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> by all means go after opiates’ supply-chain (and we can start with Perdue’s executives!) I agree with the rest of what you wrote, but I'd like to suggest tha

by Reelin 6y ago

> by all means go after opiates’ supply-chain (and we can start with Perdue’s executives!) I agree with the rest of what you wrote, but I'd like to suggest that the vast majority of the negative effects of opiates are entirely due to how society treats them. (Also note their incredibly low wholesale prices, and that (as with alcohol) most people who become addicted to them seem to have other problems in their lives that don't magically go away when the drug is banned.)

ashtonkem 6y ago
Purdue absolutely knew that they were over prescribing opiates.
- Reelin 6y ago
  That's completely unrelated to what I wrote. I was suggesting that opiates themselves aren't the problem and that we shouldn't persecute their use. (Also Purdue wasn't prescribing anything. They're a drug manufacturer not a clinical practice.)
  - DaiPlusPlus 6y ago
    Purdue was engaged in aggressive marketing of their opiate drugs to doctors who then prescribe them. Their marketing objective was to rehabilitate doctors’ then dim-view on opiates - and their marketing material went with unchallenged claims such as that they had developed new opiate formulations that weren’t addictive or otherwise had less addictive potential compared to older opiates - these claims have all since been debunked. I understand that the marketing executives at Purdue and others were aware that they were both being dishonest and that what they were doing would result in more OD deaths and ruined lives. Charitably, it can be argued that making opiates more accessible to those who benefit from them who were previously denied them due to doctors’ reservations about opiates - despite increased OD deaths - would still result in a net improvement in overall disability-adjusted-life-years, but because Purdue’s leadership stood to personally gain from increased sales (and cynically: assured long-term sales due to iatrogenic addiction) we cannot assume they were simply acting in the public’s best interest and the increased revenue was just a pleasant side-effect. That is the problem. I recommend checking-out the work of Ben Goldacre if you’re interested to find out more. Pharma companies, of all sizes, manufacture drugs with very high addictive potential - no-one is angry at other companies for making generic fentanyl: those companies weren’t telling doctors it was somehow “safe”. (So I’m not saying it was only Purdue).

by Reelin 6y ago

ashtonkem 6y ago

Purdue absolutely knew that they were over prescribing opiates.

Reelin 6y ago
That's completely unrelated to what I wrote. I was suggesting that opiates themselves aren't the problem and that we shouldn't persecute their use. (Also Purdue wasn't prescribing anything. They're a drug manufacturer not a clinical practice.)
- DaiPlusPlus 6y ago
  Purdue was engaged in aggressive marketing of their opiate drugs to doctors who then prescribe them. Their marketing objective was to rehabilitate doctors’ then dim-view on opiates - and their marketing material went with unchallenged claims such as that they had developed new opiate formulations that weren’t addictive or otherwise had less addictive potential compared to older opiates - these claims have all since been debunked. I understand that the marketing executives at Purdue and others were aware that they were both being dishonest and that what they were doing would result in more OD deaths and ruined lives. Charitably, it can be argued that making opiates more accessible to those who benefit from them who were previously denied them due to doctors’ reservations about opiates - despite increased OD deaths - would still result in a net improvement in overall disability-adjusted-life-years, but because Purdue’s leadership stood to personally gain from increased sales (and cynically: assured long-term sales due to iatrogenic addiction) we cannot assume they were simply acting in the public’s best interest and the increased revenue was just a pleasant side-effect. That is the problem. I recommend checking-out the work of Ben Goldacre if you’re interested to find out more. Pharma companies, of all sizes, manufacture drugs with very high addictive potential - no-one is angry at other companies for making generic fentanyl: those companies weren’t telling doctors it was somehow “safe”. (So I’m not saying it was only Purdue).