No more Purdue Pharma

[11B10]

Some here may remember me posting about my personal history with Oxycontin, a drug that while beneficial to me personally, has been responsible for so much human tragedy. We now know that the lives ruined were driven by greed. I've been blessed in countless ways - and one is that I've survived Oxycontin and have been free from it for nearly 3 years. This plea bargaining by Purdue Pharma/Sackler family led me to do some reading, which led to the link below. If you really want to get worked up, pay close attention to the quotes from the Sackler family (especially David).




https://filmdaily.co/news/sackler-family-wealth/

[Stephanie B]

How do you suggest that physicians monitor their patients to insure that they are using a controlled substance safely?

A presumption of innocence, for starters? Not implying that they are a bunch of druggies? Maybe taking the time to get to know what's going on with their patients, instead of a nearly drive-by visit and "here's a script for 90 Oxys"?

My recollection of a dozen or so years ago was that it was pretty common knowledge which doctor one needed to go see if one wanted a shitload of oxy. If the lay population knew, surely the pharmacists knew who were the candymen. So, likely, did the other doctors.

Funny thing: Don't we see this over and over? Some people abuse something and then everyone else's use of that thing gets restricted.

[willie]

How do you suggest that physicians monitor their patients to insure that they are using a controlled substance safely?

Perhaps they could screen them more closely before issuing opioids, and then meet with them face to face to monitor patient need. Are these doctor/cya steps? The reason I ask is that my friend's pain specialist prescribes more pills than needed, and at the same time reminds my buddy to take them before urine tests. I predict that more older people will commit suicide if pain levels are not managed. Since this area has become so controversial, I wonder whose research we can rely on to draw valid conclusions. I am not qualified to say much other than than wondering who determines consensus. I know that truth changes as data changes, and different interpretations arise. Today's consensus will differ from the 2040 consensus.

[Baldanders]

Perhaps they could screen them more closely before issuing opioids, and then meet with them face to face to monitor patient need. Are these doctor/cya steps? The reason I ask is that my friend's pain specialist prescribes more pills than needed, and at the same time reminds my buddy to take them before urine tests. I predict that more older people will commit suicide if pain levels are not managed. Since this area has become so controversial, I wonder whose research we can rely on to draw valid conclusions. I am not qualified to say much other than than wondering who determines consensus. I know that truth changes as data changes, and different interpretations arise. Today's consensus will differ from the 2040 consensus.

My mother's recent experiences with severe chronic pain management lead me to believe we are undermedicating pain in many people now.

But I may be biased by hearing my mom give her opinion on how the "pain management pendulum" swings from "too damn much" to "way too little," based on her experiences as an RN....25-30 years ago. 😔

Maybe drug companies and Drug War Puritans aren't the best people to decide opioid management strategies?

[Baldanders]

Funny thing: Don't we see this over and over? Some people abuse something and then everyone else's use of that thing gets restricted.

Gee, whatever could you be talking about? Nothing that relates directly to this forum's central concern, I'm sure. 🤣

[TC215]

I don't see much meth at all locally. Heroin and/or Fentanyl seem to be the most common. Pills are less common as well. Heroin is hard to compete with price wise, pills are much more expensive to obtain. I don't know about the more rural areas currently but Opana was the big issue after meth died down. Which did lead to it's own issues, due to needle sharing.

Heroin/fentanyl is catching up to meth here. We’re having a ton of OD deaths (I’m working multiple OD cases right now). A lot of the pills we’re seeing are actually pressed fentanyl made to look like oxy’s.

One other thing that this slight drift made me think of is that the legalization of weed has probably forced the narcos to diversify their product lines as well. Weed isn’t in as much demand, fine call up some factories in China and get your meth cooking on.

The black market for weed is alive and well, and there is huge money in it. My old drug unit seized almost a million dollars and a couple hundred pounds of weed this year off an 18 year old that just got out of high school. His weed came from a state where it’s legal, which is extremely common.

[TGS]

A presumption of innocence, for starters? Not implying that they are a bunch of druggies? Maybe taking the time to get to know what's going on with their patients, instead of a nearly drive-by visit and "here's a script for 90 Oxys"?

My recollection of a dozen or so years ago was that it was pretty common knowledge which doctor one needed to go see if one wanted a shitload of oxy. If the lay population knew, surely the pharmacists knew who were the candymen. So, likely, did the other doctors.

Funny thing: Don't we see this over and over? Some people abuse something and then everyone else's use of that thing gets restricted.

I don't see the process/program as being a problem.

What's likely the problem from my experience as a patient and also working is healthcare, is probably "bed-side manners" on the end of the doctors. No offense to our good doctors here, but that community generally has the human social skills of Patrick Bateman, and can turn what should be pleasant experiences into needlessly miserable, condescending, insulting, and confrontational ones. I, as well as most of my (former) coworkers are genuinely convinced that most doctors are on the autism spectrum (which makes sense given their intelligence and razor-sharp focus for 24 hour shifts), but that comes with the price of human interaction skills and being able to detect the impact that their tenor/speech and actions have on people.

Hence, my generally positive fervor for NPs and PAs. It's always good to have a people person who can take the specs from the customers and translate between the engineers and customers. (brownie points if anyone gets the reference)

[11B10]

A presumption of innocence, for starters? Not implying that they are a bunch of druggies? Maybe taking the time to get to know what's going on with their patients, instead of a nearly drive-by visit and "here's a script for 90 Oxys"?

My recollection of a dozen or so years ago was that it was pretty common knowledge which doctor one needed to go see if one wanted a shitload of oxy. If the lay population knew, surely the pharmacists knew who were the candymen. So, likely, did the other doctors.

Funny thing: Don't we see this over and over? Some people abuse something and then everyone else's use of that thing gets restricted.

Stephanie - you did what you always do - nailed it.

[Jim Watson]

I was a bit surprised to see that they are dissolving the company and replacing it with a government-run company.

Government made dope is supposed to be an improvement?

[Half Moon]

Government made dope is supposed to be an improvement?

If it's .gov made its not dope; it's soma. Totally different :-P