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My Imaginary GF posted:Sounds like a desperate need for some tort reforms so that you can deny an addict another useless medical test which wastes everyone's time and money. The problem I run into is that the boy who cried wolf isn't an aspirational story for doctors. Turns out doing IV drugs is super bad for you and just because you didn't have a bleeding gastric ulcer or varices doesn't mean you won't get one. I always work everything up at face value because I've seen people who have been to the ED 40 times in a year for abdominal pain, but actually had appendicitis on the 41st time. I'm genuinely working theses things up by the book not out of some abstract fear of lawsuits, but because I don't want to let someone die.
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Apr 4, 2016 18:09
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My Imaginary GF posted:Sounds like a desperate need for some tort reforms so that you can deny an addict another useless medical test which wastes everyone's time and money. Possibly gently caress the public healthcare system for not providing them another way to treat their condition?
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Apr 4, 2016 18:10
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Once when I was about 20 I went to the doctor for some minor malady. The doctor gave me a stern glare and told me "I know what you are looking for young lady, and you won't get it from me!" I have always wondered if my random symptoms matched up with some typical drug-seeking behaviour. Or whether he was just crazy!
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Apr 4, 2016 18:24
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BarbarianElephant posted:Once when I was about 20 I went to the doctor for some minor malady. The doctor gave me a stern glare and told me "I know what you are looking for young lady, and you won't get it from me!" You might have been profiled. Some health care people are really asses about tattoos.
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Apr 4, 2016 18:32
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deathbysnusnu posted:You might have been profiled. Some health care people are really asses about tattoos. No tattoos, and I've got a generally meek and nerdy appearance.
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Apr 4, 2016 18:35
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I remember when I had a toothache it took me 48 hours of being awake in agony before I could get someone to give me decent painkillers. Apparently when you're sitting in a chair sweating and shaking and looking like death, doctors don't like giving you drugs. Whodathunkit.
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Apr 4, 2016 18:36
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OwlFancier posted:Possibly gently caress the public healthcare system for not providing them another way to treat their condition? Like god, government helps those who help themselves. The public healthcare system, in response to the will of the American electorate, provides addicts with several viable, evidence-based pathways for treatment. Addicts should not be able to get away with wasting everyone else's time and tax dollars with useless costs as they attempt to lie their way to unpaid treatment.
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Apr 4, 2016 18:42
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My Imaginary GF posted:Like god, government helps those who help themselves. The public healthcare system, in response to the will of the American electorate, provides addicts with several viable, evidence-based pathways for treatment. Addicts should not be able to get away with wasting everyone else's time and tax dollars with useless costs as they attempt to lie their way to unpaid treatment. Wouldn't it be easier to just hand out clean pharmaceutical grade drugs to anyone who wants them, and save all that time and money with the doctor, then I wonder?
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Apr 4, 2016 18:49
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OwlFancier posted:Wouldn't it be easier to just hand out clean pharmaceutical grade drugs to anyone who wants them, and save all that time and money with the doctor, then I wonder? It was that sort of thinking by doctors in the naughty aughties which gave us this epidemic in the first place. You're a bad doctor, OwlFancier.
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Apr 4, 2016 18:52
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My Imaginary GF posted:Sounds like a desperate need for some tort reforms so that you can deny an addict another useless medical test which wastes everyone's time and money. Yet for some reason you don't oppose all of the "help" the criminal justice system provides drug users, even non-addicts who would otherwise have absolutely no impact on your life whatsoever. You're just another moralizing authoritarian who wants to punish the morally impure based on a completely arbitrary drug classification system.
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Apr 4, 2016 18:53
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Then perhaps a happy middle ground where if someone shows up clearly just wanting drugs you can just give them drugs and a referral to a rehab program, then they don't need to keep coming and getting you to do tests they don't need.
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Apr 4, 2016 18:54
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OwlFancier posted:Then perhaps a happy middle ground where if someone shows up clearly just wanting drugs you can just give them drugs and a referral to a rehab program, then they don't need to keep coming and getting you to do tests they don't need. Yes, isn't this what already happens for those of means? Those without means, we have a publicly funded rehab system: its called jail.
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Apr 4, 2016 18:58
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deathbysnusnu posted:That's a really tough question that we probably won't be able to answer for a decade or so. So my take is that heroin use has gone way up because recreational pills are becoming prohibitively hard to get due to KASPER. On the flip side, I'm hoping heroin use overall will go way down in time because most people get on heroin because they first got addicted to pills which is becoming a lot harder now. Hope so. I am pushing my hospital to move to mandatory registration with the local background check system for all providers in our system. The ultimate goal is to get a system Mandated background check on all substances as part of hospital policy. I do it on everyone before I give them narcotics of any kind. Usually comes up with nothing, sometimes it's a 40 page report for 6 months with over 3000 pills of dilaudid/Percocet/norco/Xanax/Valium and god knows what else.
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Apr 4, 2016 19:12
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My Imaginary GF posted:Yes, isn't this what already happens for those of means? Those without means, we have a publicly funded rehab system: its called jail. Not really very good at it though.
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Apr 4, 2016 19:14
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So we should put addicts who haven't even necessarily committed any crimes into jail? Step it up, MIGF.
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Apr 4, 2016 19:42
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I would even venture that aspects of MIGF's obsessive and compulsive posting clearly show an addict beyond self-control who should be remanded to society's control for his own good.
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Apr 4, 2016 19:48
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deoju posted:I don't know much about the chemistry, but I read that since one of the precursor drugs, codeine is controlled, it is not profitable to cook in the US. Codeine is, in some formulations, OTC in Canada too, and I haven't heard about krokodil being a problem here ever since the original media freakout over it.
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Apr 4, 2016 19:55
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Yeah I think it's more a function of there not being other potent opiate options in Russia, though the situation may have changed I don't know.
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Apr 4, 2016 20:30
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Radbot posted:So we should put addicts who haven't even necessarily committed any crimes into jail? Step it up, MIGF. Using heroin is a crime. Don't like it? I'd recommend you lobby Congress to change the regulatory framework. Failing that, man the gently caress up and be a law-abiding citizen or get enough funds through your hard, stable work to pay the penalties.
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Apr 4, 2016 20:47
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Can't I get funds through other people's hard work instead to spend on drugs like a normal bourg?
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Apr 4, 2016 20:53
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My Imaginary GF posted:Using heroin is a crime. Don't like it? I'd recommend you lobby Congress to change the regulatory framework. Failing that, man the gently caress up and be a law-abiding citizen or get enough funds through your hard, stable work to pay the penalties. Oh, is it now? Can you quote me some law where "having used heroin at some indeterminate point in the past, yet not currently possessing or distributing it" is defined as criminal behavior?
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Apr 4, 2016 20:57
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My Imaginary GF posted:Using heroin is a crime. Don't like it? I'd recommend you lobby Congress to change the regulatory framework. Failing that, man the gently caress up and be a law-abiding citizen or get enough funds through your hard, stable work to pay the penalties. To reiterate, if you weren't a hypocritical authoritarian piece of poo poo you would care about all of the law enforcement resources being wasted on drug users, including non-addicts. What happened to the fiscal conservatism you were displaying a few posts ago? Medical tests for addicts are "bankrupting" our healthcare system yet the completely pointless, counterproductive war on drugs we spend billions on is a nonissue? Not to mention that I could compile a long list of things that "bankrupt" our healthcare system more than that which we do not give people felony charges and prison time for. MaxxBot fucked around with this message at 22:52 on Apr 4, 2016 |
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Apr 4, 2016 22:46
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kliksf posted:The thing is there are people who want to use or abuse opiates they want to get whatever feeling or relief they can get from them. The ting these days with fentanyl is, not unlike with molly, there's a lot of stuff passed around that's sold as one thing, Xanax, vicodin or whatever and people make up bogus pills that are easy as gently caress to OD on. I don't know this for sure, but some shady dealers will have heroin cut with fentanyl and have people end up dying off of it. Junkies end up flocking to them because they hear about people dying and think it's some kind of super potent H. Not sure if this how it works, but it's what I've heard.
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Apr 4, 2016 22:50
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Radbot posted:Oh, is it now? Can you quote me some law where "having used heroin at some indeterminate point in the past, yet not currently possessing or distributing it" is defined as criminal behavior? If you use heroin, and its in your blood, you're in possession of it.
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Apr 4, 2016 22:57
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Only if you find them within under 5 minutes of shooting up. The whole point of heroin is that it's a prodrug that is converted rapidly into other things within the body, which then have a longer lasting analgesic effect. Unless you plan to arrest people for possession of endogenous drugs, in which case better arrest everyone for possession of DMT.
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Apr 4, 2016 23:07
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ToxicSlurpee posted:AA is actually pretty ineffective. Their recovery rates, last I heard, are better than people trying to get clean by themselves but not by much. Trust me, I know all about family pressures and lack of social circles for support. Moving in with your parents after limping to graduation with being somewhat of a loner and having them scream at you in your room for being a failure and having "failed" can easily lead to abusive drinking.
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Apr 5, 2016 00:16
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ToxicSlurpee posted:AA is actually pretty ineffective. Their recovery rates, last I heard, are better than people trying to get clean by themselves but not by much. [citation needed] Last I checked, and I'm IN AA and NA, we helped shittons of people who came to us because they could not get sober or clean by themselves.
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Apr 5, 2016 15:57
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The thing with AA/NA isn't so much the program itself, it's that the program gives structure and a group of sober people to hang out with. Once you start doing drugs, you start hanging out with others that do drugs, and it becomes so much harder to get off of them, because even if you want to stop, you hang out with your buddy and he's offering you a line, and why the gently caress not? The NA workbook has some good stuff in it, the big book has some good stuff in it, but the biggest benefit to it is the fact that you have some structure and other people to hang out with that aren't using. And I am one of those people who vomits profusely off of tramadol and (oral) toradol. I give 0 fucks if I'm rxd them, I just need zofran with them. Or a shot in the rear end with the toradol. Just saying, not everyone that comes in claiming allergy with them is lying.
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Apr 5, 2016 16:20
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Just as an aside and not disagreeing with anyone, but I think a lot of folks (esp. young guys) don't understand how important social support/influence is to humans, or at least neurotypical humans. Also GIVING social support, which really turns a light on for some people. We mostly buy that, say, solitary confinement would be rough but when it comes to meaningful interaction a lot of people are basically walking around in solitary confinement.
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Apr 5, 2016 16:36
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Tias posted:[citation needed] Never said they were completely ineffective or totally useless; the fact that AA and NA works for some people already justifies its existence. If it works for some people then hey it can keep working for those people. AA is for Quitters posted:The thing with AA/NA isn't so much the program itself, it's that the program gives structure and a group of sober people to hang out with. That's the big one; one of the reasons that people don't get clean is that, well, if you go to jail and get back out, who are your friends likely to be? Same old users you used to hang out with. It can be hard to get out of that scene if, say, your primary social activity was "go to bar -> get hell of drunk -> do it again tomorrow." Attending meetings forces you to break your routine which is very helpful. Which is why I say AA is kind of "meh" in its effectiveness; it's a good way for some people to get a support group but it isn't AA itself doing it. Think of quitting smoking. If literally all of your friends and family smoke good loving luck with quitting but if you quit hanging out with smokers it gets way easier. But...are you going to just give up all your friends and family that easy? What if you live in an area where drugs are just kind of everywhere?
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Apr 5, 2016 17:17
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Tias posted:[citation needed] That AA is about as effective as doing it yourself doesn't mean it's effective for the same people. A 5% success rate or whatever is still helpful so long as it's not the same 5% who succeed alone.
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Apr 5, 2016 20:29
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If there was any treatment with a high chance of success, addiction wouldn't be a big problem, would it? Addicts seem to use the low chance of success/high religion quotient of existing treatment programs as an excuse to try nothing rather than try everything. Some kind of learned helplessness I suspect, probably from the same issues that pre-dispose them to become addicts.
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Apr 5, 2016 22:36
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I uh, think people who have a sense of learned helplessness would probably fit right in with AA tbh.
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Apr 5, 2016 22:49
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BarbarianElephant posted:If there was any treatment with a high chance of success, addiction wouldn't be a big problem, would it? Implementing a solution is often much harder than finding a solution in the first place.
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Apr 5, 2016 23:16
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I can envision a treatment with a high chance of success (outside of the people where it's REALLY progressed, I guess) if you could limit the inpatients to people who have decided they really want to get better and are willing to change/let go. But yeah that's sort of like saying I can cook a delicious dinner as long as the guests are starving. It's going to be a 2 way thing for the foreseeable future; there isn't a FO4 addictol on the horizon.
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Apr 6, 2016 01:01
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pangstrom posted:I can envision a treatment with a high chance of success (outside of the people where it's REALLY progressed, I guess) if you could limit the inpatients to people who have decided they really want to get better and are willing to change/let go. But yeah that's sort of like saying I can cook a delicious dinner as long as the guests are starving. It's going to be a 2 way thing for the foreseeable future; there isn't a FO4 addictol on the horizon. I have a friend who "really wants to get clean" but doesn't understand the difference between "wanting" something and taking real action. We go to the same program, but she does nothing but the barest minimum and acts surprised that she's still miserable. And we have the same teary-eyed conversation every couple days. And nothing changes except how loud she is about how hard she's wishing her problems away. I've known plenty iterations of that personality type, especially within recovery groups and inpatient treatment, Personally, I was on fire for sobriety after my 2nd completed inpatient rehab, but I relapsed with in a month (with guys in my halfway house). I limped along for another few months, doing things like moving into a stable environment and reconnecting with my sober [then]partner, working long hours, and (detrimentally) trying to pretend my addiction never happened. As it were, I didn't understand what I was doing, and I was strung-out soon enough. And this story is anything but rare. Recovery is absolutely a daily process, replete with intricacies. But too many people are like inept bodybuilders...we get all buff and fit over the course of a couple months, and then we get lazy....soon enough regressing into a blubbering mess. Recent studies indicate long-term participation in a recovery community correlates strongly with long-term sobriety. Seems simple and obvious, but I attribute much of my past failures to an inability to grasp that concept. These days, I train my "recovery muscles" consistently. Group/counseling is nearly a daily activity, meditation is daily, my mindfulness practice demands persistence, I think about everything I eat, and so on. Recovery is absolutely possible. How to convince addicts to "buy-in" to the best, individualized treatment modality is quite another.
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Apr 6, 2016 03:30
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BarbarianElephant posted:If there was any treatment with a high chance of success, addiction wouldn't be a big problem, would it? Treating addiction is treating the symptom instead of the disease. One of the issues with AA and NA is that they are played up like miracle cures that can work for absolutely anybody. It's common to force people to go to them after they get out of jail for possession or get a DUI or something. Yes I know this will affect its success rate but AA/NA meetings (where I've lived, anyway) are often tied to churches. At first it starts with "you must find a higher power to believe in" but before long it turns to "by the way we mean God. You can be a Christian or you can get out." That I imagine also factors in with its success rate. I'd be pretty furious if somebody said "yeah hey come to Jesus or you'll fail at being clean." Which is again not helping; saying you will just go back to using if you don't accept Jesus can be a real self-fulfilling prophecy. It also doesn't help that actual, genuine rehab isn't cheap.
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Apr 6, 2016 18:36
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pangstrom posted:Just as an aside and not disagreeing with anyone, but I think a lot of folks (esp. young guys) don't understand how important social support/influence is to humans, or at least neurotypical humans. Also GIVING social support, which really turns a light on for some people. We mostly buy that, say, solitary confinement would be rough but when it comes to meaningful interaction a lot of people are basically walking around in solitary confinement. I was reading a study today that addiction is associated with poor awareness of others and that, even when an addict is recovering, they are not mindful of how their actions impact others. The other thing I was reading was on Naltrexone? Why is naltrexone treatment not a standard requirement for release from corrections?
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Apr 6, 2016 21:07
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The_Book_Of_Harry posted:I have a friend who "really wants to get clean" but doesn't understand the difference between "wanting" something and taking real action. I think it's a question of resources. By the time someone is an addict, treating them will cost enough that you will have failed to prevent others becoming addicts. If an addict does not buy-in to treatment, spending any resources on attempts to produce buy-in is an absolute waste.
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Apr 6, 2016 21:55
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My Imaginary GF posted:I think it's a question of resources. By the time someone is an addict, treating them will cost enough that you will have failed to prevent others becoming addicts. If an addict does not buy-in to treatment, spending any resources on attempts to produce buy-in is an absolute waste. Half of what you said makes sense. Putting people who don't want help into treatment is generally pointless. We agree on that. -------- I'm not really sure what you mean by spending money on preventing people from becoming addicted. Everyone knows drugs are addictive and unhealthy. Actual prevention is arresting the cycle of substance use, and getting the substance abuser to continue with sobriety (and long-term treatment) before they exact any (more) costs upon society and themselves.
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Apr 6, 2016 23:20
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