Opioid crisis in USA

[AstralTraveller (David)]

My understanding is that in Australia the consumption of the legal drugs alcohol and tobacco is falling while the consumption of illegal drugs is rising. It's pretty hard to have a reasoned conversation with someone while calling them a criminal.

BTW I heard on TV some American street slang drug advice: "bake and wake". It means: "smoke cannabis and don't die of a heroin overdose". It strikes me that it's all very well to tell kids to stay straight but when that advice has a snowflake's chance it's better to direct them towards something that has less potential for a catastrophic outcome.

[Visionary (David)]

Originally Posted by xelasnave

I think a good case can be made for managing the drug problem in society by treating it as a medical problem rather than a crime.
Making a drug illegal provides the opportunity for criminals to make money and one could wonder how crimes committed to obtain money to fund a habit may become less.
Prison numbers would be down I expect and less may need to be spent on police.
Drug abuse is the problem be the drug legal or not...well consumption in excess is the problem.
I can have a drink but I don't need one every day...many do.
Alex

Alex,

I doubt anyone using drugs for the first time desires to be in the position where they have a dirty needle off their arm, while poised on the edge of a filthy Public Toilet. Drug addiction is a medical/social issue and needs to be addressed as a medical problem.
Responses to Opioids vary widely, some suffering chronic pain can vary their dosage of Opioids from virtually zero, to heavy doses, precisely reflecting their actual perceived pain level. Whilst others suffering from chronic pain only need a whiff of the stuff and they are ingesting ever escalating dosages, dosages that fail to reflect their actual level of perceived pain rather dosages that reflect their level of addiction.
The above explains why I believe we need to address all drug addiction (alcohol, tobacco etc as a medical issue. What's more, I also believe that Morbid Obesity should be treated as a medical condition and lap band surgery and other surgical remedies to Morbid Obesity should be provided under Medicare.
I am a Liberal-Conservative, I have an abhorrence of reckless Public spending and on the surface of would appear a "least likely" advocate of the Public provision of Drug treatment (obesity) however, the long-term cost of carrying large number of addicts is extraordinarily high, so.... just address the issue asap and provide the services necessary to assist those addicted to drugs to regain their rightful place within mainstream society.

[xelasnave]

David on the issues you cover you have my vote.
Alex

[xelasnave]

Obesity...I can not understand how someone can let themselves become fat..mind you I have a little fat now because I get no exercise but for folk who can exercise I can't understand how they can let fattness overtake them.

I had started back with my exercise program and then got the shingles recovered and then the flu and have only started exercise again within the last week.

I have a fat young friend I can't say anything but she does not seem to care. It is sad.

I really think eating is like a drug for her satisfying more than hunger.

I have a friend who is a big drinker he can drink as much as me on a bender but every day.. Only fifty and you can see him going downhill.
What can you do..nothing.
Alex

[graham.hobart (Graham stevens)]

In the U. S there are powerful vested interests at play in the pharmaceutical world, plus there are financial obstacles to treating pain non pharmacologically. If you don't have money or insurance you cannot see a pain psychologist or physio or a pain specialist.
Lack of basic social support feeds into the problem, a situation we in Australia and the those in the UK should heed. I read yesterday that in the UK you had a higher chance of dying from cancer than from graduating from Uni.
We take our families and social network for granted, but when you do not have these, and rely on the state, and the state offers none, then you truly having nothing and no where to turn.
It's a pretty poor reflection on a society when you have to call your insurer before you call the ambulance/doctor.
Graz

[xelasnave]

All medical treatment should be free...nothing less.

I have been reading on the income of various sports stars...multiple millions.

Entertainers similar.

And yet while such is acceptable those... who we can only call lesser humans because that is the way society treats them... can die because they can not afford treatment... That's the US approach it seems..and yet Cuba that vile backward country seems to treat folk with decency and compassion.

The basic premise of Christianity is that one should love your fellow man...well yes if he is rich and famous but if he is poor he is to be hated for failing to make it big.
An ant colony even does a better job of caring about tribe members.
Alex

[AndrewJ]

Gday Alex

All medical treatment should be free...nothing less.

I think the providers of the medicine should get an acceptable wage.
The problem is the "corporate" medicine model in the US allows people to charge whatever they can get, and we are heading that way here.
Better to have 100 patients willing to pay a million each for care than a million ones willing to pay $100.
Just looking at the top paying jobs in the US, its a subjective view for sure, but the no of "health/medicine" type jobs in the max remunerations is scary, and they all send "patients" to their mates as required until the patients pockets are empty.

Andrew

[xelasnave]

Maybe I should get back to drafting the rules for society under my proposed new world order.
Equality will be the primary consideration.
I have no problem with folk being rich but when folk live or die based on the money such an inequity should be addressed.
I can see signs that we may follow the US model and that will be wrong.
I hope they can sort things out I don't want to intervene.
Alex

[LewisM]

Viva la Revolution Alex, da comrade?

As a FAT MORBIDLY OBESE person, I can readily admit it is entirely of my own doing. I don't drink (maybe twice a month if that, sometimes MONTHS without a single drop of alcohol), I don't smoke (never have), I don't do drugs and I REFUSE to take medication. My cholesterol is lower than a 20 year olds, and I still pass Class 1 aviation medicals without a hitch (though now need reading glasses - my distance vision is VERY sharp). Blood pressure is normal to lower than normal (figure that one out medicos!), and my BGL is NON-diabetic (though one quack tried putting me on diabetic tablets because he THOUGHT I was diabetic and insisted I should be!).

I had to take Oxycodone for a severely dislocated shoulder combined with paralysis-potential kyphosis - it had NIL effect on me in a psychotropic or hallucinatory way, and only made me talk more than usual (which must have meant I had verbal diarrhoea!). I stopped taking it cold turkey after 3 weeks, and had NO side effects whatsoever - nil dependency, nil cravings. They then prescribed me Endone and Lyrica, and I too stopped taking them cold turkey. Tried codeine - narp. The pain - then well and truly chronic was just the same with or without - I am obviously highly resistant to opiates and barbiturates. It plagued my life for 3 years - I just learned to live with it. It never subsided, it was always there, especially in my sleep. Then, one day it stopped hurting, the nerve tingling stopped and full muscle function returned. By itself. No intervention. Probably because I FORCED myself to use it. In fact, I find myself using my left arm more than ever before.

I probably should be dead according to all the quacks that prescribed every damned thing under the Sun. I guess I am not. I now simply refuse medication.

Also bear in mind some people do gain weight and not through any fault of their own. My step mother has Cushing's Syndrome - she looks perpetually bloated, moon-faced and outright fat. No matter the diet. Sure, most fat farts like myself are self-induced, whether they want to admit it or not (I cannot stand those who are angrily defensive about it - your doing, deal with it fatso!) but it is that person's decision one way or the other. Don't judge them, and at the same time do not pity them. Addictions are a personal doing - be it food, alcohol, nicotine, drugs - so it is up to that person to make the decision what they do.

Now, as to those Tabulam hippie sailors...

[xelasnave]

Lewis there will be no revolution I feel that would be a sheer waste of time I would go straight to the reign of terror.
There will of course be no prisons as all crimes will be a capital offence.
Thank you for sharing your experience and as always I find your input delightful.
Although the following will show my right wing tilt I think I should outline my new world order as to education and religion.
Education free but only one school..no private schools or anything that may erode equality of learning.
All religion superstition and black magic will be a crime...the government will be small because there won't be many left after the reign of terror.
Tabulam will of course become the National capital and all shipping will be sail power only.
Alex

[casstony]

On the subject of obesity, while acknowledging that habits are hard to break, if bread, pasta and sweets are eliminated from the diet the kilo's will fall away.

Eat as much vegetables (excluding potato), fruit and lean meat as you need to feel full. After a few weeks the cravings for sugar and bread are gone and you can reintroduce modest amounts once the desired amount of weight has been lost.

[xelasnave]

Yes...eating sweets.. having too much bread.. Crimes for sure.
But only red or green vegetables.
Alex

[ChrisV (Chris)]

Medication is not the problem in itself. The problem is the type of pain and how it is diagonsed/treated.
- The big problem pain is chronic pain and that is not always fixed by opioids. There others drugs and other treatment options.
- Compounding that, your average GP does not understand chronic pain. Or that they should refer patients with intractable to pain specialists - just as they refer to cardiologists etc etc. Is easier to hand over the drugs.

And wait till I get on my soap box ...

[xelasnave]

When I had the business I employed a guy who was previously a medical sales rep.
He told me some stories about the incentives that were offered to GPs which no doubt would not go on these days.
But it seemed strange to me that such things went on in the world
Alex

[Renato1 (Renato)]

According to the Tucker Carlson Tonight program on Fox News (which has been following this issue intensely), the opiate addiction epidemic in the USA started when under the Obama administration changes were made to how the drugs were prescribed. Previously, Doctors had to prescribe the opiates, but with the new rules, big pharmacies could prescribe them as well as the Doctors. And the prescriptions soared under the new regime.

We haven't done such a silly thing in Australia, so I don't expect the epidemic to take off here.

Funnily enough, as bad luck would have it, a disc in my back disappeared at the beginning of March, resulting in my being on Targin 20mg (equal to four slow release Endones of 5mg Oxycodone) twice a day for eight weeks till my back operations took place. And I had to live day and night on my bean bag, since I couldn't sit, stand or walk for more than a few minutes. The initial drugs I got from the GP were codiene and Tramadol, which were totally useless. The Doctor in hospital said that Targin and Lyrica are the drugs that work for bad back pain - and he was right - I could brush my teeth standing up without being in total agony after using them.

After the operations, I was on the two Targins a day plus five or six Endones a day for another three weeks (i.e. equivalent to 13 to 14 Endones a day). Then I eventually went to one 20mg Targin a day for a few more weeks, without which it would have been impossible to do the out-patient rehab physiotherapy execrcises. Then I dropped to 10mg Targins, till I took my last one about two weeks ago, when I switched to the lower powered Tramadols. One problem during that period was that I would forget to take the pills, and wind up with lots of leg and back pain before being forced to take them.

At the moment I'm puzzling over whether I am an opiate addict, as every so often I REALLY need the pain-killers, though that coincides with pain from my having done some difficult exercise or activity, as I push myself trying to get back to normal. Anyhow, my intention is to do what my doctors tell me, namely to keep dropping the dosage of pain-killers as the level of pain drops, and see what happens.

Regards,
Renato

[xelasnave]

Hi Renato
Thank you for sharing your experience and I must say that I am sorry to hear that things have not been the best.
However it would seem yours is a case where there is genuine need and I don't think you should worry too much...just get better.
My only thought would be to caution you on trying to do too much..rest may be the best thing.
I wish you all the best for the future and hope you achieve a full recovery.
Alex

[casstony]

Originally Posted by Renato1

At the moment I'm puzzling over whether I am an opiate addict, as every so often I REALLY need the pain-killers, though that coincides with pain from my having done some difficult exercise or activity, as I push myself trying to get back to normal. Anyhow, my intention is to do what my doctors tell me, namely to keep dropping the dosage of pain-killers as the level of pain drops, and see what happens.
Regards,
Renato

Slowly weaning off is the way to avoid excessive symptoms, but if you only need the drugs intermittently you're not addicted.

My wife's side of the family has bad backs and a few (successful) fusions. The doctors recommended walking, swimming and laying down during the lengthy recovery and to avoid sitting. No bending or lifting at all.

[Renato1 (Renato)]

Originally Posted by xelasnave

Hi Renato
Thank you for sharing your experience and I must say that I am sorry to hear that things have not been the best.
However it would seem yours is a case where there is genuine need and I don't think you should worry too much...just get better.
My only thought would be to caution you on trying to do too much..rest may be the best thing.
I wish you all the best for the future and hope you achieve a full recovery.
Alex

Thanks very much Alex.
It pretty much depends which procedure one has. Some require heaps of rest and no heavy lifting, whereas I had no restrictions from day one - and the Rehab staff try push one to the point of soreness, but not to the point of pain, which makes one useless for exercises the next day. And I've been doing that since I came home, as when I push too hard, because of the subsequent pain, rest becomes automatic for the next day or two.

I am now infinitely better off than before I had the operations, and count my lucky stars. Had this happened to me say 30 years ago when such operations weren't routine, my life would effectively have been over.
Cheers,
Renato

[Renato1 (Renato)]

Originally Posted by casstony

Slowly weaning off is the way to avoid excessive symptoms, but if you only need the drugs intermittently you're not addicted.

My wife's side of the family has bad backs and a few (successful) fusions. The doctors recommended walking, swimming and laying down during the lengthy recovery and to avoid sitting. No bending or lifting at all.

Thanks Tony,
While for most of that time I could skip the drugs without problem, more recently I noticed that on some days I suddenly and inexplicably get very cold and sleepy, and have to go off to bed. I'm not sure if that's a sign of addiction or not. Regardless, I keep trying to increase the time between having to take the pills.

Yes, sitting is the worst activity I had, which made using my computer a very quick activity. My bean bag has been the best thing I had, as there was always a position on it that minimized or eliminated pain.

The activity which caused me the most grief was splitting wood. I have only just now gotten to the point where I can split it without having significant pain later.
Regards,
Renato

[xelasnave]

Renato...
Splitting wood !!!!
I can't imagine any thing worse.
Talk about do or die approach.
Buy a block splitter.
Alex