The Opioid Crisis

crescent said:
Did you know that acetaminophen/paracetomol/Tylenol and ibuprofen/Advil/Motrin are different enough to allow full doses of both to be taken at the same time? They can be more effective in combination than alone?
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In America you can find "Migraine Strength" pain relievers that contain Aspirin and Acetaminophen. I am not allowed to take either, but when I feel a migraine coming on I do take it, and it helps, sometimes avoiding a whole debilitating episode. The same doesn't do much for the back/joint pain that is nearly constant.

The narcotics have little to no impact on migraine onset.

Belz... said:
I think the question is in what way does this affect dosage? If it doesn't, then Sadhatter is asking what the problem is. I think you're talking past one another.
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The dosage, for my spouse, works out to slightly less that half what she was getting. I don't know how that could be missed in what I've posted.
 
The Greater Fool said:
In America you can find "Migraine Strength" pain relievers that contain Aspirin and Acetaminophen. I am not allowed to take either, but when I feel a migraine coming on I do take it, and it helps, sometimes avoiding a whole debilitating episode. The same doesn't do much for the back/joint pain that is nearly constant.

The narcotics have little to no impact on migraine onset.



The dosage, for my spouse, works out to slightly less that half what she was getting. I don't know how that could be missed in what I've posted.
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My wife's neurologist has told her the opioids tend to make the migraines worse. She's trying to cut back on them for that reason. But her back really doesn't want her to.

Pharma advertising has been mentioned a couple of times in the thread. While there's a whole lot wrong with it, I don't think the opioid crisis is one of them. Opioids are generic and cheap. And Pharma doesn't really need to advertise to sell them.

I personally avoid them strenuously because of what they do to my GI tract. When I got hurt five years ago I spent four or five extra days in the hospital because my intestines had flat shut down. They were sucking my stomach contents out through my nose. That was lovely.
 
Belz... said:
Ok so that was the claim. I was a bit confused as well. The issue is not the amount of medecine in the bottle but how much she can take daily.
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The claim is that my spouse will receive 1/2 of the active ingredients in her medicine for the same period of time the medicine is intended to be active.

Perhaps the problem is some people can't grasp how the Governor would sign a bill that, despite medical need, has limited what Doctors can prescribe their chronic pain patients. Not the number of pills or patches, the total dosage of those pills and patches.

I would not be complaining or worried if my spouse could get her medications in a different form or on a different schedule, as long as it handles the pain. It will not handle her pain, and I'm not going to sit by and allow her to suffer until she decides to end it.

Trebuchet said:
My wife's neurologist has told her the opioids tend to make the migraines worse. She's trying to cut back on them for that reason. But her back really doesn't want her to.
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It's hard to compare apples to apples on this. I've gotten migraines my entire adult life (I don't remember my childhood, so who knows there). They were more frequent when I was younger, perhaps one a month(ish). Now, one a year seems more like it.

I personally avoid them [opioids?] strenuously because of what they do to my GI tract. When I got hurt five years ago I spent four or five extra days in the hospital because my intestines had flat shut down. They were sucking my stomach contents out through my nose. That was lovely.[/QUOTE]
I don't find I have that issue (nor does my spouse).
 
What helped my bad back was not Oxycontin but dropping 50 lb and exercising and keeping the weight off my midsection
 
applecorped said:
What helped my bad back was not Oxycontin but dropping 50 lb and exercising and keeping the weight off my midsection
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Many people seem to underestimate the extra pounds that are making the pain worse. I started to think about having a 10 or 15 pound sack tied to my body 24/7.

So, watching my weight, trying to get exercise daily, 40 mgs of Oxycodone a day, while trying to maintain a sense of humor, seems to get me through chronic pain and help prevent it from becoming unbearable.
 
Fudbucker said:
Focusing on the drug of choice is not going to solve the problem. We have to understand why people in this society are self-medicating so much.
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How does America compare to other first world countries in drug use? Is there no prob in Germany, France, UK?
 
casebro said:
How does America compare to other first world countries in drug use? Is there no prob in Germany, France, UK?
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Pretty bad overall. Our numbers both for opioid use and opioid overdoses are substantially higher than in other comparable countries.

But those countries, in general, don't have drug advertising (or at least anything resembling it's form in the US) and have much higher restrictions on opioids, doctors don't prescribe them nearly as much and insurance doesn't cover them nearly as much but that's the thing we're being told we can't do because it will be a burden on chronic pain suffers.

https://www.vox.com/policy-and-politics/2017/8/8/16049952/opioid-prescription-us-europe-japan
 
wasapi said:
Many people seem to underestimate the extra pounds that are making the pain worse. I started to think about having a 10 or 15 pound sack tied to my body 24/7.

So, watching my weight, trying to get exercise daily, 40 mgs of Oxycodone a day, while trying to maintain a sense of humor, seems to get me through chronic pain and help prevent it from becoming unbearable.
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Exactly. There are a number of methods of helping to diminish pain. For mild to medium level pain these, plus perhaps taking Tylenol and ibuprofen may be enough. But for truly intense pain, such as that experienced by my Dad, or by you, dropping one's weight, exercising more, and taking an over-the-counter analgesic are not going to eliminate the need for opioids. I fear that too many people do not truly understand this and that together with their misperceptions about the risks of opioids when used under medical supervision, these misunderstandings will result in some horrendous laws.
 
The Greater Fool said:
Then be astonished.

Here, in AZ and in most states, you can only get a 1 month supply of narcotics. That has not changed. What has changed that in my spouse's case, the new Law allows her only half of what she's had for 20 years. That's 50%. That's how I define 1/2.
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Please post a link to the law as you are being very obtuse.
 
sadhatter said:
Please post a link to the law as you are being very obtuse.
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Obtuse?
Klimax said:
Direct link to law would be better. Reporters damn too often get things wrong.
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I was unable to find the text of the actual law. However, this PDF from the AZ Governor website should do you the trick. Page 14 is the one that clobbers my spouse, who was at about 180 MME. The exemptions spoken of are for cancer or dying patients. Basic Chronic Pain folks don't qualify.

The new max = 90 MME. As I said, and no I have no documentation, the 2 certified Pain Specialists (my spouses and mine) both are not inclined to go over that value as they don't want AZ and DEA in their lives. My spouses Doc is already acting on this max, reducing my spouses meds.

This law is virtually forcing me to get the illegal drugs they are trying to limit, if I can't move to a more enlightened state.

Yeah, you're right, I'm being obtuse. :rolleyes:
 
The Greater Fool said:
Obtuse?

I was unable to find the text of the actual law. However, this PDF from the AZ Governor website should do you the trick. Page 14 is the one that clobbers my spouse, who was at about 180 MME. The exemptions spoken of are for cancer or dying patients. Basic Chronic Pain folks don't qualify.

The new max = 90 MME. As I said, and no I have no documentation, the 2 certified Pain Specialists (my spouses and mine) both are not inclined to go over that value as they don't want AZ and DEA in their lives. My spouses Doc is already acting on this max, reducing my spouses meds.

This law is virtually forcing me to get the illegal drugs they are trying to limit, if I can't move to a more enlightened state.

Yeah, you're right, I'm being obtuse. :rolleyes:
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So your doctor was prescribing X, until the rule Rule changed and the doctor switched it to Y rather than make the effort to jump through the hoops for X?

Regardless of the law, I would seriously question that doctor's judgement, even around the original prescription.
 
BobTheCoward said:
So your doctor was prescribing X, until the rule Rule changed and the doctor switched it to Y rather than make the effort to jump through the hoops for X?

Regardless of the law, I would seriously question that doctor's judgement, even around the original prescription.
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The article I read said there are a whole, whole, whole lot of doctors in the same boat. The hoops are numerous and apparently very onerous (and legally intimidating) by design, it appears.
 
This is essentially an uncontrolled mass medical experiment being thrust upon chronic pain patients in AZ. It doesn't even seem medically sound to reduce the max dosage by half all at once. At least tapering over 6 months or more combined with mandatory opioid rotation would maybe make sense biologically, from what I understand.
 
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