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Teriyaki Koinku posted:I see the thread title has been updated from 2016 to 2018. Has there been any improvements or statistics showing notable trends between addiction rates/opioid prescription/other happenings since then under the Trump administration's proclamation of attacking the opioid epidemic? No jokes please, let's keep this thread serious.
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May 11, 2018 01:23
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For global context, here's a really fascinating (and illustrated!) Buzzfeed piece on how Tramadol is becoming a massive addiction issue in Nigeria: https://www.buzzfeed.com/monicamark/tramadol-in-nigeria?bftwnews&utm_term=.tpVgdzW7N#.laZk7vQVZ
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May 21, 2018 04:56
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OXBALLS DOT COM posted:I think they were worried that if patients were given more control, some of them would overtreat their pain or even abuse pain medication. Yeah, I had some pain medication once for a routine procedure and drat was it an utterly fantastic feeling. I never want it again unless I absolutely need it because that poo poo is bliss in a bottle. If I had the option of prescribing it to myself, I probably would end up doing so. However, I don't have chronic pain or a condition that requires me to manage pain. If I did have such a condition, I would want access to the tools to help me deal with it, so I can see where the argument of giving patients more control is important for those who suffer from chronic pain.
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May 21, 2018 08:37
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so that poo poo about 14-cm-oxycodeinone / other stuff is starting to happen. very strange opioids can be made out of naloxone or naltrexone if you have access to certain precursors, and some people do. it's probably not going to be as big as fentanyl at this point, but it could be. also there's an oxymorphone analog called MR-2096 making rounds and the R isomer is an opioid while the S isomer is an antagonist. apparently it's as good as oxycodone.
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May 21, 2018 09:12
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This is very slow motion, even by political football standards, but maybe we'll have 4 safe injection sites in NYC at some point. Things that happen really slowly have a knack of never actually happening, though. https://www.politico.com/states/new...timeline-400200
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Jun 11, 2018 19:57
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Dirk the Average posted:Yeah, I had some pain medication once for a routine procedure and drat was it an utterly fantastic feeling. I never want it again unless I absolutely need it because that poo poo is bliss in a bottle. If I had the option of prescribing it to myself, I probably would end up doing so. My feeling is that it's mostly a matter of correctly evaluating the costs/benefits, and the problem is that most non-addicts (including doctors) aren't capable of correctly evaluating the costs of addiction. There is obviously a level of chronic pain/suffering so debilitating that opioid dependence/addiction is still worth it, but the problem is that a lot of people have pain that is bad, but they underestimate the full long-term cost of developing opioid dependence/addiction (and the problem is that there's no way to really know if you're particularly vulnerable to opioid addiction until it's already too late). Basically, longer-term (more than a couple weeks or so) opioid treatment should be a tool in the toolbox, but it should be one that is only used in situations where there isn't any other reasonable alternative, and ideally other options (like the more powerful prescription NSAIDS, lyrica/gabapentin, or marijuana) should be tried first.
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Jun 11, 2018 20:22
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For folks with a background in heroin, what do people think of "free heroin" programs like they have in Switzerland? https://news.vice.com/article/only-in-the-netherlands-do-addicts-complain-about-free-government-heroin My amateur gut response is it sounds pretty good, since in theory it cuts the legs out from under the heroin black market, provides safe product, and dosing levels are explicitly known. What I found especially fascinating is that Switzerland lets clients choose their dosage levels, and were initialhy concerned people would "rat and lever" themselves into oblivion. But on the average, patients with an explicit number for their dosage tended to taper themselves off over time to avoid withdrawal symptoms while making themselves more functional. Thoughts? Is free heroin in a boring sterile location a good deal, or is it still more rewarding to rustle up the money and do it with your friends? What percentage of the black market would be removed by free heroin (assuming the vast majority of clients have access to a facility)?
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Jun 19, 2018 03:19
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Given the utter horseshit we've been dealing with recently (mainly people thinking they're buying heroin and ending up with fentanyl mixed with cocaine, so they turn into wide-eyed, incoherent, screaming lunatics after naloxone reversal) I wish there were someplace that people had access to guaranteed, actual loving heroin. No way in hell it would fly in the states, though. There's already too high a risk that Philly's safe injection site is going to get raided.
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Jun 19, 2018 11:29
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A study over at the American Journal of Public Health has found that Prescription Drug Monitoring Program increase overdose deaths by, like, alot. https://www.vox.com/policy-and-politics/2018/8/23/17769392/opioid-epidemic-drug-overdose-death-study
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Aug 27, 2018 10:03
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TapTheForwardAssist posted:For folks with a background in heroin, what do people think of "free heroin" programs like they have in Switzerland? We have them in Denmark, and while I was never a junkie, the addicts seem to live longer and have more success in rehabilitation. Also, since it's combined with an injection site complete with nurses who administer, user mortality within the facility is 0%
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Aug 27, 2018 15:26
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KingEup posted:A study over at the American Journal of Public Health has found that Prescription Drug Monitoring Program increase overdose deaths by, like, alot.
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Aug 27, 2018 16:40
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tetrapyloctomy posted:In the short term, anyway. That result should be blindingly obvious anyway: when one sees someone has multiple narcotic prescriptions in the database (often from multiple prescribers), one denies them another prescription. Decreasing access to prescribed opiates prompts people who are addicted to narcotics to buy street drugs with often inconsistent strength and/or purity. PDMPs remain a critical step in curbing the opiate crisis regardless, because cutting back on inappropriate prescribing, noting abusive patterns, and referring to appropriate intervention is how you prevent people from getting addicted in the first place. The article does go into this - they mention that some of these programs will have much more positive effects when put into place in conjunction with other programs. It's just that if you straight up cut off access without also funding intervention programs, then the number of deaths will increase.
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Aug 27, 2018 16:58
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OhFunny posted:https://www.nytimes.com/interactive...WT.nav=top-news https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html Update on this. Overdose deaths in 2017 are around 72,000 in the preliminary report from the CDC. Up 8,000 from 2016.
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Aug 27, 2018 22:42
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quote:Americans struggling with addiction need treatment and reduced access to deadly drugs. They do not need a taxpayer-sponsored haven to shoot up. The deputy AG has decided that more prohibition will solve the opioid crisis.
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Aug 28, 2018 00:26
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KingEup posted:The deputy AG has decided that more prohibition will solve the opioid crisis. It has been working for the past 40 years and of course it shows no sign of stopping. 
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Aug 28, 2018 00:36
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Zil posted:It has been working for the past 40 years and of course it shows no sign of stopping. Just 1.25 Vietnams per year. Maybe if we outperform, we can match the number of total WWI deaths for one year.
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Aug 28, 2018 05:47
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welp... Crackdown On Supervised Injection Sites quote:"I'm not aware of any valid basis for the argument that you can engage in criminal activity as long as you do it in the presence of someone with a medical condition," Rosenstein says. quote:"Just because someone tells you in San Francisco that San Francisco is not going to prosecute you for doing something, that does not make it legal. It remains illegal after federal law," Rosenstein says. "If anybody thinks this is a good idea, there's a way to accomplish that: try to persuade the U.S. Congress to legalize it." I see safe-injection sites as a major positive, but obviously people in and out of power are stuck in the stone ages when it comes to addicts. Forgot to add my favorite quote quote:"This is not a disease that gets spread like the flu," Rosenstein says. "People can only become addicted if they have access to these illegal drugs. And so if we can prevent that access, we can prevent the addiction." 
Kithyen fucked around with this message at 00:29 on Aug 31, 2018 |
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Aug 31, 2018 00:27
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Christ, that's awful. People will die because of this. The sites don't even provide the access to the drug, right? Don't they just provide the needles and staff in case of overdoses?
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Aug 31, 2018 02:19
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Yeah, it's pretty gross and really loving ignorant. That being said, I do have a problem with safe injection sites in their current form. They should be widespread and inconspicuous, because otherwise the social ills associated with drug use become more concentrated in one place. As we must come to accept that opiate abuse is not something that only affects "the other," we should have places to safely use these drugs widespread, in rich areas and poor; in urban, suburban and rural locations, etc. Ideally we'd also supply clean drugs to addicts, so there's no problem with unknown dosages, adulterated drugs, theft and other crime associated with drug trade, but first things first.
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Aug 31, 2018 02:59
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PT6A posted:Ideally we'd also supply clean drugs to addicts, so there's no problem with unknown dosages, adulterated drugs, theft and other crime associated with drug trade, but first things first. You mean something other than methadone?
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Aug 31, 2018 05:12
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King Possum III posted:You mean something other than methadone? or something in addition to methadone, like diamorphine.
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Aug 31, 2018 06:04
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KingEup posted:or something in addition to methadone, like diamorphine. I've read about programs in Switzerland, and I think a few other countries that are doing exactly that. Apparently they have equal or greater success in harm reduction compared to methadone clinics in the US.
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Aug 31, 2018 07:40
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King Possum III posted:You mean something other than methadone? Yep. Whatever they want, honestly. We need to stop looking at substance addiction as some kind of moral failing. If giving people their drug of choice keeps them from dying, contracting serious illnesses, or committing crimes to fund their habit, we should give it to them.
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Aug 31, 2018 15:01
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PT6A posted:Yep. Whatever they want, honestly. We need to stop looking at substance addiction as some kind of moral failing. If giving people their drug of choice keeps them from dying, contracting serious illnesses, or committing crimes to fund their habit, we should give it to them. Under the old system in the UK, addicts could register with the government and receive pharmaceutical heroin (and if they wanted it, cocaine), with sterile injection equipment. Apparently it was very effective at keeping illicit opioids from becoming as widespread as in the US up until the 1980s. One article I read said that in the early 1950s, there were just 56 registered heroin addicts in the UK. But IIRC, the NHS now offers only heroin or (preferably oral) methadone to new patients, and I'm not sure if people registered under the old system can still get their coke.
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Aug 31, 2018 17:49
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They blocked offering any form of heroin/diamorphine to new patients, it's only the ones who were grandfathered in after clinics like John Marks' were shut down (allegedly due to some pressure from the US DEA). There are calls to reallow medical heroin where methadone keeps failing, but I don't know how far along that is. This might be the article that you were thinking of for the low number of UK heroin addicts in the 50s. It's worth noting that there were a fair few more problem users of morphine and naturally occurring opiates at the time, but still overall low compared to post war on drugs.
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Aug 31, 2018 17:54
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I first read about this a long time ago, and don't remember the original source. So I did a quick search, and found several articles that covered this. This is the one I got that figure from; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539406/
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Aug 31, 2018 18:03
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For those of you who are doing research/curious about opioids in the greater Boston area: A video on Methadone Mile in Boston. Deaths and incidents statewide. 2000 last year. Mass State senate include SIF money. Mooseontheloose fucked around with this message at 01:48 on Sep 1, 2018 |
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Sep 1, 2018 01:03
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https://twitter.com/washingtonpost/status/1038392757935656960 I don't even know where to start with this.
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Sep 8, 2018 15:29
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Why are they making another buprenorphine medication? I figured suboxone strips still can't have generics. Is it a different company also trying to profit from their own non-generic buprenorphine drug?
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Sep 8, 2018 16:28
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ill give you Two Guesses
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Sep 8, 2018 16:55
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Ytlaya posted:Why are they making another buprenorphine medication? I figured suboxone strips still can't have generics. Is it a different company also trying to profit from their own non-generic buprenorphine drug? It's a once a month shot that costs a couple thousand dollars and they're bypassing the medical establishment entirely and pitching it directly to judges, DAs and prison wardens trying (and succeeding!) to make it the go-to for judicially mandated treatment options. I can kinda see their point given the guaranteed compliance and low potential for diversion with that solution but still, 
shame on an IGA fucked around with this message at 17:40 on Sep 8, 2018 |
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Sep 8, 2018 17:35
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There’s another company that makes a 1 month long acting injectible form of Narcan. I don’t really see the buprenorphine one becoming more than a niche in court ordered treatment when you have an alternative that’s more authoritarian. There was also a surgically implanted long acting (I think 6 months) of buprenorphine that failed hilariously. You would think that one would’ve been more popular with judges but /shrug
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Sep 8, 2018 19:02
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Lote posted:There’s another company that makes a 1 month long acting injectible form of Narcan. I don’t really see the buprenorphine one becoming more than a niche in court ordered treatment when you have an alternative that’s more authoritarian. thats not narcan its naltrexone (narcan is naloxone)
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Sep 8, 2018 20:27
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Vivitrol is the brand name. It also works for alcoholics
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Sep 8, 2018 23:48
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Naltrexone literally is naloxone with a slight change to an end group in order to increase its duration. No one would quibble if you said "Penicillin V is an oral version of Penicillin G" and they share about the same structural difference from each other as naltrexone from naloxone.
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Sep 8, 2018 23:55
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tetrapyloctomy posted:Naltrexone literally is naloxone with a slight change to an end group in order to increase its duration. No one would quibble if you said "Penicillin V is an oral version of Penicillin G" and they share about the same structural difference from each other as naltrexone from naloxone. they arent the same substance tho. naltrexone is not only longer acting but weaker by wright and orally bioavailable. codeine is just methylmorphine but noone would act like the distinction is quibbling
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Sep 9, 2018 00:10
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sea of losers posted:they arent the same substance tho. naltrexone is not only longer acting but weaker by wright and orally bioavailable.
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Sep 9, 2018 00:44
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fair enough
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Sep 9, 2018 17:47
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deoju posted:I don't even know where to start with this.
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Sep 10, 2018 15:13
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tetrapyloctomy posted:My read of his post was simply "There's an opioid antagonist called naltrexone that's basically like long-acting Narcan," not that he was saying they were in fact the exact same drug. Yeah. I don’t know how many people are familiar with naltrexone and Vivitrol. More people are familiar with Narcan.
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Sep 10, 2018 15:20
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