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> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling unde

> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful than morphine. By 2012 it was one in three. I find this absolutely outrageous. I'm not American, but I stumble upon articles mentioning this, and I do watch enough American TV series and movies to have an idea of how acute the problem is (it's crazy how often in TV series doctors seem to give pain killers like it's candy). I have the impression that in Europe, painkillers are much less used but I would not be surprised if the American trend were to contaminate medical practice here. Pain is a minor consequence of disease or trauma. Pain won't kill you, so why would you risk become addicted to very dangerous drugs just to relieve it?

pjc50 10y ago
> Pain is a minor consequence of disease There speaks someone young and healthy. Some conditions are extremely painful in the long term. "It is estimated that more than 100 million people suffer from chronic pain in this country,[11] and for some of them, opioid therapy may be appropriate. The bulk of American patients who need relief from persistent, moderate-to-severe non-cancer pain have back pain conditions (approximately 38 million) or osteoarthritis (approximately 17 million)." Source: https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse https://www.drugabuse.gov/about-nida/legislative-activities/... "aggressive marketing by pharmaceutical companies" "United States their biggest consumer globally, accounting for almost 100 percent of the world total for hydrocodone (e.g., Vicodin) and 81 percent for oxycodone (e.g., Percocet)" That does make it sound like a problem created by pharma drug pushing on TV. But that doesn't mean the pain isn't real either. Really the whole thing needs to be seen as a widespread public and social health problem - which is exactly the sort of thing the US system is set up to avoid seeing. Healthcare is not just a matter of individual responsibility or a contract between someone and their employer.
- grondilu 10y ago
  > "aggressive marketing by pharmaceutical companies" I'm wondering what that means, concretely. How exactly do they convince GPs to prescribe pain killers even when it's not really appropriate? They can't just pay them, can they?
  - pjc50 10y ago
    Well, yes: http://www.pharmadisclose.org/cme/ut000309.html http://www.pharmadisclose.org/cme/ut000309.html http://fortune.com/2016/06/21/doctors-cheaper-drug-prescriptions/ http://fortune.com/2016/06/21/doctors-cheaper-drug-prescript...
mirimir 10y ago
You either have a high pain threshold, or just haven't experienced severe pain. Extreme pain can cause neurogenic shock.

pjc50 10y ago

> Pain is a minor consequence of disease There speaks someone young and healthy. Some conditions are extremely painful in the long term. "It is estimated that more than 100 million people suffer from chronic pain in this country,[11] and for some of them, opioid therapy may be appropriate. The bulk of American patients who need relief from persistent, moderate-to-severe non-cancer pain have back pain conditions (approximately 38 million) or osteoarthritis (approximately 17 million)." Source: https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse https://www.drugabuse.gov/about-nida/legislative-activities/... "aggressive marketing by pharmaceutical companies" "United States their biggest consumer globally, accounting for almost 100 percent of the world total for hydrocodone (e.g., Vicodin) and 81 percent for oxycodone (e.g., Percocet)" That does make it sound like a problem created by pharma drug pushing on TV. But that doesn't mean the pain isn't real either. Really the whole thing needs to be seen as a widespread public and social health problem - which is exactly the sort of thing the US system is set up to avoid seeing. Healthcare is not just a matter of individual responsibility or a contract between someone and their employer.

grondilu 10y ago
> "aggressive marketing by pharmaceutical companies" I'm wondering what that means, concretely. How exactly do they convince GPs to prescribe pain killers even when it's not really appropriate? They can't just pay them, can they?
- pjc50 10y ago
  Well, yes: http://www.pharmadisclose.org/cme/ut000309.html http://www.pharmadisclose.org/cme/ut000309.html http://fortune.com/2016/06/21/doctors-cheaper-drug-prescriptions/ http://fortune.com/2016/06/21/doctors-cheaper-drug-prescript...

mirimir 10y ago

You either have a high pain threshold, or just haven't experienced severe pain. Extreme pain can cause neurogenic shock.