Medical Doctors / General Practitioners

[drkitten]

And yet those things happened while drugs are illegal.

My apartment was broken into a number of years ago, and I lost several thousand dollars worth of stuff.

This happened while burglary was illegal. Is this an argument for legalizing burglary, or for better enforcement of the laws against burglary?

 

[Richard Masters]

My apartment was broken into a number of years ago, and I lost several thousand dollars worth of stuff.

This happened while burglary was illegal. Is this an argument for legalizing burglary, or for better enforcement of the laws against burglary?

Burglary is almost always expected to result in intentional harm or injustice by an aggressor.
Drug use is not.

 

[drkitten]

Burglary is almost always expected to result in intentional harm or injustice by an aggressor.
Drug use is not.

A friend of mine had her car wrecked by a drunk driver. Driving while drunk is not expected to result in intentional harm. I assume, therefore, the fact that drunk drivers are more dangerous than sober ones means that drunk driving should be legalized?

 

[Richard Masters]

A friend of mine had her car wrecked by a drunk driver. Driving while drunk is not expected to result in intentional harm.

But it is expected to substantially and directly harm people who had no control over that choice.

I assume, therefore, the fact that drunk drivers are more dangerous than sober ones means that drunk driving should be legalized?

No. Doesn't follow.

 

[drkitten]

But it is expected to substantially and directly harm people who had no control over that choice.

Which is exactly the situation cited upthread by gdnp. In their words, "I used to be against anti-drug laws, but I changed my mind as I saw the consequences of drug use were not limited to the users."

 

[Richard Masters]

Which is exactly the situation cited upthread by gdnp. In their words, "I used to be against anti-drug laws, but I changed my mind as I saw the consequences of drug use were not limited to the users."

The negative consequences of driving are not limited to drivers either. That's why it's OK to drink alcohol, but it is not OK to drink alcohol and drive.

That doesn't mean we outlaw driving.

 

[The Atheist]

My apartment was broken into a number of years ago, and I lost several thousand dollars worth of stuff.

This happened while burglary was illegal. Is this an argument for legalizing burglary, or for better enforcement of the laws against burglary?

Attack the argument and keep it civil, please.

Replying to this modbox in thread will be off topic  Posted By: Tricky

Taking drugs is a victimless crime, burglary isn't. The worst part is, you know that, but said it anyway.

Genius.

 

[Miss_Kitt]

So, to get back more-or-less on topic, I think where the thread is at is:

Most of the posters agree that some substances need to have at least intermittant medical consultation. The question then is, how do you determine which can be bought without? RM thinks that if one can demonstrate being reasonably smart and educated, one should be allowed to self-prescribe pretty much anything--though each group of similar drugs might have a separate "fitness to self-prescribe" exam. (Do I have that right, sir?) Others believe that the requirement for a doctor's (or nurse practitioner's) consultation is overall a better choice for public safety.

Much of the argument seems to depend upon whom one expects to 'clean up the mess' when the system fails (as it will, inevitably, regardless of whom is prescribing). When the solution, explicitly or implicitly, is that the taxpaying public will take care of damaged folks, support the underage children of ODs that die, etc. it makes sense to look more toward controls. If it is possible and enforcable that only the self-prescriber lives with the consequences of a bad decision, it may be better to let them take control. The devil, as always, is in the details...

An early poster reminded me that prescriptions usually are good for a number of refills over a period of time (no longer than a year). A good rule of thumb is that the more 'abusable' a drug is, the more frequently you need to check in. I don't know if that is a regulatory requirement, or just a safety rule that doctors follow. (Linda? and any US physician we have?) I will disclose that I have a non-renewable scrip for 15 or 18 Vicodin, which I take when I have a "big M" Migraine headache (the kind where you want to die) as opposed to a normal migraine, which yields to less vigorous meds. I know if I wanted that renewed in less than a year, my doc would want to find out why I was out so soon...conversely, my nasal spray for my spring allergies I refill until the season runs out, and it's not a big deal.

RM, does your doctor have you on a very 'short leash' in terms of refills, or is it just that the need for a med check visit came at a bad time economically?

 

[Richard Masters]

So, to get back more-or-less on topic, I think where the thread is at is:

Most of the posters agree that some substances need to have at least intermittant medical consultation. The question then is, how do you determine which can be bought without? RM thinks that if one can demonstrate being reasonably smart and educated, one should be allowed to self-prescribe pretty much anything--though each group of similar drugs might have a separate "fitness to self-prescribe" exam. (Do I have that right, sir?)

Yes, that's pretty much what I was saying, though I would prefer reasonably careful instead of reasonably smart as one of the core criterion. A practicable intuitive understanding of statistics (correlation vs causation) would be a plus.

Others believe that the requirement for a doctor's (or nurse practitioner's) consultation is overall a better choice for public safety.

I just want to add that I consider current policy to be adequate in terms of safety, but also too restrictive under some circumstances.

Much of the argument seems to depend upon whom one expects to 'clean up the mess' when the system fails (as it will, inevitably, regardless of whom is prescribing). When the solution, explicitly or implicitly, is that the taxpaying public will take care of damaged folks, support the underage children of ODs that die, etc. it makes sense to look more toward controls. If it is possible and enforceable that only the self-prescriber lives with the consequences of a bad decision, it may be better to let them take control. The devil, as always, is in the details...

I believe you can preemptively 'clean up the [bulk of] the mess' through driver-like licensing.

An early poster reminded me that prescriptions usually are good for a number of refills over a period of time (no longer than a year). A good rule of thumb is that the more 'abusable' a drug is, the more frequently you need to check in. I don't know if that is a regulatory requirement, or just a safety rule that doctors follow. (Linda? and any US physician we have?) I will disclose that I have a non-renewable scrip for 15 or 18 Vicodin, which I take when I have a "big M" Migraine headache (the kind where you want to die) as opposed to a normal migraine, which yields to less vigorous meds. I know if I wanted that renewed in less than a year, my doc would want to find out why I was out so soon...conversely, my nasal spray for my spring allergies I refill until the season runs out, and it's not a big deal.

RM, does your doctor have you on a very 'short leash' in terms of refills, or is it just that the need for a med check visit came at a bad time economically?

No, my doctor is surprisingly relaxed with me about non-refillable medications; and that's very helpful (though it is still a pain to wait up to 2 hours for a medication and get occasional suspicious or curious looks from pharmacy agents every month. But that's part is not up to my doctor, obviously).

The main issue was a relatively small payment on a previous visit I couldn't yet afford. He wrote the prescription with the warning that I'd need to make the payment before he issued any future prescriptions, but the withdrawal effects of one of the less-controlled medications were basically intolerable, and I was upset that I had already been forced to abruptly discontinue a medication that you are supposed to gradually come off of.

Any future payments were contingent on being able to take one of the two medications I had been prescribed.

But additionally, there have been many times with idiopathic symptoms when I can tell which medications are being prescribed off-label and why, and it seems like it would be cheaper, faster, and more convenient to do the trials myself at my own pace, preferably with the input and advice from a doctor when I can afford one, but to have the ability to omit that option when I can't afford it or feel like the visit is unneeded.

 

[KoihimeNakamura]

Glad to see you haven't found any brains since last time I conversed with you, doc.

Idiotic non-analogy.

Taking drugs is a victimless crime, burglary isn't. The worst part is, you know that, but said it anyway.

Genius.

I think the people who have died to DUI drivers have a word to say about that.

Or the two people cited in GDNP's post. You know, the victims in those victimless crimes?

 

[Roboramma]

Glad to see you haven't found any brains since last time I conversed with you, doc.

Idiotic non-analogy.

Taking drugs is a victimless crime, burglary isn't. The worst part is, you know that, but said it anyway.

Genius.

Considering that the analogy was used only to point out that things that making things legal doesn't make them less likely to occur, it seems pretty apt to me.

Moreover, reread the post that she was responding to: it's your attempt to suggest that the victims of drug abuse (ie. those that gdnp references) are somehow victims of the illegality of drug abuse. An odd point to make if drug abuse is a victimless crime.

 

[Richard Masters]

I think the people who have died to DUI drivers have a word to say about that.

Or the two people cited in GDNP's post. You know, the victims in those victimless crimes?

Was the crime drinking? Or drinking and driving?

It's like saying using a cell phone, ever, should be illegal because driving under the influence of a cell phone results in crimes with victims.

 

[The Atheist]

I think the people who have died to DUI drivers have a word to say about that.

Or the two people cited in GDNP's post. You know, the victims in those victimless crimes?

Fail.

What does drinking and driving have to do with taking drugs?

(I can answer that - nothing.)

You do realise that taking drugs and committing crimes while under the influence of drugs are two different things as well? I sincerely hope so after you quote DUIs, because I bet you're not a prohibitionist.

Considering that the analogy was used only to point out that things that making things legal doesn't make them less likely to occur, it seems pretty apt to me.

The drug legalisation/prohibition debate isn't only about the number of users and your point is also irrelevant to anything mentioned so far.

(Plus, there's a good deal of evidence from places which have legalised/decriminalised drugs to show that it is indeed the case that usage falls.)

Moreover, reread the post that she was responding to: it's your attempt to suggest that the victims of drug abuse (ie. those that gdnp references) are somehow victims of the illegality of drug abuse. An odd point to make if drug abuse is a victimless crime.

Considering that wasn't the point I was making, I'm happy to agree that it would be silly to suggest that.

What I did in fact do, was ask whether the people who are demanding prescription-only drugs are for or aganist prohibition of illegal drugs.

If they aren't, then they don't have a problem.

My original point was that I believe there should be no illegal drugs, therefore if one can obtain heroin or crystal methamphetamine without a prescription, my view is that people should equally be able to access what are now prescription drugs as well.

I've found that lots of skeptics feel the same way I do on illegal drugs, so I wanted to check to see whether any positions are being held hypocritically, as I suspect is the case.

Whether you agree or disagree on the legality of drugs is quite irrelevant to the question.

 

[Miss_Kitt]

(snippage)
What I did in fact do, was ask whether the people who are demanding prescription-only drugs are for or aganist prohibition of illegal drugs.

If they aren't, then they don't have a problem.

My original point was that I believe there should be no illegal drugs, therefore if one can obtain heroin or crystal methamphetamine without a prescription, my view is that people should equally be able to access what are now prescription drugs as well.

I've found that lots of skeptics feel the same way I do on illegal drugs, so I wanted to check to see whether any positions are being held hypocritically, as I suspect is the case.

Whether you agree or disagree on the legality of drugs is quite irrelevant to the question.

Italics Added.

TA -- I'm sorry, I didn't follow your statement (italicized above). I mean that quite literally, I am uncertain of how to construe it grammatically. What do you mean by "people who are demanding prescription-only drugs": People who are demanding that some drugs be available by prescription only? Or, people who are demanding access to drugs that are currently prescription only?

Then, how does "for or against" compare with "if they aren't"?

I've been enjoying the discussion, but I lost my Zen on this post.

Thanks for clarifying, MK

ETA -- Further down, you talk about having access to heroin versus access to prescription-only drugs. Well, you have exactly the same access today to drugs you don't have a prescription for as you do for heroin: You buy it illegally, and take your chances that the person who sells it to you is supplying you with the drug you want, and of the strength and purity reported. So I don't follow that, either? Maybe I'm up too late.

 

[gdnp]

And yet those things happened while drugs are illegal.

And would presumably happen at increasing frequency if they were legalized.

ETA: If others wish to continue this discussion, you could start or resurrect a thread on legalizing drugs. I'm sure this has been discussed in the past. It threatens to derail this thread.

I continue to believe that some drugs should be available only by prescription. Whether certain prescription drugs should be made available over the counter should be handled on a case by case basis. Whether there are drugs that should be given infinite refills is perhaps also worthy of discussion.

I don't like the idea of allowing people to buy drugs without a prescription once they have passed a test. Even if they demonstrate that they understand the dosage, side effects, interactions, etc of the drug, how do they demonstrate that they have the diagnostic skills to determine if the drug is correct for them in the first place?

 

[The Atheist]

Thanks for clarifying, MK

Yes, sorry, it doesn't read well at all - missing a word.

Just trying to find whether those insistent that phramaceutical drugs be prescription-only are for or against decriminalisation/legalisation of narcotics.

ETA -- Further down, you talk about having access to heroin versus access to prescription-only drugs. Well, you have exactly the same access today to drugs you don't have a prescription for as you do for heroin: You buy it illegally, and take your chances that the person who sells it to you is supplying you with the drug you want, and of the strength and purity reported. So I don't follow that, either? Maybe I'm up too late.

No. It's not - in my experience - possible to buy prescription drugs from drug dealers, aside from a few with mind-altering potential; diazepam, fluoxetine, etc, which are much harder to find than narcotics, cocaine, etc.

 

[Tim Moen]

I'm with you Atheist. Anybody who claims to love liberty should agree that what one person does with their own body is their own business. A drug vendor should be able to sell to any consenting adult, just like any consenting adult should be able to benefit (or harm themselves) by consuming any substance they desire, without having to get permission from a 3rd party.

 

[Gord_in_Toronto]

I'm with you Atheist. Anybody who claims to love liberty should agree that what one person does with their own body is their own business. A drug vendor should be able to sell to any consenting adult, just like any consenting adult should be able to benefit (or harm themselves) by consuming any substance they desire, without having to get permission from a 3rd party.

And if that drug turns the recipient into a raving, homicidal berserker who then chops off the head of some random person, oh say, Tim Moen, what then? Civilization imposes constraints on all its members. That's why it works. If you don't like it, there are a few empty caves left for occupancy in the World.

 

[Richard Masters]

And if that drug turns the recipient into a raving, homicidal berserker who then chops off the head of some random person, oh say, Tim Moen, what then?

Then that drug is expected to result in crimes against others, and taking it would be the equivalent of chopping someone's head off.

Then you would have a real case against it, but not against all drugs under all circumstances.

 

[Richard Masters]

Whether certain prescription drugs should be made available over the counter should be handled on a case by case basis.

That hasn't really happened yet because the FDA is not willing to pay its self-generated overhead costs.

I don't like the idea of allowing people to buy drugs without a prescription once they have passed a test. Even if they demonstrate that they understand the dosage, side effects, interactions, etc of the drug, how do they demonstrate that they have the diagnostic skills to determine if the drug is correct for them in the first place?

Besides what had already been presented? Presumably by doing the research and/or consulting as needed with a doctor.