Opioid "epidemics"?
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23-06-2017, 05:53 PM
RE: Opioid "epidemics"?
(22-06-2017 09:36 AM)Vera Wrote:  Wasn't sure where to put this, but decided I want more a scientific opinion than a political one, so here goes.

Recently, I've been seeing A LOT of articles about evil Pharma and the big opioid addiction epidemics. The thing is, as far I was aware, we still do not have another type of painkiller and everything we have so far is based on the way opium works. If this is case (please, do correct me if I'm wrong, I'm really looking for an answer on this), what's with the demonisation of what is for MANY the only thing that makes their lives even remotely livable. I mean, there are people living with severe chronic pain, what are they supposed to do?

People have abused EVERYTHING that could possibly be abused, why the sudden (or maybe not so sudden) hatred for opioids?

And seeing as we have some really smart and knowledgeable folk here, I'd truly appreciate opinions and expertise on this.
Is pot an opioid?
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23-06-2017, 06:00 PM
RE: Opioid "epidemics"?
(23-06-2017 05:53 PM)Born Again Pagan Wrote:  Is pot an opioid?

Different plant. Think poppies. Rolleyes

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23-06-2017, 06:04 PM
RE: Opioid "epidemics"?
(22-06-2017 08:32 PM)Brian37 Wrote:  Why does everyone keep missing my point. EVERYONE is an individual, but again, with EVERY medication that doctor when ethical will monitor you long term on EVERY medication, tweak or switch or eventually take you off it. They will not keep you on anything longer than they have to.
It may not even be a matter of the doctor being ethical, so much as overworked. Docs who work for HMOs here are expected to see a certain number of patients each hour. With long days and looming quotas that generally means that any individual patient doesn't get a whole lot of face time with the doctor.

My current PCP, that I've had for five years, has never once bothered to mention any side-effects when handing me a prescription; I always have to ask. And his response is to shrug, say "everything has side effects", ask a nurse to hand me a generic printout from the computer, and move on to the next patient.

Doctors should be monitoring the effects of prescriptions on their patients a lot more closely than they generally seem to do. But that assumes having enough time to get to know patients as individuals, and to treat them as such.

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23-06-2017, 06:32 PM
RE: Opioid "epidemics"?
(23-06-2017 05:53 PM)Born Again Pagan Wrote:  Is pot an opioid?
No, it's a cannabinoid.

BTW, Oregon has had medical marijuana for almost 20 years, and legal recreational marijuana for 2 years.
But we still haven't seen a whole lot people jump on the research bandwagon, despite having universities and health science institutes aplenty.
There's a good reason for that.

Under federal law marijuana is still a Schedule I narcotic, which means that -- according to the feds -- it's highly addictive and has no medical value. The places which tend to house the facilities and brainpower to do serious research on the topic, tend to be places which also rely significantly on federal funding to stay in business. No one wants to risk having the feds pull the plug on their funding by becoming prominently involved in research which the feds have declared off-limits.

I once worked in a university neurobiology lab where some of the researchers tried to get a permit to use LSD on experiments with sea slugs. The protocols, vetting procedure, and restrictions on doing this turned out to be more elaborate, complicated, and obstructionist than getting a permit to work with high-level nuclear material. After nearly a year of forms, site visits, interviews, background checks, etc., we were denied the permit.

But we did get the permit for the radionuclides; it took about five weeks. Blink

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23-06-2017, 07:30 PM
RE: Opioid "epidemics"?
(22-06-2017 10:12 AM)RearViewMirror Wrote:  So to answer your question in a long round about way is, pain pills are extremely addictive. The only pain killer in pain pills is the acetaminophen and the opioid "basically" just makes you forget about the pain.

That is not even close to true. Opiates and opioids are powerful analgesics.
Acetaminophen is added for its analgesic and fever-reducing effects.

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23-06-2017, 07:43 PM
RE: Opioid "epidemics"?
(22-06-2017 11:50 AM)Dom Wrote:  Weed in the proper dosage fixes some issues, like nausea and urge to vomit.

It also works for some other things, like spasms and convulsions. There is much research being done now to properly define the many effects of the different components in weed.

For pain - the proper dosage of weed (not the down and out stoner dosage) will help by allowing you to ignore the pain if you get up and are active. I have gotten quite good at gauging this for my arthritis and it works - up to a certain pain level.

All this pharma and we still don't have an acceptable fix for pain. There is none.

I find opiates, opioids, NSAIDS, and acetaminophen all acceptable. Drinking Beverage

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23-06-2017, 07:48 PM
RE: Opioid "epidemics"?
(22-06-2017 01:10 PM)unsapien Wrote:  In Canada we had the same drug problems that they have everywhere...

But THE NEW and REAL opioid crisis we are now facing in here is about drug dealers cutting "regular" drugs like cocaine etc... and even marijuana with a "new" synthetic drug call Fentanyl and the even more deadly Carfentanyl .

It started in B.C. coming from China mainly, and it killed 922 people in 2016 just in B.C. alone.

It is so powerful that a cop was reported to have overdosed on in just by skin contact after he brushed some power off his uniform after a traffic stop.

This shit is a whole new level of fucked up.

I wouldn't call Fentanyl "new" as it was introduced more than 50 years ago and carfentanil was created in the 1970's.

What is new is it being on the street.

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23-06-2017, 07:57 PM
RE: Opioid "epidemics"?
(22-06-2017 05:49 PM)Jeanne Wrote:  Those who have intractable pain are the ones getting screwed by this witch hunt. First their Primary Care Physicians got hounded about prescribing and then the hoops to jump through just to prescribe got smaller and more numerous.

Yes...there were doctors who were over-prescribing and wrongfully prescribing, but they had been "taught" by their associations to control ALL pain, to make their patients pain-free at all times and were penalized if on a survey the patient indicated that they left the ER still in any pain. And...pharma pushed the heavy pain killers. A lot of them got caught and paid for their misdeeds.

So...now, the old docs are retiring and those who are still practicing do not want the headache and danger of prescribing for their chronic pain patients. They get shifted over to regional pain clinics and once they are a registered patient of a pain clinic, they can never be treated for pain by another PCP.

Okay...this is our experience in Maryland.

Pain clinics are limited as to what and how much they are allowed to prescribe. Forget about stopping the pain. If the drug of choice doesn't work, then it is the patients job to work to get them to change it. Most of these people are in desperate condition and they are treated as if they are drug addicts, now.

Intractable pain, such as, cancer and adhesive arachnoiditis takes opioids to lessen. It isn't going to get better. But since we have an "epidemic" of high school kids and other young people who MAKE A CHOICE to take a opioid pill with alcohol at a party and then go on to become addicted to opioids and maybe die from it or develop a heroin addiction and die from it...the people with chronic pain and intractable pain must now suffer.

So...they give them Extended Release Opioids, which are "addiction proof" but do not work nearly as well as the Standard Release Opiods. "And...no, we can't prescribe a "break-through" medication for you. You can take tramadol or ibuprophen in between."

Patches were thought to be a good addiction proof way of dealing with the problem, but addicts chewed the patches. And addicts chew the ER opioids, often killing themselves in the process.

And...still the chronic pain and intractable pain people get screwed and treated like addicts. Pee test every month when you pick up your prescription, which cannot be filled a day too early. And you are allowed one time a year for someone else to pick up your prescription...maybe, if we think you are worthy. "We know you are all selling your opioid meds and you don't really have such bad pain." Or at least that is the way they are made to feel.

"And...really we consider that if your pain level is a 4, then you are one of our successes. We aren't here to get you to be pain free. It doesn't matter that for 12 years you were mostly pain-free under your PCPs care, using Standard Release opioids. The government won't allow that anymore."

My family has had the sorrowful experience of knowing two young people who could not get the pain meds that they needed for the intractable pain they suffered. It was so ridiculous. One was allowed 7 pills per month for pain they had nearly every day for years...and yes, they used other means of trying to dull the totally debilitating pain. Finally, they each "overdosed."

We are hoping that our new medical pot clinics that will open next year in Maryland will be of some help.

When my husband can no longer get a prescription for his opioids...well, he will be in no condition to do anything, so I will call an ambulance. If such a time exists when there is no ambulance and no hospital, then he will choose to die by his own hand or by mine.

That is the kind of pain that many people try to numb with opioids and it is getting harder and harder to get any help from the medical institutions to do it.

I say let the addicts kill themselves with opioids and heroin and leave the people who actually need the pain control alone. If a kid is so stupid as to pop that pill and drink and move on to heroin and finally kill himself, well I hope he didn't breed.

Jesus Christ! I am sick to death of the whine about bored children who get into trouble despite the "fact" that they were just good kids looking for fun. Let them get a fucking job and make something of themselves.

Is this post dripping with venom? So sorry...

Really...I am sorry. I have so much anger over this issue. I barely let it out in this rant. I know there is another side to this tragic story and I am sorry for that side and for any who have experience with it.

-Jeanne

Yeah, that ↑. It's pretty much like that in the People's Democratic Republic of Massachusetts. Dodgy

My doctor - who has been my PCP since 1981 - cast me into the clutches of a damn pain management clinic instead of continuing to prescribe Vicodin for my chronic pain when there had been no issues for 25 fucking years. Angry
It wasn't like it was a lot or all the time, either. Sometimes it was more than a year without, then a few months with, then none, etc.

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23-06-2017, 08:01 PM
RE: Opioid "epidemics"?
(22-06-2017 06:41 PM)Brian37 Wrote:  
(22-06-2017 10:34 AM)Vera Wrote:  Only, opioids actually have a primary reason for existing which is NOT the entertainment (or however you want to call it) value.

The fact that people would abuse anything that comes their way shouldn't mean that people living in excruciating pain should be denied the only thing we have so far that can help them.

It isn't about denial of the pain, it is about NOT KILLING THEM by allowing them to become addicted.

There is a huge difference between being terminal and pain management outside of being terminal. Doctors have to weigh the risks and benefits. There are risks to taking pain pills and it isn't just about the pain itself. If a doctor thinks giving it to them can speed up body damage, or cause them to be uncoordinated like a drunk person, that can cause that person to have accidents in the home which could in tern cause them to fall or break bones, especially with elderly with mobility problems.

Like heroine and alcohol it becomes your brain screaming for it beyond your own will power. Ethical doctors will ask you questions and check your blood, and if they feel you are on too much of a high dose OF ANYTHING, they will try a different medication or a lower dose or take you off of it completely. Having taken care of an elderly mother for several years I can tell you you don't keep someone on something and not monitor it, and that is with any medication, not just pain pills.

With any medication, not just pain pills, the issue is risk vs benefit and frequent monitoring. If a doctor is not doing that, they should lose their licence.

What good would a pain pill do you if it destroys your liver or kidneys or if you become so incoherent and rubbery you have an accident in your home, or worse, you drive on them and have an accident?

Pain pills in general are only meant for short term relief. They are not meant to be taken forever. The only time you can say they are far more appropriate is for terminal people.

Bullshit.
Chronic pain is well-managed by narcotics. If someone chooses to drive or operate other dangerous machines while under the influence, that is on them, not the doctor, not "Big Pharma", not anyone but themselves.

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23-06-2017, 08:08 PM
RE: Opioid "epidemics"?
(22-06-2017 06:55 PM)Jeanne Wrote:  Do people who use opioids for chronic and intractable pain become addicted?

In only the same way a diabetic becomes addicted to his or her insulin.

Yes, no doubt there are addictive withdrawal symptoms when a chronic/intractable pain victim is taken off or weans off the opioid meds. But...the symptoms pale in comparison to the EXCRUCIATING PAIN that they have again.

Using for pain does not create a high like a drug addict gets. There is a time of slight general well-being when the meds kick in and start relieving the unrelenting pain. Oh gosh, that might be an addicting feeling.

If you need pain pills for short term relief, then you don't need opioids and you don't have chronic or intractable pain. I will agree with you there.

There are many non-terminal people who need opioids. Well...we are all terminal, but you know what I mean.

The difference between taking a narcotic to manage pain and taking it for pleasure is notable. I think you have hit the nail on the head.

Quote:Most people with AA take more than one opioid to relieve their pain to a bearable degree. And..OTC stuff and maybe an implant, as well. It is cruel shit, is Adhesive Arachnoiditis.

Is that some sort of sticky spider? Consider

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