4 ms·

One note: Research pretty thoroughly debunks the idea that a substantial percent of opioid as addictions come from prescribed pain treatments: https://www.fivet

by cm2012 8y ago

One note: Research pretty thoroughly debunks the idea that a substantial percent of opioid as addictions come from prescribed pain treatments: 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... Now this article is about something different - teaching doctors the warning signs of when already addicted patients are drug seeking, so they can avoid prescribing then. The key fact here is that almost all of the deceased had gotten prescriptions from multiple doctors.

jeffdavis 8y ago
What is the predominant mechanism of becoming addicted then?
- cm2012 8y ago
  "Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."
  - simonbarker87 8y ago
    You could still draw a link: high prescription rates of opioid pain killers normalises the use of them and as such someone is more likely to be offered them by family and friends for something minor. Also, is “throughly” debunked really the case? That makes it sound like there can be no link at all, but higher levels of these in society legally could lead to an increase in abuse. On complex topics like this it is rarely possible to talk in absolutes.
    - cm2012 8y ago
      What's debunked is the very common narrative in this thread that poor Uncle Billy went to the doctor with a bad back and came back a rabid addict. Non addicts becoming addicts from regular prescriptions is very rare according to all studies. There is definitely a big complex drug ecosystem otherwise, though.
      - deleted 8y ago
        [deleted]
  - cma 8y ago
    All that tells is that there is a layer a indirection. The friends, family, and dealers to some degree get pills from people that got them from doctors. Some may come from overseas, theft, etc., but if 25% are hooked directly from having been prescribed them, I would guess a big portion of the 75% is people within a few hops away. Often what happens is that the 25% that got hooked from being prescribed start buying additional pills. Eventually they can't afford that and they switch to cheaper heroin, often funded by selling their prescription pills.
  - srj 8y ago
    I followed these links last night and didn't find much support for that statement. If you're going to quote something, how about the paper?
javadocmd 8y ago
And yet the CDC notes that your likelihood of developing opioid use disorder rises precipitously after as little as five days on prescription opioids. https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm Regardless of whether or not this accounts for the majority of addictions, it is sufficient to say that opioids are far more dangerous for patients than many doctors believe. Addressing prescribing habits is a necessary part of a multi-pronged solution to opioid addiction.
deleted 8y ago
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throwaway91241 8y ago
You keep posting this article, but it has no evidence in it. It links to several papers that tangentially support your claim. Let's look at a different paper that somewhat refutes it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032801/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032801/ Here's the raw data on prescriptions and outcomes summarized in that paper, built from claims data for 2000–2005: Opioid Dose and Days Supply total addiction No opioid use 371,371 150 (0.04%) Low dose, acute 90,415 111 (0.12%) Low dose, chronic 6,902 50 (0.72%) Medium dose, acute 83,542 101 (0.12%) Medium dose, chronic 3,654 47 (1.3%) High dose, acute 12,378 15 (0.12%) High dose, chronic 378 23 (6%) So acute opioid doses 3x your risk of addiction, no matter the strength. And long term dosing will 18x to 150x your risk, depending on the strength. Relatively few people are receiving chronic (90+ days) opioid doses, but those that are have a significant risk of addiction. I'm not the right person to do this analysis properly, but I'd hardly call this "thoroughly debunked"

by cm2012 8y ago

jeffdavis 8y ago

What is the predominant mechanism of becoming addicted then?

cm2012 8y ago
"Far greater risk comes from simply being young and from using alcohol and other recreational drugs heavily. Ninety percent of all drug addictions start in the teens — and 75 percent of prescription opioid misuse begins when (mainly young) people get pills from friends, family or dealers — not doctors. Opioids are rarely the first drug people misuse."
- simonbarker87 8y ago
  You could still draw a link: high prescription rates of opioid pain killers normalises the use of them and as such someone is more likely to be offered them by family and friends for something minor. Also, is “throughly” debunked really the case? That makes it sound like there can be no link at all, but higher levels of these in society legally could lead to an increase in abuse. On complex topics like this it is rarely possible to talk in absolutes.
  - cm2012 8y ago
    What's debunked is the very common narrative in this thread that poor Uncle Billy went to the doctor with a bad back and came back a rabid addict. Non addicts becoming addicts from regular prescriptions is very rare according to all studies. There is definitely a big complex drug ecosystem otherwise, though.
    - deleted 8y ago
      [deleted]
- cma 8y ago
  All that tells is that there is a layer a indirection. The friends, family, and dealers to some degree get pills from people that got them from doctors. Some may come from overseas, theft, etc., but if 25% are hooked directly from having been prescribed them, I would guess a big portion of the 75% is people within a few hops away. Often what happens is that the 25% that got hooked from being prescribed start buying additional pills. Eventually they can't afford that and they switch to cheaper heroin, often funded by selling their prescription pills.
- srj 8y ago
  I followed these links last night and didn't find much support for that statement. If you're going to quote something, how about the paper?

javadocmd 8y ago

And yet the CDC notes that your likelihood of developing opioid use disorder rises precipitously after as little as five days on prescription opioids. https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm Regardless of whether or not this accounts for the majority of addictions, it is sufficient to say that opioids are far more dangerous for patients than many doctors believe. Addressing prescribing habits is a necessary part of a multi-pronged solution to opioid addiction.

deleted 8y ago

[deleted]

throwaway91241 8y ago

You keep posting this article, but it has no evidence in it. It links to several papers that tangentially support your claim. Let's look at a different paper that somewhat refutes it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032801/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032801/ Here's the raw data on prescriptions and outcomes summarized in that paper, built from claims data for 2000–2005: Opioid Dose and Days Supply total addiction No opioid use 371,371 150 (0.04%) Low dose, acute 90,415 111 (0.12%) Low dose, chronic 6,902 50 (0.72%) Medium dose, acute 83,542 101 (0.12%) Medium dose, chronic 3,654 47 (1.3%) High dose, acute 12,378 15 (0.12%) High dose, chronic 378 23 (6%) So acute opioid doses 3x your risk of addiction, no matter the strength. And long term dosing will 18x to 150x your risk, depending on the strength. Relatively few people are receiving chronic (90+ days) opioid doses, but those that are have a significant risk of addiction. I'm not the right person to do this analysis properly, but I'd hardly call this "thoroughly debunked"