Opioid Epidemic

For those who might have missed it, this discussion began with the Morphine thread under General Discussion.

A young woman I know, 27 years old, died of an overdose of who knows what, something she injected, last week. My guess is heroin laced with fentanyl. I am not related to her, but she was related to people I am related to. She was raised by a single mom, drug addict, 5 kids from 5 dads, and struggled between taking care of her siblings, who were younger, and falling into her mom's bad habits, probably because that's the life she knew.

She got into a fight with her husband, possibly over her use of drugs or her desire to return to them, I don't know for sure, called the cops and got her mom to back up her story that he was abusing her, got him jailed, went out with $250 and came home with $5 and a boyfriend. When the boyfriend woke up she was dead.

The husband is sort of a Forrest Gump type, he's devastated, left with two small kids.

So, this subject has been on my mind this week. Again. My first wife died of an overdose about a year after our divorce. I spent many years as a nurse, mostly ER and ICU, I've seen all aspects of this, up close and personal.

It is a complex problem.

I'd like to start by saying that I really appreciate @Sketch6995 's remarks concerning Suboxone. So far, he's dead on the money with everything I read in the Morpine thread. I'll give one example of someone I've known, then leave this for awhile because I've got stuff to do.

I know a patient who'd been addicted to morphine since he was a small child. At the time I met him he was in his 4th decade of life, and using 300 - 500mg of morphine daily. Yes, you read that right and I typed it right. His life was a wreck, lived off his parents, slept 18 hours daily, and was worthless for the other 6 hours. After 2 years of Suboxone he was down to 6 - 8 mg of suboxone weekly, yes weekly, skin and eyes clear, holding a full time job, and no arrests or court actions in that 2 year period.

That is nothing short of miraculous.

Your turn:

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Sketch6995

Moving here.

Here in Colorado you can just walk in to the pharmacy and Purchase narcan.
And while it is great for reversing an overdose it doesn't do anything to help you stay clean.
I carry one around in my truck with me wherever I go, and it cost me 250 bucks for a single dose. I had an occasion to use it in a Family Dollar store a few months ago.
It is something of a miracle drug. When you see some overdosing girl all gorked out on the floor not breathing, And you spray that stuff in her nose, They wake up and start swearing to God and Sonny Jesus that they didn't take any heroin.
It can save lives and it does.
But in order to stay clean you need suboxone..... That's stuff prevents you from being able to get high on narcotics. Because it contains 2mg of narcan. People who really want to change their lives need this drug.
Not only does it prevent you from getting high, But it also prevents withdrawal symptoms.
Anyone who's ever gone through withdrawals knows how horrible it is.
Yet the DEA makes it so hard to get that most people just give up.
It's also dreadfully expensive. $15 for a strip, And most people are perscribed 2 A-day.
Rocky Mountain medicaid will only pay for it if you are in their program. They will cut off payments from other doctors and refuse to pay for the prescription unless you join their program.
It's kind of a no win scenario can you say Kobayashi maru?

Sketch6995

I work with a lot of addicts a daily basis.
This thread is very important to me.

jd50ae

I watch all of the "Cop Reality" shows and I am amazed at how often Narcan is used to save a life and at how fast the stuff works. And yes @Sketch6995, they all deny using heroin or any drug.
This is the first time I have heard of suboxone, sounds promising.
Why is the stuff (both) so expensive? There is tons of it, so it would seem it is easy to produce. Is this another insulin price gouging type of profit making?

Sketch6995

I just wrote a big huge response and it didn't post and its lost now

Sketch6995

@jd50ae
Right from the beginning the drug companies misled physicians about the addictive potential of pain killers.
They gave the doctors a bunch of false information and cash incentives to use opiates for long term pain management.
But then they started touting how it was wonderful for a short term pain management as well.
Suboxone Has been around since 2003, But the doctor has to take special classes and get a special license to dispense it, From the DEA. Not only that but they're only allowed a handful of patients To begin with.
To get A prescription of you must fill out DEA forms at the doctor's office. Every month when you need a refill you have to come back to the doctor's office and fill out the same form.
Now the pharmacist has to go through special steps to dispense it. They will not fill it even one day early.

Next thing that happens is the drug companies partner with the insurance company and open a treatment center.
On its face it seems like a good idea.
But then the insurance company cuts off payments to the pharmacy. You're stuck paying cash they just deny payment out of the blue.
When you call them to find out why they try steering you towards their new treatment center. That is the only way they will cover your prescription. A months worth can easily be $700. And usually more.

So 1st they get you addicted to it, Then they try forcing you into their treatment center.

Something Stinks

Sketch6995

Here's a good article.

Sorry about the source but the facts are true.

http://thehill.com/opinion/healthcare/399867-some-treatment-options-for-opioid-epidemic-risk-serious-unintended

ForMud

That's the most ridiculous thing I've in a long time...You mean to tell me they have no problem with doctors passing out opiates like candy....But they make it that hard to get basically the same type of drug to help you get off it?

TX98Z28

I could share many stories involving numerous people but that’s the past and I’m never going back to it! When it comes to ANY drugs my personal advice is first don’t use them if not necessary, and if they are necessary use moderation and get the hell off them if you can’t. If not welcome to “The Trap”...

Sketch6995

ForMud said:

That's the most ridiculous thing I've in a long time...You mean to tell me they have no problem with doctors passing out opiates like candy....But they make it that hard to get basically the same type of drug to help you get off it?

That is exactly the case. Even though it cannot get you high, The DEA has a stranglehold on it. Even though it cannot get you high, They claim people will abuse it.
It's formulated to prevent Abuse

GaryThompson

Methadone clinics all over the damn place but this stuff is the boogeyman to "The Man"?

Diver43

I remember starting to listen to a politically motivated video talking about this. I thought it was BS and no way our Government and people in Government could do this. Boy was a wrong! A certain politician was given huge amounts of money to keep it going. Knowing that our politicians take so much from large pharmaceuticals makes me gag and don't get med going on the FDA and DEA

Sketch6995

Several years ago the DEA actually tried to do a good thing by preventing doctors from perscribing open ended narcotic prescriptions.
Our wonderful Congress critters banded together to Stop them.

https://www.washingtonpost.com/graphics/2017/investigations/dea-drug-industry-congress/?noredirect=on&utm_term=.d3af19a26fb8

Now this is one time I was in agreement with what the DEA were trying to do, unfortunately they were going about it in the wrong way.
In the end all that happened is people with cancer, painful and terminal illnesses were the ones that got screwed.

Amos_Umwhat

jd50ae said:

I watch all of the "Cop Reality" shows and I am amazed at how often Narcan is used to save a life and at how fast the stuff works. And yes @Sketch6995, they all deny using heroin or any drug.
This is the first time I have heard of suboxone, sounds promising.
Why is the stuff (both) so expensive? There is tons of it, so it would seem it is easy to produce. Is this another insulin price gouging type of profit making?

jd, in a nutshell the answer to your question is "yes". I've been prescribed buprenorphine, or "Talwin" as it used to be known for back pain in the late 80's, and Naloxone is another old drug that is no longer expensive to produce. A single dose, I'm guessing, should cost the drug company somewhere between 5 and 25 cents to produce, 50 cents max.

Which brings up the other thing the governmental / big pharma guys don't want to talk about, the stuff is a pretty damn good pain reliever! With no overdose potential, and no addiction. Now, why don't they want you to know that?

Oh, and I almost forgot, It's illegal in most states to prescribe it for pain management!!!
.

Sketch6995

@Amos_Umwhat

And today a single dose of that same drug is $250.

TX98Z28

Sketch6995 said:

@Amos_Umwhat

And today a single dose of that same drug is $250.

Pure damn greed!

YankeeMan

I'm glad this got started, I've been tied up at school lately with fall registration and haven't had too much time to check the site.

I did a presentation at school about the opioid epidemic in NC. Accidental overdoses has become the leading cause of death in NC. I called my presentation "Killer on the Loose." It is indeed an equal opportunity killer. No discrimination by race, gender, age, ethnicity, etc.

In Edgecombe County, where I live, the youngest to die from an overdose was a 6 year old and the oldest was 96. Narcan does indeed work, but it has to be administered immediately for it to work. Almost all of the first responders here carry it.

We all can help by insuring our meds are secure. If we have elderly parents, make sure they are taking the right medication and not in a fatal combination with other drugs. If you have to, make up their pill dispenser for them do so or take care of giving them the proper dosages.

ForMud

Canada is on the right track.
https://globalnews.ca/news/4062491/opioid-addiction-treatment-guidelines-suboxone/

dirtdude

We looked into suboxone as an option when my son decided to get off heroin last fall. There were no local options, doctors need a special license to dispense, would have been a daily trip to Tucson as they only give it a day at a time. After a few days cold turkey he was about to break, we went to Nogales and asked a pharmacy down there, they only have buprenorphine, got 10 for like $80, it was enough to take the edge off for sonny and he has been clean since. He has a job interview next week and looks to be ready to re-join society.

Sketch6995

@dirtdude
That's a great story. It's just too bad you had to go to Mexico to get it but I'm glad it was cheaper.
The DEA has had a stranglehold on that drug since it was invented in 2003.
Almost like they don't want people to get better they would just rather see them die.

Amos_Umwhat

Makes you wonder, is it just coincidental that the "opioid epidemic", which I guarantee you has been going on since the invention of opioids, is only recognized after we owned the trade in Afghanistan?

When the opioids (hydro and oxycodone) are taken away, the addicted quickly find a source of opiates (natural derivatives, opium and morphine and heroin).

Anyone here remember who was bringing in the opiates when we owned Vietnam?

Amos_Umwhat

Sketch6995 said:

unfortunately they were going about it in the wrong way.
In the end all that happened is people with cancer, painful and terminal illnesses were the ones that got screwed.

This is a good point, and another side of the issue. Two things, there are people who need opioids to live anything like a normal life, and there are people who don't end up addicted. They may be dependent, but that's a different thing.

I have to use myself as an example here. For a long time I took hydrocodone or oxycodone every day. By long time, I mean years. The insurance company wouldn't approve my knee replacement, which was the only solution left when I was only 42 years old. Had to wait another 10 years for that, and my right shoulder had 3 labral tears and the rotator cuff was completely torn up and all the cartilage was worn from my humoral head, still is.

At my peak usage, just prior to the knee replacement, I was taking 6 or 8 10mg oxycodone's daily, just to be able to function normally. Once I started recovering, and the pain lessening, I just cut it down gradually. No problems whatsoever. After the rotator cuff surgery, which was nowhere near as painful as the knee, I cut down more and more until I got where I am today, which is every once in a while, maybe couple times a month or so, I take a hydrocodone. No problem.

The point being that if I based my opinion solely on my own experience, I'd think that this was all nonsense. BS, there's no such thing. But there is, and it is. I just got the right genetics. There are many intelligent, moral, upstanding people who aren't so lucky. Within a couple weeks of starting on an opioid they are truly on a bad road. In no time flat they are seeking more and more and more...until they die in their addiction. It breaks my heart to see it.

Currently there is some amazing research being done in this field, identifying genetic markers and patients who are more or less likely to be able to use these, and other, meds and treatments. Who knows where that might lead? Also, PTSD is a major factor in addiction predisposition, especially as related to childhood problems that many of the victims have suppressed to a point where they absolutely deny that they could possibly have PTSD. But they do. I don't know if it's still available online, but if you're interested in that try looking up a study called "ACES too high". Very interesting stuff.

jd50ae

One thing is not talked about much.
Laws are for honest people. And you can bet the only ones that will suffer any consequences at all, from any new laws, will be the people who really need the pain meds.
About half the doctors (probably more) in this area will not even prescribe them because of the paperwork they are forced to put up with. And the ones that do force their patients to go through a drug screening. No accusation of drug abuse, no arrest on drug charges and the doctor's office becomes an arm of the law.
Meanwhile my drug abusing step kids chuckle about how easy it is to get it on the streets. And china and mexico smuggle tons into this country.

Sketch6995

@jd50ae
Exactly right.
We always need to remember that there are people who are in legitimate need of these medications. Now I tout the benefits of medical marijuana wherever I can, but even I am forced to admit there are some levels of pain it cannot deal with.
And they are always the 1st ones to suffer when people start to abuse it.

Sketch6995

3 years and well over 250000 spent on legal fees and we finally beat the shouters, pouters and doubters.
I have been asked a million times why don't I just give up? How much money are you going to waste on a lost cause they say? They say I'm never going to win this battle. Once I sink my teeth in I will never be dislodged.
O and I'm not done yet. I won't be done until the school nurse can administer the meds, Instead of the family having to leave work to come to the school to administer medications.
And in case some knucklehead is wondering.... No elementary school child smokes marijuana, It's usually given in drops under the tongue or in pill form.

dirtdude

Keep after them @Sketch6995, you are a warrior bro.

Diver43

@Sketch6995 they have taken the first step here in South Florida.
Some may call it a baby step, but at least its a step in the right direction.

https://www.nbcmiami.com/news/local/Broward-Schools-Set-New-Rules-on-Medical-Marijuana.html

Sketch6995

@Diver43
Very nice.

jd50ae

We have to get the opioid lobbyists out of the TN lawmakers offices to do anything positive.

0patience

The painkiller problem has to get sorted out.
When the US has problems getting products shipped, because half the truck driving force is no longer allowed to drive, because they are now testing for painkillers on the DOT drug testing, then maybe the problem will get looked at.

If you test positive for any painkillers, like Vicodin, hydrocodone or any of those, you can lose your commercial driver's license.
There are exceptions, but a person would be surprised at how many are using painkillers.

They can't take painkillers, can't use CBD or pot, then what?
How does a person do pain management, if everything is prohibited?

0patience

This is just like over the counter asthma meds.
Ephedrine and Epinephrine are the primary ingredients for asthma meds over the counter.
And since it also can be used to make meth or what ever it makes, all of the over the counter meds that were available to folks without a prescription are no longer available.
Primatene, one of the leading OTC asthma meds now requires a prescription in a lot of states and went from $15/box to $50/box.

So let's not deal with the actual problem, let's make the law abiding people who need the product suffer.
The good ol' US of A way.