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Popular Thug Drink posted:From what I've read, we've created a stealth class of opiate addicts through relatively generous pain pill policies, because these are powerful drugs just good drugs because they're legal and doctors said you could take them. Except if you start cracking down on how many pills an addict can get a month or how stringent perscription policies are (cracking down on pill mills) people suddenly can't get the pills anymore and since you're breaking the law anyway cheaper and easier to get heroin might start looking like a good option. Yeah the article fade5 posted suggests it's just people that would traditionally get pain problems, like coal miners in Appalachia, being prescribed stronger opioid painkillers all of a sudden. Heroin-related deaths are more common in the Mid-Atlantic region and Illinois (which could be either due to crackdowns on people addicted to prescription opiates like you said, or just because PA/NY/IL have bigger cities where traditional illicit use is more common) while people are just dying from overdoses of the pills themselves in WV and the Midwest. Solkanar512 posted:How do we know that pain meds are being prescribed too much rather than other nations simply not caring about pain? It seems rather cruel to tell a patient, "just suck it up, it's only terminal cancer". How much higher are these rates? Are doctors generally giving refills on these automatically? Or does this have to do with the lack of records that cross state lines? Because of the geographic distribution of overdoses, it seems more likely that strong painkillers are being prescribed for things other than cancer. Workplace injuries related to manual occupations. No one is going to fault someone slowly dying of agonizing cancer for slapping a fentanyl patch on every day, but someone with a moderate strain injury should at least be given weaker options at first. You want to save drugs this powerful for when it's clear there is no other option, because pulling the rug out from under people's feet after prescribing them is probably just going to lead to street drug use.
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Jan 21, 2016 01:42
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Another new documentary that focuses on fentanyl prescriptions for non-cancer patients and street heroin cut with fentanyl. Around the middle, it goes into some of the scummy practices used by companies like Insys to get people with mild pain using their product. They had someone who was told to say "uh huh" on the phone to insurance companies when asked if the patient had cancer, the only disease that guaranteed it would be covered, because "uh huh" doesn't count as "yes" and they couldn't be held liable. Another company put out an ad with an old man sucking on a fentanyl lollipop like it's no big deal and was forced to pay out millions of dollars.
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Feb 3, 2016 19:18
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Spacewolf posted:I am not a fan of "just let addicts be addicted" - I don't think that's a viable option for society. But addiction is a (non-communicable) medical condition, and it is a short step from "kill the addicts" to "kill the mentally ill" or "kill the disabled". This was going to be my response earlier in the thread. Not just from an ethical perspective, but also from a practical one. Assisted suicide for addicts will never be allowed unless assisted suicide for people with chronic depression is allowed. Both of these groups of people would be making a desperate decision while an illness prevented them from thinking clearly. We already institutionalize people for being "a danger to themselves or others" and have essentially agreed as a society that people who would want to kill themselves in the first place are not competent to make the decision. The only exception is for the terminally ill, since "you face certain death anyway, and killing yourself first will prevent suffering or indignity" is one of the only circumstances in which most mentally healthy people would agree that suicide makes sense. Obviously, even that is controversial. The only way it would ever be allowed is if there was some sort of mandatory period (of say, 5 years) before death in which the candidates were given several lines of treatment in an effort to help them recover. Without this, every doctor involved would eventually end up getting charged with malpractice for euthanizing someone who was clearly in a relatively good position to make a recovery. Even after that, there would be all sorts of paperwork involved before the act itself could go ahead. There would be court cases left and right. If the families of people who want to die can be a nuisance now, imagine how much worse they would be in this situation (your dad who is dying of lung cancer, you're not going to get him back under any circumstances, but you might eventually get your addict son or depressed wife back if you prevent them from being stupid and killing themselves first). All of this legal nonsense and mandatory medical intervention from the state would end up wasting more resources than it saved. In any case, most people waste more resources during their life than they produce. It seems absurd to focus on addicts and the disabled, as if they're the only people who do that.
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Mar 19, 2016 11:27
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Guavanaut posted:Which is exactly the same logic that they used when saying that runaway slaves, outspoken women, lazy servants, communists, anti-communists, unwed mothers, and homosexuals should be locked away. We believe in free will, but obviously no sane person would do that, therefore we need to lock up anyone doing that. What do you mean we're just saying this because they're inconvenient to our social values? Well yes, I didn't mean to suggest that the argument about free will and mental competence was a closed book. What you're talking about has more to do with the trouble defining mental illness than anything else. I do think it's a fairly clear case when the same person begging to die one week will soon say "I was feeling really sick last friday, good job I didn't go through with it" without any external intervention. Mentally ill people have a struggle going on between the helplessness and pain caused by their illness and the will to survive that's still underneath. Nobody else you mentioned would do that without significant psychological manipulation, because there is no struggle, except against a hostile society. I don't think it's disrespectful to attempt to achieve the thing that society values when the individual themselves is clearly conflicted, or when it is impossible to ask for consent first. We do this in all sorts of situations, and I can't think of a better way of dealing with ambiguous cases, although you do have to keep an eye out for interest groups who will push for the socially expedient solution against the best interests of the individual. That does leave out the few people who would be consistent about wanting to die, and I see no real reason to deny them if they had been rigorously vetted first. Though they'd be so small in number that it would make more sense for the state to turn a blind eye to it than to actively assist them. There's already nothing stopping opiate addicts from killing themselves in a relatively painless way other than their own will to live (and possibly the absence of a quiet place to overdose where they won't be found and resuscitated). In any case, if you want euthanasia for people with mental disorders on the grounds of respecting consent, you might think of all the things in my second paragraph as being worth it. It's difficult to argue that it wouldn't be more expensive than the situation we have now, not less, which is what the poster who suggested it was concerned about.
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Mar 19, 2016 22:46
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reagan posted:Pharmacist viewpoint: Antidepressants are some dark age poo poo compared to drugs for lets say, infectious diseases or hypertension. Do they work? Yes. Do they work for everyone? No. Do we have room for improvement? Lots. They seem so inconsistent in their effects on different people, and even the same person at different points in time. Everybody talks about Effexor/venlafaxine being a horrible drug that causes awful withdrawal and scary sounding poo poo like "brain zaps", which I've never experienced. But when I went back on it after about 9 months of not taking any medication, I had completely different side effects  The first time I got mild sexual side effects and a reduced appetite, but nothing else. The second time I got constant nausea and euphoria, and no sexual side effects. It was the same dose, release time, and manufacturer. I wasn't taking anything that would have interacted with the drug, either.Hopefully in another hundred years or so psychiatric treatment will seem less random and unpredictable?
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Feb 26, 2017 00:16
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