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Washington faltered as fentanyl gripped America

washingtonpost.com

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Re: Washington faltered as fentanyl gripped America

#221

Post by refurb »

Barrin92 wrote: post #219
refurb wrote: post #74

Earlier quoted context omitted.

It’s not. They have drug sales reps in the UK. I actually don’t know of any country that bans them. I mean, if a doctor has a question about a drug, who better to ask than the rep from the company who makes it? I worked in the industry and reps are generally account managers for the company.

>if a doctor has a question about a drug, who better to ask than the rep from the company who makes it? ideally a third party in the form of a board of scientists who don't have a direct conflict of interest. Look at the billion dollar settlements of J&J in the last decade alone for misleading marketing and health risks from products including hip replacements, psychoactive drugs and implants.

Those already exist and are accessible.

But if your patient is having a specific side effect and you want to know what information is available, your only choice is the company because they collect the information.

To ban sales reps is like running a garage to repair cars and never talking to the manufacturer.

Re: Washington faltered as fentanyl gripped America

#222

Post by refurb »

ndsipa_pomu wrote: post #59
the_other wrote: post #53

Earlier quoted context omitted.

In my limited experience, you get better results from GP visits if you come with opinions and data about your own conditions and care hopes. They’re too busy; the current system that has forced 10min bookings weeks ahead as the only means of access means it goes better if you do the research for them.

I agree, but wouldn't consider watching TV to be meaningful research.

The FDA’s own research suggests otherwise. DTC isn’t perfect but has a lot of benefits according to doctors surveyed:

- Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. About the same percentage of physicians thought the ad made their patients more aware of possible treatments.

- Many physicians thought that DTC ads made their patients more involved in their health care.

- Physicians thought the ads did not convey information about risks and benefits equally well. Seventy-eight percent of physicians believe their patients understand the possible benefits of the drug very well or somewhat, compared to 40 percent who believe their patients understand the possible risks, and 65 percent believe DTC ads confuse patients about the relative risks and benefits of prescription drugs. In addition, about 75 percent of physicians surveyed believed that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.

- Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.

- DTC ads help patients have better discussions with their physicians and provide greater awareness of treatments. The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. And 80 percent of physicians believed their patients understood what condition the advertised drug treats.

- Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment. Eighty-two percent responded either "very well" or "somewhat" when asked whether they believe that their patients understand that only a doctor can decide whether a drug is right for them.

https://www.fda.gov/drugs/information-consumers-and-patients...

Re: Washington faltered as fentanyl gripped America

#223

Post by refurb »

deathclassic wrote: post #172

The fact that vivitrol is both rare and stupidly expensive is a tradgedy. Like, if the goverment just forced pharma companies to supply the stuff for free or extremely cheap it would help addicts immensely. Also why not hit people with the vivitrol shot the second they get caught with opioids or show up in the emergency room because of an OD? Don't bother with criminal charges or forced rehab, just mandate the person…

Addicts need to detox before getting Vivitrol or they go into massive withdrawal.

Plus forcing people to take medicine against their Will is fraught with civil rights issues.

Re: Washington faltered as fentanyl gripped America

#224

Post by jesterson »

rnk wrote: post #212
5440 wrote: post #113

I audit a lot of these Fentanyl API (Active Pharma Ingredient) factories in China. Its noticeable to me when I go through the warehouses as to how much product is going to Mexico. Other segments go to India for legal fill finishing prior to North America, while other small shipments are going to compounding facilities across the US. I always thought FDA might want to relay this information to homeland security, becau…

You are an auditor, you see legal and nefarious activity and apparently you don't report the nefarious activity? Because then it would probably stop.

Auditor checks adherence to particular rules. You can assert nefarious activities at higher level, but it's likely out of job scope to do something about it

Re: Washington faltered as fentanyl gripped America

#225

Post by dkarras »

the__alchemist wrote: post #98

Getting a needle inserted for blood draw sucks. Getting one of the fatter ones that can inject things into a vein hurts! How good could the high be that it's worth that, if you're not suffering from a serious injury or disease that would warrant painkillers?

Not everyone is that averse to needles. I am not a drug user but I don't mind needles, so I wouldn't care.

Re: Washington faltered as fentanyl gripped America

#226

Post by dang »

TheCenterSeat wrote: post #150

I thought ycombinator tried to stay away from political stuff? I've been around for years and that was usually the case. Why is there a popular post about drug addiction and the response from "Washington"? This isn't tech related. https://news.ycombinator.com/newsguidelines.html#comments I'll quote the guidelines here: "Please don't use Hacker News for political or ideological battle. That tramples curiosity." Most c…

Some intellectually interesting stories have political overlap. It's possible to discuss them in a thoughtful way, without descending into political or ideological battle.

Past explanations on this point: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...

Re: Washington faltered as fentanyl gripped America

#228

Post by swores »

Gordonjcp wrote: post #198
chownie wrote: post #24

Earlier quoted context omitted.

Are you thinking of Oramorph? I know a bunch of older ladies who use it because they have nerve pain, it's derivative of poppies/opium so it's morphine rather than fentanyl.

No, definitely Fentanyl. Oramorph is pretty tightly regulated.

Fentanyl is definitely as, if not more, restricted in the UK than morphine (oramorph being a brand name for liquid morphine).

Re: Washington faltered as fentanyl gripped America

#229

Post by dsfyu404ed »

sklargh wrote: post #80

Operational question, why do the DEA and ATF exist? It seems that they are A. Failures* and B. Lack any distinctive law enforcement mission. Couldn't we just roll their missions up into the FBI? Perhaps the Secret Service as well? This feels far more efficient than several fragmented failures occurring simultaneously. *Eyeballing success by the number of murders with illegal firearms and drug deaths.

>Operational question, why do the DEA and ATF exist?

Same as every other specialty law enforcement agency (campus police, transit system police, etc), prioritizing stuff that the "real police" would get raked over the coals for wasting resources on. You couldn't have the FBI kicking down the doors of medium time drug dealers and suburban dads who violated some arcane statute the way the DEA and ATF do in the same way that a city police department can't justify pissing away man-hours chasing every bum that Karen calls in for pissing on the train tracks. Easier to just spend the money on a bespoke enforcement agency than to have the hard conversations about political will and how much the long tail of stuff these organizations do actually matters.

Re: Washington faltered as fentanyl gripped America

#230

Post by avbanks »

rhaway84773 wrote: post #185
thepasswordis wrote: post #69

Earlier quoted context omitted.

Parts of San Francisco have implemented these exact policies and they have made the problems a LOT worse.

San Francisco has 0 safe usage sites. I think the U.S. overall has low single digits. And even those exist in an extremely dubious legal space, requiring the cops to turn a blind eye to their existence.

NYC does and the problem got worse :/
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