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03-14-2019, 05:19 PM | #46 | |
Blah Blah Blah
Join Date: Mar 2003
Location: In front of the computer.
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Not able to post video with this device, but the "Frank can't poop" vid is good for a laugh. https://youtu.be/cNQ3sxvslhQ |
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Posts: 12,557
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03-14-2019, 05:25 PM | #47 | |
Cynical Misanthrope
Join Date: Apr 2013
Location: Alaska
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You ever address a 14 year old's addiction problem because she is huffing gas to stop thinking about when she was gang raped and she lives in a dry village so she cannot afford the $150 for a 750ml bottle of rot gut vodka? I have. You ever represent someone whose alcohol problem is so bad that her BAC was over .5 when she was arrested for DUI (legal limit is .08 and .4% is generally considered fatal)? I have. You ever represent someone who cannot really finish a sentence because he was grinding up oxys and smoking them for several years? I have. I've represented people who started abusing oxys because their body hurt after years of pouring concrete but without health insurance, they had no access to health care. I've represented people who started drinking to stop thinking about the death of their child. I've represented people who refuse to touch drugs but make a good amount of money off it. I've represented physicians who were investigated for 'over-prescribing'. I've represented people prosecuted for forging prescriptions when they were caught seeking their fifth oxy prescription in one day (different doctors and different pharmacies). The majority of my clients have addiction issues of some kind. I have hired numerous experts regarding substance abuse, drug-seeking behavior, psychological effects of various chemicals, recidivism, treatment and "cure". I have worked with treatment providers, treatment courts, clients, prosecutors, probation officers, physicians, social workers, and therapists to address my client's needs and help them get treatment. I have read numerous article, treatises and journals about addiction in an effort to represent my clients. No, I am not a physician, nor am I a drug treatment provider, but based upon my experience and what I have studied, as outlined above, I am qualified to say that the risks someone will develop drug-seeking behavior from taking pain meds as directed following surgery are low. |
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Posts: 3,934
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03-14-2019, 05:30 PM | #48 |
Has a particular set of skills
Join Date: Dec 2003
Location: On the water
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I’ve taken Oxy for chronic pain. After the first couple of days, never got “high” from it. Never brought full pain relief. Just level 8 pain down to 3-5. Took it for years.
Only got a couple of weeks of insomnia getting off it. Cold turkey worked for me. But, you can just read anywhere that my experience is different from most. That shit is highly addictive. Take only as really really needed to function as a human being. |
Posts: 79,234
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03-14-2019, 05:31 PM | #49 |
Praise Him
Join Date: Aug 2000
Location: none ya
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Wus!
Broken foot, broken hand, vasectomy, and prostate removed....no meds except ibuprofen. |
Posts: 12,181
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03-14-2019, 05:31 PM | #50 | |
Cynical Misanthrope
Join Date: Apr 2013
Location: Alaska
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We disagree about the potential risk of following a physician's recommended pain medication. I believe the risk of developing drug-seeking behavior is low. You disagree. Given your apparent perception of risk, I would expect that you would not prescribe any opioids. If you do prescribe opioids for pain you are logically inconsistent with your stated opinion about the risk of developing drug-seeking behavior. |
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Posts: 3,934
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03-14-2019, 05:37 PM | #51 | |
MVP
Join Date: Oct 2017
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The current recommendation is to remain on opiates for the shortest time possible for acute and post-operative pain due to the risk of dependence. You have back-pedaled significantly from your original statement that it takes "months or longer" to develop an addiction. I have shown you evidence that the risk increases significantly at the 5 day and 15 day mark. |
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Posts: 7,333
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03-14-2019, 05:42 PM | #52 | |
MVP
Join Date: Oct 2017
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I never said anything about taking opiates as prescribed, all I said was that there is risk of dependence even from even a short-term prescription. I do prescribe opiates, and follow the CDC guidelines to minimize risk, because the risk definitely exists. This contradicts nothing that I say. All medications have risks, controlled medications have higher risks that need to be taken very seriously. |
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Posts: 7,333
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03-14-2019, 06:01 PM | #53 | |
Has a particular set of skills
Join Date: Dec 2003
Location: On the water
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I do think that addiction is tied to your personality or pre-disposition to addiction. I was able to get off them pretty easily compared to others. Consider myself really lucky. |
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Posts: 79,234
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03-14-2019, 06:03 PM | #54 | |
MVP
Join Date: Oct 2017
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Posts: 7,333
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03-14-2019, 06:14 PM | #55 |
Has a particular set of skills
Join Date: Dec 2003
Location: On the water
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I got the shot of steroids directly into the spine. That got me to pain free. That was the most wonderful thing to be pain free. Not needing the Oxy anymore was nothing compared to that feeling. I did a shit ton of drugs in my youth. Not interested in reliving those days from decades ago.
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Posts: 79,234
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03-14-2019, 06:16 PM | #56 | |
Cynical Misanthrope
Join Date: Apr 2013
Location: Alaska
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Here are two scenarios: 1. Person is prescribed opioids by physician. Person takes them long enough to develop drug-seeking behavior. Because of that drug-seeking behavior, that person is still using opioids 1 year after initial prescription. 2. Person is prescribed opioids by physician. Person continues to be in great pain because they suffered tremendous injuries. Because those injuries cause that person pain a year later, that person continues to use opioids a year after initial prescription. The article you gave made no effort to distinguish between scenario 1 and scenario 2, yet that is a significant distinction on this topic. The article only notes "drug use" when the distinction between those two scenarios is indeed significant. It also noted that taking opioids for longer than 30 days is a sign of a risk that someone will keep taking them. That is consistent with what I said. OP is concerned about being addiction. Fine. That is a good sign. It shows that he has some positive incentives to avoid drug-seeking behavior and lowers the risk that he will wind up demonstrating drug-seeking behavior. This is something that is taught frequently in drug-counseling treatment: if you don't want to change, you won't. If OP doesn't want to be an addict, he has a powerful incentive to avoid such. And taking opioids for a few days is a low (emphasis on low) risk. So is riding in a car. So is flying on a Boeing 737-Max. So is drinking booze. So are a lot of things. I get that there are few ways to ruin your life than by abusing controlled substances. and I agree that you shouldn't take opioids longer than necessary for a whole bunch of reasons (one reason why marijuana can be a good idea for persons with pain management issues). But paranoia/hysteria about addiction does not help the situation at all. Part of my issue is I do not like the CDC or the DEA. I think it is not the government's business what medications someone is on. And from my side of the fence, I see a lot of harm done in the name of harm prevention, including people addicted to opioids. And an inordinate focus upon the negative without putting it into context is a way to do harm in the name of harm prevention. As an example, are you familiar with the death of Jonathan Swift? I give his death because it is historically documented. Modern medicine might have been able to treat him but his is a case in which concern for addiction should go right out the window. And I've seen the DEA prosecute physicians for "over-prescribing" in similar situations. A friend of mine represented a physician who took pain patients few other physicians would. He would not accept patients who demonstrated drug-seeking behavior. If you went to another physician or to a pharmacy other than the one agreed upon between his client and the patient, the patient was kicked out. Many of his patients had suffered severe injuries or were in chronic pain for other reasons. The DEA arrested him. His patients had nowhere to go. I know of one patient who killed herself because of the pain. All so the DEA could show that they were serious about stomping out 'drug abuse'. He was acquitted at trial, but he had learned his lesson. I think that is inhumane and I think DEA policies are more designed to make sure the populace knows the government is in charge than for any of our well-being. If the DEA was truly concerned about over-prescription of drugs, they would focus upon over-prescription of antibiotics because that creates a much greater public health issue than over-prescription of opioids. Apparently we are not going to agree. That is fine. I will stipulate that you do not accept my qualifications and that you think I am wrong. |
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Posts: 3,934
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03-14-2019, 06:39 PM | #57 | |
MVP
Join Date: Oct 2017
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Opiates have consistently failed to demonstrate long-term benefit in chronic musculoskeletal pain, which is why as a prescribing physician I'm trying to minimize the risk that a patient will end up dependent on the medication long-term. from a prescribing point of view there is little reason to distinguish between the two situations. My goal is for my patients to not be on chronic opiate therapy for musculoskeletal pain, because their use in this situation is not evidence driven. I am not discounting the fact that in a small minority of patients it will be necessary to be on opiates long-term for their musculoskeletal pain, merely stating that this is the exception rather than the rule. also, 30 days or more is not consistent with what you said. Will you please address the fact that you said it takes "months or longer" to develop opiate dependence. This is the crux of my disagreement with you OP should definitely continue his prescription as his pain dictates, but there is definitely risk involved in even short term prescriptions. In OPs case the benefits definitely outweigh the risks. |
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Posts: 7,333
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03-14-2019, 06:54 PM | #58 | |
Cynical Misanthrope
Join Date: Apr 2013
Location: Alaska
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As far as "months", that is likely because its a term of art in my business. 31 days would be 2 months because it has rolled over into a second month. 61 days would be 3 months, etc. For one, as stated above I am focused on drug-seeking behavior as opposed to dependence, which I anticipate would take longer. Second, months could be two months, short as 31 days, or 4+ weeks. I regret the confusion. * I don't see those with a drug dependence engaging in various risky behaviors, such as needle-sharing, prostitution, or cutting drugs with non-safe substances, such as lye. |
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Posts: 3,934
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03-14-2019, 06:54 PM | #59 | |
Politically Incorrect
Join Date: Feb 2009
Location: Scottsdale, AZ
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Posts: 50,786
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03-14-2019, 06:56 PM | #60 |
Shit
Join Date: Jun 2008
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I'm not a pill or medicine taking guy.
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Posts: 55,715
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