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This is (well, was) a new drug. Doctors cannot have learned about a drug in medical school when that drug did not exist when they were studying. My parents are
by vanderZwan 6y ago
This is (well, was) a new drug. Doctors cannot have learned about a drug in medical school when that drug did not exist when they were studying.
My parents are retired Dutch GPs who also ran a small pharmacy[0], so I know a little about how this works, at least in the Netherlands (I admit that this is a pretty big caveat, because (aside from the obvious biases that this introduces) the opioid crisis doesn't exist here - it seems to be a US-only thing. On the other hand, that only gives me more reason to suspect that the problem is systemic, not something to be blamed on individual doctors).
Every year doctors (or any other medical professional as well) have to attend a mandatory amount of lessons to update their knowledge of recent developments in their medical field. In my parents case this also was true for pharmaceutical knowledge. This is where they learn about new medications and their usage. So yeah, they do in fact learn which drug is supposedly safe to prescribe under which circumstances. But you know what is required for all of that to work? An authoritative source of trustworthy information on drug use.
Doctors only start prescribing a drug after it has been approved by the relevant governmental bodies for their usage. So if OxyContin got through the FDA, and was marked as safe for the usage it was advertised for, then I do not understand why you suggest that it's the fault of doctors that they prescribed it in those cases.
Sure, there might have been some stories going around that this drug might not be quite as safe as claimed, but keep in mind that at any given moment hundreds of quack medicine scaremongering stories are making the rounds. When given a choice between believing those, or the official body that is supposed to verify which drugs are safe or not, doctors will usually pick the latter, and in most cases rightly so.
[0] in the Netherlands this is relatively common in small countryside villages that are too small to sustain a pharmacist, who typically needs at least 5000 clients to be sustainable
- Scoundreller 6y ago> Doctors only start prescribing a drug after it has been approved by the relevant governmental bodies for their usage. So if OxyContin got through the FDA, and was marked as safe for the usage it was advertised for, then I do not understand why you suggest that it's the fault of doctors that they prescribed it in those cases. The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for anything else in their judgement. Oxycontin wasn’t approved for chronic non-cancer pain, because it’s a poor choice for that, but that’s where the recurring revenue is and somehow accounted for most of its usage. Short-term post-operative pain and cancer pain just isn’t that big of a market.
- vanderZwan 6y agoThat is a fair point, and does imply that there are other big problems with how drugs are prescribed in the US.
- chimeracoder 6y ago> The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for anything else in their judgement. The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for anything else in their judgement. Yes, but pharmaceutical companies cannot market the drug for non-approved uses or discuss off-label use when promoting or selling the drug. That is illegal. That illegal activity is exactly what the courts determined Purdue did - bribery, fraudulent marketing, and more. The issue is that Purdue broke the law (and that their sentences for breaking the law were way too light).
- jessaustin 6y agoOxycodone was first formulated in 1917, so it's not really "new". There are lots of FDA-approved drugs that are highly inappropriate for most patients. One of the reasons we tolerate the professional status of physicians is because of their purported expertise in prescribing these drugs safely. If they don't know the function and habit-forming potential of opioids, one might well question that expertise. They aren't regulated in any sense by FDA, and they can't blame FDA for their ignorance.
- DanBC 6y ago> Oxycodone was first formulated in 1917, so it's not really "new" The drug being talked about was given a new time-release formulation which was described as less addictive. The drug company spent a lot of time and money distorting the image around addictiveness. Here's a list of things Purdue did: https://www.feinberg.northwestern.edu/sites/ipham/conferences/globalhealthsymposium/docs/Third_Amended_Complaint_14_cv_04361.pdf https://www.feinberg.northwestern.edu/sites/ipham/conference...
- jessaustin 6y agoI agree, go after the deep pockets. I sympathize with patients who became addicted to oxy, while at the same time I'm convinced that opioids should be available to those who need them. I'm glad I got some Demerol when I needed it. I even sympathize with physicians who weighed their patients' needs against the risks of addiction, carefully followed up on their oxy prescriptions, and still had some patients succumb to addiction. I don't sympathize with blanket statements like "doctors just trusted Purdue". Any physician who refilled an opioid prescription without asking the patient some blunt questions and being satisfied with the answers is a piss-poor physician.
- s1artibartfast 6y ago>Doctors only start prescribing a drug after it has been approved by the relevant governmental bodies for their usage. So if OxyContin got through the FDA, and was marked as safe for the usage it was advertised for, then I do not understand why you suggest that it's the fault of doctors that they prescribed it in those cases. Given that the same opioids are approved in the US and Netherlands, with the same warnings and information, why do you think the outcomes are so different between countries?
- vanderZwan 6y agoI cannot say, because I don't know enough about the US system