OxyContin's 12-hour problem • Hacker News Board

Re: OxyContin's 12-hour problem

#371

Post by capote » Mon, May 09, 2016, 6:18 PM UTC

hackuser wrote: post #152

capote wrote: post #113

Earlier quoted context omitted.

Can you explain more how competition, availability, and legality will stop the more addiction-prone (low-income, chronic pain among other health problem) parts of society in America from doing drugs and becoming addicted? If I read your argument correctly, it's that the pharma firms will not market it as much and not profit as much. In my mind that's not enough reasoning that people who simply have a bad situation wo…

> addiction-prone (low-income Are low-income people more likely to become addicted? I'd like to see some statistics. A few thoughts: * There are many more low-income people than wealthy people, so low-income addicts may be greater in sheer numbers but not in rate. * I expect that addition tends to reduce income, so people who started wealthier may become low-income * Prescription opiods are by reputation the wealthy…

There is no correlation. People of all incomes become addicted to all sorts of things. And it was perhaps wrong of me to phrase myself that way.

I suppose the motivation for that parenthetical was just subconscious--as I've seen some people who happened to be lower income have their lives ruined by their pain meds, whereas in the higher income circles I've seen, they're more addicted to strictly recreational drugs.

Re: OxyContin's 12-hour problem

#372

Post by dcposch » Tue, May 10, 2016, 1:18 AM UTC

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…

> he was hanging around my coffee area

What? Are they allowed to just enter hospitals as neither doctor, patient, nor visitor, and hang around promoting their companies' drugs? If so, why??

Re: OxyContin's 12-hour problem

#373

Post by throwaway7767 » Tue, May 10, 2016, 2:11 PM UTC

SCAQTony wrote: post #148

mwsherman wrote: post #117

Earlier quoted context omitted.

I don’t think legalization will reduce addiction (though would defer to empirical studies here). It would make the economic cost of addiction lower for the individual – one problem instead of two. More importantly, it would make doctors (and regulators) more honest participants. If a doctor wants to recommend opiates, it would largely remove their economic incentives for doing so. We don’t think of doctors having muc…

I have to agree! The bad floats with the good and likewise. From the New York Times: "Actually, Prohibition Was a Success By Mark H. Moore; Mark H. Moore is professor of criminal justice at Harvard's Kennedy School of Government." "... Second, alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals…

> Second, alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

From http://www.slate.com/articles/health_and_science/medical_exa...:

> In 1926, in New York City, 1,200 were sickened by poisonous alcohol; 400 died. The following year, deaths climbed to 700

The poisonous alcohol was a direct result of prohibition. So I think focusing on just cirrhosis deaths paints an unfair picture of the actual health effects.

Re: OxyContin's 12-hour problem

#374

Post by hackuser » Tue, May 10, 2016, 5:21 PM UTC

capote wrote: post #371

hackuser wrote: post #152

Earlier quoted context omitted.

> addiction-prone (low-income Are low-income people more likely to become addicted? I'd like to see some statistics. A few thoughts: * There are many more low-income people than wealthy people, so low-income addicts may be greater in sheer numbers but not in rate. * I expect that addition tends to reduce income, so people who started wealthier may become low-income * Prescription opiods are by reputation the wealthy…

There is no correlation. People of all incomes become addicted to all sorts of things. And it was perhaps wrong of me to phrase myself that way. I suppose the motivation for that parenthetical was just subconscious--as I've seen some people who happened to be lower income have their lives ruined by their pain meds, whereas in the higher income circles I've seen, they're more addicted to strictly recreational drugs.

What a classy response! And perhaps I put too much weight on one short parenthetical phrase.

Re: OxyContin's 12-hour problem

#375

Post by forgotpwtomain » Wed, May 11, 2016, 12:39 PM UTC

GordonS wrote: post #332

forgotpwtomain wrote: post #21

Earlier quoted context omitted.

> 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

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

I'm well aware of this. If you read some more research the dosage prescribed for nerve pain is as I mentioned ~4xish of anti-deppresant dosage. More so I recommend you look into some research on withdrawal effects of antidepressants (of course there is less of it since drug companies have a vested interest in the actual lack of such research).

Re: OxyContin's 12-hour problem

#376

Post by Spooky23 » Fri, May 13, 2016, 10:50 PM UTC

stryk wrote: post #275

MichaelGG wrote: post #252

Earlier quoted context omitted.

Don't understate the "do not do crime". I've known addicts and the biggest damage they cause (apart from dying when they OD on unknown-quality junk) is that they become thieves and liars. No one trusts them and it tears relationships apart. Both are fixed by having more legal availability. If they were simply able to get opiate as easily as pot, then addicts for the most part would be just like potheads. Perhaps bein…

"Being addicted, by itself, is not a big deal." - As someone with an en extensive amount of first-hand knowledge, I disagree very very much. It is in fact so big of a deal that it becomes your one and only deal. The worst part is, if you use opiates for a long period of time consistently - you WILL become reliant upon them. Your body will be chained to them, physically dependent, and I don't care who you are, where y…

Heroin has been illegal for a hundred years. We still have junkies.

You can say the same about alcohol. Does alcohol ruin lives? Yes. But we limit many of the social impacts by treating it as a regulated substance vs a controlled substance.