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OxyContin's 12-hour problem

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Re: OxyContin's 12-hour problem

#311

Post by ascorbic »

wiredfool wrote: post #174
jakobegger wrote: post #141

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.

Yes, Co-codamol (paracetamol and codeine) is cheap and available over the counter in the UK. They have "Three days use only" in large letters on the front, like cigarette packet warnings.

Re: OxyContin's 12-hour problem

#312

Post by L_Rahman »

stryk wrote: post #307
maxerickson wrote: post #270

Earlier quoted context omitted.

The naloxone is not well absorbed when taken orally. It's in the Suboxone to deter injection. This marketing says it's in the Targin to reduce constipation: http://multivu.prnewswire.com/mnr/targin/36704/

I see. I didn't know that, that's interesting. Question you may be able to answer: The naloxone/Narcan sticks that EMTs and some police have, they also pass them out at needle exchanges, etc. is that why are those applied in the nasal passage? I'm a layman, but if i'm guessing right the term for this might be 'bioavailability' of the drug, is that correct? for example drug A may be absorbed faster and more easily thr…

You used the correct term - bioavailability describes the fraction of a drug dosage that can enters the bloodstream.

Your example however makes an incorrect assumption. Bioavailability from snorting a powdered drug is higher than oral ingestion. When snorted, the drug passes through the thin lining of the nose and enters the bloodstream directly. When ingested orally, the drug has to make it through the chaos of the stomach and small intestine, get through the hepatic pathway (stomach and intestinal lining to liver to general bloodstream) before it reaches the rest of the body.

Re: OxyContin's 12-hour problem

#313

Post by KaiserPro »

ars wrote: post #293
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.

You'll need data to back that up.

So long as opiates are used for acute pain, not long term chronic pain, the chances of addiction are pretty low.

It does happen, with about 30K people addicted in the UK total.

The reason why its much harder is that unless you have lots of money you'll have to persuade your GP that there is a medical reason for continuing. This is much harder in the UK where patients are patients, not customers that must be pleased.

Re: OxyContin's 12-hour problem

#314

Post by MichaelGG »

stryk wrote: post #303
MichaelGG wrote: post #300

Earlier quoted context omitted.

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).

I mean the guys who are successful you mentioned, i assume they have nice jobs, families, maybe children -- the good stuff. Once shit hits the fan and they get a taste of dopesickness they will ignore all of that, the drug becomes priority #1 hell with everything else. Then they will do whatever and screw over whoever to fix the link of the chain that broke (ie, where to get them or how to pay for them, how to hide i…

So it sounds like you're saying that the issue is availability, pricing, and legality. We're in agreement.

Re: OxyContin's 12-hour problem

#315

Post by MichaelGG »

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.

Heroin isn't that cheap, and the availability is sporadic, if you take quality control into account. Factored into this is the legality aspect, meaning a patient might not be able to buy when the need arises. It should be as easy to get as alcohol or Tylenol.

Look at the prices of morphine on goodrx: I don't think unlicensed manufacturers and retailers approach the low cost legit ones do.

Re: OxyContin's 12-hour problem

#316

Post by cromulent »

sgnelson wrote: post #232

Does anyone know what caused the sales the sales (The chart: "Oxycontin Sales 1996 - 2014)" took a major dip in the years 2005 and 2006 and then rebounded like crazy in 2008?

I think it might be due to Endo's release of a similar drug, which was then withdrawn a couple of years later after a settlement with Purdue.

Re: OxyContin's 12-hour problem

#317

Post by Fede_V »

cant_kant wrote: post #260

Sensible doctors do not believe drug company marketing. I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin. On Friday, I had a drug company representative attempt t…

Have you read Bad Pharma by Ben Goldacre? One of the more interesting findings discussed in the book is that doctors were convinced they were personally not affected by drug company PR/goodies (3 day conferences in Bahamas, etc) but they were all worried that their colleagues were.

It's an excellent book and I highly recommend it.

Re: OxyContin's 12-hour problem

#318

Post by joosters »

Fede_V wrote: post #317
cant_kant wrote: post #260

Sensible doctors do not believe drug company marketing. I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin. On Friday, I had a drug company representative attempt t…

Have you read Bad Pharma by Ben Goldacre? One of the more interesting findings discussed in the book is that doctors were convinced they were personally not affected by drug company PR/goodies (3 day conferences in Bahamas, etc) but they were all worried that their colleagues were. It's an excellent book and I highly recommend it.

It's a standard reaction, like how most people believe that they aren't affected by TV/newspaper advertising but they worry about how it affects other people.

Re: OxyContin's 12-hour problem

#319

Post by WalterBright »

joosters wrote: post #318
Fede_V wrote: post #317

Earlier quoted context omitted.

Have you read Bad Pharma by Ben Goldacre? One of the more interesting findings discussed in the book is that doctors were convinced they were personally not affected by drug company PR/goodies (3 day conferences in Bahamas, etc) but they were all worried that their colleagues were. It's an excellent book and I highly recommend it.

It's a standard reaction, like how most people believe that they aren't affected by TV/newspaper advertising but they worry about how it affects other people.

I am well aware I am affected by advertising, but I am responsible for its effect on me.

Re: OxyContin's 12-hour problem

#320

Post by philjohn »

BurningFrog wrote: post #296
ams6110 wrote: post #286

Earlier quoted context omitted.

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.

Not quite ... they tell people to ask about a certain, non-generic, drug.
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