tag:blogger.com,1999:blog-8078379512095504946.post3306812614909161560..comments2024-03-26T06:17:49.527-07:00Comments on Had Enough Therapy?: Anatomy of the Opioid CrisisStuart Schneidermanhttp://www.blogger.com/profile/12784043736879991769noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-8078379512095504946.post-31623275137193203212018-11-16T09:07:34.360-08:002018-11-16T09:07:34.360-08:00Look closely at the anti-big pharma movement and y...Look closely at the anti-big pharma movement and you'll find anti-Capitalist fingerprints. It amazes me how many people who should know better buy into this ruse.MikeyParkshttps://www.blogger.com/profile/10340315556967357170noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-27989623390065029822018-11-12T11:53:01.273-08:002018-11-12T11:53:01.273-08:00Generally, I agree with most of the content on thi...Generally, I agree with most of the content on this blog. Wonderful insight that I appreciate.<br /><br />I do not, however, agree with the conclusions presented in the referenced citations. The number of accidental deaths related to drug overdoses, and in particular those invovling opiods, has increased every year since the newer restrictions were placed on prescription opiods such as oxycodone and hydrocodone. These drugs are dangerous when abused, not necessarily when prescribed, as NIDA estimates that 8-12% of people prescribed opiods for pain develop an opiod use disorder. <br /><br />If the opiod crisis, as defined by the number of overdose deaths, was fueled by the over-prescribing and over-consumption of these opiods, then the curtailing the prescribing of these medications should have seen a sharp decline in the number of overdose deaths attributed to these medications. We do not. Instead, the rate of overdose deaths caused by presecription opiods remained nearly constant from 2010-2017.<br /><br />For example, see https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates, which shows death rates greatly increased after enactment of the new presecribing guidelines and limitations on opiod prescriptions.<br /><br />The culprits are heroin and fentanyl, whether alone or in combination. In 2017, fentanyl is attributed to 30,000 deaths from overdose, whereas heroin is attributed to 16,000 deaths from overdose (these groupings are not mutually exclusive). Note also there is a dramatic increase in deaths involving cocaine and methamphetamine during the same 2010-2017 period. These death rates, and their increases since 2010, are unlikely related to the overprescribing of opiods for pain relief. <br /><br />More importantly, from 2010-2017 the number of deaths from prescription opiods remained constant while the number of deaths from illicit opiods drastically increased. The net effect of limiting opiod prescriptions was to cause more pain to patients--there was no harm reduction. <br /><br />Why is this even a story? What prescription opiod epidemic? I do not see one--only an illicit drug overdose epidmic can be seen from the data estimates from 2010-2017. <br /><br />Instead, we need to consider the number of annual deaths and costs related to smoking (480,000 people; $300 billion) and alcohol (88,000 people; $249 billion), so that we can keep the "prescription opiod epidemic" (19,354 people; $78.5 billion) in perspective. <br /><br />Give the patients their pain relief.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-73513345462964820682018-11-12T02:43:10.379-08:002018-11-12T02:43:10.379-08:00This comment has been removed by a blog administrator.Sensory Bouncehttps://www.blogger.com/profile/01299686552726919159noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-1782954265650881492018-11-11T10:30:21.961-08:002018-11-11T10:30:21.961-08:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-26642627603563750382018-11-11T05:18:53.330-08:002018-11-11T05:18:53.330-08:00It's been over three decades since Barbara Gor...It's been over three decades since Barbara Gordon exposed the addictive quality of Valium in her book, I'm Dancing as Fast as I Can.... I had thought that most physicians had gotten the message... but apparently not.Stuart Schneidermanhttps://www.blogger.com/profile/12784043736879991769noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-6262202380692260852018-11-11T04:12:36.715-08:002018-11-11T04:12:36.715-08:00It is not just opioids. My wife is currently with...It is not just opioids. My wife is currently withdrawing from Ativan. It was so blithely and readily prescribed, who would have thought it to be so destructive? After not-very-exhaustive internet research, one comes to the conclusion that it is a veritable scourge, withdrawal from which is often described by those with personal knowledge as worse and more difficult than heroin addiction. Look it up if you doubt me; a simple google inquiry about benzo withdrawal should satisfy any curiosity. Yet doctors prescribe benzos (Ativan, Valium, etc.) at staggeringly high rates. Same with SSRI's. We have, in fact become a nation of mind-numbed robots. So sad.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-25418398129096778442018-11-11T03:19:13.884-08:002018-11-11T03:19:13.884-08:00For those who are discomfited by the fact that I a...For those who are discomfited by the fact that I am not an expert, if they had read more carefully they would have seen that I do not offer my views... I summarize and report the analysis of an expert in the field... Stuart Schneidermanhttps://www.blogger.com/profile/12784043736879991769noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-22103425348494775752018-11-10T18:45:28.246-08:002018-11-10T18:45:28.246-08:00ASM826, abuse of opioids far more terrifying than ...ASM826, abuse of opioids far more terrifying than small arms. <br /><br />Every report of Opioid addiction seems to encounter the hardest time avoiding it for good once they have ceased using it. Apparent relapse is easy, even if it was many months. Possibly worse that quitting alcohol.<br /><br />I have not experience with opioids other than a codeine-tylenol prescription which didn't help pain at all but instead made my skin crawl and itch. So I gave up on it and learned to like the pain with some ibuprofen.<br /><br />Thanks for sharing your story ASM. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-27910733551176493612018-11-10T16:50:13.409-08:002018-11-10T16:50:13.409-08:00My mother died of cancer in hospice two years ago....My mother died of cancer in hospice two years ago. Her last couple of months were made comfortable, and then as the end neared, tolerable by morphine. If she had not had it, she would have died screaming. In the effort to deal with the abuse of opioids and the problems it brings, let's not forget that there is a use to these drugs in relieving the suffering of those in incurable pain.ASM826https://www.blogger.com/profile/04017388670319590449noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-7465042376174868002018-11-10T16:42:22.857-08:002018-11-10T16:42:22.857-08:00Officer Margraf of the Comment Thread Police just ...Officer Margraf of the Comment Thread Police just arrived, demanding more information. They are the guys who put the "dud" in "dudgeon".Dr. Irredeemable Dregnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-56777524230976435582018-11-10T14:02:25.221-08:002018-11-10T14:02:25.221-08:00I had heart surgery and was sent home with oxycodo...I had heart surgery and was sent home with oxycodone. The next day I was pain-free. After a month, I took all the oxy to the local P.D.'s drug dump.Sam L.https://www.blogger.com/profile/00996809377798862214noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-78702300665000627752018-11-10T13:38:57.857-08:002018-11-10T13:38:57.857-08:00Dorothy Margraf,
The problem is biology itself is...Dorothy Margraf,<br /><br />The problem is biology itself is a WEAPON, as such its future appears to belong to governments, MICs, large corporations (and their networks), intelligence, and the engineering scientists on their payrolls. <br /><br />Individual doctors and patients CANNOT compete against this reality.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-55069817654921501472018-11-10T12:58:58.544-08:002018-11-10T12:58:58.544-08:00I think the article can be covered by the opening ...I think the article can be covered by the opening sentence. "I am hardly expert on this matter, but America’s opioid crisis deserves close examination." Better it should have been written by someone an expert in the field. The article appears to be written by someone not knowledgeable in the field of medicine, but very skilled in doing internet research. When doctors must be more responsive to the government than they are to their patients, we are in big trouble. Someone get out the literature on bioethics and the eugenics movement. In addition, we need to find out who stands to make big money in the legalization of marijuana as a much easier to get, legal pain killer. We need more information on who is bringing fentanyl into this country in such large amounts that are killing so many people. Doctors I've talked to know this demonization of opioids is one big scam and, again, it would be interesting to know who is behind it. <br /><br />The comments are more informative than the article. Well, with exception of simplistic terms like 'good pain' and "bad pain" based on one experience with pain and silly comments about fat people and fried chicken. Dorothy Margrafhttps://www.blogger.com/profile/16950986826060755676noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-73223065993969144522018-11-10T12:39:44.292-08:002018-11-10T12:39:44.292-08:00What's most amazing is the duration of the pro...What's most amazing is the duration of the problem, while we still can't seem to stop it. I suppose the money is just too good, and the short term benefits of pain relief too attractive.<br /><br />I broke my collarbone in a bike accident in 2005 and was prescribed vicodin for at least 2 weeks. I didn't even know what was in it, or that it could be addictive, only recently looked it up to see it contains an opioid, hydrocodone. I used less than half of it, and saved the rest for a few years unused. I remember at the emergency room, they asked my pain level 1-10, and I think I said 3 when I wasn't moving. When an intern stood me up and tried to put a shoulder brace on me, I could have said 10, but I think "good pain" is the sort that says "Don't do that!", while bad pain keeps hurting no matter what you do.<br />Ares Olympushttps://www.blogger.com/profile/09726811306826601686noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-91531340161111985792018-11-10T12:15:37.105-08:002018-11-10T12:15:37.105-08:00Agreed.Agreed.Dr. Irredeemable Dregnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-24428667746764512842018-11-10T12:01:11.077-08:002018-11-10T12:01:11.077-08:00I would add, anything you destigmatize you also ge...I would add, anything you destigmatize you also get more of.Stuart Schneidermanhttps://www.blogger.com/profile/12784043736879991769noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-2463681307841498292018-11-10T11:28:37.657-08:002018-11-10T11:28:37.657-08:00To begin with, I have been using and teaching stat...To begin with, I have been using and teaching statistics for over 30 years. So stow the lectures for my benefit about correlation and causality.<br /><br />The correlation between the increased abuse of opioids and Medicaid expansion is stunning. When physicians are underpaid, patient load is increasing relative to the supply of providers, and the approved pharmacopeia is limited, one shouldn't be surprised when corners are cut. Medical care delivery systems designed by Congress and a gaggle of professional bureaucrats was never going to work; e.g., the VA and the Indian Health Service. <br /><br />As CB notes, the most acute national overdose problem is with fentanyl and street drug concoctions. BUT... the fact is that between '07 and '12 (interesting years, eh?), 780,000,000 doses of hydrocodone were shipped to WV alone, my home state. The total state population, including children, is less than 2M. Most of the pain pill overdoses have been in four (of 55) counties, and all four are southern (former) coalfield counties, rural and poor, with heavy welfare dependency and high unemployment. The health care sector of the state economy has vastly outperformed any other sector since 2014 (another interesting year). When I visit my family, it's easy to believe that the biggest single state industry is health care, because there's a pain clinic on every corner. And, BTW, obesity - and I mean major lardass obesity that demands a scooter at Wal-Mart, not just fat folks - is off the scale, and virtually every convenience store offers hot fried chicken under the lights and sports an EBT sign in the window. <br /><br />Anything you subsidize, you will get more of. Dr. Irredeemable Dregnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-30664026641339382872018-11-10T10:12:16.475-08:002018-11-10T10:12:16.475-08:00The problem with this theses of 'why opiods...The problem with this theses of 'why opiods' is that it generally ignores most opiod ODs are from fentanyl, often when mixed with other drugs at street level, not oxycodone and other widely prescribed pain medications. It also trades on the myth that 'Big Pharma' and unethical doctors are behind most of the issues we have with health care in the US, not that they are the entirely predictable outcome ofof t over use of third party payors for health care financing.Christopher Bhttps://www.blogger.com/profile/00396671757183163171noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-59526328227831234822018-11-10T08:45:56.581-08:002018-11-10T08:45:56.581-08:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-66773055759563583422018-11-10T08:21:34.876-08:002018-11-10T08:21:34.876-08:00A healthy amount of addiction is a natural sign of...A healthy amount of addiction is a natural sign of being alive. Pain is the same. Too much or too little is a problem with almost anything. Anonymousnoreply@blogger.com