posted
Let's all keep pretending as a society that prescription pain medications are perfectly safe because they're legal. Meanwhile over half of what's produced is being abused or over-prescribed.
It's a great, great business, that kills lots of people. Sorry, yes, I'm talking about this again. I went through the medicine cabinet with my mother when I was visiting at my parent's last year, and with the greatest amount of patience, tried to explain why taking an Oxycontin that had been prescribed after a surgery is not ok when one experiences minor joint pain. Granted, not the same thing at all, but hell, we seem to be perfectly fine with the average medicine chest being a cornucopia of left over addictive controlled substances.
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posted
Prescription medications are absolutely something of serious concern. They are powerful chemical agents, and the frequency with which they are abused is horrifying to me, having seen the effects of it first hand.
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quote:Originally posted by Orincoro: we seem to be perfectly fine with the average medicine chest being a cornucopia of left over addictive controlled substances.
What do you suggest as an alternative?
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posted
Prescribe smaller amounts that require more refills and limit the opportunity for more leftovers?
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Personally, rivka, I'd like to see smaller prescriptions. Doctors should hesitate before writing more than a couple days' worth of prescription pain meds. If the pain meds run out, and you are still in pain, then you should call and ask for more to be authorized - but you should have to check in with the doctor.
What Orincoro describes is all too common - a prescription of powerful pain meds is issued, the person doesn't need that many, so they hoard the rest away for another time...and wind up taking them for more minor aches and pains and then they need more for the next ache or pain....and so it goes.
I've seen two people in my close family become addicted to prescription drugs. It is a horrific, terrible addiction and it tears families apart. Both of those people are dead now, and the addiction most definitely played its part in their early deaths.
I just want doctors to be more careful with how they dispense meds. In addition, there should be, with today's technology, some sort of system by where one can check easily to see if the patient has received prescription pain meds elsewhere...this could cut down on the doctor shopping that addicts do to score another prescription. If you show up in the Birmingham ER asking for pain meds for back pain and that doctor can see that yesterday you were at a clinic asking for prescription pain meds for the same thing...that's something that should be easily traced and identified.
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quote:Originally posted by Lyrhawn: Prescribe smaller amounts that require more refills and limit the opportunity for more leftovers?
Which means higher cost (most insurers charge the same co-pay for 5 days' worth or 15 or 30) and more trips to the pharmacy. More trips for someone in pain, mind.
There already ARE severe limitations on maximum amounts that can be obtained at once, and I disagree that reducing that further is the answer. I've known people addicted to pain meds as well, and I don't believe this would reduce that.
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posted
While I quoted you, I was responding to Belle as well. These are not simple problems, and simple solutions aren't likely to do the trick.
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quote:Originally posted by Belle: In addition, there should be, with today's technology, some sort of system by where one can check easily to see if the patient has received prescription pain meds elsewhere.
I think there are some (limited) systems like this in place, but HIPAA makes it difficult. So does getting funding, getting many different organizations on a single system, and so on.
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posted
When did this become an anti drug abuse thread? I like how 9 out of 10 posts were about the drugs, while all Whitney Houston got was an emoticon.
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posted
I am not suggesting anything simple. HIPAA is a concern....but there has to be some way. One person I lost had prescriptions at the time of her death from six different doctors for incredibly powerful painkillers. There HAS to be a better way to spot that kind of thing so that the second, third, fourth, fifth, and sixth doctor don't also prescribe painkillers. When someone has six prescriptions for at least four different types of painkillers...that's a big problem. someone needs to spot this, know this person is doctor shopping, and get them some help! Instead, they all just wrote more prescriptions and more prescriptions.
Better training for physicians, especially emergency department physicians would be a good start too. Not to mention, more research into other ways to help people deal with chronic pain rather than just giving them more opiates. There's a lot to be done, and none of it's simple.
But we have GOT to stop the 30 and 45 day supplies of Lortab that fly out of some doctor's offices. Both the people I know had long-term prescriptions for large quantities. If you have a chronic pain condition you need to be treated in a chronic pain clinic by doctors who are specially trained and can help you, and who are up on the latest research into alternatives to opiates. If you have an acute condition, say recovery from surgery - you need a short prescription for the days of the most intense pain only, then you need to get by with NSAIDS and if your pain is too intense for that, then you should call your doctor. It could be that something's wrong, and he/she needs to see you and see why you are still in so much pain. If you need painkillers again, then they should issue another short term prescription. The extra co-pay and the extra trip will make patients think twice about refilling it and that's a GOOD thing! They should think twice! These drugs are dangerous and shouldn't be taken lightly or without pausing and asking are they really necessary? Or can you get by with rest, and over-the-counter meds?
The CDC, by the way, has a plan for reducing the large number of prescription medicine overdose deaths that they call an "epidemic" in America. It includes much of what I've mentioned, including the establishment of prescription drug monitoring systems that track prescriptions and also plans to address "doctor shopping." When this report was written last November 35 states had some form of monitoring system but that needs to be nationwide and more comprehensive.
quote:Originally posted by Orincoro: we seem to be perfectly fine with the average medicine chest being a cornucopia of left over addictive controlled substances.
What do you suggest as an alternative?
Honestly? Delivery of prescribed daily doses by courier. Impractical, granted.
Look, the point is, we spend WAY WAY less on this problem than we do on stuff that hardly matters. The Feds dedicate billions to marijuana, but don't fund a federally regulated drug Rx registry. Why? They are lobbied by drug companies that make lots of money. Meanwhile, drug deaths are a leading cause of accidental death in America.
When the marketplace is flooded by a *majority* of product that is being used improperly, I don't think the onus is on *me* to provide workable solutions. There is clearly then a lot of money and a lot of power behind stopping the system from being fixed. I can't fight greed with logic, I can only shed light on it.
posted
I watched The Bodyguard last night after not having seen it for years. I know it gets a lot of crap from reviewers, but I really do like that movie a lot.
It's also such a perfect movie for displaying just how talented Houston was. Part of my reaction to her death is a big "so what?" We've all suspected she was heading in this direction with her death spiral over the last few years. But another part of me is still sad, because I grew up during the height of her reign as a major icon, and it'll be years before we get another performer like her.
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quote:Originally posted by Lyrhawn: I really do like that movie a lot.
Me too, and not just because it's one of the only movies I was ever at the premiere of. (I don't even remember now how we got tickets, but we had four and took friends.)
quote:Originally posted by Lyrhawn: Part of my reaction to her death is a big "so what?" We've all suspected she was heading in this direction with her death spiral over the last few years. But another part of me is still sad, because I grew up during the height of her reign as a major icon, and it'll be years before we get another performer like her.
Agreed on both points.
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posted
Prescription meds are not a problem in our society. Abuse of prescription drugs, however, is.
The CDC report I linked to has some startling statistics, not the least of which is that prescriptions of opiates has increased 403% from 1997 to 2007. That's an awful lot of opiate use...and I seriously doubt we as a society have had a 403% increase in pain. Instead, what I think is happening is that people are quick to request pain meds and doctors are far too quick to provide them for minor things that shouldn't even require that much.
On topic, I agree with Lyrhawn's statement about Houston. I was not surprised not all that sad...but she was brilliant and wonderful in her prime and that type of talent is truly rare. Sad to see it pass from the world.
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quote:Originally posted by Orincoro: Let's all keep pretending as a society that prescription pain medications are perfectly safe because they're legal. Meanwhile over half of what's produced is being abused or over-prescribed.
It's a great, great business, that kills lots of people. Sorry, yes, I'm talking about this again. I went through the medicine cabinet with my mother when I was visiting at my parent's last year, and with the greatest amount of patience, tried to explain why taking an Oxycontin that had been prescribed after a surgery is not ok when one experiences minor joint pain. Granted, not the same thing at all, but hell, we seem to be perfectly fine with the average medicine chest being a cornucopia of left over addictive controlled substances.
I wonder what the street value of my medicine cabinet is right now. The only prescription pain med I have is a bottle of Tylenol with Codine, but I have mostly full bottles of ADHD stimulants in there...
Posts: 1321 | Registered: Jun 2006
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posted
Speaking as an urban high school teacher - your street value is pretty high.
I've personally sat in on discipline hearings sending kids to alternative school and/or expulsion due to sale or possession of prescription drugs, and ADHD meds are pretty highly sought after. The Tyelonol with codeine would be taken as well, but they would prefer something stronger. Lortab seems to be a favorite of kids...but probably that's because it's so readily available.
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posted
Good GOD, has anyone else seen all the posts on Facebook and/or the pictures floating around comparing Whitney Houston's death to a dead soldier? Things like "Whitney Who? When Celebs get more credit than real Heros".
posted
There's always going to be people who not only don't care that a certain person died. But will attempt to make you feel bad for caring by trying to put forward somebody else they may or may not think deserves more attention, but who you couldn't really argue against because it makes you look bad.
People pretty much do it with events like football games too. "If only people cared about Jesus as much as they do the Patriots." Invariably the person turns out to not actually like or appreciate the noun they are criticizing.
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posted
Theory I read says that Whitney did it on purpose. The week up to her death she kept talking about how she was going to see Jesus real soon and couldn't wait.
As for the drug issue:
As someone who is in a lot of pain a lot of the time it bothers me how much we worry about suffering that might happen as opposed to suffering that IS happening. I can't seem to get something as simple as a sudafed without displaying my papers because a few meth-heads might blow themselves up.
The doctors I've been to tend to under-prescribe painkillers because they're scared of being put on an FBI watch list. So I make do with a couple of advil or aleve and suffer through the day till I can go to sleep.
I know the regulars here aren't big on letting people decide things for themselves. That either God or the Government (or both) know best... And that the idea of personal responsibility is something to scoff at... but it sure would be nice to have something effective without immediately being a suspect.
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quote:I know the regulars here aren't big on letting people decide things for themselves. That either God or the Government (or both) know best... And that the idea of personal responsibility is something to scoff at... but it sure would be nice to have something effective without immediately being a suspect.
That's not what it's about, at least not for me. I have already said people with chronic pain conditions are not what I have issue with. My issue is doctors who over-prescribe and give opiate painkillers for acute conditions.
There needs to be responsibility on all sides...including the doctors. I've had painkillers prescribed on many different occasions for acute situations - recovery from surgery, after a specific injury, etc. I've always been given way more pills than I needed and wound up flushing the leftovers.
I've also, twice in my life, had chronic pain associated with either a disease process or with a treatment (chemo). One doctor wrote huge prescriptions and never followed up. Another asked me good questions about my type of pain, discussed pain management with me, warned me of the problems of addiction and sat down with me to work out a treatment plan which included opiates, but wasn't entirely reliant on it. He gave me advice of how to alternate types of NSAIDS, to take pills on a schedule so pain never has a chance to build, and ensured I had painkillers for those time when I needed them. For me, pain was always worse at night, so that is when I used the prescription strength stuff. During the day, I got by with other methods of pain management. He followed up every time I saw him on how my pain was being managed. He changed my prescriptions periodically to adjust and deal with things. He continued to discuss the dangers of opiate abuse and ask me how I was doing.
I am for a medical system where the latter situation is much more common than the former.
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My wife had endometriosis since young teen years (two babies seems to have taken care of that, yay!) but has been getting migraines ever since having our second child. Long story short, she's had chronic pain with little that can be done for her medically other then meds.
The vast majority of MDs she has had to deal with are deathly afraid of proscribing opiates, and are very suspicious and seem to assume everyone who hurts is a drug seeker.
I'm fully for a database where MDs can see what a patient is getting from other MDs! But I don't think over prescribing pain meds is the problem.
That being said, a smaller amount for an acute problem seems very reasonable.
My wife has had no less then five OBGYNs say to her (starting in teen years) "The only thing I can do for you is a hysterectomy. If you want anything else, see another doctor."
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