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re: What Big Pharma (and theFDA) dont want you to know about Opioid Epidemic

Posted on 6/2/16 at 3:58 pm to
Posted by NoHoTiger
So many to kill, so little time
Member since Nov 2006
46092 posts
Posted on 6/2/16 at 3:58 pm to
quote:

We condemned big tobacco for making nicotine addicts,

No, we condemned big tobacco for knowing that nicotine was addictive and conspiring to hide that fact. When drugs first come out and are thought to be non-addictive (benzodiazipines for example) they are marketed that way to patients. However, once the addictive properties are discovered, then possible addiction has to be weighed against therapeutic benefits.

As far as I know, cigarettes have no true therapeutic benefits.

In the case of opiates, there are times when the therapeutic properties will outweigh the possible addiction. However, one of the issues with pain killers is that we have been conditioned to think that all pain is bad pain and the only successful pain management is no pain. Now, we're seeing that is not really the case. Pain actually has therapeutic benefit. Feeling no pain can be deceptive. Feeling too much pain can be unbearable. It then becomes treating pain at a manageable level. Manageable levels of pain are subjective and patient-dependent.
Posted by AU66
Northport Al
Member since Sep 2006
3304 posts
Posted on 6/2/16 at 3:58 pm to
[quote]All kratom did was give me a rash, and I bought a supposedly strong strain from an online dealer with a good reputation.

everyone`s chemistry is different, but from my own personal experience and hundreds of other testimonials I've read, it`s helped so many with chronic pain problems that would turn to opiates if it isn`t available, i tried the pharma ones, lyrics, mirapex, requip, none worked then ran across kratom, instant relief. point is you mighta got a rash but you won`t stop breathing suddenly from taking it.
Posted by CptRusty
Basket of Deplorables
Member since Aug 2011
11740 posts
Posted on 6/2/16 at 3:59 pm to
quote:

no one can argue that we had safe guards in place, at that time, to prevent many patients that ended up addicts...



how about the print on the fricking bottle?

what other kind of safeguards do you want?
Posted by PhilipMarlowe
Member since Mar 2013
21644 posts
Posted on 6/2/16 at 4:02 pm to
Auto downvote for the usage of "lamestream media"
Posted by chRxis
None of your fricking business
Member since Feb 2008
26689 posts
Posted on 6/2/16 at 4:12 pm to
quote:

how about the print on the fricking bottle?

15 years ago, prescription opiates were not as scrutinized as they are now... the sheer number of prescriptions written for an opiate painkiller was staggering then... it wasn't realized just how addictive and dangerous these meds were, especially when given for the length of time they were being given....

essentially, it's a bad idea to treat long term, chronic pain with short acting opiates, but that's what was done time and time again... eventually, people develop tolerance, then get addicted...

quote:

what other kind of safeguards do you want?

well, now we have systems in place to prevent so many scripts for opiates being written, along with more education about opiates and prescribing opiates for healthcare professionals.... combined with monitoring programs to make sure patients aren't getting multiple scripts, the use of prescription opiates should curtail a bit.... sure, it will push some to heroin, and that's terrible, but there had to be something drastic done being it was a drastic situation...
This post was edited on 6/2/16 at 4:13 pm
Posted by VaBamaMan
North AL
Member since Apr 2013
8027 posts
Posted on 6/2/16 at 4:13 pm to
quote:

Is that what your prescription said to do? Serious question, I'm not being flippant.


Yes, but I'm a little different than most. My tolerance levels are about equal to horse.

When going under for surgery it takes 3.5 times the normal human dose to put me out.

Edit: I'll add that I get used to things very quickly. I literally have to swap between Norco and Percocet every month so my body doesn't get used to the chemical combination too quickly. Something to do with my stomach enzymes is the problem.
This post was edited on 6/2/16 at 4:19 pm
Posted by papasmurf1269
Hells Pass
Member since Apr 2005
21365 posts
Posted on 6/2/16 at 4:16 pm to
There is a thing called personal responsibility too.
Posted by Luke
1113 Chartres Street, NOLA
Member since Nov 2004
14125 posts
Posted on 6/2/16 at 4:18 pm to
Wife number one died from that #$%&.... MD's are just as much to blame as the pill-poppers for this epidemic...
Posted by BayouFann
CenLa
Member since Jun 2012
7147 posts
Posted on 6/2/16 at 4:25 pm to
You're right. They give out drugs like candy and ultimately get paid 2-4 times from one patient for different but related heath issues
Posted by BayouFann
CenLa
Member since Jun 2012
7147 posts
Posted on 6/2/16 at 4:28 pm to
I have three full health and hospital coverages but I refuse to be on a schedule of their meds. Good cannabis, vodka and a sensable diet is all I need.
Posted by LSU alum wannabe
Katy, TX
Member since Jan 2004
27569 posts
Posted on 6/2/16 at 4:37 pm to
So much is fricked up here with this. Vicodin/Hydrocodone being made triplicate has been a tipping point for all of this. Heroin use is up now because it is cheaper than Norco.

Pound of prevention worth an ounce of cure.?
Posted by yallallcrazy
Member since Oct 2007
826 posts
Posted on 6/2/16 at 4:45 pm to
quote:

My wife has reviewed mutiple medical reports for pa tints whose previous doctors had prescribed over 70 pills a week for patients with things like back pain, arthritis, and an already healed broken wrist.



Against the patients wishes? Forced them to take the pills?

Bottom line, the ONLY reason for any doc to do that kind of prescribing is if the patient is constantly complaining how much they hurt, how nothing works, what are you going to do, etc.
There is no other benefit to the doctor. None. Compensation is the same for a prescription for an NSAID, a narcotic, or nothing at all.
Posted by OweO
Plaquemine, La
Member since Sep 2009
119989 posts
Posted on 6/2/16 at 4:46 pm to
A friend of mine became addicted to oxy after having surgery on his shoulder from a baseball injury. luckily he was sent to a rehabilitation center that keeps you for several months, then works people back into society. They use temporary jobs (mostly doing some type of labor) to get them on a schedule and transition back to a "normal" life.

Not all doctors prescribe pain meds hand over fist, but for years it hasn't been hard for people to find a doctor who will continue to give patients the prescriptions they want. With that said, even with a prescription, there are people who will go through a monthly prescription in 2 weeks so they have to buy on the streets.

In order to supply the dealers on the street, they have people who they get to go to several doctors a month, dealer pays for the appointment, pays to have scripts filled and will pay the person who does it by giving them a few pills from each script. They know what doctors to use and its not hard to find a small town, family owned pharmacy that will fill pain med prescriptions for the same person, several times a month. They are paying in cash so these pharmacies turn a blind eye to it all.

I think its getting harder and harder to do this, but today I can think of 4 or 5 people off the top of my head who are addicts. 10 years ago I don't think I knew anyone addicted. I would hear a story about someone's sibling or a friend of a friend, but then it seems like it started to spread like a virus.

Look at how crack became an epidemic. In the mid 80s, rebels (supported by the US) in the Nicaragua war funded their role in the war by selling cocaine. Obviously turning it into crack made it highly addictive then they looked for areas that had a low police presence so they could get it out into the communities without having to worry about law enforcement as much. South central L.A. became the posterchild area of the crack epidemic, but I think when you break it all down, its the people on the very top of the chain who should be blamed and money is always the motivator.
Posted by LSU alum wannabe
Katy, TX
Member since Jan 2004
27569 posts
Posted on 6/2/16 at 4:54 pm to
quote:

well, now we have systems in place to prevent so many scripts for opiates being written, along with more education about opiates and prescribing opiates for healthcare professionals.... combined with monitoring programs to make sure patients aren't getting multiple scripts, the use of prescription opiates should curtail a bit.... sure, it will push some to heroin, and that's terrible, but there had to be something drastic done being it was a drastic situation...


Prevention of scrips being written was the over reach IMO. Monitoring was needed. Monitoring of MDs who were candy men. And of patients who doctor hop and doctor shop. Privacy laws prevented docs from having access to mess prescribed and poor record keeping by pharmacies. This all needed changing, and I believe was. As a nurse though I feel,bad sending a kidney stone or an actual fracture home without Vicodin. You earned it. It was standard of care for years, and now can't be given due to triplicate status. Some docs don't want to even frick with having a triplicate pad, and I understand why.

Causes you to send some people down the pain management route? Which can be sketchy. Has the crackdown caused a boom for pain management doctors? As they are now the ones who will write Vicodin? Also, now a new batch of patients to try and sell invasive procedure (ESI's).

As a nurse though I also like being able to tell drug seekers to frick off. I am typing this from a facility that has ZERO Dilaudid in it. It's kind of nice. Word travels fast and we see very few seekers here. But still feel bad sending legit acute pain or injury patients home with inferior meds.
Posted by yallallcrazy
Member since Oct 2007
826 posts
Posted on 6/2/16 at 4:56 pm to
For a patient without pain complaint? BS

More like, "Doc, I can't take it! I have a real high tolerance for pain but this is killing me. I can't take Toradol or Motrin. They gave me something in ER, but it didn't work. It was Lor, Lor, I don't know. Lor something. But I do know the Percocet works, but not the 7.5." No, let's try Ultram. Patient back in office next day. "Nope didn't work. This is killing me"


Remember now, if patient is dissatisfied your rating goes down and your likelihood of lawsuit goes up. And the patient does have an injury history. Sure, patient seems kind of wimpy about the pain, but there was an MVA. So, sometimes you write a script just to last until the next step in workup is done. MRI, PT, etc.

I seriously doubt any doc is telling people who aren't asking for pain meds that they MUST take pain meds.
Posted by PurpleandGold Motown
Birmingham, Alabama
Member since Oct 2007
23901 posts
Posted on 6/2/16 at 5:01 pm to
I broke my back several years ago. Doctor prescribed me 100 lortab 10s refillable 4 times.

Yeah, I got addicted. Still am. Can't be around the things.I'll eat them like skittles.

I was in pain. I took them as prescribed for the first couple months. After that, it was all over but the shouting.

I never really drank much before that. But after my life has been a constant cycle of doing good and doing very bad.

Fortunately I come from a good semi prominent family that's always given me love and support. 90% of the population would be dead in a gutter or in prison.
This post was edited on 6/2/16 at 5:05 pm
Posted by GoT1de
Alabama
Member since Aug 2009
5041 posts
Posted on 6/2/16 at 5:17 pm to
Some people like the feeling that drugs provide (me included)
But ... Why should those that overuse their prescriptions stop doctors from prescribing them to people in pain that don't overuse them?

Because a guy has a car wreck, should we stop gasoline?
Sure some abuse things and die.
They made their choice.
Why should others suffer because some make bad decisions?
Posted by BayouFann
CenLa
Member since Jun 2012
7147 posts
Posted on 6/2/16 at 5:25 pm to
quote:

Against the patients wishes? Forced them to take the pills?

Bottom line, the ONLY reason for any doc to do that kind of prescribing is if the patient is constantly complaining how much they hurt, how nothing works, what are you going to do, etc.
There is no other benefit to the doctor. None. Compensation is the same for a prescription for an NSAID, a narcotic, or nothing at all.

You are out of touch with this one. They want the prescriptions dished out as much as possible and the lazy arse doctors aren't one with physical therapy, natural herbs, and actual care for patients' wellbeing like they should. The VA is a prime example
Posted by yallallcrazy
Member since Oct 2007
826 posts
Posted on 6/2/16 at 5:39 pm to
quote:

doctors aren't one with physical therapy, natural herbs, and actual care for patients' wellbeing like they should


May be some merit to this, may not be. But it doesn't change the fact that these patients are not being given prescriptions against there wishes.
Posted by GEAUXT
Member since Nov 2007
30390 posts
Posted on 6/2/16 at 5:47 pm to
quote:

More like, "Doc, I can't take it! I have a real high tolerance for pain but this is killing me. I can't take Toradol or Motrin. They gave me something in ER, but it didn't work. It was Lor, Lor, I don't know. Lor something. But I do know the Percocet works, but not the 7.5." No, let's try Ultram. Patient back in office next day. "Nope didn't work. This is killing me"


Remember now, if patient is dissatisfied your rating goes down and your likelihood of lawsuit goes up. And the patient does have an injury history. Sure, patient seems kind of wimpy about the pain, but there was an MVA. So, sometimes you write a script just to last until the next step in workup is done. MRI, PT, etc.


This is ABSOLUTELY how it goes down every single time.

Like stated in the thread yesterday, physicians are forced to treat a subjective thing (pain) to meet objective goals, especially with the move away from fee for service reimbursements.

Narcotics should never be used as a treatment. As a temporary adjunct to actual treatment though they are very effective. When they come out with readily available and cost effective substitute that is not addictive I'm sure the collective medical community will rejoice.

It is no fun having to be suspicious of every single person who walks in the office complaining of pain.
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