4 ms·

The opioid crisis would have happened without the war on drugs. The fundamental driver of it is Oxycontin's dosing schedule, which was optimized for causing add

The opioid crisis would have happened without the war on drugs. The fundamental driver of it is Oxycontin's dosing schedule, which was optimized for causing addiction. Marketing for Oxycontin is all about how it "lasts twelve hours", when it often doesn't. Doctors were trained and pressured to increase the prescribed dose when patients complained of pain in the hours before their next scheduled dose, rather than switching to something like an every-eight-hours schedule. The end result is a medication profile with a pronounced sawtooth pattern. On a daily basis, patients get relief from pain, suffer waiting for their next dose through a few hours of agony, and then get relief again. If they try to fix this problem and complain of untreated pain, the doctor ups their dosage and makes the sawtooth even worse. What the war on drugs does is add inflexibility and a criminal dimension to the newly-minted opioid addict's interaction with society. Run out because you accelerated your dosing schedule in order to avoid hours of daily agony? You're not allowed to refill early for any reason whatsoever, and it may get you a drug-seeking label that kicks you out of the official reason entirely.

dillondoyle 6y ago
That undersells their liability and (i think) evil behavior. The original Dr. Sackler invented modern marketing of drugs directly to consumers, starting with getting millions addicted to Valium - which BTW was totally gross sexism. the very Mad Men 60s style marketing /r/oldschool ridiculous keeping women in the house and dealing with their 'emotions and feelings' with downers etc. The Netflix doc the Pharmacist is really good I highly recommend. Purdue gave direct $ bonus' to their sales people, using prescriber data to knowingly target Drs. prescribing insane amounts of opiates. On purpose because they identified it as the most profitable. They also basically bribed doctors to attend conferences and put their name on BS 'research.' they spent millions to induce an earth shaking change in pain management - opiates weren't widely used long term before their 'investment.' Plus the first baseline research they use to justify this was total overstated from one Drs opinion. It's also the pharmacies, Walmart optimized profits and kept pharmacists from questioning scripts. And now last I checked the Sacklers still have their billions and are using the same playbook with a new company in the developing world/India. I'm also totally against the war on drugs and believe we need to fundamentally change attitudes and pretty much remove possession laws. Personally I would go so far as to provide free prescriptions/handouts for addicts of opiates/stims that are pure, clear doses, and safer to inject or use. Make it mandatory to interact with mental health professionals to get the drugs and offer free treatment (medication focused) when the user is ready themselves to attempt to get clean. It's also gross that it's a good amount harder for a doctor to prescribe suboxone than it is opiates. https://www.theguardian.com/world/2019/aug/27/india-opioids-crisis-us-pain-narcotics https://www.theguardian.com/world/2019/aug/27/india-opioids-...
strbean 6y ago
> On a daily basis, patients get relief from pain In fact they get a dosage in excess of what they need for relief from pain. So, on a daily basis, they are just straight up getting high on opiates, and then withdrawing.

dillondoyle 6y ago

That undersells their liability and (i think) evil behavior. The original Dr. Sackler invented modern marketing of drugs directly to consumers, starting with getting millions addicted to Valium - which BTW was totally gross sexism. the very Mad Men 60s style marketing /r/oldschool ridiculous keeping women in the house and dealing with their 'emotions and feelings' with downers etc. The Netflix doc the Pharmacist is really good I highly recommend. Purdue gave direct $ bonus' to their sales people, using prescriber data to knowingly target Drs. prescribing insane amounts of opiates. On purpose because they identified it as the most profitable. They also basically bribed doctors to attend conferences and put their name on BS 'research.' they spent millions to induce an earth shaking change in pain management - opiates weren't widely used long term before their 'investment.' Plus the first baseline research they use to justify this was total overstated from one Drs opinion. It's also the pharmacies, Walmart optimized profits and kept pharmacists from questioning scripts. And now last I checked the Sacklers still have their billions and are using the same playbook with a new company in the developing world/India. I'm also totally against the war on drugs and believe we need to fundamentally change attitudes and pretty much remove possession laws. Personally I would go so far as to provide free prescriptions/handouts for addicts of opiates/stims that are pure, clear doses, and safer to inject or use. Make it mandatory to interact with mental health professionals to get the drugs and offer free treatment (medication focused) when the user is ready themselves to attempt to get clean. It's also gross that it's a good amount harder for a doctor to prescribe suboxone than it is opiates. https://www.theguardian.com/world/2019/aug/27/india-opioids-crisis-us-pain-narcotics https://www.theguardian.com/world/2019/aug/27/india-opioids-...

strbean 6y ago

> On a daily basis, patients get relief from pain In fact they get a dosage in excess of what they need for relief from pain. So, on a daily basis, they are just straight up getting high on opiates, and then withdrawing.