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"...i find the FDAs policies and procedures eminently sensible..." Damn shame the FDA was asleep at the wheel during the opioid epidemic! (It's a shame you've

"...i find the FDAs policies and procedures eminently sensible..." Damn shame the FDA was asleep at the wheel during the opioid epidemic! (It's a shame you've not bothered to justify that statement in the light of overwhelming evidence to the contrary.) The FDA did SFA to stop Purdue Pharma selling—sorry—pushing boxes of OxyContin to all and sundry as if they were kids lollipops despite the fact that it would have been aware of over a hundred or more years of solid medical evidence of the dangers of narcotics and narcotic addiction. The fact that any opioid narcotic that's capable of killing pain is addictive—and if not very carefully managed—very addictive is 101 medical/pharmacy knowledge. Even kids know the fact! Armed with this knowledge the FDA knew what Purdue was doing was completely unacceptable, so why didn't it act? https://www.theguardian.com/us-news/2019/jan/24/fda-opioids-big-pharma-prescriptions https://www.theguardian.com/us-news/2019/jan/24/fda-opioids-... The FDA still has a lot to answer for its negligence over the Purdue/Opioid crisis. Its ethics are nothing like they were in Frances Kelsey's day. — Later edit: Let me add Frances Kelsey was a true hero, she saved many kids from developing terrible deformities! Despite current criticism of the FDA by many including myself, we should never forget her contribution to medicine.

thereare5lights 6y ago
Racism played a part in this too > If a doctor subscribes to stereotypes of what an addict looks like — nonwhite, from a low-income community — the physician may assume their white, middle-class patients are immune to addiction, he says. https://www.wbur.org/hereandnow/2020/01/03/bias-opioid-prescribing-black-americans https://www.wbur.org/hereandnow/2020/01/03/bias-opioid-presc...
- hilbert42 6y ago
  Yeah, I'm not a bit surprised, but in my view there's an even deer systemic reason and we need to fix it. The overriding issue is that medicos, pharmacists and opioid drug manufacturers should know the dangers of opioids like the back of their hand. I'd even argue that such knowledge is almost a priori in the sense that the vast majority of medical professionals would have already known the essential details before they'd even entered training from the fact that it's common knowledge that opioids are very addictive and dangerous if not managed with considerable care. As I see it, just about everyone knows the multiple reasons behind the decades-old war on drugs by just about every government anywhere on the planet. Even if the way this war was and is still being conducted is ineffective and counterproductive (which, incidentally, is my view), one would have had to have been Sleeping Beauty and have slept though the past 100 years not to know that narcotic opioids, heroin, morphine, etc. along with stimulants, cocaine, methamphetamine, etc. are at the center of this war. (When I was a kid, drugs were never an issue as fortunately we kids never came across any—not even pot! That's to say, with respect to knowledge about drugs, we kids were about as naïve as it gets, nevertheless, even as a nine or ten year old, I'd heard of heroin and morphine and was very well aware of their dangers!) What I am saying is that the relationship between opioids and addiction is so well known—and that these facts are so central to medical and pharmacy training—that it's impossible for professionals not to know about such matters. Thus, the fact that everyone wasn't immediately up in arms and pointing to the problem and demanding that something be done about the problem is very strange indeed. I'd go so far as to say that it's a sociological phenomenon worthy of research. It's not just a matter of penalizing and disciplining the perpetrators but getting to the core of why it actually happened given that basic training, existing laws, dispensing protocols, FDA rules, FDA experience etc. any one of which should have been able to prevent the crisis but didn't.) (In my opinion, the opioid crisis has a similar ring it to what happened at Boeing with the 737 Max where once the notion critical systems engineering and attention to safety details was paramount and inculcated deep within every level of the organization and its work culture but which in recent times vanished. Clearly, we have to get to the heart of the problem and understand it before we can rectify it.)

thereare5lights 6y ago

Racism played a part in this too > If a doctor subscribes to stereotypes of what an addict looks like — nonwhite, from a low-income community — the physician may assume their white, middle-class patients are immune to addiction, he says. https://www.wbur.org/hereandnow/2020/01/03/bias-opioid-prescribing-black-americans https://www.wbur.org/hereandnow/2020/01/03/bias-opioid-presc...

hilbert42 6y ago
Yeah, I'm not a bit surprised, but in my view there's an even deer systemic reason and we need to fix it. The overriding issue is that medicos, pharmacists and opioid drug manufacturers should know the dangers of opioids like the back of their hand. I'd even argue that such knowledge is almost a priori in the sense that the vast majority of medical professionals would have already known the essential details before they'd even entered training from the fact that it's common knowledge that opioids are very addictive and dangerous if not managed with considerable care. As I see it, just about everyone knows the multiple reasons behind the decades-old war on drugs by just about every government anywhere on the planet. Even if the way this war was and is still being conducted is ineffective and counterproductive (which, incidentally, is my view), one would have had to have been Sleeping Beauty and have slept though the past 100 years not to know that narcotic opioids, heroin, morphine, etc. along with stimulants, cocaine, methamphetamine, etc. are at the center of this war. (When I was a kid, drugs were never an issue as fortunately we kids never came across any—not even pot! That's to say, with respect to knowledge about drugs, we kids were about as naïve as it gets, nevertheless, even as a nine or ten year old, I'd heard of heroin and morphine and was very well aware of their dangers!) What I am saying is that the relationship between opioids and addiction is so well known—and that these facts are so central to medical and pharmacy training—that it's impossible for professionals not to know about such matters. Thus, the fact that everyone wasn't immediately up in arms and pointing to the problem and demanding that something be done about the problem is very strange indeed. I'd go so far as to say that it's a sociological phenomenon worthy of research. It's not just a matter of penalizing and disciplining the perpetrators but getting to the core of why it actually happened given that basic training, existing laws, dispensing protocols, FDA rules, FDA experience etc. any one of which should have been able to prevent the crisis but didn't.) (In my opinion, the opioid crisis has a similar ring it to what happened at Boeing with the 737 Max where once the notion critical systems engineering and attention to safety details was paramount and inculcated deep within every level of the organization and its work culture but which in recent times vanished. Clearly, we have to get to the heart of the problem and understand it before we can rectify it.)