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Thread: Opioid crisis bullshit

  1. #1
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    Opioid crisis bullshit

    This story just ticked me off:

    https://www.washingtonpost.com/natio...0f5_story.html

    A quarter of the adults who went to hospital emergency departments with sprained ankles were prescribed opioid painkillers, a new study shows, in another sign of how commonly physicians turn to narcotics even for minor injuries.
    News flash -- if they're in the ER because of a sprained ankle, odds are, it's bad enough where they're not sure if it's broken or not. And, sprained ankles are occasionally not the only thing an ER person has. Some people with such ankles took a hit or a fall. So, duh, opioids get prescribed.

    Patients who received the largest amounts were five times as likely to continue with prolonged opioid use than those given 10 tablets or fewer, though their overall numbers were relatively small.
    Hmm... maybe the ones given more opioids HAD MORE PAIN?!? DUH!

    Yes, there' a real opioid crisis -- a real pain management problem. But, there's all sorts of bullshit surrounding it, which seems to gloss over the fact that some people have a real pain problem. If opioids aren't the right answer, what is? Live with pain, which is often code for "don't move around, watch TV, play video games, get fat"? Or is it "mindfulness", which is realizing and actualizing that your life sucks in the moment AFAICT? Insurance prefers to not cover poorly-understood "chronic pain"-type conditions. Live with it, you fuckers!

    If people can predict what your pain, healing, and tolerance levels ought to be for a given injury, why aren't opioids prescribed in descending order of pain strength? You start out with the strong Norco or Vicodin for the first day or two, then get ratchet'ed down as you should be getting better? No, you tend to see "take as needed" directives. If you're so fucking sure, prescribe that way.

    No, I don't have a pain problem (apart from my ankle when I run too long --- getting old sucks but aspirin helps). I have strong opioids in my medicine cabinet dating back many years due to misdiagnosed pain, so no addiction. But, I see people with real pain being mishandled way too often. The solution to opioid tolerance and opioid addiction (two separate things) leading to escalated opioid stupidity is less opioids, not better pain relief. Fuck you unless insurance buys you better drugs!

  2. #2
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    Oh joy...
    WASHINGTON — An injectable drug that the manufacturer says is too dangerous to use along the spine is growing in popularity for back pain as doctors turn away from opioids.
    https://www.nytimes.com/2018/07/31/h...njections.html

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    Investigators found that legalization and access to recreational marijuana reduced annual opioid mortality in the range of 20% to 35%, with particularly pronounced effects for synthetic opioids.
    https://www.sciencedaily.com/release...0807092350.htm

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    For all the seeming complexity of these inputs, what doctors see on their screen when they call up a patient’s NarxCare report is very simple: a bunch of data visualizations that describe the person’s prescription history, topped by a handful of three-digit scores that neatly purport to sum up the patient’s risk.

    Appriss is adamant that a NarxCare score is not meant to supplant a doctor’s diagnosis. But physicians ignore these numbers at their peril. Nearly every state now uses Appriss software to manage its prescription drug monitoring programs, and most legally require physicians and pharmacists to consult them when prescribing controlled substances, on penalty of losing their license. In some states, police and federal law enforcement officers can also access this highly sensitive medical information—in many cases without a warrant—to prosecute both doctors and patients.

    In essence, Kathryn found, nearly all Americans have the equivalent of a secret credit score that rates the risk of prescribing controlled substances to them. And doctors have authorities looking over their shoulders as they weigh their own responses to those scores.
    https://www.wired.com/story/opioid-d...-chronic-pain/

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    https://www.sciencedaily.com/release...0819102703.htm

    For example, one of his studies found that almost 80% of dental opioid prescriptions for adolescents and young adults are for tooth extraction, a procedure for which ibuprofen provides effective relief.
    Fucking dismissive one-size-fits-all bullshit. Some tooth extractions are worse than others. Did they evaluate the patients at the time? No, they just lined up prescriptions to diagnosis codes. Clever.

  6. #6
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    Predictable.

    https://www.sciencedaily.com/release...0825120132.htm

    in states that mandated PDMP use, opioid prescriptions decreased as intended. The mandates, however, had the unintended effect of driving existing opioid users toward more lethal illicit substitutes, such as heroin.

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    Will we ever hear about this again? I'm betting no...

    https://scitechdaily.com/better-than...and-addiction/

    The successful separation of analgesic properties and sedation is an important milestone in the development of non-opioid pain medication. It is especially noteworthy because the newly-identified agonists are comparatively easy to manufacture and administer orally to patients.

    However, Prof. Gmeiner has to dampen any hopes of rapid widespread use in human medicine: ?We are currently still talking about basic research. The development of medication is subject to strict controls

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