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"Opioid prescriptions have been falling, even as the death rates from overdoses are rising" Gee, it's almost as if "overprescribing" and then cutting off the su

"Opioid prescriptions have been falling, even as the death rates from overdoses are rising" Gee, it's almost as if "overprescribing" and then cutting off the supply had the affect of driving some who are addicted to buy opiates with less quality control, and they are dying from it.

presscast 8y ago
I'm a bit puzzled by your comment. Are you suggesting that we should have continued to over-prescribe?
- dbatten 8y ago
  Judging by the quotes around overprescribe, I'm assuming the parent comment is skeptical of the idea that we were over-prescribing. Also, they're likely criticizing the whipsaw fashion in which we allowed drug companies to convince everybody these opioids were totally safe, then drastically cut off the supply without doing anything to help people who had already become addicted.
  - deleted 8y ago
    [deleted]
- wesd 8y ago
  sampleinajar is stating that when doctors were over-prescribing the patient became addicts. When those patients were cut-off from legally buying the drugs, they turned to black market where the quality of the drug is unknown which leads to overdose.
- tonyarkles 8y ago
  There's a middle ground there. Cutting back on the number of new opiod prescriptions is definitely a good thing, but you've got to be careful of how you handle existing patients who have already been pulled into the problem. From a harm reduction perspective, taking a patient who is, say, addicted to legal oxycodone because they were overprescribed it. Now what do you do from the perspective of what's best for the patient? Is it a good thing that they're addicted to it? No... but is it more harmful to cut them off cold-turkey? Or is it better to help work with them to figure out how to get off it in a way that doesn't result in them seeking out street drugs to handle the withdrawal?
  - closeparen 8y ago
    Is it definitely a good thing to have more people experiencing more pain?
- maxxxxx 8y ago
  I think the comment says that if there was overprescription before you can't just cut off supply without negative consequences. Yes, prescription rates go down but the already addicted will find other ways to get their fix.
- dillondoyle 8y ago
  Personally I'm all for government suppled morphine. Pure, set & clear doses, clean needles. Would save a ton of money (and you know save lives but there is a lack of compassion on this issue)
belorn 8y ago
Have there not been rather overwhelming number of reports/studies that say that opioid prescriptions for medical pain relieve do not contribute to drug addiction? As I understand it, drug addicts usually start with opioid pain relievers by getting it from friends/family since that's the easiest way to start, but if ease of access is relevant to drug addiction rates is questionable since then the war on drugs should also have worked by making drugs harder to access. Increased suicide rates, depressions, and loneliness seems a much more likely culprit for increase addiction behavior in a nation.
- deleted 8y ago
  [deleted]
jnbiche 8y ago
I'll get shit from doctors on HN for saying this, but there are some chronic disease conditions that are so unimaginably painful that patients will go to any lengths to ease the pain, including -- if they're unable to obtain legal drugs for pain -- buying drugs off the street. Older doctors are aware of this. But younger doctors have been taught recently at med school that opiates must only be used for acute, post-surgical pain. So an increasing number of chronic pain patients are being cut off from licit avenues, and turning to the far more dangerous street drugs.
- IggleSniggle 8y ago
  Opiates can also be a cause of pain. Physical pain and psychological pain are indistinguishable in the brain. Introducing a highly addictive drug may help with short term pain, but may also introduce a chronic pain condition. I think the response of younger doctors in regards to cutting down prescriptions to opiates has more to do with avoiding the moral and legal entanglements with prescribing something that will long term cause chronic pain than it does an unwillingness to prescribe. Western medicine has long been accused of being too focused on acute conditions. The pendulum is swinging in the other direction. There will continue to be doctors that find and understand balancing these risks to optimize a life, not just a body. There will also continue to be clinics that find and understand balancing malpractice insurance, not just patient throughput.

presscast 8y ago

I'm a bit puzzled by your comment. Are you suggesting that we should have continued to over-prescribe?

dbatten 8y ago
Judging by the quotes around overprescribe, I'm assuming the parent comment is skeptical of the idea that we were over-prescribing. Also, they're likely criticizing the whipsaw fashion in which we allowed drug companies to convince everybody these opioids were totally safe, then drastically cut off the supply without doing anything to help people who had already become addicted.
- deleted 8y ago
  [deleted]
wesd 8y ago
sampleinajar is stating that when doctors were over-prescribing the patient became addicts. When those patients were cut-off from legally buying the drugs, they turned to black market where the quality of the drug is unknown which leads to overdose.
tonyarkles 8y ago
There's a middle ground there. Cutting back on the number of new opiod prescriptions is definitely a good thing, but you've got to be careful of how you handle existing patients who have already been pulled into the problem. From a harm reduction perspective, taking a patient who is, say, addicted to legal oxycodone because they were overprescribed it. Now what do you do from the perspective of what's best for the patient? Is it a good thing that they're addicted to it? No... but is it more harmful to cut them off cold-turkey? Or is it better to help work with them to figure out how to get off it in a way that doesn't result in them seeking out street drugs to handle the withdrawal?
- closeparen 8y ago
  Is it definitely a good thing to have more people experiencing more pain?
maxxxxx 8y ago
I think the comment says that if there was overprescription before you can't just cut off supply without negative consequences. Yes, prescription rates go down but the already addicted will find other ways to get their fix.
dillondoyle 8y ago
Personally I'm all for government suppled morphine. Pure, set & clear doses, clean needles. Would save a ton of money (and you know save lives but there is a lack of compassion on this issue)

belorn 8y ago

Have there not been rather overwhelming number of reports/studies that say that opioid prescriptions for medical pain relieve do not contribute to drug addiction? As I understand it, drug addicts usually start with opioid pain relievers by getting it from friends/family since that's the easiest way to start, but if ease of access is relevant to drug addiction rates is questionable since then the war on drugs should also have worked by making drugs harder to access. Increased suicide rates, depressions, and loneliness seems a much more likely culprit for increase addiction behavior in a nation.

deleted 8y ago
[deleted]

jnbiche 8y ago

I'll get shit from doctors on HN for saying this, but there are some chronic disease conditions that are so unimaginably painful that patients will go to any lengths to ease the pain, including -- if they're unable to obtain legal drugs for pain -- buying drugs off the street. Older doctors are aware of this. But younger doctors have been taught recently at med school that opiates must only be used for acute, post-surgical pain. So an increasing number of chronic pain patients are being cut off from licit avenues, and turning to the far more dangerous street drugs.

IggleSniggle 8y ago
Opiates can also be a cause of pain. Physical pain and psychological pain are indistinguishable in the brain. Introducing a highly addictive drug may help with short term pain, but may also introduce a chronic pain condition. I think the response of younger doctors in regards to cutting down prescriptions to opiates has more to do with avoiding the moral and legal entanglements with prescribing something that will long term cause chronic pain than it does an unwillingness to prescribe. Western medicine has long been accused of being too focused on acute conditions. The pendulum is swinging in the other direction. There will continue to be doctors that find and understand balancing these risks to optimize a life, not just a body. There will also continue to be clinics that find and understand balancing malpractice insurance, not just patient throughput.