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A Sad Report from Deep in Mountain Music Country

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Jul 18, 2019 - 9:45:05 AM

Bill Rogers (Moderator)

USA

22100 posts since 6/25/2005

Jul 18, 2019 - 10:34:26 AM
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DC5

USA

6415 posts since 6/30/2015
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Coal country was the epicenter for the opioid crisis. Pain clinics were opening up and giving scripts to anyone who walked in the door. The myth that you could not become addicted as long as you were in pain contributed, but the pharmaceutical companies pushed this myth. They should be sued into oblivion, but it won't happen. Heroin and fentanyl are on the rise due to a cutback in prescription opioids.

Jul 18, 2019 - 11:21:55 AM
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8690 posts since 2/22/2007

I always wonder about the supply side of the situation, as news stories always talk about the quantities delivered to an area. But where is the demand coming from? Are the people there, (and most everywhere it seems), ready and eager to become addicts if only there was plenty of supply? Seriously, how many of you would walk into the corner drug store and buy fentanyl or oxycodone if it were available cheap and legal without prescription?
I simply do not believe that otherwise healthy and normal individuals are being helplessly addicted because a big load of opioids arrived in town. I believe that the addiction is a symptom of an underlying issue that is already there.

Jul 18, 2019 - 11:44:23 AM
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csacwp

USA

2258 posts since 1/15/2014

quote:
Originally posted by banjo bill-e

I always wonder about the supply side of the situation, as news stories always talk about the quantities delivered to an area. But where is the demand coming from? Are the people there, (and most everywhere it seems), ready and eager to become addicts if only there was plenty of supply? Seriously, how many of you would walk into the corner drug store and buy fentanyl or oxycodone if it were available cheap and legal without prescription?
I simply do not believe that otherwise healthy and normal individuals are being helplessly addicted because a big load of opioids arrived in town. I believe that the addiction is a symptom of an underlying issue that is already there.


Yes. Likely due to folks losing manufacturing and mining jobs, leading to depression which in turn manifests itself as chronic psychosomatic pain. This is a well studied psychological phenomenon.  

Jul 18, 2019 - 11:45:47 AM
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chuckv97

Canada

41901 posts since 10/5/2013

Causes of addiction are complicated & many-fold. That’s why the cure is so elusive.

Jul 18, 2019 - 12:03:24 PM
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DC5

USA

6415 posts since 6/30/2015
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quote:
Originally posted by banjo bill-e

I always wonder about the supply side of the situation, as news stories always talk about the quantities delivered to an area. But where is the demand coming from? Are the people there, (and most everywhere it seems), ready and eager to become addicts if only there was plenty of supply? Seriously, how many of you would walk into the corner drug store and buy fentanyl or oxycodone if it were available cheap and legal without prescription?
I simply do not believe that otherwise healthy and normal individuals are being helplessly addicted because a big load of opioids arrived in town. I believe that the addiction is a symptom of an underlying issue that is already there.


The problem originated with people in pain, not people seeking a high.  Pain is relatively common among coal miners, construction workers and agricultural workers.  The pain clinics issued the pills, and since those taking them became addicted, the endless supply chain continued.  Add to this the loss of good jobs and general local depression in the economy and you have a perfect storm for addiction.  Sam Quinones did an excellent job of documenting this in his book Dreamland.  The manufacturers pushed the pills claiming they were not addictive when used for treating pain.  There was a general belief that no one should have to endure any pain - this was the origin of the 1-10 scale of smiley faces you find in the E.R.  10 day supplies were common, and it only takes 5-7 days to become addicted, fewer for some people.  

BTW, before I read the book I had the same thoughts that you have stated here.  The book was a true eye opener.  I also had the pleasure of getting to see Mr. Quinones speak in person.  

Jul 18, 2019 - 12:10:37 PM

Bill Rogers (Moderator)

USA

22100 posts since 6/25/2005

Sam Quinones is one of the best reporters around. The work he’s done and the risks he’s run put him among the finest ever in the business.

Jul 18, 2019 - 12:13:45 PM
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51931 posts since 12/14/2005

When I saw the title, I thought someone had died.
Turns out LOTS of people have died.
That's even sadder.

Jul 18, 2019 - 1:05:40 PM

8690 posts since 2/22/2007

I also worry about those who actually DO need these medicines. My MIL has passed, but until she did she was in pain management, where they treated a crippled 86-yr old as is she were a criminal suspect, made her pee in jar every 30 days and she lived in terror of running out, because her spine was steadily shaping itself into a question mark and her vertebrae had fused together, which without a strong regimen of opioids would have left her in screaming pain with suicide the only option.
And that option is chosen many times when doctors are told by regulators what a patient that they know nothing about, actually needs. Or as one genius said "just take a Tylenol".
I must admit that I wished that he would know that desperate pain up close and personal one day.

Jul 18, 2019 - 2:16:55 PM
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figmo59

USA

29095 posts since 3/5/2008

I have opinions that can not be shared ..here..

As fer the addiction...

I can see where it might be easy to be addicted to ..not feelin pain...

I personally refused most all pain meds even through me recovery from me minor Heart surgerys.........

Truth is.. I was afraid of becommin..dependant on them......

Howevah Tylenol...did help me sleep betta...

I have strange enuff ..dreams now...without the morphine...

Jul 18, 2019 - 3:13:31 PM
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donc

Canada

5908 posts since 2/9/2010

Without ever having a long term incurable pain I'm no expert. I'm sure that chronic pain can easily cause people to take drastic measures. We have faith that our local doctors will cure almost any pain, but when they tell you they can't ...then what ?

Jul 18, 2019 - 3:45:08 PM
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8807 posts since 1/15/2005

Pain and pain medications are funny (not in a ha ha way). I have a relative who seems to live for taking pain medication and for every medical procedure insists that they be given pain medication. In one case, after some eye surgery, and they complained about the pain, the doctor said "you are supposed to be in pain, you just had surgery". On the other hand I, like Figmo, absolutely hate pain medication, mostly because I hate the side effects and do fear becoming dependent on it. I have a high tolerance for pain .... not that I am proud of it, but that is just the way it is. After surgery for a Pilonidal Cyst, where they remove a 3" long 1'+ deep chuck of flesh from your tailbone, I never took anything stronger than a Darvon. It was done abort the USS Sanctuary off the coast of Viet Nam, so pain medication was not scarce!

Later in life I had a kidney stone and experienced a level of pain where I definitely could sympathize with those who have unbearable and chronic pain. It sure gave me a perspective of what it feels like to hurt so bad that you would do anything for relief. I have the utmost empathy for those who suffer that level of pain .... and those who get hooked on the meds .... although I realize there are some who started taking them for all the wrong reasons.

Jul 18, 2019 - 4:29:02 PM

2507 posts since 7/28/2015
Online Now

quote:
Originally posted by banjo bill-e

I also worry about those who actually DO need these medicines. My MIL has passed, but until she did she was in pain management, where they treated a crippled 86-yr old as is she were a criminal suspect, made her pee in jar every 30 days and she lived in terror of running out, because her spine was steadily shaping itself into a question mark and her vertebrae had fused together, which without a strong regimen of opioids would have left her in screaming pain with suicide the only option.
And that option is chosen many times when doctors are told by regulators what a patient that they know nothing about, actually needs. Or as one genius said "just take a Tylenol".
I must admit that I wished that he would know that desperate pain up close and personal one day.


Most opioid addicts feel themselves to be in the same situation as your MIL.  The guy buying fentanyl off the street is thinking that the government doesn't understand his medical condition and his individual pain and that he is forced to do illegal things.   That is the problem with opioids is that they don't actually treat pain but make it easier to live with.  Back pain in particular has very poor indications for opioids.  Whereas an 86-year-old woman who is addicted to opioids will most certainly be in screaming pain without them.  

The present opioid crisis started because regulations were loosened because people rightly thought it was crazy to deny terminal cancer patients medicine that would ease their suffering.   They reasoned that there is no risk of addiction for terminal patients.   From there the pharmaceutical companies started pushing for their use in more and more cases and did things like produce seminars on how to start a pain clinic, where opioids would be prescribed simply to deal with opioid addictions.   They urged doctors to simply prescribe patients these medicines and patients would go from their primary doctor to the pain clinic when the family doctors who did know what was best for the patient would not continue prescribing it for them.  It is well and good to say that individuals know their health needs best but this is a case where the individuals in question were acting in the framework of addiction.  You might as well say that the inner city crack users in the 1980s should not have been regulated from the government because who knows the individual mental health conditions of all those individuals.

Jul 18, 2019 - 4:36:58 PM

8690 posts since 2/22/2007

Frank, this was not "back pain" it was a combination of spinal stenosis and the worst case of scoliosis that the doctors have ever seen. They were not able to get a needle between her vertebrae for a test. It is the doctor who told us that her pain would be unbearable without the opioids, as she HATED the idea of "being on drugs".
Sorry but I see a huge difference between those who chose their pain and those who had it visited upon them.

Jul 18, 2019 - 4:40:15 PM
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RV6

USA

1215 posts since 2/3/2012
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I just read an article written by Bethany Mclean, now with VanityFair,  that I thought was well done.  Bethany wrote "Enron, the Smartest Guys in the Room".  She's the one who blew the lid off the Enron scandal.  Her folks live here part time and her dad is my old backpacking and fly fishing buddy.  I backpacked with her and her dad and his friends many years ago.  She came from New York and backpacked into the Cloud Peak wilderness area.   One tough cookie coming from sea level and going to 10,000 plus feet.  I think she's a really good researcher and writer and generally all around, good person.

https://www.vanityfair.com/news/2019/06/david-sackler-pleads-his-case-on-the-opioid-epidemic

I hope this link works.   I thought the article was very well done.

As an aside, I had tremendous pain associated with CRPS due to a shattered left wrist.  (BTW, CRPS tops the pain scale index.)  I can say that I'd rather pass another kidney stone and have an abscessed tooth at the same time as have another case of CRPS.  (And, yes, I've had both so I know what I'm talking about.)  On the bright side, after doing 6 plus months of twice a week therapy and continuing the therapy at home for a year, it prompted me to celebrate having an actual, functioning left hand, wrist, arm instead of a "hat rack" to  buy my first musical instrument at age 65 --- a banjo!  It took me two months of therapy before I could tie my shoes and a bout one year before I could make a clean, "C" chord.  To say that I'm grateful to the wonderful physical therapist, "Martha, the goddess of pain",  would be and understatement.

Having read accounts of problems with various prescription drugs, I decided not to take the prescription offered to me (Oxycontin) as I was a bit concerned after reading about them.  (Although, if I went through the experience I had 8 years ago, now, I might reconsider.)

Edited by - RV6 on 07/18/2019 17:00:30

Jul 18, 2019 - 6:42:17 PM

2507 posts since 7/28/2015
Online Now

quote:
Originally posted by banjo bill-e

Frank, this was not "back pain" it was a combination of spinal stenosis and the worst case of scoliosis that the doctors have ever seen. They were not able to get a needle between her vertebrae for a test. It is the doctor who told us that her pain would be unbearable without the opioids, as she HATED the idea of "being on drugs".
Sorry but I see a huge difference between those who chose their pain and those who had it visited upon them.


I don't doubt it.   The problem is that a lot of people out there who are in the category of "chose their pain" actively believe that they are in the category of "those who had it visited upon them".    I don't see a free market solution to prevent the latter group from seeking to be treated like the former.

Jul 18, 2019 - 7:25:03 PM
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2494 posts since 2/16/2017

Taking opioids recreationally is very much a thing too. In high schools and especially colleges. Addiction can happen much faster and easier than young people realize.

Jul 18, 2019 - 7:46:59 PM

bubbalouie

Canada

12525 posts since 9/27/2007

I agree with Figmo!  People are such pussies now, any little pain needs a pill. I had 5 by passes & the strongest thing  I took was Tylenol too. 

I know Big Pharma trapped a lot of people but suck it up do your physio & get healthy again.

Stick a needle in your arm? What do you expect? It's a major problem here too.

i know guys that get a cold & make life miserable for everyone around them. They leave snot rags all over & cough on everything. Go home & get your Mommy to rub some Vicks on your chest you precious snowflake.

Sore knee? That's all? Do some work & it won't hurt 'till later.

I heard getting off hard drugs was like having a bad flu for a couple weeks. Too much pain.

Jul 18, 2019 - 8:54:03 PM

Paul R

Canada

11439 posts since 1/28/2010

I was prescribed Oxycodone back in '01. I took one and told my colleagues, "This doesn't kill the pain, it just makes you feel real good about it." I didn't take another one.

If something can deal with the pain without being mind-altering, I'm fine with it. Otherwise, I'd prefer to so without. I want to be in control, not hand control over to a substance, be it a drug, alcohol, or something else.

Last September I had two hernia surgeries in three days. I was offered a choice from three drugs, the third being an opioid. I chose from the first two. I'm sure there are levels of pain I've never come close to experiencing, but, for now, I'd rather hold onto reality.

Jul 18, 2019 - 9:09:56 PM

chuckv97

Canada

41901 posts since 10/5/2013

I had a kidney stone about 6 years ago, real pain I’ve never had before, sweating, vomiting, dry mouth. After 45 minutes they got me to the hospital , then another half hour before they gave me a shot of morphine. What a relief! A script of morphine tablets was tossed out a day later. I was hooked on opiates ( what we used to call them) for 8 years. I can’t take chances - they like me too much.

Jul 19, 2019 - 6:48:29 AM

659 posts since 4/22/2018

I can’t comment for across the pond, but on this side, I think the way the drugs are available on repeat prescription is part of the problem. If you have been prescribed a drug by a doctor, you, more often than not, can go back after it is used up and request it again without physically seeing the doctor. Admittedly the prescription is signed/agreed by a doctor but is suspect they are sigh]Ned in vast quantities by an overworked GP. My wife has a condition that sometimes requires very strong pain relief and we are able to almost order the drugs as and when she needs them from the repeat prescription rather than talking to the GP. Fortunately, as a former nurse, she is responsible and uses them as and when required, however I could see how it would be very easy to abuse this system, or simply slide into addiction.

As part of a role I have in a rescue team, I have a licence to prescribe and give certain controlled drugs that would normally be limited to a doctor or paramedic, and this is strongly monitored and controlled. However, I could if I wanted, get hold of far more drugs of this type if I was so inclined to abuse the repeat prescription system we have - crazy eh?

Jul 19, 2019 - 7:26:55 AM

phb

Germany

1903 posts since 11/8/2010

quote:
Originally posted by banjo bill-e

I also worry about those who actually DO need these medicines. My MIL has passed, but until she did she was in pain management, where they treated a crippled 86-yr old as is she were a criminal suspect, made her pee in jar every 30 days


Did they perhaps do that because they wanted to see whether she really took the pills and not somebody in her family? I read so many stories where some people happily consume or sell their family member's medication that I guess they now want to make sure that none of the prescribed drugs go into the illegal market.

Jul 19, 2019 - 8:53 AM

8690 posts since 2/22/2007

Phillipp asked--"Did they perhaps do that because they wanted to see whether she really took the pills --"

Yes that is the rationale but it is applied indiscriminately, and they KNEW her condition. Now, every single month in the waiting room were several patients that looked VERY sketchy to me, along with others like my MIL who were obviously sick, and I thought that I could group them by sight from across the room. But to hold off the eager lawyers ready to pounce on any medical establishment (which by the way is a huge part of our medical expense problem) the staff is instructed to treat every patient as if they are criminals trying to scam the system.

Jul 19, 2019 - 1:17:20 PM

donc

Canada

5908 posts since 2/9/2010

After my second hernia operation the nurse asked me how I was feeling as I woke up. I said something weak and sarcastic implying that I wasn't exactly comfortable. Without further discussion she gave me a shot of Demerol. It was the most wonderful experience of my life. The sight of blank walls and hospital light fixtures made me feel elated. I know now how easy it is and why people get hooked on legal drugs.

Jul 19, 2019 - 1:22:40 PM

mander

USA

3635 posts since 10/7/2007

I think people rely on doctors to be educated, honest, compassionate, and actually looking out for the well being of their patient. I have met the "Marcus Welby MD" types, but all too many are glorified street pushers without an ounce of principal.

I went to doctor who was highly recommended and a long time friend of the family. He came into his office, without an exam, or even a hey how are you, opened up a drawer and said, "Whatever you want, I got it, free from the drug companies. It's yours for the asking." I made polite excuses, left and never went back.

When I was first injured, it was the same thing. Folks recommended a slew of doctors, and none of them knew what was wrong, but nearly all of them were willing to prescribe me a slew of drugs. Didn't take them. Later, when the pain was causing me to go insane, I went back, but the laws had tighten and no one would give me anything. Just as well.

Jul 19, 2019 - 2:45:46 PM

8807 posts since 1/15/2005

quote:
Originally posted by mander

I think people rely on doctors to be educated, honest, compassionate, and actually looking out for the well being of their patient. I have met the "Marcus Welby MD" types, but all too many are glorified street pushers without an ounce of principal.

I went to doctor who was highly recommended and a long time friend of the family. He came into his office, without an exam, or even a hey how are you, opened up a drawer and said, "Whatever you want, I got it, free from the drug companies. It's yours for the asking." I made polite excuses, left and never went back.

When I was first injured, it was the same thing. Folks recommended a slew of doctors, and none of them knew what was wrong, but nearly all of them were willing to prescribe me a slew of drugs. Didn't take them. Later, when the pain was causing me to go insane, I went back, but the laws had tighten and no one would give me anything. Just as well.


I know that kind of stuff happens, but I have never remotely come in contact with a doctor that would do that.  All of my friends that are doctors and all of the ones I have visited are extremely reluctant to prescribe any type of pain killers that are addictive.  One day as my wife got out of her chain her back went out (I was away out of town) and she literally could not get up off the floor.  She call one of our best friends who ran the emergency room at our local hospital system and asked him for some pain medication while my brother was on his way to the house to help her up.  He would not prescribe her anything without seeing her although he knew full well that it would not be abused.  My wife still holds that a little grudge about that!

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