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Yay. Recreational marijauna user here and opioids scare the crap out of me. Had to take 10 oxycodone after a surgery and if they can hand those out they can han

• colechristensen 4y ago
  Are opioids really making that much money? Most of what is prescribed are generics and they're not expensive.
  • bsedlm 4y ago
    that's just how cheap they're to make (once you have the factory setup; which isn't cheap)
  • encoderer 4y ago
    Don’t worry they are literally prescribing billions of them. It adds up to enough money for everybody (at the top).
    • colechristensen 4y ago
      But 30 generic percoset, for example, looks to cost about $14 locally where one struggles to pay less than that at lunch outside McDonalds. Doesn't really seem like a cash cow.
      • staticassertion 4y ago
        Is that before or after insurance? Some quick googling and all I can find is anywhere from 100s of millions to 10s of billions.
      • swatcoder 4y ago
        Pretty sure Netflix and Spotify do alright with less than that. And it’s not even accounting for those premium tier subscriptions that come with trendy new formulations not yet acknowledged as dangerous.
        • lotsofpulp 4y ago
          You are saying that selling something for $14 per month with no information about cost of goods sold or sales volume is sufficient to conclude one is doing “alright”? FYI, Spotify has only ever lost money: https://www.macrotrends.net/stocks/charts/SPOT/spotify-technology/net-income https://www.macrotrends.net/stocks/charts/SPOT/spotify-techn...
          • swatcoder 4y ago
            That was precisely the point I was making to the commenter I replied to (unit price doesn’t determine business scale on its own), but interesting info on Spotify regardless.
      • sleepymoose 4y ago
        This also fails to account for those that demand a specific brand of pill, and will gladly pay more for it. You'd be suprised how large the difference is to an addict when comparing a yellow pill to a white one.
      • encoderer 4y ago
        At scale it probably costs pennies to make a Percocet. If the drug maker gets $7 for a prescription that costs them $0.50 to manufacture, and they do that 150 million times in America in a year, that’s a billion dollars in gross margin.
        • projektfu 4y ago
          They're available from the distributor at around 10¢ each. So $3 goes to the manufacturer and distributor and $4 goes to the pharmacy. Incidentally, the huge difference between street price and wholesale price is the reason why diversion is a problem. If the drugs were sold at $10/pill but with instant rebates to the recipients of $9.90 then they'd probably be kept very strictly controlled, even without the DEA involved...
  • ceejayoz 4y ago
    https://www.npr.org/2022/03/03/1084163626/purdue-sacklers-oxycontin-settlement https://www.npr.org/2022/03/03/1084163626/purdue-sacklers-ox... > Court filings show the [Sackler] family took in $10 billion in profits from OxyContin... https://www.nytimes.com/2020/05/27/health/opioids-pharmacy-cvs-litigation.html https://www.nytimes.com/2020/05/27/health/opioids-pharmacy-c... > From 2006 through 2014, the Rite Aid in Painesville, Ohio, a town with a population of 19,524, sold over 4.2 million doses of oxycodone and hydrocodone. The national retailer offered bonuses to stores with the highest productivity. https://www.pbs.org/newshour/economy/judge-says-pharmacies-owe-2-ohio-counties-650-million-in-opioids-suit https://www.pbs.org/newshour/economy/judge-says-pharmacies-o... > Roughly 80 million prescription painkillers were dispensed in Trumbull County alone between 2012 and 2016 — equivalent to 400 for every resident. In Lake County, some 61 million pills were distributed during that period. It's clearly quite profitable.
  • btbuildem 4y ago
    They make the money in volume. They're really following the same business model as illicit drug dealers -- get their users hooked on an addictive substance, then become their exclusive supplier. Except this is at industrial scale.
• Zagill 4y ago
  It's still crazy to me that I was just given hydros when I got my wisdom teeth out at 18. I didn't even need them, I was barely sore.
  • freedomben 4y ago
    I'm really glad for you, but I don't know how I would have survived my wisdom teeth removal without them. Even with the pills the pain was still excruciating. I lost a lot of weight from inability to eat or even drink. In my opinion, giving somebody pills who doesn't need them (what used to be the norm) isn't great but the vast majority of people don't suddenly become junkies. Most people are perfectly fine. You yourself is evidence of this. But not giving somebody pills who does need them (which is now the norm) is literal torture, and the practice disgusts me. I'm really glad you were fine, but not everybody is so lucky, and the number of people who say as you do but also have the power to enforce their views on everyone else have literally been responsible for torturing others. The only thing worse than sitting in pain and misery is knowing that the means to relieve some of that pain is readily available, but some person decided you shouldn't have them so you get to suffer.
    • munk-a 4y ago
      The problem with talking about "giving somebody pills" is that it's extremely imprecise. A coworker of mine was once given a two week script for oxy after they injured their arm, they had two days of serious pain and then just mild soreness - this was an insane over prescription and my friend knew it. They used cannabis to manage their pain for two days and never filled the script. I think a script for two or even three days would have been perfectly reasonable with a "Call me back if the pain is too much after that period".
      • dwringer 4y ago
        I think one problem is people have vastly different thresholds of pain. Somebody else having the same injury might be calling their doctor back begging for a refill because they can barely function. Of course determining how much of that is a medical need versus how much is "the pills talking" is never going to be easy.
• wanderr 4y ago
  They gave me opiods after an invasive surgery that had me on crutches for a month. That stuff was strong enough that I could not safely crutch to the bathroom, I was too dizzy. Switched to low dose edibles and had no problem falling asleep, they didn't make it impossible to get to the bathroom safely, and I didn't have to worry about addiction.
  • davidw 4y ago
    I got sent home with opioids after a collapsed lung surgery many years ago. I was in a lot of pain, so I took one, felt great for a half an hour and then things started to spin and I felt nauseous for like 4 hours where I just stared at the ceiling. Even a sneeze hurt like hell where I'd been stitched up - I really did not want to barf. After that, I took over the counter painkillers and just kind of dealt with the pain, as it was better than feeling all wobbly and dizzy.
    • throwayyy479087 4y ago
      I have kidney stones from time to time. NSAIDs + "deal with it" are an underappreciated pain approach - it's ok to be in pain. It's not OK to be in so much pain you're going to blind and writhing, but those are totally different things.
      • mikeyouse 4y ago
        Unfortunately, there are a ton of incentives from insurance companies and Medicare for patients to be pain-free. Part of your hospital and surgeon's reimbursement is determined by their patient satisfaction score, and uncomfortable patients provide low scores so docs overprescribe and steer clear of uncomfortable topics like behavioral changes, etc; https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/HCAHPS1 https://www.cms.gov/Research-Statistics-Data-and-Systems/Res...
        • egl2021 4y ago
          It can get worse than a bad satisfaction score. Look up "Saint Francis Health System shooting".
• delecti 4y ago
  It never feels good using them either, I always stick to half doses and even that leaves me feeling uncomfortably out of it.
• 2OEH8eoCRo0 4y ago
  The last time I was prescribed an opioid I never had it filled.
• yamtaddle 4y ago
  I've had pain killers prescribed maybe a half-dozen times and the only one for which pot wouldn't have been at least as good was the time I had fairly serious abdominal surgery—and even in that case, I'm not 100% sure weed wouldn't have done the job. Plus, they usually prescribe me way more than I want or need—I may take one or two pills, and they prescribe me six or eight or ten—which inflates sales for these companies while doing no actual good. For most of those cases (plus some times when I don't/can't get a prescription but still feel really bad—which makes weed a super-hero because I don't have to do the "will I still feel bad enough in 24 hours that it's worth losing 3 miserable hours to driving and waiting rooms and lines, trying to get a prescription?" gamble, I just already have some on hand or can go out and get it in like 30 minutes, guaranteed) I really just need something that can let me sleep at night. Weed does that just fine unless the pain or discomfort is really extreme.
  • meroes 4y ago
    I didn't mean to make the point weed should be substituted for opioids. But all of weed's symptoms are a proper subset of all of opioid's. Less powerful but less addicting and harmful to simplify. And that alone means we should be able to prescribe weed where appropriate.
  • tastyfreeze 4y ago
    After minor abdominal surgery I found that the prescribed opiates made the pain go away to where I felt like I could do everything I normally did. So, instead of resting like I should have I would try to do things and be in serious pain when the opiates wore off. Cannabis, on the other hand, I could still feel the pain but I could put it in the back of my mind. This allowed me to be aware that I needed to rest and heal and not be completely focused on the pain. I stopped taking the opiates after the first day.
• jnovek 4y ago
  They’re not completely useless, but I agree that we overprescribe them. I had a kidney stone with complications that required three procedures to take care of. The only thing that would touch that pain was opioids. It was a miserable experience and, thanks to the opioids, I essentially have a four-month hole in my memory. They made me nauseous, dizzy and cognitively useless. I had to titrate off of them because I had developed some degree of dependence. Still, in that situation I would take them again, the pain was unreal.
  • treeman79 4y ago
    Have a mix of nerve pain and a number of kidney stones. A bad kidney stone will leave you suicidal after awhile. Tramadol was only thing that go me through those. Nerve pain is harder as it’s long term. Never as bad as a kidney stone. But it is it something you can live with indefinitely. Tramadol works. But then you get long term addiction. I would stop for a month every few months just to detox some. Eventually I discovered LDN. Which got pain under control. Plus side you can’t take opioids. Was a nightmare finding a doctor that would prescribe it though.
    • SmileyJames 4y ago
      https://en.m.wikipedia.org/wiki/Low-dose_naltrexone https://en.m.wikipedia.org/wiki/Low-dose_naltrexone
    • avgDev 4y ago
      I have some nerve pain. I tried LDN for maybe a month and it did nothing for me. What dosage are you and how long have you been taking it before seeing an improvement?
      • treeman79 4y ago
        4.5 Started at 1.5. Fairly quick results. Only side effects being externally vivid dreams. After a week went to 3, week later to 4.5 I alternate between 3 and 4.5 mostly because dreams can be a bit much. But pain reduction is great. I have Sjogrens autoimmune as underlying condition. Other trick I found was I was taking a b complex. Removing the b-6 seemed to help.
• BoxOfRain 4y ago
  I'm a medical cannabis patient in the UK (medical cannabis was quietly legalised in 2018, there's only 10-20k private patients and virtually none on the NHS so even a fair few police officers don't know it's a thing yet!) and opiates scare me too. Anecdotal I know but I was given a box of codeine after having my appendix out recently and didn't even need a quarter of them so I could definitely see cannabis displacing the less powerful opiates to some extent in the future. I guess it depends on the type of pain but I find cannabis more effective than codeine for the neurological pain I'm prescribed it for anyway.
• Theodores 4y ago
  I like to search and replace 'cannabis' with 'cake'. It has been a while since I have baked a cake but there is only an absence of a cake tin to stop me doing that now. Cake has sugar in it and I am addicted to sugar. I can talk about sugar with my doctor, he can ask me how many cakes I am scoffing and answer almost honestly. Unlike most food there is VAT on cake. If I make my own cake I deprive the tax man but I did pay tax on the cake tin, the electricity and the chocolate. I could make cake and sell it to my workmates, putting that vending machine out of business, partially since I am not yet frying 'crisps'. Imaginably HR could be onto me after a while, the stern email would arrive and a multitude of issues relating to the validity of my 'food hygiene certificate' could come to the fore. But I would still be fine bringing in cake for a workmate's birthday. Really cannabis needs to be something you can do at home without anyone coming for you. If you want to spend months growing plants then you are probably going to learn more about horticulture and get significant benefits from just doing that, growing plants. Much like making a cake, there is enjoyment in the baking that is separate to the eating. This might be fun to do as a student but, in a world where one can't be bothered to bake a cake, I imagine people will move on with their lives and not have a mini cannabis plantation at home. It used to be the same with beer, you could brew your own at home with much fun to be had perfecting your brew. There is nothing to stop you doing that now, however, the kit is not generally sold on the High Street like it used to be - people stopped bothering, they just buy booze rather than brew. If you are growing your own weed and medicating for pain or childhood trauma, you should be able to tell your doctor, much like how you can discuss alcohol or sugar consumption. In that way we can better understand these things. Getting back to the article with search and replace on, the active ingredient for cakes and beer is yeast or a yeast substitute. I can't see how sales of yeast or sugar for home grown cake/beer making can affect the stock value of the big industrial food concerns or brewers.