While Pill Mill docs played a role, the government is the one that created the “nuisance”.

Ironically, Kermit Gosnell didn’t get into trouble for killing newborn babies but rather because he ran a pill mill.  The DEA found a bunch of full-term babies in his freezers and try as they may, they couldn’t ignore it.

Meh....the biggest issue was successful lawsuits against doctors for “under-treating pain” as well as the option of filing anonymous complaints against a doctor if you weren’t happy as a patient.  Doctors are afraid of board & hospital inquiries—baseless or not—they cost time, money, sleeplessness, doubt, expensive over-testing & ultimately—over-prescribing.

It’s often easier to give a patient what they want vs. spending 30 minutes explaining why you’re worried they’re an addict, abusing or diverting narcotics.

Like many things—it isn’t as simple as GD thinks.

Did I just read right... the state is using ‘if you oversupply, people will die’ line?

Also just read an article about some of the attorneys involved, all contributors to the ag political fund... no limit on the millions they will make

It sounds like they’re using the playbook of another old Democrat and his suit with big tobacco

JJ is going to put up a hell of a fight. They presented info that their opioid product is not the source of a very real problem.

If this is decided on facts, my money is on JJ.

But the judge is an elected official. Will he be willing to throw himself under the bus and not side with the State and its AG?

Well, that’s because opioids are really safe (when used with focus and as directed - and not thrown about Willy nilly).

Yup. The State even referenced "if the glove fits...."   Frankly, State came off sounding like an 8th grade debate team.

They are going after JJ because that's where the money is.

J&J = Gillette = Fuck them

Did you punch him for being a statist commie fuck?

I'm a guest in this State. I didn't even blade at 45.

This is all about money and politics and nothing else.

I accept, thought about, do NOT argue this possible scenario.

Do you disagree?

I've spent a lifetime doing dumb shit and injuring myself every few years in some way or another. This year for a knee surgery I was given a few days of Tylenol 3. A few years ago for a root canal I was given a week worth of 10mg Percocets.

Now, to me the answer seems like it is somewhere in between, but having gone through lots of pain I would err towards too much rather than too little.

Going through PT with too little has really sucked, and has meant that I just couldn't do the work some days. I'd rather risk a little exposure to addictive substances so that I can quickly and aggressively get my range of motion and strength back so that I can go back to being a productive, contributing member of society.

A few failed docs in pill mills did not create policy, oh great and wise EMT.

A system brought to us by politicians and plaintiff's lawyers.

In on 2.  My brother handles real estate for the Sackler Family (Purdue Pharma aka Oxy Contin).

Prepare for long winded answer or skip it, I don't care.

About 15 years ago my agency was switching medical controls(the doctors who govern our medical protocols).  The old was just starting to tell us "We want no pain".  We switched, the new medical control told us "your pain scale is 0 to 10 and we are striving for 0, if a patient still has pain you keep giving pain meds until you exhaust what protocols allow".  At which time I was the guy who raised his hand(a lowly paramedic) and asked the doctor how do you think this is going to end?

He told me the industry was going this direction and people cannot heal in pain.

Fast forward, I have had 2 shoulder surgeries and a back surgery.  I healed in pain.  Yes I took a few vicodin in the process.  But for the most part it was minimal.  I went to therapy with every surgery.  I did my part, and sometimes it hurt.  I do not think I have any kind issue where I don't feel pain.  I just think I can take it to a degree.  I actually think I can take a hell of a lot of pain.  And I think most people can take more pain than they do, IF THEY WOULD JUST PRACTICE NOT BEING PUSSIES.  That is not aimed at you and your illnesses.  That is aimed at the douchebags I run on who stub their toe and need pain meds.

So yea, I don't want to see opioids go anywhere.  I would like to see them managed better than they were, but still available to those who need them.

Since my back surgery a few years ago I have taken a couple vicodin from overdoing it.  I went to my doctor with 15 vicodin in a bottle.  I told him the prescription was out of date by a couple years and I would not be safe if I took even one and got random drug tested and it showed up.   I told him I needed a current prescription.  I told him I was not an addict.  I asked to replace the 15 in the bottle with new ones and he COULD HAVE THE OLD ONES.  This could not be done according to him because he is under such scrutiny.  I checked and he is not under any state sanction.  He is just running scared to NOT BE.

So there is a happy medium.  I haven't had a vicodin in months maybe over a year.  I am not an addict.  But once in a blue moon my back flairs up from working to hard.  I would love to lay back, rest, and just numb it for a little while.

But because irresponsible people exist I take motrin so I can keep my job, when this happens.  And then I just suck it up.

First witness for the State is essentially selling the sizzle. IOW, a PhD talking about how they will spend the winnings on wonderful treatment centers.

Betting on the come for public consumption.

Lighten up.  I know you are a doc.  I am not claiming to supercede your greatness or authority.  As a matter of fact I have nothing against you.  But irresponsible people are the problem.  The legal pills can be controlled.  China and Mexico are a wild card.

Thanks for the dialogue.

Opiate manufacture and other addictive drugs are the darkest part of american history. Untold millions hooked, hundreds of thousands killed and no end in sight. This started long before J and J but all players are guilty

But guess who paid the doctors to write pain management  articles in journals?

JJ contends that their opioid product, a fentanyl patch, is a tiny part of the opioid industry and by far the least addictive and rarely diverted. Essentially it is the empty chair defense.

It's  a money grab.

Its ridiculous to hold the manufactures accountable for doctors misprescribing or playing fast and loose.

The pendulum has swung backwards in the other way far too far now. I admit there was a problem with too much over prescribing but now its going way to far into the doctors ability to provide care to longer term chronic pain patents.

I have a buddy who got really fucked up in a car accident, and has been on some stronger pain killers for years. And hearing about what its like from someone whose having to deal with the legislative and insurance hurtles is ridiculous.

If I remember correctly he was on some Morphine for all day pain, and Vicodin for when it gets really bad. Well the insurance company's started requiring prior authorizations on the Morphine. So I guess the doctor had to call that in every few months, before the insurance would pay for it. This past year, they started requiring it on the Vicodin. He has been on this shit for a long time, as long as I have known him, and it doesn't make him loopy or a stoner or anything, he can just function better, and try to live a somewhat normal life. He was recently switched to the "deadly" oxycotin and he said it works 100x better then the morphine, but the insurance fought the doctor to allow him to be prescribed it. Without insurance he said it would be like 600+ bucks per month for just that one.... (seriously who could afford that shit out of pocket)

He told me he has pill counts every doctors visit, piss tests and all that jazz, and the new thing is pharmacy's refusing to fill prescriptions because they "feel" the dose is too high, or won't accept the authorization codes. Basically he said if you don't have stage 4 cancer they don't think you should be getting anything narcotic.

Now you explain to me how a fucking pharmacist, should be able to tell a patent who sees a doctor every month, they know better then a doctor who specifically deals in pain management.

Hell my dad had a toe amputated last year. They gave him 15 Vicodin and the pharmacist refused to fill it without him buying narcan as well.

Its gotten out of control. I can't even imagine having to deal with all that bullshit, and then being made to feel like a junkie at the pharmacy every month.

I can't take any post that requires a [sic] seriously.

Just like all gun manufacturers are to blame for ethnic cleansing?

Put away bad docs for long sentences.  Problem solved.

Taking the prescriptive power away from the doctor that knows you best (PCP) and creating the pain doctor industry only made it worse by making it easier for the criminals.

And for fucks sake stop purposely conflating the prescribed use problems (important but tiny) with the off the street problem (massive and deadly)

So the ag deputized the big baller  ambulance chasers to give them the power and resources of the state

Also read that the ag last opioid suit ended in a 270 million settlement, but kept it out of the state coffers, and made a deal to give it to OSU... which is where his son recently went to go work

https://nondoc.com/2019/04/19/mike-hunter-sons-job-at-osu-health-center-a-coincidence/

Can you please cite examples?  Specifically what did these articles say, or is this a case of a broad brush but little paint.

Thanks for the response. I think we agree more than we disagree.

I just think this is a medical matter and as such should be between patient and provider. Go after the bad docs, treat the addicts instead of forcing them to the streets, and let the rest of responsible society get on with enjoying the miracles of modern medicine.

I for one am a giant pussy, and I don't deal well with high levels of pain. I wish I could control that, but I can't.

I was in a motorcycle accident and broke both my wrists about 12 years ago. They gave me Vicodin.  When I went back in a week after my casts got messed up the doc asked about my pain meds I said they didn't do shit, and before I finished my sentence they offered to up the dosage of get me something stronger.

I was trying to tell them they don't do shit so I didn't take them. I was fine with Tylenol but they were all ready to give me something stronger.

I would answer this with what was that oath those doctors swore?

ETA: I think most doctors are good to go.  I think there are some shitty ones who call to much attention with the fast and loose.

This is a big problem. Across the board. They spend 2 minutes with you. How can they even participate a little?

State just showed animation of a cartoon kiwi bird like creature becoming an addict.

State's case looks like some 8th graders prepared for as an emotional jury trial and got stuck with judge.

My stepson works for the State's hired guns and it is embarrassing. I can't believe OK spent two years on their complaint.

It seems amateurish.

If you lick the barrel of an Ak you dont need it every day after

Be back in a bit

If you google EMS and pain management hundreds of articles surface. Nurses involved in patient care also were heavily encouraged to treat pain as a vital sign even though the majority of us knew that it was just an attempt to increase satisfaction surveys and get people into calling 911 when they were hurting.. This happened and I am not smart enough to go an cite the correct journals and trace back which doctors got backdoor payments to push certain medications. You are I am sure as well as everyone else is aware of how this started back in the 90s. I agree it was unfair of me to claim that big pharma paid doctors to prescribe more pain meds. But I can assure you that the companies that produce fentanyl got a windfall from just the company I worked at . I went from using maybe 10 mg of morphine a month to treat pain to 5 vials of fentanyl a shift sometimes. And this was enforced by protocol and if I did not give it there would be repercussions including loss of employment possible.
Here is one article that is typical of the type of information given to us in briefings.

https://www.jems.com/articles/print/volume-41/issue-11/features/a-guide-to-prehospital-pain-management.html

Sorry to say this, but a great many courtroom lawyers suck at doing courtroom stuff.  They don't understand how to sell their audience on their case.  They argue, go thru the bare motions of entering stuff into evidence without telling a story, and get so wrapped up in the facts that they forget to teach the jury (or judge) those facts in a compelling story that makes sense.

I did trials for a while, had my fun, got what I wanted out of it, and moved on to a less stressful field with fewer deadlines.

Maybe they were expecting jury trial?

I swear you drug warriors are more delusional than some of even the most rabid leftists.

How you can type shit like this with a straight face is fucking mind blowing

It goes way beyond that.  Prescribing an opiate pain medication gets the patient out of the office.  Yes, it can be lazy medicine.  Sometimes that is perfectly appropriate as it’s the only treatment option (eg. terminal cancer).

Many times, it’s out of expediency.  There are no other ulterior motives other than it solves the problem (temporarily) and allows you to get to the next patient.  The problem with this is it leads to tolerance and dependence, and you will eventually reach a point where you will not further increase their dosage and this makes them angry/frustrated.  It’s why it is better not to go down that road in the first place, and spend the time with the patient (getting further behind in your day) to find other alternatives to opiates (what I do the vast majority of the time).

The pendulum swinging has actually made it easier to avoid opiates as we can cite the current fucktardedness of the government.

Right?  I mean how dare them try and make you more comfortable!!!!!!

I'm not coming for your pain pills friend, so please take my post seriously.

You can’t give prescriptions out without having recorded it in some kind of medical record.  It’s interesting that they are prosecuting him criminally.

An alternative would be to sit him down with his lawyer and offer him no criminal charges and permanent revocation of his medical and DEA licenses as a deal.  His name goes into the national database and he cannot get a license anywhere else.

I’d say it was not the ag finding hired guns... it’s a cabal of trial attorneys who found the ag and using him and his elected position... he probably sold out for the promise of publicity, pumping money into his campaign, jobs for his family and cronies, a gig after political life has expired.

The public courtroom trial is just one leg of their strategy, with one of the others being to drag them through the mud, with the help of the media

Not everyone needs opiates to feel better. Sorry about your inability to deal with discomfort, but some people would rather have their doctor listen to them and not just assume everyone is out to up their dosage of pain pills like some of you.

About double those surgeries and plenty of broken femurs and shit and allergic to all opioids. Synthetic seem to be mostly ok.

Does anyone know of an addict that would just simply not be one if their drug of choice was unavailable? I don't.

This "opioid crisis" shit is infuriating. A few hundred pounds of fentanyl are found crossing the border every week or so, but my 90+ year old great grandma who is actively dying from her bones turning to dust can't get a refill on her weak-ass pain pills unless she physically goes to the doctor (which she can't do without her spine collapsing and killing her). No option to send a legal representative to get it filled, no option to get it resolved via phone call, no we have to keep a 90 year old woman in pain because she might get addicted or sell the pills. Fucking infuriating virtue signaling bullshit

I honestly don't care if a bunch of addicts die. Fuck them. Don't take it out on my relatives who actually need the stuff, especially when the measures in place don't do jack shit to affect the black market (see: all the foreign-sourced fentanyl coming in).

Your experience is vastly different than others. Kudos to your Dr for being a responsible human being.  Others, not so much.  I've personally seen family and friends be destroyed by these drugs.

ETA: I an not advocating for or against big pharma.  There is enormous amount of greed from the DRs and pharma companies.  There is also a lack of personal responsibility from the "victims" of opiate addiction.

Cartels have friends in even higher places than drug companies.

I'm surprised J&J didn't settle.

Holy shit.  

Treating grown adults like fucking children.

Sooner or later, someone with nothing to lose who does have Stage 4 cancer is going to decide to react....poorly...to that horseshit.

Similarly, does anyone know a normal person who would suddenly turn into a depraved addict, sucking dicks in back alleys for their next hit of smack, if these drugs were easily available?*

* I should say more easily.  They are easily available, if youre willing to break the law.  The junkies can still easily get their shit.