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OxyContin's 12-hour problem

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Re: OxyContin's 12-hour problem

#171

Earlier quoted context omitted.

Maher doesn't say that vaccines are bad. He's saying that not all vaccines are good, and that Merck has discovered that it's a new stream of profits by convincing doctors that everyone should take vaccines for low-risk diseases. So there's a difference, and I agree with him. I vaccinated my kids, and I even take the flu shot because my kids are still young. But given the fact that the flu vaccines is sometimes less t…

>>and that Merck has discovered that it's a new stream of profits by convincing doctors that everyone should take vaccines for low-risk diseases. Depends on what you mean by "low-risk disease." If you mean diseases that are rarely seen, then I think you need to re-examine your stance. The reason a lot of those diseases are low-risk is because the population has herd-immunity from decades of vaccination. This is a goo…

I mean things like HPV vaccination. I'm not going to get my son vaccinated. This is an example of Merck and the other drug manufacturers manufacturing a vaccine to treat a low-risk disease. Pushing it on boys, as well, is simply expanding the market to get more money. When my daughter is old enough, she can get the vaccine, once we have figured out if there are long-term effects from this vaccine of if it's just scare mongering.

Yes, HPV causes cervical cancer in some cases. But they want to innoculating every single child for a disease that kills 3000 women a year in the US. That is less 10% of the number of people killed in driving accidents per year. That sounds like a money grab by the drug manufacturers by making up a boogyman in HPV, and collecting the money from our government and us through our taxes. It's genius, in some senses.

It's the equivalent of banning all peanut products from every school in the US to protect those few that are deathly allergic, and then paying a company for the enforcement of the ban.

Re: OxyContin's 12-hour problem

#172

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)

> 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.

That's similar to Ben Goldacre's project http://www.alltrials.net/

Re: OxyContin's 12-hour problem

#173

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)

I think your second bullet is already partially true [0]. The broader question of cherry picking in scientific studies is pretty interesting [1].

[0] https://clinicaltrials.gov/ct2/manage-recs/fdaaa#WhichTrials... [1] http://www.npr.org/templates/transcript/transcript.php?story...

Re: OxyContin's 12-hour problem

#174

I can't believe how doctors apparently routinely prescribe addictive painkillers in the US. Here in Europe, as far as I know, doctors only prescribe non-opioid painkillers. I don't know anyone who was prescribed an opioid drug outside of an ICU. Ibuprofen is surprisingly effective for many types of pain, I don't see why doctors immediately prescribe something as dangerous as OxyContin.

My experience with family in the UK and Ireland is that it's not hard to get the equivalent of Tylenol with codeine. Antibiotics seem to be perscribed more often as well, but that's off topic.

Re: OxyContin's 12-hour problem

#175
ER Resident Physician here, we are many years in from The Joint Commission's administrators claiming that pain is the "5th vital sign" and mow feeling the effects of this disastrous policy. My ED is filled with drug seekers; studies have shown up to 20% ED visits may be Drug-Seeking Behavior (DSB). Really demoralizes physicians who want to help not only these people but those in the overflowing waiting rooms.

Re: OxyContin's 12-hour problem

#177

Why don't patients for whom OxyContin does not work 12-hours ask their doctor for some another drug? With smaller interval, generic, and much cheaper? Would a doctor refuse to prescribe different, much cheaper drug, keeping them on expensive drug that does not work? Should not they then lose licenses? The whole prescription medicine system always seemed evil to me.

Hydrocodone is relatively cheap and anecdotally quite effective. When I broke my ribs, I was told to take both Hydrocodone/paracetamol (Norco) and ibuprofen every day. However, I knew my doctor was trying to get me hooked on it. So I spaced it out, I'd do one day Norco, then the next day ibuprofen, and I didn't really develop much of a tolerance.

I did notice, however, when I had some shoulder pain the other day from weightlifting, that Norco is now very hit or miss for me. So I usually end up going with a high CBD edible or strain whenever I have acute pain.

Re: OxyContin's 12-hour problem

#178

It's quite simple: Don't do drugs. Next question please.

People are weak. But boy, they can sure click a little triangle. The world is safe now.

Please stop posting uncivil and unsubstantive comments to Hacker News. We're looking for thoughtful discussion here.

https://news.ycombinator.com/newsguidelines.html

https://news.ycombinator.com/newswelcome.html

Re: OxyContin's 12-hour problem

#179

I can't believe how doctors apparently routinely prescribe addictive painkillers in the US. Here in Europe, as far as I know, doctors only prescribe non-opioid painkillers. I don't know anyone who was prescribed an opioid drug outside of an ICU. Ibuprofen is surprisingly effective for many types of pain, I don't see why doctors immediately prescribe something as dangerous as OxyContin.

I've seen a wide variety of opiates prescribed in England. They were all for short temr pain though.

Re: OxyContin's 12-hour problem

#180
post #177

Why don't patients for whom OxyContin does not work 12-hours ask their doctor for some another drug? With smaller interval, generic, and much cheaper? Would a doctor refuse to prescribe different, much cheaper drug, keeping them on expensive drug that does not work? Should not they then lose licenses? The whole prescription medicine system always seemed evil to me.

Hydrocodone is relatively cheap and anecdotally quite effective. When I broke my ribs, I was told to take both Hydrocodone/paracetamol (Norco) and ibuprofen every day. However, I knew my doctor was trying to get me hooked on it. So I spaced it out, I'd do one day Norco, then the next day ibuprofen, and I didn't really develop much of a tolerance. I did notice, however, when I had some shoulder pain the other day from…

Ibuprofen is often prescribed (or just recommended) for its anti-inflammatory effects.

(opiates and paracetamol do not have those effects)

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