Profits drive Prescription Opiate drugs which drive Heroin which drive deaths


#97

Tman, thanks for that page of dribble. A regurgitation of my posts, apparently because you don’t like them. I stand by most of them, but they appear to have been chosen randomly.

What exactly are you trying to prove by lumping them together like that?

There was about 20 posts of school-girlish baiting about ‘data’. Now that there is some data there, from the same source they were quoting, that is a rather emphatic denial of the opioid epidemic, they’ve had the common decency to not say so much for a few hours. You are a different story.

If you had even a passing interest in the opioid epidemic that was academic, your sole concern would be that graph.

But for you, apparently it’s more important to talk about me…

I’ve gone and reviewed your previous posts in this thread, and your Vox link, and I find them simplistic in the extreme.

Apart from all the utter self-involved bullshit in your post, there was one genuine question there. Why are you posting here? With these guys, who you clearly don’t share a common ground with on this issue?

  1. I am one of these people, who have been quite thoroughly disabled by the utter incompetence of surgeons, at 33. I do not want or desire your pity, or to hear your garbage about that time you or your wife took some pills because of transitory disc issues (I never bloody did for a permanent issue), or high minded rubbish about how you couldn’t cope with it if it was permanent. After a few years of resisting it, I am slowly being forced onto opiates in order to sleep a little bit. It absolutely turns my guts to read a thread like this, with people approaching this issue in the same way they do Trump garbage etc.

Nonsense statements like ‘doctors need to look harder at pain mgt in the long term’. This means nothing - it is the equivalent of saying an expert needs to find a solution. Sometimes you hear equally stupid remarks about North Korea, a foreign policy expert needs to find a solution. It is an abdication of common sense responsibility to recognise the fact that there isn’t a solution.

  1. I guess my real reason for posting - I’ve already stated clearly that there are no black and whites, and a restriction of supply will have certain results. I would hate for that to be done in an environment of hysteria. In my view this campaign has all the hallmarks of hysteria. It is just one unending flow of groupthink. Instantaneous media only facilitates that.

If that graph makes even one of these guys (not you, obviously) stop and think, that maybe perhaps the data behind this campaign isn’t particularly deep or complex - that perhaps the data itself in matters like these is often ambiguous - and causes them to reassess their position of ‘right and wrong’ in regards to this issue. Well, that’s fuck all really, but it’s one person.

So there you go Tman. I mean, the truth is, I just don’t care what you think, as you are a fucking spectator. You don’t have a dog in the fight, and it is your great fortune that you most likely never will. This whole thing is essentially an amusement - just another issue for people to get outraged about - so you will have to forgive my deep cynicism on the issue.

The truth is these doctors are mostly incompetent to treat. The site below details some of the activities of the pain management doctors. It looks like a crank site, yeah? But the guy is a neurosurgeon who worked out of John Hopkins, who put in some of the first stims. Anyone who spends any time around medicine, soon learns that it is an art, and not a science

Ultimately this debate must hinge on the effectiveness of opioids in long term use. These are the pill mill people the DEA immediately targeted. But this can never be done, because we can’t measure pain in anything approaching an objective manner. We simply can’t assess it, so we are left with very poor data by definition.

I believe ultimately the entire system needs to transition to something more involving of patient choice, to prevent them being at the mercy of the doctors intuition as to their true state. A collary of the boundaries of this debate is that we are moving ever farther from it.

Yes, people are dying, yes prescriptions are increasing. That is the only hard data. Is there a prescription driven epidemic, driving a heroin epidemic? Maybe. I haven’t seen any data to back that up, here or elsewhere. Certainly not in the ‘tons’ of data you’ve provided. I don’t think such data could exist, and we are left with our inferences.

My personal experience does not tally with these drugs being easily available, nor does the experience of many others in a similar situation. Typically in the US, there are no script refills, and you are subject to contract with your doctor and routine drug testing. All this talk of opiates being freely available, outside of occasional recreational use, I find it baffling.

The CDC page is intentionally misrepresenting the data, claiming more than a 100% prescription per person. It’s an absurdity, but you guys think you are oh so clever by posting a pictogram and a link to it. Why isn’t the prescription rate normalised to the time length of the fucking prescription? I am asking too much, for the fucking CDC, to provide meaningful data in their public information sites?

Do you seriously intend to tell me, that not a single one of you, does not raise an eyebrow when you are told that Tennesse has up to a 143% prescriptions per 100 persons? Why not per thousand, or per million? What possible meaning could data presented in that fashion have?

You guys are fucking engineers right? Yet you are linking this garbage without engaging even your most basic critical faculties.

The greater question, is why isn’t the CDC informing you of the true prescription rate. Data which I am sure they do have. It may be that it wouldn’t appear so outrageous prima facie.

I mean, Tman, if you find that tiresome, just go and take a fucking nap or something. God knows I find it tiresome reading your comments.


#98

U mad


#99

I am not defending these drugs as a cure all Skipper, and what you have described in discontinuing treatment is not necessarily atypical. I don’t believe I’ve provided a comment to counter in that regard. I assume she is a close relative, so I wish you well with this journey.

Fact is they are evil bloody drugs, but life is often about lesser evils. Sometimes hard to tell which is which. Sometimes it’s the right decision to get off them. Sometimes not. Often it is not the patient who makes the decision, in her case by necessity.

The report I linked was from a page linked by members of this forum, so they can answer for its content.

I don’t doubt they’d be under intolerable pressure to act in the face of a steadily increasing death rate.

I do acknowledge that the campaign itself is characterised by the use of these drugs being delegitmised, presented as medically inappropriate at best. If there was a clear basis for that, it would be acceptable.

But there are many injustices, that are treated as right and normal, so it is what it is.


#100

haha Adam you are such a bitch!


#101

You are in need of help.


#102

You’re a bitch too, @Tman!


#103

lol, you trying to take away his fire & thunder?


#104

There is no help, Tman.

I am here now, as the result of help from highly trained medical professionals.

There is nothing more profoundly disempowering of someone, than an attempt to help them.

This is not something that you will have to learn, unless the unimaginable happens.

This is just a bunch of cliquey, bitchy little guys having a good old natter. It could be opiates, Trump, whatever, the subject matter is irrelevant. Which is fine, I guess. But all the self righteous crap gets a bit old, and calls of ‘data’ are clearly frank stupidity. But that doesn’t bother you does it? Because that is not the point of why you are doing this.

Lives will be saved by this campaign, and I’m sure there will be a certain amount which are unnecessarily damaged as a result of it. It is a great shame that the media cannot reflect this in their coverage. You guys will take your cue from them entirely.

The greater shame is the behaviour of the researchers and doctors in this field, who have moved beyond the boundaries of measured interpretation and caution, into advocation on grounds that are often quite thin.

But it is what is and won’t change. You can do what you like with it.


#105

Irony levels are over 9000


#106

@BadSport Hey, you clearly are passionate about this subject. Underlying your arguments, as best i can gather, is a belief that this is an epidemic that is being “manufactured” by the media, that the increased use of opioids reflects real demand and which products do real good, and there is negligible addiction or abuse of these drugs beyond the baseline, and that restricting access to these drugs will hurt people. Something like that?

You have to forgive for not having a dog in this hunt, which clearly you do, and assuming that the overwhelming information people are hearing in many different media sources saying there is an epidemic. However, the link you provided to the burtonreport.com, even recognizing it as a crank site, is still hard to swallow (the next article after the one you linked to is his random idea to knight people Paladins, essentially ultra-verified concealed carry citizens, because increasing crime rates are not being addressed by the government). So it’s hard for me to sort of follow your train of thought here. Admittedly I’m not spending hours doing so. But from the outside it looks like the same sort of thing as climate change denial or something.

I suppose the opposite question I would have for you is - what if there really were a crisis in opioids addiction and your interpretation of things was somewhat flawed? I suppose you would still oppose tightening or restricting their use in the event because of the benefits they provide outweigh the potential negatives?


#107

Hey, that paladin idea is brilliant, because you can give them all kinds of powers, and if they ever do something that isn’t lawful good, they lose them!


#108

No worries. Not a family member, but one of a dear friend. She’s had quite a struggle.

For comparison though, I turn 50 this year. I’ve been fortunate to not have had any major surgeries or ailments that put me into serious pain for at least the last 15 years. But I have many friends of the same age who have. Two of them have battled opioid addiction due to initial prescription use. Both had surgery, one starting using prescribed opiates prior to the surgery and they continued post-surgery. One successfully made it out of the addiction, and did so with help from doctor/friends. The other is still in that fight. I have long since distanced him as a friend, because the personality change, mood swings, and belligerence when he mixed pain killers dangerously with alcohol, drove me away from him as a friend. It’s a nasty, nasty cycle. There has to be a better way. I’m hoping that we find a solution, either with regulation, with changes in the medical profession, or perhaps with the design of better and safer drugs. I don’t have the answer, I just know that seeing people succumb to this it a very tough thing to watch.

For a perspective on the craziness of it, though, the documentary on NFL players and pain killer use was sobering in the extreme, as was the reference to how many leave the league as addicts. I mean, at the level of use they were at, how could things not end up that way?


#109

Timex you were one of the guys laughing at my dismissal of the data, after the CDC site was linked.

The irony is that it disproves your argument and that of your fellow travellers. Perhaps the greater irony is it escapes you.

It’s the data you support, not me, and outside of that I have no further comment.


#110

I don’t believe there is a better way Skipper, or an answer.

If the drugs are out there, they will be misused. It is the nature of the beast. There is declining support for their use in the medical profession for this reason.

But a close reading of the literature demonstrates that there is mostly supposition. There is only one long term trial on their use (in a VA environment), that demonstrated no difference. But the paper has not yet passed review, and the ‘no opiate’ group were allowed tramadol, which is ridiculous.

Ultimately we cannot measure pain or function particularly well, as it is a psychological phenomenon too. Unfortunately this often means we resort to dismissing it’s corporeal nature.

For every anecdote of the horrors of addiction, there is anecdotal evidence of people having an improved quality of life opioids.

I find it very hard to believe that the story is so clear cut. I think the medical profession tacitly agrees, otherwise they would simply ban their use entirely except in terminal cases. Instead they maintain them as a drug of last resort.

I know one guy who is on morphine. He refused to take lyrica because of the gross personality changes. They’ve taken him off it, put him back on it. Eventually I think they’ve just left him on it because he’s better off. In terms of him being able to sleep, interact with his wife. By doing that they run the risk of him becoming addicted, in the sense of pursuing street drugs and all the other outcomes of addiction.

That sort of narrative is not even getting off the ground in this environment, but it is there to be reported, and probably should be - in the interest of balanced reporting. These people are not hard to find. I don’t think such cases are necessarily an exceptional minority either.

I suspect such cases are not only invisible to the wider community, but invisible to the medical research as well, as it can’t be quantified.

The issue is now essentially a public one, and the public deserves to be informed fully, so they can make a balanced judgement of a contradictory issue.

The NFL guys simply aren’t representative of normal peoples interactions with the medical community.


#111

If they are a last resort, I’d like to know what else is prescribed more. From here.


#112

Enidigm, they are harmful and dangerous drugs and that is why they are restricted.

I do question the extent of our knowledge of the nexus between prescription opioid use and heroin. The article below is quite damning, but look at Figure 6. 50 % of new heroin initiates have prior use of prescriptions, but not in the past year.

Does that mean because you took oxycodone more than a year ago, you are now progressing to heroin use? Maybe, maybe not. There may be wider social trends which are resulting in increased drug use regardless.

https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm

You’ve asked a genuine question, but I think you’re looking for an either/or answer, and that’s not how it works.

By making these drugs we accept a certain number of lives destroyed. Because this is a social matter, we are not sensitive to the death rate, so much as we are to the change of death rate.

I think we are witnessing a reshaping of the role these drugs are going to occupy in our society, and this campaign is part of that.

I am somewhat concerned that it is so fervent that we may end up over-doing it.


#113

I don’t know what prescription rate you’d be happy with Tman. That’s the real question which this debate studiously ignores.

Last resort is a medical term which refers to their treatment regime, which for nociceptive pain is paracetomol, anti-inflammatory, opiates. Sometimes they will even try lyrica as an alternative.

There is a discord between you wanting a solution and the circumstances you witnessed personally, in which your wife was given an opioid for acute pain.

It is probably such circumstance which has resulted in increased use, and there is no indication you have awareness that you are arguing for no pain relief in that situation. Which is the correct course of action for acute pain.

But there are other situations, in which people are sometimes driven to suicide. While there are many pain management docs who make a career out of saying no opiates and injecting people with steroids, I don’t think the science is as clear cut in that area as it’s made out to be.

For my personal opinion, they are terrible, evil drugs that destroy lives. But I don’t agree with the character of this campaign.

I don’t really want to debate it any more, as whatever point I have to make is made, and I’ve got to go on to what awaits me.


#114

Burton is neurosurgeon who has held some prestigious appointments, surprisingly enough. His CV is on that website.

What he details for you is the nature of the pain management industry.

So when people say things like, we have all these nifty techniques as an alternative, they are talking about epidural steroids quite often.

You can read the association of that with adhesive arachnoiditis if you like. Much as spinal surgeons produce a large cohort of disabled people as a result of their activities, so to can these pain docs.

Any damage they do is of course obscured by the reasons why people turned up their in the first place.

The point is, we often hide behind ineffective medicine, as the alternative it to openly admit we are powerless.

Take care


#115

Here is a good article trying to highlight some normal people trying to fight congress, their own senators, the FDA and Big Pharma:


#116

Here is article that purports that Insurance companies are a part of the problem as well.

Leo Beletsky, an associate professor of law and health sciences at Northeastern University, went further, calling the insurance system “one of the major causes of the crisis” because doctors are given incentives to use less expensive treatments that provide fast relief.


The opioid crisis