Opiod crisis?

[whitewave]

Did any of you see this on Daily Mail? Cashiers in California having trouble checking customers out...

http://www.dailymail.co.uk/news/article-5117359/Drugged-cashiers-fall-asleep-register.html

 

[ksinger]

Other than the fact that The Daily Mail (the British equivalent of The Enquirer) is taking serious liberties with extrapolating too much from a video clip, it was just as likely, maybe more, that they were stoned on pot edibles they ate a couple of hours before at lunch time.

There is another, sadder side to the opioid "epidemic": undertreatment of chronic pain. This is not my problem, but from my personal experience, there is also even undertreatment of shorter term acute pain. Doctors now seem to reflexively assume that everyone is an addict all the time, and treat their patients with that level of suspicion. Many also seem have no clue how to properly prescribe opioids, and are too freaked out by the regulatory environment, to bother learning. So, here's some food for thought on that, with a quote from the linked article, that pretty much addresses the tone from The Daily Mail piece, and many other online sources.

http://www.socialworktoday.com/archive/091712p16.shtml

"...for individuals who legitimately require and benefit from opioids, the undertreatment of chronic long-term pain is a problem unrecognized even by those in healthcare due to the focus on opioid abuse. “The media generally does not report the issues around opioid use with accuracy, neutrality, and critical thinking. The tide has shifted from demonizing pain medication to demonizing people with pain, continuing the suffering of millions with untreated or undertreated pain,” says Yvette Colón, PhD, MSW, a psychosocial specialist at The MetaCancer Foundation."

 

[YadaYadaYada]

If this was happening in front of me I wouldn't record it on my phone, I would call the police to have them checked on. They could very easily be robbed and not be able to defend themselves or if it is something more than edibles, they could pass out and go into respiratory failure and die.

It seems that the purpose of recording them was to exploit the situation and use it as a form of entertainment which is sad.

 

[mary poppins]

Daily Mail is a British rag that got the location wrong. I saw the video on Reddit yesterday morning where the location was identified by redditors as Indiana based on Sisters of Savings advertisement in the recording. Sisters of Savings is associated with a car dealership in Noblesville. This definitely does not depict use of marijuana edibles. It's likely opiates, meth or heroin. Ironically, weed, which is often villainized based on improper sc;heduling, can actually help people get off the harder drugs or prevent their use in the first place.

Also posted in the thread was this interesting and horrifying data about the prescription opioid epidemic.
https://www.cdc.gov/drugoverdose/data/prescribing.html Opioids are often the precursor to meth and heroin. Many parts of the US are a sad mess.

 

[whitewave]

I agree it's not edibles and I agree chronic pain patients are back to "expect pain" and "deal with it" now.

 

[ksinger]

Daily Mail is a British rag that got the location wrong. I saw the video on Reddit yesterday morning where the location was identified by redditors as Indiana based on Sisters of Savings advertisement in the recording. Sisters of Savings is associated with a car dealership in Noblesville. This definitely does not depict use of marijuana edibles. It's likely opiates, meth or heroin. Ironically, weed, which is often villainized based on improper sc;heduling, can actually help people get off the harder drugs or prevent their use in the first place.

Also posted in the thread was this interesting and horrifying data about the prescription opioid epidemic.
https://www.cdc.gov/drugoverdose/data/prescribing.html Opioids are often the precursor to meth and heroin. Many parts of the US are a sad mess.

Not demonizing weed, although unless you are experienced with pot edibles with modern pot strains, you might not believe the effects they can have, or how fast and hard they can hit. (A lot of cancer in my family and around me at present, so I have some first-hand OMGs about those). The point was that the rag that The Daily Mail is, is all about sensationalizing (dare I say fictionalizing) headlines. Agreed?

Yes, opioids are a problem. But doctors are now knee-jerking too far in the opposite direction and are often refusing to acknowledge (by assumption of patient overstating pain for express purpose of obtaining pain meds) and treat even limited duration ACUTE pain. It is a real problem. And it's only going to increase.

I've come to the unpleasant realization that in the current environment, for most attacks of acute pain, I'm pretty much on my own. MS is painful, and often suddenly and randomly so. Doctors like to feel that if they can't attribute the reported pain to something (a one-to-one lesion correspondence is a favorite - because if you can't SEE the damage on MRI slice, it can't be there The too large you-must-be-making-it-up-because-I-can't-figure-out-why crowd even amongst neuros, is the scourge of an MS'ers life) They'll give you a lifetime supply of antidepressants if you even look a tiny bit sad, but come in trying to claw your own head off? You're clearly histrionic. Go home, bite on a leather strap. Able to keep it together to string together a coherent sentence? That's pretty damning too, clearly it's not that bad. Go home, bite on a leather strap. Or, nowadays, figure out on your own, how much pot to ingest/inhale to treat yourself. I guess it's OK to do that on your own (and you have to in states where pot is not yet legal), but being a grown up who can actually take an opioid and not instantly become an addict is beyond the realm of possibility. And yes, I personally know people who have standing prescriptions for opioids. But the 2 times in 15 years when I've asked for them for acute pain? Got treated like a drug addict. Both times by doctors who had been my docs for years prior.

mary poppins, none of that rant was directed at you personally. Please don't think it is. I just have too much personal experience and the tales of too many of my MS friends' suffering. Undertreatment of pain is not a problem, until it's you or yours, then you're like, ohhhh, now I get it.

I hope no one here ever "gets it".

 

[Slickk]

Not demonizing weed, although unless you are experienced with pot edibles with modern pot strains, you might not believe the effects they can have, or how fast and hard they can hit. (A lot of cancer in my family and around me at present, so I have some first-hand OMGs about those). The point was that the rag that The Daily Mail is, is all about sensationalizing (dare I say fictionalizing) headlines. Agreed?

Yes, opioids are a problem. But doctors are now knee-jerking too far in the opposite direction and are often refusing to acknowledge (by assumption of patient overstating pain for express purpose of obtaining pain meds) and treat even limited duration ACUTE pain. It is a real problem. And it's only going to increase.

I've come to the unpleasant realization that in the current environment, for most attacks of acute pain, I'm pretty much on my own. MS is painful, and often suddenly and randomly so. Doctors like to feel that if they can't attribute the reported pain to something (a one-to-one lesion correspondence is a favorite - because if you can't SEE the damage on MRI slice, it can't be there The too large you-must-be-making-it-up-because-I-can't-figure-out-why crowd even amongst neuros, is the scourge of an MS'ers life) They'll give you a lifetime supply of antidepressants if you even look a tiny bit sad, but come in trying to claw your own head off? You're clearly histrionic. Go home, bite on a leather strap. Able to keep it together to string together a coherent sentence? That's pretty damning too, clearly it's not that bad. Go home, bite on a leather strap. Or, nowadays, figure out on your own, how much pot to ingest/inhale to treat yourself. I guess it's OK to do that on your own (and you have to in states where pot is not yet legal), but being a grown up who can actually take an opioid and not instantly become an addict is beyond the realm of possibility. And yes, I personally know people who have standing prescriptions for opioids. But the 2 times in 15 years when I've asked for them for acute pain? Got treated like a drug addict. Both times by doctors who had been my docs for years prior.

mary poppins, none of that rant was directed at you personally. Please don't think it is. I just have too much personal experience and the tales of too many of my MS friends' suffering. Undertreatment of pain is not a problem, until it's you or yours, then you're like, ohhhh, now I get it.

I hope no one here ever "gets it".

I get it ksinger and I am sorry you have such pain. I too have chronic pain due to auto immune issues and a cervical fusion (harms cage and plates). It's very hard to get pain relief as the doctors look at you like you're trying to get some drugs to sell or overuse. I half or quarter the small amount of pills I am given and even have had to resort to offering to take friends' old pain pills...they often will help me ease my pain by giving me their leftovers. But it's a real hassle and makes me feel like a druggie.

 

[House Cat]

Not demonizing weed, although unless you are experienced with pot edibles with modern pot strains, you might not believe the effects they can have, or how fast and hard they can hit. (A lot of cancer in my family and around me at present, so I have some first-hand OMGs about those). The point was that the rag that The Daily Mail is, is all about sensationalizing (dare I say fictionalizing) headlines. Agreed?

Yes, opioids are a problem. But doctors are now knee-jerking too far in the opposite direction and are often refusing to acknowledge (by assumption of patient overstating pain for express purpose of obtaining pain meds) and treat even limited duration ACUTE pain. It is a real problem. And it's only going to increase.

I've come to the unpleasant realization that in the current environment, for most attacks of acute pain, I'm pretty much on my own. MS is painful, and often suddenly and randomly so. Doctors like to feel that if they can't attribute the reported pain to something (a one-to-one lesion correspondence is a favorite - because if you can't SEE the damage on MRI slice, it can't be there The too large you-must-be-making-it-up-because-I-can't-figure-out-why crowd even amongst neuros, is the scourge of an MS'ers life) They'll give you a lifetime supply of antidepressants if you even look a tiny bit sad, but come in trying to claw your own head off? You're clearly histrionic. Go home, bite on a leather strap. Able to keep it together to string together a coherent sentence? That's pretty damning too, clearly it's not that bad. Go home, bite on a leather strap. Or, nowadays, figure out on your own, how much pot to ingest/inhale to treat yourself. I guess it's OK to do that on your own (and you have to in states where pot is not yet legal), but being a grown up who can actually take an opioid and not instantly become an addict is beyond the realm of possibility. And yes, I personally know people who have standing prescriptions for opioids. But the 2 times in 15 years when I've asked for them for acute pain? Got treated like a drug addict. Both times by doctors who had been my docs for years prior.

mary poppins, none of that rant was directed at you personally. Please don't think it is. I just have too much personal experience and the tales of too many of my MS friends' suffering. Undertreatment of pain is not a problem, until it's you or yours, then you're like, ohhhh, now I get it.

I hope no one here ever "gets it".

What in the hell do they want you to do for pain?

Have you seen a pain management specialist of some kind?


I’m baffled. My doctor hands out opiates like candy...when I tell her I don’t want them. When I beg for physical therapy and acupuncture.

 

[ksinger]

What in the hell do they want you to do for pain?

Have you seen a pain management specialist of some kind?


I’m baffled. My doctor hands out opiates like candy...when I tell her I don’t want them. When I beg for physical therapy and acupuncture.

It is messed up isn't it? Those who need it can't even get a little (you get a complimentary leather strap to bite on though), while those who don't want it, like you, or worse, those who can't handle it without addiction, can't get them to quit shoving it down their throats. Which was kind of the point of my rant. Grr.

Well, around here you can't get in to see a pain management specialist as a new patient until 4 weeks from next January (typically). Oh yeah, I have some tales there too. Yes, I finally did see a pain management specialist, but since they are usually dealing with chronic pain (which I do have, but long ago decided to just deal with for several reasons) not acute, by the time I got the appointment, the acute pain was past its worst, and starting to slowly resolve. The guy I saw was a trigger point god, they say, and at one point he was exasperated, and said, "If you don't have any pain why are you here?" (I was still in pain, but the pain had modulated by then and was odd in several ways. Anyway his subtext was: pain that I can easily pinpoint) Me: "Well, if I could have gotten in 4 WEEKS ago like I needed to...". It's that chronic vs acute thing again.

Basically, I'm pretty sure I had an MS exacerbation, but will never know for sure now. But I never got in to see my neuro (also one of those who need a loooong lead time), and other docs like GPs are usually freaked out by the high weirdness our symptoms can exhibit, and so don't believe us, and have zero clue how to proceed.

Just in case anyone is wondering, I had something that presented and felt an awful lot like occipital neuralgia.

http://www.msunites.com/multiple-sclerosis-ms-symptoms-occipital-neuralgia/

which is pretty rare, (but not quite so rare in MS patients), and is often misdiagnosed as other things. It took a full 6+ weeks to resolve completely, which is also typical of an MS attack.

OK, end of ranting now, for real. Right now I don't hurt and therefore I need to make cherry pie.

 

[Bron357]

I have an ongoing gall bladder issue. The gall bladder is gone but the tube from the liver that now goes straight into my stomach sometimes goes into spasm and closes over causing the exact same pain as a gall bladder attack. The pain can be so extreme that I pass out from it. Adding to the problem is the opioids I have to take, I will often just vomit straight back up due to the pain. My doctor however will only give me one prescription a year so I have to weigh up whether I can tolerate the pain or not or whether I’ll go through 3 tablets trying to keep one down long enough. The crazy thing is that have ended up calling an ambulance because I’m “out of pain meds”, and off to hospital I go for morphine - what a waste of time, money and resources. I am certainly no “addict” but to be treated as if I am is awful. Addicts I believe will always find a ways or means but ordinary people get caught up in procedures meant to stop addicts (and don’t).

 

[Huff26]

Hello-

I don't post much but I often lurk, as I am sure others do. Just wanted to add to this thread from a nurse's point of view. I work in emergency and have seen the direct result of overuse of opioids, as well as the response medical professionals have had.
There is certainly an attitude against "drug seekers" and most people experiencing pain. Typically traumatic injuries are seen as a go ahead with opioids, but otherwise many of the doctors are hesitant to prescribe pain medication. I think there are several reasons to this, but two come to mind as the most prominent.
I agree with previous posters on lack of education. Our society is a real "fix it and be done" society. We reward problems solvers and condone those who don't fit into that mold. The same goes in medicine. Doctor's are touted for their statistics on seeing patients, diagnosing aliments, and subsequently treating whatever is ailing said patient. Where the struggle comes in is chronic patients. Chronic patients don't fit into that problem and solution mold, so their problems become a merry go round of specialists who again, specialize in fixing certain problems, not treating them longterm. Education is needed now that patients are living longer and living though previous conditions that they would not have been able to survive previously. We now need to see patients through the other side of great healthcare, which is the darker side of patients living half lives in pain.
The second part I see revolves around all of healthcare. Time and patient ratios. Not being rude, but it's truly difficult for me to empathize with your pain in the ER, when next door I have a kid who's dad broke his arm, a patient across the hall who I am giving narcan to for drug overdose, and across from them a patient coding with a STEMI heart attack. I am being most sincere when I say I am sorry but I can't give you my empathy and my best like I should, because your pain is important. However with the way healthcare works I don't have the capacity to advocate for your treatment like I should. Now you may say Huff26, that's your job! It's to care and care for your patients. And I agree with you, but now we go back to number one, which is essentially in this situation, can I actually fix your problem which is all my employer cares about? The kid I can report his dad to defax and splint his arm. The drug overdose I can give narcan to and save his life. The heart attack- same thing. But your chronic pain? You are someone I can't solve a problem for.
I see many of you in my rooms at night and when I close my eyes at 9am when I get home, you are the patients who haunt me. Because I see so many of you in pain and I know we are failing you. From a nurse I hope you will accept an apology.

 

[autumngems]

So sad, just found out my niece's daughter died over Thanksgiving due to this and she leaves behind 3 little ones.

 

[Karl_K]

So sad, just found out my niece's daughter died over Thanksgiving due to this and she leaves behind 3 little ones.

I am so sorry to hear that.
Thoughts and prayers are outgoing.

 

[Karl_K]

I experience the war on pain management first hand and I see both sides.
I know someone who is a seeker and I know people who have lost loved ones to an OD.
I feel for them very much.

I can't take 99.9% of pain medication due to being on blood thinners from a chronic clotting issue.(100s of blood clots, 4x+ dvt, 1 PE)
I also have bad arthritis and a repaired elbow that always hurts to some extent.
The vast majority of the time I have learned just to live with it.
I had a set amount of low end pain med I can use in a month, I dont even like taking them so dont most of the time, dont get them because its takes a doctors visit to get a refill now.
The problem come in when I have stronger pain.
Like when I had an abscessed tooth and was having a hard time getting into a dentist.
What I had was not touching it at the max dose my prescription would only last a few days.
Doctors are flat out scared of legal issues to prescribe opioids when you are already on them even if they are the lowest strength and very limited quantities.
"I want to help you but it could cost me my license said with a very sad look on his face"
That is pain management in the US and it is going to get worse.

 

[AprilBaby]

I had ankle surgery 10 days ago. Dr gave me Vicodin for pain but said in 3 days I would feel fine. He gave me 60 Vicodin for three days. Today I went to have stitches out but I have been in a lot of pain and the Vicodin gave me hives. Turns out my ankle is infected badly and I got antibiotics and they gave me 60 Tramadol. I think I could open a pharmacy. If I understand, you need opioid receptors to be an addict and I apparently don’t have any. Neither med gives me any kind of “high”. Just hives or a headache. If I was an addict I could go on a bender!

 

[Arkteia]

It hit very close to home. A friend's son, 20 years of age. We all remember and mourn him.

Obviously, opiate addiction, as any other addiction, is genetic. I would never blame chronic pain patients for needing painkillers, and likely, I would blame opiate addicts no more than I would blame alcoholics. Not people's fault that they were handled a certain deck of genes and the drugs are there. It is not the wrong choice.

I have a question. Do people think that opioid crisis will be better handled with tighter laws, or with legalizing the drugs. Having read about Prohibition, in principle, I am for legalizing the drugs, about opiates, I am on the fence due to their high potential for overdosing.

What do people think? Are there any other reasonable options short of war on drugs (that we have lost) and legalization of opiates?

(I don't seem to carry the genes that would make me crave opiates. I hate their side effects, So after 2nd abdominal surgery, I tried to survive on Tylenol since day 2, and walk more for better wound healing. I have a feeling that if you are not asking for painkillers, they are offered to you - I had to call my surgeon and ask him to rewrite the orders in favor of Tylenol DS).

 

[Arkteia]

I had ankle surgery 10 days ago. Dr gave me Vicodin for pain but said in 3 days I would feel fine. He gave me 60 Vicodin for three days. Today I went to have stitches out but I have been in a lot of pain and the Vicodin gave me hives. Turns out my ankle is infected badly and I got antibiotics and they gave me 60 Tramadol. I think I could open a pharmacy. If I understand, you need opioid receptors to be an addict and I apparently don’t have any. Neither med gives me any kind of “high”. Just hives or a headache. If I was an addict I could go on a bender!

Every person has receptors to endorphins and enkephalines. Our tribal ancestors needed them in times when analgesia was not available. Opiates bind to the same receptors, but are way more potent.

I suspect that a certain degree of emotional "high" in response to own endorphins helped survival in ancient times. But everyone has different emotional response to both own endorphins and exogenous opiates. (Me, for example, opiates and alcohol put to sleep, and opiates cause nausea on top of it).

And I agree, because I refused them, I had the feeling that they were pushed on me. I said to the doctor, a prescription for Vicodin for a week would be more than enough upon discharge, and did not plan to fill even that, but the nurses told my husband that it would cost much cheaper to fill it in the hospital pharmacy, so he went and bought it. It was never used.

 

[Karl_K]

The real answer is new better pain medication.
What we have now are all pretty harmful.

 

[House Cat]

It hit very close to home. A friend's son, 20 years of age. We all remember and mourn him.

Obviously, opiate addiction, as any other addiction, is genetic. I would never blame chronic pain patients for needing painkillers, and likely, I would blame opiate addicts no more than I would blame alcoholics. Not people's fault that they were handled a certain deck of genes and the drugs are there. It is not the wrong choice.

I have a question. Do people think that opioid crisis will be better handled with tighter laws, or with legalizing the drugs. Having read about Prohibition, in principle, I am for legalizing the drugs, about opiates, I am on the fence due to their high potential for overdosing.

What do people think? Are there any other reasonable options short of war on drugs (that we have lost) and legalization of opiates?

(I don't seem to carry the genes that would make me crave opiates. I hate their side effects, So after 2nd abdominal surgery, I tried to survive on Tylenol since day 2, and walk more for better wound healing. I have a feeling that if you are not asking for painkillers, they are offered to you - I had to call my surgeon and ask him to rewrite the orders in favor of Tylenol DS).

The opioid crisis would be better handled with neither. We need to treat this as a medical condition. There are addiction protocols out there that have a much better success than abstinence and white knuckling one’s way through life.

These protocols involve medications that help a person with cravings...not so much methadone type meds but more psychotropic medications that treat addiction. Then these people need emotional support. There is a ted talk that talks about the fact that when we isolate our addicts, it motivates them to use or relapse. We are famous for isolating our addicts in this society. They need physical support, house, job, how to live. Basically, a whole person approach. This is a crisis of the soul that takes a whole person approach for success. This is a person who is on the bring of death that must be saved. Until we see it that way, we aren’t going to help these people.

Making these drugs legal (they alread are) or criminal isn’t a factor for helping these people as far as I can see. They are addicts who don’t care about either of these issues. The activated addiction makes it so they only care about getting high.

 

[House Cat]

The real answer is new better pain medication.
What we have now are all pretty harmful.

I feel we are on the right path with drugs like gabapentin and cymbalta for long term chronic pain but it is my feeling that these drugs aren’t sophisticated enough.

I agree that we need something for acute, short term pain.

 

[Arkteia]

The opioid crisis would be better handled with neither. We need to treat this as a medical condition. There are addiction protocols out there that have a much better success than abstinence and white knuckling one’s way through life.

These protocols involve medications that help a person with cravings...not so much methadone type meds but more psychotropic medications that treat addiction. Then these people need emotional support. There is a ted talk that talks about the fact that when we isolate our addicts, it motivates them to use or relapse. We are famous for isolating our addicts in this society. They need physical support, house, job, how to live. Basically, a whole person approach. This is a crisis of the soul that takes a whole person approach for success. This is a person who is on the bring of death that must be saved. Until we see it that way, we aren’t going to help these people.

Making these drugs legal (they alread are) or criminal isn’t a factor for helping these people as far as I can see. They are addicts who don’t care about either of these issues. The activated addiction makes it so they only care about getting high.

House Cat, about the medical part I am aware. I am thinking about the social part.

As long as drugs are illegal, and criminalized, there are groups making money off selling them. And there is a push to use them.

Also, if you compare alcohol with addiction, alcohol is slightly better than heroin, but not that much. Still, a very addictive drug with the potential for lethality. Yet alcoholics get a lot of support, AA, "let me be your sponsor", "I had the same problem, here is my St. Christopher medal", etc, etc. What happens if someone admits to being hooked on opiates? Or methamphetamines, for that matter? Probably he, or she, will lose friends because of the "druggie" issue. NA is infested with dealers coming to look for vulnerable people, so it is not much of a help.

I think that the biggest difference in the attitude is because alcohol is legal, and drugs are not. Hence, there is not much moral support for the addicts to expect. And then, even people who are having chronic pain issues are encountering the same stigma.

In short, I don't believe that keeping drugs illegal is helpful, but how to change things, I don't know.

I remember that at the time of prescribed Oxycontin there were fewer OD'es from opiates. Then it was decided to make the drug unavailable and most addicts switched over to heroin. Which is now cut with fentanyl so the rate of OD's is even higher.

There is one more issue - when people buy drugs on the street, they never know what exactly they buy, so from the same dose, they may not get enough high one day and OD on another one.

 

[AprilBaby]

Every person has receptors to endorphins and enkephalines. Our tribal ancestors needed them in times when analgesia was not available. Opiates bind to the same receptors, but are way more potent.

I suspect that a certain degree of emotional "high" in response to own endorphins helped survival in ancient times. But everyone has different emotional response to both own endorphins and exogenous opiates. (Me, for example, opiates and alcohol put to sleep, and opiates cause nausea on top of it).

And I agree, because I refused them, I had the feeling that they were pushed on me. I said to the doctor, a prescription for Vicodin for a week would be more than enough upon discharge, and did not plan to fill even that, but the nurses told my husband that it would cost much cheaper to fill it in the hospital pharmacy, so he went and bought it. It was never used.

So what causes one person to get high and another to have no reaction at all? I could take quite a few and just get a headache.

 

[Arkteia]

I think that in the case of severe pain, we all might need opiates and will all respond to them in the same way. A battleground abdominal wound would produce horrible pain, amenable only to opiates, and who cares if you also have headache, or not?
(The first postoperative night, I needed patient- controlled analgesia, but later, could survive on my own, with Tylenol. I am a woman with two kids and the genotype that makes me less sensitive to pain than some people. My FIL, on the contrary, is extremely sensitive to pain, and has genes for opiate addiction. I am glad that no one prescribed him opiates for his headaches, so he probably never met his "drug".)

 

[ksinger]

House Cat, about the medical part I am aware. I am thinking about the social part.

As long as drugs are illegal, and criminalized, there are groups making money off selling them. And there is a push to use them.

Also, if you compare alcohol with addiction, alcohol is slightly better than heroin, but not that much. Still, a very addictive drug with the potential for lethality. Yet alcoholics get a lot of support, AA, "let me be your sponsor", "I had the same problem, here is my St. Christopher medal", etc, etc. What happens if someone admits to being hooked on opiates? Or methamphetamines, for that matter? Probably he, or she, will lose friends because of the "druggie" issue. NA is infested with dealers coming to look for vulnerable people, so it is not much of a help.

I think that the biggest difference in the attitude is because alcohol is legal, and drugs are not. Hence, there is not much moral support for the addicts to expect. And then, even people who are having chronic pain issues are encountering the same stigma.

In short, I don't believe that keeping drugs illegal is helpful, but how to change things, I don't know.

I remember that at the time of prescribed Oxycontin there were fewer OD'es from opiates. Then it was decided to make the drug unavailable and most addicts switched over to heroin. Which is now cut with fentanyl so the rate of OD's is even higher.

There is one more issue - when people buy drugs on the street, they never know what exactly they buy, so from the same dose, they may not get enough high one day and OD on another one.

What exactly do you mean by "legal"? All of these medications - or at least the ones I am thinking of - oxycodone, hydrocodone, etc, are legal, they are just not available without a prescription. Are you saying that these prescription meds with potential for abuse - or accidental overdose - resulting in death, should be reclassified and sold OTC like cold meds? Seriously? Why have prescriptions at all then? By that logic I should be able to dose myself with anything I think I need, anytime I like.

I'm like you - not an addictive bone in my body or gene in my makeup. But there is no way that these prescription meds should be easily available. They need to be properly prescribed and then the patients followed by doctors who are doing their jobs correctly. House Cat should not have mayonnaise jars full of them, and at the other extreme, I needed (for my acute suspected occipital neuralgia attack) more than the 10 pills that were supposed to be enough for 10 DAYS. Both scenarios are idiotic. Selling the stuff OTC would be the silliest of all.

At the risk of sounding like I don't care, I....don't care...about the nitty details about addicts. There will always be something and addicts of that something, because as you say, genetics. What I care about as a patient, is not being believed by doctors, and not being able to get properly prescribed pain meds once per bloody decade for acute pain, because of general societal hysteria over addicts.

 

[Karl_K]

Tylenol1 mixed with caffeine to counter some of the high was otc 18+ years old up until 2 years ago in Canada.
It is roughly 1/4 the strength of a tylenol3 prescribed in the US.
They changed it to prescription, not because of a huge number of problems but because the US government was having a fit about it.
Part of the problem in the US imho is norco and vicodin not to mention oxy are prescribed when tylenol3 or even 1 could be enough.
For many people 1 tylenol1 every 4 hours is more effective than a vicodin every 6 hours.
Because of far fewer side effects they are more likely to take it before pain reaches the break though stage.
Because of how hard effective pain medication is to get in the US many people wait until the pain is in the break through stage before taking anything. Which takes more medication and creates a vicious circle.

 

[missy]

https://www.managedhealthcareconnec...r-drug-fight-opioid-addiction-approved-us-fda

FDA APPROVALS
INDIVIOR DRUG TO FIGHT OPIOID ADDICTION APPROVED BY U.S. FDA
December 1, 2017


By Reuters Staff

(Reuters) - Indivior's experimental drug to help fight America's growing opioid addiction crisis was approved by the U.S. Food and Drug Administration late on Thursday, boosting its sales prospects as competitors threaten revenues from an older product.

Shares in the London-listed company, which specializes in addiction treatment, were up 10.9% at 411 pence at 0818 GMT on Friday. The stock was the top gainer on the FTSE Midcap index.

"We believe this decision is key for Indivior's investment case ... A decent label and price should also help support near-term sentiment and a re-rating of the shares," said Jefferies analysts, who rate the stock as "buy".

The approval comes after an advisory committee to the FDA voted 18-1 that Indivior's injectable drug, known as RBP-6000 or Sublocade, could benefit addicts.

Sublocade is expected to be available to patients in the United States in the first quarter of 2018, Indivior said.

"We are encouraged by this approval and ... we expect the story to shift more and more towards Sublocade as it grows," Morgan Stanley analysts said.

United States is battling an opioid abuse epidemic that in 2015 killed 33,000 people. President Donald Trump recently declared the problem a national public health emergency.

Indivior's product is the first monthly injectable buprenorphine treatment. Indivior already sells Suboxone Film, a product that combines buprenorphine and nalexone and is placed under the tongue or inside the cheek.

In September, a U.S. court ruling cleared the way for a generic rival to Suboxone Film, knocking back Indivior's shares.

FDA Commissioner Scott Gottlieb recently announced the agency's plans to encourage widespread use among opioid addicts of less harmful opioids such as methadone and buprenorphine, the active ingredient in Sublocade.

(c) Copyright Thomson Reuters 2017. Click For Restrictions - http://about.reuters.com/fulllegal.asp

 

[doberman]

I have very strong opinions on this. I've seen a hell of a lot more people die as a result of cigarette smoking and obesity as compared to opiate ODs. Is there a smoking and eating crisis? Of course not. Frankly this whole thing is just going to make it more difficult for those in pain to receive narcotics they need. It reminds me of the crack baby "crisis" which turned out to be not much of a crisis at all.