Lets talk about the opioid crisis

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Turdacious
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Lets talk about the opioid crisis

Post by Turdacious » Tue Mar 14, 2017 2:47 am

The nation’s opioid epidemic is changing the way law enforcement does its job, with police officers acting as drug counselors and medical workers and shifting from law-and-order tactics to approaches more akin to social work.
https://www.washingtonpost.com/national ... 379ecdf558.
Complicated, multi-faceted issue. Discuss.
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Re: Lets talk about the opioid crisis

Post by Sassenach » Tue Mar 14, 2017 3:45 am

Over-prescribing is an enormous part of the problem in my opinion. I recently had my tonsils out and discussed with my doctor at length about NOT wanting opioids (for a variety of issues but mostly because they make me feel fucking disgusting) only to be told my only option for take home medication was a less potent opioid - which I still have half a bottle of left because I was prescribed 50 of them. I woke up in the recovery room to hear the nurse saying "okay, I'm giving you fentanyl for short term pain and dilaudid for long-term pain". I had to tell her three times not to give me any more. I had to stay overnight for observation and every single time the nurse came in to give me my 325mg of tylenol and shot of toradol I was reminded I could have up to 15mg of oxy whenever I wanted.

I read this a few days ago: https://www.washingtonpost.com/news/to- ... 113deb5a75

I thought the results were pretty interesting - but the scarier part to me was that they don't really seem to teach doctors how much pain meds someone would need for a particular surgery.

From a law enforcement perspective - I think I've seen an institutional change over the past four years or so. I think law enforcement is slowly starting to realize these people don't necessarily need to be caught up in the justice system but at the same time we don't always have the resources to help them. We see the same people over and over, and sometimes the person just escalates things to the point of having to be put in jail either because that's where they want to go or they've done something really criminal trying to get money for more drugs.

It's definitely a big community health issue.
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Re: Lets talk about the opioid crisis

Post by Turdacious » Tue Mar 14, 2017 4:04 am

Some organizations are getting on the targeting opioids effectively bandwagon.
Well, one anyway. http://khn.org/news/hmo-doctors-take-pa ... criptions/
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Re: Lets talk about the opioid crisis

Post by Sassenach » Tue Mar 14, 2017 4:16 am

Turdacious wrote:Some organizations are getting on the targeting opioids effectively bandwagon.
Well, one anyway. http://khn.org/news/hmo-doctors-take-pa ... criptions/
They also pushed colleagues to expand the use of non-drug options for chronic pain sufferers: physical therapy, acupuncture, cognitive behavioral therapy, healthier diets and increased exercise.

Five years into its initiative, Kaiser’s Southern California operation reports prescriptions of opioids have plunged.

Prescriptions of opioid pills such as Vicodin and Percocet in amounts greater than 200 tablets dropped from 2,500 a month to almost zero, according to the HMO. So, too, have prescriptions that include potentially dangerous combinations of muscle relaxants, anti-anxiety medications and opioids, as well as prescriptions of brand-name opioids in general.
Yup. They have to turn off the drug fountain and stop creating new addicts before anything substantial can be done down stream.
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Re: Lets talk about the opioid crisis

Post by JimZipCode » Tue Mar 14, 2017 4:41 am

Sassenach wrote:I read this a few days ago: https://www.washingtonpost.com/news/to- ... remarkable
I read that a few days ago, too. Extremely interesting.
At least they're taking a first step toward some data-driven guidelines.
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Re: Lets talk about the opioid crisis

Post by johno » Tue Mar 14, 2017 5:34 am

Whatever our Overlords deem we deserve....
The best lack all conviction, while the worst
Are full of passionate intensity.

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Re: Lets talk about the opioid crisis

Post by WildGorillaMan » Tue Mar 14, 2017 12:07 pm

This was an interesting article about the big business decisions that drove the opioid crisis.

http://www.theglobeandmail.com/news/inv ... e33448409/


And none of the drug company executives who made this happen will ever see the inside of a jail cell.
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Re: Lets talk about the opioid crisis

Post by Turdacious » Tue Mar 14, 2017 2:17 pm

A big part of the problem is on the public side.
Medicare enables overprescribing
https://www.propublica.org/article/frau ... hdog-finds
https://www.propublica.org/article/a-ra ... ug-program
And the DEA, hamstrung by a complicit WH and Congress over the last eight years, has been ineffective
https://www.propublica.org/article/drug ... d-epidemic
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Re: Lets talk about the opioid crisis

Post by Turdacious » Tue Mar 14, 2017 2:18 pm

Of coarse, if someone wants to use opioids for recreational purposes, should they have that right? Interested to see if there is an argument here from that perspective.
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Re: Lets talk about the opioid crisis

Post by dead man walking » Tue Mar 14, 2017 2:39 pm

i've got about 30 oxy sitting in my medicine cabinet, a remnant from my surgery a few years ago.

awhile back, doctors were encouraged to be more aggressive managing pain. so they gave out pills.

now we've got a too many pills in circulation and docs are encouraged not to give out so many.

yo-yoing is a time-honored method of finding the sweet spot.
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Re: Lets talk about the opioid crisis

Post by johno » Tue Mar 14, 2017 3:36 pm

This is just me: I am a Big Boy. I know when I'm in pain. And when the pain is great enough, I will take an opioid painkiller. It may make me mildly loopy, which is pleasant. When the pain subsides, I stop.

Who wants to tell me when I'm in pain that I can't have a painkiller? Or that I'm not really in pain?

*****

Conservatives totally forget Free Market economics when it comes to drugs. Uncontrolled quality? Skyrocketing prices? Overdoses? Extralegal dispute resolution? Drug Gangs? Young men destroying their futures with drug convictions? Cops kicking in doors without knocking? Hmm.

Wonder what causes all that? If only we could look to some experience in our past (say the 1930's) when we made a dangerous substance illegal, worsening the situation...but learned from our mistake, reversed course, legalized the substance, and learned to live with it.

Regardless of good intentions, Big Brother creates the Black Market. The OD's result from that.



PS - I had to snicker at the Flashbang in the Fentanyl stash house. Hilarious.
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Re: Lets talk about the opioid crisis

Post by dead man walking » Tue Mar 14, 2017 4:12 pm

johno wrote:Conservatives totally forget Free Market economics when it comes to drugs.
just a friendly reminder, johno, that there are no "free" markets. markets have rules. with good rules, the market works. impose bad rules, the market has distortions. but always there are rules.
Big Brother creates the Black Market. The OD's result from that
.
really. are you saying we'd wouldn't have any od's if opioids were available as alcohol is? that strikes me as, uh, optimistic.
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Re: Lets talk about the opioid crisis

Post by johno » Tue Mar 14, 2017 4:37 pm

dead man walking wrote:
Big Brother creates the Black Market. The OD's result from that
.
really. are you saying we'd wouldn't have any od's if opioids were available as alcohol is? that strikes me as, uh, optimistic.
Not all. Just the vast majority. Consider how much more likely an OD is when there is no quality control of the product...when a user thinks he's getting the same heroin he got yesterday, but instead gets fentanyl mixed with God knows what.
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Re: Lets talk about the opioid crisis

Post by Blaidd Drwg » Tue Mar 14, 2017 4:48 pm

dead man walking wrote:i've got about 30 oxy sitting in my medicine cabinet, a remnant from my surgery a few years ago.

awhile back, doctors were encouraged to be more aggressive managing pain. so they gave out pills.

now we've got a too many pills in circulation and docs are encouraged not to give out so many.

yo-yoing is a time-honored method of finding the sweet spot.

Talk to me goose.
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Re: Lets talk about the opioid crisis

Post by Sassenach » Tue Mar 14, 2017 6:22 pm

WildGorillaMan wrote:This was an interesting article about the big business decisions that drove the opioid crisis.

http://www.theglobeandmail.com/news/inv ... e33448409/


And none of the drug company executives who made this happen will ever see the inside of a jail cell.
Jesus.
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Re: Lets talk about the opioid crisis

Post by TerryB » Wed Mar 15, 2017 4:01 am

I don't click links.
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Re: Lets talk about the opioid crisis

Post by Turdacious » Wed Mar 15, 2017 5:40 am

Opioid painkillers stimulate receptors in the brain and elsewhere to produce a powerful pain-numbing effect. They also lessen anxiety and depression—two common side-effects of intense pain. The sensation they induce is often described as euphoria. Some, such as morphine, are made from the opium poppy; others, such as oxycodone, are semi-synthetic or synthetic. They are highly addictive: even brief use can be followed by withdrawal symptoms. As a result, for most of the 20th century they were usually reserved for acute pain, after a serious accident or surgery, say, and palliative care, a branch of medicine dedicated to curbing the pain of those with illnesses such as cancer or AIDS.

But in the 1980s a series of papers by American researchers claimed that opioids could be used safely for longer periods. The evidence was slight, but, combined with a formidable marketing effort by drug firms, it led to American doctors prescribing opioids with abandon for chronic, non-terminal pain
http://www.economist.com/news/internati ... ntries-die
TL/DR (and to be fair I didn't quote the underlying theme of the article)-- opioid addiction is a white people problem. Is that right? Discuss.
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Re: Lets talk about the opioid crisis

Post by DrDonkeyLove » Wed Mar 15, 2017 12:43 pm

It's about lead in fuel but otherwise it's pretty much the same story. Some corruptions are timeless.
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Re: Lets talk about the opioid crisis

Post by Herv100 » Wed Mar 15, 2017 3:53 pm

Who cares
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Re: Lets talk about the opioid crisis

Post by climber511 » Wed Mar 15, 2017 4:12 pm

I just had an abscessed tooth - then a dry socket after extraction - couldn't get anything prescribed without a struggle. So there is the reverse issue as well now. Finally was able to get 10 Hydrocodone and that was all. Thankfully it was enough to get me through but it could have been rough if it had gone on any longer.

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Re: Lets talk about the opioid crisis

Post by Bobby » Wed Mar 15, 2017 7:44 pm

We just got the happy news that we have at least a 100 new smoke heroin addicts in Uppsala (Sweden and it isn`t that big 200 000 something) and all people who claim to be youngsters/teens from the hazar people of Afghanistan.So,wouldn`t say opiate addiction is a white people addiction.With any luck we will ship them back to Iran where they arrived from (they claim that they are afghan refugees,but they arrived from Iran and I don`t believe our idiots in charge will do anything).
You`ll toughen up.Unless you have a serious medical condition commonly refered to as
"being a pussy".

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Re: Lets talk about the opioid crisis

Post by Sassenach » Wed Mar 15, 2017 8:26 pm

Turdacious wrote:
Opioid painkillers stimulate receptors in the brain and elsewhere to produce a powerful pain-numbing effect. They also lessen anxiety and depression—two common side-effects of intense pain. The sensation they induce is often described as euphoria. Some, such as morphine, are made from the opium poppy; others, such as oxycodone, are semi-synthetic or synthetic. They are highly addictive: even brief use can be followed by withdrawal symptoms. As a result, for most of the 20th century they were usually reserved for acute pain, after a serious accident or surgery, say, and palliative care, a branch of medicine dedicated to curbing the pain of those with illnesses such as cancer or AIDS.

But in the 1980s a series of papers by American researchers claimed that opioids could be used safely for longer periods. The evidence was slight, but, combined with a formidable marketing effort by drug firms, it led to American doctors prescribing opioids with abandon for chronic, non-terminal pain
http://www.economist.com/news/internati ... ntries-die
TL/DR (and to be fair I didn't quote the underlying theme of the article)-- opioid addiction is a white people problem. Is that right? Discuss.
I does seem like white people are dying earlier: http://www.pnas.org/content/112/49/15078.abstract
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Re: Lets talk about the opioid crisis

Post by DrDonkeyLove » Wed Mar 15, 2017 8:52 pm

Sassenach wrote:
Turdacious wrote:
Opioid painkillers stimulate receptors in the brain and elsewhere to produce a powerful pain-numbing effect. They also lessen anxiety and depression—two common side-effects of intense pain. The sensation they induce is often described as euphoria. Some, such as morphine, are made from the opium poppy; others, such as oxycodone, are semi-synthetic or synthetic. They are highly addictive: even brief use can be followed by withdrawal symptoms. As a result, for most of the 20th century they were usually reserved for acute pain, after a serious accident or surgery, say, and palliative care, a branch of medicine dedicated to curbing the pain of those with illnesses such as cancer or AIDS.

But in the 1980s a series of papers by American researchers claimed that opioids could be used safely for longer periods. The evidence was slight, but, combined with a formidable marketing effort by drug firms, it led to American doctors prescribing opioids with abandon for chronic, non-terminal pain
http://www.economist.com/news/internati ... ntries-die
TL/DR (and to be fair I didn't quote the underlying theme of the article)-- opioid addiction is a white people problem. Is that right? Discuss.
I does seem like white people are dying earlier: http://www.pnas.org/content/112/49/15078.abstract
This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity.
Feels like the behavior of a people who have lost their way and don't have the tools to cope with it.
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Re: Lets talk about the opioid crisis

Post by nafod » Thu Mar 16, 2017 12:08 pm

DrDonkeyLove wrote:
Sassenach wrote:
Turdacious wrote:
Opioid painkillers stimulate receptors in the brain and elsewhere to produce a powerful pain-numbing effect. They also lessen anxiety and depression—two common side-effects of intense pain. The sensation they induce is often described as euphoria. Some, such as morphine, are made from the opium poppy; others, such as oxycodone, are semi-synthetic or synthetic. They are highly addictive: even brief use can be followed by withdrawal symptoms. As a result, for most of the 20th century they were usually reserved for acute pain, after a serious accident or surgery, say, and palliative care, a branch of medicine dedicated to curbing the pain of those with illnesses such as cancer or AIDS.

But in the 1980s a series of papers by American researchers claimed that opioids could be used safely for longer periods. The evidence was slight, but, combined with a formidable marketing effort by drug firms, it led to American doctors prescribing opioids with abandon for chronic, non-terminal pain
http://www.economist.com/news/internati ... ntries-die
TL/DR (and to be fair I didn't quote the underlying theme of the article)-- opioid addiction is a white people problem. Is that right? Discuss.
I does seem like white people are dying earlier: http://www.pnas.org/content/112/49/15078.abstract
This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity.
Feels like the behavior of a people who have lost their way and don't have the tools to cope with it.
It reminds me of life on the Indian reservations.
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Re: Lets talk about the opioid crisis

Post by Turdacious » Fri Mar 17, 2017 3:05 pm

According to the Ohio Department of Health, the number of opioid-related deaths skyrocketed from 296 in 2003 to 2,590 in 2015 — a 775 percent jump over a 13-year period. These numbers include deaths involving prescription opioids, heroin and fentanyl, which is similar to morphine but is 50 to 100 times more potent.
https://www.washingtonpost.com/news/to- ... 54cb91ac1a

The article also goes into toxicology and other costs that are borne at a county level.
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