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It's interesting we could be developing whole new non addictive classes of pain killer from cannabis extracts but instead we standardize on oxyconton and opiate

It's interesting we could be developing whole new non addictive classes of pain killer from cannabis extracts but instead we standardize on oxyconton and opiates. With a beat up, aging population of working people with chronic pain of course it's a perfect storm. But in states that have embraced cannabis we don't see this level of crisis .

StevePerkins 9y ago
I think you're seriously downplaying a few variables, to reach a desired conclusion. How many coal mines and textile mills are there in Portland or San Francisco?
- hirsin 9y ago
  And there's definitely no aging physical labor population in Washington, home of Boeing plants and a massive agricultural industry.
  - StevePerkins 9y ago
    Sure, but skilled machinist work in a Boeing plant isn't even remotely comparable to the forms of unskilled manual labor common to Appalachia. While the strawberry pickers of California's agricultural industry tend to be undocumented immigrants, and one's drug of choice is significantly shaped by demographics. I'm not arguing against the merits of cannabis, mind you. I'm just saying that it's lazy and ridiculous to argue, "We don't have strung-out hillbillies on the Pacific coast. Must be due to the presence of marijuana! (rather than the absence of hillbillies)".
    - rabboRubble 9y ago
      The loggers here might disagree with you.
  - home_boi 9y ago
    The barrier to move and change jobs is much lower
- deleted 9y ago
  [deleted]
dreamdu5t 9y ago
It's a myth that heroin and opiate addiction are the result of pain killer prescriptions: "According to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer. "
- throwanem 9y ago
  That certainly is the result of painkiller prescriptions - just not ones written for the person who starts using.
  - deleted 9y ago
    [deleted]
- myleshenderson 9y ago
  The initial availability of the drugs was from a prescription. If it weren't for the ready availability of the drugs, far fewer people would be addicted.
  - notadoc 9y ago
    People are addicted to pain killers usually because they are dealing with pain, and they are either medicating or self-medicating to manage it. If mere availability of something addictive was the problem, then we'd have a nation of nothing but alcoholics and cigarette smokers considering you can buy either in an unlimited quantity at any corner store.
- DanBC 9y ago
  that's from https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/ https://blogs.scientificamerican.com/mind-guest-blog/opioid-... Which says eg > A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent. Let's have a look at what that Cochrane review says: http://www.cochrane.org/CD006605/SYMPT_opioids-long-term-treatment-noncancer-pain http://www.cochrane.org/CD006605/SYMPT_opioids-long-term-tre... > The findings of this systematic review suggest that proper management of a type of strong painkiller (opioids) in well-selected patients with no history of substance addiction or abuse can lead to long-term pain relief for some patients with a very small (though not zero) risk of developing addiction, abuse, or other serious side effects. However, the evidence supporting these conclusions is weak, and longer-term studies are needed to identify the patients who are most likely to benefit from treatment. This tells us that the carefully selected patients were not getting pain relief or had too many side effects; (a third dropped out because of these) and we can't say too much about addiction because not all the studies reported it: "Signs of opioid addiction were reported in 0.27% of participants in the studies that reported that outcome" It's hard to see that 0.27% (with who knows how many unreported cases of addiction) and that later 8-12% in the same paragraph. > Moreover, a study of nearly 136,000 opioid overdose victims treated in the emergency room in 2010, which was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition. I mean, doesn't that tell you there's a massive problem with prescribing? > recent research on roughly one million insurance claims for opioid prescriptions showed that just less than five percent of patients misused the drugs by getting prescriptions for them from multiple doctors. THat para links to a document called "THE OPIOID CRISIS IN AMERICA'S WORKFORCE" http://www.castlighthealth.com/typ/the-opioid-crisis/ http://www.castlighthealth.com/typ/the-opioid-crisis/ The first para of that report says: > The use and abuse of prescription opioids continues to be a challenging and costly crisis for the U.S. The facts underscore the severity of this crisis: > • Nearly 2 million Americans are abusing prescription opioids1 > • 16,000 people die every year from prescription opioid overdoses2 > • Sales of opioid prescriptions in the U.S. nearly quadrupled from 1999 to 20103 > • 259 million opioid prescriptions were written in 2012, enough for every American adult to have their own bottle of pills4 That Scientific American writer has misrepresented every source so far. For fuck's sake, that last link specifically says: > One out of every three (32%) opioid prescriptions is being abused.
throwanem 9y ago
Transparently tendentious reasoning of this sort fails to serve your turn, and that's especially regrettable in this case because I agree with you that we would be very well served to look for means of addressing severe and chronic pain that don't involve the most addictive class of drugs known to man. I would esteem it a kindness of you to find a way of advancing your thesis that does more to support it than, by retreat into intellectually dishonest tactics, to make it look indefensible.
notadoc 9y ago
> but instead we standardize on oxyconton and opiates That's because oxycontin and opiates work for relieving pain. > But in states that have embraced cannabis we don't see this level of crisis . That's a baseless claim that couldn't be further from the truth. Take a walk around SF, LA, Seattle, Portland, etc, there are tons of strung out junkies laying around on the streets surrounded by needles. The existence of painkillers are not the reason we have drug addicts.
- DanBC 9y ago
  > That's because oxycontin and opiates work for relieving pain. They do not work for relieving long term pain. https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware > > 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain > > 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation). > The existence of painkillers are not the reason we have drug addicts. This is just untrue. Please provide a valid source.
  - notadoc 9y ago
    Your own citation disputes your opinion and claim. > This is just untrue. Oh are you saying this from your own research or clinical experience? Do you work directly with persistent pain patients? Are you an anesthesiologist? Or are you just Doctor Google?
    - DanBC 9y ago
      > Your own citation disputes your opinion and claim. I'm confused, please can you point out where my citation disputes my claim? Also, can you provide a citation?
  - Powerofmene 9y ago
    It seems that if opioids and opiates did not relieve long term pain the entire pain management industry would implode because health insurance would not pay for the millions of prescription pain management doctors write. I have my own opinions about pain management doctors but that aside' insurance companies are very quick to deny something with no medical benefit or no medical basis for the prescription/procedure. I know people with debilitating pain that have been on pain melds for over a decade and while the medications do not make the pain disappear it makes it manageable. Some people are not candidates for surgery and have to manage with medications. Bottom line though, individuals who have been using these drugs for so long whether for a legitimate reason or not suffer from memory issues, fatigue, irritability, impulse control, etc and those factors can certainly have an impact on children.

StevePerkins 9y ago

I think you're seriously downplaying a few variables, to reach a desired conclusion. How many coal mines and textile mills are there in Portland or San Francisco?

hirsin 9y ago
And there's definitely no aging physical labor population in Washington, home of Boeing plants and a massive agricultural industry.
- StevePerkins 9y ago
  Sure, but skilled machinist work in a Boeing plant isn't even remotely comparable to the forms of unskilled manual labor common to Appalachia. While the strawberry pickers of California's agricultural industry tend to be undocumented immigrants, and one's drug of choice is significantly shaped by demographics. I'm not arguing against the merits of cannabis, mind you. I'm just saying that it's lazy and ridiculous to argue, "We don't have strung-out hillbillies on the Pacific coast. Must be due to the presence of marijuana! (rather than the absence of hillbillies)".
  - rabboRubble 9y ago
    The loggers here might disagree with you.
- home_boi 9y ago
  The barrier to move and change jobs is much lower
deleted 9y ago
[deleted]

dreamdu5t 9y ago

It's a myth that heroin and opiate addiction are the result of pain killer prescriptions: "According to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer. "

throwanem 9y ago
That certainly is the result of painkiller prescriptions - just not ones written for the person who starts using.
- deleted 9y ago
  [deleted]
myleshenderson 9y ago
The initial availability of the drugs was from a prescription. If it weren't for the ready availability of the drugs, far fewer people would be addicted.
- notadoc 9y ago
  People are addicted to pain killers usually because they are dealing with pain, and they are either medicating or self-medicating to manage it. If mere availability of something addictive was the problem, then we'd have a nation of nothing but alcoholics and cigarette smokers considering you can buy either in an unlimited quantity at any corner store.
DanBC 9y ago
that's from https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/ https://blogs.scientificamerican.com/mind-guest-blog/opioid-... Which says eg > A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent. Let's have a look at what that Cochrane review says: http://www.cochrane.org/CD006605/SYMPT_opioids-long-term-treatment-noncancer-pain http://www.cochrane.org/CD006605/SYMPT_opioids-long-term-tre... > The findings of this systematic review suggest that proper management of a type of strong painkiller (opioids) in well-selected patients with no history of substance addiction or abuse can lead to long-term pain relief for some patients with a very small (though not zero) risk of developing addiction, abuse, or other serious side effects. However, the evidence supporting these conclusions is weak, and longer-term studies are needed to identify the patients who are most likely to benefit from treatment. This tells us that the carefully selected patients were not getting pain relief or had too many side effects; (a third dropped out because of these) and we can't say too much about addiction because not all the studies reported it: "Signs of opioid addiction were reported in 0.27% of participants in the studies that reported that outcome" It's hard to see that 0.27% (with who knows how many unreported cases of addiction) and that later 8-12% in the same paragraph. > Moreover, a study of nearly 136,000 opioid overdose victims treated in the emergency room in 2010, which was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition. I mean, doesn't that tell you there's a massive problem with prescribing? > recent research on roughly one million insurance claims for opioid prescriptions showed that just less than five percent of patients misused the drugs by getting prescriptions for them from multiple doctors. THat para links to a document called "THE OPIOID CRISIS IN AMERICA'S WORKFORCE" http://www.castlighthealth.com/typ/the-opioid-crisis/ http://www.castlighthealth.com/typ/the-opioid-crisis/ The first para of that report says: > The use and abuse of prescription opioids continues to be a challenging and costly crisis for the U.S. The facts underscore the severity of this crisis: > • Nearly 2 million Americans are abusing prescription opioids1 > • 16,000 people die every year from prescription opioid overdoses2 > • Sales of opioid prescriptions in the U.S. nearly quadrupled from 1999 to 20103 > • 259 million opioid prescriptions were written in 2012, enough for every American adult to have their own bottle of pills4 That Scientific American writer has misrepresented every source so far. For fuck's sake, that last link specifically says: > One out of every three (32%) opioid prescriptions is being abused.

throwanem 9y ago

Transparently tendentious reasoning of this sort fails to serve your turn, and that's especially regrettable in this case because I agree with you that we would be very well served to look for means of addressing severe and chronic pain that don't involve the most addictive class of drugs known to man. I would esteem it a kindness of you to find a way of advancing your thesis that does more to support it than, by retreat into intellectually dishonest tactics, to make it look indefensible.

notadoc 9y ago

> but instead we standardize on oxyconton and opiates That's because oxycontin and opiates work for relieving pain. > But in states that have embraced cannabis we don't see this level of crisis . That's a baseless claim that couldn't be further from the truth. Take a walk around SF, LA, Seattle, Portland, etc, there are tons of strung out junkies laying around on the streets surrounded by needles. The existence of painkillers are not the reason we have drug addicts.

DanBC 9y ago
> That's because oxycontin and opiates work for relieving pain. They do not work for relieving long term pain. https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware > > 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain > > 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation). > The existence of painkillers are not the reason we have drug addicts. This is just untrue. Please provide a valid source.
- notadoc 9y ago
  Your own citation disputes your opinion and claim. > This is just untrue. Oh are you saying this from your own research or clinical experience? Do you work directly with persistent pain patients? Are you an anesthesiologist? Or are you just Doctor Google?
  - DanBC 9y ago
    > Your own citation disputes your opinion and claim. I'm confused, please can you point out where my citation disputes my claim? Also, can you provide a citation?
- Powerofmene 9y ago
  It seems that if opioids and opiates did not relieve long term pain the entire pain management industry would implode because health insurance would not pay for the millions of prescription pain management doctors write. I have my own opinions about pain management doctors but that aside' insurance companies are very quick to deny something with no medical benefit or no medical basis for the prescription/procedure. I know people with debilitating pain that have been on pain melds for over a decade and while the medications do not make the pain disappear it makes it manageable. Some people are not candidates for surgery and have to manage with medications. Bottom line though, individuals who have been using these drugs for so long whether for a legitimate reason or not suffer from memory issues, fatigue, irritability, impulse control, etc and those factors can certainly have an impact on children.