5 ms·

> It's facile and wrong to think of Oxycontin as an unmitigated evil in society. What about all the people who were diagnosed with terminal cancer and were suf

by aikah 6y ago

> It's facile and wrong to think of Oxycontin as an unmitigated evil in society. What about all the people who were diagnosed with terminal cancer and were suffering from unimaginable pain? It doesn't matter if you will get a crippling addiction if you're going to be dead in 8 months anyway. From what I've read, Oxycontin was the first available drug that could be easily administered at home once or twice a day and gave meaningful pain relief even for the worst pain. The drug may well have made bearable the last months of millions of people. Problem is that it was pushed on people who didn't suffer from terminal disease but milder chronic pain, only to make more money, not for the sake of their health. Yes it was effective but it turned people in hardcore addicts who then turned to nastier drugs when they couldn't get their fix. It killed a lot of people and destroyed a lot of families.

AndrewUnmuted 6y ago
So, in this scenario, you have a pill and a doctor. You have an inanimate object that cannot defend itself against being prescribed to a person unnecessarily... and you have a doctor, who prescribes drugs to patients. You are choosing to blame the inanimate object, when it is clearly the doctor who has acted unscrupulously.
- deleted 6y ago
  [deleted]
- tlrobinson 6y ago
  You’re conveniently ignoring the people who produced and promoted (including apparently paying doctors to prescribe) the inanimate object.
  - AndrewUnmuted 6y ago
    Precisely - I ignored it out of convenience. OxyContin could grow on trees for all I care - it doesn't matter who made it, and that property doesn't do anything to strengthen or diminish my argument. To make the argument you're making, you would have to prove that it doesn't need to exist and was fraudulently made and promoted to deceive, not to help. The problem is that the thing exists, it has a necessary purpose for existing, and by existing it makes the world better for millions of people.
    - edmundsauto 6y ago
      That doesn’t give the company a free pass on anything else. The drug helped some, it hurt others. In an effort to increase sales, Purdue misled doctors and broke acceptable marketing practices in an effort to indiscriminately increase usage - good and bad. The claim is not that oxy didn’t help. The claim is that it also hurt, Purdue knew this, but ignored it for the sake of profit.
bryan0 6y ago
> Problem is that it was pushed on people... Pushed by whom? Who was prescribing these drugs and why? How did this become standard care? There’s obviously plenty of blame to go around but it appears to be a general failure of the healthcare system. edit: I get people want to assign blame on one single malicious actor but its not that simple. this article [0] explores the failings of the system and calls out some of the main actors: "Purdue Pharmaceutical, the Joint Commission, Press-Ganey, and CMS and hospital administrators ." [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/
- FireBeyond 6y ago
  Doctors, who were taught that "pain is the fifth vital sign" in studies and "direction" lead by research institutes that were funded by pharma companies, hidden via layers of indirection. Doctors that were assured that OxyContin was not addictive and "low risk" in the educational material supplied to them by the suppliers.
  - hilbert42 6y ago
    'Doctors that were assured that OxyContin was not addictive and "low risk" in the educational material supplied to them by the suppliers.' If gullible doctors actually believed this 'low risk' nonsense then it's a terrible blight on the medical profession's training. Every doctor knows (or he or she ought to) that for most opioids used for pain relief, the respective amount of any specific opioid used to provide x amount of pain relief has y amount of potential for addiction. That's to say, an amount of one type of opiate necessary to achieve a specific level of pain reduction has about the same addictive properties and another different opioid that achieves the same level of pain reduction as the first one. There are some differences such as pethidine which works wonders in renal colic for instance (but it's not as effective even in high doses for some other types of pain as are other opioids). I don't want to get bogged down in detail here but the principle difference between opioids is in their different strengths and in the different way they are administered. Irrespective of how they're administered, if they kill pain and they're not administered with considerable care the patient will likely get addicted, especially so if the drug is administered over a longish time and or the patient is given too much. Essentially there's no such thing as a low risk opioids except at perhaps the very margins. We've been down this well-trodden road before with heroin. At the turn of the 20th Century ca 1900, Bayer released heroin, it was supposedly not as addictive as morphine when in fact it was even more addictive. It didn't take long to realize that its ability to suppress pain to a deeper level than any amount of morphine also went hand-in-hand with it to be significantly more addictive. This low risk argument is absolutely outrageous. The fact that I have to labor facts here that 99.9% of doctors and pharmacists already know attests to the paucity of Purdue's argument. As I said elsewhere, the true tragedy of this saga is that both the FDA and much of medical profession pretended they didn't know these well-known facts or ignored what was happening for self-serving, ulterior motives (I find it very hard to believe it was incompetence or lack of knowledge on their behalf).

by aikah 6y ago

AndrewUnmuted 6y ago

So, in this scenario, you have a pill and a doctor. You have an inanimate object that cannot defend itself against being prescribed to a person unnecessarily... and you have a doctor, who prescribes drugs to patients. You are choosing to blame the inanimate object, when it is clearly the doctor who has acted unscrupulously.

deleted 6y ago
[deleted]
tlrobinson 6y ago
You’re conveniently ignoring the people who produced and promoted (including apparently paying doctors to prescribe) the inanimate object.
- AndrewUnmuted 6y ago
  Precisely - I ignored it out of convenience. OxyContin could grow on trees for all I care - it doesn't matter who made it, and that property doesn't do anything to strengthen or diminish my argument. To make the argument you're making, you would have to prove that it doesn't need to exist and was fraudulently made and promoted to deceive, not to help. The problem is that the thing exists, it has a necessary purpose for existing, and by existing it makes the world better for millions of people.
  - edmundsauto 6y ago
    That doesn’t give the company a free pass on anything else. The drug helped some, it hurt others. In an effort to increase sales, Purdue misled doctors and broke acceptable marketing practices in an effort to indiscriminately increase usage - good and bad. The claim is not that oxy didn’t help. The claim is that it also hurt, Purdue knew this, but ignored it for the sake of profit.

bryan0 6y ago

> Problem is that it was pushed on people... Pushed by whom? Who was prescribing these drugs and why? How did this become standard care? There’s obviously plenty of blame to go around but it appears to be a general failure of the healthcare system. edit: I get people want to assign blame on one single malicious actor but its not that simple. this article [0] explores the failings of the system and calls out some of the main actors: "Purdue Pharmaceutical, the Joint Commission, Press-Ganey, and CMS and hospital administrators ." [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/

FireBeyond 6y ago
Doctors, who were taught that "pain is the fifth vital sign" in studies and "direction" lead by research institutes that were funded by pharma companies, hidden via layers of indirection. Doctors that were assured that OxyContin was not addictive and "low risk" in the educational material supplied to them by the suppliers.
- hilbert42 6y ago
  'Doctors that were assured that OxyContin was not addictive and "low risk" in the educational material supplied to them by the suppliers.' If gullible doctors actually believed this 'low risk' nonsense then it's a terrible blight on the medical profession's training. Every doctor knows (or he or she ought to) that for most opioids used for pain relief, the respective amount of any specific opioid used to provide x amount of pain relief has y amount of potential for addiction. That's to say, an amount of one type of opiate necessary to achieve a specific level of pain reduction has about the same addictive properties and another different opioid that achieves the same level of pain reduction as the first one. There are some differences such as pethidine which works wonders in renal colic for instance (but it's not as effective even in high doses for some other types of pain as are other opioids). I don't want to get bogged down in detail here but the principle difference between opioids is in their different strengths and in the different way they are administered. Irrespective of how they're administered, if they kill pain and they're not administered with considerable care the patient will likely get addicted, especially so if the drug is administered over a longish time and or the patient is given too much. Essentially there's no such thing as a low risk opioids except at perhaps the very margins. We've been down this well-trodden road before with heroin. At the turn of the 20th Century ca 1900, Bayer released heroin, it was supposedly not as addictive as morphine when in fact it was even more addictive. It didn't take long to realize that its ability to suppress pain to a deeper level than any amount of morphine also went hand-in-hand with it to be significantly more addictive. This low risk argument is absolutely outrageous. The fact that I have to labor facts here that 99.9% of doctors and pharmacists already know attests to the paucity of Purdue's argument. As I said elsewhere, the true tragedy of this saga is that both the FDA and much of medical profession pretended they didn't know these well-known facts or ignored what was happening for self-serving, ulterior motives (I find it very hard to believe it was incompetence or lack of knowledge on their behalf).