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I think that peak opiates will prove to be true. The government has cracked down on physicians prescribing them and pharmacies filling them. None of my pharma

I think that peak opiates will prove to be true. The government has cracked down on physicians prescribing them and pharmacies filling them. None of my pharmacist friends will even fill an opioid anymore until the patient has filled and tried using a Rx Tylenol first.

loeg 8y ago
Why the fuck would anyone pay for a highly qualified pharmacist to fill tylenol when patients can just buy the regular kind in the drug store and take 1.5 (or whatever the prescription is for)?
- L_Rahman 8y ago
  GP might be referring to a Tylenol with Codeine that's only available with a prescription. I may be wrong however because codeine is still an opioid.
- will_brown 8y ago
  Over the counter Tylenol is not the same as Rx Tylenol. And you will do it because due to the crackdown on physicians all their new Rx say don’t fill the opioid until the patient has tried the Tylenol.
  - loeg 8y ago
    Pray tell, what is the difference between tylenol and explicitly non-opioid Rx tylenol, aside from the dose of acetaminophen per pill? And if the difference is merely dose and you're suggesting people should do it or otherwise they won't get the effective painkillers, this seems like an obvious injection of cost disease into the existing stupidly expensive healthcare system.
    - will_brown 8y ago
      >you're suggesting people should do it I never suggested people do anything. Just explaining certain changes to the system as a result of the crack down. But I think the thought is requiring the Rx Tylenol be tried first does successfully deter people who fit drug seeking behavior and second physicians were to often writing opioids as a first line of defense to pain, whereas Tylenol will work just fine for most. My guess is studies also show that overall healthcare costs go down and not up as you say. Maybe in those instances a patient really needs the opioid for pain they have a slight cost increase, but for many others it will save them from addiction, weed out a lot of drug seeking patients and the costs associated with addiction/hospitalization/OD/etc.... There are a lot of hidden costs in opioid abuse. Still it’s not my rules or changes, if you don’t like it and think you can show in the aggregate these changes are driving up costs in healthcare to the detriment of patients who legitimately need opioids, write your congressman. But I don’t think to many people will give your stance a sympathetic ear so long as people who do need them can still get them.
    - drspacemonkey 8y ago
      >Pray tell, what is the difference between tylenol and explicitly non-opioid Rx tylenol, aside from the dose of acetaminophen per pill? After some emergency dental work last week, I was given Rx Tylenol. It has a low dose of codeine, which is an opiate.
      - loeg 8y ago
        Ok, so the statement this was all in reply to: > None of my pharmacist friends will even fill an opioid anymore until the patient has filled and tried using a Rx Tylenol first. Is an oxymoron? (Opioids are a superset of opiates, for what it's worth.)
        will_brown 8y ago
        Well what you are referencing now is typically called Tylenol 3 which has codine (an opioid/narcotic) but it doesn't have the same abuse rates as oxycodone, for example. They usually don’t start with Tylenol 3 either though. There are scales to this stuff, like you wouldn’t lump heroin or morphine (both opiates) with Tylenol with codine (then again...maybe you might), but that’s the point you said you didn’t want to have a highly trained pharmacist fill your Tylenol, but based on all the questions you have, that is probably the most appropriate course of action. Then you can get a handle on the risks of these therapies, the difference and allow that to inform your decisions.

loeg 8y ago

Why the fuck would anyone pay for a highly qualified pharmacist to fill tylenol when patients can just buy the regular kind in the drug store and take 1.5 (or whatever the prescription is for)?

L_Rahman 8y ago
GP might be referring to a Tylenol with Codeine that's only available with a prescription. I may be wrong however because codeine is still an opioid.
will_brown 8y ago
Over the counter Tylenol is not the same as Rx Tylenol. And you will do it because due to the crackdown on physicians all their new Rx say don’t fill the opioid until the patient has tried the Tylenol.
- loeg 8y ago
  Pray tell, what is the difference between tylenol and explicitly non-opioid Rx tylenol, aside from the dose of acetaminophen per pill? And if the difference is merely dose and you're suggesting people should do it or otherwise they won't get the effective painkillers, this seems like an obvious injection of cost disease into the existing stupidly expensive healthcare system.
  - will_brown 8y ago
    >you're suggesting people should do it I never suggested people do anything. Just explaining certain changes to the system as a result of the crack down. But I think the thought is requiring the Rx Tylenol be tried first does successfully deter people who fit drug seeking behavior and second physicians were to often writing opioids as a first line of defense to pain, whereas Tylenol will work just fine for most. My guess is studies also show that overall healthcare costs go down and not up as you say. Maybe in those instances a patient really needs the opioid for pain they have a slight cost increase, but for many others it will save them from addiction, weed out a lot of drug seeking patients and the costs associated with addiction/hospitalization/OD/etc.... There are a lot of hidden costs in opioid abuse. Still it’s not my rules or changes, if you don’t like it and think you can show in the aggregate these changes are driving up costs in healthcare to the detriment of patients who legitimately need opioids, write your congressman. But I don’t think to many people will give your stance a sympathetic ear so long as people who do need them can still get them.
  - drspacemonkey 8y ago
    >Pray tell, what is the difference between tylenol and explicitly non-opioid Rx tylenol, aside from the dose of acetaminophen per pill? After some emergency dental work last week, I was given Rx Tylenol. It has a low dose of codeine, which is an opiate.
    - loeg 8y ago
      Ok, so the statement this was all in reply to: > None of my pharmacist friends will even fill an opioid anymore until the patient has filled and tried using a Rx Tylenol first. Is an oxymoron? (Opioids are a superset of opiates, for what it's worth.)
      - will_brown 8y ago
        Well what you are referencing now is typically called Tylenol 3 which has codine (an opioid/narcotic) but it doesn't have the same abuse rates as oxycodone, for example. They usually don’t start with Tylenol 3 either though. There are scales to this stuff, like you wouldn’t lump heroin or morphine (both opiates) with Tylenol with codine (then again...maybe you might), but that’s the point you said you didn’t want to have a highly trained pharmacist fill your Tylenol, but based on all the questions you have, that is probably the most appropriate course of action. Then you can get a handle on the risks of these therapies, the difference and allow that to inform your decisions.