3 ms·

"The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids -- and 99 percent of the world's hydrocodone, the

"The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids -- and 99 percent of the world's hydrocodone, the opiate that is in Vicodin." [1] I spend a lot of time listening to podcasts where addiction medicine doctors talk about the state of their industry. Their views and their guests views, are almost in complete alignment and those views are the exact opposite of the comments in this thread. I find that alarming. If you listen to addiction medicine doctors, they will tell you: 1) There is a massive epidemic of opioid addiction. Opioids are wildly addictive and are negligently / over prescribed. 2) There is little evidence that opioids provide benefit for long term chronic pain and evidence that long-term use of opioids actually causes many problems. Getting off the opioids tends to reduce the chronic pain. 3) Patient surveys rule supreme and patients want pain-killers even if the doctor does not believe they are the solution. Anecdotally, if you watch the A&E show "Intervention", the number of opioid and heroin cases has shot through the roof since the series started two decades ago. There has been a titanic shift in addiction. It's painful to watch some of these addicts lie to their doctor to get opioids, turn around and sell them, then use the money to get heroin because the opioids aren't strong enough anymore. This comment thread really saddens me. [1] http://abcnews.go.com/US/prescription-painkillers-record-number-americans-pain-medication/story?id=13421828 http://abcnews.go.com/US/prescription-painkillers-record-num...

throwawayheroin 10y ago
I'm 23 years old living in a major city in the midwest, grew up a in a middle-small town (120k population) a few hours away. Everyone I grew up with is either selling heroin or taking it, or both. The fact that I'm a software developer (making a living legally) and not taking and/or selling heroin is an anomaly.
- PKop 10y ago
  I'm seeing similar increases in heroin use in my small midwest hometown. Multiple overdose deaths monthly, as well as arrests. I honestly don't get what most of the other commenters are going on about. The stats are pretty widely reported on the massive increase in opioid abuse. They must live on the coasts or otherwise have avoided what has been plaguing many states in recent years http://www.economist.com/blogs/graphicdetail/2017/03/daily-chart-3 http://www.economist.com/blogs/graphicdetail/2017/03/daily-c... Here's a long but very informative article outlining a few important issues plaguing the US, drug abuse playing a significant part: https://www.commentarymagazine.com/articles/our-miserable-21st-century/ https://www.commentarymagazine.com/articles/our-miserable-21...
  - deleted 10y ago
    [deleted]
slavik81 10y ago
For me, the problem is fear. A decade or so back, I badly broke my arm in a mountain biking crash. The event itself barely hurt at all, but the muscles around the broken arm all tensed up, and after several hours were extremely painful. The hospital gave me morphine. As far as I could tell, the morphine did nothing. I remained in significant pain for a few hours while I awaited treatment. It's impossible for me to say why. Is morphine just ineffective for that sort of pain? Or was I underdosed to prevent negative interactions with the drugs they gave me later? Or was I underdosed as a precautionary measure for opiates due to addiction? All I know is that I'm afraid of ending up in pain in the future and being denied effective treatment out of misguided concern that I will become an addict. I do not fear addiction. I fear pain.
- DanBC 10y ago
  Parent poster is talking about the problems of opioids for long term pain. A broken arm is not long term pain. Most doctors are not worried about opioid use for short term pain.
- stinos 10y ago
  The hospital gave me morphine. This seems to illustrate the US mentality towards opioids: I had a similar accident and the fracture itself didn't really hurt but the muscle tension was indeed very painful and all I got in a Belgian hospital was some Brufen (Advil in the US if I'm not mistaken) - and that did work. In Belgium opioids are generally looked at 'only if it's really necessary'. Belgium does have a severe problem with prescription antibiotics though.
- mtreis86 10y ago
  The old standard for morphine is give however much stops the pain. They should have pushed up to the max they're allowed, if you were still in pain. I was in an accident, and the docs gave me as much morphine and dulaudid as it took and explained that opiod reception varies greatly when in pain. The amount of dilaudid that would make you loopy now may do nothing while you're hurt, and the amount to make you comfortable while hurt would easily kill you now. Effectively the LD50 varies with pain levels.
- 10y ago
empath75 10y ago
I have a friend with 'back problems' who was on OxyContin for 10+ years. His pain problems miraculously went away after he weened himself off of it over the course of a few months.

throwawayheroin 10y ago

I'm 23 years old living in a major city in the midwest, grew up a in a middle-small town (120k population) a few hours away. Everyone I grew up with is either selling heroin or taking it, or both. The fact that I'm a software developer (making a living legally) and not taking and/or selling heroin is an anomaly.

PKop 10y ago
I'm seeing similar increases in heroin use in my small midwest hometown. Multiple overdose deaths monthly, as well as arrests. I honestly don't get what most of the other commenters are going on about. The stats are pretty widely reported on the massive increase in opioid abuse. They must live on the coasts or otherwise have avoided what has been plaguing many states in recent years http://www.economist.com/blogs/graphicdetail/2017/03/daily-chart-3 http://www.economist.com/blogs/graphicdetail/2017/03/daily-c... Here's a long but very informative article outlining a few important issues plaguing the US, drug abuse playing a significant part: https://www.commentarymagazine.com/articles/our-miserable-21st-century/ https://www.commentarymagazine.com/articles/our-miserable-21...
- deleted 10y ago
  [deleted]

slavik81 10y ago

For me, the problem is fear. A decade or so back, I badly broke my arm in a mountain biking crash. The event itself barely hurt at all, but the muscles around the broken arm all tensed up, and after several hours were extremely painful. The hospital gave me morphine. As far as I could tell, the morphine did nothing. I remained in significant pain for a few hours while I awaited treatment. It's impossible for me to say why. Is morphine just ineffective for that sort of pain? Or was I underdosed to prevent negative interactions with the drugs they gave me later? Or was I underdosed as a precautionary measure for opiates due to addiction? All I know is that I'm afraid of ending up in pain in the future and being denied effective treatment out of misguided concern that I will become an addict. I do not fear addiction. I fear pain.

DanBC 10y ago
Parent poster is talking about the problems of opioids for long term pain. A broken arm is not long term pain. Most doctors are not worried about opioid use for short term pain.
stinos 10y ago
The hospital gave me morphine. This seems to illustrate the US mentality towards opioids: I had a similar accident and the fracture itself didn't really hurt but the muscle tension was indeed very painful and all I got in a Belgian hospital was some Brufen (Advil in the US if I'm not mistaken) - and that did work. In Belgium opioids are generally looked at 'only if it's really necessary'. Belgium does have a severe problem with prescription antibiotics though.
mtreis86 10y ago
The old standard for morphine is give however much stops the pain. They should have pushed up to the max they're allowed, if you were still in pain. I was in an accident, and the docs gave me as much morphine and dulaudid as it took and explained that opiod reception varies greatly when in pain. The amount of dilaudid that would make you loopy now may do nothing while you're hurt, and the amount to make you comfortable while hurt would easily kill you now. Effectively the LD50 varies with pain levels.
10y ago

empath75 10y ago

I have a friend with 'back problems' who was on OxyContin for 10+ years. His pain problems miraculously went away after he weened himself off of it over the course of a few months.