The opiod epidemic....

[Tobra]

Originally Posted by 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.

You all need to read this twice, 95% of the thread is utter nonsense.

[KFC911]

Originally Posted by Tobra

You all need to read this twice, 95% of the thread is utter nonsense.

BS...Percocets were over-prescribed for someone who didn't need them (me) in '88. I've been observing it for decades, and the marketing to docs by Purdue Pharma is well documented.

[Rick Lee]

Originally Posted by KC911

BS...Percocets were over-prescribed for someone who didn't need them (me) in '88. I've been observing it for decades, and the marketing to docs by Purdue Pharma is well documented.

Mrs. Lee and I have both had Vicodin, Codeine or other similar things prescribed for post-procedure pain relief, and we never touched them. I highly doubt our docs would have agreed to refill any of them without an office visit to see why the pain was still present. If people are getting multiple refills for this kind of stuff with no attempt to find the source of the problem, I would think someone needs to look into that. But it would be on the prescribing docs, not the pill producers or pharmacists who just fill orders. I wonder what would happen if a pharmacist refused to fill a script just because he thought the patient had been there too many times and he disagreed with the doctor.

[KFC911]

Originally Posted by Rick Lee

Mrs. Lee and I have both had Vicodin, Codeine or other similar things prescribed for post-procedure pain relief, and we never touched them. I highly doubt our docs would have agreed to refill any of them without an office visit to see why the pain was still present. If people are getting multiple refills for this kind of stuff with no attempt to find the source of the problem, I would think someone needs to look into that. But it would be on the prescribing docs, not the pill producers or pharmacists who just fill orders. I wonder what would happen if a pharmacist refused to fill a script just because he thought the patient had been there too many times and he disagreed with the doctor.

I dunno about refills Rick...the single bottle I was prescribed was enough to get one hopelessly addicted....easy. I do know of one particular local doc from decades ago...reknowned for his "script writing"....he was jacked up against a hospital elevator wall by an irate husband and told "no mas"...the husband put his career on the line, but he meant business.

Around here, I think it's CVS, they have begun limiting fills to seven days (I think it is) for some pain meds...regardless of the script.

They are attempting to save people's lives....or maybe it's good PR....who knows?

[Rick Lee]

Ok, so one script is enough to get addicted. I have no experience with that, but I believe it. Who's writing the refills? And who is CVS to decide that the refills aren't valid? I did some deliveries to pharmacies in college and plenty of the stuff I delivered came with DEA control tags on the bins. That was in 1994, so I'm sure DEA can track this stuff if they think someone's filling too many scripts. They then go to that pharmacy and ask who's writing all those scripts and eventually have a chat with the doctor. How hard can that be?

[tadd]

Geeze guys.... yall should be grateful if you haven't needed to take narcotics for pain.

That just means you haven't had major stuff done.

The wife just had a double mastectomy a few weeks ago. They sent her home with Tylenol! In this procedure they cut out two organs, scrape out the underlying tissue, and insert drains in an area that is filled with nerve endings (nipples anyone?!). This is major invasive and how anyone thinks this might not smart is beyond me.

What is so damn wrong with sending someone home with 3-5 days of pain killer? You cant use an NSAID after surgery to avoid bleeding issues. So all ya got is opiates like codeine.

Problem is when you send someone home with a months load. Drugs should be staged. First round is a given, next round requires some effort, and another round should require serious proof of need.

[KFC911]

Originally Posted by tadd

Geeze guys.... yall should be grateful if you haven't needed to take narcotics for pain.

That just means you haven't had major stuff done.

The wife just had a double mastectomy a few weeks ago. They sent her home with Tylenol! In this procedure they cut out two organs, scrape out the underlying tissue, and insert drains in an area that is filled with nerve endings (nipples anyone?!). This is major invasive and how anyone thinks this might not smart is beyond me.

What is so damn wrong with sending someone home with 3-5 days of pain killer? You cant use an NSAID after surgery to avoid bleeding issues. So all ya got is opiates like codeine.

Problem is when you send someone home with a months load. Drugs should be staged. First round is a given, next round requires some effort, and another round should require serious proof of need.

We are in total agreement....

CVS has implemented their new policy nationwide. First time opiod users will be limited to seven days only....it's prudent.

Pain management is real, and no one is saying otherwise here...certainly not me.

[wdfifteen]

Sometimes they overdo pain management. After my foot surgery my doc sent me home with a prescription for the baby Vicodins (they call it Norco now - 5-325s) Everyone said “take them and stay ahead of the pain.” By day four I was in the bathroom every 20 minutes peeing half an ounce at a time. Thank goodness for the internet. A google search confirmed that the drugs were clogging up my plumbing. It took two days to get back to normal. The pain of trying to pee through an enlarged prostate was far worse than the post surgery pain in my foot. No narcotics for me ever again.

[daepp]

Originally Posted by 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
Incredible.

EXTREMELY MISLEADING. Incredible (as in not-credible) is correct!

The headline states the doctors are being paid to prescribe more; the article states they're being paid to speak. That's a huge difference.

And the authors of the study they cited (Harvard researchers), ..."said it's not clear whether the payments encourage doctors to prescribe a company's drug or whether pharmaceutical companies seek out and reward doctors who are already high prescribers." Boom - right there. They couldn't make a link.

Just one more non-news story from CNN. Clearly they want to make a point, but the study they cite doesn't make that point.

More feelings-based writing,, designed to tug at the hear strings: "CNN spoke with two women who've struggled with opioid addiction, and they described the sense of betrayal they felt when they learned that their doctors had received large sums of money from the manufacturers of the drugs that had created such havoc in their lives." Wow - two whole women felt betrayed. Would you look at that. That's some hard hitting journalism there.

[daepp]

Unless and until this country stops blaming others and looks at the underlying issues of addicts, you could ban every micrograin of opioid and millions in this country will still suffer the bonds of addiction.

[daepp]

I mean, do you not know about the tremendous amounts of FENTANYL that's flooding our cities now? It's hundreds of times more potent than prescribed meds, comes in by the truck/plane/ship load, sold on the streets, and its strength cannot be relied upon by addicts. It's killing users all across the country.

[KFC911]

Originally Posted by daepp

I mean, do you not know about the tremendous amounts of FENTANYL that's flooding our cities now? It's hundreds of times more potent than prescribed meds, comes in by the truck/plane/ship load, sold on the streets, and its strength cannot be relied upon by addicts. It's killing users all across the country.

Yes, we are quite aware of the illegal aspect of Fentanyl laced heroin....it is killing folks every day too...about half of them. The other half OD on prescription meds, and almost all started with a script initially....the heroin and Fentanyl users too, then they turn to the cheaper stuff. An addict is an addict...they will not stop because the prescriptions stop.

[Tobra]

Originally Posted by KC911

BS...Percocets were over-prescribed for someone who didn't need them (me) in '88. I've been observing it for decades, and the marketing to docs by Purdue Pharma is well documented.

So you are taking your experience and extrapolating it out to what happens to everyone else. That seems reasonable

ALL medical device and pharmaceutical companies market to doctors.

I will say it again, 95% of this thread is crap.

Originally Posted by KC911

CVS has implemented their new policy nationwide. First time opiod users will be limited to seven days only....it's prudent.

I am quite certain that CVS is violating the laws of Texas and California with this policy. I am not familiar with the laws of other states in this regard.

[KFC911]

Originally Posted by Tobra

So you are taking your experience and extrapolating it out to what happens to everyone else. That seems reasonable

ALL medical device and pharmaceutical companies market to doctors.

I will say it again, 95% of this thread is crap.

I am quite certain that CVS is violating the laws of Texas and California with this policy. I am not familiar with the laws of other states in this regard.

You are no more of an expert on this matter than I am. Not only my personal experience, but much validated by others, some who are "so called" experts on the matter. CVS probably has a decent legal team, and their policy took effect nationwide on Feb. 1.

You just might not be as familiar with a lot of stuff you aren't familiar with as you think?

[Tidybuoy]

Originally Posted by ckelly78z

You can blame big Pharma, or the prescribing doctors if you want, but ultimately, it is the weak willed consumer who is popping the pills, and demanding more, creating an addiction.

Agreed.

My sister is an Oncologist/Hemotologist and deals with a lot of patients that are in desperate shape. We have had discussions about Pharma and she tells me it is an uphill battle. She said that patients come in after seeing commercials and demand that she prescribe something and if they don't get their way, they will go somewhere else until they get it. (mostly, we are talking cancer drugs and not pain killers here).

I also agree with building the southern wall as a lot of addicting drugs are coming thru Mexico and things like meth are being produced at the factory level vs. home factories.

[daepp]

The problem lies not with pharmaceutical companies; but in ourselves.

[daepp]

Originally Posted by KC911

You are no more of an expert on this matter than I am.

Isn’t one of you an MD and the other not?

[wdfifteen]

Originally Posted by daepp

EXTREMELY MISLEADING. Incredible (as in not-credible) is correct!

The headline states the doctors are being paid to prescribe more; the article states they're being paid to speak. That's a huge difference.

And the authors of the study they cited (Harvard researchers), ..."said it's not clear whether the payments encourage doctors to prescribe a company's drug or whether pharmaceutical companies seek out and reward doctors who are already high prescribers." Boom - right there. They couldn't make a link.

.

The headline doesn’t say what you claim it says. It is actually perfectly consistent with the quote from the Harvard researchers.

[KFC911]

Originally Posted by daepp

Isn’t one of you an MD and the other not?

I'll defer to the experts on this opiod epidemic, but stand by every post I've made. Toby is FOS when he states 95% of this thread is crap imo. I know damn well my and others' stories aren't crap...

You get a head start Doc...go first...

[74-911]

Originally Posted by Tidybuoy

............. I also agree with building the southern wall as a lot of addicting drugs are coming thru Mexico and things like meth are being produced at the factory level vs. home factories.

Most of the drugs crossing the border from Mexico come across through Ports of Entry in cars, trucks and semi's in hidden compartments. It may stop some trafficking but overall the wall won't make a dent in the amount of drugs coming from Mexico, just more hyperbole from Trump.