Heroin Addiction absent or rare in UK prescribing


.

.

.

Diamorphine (heroin) is prescribed for pain in the UK . Yesterday’s LA Times Op-Ed

What’s really causing the prescription drug crisis?

.

Studies show addiction to opioids of any kind, even heroin, is rare in the UK. Not what we see in the US. They have more socialized care for housing, medical care, medications including for the jobless. They do not have the hopelessness that leads to desperation and addiction. Desperation is why all patients with chronic pain must work with a psychologist. Pain is not in your head, but desperation is, and a psychologist can help you learn tools to deal with desperation. If you don’t, pain will go up, up, up and that’s what’s in your head. Unless you use those tools, I promise you will suffer because it will get worse and worse and worse.

.

.

.

“Doctors in many parts of the world — including Canada and some European countries — prescribe more powerful opiates than their peers in the United States. In England, if, say, you get hit by a car, you may be given diamorphine (the medical name for heroin) to manage your pain. Some people take it for long periods. If what we’ve been told is right, they should become addicted in huge numbers.

.

But this doesn’t occur. The Canadian physician Gabor Maté argues in his book “In the Realm of Hungry Ghosts” that studies examining the medicinal use of narcotics for pain relief find no significant risk of addiction. I’ve talked with doctors in Canada and Europe about this very issue. They say it’s vanishingly rare for a patient given diamorphine or a comparably strong painkiller in a hospital setting to develop an addiction.

.

Given that really powerful opiates do not appear to systematically cause addiction when administered by doctors, we should doubt that milder ones do. In fact only 1 in 130 prescriptions for an opiate such as Oxycontin or Percocet in the United States results in addiction, according to the National Survey on Drug Use and Heath.

.

So what’s really happening? The second, clashing story goes, again, crudely, like this: Opiate use is climbing because people feel more distressed and disconnected, and are turning to anesthetics to cope with their psychological pain.

.

Addiction rates are not spread evenly across the United States, as you would expect if chemical hooks were the primary cause. On the contrary, addiction is soaring in areas such as the Rust Belt, the South Bronx and the forgotten towns of New England, where people there say they are lonelier and more insecure than they have been in living memory.”

.

Healthcare costs in the US are a very serious problem. Opioids require monthly visits. Patients on opioids are forced to see a pain specialist, many for decades when pain is chronic. That’s bad enough, but the cost of opioid medications are outrageous. I know some whose opioids cost $17,000 per month or more. And some doctors in my area have mandated urine drug tests every single month, $750 per test, to prove you are not taking street drugs. High risk patients and nonaddicts alike, every month, just to pee in a cup and get your prescription opioid. 

.

Now congress is getting rid of the ACA, to make it better. I can only imagine how helpful they have been. Privatize social security, privatize medicare, privatize everything. Of course that will be better for them. Will it help anyone else? 

 

.

.

.

.

.

.

The material on this site is for informational purposes only.
.
It is not legal for me to provide medical advice without an examination.

.
It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~
This site is not for email and not for appointments.

If you wish an appointment, please telephone the office to schedule.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

.

Please IGNORE THE ADS BELOW. They are not from me.

.

.

.

.

 

 

 

 

 

 

Advertisements

Oxycontin Investigation – A Pulitzer for LA Times?


.

.

.

.

A TIMES INVESTIGATION

.

Inside an L.A. OxyContin ring that pushed more than 1 million pills. What the drugmaker knew

.
By HARRIET RYAN, LISA GIRION AND SCOTT GLOVER

.

JULY 10, 2016

.

This LA Times investigative report by Ryan, Girion and Glover is now a contender for Pulitzer Award. They expose years of passively tracking extreme volume sales by leaders at the top of Purdue Pharma, the maker of OxyContin. While they racked up billions in sales, they tracked the surge in prescriptions from pill clinics in LA to gangs trafficking in Washington State for sale on the street. 80 mg tablets, deaths, crime, gangs, heroin – waves of heroin related crime and overdoses in cities all over the world.

.

Purdue could track suspicious high volume sales of their pill:

.

Until a decade ago, Purdue, like most drug manufacturers, didn’t monitor pharmacies for criminal activity. The DEA has held wholesalers, not drugmakers, responsible for identifying and reporting suspicious orders from their customer pharmacies.

In 2007, the DEA pressured drug manufacturers to do more to stem the prescription drug crisis and warned that it would be looking at every step in the supply chain. In response, Purdue decided to gather detailed information about pharmacies, Crowley said.

The company approached wholesalers and struck agreements allowing the company access to their sales reports. With the new data, the security team in Stamford could see all wholesalers’ OxyContin sales to individual pharmacies, down to the pill.

“I can look at something and say, ‘Geez, that stinks’ without me even visiting the place,” Crowley recalled.

.

.

……What Purdue knew

.
More than 194,000 people have died since 1999 from overdoses involving opioid painkillers, including OxyContin. Nearly 4,000 people start abusing those drugs every day, according to government statistics. The prescription drug epidemic is fueling a heroin crisis, shattering communities and taxing law enforcement officers who say they would benefit from having information such as that collected by Purdue.

.

A private, family-owned corporation, Purdue has earned more than $31 billion from OxyContin, the nation’s bestselling painkiller.

 

.

In 2015, the Week published:

.

How the American opiate epidemic was started by one pharmaceutical company

.

From Pacific Standard

Mike Mariani

.

OxyContin’s ball-of-lightning emergence in the health care marketplace was close to unprecedented for a new painkiller in an age where synthetic opiates like Vicodin, Percocet, and Fentanyl had already been competing for decades in doctors’ offices and pharmacies for their piece of the market share of pain-relieving drugs.

.

.

These reports must demand a Congressional investigation into Oxycontin (before and after the 2010 abuse deterrent version) and all potentially addicting drugs currently on the market, not just pain killers.

.

Congress needs to address pharma’s drug trafficking, data collection, and,duty to report.

.

Pharma needs to be tracking distribution not just for sales and profit, but for common sense to interrupt drug trafficking. Obviously there is no law.  Profit always wins.

.

Business ethics is not good enough to justify the explosion of opioid abuse that stems from years of Oxycontin pills. Profiteering at the cost of deaths and drug abuse. Vote with your stock holdings.

.

.

.

Cannabis for pain and symptom relief

.

Congress has lost the average person’s respect for scheduling cannabis as Schedule 1. It is an essential medication that has been used medically, safely for thousands of years. Patients are arriving in office with the discovery that CBD, simply CBD, works for their intractable pain. That’s not exactly correct, but there is a topical cannabis mixture that can relieve malignant pain – I mean disabling, not cancer.

.

Reschedule cannabis as Schedule 3 immediately. It needs to be legalized, studied and taught. When MD’s are not taught about the cardiovascular potential with THC and when patients arrive in the ER without knowing what was in the marijuana they used, our hands are tied.

.

Congress owes a release to the millions jailed simply for felony cannabis possession.

.

Cannabis  “to date has been responsible for the arrest of about 20 million US citizens,” written in 2010 by Emeritus Professor of Psychiatry Lester Grinspoon.

.

.

.

.

.

This website is for educational purposes only, not for medical advice or treatment. It is not for email.

.

.

.

.

.

.

.

Advertising below this page is an unintended feature of this free blog and is not endorsed by me.

.

.

.

.

.

 

Demoralized Jeb Bush Succumbs to Heroin Epidemic in New Hampshire


.

.

.

Demoralized Jeb Bush Succumbs

.

To New Hampshire 

.

Heroin Epidemic

.

Headlines, the Onion

.

– The picture of Jeb is wonderful –

.

Or

.

All street drugs should be legalized and in free clinics

where counseling is also available only if desired.

Why We Need To Image Glia, Cure Addiction, & Get Good Pain Control

Not just for former NFL players dying of CTE

Who does not fear Alzheimers?

 

Ever thought about neuroinflammation?

A renowned researcher imaged glia at Max Planck in the 1990’s,

now in Sydney

 .

Professor Richard Banati is an internationally recognized scientist with interdisciplinary research interests in the brain’s innate immune system and the development of advanced medical imaging for the non-invasive study of brain function.

.

Look, we already spent a trillion dollars on the war on drugs. And what does Prohibition breed? Gangs, the drug mafia.

.

 

.

.

Don’t worry, I’ll tie this together, but I want you to understand this is a unified field.

.

The heroin epidemic is a big issue including among upper and middle class. It’s everywhere and cheap.

.

Pain is a neurological disease, so is addiction. So are psychiatric diseases (Freud). Don’t you think it’s about time we studied them? All street drugs need to be legalized. Research: Portugal decriminalized drugs 14 years ago. It saves billions and treats the cause. Shall we base the practice of medicine on criminal justice or a health-based approach?

.

A major cause of addiction and or heroin abuse is seeking pain relief. People use heroin for pain: think former NFL football players, athletes, business people, mothers, actors, people of all ages with nerve and bone crushing diseases – a major cause of addiction is people cannot get pain treated, even if they are rich or live in certain states like Florida where laws are unusually strict.

.

Jeb Bush actually was the governor when some of the strictest laws of the country were enacted in his state to prevent adequate pain medication. His current statement says:

.

“Beyond the Mexican cartels, abuse of prescription painkillers, such as hydrocodone and oxycodone, is a contributing cause of the epidemic of heroin and fentanyl abuse, and a major concern in its own right. A staggering four in 10 Americans know someone who has been addicted to prescription painkillers.”

.

He enumerates the devastating financial costs when we do things the old way. And wants stiffer law enforcement. Research shows the opposite works better, saves billions. Portugal.

.

It’s a hot topic. Who can disagree? Drug laws don’t work – research in 11 countries. Inescapable.

.

Shocking that so many pain specialists and pain researchers in Florida have strong words to say about Florida laws that tie the hands for pain relief.

.

From a conservative view point, you’d think government should take its hands off and allow medicine to follow standard of practice set by research, not politicians.

.

Florida attracts former athletes and seniors who like warm weather on their bones and joints.

.

Jeb was also the governor who signed the “Stand your ground laws.” How wise or controversial is that? How many states have jailed patients for seeking pain control like Florida? See 60 Minutes more than a decade ago. Maybe Jeb will be swayed by research. We all need to understand the brain. Ask every candidate how much their health plan covers behavioral therapy. Pain is an emotional experience. So is addiction. Biological too. But the emotionals have to cope with it. The amygdala gets battered by fear and pain and craving.

.

All things being equal, pain care is most difficult in Florida.

.

I know plenty of pain patients who stop craving when they have a spare they know they can always rely on, rather than squeek by with not enough. Fear is a natural reaction with pain. More than a third of middle class cancer patients at Memorial Sloan Kettering Cancer Center overused their opioids or loaned them to a friend per a study done around 1991 when I was there. It gets confusing what we are dealing with. And some people don’t always follow rules – does your mother? Grandmother? 

.

You can lose everything when you have severe pain. If you cannot concentrate, then you cannot play bal.l no matter how high paying and dynamic your job could be. Pain takes everything out of you. All that free time, wanting to go back to work – it used to be your life. Playing football, disabled at 24, made the team but injuries. No money. Heroin is everywhere. I’ve seen how retiring as a major player destroys the ego. Even Namath mentioned that the other day, did he not? Imagine the pain taking you out early when you held such promise.

.

You may not be an addict, but you know heroin is cheap. Pain justifies many things. Loss of job, loss of friends as old friends call you for Christmas or Thanksgiving but pain is so severe you always have to pass.

.

.

A major cause of addiction or heroin abuse is failure to obtain pain relief.

.

I’d like to see this research:

.

  • How many suicides are related to untreated pain?

  • How many heroin addicts have untreated pain?

.

We need research to inform the best approach. And we need to get up to speed on the vast benefits of legalizing all drugs of all kinds. See the results of Portugal’s studies. See the last thing I posted.

.

Most important of all we must be able to image glia. The clinical work for that should begin in La Jolla near Scripps and UCSD where we have a nearby cyclotron and the renowned Alzheimer’s leadership at UCSD. CTE can be imaged and many former NFL players live here, as do seniors and a vibrant research community for stem cells and new immunopharmacologies. Scripps Research Institue, Sanford Burnham, so many renowned research institutes all new the scanner. Read my post January 2011 on glia, pain and the immune system.

.

I am led to believe a politician would succumb of asphyxia if they mentioned there is a better way to treat addiction and pain.

.

.

They should walk into any cancer hospital and see untreated pain. It’s not the cancer that always kills. UCLA research mid 1970’s by past president of the American Pain Society proved PAIN KILLS. It aggressively triggers cancer to grow faster and more metastatic, killing far sooner than the group whose cancer pain was treated.

.

Pain Kills

.

Heroin Kills.

.

Legalize it and stop treating pain patients like addicts.

.

Every single time they see a doctor or pharmacist, year after year, month after month until they are in tears.

.

We Need:

.

  • A billion dollars for pain research. Someone’s got to pursue repurposing old drugs for new uses: to reduce neuroinflammation and get at the root cause of all diseases it creates including neuronal death. Glia are 10 times more numerous than neurons. They are cells in the CNS that are your innate immune system. Inflammation is the basis of almost all known disease. 

.

  • A billion dollars for addiction – Portugal’s model that legalizes all drugs.

.

  • Finance this by holding back from the federal prisons that incarcerate youth who once had a fraction of an ounce of marijuana and were sentenced to life – man that costs a fortune! and from the trillion dollar war on drugs.

    .

Come on boys, it’s in your families too. Every politician knows someone with pain, Alzheimers, even addiction. Professor Banati knows the best way to proceed. He’s led the field since the 1990’s. How long will we wait to address brain damage? How long can we afford to overlook cells that outnumber neurons by 10 to 1? That create inflammation that destroys neurons?

.

We have an epidemic.

.

It costs money and lives.

.

Who is not afraid of Alzheimers or of pain?

.

.

.

.

.

 

 

 

.

This site is not for email.

If any questions, please schedule an appointment with my office.

.

.

.

The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment

provided by a qualified health care provider.

Relevant comments are welcome.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

.

.

.

 

.

.

.

Please be aware any advertising on this free educational website is

NOT advocated by me and NOT approved by me.

.

.

.

.

 

 

.

.

.

.

.

.

.

.

.

.

.

 

.

.

.

.

%d bloggers like this: