The opiod epidemic....

[911SauCy]

Originally Posted by fintstone

What leads you to believe that doctors are “in the pocket” of pharma?

Where would you expect people who worked at FDA onocolgy to work after leaving? McDonalds?

I do believe this is accurate when rephrased as "big pharma is in the pocket of Doctors".

It's in a Dr's best personal financial interest to prescribe a medication. Drug company makes money, they make money, and if the patient get's hooked...it's recurring revenue for both... win win $$

This is why the US is the most "prescribed" and one of the least healthy countries globally. (Let's not discuss the gov't driven food processing industry designed to get and keep people unhealthy to drive the need for Dr's and the big pharma that backs them up) I'd argue we are in the poorest health globally if you consider the wealth and "programs" that are supposed to be "helping" and "educating" people to stay healthy.

I'd like to think I'm speaking from experience also. Had back surgery about 18mo ago. Dr hands me 2 Rx's, Oxy and Cyclobenzoprine (muscle relaxer)...told me I MUST take them as prescribed, for 2 weeks, and he'd determine whether or not I could get off them at my 2wk follow-up. REALLY!? Take Opiods for 2 weeks just because...sounds like just long enough to start a nice habit...

I took them for 2 days, and stopped because the side effects were intolerable and there was truly no noticeable difference in pain when on them. DR office calls 3 days in...because they know...to ask if they could prescribe more meds for the constipation the opiate caused. Wasn't that thoughtful.

I ditched the drugs, drank some tequila and rested...

The Dr is a "top 3" Lumbar Surgeon in the USA...

[wdfifteen]

Originally Posted by 911SauCy

The Dr is a "top 3" Lumber Surgeon in the USA...

Don’t you just love autocorrect.

[911SauCy]

Originally Posted by wdfifteen

Don’t you just love autocorrect.

COmmeee onnn LOL

[tevake]

60 minutes did a strong piece a while back, featuring a very frustrated ex senior DEA agent. Who had spent years building a solid case against a large Pharms Co at the center of Opioid production and distribution, only to have The justice Department fail to persue it.

https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/

Quite enlightening from law enforcement perspective. This ties in closely with the experence of my nephew in New Orleans who is a senior DEA field agent there, and see similar frustrations there regularly.

I'll leave you to take from it what you will.

Cheers Richard

[kach22i]

March 11, 2018
CNN Exclusive: The more opioids doctors prescribe, the more money they make
https://www.cnn.com/2018/03/11/health/prescription-opioid-payments-eprise/index.html

(CNN) As tens of thousands of Americans die from prescription opioid overdoses each year, an exclusive analysis by CNN and researchers at Harvard University found that opioid manufacturers are paying physicians huge sums of money -- and the more opioids a doctor prescribes, the more money he or she makes.

In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time.
Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid....................

"The medication that was being prescribed to me was for his benefit, not my own," she said.

Incredible.

[dewolf]

I've taken opiods for an extended period due to a nasty shoulder injury which would keep me awake at night. I'd only take one tablet an hour before bed and never during the day. After being on them for a month I had to get approval from a government entity here called 'The Dependent Drug Unit' or DDU. My Dr fills out a form stating the nature of why I'm on narcotics and how we (Dr & I ) have tried other meds or physio etc to alleviate pain. He then signs a statutory declaration stating the same. If he's caught giving out these drugs to anyone longer than a month without approval he risks a $100,000 fine and can find himself in need of a new job. The pharmacist where you hand in the prescription have to register each prescription for any narcotics. This is how the DDU find out if the Dr is handing out controlled meds.

[Bill Douglas]

Another thing the drug companies do is put on "conferences" so the doctors prescribe their brand of drugs (relevent to the topic - opiods.).

My GF worked on a drug trial and was always flying first class, the best hotels etc to go to a conference in Berlin or Sydney. She told me not a lot was said other than it's all going well and enjoy yourself while here in Berlin...

That way it's not a bribe or a back hander.

[john70t]

And acupuncture is still not a covered treatment.
Despite a couple thousand years of Eastern proof from the emperor on down.
.
And it's definitely not considered preventative medicine (unlike sponsored sex protection/gyno everything/heart/blood meds/vaccines/fluoride/etc/etc.)
.
And while child protective services are so randomly proactive, nobody is watching them get trained to eat the standardized processed junk food filled with antibiotics/hormones/GMOs which leads to diabetes and other worse dysfunctions.

[pavulon]

A lot of the opiate abuse issue can be traced to 2000 when JCAHO made pain the "5th vital sign" and in turn began using pain control as a way to regulate payment to hospitals. While pain control is important (I feel qualified as any to say that), this overstep by this organization (and subsequent oversteps by hospital administrators) let a genie out of its bottle. Patients became hooked on their pain meds and when the prescriptions run out, many look for opiates anywhere they can find them (ie heroin or black market meds). Of course, prescribers are now being pushed the other way by regulators as they try to undo a problem they were forced to create.

[flatbutt]

Originally Posted by targa911S

Thank you my friend... 30 years sober and counting..never a regret.

Wow, well done you!

[Bugsinrugs]

Just as the states sued the tabacco industry they should sue the pharmaceutical industry to pay for the emergency room visits. We, the taxpayers are footing the bill.

[flatbutt]

Originally Posted by Bill Douglas

Another thing the drug companies do is put on "conferences" so the doctors prescribe their brand of drugs (relevent to the topic - opiods.).

My GF worked on a drug trial and was always flying first class, the best hotels etc to go to a conference in Berlin or Sydney. She told me not a lot was said other than it's all going well and enjoy yourself while here in Berlin...

That way it's not a bribe or a back hander.

Those practices led to the passage of the US Foreign Corrupt Practices Act (FCPA) 2013?. My company had a huge problem in China with this corruption and IIRC twelve executives were fired immediately but I don't remember if China imprisoned them.

The conferences still go on but they are under close scrutiny. Still a long way to go though.

[tevake]

Originally Posted by Bugsinrugs

Just as the states sued the tabacco industry they should sue the pharmaceutical industry to pay for the emergency room visits. We, the taxpayers are footing the bill.

That's starting to happen now.

https://www.bloomberg.com/news/features/2017-10-05/the-lawyer-who-beat-big-tobacco-takes-on-the-opioid-industry

[flatbutt]

Originally Posted by 911SauCy

It's in a Dr's best personal financial interest to prescribe a medication. Drug company makes money, they make money, and if the patient get's hooked...it's recurring revenue for both... win win $$

..

Is it your belief that a doctor makes money from each prescription? Or are you making an indirect connection between writing a prescription and a subsequent office visit related to the script?

[Rick Lee]

Originally Posted by flatbutt

Is it your belief that a doctor makes money from each prescription? Or are you making an indirect connection between writing a prescription and a subsequent office visit related to the script?

My doc renews my scripts just by my entering a digit on my phone when I call the pharmacy. The pharmacy contacts the doctor for the renewal. About once a year the doc will tell me I need to come in. I don't mind. I figure he needs to get some money out of me for an office visit just to cover all the admin costs of his staff handling scripts renewals alone. Unless he's getting a kickback from the drug makers, I can't see how it's in his financial interest to write scripts. Last time I was in the waiting room there and a drug rep. came in to ask for a date to bring lunch to the office staff, they told him they were booking for 2019 already.

[KFC911]

I heard some doc mention this aspect. Not a direct kickback...nothing along those lines at all. He was just referring to the time factor....easier to write a script and on to the next patient, rather than spend a more time consuming approach pursuing alternatives.

[Rick Lee]

Originally Posted by KC911

I heard some doc mention this aspect. Not a direct kickback...nothing along those lines at all. He was just referring to the time factor....easier to write a script and on to the next patient, rather than spend a more time consuming approach pursuing alternatives.

I have to be about two weeks into suffering before I'll start to think I have a sinus infection and need antibiotics. And even that only happens once every few years. But a few times the doc has told me he thinks it's not a sinus infection and I just need to ride it out a little longer. They offer to write me a script, but ask me to hold off on filling it unless I just can't stand it any longer. Twice they've been right and it's gone away on its own. But for regular scripts like bp, cholesterol, etc., once your blood work says you need them and then shows improvement after getting them and with no side effects, I don't know that a lot of discussion and follow up is necessary. So for that stuff they just give me all the renewals I ask for, knowing I'll still come in for blood work a few times a year and an office visit to discuss at least once a year.

[svandamme]

Originally Posted by KC911

Not a direct kickback...

I'm sure the MD's have a invested big in Big Pharma stocks

[RKDinOKC]

Dern, I never get any of the fun prescriptions.

[KFC911]

Originally Posted by svandamme

I'm sure the MD's have a invested big in Big Pharma stocks

A lot of them might not be astute investors....ya never know . I do recall the knee surgeon who wrote me the script for 50 Percocets decades ago was partners in the rehab place with two other docs. After the initial visits, I was basically going to a nice gym (set up for pro athletes) by the three and working just on my knee on my own, no PT involved. Would ins. pay for a gym, no way...but months of $125 visits three times a week..cha ching!
The rehab cost more than the surgeries, was essential, and worth it (to me, the patient)....but certainly not cost effective imo.