Yeah I know. That’s the other side of the coin. I do believe the doctors involved were just doing what they knew to do. These issues couldn’t have been avoided. But I kinda feel theres a lack of accountability with people in general. I’m sure that applies to me too. It’s something I make a conscious effort to work on. I’d like to think if I was a doctor I would want to be more aware of the consequences involved in what medications I provided access to. I feel like back in the 90’s pain medicine was threw around too much when the risks were more obvious then most seem willing to admit. It was super easy to get pain medicine from a dentist back then. But now they are more careful. Tbh when I consider accountability I wanna blame Pharma Purdue for how they pushed OxyContin
“You don’t chase a market….you create it.”
That statement wasn’t just fictionalized. I looked into it. I had to know. The fact that that company had a conversation with that motive is extremely personal to me. That was my life. Im one of those patients.
People thought it must be OK because the FDA labelled it safe for moderate pain use. The FDA chief that did so would a year later go to work at the Pharma company for $400,000 a year.
When the effects proved not to last 12 hours, patients' discomfort was rebranded as "breakthrough pain" and the solution suggested by the makers was to double the dose
But you’re dealing with different factors now. Now we are more aware of these risks going forward. But in an effort to save face against this issue now they’ve made it almost impossible for people that are in legit pain to have any relief. Although I understand it’s necessary I just hate the fact that liability, covering your own ass and making money always has to be the priority more then the patient….the people actually suffering.
I wish we all could win
What a well-written summary of what has happened in the world of legit prescriptions for opioid pain meds.
I slightly differ from you, in that I put most of the blame on over-prescribing doctors. They want to claim that the pharmaceutical companies misled them . . . that they didn't realize how addictive opioids were. I don't buy that.
I was a nursing student in the '70's. We knew back then that opioids were very addictive. In the early '80s, the state and federal governments started cracking down on the use of sedatives and opioids in nursing homes. We used to hand out Seconal to rich old ladies. That stopped almost overnight. (I watched one such patient die in barbiturate withdrawal, after almost a week of insomnia. She went from being mentally competent to being psychotically disoriented. It was horrible to behold. You had to see this to appreciate how bad it was for this poor soul. Detox should not be done in a nursing home. We had not the expertise.) It took longer for the governments to get to opioids, but they finally got to them.
Opioids have been around a very long time. The whole world knows what they do. Also, healthcare professionals all know how prevalent opioid addiction is among their felllow nurses and doctors. Every state has special programs (diversion programs) to enforce discipline and keep professionals out of prison, and they publish a list of affected professionals that is sent out to each group of licensed professionals, at least every few months. So, for doctors to be professing this wide-eyed innocence about opioid abuse is impossible for me to believe. There probably is not a doctor in the U.S. who hasn't known, or known of, an opioid addicted fellow physician.
Shortly after getting out of nursing school, I was told by co-workers where I worked, about a fellow nurse they believed was stealing narcotic pain pills. Darvon and Tylenol with codeine were the hot items back then. In more recent years, I worked with a nurse who fatally overdosed. I've worked with other nurses who were not allowed access to the narcotic cabinet because they were in "diversion programs." From what I read, doctors abuse opioids worse than nurses do, probably because they have such ready access. The argument that physicians "just didn't realize" is too flimsy for me.
In fairness to doctors, it was back in the '70s that an anti-pain movement went into full swing. Nurses and doctors were told that pain is what the patient says it is. We were told that pain-relief is a "patient right." Doctors, I hate to say, are herd animals. Medicine may be a science, but doctors are typically not scientists. They want to be in step with what they think is the standard, accepted way of doing things. They copy their peers. Trends are big in their line of work. ("Baby aspirin a day might prevent a stroke or heart attack." That was big for many years. Now it's debunked as dangerous advice.) Physicians live in fear - fear of law suits, and fear of government oversight, and fear of insurance programs not paying them. Staying with the herd affords some safety. They parrot off things they've been told, if that's what everyone else is saying. Now the wind has shifted, so the herd runs in a different direction.
As a cover, there's loads of stuff being printed that says opioids don't even really relieve pain . . . not for long. This is a way for doctors to sooth their consciences when they leave patients in pain. Opioids do relieve pain, even after tolerance develops.
There's been a mad scramble to market non-drug pain relievers. TENS units were big in the '70s. (They send electric stimulus to the nerves.) Their popularity went down over the later '80s. They're back on the market, as an over-the-counter device that anyone can buy. The research on their usefulness is very disappointing.
A lot of seniors are taking way more Tylenol and ibuprofen than is safe, as a substitute for opioid pain meds. The kicker is that those 2 drugs can be more toxic than opioids. I was put on Indocin (indomethacin) to reduce my need for hydrocodone. It's an NSAID, same family as aspirin or Motrin (ibuprofen), but way stronger. It works great. But, after a few months taking Indocin 3 times a day, I ended up with bleeding ulcers in my stomach and colon. I went to the hospital because of extreme weakness. They said I had lost one third of my red blood cells to the silent bleeding. The gastroenterologists told me to never take an NSAID again. Now I stick to the hydrocodone. This is an example of "unintended consequences" from poorly thought out policy.
I hope the pendulum is starting to swing back. It was an over-correction, unfair to people in pain. Effective treatment for pain is a right.