Study: Opioid overprescription a problem for all doctors

Seems things are out of control. I know heroin is pretty bad around here. Something needs to be done

Washington University School of Medicine: Overprescribing opioids

nope!

I have no rebuttal for such a overwhelming argument

That involves too much freedom and not enough bureaucracy.

You do realize that all alcoholics bought their first drink from a state/federal licensed or run store.  Half the fatal car accidents are due to alcohol yet the stores stay open.

Lol, so then patients get no Schedule II opiates and drug addicts can still buy all the Heroin, Fentanyl, Carfentanyl, etc.  Sounds like a great plan.

Just my .02

So we want gov out of our life, but we want the gov to pay for opiates?

Is this correct?

Alcohol is not addictive like opioids. Alcohol has no reason to be prescribed as a solution

Opioid problem is real and some doctors are the cause

Small over-prescription of opioids increases risk of abuse: Study

WTF?

There's no way to argue with someone who, genuinely, has no grasp of reality.

Try me, one of my favorite undergrad courses was psychopharmacology.

You must have failed that course

I think this accounts for some of our "gun violence" when it comes to guys. A guy comes to the understanding that instead of working and providing for his family, he instead, is going to spend the rest of his life in terrible pain every day not working and instead running his family into financial ruin. So he kills himself. I know people who get up and go to work everyday only because pain pills keep the pain dampened down enough for them to do it.

My dad drank a lot of vodka every night of the week and he got really mad if he couldn't get it.

Fucking Junkies...

I rarely drink, have never smoked, and have never so much as set hand to any sort of illegal drug except when required to by work (in the process of confiscating them), let alone done any.

4 out of 6 times I've ended up in the ER for something I have been accused of drug seeking.  


I have no doubt the docs see it day in, day out, but they fucking suck at ID'ing people faking injuries or illness.

Again, why would I "try you?"

You've consistently proven you aren't worth the conversation it would take to prove your "theories" wrong.

You're the kind of poster that makes me sad. It hurts my heart to think that there's people walking this world who really believe the kinds of shit you talk about, openly. I'm sorry that you have to endure living in your own head and hearing those thoughts all day. I just wish you could refrain from making us hear them, too.

Um' do people realize that pain meds are effectively over the counter in much of the developing world

I would also suspect that there is very good tracking of pain meds in the US (the narcotic prescription pads or whatever they are called). In many other places these meds are much less controlled in practice. I would suspect that the better tracking and the centralization of data by the DEA accounts for a good bit, but not all of that difference.

We would need to look at the per capita consumption using some metric like amount imported, manufactured or distributed. Which still wouldn't be accurate in a lot of places given the amount of tax / import tariff evasion.

One of my friends, and unnamed fellow arfcomer, made a good attempt at removing his finger with an angle grinder at work. He actually cut into the tendon with the disk. They offered him a perscription for ibuprofen after they realized that he was in pain half way through debriding/stitching

The dude doesn't touch drugs and barely drinks.

Can we confess things here?

I nearly ripped the end of my thumb off and they gave me really effective anesthetic(?) to keep it numb when they stitched it back together. The hand surgeon took a long time to get to the hospital and when he showed up the first shots of lidocaine(?) had already lost it's effectiveness. I just told him to please make sure it's absolutely numb before he did anything because I was super worried he's going to hit some spot that was extremely sensitive. He gave me something different, but I dont remember what it was. Mayeb something called Hydromorphone? I just remember it sounded like it was really serious stuff. I think whatever it was, was on top of the lidocaine he put in my thumb. Lol I only was prescribed Tylenol 3 for post "surgery". Really not that effective, but I got my hands on some more effective stuff.

Hydromorphone is Dilaudid. Best of the best.

3 days... lol... when was the last time your jaw was broken in 4 places. Ooooohh I'm a junkie

In this thread we learn who has never had a major accident or surgery. When I get an x ray at the dentist they call other people over to look at all the metal in my face. Was I doped up on everything you can imagine for quite a while? ... yeah it brought the pain down enough to sleep some nights.

Education is not - I repeat, NOT - the problem.  The issue is fundamentally simple: a percentage of the population is simply prone to drug addiction, for whatever reason(s).  Blame it on nature/nurture, personality disorder, weakness,..whatever.  There are simply going to be those among us who pursue drugs.  Tell them it's harmful, show them the proof, & yet facts be damned, they'll still hunt for a fix.  The majority of us go about our lives without getting caught up in such dead end pursuits.

Adults have to learn how to do adult things like make judgement calls on using a Rx'ed drug, if it's working, how it makes them feel, etc.  Responsible adults will realize if they are getting - or have gotten - over their head & attempt to change course.  Some will have struggles.  Others will get hooked.  Regardless, the LE approach isn't going to alter the good/bad relationship that human beings have with drugs.  Nor will it eradicate drugs or dealers from the face of the earth.  We have to come to terms with the fact that this is the way things are between people & addictive substances, & be honest about how to mitigate the issue of addiction.  That hasn't happened yet.  We're still doing the same thing without changing the result (ie. Drug abuse rates have remained unchanged since before the advent of the current policy).  It's fine to be morally opposed to even casual drug use.  I agree with that moral stance.  But I can also look at the evidence & realize that when nations like Portugal are seeing progress via a different path than ours, the hard line "war" policy we've chosen to pursue isn't the way to do it.

Some people are just going to use.  That's all there is to it.  We have to learn how to effectively deal with the issues that draw people in to that lifestyle.  Further, we have to admit that some people will even abuse drugs no matter how dire their personal circumstance become because of it, because they're apathetic & selfish.  The incarceration model isn't altering that reality (Hell, one can even get illicit drugs in prison).  We have to deal with the users & take control of the drug market from the cartels.  This latest policy shift is just going to raise their market share.

It ends the moment when we, as freedom-loving Americans, have grown so tired of being treated like subjects that we decide that proverbial Tree of Liberty needs refreshing....again.

the current version of prohibition is not working so why not try something different


set up gov heroin operations in impacted communities
junkies get maintenance doses of clean heroin at no cost
they also have access to counseling if they choose to attempt to quit.

no more overdoses in the street
cut down on cartel money and drug violence
addicts no longer have to commit crime to support their addiction.

the downside is you have to accept that there will be some lifelong addicts leading mostly normal lives (soccer mom getting 3-4 doses a day)

This is what defeat looks like. You haven't made a single point in any of your posts other than I'm wrong. Keep racking up the losses

I've made lots of points, just none in my discussion with you. Mostly because you, personally, aren't worth the effort to debate. I can fix ignorance, I can't fix willful ignorance and a penchant for lunacy. That's all I've seen you post, thus far.

I didn't read the whole thread but when I went in for my last pain specialist appointment I was told they are going to stop making Opana. 

Its  one of two pain meds I'm on. It sucks cause after two years my current combination works but they are stopping production because people abusing it to get high 

I'm sure you know more than the the Washington Anesthesiologist who made the statement.

Meperidine (demerol) is already hard to come by. I got a scrip from my urologist a few weeks ago because of chronic kidney stones and had to wait 5 days for the pharmacy to order some and have it shipped to them. I cannot afford to go to the ER every time I have a stone and I keep a current scrip of the drugs on hand to self medicate. I usually just take ibuprofen or Tylenol for the pain but when it hurts enough to make me puke, it's time for the demerol. I fear that one day I might have to turn to street drugs to ease the pain associated with a kidney stone. I pray that day never comes.

"The dude"

Then it's "We need more laws and more tax payer money to fight it."

Did he abide?

So glad I don't work in the ED anymore. All the drug seekers were a giant pain in the ass. Fuckin junkies.

All the OD's won't cost billions in healthcare costs in ED time and resources. Brilliant.

Tramadol is a godsend for me.  Makes my back loosen up just enough to maintain.  

We could shit can EMTALA.....

How else will the ice cream lick itself?

I've said it before and I'll continue to say it.  Don't fuck with ARFCOM'S two addictions:  Entertainment and prescription drugs.

The last time I was in an ER for a stone the doc accused me of being a drug seeker. I had a 4mm stone with 21 more I passed in the next 2 weeks ranging from a grain of sand to 3mm. Fuck him, I filed a complaint on him. Fuck, all they need to do is pull my records. I've had over 100 of them in 28 years yet he treated me like someone with no past history.

About two or three weeks ago I had to go to the ER because I was out of my pain medication thanks to the insurance company wanting to do a preauth. 
The wife took me to one of those private, stand alone ERs, I was really impressed. 

After telling them them what I was in for and the Dr checking my medical records there in the room, I had a Delaudid drip within 10 minutes of walk in the front door. 

My point was mostly about statistics, the skewing of data and inference. These are areas with which I am professionally engaged on a daily basis. Much more so than your mean  anesthesiologist. Perhaps, I should have been more clear or made my point about bad monitoring and skewing differently.

We have very good data collection in the US, with respect to prescription and addiction, many other countries simply don't. This means that we collect very reliable and accurate data about the quantity of opioids prescribed and the number of addicts. To include some longitudinal information about people who were first perscribed a narcotic and latter became an addict. Whereas other countries often don't reliably collect or centralize data about narcotic prescriptions or addiction.

There could also be huge differences in policy and collection methodology. Tramadol for instance isn't scheduled in a lot of places. So, if you go ask xyz country how many narcotic prescriptions per capita they might return a result that excluded Tramadol.

Put differently, its very easy to make big mistakes when playing with big data. My read is that the epidemic is not that much worse in the US when compared with other areas. My suspicion from spending time overseas, including time involved with the medical field, is that there are tons of addicts and opioids floating around overseas. Often more than in the US, we simply have very aggressive reporting.

ETA: Corrected drug spelling.

FPNI

But we're a "free country with liberty and freedom and junk!"

Government controls all. 

Fact

Ordinary people getting shitty care and being accused of perpetrating a crime are just an every day part of medical treatment in the US. 

There's a new thing called the ignore function.  Not sure if you've heard about it before. 

I was in the ER a few months ago for a neck problem, and I met this guy in his 50's who was a long-term alcoholic. I was amazed he opened up to me so quickly, but it seems he and his friends have this scam where they check-in to the hospital for alcohol detox because the hospital gives them Ativan to help in the detox. Once they get the Ativan, they go back to drinking as usual, and then check themselves back into the hospital for another dertox to get more Ativan. He said they have been doing it for years.

I don't know a lot about Ativan, but I remember the couple of times I was in the hospital in the past 10 years, when my back hurt so bad I could not sleep, Ativan was the cure. The pain pills alone did not cut it. I needed the pain pills and Ativan to finally get some sleep.

Is Ativan additive? Does the fact some drunks abuse it mean it will be banned for everyone at some point? That seems unfair.

Just as it seems unfair to ban a certain class of opioids because a small percentage of individuals abuse them.

It sounds like gun control for meds. Ninety-nine percent of gun owners never do anything illegal with guns, but because 1% do, all guns should be banned or gun ownership curtailed?

Makes sense.