Are there any realistic plans that won't just cause more suffering while having little effect on high-seekers?
Click to expand...

I like the question. I'm really not sure where you are getting that people in pain can't get pills easily now. Hop on over to WV and you can buy it like candy. I agree that it would be hard to solve the problem if we are trying to just stop addicts from getting a hold of pills. They will find a way. Drug companies should be held accountable for flooding different areas with pills, and doctors need serious training on what proper prescriptions are. Beyond that it becomes a harder question to answer.
 
Goshin said:
Past a certain point, perhaps not. But the harm they do to others along the way is abhorrent to me.

Locally I've given up on trying to help the addicts get clean, as it has so far been empirically futile. I've refocused on helping the families cope.


In some cases this means cutting ties and letting the addict go. I don't want to sound callous... in some cases it breaks my heart. But how much damage do you let them do before you say that's enough and no more?

There's a saying I heard not too long ago, goes like this: "Addicts don't have families, they have hostages." I've seen it fall out that way so often I consider it an unpleasant truth in most cases. Here in the land of meth and pills, addicts use and abuse their families, feed off them materially and emotionally, mistreat them and use them as pawns to satisfy their wants and egos.


I've reached the point, personally, where I have to focus my efforts on the families and minimizing the damage. I can't do anything about the addicts themselves. I wish it were otherwise, but locally we're getting very close to "lifeboat rules" conditions.


It's bad.
Click to expand...



And as I mentioned that is all you can do. Unlike cancer or another deadly disease the patient is not helped by our company, we become a source of cash; if they can't talk you out of it they will steal it. Part of the disease.

It's worse than bad, and we have been merely been paying lip service to the problem. We have been ignoring the "collateral damage" of the impact on families, employers and friends. A lot of it is a lack of will. Too many people see the addict as a criminal who does not "deserve" compassion etc.

Finally, if we put out addicts out to a pasture somewhere we'll lose all our rock stars and actors
 
Goshin said:
Damn right it does. There's people around here who fill real pain-management needs off the black market when they can't afford another office visit or the runaround and wait required.

And getting rid of that black market is about as likely as getting rid of any other....
Click to expand...

I think on balance we might to better tying to provide legal access to clean drugs for addicts and offer them treatment when they want it. That might cost us less in blood and treasure over time than the 'war on drugs', which is throwing money into a fire. I'm not sure, and I agree that there are drugs I think are too dangerous to just hand out, so I'm willing to listen to other options.
 
Fearandloathing said:
Well, I can't disagree more. I was one of the ones you want to "get it over" some years ago. I stood at the precipice of suicide. Since then I have built a computer sales and consulting business, help a good number of others sober up and created a social enterprise for people in recovery to find their way back to employment.

In 28 years I have found that most recovered addicts are preferable company to "normal" company who judge easily and without adequate information
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I'm not the least bit opposed to helping people that accept that help but I'll be damned if I'll support some kind of revolving door program where the same bodies come through the door time and time again. It's kind of the "Screw me once, shame on me. Screw me twice, shame on you" plan.

I can't even begin to tell you how sick and tired I am of reading stories about people that ignore their kids because they can't get off drugs or can't hold down a job because it interferes with their drug abuse. I'm sick and tired of seeing babies born with all kinds of issues because their mother was getting high while pregnant. I'm sick and tired of grandparents with barely two nickles to rub together having to take care of their grandkids because their kids are messed up on drugs.

If your crime is simple possession of some of this crap I'm willing to give you a chance....ONE chance. The next time I see you on the street and your high or holding it's sayonara, sucker. You had your chance and you blew it. Go live with the rest of the troglodytes.
 
Fearandloathing said:
Welcome to the new world. Vancouver has been in crisis mode for two years. The ONE major argument I have with out federal government they are slow to catch on, the health minister opened her file on this by stating there should be "better labeling"

Last year over 900 people died, a two hundred and fifty percent increase over the year before. This year we expect to hit close to 2,000. We have issued 10,000 anti-opioid syringes, free to anyone who will take a five minute course. Out treatment facilities are over-run, some of us AA old timers are trying to get a "safe house" going.

We have opened three new harm reduction centers and OD's of heroin, coke and crack have fallen to near zero, the Fentanyl epidemic continues to rage like the wild fires of last summer.

Enforcement switch from user to traffickers years ago and we have put a few thousand people in jail. We have aerial reconnaissance all along the border and they are stopping everything that looks suspicious coming in from Alaska or Alberta.

EMT's are burning out from having to scrape so many children off the street. We have done everything every drug expert and activist can think of and it continues unabated.

This has little to do with actual physical pain relief, but addiction itself. Fenantyl is easily and cheaply made from components on any drug store shelf. You are correct that in taking it off the street you force the addict to move to something else. For years this has been our default system of treatment...usually ending with heroin which is easier to kick than alcohol.

This is different. Neither myself or any of my colleagues in addictions, long time police, addicts with long term sobriety and some medical staff has anyone ever seen anything like before. usually the deaths start with laced or impure street drugs and then fade when we can it off the street. We can't stop this. For every bust there are ten more behind them, for every user death there twenty in waiting.

I fear for much of the US. We have been far ahead of many of the more progressive programs and we're losing. After hearing Trump stumble through an announcement he clearly didn't understand didn't improve my disposition.

But make note of this. There are ten thousand syringes out there, in the city of Vancouver, an anti-dote that will save the lives of the victim 90% of the time, 10,000 and we haven't even slowed the growth rate.
Click to expand...

Re the bold

I have never heard that about Fenatyl, GHB and meth yes. MDMA is not hard to make but still has controlled substances that make getting the raw materials difficult
 
Lutherf said:
I'm not the least bit opposed to helping people that accept that help but I'll be damned if I'll support some kind of revolving door program where the same bodies come through the door time and time again. It's kind of the "Screw me once, shame on me. Screw me twice, shame on you" plan.

I can't even begin to tell you how sick and tired I am of reading stories about people that ignore their kids because they can't get off drugs or can't hold down a job because it interferes with their drug abuse. I'm sick and tired of seeing babies born with all kinds of issues because their mother was getting high while pregnant. I'm sick and tired of grandparents with barely two nickles to rub together having to take care of their grandkids because their kids are messed up on drugs.

If your crime is simple possession of some of this crap I'm willing to give you a chance....ONE chance. The next time I see you on the street and your high or holding it's sayonara, sucker. You had your chance and you blew it. Go live with the rest of the troglodytes.
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Well that's not the way it is. I wish it were. I am one of two people I know who went to AA and stayed clean and sober. anyone near the situation has to accept that, it's part of the disease.

I am sick and tired of all those things too, but I am not about to ship them off like slaves. They are still human beings.

I would suggest you spend some time at a couple of AA meetings and listen to their struggle, what they are doing to get off drugs.

What would happen if suddenly the government made it a crime to smoke cigarettes. Would you jail anyone who didn't quit? If not, why not? And yet NO ONE I know ever quit the fist time. With me it took about two dozen tries, but I am cigarette free no for six years and counting. Think of cigarettes when I say they don't have real control of what's happening.

On that, cigarette are many times more addictive than alcohol, heroin, speed, AND alcohol. Probably more so because I've been on the front lines for over two decades, I hate it too, but there is **** all I can do about it, other than be there for that magic moment when one of them wants out.
Have a conversation with an ex smoker about what it's like to try quitting, then magnify that by five and you have the challenge these people face
 
Another thing to bear in mind is that the vast majority of these deaths are due to variable amounts of fentanyl and carfentinil being mixed in by mid-high level dealers. A huge increase in death rate doesn't necessarily mean there's a huge increase in addiction rate.



If we really wanted to focus on stopping deaths first, we'd start using Switzerland's model: clinics where you go, declare addiction (officially even, I think) and you get your doses of pure heroin there. Sure, you're still an addict, but you're not gambling with your life with every shot.

I think we can guess how well that will go over in America, where it's almost always more important to defend some principle costs-be-damned than aim for the best pragmatic solution.



The bottom line is we're never going to get rid of it. Humans have always used drugs. The best thing we need are pragmatic solutions aimed at harm-reduction and honest education. Not the idiotic lies D.A.R.E. used to peddle.
 
Goshin said:
What are we realistically going to do about it?


The rules are already so strict that people in real need of pain management have trouble getting what they need.


Tightening down on that is mainly going to make it harder for people with real needs... causing people in pain to suffer more for the sake of trying to stop people from getting high, which has proven over and over to be ****ing futile.



Are there any realistic plans that won't just cause more suffering while having little effect on high-seekers?
Click to expand...



I think this happens with many things. Because people abuse certain things, it ends up being harder for people who don't.
 
I just saw this.

In two years, the town of Kermit in West Virginia received almost nine million opioid pills, according to a congressional committee.
Just 400 people live in Kermit.
Nationally, opioids killed more than 33,000 people in 2015, according to the Centers for Disease Control and Prevention.
That figure includes deaths from heroin, an illegal opioid. But almost half involved a prescription opioid - that is, a painkiller available from a pharmacy with a note from a doctor.
So why does America - more than any country in the world - have an opioid problem?
There is more than one cause. But these are some of the most important.
American doctors prescribe - a lot
Unlike most European countries, the US does not have universal healthcare paid for by taxes.
Instead, Americans must get their own insurance - usually via an employer or the government.
"Most insurance, especially for poor people, won't pay for anything but a pill," says Professor Judith Feinberg from the West Virginia University School of Medicine.
"Say you have a patient that's 45 years old. They have lower back pain, you examine them, they have a muscle spasm.
"Really the best thing is physical therapy, but no one will pay for that. So doctors get very ready to pull out the prescription pad.
"Even if the insurance covers physical therapy, you probably need prior authorisation (from the insurer) - which is a lot of time and paperwork."
The CDC says opioid prescriptions have fallen by 18% from their peak in 2010. But the total is still three times higher than in 1999.
Click to expand...

Why opioids are such an American problem - BBC News

So it seems one quick improvement would be to free up doctors to easily prescribe physical therapy instead of pills.
 
Lord Tammerlain said:
Re the bold

I have never heard that about Fenatyl, GHB and meth yes. MDMA is not hard to make but still has controlled substances that make getting the raw materials difficult
Click to expand...

I don't know about the drug store shelf thing, but a lot of the fentanyl ending up in heroin is made in Mexico, with the component chemicals being easily purchased from China. Not sure if they can get the components shipped here.
 
SmokeAndMirrors said:
I think we really need to look at WHEN opiods are being prescribed. As you know, I went through that judgmental crap with law enforcement about my dad's pain medication, even though the reason he had it was because he was literally dying of cancer (Not only is that ridiculously painful obviously, but frankly, who cares if he DID get addicted to it at that point? What, is he gonna have to detox in the afterlife?). That is absurd, and denies the dignity of people in suffering.

But I can also tell you I've been prescribed opiods 4 times, despite that I have never had any pain that couldn't be managed by NSAID's and other OTC medication. I only took it once, and the rest of the time threw it in the trash. But some people aren't aware of how incredibly easy it is to get addicted.

Why was I given an addictive painkiller for a problem that I TOLD the doctor I was successfully medicating with ibuprofen? Why was I given an addictive painkiller for an operation so minor they didn't even need to use a single stitch? That makes no sense.

We need the evaluate the protocol for WHEN we give opiods. We need to have a better process for trying other medications and pain alleviating therapies for conditions that may be able to be addressed elsewise. Lots of countries have found ways to successfully and humanely manage even fairly large amounts of pain without resorting to opiods. Most pain can be managed and treated without it.

But we also need to acknowledge some pain requires these drugs. After all, they were originally invented because they were the only thing that could stop people from dying of shock alone after getting a leg blown off. For truly extreme pain, they are literal life-savers. And for those sorts of extreme conditions and injuries, we need to simply provide the management these people need.

We need to be realistic that these people will become dependent, and that fact is part of the cost of using these drugs. But if they have a condition which legitimately cannot be treated with any other form of pain medication, then it is cruel to deny that to them, regardless of whether they become dependent.

We need to look at dependency as an expected side effect, and then make the call of when the ends justify the means.

And if we've determined they do, then we need to just commit to that trade-off and stop tormenting people with such incredibly painful medical problems.
Click to expand...


I thought I would reply to this because it brings up a good point.

I think we need to look at WHY opiods are being prescribed.

In many cases.. they are being prescribed because the person has pain that's uncontrolled OTC medication.

In some cases. they are being prescribed because its the only answer the physician/provider has to help this patient. Because other interventions that might work.. are simply not covered or allowed by their insurance. I have a fellow that needs back surgery. He has legitimately tried alternatives to surgery. Physical therapy, chiropractic and injection. To even GET these alternatives.. there was a long delay... he got to chiropractic rather quickly but that made him worse. So therapy was prescribed. His insurance delayed authorization for therapy for a month. then they gave him 3 visits. And then another delay of another month until he got approved for more therapy. That helped but he was not approved for any more therapy. So he referred to see if injection would work. 4 months later he was approved for injection. Injection helped about 20%. but he was not approved for further injections. So now.. he sits in limbo waiting for approval for back surgery.

He has been on opiods now for almost a year. He most certainly is dependent. (there is a dramatic difference between dependency and addiction). but whats the alternative? so much pain that he cannot function?

So.. the problems with the healthcare system have basically tied the physicians hands to the point of giving out opiods. (and before someone jumps up to say.. "well government insurance would be better... the patient is on government insurance).

As the healthcare system in the US has gotten squeezed for reimbursement since the late 1990's.. more and more, the only help that a physician can offer for pain.. is opiods. And now.. that's being curtailed..and now I fear my patients who come January first.. that if the proposed rule is implemented, their insurance will not pay for opiods for any reason other than metastatic cancer. If this occurs.. I see a portion of my patients will be seeking pain relief from their local black market.
 
Goshin said:
What are we realistically going to do about it?


The rules are already so strict that people in real need of pain management have trouble getting what they need.


Tightening down on that is mainly going to make it harder for people with real needs... causing people in pain to suffer more for the sake of trying to stop people from getting high, which has proven over and over to be ****ing futile.



Are there any realistic plans that won't just cause more suffering while having little effect on high-seekers?
Click to expand...

Hi Goshin, while I agree with you that there are those in real pain where these prescriptions are warranted like people battling the last stages of cancer as they were intended, it has also been proved these drugs have been abused and over prescribed for crap that didn't warrant them.

They are highly addictive. If someone dying of cancer gets addicted so what! Some doctor prescribing them for a back injury or another boo boo is not acceptable because it gets a lot of folks addicted that could be an addict in the making for 40 years or more.

The drugs have been abused by the medical profession, the pharmaceutical profession.

Look I had a younger brother who had an addiction to opiods. It started with shoulder and neck surgery. His wife died from an overdose of Oxycontin from the same doctor that prescribed the crap to my brother monthly for his surgery/ injuries. She underwent back surgery. It was prescribed to her and the same family physician that continued to prescribe it to my brother prescribed it to her too on a monthly basis. After awhile, the prescribed dosage isn't enough to reach that high they seek so they tend to overdose.

After my brother and my sister in law who both got on to Oxycontin due to surgeries and a family doctor willing to prescribe them long after, both turned into worthless human beings unable to work and provide for themselves. Both overdosed and both died within years of each other. Sis in law was from a direct overdose and brother was due to his liver giving out due to the abuse. They were both in their 50's. When cleaning out brother's home after his death, he had a prescription bottle for Oxycontin in his possession for that month for a number of pills. The bottle was empty with more than two weeks left on the prescription. Obviously he had been popping a lot more pills that what he had been prescribed before his liver failed him and died.

I am all for means that reign in the abuse of these drugs being prescribed for things they were never intended and stop the abuse of creating addicts.
 
Goshin said:
What are we realistically going to do about it?


The rules are already so strict that people in real need of pain management have trouble getting what they need.


Tightening down on that is mainly going to make it harder for people with real needs... causing people in pain to suffer more for the sake of trying to stop people from getting high, which has proven over and over to be ****ing futile.



Are there any realistic plans that won't just cause more suffering while having little effect on high-seekers?
Click to expand...

Hi Goshin, while I agree with you that there are those in real pain where these prescriptions are warranted like people battling the last stages of cancer as they were intended, it has also been proved these drugs have been abused and over prescribed for crap that didn't warrant them.

They are highly addictive. If someone dying of cancer gets addicted so what! Some doctor prescribing them for a back injury or another boo boo is not acceptable because it gets a lot of folks addicted that could be an addict in the making for 40 years or more.

The drugs have been abused by the medical profession, the pharmaceutical profession.

Look I had a younger brother who had an addiction to opiods. It started with shoulder and neck surgery. His wife died from an overdose of Oxycontin from the same doctor that prescribed the crap to my brother monthly for his surgery/ injuries. She underwent back surgery. It was prescribed to her and the same family physician that continued to prescribe it to my brother prescribed it to her too on a monthly basis. After awhile, the prescribed dosage isn't enough to reach that high they seek so they tend to overdose.

After my brother and my sister in law who both got on to Oxycontin due to surgeries and a family doctor willing to prescribe them long after, both turned into worthless human beings unable to work and provide for themselves. Both overdosed and both died within years of each other. Sis in law was from a direct overdose and brother was due to his liver giving out due to the abuse. They were both in their 50's. When cleaning out brother's home after his death, he had a prescription bottle for Oxycontin in his possession for that month for a number of pills. The bottle was empty with more than two weeks left on the prescription. Obviously he had been popping a lot more pills that what he had been prescribed before his liver failed him and died.

I am all for means that reign in the abuse of these drugs being prescribed for things they were never intended and stop the abuse of creating addicts.
 
vesper said:
Hi Goshin, while I agree with you that there are those in real pain where these prescriptions are warranted like people battling the last stages of cancer as they were intended, it has also been proved these drugs have been abused and over prescribed for crap that didn't warrant them.
....

I am all for means that reign in the abuse of these drugs being prescribed for things they were never intended and stop the abuse of creating addicts.
Click to expand...


I don't claim to have the answer. I think you've got a definite point, b/c most of the people I know that got hooked on them started off taking them for a legitimate reason, then started abusing them.

But then again I also come back to how, with so many addicts, if you take access to Drug A away they just switch to Drug B, and often B is worse.
 
jaeger19 said:
I thought I would reply to this because it brings up a good point.

I think we need to look at WHY opiods are being prescribed.

In many cases.. they are being prescribed because the person has pain that's uncontrolled OTC medication.

In some cases. they are being prescribed because its the only answer the physician/provider has to help this patient. Because other interventions that might work.. are simply not covered or allowed by their insurance. I have a fellow that needs back surgery. He has legitimately tried alternatives to surgery. Physical therapy, chiropractic and injection. To even GET these alternatives.. there was a long delay... he got to chiropractic rather quickly but that made him worse. So therapy was prescribed. His insurance delayed authorization for therapy for a month. then they gave him 3 visits. And then another delay of another month until he got approved for more therapy. That helped but he was not approved for any more therapy. So he referred to see if injection would work. 4 months later he was approved for injection. Injection helped about 20%. but he was not approved for further injections. So now.. he sits in limbo waiting for approval for back surgery.

He has been on opiods now for almost a year. He most certainly is dependent. (there is a dramatic difference between dependency and addiction). but whats the alternative? so much pain that he cannot function?

So.. the problems with the healthcare system have basically tied the physicians hands to the point of giving out opiods. (and before someone jumps up to say.. "well government insurance would be better... the patient is on government insurance).

As the healthcare system in the US has gotten squeezed for reimbursement since the late 1990's.. more and more, the only help that a physician can offer for pain.. is opiods. And now.. that's being curtailed..and now I fear my patients who come January first.. that if the proposed rule is implemented, their insurance will not pay for opiods for any reason other than metastatic cancer. If this occurs.. I see a portion of my patients will be seeking pain relief from their local black market.
Click to expand...



It's a mess, to be sure.


I blew my knee out at work almost a year ago. Workman's comp. Got sent to a place for rehab.

In the first session the guy hurt me so bad I could barely walk back to my car. I was set back a week in terms of recovery. Literally, he damaged me despite me telling him he was manipulating my knee too far and too hard.

Let me be clear here, I am no stranger to pain and have a high tolerance for it; that therapy was gonna hurt was no surprise to me, but I wasn't simply subjected to a little pain, I was *damaged*.

Second time I requested a new therapist. I was asked why and stated my case as calmly as I could, specifying that I wasn't going to make an issue of it but I wasn't going to put up with being injured either. Well, the Dr didn't believe me and acted like I'd dropped in at the Vatican and took a crap in the Pope's hat. She made it clear that my opinion (never mind that it was my own personal knee here) was a pile of steaming dog poop in her eyes and her therapist guy could do no wrong.

So I said "right, frack the lot of you", and didn't go back. I got a cheap gym membership and did my own @#$#-durn therapy. It cost me my WC payments and ultimately my job, but I was at the point I didn't care. I had a knee to rehabilitate.


So sometimes, ****ty therapy by people who don't really care is worse than no therapy...
 
jaeger19 said:
I thought I would reply to this because it brings up a good point.

I think we need to look at WHY opiods are being prescribed.

In many cases.. they are being prescribed because the person has pain that's uncontrolled OTC medication.

In some cases. they are being prescribed because its the only answer the physician/provider has to help this patient. Because other interventions that might work.. are simply not covered or allowed by their insurance. I have a fellow that needs back surgery. He has legitimately tried alternatives to surgery. Physical therapy, chiropractic and injection. To even GET these alternatives.. there was a long delay... he got to chiropractic rather quickly but that made him worse. So therapy was prescribed. His insurance delayed authorization for therapy for a month. then they gave him 3 visits. And then another delay of another month until he got approved for more therapy. That helped but he was not approved for any more therapy. So he referred to see if injection would work. 4 months later he was approved for injection. Injection helped about 20%. but he was not approved for further injections. So now.. he sits in limbo waiting for approval for back surgery.

He has been on opiods now for almost a year. He most certainly is dependent. (there is a dramatic difference between dependency and addiction). but whats the alternative? so much pain that he cannot function?

So.. the problems with the healthcare system have basically tied the physicians hands to the point of giving out opiods. (and before someone jumps up to say.. "well government insurance would be better... the patient is on government insurance).

As the healthcare system in the US has gotten squeezed for reimbursement since the late 1990's.. more and more, the only help that a physician can offer for pain.. is opiods. And now.. that's being curtailed..and now I fear my patients who come January first.. that if the proposed rule is implemented, their insurance will not pay for opiods for any reason other than metastatic cancer. If this occurs.. I see a portion of my patients will be seeking pain relief from their local black market.
Click to expand...

You make a good point that it needs to come from a prioritization of the best possible healthcare, not just government control of said healthcare.

I had the weirdest problem in the UK. I still take ibuprofen for aforementioned pain problem once every few weeks as I need it (it's pretty random). But in the UK, you can't buy more than 2 boxes at once, and boxes have fewer pills than they do in the US. In the US, normally I just stock up for a few months so I can manage it if I get caught off guard, but I couldn't do that. I go through a box in a day, since I take a doctor-prescribed dose.

So one time, I ran out because I hadn't been permitted to buy enough to get through a day, and got hit off guard. I had stuff to do, and I couldn't function (it's a fair bit of pain -- which goes to show how much non-opioid painkillers really can handle on their own). The only thing we had left in the house... was my roommates's opioid-based medication from a dentist.

I hemmed and hawed, but eventually I took it because I couldn't get out the door, and I needed to be able to get on with my day. I needed to at least be able to GET to the store so I could ACQUIRE ibuprofen.

Basically, I had to take opioids because the government got in the way of me getting ibuprofen. How ****ing crazy is that?

Some government healthcare doesn't prioritize what might be longer-term treatments that can help people avoid opiods any more than our private system does. Some do -- Sweden's a good example. But others don't, and overprescribe opiods just like we do, like the UK. After years of battling their street heroin problem and finally making some headway, now they're just replacing it with a pill problem.

This needs to come from the medical industry itself. They have to make their own effort to make non-opioid pain management a priority for as many people as possible -- which is the vast majority of people, apart from end-of-life care.

Single payer alone won't fix that lack of prioritization. It needs to come from the medical industry, and the medical community.
 
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Goshin said:
What are we realistically going to do about it?


The rules are already so strict that people in real need of pain management have trouble getting what they need.


Tightening down on that is mainly going to make it harder for people with real needs... causing people in pain to suffer more for the sake of trying to stop people from getting high, which has proven over and over to be ****ing futile.



Are there any realistic plans that won't just cause more suffering while having little effect on high-seekers?
Click to expand...

Take marijuana off the schedule 1, and let that be prescribed for pain management. In fact, those states that have medical mj laws where that can be prescribed instead of opiod pain killers had a signifigent drop in opiod abuse

https://www.beckersasc.com/asc-qual...-lower-opioid-abuse-rates-4-observations.html

I wouldn't mind of Marijuana was strictly by prescription.. as long as there is good quality control.
 
I read a lot of "Oh **** what now" crap in this thread and man it pisses me off.

I lost a brother and sis in law to opiod addiction. Both started with surgeries and both had the same doctor willing to supply them with Oxycontin monthly for "pain"months and years after their surgeries that resulted in overdoses and livers failing. .
To thwart the opiod addiction starts with overseeing doctors that over prescribe the medication. Plan and simple. Opiods like Oxycontin were designed to relieve the pain of those suffering from terminal diseases. It has been abused.
 
RAMOSS said:
Take marijuana off the schedule 1, and let that be prescribed for pain management. In fact, those states that have medical mj laws where that can be prescribed instead of opiod pain killers had a signifigent drop in opiod abuse

https://www.beckersasc.com/asc-qual...-lower-opioid-abuse-rates-4-observations.html

I wouldn't mind of Marijuana was strictly by prescription.. as long as there is good quality control.
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When my sister was terminal, she found that cannabis oil in addition to morphine was very helpful...until she was sent a batch from California and didn't use it correctly, taking it orally rather than rectally as instructed. The experience was so terrible that she stopped using the cannabis oil altogether.
 
vesper said:
I read a lot of "Oh **** what now" crap in this thread and man it pisses me off.

I lost a brother and sis in law to opiod addiction. Both started with surgeries and both had the same doctor willing to supply them with Oxycontin monthly for "pain"months and years after their surgeries that resulted in overdoses and livers failing. .
To thwart the opiod addiction starts with overseeing doctors that over prescribe the medication. Plan and simple. Opiods like Oxycontin were designed to relieve the pain of those suffering from terminal diseases. It has been abused.
Click to expand...

Addressing the doctors is addressing a symptom not the source. To address the source, we need to educate the public so they can make informed decisions about pain killers fully aware of the costs and risks.

Education, not bureaucracy, is the place to start.
 
nota bene said:
When my sister was terminal, she found that cannabis oil in addition to morphine was very helpful...until she was sent a batch from California and didn't use it correctly, taking it orally rather than rectally as instructed. The experience was so terrible that she stopped using the cannabis oil altogether.
Click to expand...

I am sure different people had different experiences. Getting too much THC would not be pleasant, but unlike opiods, it wouldn't be fatal. I would like to see medical mj more available . mainly because I am getting older, and I would like the option for pain relief. It certainly does not promote addiction like opiods, but I don't think addiction is an issue if you are terminal. However, if properly used, I suspect for most people, the combination would be better than opiod alone would be.
 
ecofarm said:
Addressing the doctors is addressing a symptom not the source. To address the source, we need to educate the public so they can make informed decisions about pain killers fully aware of the costs and risks.

Education, not bureaucracy, is the place to start.
Click to expand...

I agree with you Eco to a point.

If it were not for the addicts the physicians created over the years in the abuse of prescribing such drugs making them addicts following their physician's instructions and willingness to continue their supply of such drugs long after a surgery etc..... but there is evidence of real abuse on the part of physicians and that needs to be addressed. Once one gets addicted and their supplier is their physician come on, something needs to change.
 
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