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Judge rejects Purdue Pharma's $4.5B opioid settlement

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Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#21

Post by gostsamo »

fallingknife wrote: post #17

Doctors prescribe drug -> pharmacy dispenses drug -> pharmacy orders from manufacturer. All I hear about is pharmacies and manufacturers getting sued, but why not doctors? Why do they seem to get off the hook when they are the main cause. Sure, Perdue marketed it to doctors (and I don't even see a way that pharmacies were responsible at all), but "I was manipulated by marketing" isn't a convincing defense from an exp…

Also, the producers pay he doctors and provide different insentives to make them prescribe their drugs.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#22

Post by donkeyd »

starklevnertz wrote: post #3

Can anyone explain why opioids are still being sold and prescribed?

Because they're extremely effective in treating extreme pain. In some cases, this is necessary because pain limits recovery. Use of them needs to be managed extremely well though and when that doesn't happen it's easy to get addicted.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#23

Post by stathibus »

scotty79 wrote: post #20
fallingknife wrote: post #17

Doctors prescribe drug -> pharmacy dispenses drug -> pharmacy orders from manufacturer. All I hear about is pharmacies and manufacturers getting sued, but why not doctors? Why do they seem to get off the hook when they are the main cause. Sure, Perdue marketed it to doctors (and I don't even see a way that pharmacies were responsible at all), but "I was manipulated by marketing" isn't a convincing defense from an exp…

I think doctors were directly lied to that those drugs are non-addictive.

This may have been a valid argument some decades ago.

Greedy doctors killed my aunt by selling her all the drugs she asked for. This is commonplace in the US.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#24

Post by rand_r »

tialaramex wrote: post #9
starklevnertz wrote: post #3

Can anyone explain why opioids are still being sold and prescribed?

The problem was never that they don't work the problem was that they're addictive . So since they do work this means it remains appropriate to prescribe them, it just isn't appropriate to give them to everybody to pop one every day before work and say it's "non-addictive". Drugs that work but have a terrible reputation are almost always still available. For example Thalidomide works, but it causes birth defects. Well…

The idea that opioids are addictive is a myth. People taking them are treating “pain” that isn’t diagnosed in the medical system. For example, joblessness. It’s an easy scapegoat for politicians to let them avoid dealing with harder structural problems.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#25

Post by PMan74 »

dstick wrote: post #16

Good. For those that haven't watched them yet, there are 3 John Oliver segments on the subject that will back up the "Good." statement: Opioids https://www.youtube.com/watch?v=5pdPrQFjo2o Opioids II https://www.youtube.com/watch?v=-qCKR6wy94U Opioids III (this one focuses 100% on the Sacklers) https://www.youtube.com/watch?v=uaCaIhfETsM

The Pharmacist on Netflix also worth a watch

https://www.netflix.com/ie/title/81002576

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#26

Post by joshgel »

stathibus wrote: post #23
scotty79 wrote: post #20

Earlier quoted context omitted.

I think doctors were directly lied to that those drugs are non-addictive.

This may have been a valid argument some decades ago. Greedy doctors killed my aunt by selling her all the drugs she asked for. This is commonplace in the US.

Sorry that happened to your aunt.

Doctors aren’t reimbursed for prescribing medications directly (except chemotherapy infusions). Was the physician selling the medication directly? That’s not commonplace.

Clinicians may financially benefit from not refusing their patients requests and thus losing the patient to another doctor that will acquiesce. But that’s a tricky topic to untangle.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#27

Post by aaronmdjones »

hermes8329 wrote: post #12
alienchow wrote: post #6

Earlier quoted context omitted.

Fentanyl is used in epidurals, for one.

It's used in all sorts of surgical procedures. I've had it a few times, used as a relatively minor painkiller under those circumstances. Which sounds crazy considering how much news is about how strong it is. But it works well in those controlled circumstances

You would have been given micrograms of Fentanyl. Certainly not a milligram, and certainly not 2mg, which will probably kill you. For comparison, you require more than 10 times as much Heroin to do that.

This illustrates it pretty well; a lethal dose of Heroin (left) and Fentanyl (right): https://www.statnews.com/wp-content/uploads/2016/09/Heroin-F...

This is why it's been in the news and why you've read about how strong and dangerous it is. Usage in a medical setting is much safer because they have a known purity and precise dispensing and dosage schemes; something you won't find and can't achieve on the street.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#28

Post by donkeyd »

skywal_l wrote: post #13
mousetree wrote: post #5

Earlier quoted context omitted.

There are people who still have legitimate need for pain medication

But what are the the criteria to decide legitimacy of those needs? Pain is a symptom. It is your body signaling a problem. Indeed, sometimes, there are no solution to those problems but I doubt that all those who got prescribed opioids and got addicted didn't have an underlying solvable problem. If you are obese because you eat too much and your knees hurt, the solution is not an opioid. The whole discourse about pai…

> I doubt that all those who got prescribed opioids and got addicted didn't have an underlying solvable problem.

The US health care system is set up to cause exactly these kinds of issues. If you're in pain because of a bad hip, if you're uninsured, it may be much cheaper to just buy pain killers in stead of getting surgery. Once you get used to the pills, the pain is even worse if you stop taking them and might get withdrawals.

Opioids are indispensable in cancer treatment and after many surgeries. In some cases they can be used to combat chronic pain or leading up to surgery. But you're right, they shouldn't be a replacement.

If the US wants to fix this epidemic, just decreasing sales of opioids won't be enough, they'll have to provide the alternative. If people can't get affordable health care, they'll get affordable pain killers.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#29

Post by SamoyedFurFluff »

skywal_l wrote: post #13
mousetree wrote: post #5

Earlier quoted context omitted.

There are people who still have legitimate need for pain medication

But what are the the criteria to decide legitimacy of those needs? Pain is a symptom. It is your body signaling a problem. Indeed, sometimes, there are no solution to those problems but I doubt that all those who got prescribed opioids and got addicted didn't have an underlying solvable problem. If you are obese because you eat too much and your knees hurt, the solution is not an opioid. The whole discourse about pai…

Opioids are also prescribed for short term healing from major surgery, of which there is no root cause beyond having major surgery or other painful injury.

Re: Judge rejects Purdue Pharma's $4.5B opioid settlement

#30

Post by ejb999 »

stathibus wrote: post #23
scotty79 wrote: post #20

Earlier quoted context omitted.

I think doctors were directly lied to that those drugs are non-addictive.

This may have been a valid argument some decades ago. Greedy doctors killed my aunt by selling her all the drugs she asked for. This is commonplace in the US.

I agree - goes on still, all day everyday all across the USA. Easiest thing for a doctor to do to not have to deal with a problem patient (i.e. a drug seeker - not saying your aunt was one of them), is give them what they want, and send them on their way.

Doctors should be held accountable - every script they write, is tracked - it would not be hard to find the doctors that are outside the range of normal.

Insurance companies should also be held accountable - they pay for a big portion of these oversubscribed opioids, they know who is writing those scripts, they know when a duration or quantity is out of the normal bounds, and yet they still keep enabling it.

But doctors do not get a cut of the prescriptions they write, not legally anyway, so don't think its greedy doctors - more like doctors who have to see upto 32 patients a day, in 15 min increments, and don't have time to argue with persistent drug seekers, so the close their eyes and pretend they don't know what is going on - and move on to the next 15 min appointment.

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