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Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe th

Clearly I'm just a layman but I find it so surprising that the medical community isn't 100% aware of the over prescribing of opiods by now. I have to believe they are totally aware of the situation, but don't know what else to do. Or maybe they're totally fine with it /shrug. I'd love to know more about the medical community's reaction and reformation efforts around the issues with opiods and addiction.

fjsolwmv 8y ago
Awareness in general and being forced to directly think on a specific person you killed are two different things.
cheeze 8y ago
Everybody is aware. Many just don't care.
- thomasfedb 8y ago
  I think this is mean and unnecessarily so. People have pain and expect doctors to fix it, but the tools we have to treat it are dangerous. Going too far either way will cripple or destroy lives. Getting the balance right isn't a job anybody is envious of.
slededit 8y ago
The article states most doctors think they prescribe below average amounts - similar to everyone thinking they are an above average driver.
- nostromo 8y ago
  It’s entirely possible, even likely, that most doctors prescribe below average amounts.
rz2k 8y ago
Search: “Pain is the fifth vital sign” There was a very strong campaign to re-educate physicians to not consider pain as only a symptom. It was suggested that there was liability in not treating pain for the sake of getting rid of pain alone, but mostly it didn’t just change prescribing practices out of fear of liability, the focus of attention on pain changed prescribing habits. In practice, someone who hardly has enough time for the patients they see, may subconsciously think that in spite of the prevalence of national opioid deaths, no one they treat has died or destroyed their lives through addiction, simply because those who do also stop booking appointments. These letters sound like a great idea.
- javadocmd 8y ago
  Even for doctors who express awareness of the problem with opioid prescribing, it's not uncommon to believe that every other doctor is the problem, and not themselves. Either not realizing their prescribing is above average, or realizing but justifying it with the thought that they somehow have a patient population with above average pain needs.
xup 8y ago
Another factor: Many doctors and hospitals are rated according to patient satisfaction, with reimbursement rates from the government partially based on those satisfaction surveys. And in many cases, if patients have any pain whatsoever, they rate the doctors and hospitals poorly, and therefore the doctors and hospitals get a lower reimbursement rate from the federal government. So doctors and hospitals are incentivized to make patients have no pain whatsoever in recovery, in order to have higher reimbursement rates, even if it means addiction in the long run. Source: Many doctors in my family who talk about their experiences.
baxtr 8y ago
I guess it’s also an cultural issue. If it’s ok to mute any pain, then not giving opioids is maybe not even considered. My father had 2 bad operations last year. He suffered a lot of pain afterwards, but he refrained from taking strong drugs. I’m not sure if he did the right thing and if I’d do the same. But there’s is definitely middle ground between killing every pain and enduring all of it. I found this article interesting: https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-germany-vicodin.html https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-ge...
cm2012 8y ago
Just FYI, doctors very rarely cause opioid addictions: https://www.fivethirtyeight.com/features/what-science-says-to-do-if-your-loved-one-has-an-opioid-addiction/ https://www.fivethirtyeight.com/features/what-science-says-t... As the article shows, at worst they get bamboozled by addicts sometimes, who go to multiple doctors and lie.
johnpowell 8y ago
I went to the dentist around four months ago to get a tooth pulled. I was given 36x325Mg Hydrocodone (not a typo) and 14x600 Mg Ibuprofen. Which is pretty absurd. I only used 6 of the Ibuprofen. I'm not sure why I wasn't just given a two day supply of Hydrocodone and if more was needed I could have just called it in asking for a more if the pain was bad. It was such a over-prescription I hope it was just sloppy handwriting.
- selectodude 8y ago
  You were reading the bottle wrong. Those pills were either 5mg or 10mg of hydrocodone with 325mg of acetaminophen. 36 of those, while a lot, is really not more than 4-5 days worth. They only last 4-6 hours each. 325mg hydrocodone would have killed you several times over unless you’re, like, a late stage cancer patient or a severe heroin addict.
  - pdkl95 8y ago
    Additionally, 600mg Ibuprofen is just 3 of the common over-the-counter 200mg pills. The adult dose for OTC Ibuprofen is 1 or 2 of the 200mg pills, so 600mg is only 150%-300% larger. Whi8le that kind of higher dose can become a problem if used continuously for more than a few days (be careful with any medication), it's a fairly standard dose for a handful of days after a dental procedure. It's certainly not "absurd". (I've been prescribed 1200mg Ibuprofen "every 4-6 hours" a couple times)
    - johnpowell 8y ago
      I am not saying the ibuprofen was a problem. I'm saying it should have been the first thing recommended. I was told to take the ibuprofen for swelling and the hydrocodone for pain.
  - johnpowell 8y ago
    You are correct. It says Hydrophone-Acetomaminophen 5-325MG Tab Mall. But there is a line break. after "5-" so since I am not a doctor I think my interpretation is a reasonable one. You knew exactly what I meant, so cool.

fjsolwmv 8y ago

Awareness in general and being forced to directly think on a specific person you killed are two different things.

cheeze 8y ago

Everybody is aware. Many just don't care.

thomasfedb 8y ago
I think this is mean and unnecessarily so. People have pain and expect doctors to fix it, but the tools we have to treat it are dangerous. Going too far either way will cripple or destroy lives. Getting the balance right isn't a job anybody is envious of.

slededit 8y ago

The article states most doctors think they prescribe below average amounts - similar to everyone thinking they are an above average driver.

nostromo 8y ago
It’s entirely possible, even likely, that most doctors prescribe below average amounts.

rz2k 8y ago

Search: “Pain is the fifth vital sign” There was a very strong campaign to re-educate physicians to not consider pain as only a symptom. It was suggested that there was liability in not treating pain for the sake of getting rid of pain alone, but mostly it didn’t just change prescribing practices out of fear of liability, the focus of attention on pain changed prescribing habits. In practice, someone who hardly has enough time for the patients they see, may subconsciously think that in spite of the prevalence of national opioid deaths, no one they treat has died or destroyed their lives through addiction, simply because those who do also stop booking appointments. These letters sound like a great idea.

javadocmd 8y ago
Even for doctors who express awareness of the problem with opioid prescribing, it's not uncommon to believe that every other doctor is the problem, and not themselves. Either not realizing their prescribing is above average, or realizing but justifying it with the thought that they somehow have a patient population with above average pain needs.

xup 8y ago

Another factor: Many doctors and hospitals are rated according to patient satisfaction, with reimbursement rates from the government partially based on those satisfaction surveys. And in many cases, if patients have any pain whatsoever, they rate the doctors and hospitals poorly, and therefore the doctors and hospitals get a lower reimbursement rate from the federal government. So doctors and hospitals are incentivized to make patients have no pain whatsoever in recovery, in order to have higher reimbursement rates, even if it means addiction in the long run. Source: Many doctors in my family who talk about their experiences.

baxtr 8y ago

I guess it’s also an cultural issue. If it’s ok to mute any pain, then not giving opioids is maybe not even considered. My father had 2 bad operations last year. He suffered a lot of pain afterwards, but he refrained from taking strong drugs. I’m not sure if he did the right thing and if I’d do the same. But there’s is definitely middle ground between killing every pain and enduring all of it. I found this article interesting: https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-germany-vicodin.html https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-ge...

cm2012 8y ago

Just FYI, doctors very rarely cause opioid addictions: https://www.fivethirtyeight.com/features/what-science-says-to-do-if-your-loved-one-has-an-opioid-addiction/ https://www.fivethirtyeight.com/features/what-science-says-t... As the article shows, at worst they get bamboozled by addicts sometimes, who go to multiple doctors and lie.

johnpowell 8y ago

I went to the dentist around four months ago to get a tooth pulled. I was given 36x325Mg Hydrocodone (not a typo) and 14x600 Mg Ibuprofen. Which is pretty absurd. I only used 6 of the Ibuprofen. I'm not sure why I wasn't just given a two day supply of Hydrocodone and if more was needed I could have just called it in asking for a more if the pain was bad. It was such a over-prescription I hope it was just sloppy handwriting.

selectodude 8y ago
You were reading the bottle wrong. Those pills were either 5mg or 10mg of hydrocodone with 325mg of acetaminophen. 36 of those, while a lot, is really not more than 4-5 days worth. They only last 4-6 hours each. 325mg hydrocodone would have killed you several times over unless you’re, like, a late stage cancer patient or a severe heroin addict.
- pdkl95 8y ago
  Additionally, 600mg Ibuprofen is just 3 of the common over-the-counter 200mg pills. The adult dose for OTC Ibuprofen is 1 or 2 of the 200mg pills, so 600mg is only 150%-300% larger. Whi8le that kind of higher dose can become a problem if used continuously for more than a few days (be careful with any medication), it's a fairly standard dose for a handful of days after a dental procedure. It's certainly not "absurd". (I've been prescribed 1200mg Ibuprofen "every 4-6 hours" a couple times)
  - johnpowell 8y ago
    I am not saying the ibuprofen was a problem. I'm saying it should have been the first thing recommended. I was told to take the ibuprofen for swelling and the hydrocodone for pain.
- johnpowell 8y ago
  You are correct. It says Hydrophone-Acetomaminophen 5-325MG Tab Mall. But there is a line break. after "5-" so since I am not a doctor I think my interpretation is a reasonable one. You knew exactly what I meant, so cool.