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Purdue and other big Oxy peddlers now face trial in federal court

theamericanconservative.com

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Re: Purdue and other big Oxy peddlers now face trial in federal court

#11

Post by elliekelly »

nraynaud wrote: post #8
Tade0 wrote: post #4

Earlier quoted context omitted.

There's a control group in the form of Europe where overdoses are an order of magnitude lower and have remained relatively stable over the last 10 years at least.

I had a medical issue with incredible pain in France, I have not been given an addictive pain killer, they started with the most common (Tylenol), then went one notch up (Acupan) when it became ineffective (I think I am very receptive because I rarely take medicines). But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the to…

> But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the toolbox

I know in the U.S. addicts/dealers will sometimes go "doctor shopping"[1]. Most U.S. doctors don't track or even realize when a chronic pain patient (or any patient, for that matter) doesn't follow up and a doctor wouldn't typically be told if a patient decided to seek treatment from another physician.

I would guess "doctor shopping" would be more difficult in France under the single-payer healthcare system? Do you mind explaining how your system works? Is it difficult to change doctors? Or to get a second opinion? If a patient doesn't follow-up with the doctor will someone from the doctor's office check in?

[1]https://en.wikipedia.org/wiki/Doctor_shopping

Re: Purdue and other big Oxy peddlers now face trial in federal court

#12

Post by wil421 »

nraynaud wrote: post #8
Tade0 wrote: post #4

Earlier quoted context omitted.

There's a control group in the form of Europe where overdoses are an order of magnitude lower and have remained relatively stable over the last 10 years at least.

I had a medical issue with incredible pain in France, I have not been given an addictive pain killer, they started with the most common (Tylenol), then went one notch up (Acupan) when it became ineffective (I think I am very receptive because I rarely take medicines). But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the to…

In the US it is very similar. I’m in my 30s and never had the option to use painkiller for neck and back pain. In fact, the only time I ever received it was after a dental operation which removed an impacted and painful wisdom tooth.

A lot of people will just doctor shop until they find one who will prescribe painkillers.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#13

Post by elliekelly »

raiyu wrote: post #3
cal5k wrote: post #2

As with any phenomenon, I don't buy a single-cause explanation. It's way too pat. What about substitutes? Has anyone tried to demonstrate that OxyContin addiction, for example, might not have been heroin addiction if OxyContin wasn't available? Would people in chronic pain not pursue illegal solutions if legal ones weren't available to them?

While there will be some overlap there was also a lot of perverse behavior. Basically the drug company creates a drug that it wants to sell, drug reps travel to doctors explaining the drugs, when the doctor does the prescription, the doctor and sales rep get cash. Now you have an incentive structure where doctors are prescribing drugs to patients that may not need them, may not need the dose prescribed, and so forth.…

It's kind of nuts to me that we even allow the concept of a "pharmaceutical sales rep" to exist. Especially one that's paid on commission. That doesn't seem like the incentive alignment that works best for society. There's only one thing I want influencing my doctor's prescriptions: science. And I'm sure I'm not alone in feeling that way.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#14

Post by [deleted] »

elliekelly wrote: post #11
nraynaud wrote: post #8

Earlier quoted context omitted.

I had a medical issue with incredible pain in France, I have not been given an addictive pain killer, they started with the most common (Tylenol), then went one notch up (Acupan) when it became ineffective (I think I am very receptive because I rarely take medicines). But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the to…

> But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the toolbox I know in the U.S. addicts/dealers will sometimes go "doctor shopping"[1]. Most U.S. doctors don't track or even realize when a chronic pain patient (or any patient, for that matter) doesn't follow up and a doctor wouldn't typically be told if a patient decided…

[deleted]

Re: Purdue and other big Oxy peddlers now face trial in federal court

#15

Post by leetbulb »

ThrustVectoring wrote: post #9
cal5k wrote: post #2

As with any phenomenon, I don't buy a single-cause explanation. It's way too pat. What about substitutes? Has anyone tried to demonstrate that OxyContin addiction, for example, might not have been heroin addiction if OxyContin wasn't available? Would people in chronic pain not pursue illegal solutions if legal ones weren't available to them?

The opioid epidemic is directly caused by the OxyContin manufacturer's desire to sell a pain drug that "lasts twelve hours". These patient instructions almost couldn't be better designed to foment addiction. The big selling point was the "twelve hour" length of action. OxyContin was often not effective for the full twelve hours, causing a whiplash between under-treating pain and taking the medication at the prescribe…

This makes a lot of sense and definitely applies to more than just OxyContin. I am currently experiencing this with Vyvanse. Luckily, it's way easier to reverse compared to opioids, but still pretty damn hard.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#16

Post by nraynaud »

wil421 wrote: post #12
nraynaud wrote: post #8

Earlier quoted context omitted.

I had a medical issue with incredible pain in France, I have not been given an addictive pain killer, they started with the most common (Tylenol), then went one notch up (Acupan) when it became ineffective (I think I am very receptive because I rarely take medicines). But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the to…

In the US it is very similar. I’m in my 30s and never had the option to use painkiller for neck and back pain. In fact, the only time I ever received it was after a dental operation which removed an impacted and painful wisdom tooth. A lot of people will just doctor shop until they find one who will prescribe painkillers.

I know my American mother in law got oxycotin on first intention without specific instructions or recommendation after an operation.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#17

Post by tacomonstrous »

cal5k wrote: post #2

As with any phenomenon, I don't buy a single-cause explanation. It's way too pat. What about substitutes? Has anyone tried to demonstrate that OxyContin addiction, for example, might not have been heroin addiction if OxyContin wasn't available? Would people in chronic pain not pursue illegal solutions if legal ones weren't available to them?

>Has anyone tried to demonstrate that OxyContin addiction, for example, might not have been heroin addiction if OxyContin wasn't available?

The facts on the ground are that a pharmaceutical company actively encouraged and massively profited off the sales of a product they fully knew to be addictive, leading to a severe public health crisis. If we want to argue that these people would have just turned to illegal substances instead, then the logical conclusion is that the company should be prosecuted like any other common purveyor of controlled drugs would be. That wouldn't end well for Purdue.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#18

Post by jlarocco »

wil421 wrote: post #12
nraynaud wrote: post #8

Earlier quoted context omitted.

I had a medical issue with incredible pain in France, I have not been given an addictive pain killer, they started with the most common (Tylenol), then went one notch up (Acupan) when it became ineffective (I think I am very receptive because I rarely take medicines). But doctors have to be willing to spend the time to follow the patient and do the gradation instead of going straight for the strongest thing in the to…

In the US it is very similar. I’m in my 30s and never had the option to use painkiller for neck and back pain. In fact, the only time I ever received it was after a dental operation which removed an impacted and painful wisdom tooth. A lot of people will just doctor shop until they find one who will prescribe painkillers.

That doesn't match my experience.

Both times I've dislocated my shoulder I've been sent home from the ER with percocet that I didn't need (and never took). They wouldn't even let me opt-out, and sent it home with me "just in case."

Re: Purdue and other big Oxy peddlers now face trial in federal court

#19

Post by ThrustVectoring »

leetbulb wrote: post #15
ThrustVectoring wrote: post #9

Earlier quoted context omitted.

The opioid epidemic is directly caused by the OxyContin manufacturer's desire to sell a pain drug that "lasts twelve hours". These patient instructions almost couldn't be better designed to foment addiction. The big selling point was the "twelve hour" length of action. OxyContin was often not effective for the full twelve hours, causing a whiplash between under-treating pain and taking the medication at the prescribe…

This makes a lot of sense and definitely applies to more than just OxyContin. I am currently experiencing this with Vyvanse. Luckily, it's way easier to reverse compared to opioids, but still pretty damn hard.

Vyvanse is a prodrug, which means that dosage largely controls duration of effect rather than intensity. I suspect you eat a high protein breakfast or otherwise have a physiology that turns the prodrug into dextroamphetamine more quickly than expected. If Vyvanse doesn't last as long as the manufacturer assumes and comes on more intensely than you need, it's likely a good idea to switch over to dextroamphetamine with an actual extended release mechanism (and don't defeat the mechanism, of course). The combination of the effect being too intense and not lasting long enough is pretty rough to deal with, psychologically.

Re: Purdue and other big Oxy peddlers now face trial in federal court

#20

Post by ineedasername »

cal5k wrote: post #2

As with any phenomenon, I don't buy a single-cause explanation. It's way too pat. What about substitutes? Has anyone tried to demonstrate that OxyContin addiction, for example, might not have been heroin addiction if OxyContin wasn't available? Would people in chronic pain not pursue illegal solutions if legal ones weren't available to them?

Heroin addiction rates & related deaths have also been increasing at the same time, so it's not that Oxy has been cannibalizing heroin sales. However, the fact that heroin addiction has increased at the same time would speak to aggressive Oxy sales not being the whole problem. Although I've also seen in mentioned that Oxy addiction has lead to increased heroin use as addicts turn to the illegal market when their legal outlet runs dry.
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