2 ms·

Thanks for this thoughtful reply. I should probably not have commented on frequency of meth prescriptions, my only reference point is that it's never been broug

by asxd 5y ago

Thanks for this thoughtful reply. I should probably not have commented on frequency of meth prescriptions, my only reference point is that it's never been brought up to me by my doctor and don't know any friends who take it for ADHD. Regarding withdrawal symptoms, it's again anecdotal on my end. I have been taking prescribed adderall for ADD since I was a teen. When I do go off it for a prolonged period of time, I don't notice withdrawal so much as a mood shift and a decline in productivity. I'm more or less comfortable being lethargic and lazy when I'm off it, but I take it because I think it makes me better at being a person (ability to focus for one, but also just taking the time to do menial but important every-day tasks I might otherwise let go by the wayside, for example). I think this speaks to your point though, that in correct dosages the withdrawal in (pharmaceutical grade) drugs can be safely mitigated. On a slight tangent, I'd like to point to the ongoing opioid crisis. I wonder if the reason it occurred was not only because doctors made the drug readily available, but because so many people were told by their doctor--a generally trusted authority--to take larger doses? If it were only accessibility that led to the crisis, there may be some truth to the idea that some drugs are true public health hazards. Apologies for rambling a bit, I'm somewhat on the fence about this topic, and I know this is a complicated issue to unravel.

Lazare 5y ago
The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested. Note that the rate of opioid prescription in the US had dropped by nearly 50% since 2012 [1], while the overdose rate has more than doubled [2]][3]. Meanwhile the same crackdown that has led to a huge decline in prescriptions has also led to a decrease in the amount prescribed, to the extent that there is strong evidence it is harming patients because doctors are so afraid of losing their license they are unwilling to prescribe the correct therapeutic dose to patients. A study in JAMA recently found that when doctors reduce the dosage of pain medication prescribed to long term opioid therapy, it leads to a threefold increase in suicide attempts and a 69% increase in overdoses[4]. In other words, the federal guidelines adopted to try and ensure that the drug was less readily available from doctors and prescribed in smaller doses seems likely to have cost a significant number of lives. There don't seem to be easy answers, and the driving forces behind (and possible solutions to) the massive increase in overdose deaths in the US remain elusive. But at a minimum a simple model of "it's caused by doctors giving people prescriptions for painkillers" seems to not be supported by evidence at this time. [1]: https://www.cdc.gov/drugoverdose/rxrate-maps/index.html https://www.cdc.gov/drugoverdose/rxrate-maps/index.html [2]: https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/drug-topics/trends-statistics/over... [3]: https://apnews.com/article/overdose-deaths-record-covid-pandemic-fd43b5d91a81179def5ac596253b0304 https://apnews.com/article/overdose-deaths-record-covid-pand... [4]: https://jamanetwork.com/journals/jama/fullarticle/2782643?guestAccessKey=a13d0857-892c-4c51-b888-0412f36c9640&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=080321 https://jamanetwork.com/journals/jama/fullarticle/2782643?gu...
- DanBC 5y ago
  > The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested. No, it really isn't. US doctors were massively over-prescribing very strong opioids and telling patients that these were not addictive. This meant that communities were flooded with clean, pure, strong, opioids. This supply was legal. The fact that it subsequently got diverted into the misuse supply chain doesn't alter the known facts of the opioid crisis - that there was massive over-supply of legal meds.

by asxd 5y ago

Lazare 5y ago

The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested. Note that the rate of opioid prescription in the US had dropped by nearly 50% since 2012 [1], while the overdose rate has more than doubled [2]][3]. Meanwhile the same crackdown that has led to a huge decline in prescriptions has also led to a decrease in the amount prescribed, to the extent that there is strong evidence it is harming patients because doctors are so afraid of losing their license they are unwilling to prescribe the correct therapeutic dose to patients. A study in JAMA recently found that when doctors reduce the dosage of pain medication prescribed to long term opioid therapy, it leads to a threefold increase in suicide attempts and a 69% increase in overdoses[4]. In other words, the federal guidelines adopted to try and ensure that the drug was less readily available from doctors and prescribed in smaller doses seems likely to have cost a significant number of lives. There don't seem to be easy answers, and the driving forces behind (and possible solutions to) the massive increase in overdose deaths in the US remain elusive. But at a minimum a simple model of "it's caused by doctors giving people prescriptions for painkillers" seems to not be supported by evidence at this time. [1]: https://www.cdc.gov/drugoverdose/rxrate-maps/index.html https://www.cdc.gov/drugoverdose/rxrate-maps/index.html [2]: https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/drug-topics/trends-statistics/over... [3]: https://apnews.com/article/overdose-deaths-record-covid-pandemic-fd43b5d91a81179def5ac596253b0304 https://apnews.com/article/overdose-deaths-record-covid-pand... [4]: https://jamanetwork.com/journals/jama/fullarticle/2782643?guestAccessKey=a13d0857-892c-4c51-b888-0412f36c9640&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=080321 https://jamanetwork.com/journals/jama/fullarticle/2782643?gu...

DanBC 5y ago
> The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested. No, it really isn't. US doctors were massively over-prescribing very strong opioids and telling patients that these were not addictive. This meant that communities were flooded with clean, pure, strong, opioids. This supply was legal. The fact that it subsequently got diverted into the misuse supply chain doesn't alter the known facts of the opioid crisis - that there was massive over-supply of legal meds.