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OxyContin's 12-hour problem

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Re: OxyContin's 12-hour problem

#331

Post by GordonS »

koluft wrote: post #233
groovy2shoes wrote: post #190

Earlier quoted context omitted.

Pills in tablet form typically consist of the active ingredients mixed with a buffering agent and a caking agent, followed by a coating. Those agents and coating hold the pill together as a tablet, but are not particularly strong and can easily be cut, crushed, or shaved. The "abuse-resistant" tablets are made by mixing the active ingredients with a polymer, a plastic- or glue-like substance that, when dried, is very…

What do addicts crush/shoot drugs, instead of just eating them?

Higher bioavailability, and faster action. From memory, morphine (as an example) has 100% bioavailability when I'D, but only around 20% orally.

Re: OxyContin's 12-hour problem

#332

Post by GordonS »

forgotpwtomain wrote: post #21
DanBC wrote: post #9

Earlier quoted context omitted.

Many people are inappropriately given opiates by their doctors to treat long term pain. Those people are not "doing drugs", they are following (bad) medical advice. People with long term pain need better access to pain management clinics; better access to physio therapy and exercise therapy; better access to different meds; and if they're still in pain better prescribing of opiates carefully following protocols. http…

> Many people are inappropriately given opiates by their doctors to treat long term pain. While I am sure this is true in many cases, my personal experience was the opposite. I had significant nerve pain after an accident, which kept me from being able to sleep or focus on anything very well. The physician I saw after my hospitalization was apparently worried I was trying to satisfy a drug-craving? So instead of givi…

A lot of research has shown SNRI and SSRI antidepressants are actually great for nerve pain, e.g. gapapentin, pregabalin, duloxetine.

They didn't work for me personally, opioids did, but prescribing such antidepressant type medications first seems a reasonable course of action

Re: OxyContin's 12-hour problem

#333

Post by stryk »

MichaelGG wrote: post #314
stryk wrote: post #303

Earlier quoted context omitted.

I mean the guys who are successful you mentioned, i assume they have nice jobs, families, maybe children -- the good stuff. Once shit hits the fan and they get a taste of dopesickness they will ignore all of that, the drug becomes priority #1 hell with everything else. Then they will do whatever and screw over whoever to fix the link of the chain that broke (ie, where to get them or how to pay for them, how to hide i…

So it sounds like you're saying that the issue is availability, pricing, and legality. We're in agreement.

Those things (except legality, because that's not stopping anyone) can be part of the problem, sure but it's a lot more than that. It's such a fragile house of cards you're describing with that situation and I don't know if you just don't believe me or you're taking it WAY too lightly.

Those people who are successful are headed for disaster, even if they have the money to mitigate supply issues/price. If you care about these people, tell them rich people go to Passages in Malibu. It costs $80,000 and i can prove that. but maybe they can afford it?

Re: OxyContin's 12-hour problem

#334

Post by CydeWeys »

ssmoot wrote: post #231
CydeWeys wrote: post #208

Earlier quoted context omitted.

You're arguing against a strawman. I'm not in favor of banning opioids and I don't know where you even got that impression from.

I assumed you were replying to my comment you quoted. Sounds like we misunderstood each other.

Other way around. You replied to me and turned it into a different topic.

Re: OxyContin's 12-hour problem

#335

Post by nommm-nommm »

DanBC wrote: post #321
MichaelGG wrote: post #266

Earlier quoted context omitted.

What you keep saying in these threads is that opiates aren't effective. Why then do people continue to use them? Certainly if you're in pain, you're not taking a gram of morphine-equivalent per day just because. If there are effective alternatives, why are they not used? Then with pain under control, you can slowly (over a year, say) taper down.

I'm not saying it. National organisations are saying it - Public Health England (part of government); the Faculty of Pain Medicine (part of the Royal College of Anaesthetists); NICE (The National Institute for Health and Care Excellence, a non-departmental public body) all say it. So, unusually, do the CDC: http://www.cdc.gov/vitalsigns/opioid-prescribing/index.html If they were effective and if addiction could be sa…

This is what I've seen firsthand from the treatment facility I've volunteered at. Long term use becomes a problem for many patients and eventually they have pain even with dangerously high doses of opiodes.

Re: OxyContin's 12-hour problem

#336

Post by goldenkey »

GordonS wrote: post #325
_acme wrote: post #306

Earlier quoted context omitted.

To counter your anecdote, tapentadol (Nucynta) leaves me extremely foggy and out of it at doses below the required dose for pain relief -- far loopier than hydrocodone, oxycodone or oxymorphone.

I'm the same, as I was with straight SNRIs too. I think some people just can't tolerate SNRIs and SSRIs. But for those who can, they can make a big difference to pain levels

I feel more awake and stimulated from it. A laser focus. And the pain relief is far better than Tramadol or conventional opiates that lack an adrenal boost. I would guess you are right and it can definitely be a genetic variability. Its actually difficult for me to sleep on Tramadol or Nucynta .. so exactly the opposite of drowsy.

Re: OxyContin's 12-hour problem

#338

Post by golergka »

SeanDav wrote: post #329
cant_kant wrote: post #260

Sensible doctors do not believe drug company marketing. I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin. On Friday, I had a drug company representative attempt t…

Depends on what you mean by "Sensible doctors". Clearly, doctors are influenced by marketing, otherwise pharmaceutical companies would not have spent and continue to spend, multiple millions of dollars targeting doctors.

It's not about conversion rate, it's about LTV.

Even if they only influence 1 doctor in a hundred, but that doctor brings enough revenue, it's worth it.

Re: OxyContin's 12-hour problem

#340

Post by limelight »

cant_kant wrote: post #260

Sensible doctors do not believe drug company marketing. I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin. On Friday, I had a drug company representative attempt t…

The problem is that there's absolutely no incentive for doctors to act ethically. You don't win any points for ignoring drug company marketing.

Vendor marketing exists in all fields, technology included. The difference is that when I'm spending money on a vendor as a tech manager it's coming out of my budget. I have an incentive to make sure that the spending is intelligent and the solution is effective.

Where is the incentive for doctors to do that? They're spending other people's money on other people's problems.

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