[PatientTrades]

Most of this stems from the overprescription of opioids. I remember when I had surgery for a broken leg the amount of drugs I received after the surgery was astounding. It was almost as if the hospital wanted me to become hooked. I didn't need or ask for the opioids, they were just prescribed for pain killing. A regular Tylenol or Advil would have done the job. Not saying hospitals want people on drugs, but at some point we have hold the people initially prescribing the drugs accountable.

[snuxoll]

It's incredibly easy to get hooked when taking prescription opiates even if you're fully aware of the situation. I had a wisdom tooth extracted last year, and by the time the pain was finally down to the level I could manage with OTC pain relievers I realized I had developed a mild physical addiction to the hydrocodone.

I had no desire to get high off the pain killers, hell, they didn't even do anything for me in that regard - but I could feel the need to take them. I can easily see how someone without the awareness, willpower and a number of other factors could give in and start down the path of self-destruction. It was a terrifying place for me to be in, and as someone who has responsibly taken prescription opiates for multiple other oral surgeries as well as a septoplasty it was one I never thought possible.

[loverofcode]

There is a difference between dependence and addiction. People who are in pain 24/7 rely on these medications and are being thrown into the streets because of the DEA, when if fact this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe

[snuxoll]

Don’t take my anecdote to mean I’m against prescription opiates, there’s no way in hell I would have been able to manage my pain after these procedures without them - in fact I think we’re steering the ship far too hard away from their use in a reactionary move to combat these deaths. But I don’t have any doubt many people have become physically dependent on these drugs and are now turning to the black market - it very well could have been me in another life.

The war on drugs really needs to come to an abrupt end, people who need opioids to manage their pain should have them, people who are hopelessly addicted should have access in a controlled and safe manner, and for crying out loud can we just legalize weed already?

[ellyagg]

What makes you say that? It's trivial to get opioids on the streets and it's common to be introduced to them as a recreational drug, as I know first hand.

In fact, I don't know anyone who got addicted to opioids due to overprescription, but I know several people who didn't get prescribed opioids they needed because of the fears of overprescription, and thus were left in terrible pain. I don't know how you draw the line, but I think it's evil to leave people in pain because you're afraid they'll use the drugs for fun. Most people who take opioids do not get addicted.

[gebeeson]

I went through open heart surgery two years ago April and opioid over-prescription was already a concern. After discharge I received a six day script for the lowest dose of fentanyl and a month of Lyrica. I have a freakishly high pain tolerance so I managed to 'stretch' the fentanyl patches out to nearly one month (each patch lasted roughly three days). Hindsight being what it is - I obviously made it through. Being down in it though, it was far far less than pleasant. Especially that I was supposed to be active and all the usual recovery stuff. It was a bit of no joke as far as pain load goes. I didn't expect to be completely pain free as that isn't life as far as I am concerned, it would have been nice to have taken a little bit more of the edge off. Round the pain off some.

[hiram112]

Agreed.

I too have had a major surgery several years ago. I was given morphine and than Oxycodone when discharged, but not at high enough dosage for adequate relief - 3 or 4 days of pure misery. There is no reason, when short-term opiate use is easily available, for patients to suffer like this.

It seems like the medical establishment was really pushing opiates for years, even when they probably weren't needed. Now they're swung too far in the other direction: under-prescribing them for fear of overdosage, addiction, and even punishment by the DEA and government. Wish we could find some middle ground.

[munk-a]

People generally say that over-prescription leads to harder opioid usage because it does. I have had co-workers familiar with the neurological effects of the drugs they've been given balk at it. I've also known community members who had injuries slide into the obscurity of addiction.

A very real factor of this crisis is the pain aversion, people working in dentistry have higher rates of depression and suicide due to the psychological effects of inflicting pain on people (unless the dentist is played by steve martin ofc) and it's a problem without clear solutions. Legalization of marijuana would probably help reduce the mild-moderate pain classes in a non-addictive manner, but for extreme pain there isn't a good solution.

Anyways... there are plenty of first-hand accounts and plenty of studies showing the connection here, please do a little research before posting unsupported claims.

[incadenza]

It's important to note that the epidemic that people refer to is the overdose epidemic, often labelled the opiate epidemic for whatever reason.

I haven't seen any evidence that actual rates of heroin abuse increasing year over year. Just wealthier people dying from poorly cut drugs at a more alarming rate.

This was the most recent report I could find: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2...

[loverofcode]

That is not true, first dentist have a higher suicide rate not because of the pain on people but because so many people hate to see them. It is never a pleasant experience. You also should be aware of the suicide rate in pain patients because their pain cannot be under control. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe

[nickik]

What makes him say that is that it is a well documented problem. Many other people recognize it and treat it accordingly.

My father is a Anthologist and they are very careful with how much they give. It is a major issue.

For some reason, the US, including doctors, have developed a anti-pain philosophy where they oversubscribe these drugs and it is know to cause addiction.

[refurb]

If you've been around long enough you'd realize we're come full circle. Prior to the 1990's pain meds were very rarely handed out.

Then a few things happened: (1) more data was collected that suggested when used for severe pain, the addiction potential was low, (2) adequately controlled pain leads to quicker recovery times and (3) there was a lot of untreated pain at the time.

As a result, opioid use when way up. One could argue it went to far with very strong opioids being given for mild or moderate pain.

The sad thing is that we're already seeing doctors get more stingy with opioids. My guess is we'll swing too far in the other direction and in a decade we'll have people with severe, incurable cancer pain being told "you don't need opioids".

[adfm]

For more background on why we've got a dope problem, check out this LA Times piece on Oxycontin's 12-hour Problem:

http://www.latimes.com/projects/oxycontin-part1/

[refurb]

That article was written by someone not that familiar with the pharma market.

It would be illegal for Purdue to promote on any other than 12 hours. It's called off-label promotion and companies pay multi-billion dollar fines for it.

[firebones]

While it is factually true that it would be illegal for Purdue to promote off-label, they also need to be held accountable for playing fast and loose with the research studies (even altering the definitions used in the trials) in order to be able to claim 12h coverage when nearly half the patients weren't getting 12h coverage. This, combined with the recommendation to push higher doses to achieve 12h coverage, combined with the gap in coverage, drove a lot of people into a cycle of unhealthy and deadly dependency.

At the very least it's a case of consumer product safety liability and negligence fueled by profit motive.

[refurb]

Shouldn't the FDA be held accountable? They approved the trial design and overall application.

[firebones]

I wish regulators could be perfect, and if they were, we'd reduce harm a lot. But since we know they're not, we can, as participants in society, be as Caesar's wife--above suspicion--and avoid these situations entirely.

A lot of capitalism's woes would be overcome should that standard be applied.

[loverofcode]

Untrue. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe