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OxyContin's 12-hour problem (2016)

latimes.com

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Re: OxyContin's 12-hour problem (2016)

#11

Post by tptacek »

panzer_wyrm wrote: post #7

Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers? Is it cultural?

There's no "chronic pain epidemic". As is often the case, the pharma market created (or rather, in this case, reshaped) a problem for a particular kind of product to solve.

Obviously, ceteris paribus, less pain is much better than more pain, and there will probably always be acute and chronic pain for therapeutic innovation to tackle. There's no virtue in the experience of chronic pain. But the evidence strongly suggests that patients are worse off with casual access to powerful opiates, and that these products are packaged and sold irresponsibly.

No legitimate underlying medical phenomenon spurred the uptake in opiates.

Re: OxyContin's 12-hour problem (2016)

#12

Post by Alex3917 »

elipsey wrote: post #8

Published May 5, 2016. Article argues that OxyContin caused strong withdrawal symptoms when used as directed. Important, imo, because at a societal level we substantially blame addiction on "drug abuse" which is not always an adequate model.

> at a societal level we substantially blame addiction on "drug abuse" which is not always an adequate model.

While I agree that this model is not accurate, I'd also point out that just because you're taking a drug as directed doesn't mean you're not abusing it.

For whatever reason most people in the U.S. seem to have a wildly unjustifiable level of faith in western medicine, either way too much or way too little. Belief and disbelief in various forms of medicine have been successfully marketed as personal identities, which is easy to see from reading most HN comment threads on health issues.

Re: OxyContin's 12-hour problem (2016)

#13

Post by panic »

panzer_wyrm wrote: post #7

Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers? Is it cultural?

The root cause is Purdue Pharma, who successfully marketed the drug to primary care physicians by lying about the risk of addiction:

Perhaps knowing that doctors would be vigilant against prescribing drugs with the potential for abuse, Purdue set out to distinguish OxyContin from rivals as soon as it dropped. The cornerstone of its marketing campaign was the drug's incredibly low risk of addiction, an enviable characteristic made possible by its patented time-release formula. Through an array of promotional materials, including literature, brochures, videotapes, and Web content, Purdue proudly asserted that the potential for addiction was very small, at one point stating it to be "less than 1 percent." (http://theweek.com/articles/541564/how-american-opiate-epide...)

Re: OxyContin's 12-hour problem (2016)

#15

Post by fb03 »

panzer_wyrm wrote: post #7

Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers? Is it cultural?

Overeagerness to prescribe. Other countries have similar problems too.

Conversely, the country I live has a benzo problem. Hell, go into any doctor complaining you haven't been sleeping properly and he'll happily prescribe you clonazepam to help you with that. You have just been prescribed an addictive and strong psychoactive drug, just like that. He won't care if you have been working too much, or not eating or sleeping well, he will not care at all about possible factors that may be causing your current insomnia.

"take this and come back to reassess in 2 months", the doctor will say, and ofc, in 2 months you will come back saying this helped immensely, and from that there's a whole slew of problems that everyone knows: try to wane off it, insomnia comes back, sometimes worse. or maybe some new anxiety gets thrown in....

They want money, because if they wanted you to get well they you'd be treating the cause of your symptoms and not your symptoms :D

Re: OxyContin's 12-hour problem (2016)

#16

Post by mtdewcmu »

Doctors should be more skeptical of pharma companies' marketing claims, right? Who believes everything they read? There's probably a case to be made that the FDA should have been more involved, too.

The data on how fast OC released its drug would have been available to the FDA, if not doctors.

Re: OxyContin's 12-hour problem (2016)

#17

Post by gragas »

panzer_wyrm wrote: post #7

Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers? Is it cultural?

>What caused it, why it is more than in other parts of the world and why so many painkillers?

>Is it cultural?

That's actually a really common misconception on HN. The United States ranks 27th among countries which abuse opiates, [1] behind many first-world countries like the UK, Italy, Spain, Switzerland, Ireland, and Russia, to name a few.

What's the cause? A lot of HNers like to pin it on unemployment and low-wage, low-skill jobs. I think that's narrowing the field in the right direction, but it isn't quite right; I know many very happy people who just make ends meet. There's something more that no one has been able to pinpoint quite yet.

1. https://en.wikipedia.org/wiki/List_of_countries_by_prevalenc...

Re: OxyContin's 12-hour problem (2016)

#18

Post by [deleted] »

elipsey wrote: post #8

Published May 5, 2016. Article argues that OxyContin caused strong withdrawal symptoms when used as directed. Important, imo, because at a societal level we substantially blame addiction on "drug abuse" which is not always an adequate model.

[deleted]

Re: OxyContin's 12-hour problem (2016)

#19

Post by Spivak »

I'm sure this is an easy question to answer, but it was bugging me during the whole article.

What's preventing a pill that releases a dose immediately and one after 6 hours? Or something like a diabetic pump that dispenses medication continuously? Surely such systems have the potential to be safer and more effective for patients?

Re: OxyContin's 12-hour problem (2016)

#20

Post by wayn3 »

panzer_wyrm wrote: post #7

Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers? Is it cultural?

People take painkillers because they can't afford surgery.

Say you have a messed up disk in your spine. Surgery is tens of thousands of dollars. Getting a prescription for opioids from a primary care physician is a bit cheaper.

You don't see doctors in europe routinely prescribing hard pain killers because they try to fix the problem instead.

Healthcare in america is set up in such a way that hospitals just bill whatever and then have the lawyers argue over whats reasonable. That kinda works when youre part of the medicare system and their lawyers represent your side, but when youre on your own, you're suddenly in hospital recovering from major surgery, facing bankruptcy and have to hire a lawyer to tell the hospital to suck it.

So you just take the painkillers and hope for the best.

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