6 ms·

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medici

Your ignoring the fact that up until recently, pain was considered to be the fifth vital sign and was just as important to treat as things like a fever. Medicine as a field is largely about removing discomfort, as many medical conditions could be relatively debilitating. Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day, rather than needing to lay in bed in agony. For people with chronic pain, or those coming out of surgery, perceived recovery time can be a big thing for people. Additionally, the article didn't address the fact that it could very well be that doctors were being paid off to prescribe a particular brand of opioid rather than just opioids in general, something that is relatively common when there are a large number of drugs that can equally help treat a given ailment.

lr4444lr 9y ago
I think you're raising an interesting point, but I disagree with your example - what pain that is so bad its sufferer needs "to lay in bed in agony" can be relieved by ibuprofen, acetaminophen, or any other OTC pain reliever? The Great Binge[0] ended long ago - perhaps for the wrong reasons, but ended nonetheless, until recently when legal opioid prescriptions spiked. This is about doctors putting their patients at risk in the process of treating them for routine problems which did not result in opioid addiction rates as recently as 25 years ago, and certainly were not prescribed with any other side benefit as far as I've heard. [0]https://en.wikipedia.org/wiki/The_Great_Binge https://en.wikipedia.org/wiki/The_Great_Binge
- mnm1 9y ago
  Headaches can easily be that bad and relieved with ibuprofen. Otherwise yeah, it's lay in bed and try to sleep and hope they don't last into the next day.
  - abakker 9y ago
    Or, sometimes, they're not. My wife gets bad migraines. For the most part, nothing works. She has not tried, and is not interested in trying opioids for them, though.
    - GordonS 9y ago
      She should try sumatriptan. Works amazingly well for me.
- stephengillie 9y ago
  Tangental - having never heard of The Great Binge described before, it's interesting to note the time period begins just at the end of the Opium Wars. Almost as though it was just a shifting of focus.
- deleted 9y ago
  [deleted]
rossjudson 9y ago
As if "taking a kickback to promote a particular pharmaceutical company's products" isn't equally bad. Yeah -- BigPharma is going to account for the kickback under "Research and Development (Of Profit)".
csr12928834 9y ago
The problem in my mind, that the parent is intimating at, is that we confer far too much control to and assume far too much competence and beneficence on the part of physicians. I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it. The entire drug regulation system is predicated on the idea that you have certain providers, namely physicians, who are competent to make decisions, and shifting that decision-making power to those providers protects us from harm. The opioid crisis has demonstrated that whole paradigm is faulty. The problem is that no one profession should be entrusted with that level of power or command over decisions. Imagine, instead, a system where there was no drug regulation. Rather than assuming that physicians were making the best decisions about opioid use and sweeping the problem under the rug, such use would be constantly scrutinized. We need more competition, and fewer gatekeepers. Gatekeeping means there's only one thing that needs to be breached.
- frankydp 9y ago
  Aren't there multiple groups that provide the guidelines for treatment? Specifically all of the specialty associations. (Gastro, Oncology...) Going outside recommended guidelines can be very very expensive for a physician. The understanding of opioid use has clinically changed drastically in the last 40 years, similar to SSRIs in the last 70 years. Not that I do not agree with your premise, but the issue seems to be much more institutional and related to human, research, and implementation error than a bunch of individual bad actors. https://www.guideline.gov/ https://www.guideline.gov/
- davidmr 9y ago
  I'm not sure I understand what you're trying to say. Is it your contention that, if anyone could get opiates without any regulation or prescription, fewer people would take them than they do now? Why would scrutiny of any kind by anyone lead to reduced usage in a case like this if that scrutiny had no regulatory effect on who could obtain narcotic painkillers? I understand (though disagree with) the libertarian philosophy that you should be free to take anything you please, but I fail to see how such a situation would lead to decreased use.
curun1r 9y ago
> Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day... I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equanimity...distancing myself from the pain and just observing it rather than feeling it, it all but goes away. I have more chronic pain than I've ever had and, yet, I haven't taken a single pain killer in the past 3 years. I want to believe that somehow my pain is less than everyone who's getting caught in the net of opioids and that they do really need pharmaceutical help to deal with their pain, but my experience leads me to believe otherwise...that much of their need for drug help comes from their mental state and the unproductive way they accept pain into their lives. I also can't help but wonder whether today's increasingly disconnected society leads people to seek connection with a substance rather than other people. Would we still have an opioid epidemic if people spent more time having in-person conversations and less time liking things on Facebook?
- emiliobumachar 9y ago
  Good for you, but, even if - if!- meditation would work for everyone,it's unrealistic to expect everyone to start meditating. Exercise is good for virtually everyone, and that's common knowledge. Yet relatively few go through the trouble.
  - curun1r 9y ago
    I'm not saying that everyone should meditate. I'm only bringing it up because I think it sheds a light on the true nature of pain and why simply removing it with chemicals at all costs is a very dangerous thing to be doing. We need to better understand that nature of pain and understand how to deal with it both physiologically and psychologically rather than taking the naive approach using chemicals, because a mind-body solution will be so much more successful than one that only considers one side of the equation.
    - icelancer 9y ago
martinald 9y ago
Let's also keep in mind that as recently as the 1970s doctors in the US often did not prescribe opioid medication, whatsoever. In some cases, even for terminally ill patients. I think this made fertile ground for huge swing back that pharma got from prescribing it. The situation of such massive underprescribing allowed massive overprescribing, in a way.
senorjazz 9y ago
>. For people with chronic pain, or those coming out of surgery, perceived recovery time can be a big thing for people Chronic / serious pain yes. I read that 1/3 of people in the US are on (or perhaps have taken?) an opiod prescribed pain killer. If true, that is insane! That is not chronic pain. * Drs have over prescribed opiate based painkillers. Fact. * Big Pharma corporations have pushed opiate painkillers recklessly. Fact * Profits became more important than the health of the customers/(patients). Fact This has caused the death of 1000s. Yet no one actually responsible will be held accountable. Sure some Drs will lose their license, but the real guilty parties are further up the tree and will be untouchable. Unfortunately, that seems to be the American way.
- Spivak 9y ago
  If the metric is 'has ever taken' then I would believe that number is low. Most people will get opioids after they get their wisdom teeth out.
- hvo 9y ago
  Big Pharma companies are the problem of US health care crisis. They have figured out ways to manipulate the doctors and the patients for gains. If you are a drug addict,there is a pill for that. If there are side-effects to the pill you are taking to get you off addiction,there is a pill for that. And if you take too much pills,there is a pill for that one too.

lr4444lr 9y ago

I think you're raising an interesting point, but I disagree with your example - what pain that is so bad its sufferer needs "to lay in bed in agony" can be relieved by ibuprofen, acetaminophen, or any other OTC pain reliever? The Great Binge[0] ended long ago - perhaps for the wrong reasons, but ended nonetheless, until recently when legal opioid prescriptions spiked. This is about doctors putting their patients at risk in the process of treating them for routine problems which did not result in opioid addiction rates as recently as 25 years ago, and certainly were not prescribed with any other side benefit as far as I've heard. [0]https://en.wikipedia.org/wiki/The_Great_Binge https://en.wikipedia.org/wiki/The_Great_Binge

mnm1 9y ago
Headaches can easily be that bad and relieved with ibuprofen. Otherwise yeah, it's lay in bed and try to sleep and hope they don't last into the next day.
- abakker 9y ago
  Or, sometimes, they're not. My wife gets bad migraines. For the most part, nothing works. She has not tried, and is not interested in trying opioids for them, though.
  - GordonS 9y ago
    She should try sumatriptan. Works amazingly well for me.
stephengillie 9y ago
Tangental - having never heard of The Great Binge described before, it's interesting to note the time period begins just at the end of the Opium Wars. Almost as though it was just a shifting of focus.
deleted 9y ago
[deleted]

rossjudson 9y ago

As if "taking a kickback to promote a particular pharmaceutical company's products" isn't equally bad. Yeah -- BigPharma is going to account for the kickback under "Research and Development (Of Profit)".

csr12928834 9y ago

The problem in my mind, that the parent is intimating at, is that we confer far too much control to and assume far too much competence and beneficence on the part of physicians. I am not saying they are a corrupt class, nor would I mean to imply that. But I do think we need to think of physicians as a part of health care, rather than at the top of it. The entire drug regulation system is predicated on the idea that you have certain providers, namely physicians, who are competent to make decisions, and shifting that decision-making power to those providers protects us from harm. The opioid crisis has demonstrated that whole paradigm is faulty. The problem is that no one profession should be entrusted with that level of power or command over decisions. Imagine, instead, a system where there was no drug regulation. Rather than assuming that physicians were making the best decisions about opioid use and sweeping the problem under the rug, such use would be constantly scrutinized. We need more competition, and fewer gatekeepers. Gatekeeping means there's only one thing that needs to be breached.

frankydp 9y ago
Aren't there multiple groups that provide the guidelines for treatment? Specifically all of the specialty associations. (Gastro, Oncology...) Going outside recommended guidelines can be very very expensive for a physician. The understanding of opioid use has clinically changed drastically in the last 40 years, similar to SSRIs in the last 70 years. Not that I do not agree with your premise, but the issue seems to be much more institutional and related to human, research, and implementation error than a bunch of individual bad actors. https://www.guideline.gov/ https://www.guideline.gov/
davidmr 9y ago
I'm not sure I understand what you're trying to say. Is it your contention that, if anyone could get opiates without any regulation or prescription, fewer people would take them than they do now? Why would scrutiny of any kind by anyone lead to reduced usage in a case like this if that scrutiny had no regulatory effect on who could obtain narcotic painkillers? I understand (though disagree with) the libertarian philosophy that you should be free to take anything you please, but I fail to see how such a situation would lead to decreased use.

curun1r 9y ago

> Think how many times taking an ibuprofen/acetaminophen just made it possible for you to go on with your day... I used to think like that. But since starting meditation practice, I've come to experience pain very differently from the way that I did before. And I've come to realize that only around 10% of pain is physical. The rest is mental...it's how your mind responds to the 10% physical pain. If I react with equanimity...distancing myself from the pain and just observing it rather than feeling it, it all but goes away. I have more chronic pain than I've ever had and, yet, I haven't taken a single pain killer in the past 3 years. I want to believe that somehow my pain is less than everyone who's getting caught in the net of opioids and that they do really need pharmaceutical help to deal with their pain, but my experience leads me to believe otherwise...that much of their need for drug help comes from their mental state and the unproductive way they accept pain into their lives. I also can't help but wonder whether today's increasingly disconnected society leads people to seek connection with a substance rather than other people. Would we still have an opioid epidemic if people spent more time having in-person conversations and less time liking things on Facebook?

emiliobumachar 9y ago
Good for you, but, even if - if!- meditation would work for everyone,it's unrealistic to expect everyone to start meditating. Exercise is good for virtually everyone, and that's common knowledge. Yet relatively few go through the trouble.
- curun1r 9y ago
  I'm not saying that everyone should meditate. I'm only bringing it up because I think it sheds a light on the true nature of pain and why simply removing it with chemicals at all costs is a very dangerous thing to be doing. We need to better understand that nature of pain and understand how to deal with it both physiologically and psychologically rather than taking the naive approach using chemicals, because a mind-body solution will be so much more successful than one that only considers one side of the equation.
  - icelancer 9y ago

martinald 9y ago

Let's also keep in mind that as recently as the 1970s doctors in the US often did not prescribe opioid medication, whatsoever. In some cases, even for terminally ill patients. I think this made fertile ground for huge swing back that pharma got from prescribing it. The situation of such massive underprescribing allowed massive overprescribing, in a way.

senorjazz 9y ago

>. For people with chronic pain, or those coming out of surgery, perceived recovery time can be a big thing for people Chronic / serious pain yes. I read that 1/3 of people in the US are on (or perhaps have taken?) an opiod prescribed pain killer. If true, that is insane! That is not chronic pain. * Drs have over prescribed opiate based painkillers. Fact. * Big Pharma corporations have pushed opiate painkillers recklessly. Fact * Profits became more important than the health of the customers/(patients). Fact This has caused the death of 1000s. Yet no one actually responsible will be held accountable. Sure some Drs will lose their license, but the real guilty parties are further up the tree and will be untouchable. Unfortunately, that seems to be the American way.

Spivak 9y ago
If the metric is 'has ever taken' then I would believe that number is low. Most people will get opioids after they get their wisdom teeth out.
hvo 9y ago
Big Pharma companies are the problem of US health care crisis. They have figured out ways to manipulate the doctors and the patients for gains. If you are a drug addict,there is a pill for that. If there are side-effects to the pill you are taking to get you off addiction,there is a pill for that. And if you take too much pills,there is a pill for that one too.