The Opiod Epidemic

The Diplomat said:
Thing is, some people start out as injured and get hooked naturally.

Some people are just economical and abuse the system.

Some people are just junkies and buy the shit and do it.

But how are they getting these drugs in the first place? Doctors. The beginning of the road leads somewhere.

Leave it to @panamaican to get it wrong again.
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You mean leave it to me to point out the obvious difference in how people are treating this "epidemic"? How you want to minimize the drug abusers and put the blame on doctors who haven't done anything illegal?

How do people end up alcohol abusers? They have a drink a party and get hooked naturally...therefore the party host and the store that sold the spirits are responsible and we should excuse people's alcohol abuse.

No one takes any drug with the goal of becoming addicted. Yet people consistently discuss the drug users with disdain and assign them the lion's share of the blame for their eventual abuse. But here? You want to lead the road to the doctors? Sounds like excuse making to me.
 
Cubo de Sangre said:
Yep.

All the more reason to get rid of the prescription system. If we're not going to hold script-writers accountable for their decisions then they shouldn't be tasked with determining what a person can or can't take to treat whatever condition it is they're seeking to alleviate. As it stand, isn't there an implied responsibility?
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We do hold script writers accountable for when they do something wrong. Not for when the patient does something wrong.

You're a 2nd Amendment guy, as am I. This is the same thing. A guy legally sells a gun to someone with no reason to believe that the buyer is a psycho. We don't hold the seller responsible for when the buyer eventually does something stupid. People who try to restrict the 2nd Amendment constantly make that argument and I find it absurd. It is just as absurd here.

A doctor cannot determine if the patient in front of him/her is going to eventually become addicted. They can't determine who will intentionally disregard the treatment instructions or who will sell their drugs on the black market for personal gain.

The car dealer cannot determine if the buyer is going to drive drunk 3 weeks from now or text and drive or any myriad illegal actions that people take behind the wheel. We don't say "Well, people shouldn't sell cars."

There's a point where doctors are responsible (if they know that the patient is lying about their injuries or the doctor writes a script knowing that it's unnecessary) but 99% of the time, responsibility lies with the patient. And if they start thinking they have a problem - they should go get help. Every single one of those legal drugs warns about potential addiction.

And none of that has anything to do with the people who are hooked on heroin and looking for other ways to meet their addiction.
 
The opioid "epidemic" isn't a real thing.
It's no different than every other government labeled "drug epidemic" of the last fifty years.
 
panamaican said:
If you want to take me seriously then so be it.

It is not the doctors fault that someone disregards specific medical advice or resells their unused medication. That is fallacious. Even if a physician only prescribed the bare minimum, the patient could/would still abuse it. Until the doctor actually breaks a law, assign responsibility where it belongs - on the people who are abusing their medication.

This part of why I was pointing out the difference in how people are treating this "epidemic".

You type "personal responsibility" and then insist on blaming the people who aren't doing anything wrong. Unless the doctor is illegally writing the script then "personal responsibility" means that 100% of the fault lies with those abusing or reselling their opiods.

And doctors have nothing to do with heroin.
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Irresponsible prescribing is a huge part of this epidemic.
 
panamaican said:
We do hold script writers accountable for when they do something wrong. Not for when the patient does something wrong.

You're a 2nd Amendment guy, as am I. This is the same thing. A guy legally sells a gun to someone with no reason to believe that the buyer is a psycho. We don't hold the seller responsible for when the buyer eventually does something stupid. People who try to restrict the 2nd Amendment constantly make that argument and I find it absurd. It is just as absurd here.

A doctor cannot determine if the patient in front of him/her is going to eventually become addicted. They can't determine who will intentionally disregard the treatment instructions or who will sell their drugs on the black market for personal gain.

The car dealer cannot determine if the buyer is going to drive drunk 3 weeks from now or text and drive or any myriad illegal actions that people take behind the wheel. We don't say "Well, people shouldn't sell cars."

There's a point where doctors are responsible (if they know that the patient is lying about their injuries or the doctor writes a script knowing that it's unnecessary) but 99% of the time, responsibility lies with the patient. And if they start thinking they have a problem - they should go get help. Every single one of those legal drugs warns about potential addiction.

And none of that has anything to do with the people who are hooked on heroin and looking for other ways to meet their addiction.
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It’s difficult to hold prescribers accountable for prescribing medications for something as subjective as pain. That doesn’t mean that many aren’t guilty of gross negligence with their prescribing habits.
 
of course there is. fentanyl is everywhere now it's awful.
 
Anung Un Rama said:
It’s difficult to hold prescribers accountable for prescribing medications for something as subjective as pain. That doesn’t mean that many aren’t guilty of gross negligence with their prescribing habits.
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Are they negligently forcing pills into people's mouths? Are they negligently forcing people to resell drugs on the black market? Are they negligently making people take pills when they could manage the pain without them?

Nope. Nope. And nope.

You tell your doctor you're in pain and the doctor treats you like an adult. They give you instructions and then prescribe you enough medication to get you through what you've described to them. If you want to lie or disregard the instructions, that's not gross negligence on the doctor.

In a world where people want to push medical marijuana, homeopathic medicine and shop at GNC, are we really arguing that the patients are not responsible for their actions once they leave the doctor's office?

What should the physician do - follow the patient home? Put a camera in their house? Write them a single week's worth of medication and force them to take off work every week to get a new script, even for injuries that will require months of rehabilitation and pain management? Because it's better for people to miss work every week and pay for a new doctor's appointment every week instead of self-regulating their own behavior by following clearly presented instructions?

Obviously I disagree.
 
Opioids are great for short term treatment of pain but many people get addicted very quickly and doctors are too soft when it comes to prescribing. A physician will tell you one of the hardest things they have to do as a practitioner is ween someone off a high dose prescription. Much easier and MUCH quicker to just write the script than to try to talk them into weening themselves off.

Insurance companies play a big role in this. They can choke down the supply and require providers to justify and prescriptions over something like 80 MME's a day. MME = Morpheme Milligram Equivalent
 
panamaican said:
Are they negligently forcing pills into people's mouths? Are they negligently forcing people to resell drugs on the black market? Are they negligently making people take pills when they could manage the pain without them?

Nope. Nope. And nope.

You tell your doctor you're in pain and the doctor treats you like an adult. They give you instructions and then prescribe you enough medication to get you through what you've described to them. If you want to lie or disregard the instructions, that's not gross negligence on the doctor.

In a world where people want to push medical marijuana, homeopathic medicine and shop at GNC, are we really arguing that the patients are not responsible for their actions once they leave the doctor's office?

What should the physician do - follow the patient home? Put a camera in their house? Write them a single week's worth of medication and force them to take off work every week to get a new script, even for injuries that will require months of rehabilitation and pain management? Because it's better for people to miss work every week and pay for a new doctor's appointment every week instead of self-regulating their own behavior by following clearly presented instructions?

Obviously I disagree.
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They're prescribing a medication they know to be extremely habit forming in high quantities for degrees of pain that don't warrant it.
There are also issues related to exceeding the boundaries of their professional practice.

Gross negligence is the "lack of slight diligence or care" or "a conscious, voluntary act or omission in reckless disregard of a legal duty and of the consequences to another party."[1] In some jurisdictions a person injured as a result of gross negligence may be able to recover punitive damages from the person who caused the injury or loss.[2]

Negligence is the opposite of diligence, or being careful. The standard of ordinary negligence is what conduct deviates from the proverbial "reasonable person". By extension, if somebody has been grossly negligent, that means they have fallen so far below the ordinary standard of care that one can expect, to warrant the label of being "gross". Gross negligence may thus be described as as reflecting "the want of even slight or scant care", falling below the level of care that even a careless person would be expected to follow.[3] While some jurisdictions equate the culpability of gross negligence with that of recklessness, most differentiate it from simple negligence in its degree.[3]
https://en.wikipedia.org/wiki/Gross_negligence
 
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panamaican said:
Which rarely occurs but that's a defined crime that goes beyond some person's idea of "irresponsible".
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Rarely occurs, or is rarely prosecuted?
And outside of a court of law, irresponsibility and negligence are the same thing.
 
Anung Un Rama said:
They're prescribing a medication they know to be extremely habit forming in high quantities for degrees of pain that don't warrant it.
They're are also issues related to exceeding the boundaries of their professional practice.

Gross negligence is the "lack of slight diligence or care" or "a conscious, voluntary act or omission in reckless disregard of a legal duty and of the consequences to another party."[1] In some jurisdictions a person injured as a result of gross negligence may be able to recover punitive damages from the person who caused the injury or loss.[2]

Negligence is the opposite of diligence, or being careful. The standard of ordinary negligence is what conduct deviates from the proverbial "reasonable person". By extension, if somebody has been grossly negligent, that means they have fallen so far below the ordinary standard of care that one can expect, to warrant the label of being "gross". Gross negligence may thus be described as as reflecting "the want of even slight or scant care", falling below the level of care that even a careless person would be expected to follow.[3] While some jurisdictions equate the culpability of gross negligence with that of recklessness, most differentiate it from simple negligence in its degree.[3]
https://en.wikipedia.org/wiki/Gross_negligence
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I know the legal definition of gross negligence, lol.

Which is why I said it doesn't apply. Conscious, voluntary, reckless disregard. And a doctor is recklessly disregard what when they prescribe medication based on the statements of the patient coupled with whatever tests and examinations they have conducted?

How exactly is a doctor supposed to determine if the patient's state degree of pain is real or false? The doctor should tell the patient that the stated "Pain at 7" is really a "Pain at 3" and thus doesn't need pain meds? Or the doctor should say "I know that treating this thing takes 8 weeks but because of the chance that the patient heals in 5.5 weeks, of 10.5 weeks I will only prescribe medication for the 5.5 weeks and fuck the possibility of longer recovery periods. This way I can force another doctor's visit out of them."

I think you need to re-examine what constitutes "reckless disregard".
 
panamaican said:
I know the legal definition of gross negligence, lol.

Which is why I said it doesn't apply. Conscious, voluntary, reckless disregard. And a doctor is recklessly disregard what when they prescribe medication based on the statements of the patient coupled with whatever tests and examinations they have conducted?

How exactly is a doctor supposed to determine if the patient's state degree of pain is real or false? The doctor should tell the patient that the stated "Pain at 7" is really a "Pain at 3" and thus doesn't need pain meds? Or the doctor should say "I know that treating this thing takes 8 weeks but because of the chance that the patient heals in 5.5 weeks, of 10.5 weeks I will only prescribe medication for the 5.5 weeks and fuck the possibility of longer recovery periods. This way I can force another doctor's visit out of them."

I think you need to re-examine what constitutes "reckless disregard".
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yeah, I know you do, I find it annoying that you are using legal interpretations of commonly understood words to discuss this topic amongst laymen.

And it does apply when these medications are prescribed with conscious, voluntary, and reckless regard. See the case of Hsiu-Ying Tseng that I linked above for an example of this.

I think you need to re-examine professional responsibility if you think prescribing 180 oxycodone 30mg to a patient because they complain of pain is acceptable because the prescriber is treating the patient "like an adult".
 
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