Opioids

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Shirley
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Opioids

Post by Shirley »

This story is absolutely heartbreaking.

https://www.washingtonpost.com/news/to- ... d-at-home/

Why am I not hearing anything from national politicians about this growing menace? From that article, 28,000 Americans fatally ODed on opioids in 2014. I'm sure the problem's gotten worse since then. Yet, where's our War On Prescription Pills? I can only assume that we ignore this while continuing to fight pot and cocaine because Big Pharma doesn't sell pot (yet).

BTW, the video in that article is one of the most gut-wrenching I've ever seen.
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Re: Opioids

Post by The Sybian »

Shirley wrote:I can only assume that we ignore this while continuing to fight pot and cocaine because Big Pharma doesn't sell pot (yet).
Answered your own question.

And in the words of Nixon domestic policy advisor, John Ehrlichman, one of the fuckers responsible for creating the War on Drugs,
You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities," Ehrlichman said. "We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did."
Ehrlichman's comment is the first time the war on drugs has been plainly characterized as a political assault designed to help Nixon win, and keep, the White House.
How many lives ruined by incarceration rather than treating addiction, or for stupid, petty marijuana charges? How much wasted in time, money and resources wasted enforcing these laws? Imagine if that money went into improving infrastructure (job creation), helping the poor, improving education? Eh, who am I kidding. That money would have gone to the military and Boeing, to build some 1970s state of the art war plane that would end up being a colossal waste of money.
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Re: Opioids

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I felt aswirl with warm secretions.
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Re: Opioids

Post by DaveInSeattle »

You should read "Dreamland: The True Tale of America's Opiate Epidemic" by Sam Quinones. Tells the long sorted tale about the explosion of prescription opiods, bogus pain clinics/pill mills, and the perfectly timed influx of cheap Mexican Brown heroin.

I can't recommend that book highly enough if you are interested in this topic.
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Re: Opioids

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well this is gonna be someone's new signature - bronto
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Re: Opioids

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Legalization (or at least decriminalization) of pot is leading in all states that have it on the ballot for November.
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Re: Opioids

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Re: Opioids

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500 in New Hampshire (with a little more than twice the S.I. population). There are something like 5,000,000 doses of painkillers prescribed every month.
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Re: Opioids

Post by Shirley »

Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?

While the War On Drugs has been a complete disaster, and I'd like to see us pretty much scrap it, surely this epidemic has reached a level where we need to come up with some sort of national plan.
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Re: Opioids

Post by Steve of phpBB »

Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?

While the War On Drugs has been a complete disaster, and I'd like to see us pretty much scrap it, surely this epidemic has reached a level where we need to come up with some sort of national plan.
It is definitely bigger. I believe I read somewhere last week that more people are dying from od's now than die in car crashes.

I think there will be a national plan, because this epidemic affects normal people. I.e., rural white folks.
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Re: Opioids

Post by Rex »

Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?

While the War On Drugs has been a complete disaster, and I'd like to see us pretty much scrap it, surely this epidemic has reached a level where we need to come up with some sort of national plan.
It's white people in the suburbs this time, do the numbers matter?
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Re: Opioids

Post by Shirley »

Rex wrote:
Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?

While the War On Drugs has been a complete disaster, and I'd like to see us pretty much scrap it, surely this epidemic has reached a level where we need to come up with some sort of national plan.
It's white people in the suburbs this time, do the numbers matter?
That's why it's surprising that it's taken so long. Granted, this means we'll deal with the problem with treatment centers instead of prison sentences, but that's almost certainly better anyway.
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Re: Opioids

Post by Rex »

I think like a lot of things that happen in the suburbs, the initial instinct was to hide it in the closet and pretend it wasn't an epidemic.
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Re: Opioids

Post by BSF21 »

Rex wrote:
Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?

While the War On Drugs has been a complete disaster, and I'd like to see us pretty much scrap it, surely this epidemic has reached a level where we need to come up with some sort of national plan.
It's white people in the suburbs this time, do the numbers matter?
This is spot on. Rx abuse has it's backgrounds inside white suburbia.
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Re: Opioids

Post by SportsDoc »

This is a serious problem.

As a prescriber, I feel rules allow for too many pills to be prescribed at a time. It is not unusual for people with chronic pain or major surgeries to be given anywhere from 120-240 pills in 1 prescription.

Why?

Because the DEA doesn't allow for refills or phoned in prescriptions for Schedule II drugs, like Percocet, and prescribers don't like to have to continually rewrite. The DEA rule, while well intended, has resulted in these large dose single prescriptions which are ripe for abuse on many levels.

Some states have allowed prescribers to monitor patient prescription use, which should be good, but in my experience works against the prescriber. Case in point, I had a patient for many years who suddenly came in with unexplained dental pain. After a couple writes for 12 hydrocodones I checked the online site and found over the past 6 months the patient had received over 1,100 Schedule II pills from several practioners. I told the spouse and primary care giver my concerns. Result. Never saw the patient again and never heard back from the primary.

Seems a lot of people want to sweep this under the rug.
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Re: Opioids

Post by Gunpowder »

This has been going on for 20 years now in the burbs, but it definitely seems to be affecting wider ranges of people in wider ranges of places. I wouldn't wish heroin and heroin withdrawal on my worst enemy.

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Re: Opioids

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After my brain surgery I got a prescription for 50 hydrocodone (about a two-week supply if I took it at scheduled intervals, which I very much had to for the first 10 days. Your skull re-fusing itself back together is not a comfortable feeling).

I was supposed to get 1 refill of 50 pills, but it took almost 4 days and hunting around at several pharmacies to get a refill because there was basically no supply in southern Nevada at the time. Fortunately I had seen the writing on the wall and had squirreled away enough to get me through those days by taking only about 2 a day instead of 4 though it made for some uncomfortable hours watching the clock and dealing with the pain.

It gave me an insane amount of empathy for people dealing with chronic pain, not only the need to medicate it, but the issues with getting pain meds and the possibility of addiction not to mention side effects from continued use (don't get me started on my uncle's experience dealing with his end of life from lymphoma and the issues he had to deal with on managing pain and all of the hoops he had to jump through).
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Re: Opioids

Post by howard »

The opiate crisis is a wonderful example of the federal government getting overly involved in medical care, for well intentioned reasons, and completely fucking things up, resulting in death and mayhem.

The government fuckup by no mean exonerates Big Pharma for their role with the introduction of Oxycontin. But the fact that the government is much more responsive to the desires of Big Pharma rather than listening to, oh I don't know, the actual doctors on the front lines, is a huge part of the story.

In brief. Roughly 20 years ago, government bureaucrats became aware of a real problem in medicine. Pain, acute and chronic, was frequently undertreated by us. Real problem, resulting only in part by the regulation of opiates, but the major cause was poor education and awareness of physicians.

So the federal government went whole hog in promoting education, recognition of chronic pain problems, and actively encouraged much more prescription of opiates. They told us, "you aren't giving patients enough painkillers." They were correct, but they way overdid it.

Now, "you are giving patient too many painkillers. Even though we told you to give more." In part because Purdue Pharma told the government, "you must change doctor's behavior and prescribe more of our hugely profitable drug."

For fucks sake. I watched this entire sad story over the decades. There is tons more to the story, that is just one part of the huge fail, by society not just government. All I can do is smfh.
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Re: Opioids

Post by howard »

Oh, here is another side. The drug which is the antidote for opiate overdose, naloxone, used to cost one dollar a dose, about 7-8 years ago. But some pharma company gained a monopoly. Cost for a vial now is, wholesale, $34. A pre-filled syringe, which would be stocked by ambulances and first aid kits, $71.50, wholesale. Pitiful, this country.
Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?
I don't think so, but I have not looked at the numbers lately. I think because the crack boom of the 80s was predominantly black people in the inner city, this seems bigger. This is white people, across all income groups and communities, rural suburban and affluent urban.

The percentage of the community that crack afflicted was much larger, so that may skew my impression.
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Re: Opioids

Post by The Sybian »

Shirley wrote:we need to come up with some sort of national plan.
Like prescribing marijuana for pain relief rather than modified heroin?
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Re: Opioids

Post by brian »

Marijuana is fine and I'm absolutely pro-medicinal and recreational pot but it's just not going to cut it for serious pain. It's just not.
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Re: Opioids

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howard wrote:But the fact that the government is much more responsive to the desires of Big Pharma rather than listening to, oh I don't know, the actual doctors on the front lines, is a huge part of the story.
When you doctors start ponying up campaign donations and bribes rivaling Big Pharma, maybe to government will start listening to you.

Brian, that fucking sucks you had to skimp on the pain meds. Same problem with stimulants, if I don't bring in my prescription at least 5 days early, there is a good chance I am driving town to town looking for a pharmacy that has any in stock. My new doctor is able to prescribe narcotics online somehow. She told me it is because she is special. I laughed, but she gave me a serious glare and repeated that she is special. She is sexy as fuck, so maybe that gets her into her special club. She is Russian, so the glare and serious tone in repeating that she is special kind of freaked me out. I'm hoping next visit she will take out the ball gag and let me lick her boot.
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Re: Opioids

Post by howard »

brian wrote:Marijuana is fine and I'm absolutely pro-medicinal and recreational pot but it's just not going to cut it for serious pain. It's just not.
Generally, and in most cases, that is true. But some types of pain weed is wonderful, and even better than opiates, for selected patients.

The first that comes to mind is pancreatic cancer can press against nerves in your GI tract that cause aching, cramping type pain. Different kind of nerve fibers than your usual injury or surgical incision pain. Weed works nicely for a lot of patients with that type of 'visceral' pain.
Who knows? Maybe, you were kidnapped, tied up, taken away and held for ransom.

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Re: Opioids

Post by Rex »

howard wrote:Oh, here is another side. The drug which is the antidote for opiate overdose, naloxone, used to cost one dollar a dose, about 7-8 years ago. But some pharma company gained a monopoly. Cost for a vial now is, wholesale, $34. A pre-filled syringe, which would be stocked by ambulances and first aid kits, $71.50, wholesale. Pitiful, this country.
Shirley wrote:Without doing any research, this seems like an order of magnitude bigger than any of our previous drug problems, including the crack boom of the 80s, right?
I don't think so, but I have not looked at the numbers lately. I think because the crack boom of the 80s was predominantly black people in the inner city, this seems bigger. This is white people, across all income groups and communities, rural suburban and affluent urban.

The percentage of the community that crack afflicted was much larger, so that may skew my impression.
Totally spitballing here, but I think that the death rate is higher in the present opioid epidemic, but the hospitalization rate was higher for crack. Seems to me that crack was less lethal, but I am neither a doctor nor a Holiday Inn Express guest.
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Re: Opioids

Post by howard »

Crack kills slowly, opiates very quickly, as a general rule. Always exceptions (Len Bias/Jerry Garcia).
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Re: Opioids

Post by Rush2112 »

howard wrote:
brian wrote:Marijuana is fine and I'm absolutely pro-medicinal and recreational pot but it's just not going to cut it for serious pain. It's just not.
Generally, and in most cases, that is true. But some types of pain weed is wonderful, and even better than opiates, for selected patients.

The first that comes to mind is pancreatic cancer can press against nerves in your GI tract that cause aching, cramping type pain. Different kind of nerve fibers than your usual injury or surgical incision pain. Weed works nicely for a lot of patients with that type of 'visceral' pain.

They also have super high CBD / low THC shit so it helps even more with the pain management.
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Re: Opioids

Post by DaveInSeattle »

Again...read that book that I mentioned above. It goes into heart-breaking detail about this whole story.
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Re: Opioids

Post by Johnnie »

My home city has been ravaged by it too. My sister says that the stuff is cheap as dirt and plentiful.
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Johnnie wrote:My home city has been ravaged by it too. My sister says that the stuff is cheap as dirt and plentiful.
In that book, it talks about how the mexican cartels can bring the cheap brown mexican heroin across the border, and then they do tricks like hang out by pain clinics to get people switched off of oxy and onto heroin. And they figured out a delivery system...basically they have guys driving around with small balloons full of smack in their mouths, waiting for cell calls and then they deliver the stuff right to people.
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Re: Opioids

Post by howard »

I've heard of that book, I'll put it in the queue.

Johnnie, there is a movie you might enjoy that is set in Charlestown (I don't remember which town is your home) that deals with this topic. Cool little low budget indie movie, I found it realistic. Called Oxy-Morons, I think it is on Amazon Prime.

http://www.imdb.com/title/tt1510926/

Trailer is here:

https://oxymoronsthemovie.wordpress.com
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Re: Opioids

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From an article just this morning:
The city has had 232 opioid-related overdoses since January and 34 fatal overdoses, he said. While prescription opioids and heroin are still major factors, the sale and use of fentanyl has exacerbated the problem, he said. Rice said more than 65 percent of all fatal overdoses in New Hampshire are related to fentanyl.
That's Nashua, home to 85,000 people and the recently-named 16th-best place to live in America, according to Money Magazine. Though the neighborhoods where the deaths are occurring are decidedly NOT middle class suburbia.
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Re: Opioids

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howard wrote:I've heard of that book, I'll put it in the queue.

Johnnie (I don't remember which town is your home)
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Re: Opioids

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Ryan wrote:That's Nashua, home to 85,000 people and the recently-named 16th-best place to live in America, according to Money Magazine. Though the neighborhoods where the deaths are occurring are decidedly NOT middle class suburbia.
But close enough the suburban kids don't have to drive very far.
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Re: Opioids

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brian wrote:After my brain surgery I got a prescription for 50 hydrocodone (about a two-week supply if I took it at scheduled intervals, which I very much had to for the first 10 days. Your skull re-fusing itself back together is not a comfortable feeling).

I was supposed to get 1 refill of 50 pills, but it took almost 4 days and hunting around at several pharmacies to get a refill because there was basically no supply in southern Nevada at the time. Fortunately I had seen the writing on the wall and had squirreled away enough to get me through those days by taking only about 2 a day instead of 4 though it made for some uncomfortable hours watching the clock and dealing with the pain.

It gave me an insane amount of empathy for people dealing with chronic pain, not only the need to medicate it, but the issues with getting pain meds and the possibility of addiction not to mention side effects from continued use (don't get me started on my uncle's experience dealing with his end of life from lymphoma and the issues he had to deal with on managing pain and all of the hoops he had to jump through).
One word: Dilaudid.
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Re: Opioids

Post by Johnnie »

DaveInSeattle wrote:
Johnnie wrote:My home city has been ravaged by it too. My sister says that the stuff is cheap as dirt and plentiful.
In that book, it talks about how the mexican cartels can bring the cheap brown mexican heroin across the border, and then they do tricks like hang out by pain clinics to get people switched off of oxy and onto heroin. And they figured out a delivery system...basically they have guys driving around with small balloons full of smack in their mouths, waiting for cell calls and then they deliver the stuff right to people.
So Donald Trump is half right?

But holy shit is that horrible.
howard wrote:I've heard of that book, I'll put it in the queue.

Johnnie, there is a movie you might enjoy that is set in Charlestown (I don't remember which town is your home) that deals with this topic. Cool little low budget indie movie, I found it realistic. Called Oxy-Morons, I think it is on Amazon Prime.

http://www.imdb.com/title/tt1510926/

Trailer is here:

https://oxymoronsthemovie.wordpress.com
Syb has it right. But yea, I'll check that out.
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Re: Opioids

Post by DaveInSeattle »

Bumping this to say that the author of the book I keep bringing up, "Dreamland" (Sam Quinones) is on the most recent episode of WTF with Marc Maron. Worth a listen if you are interested in this subject.
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Re: Opioids

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mister d wrote:Couldn't have pegged me better.
EnochRoot wrote:I mean, whatever. Johnnie's all hot cuz I ride him.
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Re: Opioids

Post by Gunpowder »

Wow. That's crazy. I can't even think of an analogous past event.

But, fortunately, fentanyl has been replaced by a new and even more potent super-heroin.

http://wsvn.com/news/local/over-50-dead ... rida-drug/
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Re: Opioids

Post by Rex »

Killing your customer base seems like a bad business plan, but then again, if I had better business instincts I wouldn't have gone to law school.
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Re: Opioids

Post by Rex »

It is typically used to tranquilize elephants stronger than most other drugs.
I'm not sure exactly what that sentence is trying to convey, but it can't be good.
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