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Sure, it's an opioid. That's not the point. The point is that it's made from an inexpensive generic opioid feedstock: oxycodone. The supposed value-add isn't t
by OliverJones 10y ago
Sure, it's an opioid. That's not the point. The point is that it's made from an inexpensive generic opioid feedstock: oxycodone. The supposed value-add isn't the painkiller, it's the timed-release agent.
Unless these reporters are simply lying, there's evidence of great variability in the effectiveness of that timed-release agent. But the company's market position depends on the 12-hour dose. If the drug's needed every six hours, the only difference between it and the cheap stuff is price. In that case, most doctors won't prescribe and most payers won't reimburse the expensive stuff.
So, a doctor can ask a patient, "are you willing to take a pill every six hours?" If the patient agrees, the prescription can be very inexpensive and effective. And, wide swings in blood concentration are controllable, which helps avoid both grogginess and withdrawal struggles.
A friend who develops instruments for anesthesiologists has told me that a well-controlled minimal effective dose of pain med works, and manages risk very well. Peoples' rates of clearing these compounds vary a lot, and the timed-release compound doesn't appear to reduce that variability, contrary to the what the marketer is implicitly claiming.
If the treatment is for acute short-term pain (post-op, etc) a six-hour regime isn't a big burden, and the reduced risk of addiction justifies some inconvenience.
If the treatment is for chronic pain, a wise patient and doctor might start by trying the more frequent doses, and move to "time-release" doses if the first treatment doesn't work. Patients and doctors tune their meds all the time. Why not start trying for minimal effective dose, and move to a more addiction-prone regime if the first one desn't work?
But that would foul up the business of Oxycontin's marketer.
A weekly Narcotics Anonymous meeting just moved out of the hall of a church I serve to a bigger hall, because they're gaining members fast. That's not good.
- MichaelGG 10y agoIsn't NA mandated by courts? Even for pot sometimes? A growing group could easily just mean a change in law enforcement or sentencing.
- themartorana 10y agoWhich is a terrible intrusion upon people voluntarily there for actual support and help.
- onetwotree 10y agoSort of - we don't really mind if people come to get their court thingies signed after the meeting. The thing is, most people who don't want to be there quickly realize that they can just have anyone sign them. There's no way for a court to verify that people are going to meetings.
- sgnelson 10y agoIt could, but I guarantee you it's not. In case you haven't heard, there is a very real heroin epidemic in a large part of the country. (largely caused by the over prescription, and then cutting off, via a change in regulations and practices of prescribed painkillers). But I wasn't being (intentionally) being an asshole when I say "In case you haven't heard." It's being reported in the news, but it is largely a local story, and even in a lot of cases, its kind of like "There's a Heroin Epidemic, it's now affecting white rich kids, nobody knows what to do." I don't know if it is a function people being tired of the drug war or what, but it just seems like there's a quiet epidemic that's tragically killing (and/or negatively affecting) millions of Americans out there.
- onetwotree 10y agoThe emergence of drug courts in many parts of the country has actually led to a sharp decrease in people attending NA and AA meetings because a court ordered them to. I'm very active in the recovery community in Madison Wisconsin, and holy smokes, it's all junkies these days! Not complaining, the experience is similar enough to mine as an old fashioned booze hound with occasional forays into meth addiction that I can help them, but man - it's never been like this before!
- OliverJones 10y agoNot around here.