I found the letter to be crafted very cleverly. "This person died unnecessarily because of your decisions" then while you're feeling guilty and vulnerable "Here's a program to show you how you can atone"
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Coroner letters changed habits of doctors whose patients died of overdoses
21–30 of 89 posts
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#22It had a direct impact on several doctor's prescription habits. This is a good thing. Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients?
I am dubious and concerned this doesn't appear to have been addressed in their studies.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#23It had a direct impact on several doctor's prescription habits. This is a good thing. Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients? I am dubious and concerned this doesn't appear to have been addressed in their studies.
As a potential patient, I'm pretty sure I'd prefer to endure a little extra pain if the alternative is an increased likelihood of painkiller addiction that could lead to death.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#24It had a direct impact on several doctor's prescription habits. This is a good thing. Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients? I am dubious and concerned this doesn't appear to have been addressed in their studies.
I'm hoping the doctors just got better at finding out which patients were going to multiple doctors for opiates at the same time, since that was the case for almost all of the deceased. The average decrease was only 10% less new subscriptiona. But I wish they studied that also.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#25It had a direct impact on several doctor's prescription habits. This is a good thing. Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients? I am dubious and concerned this doesn't appear to have been addressed in their studies.
As a potential patient, I'm pretty sure I'd prefer to endure a little extra pain if the alternative is an increased likelihood of painkiller addiction that could lead to death.
There's almost no chance of you developing an opiate addiction from a prescribed dose if you don't already have a history of addiction: https://www.google.com/amp/s/fivethirtyeight.com/features/wh...
This is a false narrative that needs to go away.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#26Earlier quoted context omitted.
As a potential patient, I'm pretty sure I'd prefer to endure a little extra pain if the alternative is an increased likelihood of painkiller addiction that could lead to death.
There's almost no chance of you developing an opiate addiction from a prescribed dose if you don't already have a history of addiction: https://www.google.com/amp/s/fivethirtyeight.com/features/wh... This is a false narrative that needs to go away.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#27Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.
I went to the dentist around four months ago to get a tooth pulled.
I was given 36x325Mg Hydrocodone (not a typo) and 14x600 Mg Ibuprofen. Which is pretty absurd.
I only used 6 of the Ibuprofen. I'm not sure why I wasn't just given a two day supply of Hydrocodone and if more was needed I could have just called it in asking for a more if the pain was bad.
It was such a over-prescription I hope it was just sloppy handwriting.
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#28I will admit I'm biased: my mother died of an overdose. She was a drug addict. I, on the other hand, have a painful autoimmune disorder, but I've never taken medication. Yet every doctor I've met in the past ten years has looked at me and immediately treated me like a drug addict. Personal experience aside (as it really is not quantitatively demonstrative of anything larger) I've done my best to research this issue, and I'm still somewhat at a loss. Based on these numbers and the 2016 CDC list of leading causes of death, opiate-related deaths account for .02% of the population. On the other hand, I would guess we have quintuple that in people who suffer chronic pain. Though, I can't say how many use their medication as prescribed, I would guess it's at least more than .02% of the population. Addiction is not simple, and even people who started responsibly taking medication could develop an addiction. I don't think it's fair, however, to punish the many people who depend on pain relief. Lax laws in the 80s and 90s have now pendulum-swung to the other side. Patients are seeing their medication reduced without tapering, they are given no other option than to "suck it up," and all along, they are variously demonized or treated as though they are weak. It's a complicated situation that I am not equipped to solve. I do think there needs to be a middle ground. There needs to be a better effort that will help the entire patient population.
https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#29One note: Research pretty thoroughly debunks the idea that a substantial percent of opioid as addictions come from prescribed pain treatments: https://www.fivethirtyeight.com/features/what-science-says-t... Now this article is about something different - teaching doctors the warning signs of when already addicted patients are drug seeking, so they can avoid prescribing then. The key fact here is that almost all of th…
What is the predominant mechanism of becoming addicted then?
Re: Coroner letters changed habits of doctors whose patients died of overdoses
#30It had a direct impact on several doctor's prescription habits. This is a good thing. Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients? I am dubious and concerned this doesn't appear to have been addressed in their studies.
As a potential patient, I'm pretty sure I'd prefer to endure a little extra pain if the alternative is an increased likelihood of painkiller addiction that could lead to death.
Imagine having a solution that works for you. It manages your pain. You aren't abusing your medication. Your doctor gets this letter and all of a sudden that option is taken away. Now, that drug hasn't been shown to be unacceptable when taken correctly; and you have been. Now you're in pain again and the solution that had been working for you isn't available for some nebulous reason that isn't directly related to the benefit/risk trade-off you and your doctor already agreed to.
So, your doctor takes you through trying some other drugs, again, just as they had before they prescribed you opioids - as is current best practice. Of course, now, for your doctor that option of opioid use is no longer available, even though it is still there - out of reach. How would that feel? Living without pain management because your doctor fears losing their licence or a letter from the coroner more than helping you manage your pain.
These studies need to ensure doctors are reserving opioids for worst case management, but still prescribing them when nothing less works.
These studies need to be longitudinal. Do patients maintain their quality of life? Are doctors trying less addictive/abusable drugs first?
Focusing on reduced opioid prescription is like focusing on reducing antibiotic use. You have to track infection rates to gauge if the ineffective usage has gone down while maintaining outcomes.
You can't just track usage to gauge the effectiveness of a program. It's a vanity statistic unless you measure outcomes. Outcomes are the whole point.