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

361–370 of 376 posts

Re: OxyContin's 12-hour problem

#361

Post by gonzo »

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…

One of my questions when interviewing a new physician is to ask their opinion on "detail people".

Re: OxyContin's 12-hour problem

#362

Post by mst »

capote wrote: post #305
MichaelGG wrote: post #252

Earlier quoted context omitted.

Don't understate the "do not do crime". I've known addicts and the biggest damage they cause (apart from dying when they OD on unknown-quality junk) is that they become thieves and liars. No one trusts them and it tears relationships apart. Both are fixed by having more legal availability. If they were simply able to get opiate as easily as pot, then addicts for the most part would be just like potheads. Perhaps bein…

Even with heroin being illegal, I've seen people get it without a problem. They have to resort to no crime to get it other than getting it itself being a crime. But this hurts no one. What hurts people isn't getting it, it's what they do as addicts. Throw their lives away, resorting to crime to live day to day, get housing and food… They partly ruin the lives of those close to them too. Legalization would do nothing…

I've seen friends destroy their relationships and careers over addiction.

I've also seen a burned out house where a dealer set fire to it with the occupant inside to incentivise future debtors to pay up faster.

I've seen the grey market involved in buying such things suck far harder on somebody's lifeblood than buying alcohol would an alcoholic.

So ... my gut feeling is that, overall, legalisation would probably be an improvement. But I think that, if so, it would be an improvement overall, and that doing the math carefully beforehand is a really good idea.

Or: I think you and MichaelGG both have valid points, and that any opinion on this subject that doesn't include both is probably going to fall short of the mark.

(to be clear, I'm replying to this specific comment largely because of your last line, since I'm seeking synthesis, not antithesis, by this line of thought)

Re: OxyContin's 12-hour problem

#363

Post by mst »

DanBC wrote: post #321
MichaelGG wrote: post #266

Earlier quoted context omitted.

What you keep saying in these threads is that opiates aren't effective. Why then do people continue to use them? Certainly if you're in pain, you're not taking a gram of morphine-equivalent per day just because. If there are effective alternatives, why are they not used? Then with pain under control, you can slowly (over a year, say) taper down.

I'm not saying it. National organisations are saying it - Public Health England (part of government); the Faculty of Pain Medicine (part of the Royal College of Anaesthetists); NICE (The National Institute for Health and Care Excellence, a non-departmental public body) all say it. So, unusually, do the CDC: http://www.cdc.gov/vitalsigns/opioid-prescribing/index.html If they were effective and if addiction could be sa…

This would be basically why after breaking my hip and having it reassembled around a Dynamic Hip Screw, every week I dropped my dose of codeine so that the pain was back to being as bad as I'd been dealing with a week ago. I do wish people being prescribed opiates for situations where that's possible (i.e. the pain will lessen over time anyway) basically got a guide on doing that, not everybody's an ornery bastard like I am.

The only time opiates for control of pain that wasn't going to lessen over time seems like a good idea is in the case of palliative care for the dying; my father got several months of mostly-pain-free end of life out of it, and whether it was increased pain from the cancer or decreased effectiveness due to addiction that eventually meant the maximum dose allowable didn't help, he was dead within a week after that so even given all the obvious caveats I think he picked the right set of trade-offs.

Re: OxyContin's 12-hour problem

#364

Post by ceejayoz »

pfarnsworth wrote: post #353
minikites wrote: post #342

Earlier quoted context omitted.

Ironic coming from someone who follows the anti-vax herd despite a raft of evidence to the contrary.

lol I just said my kids and I are fully vaccinated. Militant sheep is a good name for you. Anyone who dares to say anything about a single vaccination is a part of the anti-vax herd. You should be proud of yourself, Merck would love you.

> I just said my kids and I are fully vaccinated.

You explicitly stated that this isn't going to be the case:

> I'm not going to get my son vaccinated.

Re: OxyContin's 12-hour problem

#365

Post by pfarnsworth »

ceejayoz wrote: post #364
pfarnsworth wrote: post #353

Earlier quoted context omitted.

lol I just said my kids and I are fully vaccinated. Militant sheep is a good name for you. Anyone who dares to say anything about a single vaccination is a part of the anti-vax herd. You should be proud of yourself, Merck would love you.

> I just said my kids and I are fully vaccinated. You explicitly stated that this isn't going to be the case: > I'm not going to get my son vaccinated.

HPV isn't until the kids are 11 or 12. For all of the vaccinations that are currently required for their ages, they are fully vaccinated. I don't see how I can be considered "part of the anti-vaxx herd" if my kids and I are fully vaccinated as to what is appropriate for their age groups. As I mentioned, I disagree with the HPV vaccination, but that is 1 out of dozens. To call me an anti-vaxxer is laughable.

Re: OxyContin's 12-hour problem

#366

Post by velox_io »

GordonS wrote: post #332
forgotpwtomain wrote: post #21

Earlier quoted context omitted.

> Many people are inappropriately given opiates by their doctors to treat long term pain. While I am sure this is true in many cases, my personal experience was the opposite. I had significant nerve pain after an accident, which kept me from being able to sleep or focus on anything very well. The physician I saw after my hospitalization was apparently worried I was trying to satisfy a drug-craving? So instead of givi…

A lot of research has shown SNRI and SSRI antidepressants are actually great for nerve pain, e.g. gapapentin, pregabalin, duloxetine. They didn't work for me personally, opioids did, but prescribing such antidepressant type medications first seems a reasonable course of action

I take Amitriptyline at night (in addition to opioid patches and antiinflammatories). While I find it does have some analgesic properties; the real benefit is actually a side effect, the drowsiness means I actually get some sleep.

Re: OxyContin's 12-hour problem

#367

Post by [deleted] »

ludamad wrote: post #187
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…

What about their push for higher, instead of more frequent, doses?

[deleted]

Re: OxyContin's 12-hour problem

#368

Post by noir_lord »

dang wrote: post #245
noir_lord wrote: post #6

Earlier quoted context omitted.

Yeah, I'll stop taking the drugs that allow me to function and have any kind of quality of life. That's a great suggestion! however if I do it's quite simple, don't do drugs, can you do it's quite simple don't be an empathy lacking idiot?.

No personal attacks on HN, please, regardless of how wrong or provocative someone else's comment is.

Apologies, issue touched a nerve.

Re: OxyContin's 12-hour problem

#369

Post by jlarocco »

morgante wrote: post #356
jlarocco wrote: post #355

Earlier quoted context omitted.

That comparison doesn't work. As a tech manager, you're not using your personal funds, either, you're using your employer's money. Further, if a doctor's prescription doesn't work, or is too expensive, the patients can get a second opinion, and the doctor can lose the person as a patient. An employer may not even have that option with a tech manager.

> As a tech manager, you're not using your personal funds, either, you're using your employer's money. Right, but I am spending the money of my company. They control my salary and advancement, and I also have a fixed pool to draw from. Doctors are spending money for insurance companies.

How is it different?

The insurance company can investigate the efficacy of prescriptions and stop paying for ones that don't work. The article says some of them have done exactly that with Oxycontin.

At the other end, if the pain killer isn't working, a patient can go to a different doctor who will prescribe something else.

Re: OxyContin's 12-hour problem

#370

Post by capote »

BurningFrog wrote: post #310
capote wrote: post #304

Earlier quoted context omitted.

We're not talking about inherent bad, or about oxygen. We're talking about addiction to opiates, which ruins lives and kills people. I've seen it first hand. Stop this nonsense.

Opiate specific arguments could be reasonable. But the post I responded had no such arguments.

Then go to a thread about oxygen and water. This one's about opiates.
Post reply on HN