Re:The Nonprofit Industrial Complex and the Corruption of th...
by epcoa on Thursday May 30, 2024 @11:21AM
(#40524789)
> Or one could also look at the media and public reaction to Perdue's support for the concept of "pseudo-addiction".
Problem is all those addiction behaviors were swept away under the banner of "pseudo-addiction" but they are still also TRUE addiction behaviors. The messaging was all these behaviors that have been associated with addiction (because they are) are really just pseudo-addiction. Which is sometimes true, but it's completely unreliable and removes any responsibility in judicious use of opioids, which was sort of the (cynical) point. That's why Purdue was rightly called out for its opportunistic weaponization and as a ploy to underreport addiction.
And in that wall of text you conveniently ignore the most salient point raised, that of skyrocketing opioid prescription rates being higher compared to most of the rest of the industrialized non-puritan world especially from the late 80s to 2010s.
> That puritan streak is what underlies the societal revulsion to "drug addicts" and reacts with an attitude of "cut them off".
There is clearly a historical protestant societal moral aversion to drug addicts, though opinion on that continues to shift. But let's also be clear, drug addiction is a societal blight. It has objective direct (like premature death) and indirect (too numerous) negative effects for both the addicts, and those around them both by relation and proximity.
I am pro harm-reduction, but I don't think it is so simple to implement as you make it sound as to identifying what exactly is harm-reducing vs harmful woo. And in this era of agenda and incentive driven reproducibility crisis BS, it's not like those that give a damn (I mean, most of the stuff that got us into this mess was published as legitimate "Science") actually have much to go by. Some things, like needle exchanges, MOUD are pretty clear cut. But just prescribe opioids whenever for any complaint of "chronic pain" when asked (as you are suggesting because being addicted is no big deal in your ignorance) is nuts.
> and it contributes to a lack of resources and help for people looking to escape that addiction.
Not once do you mention MOUD. You type out way too much on this subject for someone that is ignorant of this, even if you want to criticize it.
> Steroids would be an option. Long term use ...
Steroids don't have to be given systemically. You also miss indirect (comorbid) treatment and non-pharmaceutical (surgical or otherwise) alternatives.
> I'd also point out there are other conditions that cause high levels of chronic pain that aren't cancer and aren't terminal.
You completely miss the point. The risk/benefit calculus for terminal cancer pain in an 80 year old is much simpler than the 40 year old otherwise healthy (but possibly fat) dude that comes in with lower back pain.
> "might get addicted" as if being addicted to a tolerated but effective medication is the worse then being in disabling levels of pain
You're conveniently ignoring all the very real morbid negative side effects and risk of iatrogenic harm completely away. In practical use, opioids increase the risk of death and this is dose and duration dependent (and as prescribed use of NSAIDS is not even in the same ballpark). I just love it when one of my patients with untreated OSA dies in their sleep.
Did your pill mill give you Narcan? If they didn't I believe they are being negligent, they should, and this should be a good indication in itself that these things are not the harmless wonder drugs you seem to be pushing them as.
> How many innocent people will we allow to suffer, because we are unable or unwilling to punish only the guilty?
Hopefully fewer than those killed by the rampant increase in unnecessary opioid prescriptions since the early 90s. Opioids are nowhere near as effective at managing chronic pain as you have been misled to believe.
Opioid prescription rates more in line with progressive industrialized nations rather than being 7 times higher in some cases might make this not sound like the most ridiculous string of rhetorical nonsense.
Problem is all those addiction behaviors were swept away under the banner of "pseudo-addiction" but they are still also TRUE addiction behaviors. The messaging was all these behaviors that have been associated with addiction (because they are) are really just pseudo-addiction. Which is sometimes true, but it's completely unreliable and removes any responsibility in judicious use of opioids, which was sort of the (cynical) point. That's why Purdue was rightly called out for its opportunistic weaponization and as a ploy to underreport addiction.
And in that wall of text you conveniently ignore the most salient point raised, that of skyrocketing opioid prescription rates being higher compared to most of the rest of the industrialized non-puritan world especially from the late 80s to 2010s.
> That puritan streak is what underlies the societal revulsion to "drug addicts" and reacts with an attitude of "cut them off".
There is clearly a historical protestant societal moral aversion to drug addicts, though opinion on that continues to shift. But let's also be clear, drug addiction is a societal blight. It has objective direct (like premature death) and indirect (too numerous) negative effects for both the addicts, and those around them both by relation and proximity. I am pro harm-reduction, but I don't think it is so simple to implement as you make it sound as to identifying what exactly is harm-reducing vs harmful woo. And in this era of agenda and incentive driven reproducibility crisis BS, it's not like those that give a damn (I mean, most of the stuff that got us into this mess was published as legitimate "Science") actually have much to go by. Some things, like needle exchanges, MOUD are pretty clear cut. But just prescribe opioids whenever for any complaint of "chronic pain" when asked (as you are suggesting because being addicted is no big deal in your ignorance) is nuts.
> and it contributes to a lack of resources and help for people looking to escape that addiction.
Not once do you mention MOUD. You type out way too much on this subject for someone that is ignorant of this, even if you want to criticize it.
> Steroids would be an option. Long term use ...
Steroids don't have to be given systemically. You also miss indirect (comorbid) treatment and non-pharmaceutical (surgical or otherwise) alternatives.
> I'd also point out there are other conditions that cause high levels of chronic pain that aren't cancer and aren't terminal.
You completely miss the point. The risk/benefit calculus for terminal cancer pain in an 80 year old is much simpler than the 40 year old otherwise healthy (but possibly fat) dude that comes in with lower back pain.
> "might get addicted" as if being addicted to a tolerated but effective medication is the worse then being in disabling levels of pain
You're conveniently ignoring all the very real morbid negative side effects and risk of iatrogenic harm completely away. In practical use, opioids increase the risk of death and this is dose and duration dependent (and as prescribed use of NSAIDS is not even in the same ballpark). I just love it when one of my patients with untreated OSA dies in their sleep. Did your pill mill give you Narcan? If they didn't I believe they are being negligent, they should, and this should be a good indication in itself that these things are not the harmless wonder drugs you seem to be pushing them as.
> How many innocent people will we allow to suffer, because we are unable or unwilling to punish only the guilty?
Hopefully fewer than those killed by the rampant increase in unnecessary opioid prescriptions since the early 90s. Opioids are nowhere near as effective at managing chronic pain as you have been misled to believe.
Opioid prescription rates more in line with progressive industrialized nations rather than being 7 times higher in some cases might make this not sound like the most ridiculous string of rhetorical nonsense.