So painkillers used against prescription kill more people than any individual illegal drug and since people demand painkillers to treat chronic pain physicians are looking to treat chronic pain with alternatives one such is using MJ as one of those alternatives because misuse doesn't result in fatal overdoses, generally.
That wouldn't even be hyperbole, that's still just factual, with an emotionally loaded comparison. Hyperbole would be like, "painkillers kill a trillion people a year!"
It affects a lot of people yes. It's also a big problem. It's the juxta that's done in a fashion to get clicks. The article is also rather light on details.
The juxta bothers me because Rx drugs are a necessity as judged by physicians, it's not a lark. Illegal drugs on the other hand are not prescribed, for the most part, and are a different issue altogether. They address perhaps other pains, but conflating them in this sense seems dishonest.
It seems you are not catching the point of the article. Did you read? The problem is addiction and people turning to illegal drugs after becoming addicted to legal RX.
I might be completely wrong here so please correct me if I am. Why would a doctor care what a patient demands? Tell them no. There's nothing they can do about it. I can't demand any prescription drugs from my doctor (I'm in the UK) - and I've tried once. Do doctors in the US worry about losing money if they lose a patient or this that not the case?
Edit: Thanks to those who responded. Although I suspected it it still blows my mind that people don't see how and of an idea that is.
When you inexplicably decide that health care is a "marketplace" of rational and informed actors, patients become customers that need to be pleased, and lost patients become lost revenue. We are in a world of hurt over here, please send help.
It's more orders of magnitude more dangerous and addictive (in that marijuana is almost impossible to OD on, and isn't addictive at all).
Marijuana is certainly not the magical silver bullet some make it out to be, but it's incredibly effective for many people whose only other recourse would be opiates.
FYI, cannabis certainly can be addictive, just without serious physical dependance. And even on the mentally addictive side, obviously far less than opiates - but certainly there are people who fit the definition of being addicted to weed.
Cannabis is not physically addicting, and if the person is psychologically addicted then it will be that person's environment which will be the culprit.
Kratom is a great and currently legal alternative. It works on opioid receptors and cannot be fatally overdosed. Unfortunately, many sates are already moving on banning it. Big pharma lobby for the win.
What are you talking about? Link to any case of death that has been attributed exclusively to an overdose of kratom. You can't, because it doesn't exist.
Stock up while you can. However some states have unbanned it, and others yet are not voting their bans into legislation. There's hope yet, but it will be a hard fight, particularly with the FDA.
Unfortunately, there are almost no effective treatments for chronic pain available other than opiod painkillers and there is significant vested interest in the pharmaceutical industry to keep it this way.
Whenever I see an article like this, it is frustrating as there is an alternative to opiods for chronic pain management that is just as effective, carries no risk of overdosing, minimizes the the chance for dependence (and in fact is often used by those looking to break opiod dependence) and at scale, could be available for fractions of a penny. As a bonus, it can also serves as an actual replacement to ADD and antidepressant medications as well as serving as an effective tool against other types of addiction (e.g. alchoholism) and has 100s of years of "clinical trials" in the real world to support its safety. http://www.scientificamerican.com/article/should-kratom-be-l...
Unfortunately, the powers that be have no interest in changing the status quo particularly when it would undercut patented money making drugs currently available, so very little research is conducted into this area and those who wish to do so are often actively thwarted to the point one has to conclude that there is not actually a real desire to address this problem.
There's not much content in this article. However, if people tend to use a drug beyond its prescription, with very bad results, that's still a reason to change things.
I mean, ipads do not have a big red button with "rm -r /" listed. I don't see why the drug industry should be exempt from designing constraints that prevent user error.
You can't even imagine the pain and suffering the constraints currently in place cause legitimate users of pain killers. Doctors are so scared of the DEA they're doing crazy things. Someone very close to me had a ruptured disc, killing the nerves in her spine, so much that just standing would cause pain that made her black out or vomit. And even though she'd never been prescribed anything for pain, she had to hover over a urinal crying uncontrollably, to take a drug test to make sure she wasn't an addict.
If the line is between people suffering horrendous incomprehensible pain and people making a choice to abuse drugs. Well I'm pushing that line right up against the people who get the luxury of making a choice.
I dont know the details of her situation, but I think chronic pain management goes something like this:
* patient such as your friend has excruciating pain, requiring the heaviest of the narcotics (say oxycodone/oxymorphone, instead of a "mere" hydrocodone that you'd get for wisdom teeth or something ).
* these narcotics are so incredibly dangerous that they must be taken
exactly as prescribed for the following reasons. 1) Patients have a temptation to take an extra one (or snort one) to achieve a euphoric and addicting "high" that can be irresistible once its experienced. 2) In some cases taking even one or two extra pills can kill the patient. 3) Patients have incentive to Not take them because some pills can fetch up to $40 EACH on the black market.
4) not taking them exactly as planned can cause a tolerance buildup or reduction, which can stymie the physician's efforts to find the safest minimal and effective dose for continuous pain management.
* To combat all 4 of these factors, pain management specialists enter into "contracts" with their patients that they will treat their pain, if and only if, they agree to take the pills EXACTLY according to plan. To affirm compliance to this plan, the patients are subjected to random drug testing. Not just to see if they are getting high (over using them ), but also to see if they are using them at all, (i.e. not selling the pills for a massive profit ). IIRC, if you show up to your test and they find no painkillers in your urine, you can be taken OFF the plan, i.e. no pills for you.
tl;dr they drug test patients to make sure a precise plan is being followed because there are at least 4 separate "failure modes" to chronic pain management.
I learned most of this from news articles and reading junkie's tales on /r/opiates. I'm not an expert, nor user, but I just find the whole topic very interesting. Please correct me if I've said anything wrong.
The person I was referring to was so traumatized by the experience she went to a surgeon two days later and begged for the surgery, even though she was strongly advised to give the pain pills and anti-inflammatories time to work. The surgeon scheduled her 12 hours later and she's been better than new for several years now....Luckily.
People have agency. And should be allowed to make their choices. Especially in cases where not allowing them to make their own choice starts hurting innocent people. And by hurting, I mean that very very literally in this case. The type of pain that causes people to end their lives. Caused by a system more afraid of a bad decision than of leaving people alternating between howling and sobbing in pain for days.
> People have agency. And should be allowed to make their choices.
That also includes physicians. Their asses are on the line for every patient they treat. If one of their patients OD's, a full death investigation will be done, possibly including DEA, possibly including the medical board.
If any perceived misconduct is found on behalf of the doctor, s/he could be sued, censured, fired, or perhaps even jailed. When you study for 12-15 years to get a single job, the emotional pain from losing it all isn't far from the physical pain of what your friend went through. Not to mention that doctors have empathy, and would also feel guilt and remorse if their actions killed a patient.
Even though it was a painful, humiliating ordeal for your friend, that's better than cavalierly throwing opiates at her which could have possibly killed her.
> People have agency. And should be allowed to make their choices.
I am not trying to sound like an asshole here, but with pain pill addiction, you don't have agency. that's precisely what addiction is ! You lose agency, willpower, and even develop narcissistic defenses (in some cases) to provide a psychological pathway to defend the addiction. You become a slave. This is exactly why they are regulated!
"That also includes physicians." That is exactly my point. Doctors shouldn't have to make patients jump through hoops in order to prescribe medicine. Maybe I should have stated it clearer, the remedy I want is for doctors to be able to prescribe as they see fit without the DEA raiding their office and throwing them in jail.
As for over prescribing, that should be no more dangerous than any other medicine. If my doctor gives me 800mg ibuprofen and I take 10 of them in the morning, he isn't responsible. As it should be for pain killers.
As for addiction sucking, I also already agreed it is a problem, but when I weigh it against innocent people, who didn't make a conscious decision to do something wrong, I find it the lesser of evils to let people make that very bad choice. Do I really need to say I don't have a problem with doctors monitoring patients for addiction? But extreme measures are being taken, not out of an over abundance of caution for patients but because the DEA is throwing doctors in jail.
I misunderstood, sorry, I thought you meant the pt should have the "agency" to decide how to take their painkillers.
I don't have the data to back this up, but I don't think the DEA is the primary impetus for drug testing patients. What I surmise is that most likely, a double-blind academic study was done, just like how they establish every other standard treatment protocol. Likely, they determined that drug-testing patients significantly reduces the incidence of OD and abuse, i.e. reduces morbidity and mortality. Being scientists, they adopt the technique that works.
There is a big difference between treating a one-time injury and writing a prescription for 20 pills, versus someone with a pinched spinal cord that's never going to get better, that gets a permanent supply. For the latter, you go to a pain specialist. IIRC GP's dont even get involved with that.
> that should be no more dangerous than any other medicine
an NSAID "should be no more dangerous" than an opiate ? Please tell me you are aware that unrelated molecules will have dramatically different pharmacological effects on a human body.
If a doctor gives you access to a deadly product, one that could kill you if you go over by merely a single pill, and doesn't do everything they possibly can, then a jury, medical board, or (in rare cases) the cops might have a case for malpractice or patient endangerment. Anyway, I dont have any more fuel to back this argument up, but I wish your friend the best, pain-free life!
I upvoted your comment because I agree with your points, I just think doctors should be able to do what they think is right without fear of prosecution. And at my friend's pain management doctor's office, there was a big sign in the front room enumerating the steps he felt he needed to take him to protect himself from DEA prosecution. My sister's a lawyer who I asked about the sign and she said he was probably being extremely conservative, but that doctors don't even want to show up on the DEA's radar. Doctors are human like anyone else, and having a DEA agent ask to see your records would scare them silly, just like anyone else. And patients suffer. A lot.
... and a good chunk of these people end up on heroin instead when they get taken off these plans, because it's far cheaper to buy heroin on the black market than oxycodone when their doctor throws their toys out the pram. To the point where this is one of the main avenues pushing people to use heroin in developed countries today.
It's a fucked up way of dealing with people we suspect have a health problem to take an action we know makes the problem substantially worse for a large proportion of them.
The irony is that medical grade heroin in predictable doses is one of the safer alternatives, and far cheaper again. But of course these people do not get medical grade heroin - they get street heroin cut with anything from cheaper drugs to brick dust.
Vox, stop with the hyperbola.