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OxyContin's 12-hour problem

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Re: OxyContin's 12-hour problem

#291

Post by [deleted] »

blazespin wrote: post #253
KaiserPro wrote: post #182

There is a difference between marketing and actual use. Its a synthetic opioid, which means it has all the variability of opioids. Any decent doctor should know this, and the guides, if they were any good will indicate it. For example codamol is now not prescribed in a hospital setting for under 5s, after one child died because they had large amounts of the enzyme required to processes it all at once. This caused res…

This last bit is very true. Same thing in canada. Doctor shopping is very hard because there is no benefit to the Doctor, only risk.

[deleted]

Re: OxyContin's 12-hour problem

#292

Post by allenz »

ak4g wrote: post #249
arkades wrote: post #137

Earlier quoted context omitted.

First, and I want to make clear that I am strongly against any drug rep presence in any medical institution, and have advocated against it in institutions I've been affiliated with: let us draw a hard line between three levels of behavior, because conflating them is ... well, not ridiculous, not quite, but misleading. It's not ridiculous to group "slapping someone" with "beating them with a baseball bat," but it lose…

> physicians that get this money are now publicly monitored for it. > Again, these have grown increasingly rare since these are now public numbers subject to scrutiny. Where can I access this information?

https://www.cms.gov/openpayments/

ProPublica has some investigative reporting as well: https://www.propublica.org/series/dollars-for-docs

Re: OxyContin's 12-hour problem

#293

Post by ars »

KaiserPro wrote: post #182

There is a difference between marketing and actual use. Its a synthetic opioid, which means it has all the variability of opioids. Any decent doctor should know this, and the guides, if they were any good will indicate it. For example codamol is now not prescribed in a hospital setting for under 5s, after one child died because they had large amounts of the enzyme required to processes it all at once. This caused res…

> One of the many advantages of the NHS is the chances of getting hooked on painkillers if miniscule

You have got to be kidding. The UK might be behind the US, but the trendlines are pointing up, not down. The UK working hard to close the gap. "Miniscule" please.

Re: OxyContin's 12-hour problem

#294

Post by yoda_sl »

smileysteve wrote: post #226
OliverJones wrote: post #206

I wonder if the accelerometer in a smartwatch could measure levels of pain in a patient? I wonder if tense muscles and other aspects of suffering could be measured and tracked. I suppose a smartphone app could ask the patient to tap one of the ten pain-level smiley - frowny - sweaty faces at intervals as well. If so, there'd be a way to measure how fast these painkillers clear from each patient. It might even make it…

Heart Rate could be correlated with levels of stress and therefore pain.

Heart rate and blood pressure will probably work in case of extreme pain/high level of pain. I am recovering from a 2 hours and half+ surgery on my ankle which was badly damaged: the surgery did require 2 experienced surgeons. The day post surgery my pain level was shooting to the roof even if I had a pain pump, the pain level was extreme -turn out that the pain pump was busted and was not working. At one time I decided to check my blood pressure and monitor my heart beat during a cycle of pain and yes it was definitely noticeable on the blood pressure, but slightly less on heart beat.

Re: OxyContin's 12-hour problem

#295

Post by gdudeman »

ctingom wrote: post #267
Cakez0r wrote: post #262

Earlier quoted context omitted.

* Make it illegal to advertise or market any drug that requires a prescription.

What about the first amendment?

I agree - this could be tricky.

One solution for restricting advertising would be to allow consumers to sue drug companies for false claims or for misinforming doctors.

Re: OxyContin's 12-hour problem

#296

Post by BurningFrog »

ams6110 wrote: post #286
BurningFrog wrote: post #279

Earlier quoted context omitted.

The argument for these ads is that many conditions are very undermedicated. People don't know they have treatable conditions and suffer needlessly.

People are not qualified to judge. If they are suffering they should see a doctor, who is qualified to determine if they have a treatable condition.

That is exactly what these ads tell people to do.

Re: OxyContin's 12-hour problem

#297

Post by BurningFrog »

stryk wrote: post #284
BurningFrog wrote: post #280

Earlier quoted context omitted.

I am 100% reliant upon, chained to, and physically dependent on both water and oxygen. But since they are cheaply and abundantly available, I can live a full happy life anyway.

I'm sorry I don't understand your point? I mean, heroin is cheap and abundantly available.

My point is that there is nothing inherently bad about being reliant upon, chained to, and physically dependent on a substance.

Re: OxyContin's 12-hour problem

#298

Post by refurb »

VonGuard wrote: post #229
saulrh wrote: post #69

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. 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…

Happens ALLLLLLLL the time, though. Improper or not, look around at corporate America and you'll find a lot of people who were regulating a company as a government agent, then soon there after, work for the firm they were regulating.

Of course it does. If you've got two organizations competing for the experts, you'll get a lot of back and forth.

I don't disagree that it creates the appearance of impropriety, but I'm not quite sure how'd you'd avoid it. Force people at the beginning of their career to chose one or another?

Re: OxyContin's 12-hour problem

#299

Post by tempestn »

smileysteve wrote: post #222
ssmoot wrote: post #198

Earlier quoted context omitted.

> I also don't think you have much personal experience people who have been addicted to opiates. I said as much. Which is a good enough reason to be suspicious of prohibition for me. And to be clear, I'd find it very difficult to believe anyone gets a two week supply of opiates after surgery and goes all Reefer Madness after following the directions on the prescription. You're talking about people who abuse the drug.…

> You're talking about people who abuse the drug. Most people who drink don't become alcoholics The article is specifically about the effects of withdrawal when a 12 hour dose doesn't last 12 hours - when people are taking it by the prescribed schedule.

Exactly. The article rambles a bit, but the primary point is that when the effects wear off before the 12 hour interval but the patient keeps taking the drug as expected, it causes a cycle of pain and relief, which fosters addiction.

Re: OxyContin's 12-hour problem

#300

Post by MichaelGG »

stryk wrote: post #282
MichaelGG wrote: post #276

Earlier quoted context omitted.

Well I guess we have two different sets of people and experience then. I've seen people do rather successfully in business, all while using opiates on the side. (I've seen a few people die too, but that was pretty much caused by illegal supply and lack of regulation/QC.) The actual addiction part, without supply constraints, becomes very, very simple logistics.

Those logistics are not as simple as it may seem. 2 bags of dope/pills/caps/doses a day becomes 3, 4, 6, 8 twice a day + 9 on Sundays. Happens to everyone given a long enough usage period. There's that proverbial slippery slope there, and once you're over the hump it's checkmate. Wait until something happens to these successful folks - and it will. there's a weak link somewhere in the chain and when it breaks they wi…

And what is "acting like every other junkie" mean? Göring was a morphine user for what, 2 decades? Didn't stop him from becoming extremely powerful (misguided, but he accomplished a lot).
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