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The Painkiller That Saves Money But Costs Lives

Hugh Pickens writes "Over 2,000 patients have died since 2003 in Washington State alone by accidentally overdosing on a commonly prescribed narcotic painkiller that costs less than a dollar a dose and the deaths are clustered predominately in places with lower incomes because Washington state has steered people with state-subsidized health care — Medicaid patients, injured workers and state employees — to methadone because the drug is cheap. Methadone belongs to a class of narcotic painkillers, called opioids, that includes OxyContin, fentanyl and morphine. Within that group, methadone accounts for less than 10 percent of the drugs prescribed — but more than half of the deaths and although Methadone works wonders for some patients, relieving chronic pain from throbbing backs to inflamed joints, the drug's unique properties make it unforgiving and sometimes lethal. 'Most painkillers, such as OxyContin, dissipate from the body within hours. Methadone can linger for days, pooling to a toxic reservoir that depresses the respiratory system,' write Michael J. Berens and Ken Armstrong. 'With little warning, patients fall asleep and don't wake up. Doctors call it the silent death.'"

385 comments

  1. it is harder to get high on by Anonymous Coward · · Score: 5, Insightful

    because of the way it works, junkies don't prefer it. so who cares if a bunch of people die needlessly, at least it prevents people from getting high. the drug war matters more.

    1. Re:it is harder to get high on by Anonymous Coward · · Score: 5, Interesting

      Wait: You use it as a painkiller? Why do you do that? It's almost the worst opioid you could possibly use for that!

      There is no way that methadone should be used for anything other than treating opioid addiction.

    2. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      It's hard to get high on? Are you being serious right now? Methone is super strong, and doesn't have much of a ceiling effect either. It shouldn't be used for addiction anymore either. We need to make buprenorphine cheaper and call it a day. Buprenorphine is a lot safer and has a better rate of helping people.

    3. Re:it is harder to get high on by Anonymous Coward · · Score: 5, Informative

      It's prescribed as a painkiller more often than as a treatment. I'm a pharmacist and I go through methadone like mad and not on the prescriptions I fill is for addicition. I spoke to a pain doctor once who told me it was a cheaper alternative to OxyContin, which can run $600/month without insurance. Methadone runs about $30 a month without.

      Some patients with insurance won't take OxyContin because their copay is high.

    4. Re:it is harder to get high on by Anonymous Coward · · Score: 5, Interesting

      I disagree entirely. You have to select patients very carefully, but it works wonders on some. I'm a pharmacy resident at a mid-sized hospital, and I did a pain consult on a patient who was sedated and intubated in the ICU. Poor nurse was out of her mind giving him Dilaudid shots every 30 minutes so he wouldn't spike his BP and breathe against the ventilator (both signs of inadequate pain control). Wanted to give him a longer acting opioid for basal pain control. Can't use OxyContin or MSContin here cause you can't crush it to put it in a feeding tube. Guy was also morbidly obese so it would take several days for a Duragesic patch to saturate all the subcutaneous binding sites. Methadone turned out to be the perfect answer.

      Obviously you have to be extremely careful, but I don't have a problem with using methadone so long as the patient has good renal function, good hepatic function, good respiratory function (or a protected airway) and isn't taking any drugs that lengthen the QTc interval. This tends to rule out your older, sicker patients, and I suspect that most of the deaths from methadone toxicity happens in them.

      In the case specifically addressed in TFA, the fact that the patient was on both methadone and Oxy simultaneously is mind-boggling. Especially in the setting of sleep apnea. More blame rests on the prescriber than on the drug.

    5. Re:it is harder to get high on by Eunuchswear · · Score: 2

      Why not use diamorphine?

      --
      Watch this Heartland Institute video
    6. Re:it is harder to get high on by blockhouse · · Score: 4, Informative

      Why not use diamorphine?

      Too short of a duration of action. The purpose of using morphine as a replacement for OxyContin is because it's long acting, providing analgesia throughout the day. Diamorphine has a short, intense onset (which is why it's so addictive) and a similarly rapid cessation.

      The current regulatory environment in the US, where diamorphine is Schedule I, may also have something to do with it.

      (For those who are less pharmaceutically inclined, diamorphine = heroin.)

    7. Re:it is harder to get high on by sleigher · · Score: 1

      The generic version of Subutex is available, but the doctors don't like to prescribe because it can be abused. I don't believe there is a generic form of Suboxone. Suboxone is given to addicts because it is mixed with Naloxone. Naloxone is an antagonist and blocks or reverses the effects of opioids. Get a generic version of that to market and get rid of methadone. Methadone is worse than heroin. As hard or harder to kick. They can just manage your addiction with it better. I don't believe they want people getting off of opiates. They just want to manage your addiction.

      I might be wrong about the generic form of Suboxone, but I have not heard of it on the market yet. Only Subutex.

      --
      All points of time and space are connected.
    8. Re:it is harder to get high on by blockhouse · · Score: 4, Informative

      It's prescribed as a painkiller more often than as a treatment. I'm a pharmacist and I go through methadone like mad and not on the prescriptions I fill is for addicition.

      That's because in order to use methadone to maintain addiction, both the prescriber and the dispensing pharmacy have to be specially licensed. I've never heard of a chain or independent community pharmacy licensed as such. Methadone clinics usually have the prescribers and the dispensary at the same site.

      Suboxone and the other buprenorphine-containing compounds have similar restrictions on the prescribers but not on the dispensing pharmacies. That's why you see DEA numbers starting with X on Suboxone scripts . . . it means the prescriber has been specifically licensed to manage opioid dependency.

    9. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      a friend who is on methadone maintenance told me that doctors aren't allowed (in michigan, at least) to prescribe methadone for opiate addiction, that use must be covered by a methadone clinic. presumably because of monitoring issues.

    10. Re:it is harder to get high on by dotancohen · · Score: 5, Funny

      (For those who are less pharmaceutically inclined, diamorphine = heroin.)

      (For those who are more C++98 inclined, diamorphine == heroin.)

      --
      It is dangerous to be right when the government is wrong.
    11. Re:it is harder to get high on by Eunuchswear · · Score: 1

      Why not use diamorphine?

      Too short of a duration of action. The purpose of using morphine as a replacement for OxyContin is because it's long acting, providing analgesia throughout the day. Diamorphine has a short, intense onset (which is why it's so addictive) and a similarly rapid cessation.

      Interesting.

      My mum said it was great stuff, but she was in hospital and could get a hit when she wanted by pressing the button.

      Would have been harder to do at home I suppose.

      --
      Watch this Heartland Institute video
    12. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      The first is a statement of fact, the second is a question, I think a statement of fact is more appropriate.

    13. Re:it is harder to get high on by dmr001 · · Score: 3, Informative
      Methadone is actually a pretty good painkiller (http://www.aafp.org/afp/2005/0401/p1353.html) when used with 3 times daily dosing (methadone for heroin/diamorphine addicts is usually dosed once daily). Methadone's risk is that it has a long half-life (up to 5 days), and no 1:1 dosing equivalency with (say) morphine, so if you aren't careful it can accumulate and cause respiratory drive suppression - you just stop breathing. It can also cause disturbances of cardiac rhythm (that is, screw up your natural pacemaker) in higher doses.

      I do not frequently prescribe methadone (I am a physician) because it's not often I have patients on chronic opioid medicine who I consider responsible enough to use it safely. And, I have seen inexperienced staff at pain specialty clinics nearly kill people a few times. But, if your drug plan won't cover sustained-release oxycodone or morphine (common until a few years ago in the US when morphine SR finally went generic) it's a viable alternative.

      For a list of "worst" opioid agonists in terms of effectiveness for pain, consider codeine and propoxyphene (as in Darvocet in the US), both of which don't seem to be more effective than acetaminophen/paracetamol.

    14. Re:it is harder to get high on by sjames · · Score: 4, Insightful

      The problem, I gather, is that the primary selection criterion being used here is "poor'. That's a fairly bad criterion for any medical decision.

      The sad part is that there is no good reason for any of the opiates to be terribly expensive. It doesn't help that our government would rather see chronic pain sufferers dead or screaming in agony rather than admit the war on drugs is a failure.

    15. Re:it is harder to get high on by dotancohen · · Score: 1

      The first is an assignment, the second is a statement (which evaluates to TRUE). Therefore, if he wishes to state that diamorphine is heroin, rather than assign heroin to diamorphine, he needs the == operator.

      Yes, it is a subtle difference.

      --
      It is dangerous to be right when the government is wrong.
    16. Re:it is harder to get high on by shiftless · · Score: 1

      because of the way it works, junkies don't prefer it

      Really? Cause I happen to know plenty of pill popping friends who can't get enough of it, it seems.

    17. Re:it is harder to get high on by larry+bagina · · Score: 2

      diamorphine == heroin is an expression. 1 == 0 is also an expression.

      --
      Do you even lift?

      These aren't the 'roids you're looking for.

    18. Re:it is harder to get high on by larry+bagina · · Score: 1

      you can shoot up at home.

      --
      Do you even lift?

      These aren't the 'roids you're looking for.

    19. Re:it is harder to get high on by dotancohen · · Score: 2

      Sorry, you are correct.

      --
      It is dangerous to be right when the government is wrong.
    20. Re:it is harder to get high on by arth1 · · Score: 2

      Wait: You use it as a painkiller? Why do you do that? It's almost the worst opioid you could possibly use for that!

      There is no way that methadone should be used for anything other than treating opioid addiction.

      Incorrect. Probably most medications have multiple uses, and just because something is suited for A doesn't mean it can't also be used for B.

      This was a problem for me when moving to the US. Due to spinal injury, I needed a pain control method that was strong enough to affect nerve pain, fast acting enough to be used for acute pain, and would not leave me an addict.
      Buprenorphin is used for this in Europe. With pills dissoving under your tongue, it's as near instant relief as you can get without injections.
      But here in the US, it's only used for treating drug addicition. And the doctor's hands are tied by the insurance companies. If they don't want the doctors to administer class A substances for other use than the mandated ones, it won't happen.
      Metadone is the second best option. At least there is precedence here in the US to use it as a pain killer. But really, it doesn't kill the pain as much as it dulls you down to not give a shit about much, including pain. Not a perfect pain killer in other words.
      I'd love to get back to buprenorphin - 3-4 pills a year is all I need, but apparenlty that's too much to ask for cause of people like you who think that if it's used for treating addiction, it shouldn't be used against pain.

    21. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      How do you actually know he wanted to use the comparison operator and not the assignment operator?

    22. Re:it is harder to get high on by DMFNR · · Score: 2

      Methadone is a great drug for chronic pain, but it's greatest strength is also it's greatest danger; the long duration of action. Standard methadone dosing for a chronic pain patient is lower doses a couple times a day, but if someone is not familiar with the drug is really easy to take a couple extra doses thinking it's not working when it really just takes a couple hours to kick in. A lot of times a shorter acting opiate like hydromorphone or oxycodone is prescribed as well to help out with that issue, which also adds quite a bit of danger. I don't have facts to back up my suspicious, but if I had to hazard a guess I would say a lot of the deaths are happening not to the pain patients or addicts receiving the methadone, but to the people it is being diverted to. A lot of people who use drugs recreationally aren't very clued up on what they're taking (just about every opiate in the world is either percocet or vicodin to these people), and methadone is a very easy drug to either dose too much thinking its not working or end up re-dosing or mixing other depressants later in the day when the high has started to fade (rather, the person has become acclimated to it) but the levels are still high in the body.

      The question is, what can we do about this? I honestly don't know. Many people in need of strong narcotic pain medication while doctors are forced to be overly conservative to save their own asses while at the same time people are getting introduced to the drugs far to early thanks to what I would consider over prescribing of weak narcotic opiates for simple injuries or dental procedures. Throw in some states where the laws are much more lax with pain clinics that advertise like bars in the back of the newspaper and people walk in with hundreds in cash and out with an opiate, a benzo, and a stimulant right next door to the annexed cash only pharmacy and you have a huge mess with narcotic drugs in America, and I'm sure things are similar elsewhere in the world as well. As a former addict who has been on a methadone program, and currently is on suboxone, I think I speak for both pain patients and people trying to get off opiods that the people who divert their medications are scum and are fucking things up for everyone. I can honestly say with a straight face that I believe in drug legalisation, and by that I don't mean a "Legalize It Man!" hippie. I mean across the board rights to but what you want in to your own body, but in this current situation with people being so uneducated and ignorant, the people selling their scripts to anyone on the street might as well be handing out loaded handguns. Just recently here in Wisconsin we had some wonderfully sensationalized stories about a few local teens who died with massive amounts of benzos and alcohol in their systems along with suboxone in their systems, and all of the blame was placed on suboxone and soon after calls to ban suboxone and concerned parents asking why doctors are handing out drugs to addicts filled the 10 o'clock news. Even worse, the more this stuff happens the more doctors will clamp down and the harder it will be for legitimate pain patients, a lot of whom are lucky to get just enough to lay in bed comfortably enough to get a couple hours of sleep, to get their medication.

      It's just a massively fucked up situation, since man discovered the poppy it's made a mess of everything in its path. If there is a god, he is a cruel soul for putting the very chemicals that make us feel our best in to a plant, and then letting his people become convinced that it is somehow a sin for us to take it.

    23. Re:it is harder to get high on by dotancohen · · Score: 1

      Because the library author already took care of that detail. Put the cursor on diamorphine and press F3 (Eclipse):
      const Narcotic diamorphine = C21H23NO5;

      --
      It is dangerous to be right when the government is wrong.
    24. Re:it is harder to get high on by DMFNR · · Score: 1

      I've been dealing with this bullshit at the moment due to not having insurance. The generic version of Subutex would cost me like $40, where I just picked up my brand name Suboxone prescription for $260 plus a $150 fee for the doctors appointment and drug screen. The bullshit part about it is the naloxone in Suboxone is completely pointless, even if the drug is injected. Buprenorphine's binding affinity is higher than naloxone so no matter what you do with a suboxone pill that naloxone isn't going to touch a receptor. Even if it did, naloxone has so much shorter a duration than buprenorphine it would be ineffective anyway, even in heroin overdoses naloxone often has to be re-administered to prevent the patient from slipping back in to OD. Buprenorphine is the drug that blocks the other opiates, buprenorphine is the drug that will rip another full agonist off the receptor and cause precipitated withdrawal. In fact Reckitt Benckiser tried to hold up the approval of the Roxane generic saying that it contained talc fillers which would make the drug far more dangerous to insufflate or inject than their suboxone or subutex which contains cornstarch fillers.[1]

      The problem here is that the administration of drugs should be between a doctor and a pharmacist, not a doctor and a drug company. Many doctors are unbelievably ignorant about the effects of drugs, and who can blame them with as many as there are these days and the complexity of the human body, and a drug company is not exactly a patients best advocate. Doctors should work out a diagnosis and then if medication is indicated they should work this out with a pharmacist. Instead it is usually worked out by paging through colorful brochures and choosing between vacation destinations with the drug reps. The suboxone situation is actually analogous to vendor lock-in in the software world, and patents have the same effects on medicine as they do on software. Reckitt Benckiser did a very good job of making sure their brand would be the ONLY one used, and their pamphlets on suboxone are actually kind of fun to pick apart and look for half truths and straight up fiction.

      [1]http://www.naabt.org/tl/FDA-Kramer-petition.pdf

    25. Re:it is harder to get high on by BlueParrot · · Score: 1

      There are some niche cases where people respond better to one opioid than another. The same property that makes it dangerous ( it's long half-life ) is also desirable in some cases.

      Of course, substituting it for oxycodone or morphine just because it is cheaper is simply stupid.

    26. Re:it is harder to get high on by sleigher · · Score: 1

      Right, you are not supposedt o take the bupe until in withdrawal from an opiate. I thought the purpose of the Naloxone was to prevent the abusers from getting high on the bupe. You are correct that it is in fact the buprenorphine that will take you to precipitated withdrawal. With Subutex, the abusers will just inject that. With Suboxone, when you dissolve it sublingually, the Naloxone molecule will not penetrate through to the bloodstream in your mouth. I thought the Naloxone would just counter the effect of the Buprenorphine to prevent them from getting any high.

      Also, not sure it is still this way, but doctors were only allowed 15 patients on bupe. That to me is proof that the Gov. doesn't want people getting off dope. If not exactly a miracle drug, it is light years better than methadone, if used properly to step down and get off of opiates.

      --
      All points of time and space are connected.
    27. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      My wife is allergic to pretty much all the standard pain killers. She had her knee replaced this summer, and the docs decided to use Methadone. The problem was, the script was screwed up, and instead of giving her 2.5 mg, she was given 25.

      She OD'd, and almost died. Major, major screwup.

      The point is, though, that there are cases where methadone actually makes a little sense. If it's used right....

    28. Re:it is harder to get high on by Vintermann · · Score: 1

      Not insightful. In Europe, methadone is a favorite of harm reduction advocates, but has been opposed by much of the treatment industry. They say it's writing off people as lost causes.

      It is true junkies do not prefer methadone - over fast-working opiates. But they sure as hell prefer it over no opiates at all, which is why there is a thriving illegal market for methadone in many places where it's used for medication-assisted rehabilitation attempts. Since users build up tolerance to methadone, about the only thing doctors can do to determine how much to prescribe, is to ask the users. The users (the privileged few who have gained access to MAR programs) naturally overstate their need. They sell the excess (to non MAR-recipients), to get money for more preferred drugs. Then they, or their customers, quite often proceed to overdose on free government-provided opiates.

      But not surprisingly, it does reduces crime for profit. That's enough to call it a success in many people's eyes. Putting a low value on junkies' lives is not exclusive to the drug warrior approach to narcotics policy.

      --
      xkcd is not in the sudoers file. This incident will be reported.
    29. Re:it is harder to get high on by ThurstonMoore · · Score: 2

      The naloxone in suboxone does nothing it's there for marketing purposes. You can shoot suboxone just as easily as subutex. Trust me I know.

    30. Re:it is harder to get high on by colinrichardday · · Score: 1

      What if the GP meant that we assigned the name "diamorphine" to heroin?

    31. Re:it is harder to get high on by NFN_NLN · · Score: 3, Interesting

      Because the library author already took care of that detail. Put the cursor on diamorphine and press F3 (Eclipse):
      const Narcotic diamorphine = C21H23NO5;

      The chemical formula isn't specific enough. Different compounds can have the same chemical formula but entirely different structure and are known as isomers.

      It gets even more confusing when you have compounds that look the same on first glance but differ due to chirality.

    32. Re:it is harder to get high on by St.Creed · · Score: 1

      In The Netherlands, you can get methadone free of charge and on prescription if you're addicted, but when you get it, you have to drink it right at the spot where you get it - you get it in a disposable cup. They aren't handing out packages of pills.

      --
      Therefore, by the (faulty) logic you're using, you're just a cow with a keyboard - osu-neko (2604)
    33. Re:it is harder to get high on by dotancohen · · Score: 1

      That is interesting, though it makes sense. Thanks! I'm all out of wit to translate that into C++ though with objects it should be straightforward.

      --
      It is dangerous to be right when the government is wrong.
    34. Re:it is harder to get high on by sleigher · · Score: 1

      Well, I will gladly take your word for it. I take Subutex currently for a reason not pertaining to opiate addiction. However, I am not putting anything in my arm.

      --
      All points of time and space are connected.
    35. Re:it is harder to get high on by soundguy · · Score: 2

      The problem, I gather, is that the primary selection criterion being used here is "poor'. That's a fairly bad criterion for any medical decision.

      The sad part is that there is no good reason for any of the opiates to be terribly expensive. It doesn't help that our government would rather see chronic pain sufferers dead or screaming in agony rather than admit the war on drugs is a failure.

      This can't be said often enough. As far as I know, Oxycontin is nothing more than timed-release oxycodone. It must be on a new patent for the particular formulation, because the patent on the base medicine has long since expired. I'm currently dealing with a ruptured disk in my neck and just picked up a refill of generic oxycodone - 30 for $7.90. FWIW, a bottle of 30 cyclobenzaprine (generic form of Flexeril) is $4.00. It's criminal that we allow patents on trivial reformulations of drugs whose original patents expired years or decades ago, especially on basic essentials like opioid pain managers.

      --
      Nothing worthwhile ever happens before noon
    36. Re:it is harder to get high on by enormouspenis · · Score: 1

      In the case specifically addressed in TFA, the fact that the patient was on both methadone and Oxy simultaneously is mind-boggling. Indeed. I am a medical doctor and see this occasionally in terminal patients; Used to prescribe combos like that myself for patients with bone ca. or similar if they were monitored. However, sending people home on methadone along with other opioids for chronic pain control is a very bad idea. Folks using methadone already often turn up in our ED dead after using pills they buy elsewhere; and these are "professionals". I don't really know anyone who does it (except on very very rare cases) and I spend a lot of time with medicaid patients. This is the sort of thing NHS does; shouldn't happen here.

      --
      "I didn't spend six years in Evil Medical School to be called 'Mr.Evil,' thank you very much!"
    37. Re:it is harder to get high on by rahvin112 · · Score: 1

      Methadone is one of the most effective pain management opioid being produced. It is long acting, it generally doesn't cause the addictive high, it's cheap and it's very easy to produce (doesn't require expensive time release formulations and it's a simple reformulation from opium tar). In pain management practices it's one of the goto medications for pain. It's a misconception that it's only for opiod addiction, in fact it's absolutely one of the worst treatment regimes for that. They use it for that because it doesn't cause the high in most people but because of it's long acting and strength junkies will typically take the methadone dose then hit up with an additional opioid giving them a stronger high with less heroin/pills. It's one of the principle reasons that methadone treatment for narcotic addiction has such a huge failure rate (95%!). Were it not for the insane drug laws medicine would use far more effective treatments, but the government highly restricts which narcotics can be used for addiction treatment.

      If people are dieing from it it they aren't being properly instructed by a doctor on the 1/2 life and how to use the drug. In elderly patients it should be closely followed and it should include a sleep study to ensure oxygen deprivation isn't occurring during the night.

    38. Re:it is harder to get high on by soundguy · · Score: 1

      I would add hydrocodone (vicodin) to that list of worthless crap that gets prescribed way too often. I've had a doctor try to tell me that oxycodone and hydrocodone are chemically nearly identical and that hydrocodone should be adequate for a broken leg. I pointed out that alcohol and ether are "chemically nearly identical" too and I'd be happy to whip him up an ether martini. He wasn't interested.

      --
      Nothing worthwhile ever happens before noon
    39. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      My mother has Lupus, Glaucoma, Degenerative Disk Disease, bad hip .. the works. She was on Oxy for years and it did control her pain but it left her stoned all the time.

      After we moved to Idaho her new pain doctor switched her to Methadone. Her pain management is as good or better then when she was on Oxy but she isn't stoned out of her mind all the time. It has been a blessing for my mother and all of us that take care of her.

    40. Re:it is harder to get high on by demonlapin · · Score: 1

      Reformulating opioids into extended release forms that cannot easily be abused is actually quite difficult, because you can't use the usual tricks of slow-dissolving layers. Doesn't make all this right, but it shows the lengths the companies are going to to keep the government happy.

    41. Re:it is harder to get high on by uninformedLuddite · · Score: 1

      Heroin is also meant to be capitalised.

      --
      The new right fascists are bilingual. They speak English and Bullshit.
    42. Re:it is harder to get high on by Wansu · · Score: 1

      Perhaps it doesn't get you "high" but it is highly addictive. It was once used to wean junkies off heroin. Nearly every user becomes an addict. And once addicted, they become tethered to a methadone clinic where they must go and jump through hoops to receive their dose.

      Now comes reports that methadone kills. It'll be interesting to see whether the FDA does anything. They dragged their feet until 50,000 heart attacks and untold fatalities occurred with Vioxx. But they pulled PPA based Sudafed, which had been sold for nearly 4 decades, off the market due to the potential for strokes.

      --
      Wansu, th' chinese sailor
    43. Re:it is harder to get high on by hippo · · Score: 1

      For the Verilog inclined, diamorphine === heroin.

    44. Re:it is harder to get high on by RockDoctor · · Score: 1

      I'm trying to remember which company owns the trademark rights on "Heroin". I wonder why they don't enforce their rights?

      --
      Birds are not dinosaur descendants;birds are dinosaurs, for all useful meanings of "birds", "are" and "dinosaurs"
    45. Re:it is harder to get high on by RockDoctor · · Score: 1

      Methadone is worse than heroin. As hard or harder to kick.

      I've been told this by friends with experience of both.

      They can just manage your addiction with it better. I don't believe they want people getting off of opiates. They just want to manage your addiction.

      "The Authorities" are quite open about this - at least in this country, if you're talking to the civil servants and scientific/ medical advisers (talking to politicians is of negative utility, in this case as generally).

      --
      Birds are not dinosaur descendants;birds are dinosaurs, for all useful meanings of "birds", "are" and "dinosaurs"
    46. Re:it is harder to get high on by mcgrew · · Score: 1

      I've only known one or two junkies, but they DO get high on it if there's no real heroin around. The problem with it isn't the junkies, though, the problem is that it depresses the central nervous system for days rather than hours, making it incredibly easy to OD on.

      Looks to me like the war on drugs is more important than people's lives. But I guess I'd be foolish to think that lives trump ideology in a politician's mind.

    47. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      Hydrocodone is pretty nice. It works great for my pain. However, Vicodin is evil. And kills lots of people. The difference is acetaminophen, which has a lethal does that's very close to it's therapeutic dose. It's largely put there to prevent abuse. Like some of the people in this story, the war on drugs is killing to reduce abuse.

    48. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      It gets even more confusing when you have compounds that look the same on first glance but differ due to chirality.

      *cough* Thalidomide *cough*

    49. Re:it is harder to get high on by doccus · · Score: 1

      Bayer.. it was their next "wonder drug" after Aspirin.. and they *have no rights to enforce*, any more.. as the name, just like "aspirin" did, entered the public domain years ago.. They still make, and sell it though, and in europe you can choose it instead of methadone, which, actually is a pretty poor painkiller for an opiod, but the only one of the opiates where the withdrawals , also, can actually kill you.. And the premise of the original post is correct, in that if one takes the same dose of methadone at the same time each day, by the end of the week there is a real possibility of fatal overdose. That makes the current push to increase methadone use all the more despicable.. for both acute pain management (which is *never* indicated), and for maintanence. Where I live the number of "addicts" on methadone maintenance has increased by 30,000 % in the last 20 years. Most of the new ones on that program are hardly out of their teens, and a huge percentage haven't even got a history with opiates, but rather pot and stimulants, such as speed or crack.. Methadone for 'Pot Addiction" . are you kidding eddie?

    50. Re:it is harder to get high on by sjames · · Score: 1

      Just another example of the ways the War on Drugs is harming us all.The people who actually need the pain control would be happier with inexpensive generic extended release formulations using the usual tricks. Meanwhile, the abusers will find a way as usual.

    51. Re:it is harder to get high on by RockDoctor · · Score: 1
      Bayer ... wouldn't surprise me - very respectable chemical company. So "Heroin" is, like "Asprin" is another piece of European property stolen by the US-govt. "Quelle Surprise!"-NOT.

      Methadone as a "treatment" for Pot Addiction ... not surprising. I've got some thoroughly blessed Passover "Bitter Herbs" here that, if eaten in sufficient quantity, will remove suspicion of being a terrorist from you (though you might be misidentified as a fitting epileptic, and taken to an extermination camp).

      --
      Birds are not dinosaur descendants;birds are dinosaurs, for all useful meanings of "birds", "are" and "dinosaurs"
    52. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      and here's some advertising blurb for the both

      For some reason I cannot login. Must be the luddite in me.

    53. Re:it is harder to get high on by badkarmadayaccount · · Score: 1

      Hydrocodone and oxycodone are much closer that ethanol and ether - a single double bond is the difference. But, OTOH, IIRC the binding affinity difference is 5x.

      --
      I know tobacco is bad for you, so I smoke weed with crack.
    54. Re:it is harder to get high on by Slashdot+Parent · · Score: 1

      I would add hydrocodone (vicodin) to that list of worthless crap that gets prescribed way too often.

      That's interesting.

      My wife has cancer, so she has all kinds of pain management drugs. When she had a surgery done, she was prescribed hydrocodone to deal with the pain of that, and she found it to be effective. She certainly could have taken something much stronger had it not worked (Dilauded, etc.)

      --
      They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
    55. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      My Pal in West London gets 7x30mg of diamorphine freeze dried dry ampules daily +methadone + valium prescribed for addiction. He's the picture of health and been on this script for years. Heroin amps are fine for addiction. Just give the people what they want I say. "War on Drugs" ? Phooee! That one was lost before it started.

    56. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      Propoxyphene (Darvocet) is no longer permitted in the US. The side effects caused death more frequently than you's expect from such a crappy opioid agonist. "This Darvocet Recall by the FDA was due to the dangerous alterations in the electrical activity of the heart (heart arrhythmias)."

    57. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      if you want to have less of a drug in circulation, force the drug companies to make it cheaply. hilary clinton tried that with childhood vaccines. the companies that made it could not afford to continue. within a year there was a severe shortage of vaccines for children.perhaps when dictating cost to the manufacturer there should be a way to mitigate the cost, perhaps lower malpractice costs for example.

    58. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      This is untrue (I am an anesthesiologist). Methadone is an excellent painkiller for chronic pain. It has a long duration, so the difference between the peak and trough blood levels is small. Since troughs need to be high enough to cover pain and peaks need to be low enough to avoid side effects, methadone can be an excellent choice. Used properly, it can provide the minimum side effects for any level of chronic pain.

      However - if a patient becomes sick or has a change in their pain level, methadone is slow and difficult to titrate to effect. Therefore it can be dangerous in certain situtations. It is more difficult to manage than most other opiates, because it has a slow elimination and because it has nonlinear activity.

    59. Re:it is harder to get high on by Anonymous Coward · · Score: 0

      My husband took it during the last two weeks of his struggle with tonsil/lung cancer. It was a Godsend from the standpoint of relieving his pain, but totally unforgiving in the way it had to be administered. I had to adhere to a strict dosage schedule. If you're not used to the way it works and are not motivated to do what the medical people tell you, it would be real easy to overdose. Medicaid providers prescribe it because it is cheap, not because junkies don't like it. IMO it's way too risky to prescribe for someone who may not be able to read all that well or not have someone to take care of them.

    60. Re:it is harder to get high on by rhalstead · · Score: 1

      The article said "accidental overdose" so to that means they did not follow the directions on the prescriptions. The same thing happens with Tylenol and other pain killers which are over the counter.

  2. It even has its own tribute band by hessian · · Score: 0

    Methadrone, noise/drone/post-rock with a metal soul.

    http://www.myspace.com/methadrone

    1. Re:It even has its own tribute band by oodaloop · · Score: 3, Insightful

      I prefer the Crystal Method.

      --
      Tic-Tac-Toe, Global Thermonuclear War, and relationships all have the same winning move.
    2. Re:It even has its own tribute band by Trepidity · · Score: 1

      I think that has to do more with its use as a heroin replacement for addicts than its use as a painkiller...

    3. Re:It even has its own tribute band by countertrolling · · Score: 1

      I'll go with the more generic Chemical Brothers

      --
      For justice, we must go to Don Corleone
  3. Makes sense now by Anonymous Coward · · Score: 0, Interesting

    So that's why they were handing methadone out to Occupy protesters in my town. "Maybe they will fall 'asleep' in the park so we can get them out easy."

    1. Re:Makes sense now by Richard+Dick+Head · · Score: 0
      Yeah, welcome to this century's version of the world's oldest cost-cutting tactic.

      "people with state-subsidized health care - Medicaid patients, injured workers and state employees"

      And nothing of value was lost....

      Note to Self: I'm getting the hell out of this country when I retire

    2. Re:Makes sense now by Anonymous Coward · · Score: 0

      Also, Note to Self: Find out who modded me flamebait, and get them qualified for a state-subsidized healthcare plan. With a sledgehammer.

  4. Re:Nice by Anonymous Coward · · Score: 0, Insightful

    And this is exactly why having registered commenters score +1 just for posting is so wrong. Meanwhile, on-topic posts by ACs go unnoticed and will get repeated by registered users.

    And no, we will not register unless there comes a time when other users cannot ban you for what you say.

    So back to the topic... Doctors are idiots, law enforcement is corrupt and evil and pharmacists are complicit. This is what you get.

  5. Re:Cynicism by Pharmboy · · Score: 4, Informative

    No perchance, and it was idiotic to even say, since you have easily looked it up and see that its protection was basically stripped from a defeated Germany in 1947. Wikipedia is your friend, laziness is not.

    --
    Tequila: It's not just for breakfast anymore!
  6. This is ridiculous by Dunbal · · Score: 5, Insightful

    As little as 100 years ago people were using perfectly legal opium compounds such as paregoric, with little or no social problems. The fact that people are dying and people are having their lives ruined by this failed "war on drugs" and the solutions are even worse than the problem just goes to show that government has no clue what it's doing.

    --
    Seven puppies were harmed during the making of this post.
    1. Re:This is ridiculous by Zironic · · Score: 0

      What are you on about? The story is about the fact that people use the Opiod Methadone over other Opiods for painkiller use because it's cheap. However it is vastly more lethal then the other Opiods.

    2. Re:This is ridiculous by swb · · Score: 5, Insightful

      I'd wager cost has nothing to do with it and that they're being prescribed methadone over Oxycontin because of the reputation Oxycontin has, and the doctors don't want to be associated with Oxycontin.

      And it's not that Oxycontin is a 'bad' medication, but it's gotten caught up in our moralistic, war on drugs mindset.

    3. Re:This is ridiculous by Zironic · · Score: 1

      Well, the point of the article was that it was only Medicaid that was putting people on Methadone after putting it on the 'preferred drugs' list, implying that it is an 'equally safe' drug against all evidence to the contrary.

      Meanwhile those with private insurance still get prescribed the more expensive Oxycontin.

    4. Re:This is ridiculous by hairyfeet · · Score: 2

      Well if all they care about is cheap, why aren't they using morphine? Morphine is old as dirt so I seriously doubt there are patents for plain old morphine anymore, they have a version called MS Contin which is just a timed release formula, and if you are in pain MS Contin doesn't get you high it just blocks the pain. I have a relative that's been on it something like 25 years after a horrific car wreck messed his back and knees all up and the guy has been on the same dose all this time, never more, never less. Hell he even lives on the second floor of an apt building now and I honestly thought he'd be lucky to dress himself after the wreck.

      So if all they care about is cheap they should just use the natural stuff. Frankly the artificial drugs we cook up always seem to do more damage than the natural compounds and its obvious from TFA that this Methadone may be cheap but its also nasty.

      --
      ACs don't waste your time replying, your posts are never seen by me.
    5. Re:This is ridiculous by joebagodonuts · · Score: 1

      And it's not that Oxycontin is a 'bad' medication, but it's gotten caught up in our moralistic, war on drugs mindset.

      And methadone hasn't? I know it isn't what the cool kids are using, but methadone has been on the naughty list for awhile.

      BTW, it isn't our moralistic, war on drugs mindset. You can claim it if you wish, I prefer not to.

      --
      "Give a woman two glasses of wine and some pad thai, and they'll agree to just about anything." the Sports Guy
    6. Re:This is ridiculous by Eunuchswear · · Score: 1

      Well if all they care about is cheap, why aren't they using morphine? Morphine is old as dirt so I seriously doubt there are patents for plain old morphine anymore,

      Is the world opium shortage over?

      --
      Watch this Heartland Institute video
    7. Re:This is ridiculous by Anonymous Coward · · Score: 5, Interesting

      I have to post anonymously about this, as well as leave out some details due to a settlement I got because of the mess you describe.

      I have a problem with chronic kidney stones. My PCP eventually sent me to a pain clinic, where a doctor evaluated my current meds, my current needs, etc. I got a prescription for Oxycontin. Upon trying to fill this prescription, there were only two pharmacies that could fill it (several manufacturers were shut down due to illegal selling/distribution). One was at the pain clinic where I got the script, and the other was at CVS where I always filled all of my other prescriptions. The pharmacist was way way way beyond rude and pretty much called me a junky. I was absolutely furious. This man has made an extreme judgement of who I was because of my need for a powerful painkiller.

      I come to find out this particular person owns http://banoxycontin.com/. It was obvious this person had an agenda and I was just one of his targets to push it. I can't get anymore into the resolution of the situation, but rest assured I won.

      The "war on drugs" causes shit like this. It ends up just being a witch hunt and there are too many innocents that end up burning

    8. Re:This is ridiculous by Type44Q · · Score: 1

      ...just goes to show that government has no clue what it's doing

      Perhaps not but rest assured, the select few above them most certainly know what they're doing. You could even argue that they're doing a damn good job of it...

    9. Re:This is ridiculous by swalve · · Score: 1

      The implication is that methadone is longer acting, and thus easier to manage.

    10. Re:This is ridiculous by beltsbear · · Score: 1

      Oxy theft is a big deal in Maryland. A friend also uses oxy for kidney stones which happen about once a year. Around here you can not call to a pharmacy to ask if they have it, they will say they can not tell you. They will never admit to having it on the phone. You have to go there in person and if they do not have it they MAY be able to tell you where you can get it after they see your prescription. The whole time one is treated just like a junkie as you said.

    11. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Damn that Rush Limbaugh

    12. Re:This is ridiculous by ShakaUVM · · Score: 1

      >>My PCP eventually sent me to a pain clinic

      You might want to spell out primary care physician in an article about drugs. =)

      >>The pharmacist was way way way beyond rude and pretty much called me a junky

      As someone who has spent a lot of his life around pharmacists, I find this... unfortunate. If he did indeed run a website for banning oxy, that would explain that.

      Most pharmacists are very professional and nonjudgmental. That said, if you are exhibiting drug-seeking behavior, then, yeah, you might run into conflict with them. A friend of mine got yelled at for half an hour by a guy with a hand-written script for oxy, which he naturally refused to fill. Had to call security and get the guy tossed out, then he just moved on to the next pharmacy down the street.

      These things happen all the time to pharmacists... just telling you what the other side of the story is.

    13. Re:This is ridiculous by Dunbal · · Score: 2

      I'm on about why the hell do we have to be using these products at all when opium tincture (which is what paregoric and laudanum are) hasn't been wiped from the face of the earth and is more or less harmless - proof? It was widely used before, and even withdrawn from the "market" without a revolution. Opioids have been demonized by people who have zero understanding of them. And I include many of my fellow physicians in this category. They have their uses in many situations from diarrhea to pain management.

      --
      Seven puppies were harmed during the making of this post.
    14. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Methadone is used for chronic pain, but in my experience, more often for those who are being treated for drug abuse. The people treated with methadone up in Washington State may make up an entirely different patient group than the ones treated with OxyContin. Perhaps they use additional drugs to a greater degree, perhaps they have other comorbidities that give them a higher mortality, I don't know. You can't compare these groups adequately without that information.

    15. Re:This is ridiculous by ColdWetDog · · Score: 1

      Little or no problems? You need to read up on things a bit more. There were lots of problems with opium / heroin / cocaine addiction when the drugs where essentially available over the counter. It's just that making them illegal didn't improve anything. I don't think that the cure was any better than the disease, which is pretty much what I believe you're trying to say, but don't minimize the issue.

      Until we face up to the fact that humans like to use recreational drugs and deal with that in a compassionate, intelligent and not putative fashion, we're going to have these little problems.

      --
      Faster! Faster! Faster would be better!
    16. Re:This is ridiculous by bill_mcgonigle · · Score: 1

      ^this

      Shaking one's head a the rank incompetence of government is what they want you to do.

      As they say, follow the money.

      --
      My God, it's Full of Source!
      OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
    17. Re:This is ridiculous by sjames · · Score: 1

      The other effective choices are either practically impossible to prescribe because of war on drugs nonsense or are expensive due to patents AND war on drugs stupidity.

      Were it not for the DEA practicing medicine without a license, there would be safer cheap opioids available for chronic pain treatment.

    18. Re:This is ridiculous by bill_mcgonigle · · Score: 1

      What are you on about? The story is about the fact that people use the Opiod Methadone over other Opiods for painkiller use because it's cheap. However it is vastly more lethal then the other Opiods.

      I think what he's getting at is that the cost of the other medications are driven up by government regulation of drugs.

      In a free market, there's probably no pharmaceutical that could cost more than $3 a day (excluding harvested biological products, of course).

      --
      My God, it's Full of Source!
      OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
    19. Re:This is ridiculous by trout007 · · Score: 1

      I went to Home Depot to buy seeds for my garden. My 5 year old daughter came to me with a Disney Seed Packet with a picture of Belle from Beauty and the Beast and a picture of a nice big pink flower and asked if we could buy it. I said sure. I got home and looked at them and they were Poppy seeds. I though for a second and said well they can't be the heroin type of poppy seeds can they? So I looked online for a picture of the flower and sure as heck it was the same type of poppy you can use to make heroin. I decided not to plant them because knowing my luck I'd have a DEA agent in my yard. But I thought it would be funny to show that Disney is selling heroin seeds.

      --
      I love Jesus, except for his foreign policy.
    20. Re:This is ridiculous by __aajfby9338 · · Score: 2

      I'm sorry to hear about your chronic kidney stone problem. I had to pass kidney stones once, and it was the worst pain ever. In retrospect, it wasn't so bad once it was diagnosed and I got on the pain meds, but the period from the pain getting unbearable, through the ambulance ride, through waiting in the ER while they diagnosed the problem, to the first shot of painkiller finally taking effect, just felt like an eternity. I wouldn't wish that kind of pain on anybody.

    21. Re:This is ridiculous by Dahamma · · Score: 2

      Oxycontin has its reputation for a reason - it's both one of the most effective painkillers available, and one of the most addictive.

      I know at least 2 people who became seriously addicted to oxycontin after having been prescribed it. Specifically, my uncle had severe pain due to complications of meningitis, and it was by far the most effective drug for him. Unfortunately, It doesn't take long to build up a psychological and physiological addiction to it. In the end, overcoming this was possibly worse overall than the meningitis...

    22. Re:This is ridiculous by Dahamma · · Score: 1

      Growing poppies isn't illegal, making narcotics from them is illegal. I'm sure commercially available poppy varieties in your local garden center have a very low concentration of opium compared to those bred specifically for drug production.

      If growing poppies for aesthetic or culinary use was illegal, the DEA would be pretty busy with the gardening and bagel industries...

    23. Re:This is ridiculous by Dahamma · · Score: 1

      In a free market, there's probably no pharmaceutical that could cost more than $3 a day (excluding harvested biological products, of course).

      Amazing how people always ignore R&D when talking about drug costs.

      A big part of the reason some drugs (especially, say, cancer drugs where the market is fairly small) are so expensive is that they cost a couple billion dollars to develop and test, and the money for those efforts has to come from somewhere.

      If you are talking about "free market" as in no government regulations of safety or liability, then they would probably be significantly less expensive, and significantly more dangerous.

      If you are talking about "free market" as in no patent protection for any drugs developed, then a large number of modern pharmaceuticals would not even exist...

    24. Re:This is ridiculous by X0563511 · · Score: 1

      Correct. The cultivars you are going to find at a home-and-garden are not going to be that efficient (intentionally or not).

      I used to work with an idiot who was all into that. Pretty lame to hear him talking about it all the time. I'm surprised he didn't get busted.

      --
      For large sets, this will be our guide even unto death, for the LORD will work for each type of data it is applied to...
    25. Re:This is ridiculous by trout007 · · Score: 1

      The ones my little girl picked out are the kind Papaver somniferum that are known as the Opium Poppy. Now you are right there might be different ones that have more or less of the chemicals in them. Still you don't see marijuana seeds at Home Depot.

      --
      I love Jesus, except for his foreign policy.
    26. Re:This is ridiculous by Vintermann · · Score: 1

      Correct. The cultivars you are going to find at a home-and-garden are not going to be that efficient (intentionally or not).

      I hear they are efficient at defrauding would-be drug-experimenting kids out of their money, by selling their byproducts on online auction sites.

      For the record, I do not recommend this.

      --
      xkcd is not in the sudoers file. This incident will be reported.
    27. Re:This is ridiculous by Anonymous Coward · · Score: 0

      MS Contin is significantly more expensive than methadone.

    28. Re:This is ridiculous by countertrolling · · Score: 2

      Amazing how people always ignore R&D when talking about drug costs.

      That's because compared to marketing and lobbying, heavy discounts for major hospitals and the insurance companies which are not passed on to the rest of us, R&D comprise a relatively minor cost of doing business.

      --
      For justice, we must go to Don Corleone
    29. Re:This is ridiculous by khipu · · Score: 2

      Yes, and "other opioids" are expensive because they are controlled. Opium used to be cheaper than alcohol until it was controlled.

      Having said that, methadone is not intrinsically "more lethal" than other opioids, it is simply more likely to be used incorrectly. But the property that makes it more likely to be used incorrectly (long half life, less addictive) also makes it useful in many situations.

    30. Re:This is ridiculous by JDG1980 · · Score: 1

      As someone who has spent a lot of his life around pharmacists, I find this... unfortunate. If he did indeed run a website for banning oxy, that would explain that. Most pharmacists are very professional and nonjudgmental.

      And a lot of pharmacists are judgmental assholes. Many of them want the right to refuse to fill prescriptions for birth control or the morning-after pill if their "conscience" forbids it. If you don't want to do your damn job, get out of the way for someone who will. (Can a PETA member work at a butcher shop and refuse to serve anyone since they are opposed to eating meat?) Personally, I don't see why we need every single prescription to be filled by a pharmacist. Most of the time all they're doing is putting pills into a bottle - why can't this be automated? The last time I needed a medicine to actually be compounded (Doxycycline - for my cat!) I had to go to about 5 different pharmacies before I found one who could do compounding. (They all had Doxycycline in pill form, though.) Why do we need expensive, degreed workers to do what amounts to standard retail work? Especially when they start to get ideas about how important they are and how everyone should bow down to their "conscience."

    31. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Maybe some of us want to take better care of our livers?

    32. Re:This is ridiculous by catmistake · · Score: 1

      As little as 100 years ago people were using perfectly legal opium compounds such as paregoric, with little or no social problems.

      Actually, paregoric opiate addiction destroyed thousands of lives, so I don't know what you mean by "little or no social problems." Big problems... it caused lasting physiological and social damage to all that used it.

    33. Re:This is ridiculous by mirix · · Score: 1

      Possession and production of any part of the opium poppy is illegal in the US, excepting the seeds. So those poppies growing in grandmas garden are just as illegal as a bag of cocaine.

      Of course they don't enforce it unless you know what it is, which is a rather odd way of doing things.

      --
      Sent from my PDP-11
    34. Re:This is ridiculous by budgenator · · Score: 1

      Well, the point of the article was that it was only Medicaid that was putting people on Methadone after putting it on the 'preferred drugs' list, implying that it is an 'equally safe' drug against all evidence to the contrary.

      I'm not sure why being on a benefits provider's "'preferred drugs' list" would have anything to do with "'equally safe' drug" unless that benefits provider was also providing malpractice insurance. At least with commercial providers, they have to provide enough benefits to keep the clients paying while paying the physicians enough to keep them participating.
      There are other ways to control costs for example, Methadone HCL 10mg;
      RITE AID PHARMACY 1607 24TH STREET PORT HURON, MI 48060, 90 ea is $21.99,
      BLUE WATER PHARMACY 1209, 10TH STREET STE A PORT HURON, MI 48060, 90ea is $248.60.
      Hydocodone/APAP 5-500 ranges from $10.00 through $65.10 for 30ea;
      Hydocodone/APAP 10-500 ranges from $59.29 - $155.60 per www.michigandrugprices.com
      our Meijers pharmacies doesn't charge from most common generic antibiotics, our Kroger's has common generics at $4.00 for 30 and $10.00 for 90day supplies so just by shopping smart, I haven't paid even a full co-pay in years.

      --
      Apocalypse Cancelled, Sorry, No Ticket Refunds
    35. Re:This is ridiculous by fru1tcake · · Score: 1

      Yes, a PETA member can refuse to sell you meat, if they own the butcher shop, just as a newsagent can refuse to stock pr0n. The butcher might go out of business, but that doesn't mean they can't do it. Shopkeepers are not under compulsion to stock products they disagree with.

      I'm not advocating for judgementalism, but an important aspect of freedom is the ability to stick to your personal convictions in the course of your trade. Your customers also have the freedom to go elsewhere if you refuse to supply what they want.

      --
      It's not a bug, it's a lepidopter!
    36. Re:This is ridiculous by rahvin112 · · Score: 1

      I passed 3 kidney stones. One was 3mm (the max limit before they try to break them with ultrasound (very dangerous). I've felt pain that intense, but not that sharp. The onset is so fast too that it just takes your breath away. I went from mild back pain to the hot knife stabbing in about 10 minutes and it just keeps building. Once I got to the emergency room I had to wait due to patient load, I finally begged them to just give me a shot of morphine while I waited and they stuck me on a gurney in a hallway and dosed me. I'd wager it was about 1.5 hours from onset to the injection. The pain is just unbelievable. I've been told by a woman that's had 8 kids that kidney stones are far more painful than child birth and they at least give you an epidural for that!

    37. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Most pharmacists are very professional and nonjudgmental. That said, if you are exhibiting drug-seeking behavior, then, yeah, you might run into conflict with them. A friend of mine got yelled at for half an hour by a guy with a hand-written script for oxy, which he naturally refused to fill. Had to call security and get the guy tossed out, then he just moved on to the next pharmacy down the street.

      These things happen all the time to pharmacists... just telling you what the other side of the story is.

      You've been watching too much TV. That almost never happens to pharmacists. When it does cops are always called. Forging a prescription is a felony. Not reporting the attempt would be a serious violation in itself. If your "friend" actually exists you need to report him to the authorities.

    38. Re:This is ridiculous by bill_mcgonigle · · Score: 1

      If you are talking about "free market" as in no government regulations of safety or liability, then they would probably be significantly less expensive, and significantly more dangerous.

      Because people really want to buy drugs that are dangerous and would never look at third-party certification?

      --
      My God, it's Full of Source!
      OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
    39. Re:This is ridiculous by Dahamma · · Score: 1

      Maybe somewhat surprisingly papaver somniferum is the same species used for my favorite bagel topping and Afghanistan's largest cash crop. It's all about the "variety".

      Kale, cauliflower, broccoli, and cabbage are all the same species, as well - just some seriously different varieties.

      And, actually, cannabis sativa is grown widely for industrial uses like rope and textiles, etc. They just use the subspecies/variety "sativa" (which is available as seeds in many countries, as its THC content is too low to be useful as a drug - the US is just idiotic and/or bought by the cotton industry and doesn't allow growing it, while still being the #1 importer of hemp). Subspecies "indica", on the other hand, does have other popular uses...

      Anyway, it is still kind of funny that they were selling Disney-branded poppy seeds. Not illegal, but funny :)

    40. Re:This is ridiculous by Dahamma · · Score: 1

      It is legal to grow them in a number of states. Then again, it's legal to grow cannabis in a few states - just the latter is rarely done for its hemp fiber, so the US govt does tend to police it more :)

    41. Re:This is ridiculous by ShakaUVM · · Score: 1

      >>If your "friend" actually exists you need to report him to the authorities. :P

      Yes, my friend exists. I'm friends with a dozen or so pharmacists. And no, I'm not going to report him.

      >>That almost never happens to pharmacists.

      Uh, no. It happens all the fucking time.

    42. Re:This is ridiculous by ShakaUVM · · Score: 1

      >>Many of them want the right to refuse to fill prescriptions for birth control or the morning-after pill if their "conscience" forbids it.

      It's called a conscience clause, and it's a fucking good thing to have. You're only being righteously indignant about it because their code of ethics disagrees with yours. Switch roles for a second, and you'll see why a conscience clause is a good thing.

      We should NEVER force medical professionals to act in a manner they find unethical. If they can't do the job, they're required (by law) to provide the patient with a place where they can.

      >>Can a PETA member work at a butcher shop and refuse to serve anyone since they are opposed to eating meat?

      Can you sue a vegan restaurant for not selling meat? (See how stupid your argument is?)

      >>I had to go to about 5 different pharmacies before I found one who could do compounding.

      Most pharmacies don't do compounding these days, so you're either being disingenuous, or ignorant.

      >>Why do we need expensive, degreed workers to do what amounts to standard retail work?

      Ok, ignorant it is.

      (This is one of the most idiotic statements I've heard in a long time, BTW, and I listen to political talk radio.)

    43. Re:This is ridiculous by ShakaUVM · · Score: 1

      Continued. (Sorry, didn't realize I'd skipped one of your ignorant claims.)

      >>Personally, I don't see why we need every single prescription to be filled by a pharmacist. Most of the time all they're doing is putting pills into a bottle - why can't this be automated?

      Time for you to learn the difference between:
      http://en.wikipedia.org/wiki/Pharmacy_technician
      and
      http://en.wikipedia.org/wiki/Pharmacist

      You might also want to look at the difference in salaries between those that simply count pills into bottles, and those that counsel patients on correct drug usage and keep an eye out for medical errors and bad drug-drug interactions.

      Now you know, and knowing is half the battle.

    44. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Let me get this straight. You are confirming, on a public communications channel, that you are willfully ignoring felonies that happen "all the fucking time". Is this correct and true information? How many instances are you aware of?

    45. Re:This is ridiculous by ShakaUVM · · Score: 1

      I'm not ignoring any felonies.

    46. Re:This is ridiculous by Anonymous Coward · · Score: 0

      Thank you. From http://www.banoxycontin.com

  7. Re:Cynicism by antifoidulus · · Score: 0

    Congrats, you're an idiot. You obviously didn't even bother to read the first fucking sentence of the article, saves MONEY but costs lives. IE the drug is really cheap and not patented, and surprise! It isn't. Actually a lot of drugs in the list(all but oxycontin, and thats sort of up in the air right now, and will be expiring soon anyway). But don't let facts get in the way of your vapid statement.

  8. Accidental overdose? by loufoque · · Score: 1, Funny

    How can you accidently take more than the prescribed amount?
    Can't decipher the doctor handwriting?

    1. Re:Accidental overdose? by Zironic · · Score: 5, Informative

      Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

      As such most overdoses are accidental.

    2. Re:Accidental overdose? by Anonymous Coward · · Score: 2, Interesting

      Easily. How can you accidentally do anything?

    3. Re:Accidental overdose? by loufoque · · Score: 0

      If the doctor prescribed more than your body can handle, then the problem is with the doctor, not the drug.

    4. Re:Accidental overdose? by syousef · · Score: 3, Insightful

      How can you accidently take more than the prescribed amount?
      Can't decipher the doctor handwriting?

      Forget you've taken it and take it again. Anyone can become distracted but the very old (prone to memory related illnesses) and very young (in the care of others) are particularly susceptible.

      --
      These posts express my own personal views, not those of my employer
    5. Re:Accidental overdose? by Zironic · · Score: 3, Insightful

      As far as I know, usually what happens is that while the drug is strong, it's not effective in treating chronic pain because the effectiveness is erratic.

      The patient will then take more of the drug, because they think that their dose is too low since it's not being effective, thus ending up overdosing themselves.

    6. Re:Accidental overdose? by GreatBunzinni · · Score: 4, Insightful

      From the article, it sounds like this is not a problem caused by cheap drugs but by piss-poor medical care. If a patient is given a specific form of Opioid which is known for stuff such as 'With little warning, patients fall asleep and don't wake up", and it does so frequently that they even gave this form of death the pet nickname, "silent death", then it does look like the only problem is that patients aren't monitored accordingly. To put it in other words, it does sound like they are putting the blame on a drug for a problem which is caused by incompetent medical staff which are routinely slacking off monitoring their patients and doing their rounds. Giving poor people sub-standard health care to the point of being considered neglect is a much more serious problem than providing cheap drugs.

      --
      Slashdot, fix your code or at least hire someone who is competent at it to do it for you.
    7. Re:Accidental overdose? by Zironic · · Score: 1

      Huh? This is about pain medication that you're prescribed, not the pain medication you get while at the hospital (which tends to be mostly injected Morphine afaik).

    8. Re:Accidental overdose? by HeLLFiRe1151 · · Score: 4, Interesting

      Ritalin used to be the same size and color as methadone until one pharmacist accidentally put Methadone in some kids prescription of Ritalin. No one could figure out what was wrong with the kid, even as far as making the kid take more of it. The kid died. That's how you accidentally overdose.

      --
      I've got 101 mod points and you can't have them!
    9. Re:Accidental overdose? by Anonymous Coward · · Score: 1

      It may not be intentional, but damn. I hate it when people think they're so smart and think it's OK to go above prescription. Instructions are often there for good reason, if its not cutting the problem, its better to go to the physician again.

    10. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      It's an overdose in both cases, and it can also be accidental in the former case.

    11. Re:Accidental overdose? by Anne+Thwacks · · Score: 2

      I think you will find there is no law against stupidity. In fact, the truly stupid get an award named after a famous scientist - its called the "Darwin Award".

      --
      Sent from my ASR33 using ASCII
    12. Re:Accidental overdose? by moortak · · Score: 2

      Or perhaps people people on high doses of opiates. My wife was on a very heavy dose of Oxycontin for a long time and there were more than a few occasions wherre she wasn't sure if she taken her pills yet. We always played it safe and held off when there was doubt, but there were a few occasions where I had to stop her because she was sure she hadn't taken it. Large doses of these rugs don't exactly leave you clear headed.

      --
      Xavier Rabourdin for president 2012
    13. Re:Accidental overdose? by AndroSyn · · Score: 1

      No one could figure out what was wrong with the kid, even as far as making the kid take more of it. The kid died. That's how you accidentally overdose.

      [citation needed]

    14. Re:Accidental overdose? by thue · · Score: 1

      > Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

      According to Wikipedia, an overdose "describes the ingestion or application of a drug or other substance in quantities greater than are recommended[1] or generally practiced.[2]"

      So your use of the word is incorrect.

    15. Re:Accidental overdose? by Ihmhi · · Score: 1

      Aren't most doses measured by body weight? A 100 lb. woman taking four tylenol would be more affected than a 200 lb. woman. Perhaps a decent medical regulation would be factoring in whatever metrics are needed before dosing.

      It would also solve a few problems. I'm a rather large guy (definitely vertically, and a fair bit horizontally). A "normal" dose of Nyquil might make me a wee bit drowsy. A double dose will put me out. If they had weight ranges (or whatever the dosing factor might be), then maybe people would stop ODing because they take too much of something on account of the prescibed dose not doing crap for them.

    16. Re:Accidental overdose? by Lumpy · · Score: 4, Insightful

      You've never been in serious pain then.

      Even a perfect health 20 year old in a scale of 1 to 10, a 10 in pain will not only forget they took a painkiller, but will want the pain to subside so badly that taking another one is certainly a thought process they go through.

      Stick a railroad spike in your head and then pour salt and lime juice on it. Then tell me you will sit there and remember you took a pain pill 30 minutes ago.

      --
      Do not look at laser with remaining good eye.
    17. Re:Accidental overdose? by Anonymous Coward · · Score: 1, Informative

      Here you go, slothbag;

      http://www.pharmacy-mistake.com/eight-year-old-sickened-after-pharmacy-refills-prescription-with-methadone-instead-of-ritalin
      http://www.wate.com/Global/story.asp?S=3580654

      That took 30 seconds. Maybe you could have helpfully posted it yourself in about the same length of time it took to be a prick about it. And being wrong in your implication that it was false.
       
      Asshole.

    18. Re:Accidental overdose? by pz · · Score: 1

      I am not a doctor, and this is not medical advice.

      A proper, correct dose (total amount) of drug is determined by the dosage (amount per body weight) and the weight of the individual. It also should account for individual variations in sensitivity.

      Mostly, to save time, doses are determined by multiplying the dosage by an average body weight. For most drugs, which have a very broad dose / response curve, and thus a wide range of therapeutically useful values, that's fine. For some drugs, you have to be more careful.

      My wife (yes, this geek got lucky) is quite small, and thus nominally takes about 1/2 of prescribed doses (to be entirely accurate, she should be taking about 2/3, but most drugs have a broad dose / response curve, and 1/2 a pill is easier to create than 2/3 of a pill). I'm about average weight, and so the nominal doses typically work fine for me. Over-the-counter drugs have doses (again, total amount) based on a 170 lb body weight; it's pretty easy to normalize by 170 to get the dosage (again, amount per body weight) and multiply by your weight to get a more accurate dose. If you weigh anything close to 170 lbs, it isn't worth the effort.

      This is not medical advice, I am not a doctor, and you should take the preceeding only as interesting information. What you do with it, and any consequences, are entirely your responsibility.

      --

      Put my fist through my alarm clock with its ding-dong death inside my ear. - The Blackjacks.
    19. Re:Accidental overdose? by Anonymous Coward · · Score: 2, Informative

      You said the kid died. Nobody died.

    20. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      Asshole.

    21. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      u mad bro?

    22. Re:Accidental overdose? by blockhouse · · Score: 1

      > According to Wikipedia, an overdose "describes the ingestion or application of a drug or other substance in quantities greater than are recommended[1] or generally practiced.[2]"

      So your use of the word is incorrect.

      We don't recommend "ingestion or application of a drug or other substance" in quantities greater than what your body can handle, so therefore taking more drug that the body can handle is, in fact, overdose.

      Seriously, you're going to bicker over semantics?

      I know, I know, I must be new here, etc. etc.

    23. Re:Accidental overdose? by Rich0 · · Score: 1

      Well, you're describing what you do - but most doctors prescribe whatever the product circular tells them to, and most people take what is prescribed. If you're in a hospital they'll refuse to give it to you most likely if you won't take it as prescribed.

      However, in terms of the dosage that is most likely to work for you, the chemistry works more-or-less as you describe. Weight should almost always be a considerating when prescribing medication.

      The problem is that many drugs are only available in a few potencies, and most clinical trial data is just the average across the population at each potency. Maybe the manufacturer has more data on a mg/kg basis, but I doubt doctors have access to it.

      My own wife is small and takes many medications - it is a bit of an empirical thing but I'm fairly confident that on average she gets prescribed more than she really needs. Prescription practices are based as much on tradition as science, except maybe if you're talking about chemotherapy or something like that.

      Oh, and body weight isn't necessarily the best indicator of dosing. I'm not an expert, but I'd think that you'd also need to consider how the drug is partitioned in the body - if it is more lipid-soluble then body fat might matter more, and so on. As we all learned in physical chemistry chemicals distribute themselves in equilibrium between various phases as governed by their partition coefficients (once everything reaches steady state). Since drugs are engineered to target particular tissues/etc, I'd think that they'd be more sensitive to this than most. If the dissociation constant with its target is low enough, then binding might be near-stoichiometric so dosing might be based more on the total mass of the target in the body, and some organs don't scale with weight so much.

      And again, I'm not an expert in such things - I just know a little chemistry...

    24. Re:Accidental overdose? by blockhouse · · Score: 1

      Aren't most doses measured by body weight? A 100 lb. woman taking four tylenol would be more affected than a 200 lb. woman. Perhaps a decent medical regulation would be factoring in whatever metrics are needed before dosing.

      Proper dosing of opioids depends on a number of factors. Weight, as you mentioned, is one of them. Depending on exactly what opioid it is, you also have to consider renal function, kidney function, other drugs that might interact, and whether the patient has any genetic differences that may make them respond in a way you wouldn't expect. You also have to consider prior exposure to other opioids, as the patient may have developed cross-tolerance. Then too you have to look at the kind of social support they have, and whether they have any risk factors for adverse events. You probably want to be a little more conservative with the frail 80 year old patient who lives alone because a fall could be devastating.

      Bottom line, there are so many factors in play that many prescribers pick a conservative dose and titrate upward until the desired therapeutic effect is seen.

    25. Re:Accidental overdose? by TheLink · · Score: 1

      Maybe the pain is so much you don't care if you die? Dying over years/decades in debilitating pain may not be considered to be much better than dying overnight in an overdose.

      I think the doctor should find a better drug. Is there a cheap drug where the effective dose is not as close to the fatal dose?

      --
    26. Re:Accidental overdose? by Svartalf · · Score: 1

      In the case of Methadone, you can HAVE an accidental overdose. It lingers in your system and can leave the normally prescribed dose that would otherwise be safe to be a lethal amount.

      --
      I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
    27. Re:Accidental overdose? by Svartalf · · Score: 1

      Yep. Been there, done that. You can keep the fucking t-shirt. I won't go into details about what, but when ER doctors challenge my rating the pain at a 6-7 and being able to coherently hold a conversation, I tell them what I experienced at the age of 10 and they turn green at the gills and quite simply prescribe the pain killer to cut the pain while I'm in there without further debate.

      When you're in that much pain, you more often than not can't think coherently and you just want the pain to STOP.

      --
      I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
    28. Re:Accidental overdose? by Fnord666 · · Score: 1

      According to Wikipedia, an overdose...

      According to a guy at the bus stop, an overdose...

      --
      'The tyrant will always find pretext for his tyranny.' - Aesop's Fables
    29. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      I am presently in a drug study for long term opiate medication. I was in a bad accident and have serious problems with my neck. I also am trying to remain a productive member of society, despite qualifying for Social Security in my 20's. One of the things that they ask in the study, to weed out the drug seekers, is how often you are preoccupied with your medication. That is to say: 1) When you can take your next dose 2) Whether the medication will last long enough (supply), etc. Number one really bothers me. If you're in a lot of pain, you are constantly aware of when you can get more medicine.

      The pain can often make you forget that you've taken your medicine. I go through great lengths to both protect my medicine from theft and abuse, and to make it as difficult to take as possible so that I do not take more than I am supposed to. Its easy to do. I have my narcotic medicine in a safe. Its easier to remember going in to the safe to take my medicine, than it is to remember going into the medicine cabinet. Sometimes I have to think very hard about whether or not I took my arthritis medicine (celebrex). I'm more likely to take too much celebrex, than to accidently double dose myself on the narcotic. But even too much celebrex can be dangerous, as it can cause serious ulcers.

    30. Re:Accidental overdose? by wzzzzrd · · Score: 1

      It may not be intentional, but damn. I hate it when people think they're so smart and think it's OK to go above prescription. Instructions are often there for good reason, if its not cutting the problem, its better to go to the physician again.

      There is only one way to solve the problem: educate the patients. When I was in hospital and got a lot of painkillers, the nurse handing them out to me was frustrated that the people just swallow everything the physician prescribes. So she told me what kind of drugs it is, how it works and what would be dangerous about it. It has NOTHING to do with stupidity. Even a stupid person can understand how drugs work on a generic level.

      For example:

      As far as I know, usually what happens is that while the drug is strong, it's not effective in treating chronic pain because the effectiveness is erratic. The patient will then take more of the drug, because they think that their dose is too low since it's not being effective, thus ending up overdosing themselves.

      The GP's information really should be given to patients. It's easy to understand and will most certainly save lives. The problem is that politics is working hard to give the general public the feeling they are stupid and they have to trust their lives to the people "in the know", because everything is rocket science. Trust the public a bit more, INFORM THEM BETTER and let themselves decide whether they can handle the information or not.

      --
      On second thought, let's not go to Camelot. It is a silly place.
    31. Re:Accidental overdose? by thue · · Score: 1

      > Seriously, you're going to bicker over semantics?

      The grandparent's post was about the semantics of "overdose", and he got a +5 informative for it. Saying

      > Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

      is a semantic argument. So why shouldn't I point out that he is wrong.

    32. Re:Accidental overdose? by strength_of_10_men · · Score: 1

      According to a guy at the bus stop, an overdose

      According to a guy in a tech forum, an overdose...

    33. Re:Accidental overdose? by sjames · · Score: 1

      The extremely long half-life of methadone makes titration to a correct dose very hard and causes even the slightest excess to accumulate into a fatal overdose.

    34. Re:Accidental overdose? by sjames · · Score: 1

      I saw that (or a very similar case) on Dr. G.

    35. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      M-related deaths in pain patients have been increasing nationally since 2001 and contribute to a disproportionally high percentage of opiate-related deaths. A panel of pain doctors and public health specialists who studied this situation concluded that a major cause of the problem is that conversion tables — used by physicians to transition patients from one opioid to another — recommend too much methadone for most patients. In fact, the FDA recommended starting dose of methadone up until 2006 was 80 mg/day, compared to the new FDA recommendation that an appropriate initial dosage is 30 mg/day.

      The panel also suggested that many patients receiving methadone also had other medical and psychiatric issues, including substance use disorders, and the presence of other central nervous system depressant drugs, such as alcohol, benzodiazepines, or antidepressants.

    36. Re:Accidental overdose? by thegameiam · · Score: 1

      Absolutely true. I recently had a trauma which redefined my pain scale - it used to be that kidney stones and the EMG were the 9, while the spinal taps were about a 7. Now those are both 6, and the torsion was the 9. I only call it not a 10 because I have a particularly vivid imagination, and a 10 sounds like being drawn and quartered while alive, for instance...

      --
      Need Geek Rock? Try The Franchise!
    37. Re:Accidental overdose? by Dahamma · · Score: 1

      Oh, and body weight isn't necessarily the best indicator of dosing. I'm not an expert, but I'd think that you'd also need to consider how the drug is partitioned in the body - if it is more lipid-soluble then body fat might matter more, and so on

      Yep, many drug dosages are supposed to be calculated based on "ideal" or "lean" body mass - which makes prescribing the correct dosage more complicated for significantly obese patients.

      There are also some drugs that have very little mass-dependence - for example, those metabolized/cleared by your liver are far more dependent on liver function than body mass (which is one of the main reasons why children, elderly, and those with certain health issues need a lower dose of some drugs).

    38. Re:Accidental overdose? by X0563511 · · Score: 1

      Indeed. For example, not many people realize that acetaminophen/paracetamol (Tylenol) can utterly destroy your liver... and it's not even difficult to reach the dosage to do that. Look here for some likely numbers.

      I know I was close to the line when I was having some trouble with my teeth. I was keeping a running tally per 24-hour period. How many people do you think would do that?

      --
      For large sets, this will be our guide even unto death, for the LORD will work for each type of data it is applied to...
    39. Re:Accidental overdose? by Stormthirst · · Score: 1

      It is often preferred that a patient is given medication orally, even in a hospital setting. There are a number of reasons for this: cost and reduced rate of infection being two obvious ones. MRSA is a common infection at the site of permanent lines. Shouldn't happen of course, but it does. Oramorph is an example of orally taken morphine. The other thing you should realise is that doctors still prescribe medication when you're in hospital.

      The main concern is once people leave hospital and are no longer under the direct care of a doctor and the team of nurses (trust me - nurses are far scarier when it comes to regiments of taking medication).

    40. Re:Accidental overdose? by Mashiki · · Score: 1

      I agree, they haven't been in serious pain. Back pushing 20 years ago I had testicular torsion. I'm pretty fucking sure that the railroad spike in the head, along with salt and lime juice would have been preferable. I know, because it took 3 shots of morphine to take the edge off the pain. And I asked for more, while the urologist was coming in, along with the surgeon. People hear the stories about bad injuries that make you curl up inside, and give you odd visions and weak knees, and you start to feel nauseous, and want to faint. Yeah that was one of those. I haven't experienced anything like it since, and I'm hurt myself a lot since then. Including taking large chunks of building materials to the skull, and having migraines bad enough to put me in the hospital.

      Since then I've fractured both my C2 and C3, lucky as hell I didn't ruin any nerves, though some pinch and cause unbelievable spasms, and uncontrollable pain and I take two different muscle relaxants for, along with 10mg of endocet every 2hrs as needed upto a max of 8 pills every 6 hours. Luckily that's it.

      --
      Om, nomnomnom...
    41. Re:Accidental overdose? by CharlieG · · Score: 1

      Yeah - I had one (no details) where I was calling a 8, when they realized what I HAD, they were saying most people call it a 9-10, and I said I could imagine worse. 12 days of high doses of morphine. What fun. I'd rather NOT go through that again. Something about being in too much pain to even scream, just moan, BP and heart rate spiked, curled up, semi concious. They told me that if I had come to the hospital 12-24 hours later, I would not have come home

      --
      -- 73 de KG2V For the Children - RKBA! "You are what you do when it counts" - the Masso
    42. Re:Accidental overdose? by BertieBaggio · · Score: 1

      Curious medical student here... perhaps too curious! What happened to you when you were 10?

      --
      If all you have is a grenade, pretty soon every problem looks like a foxhole -- MightyYar
    43. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      Also, speaking as someone who has been in chronic pain, when the pain flares up to higher levels, the stress of it tends to make your forgetful.

    44. Re:Accidental overdose? by budgenator · · Score: 1

      The problem is a drug like methadone has a long half-life, so you have to build up to a therapeutic dose slowly, and if you over-shoot it takes a long time to clear. Taking an extra pill because the normal dose isn't "working" can push you into a toxic range;

      Methadone has a typical elimination half-life of 15 to 60 hours with a mean of around 22. However, metabolism rates vary greatly between individuals, up to a factor of 100,[46][47] ranging from as few as 4 hours to as many as 130 hours,[48] or even 190 hours.[49] This variability is apparently due to genetic variability in the production of the associated enzymes CYP3A4, CYP2B6 and CYP2D6. Many substances can also induce, inhibit or compete with these enzymes further affecting (sometimes dangerously) methadone half-life. Methadone

      and with a halflife in the 1 day range on a once a day drug, the OD can happen well after the extra dose.

      --
      Apocalypse Cancelled, Sorry, No Ticket Refunds
    45. Re:Accidental overdose? by reub2000 · · Score: 1

      I'm not an expert, but I'd think that you'd also need to consider how the drug is partitioned in the body - if it is more lipid-soluble then body fat might matter more, and so on.

      You might want to look at numbers like volume of distribution, and protein binding. These numbers should be available in the prescribing information. There are a few more variables, like the metabolism of the drug. Even knowing this, very few drugs have a known serum levels that is known to induce the desired effect. Mix in things like (cross) tolerance, differences the severity of illness, presence or absence of side effects, trial and error is probably the best idea.

      Like the GP, I'll leave the disclaimer that I'm not a doctor, and if your using my advice to determine anything of a medical nature, then your insane.

    46. Re:Accidental overdose? by ChrisMaple · · Score: 1

      Doctors are overpaid, drugs are criminally expensive and insurance is garbage all because a bunch of assholes in the 1% whined about universal healthcare. We hate the poor and working class here in the USA so we make sure that proper medical care is out of reach.

      Look here, you goddamned thief. You have no right to the money I've earned. You're so cowardly, you won't even steal it yourself, you have the government do it for you. Healthcare is not a right. You have no right to live on the efforts of others.

      --
      Contribute to civilization: ari.aynrand.org/donate
    47. Re:Accidental overdose? by cochito · · Score: 0

      This.

      Last time I tried to regulate my prescription of oxycodone, I was found at the kitchen table with my face in a soup bowl.

      I had been there for three hours.

      When I woke up, I asked why my soup was cold.

    48. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      > Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

      According to Wikipedia, an overdose "describes the ingestion or application of a drug or other substance in quantities greater than are recommended[1] or generally practiced.[2]"

      So your use of the word is incorrect.

      I'll see your Wikipedia link, and raise you a link to an actual Medical dictionary:
      http://medical-dictionary.thefreedictionary.com/overdose
      overdose (OD)
      [-ds]
      an excessive use of a drug, resulting in adverse reactions ranging from mania or hysteria to coma or death.

      AND
      Consumption of a therapeutic agent, drug, or narcotic, in excess of that required to produce the desired effects;
      Note the specific use of the word "required" not "recommended".

      And throw in a link to Merriam-Webster as well:
      http://www.merriam-webster.com/dictionary/overdose
      1
      : too great a dose (as of a therapeutic agent); also : a lethal or toxic amount (as of a drug)

      Neither of which agrees with the "Dipshit-O-Pedia" page you cited.
      I will also note, since you obviously did not bother to check, that the Weak-i-pedia's citation for that definition comes from a Rehab website in the UK which makes money by referring people to various rehab clinics.
      So I will quote the original definition used as the source for the Fuck-You-Pedia page, notice the differences:

      Strictly, an overdose is taking more than the suggested dose, whether of a medical drug or otherwise. So taking more than two paracetamol within the set time-frame would be an overdose. More usually, the term is used when there is an associated risk to health or even life. Many people overdose, but fatal overdoses are less common.

      So the parent's use of the word falls within acceptable definitions using your own goddamn citation as proof. While your definition is not entirely incorrect, you are entirely wrong in calling the parent wrong.

      DON'T USE FUCKING WIKIPEDIA LINKS to support your claims. There's a source for every bit of info on that site which is worth repeating, so take the 2 seconds to scroll down and use the original source, not some half-assed summary written by some no-name dickwad with an axe to grind.

      end rant.

    49. Re:Accidental overdose? by DrGamez · · Score: 1

      INTERNET FIGHT YES

    50. Re:Accidental overdose? by Anonymous Coward · · Score: 0

      I have a bad back and a chronic pain problem. I don't use opioids because I DO forget the last time I took pain medication - almost daily. I try to use pain medication only when I can't stand the pain any longer. Sometimes that's once or twice a day. Other times, I hurt so badly I would take a pain pill every hour if I could.

      When you have pain that you'd rate between 6 and 8 for DAYS ON END, you'd do just about anything to get rid of it. If you're elderly and already forgetful and you're taking a medication that can build up in your system, you're a dead man walking.

  9. Possible FRAUD Alert by Futurepower(R) · · Score: 4, Informative

    I don't think I know anyone who takes pain drugs, so I have no personal knowledge. However, I found a short article about Methadone on the Seattle Times web site recently when I was looking at Google Health news. Even the summary seemed obviously suspicious, so I looked at the article.

    To me, that article and all the data to which the Slashdot story linked screamed incompetence or fraud. Now that I've read a little of the linked data, I realize the writers are at least partly incompetent. Possibly only whoever started them looking was engaged in fraud to sell more expensive drugs.

    I just discovered that I'm not the only one who thinks that. Short quotes, read the full comments:

    "It does not matter if you switch every body to oxycontin or oxycodone. These drugs are terrible at controlling pain and all are very dangerous."

    "... I have an issue with how the Seattle Times is drawing a correlation between poverty and methadone poisoning. ..."

    Possibly Methadone is more often given to people who have little education, and who are therefore more likely to overdose because they didn't understand the instructions, or because they have other issues that confuse them.

    1. Re:Possible FRAUD Alert by Anonymous Coward · · Score: 0

      In the comments you link to is evidence directly opposing your view that the article is a fraud. Especially since the first quote you picked is part of a larger comment that agrees with the article, not you.

      The issue apparently is that Washington state has been pushing the use of methadone as a cheap alternative, but at the same time the group in charge of rating the safety of methadone has ignored serious flaws and issues when it says methadone is safe. Other opiates may not be much better for pain relief, but the government has been covering up the unique issues with methadone. Namely, that is has a longer half-life in the body which means it is easier to overdose on than other opiates.

    2. Re:Possible FRAUD Alert by Anonymous Coward · · Score: 0

      "It does not matter if you switch every body to oxycontin or
      oxycodone. These drugs are terrible at controlling pain and all are very
      dangerous."

      Oxycontin IS oxycodone, so your quoted source is pretty weak on the face of it. Also, the notion that isn't good at pain... is just wrong. I can personally attest to it after nice long trip through chemo this year.

    3. Re:Possible FRAUD Alert by Anonymous Coward · · Score: 0

      I'm a long-time /. lurker, but mainstream journalism trying to cover medical issues like this is so poor I have to respond.

      Proportional effects in numbers - The article makes a statement about Washington State pushing this cheaper drug to save money, and follows with "In 2004, the amount of methadone used in Washington had soared to about 224,000 grams. Oregon, meanwhile, used about 157,000 grams." Mind you, Washington has a population nearly DOUBLE that of Oregon, so per capita they actually use a lower % of the drug, but a higher % of deaths related to the drug in 2004 (256 vs. 99), which could be indicative of secondary factors in the deaths that are being ignored.

      This reminds me of a few years ago when I saw a single study about cardiac stents be blown into a major news item. After congressional review, it was clearly shown the study was in error because they included high risk [of complication/death] patients as a disproportional amount of the survey population. Proven wrong, yet not until the industry was hit with over a 30% decline in sales because of bad publicity.

      A 'good' report would have gone past saying that people are dying to this one drug and cite rising numbers, and looked at useful data. Examples: What percent of users of this drug die? What is the percent mortality of the more expensive alternative? Why does Oregon, which uses a higher amount of the drug relative to its population size, have a lower mortality rate? Looking beyond the couple tragic cases mentioned of younger patient deaths, what percent of the deaths have alternate causes significantly contributing to death? How does that compare to the expensive alternative?

      Answers to these questions would really shed some light onto the situation and prove any dangers to this drug. As it stands, looks like there is some agenda behind this story to make those lacking logic make an outcry for increased government spending.

    4. Re:Possible FRAUD Alert by Anonymous Coward · · Score: 0

      This /. -submission is the first place I heard methadone has been used to manage pain. It has been exclusively used to substitute heroin for recovering drug addicts here.

    5. Re:Possible FRAUD Alert by Anonymous Coward · · Score: 0

      I read this very same Troll before this article made it to the front page of Slashdot. I didn't bother replying because, well, you don't reply to Trolls. But seeing as how your post got up-moderated to +5 I'll state here and now that Futurepower(R) either never bothered to read the articles (or he is lying about the article because he has some agenda).

      He also happens to selectively quote the negative responses and not the positive responses. Of course, a vague and meaningless opinion like:

      "It does not matter if you switch every body to oxycontin or oxycodone. These drugs are terrible at controlling pain and all are very dangerous."

      demonstrates nothing but a bias against oxycontin.

      As somebody famous once said, "Reality has a well known liberal bias."

  10. Is it cost, or painkiller paranoia? by swb · · Score: 5, Interesting

    Doctors don't generally like to prescribe pain killers. They worry about addiction, they worry about the DEA auditing their prescribing habits and yanking their license, without which it's kind of hard to be a doctor.

    When they prescribe methadone, is it really out of cost, or have they grown so fearful of prescribing Oxycontin that somehow methadone seems like a reasonable alternative? And how many of those fears are medical/pharmacological, and how many are "if I prescribe Oxycontin I'll get in trouble" or "gee, there's a lot of press about Oxycontin, I shouldn't prescribe it"?

    1. Re:Is it cost, or painkiller paranoia? by Pharmboy · · Score: 5, Interesting

      You raise a good point. I see a pain specialist because of tendon and back problems. Regular doctors are regularly audited, but pain specialists are super audited, and the DEA puts so much pressure on them, that they do NOT like to prescribe pain killers at all if they can help it. (Based on input from 3 different doctors here). They have to keep records beyond the norm, prove that other methods were tried first, etc. I had not had a physical last year, and he wouldn't re-up my prescription until I did. His reasons weren't my health, he flatly said that he could get in trouble. So now our national health policy is party "ruled" by the DEA, a bunch of fucking idiots with a faulty agenda and no real world experience in front line medicine....great.

      --
      Tequila: It's not just for breakfast anymore!
    2. Re:Is it cost, or painkiller paranoia? by swb · · Score: 3, Insightful

      Worse than that, I don't even think the DEA applies medical logic -- I think their logic is all about drug control. They could care less about whether clinically effective medicine is taking place, they just want fewer painkillers in civilian hands.

    3. Re:Is it cost, or painkiller paranoia? by snowgirl · · Score: 2

      Apparently, my mileage varies greatly from others. I had a UTI, and they gave me a narcotic. No questions asked, just "here's a week's supply". And since I had 100% coverage, I didn't even give them any cash. It felt weird getting narcotics for just a signature, but there you go.

      Later on, during recovery from some major surgery, I had my Oxycotin prescription renewed without question, or hassle for about 2 months (at one point, they later switched me to Vicodin, same stuff, just a higher Tylenol to narcotic ratio).

      Although, I suppose in the surgical instances, no DEA agent is ever going to question why you're giving a patient narcotics after surgery... and then in the first case, I was peeing blood, so... probably no reason to expect to be hassled about that as well. Then of course, none of these three were for chronic pain, but rather for acute pain, that was expected to subside relatively quickly.

      Come to think of it, after I had my big motorcycle crash, I think they gave me a short-term supply of narcotics as well, no questions asked. But then again, also not for chronic pain.

      Meh, I don't know. I suppose what I'm saying is that I've never had trouble getting any narcotics. In fact, beyond the signing for it, I don't think I've ever had any more hassle getting narcotics than getting any other prescription drug. But then as noted, all of it was short-term, and none of it chronic. Likewise, all of them were well justified pain prescriptions.

      --
      WARNING! This girl exceeds the MAXIMUM SAFE standards established by the FDA for BRATTINESS
    4. Re:Is it cost, or painkiller paranoia? by sribe · · Score: 3, Interesting

      When they prescribe methadone, is it really out of cost, or have they grown so fearful of prescribing Oxycontin that somehow methadone seems like a reasonable alternative? And how many of those fears are medical/pharmacological, and how many are "if I prescribe Oxycontin I'll get in trouble" or "gee, there's a lot of press about Oxycontin, I shouldn't prescribe it"?

      Well, let me just tell you: I am not an "addictive personality" and have never had any problems whatsoever like that; I was on Oxy for 1 week after shoulder surgery, and wow; I actually went through (mild) withdrawal--headaches, night sweats, chills... Of course for me there was no temptation to get more to ease those symptoms, instead my reaction was "wow, I sure wouldn't want to take this shit any longer".

      And oh yeah, I did feel really good on it, no question about that...

    5. Re:Is it cost, or painkiller paranoia? by swalve · · Score: 1

      I think one of the big flags are maintenance doses. There's no problem with a bunch of one-off 14 pill scripts for the hard stuff to different people, but when you are giving 30 day supplies to the same people over and over, there will be scrutiny.

    6. Re:Is it cost, or painkiller paranoia? by swalve · · Score: 1

      I had the same reaction to Vicodin. Only took it for a couple of days, and I REALLY wanted more when I stopped. Very scary. A fun couple of days though.

    7. Re:Is it cost, or painkiller paranoia? by swillden · · Score: 1

      But then as noted, all of it was short-term, and none of it chronic. Likewise, all of them were well justified pain prescriptions.

      That's the key.

      My mother-in-law has severe scoliosis and has been in terrible pain for almost 20 years. She also gets lots of narcotics, but both she and her doctor have to jump through a lot of hoops. I had my appendix removed last year and they gave me a prescription without blinking. It actually makes perfect sense, if you buy the whole War on Drugs theory.

      --
      Note to ACs: I usually delete AC replies without reading them. If you want to talk to me, log in.
    8. Re:Is it cost, or painkiller paranoia? by Anonymous Coward · · Score: 0

      For what it's worth, I am an orthopedic surgeon, and at least here in Maryland, methadone is essentially verboten. I hate giving oxycontin too, but it's relatively easy to dose. Methadone, on the other hand, behaves differently due to the long half life, lack of experience with related drugs, etc. I have no problem writing for big doses of short acting narcotics but then, all of my patients just had what most people would call a big surgery, and I've never had any trouble with the doses I write for. If I ever run into a patient who I can't mange with oxycontin, or even if they need narcotics for more than a couple of months, it's off to the pain specialist with you - I'd go so far as to say I will never start someone on methadone ever..

    9. Re:Is it cost, or painkiller paranoia? by swb · · Score: 1

      I took Percocet 24 hours a day for two weeks (roughly equivalent to daily 20 mg Oxycontin tablets) as a result of a bad infection in a wisdom tooth and the subsequent extraction (it's far rougher when you're in your 40s).

      I couldn't wait to be off of it -- there was little euphoria as the initial infection's pain was the WORST I had ever experienced, and there was a lot of pain after the extraction (which due to scheduling problems took 4-5 days after the infection).

      But after a while, I was just tired and lethargic -- like I couldn't quite wake up. I was glad to be done.

      Anyway, I think the lesson there isn't that oxycodone is magically addictive, but different people have different reactions. I don't think a week is really enough to develop any kind of meaningful physical dependence, either, otherwise they would want to supervise your withdrawal with taper doses or possibly a mild tranquilizer.

    10. Re:Is it cost, or painkiller paranoia? by darkmeridian · · Score: 3, Informative

      From the other perspective, my brother is an ER doctor. He sees many drug-seekers every week. They'll come in claiming specious injuries (my neck hurts) and demand Oxycontin. Last week, some guy claimed that he never had Oxycontin before but needed it. A quick check revealed he had eight prescriptions already. And it's not just anecdotal evidence. Countering drug seeking behavior is one of the more important lessons ER doctors have to learn.

      What is anecdotal is my brother's disdain for pain management doctors. He calls most of them quacks who are legalized drug pushers. That's not to trivialize your experience or to denigrate your doctor, but apparently many of these dudes are making money pushing Oxycontin.

      --
      A NYC lawyer blogs. http://www.chuangblog.com/
    11. Re:Is it cost, or painkiller paranoia? by sribe · · Score: 1

      I had the same reaction to Vicodin. Only took it for a couple of days, and I REALLY wanted more when I stopped. Very scary. A fun couple of days though.

      No problem, with the Vicodin. Only the Oxy. Yes, they had me on both ;-) Quit the Oxy first, was on the Vicodin for 2 or 3 weeks...

      Also, it's possible I'm remembering it backwards as to which one gave me the withdrawal...

      But I remember thinking in my happy fog "it still hurts a little, geez what would it be like without the pills!"

    12. Re:Is it cost, or painkiller paranoia? by TheLink · · Score: 1

      There's a theory that some chronic back pain is due to low-virulent bacterial infection, and you can cure it with a course of the right antibiotics: http://bjsm.bmj.com/content/42/12/969.full

      I won't be surprised if that's true. Periodontal bacteria has been linked to heart disease, and antibacterial mouthwash reduces the risk of preterm deliveries ( http://www.thehealthage.com/2011/02/anti-bacterial-mouthwash-reduces-risk-of-preterm-deliveries/ ).

      It took a while for people to find out and prove that helicobacter pylori was responsible for many cases of chronic gastritis and gastric ulcers.

      Not all bacteria are harmful and not in all cases. It can get quite complex - the same bacteria might be fine in one person or fine when with other bacteria. Nowadays some doctors are even resorting to fecal transplants to cure certain gastrointestinal problems: http://www.wired.com/wiredscience/2011/12/fecal-transplants-work/
      http://blogs.wsj.com/health/2011/10/31/fecal-transplants-have-the-ick-factor-but-research-suggests-they-work/

      Hence many of these chronic problems actually being caused by bacteria or an imbalance in bacterial ecosystems would not be surprising to me.

      --
    13. Re:Is it cost, or painkiller paranoia? by Svartalf · · Score: 1

      (at one point, they later switched me to Vicodin, similar stuff, just a higher Tylenol to narcotic ratio).

      FTFY. Vicodin is hydrocodone with tylenol. Oxycontin is Oxycodone , a chemically similar drug- but not the "same stuff".

      Vicodin's Pharmacology
      Oxycontin's Pharmacology

      --
      I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
    14. Re:Is it cost, or painkiller paranoia? by Svartalf · · Score: 1

      It's a bit of both, in this case. Medicare's got Oxycontin and Hydrocodone on a restricted list for pain management, partly because of expense and partly because of the fear you mention. What IS on the list, strangely enough, is Methadone and Morphine (yes...orally administered Morphine...) for pallative care and general pain management. Little else.

      Methadone's damned dangerous and we know Morphine's risks. Both are actually cheaper than the "safer" alternatives which is part of the reason they're on the Medicare part D list of approved meds.

      --
      I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
    15. Re:Is it cost, or painkiller paranoia? by Anonymous Coward · · Score: 0

      They are very well monitored, and so are the patients. I had to agree to allow the doctor or law enforcement to A)Request to see my prescription at any time, and to submit to a count of the pills / patches / whatever. B) Submit to random drug screening by the doctor or law enforcement at any time. C) submit to quarterly drug screens while at the doctors office for my routine visits. D) I have to come into the office every month to get new medicine. I can only come in so many days early, if I have to travel. This means that I have to plan vacations, business trips, and any other travel around my doctors appointments. It's quite annoying, but understandable.

    16. Re:Is it cost, or painkiller paranoia? by jittles · · Score: 1

      , I had my Oxycotin prescription renewed without question, or hassle for about 2 months (at one point, they later switched me to Vicodin, same stuff, just a higher Tylenol to narcotic ratio).

      You are thinking of oxycodone, which is a different formulation of hydrocodone. They have about the same strength, but oxycodone is generally more effective at treating pain. Typically if you've become resistant to hydrocodone, you can switch to oxycodone and have better effectiveness for a short period. They metabolize into the same chemicals. Oxycontin is an extended release version of oxycodone, that typically lasts for 24 hours. Its also a much higher dosage than what you find in percocet (5-10mg oxycodone and 325mg tylenol). You can also get vicodin with 5-10mg of hydrocodone and 325-500mg of tylenol.

      Although, I suppose in the surgical instances, no DEA agent is ever going to question why you're giving a patient narcotics after surgery... and then in the first case, I was peeing blood, so... probably no reason to expect to be hassled about that as well. Then of course, none of these three were for chronic pain, but rather for acute pain, that was expected to subside relatively quickly.

      Come to think of it, after I had my big motorcycle crash, I think they gave me a short-term supply of narcotics as well, no questions asked. But then again, also not for chronic pain.

      Meh, I don't know. I suppose what I'm saying is that I've never had trouble getting any narcotics. In fact, beyond the signing for it, I don't think I've ever had any more hassle getting narcotics than getting any other prescription drug. But then as noted, all of it was short-term, and none of it chronic. Likewise, all of them were well justified pain prescriptions.

      It's only an issue when they prescribe a lot of narcotics, or a lot of narcotics to the same individual. If you are a PCP, then you typically would prescribe a variety of medicines, and narcotics should be a small percentage of all the medicine prescribed.

    17. Re:Is it cost, or painkiller paranoia? by ShakaUVM · · Score: 1

      >>From the other perspective, my brother is an ER doctor. He sees many drug-seekers every week

      I'm friends with a number of pharmacists, and am married to one. Every week they'll get a guy come in with some sort of fake drug script, try it on them, and then move on down the street until they find a place that'll fill it. Another friend of mine is a doctor, and they have to haul all their drugs around in a very heavy iron suitcase to stop patients from running off with the drugs on the inside.

      Drug-seeking behavior is a real thing, and the safeguards are there to stop people like them from abusing drugs.

      The GP was complaining about the amount of scrutiny that the DEA gives, interfering with "real medicine", but basically they just care about tracking where every pill produced ends up, and catching drug seekers.

    18. Re:Is it cost, or painkiller paranoia? by Anonymous Coward · · Score: 0

      but apparently many of these dudes are making money pushing Oxycontin

      How? Do they own the pharmacy, or..?

    19. Re:Is it cost, or painkiller paranoia? by darkmeridian · · Score: 1

      The doctors charge a whole bunch for a "check up" that confirms some sort of physical disorder that all the other doctors managed to miss. You know, they're specialists who find things that all the other doctors miss, so they have to charge more for their expertise, in uh, finding more reasons to give prescriptions than all the other doctors who have previously treated their patients.

      --
      A NYC lawyer blogs. http://www.chuangblog.com/
    20. Re:Is it cost, or painkiller paranoia? by uniquename72 · · Score: 1

      I've been on both sides of this:

      Ater my knee surgeries (also caused by motorcycle accidents!) I was given ridiculous amounts of hydrocodone. Like, a 3-month's supply, plus a refill. More than I could ever have needed for knee pain. In both cases, I used it as an occasional sleep aid for 2 years.

      But I also occasionally have back problems, and exactly 1 thing can help me: taking an opiate and a muscle relaxer and staying in bed for a day or 2. But because so many junkies use "back pain" as an excuse to get a fix, and because so many junkies got that way because of medication given to them for back problems, I have a hell of a time finding a doctor to prescribe it, even in very small doses.

      I've gotten to the point that I no longer even go see a doctor when I get a flair up; there are always other ways to get pills. It costs more since insurance doesn't cover it, but for under $20 ($3 a pill) I can get the treatment I need and that many doctors will flat out refuse to give me.

    21. Re:Is it cost, or painkiller paranoia? by Anonymous Coward · · Score: 0

      Oh, you were talking about nutjob conspiracy theories, right.

    22. Re:Is it cost, or painkiller paranoia? by __aajfby9338 · · Score: 1

      I took Vicodin when I was passing kidney stones. Once my little unwanted guests left, I felt no need to take any more Vicodin, and I just continued taking the ibuprofen that they also prescribed for another day or two. I guess I'm lucky that I don't seem to have a strong propensity to get hooked on the stuff. The Vicodin seemed to make me pretty sleepy, but I didn't feel particularly foggy in the head when I was awake.

    23. Re:Is it cost, or painkiller paranoia? by zippthorne · · Score: 1

      The GP was complaining about the amount of scrutiny that the DEA gives, interfering with "real medicine", but basically they just care about tracking where every pill produced ends up, and catching drug seekers.

      But the thing is.. what do they do when they catch them?

      --
      Can you be Even More Awesome?!
    24. Re:Is it cost, or painkiller paranoia? by catmistake · · Score: 1

      Not sure what doctors you're talking about... but the pain doctors I have heard of were basically just tools of Big Pharm. These doctors helped create the massive scourge of oxycontin addiction in the US. Oxycontin is a drug conceived and created for terminally ill patients. But there just aren't enough terminally ill patents, and patents don't last forever... so ... they give it to anyone and everyone for everything. OK, maybe not so much anymore now that we have pregnant women robbing pharmacies... but this shift in care where doctors care about their patients' addictions is a relatively new... of course good doctors have always cared, but the new addiction scrutiny that every doctor now seems to have only came about after oxycontin was invented and people who had no business being prescribed it became addicted.

    25. Re:Is it cost, or painkiller paranoia? by catmistake · · Score: 1

      Well, let me just tell you: I am not an "addictive personality"

      Oh, and I suppose those aren't your opiate receptors, you're just holding them for someone, right? Just adding to your point... when it comes to opiate-derrived or opiate-simulated narcotics, everyone has an addictive personality.

    26. Re:Is it cost, or painkiller paranoia? by snowgirl · · Score: 1

      , I had my Oxycotin prescription renewed without question, or hassle for about 2 months (at one point, they later switched me to Vicodin, same stuff, just a higher Tylenol to narcotic ratio).

      You are thinking of oxycodone, which is a different formulation of hydrocodone. They have about the same strength, but oxycodone is generally more effective at treating pain. Typically if you've become resistant to hydrocodone, you can switch to oxycodone and have better effectiveness for a short period. They metabolize into the same chemicals. Oxycontin is an extended release version of oxycodone, that typically lasts for 24 hours. Its also a much higher dosage than what you find in percocet (5-10mg oxycodone and 325mg tylenol). You can also get vicodin with 5-10mg of hydrocodone and 325-500mg of tylenol.

      This clearly looks well researched and knowledgeable about the pharmacology involved. Say, that I'm allergic to morphine (because I am), are oxycodone, and hydrocodone different enough that I wouldn't be allergic to them? Or rather, what I mean is, is there a high or low correlation between allergy to morphine and those two opiates?

      Why I ask, is because I know that I am allergic to morphine (was told by doctors, kept them informed, later I had a spider vein inflammation from an injection given only because I was screaming bloody murder, and they decided the risk was worth it (I generally agree with this decision)), yet I have never had an apparent allergic response to any other opiates that I have taken in pill form.

      I'm kind of rather clueless, and while I could probably work out an answer, it would take me a long time of study, much longer than I think is really necessary for a "I wonder..."

      --
      WARNING! This girl exceeds the MAXIMUM SAFE standards established by the FDA for BRATTINESS
    27. Re:Is it cost, or painkiller paranoia? by jittles · · Score: 1

      Say, that I'm allergic to morphine (because I am), are oxycodone, and hydrocodone different enough that I wouldn't be allergic to them? Or rather, what I mean is, is there a high or low correlation between allergy to morphine and those two opiates?

      I'm not sure. My understanding is that they all metabolize into the same chemical inside of the body. There could be some difference between them, I suppose. Oxycodone and hydrocodone are just synthetic versions of the same basic chemical, I believe. Typically when people have reactions to opiates they become very sick and cannot keep anything down. Is that the same with you? I feel sorry if that is the case, as narcotic pain meds can be very important if you need surgery, or have a bad accident.

    28. Re:Is it cost, or painkiller paranoia? by gmhowell · · Score: 1

      Yeah, watch out in MD. My father is still dealing with shitheads at the state after several years of being on the 'no-no' list. Turns out it's better to send someone three hours away than to prescribe various opioids in medically underserved areas of the state.

      --
      Jesus was all right but his disciples were thick and ordinary. -John Lennon
    29. Re:Is it cost, or painkiller paranoia? by ShakaUVM · · Score: 1

      >>But the thing is.. what do they do when they catch them?

      If a pharm tech or something is diverting a C2 drug to sell on the street, they'll probably go to jail. If drugs went missing, there's a reconciliation process, IIRC.

      Diversion the main concern of the DEA, which is why they maintain extensive records on the supply chain of every C2 drug.

      Once it's in the hands of the legitimate patients, they don't seem to care very much. After my grandmother died, we had about a gallon of liquid morphine left over. They just told me to pour it down the drain, which seemed kind of odd to me (don't they want to verify it?) but I did, and that was that.

    30. Re:Is it cost, or painkiller paranoia? by Anonymous Coward · · Score: 0

      the corollary is that if the safe guards were not there, the market would provide enough supply to meet the demand and doctors would not have to worry about fake scripts, or iron suitcases.

  11. Well, pain killer, lol by Anonymous Coward · · Score: 1, Interesting

    Actually here around it's better known as a "legal" (when given in the correct programme) substitution drug for heroine. (Basically instead of letting junkies do crimes to get their hand at illegal drugs, let's doctors prescribe it, with the official "goal" of getting the junkie some time in the far future clean).

    And it's that narcotic, that you do not only need special prescriptions, nope, the drug is usually not given out to the "patient", they are forced to go in daily to the pharmacy and consume it on site.

    One last thought, opiates are known to create very strong addictions, hence locally they are usually only administered in very restricted circumstances, e.g. as after care after surgery known to induce extreme pain, if really any other pain medication does not help, but only for a short term till the reasons can be fixed, and mostly for terminally ill patients (where the addiction aspect is irrelevant, but the painless sleep potentially into death is quite relevant).

    Basically, cost accounting and medicine do not mash to well, and especially state run (but private insurances are not much better, but they tend to do it on a case by case base) systems have a tendency to go for cheap treatments even if they are not medically sound. (And using heavy addiction inducing drugs as a general pain killer medication is not sound policy). The only way (locally) to get them to do the right thing is usually to force the "cost controlling" MDs (it's always MDs here around that need to decide) to put their decision in writing including the reasoning, and mention that one needs this for the Social Court (locally we've got special courts for stuff related to social services and employment situations, and they usually tend to rule favorably), ... => more than once the MD reevaluated her decision while trying to formulate the reasoning.

    1. Re:Well, pain killer, lol by subreality · · Score: 3, Insightful

      Basically instead of letting junkies do crimes to get their hand at illegal drugs, let's doctors prescribe it, with the official "goal" of getting the junkie some time in the far future clean).

      And it works! If you give a junkie a reliable, free supply of opiates, they quit the cycle of binging then stealing things when they run out, are generally able to function in society, and gradually wean themselves off. It is more effective than any other treatment.

      Methadone is particularly effective because for this because it's very long-acting. It doesn't provide a reward rush when you take it, and it doesn't crash fast leaving them desperately craving.

      they are forced to go in daily to the pharmacy and consume it on site.

      Sure. Heroin users are used to gauging their dose by the immediate response. Methadone is really slow, so they think they didn't take enough and take more, only to end up overdosing when it hits. For non-addiction prescriptions they just give you a 30-day supply.

      And using heavy addiction inducing drugs as a general pain killer medication is not sound policy

      What would you suggest for severe pain? Advil isn't going to do it.

    2. Re:Well, pain killer, lol by Anonymous Coward · · Score: 0

      That was spoken like someone that has a wonderful education themself.

  12. Are these all really "accidents" . . . ? by PolygamousRanchKid+ · · Score: 2, Insightful

    . . . faced with a life full of incurable, chronic, unbearable pain . . . this "silent death" might seem like a more pleasant option for some folks.

    It would seem like an alternative for a doctor forbidden by law from assisting a patient requesting euthanasia. The doctor prescribes the medication and describes the risks. It is the patient's choice to take a lethal amount.

    --
    Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
  13. I live with pain by Kilz · · Score: 5, Interesting

    18 years ago I messed up my back, 8 years ago I did it again. The second time around didnt have the results of the first. I live with constant pain while awake unless laying down.
    Pain is depressing, it ruins your attitude and life. I have learned to live with it, with pain pills to manage the pain. When sent to pain management every so often to get the pain medication adjusted methadone is always pushed, I am also low income. I have done a lot of study of pain drugs and will always tell the doctor that is one medication I want to avoid. At present I am on Percoset (oxycodone/acetaminophen). While it isnt as cheap as the methadone on my crappy insurance, my life is way more important than the $10 a month extra it costs me.
    But the problem may not be the drug itself but the idea that some people in pain have that they can avoid pain completely. This isnt always the case when you are on these types of medication. You can control pain, you can moderate pain. But if you think that if I take a pill or two extra it will get rid of it altogether you are on a slippery slope. My brother tried that, he ended up taking more and more pills because over time your body starts resisting them. Thats where the danger lies. You take so many that you end up killing yourself by overdose, like my brother did at 36.

    --
    I trust Microsoft as far as I could comfortably spit a dead rat
    1. Re:I live with pain by Anonymous Coward · · Score: 0

      And experimenting with pain medication - with a doctor's help, of course - is extremely difficult because docs are afraid of getting into trouble. Yeah, War on Drugs.

      And if you have a history of drug abuse - even if you were trying to self medicate (which is what all drug abuse is about anyway) - you're pretty much screwed with getting the help you need.

    2. Re:I live with pain by Rich0 · · Score: 4, Interesting

      You just illustrate the problem with the war on drugs. You're taking acetaminophen. The only reason it is in the pills is to kill you if you dare to take too much. They could either prescribe the oxycodone on its own or in combination with a safer NSAID and it would only be safer and more effective.

      Too many painkillers are designed with a LACK of safety being a design criterion - all because we'd rather kill people who get the dosing wrong rather than risk somebody getting high.

    3. Re:I live with pain by Anonymous Coward · · Score: 0

      I am in the same boat as you. I can tell you that the best medicine I have taken is the duragesic patch (fentanyl 25ug). I actually feel like a normal person again on this medicine. I still have bad days where I don't want to get out of bed, but I find that I can be productive and not have medicine head all day. It has made an amazing difference.

    4. Re:I live with pain by Anonymous Coward · · Score: 0

      You're a bit of a redneck when it comes to medicine, aren't you?

    5. Re:I live with pain by Anonymous Coward · · Score: 0

      Acetaminophen is not an NSAID. It is a COX inhibitor with anti-inflammatory properties. Very different. One can kill me, the other can't.

    6. Re:I live with pain by Rich0 · · Score: 1

      Most of the common NSAIDs are COX inhibitors. I couldn't find anything really contrasting them.

      In any case, if you stuck ibuprofen in the drug I can't see how it would work any less well, aside from not causing liver toxicity.

    7. Re:I live with pain by adolf · · Score: 1

      This.

      Tylenol (acetaminophen), when mixed with other drugs, is the work of thugs and crooks and politicians.

      It's somewhat useful by itself (as long as the patient doesn't drink much alcohol), but is easily deadly when abused (and/or the liver is otherwise-compromised).

      I have a wide array of pills in my medicine cabinet, for a wide array of ailments, and when I decided one day to childproof it the very first thing I did was to get rid of everything containing (or consisting of) acetaminophen.

      Because, frankly, nothing else in there was anywhere near as dangerous -- even in fistful-of-pills sorts of doses.

      To be clear, I'm not necessarily against doctoring up various "fun" drugs to make them less fun [or downright unpleasant] for those who want to eat them in recreational quantities, but killing their liver [and thus the user] is going just a wee bit too far.

      Death sentences should only occur at the hand of a jury.

  14. Do you have poor reading comprehension? by arcite · · Score: 2

    The key point of the linked article was not that those who were given the drug overdose because they have less education and cannot read the medical instructions, but that they are given the drug because it all they can afford given the status of their medicare. Poverty does not discriminate between those who are educated and those who are not. We shouldn't blame the victim, blame the doctors and the insurance companies.

    1. Re:Do you have poor reading comprehension? by Anne+Thwacks · · Score: 4, Informative
      Poverty does not discriminate between those who are educated and those who are not.

      Maybe not on your planet, but here on earth, educated people have a much better chance of making money, and people with money are likely to get a better education. People with poor reading skills, or other problems with communication are likely to be on very low incomes all their lives.

      I acknowledge that educated people can be poor whether short or long term, but they are not the same boat at all.

      --
      Sent from my ASR33 using ASCII
    2. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 2, Informative

      I just bought a 50-pack of Ibuprofen 600 for 5€ (the same price that every drug costs) and a 30-pack of Omeprazol for 0€ (unless it's free ;), thanks to my health insurance which is paid by a tax going off of my salary.
      And if I lose my job, there is a government agency that pays for it no matter how long I'm without a job. (Yes, they push you into getting a job and send you job offers. But there is nothing wrong with that.)
      I can go to the doctor or hospital as often as I want and I get what's necessary. It's not perfect, but for a couple of € more a month, I get premium healthcare.

      Problem, America? :D

    3. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 0

      Some day I hope we get a semblance of sane health care.

    4. Re:Do you have poor reading comprehension? by zippthorne · · Score: 1

      I wonder if any of this is related to the impending potential breakup of the € we keep hearing about, though...

      --
      Can you be Even More Awesome?!
    5. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 1

      Ibuprofen and Omeprazol are fairly inexpensive in the States without being forced to go through any sort of health insurance.

      A 40-pack of Omeprazol (the most common brand name in the USA is Prilosec) costs around $20 (about 15 Euros). Ibuprofin (Advil, Motrin IB) is around $20 for a 300-pack, though those are 200 mg tablets, not 600 (so, 15 euros for the equivalent of twice your 50-pack). So Ibuprofen is barely higher cost. Prilosec is a bit more. You're also double-paying for both, as you've already paid for it in tax - the USA gets them OTC.

      Plenty of problems here, thanks. But what you describe? Not one of them.

    6. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 0

      Could we at least eliminate that correlation as a possibility before jumping to the conclusion that poor people are being attacked by maliciously stupid doctors? Nobody here is saying "Fuck the poor! Give them more of the stuff!" The only thing he's saying is that sometimes people fuck up, and less educated people are less likely to actually have the background language skills to understand or even read the instructions they're given. Maybe the Methadone isn't the problem, but the instructions are the problem.

    7. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 0

      Also, I should add those are the costs for non-generics.

      Ibuprofen generic can be had, 750 tablets of 200mg, for $15 (12 euros). Converting that to 600mg equivalents, that's 250 doses for 12 euros. You pay 5 euros for 50 without factoring tax. You're paying twice as much WITHOUT tax.

    8. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 0

      Getting sick will wipe you out financially no matter how rich or educated you are.

    9. Re:Do you have poor reading comprehension? by dunkelfalke · · Score: 1

      Ibuprofen is sold over the counter in many European countries, but only up to 400mg. Higher strength is prescription only where I live. What medicaments are prescription only and what can be sold over the counter varies somewhat in every European country.

      Omeprazol is also sold over the counter here, but only in 7- and 14-packs. Larger ones aren't. A 14-pack costs about 5 EUR, so the price is comparable, except that European prices always include VAT, but, from what I know, sales tax in the USA varies a lot.

      --
      "It's such a fine line between stupid and clever" -- David St. Hubbins, Spinal Tap
    10. Re:Do you have poor reading comprehension? by Anonymous Coward · · Score: 0

      IB is available over the counter for half that price here in the states. No tax necessary.

  15. Heroin substitute. by salparadyse · · Score: 1

    Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply, hence its use.
    The glaringly obvious solution of the State control and supply of heroin to addicts is apparently beyond those who make such decisions. Far better to throw money up the wall buying a substitute and then pretend you're handing out medicine.

    1. Re:Heroin substitute. by myowntrueself · · Score: 1

      Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply, hence its use.

      The glaringly obvious solution of the State control and supply of heroin to addicts is apparently beyond those who make such decisions. Far better to throw money up the wall buying a substitute and then pretend you're handing out medicine.

      yeah and the side effects of methadone are supposed to be unpleasant enough to deter addiction. Well thats what the Nazis figured when they invented the stuff...

      --
      In the free world the media isn't government run; the government is media run.
    2. Re:Heroin substitute. by pla · · Score: 4, Interesting

      We use it like that here in the US, but thanks to our Puritanical roots, we frequently see it used only "unofficially" in that capacity.

      We have tons of rules regarding where methadone clinics can go, how many people they can serve, under what conditions people can use it, how long, etc. So you end up seeing a lot of methadone prescribed for "chronic pain", despite the fact that it really kinda sucks for the whole "pain management" thing that opiates normally excel at.

      Really, it does one and only thing well - It keeps people from going into withdrawal.

      So basically, when you see a cluster of poor minorities with loq education OD'ing on this stuff, it doesn't mean their doctors have failed, it means a not-quite-ex-addict tried to get high on it and learned the hard way that it doesn't work very well for that, either.

    3. Re:Heroin substitute. by Blue+Stone · · Score: 1

      >Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply

      Actually I don't think that's the issue - the predictable quality and supply - that's only an issue with illegal drugs - because of the dealers cutting them and drug prohibition endangering supply. If you gave the patient medical grade heroin or another opioid - they would also have predictable quality and supply.

      I think the real reason they give methadone instead of heroin to addicts is that it doesn't give the user the same euphoric effect - it's a psychological-political issue - about the state of mind a government will allow people to experience - and this 'high' is seen as dangerous and forbidden.

      Studies have proven elsewhere that regualr controlled presribing of heroin - under supervision- allows an addict the stability they need to sort their life out and return to a regualr family & work life - giving them the confidence to ditch the drug in their own time.

      Methadone use for drug addicts is a perverse symptom of prohibition and polidical ideology that does more harm than good.

      --
      Corporation, n. An ingenious device for obtaining individual profit without individual responsibility. - Ambrose Bierce
    4. Re:Heroin substitute. by Anonymous Coward · · Score: 1

      It's actually on cost and dosing grounds. Diamorphine costs the NHS up to £20,000 per year at doses used for opioid detox (because of the huge doses involved and multiple times per day usage) whereas methadone doesn't go over about £600.

  16. Re:Cynicism by Anonymous Coward · · Score: 0

    Love how everyone jumped on this calling the poster an idiot. Perhaps it was a legit question. I would question his wisdom of asking slashdot for any reliable information but to blast him/her as lazy and stupid for asking a question where you can't tell the tone shows what's wrong with internet forums in general and slashdot in particular.

  17. Re:It's called by Anonymous Coward · · Score: 0

    or euthanize the people who find it easier to blame others for their lot in life than attempt to improve it. Yes thats right, it was a plot by a secret organization to keep you down, in order to further their fiendish goals.... dumbass

  18. The Republican Face of Future Medecine... by Anonymous Coward · · Score: 3, Insightful

    ...is more of this. Republicans want to turn Medicaid into a block grant program to states, with eroding value because payments won't keep up with inflation. States, squeezed to do more with less, will continue to do the cheap thing instead of the right thing for the poorest, most vulnerable (those with no cash to buy influence), and the poor will suffer and die in a greater and growing proportion to the rest of us.
     
    They'll do the same thing to Medicare. So keep it up, poor and middle class, keep voting directly against your own economic interests, and watch your mortality rates soar.

    1. Re:The Republican Face of Future Medecine... by countertrolling · · Score: 1

      ...the poor will suffer and die in a greater and growing proportion to the rest of us.

      "Fuck the poor!"

      --
      For justice, we must go to Don Corleone
    2. Re:The Republican Face of Future Medecine... by Anonymous Coward · · Score: 0

      Neither party cares about the Middle Class. The middle class in this discussion is the group of people who make less than 60k/yr but who are insured privately. I could care less about the uninsured poor, because I already pay 25% of my income in taxes. Half of that is for Medicare. That's twice what I pay for food. Why would I want to pay more taxes to subsidize people who aren't as motivated as me to demand better pay? Fuck Medicare, half of my taxes pay for that program and according to you and everyone else, it isn't effective. Would you like me to stop eating so that we can make it effective? Where do you draw the line as far as cutting into my income?

      That's the problem with class war. It's not the lower class and middle class versus the upper class, it's the lower class and the upper class versus the middle class.

    3. Re:The Republican Face of Future Medecine... by Bill+Dog · · Score: 2

      And that's because only the lower and upper classes have advocates for them in govt.

      --
      Attention zealots and haters: 00100 00100
  19. Re:Cynicism by myowntrueself · · Score: 1

    I heard that the Nazis developed methadone because they wanted a pain killer that wouldn't be as addictive as other opiates.

    They figured that if they made the side effects sufficiently horrible, people wouldn't get addicted to it.

    How wrong they were...

    --
    In the free world the media isn't government run; the government is media run.
  20. Drugs == Accellerated Darwinism by erroneus · · Score: 0, Troll

    They should allow people do do all the drugs they want. Give them a location on a rail right above a giant wood chipper so that when they do it to themselves, they also dispose of themselves in a way that could feed fish or fertilize a field somewhere.

    Perhaps the 'defect' is with me though. I find the idea of putting a chemical into my body to induce a feeling to be stupid and unattractive. It would seem the majority of people are disagreement with me on this point. I guess when the end of the world comes about, some people will be easier to control and put down than others.

    1. Re:Drugs == Accellerated Darwinism by spire3661 · · Score: 1

      Eating food induces feelings, not sleeping induces feelings, absorbing the suns rays induces feelings. There are many ways to alter state, this is not a wrong or bad thing. Trying to ESCAPE from bad feelings using a substance is the unhealthy part of the activity, be it food, chemicals, drink etc. You might want to be careful up on that high horse of yours....

      --
      Good-bye
    2. Re:Drugs == Accellerated Darwinism by Anonymous Coward · · Score: 0

      I guess when the end of the world comes about, some people will be easier to control and put down than others.

      Yeah. You. Because the drug addicts won't have any remorse for "controlling" your dumb ass. And they'll have the advantage of diminished sense of pain, out of control adrenaline, or whatever depending on which drug they're on.

  21. Not a valid study by Anonymous Coward · · Score: 0

    Working in the medical field, I can say that the majority of people prescribed methadone are for Maintainance therapy of chronic narcotic users/abuses. As such this story makes no sense because the risk profile of this group is different that the general population and to compare the two is not valid.

  22. We have money for bombs, but not people. by unity100 · · Score: 4, Interesting

    And, what's more, there are pieces of shit who advocate even canceling what little we give to the unfortunate.

    figures why the world is STILL deep in shit in godfrigging 21st century.

    1. Re:We have money for bombs, but not people. by 32771 · · Score: 1

      This is only a part of why, and the shit will probably only get deeper.

      --
      Je me souviens.
  23. Medical Marijuana by Anonymous Coward · · Score: 0

    To hell with the law. If you need medicine, there is no harm in trying. Even if you live in a "medical" state, don't ask for permission, just do it. It is your moral right.

  24. Methadone does more than save money by sirwired · · Score: 1

    With a skilled doctor and a well-instructed patient, Methadone is a perfectly legitimate and normal Opioid pain reliever. The longer effects of the drug (vs. other options) mean the level in the bloodstream stays more level. Yes, if the patient cannot follow instructions, or the doctor is not aware of how Methadone is metabolized in the body, this can be harmful; there are tradeoffs with almost any drug. You can hardly blame the drug if the doctor ignores the prescribing information or the patient doesn't properly taper off of other painkillers while starting up the Methadone.

  25. Re:So it's killing welfare recipients? by Anonymous Coward · · Score: 0

    Ron Paul 2012!

  26. Re:Waaaaa by roman_mir · · Score: 1

    About 10 years ago my knees started hurting and they never stopped and I've been to doctors around the globe pretty much and nobody can identify why I have this pain. I tried a few types of medication and realized that I can't live my life on drugs, so I learned to live with the pain, I just learned not to pay attention. I tell you what, if you want to get your ass kicked by somebody who doesn't care about pain anymore, talk to me, I'll arrange it in a hurry.

  27. Re:Nice by Anonymous Coward · · Score: 0

    And no, we will not register unless there comes a time when other users cannot ban you for what you say.

    You can't be banned for what you say, otherwise we'd have rid ourselves of cunts like this one ages ago.

  28. Both Major Parties' Face of Future Medicine... by SteveFoerster · · Score: 5, Insightful

    Washington State is controlled by Democrats. The majority of both houses of the legislature there are Democrats, as is the current governor and the last two governors before her. I expect, though, that you're too busy hating Republicans to recognize the Democrats are no different.

    --
    Space game using normal deck of cards: http://BattleCards.org
    1. Re:Both Major Parties' Face of Future Medicine... by Svartalf · · Score: 1, Flamebait

      Oh, don't confuse them with facts...their mind's made up.

      --
      I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
    2. Re:Both Major Parties' Face of Future Medicine... by Rockoon · · Score: 0

      I expect, though, that you're too busy hating on Republicans because the Democrats appeal to your emotions while screwing you to recognize that the the Democrats are usually worse.

      Fixed that for all of us.

      --
      "His name was James Damore."
    3. Re:Both Major Parties' Face of Future Medicine... by Moryath · · Score: 2, Informative

      Yes but the policy was put in place during a time when the Republicans controlled 100% of the federal legislative line (House, Senate, Congress) and were screwing with the funding that comes from Medicaid/Medicare, forcing states to try to do precisely this.

      And it's not just Washington state, this is happening across the nation. Where I live, public medical care (which my grandmother is on) REFUSES to pay for a prescribed non-generic medication if there is a "generic alternative" available, even if her doctor's specifically prescribed the non-generic due to previous reactions to the generic or the generic not being effective in the patient's case.

      So yes, I blame the Republicans. They were in charge federally, they're the ones on the "cut costs cut costs cut costs we don't give a fuck about human lives" bandwagon. You think what Washington State has right now is bad, imagine what it'll be like when these retarded motherfuckers pass something like the "Ryan Plan" where everyone has to hunt for private insurance and hope to god that they don't have a preexisting condition that'll prevent them from getting it.

    4. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 3, Interesting

      The hell with all of you. This thing isn't a partisan issue, though historically the Republicans have been the biggest proponents of the War On Drugs (TM), it is completely true that Democrats have not done much of anything to do away with it. Partly that's because anybody who does anything contrary to what police, prosecutors, judges, and the private prison system wants are immediately subjected to a well-financed publicity barrage calling them "soft on crime" (unless, that is, the crime is that of stealing money from poor and middle class people through banking fraud, but I digress...) Partly it's because most actual Democratic politicians are just as corrupt and profit-driven as their Republican counterparts, even if those values aren't the same as their supporters. In the US we have a choice between "ultra right-wing" and "mildly right-wing packaged as 'liberal' for political purposes" when it comes to electing people these days.

      It is because of both Democrats and Republicans that I have to have a record made with the DEA every time I want to buy some damned cold medicine, Obama has not told his so-called Justice Department to shut up about medical marijuana--continuing a harassment policy began by his Republican predecessor. There are no choices in politicians these days, only marketing.

      The poster who said that it's more important to prevent people from getting high than it is to prevent them from dying these days is spot on. There is something else though: if this is to save money, it is because sufficient money is not provided for the program. Republicans more than Democrats (other than the now-decimated Blue Dogs) oppose properly funding health initiatives, and they love means-testing them. Why? Because it's easier to cut a program which serves poor people in this country than it is to cut a program that serves everyone. That's pretty much their irrational hatred of Medicare and Social Security in a nutshell by the way. The only thing Republicans wanted to fund with Medicare is the prescription drug "benefit", which was entirely their idea and which contains a prohibition against negotiating with drug companies for lower prices. Therefore, it's a giveaway of tax money to large corporations--a Republican specialty. However, do you hear Democrats calling them out on it loud and clear? No? Why not? Everyone needs to start asking questions like that.

    5. Re:Both Major Parties' Face of Future Medicine... by SteveFoerster · · Score: 2

      The only thing Republicans wanted to fund with Medicare is the prescription drug "benefit", which was entirely their idea and which contains a prohibition against negotiating with drug companies for lower prices. Therefore, it's a giveaway of tax money to large corporations--a Republican specialty. However, do you hear Democrats calling them out on it loud and clear? No? Why not? Everyone needs to start asking questions like that.

      That's actually really easy to answer: your assumption that corporatism is a Republican specialty doesn't hold water. The Democrats are just as bad.

      --
      Space game using normal deck of cards: http://BattleCards.org
    6. Re:Both Major Parties' Face of Future Medicine... by Rockoon · · Score: 2, Informative

      Therefore, it's a giveaway of tax money to large corporations--a Republican specialty. However, do you hear Democrats calling them out on it loud and clear? No? Why not? Everyone needs to start asking questions like that.

      The largest giveaway to large corporations in the history of the world was signed into United States law with a Democrat House, a Democrat Senate, and a Democrat President. Only a single Republican, in both House and Senate combined, had voted for the bill.

      It was called the Patient Protection and Affordable Care Act, a name that appeals to emotion.

      The Republicans do call out corporate give-aways, but the heart-string yanking Democrats have bamboozled everyone into believing that the Republicans are the #1 offenders, and oh.. they are rich racists too. More than one Republican tried to stop the government-funded housing bubble years before it exploded.. they (such as McCain and Paul) were called racists right there on the floors of both House and Senate by Democrats (such as Frank and Waters) when they tried.

      If the obscene buying of Democrat votes as the Health Care bill ballooned into thousands of pages didn't convince you, nothing fucking will.

      --
      "His name was James Damore."
    7. Re:Both Major Parties' Face of Future Medicine... by circletimessquare · · Score: 1

      democrats suck. therefore, that republicans suck more is excusable?

      --
      intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
    8. Re:Both Major Parties' Face of Future Medicine... by forkfail · · Score: 1

      Washington State is also teetering on the edge of bankruptcy. Schools, infrastructure - it's all getting cuts. Including benefits, which means that the cheaper insurance is going to steer folks towards the cheaper drugs.

      Additionally, there's Tim Eyman throwing one wrench after another into the budget process - trying to apply misguided bandaids to the state's problems when the core problem is the fact that we're pouring our nation's treasure out on to the sands of Iraq and Afghanistan, and the states are feeling the draw.

      There's a not a lot of choice here. If it were Republicans in power, folks on the right would be beating the drum of fiscal responsibility.

      --
      Check your premises.
    9. Re:Both Major Parties' Face of Future Medicine... by nomadic · · Score: 1

      Ok, SteveFoerster, let me get this straight: your argument is that if Washington State was controlled by Republicans, we would see an equal or increased amount of public spending on healthcare for the poor?

    10. Re:Both Major Parties' Face of Future Medicine... by colinrichardday · · Score: 4, Insightful

      If it were Republicans in power, folks on the right would be beating the drum of fiscal responsibility.

      As they did during the Bush 43 administration?

    11. Re:Both Major Parties' Face of Future Medicine... by catmistake · · Score: 1

      More than one Republican tried to stop the government-funded housing bubble years before it exploded

      Wow, you have a way with history. The subprime lending bubble (2008 recession) was not the brainchild of Democrats, but rather was directly caused by systematic deregulation and removal of banking financial oversight by each Republican administration starting with President Reagan. This recession was set into motion and brought to fruition fully by Republicans and conservatives fighting the bad "Big Government" ideals of Democrats.

    12. Re:Both Major Parties' Face of Future Medicine... by antifoidulus · · Score: 1

      . Partly that's because anybody who does anything contrary to what police, prosecutors, judges, and the private prison system wants are immediately subjected to a well-financed publicity barrage calling them "soft on crime"

      Ultimately a lot of the blame rests on the shoulders of the American people. One thing I could never understand about Americans, esp. the rabid Republicans, is this whole law and order fantasy. That somehow making anything you don't like illegal will mean it will magically go away(pick your poison, drugs, homosexuality, abortion, the list goes on). And it's not like it's just the for profit prisons that are pushing this, a lot of this is self-inflicted by the American people.

      Take for instance child molestation, obviously a hideous crime and one that should be prosecuted(including the pope, but I digress). In an effort to try to impose "law and order", the American people have decided that if a guy walks in to a psychiatrists office and admits he is a pedophile(note, not that he has actually committed a crime, merely that he has sexual thoughts about children), the therapist by LAW has to report the guy. Whereas in the past the therapist could offer him therapy as well as medication, up to and including chemical castration if the person feels they cannot control their urges, now the therapist can do almost nothing for the guy without risking losing his license. He won't' be arrested, but it's pretty much guaranteed that word will get out about this guy ruining his life. Since very few people are going to risk being outed and have their entire lives ruined, they go without any sort of help and some of them end up not being able to control themselves. While I am certainly not advocating we let child rapists go free, we should NOT be punishing those who merely have thoughts, thoughts that they often cannot control, and instead be encouraging them to get help. A lot of child rapists who get out of prison and attend the mandatory counseling sessions and take the medication have said that it works wonders for them, and had they had this BEFORE they committed their crimes, they probably would have been much less likely to do so. But in America we cannot tolerate anyone that might hold any "unsavory" thoughts and instead think that shaming them, arresting them, and keeping them in jail, where they cost the taxpayer massive amounts of cash is somehow a better way of doing business.......

    13. Re:Both Major Parties' Face of Future Medicine... by LrdDimwit · · Score: 1

      Republican ... Democrat ... Does it really matter? Neither party's mainstream will support this. I mean, you couldn't ask for a better example of a death panel, unless they were to actually rename this Pharmacy and Therapeutics Committee to "death panel". As it is, "Pharmacy and Therapeutics Committee" is already Orwellian enough.

    14. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      Those people came at the end. They are called "The Tea Party". The same group is also against a National healthcare system that specifically calls for exactly this sort of thing under the new system recently signed into law. It is called 'ObamaCare".

    15. Re:Both Major Parties' Face of Future Medicine... by crunchygranola · · Score: 1

      That's actually really easy to answer: your assumption that corporatism is a Republican specialty doesn't hold water. The Democrats are just as bad.

      Naah. The Democrats are bad, the Republicans are worse. There is no question that all of American politics is in fealty to corporate interests, but the Republicans are leading the charge to enshrine corporate and big money control over all aspects of American life as quickly as they can. The principal decision in the Citizens United case, allowing corporation to spend unlimited funds in influence political campaigns, was passed strictly by Republican appointees and opposed by Democratic ones.

      --
      Second class citizen of the New Gilded Age
    16. Re:Both Major Parties' Face of Future Medicine... by rahvin112 · · Score: 1

      I didn't know fiscal responsibility was called tax-cut and spend. IMO that's worse than tax and spend.

      We had a balanced budget during the final 2 years of the Clinton administration. That's a centrist democrat president with a republican congress. They spent so much time wondering who was sucking Clinton's dick that they couldn't fuck the rest of America over. Bush Jr. Fixed that.

    17. Re:Both Major Parties' Face of Future Medicine... by Rockoon · · Score: 2

      Wow, you have a way with history.

      Yes. Accuracy.

      The subprime lending bubble (2008 recession) was not the brainchild of Democrats, but rather was directly caused by systematic deregulation and removal of banking financial oversight by each Republican administration starting with President Reagan.

      Thats what the Democrats told you.

      2001: Bush Administration asks congress to look into heavier regulations, stating that they are a "potential problem, financial trouble could cause strong financial repercussions in financial markets"

      2003: Bush Administration pushed hard for a new federal agency to regulate and supervise fannie and freddie, stating "We need a strong regulatory agency to oversee the prudential operations of the GSE's, and the safety and soundness of their financial activities." The Democrats, in committee led by Frank (D), responds "Fannie and freddie are not in a crisis" and further says that the federal government should be encouraging even more lending by the GSE's, and "The more people, in my judgment, exaggerate a threat of safety and soundness, the more people conjure up the possibility of serious financial losses to the Treasury, which I do not see. I think we see entities that are fundamentally sound financially" -- the Democrats blocked the legislation.

      2004: Royce (R) calls for "a new regulatory structure for fannie, freddie, and the federal home loan banks." Clay (D) responds by calling the proposal a "political lynching" (referring to the fannie scandal) and that issues with fannie and freddie have been addressed in other legislation. Shays (R) then states "I realized that fannie and freddie wouldn't even come under it. They weren't under the 34 act. They weren't under the 33 act. They play by their own rules and I am tempted to ask how many people in this room are on the payroll of fannie."

      2005: Alan Greenspan states "Enabling these institutions to increase in size - and they will once the crisis in their judgment passes - we are placing the total financial system of the future at a substantial risk." and "If we fail to see new GSE regulation we increase the possibility of insolvency and crisis. Frank (R) states on the House floor "you are not going to see a collapse that you see when people talk about a bubble."

      2006: John McCain (R) sponsors legislation pushing for regulation, stating on the Senate floor "for years I have been concerned about the regulatory structure that governs fannie and freddie, and the sheer magnitude of these companies and the role they play in the housing market. The GSE's need to be reformed without delay." That Bill was voted on by the senate banking committee, a party-line vote with 100% of the Democrats voting against it.

      The question you should be asking yourself is how you ended up so ignorant about the largest financial melt-down in 80 years.

      --
      "His name was James Damore."
    18. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      I knew people like you would fail to get the point. The point, of course, is that states, ruled by Republicans, Democrats, "Libertatrians", or Unicorns, would set policies based on national strictures. Those are more severe (in fact, draconian) when Republicans control the national policy, than when Democrats do.
      National policy set by Republicans will kill and maim many more people in states than national policies set by Democrats. It's just true.
      I do dislike Republicans, it's true, for reasons that include their "pro-life" policies which result in many more abortions.
       
      But that's just me - I look for humane and rational results from the government I purchase.

    19. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      Douche bag, Republicans are responsible for the deregulation. Republicans hate big government, so that's what they do, dismantle all the infrastructure necessary for a free market to actually be fair and free in the hopes that they, rich Republicans, maintain their financial superiority. Republicans want the rich to hold the money; Republicans know the way for the rich to keep their money is for all government to disappear. Democrats like big government. They LOVE banking oversight. Pull your head out of your ass and your dick out of your hand, Adolf, Republicans made the 2008 recession all by themselves. Perhaps the Dems could have stopped it sometime during Clinton, but it was CERTAINLY not caused by any Democratic initiatives.

      Perhaps you should be asking yourself why you are so quick to shill Republican ideals when you post on slashdot and likely make less than $40K/year? Put another way, why do you allow your politics to be askew of your best interests? Unless you make over $200K a year, you have no business being a Republican. "Yeah! I wanna pay MORE taxes even though I'm not rich, and I want rich people to pay even LESS!" Idiot.

    20. Re:Both Major Parties' Face of Future Medicine... by catmistake · · Score: 1

      You keep bringing up worthless facts that were reactions to the recession. The recession didn't magically appear in 2008. The market peaked in 2005 and it was a steady decline in property values since. But there were obvious issues as early as 2000, when the mortgage debt consolidation started to go into overdrive, and banks were basically gambling with our money... gambling on us losing.

      You keep touting McCain. The LONE Republican that stood against the deregulation. In 2006. When shit was already flying everywhere. Yeah, that guy lost a presidency because he was too middle of the road, which you can read as: he happily takes on the popular politics. And the idea was completely wrong headed.... this sort of legislation would not have prevented the recession which was already imminint by 2001

      Greenspan... was a key player in the deregulation, Sherlock. I can't think of anyone more singularly responsible for that recession than him, so my mind boggles why you'd quote him as though he were some hybrid Republican or something. He's a fucking banker. He was one of the architects for the deregulation that began in the 80's.

      Ah, more Republican bullshit... rewrite history with false interpretations, off-topic distraction and flat lies.

      People like you give Republicans a bad name. Perhaps you should be asking yourself how you ended up being either so dishonest, or so delusional that you're oblivious.

    21. Re:Both Major Parties' Face of Future Medicine... by shutdown+-p+now · · Score: 1

      REFUSES to pay for a prescribed non-generic medication if there is a "generic alternative" available, even if her doctor's specifically prescribed the non-generic due to previous reactions to the generic or the generic not being effective in the patient's case.

      That doesn't make much sense. A generic is, by definition, a medication that has the same exact active component. Why could it not be effective when the original non-generic equivalent is?

    22. Re:Both Major Parties' Face of Future Medicine... by Rockoon · · Score: 1

      But there were obvious issues as early as 2000, when the mortgage debt consolidation started to go into overdrive, and banks were basically gambling with our money... gambling on us losing.

      Yeh, thats why I began with 2001, blind-boy.

      The Republicans tried to do something about it the whole way while the Democrats prevented anything from being done about it the whole way.

      You keep touting McCain. The LONE Republican that stood against the deregulation.

      The only major related deregulation that the Republicans had any control over was the Commodity Futures Modernization Act of 2000, but this bill passed the House with a vote of 377 in favor and only 4 again. In other words, the Democrats influenced by a presidential working groups public support (thats Clinton, Democrat) were gleefully in favor of this bill and almost unanimously voted in favor of it.

      Why are you trying to claim that the Republicans are to blame for deregulation when the Democrats were nearly unanimously in favor of the deregulation that you are blaming on the Republicans?

      My guess is that you really didnt know that the Democrats were gung-ho in favor if it because while they were nearly unanimously voting for the deregulation, they were already (always and forever) blaming it on the Republicans (just like they blamed the obscene vote buying for the health care bill on the Republicans, while they were in closed sessions buying democrat votes with thousands of pages of corruption!)

      The fact remains that the Republicans repeatedly tried to regulate fannie and freddie from 2001 on and the Democrats repeatedly blocked them from doing so... of course thats not what the Democrats are telling you.. they are amazingly blaming their nearly unanimous support for the deregulation on the Republicans and getting away with it because of clueless fucks that only want to listen to what they say, rather than look at what they actually do.

      The question you still should be asking yourself is how you ended up so ignorant about the largest financial melt-down in 80 years.

      --
      "His name was James Damore."
    23. Re:Both Major Parties' Face of Future Medicine... by catmistake · · Score: 2

      Alright, Rockcoon, challenge accepted. I am going to show with the facts in this post that you are both stubornly stupid, and unabashedly dishonest.

      The Republicans tried to do something about it the whole way while the Democrats prevented anything from being done about it the whole way.

      Yeah... that's complete bullshit. Sure... there was the Home Ownership and Equity Protection Act (94), which directed the Federal Reserve to issue regulations of mortgages, but Greenspan refused to use it. Greenspan has ever been against regulation in any form (again... my mind boggles why you mentioned him in a previous post as though it supported your falicious arguments).

      Why are you trying to claim that the Republicans are to blame for deregulation when the Democrats were nearly unanimously in favor of the deregulation that you are blaming on the Republicans?

      Complete lie wrapped in a question... nice work. But wow... you have it exactly backwards, retard.

      My guess is that you really didnt know that the Democrats were gung-ho in favor if it because while they were nearly unanimously voting for the deregulation

      Ah. Another flat lie. You really have a pliable relationship with the truth, don't you. Maybe if you keep repeating lies... it will actually change the past! Dipshit... that's not how it works... hundreds of millions of people already know the truth. You can attempt to rewrite history, but any fact checking will reveal your statements to be complete dogshit.

      The fact remains that the Republicans repeatedly tried to regulate fannie and freddie from 2001

      Again... regulating these firms by then would have done nothing to stop the recession, which was being brought on by banks and their insistence that derivatives not be regulated. ÂThe roots of the recession began in the 1980's under the Reagan Administration. Not sure if you are aware, but Reagan was Republican, and while Congress at the time was split about equally, he had a VERY strong conservative administration. The only thing that kept Reagan's debt increases in check was the Democratic House.

      Here's the basic line of how we ended up with our dicks handed to us in 2008. In 1981, President Reagan appointed Donald Reagan (Meryl Lynch) to be his Treasury Secretary. The Reagan administration, supported by Wall Steet economists and financial lobbyists, started Âa 30 year period of financial deregulation. By 82, the Reagan administration had deregulated savings and loan companies, allowing them to make risky investments with their customers' money. By 1990, hundreds of savings and loan companies had failed. This cost taxpayers $124 BILLION.

      Alan Greenspan is on record all over the 1980's in support of the deregulation and allowing these S&L's to make the risky investments. Reagan subsequently appointed Greenspan to head the Federal Reserve, and this move was repeated by Bush1 and Clinton. Under Clinton, Greenspan continued the deregulation. Clinton's adminstration, naively trusting Greenspan's expertise (typical Democrat shit), allowed the finanical sector grow into just a few massive companies, where if any one failed, we'd all be in trouble.

      You remember all the scandals in the late 90's early 00's with the cooking of books, defrauding of customers... $100BILLION of drug money funneled out of Mexico by Citibank... Fannie Mae overstated their earnings between 98 and 03 by $10BILLION.... you think there's ANY support for Democrats from those guys? No... they were propping up Republicans that shared their interest.

      Democrats share blame as well, but its always the same thing with Democrats... always being bamboozled by Republicans, and can't get their shit together, even when they control both houses of Congress. To say Democrats helped cause the recession because they did nothing to stop it is like saying a witness is as morally responsible as a murderer because the witness didn't s

    24. Re:Both Major Parties' Face of Future Medicine... by mcgrew · · Score: 1

      Obama has not told his so-called Justice Department to shut up about medical marijuana--continuing a harassment policy began by his Republican predecessor. There are no choices in politicians these days, only marketing.

      You don't have to vote for a man who wants to incarcerate you. You can vote Green or Libertarian, bot those parties are for ending prohibition. Why are you wasting your vote on a man who wants you in prison? Anybody smoking pot or using any other illegal drug is an idiot if he votes R or D.

    25. Re:Both Major Parties' Face of Future Medicine... by eam · · Score: 1

      If the active ingredient is the same it is considered the same. However, binders and coatings can have a dramatic effect on how it works.

    26. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      I recall GWB not being able to find his veto pen for six years.

    27. Re:Both Major Parties' Face of Future Medicine... by Moryath · · Score: 1

      A generic is, by definition, a medication that has the same exact active component.

      Binders and coatings can make a huge difference.

      Often too, the "Generic" in the term most often used for these programs is an earlier formulation that's gone out of patent (see the revolving door "we changed it just enough to re-patent it" scam that so many drug companies come up with). Depending on how it's produced, the newly "generic" older formulation may have different effects for different individuals, or may have different effectiveness for different symptoms/diseases based on dosage timing or minor chemical differences.

    28. Re:Both Major Parties' Face of Future Medicine... by stdarg · · Score: 1

      Again.. let me clue you in to the general idealisms of our two party system:

      Democrats like taxes, social services, big government, and regulation and oversight. Twas always thus in modern politics.

      You forgot wealth redistribution, their most revered ideal. And that's exactly why they support overspending by the government -- because when big programs like Medicare run over their budgets, or Fannie needs a bailout, or GM's unions accidentally drove GM out of business and need help... the taxpayer is on the hook. And the net-positive income taxpayer overall is in the top 50% of the population by income. And of course a large chunk of the tax income comes from the top 5%. So any program that overspends disproportionately affects the top 5%. That's the rationale behind the entire democratic platform.

      Republicans like a hands off government, or no government at all. They do not like regulation, or government EVER getting involved in business. Twas never any different in modern politics.

      If you think Republicans supported crap like the Community Reinvestment Act (which forced banks to lend to unqualified people.. because expecting to be paid back is racist and predatory, you know?) you're just crazy.

      Look at the costs of the CRA and you'll see what I mean about the Democrats' platform being based on wealth redistribution. You give loans to unqualified people who you *know* are going to make banks less profitable. But who cares, you make the banks do it... because you also know that the "rich" people will make up for the loss in higher fees, higher PMI rates, and higher taxes that support even more government programs supporting those garbage mortgages. Stealing from the "rich" (half the country) to give to the other half.

    29. Re:Both Major Parties' Face of Future Medicine... by catmistake · · Score: 1

      I'm a broad strokes kind of guy and even I am perplexed why I know anything about that recession. I'm not really a party guy, more into recognizing exceptional individuals. I think Presidents Barrack Obama, Bill Clinton, George H.W. Bush, Jimmy Carter were my kind of hero-worshipable individuals, and (duh) Presidents in general tend to end up being these kinds of highly exceptional individuals, and even though the logic intimated here is fallicious, we do at least know more than a few Presidents were really quite brilliant, regardless of Presidential effectiveness or popularity.

      Every election its the same kind of partisan-driven history re-write. Except that more and more we see attempts to destabilize even our belief in the reality of the two party system, that these parties are now corrupted or cross-pollinated to the point that, while still different, they become homogenous when you start removing the minutia criterium. So I like a perspective that is inscrutable... like a martian's perspective. Put an R and a D in front of a martian and they'll likely be unable to distinquish the two from each other, and perhaps just as unlikely to be able to distinquish humans from apes. Point here being that labels and qualities that we attribute to ideals, and the ideals themselves, usually end up meaning nothing at all in practice because the world is pretty complex... and so are people.

      I want the information. I'm tired of the bullshit and I want the damn information. I'm not quite ready to start beating news anchors with umbrellas... but somedays... you know?

    30. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      Porkbusters.

      Look 'em up.

    31. Re:Both Major Parties' Face of Future Medicine... by DrGamez · · Score: 1

      I'd give you mod points but then I might be considered a pedophile.

    32. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      The more power government has (regardless of party) the less freedom the people have and the less successful society will be. See North Korea - big government, lots of power with the politicians - sucks for everyone else.

    33. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      Yes, the folks "on the right" (by "on the right", I mean "fiscal conservatives") were beating the drum for fiscal responsibility during Pres Bush's administration.

      The movement was publicly faced as "Porkbusters" and they were initially noted for their vociferous opposition to congressional earmarks - look them up. I trust you remember how the Democrats beat up on the Republicans for earmarks (the famous "bridge to nowhere" in Alaska, etc)? I trust you also remember the Democrats were even worse? The problem was the Democrats didn't care about profligate spending, and neither did their base.

      So, the fiscal conservatives took the only step they could make: they denied support for profligate spending Republicans, costing the Republicans dearly in the 2006 mid term elections. The fiscal conservative did it again in 2008 when the Republican establishment did not get the message the first time.

      In 2009, when Pres. Obama decided that $400 billion dollar deficits were not enough, and he quadrupled them, the fiscal conservatives found themselve supported in numbers they never imagined. In February, 2009 when the rant of Rick Santelli on MSNBC went viral, and a tongue-in-cheek movement to mail teabags to representatives in Washington picked up steam. By April 15, 2009 the movement went national and became a national call to stop the spending and stop raising taxes and debt.

      Thus, the Porkbusters movement bascially evolved into the "Tea Party" movement you see today.

    34. Re:Both Major Parties' Face of Future Medicine... by Anonymous Coward · · Score: 0

      Which is why Barney Frank has been so keen on regulating and controlling Fannie and Freddie....oh wait...

    35. Re:Both Major Parties' Face of Future Medicine... by colinrichardday · · Score: 1

      Picking on Congressional earmarks instead of the Iraq and Afghanistan wars? They're being penny wise and pound foolish.

  29. Sometimes by Anonymous Coward · · Score: 0

    Death is a luxury.

    I wish the world did respect the rights of patients to take risky medicines.

  30. "silent death"...ha! by Anonymous Coward · · Score: 0

    As a recovering addict, having had and seen my fair share of overdose...I can assure you that choking on your own tongue and/or vomit is very non-silent.

  31. Bring on the doctor blame.... by RobinEggs · · Score: 5, Insightful

    Doctors are overpaid

    Can we please stop this shit? Blaming doctors doesn't help you, and they are generally not overpaid. For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.

    I know primary care physicians who've been forced quit the business after 30 years and had to go work somewhere else. How does a doctor who can't afford to be a doctor, and doesn't have enough savings to retire after 30 years, fit with your ignorant screed that doctors are overpaid?

    I also know surgeons, many of whom do make $300,000 a year, and I've never seen one of them sit still for more than 15 minutes, to watch a movie or lecture, without passing out. They work a minimum of 60 hours a week and constantly get paged for surgery in the middle of the night, whether or not they're actually 'on call'.

    So many types of doctor make so little that people are quitting left and right, while med students refuse to even consider the specialty, and many other types work so many hours with such a poor quality of life that their compensation per hour (not to mention per 3 am emergency call) makes engineering and business look like much better careers.

    Many doctors are underpaid; many others are overpaid but massively overworked and overstressed. The cross-section of doctors who are both overpaid and live comfortable lifestyles is much, much smaller than you think.

    1. Re:Bring on the doctor blame.... by khallow · · Score: 0

      For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.

      I have no trouble both underpaying them more and reducing the onerous training requirements for being a doctor.

    2. Re:Bring on the doctor blame.... by ColdWetDog · · Score: 1

      I have no trouble both underpaying them more and reducing the onerous training requirements for being a doctor.

      'Here, put this one in your mouth and this one in your asshole.'
      'Sorry, other way around ... '

      --
      Faster! Faster! Faster would be better!
    3. Re:Bring on the doctor blame.... by hackstraw · · Score: 1

      Can we please stop this shit? Blaming doctors doesn't help you, and they are generally not overpaid. For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.
       

      They are overpaid. Its by design. Its not a free market like programmers, engineers, etc.

      I also know surgeons, many of whom do make $300,000 a year, and I've never seen one of them sit still for more than 15 minutes, to watch a movie or lecture, without passing out. They work a minimum of 60 hours a week and constantly get paged for surgery in the middle of the night, whether or not they're actually 'on call'.

      Again, this is because doctors are not a free market. The AMA controls how many doctors are produced each year and which schools can make doctors. No other field in the USA is controlled this way. There is no inherent need for the cost of training to be a doctor to be so high, and no reason they are so scarce that they have to work 60 hours a week. In a repressed job market like there is today, I'm sure many, many people would be fine doctors if given the opportunity. Being a doctor is not significantly different than getting a PhD. On average, I would guess that MDs make 2x that of a PhD. That is overpaid.

      For example, in China doctors don't make that much. And there are 4 year medical degrees where people work in pharmacies and dispense OTC medication where many of the meds are only by doctor's prescription in the US. Seems like a better system to me.

    4. Re:Bring on the doctor blame.... by broken_chaos · · Score: 1

      I have no trouble both underpaying them more and reducing the onerous training requirements for being a doctor.

      So you want an undertrained, underpaid doctor operating on you, your friends, and your family?
       
      Wow.

    5. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0

      Working 60 hours is part of the problem too, because overworked doctors will be focused on getting rid of patients as quickly as possible rather than solving the problem. How about instead of paying them $300,000 to work 60 hours, lets pay them $150,000 to work 40 hours instead. Because I suspect a lot of people would be willing to quit their jobs to do the latter.

    6. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0

      Seriously? You actually want someone to manage your health who is less trained and has less monetary incentive?

      You could ask some random Joe off the street to give you health care. He'll probably do it for a dollar...

    7. Re:Bring on the doctor blame.... by andrew_d_allen · · Score: 1

      And this is the brainwashing the AMA has done to us in the last century.

    8. Re:Bring on the doctor blame.... by khipu · · Score: 1

      Can we please stop this shit? Blaming doctors doesn't help you, and they are generally not overpaid. For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.

      The "length and stress of their training" is a combination of hazing and deliberate barriers to entry. Doctors are themselves (through their professional associations) are responsible for creating these conditions, through placing tight limits on entry into the profession and tight limits on how medicine is practiced.

    9. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0

      If your income can be stated and usually is stated in terms of a salary, you're not overpaid. There are the overpaid, and there are those who live off their salary.

    10. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0


      I have no trouble both underpaying them more and reducing the onerous training requirements for being a doctor.

      Then you should have no trouble with underwhelming outcomes due to lack of experience?

    11. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0

      lolmoron

      Doctors could afford to be doctors if they didn't spend brazillions of dollars on consumer shit because they think they will be making money hand over fist.

    12. Re:Bring on the doctor blame.... by khallow · · Score: 1

      So you want an undertrained, underpaid doctor operating on you, your friends, and your family?

      Sure, because that's the doctor my society and I can afford. It doesn't hurt that undertrained and underpaid wouldn't really be so.

    13. Re:Bring on the doctor blame.... by khallow · · Score: 1

      As opposed to underwhelming outcomes that I spent a lot of money for? I'd rather spend less for the same outcome.

    14. Re:Bring on the doctor blame.... by khallow · · Score: 1

      Seriously? You actually want someone to manage your health who is less trained and has less monetary incentive?

      You mean, like, a nurse, the one who actually does most of the health care in most of the world? Why that's crazy talk!

    15. Re:Bring on the doctor blame.... by Elrond,+Duke+of+URL · · Score: 1

      In case you hadn't noticed, medicine is vastly more complex now than it was one hundred years ago. The medical community knows much more and therefore doctors must know far more as well. Regardless of what type of doctor you are, you need to know at least something about virtually all of the fields besides your own. That's how we avoid complications.

      Due to my particular medical/genetic condition, I see a handful of doctors on a regular basis. I know that I am personally very glad that they are as well informed as they are.

      --
      Elrond, Duke of URL
      "This is the most fun I've had without being drenched in the blood of my enemies!"-Sam&Max
    16. Re:Bring on the doctor blame.... by khallow · · Score: 1

      Due to my particular medical/genetic condition, I see a handful of doctors on a regular basis. I know that I am personally very glad that they are as well informed as they are.

      I find there's this tendency towards moralizing and discounting of cost among people with serious medical problems who get other people to pay for the associated care, either through a public program or medical insurance that is grouped by force with a bunch of healthy people. It seems a rather sad form of selfishness to me.

    17. Re:Bring on the doctor blame.... by Anonymous Coward · · Score: 0

      This is precisely why I chose to enroll in dental school instead of med school! In medicine the specialties in which you can expect to work "normal" hours are basically restricted to primary care(which pays ~120-160k yr) or dermatology & radiology(which pay 250-350k yr). Needless to say the latter two specialties are most sought after by medical students. As a dentist you take out more initial loans but you get to start working right away so counting interest on your loans it costs about the same as becoming a doctor w/ out the hassle of bureaucracy & massive liability insurance. he lifestyle is much more conducive to raising families ect. People should stop knocking physicians so much, you really do make a lot of sacrifices to become one.

    18. Re:Bring on the doctor blame.... by Elrond,+Duke+of+URL · · Score: 1

      I find there's this tendency towards moralizing and discounting of cost among people with serious medical problems who get other people to pay for the associated care, either through a public program or medical insurance that is grouped by force with a bunch of healthy people. It seems a rather sad form of selfishness to me.

      And I find this attitude rather disheartening. :(

      I have the exact opposite view of healthcare, it would seem. I feel that healthcare should be universal. Available to all and funded through tax. It's called "insurance" for a reason... too many people (not saying you are one of them) take the view that they are healthy enough to chance not purchasing insurance when they are young and healthy and then either get it later in life when nearly everybody has some sort of medical need, or they get sick without insurance and rely on current free options which they didn't bother to even try to buy into.

      Universal healthcare is a net win for society and I feel no guilt wishing it were so and no ill will to those poor enough to be on Medicaid or some state program. A good and proud society should want to help those in need. And, the only way for it to work is if all people, well and sick, are in the program. I like this country (the US, that is) a great deal, but our current healthcare system (the funding, not the expertise) is one of our greatest failings. I'm optimistic enough to believe that we will eventually arrive at some sort of single-payer/universal system. I just wish it would happen sooner rather than later.

      And, I can honestly say that even if I were not ill, I would still have this same opinion, because it is how I felt before I was initially diagnosed.

      --
      Elrond, Duke of URL
      "This is the most fun I've had without being drenched in the blood of my enemies!"-Sam&Max
    19. Re:Bring on the doctor blame.... by khallow · · Score: 1

      Universal healthcare is a net win for society

      Only if you ignore the costs. The fundamental problems are that health care costs are unlimited. There's no upper bound to how much you could spend to prolong someone's life. And universal healthcare typically separates the people making the decision to consume healthcare resources from the people paying for that consumption. That's always economic fail via some variant of the tragedy of commons usually combined with artificially high medical care prices. Keep in mind that there's only so much wealth available per person. So there's only so far you can go in keeping someone alive before you use up the wealth of society.

      The second problem is that ultimately, health care always results in a very negative consequence, death, and usually, in developed world societies, reaches that point through a very expensive process. Efforts to prolong someone's life and quality of life quickly grow expensive for what you get out. Frankly, I think we've already passed the point of diminishing returns from universal healthcare in the developed world. If you really want to attempt to live longer, it should be with your money, not the rest of society's.

  32. methadone is very useful in managing chronic pain by ridgecritter · · Score: 5, Informative

    Methadone's pharmacokinetics give it a long half-life, and therefore a long duration of action. This is an asset in managing chronic pain from cancer and some other diseases. Methadone has much less tendency to lose its analgesic effect through habituation. Morphine, for example, while an effective pain reliever due to its action on the mu-opioid receptor, has a metabolite that acutally upregulates perception of pain due to action on the NMDA system. This latter effect probably accounts for most of the often-observed dose escalation needed to maintain effective analgesia in patients treated with morphine. The primary danger of methadone is that physicians who are unaware of its comparitively slow pharmacokinetics overdose their patients because they escalate the dose too fast. It is critical to make changes (either increase or decrease) in methadone dosage *slowly* - when that is done, the drug can provide chronic pain relief with a much better combination of safety and long-term effectiveness than many of the other opiates. As always, ignorance seems to be the most deadly disease.

  33. Re:Waaaaa by Anonymous Coward · · Score: 0

    Have you tried eliminating wheat from your diet long enough to see if that helps?

    The wheat genome has changed quite a bit in the last 50 years; I recommend "Wheat Belly" by William Davis as a good discussion of the evidence linking modern dwarf wheat to quite a few different ailments.

  34. That can't be the only option by Anonymous Coward · · Score: 0

    This might be my nordic-welfare-state-background talking, but I d think that even under your system, government providing some equivalent of our 10023 wouldn't be considered too socialist.

    Call the (09) 10023 Telephone Health Service every time you need medical advice or information on health care services. (09) 10023 provides answers 24 hours a day, 7 days a week, with professional skill and confidentiality, at the price of a regular telephone call. The telephone service staff consists of experienced nurses and public health nurses, and the service is also available in Swedish and English.

    Services like that are certainly not enough to replace visits to the doctor (rather, they're good when you're pondering whether you should go to the doctor or not) but they should be enough to advice you not to OD on a common painkiller.

  35. Re:Cynicism by the_raptor · · Score: 1

    IIRC Heroin was developed as a less addictive substitute for morphine. The history of opioid development is amusing in a macabre fashion.

    --

    ========
    CINC, 4th Penguin Legion
  36. Re:Accidental overdose? Can be avoided by Anonymous Coward · · Score: 0

    I am in constant pain due to compressed nerves all down my right side. I am on a pile of medications. I have developed a protocol for taking my meds:

    1) Take out the meds that I am going to take and place them in a special place.
    2) Write down what I am going to take on a tablet. Yes, I have a paper record of every pill I have taken in the last 5 years when this started. Even aspirin and Rolaids.
    3) Only then will I take the meds - after checking that everything has been written down.

    This way if the process is interrupted by say a phone call, I can re-start it and always be sure. By checking my tablet I know what I have taken and when.

    More on point to TFA, if methadone is more effective than Oxycodone or Fentanyl put me on it. I am at the ragged edge of being effective. I can still go to work but I spend the rest of my day flat on my back and weekends too. I am now on my back in bed with one of those arms that can be clamped on a desk supporting my laptop and a wireless keyboard on my knees. I will take the risk for just a couple more hours of being upright a week. If it kills me I have not lost much.

  37. This underscores the importance of... by Anonymous Coward · · Score: 0

    Use Only As Directed.

    Get my Hitchhiker's Guide Tribute Novella From Pirate Bay
    http://thepiratebay.org/torrent/6848623/Perfect_Me_By_Jason_Z._Christie

  38. You deserve what you get... by RobinEggs · · Score: 5, Insightful

    I can't believe the number of comments here about doctors being assholes, overpaid, incompetent, etc. You ungrateful, ignorant people need to wake up and realize that doctors are just as miserable under this system as the rest of you.

    First, doctors hate the most expensive parts of medicine even more than you do; they'd be ecstatic to see that business go away. Patients incur as much as half of their lifetime medical costs in the last six months or year of their life. Doctors who know it's simply time for someone to die are forced to keep them alive for a few last weeks or months by whining families who can't accept death and by stupid laws that require extreme intervention to the very end. Many people won't sign DNR orders until they've already hung on far too long, if ever; the families rarely sign them for someone too far gone to sign themselves. It's gotten so bad there's even a phenomenon called the Silent Code, when the physician running an emergency resuscitation tacitly lets a terminal and hopeless patient slip away; they walk the line between honoring laws / families' wishes and the Hippocratic duty to do no harm by not prolonging suffering. Most doctors wish that palliative care and letting people go at their time could be official; a significant minority favor outright assisted suicide. Those brave enough to take some action now do things like silent codes. How does risking your license and reducing your billable hours by letting a patient die display the kind of greedy, insensitive behavior you people seem to think almost all doctors display?

    And as for the money, doctors as a whole are not overpaid; doctors may average almost $200,000 a year, and the existence of specialist surgeons who make $700,000 a year makes it easy to assume they're all overpaid, but a complete statistical look at doctor's salaries - one that includes median, mode, and spread indicators- will tell you that the typical salary is pretty fair for a field that involves a minimum of 11 years higher education (often stretching past 15), $150,000+ in educational debt, and usually takes a lot more than 40 hours a week.

    So some doctors are overpaid, and some doctors are callous. Show me a profession with neither of those problems. The majority of doctors are paid no more than a fair wage (or even not enough), care deeply about their patients, hate the waste and legal bullshit of medicine much more than you do, and are really tired of taking shit from people who think they like the system this way or got into medicine for the money.

    The longer you assholes complain about doctors being stupid or only caring about money, the more stupid pricks who only care about the money will be the only ones willing to go to medical school. That's already starting, in my opinion. Enjoy reaping what you've sown.

    1. Re:You deserve what you get... by Anonymous Coward · · Score: 0

      I live in Quebec. I totally understand how bad our public health care system is. I suffer from cervical chronic pain and have so for more than 7 years. I have seen many doctors in my lifetime, and I can tell you that the majority are incompetent when faced with something they don't understand. I do believe that a few doctors would be better if they didn't have to handle so much patients, but that still lives a lot of doctor totally incompetent.

      I worked as a computer technician. When I don't know what something is, I look it up. If I don't know what's wrong with a computer, a network or some device, I do research. Most doctors I've met in my life aren't willing to do research. I've had neurologists who wouldn't do anything else than give me very expensive anti-migraine pills. Those never worked, and they never bother to run other tests, or suggest alternative treatments. (And I don't mean weird unproven expensive crap, I mean stuff like sending me to a clinic to fix my sleep, having me do physiotherapy, sending me to see a therapist to deal with the psychological damage pain does to you) In the end, I did manage to find good doctors at the pain-clinic and my situation has improved a lot, even if I'm still in pain every day. But for those 2 or 3 good doctors, I've had to deal with 4-5 that were insanely incompetent.

      Really, it's just like EVERY PROFESSION in the world, only a minority are actually very good at what they do. The rest just made it through somehow and it's just a job to them.

    2. Re:You deserve what you get... by quacking+duck · · Score: 2

      Mod up.

      A coworker once relayed how her husband, working hospital IT, was regularly frustrated by doctors (specifically some surgeons) kept having to ask stuff about their computers, and how is it very smart and intelligent people making over $100,000 couldn't figure out such simple concepts?

      She probably thought that as a computer geek myself I'd be completely sympathetic to this. She was floored when I said I'd complain about these surgeons not getting technology, if IT people were able to perform an appendectomy.

    3. Re:You deserve what you get... by Overzeetop · · Score: 1

      You'll have a better time arguing that doctors are not, in general, overpaid if you separate what people pay for services from what a physician makes. When I go to the hospital for a couple of days, I can expect to see a bill well into 5 figures. When you break it down, the doctor is probably only getting $80-$100/hr. Now, that's a lot of money when you figure that the average household income in the us is about $50k, or $25/hr for a single wage earner household. It's not when you can expect most licensed professionals (lawyers, engineers, accountants) to be in the $40-100/hr range. If you look at billing for those classes though, you'll find their rates tend to be $80-300/hr.

      The bigger problem is that doctors tend to be arrogant sons-of-bitches. I can empathize - my engineering colleagues tend to be the same way. The more money they make, the more intense that characteristic seems to be.

      --
      Is it just my observation, or are there way too many stupid people in the world?
    4. Re:You deserve what you get... by Vitriol+Angst · · Score: 1

      I agree with what you are saying.

      My wife wanted to be a Nutritionist, and then a Physical Therapists, however, it's almost as much work as becoming a doctor.

      >> The ULTIMATE problem here in the USA, is that Doctors are getting vilified by the groups that are sucking the profits out of the system; Health Insurers, Drug Companies, and HMOs. While doctors blame lawsuits, and patients blame bad doctors -- the AMA doesn't remove the bad doctors, the hospitals cover for them and the GOOD doctors pay the price. But the insurance rates doctors pay have LITTLE to do with actual costs, as states with Torte Reform show only about a 2% difference in fees.

      The solution is Single Payer -- it always has been. Until a doctor could proscribe "burdock root, and some Vyvance" -- meaning, prescriptions that are based on the BEST and most cost effective solution, rather than the profit-inspired treatments we have, these problems will only get worse.

      The big costs are dumped on the taxpayer now.

      The patients pay through the nose for health insurance, and it still isn't cheap to go to a hospital -- what are they supposed to do when a treatment doesn't work, it's not like people can get a refund?

      The insurance companies like when patients and doctors blame each other, so they can collect one of every two dollars in the system.

      If nobody had to PAY for medical care, lawsuits would only be based on really bad cases -- rather than as a way to SURVIVE the costs of more treatments.

      And the AMA needs to lower the bar on non-critical care, and perhaps find ways to make LEARNING MEDICINE easier. The current system of perfect grades, hazing and high fees doesn't necessarily produce the best medicine -- just the fewest doctors. Doctors should also collaborate more and use telemedicine with an on-site practitioner to reduce costs -- but that won't happen until we can reduce liability. And we can't reduce liability until we take the costs and profits out of medicine. And we can't do that until we can fix our election system. And we can't do that until we can get Public financing of elections.... ... OK, face it -- it all comes down to Occupy Wall Street and either getting social justice or letting this system collapse. EVERY problem comes back to the parasites who profit rigging the system to fail expensively for most Americans. WE keep blaming each other rather than following the money. And it really SUCKS to be a doctor these days.

      --
      >>"ad space available -- low rates!!!"
    5. Re:You deserve what you get... by Anonymous Coward · · Score: 0

      The difference is of course that technology is an easily accessible skill that comes up often in private and public life. If I ever need to perform an appendectomy to check news sites, then I'd learn how to do that.

    6. Re:You deserve what you get... by Anonymous Coward · · Score: 0

      What's your agenda? Are you a doctor? Are you in health care? Are you in health insurance? If you are then you are part of the problem.

      "You ungrateful, ignorant people need to wake up and realize that doctors are just as miserable under this system as the rest of you."

      Which doctors? The ones who willingly signed on to a system that debases us all for the sake of their own economic security?

      "First, doctors hate the most expensive parts of medicine even more than you do; they'd be ecstatic to see that business go away. Patients incur as much as half of their lifetime medical costs in the last six months or year of their life."

      read this: http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/

      then quit your whining.

      We have a problem in this country that started in 1915 when drugs were first regulated. Since then, every doctor who went along with that program violated their oath to first do no harm. If you are a doctor, you need to do some soul searching and decide if you are willing to keep that oath. If you are not a doctor you still need to realize that this horror that is being inflicted on us by the pimps and shills of a corrupt and depraved criminal justice system must come to an end.

    7. Re:You deserve what you get... by Anonymous Coward · · Score: 0

      Although as a counterpoint I would guess that the surgeon was asking how to open a DOCX file in Word 2003 or some-such. Surgeries are one of the more difficult aspects of medicine. Opening files and other end-user support tasks are one of the easier aspects of IT. Not comparable.

      Everyone should learn to use the tools of their trade well enough to perform their trade. All of their tools. No picking-and-choosing.

    8. Re:You deserve what you get... by ErikZ · · Score: 1

      Everyone has to pay for others to provide Medical care. Always. No system can remove that fact.

      --
      Democrats or Republicans. They are both taking us to the same place and they are not afraid of us anymore.
  39. Article is troll USA FUD by Anonymous Coward · · Score: 0

    because Washington state has steered people with state-subsidized health care

    It's certainly not the fault of the medical companies in the USA who keep lobbying for high medication prices and don't want any competition. No sir, that's not the cause of high prices at all.

    I mean, have you seen the price of medications in Canada? We can't have that kind of competition in the USA!

  40. California Dispensaries by Anonymous Coward · · Score: 0

    Now all the dispensaries for medical cannabis have been end run by zoning laws, perhaps they will open methadone clinics instead?

  41. there's no lifeguard by Anonymous Coward · · Score: 0

    in the gene pool

  42. I don't buy it by tgibbs · · Score: 5, Informative

    In terms of pharmacodynamics, methadone is a garden variety opiate. It has two major distinctions: it has good oral bioavailability, and it is long-acting (i.e. it has slow pharmacokinetics). These are major advantages for people with chronic pain. Morphine has poor oral activity, and also wears off fast. This makes it good for intravenous infusion in a hospital setting, but terrible for patients with severe chronic pain. One aspect of opiate analgesia is that once the pain "breaks through," it is hard to knock it down again. Opiates work best for pain relief if blood levels are kept reasonably constant. So with a short acting opiate, patients have to be constantly popping pills. A long-acting opiate makes it possible for a patient with chronic pain to live something approaching a normal life.

    Respiratory depression by opiates tracks very well with pain relief, so it is not plausible that the respiratory depression would greatly outlast the pain relief, as claimed in the article. Moreover, we have a huge amount of experience with methadone, because it is widely used for opiate maintenance in opiate addicts. Opiate addicts take methadone under supervision, so they can't escalate their doses. So we know that when methadone is taken as prescribed on a regular basis, it is safe and effective, and toxic levels do not build up in the body.

    I think that this is a problem of poor patient and physician education and poor choices by physicians in prescribing a long-acting drug to patients who don't really understand what that means. The average patient has no experience with long-acting pain relievers, because all of the commonly used medications such as hydrocodone are short-acting. The pain relief of a long-acting opiate lasts a long time, but it is also slow in onset. This is an unavoidable aspect of the pharmacokinetics of long-acting drugs. That means that you can't wait until you start hurting, then take a methadone pill and expect the pain to go away in under an hour, as with short-acting drugs. It will take days for the pain relief from methadone to build up to its full level. A patient who doesn't understand this is likely to think, "It isn't working," and take more than the prescribed dose--and then when it does build up, they end up in respiratory depression.

    There is no way to have a long acting opiate pain killer drug that does not carry the same risk as methadone. The same hazards apply to oxycontin (which is a time-release formulation of a short-acting opiate, oxycodone).

    So the patient needs to be told in no uncertain terms, "This isn't a drug where you can wait until you start hurting and then take a pill. It won't work, and it is dangerous to take it that way. You must take it on schedule, every day. You can't take extra even if you are hurting. If you miss a pill, don't take extra to make up. If you take more than the prescribed dose, or take it more often than prescribed, you may DIE." And the doctor needs to be absolutely certain that the patient understands this and is capable of complying. If not (or if there is not a reliable care-giver capable of controlling dosing), then the patient should be prescribed a short-acting narcotic (although this carries its own, different risks).

    1. Re:I don't buy it by Anonymous Coward · · Score: 1

      If not (or if there is not a reliable care-giver capable of controlling dosing), then the patient should be prescribed a short-acting narcotic (although this carries its own, different risks).

      In the past year I had a joint replacement surgery. Due to some concerns about liver function, I was prescribed Dilaudid and Oxycontin for pain relief/control. My "care-giver" (boyfriend) was ultra-meticulous about tracking my dosages, on paper. I had to laugh a little at that at the time, but he clearly was fearful of overdose or abuse/addiction, but also aware of the idea of "keeping ahead of the pain". Frankly, while I was able to manage my dosing myself at about week 3 post-surgically, and I could manage my own dosing (keeping a paper tracking log!) at that point, during those first two week, if left to my own devices, I'm pretty sure I could have eaten them all up and wanted more. Post-surgical pain is pretty brutal, for much longer than you'd think.

      I will say that the controls put in place for refilling and obtaining those meds is almost unmanageable. Chicago area; my usual pharmacy doesn't even fill those med prescriptions, so we had to call around to find a pharmacy that did. You had to have a prescription with a wet MD signature, not a computer-generated one. No call-in prescriptions or refills. My doc's office was very far away, and getting refills was a huge PITA, due to all the restrictions. On top of it, I discovered that you can't speak too positively, even in a conversational manner, to your MD about the effectiveness of the meds in controlling pain, or they look at you like you're a drug-seeker. C'mon... You just cut open my leg and chopped out a bunch of bone, and I'm telling you I'm glad the meds work so I can do my Physical Therapy, and you are afraid to hear me say that?

    2. Re:I don't buy it by __aajfby9338 · · Score: 2

      So the patient needs to be told in no uncertain terms, "This isn't a drug where you can wait until you start hurting and then take a pill. It won't work, and it is dangerous to take it that way. You must take it on schedule, every day. You can't take extra even if you are hurting. If you miss a pill, don't take extra to make up. If you take more than the prescribed dose, or take it more often than prescribed, you may DIE." And the doctor needs to be absolutely certain that the patient understands this and is capable of complying. If not (or if there is not a reliable care-giver capable of controlling dosing), then the patient should be prescribed a short-acting narcotic (although this carries its own, different risks).

      That information was not given to me when I was prescribed Vicodin while passing kidney stones. So, I learned the hard way that if I waited for the pain to start before taking another dose rather than taking it on schedule, I'd be miserable for a half hour before the new dose took effect. In hindsight, I can see how somebody could accidentally overdose in that situation, if they didn't understand that they just need to wait for the pill to take effect or if the pain was bad enough to drive them to desperation.

    3. Re:I don't buy it by ErikZ · · Score: 1

      Wow, if any post deserves the "Informative" label, it's the one above.

      --
      Democrats or Republicans. They are both taking us to the same place and they are not afraid of us anymore.
    4. Re:I don't buy it by CharlieG · · Score: 1

      Yep, been there, done that with the kidney stones. I have a very bad leg, that sometimes requires pain management, but luckly on the rough order of 2x/week (usually when the wounds are going to be debrided - yes folks, we're talking them taking a knife to my leg and cutting off all 'non viable' tissue - hurts a tad). I know from experience that if I wait till I hurt, I know that for the next 45 minutes (30-60 actually depending on what I've had to eat/drink), I'm going to be one hurting computer programmer, and THEN the pain relief kicks in over a period of oh, 5 minutes or so, and I'll be good till the pill wears off. The good news is by then, usually my body has decided to cope with it, and I don't hurt enough to take another pill. Yeah, I'll ache, but...

      --
      -- 73 de KG2V For the Children - RKBA! "You are what you do when it counts" - the Masso
    5. Re:I don't buy it by Anonymous Coward · · Score: 0

      I was prescribed Methadone for chronic pain for almost a year and there was significant respiratory depression even long after the analgesic effects had worn off. I was taking 10mg every 8 hours before I was switched to morphine.

  43. Re:methadone is very useful in managing chronic pa by ColdWetDog · · Score: 4, Insightful

    That and patients don't understand methadone kinetics (not too surprising). There is a tendency to 1) take extra doses to help dull the pain (or deal with withdrawal issues) and 2) medicate with something else. Typically the something else is alcohol. The combination of alcohol and methadone is especially dangerous. Two potent respiratory depressants with very different kinetics.

    Methadone is the poster child for all that is screwed up with pain control and addiction in this country. As usual, it is popular to shoot the 'messenger'. Until the ability to deal with narcotic addiction is wrestled away from the DEA and until patients in general feel like their problem is more of a medical one than a legal one it's just going to get worse. As an ER doc, I'm seeing methadone in a lot of urine drug screens these days. Talking to patients (the ones that will talk, anyway) they are mostly taking it to deal with withdrawal symptoms when they can't get their drug of choice. Of course, that leads them to manage their problem on their own with a very dangerous drug. Not a terribly safe nor effective combination.

    --
    Faster! Faster! Faster would be better!
  44. Re:Waaaaa by Anonymous Coward · · Score: 0

    If I could kick your ass, I would. However, I've been in constant pain for 11 years. People that are in a level of pain where they can "think it away" but still think they have the right to speak on the topic of real, chronic, life-altering, overwhelming pain need to take a step back. Realize how lucky you are, and stop telling me that I could have a real life if I just "stopped caring" about the pain.

  45. Re:Medical cannabis - Your views. by karnal · · Score: 1

    Your signature could not be more perfect.

    --
    Karnal
  46. Re:methadone is very useful in managing chronic pa by Anonymous Coward · · Score: 2, Interesting

    Forgive the posting of AC, but Methadone is a wonder drug for those that take it as prescribed. I had never thought of it as a pain reliever and was leary of taking it because of societys label on it. But it does what other pain killers wont. It has allowed me to live a prety normal life. I take twenty mg morning noon and night. I had been on percocet for 10+ years for back injuries from jobs I have had. Percocet is "a hella of a drug" I hated how badly I LOVED it, and couldn't be without it, the high, the relieff of pain. All of it. Methadone just dulls the pain. No HIGH!!!! I LOVE it. I am not stoned all day long, I can live a normal life without nodding off all day long. Even on it I still feel my spine acting like a jackhammer into my ass. But it is liveable on the drug. We went slow. I went from 5mg three times a day for a year to the 10mg three times a day. It is a good tool when used properly.

  47. It's dangerous to have in the store. by Anonymous Coward · · Score: 0

    My friend the pharmacist (he has his own pharmacy) doesn't keep Oxycontin in
    his store, and turns away a lot of people with forged prescriptions saying "I don't
    keep that in stock".

    And this is not a timid guy.

    1. Re:It's dangerous to have in the store. by X0563511 · · Score: 1

      So, why doesn't he keep the shit in a safe then?

      --
      For large sets, this will be our guide even unto death, for the LORD will work for each type of data it is applied to...
    2. Re:It's dangerous to have in the store. by josath · · Score: 1

      Putting it in a safe wont stop a determined criminal. Just like the common Slashdot aphorism that the most powerful encryption can often be defeated by a $5 wrench in a back alley.

      --
      sig? uhh, umm, ok
  48. Methadone by Anonymous Coward · · Score: 0

    I suffer from bouts of back pain lower with Sciatica from back surgery.
    Methadone is the only thing that worked for me. When you cant work your poor. price is right.
    I also dont take for constant relief, I take it to get stuff done then I dont take it till I am force to get up again after a few days you have to take a bath or poop no matter how much it hurts. In real life there is no one to sponge you down. Or bring and empty a by the bed toilet.

  49. From a physician's perspective... by Anonymous Coward · · Score: 0

    How many people see their physicians regularly enough (and take their medications exactly as prescribed) to permit use of a very long lasting drug like methadone? Speculate at will on the question, but, I can assure you that the people who are best suited to chronic pain control with methadone are few and far between...it's not surprising to me that it's often a lethal drug...

    Titrating up on methadone takes forever....and you're never really certain if the medication is being taken as prescribed (trust me, even counting a patient's pills is no guarantee they swallowed them!...and what doctor has time to count pills and take an extraordinarily precise history regarding who put what in their mouth)...add to this the complete non-sensical labeling of pill bottles that in no way make reconciling lists of medications easier (seriously, no barcodes on pill bottles! Epic fail...)

    This is why methadone is usually prescribed in specialty clinics for drug abusers...it takes a _ton_ of effort, and the physicians who do this are, IMHO, heroes.

  50. Re:methadone is very useful in managing chronic pa by yamfry · · Score: 1

    Not only do the kinetics exhibit a long half-life, the actual half life has been shown to be poorly characterized in clinical trials and even seems to vary over the course of treatment. There are also issues with drug-drug interactions with hepatic and intestinal CPY450 isoenzymes. Methadone is a drug that really needs to have regular clinician follow-up and extensive patient education about the nature of the drug and which drugs to avoid using concomitantly. It's a good (and cheap) drug, but it needs to be use intelligently or it loses that cheap characteristic -- death is not cheap as an outcome measure.

  51. Hugh Fucking Pickens... by Anonymous Coward · · Score: 0

    Geezus Fucking Christ, it's Hugh Pickens again, the "author" that can't even write properly...

    "Over 2,000 patients have died since 2003 in Washington State alone by accidentally overdosing on a commonly prescribed narcotic painkiller that costs less than a dollar a dose and the deaths [...]

    No, not "and"! Period! New sentence! "And" is not a joiner of 2 unrelated sentences! Fucking moron!

  52. you're an idiot by circletimessquare · · Score: 2, Interesting

    the most potent destroyer of freedom in the entire history of mankind, by orders of magnitude, is no government, it is drug addiction

    there is no stronger bars that the most depraved government can build then the bars the drug addiction place in your mind. a constant interrupt switch "get high... get high... get high" makes unable to work, maintain a relationship, think thoughts of philosophy, art, design, anything deep because of the pain of withdrawal

    and this is the real story of the history of opium addiction, and "little or no social problems" from 100 years ago, you idiot:

    http://opioids.com/opium/opiumwar.html

    drug addiction as a tool to destroy a society you want to subjugate

    i understand that people here detest government regulations and impositions on human freedoms. but why that means we have to accept a far worse form of freedom destruction, drug addiction, is beyond my understanding

    --
    intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
    1. Re:you're an idiot by Vintermann · · Score: 1

      drug addiction as a tool to destroy a society you want to subjugate

      This is far from the only time in history it has happened either; usually the drug of choice is liquors.

      --
      xkcd is not in the sudoers file. This incident will be reported.
    2. Re:you're an idiot by circletimessquare · · Score: 1

      such as firewater and the native american experience

      --
      intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
    3. Re:you're an idiot by Anonymous Coward · · Score: 0

      And this does not happen when the government is using it as a tool to incarcerate?
      You sir are the idiot.

    4. Re:you're an idiot by circletimessquare · · Score: 1

      what are you talking about?

      the government should treat drug addiction as a healthcare issue, not a crime issue, that's what i think

      i don't think you understand what you are talking about. let's put it this way: the most oppressive government imaginable is less freedom destroying than drug addiction, UNLESS you had a government that handed out free opium

      there is no better way to enslave mankind than there is through drug addiction. that is the proper relationship between freedom, tyranny, and drug addiction. you don't win the war for more personal freedom by accepting drug addiction, the most potent destroyer of personal freedom possible. go ahead and fight the good fight against tyranny and oppression. but please don't excuse or condone something even worse than that: drug addiction

      --
      intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
    5. Re:you're an idiot by Anonymous Coward · · Score: 0

      Aside from your views on downloading music from file sharing sites, I see that you are still a Right Wing anti-drug zealot. Too bad, I remember years ago talking to you about how your prejudiced and ignorant views on Drugs are illogical. It's obvious that you haven't learned anything, and it's obvious people like you are not interested in learning anything that contradicts your very narrow view of how the world should operate.

      Too bad that appeals to emotion and the other logical fallacies that you use to support your arguments get you rated "Insightful". It makes me want to cry, not because I am interested in using Drugs, but because I am interested in a world without irrationality and extremism.

      Honesty is the best policy.

    6. Re:you're an idiot by Anonymous Coward · · Score: 0

      Drug addiction is a choice. The information is available for those who seek it out. End of story.

    7. Re:you're an idiot by Anonymous Coward · · Score: 0

      i understand that people here detest government regulations and impositions on human freedoms. but why that means we have to accept a far worse form of freedom destruction, drug addiction, is beyond my understanding

      It's not hard to understand at all.
      Either you are able to make your own choice in the matter, or somebody else makes your decisions for you.

      Even addicts have a choice. And despite your claims, there are hundreds and thousands of people throughout history (and even today) who flat out prove you wrong in regards to making you "unable to work, maintain a relationship, think thoughts of philosophy, art, design, anything deep".

      and this is the real story of the history of opium addiction, and "little or no social problems" from 100 years ago, you idiot:
      http://opioids.com/opium/opiumwar.html [opioids.com]

      No, that's the story of what happens after 100 years of it being illegal. Try reading your source next time.

    8. Re:you're an idiot by Anonymous Coward · · Score: 0

      The slaughter at the hands of Pol Pot, Stalin, Hitler, the Armenians at the hands of the Turks, the American Government of my ancestors and innumerable others would beg to differ.

      Drug addiction is a horrible thing, but it is a matter of slavery and death of ones self. The drug war is a war on freedom to govern ones self and the death of many in the name of the collective knowing better than the individual.

      I chose the risk of the former.

  53. Re:Medical cannabis - Your views. by GEEKS+RULE!! · · Score: 0

    Thanks, It is good. I usually turn to google for the answers, it's a computer so it can't be wrong. :-)

    --
    When life throws questions at you, Google has the answers.
  54. Re:methadone is very useful in managing chronic pa by Anonymous Coward · · Score: 2, Interesting

    That and patients don't understand methadone kinetics (not too surprising). There is a tendency to 1) take extra doses to help dull the pain (or deal with withdrawal issues) and 2) medicate with something else. Typically the something else is alcohol.

    As someone who has dealt with severe pain from an accident before, I think the tendency to take extra doses or self-medicate with alcohol as well is understandable. When the pain is so strong that it cuts through everything else, the risk of death seems a small price to pay to dull the pain. I'm not exaggerating. If you're in enough pain, rational thought goes out the window.

    More effective pain treatment options would probably prevent some of these deaths. Perhaps we should be less concerned about addicts pill seeking, and more concerned about pain management.

  55. I saw the story on television. by Anonymous Coward · · Score: 0

    However, I don't recall anything about the pills being the same size and color. In fact, I think the show mentioned that they were different, but the prescription for that month was also of a different dosage, and the parents may have also filled it at a new pharmacy, and so they didn't think anything of the pills appearing to be different. When the child became tired, they called their doctor, but he told them to keep giving him the pills, expecting him to get over the tiredness. After taking a month of the medication, his parents found him dead on the floor in his bedroom. During autopsy it was found he had methadone in his system, and checking with the pharmacy it was found that they were short the number of pills of methadone as his prescription of Ritalin was for, and thus it was concluded that was what he had been taking the entire month.

    I think the show was "Dr. G Medical Examiner" or a title similar to that, if you want to try to find more information.

  56. This mostly effects the poor? by Anonymous Coward · · Score: 0

    If they are going to die, the they had better do it and reduce the surplus surface population...

    E. Scrooge.

  57. yeah by unity100 · · Score: 2

    taking care of unfortunate people should be 'voluntary' in freaking 21st century. opting in the capitalist system is not voluntary, but, fixing its ills, is. how ironic.

    if you are living IN a society, you have obligations. if you want to live with the exquisitely complex and intricate philosophy of 'me me me, my my my, self self self, myself', then go live on a mountain top.

    what provided you with the living standards that separates you from the caveman living in a cave, has been the society. and NO - it was not capitalism. technology and living standards have been developing all throughout history.

    so either learn up, or shut the hell up. dont recite a mindset that was 'new' 200 years ago.

  58. Re:Cynicism by Anonymous Coward · · Score: 0

    The criticism wasn't because he asked the question - rather, it was because he took longer asking the (admittedly dumb) question on Slashdot than it would have taken to look the answer up himself.

  59. The perfect outcome by Anonymous Coward · · Score: 0

    People are free from pain, society is free from the burden of supporting sick poor people, and the whole thing doesn't cost very much at all to operate.

    In a better world a voluntary methadone OD in exchange for a 10k payment to a family member would be the proper long-term solution for indigent care.

    Of course some people would have a problem with this.

  60. Who can you mod this fiend up? by Snaller · · Score: 2

    There is a "war" on drugs because there are too many inhuman assholes like you in society who cares about nobody but themselves.

    --
    If Google really cared they would fix Android Chrome to reflow text, instead of discriminating
  61. End the medical professsion 'guild' system by Anonymous Coward · · Score: 0

    In Canada, the medical schools artifically restrict the number of people who can become doctors, which keeps the number of new doctors down, which means all doctors must see more patients, work longer hours... The profession has created this situation themselves and lots of us would like to see the guild mentality go away. Let more people become doctors, and then the excuse that doctors must be paid so much because they work so hard would go away. As well, abolish the prolonged hazing ritual known as residency -- I know that the next time I'm in hospital for a procedure, I'm going to demand to know how long the doctor's been working before they touch me. There's no excuse for having a system where 48+-hour shifts are considered normal. No one can operate properly under those conditions.

    Imagine a system where we admitted 2-3 times as many students to medical school, who trained over a longer period and were allowed to do limited practice under supervision so they could earn a decent living while they finished their training; under supervision they could work 8-10 hour shifts, have regular weekends, and get a good night's sleep. The justification for enormous compensation would go away, and the doctors' lives would be more balanced so they'd make better decisions.

  62. I use Methadone and this story is worthless by Anonymous Coward · · Score: 0

    This is just another example of poor journalism. This story was written simply to fill the pages of a publication. I use Methadone now for the past year plus some. Yes, there are dangers but the description of a drug having a "half-life" as "toxic reservoir" can only be written by a fool who doesn't know anything about medicine nor the drug. Go read the Wiki's on Methadone and you'll be better informed than reading a fear tabloid article.

    Yes, the drug can be scary when increasing dosages in short periods of time. It is like Heroin in that the effects are different per individual. While starting out I had reduce my levels as I suffered from serious side effects, all these are known and document. One side-effect that wasn't documented though was how caffine and methadone react.

    Methadone's 'toxic resevoir" or as it is called by normal humans, the drug's half-life IS GREAT! As pointed out, other drugs last for hours leaving the patient to suffer from pain while waiting to take their next dosage. With Methadone you don't have that. You're body always has methadone working for you.
    Another benefit of Methadone over most other pain medicines, like Vicodin, Percocet, etc. is they contain Tylenol. WIth a daily limit of 2000 mg almost EVERY DOCTOR overdoses their patients when giving 2-tablets of 500 mg of Percocet or Vicodin 4 times a day. As the oxycodin in those is only about 6 mg, the rest amounts to 2400 mg of Tylenol. People with liver issues like myself can't take it. And too boot, my liver problems were caused because my doctor OD'ed me on those two pain pills for nearly two years.

  63. Pain by Anonymous Coward · · Score: 0

    Anyone who never suffered like having you leg cut off with a chain saw has nothing to say about it.

    If you have never suffered real pain your just a mouth with nothing to say.

  64. So... by Anonymous Coward · · Score: 0

    Either people can be responsible with their drugs and we can legalize them, or people are stupid enough to OD on painkillers that come with clear instructions.

  65. Welcome to Obamacare by Anonymous Coward · · Score: 0

    Die quickly.

  66. The only good druggie by Anonymous Coward · · Score: 0

    ...Is a DEAD druggie!

  67. Why is this on slashdot? by drwho · · Score: 1

    Why is this here? What geek appeal does this have? Remember when we used to talk about things like beowulf clusters of things, or that BSD was dying, or the SCO vs Linux lawsuit? Why is this here and why is Kim Song Ils death worthy of note here? Do slashdot editors think that we read nothing else? Or is it just a slow news days in the tech geek world?

    1. Re:Why is this on slashdot? by RockDoctor · · Score: 1

      Why is this here? What geek appeal does this have?

      A fair enough question. It's (in part, at least) driven a fair amount of discussion of medical and pharmacological matters - which may not be your thing, but it is reasonably technological.

      Remember when we used to talk about things like beowulf clusters of things,

      Just think of what you could do with a Beowulf cluster of methadone patients waiting for their dose? Errr, not a lot, but inserting the cabling might be "interesting".

      Why is this here and why is Kim Song Ils death worthy of note here?

      Because
      (1) some of us [/self] are trying to get work in DPRK and are concerned if this will screw the job up even more ;
      (2) DPRK probably has nukes;
      (3) any discussion of DPRK that doesn't include condemnation of them for being a bunch of pinko commie bastards is likely to get the redneck septics frothing at the mouth in a most amusing fashion.

      Or is it just a slow news days in the tech geek world?

      It's a slow news day ; you'll get over it.

      --
      Birds are not dinosaur descendants;birds are dinosaurs, for all useful meanings of "birds", "are" and "dinosaurs"
  68. What's happening in WA by Anonymous Coward · · Score: 0

    Most of you don't realize what's currently happening in WA. I just moved here from CA and I've been taking pain medications for years. What I quickly discovered after I moved here was that there's a huge beurocratic situation taking place here. There's a war taking place on patients and doctors in this state and the whole of the US is watching to see how it plays out. WA state seems to be the strictest state in the union as far as current and upcoming laws on prescription pain medications. Starting the first (or second) of the year, doctors will not be able to prescribe opiates to patients over a certain dosage a day. There's also a whole slew of other laws that put doctors in a more difficult spot. In order for the docs to practice medicine in the way for which they went to school, they have to pretty much go back to school. Because of all these strict new regs, doctors are just deciding not to prescribe pain meds all together. Hundreds of doctors are dropping patients in chronic pain; paitents these doctors have had for years. They're afraid that they may get in trouble for possibly missing a letter in the law due to how strict and harsh these new laws are. So, due to this new fear of running afoul of new overly strict drug laws, doctors are preferring to throw out their hippocratic oath and just turn away patients in legitimate need. It's an absolute crises in WA. I've had doctors prescribe me the meds I've needed for many years but now, in this state, I'm very afraid of what I'm about to run into when I see my new doctor. I'm not the only one. There's stories all over the net of what's coming next month for everyone. I just read a story about a patient who had a hydrocodone script where it was 'take as needed'. She didn't take any for a while as it wasn't needed and when she saw her doc, she was forced to take a urine test which, when it came back showing no drugs in her system, she received a certified letter from her dr office stating she was no longer allowed back to that clinic as she's now suspected of diversion. Imagine that! Cut off for not taking medication. Wow. That's just a taste of what's happening in this state.

  69. Methadone investigative series by Anonymous Coward · · Score: 0

    The entire 3-part Seattle Times series, "Methadone and the politics of pain," can be found at: www.seattletimes.com/methadone
    I think it's worth a close read. What are your reactions?

  70. DEMOCrazy Needs to Grow a Giant Set of Brass Balls by Anonymous Coward · · Score: 0

    If the Repubicans and Democlits can't figure out how to save people DESPITE being pressured to do otherwise shows why Demoncrazy isn't really the answer. What we need is China where 100% state-owned healthcare gives UNLIMITED supply of labour and working hours all FOR FREE!!!

    Death is a RELIEF ! I mean a RELEASE !!!

  71. Re:Cynicism by Anonymous Coward · · Score: 0

    Actually, the Nazis developed meperidine (Demerol) to circumvent the Allied blockade of opium sources, making morphine difficult to obtain. It turned out that Demerol has significant long-term usage problems (a metabolite has a much longer half-life than the Demerol) and caused mental issues. Some historians have hypothesized that Hitler was a Demerol user, and it accounted for poor military decisions later in the war.

  72. Methadone effective for cancer patientys by Anonymous Coward · · Score: 0

    Methadone was the only pain killer effective when my dad was dying from cancer that had spread to bones and other areas.

    Short term drugs like morphine and the others did not las long.

  73. worst opioid you could possibly use for that! by Anonymous Coward · · Score: 0

    No, actually it is an excellent analgesic in a selected population of chronic pain, high narcotic usage population. Since it has such a long half life, missing the exact scheduling dosage isn't as critical, resulting in less breakthrough pain. It also has a much lower "fell into the toilet" event rate and as previously mentioned, much less likely to be stolen/misused by the narcotic abusing population.