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Expert sounds alarm on new wave of US opioids crisis

theguardian.com

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Re: Expert sounds alarm on new wave of US opioids crisis

#41

Post by pierat »

giantg2 wrote: post #16
pierat wrote: post #2

[flagged]

"Oxycontin was misclassified due to fraudulent reportings of the drug's capabilities and marketing campaign. However that should have never affected people getting legit pain care, but it definitely did." What does legit pain care look like? Does it include the prescription of narcotics to outpatients on an ongoing basis, or for more than a couple days? While the safety of oxycontin was misrepresented, I assume there…

> What does legit pain care look like?

Oh, sure, let me just go ahead and write up a national level opiate plan here in a HN comment. I'll get right on it. /sarcasm

Re: Expert sounds alarm on new wave of US opioids crisis

#42

Post by Loughla »

ses1984 wrote: post #11
lom wrote: post #8

Earlier quoted context omitted.

How does that stop OD?

It doesn’t stop OD, but it reduces OD because it eliminates one type of very common OD: people taking seemingly safe quantities of drugs that have been laced with fentanyl.

Is that common? I'm not trying to deflect, but do you have statistics for that?

Because I've never seen stats to back that up, other than that illegal synthetic opioids are the leading cause of OD.

Those aren't necessarily the same thing, and I would like to know more about the actual reason behind OD's.

Re: Expert sounds alarm on new wave of US opioids crisis

#43

Post by devjab »

nobodyandproud wrote: post #10

I see this as analogous to the Dust Bowl, where the politicians and coastal elite ignored or dismissed the growing problem until it was too big to ignore. - https://www.smithsonianmag.com/smart-news/1000-mile-long-sto... - https://mallhistory.org/items/show/274 100 years and more information than ever, yet we have’t figured out this out-of-sight, out-of-mind problem.

As a Scandinavian I find this an odd take on the situation. To me it seems like the US has a very, very, broken healthcare system that you’ve chosen to have by electing politicians who aren’t going to reform it into something reasonable.

My wife and I presently had twins, and we spent 7 days living in the hospital with a lot of help from nurses and so on, and it cost us $130. Which was me paying for 3 days of living there because the 3 days was the max you had to pay. Sure I pay 39% in taxes on the first $120k of my yearly income and then around 55% on anything above this (well except for a bunch of sort of loop holes to invest before taxes), but it’s basically still pretty nice to have that sort of healthcare system.

I’m bipolar type 2 and I have ADHS. Now in case you don’t know, this involved a lot of trial and error with a psychiatrist to find the best medication for me. During this I learned that many prescription medications which are “normal” in the US are illegal or at least only used in extremely severe cases here in Denmark, because of how dangerous the side effects are. This is due to heavy government regulation, because we don’t elect politicians the way you do. We don’t have a winners takes all system which tends to lead to conservative governments which are heavily influenced by the private sector. Hell, you can even see it in our own local “opioid crisis” which was caused by deregulation by right leaning government (though to be fair, Danish conservatives would probably be considered communists by US standards).

As I understand it, you Americans have the ability to both influence national and stateside policies. So that if your national government fails you, then you can still regulate your local laws. Which probably should have meant voting for politicians who would regulate your healthcare system in your states and ban medicine that is clearly a threat to public health. That you chose to not do this, and then blame your costal elites is just baffling to me.

But maybe I just don’t understand your country well enough?

Re: Expert sounds alarm on new wave of US opioids crisis

#44

Post by diamondap »

A few years ago, I talked to three retired federal law enforcement agents who had each spent 20+ years fighting the cartels that were bringing drugs into the US from Mexico and South America. All three felt betrayed by the US government. They said, essentially, "We put our lives on the line many times to try to stop the flow of drugs. Then the government turned around and basically gave the pharmaceuticals license to sell this stuff professionally, through people's personal physicians."

These retired agents didn't see the drug war as a war on "bad guys," but as an effort to stop the destruction drugs wrought in people's lives. After all their work, their own government undermined their efforts.

My own doctor was taken in by Big Pharma's sales pitch and wound up going to prison for over-prescribing their pills. https://en.wikipedia.org/wiki/William_Hurwitz. Though to hear Big Pharma tell it, there was no such thing as over-prescribing.

If you want to get an idea of how out-of-hand the prescription frenzy got, take a look at John Temple's book American Pain, which describes the pill mills in South Florida. Towns in Appalachia used to send charter buses to these pharmacies. After a 12-20 hour bus ride, each passenger would pick up hundreds or thousands of pills, then ride home to sell them in their small country towns.

Some of the pill mills, which were fully licensed by the state of Florida, were cash-only and would haul garbage bags full of money to the bank each day at closing. For a summary of Temple's book, see https://adiamond.me/2020/01/american-pain-by-john-temple/

Re: Expert sounds alarm on new wave of US opioids crisis

#46

Post by giantg2 »

mdorazio wrote: post #28

It ends with an effective, non-addictive alternative to opioids for pain management + more funding and care for rehab (including the drugs to wean opioid users off them, like methadone) to current addicts. [1] explains why the first part is difficult. The second part is difficult because many opioid addicts are already in marginalized areas or groups (ex. rural Appalachia) that don't get much of any support. [1] http…

You're missing one major piece to make it end - hope. These marginalized places need decent jobs so people have hope for the future. Otherwise we'll have the same problems with different substances, including alcohol.

Re: Expert sounds alarm on new wave of US opioids crisis

#47

Post by lotsofpulp »

fifteen1506 wrote: post #36
lotsofpulp wrote: post #21

Earlier quoted context omitted.

That is what happens when the government hits them with nebulous liability for political points. Government leaders do not want to clearly define the rules, but still want to pin the problem on others. If the government makes the rules clear, and the policies result in failure, then they get blamed. If the government outsources the policing, then the government leaders can point fingers and satisfy public outrage, at…

[flagged]

Do you have any evidence to show the blame lies somewhere in the middle?

As far as I can tell, a retail pharmacy’s role is to dispense medication per a prescription, while avoiding errors caused by mixing medicines and advising people how to take medicine.

A retail pharmacy’s role is not to be the de facto front line workers for the DEA. So when our government collects fines from businesses for not policing their customers, expect the business to start discriminating against the customers, due to the lack of liability shield the government has.

An even simpler way to put it is, why would a business that earns money selling things want to sell less of those things (legitimate prescriptions)? The answer has to be the risk of selling is too high.

Re: Expert sounds alarm on new wave of US opioids crisis

#49

Post by gedy »

giantg2 wrote: post #16
pierat wrote: post #2

[flagged]

"Oxycontin was misclassified due to fraudulent reportings of the drug's capabilities and marketing campaign. However that should have never affected people getting legit pain care, but it definitely did." What does legit pain care look like? Does it include the prescription of narcotics to outpatients on an ongoing basis, or for more than a couple days? While the safety of oxycontin was misrepresented, I assume there…

> What does legit pain care look like?

A sibling was on low dose hydrocodone for years for back and ankle issues. Seemed to be fine from my perspective.

Re: Expert sounds alarm on new wave of US opioids crisis

#50

Post by giantg2 »

pierat wrote: post #41
giantg2 wrote: post #16

Earlier quoted context omitted.

"Oxycontin was misclassified due to fraudulent reportings of the drug's capabilities and marketing campaign. However that should have never affected people getting legit pain care, but it definitely did." What does legit pain care look like? Does it include the prescription of narcotics to outpatients on an ongoing basis, or for more than a couple days? While the safety of oxycontin was misrepresented, I assume there…

> What does legit pain care look like? Oh, sure, let me just go ahead and write up a national level opiate plan here in a HN comment. I'll get right on it. /sarcasm

What I'm saying is, if it wasn't oxy, it would have been vicodin or some other narcotic. The problem is how they are prescribed and the social environment. Sure oxy misrepresented safety which lead to some increase in outpatient prescription, but this is still a major source of the problem. Oxy is just the scapegoat for much larger systemic issue since they got caught misrepresenting safety. Nobody has any actual solution to this problem so far.
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