I mean I just watched “Painkiller” on Netflix (but I heard “Dopesick” is better) and it explains a few things.
Like the insanity of advertising for a drug (like going to doctors and promoting your drug). Or the way Oxycodone was pushed through the FDA with bribes. It’s no surprise that you get addicts when you push a “12-hour” painkiller that only lasts for around 6-8 hours, sending patients into withdrawal. But if they allowed doctors to prescribe a lesser dose every 6 hours for example there would be cheaper alternatives (the 12-hour thing was the entire marketing selling point). Just awful :-/
It’s no surprise that you get addicts when you push a “12-hour” painkiller that only lasts for around 6-8 hours
No, it works for 12 hours for most people. Meaning that a small bit sizable percentage would have been better off on the old kind. Which isn’t anything new in medical fields, it’s true for damn near every “extended release pill”.
But Sackler buried that, they would make way more off XR, so they wanted docs prescribing it as normal to everyone. Then the patients and the doctor could work it out on their own.
But a patient telling their doc their 12 hour opioid where’s off in 6 so they need more…
Sounds like an addict. So doctors wouldn’t and the patient had to turn to the streets. Or the doctor didn’t care and would give them multiple extra refills.
If you wanted to come up with a program scientifically designed to create opioid addicts…
You couldn’t do much better than this without giving people 5 gallon buckets of pills for a headache.
But the Sacklers are billionaires. So when they got sued the US government agreed that it wouldn’t be fair to allow their victims to touch any of the billions in personal wealth they got fucking over Americans, and definitely no jail.
Quick science edit:
The difference is our liver enzymes, everyone has different amounts. I’m a rare case where my body can’t even break down the normal opioids into their effective parts. Except for morphine, pretty much every opioid is just a chemical out body metabolizes into morphine.
My body sucks so bad at doing that, I get absolutely nothing out of even something like Percocet.
Some livers are really good at it. They’re the ones that can burn through a XR in half the time. Meaning if they follow directions they’ll twice as doped up at first, then intense pain till their next one.
Sacklers and Purdue *knew" that. But they picked the option that made them the most money, even though it created a generation of addicts
Except for morphine, pretty much every opioid is just a chemical out body metabolizes into morphine
Only codeine and heroin have this as their primary mechanism of action I’m fairly sure? Oxycodone is active itself without metabolism, as are many other opioids.
Yes, metabolism will still make a difference though.
I worked in a pain management clinic in the 2000s. The drug reps came daily, would have lunch catered from every restaurant, would go golfing with the docs and take them out for expensive dinners, and would bring branded gifts. They couldn’t force the docs to prescribe their particular pill but they would stop coming if you weren’t pushing enough of their product. It was sort of an unspoken agreement that they wrote the scripts and the reps would keep showing up.
It’s kind of crazy looking back. We were one of the clinics that took the enormous responsibility seriously and tried to serve the community and I think we did genuinely help people that were suffering. But I think that we were ultimately naive as shit about the drugs we were pushing and there’s no doubt many of those patients we had probably would go on to struggle with addiction problems.
I mean I just watched “Painkiller” on Netflix (but I heard “Dopesick” is better) and it explains a few things.
Like the insanity of advertising for a drug (like going to doctors and promoting your drug). Or the way Oxycodone was pushed through the FDA with bribes. It’s no surprise that you get addicts when you push a “12-hour” painkiller that only lasts for around 6-8 hours, sending patients into withdrawal. But if they allowed doctors to prescribe a lesser dose every 6 hours for example there would be cheaper alternatives (the 12-hour thing was the entire marketing selling point). Just awful :-/
No, it works for 12 hours for most people. Meaning that a small bit sizable percentage would have been better off on the old kind. Which isn’t anything new in medical fields, it’s true for damn near every “extended release pill”.
But Sackler buried that, they would make way more off XR, so they wanted docs prescribing it as normal to everyone. Then the patients and the doctor could work it out on their own.
But a patient telling their doc their 12 hour opioid where’s off in 6 so they need more…
Sounds like an addict. So doctors wouldn’t and the patient had to turn to the streets. Or the doctor didn’t care and would give them multiple extra refills.
If you wanted to come up with a program scientifically designed to create opioid addicts…
You couldn’t do much better than this without giving people 5 gallon buckets of pills for a headache.
But the Sacklers are billionaires. So when they got sued the US government agreed that it wouldn’t be fair to allow their victims to touch any of the billions in personal wealth they got fucking over Americans, and definitely no jail.
Quick science edit:
The difference is our liver enzymes, everyone has different amounts. I’m a rare case where my body can’t even break down the normal opioids into their effective parts. Except for morphine, pretty much every opioid is just a chemical out body metabolizes into morphine.
My body sucks so bad at doing that, I get absolutely nothing out of even something like Percocet.
Some livers are really good at it. They’re the ones that can burn through a XR in half the time. Meaning if they follow directions they’ll twice as doped up at first, then intense pain till their next one.
Sacklers and Purdue *knew" that. But they picked the option that made them the most money, even though it created a generation of addicts
There is a recent development that they and their billions might not actually be shielded:
https://www.cbsnews.com/news/supreme-court-purdue-pharma-settlement-bankruptcy-sackler-family-oxycontin/
Only codeine and heroin have this as their primary mechanism of action I’m fairly sure? Oxycodone is active itself without metabolism, as are many other opioids.
Yes, metabolism will still make a difference though.
I worked in a pain management clinic in the 2000s. The drug reps came daily, would have lunch catered from every restaurant, would go golfing with the docs and take them out for expensive dinners, and would bring branded gifts. They couldn’t force the docs to prescribe their particular pill but they would stop coming if you weren’t pushing enough of their product. It was sort of an unspoken agreement that they wrote the scripts and the reps would keep showing up.
It’s kind of crazy looking back. We were one of the clinics that took the enormous responsibility seriously and tried to serve the community and I think we did genuinely help people that were suffering. But I think that we were ultimately naive as shit about the drugs we were pushing and there’s no doubt many of those patients we had probably would go on to struggle with addiction problems.