Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

bloomberg.com

Post reply on HN
Print view View original

181–190 of 230 posts

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#181

Post by at_a_remove »

gknoy wrote: post #151
at_a_remove wrote: post #142

Earlier quoted context omitted.

I dunno, "The history of all opioids we have ever encountered has always been associated with addiction" is not a particularly difficult concept to grasp, nor can I see it taking an inordinate amount of time to cram into their education.

A huge part of most doctors' jobs is balancing the risk of bad things with the benefits of procedures, medications, etc. One of the main reasons we have doctors is so that we can trust their educated judgment. For example, mine noted that guidance had changed on when we should test for some cancers (not as early), because the risk of false positive is higher than the risk of actually having the cancer. In the case of…

Oh, I am well-aware, as I have been on a somewhat niche Schedule II prescription for over a decade now. It can be quite a hassle.

I am merely pointing out that the idea that medical doctors being unaware of a basic correlation between opioids and addiction, one which has progressed from one medicine to another over the decades, seems ... disingenuous? Preciously naive? Remember, I am replying to "If the companies are lying about safety, how are the doctors supposed to know?"

Here, I think the doctors are supposed to know in the case of opioids because this is an ongoing historical trend. A random new class of medicine? No, they will probably trust the safety sheet, as well they should. The umpteenth opioid? I would be viewing with a gimlet eye anything saying "Nah, no addictive potential."

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#182

Post by ashtonkem »

anigbrowl wrote: post #171
MegaButts wrote: post #134

Earlier quoted context omitted.

https://www.smbc-comics.com/comic/2013-04-07

That's a nice sentiment, but it's built on the idea that one should just ignore the crazies and they'll automatically be marginalized. It doesn't address the situation where one big group decides to weaponize its finge contingent, or where an angry fringe forces itself into what was intended to be a less heated conversations, as in this recent example: https://www.npr.org/2020/08/25/905785548/unmasked-protesters... T…

It’s only tangentially related to the point you’re making, but I think it’s hilarious the difference between how tough Bundy thought he was being, and the sad image of him being wheeled out of the legislature on the cheapest office chair Office Depot has to offer. He looks like a child that’s just realizing that holding his breath might not be an effective way to get what it wants.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#183

Post by at_a_remove »

boomboomsubban wrote: post #156
at_a_remove wrote: post #142

Earlier quoted context omitted.

I dunno, "The history of all opioids we have ever encountered has always been associated with addiction" is not a particularly difficult concept to grasp, nor can I see it taking an inordinate amount of time to cram into their education.

If doctors only prescribed opioids it would be simple, but they deal in all sorts of constantly evolving drugs where new research may overturn previous assumptions. Trusting the research and heavily punishing those who falsify data seems a lot more sane.

I will counter this one with a hypothetical for you. Monsanto, or Bayer now I guess, trots out a totally safe guys we pinky-swear pesticide. Would you add a little to your drinking water every day? Safety sheets say it can't hurt.

You would probably not do this because you have a historical association with pesticides turning out to be rather broader in impact than was originally let on. You understand that history.

I only suggest that this historical wariness sounds completely reasonable for opioids, whereas a brand new drug class has no history associated with it.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#185

Post by smolder »

mmm_grayons wrote: post #141
smolder wrote: post #138

Earlier quoted context omitted.

Taking it all seems fair to me. When someone steals from a retailer, we don't just make them pay for it and send them on their way, because that doesn't disincentivize stealing in the first place. The Sacklers/Purdue would need to be punished for the predatory, antisocial scheme to prevent others like it.

While an additional fine might be fair, again, just "taking it all" isn't. The Sacklers, while they might have played a small part, are being unfairly scapegoated for the whole of the opioid epidemic. This ignores the responsibility borne by states, physicians, and most importantly, those who choose to take the pills. This was also done with FDA approval. More importantly, this is a part of the larger narrative that…

I don't think they're being unfairly scapegoated. Oxycontin was an epidemic in itself. I've seen plenty of evidence from a variety of sources that their pills were aggressively and deceptively marketed as non-addictive, and that their wide availability led to an increase in opioid abuse. That includes knowing people who started on opioid addictions with brand name oxycontin and having heard countless anecdotes of the same. I'm having trouble understanding the motive for minimizing Purdue's role. The deception in marketing and all its consequences belong to them. It's difficult to imagine they merely made a mistake in trying to be effective marketers as opposed to knowingly misrepresenting what they sold in a way that was likely to harm the public.

All that said, I generally favor your stance that ending prohibition would yield the greatest harm reduction.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#186

Post by calimac »

https://ibogaineclinic.com Ibogaine Treatment is the safest fastest way to solve opiate addiction from Vicodin, Oxy's, Subutex, Suboxone, Fentynl, Heroin or any other type of addictive drug for that matter (SSRI, Riddenin, Adderol, Meth, etc...). It is the highest efficacy rate in the world and the more advanced treatment centers like Ibogaine Clinic Have developed advanced protocols to effectively treat individuals without withdrawal. It is literally wonder treatment that has not been allowed into the United States. Ibogaine Clinic has been treating thousands of people in the Maya Riviera In Playa Del Carmen Mexico over the last decade or more.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#187

Post by sevensor »

songshu wrote: post #13

I never understand why doctors are not blamed for prescribing these. Are doctors not supposed to be responsible for prescriptions? If they are not, should we stop allowing them to prescribe? Why don’t doctors unions throw out members who would claim to have been hoodwinked by pharmaceutical companies?

Doctors? Let's talk about bankers, accountants, and real estate agents. They must get paid a lot of money to turn off the part of the brain that's screaming about how dishonest this whole chain of transactions is, how much it looks like a pack of guilty people trying to put their ill-gotten wealth out of harm's way.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#188

Post by snovv_crash »

TAForObvReasons wrote: post #153
GordonS wrote: post #152

Earlier quoted context omitted.

Consider OxyContin, which the makers claimed worked for 12 hours. 2 things should be red flags here: firstly, I haven't seen an extended release formulation of anything that would work over that period; I'm not even sure if it's physically possible given the human digestion system. Secondly, the many, many patients who complained that it only worked for 6-8 hours. Any doctor with a basic understanding of pharmacology…

"doctors should have known the manufacturers' claims were bogus" is shifting the blame. The real blame should be focused on the manufacturers making false claims in the first place.

There's plenty of blame to go around, both can be at fault. My family doctor, for example, warned me to be very careful of the Oxytocin I was given by the hospital (without any warnings) after my wisdom teeth were removed.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#189

Post by dqpb »

autisticcurio wrote: post #61
casraso wrote: post #4

Earlier quoted context omitted.

This is why I am puzzled when people say 'you should fight your battles in the courts, not through protests'. It has always been about who can afford better lawyers, who can win the war of attrition, and a whole lot of luck along the way. Quite a few articles have showed up on HN the past week that reinforce this.

If the system was honest, everyone would be taught at least the basics about law, medicine and finance, but you dont, you get taught enough to be a slave.

Everyone should teach themselves the basics of law, medicine, finance.

Its easy to start. Just pick up some textbooks.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#190

Post by nickff »

rscho wrote: post #177
nickff wrote: post #170

Earlier quoted context omitted.

I really don't understand what you mean by 'culture' and 'attitude'; please explain.

By culture and attitude, I do not mean the objective criteria defining the healthcare system. I mean how things go when you have a patient encounter. American patients are perceived as far more legally agressive and vindicative. True or not, this results in an overly defensive response from american MDs. Unfortunately, medicine has that in common with war that a dead patient is less problematic than an injured patien…

The USA is definitely very litigious, but I am not sure that Canada is similar. Cultural explanations are interesting, but they can be molded to explain almost anything. I could for instance say that US doctors are motivated to prevent overdoses, as their patients are a source of recurring revenue, whereas Canadian and European doctors and systems see their patients as cost centres.
Post reply on HN