Oxycontin, Other Opioid Painkillers Tied to Higher Health Risks

[usregimechange]

MONDAY, Dec. 13 (HealthDay News) -- Two new studies suggest that Medicare patients who take opioid painkillers such as codeine, Vicodin or Oxycontin face higher health risks, including death, heart problems or fractures, compared to those taking non-opioid analgesics.

However, it's not clear if the painkillers are directly responsible for the differences in risk, experts said, and other factors could play a role. And one pain specialist who's familiar with the findings said they don't reflect the experiences of doctors who've prescribed the drugs.

In one study, researchers examined a database of Medicare recipients in two states who were prescribed one of five kinds of opiod painkillers from 1996-2005. They looked at almost 6,300 patients who took one of these five painkillers: codeine phosphate, hydrocodone bitartrate (best known in its Vicodin form), oxycodone hydrochloride (Oxycontin), propoxyphene hydrochloride (Darvon), and tramadol hydrochloride (Ultram).

Those who took codeine were 1.6 times more likely to have suffered from cardiovascular problems after 180 days, while patients on hydrocodone seemed to be at higher risk of fractures than those who took tramadol and propoxyphene.

After 30 days, those who took oxycodone were 2.4 times more likely to die than those taking hydrocodone, and codeine users were twice as likely to die, although the number of deaths was small.

http://www.nlm.nih.gov/medlineplus/news/fullstory_106591.html


Rx opiates will doom tort reform and possibly a few of our friends and family members.

[Akoto]

1. I take Tramadol daily, among other medications ...

... Had to go on pain management a couple of years ago, and I am 25 now. Without the medications, I very much doubt that I would be alive today, as my continued existence would be far too torturous.

It's true that these medications do carry risks and side effects. It's also true that they are the difference between living and just existing for many folks. I made a quality of life choice for the present, and I can only deal with the future when it comes.

[Bobbieo]

10. Darvon was taken off the market last month and my MD is substituting Apap-Codeine

for arthritis back pain. I had no problems with the Darvon - took 2 only at night for sleeping - but this new script is giving me all sorts of problems - light headedness, nausea and fatigue that lasts all day. MD, today, suggested cutting the tablet in half. Darn!!!

[Warpy]

47. Cut the tab in half until the symptoms subside

and then you can go up to the whole tab. I was on the stuff for 10 years so I know that acclimating to the drug is possible.

I'm on Ultram now because I just didn't like the buzz of any opiate and Ultram gives me the relief with no buzz. It does screw up my balance a little, so that the 20 foot extension ladder to the roof is out. I hire somebody now.

[blue neen]

2. Darvon (propoxyphene) has been taken off the market.

http://www.cnn.com/2010/HEALTH/11/19/fda.removes.drug/index.html

[sakabatou]

3. You hear that, Rush?

[tularetom]

8. You'll have to yell louder

Little blue pills already made the sumbitch deef.

[madokie]

28. LOL

I about choked on my coffee.



"Little blue pills already made the sumbitch deef."

I'd like to add that I've been taking hydrocodone for going on 6 years now for pain in my lower legs and feet due to circulation that is not due to high cholesterol either.

[rurallib]

11. wouldn't you like to deliver this news in person?

Just to see the look on his - uh - whatever it is.

[thunder rising]

4. Die MF ... we know who!!

[dogday]

5. What does medicare have to do with the study? And of course

people taking non-opioids have fewer problems than those taking the opioid drugs, but the group taking the pain medication has less pain. I think the choice is up to the individual who is in pain and how much they can tolerate.

[TexasProgresive]

25. They used the Medicare database for the study.

Makes sense to me since that database would have all health records of a large amount of people. The only down side I can see is that the study group is all elderly.

[dogday]

29. The fact that people on medicare are disabled and elderly

really plays into those stats. You take a group already known to have physical problems and you use that as your basis for everyone? Does not make any sense to me.

[TexasProgresive]

31. actually they are a group more likely to use analgesics

for chronic pain than the general population.

I won't try to change your mind. It makes sense to me- it doesn't to you. And that's the end of this discussion.

[dogday]

33. good day to you sir!

:hi:

[PhillySane]

43. I find it interesting

that they used medicare patients for the study. I'd like to know what the breakdown is of those who are prescribed these medications on medicare vs private health insurance. These drugs are both highly addictive and have adverse side affects, including death. Not a good combination. Once someone is addicted and they say they are in pain, the doctors just hand this stuff out like candy. In the end, its very hard to prove what they died of.

[jwirr]

6. Imagine what the risk is for addicts of these painkillers.

[usregimechange]

9. Big problem and growing very fast

[Dogmudgeon]

7. The War on Opiates is back

Propoxyphene was just taken off the market. Hydrocodone is being restricted. Tramadol is now the drug of choice for pain control, but it's much tougher to discontinue.

I'm in chronic pain, and depend on medication to keep me functioning. I've had to jump through a large number of hoops in order to get appropriate analgesia -- and pay for the privilege, such as $250 consults at pain clinics. (Having a preexisting condition, health insurance was very hard to come by.)

And then, every other person out there is sure that you're just a "middle-class drug addict" and it's nothing that that homeopathy, Reiki, or vegetarianism won't fix. Only medical marijuana gets any support -- funny how that works.

Pain control is political.

--d!

[Jamastiene]

26. My aunt has to take pain medication to deal with her pain.

I'm not sure what the VA is going to give her in place of her Darvocet, but she is already in agony because she is trying to make what she has left last until they decide. I hate seeing her in so much pain like that. I wish they wouldn't do that to people, just suddenly take something away that they had to rely on to manage their pain. It's just not right to do that to somebody.

[Dogmudgeon]

34. It MAY become available again

It was banned in Great Britain a few years ago, and the outcry was so loud that the National Health carved an exception in the law to allow pain patients get it. It's likely to happen in the USA, as well, but not until a lot of people are suffering. The claim is that it's cardiotoxic. That toxicity must only be detectable in huge study groups with exotic statistical tests. I studied stats at one point in my life, and propoxyphene/Darvon is one of the most intensely studied drugs in the whole pharmacopoeia.

I've been on tramadol now for about a week. It's only marginally effective, if that. I've been cranky and my sleep is all screwed up -- insomnia, nightmares, sleep paralysis. And, of course, the pain is back. I could take more oxycodone than I do now, but I don't want to rely on it too much. In the 33 years since the surgery that started the pain, I've never been truly addicted to opiates, and never had a dosing escalation. But if I have to start to depend on Oxy-Contin (time-released oxycodone), that margin of safety will end. And I consider myself lucky -- I was taking a drug holiday from propoxyphene, so I have had nearly no withdrawal problems.

LSD is also a good painkiller, with analgesic effects that last two weeks after the "trip". Try getting THAT legally! (Marijuana has no analgesic effect for me, alas!)

This is all Ralph Nader's doing; Public Citizen has been waging war against propoxyphene since 1977. And he's considered to be a progressive?

--d!

[salin]

12. a doctor/sibling has expressed concern over "pain clinics"

per how young the specialty and how few controls there are in place per this "specialty". The sense conveyed is an almost non-regulated area of medicine (rare) - and that attention only is paid when egregious (over prescriptions leading to deaths) have already occurred. This doctor's spouse is a quality care officer at a hospital, and concurred per the perils of this area of medicine.

There is a case in my hometown regarding a pain clinic which involves both multiple deaths, and very sketchy prescription practices. As the story unfolds it seems to me that the concerns of the operation were much more about profits than about the health of the patients.

[dogday]

16. I go to a pain management clinic located in the largest hospital system in the city.

These are reputable clinics inside accredited Teaching/Faculty Hospitals with Accredited degreed Anesthesiologist who prescribe medication and any additional pain therapies.

I go to my pharmacy and they know me, so having my prescription filled is not a problem, however here in Houston the pharmacies are playing Guardians of the Pain Medication. The last time I went to my Pain Management Clinic, I had to stay at the hospital for the day for some tests,I needed to fill my medication so I could take my medication at lunchtime. Problem was the pharmacy would not fill my medication.

All these dreadful pain clinics and the pharmacies, DEA, and the Doctors have no controls in place? Really? There are so many controls in place now that Doctors would rather let their patients rock back in forth in agony, then have their license revoked. Pharmacies are so uncomfortable they don't have to fill any prescriptions if they don't want to.

[Warpy]

22. Most pain clinics have stringent requirements

including set contracts with patients and the necessity of cognitive and emotional therapy, as well as exploring non drug strategies, for the relief of chronic pain.

I agree that the bad actors need to get put out of business. However, there are good pain specialists and clinics out there and they save lives.

[pacalo]

40. I agree. My husband has to give a urine sample each time he gets his monthly prescription.

Now that I've read this article, I'm glad that he's being checked.

[Warpy]

46. Right, pain clinics that are worth the name

want to spot patients who are running into trouble early rather than too late. Pee tests are part of it that I forgot to mention.

[Warren DeMontague]

23. Well, I am expressing "concern" over the "drug war"

And specifically, I'm much more "worried" that, were I to have a terribly painful or terminal "illness", my "doctor" might be so terrified of the "DEA" that he or she might refuse to "prescribe" me adequate "pain medication".

I'm sorry, but the endless hand-wringing over DRUGGGGGGGGZZZZZ!!!!! :o :o :o has been going on for far too long, now.

Liquor and Nicotine are probably two of the most dangerous and/or addictive substances on the planet, and you can buy them at the 7-11. We spend upwards of $40 Billion a year trying to keep people from smoking pot. Meanwhile, you have cases like Florida Man sent to prison for trying to manage the chronic pain from a severe spinal injury.

ENOUGH, ALREADY. If it's a choice between control freak authoritarians who would rather have terminally ill people die in agony than risk becoming "addicted", or a nation where someone, somewhere, might take an unauthorized pill, I'll go with the latter choice, thanks.

[Taverner]

38. "few controls "????? Obviously you've never tried to get a Morphine Scrip

As someone who is, and does get them for severe, crippling back pain - you cannot get refills, you cannot have the scrip called in, your scrip has to be in triplicate and the list goes on.

You also have to take drug tests regularly, and if you stop taking them, you have to account for every pill

[pacalo]

41. You are so correct -- plus, prescriptions must be picked up in person.

The pharmacy will not refill these tightly-regulated prescriptions until almost the absolute last day of the month. That can be aggravating at times.

[asdjrocky]

13. Once again...

Cannabis for the win.

[Dogmudgeon]

37. Not always effective.

I'm a chronic pain patient. Cannabis gets me stoned, but has very little analgesic action.

Then again, "pain" is a single word that describes a whole world of different conditions, some of which respond well to marijuana. Mary Jane does open me up and makes me cry, so if I ever undertake primal or grief therapy, I'll be good to go.

LSD works well for me -- two weeks of analgesia after the trip. The problem (other than its illegality) is that I also acquired head trauma and PTSD along the way, and LSD is contra-indicated in those circumstances.

As I said in my post, above -- Pain control is political.

--d!

[WCGreen]

14. I take vicodin every day....

The relief I get from the pain I am in is worth a small chance that I am doing harm...

[Bobbieo]

15. I saw my pain clinic PA-C today and am getting another cortisone shot this Friday.

I get no meds from him other than the pain shot given on a limited basis - three shots during a 6 month period. The first one was for lower back and leg pain this one will be for upper back and shoulders. The shots are supposed to take away the inflammation.

[WCGreen]

19. I was getting those but they were too expensive....

[REP]

35. I get cortisone in my shoulders, but there's only so many one can get

I have no cartilage in one shoulder and have developed bone cysts; in the other I have massive bone spurs on the clavicle and scapula that tear into my rotator cuff. At some point, the injections are going to cause even more damage. I can't take NSAIDs due to chronic kidney disease, so I'm left with narcotics, which are better than nothing. I'm lucky; the massive joint damage is readily seen on Xray and I have doctors who understand I need some use of my arms and hands. I am angry for those who don't have decent doctors.

[Jamastiene]

27. until they take it away from you suddenly, like they just

did with people who use Darvocet to manage their pain. They just banned Darvocet suddenly and my aunt is in agony while she tries to make what she has left last until the VA decides on a replacement for it. She has been in agony just like before she had the Darvocet to make life bearable. It's the only thing that has kept her from hurting so much, then, suddenly, the FDA took it away from her. So much for her quality of life now. Before, she could manage the pain and function. Now, because she is allergic to codeine, she is going to have to function on something not nearly as effective.

[pacalo]

42. Oh, I'm so, so sorry for her! Didn't her doctor have a comparable substitute for her?

I hope she finds a pain medicine that works even better for her. Chronic pain is horrible. Good luck to her!

[mucifer]

17. I'd hate to see what my hospice cancer patients would do without their opiates.

Tramadol and lyrica aren't gonna cut it.

[thunder rising]

18. I don't think those folks are considered "casual" users. ???? (Some peoples children)

[Warren DeMontague]

20. Great. Another excuse for doctors to under-prescribe for pain patients.

God Help Any of us if we get some shitty form of bone cancer or terminal illness and get a dr. who is terrified of the DEA.

Sorry, but if on one hand we have society's hand-wringing over the terror that someone, somewhere, might abuse or become addicted to a drug, and the needs of pain patients, I'm gonna go with the pain patients.

[Warpy]

21. Well, you have to be so damned sick to get any of them

that of course you're going to have a higher risk of death.

I'd have checked out years ago without pain control. Pain medication is keeping me alive.

[dogday]

30. Amen to that. Without my pain medication I would of been

dead last year. Until it happens to someone, they have no idea what it is like to live with the kind of pain we do. I wish you the best.... :hug:

[REP]

24. Heh. I'd die a hell of a lot quicker taking NSAIDs (contraindicated with kidney disease)

So I can either enjoy the pain of the bone cysts and other fun stuff the arthritis is doing to my shoulder or I can get adequate pain relief that won't cause massive renal damage. Hmmm.

[montanto]

32. Send your unwanted Oxy to Rush and wish him godspeed.

[Initech]

36. My doctor has me taking the generic vicodin right now.

[mtnester]

39. Tramadol, codeine and vicoden I cannot take

BP reaction, irregular heartrate and vomiting, and uncontrollable shaking (BP reaction adds to this) And for every pill I take, 12 hours of recovery per pill...SLEEP time recovery. Reaction starts exactly 12 hours after the first pill is taken. Good times. Add percodan to that list. Darvon was on my list as well.

I have only recently had to try and add a pain med temporarily to my use. It has proven to be most difficult. The only ones I know I can take are morphine and dilaudid, in IV form (from a previous surgery). Sometimes I wonder if what I am really reacting to is the delivery method as opposed to the actual med.

So off for an epidural steroid in the C-6 area cause the Medrol pack did not work this time...frankly, anything will be better than it is now.

[AC_Mem]

44. I take pain meds

I need to have hip replacement in BOTH hips and have been suffering chronic pain since 1976. At one point my doctor had me visit a pain clinic (when we needed to up the main medication). The doctor there was belligerent; insisted that it was my back and that all i needed was nerve blocks. Luckily I had my report from a recent MRI that was done to rule out back issues. When presented with this evidence, he got an attitude and started talking about going fishing and visiting France! At the end of the appointment he shook my hand and wished me luck.

I left that clinic furious after wasting 3 hours of my time. Called my doctor immediately. He told me not to worry, that he had to send me there because of the INSURANCE COMPANIES and that now that I took care of that he could continue to treat me.

Having a good doctor that you can be honest with is a Godsend. I cannot get the surgery because I cannot afford to be off work and cannot afford to pay the out of pocket, so I need pain medication to help me walk without excruciating pain.

On another note - my insurance not only increased my monthly payments by at least 25% this year, they just sent me a letter telling me that they would now only pay for 60 pills every 90 days for my sleeping medication!!!

What right does the insurance company have to control our health! That should be the job of our doctors. Is it not enough that they are allowed to financially rape us?

[Lyric]

45. And not a single one of them is as risky as Tylenol.

Frankly, so long as they are being taken properly (a.k.a., the proper dose for your weight and pain level), opiates and opioids are probably the safest of the "illegal" drugs second only to marijuana. They're a hell of a lot easier on your body than Tylenol is, and they're probably less dangerous than ibuprofen too. Even opiate overdoses are safer than Tylenol overdoses. A fat shot of naloxone can stop an opiate overdose instantly, but if you take an overdose of Tylenol, you have a few hours to seek stomach pumping and ER treatment before your liver is basically destroyed and you die a slow, horrible death over a period of about 2 weeks. The only thing that might save you is a liver transplant, and there aren't exactly lots of livers out there to spare. People stay on those lists for YEARS and die without ever receiving one. Why do you think drugs like Vicoden and Percocet exist? The government decided to mix commonly-abused opiates with Tylenol in order to "discourage abuse". Even the GOVERNMENT knows that Tylenol is more dangerous than opiates. Otherwise, there wouldn't be a need to add anything to the opiates to discourage abuse, because they'd be dangerous enough in and of themselves.

Like any substance, too much of an opiate can kill you. But so can too much Vitamin A and too much Iron. But I tell you this: there are few people that I despise more in this world than recreational opiate pill poppers. I don't mean the desperate people who can't get a doctor to treat their very-real pain and have to resort to buying the pills off the street. I don't even mean the sad heroin addicts who are using Oxycontin to stave off the agony of withdrawal until they can get into an affordable suboxone or methadone clinic. I don't consider the use of these pills for legitimate pain (whether prescribed legally or not) to be "abuse". I'm talking about the selfish little fuckwads who like to pop a Vicodin with the Jager Bombs, or the slimy little shits who think that stealing Grandma's Percocet and sharing it around with their buddies is a great way to spend a Saturday night. People who are NOT in pain, and whose sel-indulgent abuse of these drugs has led to horrible suffering on the part of people like my mom, me, and others who suffer from chronic pain and who can't get past doctor paranoia to get it treated properly.

I have nothing but compassion for people who are truly suffering, and I don't judge them for the things they are forced to do when doctors either can't or won't help them, but people who just take them to get high and have a mellow time? Fuuuuuck you. YOU are the reason my mother suffered for YEARS in agony before we finally, FINALLY found a doctor brave enough to treat her horrible pain with the only medicine that actually works. If you wanna go get high, smoke a bowl. Leave the pain pills to people who are actually in PAIN, and then maybe doctors won't feel the need to be so paranoid and innocent people won't cry themselves to sleep in agony every night. I honestly don't know how people like that can live with the guilt of knowing that their selfishness has condemned thousands of other people to suffer life-wrecking agony because their doctors have instituted a blanket policy of "no opiate prescriptions except for terminal patients".

:rant: