7 ms·

Drug firms poured 780M painkillers into WV amid rise of overdoses

37 points by uptown 10y ago

1024core 10y ago
I think the drug dealers could learn a thing or two from our pharma industry. When I had back pain, the doctor handed me a prescription for 100 hydrocodone tablets. I took none; just some physical therapy and stretching gave me immense relief. Later, I was shocked to find out from a friend that the street value of these tablets was $5/each.
- dx034 10y ago
  Probably more a fault of your doctor or the laws. There should be limits on that kind of painkillers, especially if you use it first time. If the doctor restricts the amount to a few days' usage, potential misuse is much easier to detect.
  - chillwaves 10y ago
    They could start with mandated patient education on the effects and addiction potential of these drugs, as well as a treatment plan to taper off. I had a severe injury in late 2013 and received neither of these things. We should work on the basics before pushing for more restrictions. To expand: I had maybe 4 different doctors writing me RX for pain meds at the time and none of them were coordinating. I remember having far more drugs than I needed for the first few months -- I had prescriptions to spare. This is because I had several doctors treating me but again, none were coordinating.
seibelj 10y ago
I was expecting to write a comment advocating for personal responsibility and not rushing to judgement. Then I read this: > The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia. That is incredible. What a damning article.
- snrplfth 10y ago
  Well, 433 over six years, 2007 through 2012. Which is about 72 per year, per person. I mean, what is supposed to be done about this? Cut off WV from painkillers? Have the DEA raid a bunch of pharmacies?
  - vkou 10y ago
    > Cut off WV from painkillers? Given the kind of logical leaps the War on Drugs takes, why not? I'm sure that someone, somewhere, in WV is getting high on pills as we speak.
    - snrplfth 10y ago
      I've never been quite able to grasp the logic of those people who think that, while the War on Drugs is a bad idea, the FDA being able to ban whatever drugs it likes is a good idea. Either the government should have the power to ban drugs or it shouldn't, but too many people seem to want it both ways: prohibition without enforcement.
      - vkou 10y ago
        The FDA bans drugs from making unverified medical claims. That's the raison d'etre for its existence. Given the circumstances, they do a pretty damn good job of this. You can put whatever the hell you want in your non-FDA-approved snake oil supplement - but then you won't have the legitimacy of the medical establishment behind you. This legitimacy depends on your drug having verifiable, understood effects. You can't have it both ways.
        snrplfth 10y ago
        Well, they still destroy unapproved drugs at the border and raid places like whole milk producers and nutritional supplement makers. It's not exactly "caveat emptor" over at the FDA. My point is really that, if somebody's solution to the problem of people overdosing on drugs is to ban them or prohibit access, then they're defacto acquiescing to the tools that make the War on Drugs possible. People seem to expect drugs they don't like to just "go away", without any of the nasty raiding and shooting.
imglorp 10y ago
Not that pharma is angelic here, but don't the doctors have the largest measure of blame for writing unnecessary scripts, failing to monitor for abuse, and failing to encourage alternate options? I'm in favor of maximum MD power. I think they should be allowed to prescribe everything from cocaine to bleach, or any other chemical compound, as suits the patient care, if they know what they're doing. But they should also bear maximum accountability for what they prescribe, including abuse potential.
- chillwaves 10y ago
  A more helpful line of inquiry to me is the culture of Rx usage. As a society, our patients expect drugs when they go to a doctor and a doctor's average time per patient is around 10-15 minutes. Does not seem like enough time to understand the patient's needs and create an individualized solution. Further, RX medicine is highly profitable and encouraged from the pharma. In this case it looks like they are incentives for pain pills to be issued on both sides -- money maker for pharma and time saver for doctors (a third side -- convenience and feel good for the patient). It is not as useful to find so-called bad actors but instead we should evaluate the medical system as a whole and put in safeguards to do less harm. Patients have generally too much influence on doctors for their treatment (otherwise why would direct to consumer marketing exist?), that doctors are not educating patients enough on the risks of narcotics and that pharma has $$ incentive to push medicine. That things like physical therapy and lifestyle changes will better deal with root causes than drugs that only address the symptom (but feel better and are easier to swallow). It's a recipe for a disaster. I was in a motorcycle accident a few years ago and broke over 10 bones. The worst part of my recovery was kicking my addiction to narcotics. I did not understand what I was getting into and I was never given a path to get off them (not in a coherent way, not until I called to say I was going through withdrawals). This should not be.
  - Pigo 10y ago
    I feel your pain, it's scary when you're blind-sided by how deep of a pit you're in. When you realize you're probably in worse shape than the guy on the corner hustling to buy a rock, and you got it from the lady you trust your child's healthcare to. I don't know if it's a willful ignorance, or if many doctors live healthy lives and have no concept of how scarily painful withdrawal is. I can't tell you how many times I've heard it's like having the flu. If people are having flu like that, then it's amazing more people don't die every winter.
commentzorro 10y ago
These are rational people making a decision for themselves if the pain relief is worth and side effects or other Iissues. Let the people of WV make up their own minds and let the market speak for itself.
- gech 10y ago
  Are addicts rational?
- wf 10y ago
  This shows a huge lack of empathy for addiction and big disrespect for the power of opioids.
- kelvin0 10y ago
  'Mama' Rand would be so proud of you :-) Seriously though, 'rational' people can also be misinformed by a large corporation and a system which does not necessarily incentivize getting people healthy, and only wish to make their shareholders happy. The 'market' will always try to optimize for profits even at the expense of everything else.
- burkaman 10y ago
  Why do you think these are rational people making rational decisions? Do you know what addiction is?

37 points by uptown 10y ago

I think the drug dealers could learn a thing or two from our pharma industry. When I had back pain, the doctor handed me a prescription for 100 hydrocodone tablets. I took none; just some physical therapy and stretching gave me immense relief. Later, I was shocked to find out from a friend that the street value of these tablets was $5/each.

dx034 10y ago
Probably more a fault of your doctor or the laws. There should be limits on that kind of painkillers, especially if you use it first time. If the doctor restricts the amount to a few days' usage, potential misuse is much easier to detect.
- chillwaves 10y ago
  They could start with mandated patient education on the effects and addiction potential of these drugs, as well as a treatment plan to taper off. I had a severe injury in late 2013 and received neither of these things. We should work on the basics before pushing for more restrictions. To expand: I had maybe 4 different doctors writing me RX for pain meds at the time and none of them were coordinating. I remember having far more drugs than I needed for the first few months -- I had prescriptions to spare. This is because I had several doctors treating me but again, none were coordinating.

seibelj 10y ago

I was expecting to write a comment advocating for personal responsibility and not rushing to judgement. Then I read this: > The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia. That is incredible. What a damning article.

snrplfth 10y ago
Well, 433 over six years, 2007 through 2012. Which is about 72 per year, per person. I mean, what is supposed to be done about this? Cut off WV from painkillers? Have the DEA raid a bunch of pharmacies?
- vkou 10y ago
  > Cut off WV from painkillers? Given the kind of logical leaps the War on Drugs takes, why not? I'm sure that someone, somewhere, in WV is getting high on pills as we speak.
  - snrplfth 10y ago
    I've never been quite able to grasp the logic of those people who think that, while the War on Drugs is a bad idea, the FDA being able to ban whatever drugs it likes is a good idea. Either the government should have the power to ban drugs or it shouldn't, but too many people seem to want it both ways: prohibition without enforcement.
    - vkou 10y ago
      The FDA bans drugs from making unverified medical claims. That's the raison d'etre for its existence. Given the circumstances, they do a pretty damn good job of this. You can put whatever the hell you want in your non-FDA-approved snake oil supplement - but then you won't have the legitimacy of the medical establishment behind you. This legitimacy depends on your drug having verifiable, understood effects. You can't have it both ways.
      - snrplfth 10y ago
        Well, they still destroy unapproved drugs at the border and raid places like whole milk producers and nutritional supplement makers. It's not exactly "caveat emptor" over at the FDA. My point is really that, if somebody's solution to the problem of people overdosing on drugs is to ban them or prohibit access, then they're defacto acquiescing to the tools that make the War on Drugs possible. People seem to expect drugs they don't like to just "go away", without any of the nasty raiding and shooting.

imglorp 10y ago

Not that pharma is angelic here, but don't the doctors have the largest measure of blame for writing unnecessary scripts, failing to monitor for abuse, and failing to encourage alternate options? I'm in favor of maximum MD power. I think they should be allowed to prescribe everything from cocaine to bleach, or any other chemical compound, as suits the patient care, if they know what they're doing. But they should also bear maximum accountability for what they prescribe, including abuse potential.

chillwaves 10y ago
A more helpful line of inquiry to me is the culture of Rx usage. As a society, our patients expect drugs when they go to a doctor and a doctor's average time per patient is around 10-15 minutes. Does not seem like enough time to understand the patient's needs and create an individualized solution. Further, RX medicine is highly profitable and encouraged from the pharma. In this case it looks like they are incentives for pain pills to be issued on both sides -- money maker for pharma and time saver for doctors (a third side -- convenience and feel good for the patient). It is not as useful to find so-called bad actors but instead we should evaluate the medical system as a whole and put in safeguards to do less harm. Patients have generally too much influence on doctors for their treatment (otherwise why would direct to consumer marketing exist?), that doctors are not educating patients enough on the risks of narcotics and that pharma has $$ incentive to push medicine. That things like physical therapy and lifestyle changes will better deal with root causes than drugs that only address the symptom (but feel better and are easier to swallow). It's a recipe for a disaster. I was in a motorcycle accident a few years ago and broke over 10 bones. The worst part of my recovery was kicking my addiction to narcotics. I did not understand what I was getting into and I was never given a path to get off them (not in a coherent way, not until I called to say I was going through withdrawals). This should not be.
- Pigo 10y ago
  I feel your pain, it's scary when you're blind-sided by how deep of a pit you're in. When you realize you're probably in worse shape than the guy on the corner hustling to buy a rock, and you got it from the lady you trust your child's healthcare to. I don't know if it's a willful ignorance, or if many doctors live healthy lives and have no concept of how scarily painful withdrawal is. I can't tell you how many times I've heard it's like having the flu. If people are having flu like that, then it's amazing more people don't die every winter.

commentzorro 10y ago

These are rational people making a decision for themselves if the pain relief is worth and side effects or other Iissues. Let the people of WV make up their own minds and let the market speak for itself.

gech 10y ago
Are addicts rational?
wf 10y ago
This shows a huge lack of empathy for addiction and big disrespect for the power of opioids.
kelvin0 10y ago
'Mama' Rand would be so proud of you :-) Seriously though, 'rational' people can also be misinformed by a large corporation and a system which does not necessarily incentivize getting people healthy, and only wish to make their shareholders happy. The 'market' will always try to optimize for profits even at the expense of everything else.
burkaman 10y ago
Why do you think these are rational people making rational decisions? Do you know what addiction is?