The crackdown on painkillers is killing people

[iscooterliberally]

Source: Vice News

Mothers, retirees, veterans, scientists, and working-class Americans sent letters by the dozens over several months to the commission formed this year by Donald Trump to help solve the opioid crisis. One concern united them: Tight restrictions on prescription pills could be driving pain patients to turn to heroin and fentanyl.

“If the U.S. government is to deal with the opioid epidemic, the first thing you must realize is that managed prescriptions to chronic pain patients didn’t cause the problem,” wrote one such patient from Kalispell, Montana. “And torturing us by denial of care will only make the mess worse when we must go into the street to get pain relief.”

And yet, 25 of the 56 recommendations included in the commission’s final report, released last week, call for a continued crackdown on prescription opioids and other “supply reduction and enforcement strategies.” At the same time, the report acknowledged that these policies likely contributed to the massive spike in fatal overdoses in recent years. It’s as if the commission, led by New Jersey Gov. Chris Christie, believes Trump can double down on an approach that made the problem worse and it will somehow produce a different result.

“This is a giant show of what is quickly doable, but it has no medical-outcome data to support it,” said Stefan Kertesz, a professor of preventive medicine at the University of Alabama at Birmingham. “There’s no evidence you stop overdoses by taking patients off opioids against their will. Moreover, that course of action frequently destabilizes patients who are being taken off of them.”

Read more: https://news.vice.com/story/how-the-crackdown-on-painkillers-is-killing-people

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I've been on opiates many many times during my life. I had a bad motorcycle wreck where I hit the pavement at 40 mph almost 10 years ago. I lived in the Florida pill mill territory and even contacted one of those places. When I found out they didn't take insurance and wanted $300 cash for a $25 bottle of pills, I passed. Sure I would love to be able to walk into a pharmacy and buy a half dozen pain pills to keep up in the cupboard. I'll always have low level chronic pain. Some days it gets worse. As an adult over the age of 21, I can buy tobacco products, and a fifth of whiskey. I have a car that weighs more than a ton and has a speedometer that says it can do 160 mph. I can also by one of those semi-automatic combat rifles too. I wonder why I can't be trusted with pain pills? What's up with that? Back when alcohol was illegal people drank gin that was made in a dirty bath tub. Now we have brands like Tanqueray. Drugs aren't simply going to go away just because we ban them. I don't think we should call people who become addicted, 'junkies' or even look down on addicts. There has to be a better way to do this. I sometimes wish that the 2nd amendment was about the right to keep and bear our drug of choice instead. Maybe then we wouldn't have to send out so many thoughts and prayers.

[Ilsa]

1. What i thought was interesting when I listened to CC discuss it

on Morning Joe, was the idea that the real problem is kids stealing it from their parents' medicine cabinets and abusing it, getting hooked, and overdosing. I don't know if that is the most frequent scenario for OD or getting addicted, but that isn't a problem of over-prescribing. That's a problem with parents being irresponsible and not dumping any remainder of excessive numbers of pills. It's only over-prescribing if the dr writes it for a month's supply if pain levels should get down to ibuprofen-managable levels after a week or less.

[iscooterliberally]

2. I guess it depends on how many pills the parents have in their medicine cabinet.

I really don't think if some kid gets a handful of pain pills they're going to get addicted. That doesn't mean that far worse things won't happen though. Pain pills, alcohol and a motor vehicle are a bad combination. I had to take pain pills daily for more than 8 weeks before I became physically dependent on them. At that point the doctor just prescribed a lower dose and then I went to Advil or regular aspirin. I honestly think that people who are addicted should still be able to get pills. That would be preferable to heroin or fentanyl which can also be cut with cement powder or rat poison and then served up in a dirty needle. The best we can do is reduce the harm. What we are doing now is exacerbating a terrible problem.

[Sunlei]

61. your Doctor weaned you off-thats what all Doctors have to do. *

* Drug Corporations must pay for this 'treatment' or our personal health care insurance will be over whelmed by "fly by night drug treatment clinic" & "weaning drug" costs.

[Blackjackdavey]

43. Simple truth

The simple truth is, the most common scenario for people to get addicted is getting a legitimate prescription for an initially legitimate condition. These pills are highly addictive, doctors and pharmaceutical companies are making huge amounts of money from addicted patients and they have an army of addicted people advocating for the status quo. The idea that heroin and fentanyl are a go to alternative because pills are restricted is in fact, ludicrous. Simple truth again: easier to get pills are the go to alternative for (obviously illegal) heroin and fentanyl.

With that said, the irony of focusing on this while we flood the country with guns and indiscriminately poison our water and air is certainly rich.

[IronLionZion]

3. Vice News has had many articles on this subject

and they did publish videos earlier interviewing heroin/opioid addicts on how they got started (prescription painkillers). They are changing their tune here. Maybe it shows how much we still don't know about the issue.

[iscooterliberally]

6. I think they're starting to connect the dots.

I remember listening to NPR a few years back when we had the pill mills here. They had a doctor on that was saying how they were going to change the law and make it harder to get vicodin. The first thing I thought was that heroin was going to make a comeback, but even I had no idea how bad it was going to be.

[Mr.Bill]

4. I wonder what kind of pain killing drugs

Chris Christie had when he needed surgery to keep him from eating himself to death.

[Coventina]

5. I wish I could rec this a million times.

I just visited my arthritis doctor.

She said that some her patients are threatening suicide, because she cannot prescribe opioids anymore.

A life in pain is not worth living.

So far, the only people being hurt by the "opioid crisis" are law-abiding people who need them to function somewhat normally.

[iscooterliberally]

7. The law is a huge part of the problem here.

We forget that our nation's drug laws were designed to punish and hurt people, not help them. If you break a bone, there really isn't anything else other than some sort of opiate. I guess you could do a boilermaker and a bong hit, but oops...there's that pesky drug law screwing it all up again.

[Coventina]

8. I'm already taking the maximum allowed NSAID daily dose.

If I break a leg, there's literally nothing but opioids for me to take.

Tylenol does literally nothing for me, never has.

My arthritis doctor told me the NSAID is actually more dangerous than opioids.

[iscooterliberally]

12. My younger sister has arthritis.

I don't know what medications she's on. I don't take NSAIDs every day, and when I do, it's usually just two pills. I like the Advil liquid gels, or I just take plain old aspirin. I have been trying to exercise at least 3 times a week. I walk my dogs more too. Mild exercise has helped a lot with my pain. On the weekends I like to drink a few beers too, but that's a whole other can of worms. Of course I don't take any kind of pain meds with beer. I hope you find something that makes you feel better!

[Coventina]

14. Yes, I go to physical therapy and practice yoga, and bicycle a lot.

All that helps, but there are days when nothing works except the poppy.

Opioids are cheap, effective, and safe (when used properly). They've been studied for hundreds of years and their uses and misuses are all well-documented.

To keep them away from people who need them is just plain cruelty.

Thanks for posting this.

[Mosby]

20. You can take nsaids every day

Try naproxen sodium, it lasts for 10-12 hours.

Long term use can cause stomach problems, and your dr should watch your kidney and liver values.

My dog takes metacam every day, saved his life (he has herniated disks).

[iscooterliberally]

23. I have tried naproxen sodium. I know it works normally for most folks.

In my case it gave my heartburn so bad that I didn't notice my other aches and pains. I might have taken it on an empty stomach, but I never tried it again. Normally the liquid gels do just fine for me. Once those kick in I move around, or go for a walk. My dogs are on carprofen. They have bad knees. My large lab mix had the same surgery on his left knee that I had (tee hee). He had a much larger incision though.

[adigal]

54. There are MANY other effective painkillers. Opioids are relatively new on the market

People need to get informed, and doctors definitely need to get educated on other effective drugs for pain.

[Coventina]

57. What are you talking about? Opioids have been around for centuries.

They are among the most well-known and studied drugs available.

As I asked you down thread: What are these other miraculous painkillers that are available? Because my doctor is unaware of them.

[adigal]

58. Ask your doctor to do some research on how Europe handles pain for their patients?

Unless they really don't suffer pain.

And I meant the opiods like Oxy, Fentanyl. In the form and strength they are in now, it is new.

And Oxy for years claimed that they were not addictive. The company paid billions in damages, but it didn't matter, cause they make way more that that.

[Coventina]

59. The Europeans don't have any magic fixes either.

I go to a cutting-edge sports clinic, plus, I went through the "Best Doctors" program to make sure that my doctor wasn't missing anything.

There is NOTHING out there that takes the place of opioids, at least, not at this time.

To deprive people of medication that works well for them is inhumane, period.

[kwalter66]

44. not sure I believe that

She CANNOT prescribe or she CANNOT just hand them out like candy? And no one NEEDS opioids to function. There are many other things that will do the trick, pot being the 1st to come to mind. I gave up pain pills for it and am doing just fine. Doctor of course wasn't real pleased to hear that. Gee, wonder why?

[Coventina]

52. Just because YOU did just fine doesn't mean other people can.

I am at the maximum allowable daily dose for NSAIDS for my arthritis and I'm not even 50 years old yet.

What am I going to do going forward?

I'm already doing yoga and meditation, physical therapy, and steroid shots.

So what do you suggest that I do, as my arthritis worsens over the coming decades?

[Lil Missy]

46. I'm curious?? Why would this Dr. not be able to prescribe opioids anymore??

Or is it that she refuses to prescribe them?

[Coventina]

48. Doctors who prescribe opioids are under intense scrutiny and are discouraged from

prescribing them, especially for chronic pain.

They are threatened by having their license pulled or even being criminally prosecuted.

[Alice11111]

51. It was obvious when they started w this bs a couple of years ago. I called my Senators. It's a LOOKS

GOOD bill. Everyone is against innocent people becoming unwittingly addicted. However, if you look at the logic behind it, it doesn't make any sense.

[adigal]

53. That is NOT true...I am a substance abuse counselor

Many, many people won't get addicted because of a crackdown. And many MDs say that other painkillers, used together, are just as effective as the addictive ones. MDs just need to get more informed instead of being lazy and writing a script for 6 Oxys a day to shut the patient up and keep the patient from filing a complaint against them.
Doctors are a HUGE part of this addiction issue.

[TheFrenchRazor]

55. so this would be the one and only time prohibition has ever worked, i guess... NOT. nt

[Coventina]

56. I'd love to know what these other painkillers are that work just as well.

I'm already at the maximum allowed dose of NSAIDs, and I'm not even 50 years old yet.

I already do yoga, meditation, steroid shots, physical therapy, and exercise.

I go to a cutting edge sports clinic, and my doctor is out of things to give me, besides opioids.

As my arthritis worsens over the next several decades, what are these wonderful options I have?

[lordsummerisle]

9. Thanks for posting k&r n/t

[iscooterliberally]

10. Thank you! This is one of my pet peeves against our government.

It would seem that our doctors, lawyers and politicians have some sort of collective insanity when it comes to managing and regulating drugs. Our system lacks logic and reason and is completely devoid of compassion.

[Ligyron]

11. Heroin.

The idea that you can get rid of a product, one pure ounce of which will supply dozens of users for a month and produce profits many, many times it initial cost - is hopeless.

Easy to hide, easy to smuggle in.

Throw Carfentanyl into the business model and profits really take off.

[iscooterliberally]

13. Last time we had a heroin epidemic it was flown in by Air America.

Now the military is apparently guarding poppy fields in Afghanistan. Hmmm....

[Chakaconcarne]

15. Just for perspective....

Many European countries do not prescribe opiates outside of inpatient care as standard practice. APAP and IBU is the extent of your outpatient pain treatment.

Is it that their patients experience less pain, better able to handle it? I can't help but think their sources of pain are no different than ours.

Is it that these countries have approached pain differently over the many decades and inherently their populations are better able to handle pain than Americans?

America does need to ween off our dependence on opioids, albeit more gradually.

I have seen physicians pull back tremendously on their prescribing habits and it does seem very abrupt and approached as a one size fits all.

[Egnever]

17. While I agree America serves up opioids more than anyone else

Are you certain that European countries don't prescribe them as well?

Saw a chart recently that showed opioid use by country and there were a lot of European countries on it.

[iscooterliberally]

18. I haven't been to Europe in decades.

I do remember we could buy codeine over the counter there back then. I even found it in the Bahamas and Canada. I know Portugal has decriminalized many drugs and they are doing much better than we are. I think there are many different issues converging into a perfect storm here. At the bottom of it all lies greed and wrath. Apparently we have Nixon on tape stating that his controlled substances act was an excuse to punish his enemies. There have been reports of the CIA flooding the US with heroin back in the 60s and 70s, and then again with crack in the 80s. I agree with your assessment that people in Europe feel pain just as much as we do. I just think that we over regulate who has access to the point that all the control of the drug market gets handed over to criminal organizations. Sure, we probably don't need to send people home with 30, 60 or 90 pain pills. On the other hand sending someone home in a cast and telling them to take Tylenol or Advil isn't right either. We need to reduce both suffering and harm.

[TheFrenchRazor]

38. maybe the abusers are messing up the curve; those #s have no bearing on legitimate pain med patients

[Honeycombe8]

16. I think the govt should stay out of this, except for prosecuting the illegal acts.

There are laws on the books.

It's like the prohibition. People are going to take what they want. You can't legislate it w/o making it worse. People are ultimately responsible for their own bodies.

In this case, people who legitimately need these drugs aren't able to get them, now, because of govt interference.

[iscooterliberally]

19. The laws on the books are a large part of the problem.

I'm not saying we don't need laws. We just need ones that work. The controlled substances act is a disaster.

[Marthe48]

21. If the government can tax opiates as they do booze, tobacco

they'd regulate it and let people get what they need. I noticed a long time ago that the government has made sure to regulate many products that people want, and will go to great lengths to get.

I'm sorry you have pain. I have arthritis and get achey. I take Ibuprofen, but only on days I don't drink alcohol. Protecting my liver I have a bag of frozen peas wrapped in a towel in the freezer if I need an ice pack. And I have a hot pad.

[iscooterliberally]

25. I use ice all the time too.

My wife bought one of those gel packs with a velcro strap on it. I use it on my knee frequently.

[Marthe48]

31. sometimes ice is my best friend :)

[Sunlei]

62. How come you don't get a knee replacement? seems to work great for people I know.

[iscooterliberally]

63. I'm not so sure about that. Not everyone is the same.

One of my co-workers who is in his early 70s just had it done. He had a really hard time with it and regretted doing it for the first few months. It knocked him out of work for over a month. I'm in my mid-50s. I had ACL surgery due to severe trauma. That knee is better for the most part, but now my other knee is starting to swell and has pain. For now ice and advil are working well. I'd rather put something as drastic as knee replacement surgery off until I'm old enough for medicare. On the other hand if my doctors start telling me I really need to get knee replacement surgery I'll reconsider.

[Sunlei]

64. you're right not everyone is the same. feel bad for people who live with pain for years.

[Happyhippychick]

22. Answer: legalize marijuana. I'm glad I live in a state where it's legal.

[iscooterliberally]

24. Oh, man. I wish it were legal in Florida.

Maybe some day. I always vote for anything that gets us closer to that goal.

[Happyhippychick]

27. If you need it, drive north or west.

[iscooterliberally]

28. I might not be legal in FL, but it is ubiquitous.

I was living in Boston for a couple of years and they just legalized it there of course right after I moved back to FL. I have to drive for almost 5 hours due north just to get to the south.

[Happyhippychick]

29. But is it medical grade? I only want it without THC

I'm boring

[TexasBushwhacker]

33. You can get CBD products in all 50 states n/t

[iscooterliberally]

40. They do have medical grade in FL.

I have no idea how or where to get that though. I'm sure things will get better once we get our current governor out of office. Maybe then we can get it legalized for recreational use. There are all kinds of seminars and trade shows here, so it's only a matter of time before the laws change for the better.

[csziggy]

45. Medical marijuana is legal in Florida now - but only in some counties

Some counties are dragging their feet about approving dispensaries. I believe there are places open in Leon County - we drive by one on the way to Publix.

Search for "florida medical marijuana dispensaries" and you should be able to find one near you.

Before I got my knees replaced, I hated using opiods - they really did not knock down the pain for me and just made me stupid spacey. Instead I used Piroxicam, which is the generic for Feldene. It is a non-NSAID anti-inflammatory and reduced the inflammation in my bone on bone knee joints better than any pain killer. It worked for me - it may not work for others.

[onecent]

26. Even if it is not legalized, that's where I'm getting my

stuff if I hurt. Not going to go out hurting for 8 or 9 years.....

I know where to get it.!!

[Haggis for Breakfast]

35. Just because it's legal doesn't mean everyone who could use it can . . .

I am a veteran. A disabled veteran. 100%. I am one of those patients who was well managed on low dose, long term, chronic pain management therapy. After the initial uproar about opioids last year, the VA did what the VA always does - threw the baby out with the bathwater. Despite the fact that the guidance specifically stated "Every patient should be examined on a case-by-case basis to see if their medical regimen is appropriate," everyone was stripped of their pain meds. My quality of life went straight to hell in a matter of days. They tried to put me on meds that I did not want to take because of their side effects. One of them gave me hallucinations and a racing heartbeat. Because I am also a stroke patient, I refused to take it again. After two more unsuccessful and damaging attempts at other meds, I was finally put back on my original meds and my life returned to what passes for normal.

Yet, if I had tried marijuana even once (which is totally legal in my state), and it had been detected, I could have been taken off ALL of my meds, forced into rehab, and possibly lost my benefits because according to the DEA (And don't even get me started on why a law enforcement agency has any authority over health care and medicine.), marijuana is as lethal as heroin.

My point is that if you are a veteran and live in a state where marijuana is legal, you STILL cannot access it.

The last time I checked, 29 states and The District have passed laws permitting some form of marijuana use. And there are upcoming state initiatives for next year's ballot. At some time, the tipping point will be reached. The outcome is inevitable.

Vote in the midterms, folks. We have got to restore sanity to this country.

[TheFrenchRazor]

37. it is insane, indeed. the anti-pain med crusaders are hurting people, not helping them. nt

[samnsara]

41. my sis has same story.. she lived in Idaho with a chronic illness..

...resulting in pain all the time. she has been prescribed morphine. As a nurse she understood the trap so she drove to visit me in 420 friendly legal land Wash state and got some pot, smuggled it over to Idaho so she could safely manage her pain. She would have been arrested if she had been caught. Now she lives in wash state and her illness resulted in an organ transplant but the pain is still there. Organ docs said NO alcohol or pot for 1 year (agreed, the organ needs to heal) but they are still prescribing her opioids...she can only get 20 at a time and has to call for a refill every single month. Maybe this IS a way to handle to crisis and helps her from becoming addicted....but she would gladly take pot over morphine any time!

[iscooterliberally]

42. Here's my two cents on the DEA.

The DEA is a redundant and parasitic government agency that is of no medical value and has a high probability for the abuse of the American people. We already have an FDA, there's absolutely no need for the DEA. I promise to show up in the midterms and every other election just for folks like you too. Cannabis should never have been made illegal in the first place.

[Marthe48]

30. I discovered essential oil Frankincense for pain

It was recommended to us for my husband's cancer. He passed away and I had 2 partial bottles left. I had a lot of pain in my left foot that had lasted from January to August. I was choosing if I really needed to go to my bedroom down a short hall, choosing which store I would shop at, because I knew I couldn't stand to go to more than one. One day, I was thinking of all the good things I'd heard about Frankincense and thought what the heck. I rolled some on the top of my foot, a few times a day and in 2 weeks my foot was better. I'm using it about once a week or less now.

I was diagnosed with heel spurs years ago and used insoles to control the pain from them. I don't know what I did to my foot to make it hurt so bad, but I'm glad I started using the Frankincense. Just passing it along in case anyone wants to try a topical solution.

Be sure to use DoTerra or Young Living. It is easy to fake the quality of e.o.

[BigmanPigman]

32. So many people say the same thing.

I had such terrible pain from a misdiagnosed disease and was in such severe pain that I had to check myself into the hospital after 4 months of it. It turned out to be Pancreatitis and 3/4 of my pancreas is dead. That cost me $4,000 for 4 days with the ACA. It was also two months of my disability income. I will need surgeries for the rest of my life since painkillers are not strong enough. When they finally properly diagnosed me no one could believe how I endured such severe pain for so long. I really was planning to jump off a bridge and was figuring out the logistics. When I can't afford the needed surgeries I will have assisted help since I believe in quality of life. My entire family and most of my friends do and they are supportive of my decision. As the population grows older this will become worse and worse for the government and doctors to deal with so the had better figure it out fast!!!!

[likesmountains 52]

34. A bit off topic, but New Yorker article about the family that made millions pushing Oxycontin is

very good.
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

[iscooterliberally]

39. Meet The Sacklers!

That was a great article and I don't think it's off topic at all. They are a huge part of the problem. Thank you!

[TheFrenchRazor]

36. thank you; prohibition does no good whatsoever, and as it said, it literally tortures people with

chronic pain, as it is getting harder and harder to get any kind remotely effective pain relief any more.

[Lil Missy]

47. I signed a "Pain Medication Agreement" with my Dr. for Tramadol for arthritis pain.

I've taken Tramadol for arthritis about 3 years now. I am also a recovering alcoholic. In the beginning she asked me to point out to her where the pain in my back and spine is at and took x-rays. According to her, the places where she saw signs of arthritis were the exact same places I pointed out that hurt.

So, she had me sign an agreement stating I could not get pain meds from any other Dr., with the exception of surgeons if surgery performed. Also, I agreed to do a urine drug screening anytime upon her request, with no notice. She just pulled a UA on me about a month ago, and it was clean.

I like it this way. I am committed to staying sober and want to be held accountable, but of course I don't want to live in pain the rest of my life.

[johnnylol]

49. painkillers

what alternative is their.. if your n so much pain that your life is unbearable you need your painkillers..

[Lil Missy]

50. i take a pain killer. I never so much as hinted that my LIFE was unbearable.

Not sure who you are trying to impress or what you aim to accomplish here. (Although, I won't lose sleep over it.)

Enjoy your stay.

[Sunlei]

60. IMO our government should force the Drug Corp 'suppliers' & Doctor 'pushers' to fund treatment.

Fund treatment for everyone they addicted, even if that 'treatment' is over-sight and continuing the addiction to keep the person pain free. Or weaning them to another medicine that helps the person. Its criminal for ANY Doctor to addict a person and dump them.

Far as fentanal, opioids pills stolen from? , or crafted from imported chemicals, even meth (so easy to make)-- those people should be filling our jails not pot growers.


This new push to start 'online addiction classes' and small clinic treatments- WILL NOT WORK. Once addicted its way to hard for people to really 'quit'. They need a Doctors care- probably for life and that has to be funded by the Pusher- the Corporations who made billions in profit off addicting people.