I am a retired nurse of 39 years. I was still working when the rules started changing for opioid prescriptions. I know the healthcare professionals and organizations weren’t ready for this change. Even with doing their best and following the new guidelines, I can’t forget the patients who suffered because of it. I am aware of what led to these changes. I am aware of drug addicts versus people needing short term pain relief. I’m all for giving the doctors back a little decision making when it comes to treating their patients. I know this is starting an even bigger discussion of the growing involvement of insurance companies in the decision making of our healthcare. I still think we need to lean toward less government control and a more physician-based plan of care. Thank you☺️.
I’m an 80 year old man. I abused alcohol and amphetamine from age 13 to 40. I’ve been a recovery since. At age 65 I began using prescribed opioids for severe pain due to neck and knee injuries. At age 70 I was diagnosed with ADHD and prescribed amphetamine. At age 75 I had a partial knee replacement. Not wanting to increase the opioid dosage for the surgical pain I decided to slowly came off the opioids prior to knee surgery, and use a non-addictive drug instead. I believe that alcohol and opioids could have masked my ADHD for 57 years. So here I am needing a drug that can help me maintain a decent quality of health and life, and because of manufacturing restrictions of the generic form of amphetamine, I’m forced into a 600% greater monthly copay for the name brand. Of course the cost of all drugs continue to rise that don’t have a generic equivalent. Many mental health drugs have no generic equivalent, yet many believe mental health is this country’s most serious health issue. I apologize for the length of this post and if it’s a bit off subject.
I am not buying that surgeons write opioid prescriptions for spouses intended for patients. This would entail, setting up a bogus medical record for the spouse, which if discovered, would most certainly result in licensure suspension. And as for patient convenience, it’s a simple matter to have the spouse pick up the prescription at the pharmacy.
I am reluctantly on board with the MAT wagon, and that is clearly where the policymakers are taking us on this issue.
However, there are going to be some "unintended consequences" there also. I have a hunch that increasing the supply of suboxone ten thousand fold might have a ripple somewhere in the pond.
This is a great article (Am j Public Health) in Australia, the overarching philosophy of The National Drug Strategy is one of Harm Minimisation; by targeting supply, demand and harm reduction strategies, although it is debatable as to whether a balanced approach to this has yet been achieved. As has been demonstrated by Alcohol Management Plans in First Nations communities; policing often receives the lions’ share of resources. Interagency collaboration as suggested here would be a step towards safer supply restriction efforts based on shared understanding of medical needs and societal conditions
This is a bunch of nonsense. The opioid crisis needs to be stopped. Of course those addicted to opioids are going to try to continue using if their supply is taken away, that doesn’t mean that our society should continue to let the supply flow freely. Police should continue to seize illegal drugs and doctors should stop over prescribing, even if the person who is addicted tries to find other sources. The problem can not continue the way it’s been going. Obviously, treatment and safe detox should be available to all in conjunction with cutting off the supply. I say this as someone who has lost family and close friends to this epidemic. We have to cut off the legal and illegal supply, in addition to compassionate medical treatment
A closely related issue of unintended consequences is abstinence-oriented interventions in opioid addiction.
The relapse rate after abstinence base residential programs is greater than 90%. About 60% of that relapse occurs within one week. Programs that rapidly detoxify dependent heroin users and place them quickly back on the street put these users at high risk of overdose death, because physical tolerance is less. The excess mortality from overdose is about 15x the baseline overdose mortality in heroin addicts. (Norwegian Study). Fentanyl is making this problem worse.
Forced abstinence in incarceration has been the norm. Opioid use typically resumes after release, the inmate released in a state of decreased physical tolerance. A former inmate’s risk of death within the first 2 weeks of release is more than 12 times that of other individuals, with the leading cause of death being a fatal overdose.
I am a retired nurse of 39 years. I was still working when the rules started changing for opioid prescriptions. I know the healthcare professionals and organizations weren’t ready for this change. Even with doing their best and following the new guidelines, I can’t forget the patients who suffered because of it. I am aware of what led to these changes. I am aware of drug addicts versus people needing short term pain relief. I’m all for giving the doctors back a little decision making when it comes to treating their patients. I know this is starting an even bigger discussion of the growing involvement of insurance companies in the decision making of our healthcare. I still think we need to lean toward less government control and a more physician-based plan of care. Thank you☺️.
I’m an 80 year old man. I abused alcohol and amphetamine from age 13 to 40. I’ve been a recovery since. At age 65 I began using prescribed opioids for severe pain due to neck and knee injuries. At age 70 I was diagnosed with ADHD and prescribed amphetamine. At age 75 I had a partial knee replacement. Not wanting to increase the opioid dosage for the surgical pain I decided to slowly came off the opioids prior to knee surgery, and use a non-addictive drug instead. I believe that alcohol and opioids could have masked my ADHD for 57 years. So here I am needing a drug that can help me maintain a decent quality of health and life, and because of manufacturing restrictions of the generic form of amphetamine, I’m forced into a 600% greater monthly copay for the name brand. Of course the cost of all drugs continue to rise that don’t have a generic equivalent. Many mental health drugs have no generic equivalent, yet many believe mental health is this country’s most serious health issue. I apologize for the length of this post and if it’s a bit off subject.
I am not buying that surgeons write opioid prescriptions for spouses intended for patients. This would entail, setting up a bogus medical record for the spouse, which if discovered, would most certainly result in licensure suspension. And as for patient convenience, it’s a simple matter to have the spouse pick up the prescription at the pharmacy.
I agree that that seems really off and so out of the norm that I cannot imagine it happening.
Good grief this stuff is dismal.
I am reluctantly on board with the MAT wagon, and that is clearly where the policymakers are taking us on this issue.
However, there are going to be some "unintended consequences" there also. I have a hunch that increasing the supply of suboxone ten thousand fold might have a ripple somewhere in the pond.
https://heal.nih.gov/news/stories/can-cbd-treat-opioid-use-disorder
Try CBD to help addiction to opiates.
Iconicsasi.com
This is a great article (Am j Public Health) in Australia, the overarching philosophy of The National Drug Strategy is one of Harm Minimisation; by targeting supply, demand and harm reduction strategies, although it is debatable as to whether a balanced approach to this has yet been achieved. As has been demonstrated by Alcohol Management Plans in First Nations communities; policing often receives the lions’ share of resources. Interagency collaboration as suggested here would be a step towards safer supply restriction efforts based on shared understanding of medical needs and societal conditions
This is a bunch of nonsense. The opioid crisis needs to be stopped. Of course those addicted to opioids are going to try to continue using if their supply is taken away, that doesn’t mean that our society should continue to let the supply flow freely. Police should continue to seize illegal drugs and doctors should stop over prescribing, even if the person who is addicted tries to find other sources. The problem can not continue the way it’s been going. Obviously, treatment and safe detox should be available to all in conjunction with cutting off the supply. I say this as someone who has lost family and close friends to this epidemic. We have to cut off the legal and illegal supply, in addition to compassionate medical treatment
A closely related issue of unintended consequences is abstinence-oriented interventions in opioid addiction.
The relapse rate after abstinence base residential programs is greater than 90%. About 60% of that relapse occurs within one week. Programs that rapidly detoxify dependent heroin users and place them quickly back on the street put these users at high risk of overdose death, because physical tolerance is less. The excess mortality from overdose is about 15x the baseline overdose mortality in heroin addicts. (Norwegian Study). Fentanyl is making this problem worse.
Forced abstinence in incarceration has been the norm. Opioid use typically resumes after release, the inmate released in a state of decreased physical tolerance. A former inmate’s risk of death within the first 2 weeks of release is more than 12 times that of other individuals, with the leading cause of death being a fatal overdose.
where i live the prescriptions are delivered and witnessed intake