Quote:
Originally Posted by zikzak
Nope. I qualified my language because I knew who I was responding to. Now I'm watching the back and forth. At no point was I arguing, except now, with you, because you're trying to ride JTM's coattails without bothering to make substantive points of your own even though this is one topic where you actually do have expertise.
This is fair.
So fine, I'll answer the OP. And critique where you guys are wrong.
Quote:
Originally Posted by will1530
So it's your contention that Purdue did not actively lobby doctors to convince them that q12h was the only appropriate way to prescribe oxy? Not only that, but they welcomed q8h schedule because profits would be higher?
Purdue Pharmaceuticals -- specifically the drug reps -- are only allowed to lobby doctors to prescribe the medication per the FDA indications. It is approved for q12h dosing. So they cannot solicit doctors to write it for q8hours. That's a fact.
It wasn't
marketing that Purdue kept up the q12hour campaign. It's because that's all they have FDA approval for and all they legally can advertise for, solicit for, and advise.
Could Purdue have went back and gotten q8hour study data? Sure. But why when they were making sick profits? Clinical trials are expensive.
So, back to the OP question:
Is "Big Pharma" responsible for the heroin epidemic?
You have to work backwards.
Why do we have a heroin epidemic now and no longer an OxyContin epidemic like we did 8-10 years ago? Because we (the government, the people) crushed all the pill mill doctors. Nearly all states now require every narcotic prescription to be entered into a state database. And states now all share this data. So now you can't doctor shop anymore. The state system will flag it when you try to fill the prescription.
So street OxyContin isn't as readily available anymore. And the few that are, via supply and demand, cost much more. So the addicts go with a cheaper fix. Heroin. And the problem with heroin is that the potency isn't known. It's a white powder. Is it cut with corn starch? Or is it 100% pure.
Why didn't we have the deaths 8-10 years ago. Sure, we had the addictions, and the street crime, but we didn't have the deaths.
And that's because the addict new his/her limit. OK, I can crush and snort 40mg OxyContin and feel good. And sure, they can keep titrating up. But they are dealing with
known quantities.
With heroin, fentanyl laced heroin, you just don't know. Fentanyl is measured in ****ing MICROGRAMS guys. Some hot shot drug distiller could have had a "lucky" pure batch and instead of making his crap heroin a little stronger, instead made every hit a death sentence.
Further backwards.
Why did we have an OxyContin epidemic? Because Americans are coddled to not have pain. Our doctors taught that pain is the 5th (or 6th, I don't know) vital sign. Doctors want to stop the pain. Give more narcotics. Pharmacies want to sell the pills to make more money. More prescriptions more money.
Humans become more and more tolerant to the analgesia effects of higher and higher doses of narcotics. So give them more! But not the side effects. So these patients are constipated, tired, and nauseous. Can't hold a job because they suck at work now. Go on disability. Nothing to do now but take more pills. You know how you liberals always say, a gun in the house makes the house more unsafe. It's the same thing with pills. More pills in the house more risk of theft from children, family, etc. Now more pills on the street. Cycle repeats. More addiction. More life's ruined.
Did "Big Pharma" cause Americans' heroin epidemic? No.
The opium poppy has been around since antiquity. Oxycodone has been around for one hundred years. All Purdue did was rap a fancy long-lasting coating on an old drug. So what, it didn't last for 12 hours instead maybe only 8-10 hours instead. But Purdue was just responding to demand. And if it wasn't extended-release oxycodone it would have been another drug, or another drug company. We have extended-release everything now. Fentanyl, hydromorphone, morphine, whatever.
It doesn't matter.
We stopped the pill mills. And the doctor shopping. But now these addicts just get heroin where the potency is unknown. And this is why they are all dying.
We treat pain like a vital sign. And patient's expect a pain score of 0. To get to a zero that patient feels euphoria from the opioids. And wants more and more. A viscious cycle.
Opioids have a role of course. But they are overused in this country. To deal with chronic pain. Or even ****ing headaches like JTM posted.
Anyway. We created this cycle. By wanting to be pain free from this sometimes painful life.
There ya go.