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Coroner letters changed habits of doctors whose patients died of overdoses

latimes.com

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Re: Coroner letters changed habits of doctors whose patients died of overdoses

#31

Post by cm2012 »

jeffdavis wrote: post #29
cm2012 wrote: post #18

One 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?

"Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#33

Post by simonbarker87 »

cm2012 wrote: post #31
jeffdavis wrote: post #29

Earlier quoted context omitted.

What is the predominant mechanism of becoming addicted then?

"Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."

You could still draw a link: high prescription rates of opioid pain killers normalises the use of them and as such someone is more likely to be offered them by family and friends for something minor.

Also, is “throughly” debunked really the case? That makes it sound like there can be no link at all, but higher levels of these in society legally could lead to an increase in abuse. On complex topics like this it is rarely possible to talk in absolutes.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#34

Post by seanmcdirmid »

kelnos wrote: post #23
justinjlynn wrote: post #22

It 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.

And if its a lot of extra pain?

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#35

Post by selectodude »

johnpowell wrote: post #27
duncan-donuts wrote: post #3

Clearly 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 handw…

You were reading the bottle wrong. Those pills were either 5mg or 10mg of hydrocodone with 325mg of acetaminophen. 36 of those, while a lot, is really not more than 4-5 days worth. They only last 4-6 hours each. 325mg hydrocodone would have killed you several times over unless you’re, like, a late stage cancer patient or a severe heroin addict.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#36

Post by cma »

cm2012 wrote: post #31
jeffdavis wrote: post #29

Earlier quoted context omitted.

What is the predominant mechanism of becoming addicted then?

"Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."

All that tells is that there is a layer a indirection. The friends, family, and dealers to some degree get pills from people that got them from doctors. Some may come from overseas, theft, etc., but if 25% are hooked directly from having been prescribed them, I would guess a big portion of the 75% is people within a few hops away.

Often what happens is that the 25% that got hooked from being prescribed start buying additional pills. Eventually they can't afford that and they switch to cheaper heroin, often funded by selling their prescription pills.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#37

Post by ewjordan »

Opiods have been around forever; pardon my ignorance, but what is different now that makes so many more people get hooked on them?

Presumably people felt the same levels of pain in the past as they do now, given the same maladies. Is the situation:

A) More surgeries with extremely painful and long recovery periods are happening, where these meds are truly necessary

B) Doctors are prescribing opiods more freely for lower levels of pain than in the past

C) People are faking pain more often

D) People who really do need pain meds are staying on them longer than they should

B) seems to be the accusation that I usually see, but have doctors really gotten worse and less careful over time? To an extent that explains the whole crisis?

My guess is that D) is the real cause, for may different reasons.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#38

Post by javadocmd »

cm2012 wrote: post #18

One 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…

And yet the CDC notes that your likelihood of developing opioid use disorder rises precipitously after as little as five days on prescription opioids. https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm

Regardless of whether or not this accounts for the majority of addictions, it is sufficient to say that opioids are far more dangerous for patients than many doctors believe. Addressing prescribing habits is a necessary part of a multi-pronged solution to opioid addiction.

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#39

Post by [deleted] »

cm2012 wrote: post #18

One 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…

[deleted]

Re: Coroner letters changed habits of doctors whose patients died of overdoses

#40

Post by cm2012 »

simonbarker87 wrote: post #33
cm2012 wrote: post #31

Earlier quoted context omitted.

"Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."

You could still draw a link: high prescription rates of opioid pain killers normalises the use of them and as such someone is more likely to be offered them by family and friends for something minor. Also, is “throughly” debunked really the case? That makes it sound like there can be no link at all, but higher levels of these in society legally could lead to an increase in abuse. On complex topics like this it is rar…

What's debunked is the very common narrative in this thread that poor Uncle Billy went to the doctor with a bad back and came back a rabid addict. Non addicts becoming addicts from regular prescriptions is very rare according to all studies.

There is definitely a big complex drug ecosystem otherwise, though.

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