Half of all white heroin users started by initially using prescription drugs

[Slew Foot]

Like I said earlier, nobody ever complained about being given too many narcotics. Sure, doctors that were easy marks and tossed around Oxy prescriptions like they were fun size Snickers bars at Halloween had happy patients. And those patients told two friends and they told two friends and so on and so on and so on.

No matter what the feds say about pain management, doctors presumably went to medical school. They know damn well the danger of opiates being addictive and they know that you can't let patients essentially self-medicate by complaining of phantom pain and getting a new scrip no questions asked. WTF did these doctors think was going to happen? Give people virtually unlimited narcotics with almost no oversight and they wind up addicted? What a shock!!

Hospitals are run by MBAs that dont care about health care anymore, they care about getting 10/10 pt reveiws so CMS doesnt cut their reimbursements. And the number one thing pts complain about is not getting enough pain meds.

 

[john3850]

When I was 18 I did dope once and for the next 18 months I was clean.
Do to drinking into the early hours I started using dope to help me work
For the next year I was doing dope 3 times a day.
Worked my entire life and have no criminal records.
I do blame the government for not stopping the flow of heroin.

 

[Pneumothorax]

Hospitals are run by MBAs that dont care about health care anymore, they care about getting 10/10 pt reveiws so CMS doesnt cut their reimbursements. And the number one thing pts complain about is not getting enough pain meds.

Finally someone who gets it. When you have $300,000+ in student loans from med school/undergrad, the last thing you want is a MBA prick (ALL hospitals are run by these imbeciles) threatening you with unemployment because your 'patient satisfaction scores' are too low and hurting the hospital's funding.
Wanna make a change? Remove all pain satisfaction scores from all medicare/medicaid related satisfaction surveys. As of 3/30/2017 they're still there...

 

[[DHT]Osiris]

Finally someone who gets it. When you have $300,000+ in student loans from med school/undergrad, the last thing you want is a MBA prick (ALL hospitals are run by these imbeciles) threatening you with unemployment because your 'patient satisfaction scores' are too low and hurting the hospital's funding.
Wanna make a change? Remove all pain satisfaction scores from all medicare/medicaid related satisfaction surveys. As of 3/30/2017 they're still there...

Uhh, why would that have ever been a thing? The reason why like 90% of people end up in the hospital is something causing them pain. The hospital is there to treat the problem, not the symptom. You may not leave pain-free, but you should leave problem-free.

What PHB came up with this crap?

 

[GagHalfrunt]

Hospitals are run by MBAs that dont care about health care anymore, they care about getting 10/10 pt reveiws so CMS doesnt cut their reimbursements. And the number one thing pts complain about is not getting enough pain meds.

I must have missed the part where the MBAs are allowed to write prescriptions for opiates. When exactly did that happen?

 

[WelshBloke]

I broke my wrist and bruised some ribs a couple weeks ago and, after all the talk recently, was pretty surprised to be prescribed a bottle of oxycodone.

When I cracked a couple of ribs my doctor told me to take some OTC painkillers and suck it up!

 

[[DHT]Osiris]

I must have missed the part where the MBAs are allowed to write prescriptions for opiates. When exactly did that happen?

Never worked in an organization where your performance is dictated/tracked/used against you by someone who's never done your job before?

 

[GagHalfrunt]

Never worked in an organization where your performance is dictated/tracked/used against you by someone who's never done your job before?

Yep. Any never once was I ordered to do something that was capable of killing someone. And if I had I'd trust to whistle-blower laws to protect me rather than willfully do something I knew could fuck a lot of people up very badly.

How about you? Ever do the easy thing and kill people or were you able to grow a backbone?

 

[[DHT]Osiris]

Yep. Any never once was I ordered to do something that was capable of killing someone. And if I had I'd trust to whistle-blower laws to protect me rather than willfully do something I knew could fuck a lot of people up very badly.

How about you? Ever do the easy thing and kill people or were you able to grow a backbone?

Attempting to call me out for being a spineless murderer, that's a bit harsh. Original poster that you were referencing was talking about prescribers being pushed for higher satisfaction ratings by those that run the hospital, as their funding depends on it. Customers ask, thus receive. Clearly this (or similar situations) has been allowed to propagate, otherwise we wouldn't be in the situation we're in.

Considering we're on the same side (I think this is both terrible and terrifying), you should aim your guns elsewhere.

 

[Sunburn74]

I think that what is overlooked with this opiod crisis is that american's in general are easily addicted to.. well almost everything.

Food, TV, cigarettes, etc etc
The opiod crisis is in the news because its new but pure old alcohol abuse is still ravaging our country left and right.

Yes most heroin users start out with a prescription agent, but a lot do not and the percent of people who get a prescription for an opiod and then become addicted is fractions of a percent in some age groups (its essentially unheard of in older people. Ie giving an opiod to a 65 or 70 year old man and then he becomes a raging heroin addict. Maybe the reason is people who tend to live to 65 are not so easily addicted to stuff and so avoid practices that would kill them). Yes opiods are addictive, there needs to be better physician prescribing practices for pain, and there is potential for misuse but lets not pretend as if all these heroin addicts were pristine angels who were unlikely to have developed some sort of substance abuse problem and a serious consequential health problem due to it anyway.

 

[chucky2]

I get the addiction issue but I don't see how people cannot be held responsible for their own actions (doctors and patients alike). Doctors know pushing addicting drugs onto patients in near unlimited fashion is a recipe for disaster, to express shock that it leads to addiction is...less than believable.

Patients know that taking pills that have a better than low likelihood for addiction for too long can lead to, well, addiction. Knowing you don't need the oxy anymore from your car accident but taking it because man it makes your somewhat sore knee and back feel great isn't an excuse for getting hooked. Bodies are wear items and along with wear comes some measure of pain. Welcome to life...

 

[ch33zw1z]

Some live with pain unbearable and tough to understand from an outside view. In the last 20 years, over prescibing of pain killers has created a overwhelming health crisis across the country.

For those of you who question how addiction starts, it's starts with euphoria.

Then tolerance, which happens very quickly with opiates.

Drug makers should be funding treatment centers to help fight the monster they created.

 

[chucky2]

Some live with pain unbearable and tough to understand from an outside view. In the last 20 years, over prescibing of pain killers has created a overwhelming health crisis across the country.

For those of you who question how addiction starts, it's starts with euphoria.

Do you mean euphoria of not having pain any longer, or, euphoria like I just popped some X and man this is a great ride?

Then tolerance, which happens very quickly with opiates.

Drug makers should be funding treatment centers to help fight the monster they created.

It's drug makers fault that doctors over-prescribe and users abuse their own meds now? I honestly don't know: Did/Do these drug makers have dosing and duration guidelines for doctors to follow or is that up to the docs? I.e. are the drug makers culpable in people becoming addicted?

 

[TheVrolok]

You're conveniently leaving out the fucksticks in government at the CMS and JC that basically force fed my generation of fellow physicians with bullshit like "Pain is the 5th vital sign", "If you don't treat the patient's pain adequately, you're abusing the patient and taking away a fundamental right of pain relief!" That crap was shoved down our throats in the late 90's and early 2000's.... Funny how the whole opioid blame game is laid fully on physicians, when we don't get even a pen from drug reps anymore...

In case you didn't know who the CMS is, they're the branch of the feds that basically set the standards for Medicaid and Medicare, which um..., are responsible for a huge chunk of my paycheck. For example did you know the CMS bases part of physician reimbursement based on patient satisfaction scores on pain relief?!!

To be fair, don't forget that the VA and JHACO were just listening to our colleagues from the APS. Might as well spread some of that blame to the anesthesiologists who needed something to do when getting pushed out of the OR by CRNAs and developed pain fellowships. Of course a lot of the blame goes to bullshit data from pharma, and as you've mentioned the transition to compensation models that rely on particular patient satisfaction metrics.

 

[ch33zw1z]

Do you mean euphoria of not having pain any longer, or, euphoria like I just popped some X and man this is a great ride?



It's drug makers fault that doctors over-prescribe and users abuse their own meds now? I honestly don't know: Did/Do these drug makers have dosing and duration guidelines for doctors to follow or is that up to the docs? I.e. are the drug makers culpable in people becoming addicted?

Euphoria is both regards. Feeding the mental addiction, feeling no pain, not caring about anything, and more... all part of opiate effects, specifically the opiate morphine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

I have been watching the NCAA tournament, the rare time of year I watch cable TV. A commercial for movantik was on constantly, and it's marketed to help with Opioid induced constipation (OIC). Commercial was on at least 4 times per hour. Seems they still plan to sell enough opiates, and keep enough people on opiates long term to make money off a known "but rare" side effect.

 

[chucky2]

Euphoria is both regards. Feeding the mental addiction, feeling no pain, not caring about anything, and more... all part of opiate effects, specifically the opiate morphine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

I have been watching the NCAA tournament, the rare time of year I watch cable TV. A commercial for movantik was on constantly, and it's marketed to help with Opioid induced constipation (OIC). Commercial was on at least 4 times per hour. Seems they still plan to sell enough opiates, and keep enough people on opiates long term to make money off a known "but rare" side effect.

Interesting, thx. I've had to take different opiates a few times for kidney stones, unfortunately for me, I must just not respond well to them as I don't remember any reduction in pain, just feeling a little out of it for a couple. I've had them all by now I'm sure, we kept switching to see which would work. Only Dilauded had good effect. Day or two after the procedure though, even though the rest of my aches and pains were gone on it, I stopped taking it. It sucks having aches and pains return but sure don't want to become an addict...

 

[theeedude]

Middle America, now it's a tragedy, now it's so hard to see, in upper class city. -Eminem