The prescription opioid epidemic in a nutshell

[GoBeers]

but was he bad enough to lose his medical license? couldn't an argument be made that we need to have some docs willing to take care of these refugees? It sounds like the dea admin personally got involved in his case, and admin with no medical background.

Honestly I don't know the guy but I've come across several of his patients who were looking for someone to continue his expert high dose management plans.

I don't think there should be any argument that there needs to be docs willing to take care of someone else's mess without any impunity.
If someone can so easily ramp things up, then they should be responsible for ramping things down or providing sensible exit strategies for all parties.

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[Disciple]

Honestly I don't know the guy but I've come across several of his patients who were looking for someone to continue his expert high dose management plans.

I don't think there should be any argument that there needs to be docs willing to take care of someone else's mess without any impunity.
If someone can so easily ramp things up, then they should be responsible for ramping things down or providing sensible exit strategies for all parties.

You mean with impunity right? Otherwise, who is going to agree to participate?

How about, the local university psyche department has to run a buprenorphine clinic, and has protections.

Or, the local community hospital, with protections and/or a significant site of service differential for the services.

 

[specepic]

Honestly I don't know the guy but I've come across several of his patients who were looking for someone to continue his expert high dose management plans.

I don't think there should be any argument that there needs to be docs willing to take care of someone else's mess without any impunity.
If someone can so easily ramp things up, then they should be responsible for ramping things down or providing sensible exit strategies for all parties.

I do not know the specifics of his case (would love to hear them)

Given that:

- There are opioid refugees
- The opioid issue is very political and the DEA and others are likely emboldened to make examples out of docs

 

[drusso]

Opinion | They Live in Constant Pain, but Their Doctors Won’t Help Them

Pain patients have become the unintended victims of a national crackdown on opioid prescribing.

www.nytimes.com

"America’s doctors have been put in a difficult position. But it doesn’t need to be this way. It is possible to stop overprescribing yet ensure that pain sufferers get the relief they deserve."

 

[epidural man]

Opinion | They Live in Constant Pain, but Their Doctors Won’t Help Them

Pain patients have become the unintended victims of a national crackdown on opioid prescribing.

www.nytimes.com

"America’s doctors have been put in a difficult position. But it doesn’t need to be this way. It is possible to stop overprescribing yet ensure that pain sufferers get the relief they deserve."

That was extremely frustrating to watch and listen to.

One of the lines said that doctors are not brave enough to prescribe opioids to give their patients relief.

Even the title is infuriating. It should read "They live in constant pain, but Their Doctors Won't Help Them in the single way that the patient demands, even when that method has been shown to not work. Doctors continue to offer loads of other treatments, but they just won't help patients in that single way that just doesn't work and is extremely harmful to the patient personally, and to society as a whole. They just won't do it."

 

[GoBeers]

That was extremely frustrating to watch and listen to.

One of the lines said that doctors are not brave enough to prescribe opioids to give their patients relief.

Even the title is infuriating. It should read "They live in constant pain, but Their Doctors Won't Help Them in the single way that the patient demands, even when that method has been shown to not work. Doctors continue to offer loads of other treatments, but they just won't help patients in that single way that just doesn't work and is extremely harmful to the patient personally, and to society as a whole. They just won't do it."

I wonder if there could be a juxtaposed piece on patients with MS, EDS, etc from other countries and how they are typically managed, expectations, opinions, etc.

 

[Ferrismonk]

I wonder if there could be a juxtaposed piece on patients with MS, EDS, etc from other countries and how they are typically managed, expectations, opinions, etc.

If you follow r/chronicpain, you will see this.

 

[lobelsteve]

Opinion | The D.E.A. Needs to Stay Out of Medicine

Restrictions on pain medications are hurting patients who are suffering.

www.nytimes.com

 

[au bon pain]

Opinion | The D.E.A. Needs to Stay Out of Medicine

Restrictions on pain medications are hurting patients who are suffering.

www.nytimes.com

What are your thoughts on this?

 

[lobelsteve]

What are your thoughts on this?

DEA is there for diversion control. One of the primary missions.

 

[au bon pain]

DEA is there for diversion control. One of the primary missions.

Yeah I think the DEA has a role to play — or at least somebody needs to be monitoring for bad/egregious actors. Pendulum going too far the other direction also does folks a disservice.

Seeing a family member go painfully from progressive cancer is awful. Author makes some fair points, though others are tangential and straw man-esque.

I'm still waiting for the blockbuster story: "No evidence that chronic opioid use improves MSK pain." The media's coverage of the opioid crisis actually does the public a disservice by not highlighting this. The press primarily focuses on opioid’s addiction ramifications and frequently seems to paint them as the mainstay of “pain medications” that exist etc ...but by framing opioids in that light, there's almost a tacit suggestion that *if* somebody doesn't suffer those awful side effects then they'll have finally found that thing that “really” works for their pain. When of course they’re usually just a trap.
This is low-hanging fruit and a huge story that, if well reported, could actually benefit our citizenry in a meaningful way. And it’s sitting right under their (and everybody’s) nose.

 

[A Deep Breath]

Yeah I think the DEA has a role to play — or at least somebody needs to be monitoring for bad/egregious actors. Pendulum going too far the other direction also does folks a disservice.

Seeing a family member go painfully from progressive cancer is awful. Author makes some fair points, though others are tangential and straw man-esque.

I'm still waiting for the blockbuster story: "No evidence that chronic opioid use improves MSK pain." The media's coverage of the opioid crisis actually does the public a disservice by not highlighting this. The press primarily focuses on opioid’s addiction ramifications and frequently seems to paint them as the mainstay of “pain medications” that exist etc ...but by framing opioids in that light, there's almost a tacit suggestion that *if* somebody doesn't suffer those awful side effects then they'll have finally found that thing that “really” works for their pain. When of course they’re usually just a trap.
This is low-hanging fruit and a huge story that, if well reported, could actually benefit our citizenry in a meaningful way. And it’s sitting right under their (and everybody’s) nose.

I’ve mentioned this elsewhere, but a reporter put out a call to healthcare professionals seeking stories of how government crackdowns had affected their patients’ ability to get opioids.

Since I’m so tired of the same spin on every opioid article, I wrote back with essentially what you said and offered to help. No response from the reporter.

They aren’t interested in reporting reality.

 

[au bon pain]

I’ve mentioned this elsewhere, but a reporter put out a call to healthcare professionals seeking stories of how government crackdowns had affected their patients’ ability to get opioids.

Since I’m so tired of the same spin on every opioid article, I wrote back with essentially what you said and offered to help. No response from the reporter.

They aren’t interested in reporting reality.

It’s almost like a post-mortem win for Purdue et al.

 

[lobelsteve]

https://www.painmedicinenews.com/Residency-and-Fellowship/Article/04-24/Outpatient-Clinic-Arrival-Time-and-Its-Correlation-With-Morphine-Equivalent-Dose/73362?sub=FB91EF6AF8C99D4BDA1617412032C789116450929F4665EAF77A779E586D57&tken=B419E9194755A0F65B65CAEFE22073FB4EBBB94F90F1F17CFC22CE5555A357D5&enl=true&dgid=U080859650&utm_source=enl&utm_campaign=20240408&utm_content=1&pos=1&utm_medium=button

10 min policy. Late and no visit. No rx

 

[lobelsteve]

Sierra Leone declares emergency over drug kush - made from human bones

Psychoactive drug kush has prompted a wave of deaths, mental health issues and the digging up of graves.

www.bbc.com

 

[au bon pain]

https://www.painmedicinenews.com/Residency-and-Fellowship/Article/04-24/Outpatient-Clinic-Arrival-Time-and-Its-Correlation-With-Morphine-Equivalent-Dose/73362?sub=FB91EF6AF8C99D4BDA1617412032C789116450929F4665EAF77A779E586D57&tken=B419E9194755A0F65B65CAEFE22073FB4EBBB94F90F1F17CFC22CE5555A357D5&enl=true&dgid=U080859650&utm_source=enl&utm_campaign=20240408&utm_content=1&pos=1&utm_medium=button

10 min policy. Late and no visit. No rx

Always fun to see folks validating these seemingly “soft” (but important) trends that most of us tend to notice. Props to these guys for putting this together.

This is pretty much the reason why the majority of my clinic visits are in the morning and last visit ends at 2p. Minimally motivated/functional patients who cannot do basic adulting need not apply