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How to download and use the DEA pain pills database

washingtonpost.com

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Re: How to download and use the DEA pain pills database

#21

Post by jdsully »

taxidump wrote: post #18
jdsully wrote: post #6

Earlier quoted context omitted.

Everyone has plausible deniability that theirs follows a secure supply chain to the pharmacy. Its those other guys that can’t control their inventory. Nobody has an incentive to audit their supply chains or doctor RXs to verify that of course.

Sorry, how does this relate to the topic?

> I don't know how on earth any executive couldn't be fucking liable for knowing the vast majority being manufactured and sold were being used illicitly.

The answer is plausible deniability. Nobody in the chain has specific knowledge of wrongdoing and nobody seeks it out.

Re: How to download and use the DEA pain pills database

#22

Post by etaioinshrdlu »

whiskers1960 wrote: post #19

As a chronic pain sufferer, opiates are a lifeline. Problem has been indescriminate use pushed by docs before they became fully aware of the risks. Now I jump through hoops to get a fairly low dose of hydrocodone 7.5. I have both rheumatoid and osteoarthritis, fibromyalgia and a host of other diagnosis. Without effective pain management, life isnt worth living. I'm only 58!

What sort of hoops do you have to jump through?

Re: How to download and use the DEA pain pills database

#23

Post by [deleted] »

etaioinshrdlu wrote: post #22
whiskers1960 wrote: post #19

As a chronic pain sufferer, opiates are a lifeline. Problem has been indescriminate use pushed by docs before they became fully aware of the risks. Now I jump through hoops to get a fairly low dose of hydrocodone 7.5. I have both rheumatoid and osteoarthritis, fibromyalgia and a host of other diagnosis. Without effective pain management, life isnt worth living. I'm only 58!

What sort of hoops do you have to jump through?

[deleted]

Re: How to download and use the DEA pain pills database

#25

Post by waltwalther »

etaioinshrdlu wrote: post #22
whiskers1960 wrote: post #19

As a chronic pain sufferer, opiates are a lifeline. Problem has been indescriminate use pushed by docs before they became fully aware of the risks. Now I jump through hoops to get a fairly low dose of hydrocodone 7.5. I have both rheumatoid and osteoarthritis, fibromyalgia and a host of other diagnosis. Without effective pain management, life isnt worth living. I'm only 58!

What sort of hoops do you have to jump through?

I cant speak for Whiskers, but my father, who is almost seventy and takes a similar dose of the same medication, is routinely forced to jump through an unreasonable amount of hoops just to get a recently-lowered prescription that barely lasts throughout the month. I say "barely lasts" because his new prescription always seems to arrive a few days late.

And the doctors could care less. Not only that, but if he complains about his medicine arriving late or about his dose being constantly lowered or about his treatment, then he is treated even worse.

The "hoops" I am referring to are: frequent drug tests, frequent classes/counseling an hours drive away, frequent alternative and experimental treatments an hours drive away, all the while being blatantly accused of being a drug-seeking addict.

My father is the most upstanding man I know. He is a Vietnam Veteran with related injuries who receives his treatment at the VA (which is the most inefficiently-run place I have ever witnessed. Seriously its a complete embarrassment. The arrogant doctors who know absolutely nothing about pain management, and who make no effort to hide that they care less doesnt even begin to cover whats wrong with that place..but I digress..). My father only agreed to accept opiates as a last resort. He has never had issues with alcohol/cigarettes/marijuana or any other drugs. He is an honest, church-going, hardworking gentleman who doesnt deserve to be humiliated multiple times per month to just live a nearly pain-free life.

This recent trend to eradicate opiates, while somewhat understandable, is leaving many good people with a life of constant severe pain.

Sorry for the rant. I got started, and I couldnt stop.

Re: How to download and use the DEA pain pills database

#26

Post by stordoff »

dillondoyle wrote: post #15
refurb wrote: post #8

Earlier quoted context omitted.

I was reading another discussion among physicians about this and the number isn't that excessive. 50M Americans have chronic pain, assume 10M (20%) are on opioids. 76B pills over 10 years is 7.6B per year, so 760 pills per [chronic pain + opioid] person per year. Take 4 pills per day or 120 per month or 1440 per year. So basically 6 months of therapy for every chronic pain patient in the US.

But that's one of the big lies - or minimally very misleading marketing: long term opiate treatment isn't as remarkably effective for chronic pain as Purdue had us believe and carries a LOT of downside: https://www.ncbi.nlm.nih.gov/pubmed/30313000

> For a number of Key Questions, we identified no studies meeting inclusion criteria. Where studies were available, the strength of evidence was rated no higher than low, due to imprecision and methodological shortcomings, with the exception of buccal or intranasal fentanyl[...]. No study evaluated effects of long-term opioid therapy versus no opioid therapy.

> No study evaluated the effectiveness of risk mitigation strategies on outcomes related to overdose, addiction, abuse, or misuse. Evidence was insufficient to evaluate benefits and harms of long-term opioid therapy in high-risk patients or in other subgroups.

> CONCLUSIONS: Evidence on long-term opioid therapy for chronic pain is very limited but suggests an increased risk of serious harms that appears to be dose-dependent. More research is needed to understand long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and risk mitigation strategies.

This doesn't show they aren't effective.

Re: How to download and use the DEA pain pills database

#27

Post by refurb »

whiskers1960 wrote: post #19

As a chronic pain sufferer, opiates are a lifeline. Problem has been indescriminate use pushed by docs before they became fully aware of the risks. Now I jump through hoops to get a fairly low dose of hydrocodone 7.5. I have both rheumatoid and osteoarthritis, fibromyalgia and a host of other diagnosis. Without effective pain management, life isnt worth living. I'm only 58!

You must be putting up with a lot, sorry to hear that.

For as much as opioids are demonized, there are a lot of people out there who can’t function without them and use them responsibly. Of course they are getting caught up in the moral panic and either being forced to stop taking them or significantly reducing their dose, resulting in a much lower quality of life.

Re: How to download and use the DEA pain pills database

#28

Post by Gibbon1 »

waltwalther wrote: post #25
etaioinshrdlu wrote: post #22

Earlier quoted context omitted.

What sort of hoops do you have to jump through?

I cant speak for Whiskers, but my father, who is almost seventy and takes a similar dose of the same medication, is routinely forced to jump through an unreasonable amount of hoops just to get a recently-lowered prescription that barely lasts throughout the month. I say "barely lasts" because his new prescription always seems to arrive a few days late. And the doctors could care less. Not only that, but if he complai…

> Not only that, but if he complains about his medicine arriving late or about his dose being constantly lowered or about his treatment, then he is treated even worse.

This is totally my experience. If you want to know why people die trying to stretch out their supply of insulin, that's why. They know they'll be punished for being too much of a pain in the ass. My friend with epilepsy carefully hoards his drugs. He knows he needs to be able to skate at least two weeks on his own.

Re: How to download and use the DEA pain pills database

#29

Post by stordoff »

rubyn00bie wrote: post #3

Woah... just woah, so am I mathing this wrong, or from 2006-2012 there were ~250 pain pills per person (man, woman, child) sold in America? Because if so, I don't know how on earth any executive couldn't be fucking liable for knowing the vast majority being manufactured and sold were being used illicitly.

I (non-US) am on (up to) 8 per day, or 2920 per year. To get an average of ~42 pills per year (250/6), it only requires 1 in 70 to be on a similar regime (2920/70 ~= 42). Given that 8% of American adults have high-impact chronic pain (frequently limits life or work activities)[1], that doesn't sound that excessive.

Sanity check: 19.6 million people * 4 pills per day * 6 years ~= 172bn pills. That's over _double_ the actual number, suggesting high-impact chronic pain sufferers are, on average, only taking 2 pills per day.

[1] https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

Edit: I overlooked that this only covers oxycodone and hydrocodone, and not the other opioids, but as they account for 3/4 of the total opioid pill shipments[2], it doesn't change the picture much (76bn * 4/3 ~= 101bn, which is still well under the number I posited above).

That's not to say there isn't an issue with diversion, but in terms of raw numbers, it doesn't seem excessive.

[2] https://www.washingtonpost.com/graphics/2019/investigations/...

Re: How to download and use the DEA pain pills database

#30

Post by milofeynman »

danso wrote: post #4

I'm not sure if WaPo just made their paywall more aggressive, but I can't seem to read this URL now w/o logging in. They do provide a direct URL from Cloudflare to the raw data, which is about 7GB compressed and uncompresses to a single tab-delimited text file with 180M rows at 80GB: https://d2ty8gaf6rmowa.cloudfront.net/dea-pain-pill-database/bulk/arcos_all_washpost.tsv.gz There is also individual state level data w…

I really wish the WaPo app opened urls from their site. I use Firefox focus so I'm never logged in, but I am logged in the app.
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