tag:blogger.com,1999:blog-8078379512095504946.post5436824399959326690..comments2024-03-29T04:06:37.402-07:00Comments on Had Enough Therapy?: What Were They Thinking?Stuart Schneidermanhttp://www.blogger.com/profile/12784043736879991769noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-8078379512095504946.post-7708399295071539102019-01-02T16:18:07.170-08:002019-01-02T16:18:07.170-08:00Some great comments. I, too, have been shaking my ...Some great comments. I, too, have been shaking my head of this notion of "overprescribed opiates." In Midlandia where I live, it's difficult to even get nitrous oxide at the dentist. Have multiple root canals, and they'll tell you to take ibufprofen. Not only is it not overprescribed here, but I've lived in 5 states over the past two decades, working in schools, and though I've seen families with probs concerning meth and heroin, prescription opiates are just not a problem.<br /><br />Have been trying to figure out the why's. All I can think of is, two alkaloids in Kratom, which helps with opiate w/drawal, have been patented by Big Pharma and the plant itself is increasingly being banned. That, taken along with the high cost of ever-changing forms of suboxone, seems to explain it. And DT, because he is staunchly anti-drug and alcohol, is taken in by those who would make money from it.<br /><br />The comment above and others I've read saying they are in chronic pain and can no longer get appropriate care for it, mirror what I've seen in real life. There's no prescription opiate crisis. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-51427737320344680122018-12-19T10:14:03.667-08:002018-12-19T10:14:03.667-08:00Dr Lembke makes money and earns fame by playing to...Dr Lembke makes money and earns fame by playing to the notion that there is an opiate crisis. The CDC report has been criticized multiple times for failing EBM. The report was written by people who benefited from the idea that there was an addiction crisis. SAMSHA has surveyed the rate of misuse of prescription drugs since 1974. They have documented that the rate has been decreasing over time. The CDC technical reports themselves admit that there is no uptick in opiate use or death from narcotics. A recent MMWR finally read the death certificates and admit it has been heroin, fentanyl, and cocaine followed by methamphetamine. Dr Zuger is an infectious disease physician whose writing in the NYT follows fashion, not EBM. Please see the recent increase in suicide of poorly treated pain patients along with articles suggesting that up to 50% of prescription overdose deaths are suicide. (CDC MMWR shows oxycodone leads list in known suicides) This is a complex issue and like most complex issues the last place to shed light is the NYT. (There is no famine in the Ukraine, There is no holocaust, There was a Russian conspiracy)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-3658931387968595892018-12-18T21:50:40.327-08:002018-12-18T21:50:40.327-08:00In my case, I’m on warfarin—which is the only drug...In my case, I’m on warfarin—which is the only drug, besides injecting myself with lovenox, that works for my clotting problem. I haven’t taken painkillers for the last 9 years, including anesthesia for dental work. They say Tylenol is ok, but it shoots my INR through the roof. Opioids are one of the few drugs that don’t interact with warfarin, but good luck with that. No painkillers should at least make me a better person, but so far only learned that I hate pain.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-80503420051748481042018-12-18T19:51:11.549-08:002018-12-18T19:51:11.549-08:00I'll agree in a general sense we're all &q...I'll agree in a general sense we're all "morally defective", and we all tend to have a low threshold for pain now, and an absent threshold for pain later. We don't step back and look a the bigger picture, and so solution lies in doing more. So we can ask doctors to document their own choices to give pain meds, and see how which patients fall into addiction, and if they take good notes, and they can record their decision process in each case, and later in the failures see what signs they missed, or where a different choice should have been made.<br /><br />And given opioids have diminishing returns, we should accept any chronic pain that lasts more than days or weeks, needs alternative treatments.<br /><br />But perhaps the biggest problem with meds is 90% of doctors might have high standards and say no, but patients willing to find that 10th doctor will have their addictions enabled. So that suggests opioids should NOT be prescribed without consulting a primary doctor of care.Ares Olympushttps://www.blogger.com/profile/09726811306826601686noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-40603664088184929502018-12-18T09:21:20.941-08:002018-12-18T09:21:20.941-08:00Could you please describe the reasoning behind den...Could you please describe the reasoning behind denying pain control to a person with physical injuries consistent with requring medication?Christopher Bhttps://www.blogger.com/profile/00396671757183163171noreply@blogger.comtag:blogger.com,1999:blog-8078379512095504946.post-65021858157671320492018-12-18T06:10:49.928-08:002018-12-18T06:10:49.928-08:00Many MDs got through their studies and residencies...Many MDs got through their studies and residencies by pleasing authority figures, and once actually in practice, they have no skills for dealing with disapproval and disappointment. They can’t say no becaseu they’ve never heard no.Anonymousnoreply@blogger.com