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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

#41

Post by veeberz »

ewjordan wrote: post #37

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 lo…

Have you considered the availability of cheap opioids such as black tar heroin from Mexico? Or fentanyl shipped from China?

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

#42

Post by [deleted] »

ewjordan wrote: post #37

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 lo…

[deleted]

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

#43

Post by javadocmd »

rz2k wrote: post #11
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.

Search: “Pain is the fifth vital sign” There was a very strong campaign to re-educate physicians to not consider pain as only a symptom. It was suggested that there was liability in not treating pain for the sake of getting rid of pain alone, but mostly it didn’t just change prescribing practices out of fear of liability, the focus of attention on pain changed prescribing habits. In practice, someone who hardly has e…

Even for doctors who express awareness of the problem with opioid prescribing, it's not uncommon to believe that every other doctor is the problem, and not themselves. Either not realizing their prescribing is above average, or realizing but justifying it with the thought that they somehow have a patient population with above average pain needs.

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

#44

Post by DanBC »

lesserroneous wrote: post #28

I 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,…

People think that opioids are an effective treatment for long term pain. They aren't. They don't work to treat the pain and the patient develops a tolerance and so ends up taking large quantities putting their health at risk.

> Patients are seeing their medication reduced without tapering, they are given no other option than to "suck it up,"

These are both bad, but these are both symptoms of the sometimes terrible healthcare in the US. People should have access to pain management clinics.

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

#45

Post by javadocmd »

ewjordan wrote: post #37

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 lo…

When a problem seems to be getting worse but it seems like not much has changed, consider that the problem used to be just as bad, it's just not being swept under the rug as effectively.

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

#46

Post by DanBC »

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.

> Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients?

Opioids are not effective at treating long term pain, so these doctors were probably maintaining the same pain management outcomes for most patients and avoiding addiction on top.

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

#47

Post by DanBC »

cm2012 wrote: post #25
kelnos wrote: post #23

Earlier 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.

You're pushing a narrative created by opioid manufacturers: "These meds aren't addictive if used to treat pain".

That's only true (if it is true) if they're used short term. People in this thread aren't talking about acute pain, they're talking about chronic (long term) pain.

It's likely that opioids are addictive if used long term to treat long term pain.

Here's what actual doctors say: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...

EDIT: FFS, your own link says this:

> “Physiological dependence is the normal response to regular dosages of many medications, whether opioids or others. It also happens with beta blockers for high blood pressure,” said Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse.

Your link says that opioids create physical addiction. The physical addiction to opioids causes all the factors of the newer definition of adddictive: tolerance, drug seeking, preoccupation, and continuing to take it even though you know it's harmful.

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

#48

Post by pdkl95 »

selectodude wrote: post #35
johnpowell wrote: post #27

Earlier quoted context omitted.

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.

Additionally, 600mg Ibuprofen is just 3 of the common over-the-counter 200mg pills. The adult dose for OTC Ibuprofen is 1 or 2 of the 200mg pills, so 600mg is only 150%-300% larger. Whi8le that kind of higher dose can become a problem if used continuously for more than a few days (be careful with any medication), it's a fairly standard dose for a handful of days after a dental procedure. It's certainly not "absurd". (I've been prescribed 1200mg Ibuprofen "every 4-6 hours" a couple times)

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

#49

Post by justinjlynn »

DanBC wrote: post #46
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.

> Now, did it do so while ensuring doctors maintained the same pain management outcomes for their patients? Opioids are not effective at treating long term pain, so these doctors were probably maintaining the same pain management outcomes for most patients and avoiding addiction on top.

> Opioids are not effective at treating long term pain

OK, so, please expand on this asssertion. Also, what does then?

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

#50

Post by justinjlynn »

DanBC wrote: post #44
lesserroneous wrote: post #28

I 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,…

People think that opioids are an effective treatment for long term pain. They aren't. They don't work to treat the pain and the patient develops a tolerance and so ends up taking large quantities putting their health at risk. > Patients are seeing their medication reduced without tapering, they are given no other option than to "suck it up," These are both bad, but these are both symptoms of the sometimes terrible he…

> They don't work to treat the pain and the patient develops a tolerance and so ends up taking large quantities putting their health at risk.

As you've already asserted in your other comments here and I've asked elsewhere, could you expand on this assertion?

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