The Opioid Crisis - What's going to happen with the opioid problem? Is it more prevelant or are we more aware?

[Medicated]

Maybe we should do something about all these people who need opiates to deal with how shitty their lives are.

As more drugs are developed, more people get addicted to more.
People aren't getting worse, but they're being given more toys to hurt themselves with.

I'm interested in why opiates are considered an epidemic, when alcohol kills more through car wrecks, violence, liver failure, and dependency. Then we put up a "drink responsibly" sign in the window, and everything is fine. What's the real reason here?

 

[Thiletonomics]

I'm interested in why opiates are considered an epidemic, when alcohol kills more through car wrecks, violence, liver failure, and dependency. Then we put up a "drink responsibly" sign in the window, and everything is fine. What's the real reason here?

Not to mention tobacco usage too, although it's not as big due to various laws and policies to restrict tobacco usage and advertising. Is secondhand smoke from vaping a thing, like with regular cigarettes and cigars?

As for opiods, the fact that some doctors have taken advantage of the opiod crisis, by running pill mill operations, just add on to the crisis. Several pill mill operations have been featured on American Greed, and the enormous profits those dirty doctors have made are flat out disgusting.

 

[Medicated]

Not to mention tobacco usage too, although it's not as big due to various laws and policies to restrict tobacco usage and advertising. Is secondhand smoke from vaping a thing, like with regular cigarettes and cigars?

As for opiods, the fact that some doctors have taken advantage of the opiod crisis, by running pill mill operations, just add on to the crisis. Several pill mill operations have been featured on American Greed, and the enormous profits those dirty doctors have made are flat out disgusting.

Oh I see, so the pharma companies are losing out on the profits because they get cut out somewhere down the line? I know this has nothing to do with helping people, because there are worse things that have been ignored by lawmakers longer, and virtually benign things legislated to the hilt.

So I'm wondering what the real angle is here.

 

[Thelostcup]

Part of it I think is because when a substance becomes controlled, people mentally assign a negative association with it and anyone who uses it because a lot of folks still haven't figured out that legality != morality. There are plenty of uncontrolled drugs you can buy for cheap on the internet that have high addiction potentials and withdrawals on par with benzos yet if you tell people that it's legal when you're clearly high as balls, most of the time they'll just brush it off like they would caffeine pills.

 

[Caesare]

It's simply a new awareness. What do y'all think? Is it new? Is there something I'm missing?

Nope, you're not wrong at all. This isn't anything "new" or "recent". It's just another "hot" story that the media's been running with. Opiate abuse whether it be through pain medication or heroin has been an issue the entire 20th century. It really started gaining momentum in the 50s and the 60s iirc.

It get's a lot of attention in cycles whenever something sad happens, like when seemingly intelligent high school kids who were just experimenting go overboard and overdose their very first time trying drugs. If high school aged kids feel the need to "experiment" they need to stick to booze, or marijuana, maybe some acid... pain medication is not the way to go. It's too dangerous and addictive for someone just trying to get their "kicks".

And every time one of them dies after experimenting, it brings out the angry mothers who start screaming at the lawmakers, "How did this happen?! Why can our babies get these horrible things?!" All this accomplishes is putting pressure on the doctors which inconveniences individuals who need their pain medication to live halfway functional lives.

It is really stupid to prescribe opiates for long term pain management. Its not effective at all...but good luck telling someone that has been abusing their meds for the last couple of years they need to get off the pills.

I agree in the case of minor long term pain, as this is better handled with alternative methods: massages, Alleve/Ibuprofen, stretching, physical therapy, etc. But, there are people that have severe pain that need these narcotic medications just to function in their day to day lives. I'm talking people with awful injuries that will linger for the rest of their lives. They really have no choice but to take their pills as they are the only things allowing them to function somewhat normally.

However, the person that just swears that they absolutely need their sixty, 10mg Norco's each month for their "fibromyalgia", these people are the frauds that give a bad name to every legitimate person suffering with long term, chronic pain. Not to mention, the ones that have been getting prescribed low strength narcotics for years and years (like the fibromyalgia person I just mentioned), these are usually the type of people who are using their medicine to supplement their income.

They should also be giving out suboxone like candy.

They already do. It's not hard to find a suboxone doctor in your area who will write to you. It works pretty great for prescription narcotic addictions as it blocks the opiate receptors in the brain, thus making it a waste of money for the addict to even try and acquire pills to abuse as they won't feel their effects at all.

It's less effective for heroin users though. These people are better off going to the clinic.

 

[JustStopDude]

I have colleague I was in military with. He got out and gets degree and becomes pharmacist. He has rural pharmacy in Kentucky.

I visit him once because I am doing job in region. His fucking place is like bank. Bullet proof glass, armed guard and shit. I ask him "Steve, why is this like this?"

He points out that in US, average armed robbery of bank is like $1200 in cash. But you steal one of his pill bottles (they come in big jugs), that bottle is worth like $50k in pills. And unlike US currency, there are no individual serial numbers to track on pills. He had to get his entire building re-enforced because local drove truck through the front to smash and grab. Guy got high as fuck in parking lot and never even tried to run.

I say this is crazy. He then shows me the cameras he had to have for employees. You see casinos where card people deal and they must flash their hands in certain way to show they not pocket chips? He must make his employees do this now because they were stealing pills.

In like 4 years, he had to participate with DEA or whatever to get three doctors to lose license for writing bullshit prescriptions. Like one of the docs is serving time for mailing him an explosive for reporting him. To get prescription filled, people have to do urinalysis onsite to show they are taking their actual meds because so many old people were just getting the pills and immediately selling them to kids.

Fucking crazy. Tiny town America and it is like wild, wild west with these pills.

 

[Medicated]

I have colleague I was in military with. He got out and gets degree and becomes pharmacist. He has rural pharmacy in Kentucky.

I visit him once because I am doing job in region. His fucking place is like bank. Bullet proof glass, armed guard and shit. I ask him "Steve, why is this like this?"

He points out that in US, average armed robbery of bank is like $1200 in cash. But you steal one of his pill bottles (they come in big jugs), that bottle is worth like $50k in pills. And unlike US currency, there are no individual serial numbers to track on pills. He had to get his entire building re-enforced because local drove truck through the front to smash and grab. Guy got high as fuck in parking lot and never even tried to run.

I say this is crazy. He then shows me the cameras he had to have for employees. You see casinos where card people deal and they must flash their hands in certain way to show they not pocket chips? He must make his employees do this now because they were stealing pills.

In like 4 years, he had to participate with DEA or whatever to get three doctors to lose license for writing bullshit prescriptions. Like one of the docs is serving time for mailing him an explosive for reporting him. To get prescription filled, people have to do urinalysis onsite to show they are taking their actual meds because so many old people were just getting the pills and immediately selling them to kids.

Fucking crazy. Tiny town America and it is like wild, wild west with these pills.

What is it that makes these meds so expensive? Are they really that cost intensive to make?

 

[CrunkLord420]

What is it that makes these meds so expensive? Are they really that cost intensive to make?

No reason. You could argue that fentanyl and oxycodone need to amortize RnD costs but they're not really any different than morphine or heroin pills that have existed for over a hundred years. Nearly all opiates with the exception of a few (like Tramadol) is just refined poppy plants. https://erowid.org/archive/rhodium/chemistry/heroinmfg.html

They already do. It's not hard to find a suboxone doctor in your area who will write to you. It works pretty great for prescription narcotic addictions as it blocks the opiate receptors in the brain, thus making it a waste of money for the addict to even try and acquire pills to abuse as they won't feel their effects at all.

It's less effective for heroin users though. These people are better off going to the clinic.

Not really, suboxone was a relatively rare thing until a few years ago. Even then the barrier to get a script is high, with monitored ingestion and doctors with prescribing limits. They actively refused to give addicts naloxone when asked until a few years ago, now they just hand them out.

Just give out free heroin.

 

[Caesare]

I have colleague I was in military with. He got out and gets degree and becomes pharmacist. He has rural pharmacy in Kentucky.

I visit him once because I am doing job in region. His fucking place is like bank. Bullet proof glass, armed guard and shit. I ask him "Steve, why is this like this?"

He points out that in US, average armed robbery of bank is like $1200 in cash. But you steal one of his pill bottles (they come in big jugs), that bottle is worth like $50k in pills. And unlike US currency, there are no individual serial numbers to track on pills.

Yeah this is a fact. Pharmacies here aren't like banks but I suppose pharmacy robberies aren't quite as big a thing here as they used to be. My uncle robbed about half the pharmacies in this state from 1975-1995. I don't think it's been as bad since he and his friends started dying.

Not really, suboxone was a relatively rare thing until a few years ago. Even then the barrier to get a script is high, with monitored ingestion and doctors with prescribing limits.

It's really not that difficult. Monitored ingestion amounts to a monthly drug screen to make sure you have the medication in your system (to make sure the patient isn't just selling their medication on the black market) and rarely, having a pill count, but most doctors don't even do that if you look halfway normal. A lot of clinics offer suboxone now, as well.

 

[CrunkLord420]

Yeah this is a fact. Pharmacies here aren't like banks but I suppose pharmacy robberies aren't quite as big a thing here as they used to be. My uncle robbed about half the pharmacies in this state from 1975-1995. I don't think it's been as bad since he and his friends started dying.



It's really not that difficult. Monitored ingestion amounts to a monthly drug screen to make sure you have the medication in your system (to make sure the patient isn't just selling their medication on the black market) and rarely, having a pill count, but most doctors don't even do that if you look halfway normal. A lot of clinics offer suboxone now, as well.

Monitored ingestion means you show up to the pharmacy every day and have a pharmacist watch you take your pill. I've seen doctors prescribe non-abusable drugs this way to addicts, it's really quite cruel.

 

[Caesare]

Monitored ingestion means you show up to the pharmacy every day and have a pharmacist watch you take your pill.

I was on it myself for just under a year and I've known quite a few people that still take it and I've never heard of this. That's pretty wild, though I am aware that the law varies greatly from state to state in this country. With the suboxone where I'm at, they write your month's prescription like they'd do with any other medication and you pick it up from your pharmacy and that's it. You have to see the doctor every month to get a new month's prescription, and your doctor will drug test you (not even every visit), but there is no monitoring involved.

The only medication that they actually monitor you is methadone, at the clinic you go to. This makes sense in a way since methadone is much more easy to abuse than suboxone. They watch you drink it before you leave and you have to come six days a week (Saturday they'll give you a take-home dose for Sunday, when they are closed). But after a month of daily visits, if you have a clean drug screen (nothing besides methadone in your system) they'll give you an extra take-home dose, so you'd only have to go 5 days a week.

They do this every month and as long as your drug screens are clean, you'll eventually only have to go twice a month. At that point, they give you your dose at the clinic (which they watch you take) then they'll give you two weeks worth of medicine to bring home.

Each state handles it differently though, as I found out when traveling and having to get my medicine at other, out of state clinics.

 

[CrunkLord420]

I was on it myself for just under a year and I've known quite a few people that still take it and I've never heard of this. That's pretty wild, though I am aware that the law varies greatly from state to state in this country. With the suboxone where I'm at, they write your month's prescription like they'd do with any other medication and you pick it up from your pharmacy and that's it. You have to see the doctor every month to get a new month's prescription, and your doctor will drug test you (not even every visit), but there is no monitoring involved.

The only medication that they actually monitor you is methadone, at the clinic you go to. This makes sense in a way since methadone is much more easy to abuse than suboxone. They watch you drink it before you leave and you have to come six days a week (Saturday they'll give you a take-home dose for Sunday, when they are closed). But after a month of daily visits, if you have a clean drug screen (nothing besides methadone in your system) they'll give you an extra take-home dose, so you'd only have to go 5 days a week.

They do this every month and as long as your drug screens are clean, you'll eventually only have to go twice a month. At that point, they give you your dose at the clinic (which they watch you take) then they'll give you two weeks worth of medicine to bring home.

Each state handles it differently though, as I found out when traveling and having to get my medicine at other, out of state clinics.

I'm from a spot that is viewed as very liberal when it comes to drug policy. I knew an individual who was prescribed monitored ingestion for valium and clonodine while trying to go cold turkey, he ended up cheeking the pills and saving them so he could try to quit later without having to walk to a pharmacy while simultaneously going through massive opiate withdrawals.

 

[JustStopDude]

What is it that makes these meds so expensive? Are they really that cost intensive to make?

They are not expensive to make. Not at all. It is street value that inflates the worth.

 

[Cryin RN]

IMO the cure is to ensure people never take them to start with. It sounds like DARE-level bullshit but there are no happy endings to heroin. People have no clue how bad opiates change your personality on a basic level and they change it way for the worse. It's literally like demonic possession, once you need your oxys, you are no longer driving the bus, your addiction is. About half of addicts get their first pills from friends or family - so one prescription in a household is all it takes to ruin multiple lives. Dentists prescribe them like candy, white people won't tolerate any pain whatsoever, and everyone wants doctors to magically fix their problems... like, they can't do that, but they can get you really high. IDK people LOVE getting high and hate not taking drugs so this problem will just have to get bad enough to overdose in a public bathroom and end for good.

 

[HIVidaBoheme]

A relative of mine suffers from serious long-term joint pain, and they were prescribed Oxycodone. How much? Six tablets per day; two in the morning, two in the afternoon, two at night. Now, since my relative is a control freak and despises feeling out of control, they purposefully only took two a day. That was still enough for them to develop a dependency on. When they eventually decided to stop taking the tablets, they experienced severe short-term withdrawal symptoms. But in the end they decided it was simply better to endure the pain than continue taking the medication even at the vastly reduced dosages they were allowing themselves. Again, they were taking less than a third of their prescription.

On a personal level, I was prescribed Oxycodone for a knee injury. Honestly it didn't even work. It just made me high. I took it for about two days running, then stopped simply because I didn't like how sick it started making me if I didn't keep taking it.

Sadly this seems to be a good part of the cause, many prescriptions are given be it by negligence or by coercion, lazyness of whatever other factor could be taken into account... rarely because it was actually needed. Sometimes it's just to avoid a lawsuit over not giving what the patient believe they need, sometimes it is because the doctor wants to save themselves the headache of actually researching the cause of the pain and treating the source. Also most opioid addicts will go to great lenghts to ensure they keep popping their pills.

And to that, add the social causes of the problem... quite a deep rooted issue.

 

[Medicated]

IMO the cure is to ensure people never take them to start with. It sounds like DARE-level bullshit but there are no happy endings to heroin. People have no clue how bad opiates change your personality on a basic level and they change it way for the worse. It's literally like demonic possession, once you need your oxys, you are no longer driving the bus, your addiction is. About half of addicts get their first pills from friends or family - so one prescription in a household is all it takes to ruin multiple lives. Dentists prescribe them like candy, white people won't tolerate any pain whatsoever, and everyone wants doctors to magically fix their problems... like, they can't do that, but they can get you really high. IDK people LOVE getting high and hate not taking drugs so this problem will just have to get bad enough to overdose in a public bathroom and end for good.

When I've been working jobs it's been the same thing, just different substances, I don't see why codiene is some special case. I've walked into the bathroom at work and seen people smoking joints on shift. I've seen people rock up to work half sloshed because it's the only way they can get through the rest of the day.

 

[Maxliam]

I have colleague I was in military with. He got out and gets degree and becomes pharmacist. He has rural pharmacy in Kentucky.

I visit him once because I am doing job in region. His fucking place is like bank. Bullet proof glass, armed guard and shit. I ask him "Steve, why is this like this?"

He points out that in US, average armed robbery of bank is like $1200 in cash. But you steal one of his pill bottles (they come in big jugs), that bottle is worth like $50k in pills. And unlike US currency, there are no individual serial numbers to track on pills. He had to get his entire building re-enforced because local drove truck through the front to smash and grab. Guy got high as fuck in parking lot and never even tried to run.

I say this is crazy. He then shows me the cameras he had to have for employees. You see casinos where card people deal and they must flash their hands in certain way to show they not pocket chips? He must make his employees do this now because they were stealing pills.

In like 4 years, he had to participate with DEA or whatever to get three doctors to lose license for writing bullshit prescriptions. Like one of the docs is serving time for mailing him an explosive for reporting him. To get prescription filled, people have to do urinalysis onsite to show they are taking their actual meds because so many old people were just getting the pills and immediately selling them to kids.

Fucking crazy. Tiny town America and it is like wild, wild west with these pills.

Tiny towns usually have the most ducked up things about them.

 

[Cosmos]

I'm interested in why opiates are considered an epidemic, when alcohol kills more through car wrecks, violence, liver failure, and dependency. Then we put up a "drink responsibly" sign in the window, and everything is fine. What's the real reason here?

Excellent point. I'm not saying that opioid addiction (and drug addiction in general) isn't terrible, because it is, but as a society we collectively ignore the fact that alcoholism is often just as bad if not worse. And yet alcohol is embraced by our society to the point where if you don't drink you're considered weird.

Also, the older I get and the more this shit goes on, the more I think decriminalization (and possibly legalization) is the right answer. It's fucking idiotic and backwards that drug addicts are treated like criminals on principle. Like, if they rob and assault people, throw them in jail, but just having drugs shouldn't be enough to throw someone in our already extremely bloated justice and prison systems. The war on drugs is an abject failure, we need a new approach.

Portugal's approach seems to be working pretty well for them. People are going to be very hesitant to get treatment for drug addiction if owning drugs is in and of itself a criminal offense. Also, if we legalize and tax relatively harmless drugs like marijuana, we can make a metric shit ton of money off of it. I've never touched weed in my life and have no personal investment in getting it legalized, but holy shit, we're sitting on a goldmine that we refuse to cash in on.

 

[Ruin]

I'm interested in why opiates are considered an epidemic, when alcohol kills more through car wrecks, violence, liver failure, and dependency. Then we put up a "drink responsibly" sign in the window, and everything is fine. What's the real reason here?

There is none, it's literally just "muh morals."

 

[Xetzyr]

It's actually a finger pointed problem, a distraction.

The real problem isn't opiates so much as non prescription sleep aides. They make billions of dollars off those sleep aides however if taken in conjunction with even the most benign of opiate analgesics they're incredibly deadly. There isn't as much money to be made off opiates though so they get all the blame and attention in order to protect the perceived safety of over the counter sleep aides.

The other big problem is Fentanyl... a man made synthetic opioid that's much cheaper and easier to make than getting the real thing... except the downside is that unlike natural opioids it carries an exponentially higher risk. Being that it's cheaper though they started mixing it in with regular opioid formulations/pharmaceuticals and even street drugs, which resulted in a sudden and drastic increase in opioid related deaths... even though they were all Fentanyl related deaths... but to avoid lawsuits they obviously want to keep that fact on the down low.