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> 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 plen

by 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).
karpierz 6y ago
When people exploit the system in order to benefit at the expense of others: yes, it is a failure of the system. But it is also a moral failing on the people exploiting the system, knowing the kind of damage they're causing. One does not preclude the other.
tlrobinson 6y ago
Did you read the article? > They found a widespread pattern of illegal misconduct in which Purdue systematically misled doctors (and the general public) about the risks associated with OxyContin
spaetzleesser 6y ago
Pushed by the company AND(!!!) also by doctors. The company spent a lot of money on spreading lies and belittling negative information. Same what the tobacco guys did. Doctors aren't faultless either. A lot of them must have seen what was happening.

by bryan0 6y ago

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).

karpierz 6y ago

When people exploit the system in order to benefit at the expense of others: yes, it is a failure of the system. But it is also a moral failing on the people exploiting the system, knowing the kind of damage they're causing. One does not preclude the other.

tlrobinson 6y ago

Did you read the article? > They found a widespread pattern of illegal misconduct in which Purdue systematically misled doctors (and the general public) about the risks associated with OxyContin

spaetzleesser 6y ago

Pushed by the company AND(!!!) also by doctors. The company spent a lot of money on spreading lies and belittling negative information. Same what the tobacco guys did. Doctors aren't faultless either. A lot of them must have seen what was happening.