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Ban All Opioids
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14 Replies
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I was a med student when OxyContin got approved for end stage cancer pain
The attending I had at that time said
This drug is going to get abused off label and create a group
Of drug addicts like no one has ever seen and the drug company will be complicitI remember at the time thinking wow this guy is way out there but damn if he wasnt right on the money
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I should say
Med student when OxyContin going through the approval process
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Why do you want to deprive legit pain patients of their medications ?
There is no need for orthopods and dentists to dole out 90 T3s after minor procedures either.
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Quote from fw
Why do you want to deprive legit pain patients of their medications ?
There is no need for orthopods and dentists to dole out 90 T3s after minor procedures either.
But how are they going to get good patient satisfaction scores if they don’t!?!?
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Rush Limbaugh was using multiple doctors so that he could give many high satisfaction scores?
He IS a saint. I knew I was wrong about him.-
Can’t we just nationwide legalize some weed. Got a back ache, smoke some Maui Wowie.
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Quote from 67ED5CC042435
What is a legit pain patient? Oncology and Sickle Cell? How did they survive prior to the explosion of oxycontin?
They received other oral opioids, straight oxycodone or oral morphine. This was done in the understanding that their time on earth was limited and usually done by their family physician. That physician was not a generic 'provider', he was the kind of doctor you could call after hours at his landline phone if things were going down-hill.
Any request from a patient who wasn't dying to be prescribed opioids was a red-flag that they are a drug-seeker and could be dealt with accordingly. There was no fear on the doctors end to be reported to the medical board for 'insufficient pain control' or to see his online satisfaction scores drop.
The stuff was treated as what it is, a poison with a narrow risk-benefit ledge. Oral opiods where used when a thinking physician decided that the benefit (superior control of severe pain) outweighed the risk of addiction. There was a physical triplicate prescription, the doc kept track in his book how much he prescribed to the two or three patients under his care that needed opioids.
It wasn't:
You had a tooth out —> here are 30 percocets
You had a bunion shaved —> here are 30 percocets and call my nurse if you want more.
You have back pain ? —-> here are 180 oxy-contins and here is your next 'pain management' appointment in 4 weeks, call us if you want more, oh and sign on this 'opiate contract' here just to keep the pharmacy board happy.
The problem are not oral opioids, the problem isn't even oxycontin. The problem is the 'pain is the 5th vital sign' bullcrap and the changes in medicine since the mid 90s that caused the indiscriminate prescribing of oral opioids for indications where the risk-benefit equation never supported it. Of course, some of this acted in concert with the reckless advertising by a few drug companies who used manipulated data to support that their opioid was not addiction forming….
Oh, the other problem are cynical colleagues of ours who have prostituted their medicial license with the running of pill-mills. The prescribing pattern information is quite lopsided. Something like 2% of prescribers are responsible for 90% of the morphine equivalent doled out.
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outpatient opiates in general are a problem. If you need such strong pain relief maybe you shouldn’t be out in the world(terminal cancers and etc are exceptions), you should probably be hospitalized. I mean this for the choles that get like 30 oxys.
I also think alternating tylenol and motrin does a lot more than people give it credit for. -
Quote from fw
Quote from 67ED5CC042435
What is a legit pain patient? Oncology and Sickle Cell? How did they survive prior to the explosion of oxycontin?
They received other oral opioids, straight oxycodone or oral morphine. This was done in the understanding that their time on earth was limited and usually done by their family physician. That physician was not a generic ‘provider’, he was the kind of doctor you could call after hours at his landline phone if things were going down-hill.
Any request from a patient who wasn’t dying to be prescribed opioids was a red-flag that they are a drug-seeker and could be dealt with accordingly. There was no fear on the doctors end to be reported to the medical board for ‘insufficient pain control’ or to see his online satisfaction scores drop.
The stuff was treated as what it is, a poison with a narrow risk-benefit ledge. Oral opiods where used when a thinking physician decided that the benefit (superior control of severe pain) outweighed the risk of addiction. There was a physical triplicate prescription, the doc kept track in his book how much he prescribed to the two or three patients under his care that needed opioids.It wasn’t:
You had a tooth out —> here are 30 percocets
You had a bunion shaved —> here are 30 percocets and call my nurse if you want more.
You have back pain ? —-> here are 180 oxy-contins and here is your next ‘pain management’ appointment in 4 weeks, call us if you need more, oh and sign on this ‘contract’ here just to keep the pharmacy board happy.The problem are not oral opioids, the problem isn’t even oxycontin. The problem is the ‘pain is the 5th vital sign’ bullcrap and the changes in medicine since the mid 90s that caused the indiscriminate prescribing of oral opioids for indications where the risk-benefit equation never supported it. Of course, some of this acted in concert with the reckless advertising by a few drug companies who used manipulated data to support that their opioid was not addiction forming….
Oh, the other problem are cynical colleagues of ours who have prostituted their medicial license with the running of pill-mills. The prescribing pattern information is quite lopsided. Something like 2% of prescribers are responsible for 90% of the morphine equivalent doled out.
Great post, fw.
Bad culture and the snowflake scenario already on scene, and now everyone complains. As if the writing wasn’t on the wall.
As he states, “Providers” and “Autonomy” and other buzzwords for governmental and corporate control, as opposed to community and relationships being the focus. But that’s what you get in modern “multicultural” America — depersonalized complaints about every broken system, broken precisely because we lost cultural cohesion, trust, and sensibility, all for more buzzwords like “diversity.”
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Come on, guys.
Let’s take it down a couple of notches and leave the name calling out of it.
It’s politically heated but we can keep it to policy 🙂-
Quote from dergon
Come on, guys.
Let’s take it down a couple of notches and leave the name calling out of it.
It’s politically heated but we can keep it to policy 🙂
The only politics I see in the opioid addiction problem is that once it was ‘only’ the problem of black and Hispanic people who caused their own problems of addiction due to their shortcomings whether due to their race or culture, etc.
But now the new reality hits, addiction is a national emergency because it has come out into everyone’s neighborhoods so it can no longer be dismissed on racial or cultural terms. Everyone’s family is at risk. Suddenly it’s not just race and politics anymore. It’s Rush Limbaugh who is very affluent and is able to go doctor hunting. It’s your friend’s family who is also affluent and whose addicted child or children have had every advantage given to them including education and never a hard life to challenge them.
That is the truth. Addiction can hit all of our families and children who have had excellent upbringings, culture, nurturing, education.
Reading all the simple solutions and complaints in this brief thread, it seems few if anyone complaining has any personal experience with addiction other than meeting addicts on the street or the ED, etc. Addicts are “those people,” easily dismissed who just have a low character.
The solution missing is that there are no simple solutions. Yes, Oxycontin is made very available and addiction has gone up. Fentanyl is used to cut heroin & causes more deaths than just heroin. These drugs are administered to help alleviate pain & pain should not to be dismissed to just “bite the bullet” & suck it up.
I have personal experience with addiction since a child. I have known opioid addicts. I am not an addict but I have family members who were addicts, one in recovery that so far finally looks good. There are no simple solutions. “Just say no!” is obvious and at the same time meaningless.
Yes, you can place tighter controls on drugs like Oxy & Fentanyl, etc and hopefully it will help but it does not answer why some people can take both Oxy and Fentanyl for pain in doses that would knock me over and out and I am not a small man, and then just stop cold turkey with not another thought about taking any more opioids once the pain’s cause is removed.
But addiction is not just opioids, it’s alcohol & meth, etc. My experiences have to do with alcoholism and is just as bad as opioids & can be worse since alcohol is easily available and legal in any dose. I have seen a family member take high doses of opioids for pancreatitis for a period of time to my great alarm and stop once the pancreatitis resolved due to alcohol abstinence and when the pain was gone, just stopped the opioids with never a look back. Because addiction comes in flavors and varieties. Their addiction was to alcohol, not opioids. Opioids never had an attraction to them so was not a risk, however odd that sounds.
Back to the original question, I agree, there should be a lot less prescriptions written for opioids and there should be a lot more regulation. They should be carefully administered when appropriate and the dose given to take home should be in low quantities. I understand why people can become addicts, I just don’t understand why some people stay addicts and what their brain gets from staying addicted. I do know that the problem seemed to grow as prescriptions for opioids became more freely available.
But it doesn’t stop there. Why addiction continues is the question.
And it has nothing to do with race or politics. Or a lack of ‘strength of character’ as some would like to dismiss it.
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[b][link=https://www.politico.com/news/2023/04/10/gop-bomb-mexico-fentanyl-00091132]GOP embraces a new foreign policy: Bomb Mexico to stop fentanyl[/link][/b]
Republicans suggest everything from terrorist labels to an invasion to decimate drug cartels in Mexico.
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Maybe not the tactics but I’m not sure I disagree with the sentiment of annihilating the cartels.
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