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OxyContin's 12-hour problem

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Re: OxyContin's 12-hour problem

#91

Post by jonknee »

ssmoot wrote: post #71
tew28 wrote: post #38

Earlier quoted context omitted.

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 don't get this mentality at all. I would guess a majority of adults in the US have had Vicodin or similar and I don't know anyone personally who ever got addicted. In some it causes nausea. You don't like it, fine. But I don't understand how people can be so pro marijuana on one hand, and so anti-opiates on the other. It's pain. It's not noble to suffer needlessly. It's complete BS that it's harder for a dentist to…

> But I don't understand how people can be so pro marijuana on one hand, and so anti-opiates on the other.

It's probably the hundreds of thousands of dead people from opiate overdoses vs the 0 dead people from marijuana overdose.

> I would guess a majority of adults in the US have had Vicodin or similar and I don't know anyone personally who ever got addicted.

You almost certainly know someone who has been addicted, you just didn't know. It is shockingly common.

Re: OxyContin's 12-hour problem

#93

Post by maxerickson »

lpsz wrote: post #90
maxerickson wrote: post #79

Earlier quoted context omitted.

I woke up when I was having my wisdom teeth extracted but promptly went back to sleep when they suggested it. My recollection is that I was briefly aware of them working in my mouth but not in any pain.

It's remarkable that in the US the much more dangerous general anesthesia is used for routine things like wisdom teeth when anesthetic shots (lidocaine) are significantly safer and simpler. This leads to additional complications due to anesthesia itself, or worse. [1] [2] If your dentist proposes things like this, please, switch to someone else. (For those unfamiliar, after the shots you feel not much other than some…

The fentanyl mentioned in the GP (probably also what I had) is an anesthetic shot.

Re: OxyContin's 12-hour problem

#94

Post by gregd »

notsotrue wrote: post #68
DanBC wrote: post #46

Earlier quoted context omitted.

> 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 .

I illegally use marijuana, not for the pain relief, it's not any more effect in my case than a bottle of Jack. But it gives me a pocket of time where I can just feel okay, mentally, knowing that I will never live another day without pain. The medical community focuses too much on symptom/treatment, and not enough on quality of life. I'm not saying that marijuana is an answer here, and I completely accept anyone who s…

I'm sorry that it's illegal for you (it's not here in Oregon). I'm hopeful that we are on the verge of widespread legalization and I'm hopeful that you will, one day soon, enjoy all the benefits of it's legalization. Hang in there...

Re: OxyContin's 12-hour problem

#95

Post by lpsz »

maxerickson wrote: post #93
lpsz wrote: post #90

Earlier quoted context omitted.

It's remarkable that in the US the much more dangerous general anesthesia is used for routine things like wisdom teeth when anesthetic shots (lidocaine) are significantly safer and simpler. This leads to additional complications due to anesthesia itself, or worse. [1] [2] If your dentist proposes things like this, please, switch to someone else. (For those unfamiliar, after the shots you feel not much other than some…

The fentanyl mentioned in the GP (probably also what I had) is an anesthetic shot.

Yikes, I was only referring to lidocaine (i.e. more typical choice for dental work.)

Re: OxyContin's 12-hour problem

#96

Post by tew28 »

ssmoot wrote: post #71
tew28 wrote: post #38

Earlier quoted context omitted.

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 don't get this mentality at all. I would guess a majority of adults in the US have had Vicodin or similar and I don't know anyone personally who ever got addicted. In some it causes nausea. You don't like it, fine. But I don't understand how people can be so pro marijuana on one hand, and so anti-opiates on the other. It's pain. It's not noble to suffer needlessly. It's complete BS that it's harder for a dentist to…

My point, which mirrored the point of the post to which I responded, wasn't that Vicodin wasn't useful in some cases. It was that it was overprescribed relative to the amount of pain of the particular procedure.

Re: OxyContin's 12-hour problem

#97

Post by shanemhansen »

School-Cotton wrote: post #80
billsix wrote: post #54

Earlier quoted context omitted.

Another way to remember is that "library" and "libel" both come from "liber", meaning "book" in Latin

As does "lb.", the abbreviation for pound.

Confession: as a kid I thought it came from 16. Because there are 16oz in a pound.

Re: OxyContin's 12-hour problem

#98

Post by velox_io »

DanBC wrote: post #46
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…

> 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 .

Then what should chronic pain sufferers take? Opiates may not be ideal, but it is one of the best options available.

Personally I do not believe that GP's should prescribe pain killers. They either under prescribe (fearing everyone will become an addict) or over prescribing (often the wrong drugs).

Pain is a very complex subject (people of different thresholds and biological responses), it should be left to specialists.

Re: OxyContin's 12-hour problem

#99

Post by maxerickson »

lpsz wrote: post #95
maxerickson wrote: post #93

Earlier quoted context omitted.

The fentanyl mentioned in the GP (probably also what I had) is an anesthetic shot.

Yikes, I was only referring to lidocaine (i.e. more typical choice for dental work.)

Right, I think I shouldn't pretend to define what the various words mean.

Still, I don't think the procedure used for wisdom teeth in the US has the same risks as the general anesthesia used in more involved surgeries. It's probably still reasonably described as sedation (in my story, I'm obviously still conscious, just not very aware. I didn't include it above, but I actually asked How much longer? and they just told me to go back to sleep).

Re: OxyContin's 12-hour problem

#100

Post by ridgeguy »

DanielBMarkham wrote: post #63

If this is true, this is one of the biggest stories of the year so far. There will be a huge class action lawsuit. Wow. It boggles the mind the number of people harmed here -- if this is true. I wonder, for those people who do not get the full 12-hour effect, are they eliminating the drug quicker or metabolizing it into its bioactive agent quicker? It could be that not only are they going into withdrawal, they're act…

Duration of action for pain medication can differ extremely among individuals.

When my wife (chronic pain patient) wanted to switch from one pain med to another because of diminishing effect, I helped her neurologist review literature on the equianalgesia properties of various options.

For several meds, blood concentration vs. time varied by one order of magnitude among patients who were otherwise well-matched subjects. Some metabolized/eliminated a med to non- therapeutic levels in a day, others took nearly two weeks. Same dose, same route of administration. Probably different P450 enzyme activities [1] among other things.

I came away from the experience appreciating how incredibly difficult it is to construct a good pain management plan. It takes more time and info than many doctors can bring to bear on each patient.

[1] https://en.wikipedia.org/wiki/Cytochrome_P450

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