Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

OxyContin's 12-hour problem

static.latimes.com

Post reply on HN
Print view View original

111–120 of 376 posts

Re: OxyContin's 12-hour problem

#111

Post by gregd »

velox_io wrote: post #98
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 .

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 specialis…

Chronic pain sufferers should try Cannabinoids

Re: OxyContin's 12-hour problem

#112

Post by nefitty »

Just to be clear, Maher has an extreme distrust of modern medicine, to the point that it led me to almost totally abandon his show. For example, he gave the fraud Sam Chachoua an inordinate amount of airtime for someone claiming he can cure HIV with goat's milk. As far as I know Maher is still an antivaxxer, as well. http://rationalwiki.org/wiki/Bill_Maher#Medicine

Anyways, I've realized to take Maher's views and endorsements regarding the medical field with a grain of salt.

Re: OxyContin's 12-hour problem

#113

Post by capote »

mwsherman wrote: post #89

The problems derive from the prohibition, which takes several forms. The forms add up for big profits and bad incentives, for which the consumer pays. FDA approval is the first layer of prohibition. Very expensive, this keeps a lot of competitors out. Lots of market (read: pricing) power is conferred to the winners. Great incentive is provided for regulatory capture. The second layer is patent protection. Again, comp…

Can you explain more how competition, availability, and legality will stop the more addiction-prone (low-income, chronic pain among other health problem) parts of society in America from doing drugs and becoming addicted? If I read your argument correctly, it's that the pharma firms will not market it as much and not profit as much. In my mind that's not enough reasoning that people who simply have a bad situation won't reach out (to their doctor, guy next door with a prescription) and find the drug

I see the experimental results in other countries that have taken steps forward on legalizing various drugs, but they also have a much better social welfare, schooling, and support system.

I just don't see the connection between making a drug more available, making more versions of it, deregulating it and having less people taking it. Without your further explanation, that is.

Re: OxyContin's 12-hour problem

#115

Post by snsr »

ghaff wrote: post #65
manyxcxi wrote: post #60

Earlier quoted context omitted.

It's kind of scary how quickly doctors seem to prescribe it. I've had a doctor prescribe me some for everything from the flu to a mild ankle sprain. That being said, I always used to wonder if it was because I can't take any NSAIDs- it's acetaminophen or nothing for me. This usually means where they could get away with a big dose of Ibuprofin for pain and anti-inflammatory I wind up with oxycodone and prednisone. Whi…

And acetaminophen has its own set of problems. It's at least a reasonable question whether it would have been approved as an over the counter drug had its level of liver toxicity been known at the time.

It's extremely toxic - opioids are a much safer option.

Re: OxyContin's 12-hour problem

#116

Post by URSpider94 »

pakled_engineer wrote: post #104

Another problem is all the anti abuse so called safeguards like timed release so the pills can't be crushed. That means you can't take half the pill and a few hours later the other half which is what some people did to get around the false 12hr relief advertising before the DEA and other government meddlers got involved. As for the FDA guy materializing at Perdue this is par for the course of all gov positions. A cab…

The timed release portion wasn't for anti-abuse, it was the whole point of the drug. It is supposed to meter out the opiate so you get an even dose, instead of peaks and valleys. If it worked, this would be great.

They don't go into the mechanism in the article, but my assumption is that some peoples bodies dissolve the costing more quickly than others, and those people get the dose in a shortened time period.

Re: OxyContin's 12-hour problem

#117

Post by mwsherman »

capote wrote: post #113
mwsherman wrote: post #89

The problems derive from the prohibition, which takes several forms. The forms add up for big profits and bad incentives, for which the consumer pays. FDA approval is the first layer of prohibition. Very expensive, this keeps a lot of competitors out. Lots of market (read: pricing) power is conferred to the winners. Great incentive is provided for regulatory capture. The second layer is patent protection. Again, comp…

Can you explain more how competition, availability, and legality will stop the more addiction-prone (low-income, chronic pain among other health problem) parts of society in America from doing drugs and becoming addicted? If I read your argument correctly, it's that the pharma firms will not market it as much and not profit as much. In my mind that's not enough reasoning that people who simply have a bad situation wo…

I don’t think legalization will reduce addiction (though would defer to empirical studies here). It would make the economic cost of addiction lower for the individual – one problem instead of two.

More importantly, it would make doctors (and regulators) more honest participants. If a doctor wants to recommend opiates, it would largely remove their economic incentives for doing so. We don’t think of doctors having much economic incentive for prescribing acetaminophen or ibuprofen, by comparison.

Re: OxyContin's 12-hour problem

#118

Post by guelo »

I'm more alarmed by the incompetence of the doctors. If someone like Microsoft started heavy pressure marketing a developer tool that did not work as advertised programmers wouldn't need the help of the FDA to tell Microsoft to fuck off. But doctors don't seem to understand or care what they're doing and just follow whatever the latest expensive marketing campaign tells them to do. It's scary.

Re: OxyContin's 12-hour problem

#119

Post by givinguflac »

capote wrote: post #113
mwsherman wrote: post #89

The problems derive from the prohibition, which takes several forms. The forms add up for big profits and bad incentives, for which the consumer pays. FDA approval is the first layer of prohibition. Very expensive, this keeps a lot of competitors out. Lots of market (read: pricing) power is conferred to the winners. Great incentive is provided for regulatory capture. The second layer is patent protection. Again, comp…

Can you explain more how competition, availability, and legality will stop the more addiction-prone (low-income, chronic pain among other health problem) parts of society in America from doing drugs and becoming addicted? If I read your argument correctly, it's that the pharma firms will not market it as much and not profit as much. In my mind that's not enough reasoning that people who simply have a bad situation wo…

It's not just making it more available. Legalization has to bring better treatment and a shift in public perception to it being perceived as what it really is- a mental and physical health problem. If nothing else, people would be far more likely to seek help if they weren't treated as criminals for doing so. Also, truth in education makes a big difference. See Portugal for a good example.

Re: OxyContin's 12-hour problem

#120

Post by Merad »

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…

As I recall, when I had my wisdom teeth out (around 1999-2000) the oral surgeon offered three options - local anesthetic only, local + some anesthetic gas (I remember he called it the "la-la land option"), or a full "you're totally out" anesthetic. I took the middle option, and I have some vague memories of people standing over me pulling on something in my mouth, but that's it. That would've been a pretty damn unpleasant experience if I was fully conscious, even if there was no pain.
Post reply on HN