Let's Talk About The Opioid Problem

[lowsparkco]

A person has to voluntarily go to therapy, week after week.

True. For those that are ready to change their lives treatment options should be available, for free.

Affording treatment is an easy barrier to remove. I think if we made talk therapy available for free to anyone we would be shocked how many people would take advantage and how much it would change the fabric of our society.

There are literally millions of anecdotes about people who aren’t ready to change, but I think amazing things could happen if there were services available on short notice for those moments of clarity when users realize that something has to change and they want to live.

[baron]

Interesting account and perspective...

https://old.reddit.com/r/SeattleWA/c..._homeless_camp

His 5 Facts summary maps pretty well to the real world reality.

^everyone should read this article

[nickwm21]

Interesting account and perspective...

https://old.reddit.com/r/SeattleWA/c..._homeless_camp

His 5 Facts summary maps pretty well to the real world reality.

Thanks for posting that.


Sent from my iPhone using TGR Forums

[Falcon3]

When I worked in child support, it was astounding how many (generally) dudes had advanced degrees in math, computer science, or engineering, and had held great jobs at Boeing or Microsoft making lots of money. Then they'd show up on my desk with $2000/month child support orders and I was supposed to go find the money from them.

When I'd talk to their ex-wives, they'd tell me their ex husband maybe had a little back strain from pick-up basketball or sitting at the computer too long and had been prescribed pain meds, and then their lives spiraled out of control pretty quickly. Many of the wives couldn't understand why they couldn't just get their shit together and start making $250k again like they did before. But when I'd talk to the guys (after often years of searching for them as they were living off-grid in homeless encampments) they'd paint a really devastating picture. Chronic pain and docs prescribing opiates, then the addiction starting and getting out of control, leading them to lose their jobs, their families, eventually ending up living under an overpass. I'd try to hook them up with social services and rehab for counseling and treatment, but the barriers were so high for those services, and most would just disappear again.

[ötzi]

My dad was a Doctor at a VA psych hospital. Lots of old guys with emphysema there. They'd get positive pressure treatment to inflate their lungs and then you'd see them outside smoking cigarettes through their tracheotomies. Addiction's a hell of a thing.

[Trackhead]

My dad was a Doctor at a VA psych hospital. Lots of old guys with emphysema there. They'd get positive pressure treatment to inflate their lungs and then you'd see them outside smoking cigarettes through their tracheotomies. Addiction's a hell of a thing.

Ding ding ding, we have a winner.

[ghosthop]

I haven’t seen it posted yet but part of the problem is how we talk about drugs and approach education around drugs.

You can get high, even use heroin, and not immediately ruin your life or your health. Drugs make you feel better than you’ve ever felt and you can go about the next day in peace. This is exactly the opposite of what you were told in health class when you were 14, so you ascribe the current situation to your own superior force of will. Which then gives you permission to keep using.

No one accidentally gets addicted, they make a choice to use a substance they know is dangerous. But we don’t talk about how addiction sneaks up on you, the same way we don’t talk about the compromises in lifestyle that sneak up on you. These things aren’t black and white, often you’re too far in before you notice the subtle changes.

This article may have been posted in the long form journalism thread but it’s a good read.

https://www.theatlantic.com/magazine...w-meth/620174/

[riser4]

When I worked in child support, it was astounding how many (generally) dudes had advanced degrees in math, computer science, or engineering, and had held great jobs at Boeing or Microsoft making lots of money. Then they'd show up on my desk with $2000/month child support orders and I was supposed to go find the money from them.

When I'd talk to their ex-wives, they'd tell me their ex husband maybe had a little back strain from pick-up basketball or sitting at the computer too long and had been prescribed pain meds, and then their lives spiraled out of control pretty quickly. Many of the wives couldn't understand why they couldn't just get their shit together and start making $250k again like they did before. But when I'd talk to the guys (after often years of searching for them as they were living off-grid in homeless encampments) they'd paint a really devastating picture. Chronic pain and docs prescribing opiates, then the addiction starting and getting out of control, leading them to lose their jobs, their families, eventually ending up living under an overpass. I'd try to hook them up with social services and rehab for counseling and treatment, but the barriers were so high for those services, and most would just disappear again.

Fuck. That's terrifying. As a middle aged guy with a BS in CS degree and a bad back from sitting in a chair too long. I don't make $250K though. Not here in VT. Fortunately I'm not on opiates. I went to the pool yesterday and that felt pretty good. First time in a while.

[Falcon3]

No one accidentally gets addicted, they make a choice to use a substance they know is dangerous.

I don't disagree with most of your post, but I do with this part. The drug companies were bribing docs and the docs were telling everyone that oxy and the like weren't addictive. Even after Oxy was shown to be as addictive as other opiates and Purdue Pharma paid a $600m penalty in 2007, they continued bribing docs to prescribe it for chronic pain (which it was shown didn't work) because they made so much money on it. So no, a lot of people didn't really know they were doing something wrong. They were in pain, and a trusted medical professional may have told them it was safe. Once they got hooked, then the nastiness of addiction takes over, but at the start, they were just like anybody else.

https://www.govinfo.gov/content/pkg/...6hhrg43010.htm

[MontuckyFried]

I don't disagree with most of your post, but I do with this part. The drug companies were bribing docs and the docs were telling everyone that oxy and the like weren't addictive. Even after Oxy was shown to be as addictive as other opiates and Purdue Pharma paid a $600m penalty in 2007, they continued bribing docs to prescribe it for chronic pain (which it was shown didn't work) because they made so much money on it. So no, a lot of people didn't really know they were doing something wrong. They were in pain, and a trusted medical professional may have told them it was safe. Once they got hooked, then the nastiness of addiction takes over, but at the start, they were just like anybody else.

https://www.govinfo.gov/content/pkg/...6hhrg43010.htm

That's the most sick and twisted part of this whole saga. Straight evil. How the Sacklers have gotten away their malfeasance is utterly insane. And some of you wonder why a few of us question "Big Pharma."

[ghosthop]

I don't disagree with most of your post, but I do with this part. The drug companies were bribing docs and the docs were telling everyone that oxy and the like weren't addictive. Even after Oxy was shown to be as addictive as other opiates and Purdue Pharma paid a $600m penalty in 2007, they continued bribing docs to prescribe it for chronic pain (which it was shown didn't work) because they made so much money on it. So no, a lot of people didn't really know they were doing something wrong. They were in pain, and a trusted medical professional may have told them it was safe. Once they got hooked, then the nastiness of addiction takes over, but at the start, they were just like anybody else.

https://www.govinfo.gov/content/pkg/...6hhrg43010.htm

Yes, I agree with you. By the time I was interested in getting high oxy had been on the market for a decade.

When I was in high school dentists were still giving out a two week script after wisdom tooth removal. Everyone knew they were dangerous but the controlled aspect was appealing. 6 od deaths in my class before graduation, although one of those was from a weekend methadone dose.

[Cono Este]

I’m In a seriously fucked up situation. I could post this in another thread, but this seems more appropriate. Met this hawt 42 yr old. Teenage mother, put herself through phd program with pieces of shot for men around. They’re all gone but left her with 3 kids one of which had od’d twice on fent in the last 12 months. Weekend was scrapped because kid is flying off the walls.

If you ever get mad at your kids, or think you have a bad one, imagine that. I should run, but damn I want to help this kid and gal. Feels impossible though.

[AK47bp]

I’m In a seriously fucked up situation. I could post this in another thread, but this seems more appropriate. Met this hawt 42 yr old. Teenage mother, put herself through phd program with pieces of shot for men around. They’re all gone but left her with 3 kids one of which had od’d twice on fent in the last 12 months. Weekend was scrapped because kid is flying off the walls.

If you ever get mad at your kids, or think you have a bad one, imagine that. I should run, but damn I want to help this kid and gal. Feels impossible though.

Pussy is one helluva drug.

[SumJongGuy]

Wife's coworker has had to had her twenty something kid arrested multiple times. Diagnosed schizophrenic.. Was attending UNC with straight As halfway through sophomore year when the psychotic break happened They'll be fine for a few days on the proper meds then go ffo them and back to the coke and opioids.. They steal anything and everything they can 24/7 when off the meds. Young black man.. probably going to be killed by the police eventually.

[Trackhead]

I don't disagree with most of your post, but I do with this part. The drug companies were bribing docs and the docs were telling everyone that oxy and the like weren't addictive. Even after Oxy was shown to be as addictive as other opiates and Purdue Pharma paid a $600m penalty in 2007, they continued bribing docs to prescribe it for chronic pain (which it was shown didn't work) because they made so much money on it. So no, a lot of people didn't really know they were doing something wrong. They were in pain, and a trusted medical professional may have told them it was safe. Once they got hooked, then the nastiness of addiction takes over, but at the start, they were just like anybody else.

And if you work in healthcare, you'll also know that Joint Commission in 2001 urged (demanded) us to consider pain as "the fifth vital sign" and that pain was "what the patient tells you it is" and that treating this pain was a "patient right". They had patient survey's that included "How often did the hospital or provider do everything in their power to control your pain?” This bullshit was thought to at least contribute to the opioid crisis, so much that the Joint Commission even published a "It wasn't our fault" memorandum of sorts.

Is big pharma to blame, yes. Are providers to blame.....yes, but placating a drug seeking patient isn't easy. Placating is easy now, because we just say fuck off, not prescribing narcotics for your XYZ diagnosis. And yes, I think Joint Commission is also to blame.

[bennymac]

yeah but that behavior will hurt your customer satisfaction score

[Trackhead]

yeah but that behavior will hurt your customer satisfaction score

Yup, and then they write bad reviews all over your name which is publicly listed. And then you get nasty-grams from admin......and graphs of your satisfaction scores declining. Trapped.

[lowsparkco]

I gave a local ER physician a ski lesson a few weeks ago. He had a lot to say about the subject. I must admit I didn't understand a lot of it. One thing I did understand is that he is a big believer in Medication for Opium User Disorder (MOUD). He seemed pretty critical of ED docs who won't prescribe Suboxone. I know he did a post-bac at Harvard and they are big advocates of MOUD. Here's an interesting article about it....

https://www.health.harvard.edu/blog/...-2018032014496

[Trackhead]

I gave a local ER physician a ski lesson a few weeks ago. He had a lot to say about the subject. I must admit I didn't understand a lot of it. One thing I did understand is that he is a big believer in Medication for Opium User Disorder (MOUD). He seemed pretty critical of ED docs who won't prescribe Suboxone. I know he did a post-bac at Harvard and they are big advocates of MOUD. Here's an interesting article about it....

https://www.health.harvard.edu/blog/...-2018032014496

Suboxone is a step better than putting a dirty ass needle in your vein. FWIW the laws around prescribing suboxone have only recently been liberalized for suboxone prescriptions as of January 2023.

[ötzi]

Pain does need to be appropriately medicated. Opiates are often the correct medication for pain. Overprescription and illegal use do not contradict that at all.

[SumJongGuy]

Pain does need to be appropriately medicated. Opiates are often the correct medication for pain. Overprescription and illegal use do not contradict that at all.

I'm still baffled that anyone thought heroin pills wouldn't be ridiculously addictive. I was working at a pharmaceutical sales training materials company and we did the Oxycontin launch.. I read those claims (and the so called peer reviewed evidence) and just shook my head thinking no fucking way...

[Trackhead]

Pain does need to be appropriately medicated. Opiates are often the correct medication for pain. Overprescription and illegal use do not contradict that at all.

Of course. But the patient isn’t always right, despite thinking they need #30 oxycodone for an ankle sprain.

[ötzi]

Obviously there's a middle ground we need to be there. I've mostly been under-medicated for pain because of my own stubbornness, unwillingness to complain and, at some level, worries about being labeled as a drug-seeker.

But there were two times when ambulance personnel basically said shut up, we're giving you the good stuff. And man I was glad they were able to do that. The jihad against opiates would probably have prevented that.

[Trackhead]

Obviously there's a middle ground we need to be there. I've mostly been under-medicated for pain because of my own stubbornness, unwillingness to complain and, at some level, worries about being labeled as a drug-seeker.

But there were two times when ambulance personnel basically said shut up, we're giving you the good stuff. And man I was glad they were able to do that. The jihad against opiates would probably have prevented that.

Rare to get declined opioids in ambulance transfers for legit reasons. I dislocated my shoulder skiing, alone, couldn’t drive manual transmission and called medics. They gave me morphine 2mg and I said that won’t go shit give me more, and they did. Required no sedation for reduction at arrival to ED…no further meds.

Time and a place.

[Dantheman]

I gave a local ER physician a ski lesson a few weeks ago. He had a lot to say about the subject. I must admit I didn't understand a lot of it. One thing I did understand is that he is a big believer in Medication for Opium User Disorder (MOUD). He seemed pretty critical of ED docs who won't prescribe Suboxone. I know he did a post-bac at Harvard and they are big advocates of MOUD. Here's an interesting article about it....

https://www.health.harvard.edu/blog/...-2018032014496

It's fucking pathetic that this is even a matter of debate.