Painkillers now kill more Americans than any illegal drug • Hacker News Board

Re: Painkillers now kill more Americans than any illegal drug

#121

Post by rwmj » Wed, Mar 09, 2016, 8:05 PM UTC

drug3737 wrote: post #117

rwmj wrote: post #103

Earlier quoted context omitted.

China has a big ketamine problem now, with whole villages producing the drug and many addicts. Singapore has a middle-class "ice" (meth) problem. In addition, there was a recent study showing that harsh penalties and rates of drug use are not correlated. http://www.theguardian.com/society/2014/oct/30/punitive-drug... If you think that particular countries have unusually low rates of use, then you may be just wrong be…

China's drugs usage death rate is very low compared to Western countries. http://www.worldlifeexpectancy.com/cause-of-death/drug-use/b...

By the same website, China deaths by alcohol use are also much lower than the West. Is the punishment for alcohol use much more severe in China than it is in the West? Erm, no - in fact none of those countries use the criminal justice system to punish alcohol users. Could it therefore be other factors like societal attitudes as I said in the comment above.

You should also remember that by far the most widely used illegal drug is cannabis (93% in the UK), and it's almost impossible to die from cannabis. About the only way I can think of is if a block of it drops on you from a smuggler's aircraft. So just looking at deaths from drug use isn't so interesting. There are other ways that drugs are both productive and enjoyable, and can be damaging.

Re: Painkillers now kill more Americans than any illegal drug

#122

Post by MichaelGG » Wed, Mar 09, 2016, 8:07 PM UTC

toufka wrote: post #32

teslabox wrote: post #12

Earlier quoted context omitted.

Some of the prescription opioids are contaminated with Tylenol, which is very toxic to the liver when consumed in excess.

They incorporate tylenol to help prevent addiction and overdose. Too much tylenol makes you sick - very unpleasantly. Too much opiods and you feel great, until you die. The tylenol is designed to provide an edge to taking too much so that the curve correlatibg dose to pleasure doesn't always angle upwards. Being very sick, and even having liver problems is generally better than death.

That's an overly generous interpretation. For a long time, hydrocodone with APAP was scheduled less than pure hydrocodone. This is similar to denatured alcohol - designed to kill people that try to go around the law.

I highly doubt the acetaminophen in vicodin is to limit abuse. Some of the pills I've seen are 750/5mg. Even a moderate addiction of 100mg a could easily kill you at that rate (that's 15g of acetaminophen). Though if you had no choice, a simple cold water extraction will eliminate enough of the acetaminophen to make it safe.

While not quite as evil as all the deaths and stripping of civil liberties the "drug war" has caused, this is a pretty obviously wicked thing to do (while still ineffective).

Re: Painkillers now kill more Americans than any illegal drug

#123

Post by digler999 » Wed, Mar 09, 2016, 8:07 PM UTC

merpnderp wrote: post #100

digler999 wrote: post #87

Earlier quoted context omitted.

> People have agency. And should be allowed to make their choices. That also includes physicians. Their asses are on the line for every patient they treat. If one of their patients OD's, a full death investigation will be done, possibly including DEA, possibly including the medical board. If any perceived misconduct is found on behalf of the doctor, s/he could be sued, censured, fired, or perhaps even jailed. When yo…

"That also includes physicians." That is exactly my point. Doctors shouldn't have to make patients jump through hoops in order to prescribe medicine. Maybe I should have stated it clearer, the remedy I want is for doctors to be able to prescribe as they see fit without the DEA raiding their office and throwing them in jail. As for over prescribing, that should be no more dangerous than any other medicine. If my docto…

I misunderstood, sorry, I thought you meant the pt should have the "agency" to decide how to take their painkillers.

I don't have the data to back this up, but I don't think the DEA is the primary impetus for drug testing patients. What I surmise is that most likely, a double-blind academic study was done, just like how they establish every other standard treatment protocol. Likely, they determined that drug-testing patients significantly reduces the incidence of OD and abuse, i.e. reduces morbidity and mortality. Being scientists, they adopt the technique that works.

There is a big difference between treating a one-time injury and writing a prescription for 20 pills, versus someone with a pinched spinal cord that's never going to get better, that gets a permanent supply. For the latter, you go to a pain specialist. IIRC GP's dont even get involved with that.

> that should be no more dangerous than any other medicine

an NSAID "should be no more dangerous" than an opiate ? Please tell me you are aware that unrelated molecules will have dramatically different pharmacological effects on a human body.

If a doctor gives you access to a deadly product, one that could kill you if you go over by merely a single pill, and doesn't do everything they possibly can, then a jury, medical board, or (in rare cases) the cops might have a case for malpractice or patient endangerment. Anyway, I dont have any more fuel to back this argument up, but I wish your friend the best, pain-free life!

Re: Painkillers now kill more Americans than any illegal drug

#124

Post by MichaelGG » Wed, Mar 09, 2016, 8:11 PM UTC

justsaysmthng wrote: post #76

twblalock wrote: post #64

Earlier quoted context omitted.

Why should your drug use, or anyone else's, create obligations for other people to support you, treat you, and help you overcome addiction? The libertarian case for legalizing drugs falls apart if society has to take responsibility for providing support systems as a reaction to the actions of individual drug users. Frankly, most people would rather continue to ban drugs than pay for treatment for people who abuse the…

Because your addiction is also your wife's problem, your parent's problem, your company's problem. Addiction affects more than just the addict. And addicts are in need of help - while it is easy to think that "they like being high, it's their choice", in fact the addicts hate their habit more than anything, yet they can't stop using without external help. Would you help a person with a broken leg ? Why ? Well, that's…

Not all addicts are in need of help. And many addicts really do enjoy being high or otherwise find opiates help them through life, work, etc. and do not want to quit. And out of those that do want to quit, I'd bet a large amount of it is due to the high prices the legal scheme enforces. With reasonable prices, the biggest issue with being an opiate user disappears.

Re: Painkillers now kill more Americans than any illegal drug

#125

Post by MichaelGG » Wed, Mar 09, 2016, 8:13 PM UTC

nathanvanfleet wrote: post #120

Just so you know, opioid pain killers are actually not useful for chronic pain at all. Over the long term it actually makes patients sense of pain GO UP. It's excellent for non-chronic pain however.

What kind of time range are you talking about here? AFAIK there's no human limit to opiate tolerance - patients can often just take more (over time).

Re: Painkillers now kill more Americans than any illegal drug

#126

Post by onetwotree » Wed, Mar 09, 2016, 8:14 PM UTC

dionidium wrote: post #84

toufka wrote: post #32

Earlier quoted context omitted.

They incorporate tylenol to help prevent addiction and overdose. Too much tylenol makes you sick - very unpleasantly. Too much opiods and you feel great, until you die. The tylenol is designed to provide an edge to taking too much so that the curve correlatibg dose to pleasure doesn't always angle upwards. Being very sick, and even having liver problems is generally better than death.

Being very sick, and even having liver problems is generally better than death. I would submit to you that deliberate contamination of a drug for the sole purpose of inflicting harm in search of a greater good is an outrageous policy.

I completely agree. Former and current opiate addicts I've met have told me that when contaminated pills are all you've got to stave off withdrawal, the risk from Tylenol poisoning doesn't really even cross your mind.

Adding risk (whether it's the risk of liver failure or prison time) to addiction behaviors doesn't do a damn thing, because addiction is a disease that fundamentally destroys our ability to make rational cost-benefit decisions when our drug or behavior of choice is concerned.

Re: Painkillers now kill more Americans than any illegal drug

#127

Post by fapjacks » Wed, Mar 09, 2016, 8:15 PM UTC

Kratom can solve this problem, but the FDA won't have it.

Re: Painkillers now kill more Americans than any illegal drug

#128

Post by brandonmenc » Wed, Mar 09, 2016, 8:16 PM UTC

Lots of comments from people who have no experience with chronic pain aghast that doctors would fulfill patient "demands" for painkillers instead of treating the underlying cause.

Pain is self-report, so all a doctor can do is prescribe based on patient demand. Maybe they can't identify an underlying cause, or maybe the treatment (ex: back surgery) is too risky.

Spine surgery that might not work and can leave you with say, loss of bladder control? I'd take the pill every time, and if my doctor didn't just hand it over, I'd find another doctor.

Re: Painkillers now kill more Americans than any illegal drug

#129

Post by fapjacks » Wed, Mar 09, 2016, 8:17 PM UTC

cik2e wrote: post #57

delecti wrote: post #33

Earlier quoted context omitted.

It's more orders of magnitude more dangerous and addictive (in that marijuana is almost impossible to OD on, and isn't addictive at all). Marijuana is certainly not the magical silver bullet some make it out to be, but it's incredibly effective for many people whose only other recourse would be opiates.

Kratom is a great and currently legal alternative. It works on opioid receptors and cannot be fatally overdosed. Unfortunately, many sates are already moving on banning it. Big pharma lobby for the win.

Stock up while you can. However some states have unbanned it, and others yet are not voting their bans into legislation. There's hope yet, but it will be a hard fight, particularly with the FDA.

Re: Painkillers now kill more Americans than any illegal drug

#130

Post by evincarofautumn » Wed, Mar 09, 2016, 8:18 PM UTC

twblalock wrote: post #64

evincarofautumn wrote: post #44

Earlier quoted context omitted.

I’m an alcoholic. I’ve cut back on my use significantly, and I’m currently in a period of abstinence. Because alcohol is legal and socially accepted, it’s entirely my responsibility to manage my behaviour and keep my use to non-problematic levels. Not everyone has the social support to make that happen. I think legalisation would be beneficial, as you say, because the criminal justice system does not serve addicts. H…

Why should your drug use, or anyone else's, create obligations for other people to support you, treat you, and help you overcome addiction? The libertarian case for legalizing drugs falls apart if society has to take responsibility for providing support systems as a reaction to the actions of individual drug users. Frankly, most people would rather continue to ban drugs than pay for treatment for people who abuse the…

> Frankly, most people would rather continue to ban drugs than pay for treatment for people who abuse them.

I agree. However, I’m talking not only about treating addiction, but preventing abuse in the first place.

The first line of social support is made up of our friends and families. Outreach and education could foster better attitudes toward mental health and addiction, and reduce the systemic effects of stress and loneliness. Rehab is very late in the game, and it’s much more difficult and costly for everyone involved.