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

161–170 of 376 posts

Re: OxyContin's 12-hour problem

#161

Post by ThePaco »

saulrh wrote: post #69
alttab wrote: post #57

Earlier quoted context omitted.

Another way to look at it was in working with Purdue, he was able to demonstrate his ability to define and walk around FDA approvals by understanding and guiding product language to get approval. This is a valuable skill. Purdue probably wanted someone like that on their product development team who could influence drug design early on which would make it less costly and more efficient to get drugs approved in the fu…

> Another way to look at it was in working with Purdue, he was able to demonstrate his ability to define and walk around FDA approvals by understanding and guiding product language to get approval. Isn't subverting the system like that almost as improper as doing it from the other side? Not as obviously, possibly not as strongly, but from having been in research myself, knowing the little details like that is often g…

I don't think so because the government created a regulatory environment that requires drug companies to find people like this that know how to get their drugs approved.

Re: OxyContin's 12-hour problem

#162

Post by _acme »

jonknee wrote: post #91
ssmoot wrote: post #71

Earlier quoted context omitted.

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,…

Is there a higher rate of opioid addiction amongst opioid users than marijuana addiction amongst marijuana users?

Re: OxyContin's 12-hour problem

#163

Post by siliconc0w »

Armchair Policy Wonk:

* Make FDA approval double blind. Can't bribe who you can't see.

* Before starting a study, if you want to include it with a future application you need to register it. All registered studies need to be included with an application. Can't cherry pick studies.

* You may only use approved claims stated in the application in marketing or product descriptions. (which I thought was already the case)

Re: OxyContin's 12-hour problem

#164

Post by kgwgk »

School-Cotton wrote: post #146
spiznnx wrote: post #82

Earlier quoted context omitted.

No, "lb." comes from "libra" meaning scales or balance, not "liber". https://en.wikipedia.org/wiki/Pound_(mass)#Roman_libra

Hm, I can't edit my comment anymore, but French wiktionary claims that French "livre" (meaning pound) comes from the Latin word for the measure that weighed about as much as a book. ("livre" also means "book" in French). I guess "lb." and French "livre" (meaning pound) aren't necessarily related. More likely: wiktionary could be full of shit, meaning I was wrong.

You have misunderstood the wiktionary entry:

> Du latin lībra (« poids d’une livre »)

tells you just that the meaning of the latin word is a measure of weight (a pound).

There is no way that can be interpreted as "the weight of a book" (that would be « poids d’un livre »).

Re: OxyContin's 12-hour problem

#165

Post by oxide »

nommm-nommm wrote: post #133
rhizome wrote: post #122

Earlier quoted context omitted.

Addiction can be managed, it's only a catastrophic problem for the patient in limited circumstances: the dosage is too strong or you can't get it . Where are you getting the goal of fewer people taking it, and why is the number of people taking it a concern at all? Pain management is the issue at hand.

Opiates are usually not a good option for long term pain relief for many patients. They can work well in the short term but long term use can ruin a person's life (I've seen it happen, it's awful) and they lose effectiveness long term and end up causing more problems than they solve. Switching opiodes from a short term option to a long term one in the 90s was a huge (and largely failed) experiment. Long term pain con…

What he meant was that dependency can be maintained.

Forever.

I disagree that opiates are not a good choice for short-term pain relief, and I also disagree that they are not a good choice for long-term pain relief.

If anything, pain is currently being under treated on a massive scale thanks to the new-wave crusaders against opiates, flying a flag of the same type of study they decry as flashy science only meant to gun for the headlines as proof undeniable.

There will always be opiate abuse. A moral backlash against abuse should not deny people in pain the quality-of-life increase they can get in return from opiates. Dependency be damned.

>Long term pain control is a complicated and multi facaded beast. We need to invest in it.

I do agree with this.

>"Just take a pill" is clearly not the solution that works.

It's the solution we have right now, though.

My grandparents, bless them, couldn't function without narcotic painkillers. without narcotics, there is no quality-of-life to speak of for them, and for a lot of people like them. Dependency be damned.

Until something as affordable and available as opiates come around, that can give them equipotent pain relief, traditional poppy derivatives can and should be used to treat pain in those who live each day in pain. Tolerance be damned.

Re: OxyContin's 12-hour problem

#166

Post by aphelion »

imglorp wrote: post #25
dcwca wrote: post #20

Earlier quoted context omitted.

What does it say?

It is the appearance of impropriety, straight out of any corporate anti-bribery ethics training. In this case, it appears they offered a cushy job to a government official in exchange for favorable regulatory treatment, leading a very lucrative business. It appears dirty but maybe can't be proven.

Had he denied the application it could just as easily be said to have shown his expertise in the regulatory approval process by detecting and rejecting a dangerous drug.

And yet, I don't think that display of competence would have landed him a job at Purdue.

Re: OxyContin's 12-hour problem

#167

Post by pron »

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…

> One can make an argument for protecting people from harming themselves.

I don't have an opinion on legalization, but I don't think that's quite the argument against (even if some people express it in this way). Not all people are free to make choices in the same way, and drugs -- similarly to fast food -- hurt some communities more than others. Drugs have a social dynamics, they're not like choosing which toothpaste to use. Of course, prohibition may make matters worse instead of better, but as you say, that requires empirical study (I don't know the findings, which is why I don't have an opinion, except that the enforcement situation now is far from good).

Re: OxyContin's 12-hour problem

#168

Post by nommm-nommm »

oxide wrote: post #165
nommm-nommm wrote: post #133

Earlier quoted context omitted.

Opiates are usually not a good option for long term pain relief for many patients. They can work well in the short term but long term use can ruin a person's life (I've seen it happen, it's awful) and they lose effectiveness long term and end up causing more problems than they solve. Switching opiodes from a short term option to a long term one in the 90s was a huge (and largely failed) experiment. Long term pain con…

What he meant was that dependency can be maintained. Forever. I disagree that opiates are not a good choice for short-term pain relief, and I also disagree that they are not a good choice for long-term pain relief. If anything, pain is currently being under treated on a massive scale thanks to the new-wave crusaders against opiates, flying a flag of the same type of study they decry as flashy science only meant to gu…

I said opioids are a good option for short term pain. They are also usually (not always) a bad option for long term pain.

Please go to a treatment facility (volunteer please) and talk to the patients there. It is beyond eye opening, I volunteered at one myself. I've seen pain medicine literary ruin lives, and it's so sad. These are people who have been through hell with their injuries, some of the worst I've ever seen, and then they go through hell again with the opiodes.

They can work on a long term basis for SOME (but not the majority) of patients.

Psychological treatments are also an important part of pain management.

Re: OxyContin's 12-hour problem

#169

Post by ams6110 »

CydeWeys wrote: post #102
ssmoot wrote: post #71

Earlier quoted context omitted.

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 pain. It's not noble to suffer needlessly. Weed is not addictive, or even if it is in some people, to nowhere near the same level as opiates. It's also not responsible for thousands of overdose cases per year. It seems to me that THC pills would be better for pain management in these situations than opiate…

Weed is not physically addictive like opiates are, but people do become psychologically dependent upon it to avoid dealing with stress and anxiety in healthier ways. And it can become difficult to stop if you haven't resolved the underlying problems that you're treating with it.

Re: OxyContin's 12-hour problem

#170

Post by oxide »

nommm-nommm wrote: post #168
oxide wrote: post #165

Earlier quoted context omitted.

What he meant was that dependency can be maintained. Forever. I disagree that opiates are not a good choice for short-term pain relief, and I also disagree that they are not a good choice for long-term pain relief. If anything, pain is currently being under treated on a massive scale thanks to the new-wave crusaders against opiates, flying a flag of the same type of study they decry as flashy science only meant to gu…

I said opioids are a good option for short term pain. They are also usually (not always) a bad option for long term pain. Please go to a treatment facility (volunteer please) and talk to the patients there. It is beyond eye opening, I volunteered at one myself. I've seen pain medicine literary ruin lives, and it's so sad. These are people who have been through hell with their injuries, some of the worst I've ever see…

Yes, opiates can ruin lives. That is not the trump card you want it to be, sorry.

If anything, the pushback against opiate prescribing has resulted in a lot of dependent patients (and addicted abusers) looking at heroin as a more potent, widely available, cheaper alternative.

opiates have been around a long time for a good reason. they can give an unrivaled increase in the quality of life of those suffering.

there will ALWAYS be opiate abuse. taking prescription painkillers out of the picture doesn't even put a dent into it.

do you think it makes more sense to spend time and money demonizing prescription opiates and prosecuting those who prescribe them, or use that time and money to implement programs and services that can help those who have become dependent or addicted?

Post reply on HN