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Opioid makers made payments to one in 12 U.S. doctors

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Re: Opioid makers made payments to one in 12 U.S. doctors

#41

Post by gayprogrammer »

>> Q: What connection might there be between drug-maker payments to physicians and the current opioid use epidemic?

The article is pure speculation. They did not correlate the payments made to doctors with the prescriptions those doctors made, nor even more broadly with national prescription rates.

This article just makes the implied assumption that doctors push pills onto patients. I don't discount that at one time doctors may have been incentivized to play it fast and loose with pain pills, but those days are LONG gone now.

I would like to see research on the population in terms of predisposition to addiction and susceptibility to chemical dependence.

Re: Opioid makers made payments to one in 12 U.S. doctors

#42

Post by jws »

liveoneggs wrote: post #11

check your doctor: https://openpaymentsdata.cms.gov/

My doctor had 16 payments in 2016. Mostly in the $10-$13 range for food and drink. Looks like a rep paying for lunch at the medical center cafeteria. Sounds a lot like "ok, I want to hear about your product, but I'm not giving up billable hours for it, so talk at lunch".

I'm not sure how doctors think, but there is no meal you can buy me that would make me go hear about your product if I didn't want to hear about your product.

Re: Opioid makers made payments to one in 12 U.S. doctors

#43

Post by rasz »

refurb wrote: post #12

This should be kept in context. Let's say the manufacturer presented new data at a conference. During that presentation they provided lunch and refreshments. Everyone of those doctors that attended will now show up in the CMS database. Do we think that a $15 lunch is going to influence a physician to over-prescribe a drug?

Except you organize that conference in Hawaii, all expenses paid.

Re: Opioid makers made payments to one in 12 U.S. doctors

#44

Post by tylersmith »

smackingly wrote: post #17
Retric wrote: post #15

Earlier quoted context omitted.

They would not be providing lunch if it did not work. Advertising demonstrates how easy people are swayed by subconscious connections.

Yeah, but I'm not sure how much of an effect it has on the quantity of opioids prescribed. Drug lunches probably influenced which drug I prescribe (for some reason Norco was the most popular oral opioid in our hospital, maybe because it only has 2 syllables). Though I've never attended an opioid lunch.

Norco is common because it's a mild opioid that is able to treat the majority of "intermediate" pains. If your pain can be treated with ibuprofen you don't need urgent care. If it can't then Norco is the lightest alternative most likely to help.

Re: Opioid makers made payments to one in 12 U.S. doctors

#45

Post by tylersmith »

09bjb wrote: post #19
smackingly wrote: post #17

Earlier quoted context omitted.

Yeah, but I'm not sure how much of an effect it has on the quantity of opioids prescribed. Drug lunches probably influenced which drug I prescribe (for some reason Norco was the most popular oral opioid in our hospital, maybe because it only has 2 syllables). Though I've never attended an opioid lunch.

Free lunches, pens, merchandise, cruises...all of these tactics work and have proven ROI for the drug manufacturers. They've known for years that they're worthwhile investments. It's not really the doctor's fault, it's just reality until there's stricter regulation.

It is absolutely a doctor's fault if they prescribe medications that are unnecessary because of kickbacks.

Re: Opioid makers made payments to one in 12 U.S. doctors

#46

Post by tylersmith »

alexandercrohde wrote: post #29
Retric wrote: post #16

Earlier quoted context omitted.

I was given strong Opioids (Hydromorphone etc) for less than 3 weeks after major surgery. They clearly worked, but even that much exposure IMO was not worth the risk as I very quickly started to get cravings. Even without getting high, freedom from pain is a ridiculously powerful motivator. And because they have such strong peaks and valleys you make a very strong association with those pills.

I was given a 30 day supply of oxy-something when I had my wisdom teeth removed. I needed 0 of the pills.

People have different pain tolerances and if you wait until it's at that point to get a prescription you'll have a real bad time. But 30 days is certainly more than necessary. They should do a few days and make it easy to get more for a couple weeks. Then require seeing the patient again for evaluation.

Re: Opioid makers made payments to one in 12 U.S. doctors

#47

Post by esterly »

elipsey wrote: post #5

Reminds me of what Rostand said about murder: "Kill one man, and you are a murderer. Kill millions of men, and you are a conqueror. Kill them all, and you are a god." Sell one oxycontin and you're drug dealer; sell a million and you're a C level.

Agreed. When a C level is profiting it is hard to change course. The onion nails it http://www.theonion.com/article/sweating-shaking-pharmaceuti...

Re: Opioid makers made payments to one in 12 U.S. doctors

#48

Post by rossjudson »

zjaffee wrote: post #33
lr4444lr wrote: post #27

Maybe it's because Americans just have this cognitive dissonance that their trusted doctor could be any less than 100% conscientious about their health, but we need to plainly face the fact that if members of the press were able to write exposés about drug makers' fudging the data about the addictiveness and effectiveness of their products, that doctors with their medical training and responsibility over actual peopl…

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in ag…

As if "taking a kickback to promote a particular pharmaceutical company's products" isn't equally bad. Yeah -- BigPharma is going to account for the kickback under "Research and Development (Of Profit)".

Re: Opioid makers made payments to one in 12 U.S. doctors

#50

Post by ransom1538 »

Feel free to browse doctors' opioid counts here. I was able to match them to their actual profiles. Take into account their field, but, even with that the numbers are ridiculous. If you are in "Family Practice" and prescribe opioids 9167 times per year you probably have a very sore hand.

https://www.opendoctor.io/opioid/highest/

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