OxyContin's 12-hour problem • Hacker News Board

Re: OxyContin's 12-hour problem

#41

Post by auggierose » Sat, May 07, 2016, 1:58 PM UTC

maxerickson wrote: post #28

auggierose wrote: post #3

It seems lots of pain was inflicted on many people because of the patent system. Usually drugs are upheld as the prime example of why patent systems are necessary. This seems more than questionable, given this example. Combined with the fact that companies have no conscience, it would be nice to have better ways to do expensive research than a) in companies and b) for patents.

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

The patent system drove that company to develop something to stay ahead of the game, and when it wasn't good enough on its own merits, they cheated.

So yes, it was partially the fault of the patent system.

Re: OxyContin's 12-hour problem

#42

Post by DanBC » Sat, May 07, 2016, 2:00 PM UTC

forgotpwtomain wrote: post #21

DanBC wrote: post #9

Earlier quoted context omitted.

Many people are inappropriately given opiates by their doctors to treat long term pain. Those people are not "doing drugs", they are following (bad) medical advice. People with long term pain need better access to pain management clinics; better access to physio therapy and exercise therapy; better access to different meds; and if they're still in pain better prescribing of opiates carefully following protocols. http…

> Many people are inappropriately given opiates by their doctors to treat long term pain. While I am sure this is true in many cases, my personal experience was the opposite. I had significant nerve pain after an accident, which kept me from being able to sleep or focus on anything very well. The physician I saw after my hospitalization was apparently worried I was trying to satisfy a drug-craving? So instead of givi…

> I had significant nerve pain after an accident, which kept me from being able to sleep or focus on anything very well.

Was that in the weeks or months after the accident? Or was it some time after that?

Pain after accidents is short term (acute) pain, and I'm only talking about long term (chronic) pain.

EDIT: Either way, it sucks that you didn't get good enough treatment, and I'm sorry you went through that. Pain freaking sucks, and being looked at as a drug seeker doesn't make it any easier.

Re: OxyContin's 12-hour problem

#43

Post by hashmymustache » Sat, May 07, 2016, 2:03 PM UTC

peteretep wrote: post #29

> it appears they offered a cushy job to a > government official in exchange for favorable > regulatory treatment I suspect that that sentence is legally actionable as slander, as well as being an (apparently) completely baseless claim of illegal activity.

You are wildly off base to the point that you seem like a shill. Learn about tort law and the first amendment. Besides it not being injurious or necessarily false, It involves a public official so good luck proving actual malice.

Re: OxyContin's 12-hour problem

#44

Post by davidw » Sat, May 07, 2016, 2:04 PM UTC

tew28 wrote: post #38

CydeWeys wrote: post #22

Earlier quoted context omitted.

I fractured my tibia recently and the urgent care gave me a short prescription for Percocet (which contains oxycodone like Oxycontin and also acetaminophen). I didn't end up picking it up as I don't have a car and mobility is understandably limited when you've fractured your tibia, but the past the first day the pain wasn't bad enough to need it anyway, and ibuprofen sufficed. And I am a wimpy person who does not do…

In a similar vein, I got an entire bottle of vicodin prescribed to me after having Lasik surgery. There was virtually no pain, merely discomfort similar to having a dirty contact lens in your eye, which went away after a day. I never used any of the vicodin.

I got some of that crap years ago. I felt good for about a half an hour, then got really nauseas, which is not something you want after surgery. Switched to ibuprofen. Pre surgery morphine had the same effect. I am not a fan of opioids.

Re: OxyContin's 12-hour problem

#45

Post by neerdowell » Sat, May 07, 2016, 2:04 PM UTC

peteretep wrote: post #29

> it appears they offered a cushy job to a > government official in exchange for favorable > regulatory treatment I suspect that that sentence is legally actionable as slander, as well as being an (apparently) completely baseless claim of illegal activity.

You mean libel. Slander is spoken, libel is written.

The easy way to remember this distinction is to know that one of the most famous libel cases in history, nicknamed the "McLibel" case, concerned printed pamphlets.

Re: OxyContin's 12-hour problem

#46

Post by DanBC » Sat, May 07, 2016, 2:06 PM UTC

CydeWeys wrote: post #22

pappyo wrote: post #7

The pervasiveness of OC provided by doctors is amazing. Even as of a year ago, I went into the hospital for back pain and left with a script for two fist fulls of oxy. I looked at the doctor and legitimately thought he was trying to get me hooked. And this was at a world renowned hospital. I have to wonder if Purdue is involved in some kickbacks to Dr's who (over)prescribe.

I fractured my tibia recently and the urgent care gave me a short prescription for Percocet (which contains oxycodone like Oxycontin and also acetaminophen). I didn't end up picking it up as I don't have a car and mobility is understandably limited when you've fractured your tibia, but the past the first day the pain wasn't bad enough to need it anyway, and ibuprofen sufficed. And I am a wimpy person who does not do…

> Experiencing pain has a limited risk potential in most people, especially when the pain is linked to a temporary condition.

People living with long term pain are at increased risk for death by suicide.

That doesn't mean we should just hand out opiates (which should not be used for chronic pain), but that we should take pain relief a bit more seriously.

Living in pain sucks.

Re: OxyContin's 12-hour problem

#47

Post by makomk » Sat, May 07, 2016, 2:06 PM UTC

maxerickson wrote: post #28

auggierose wrote: post #3

It seems lots of pain was inflicted on many people because of the patent system. Usually drugs are upheld as the prime example of why patent systems are necessary. This seems more than questionable, given this example. Combined with the fact that companies have no conscience, it would be nice to have better ways to do expensive research than a) in companies and b) for patents.

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

The entire reason the manufacturer was pushing Oxycontin's 12-hour dosing so hard was because they had a patent on it, and if it required more frequent dosing the patent gave no advantage over the cheaper patent-free formulations. That's why it was so important to them that doctors stuck to the official 12-hour dosing interval even if it led to a higher overall dosage and ineffective pain relief.

Re: OxyContin's 12-hour problem

#48

Post by vinceguidry » Sat, May 07, 2016, 2:07 PM UTC

maxerickson wrote: post #28

auggierose wrote: post #3

It seems lots of pain was inflicted on many people because of the patent system. Usually drugs are upheld as the prime example of why patent systems are necessary. This seems more than questionable, given this example. Combined with the fact that companies have no conscience, it would be nice to have better ways to do expensive research than a) in companies and b) for patents.

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

Your dismissiveness is unwarranted and wrong. The whole reason the drug was developed because their patent on their current flagship drug was expiring. It's right there in the article.

Oxycontin is essentially hydrocodone with a time-release mechanism. You need to demonstrate significant distance from existing medication in order to get a new patent.

The entire debacle, soup to nuts, was driven by the patent system. Without it, a) the drug wouldn't have even gotten developed, and b) the 12 hour marketing claim would not have been politically and economically necessary for Purdue.

Re: OxyContin's 12-hour problem

#49

Post by maxerickson » Sat, May 07, 2016, 2:09 PM UTC

makomk wrote: post #47

maxerickson wrote: post #28

Earlier quoted context omitted.

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

The entire reason the manufacturer was pushing Oxycontin's 12-hour dosing so hard was because they had a patent on it, and if it required more frequent dosing the patent gave no advantage over the cheaper patent-free formulations. That's why it was so important to them that doctors stuck to the official 12-hour dosing interval even if it led to a higher overall dosage and ineffective pain relief.

Yes, I understand the dynamic.

I refuse to see doctors as the hapless victims of a corporation.

Re: OxyContin's 12-hour problem

#50

Post by maxerickson » Sat, May 07, 2016, 2:13 PM UTC

vinceguidry wrote: post #48

maxerickson wrote: post #28

Earlier quoted context omitted.

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

Your dismissiveness is unwarranted and wrong. The whole reason the drug was developed because their patent on their current flagship drug was expiring. It's right there in the article. Oxycontin is essentially hydrocodone with a time-release mechanism. You need to demonstrate significant distance from existing medication in order to get a new patent. The entire debacle, soup to nuts, was driven by the patent system.…

The patent and the marketing didn't make hydrocodone less viable as an alternative.

I mean, the doctors can see that information coming from the company can be problematic and be cautious of it. I guess they ideally shouldn't have to be, but that's not the world.

Personally, I'd be fine dismantling Purdue for something like this. We need to start recognizing that large institutions make mistakes for reasons that can't be fixed.