Augie Posted June 30, 2019 Share Posted June 30, 2019 1 minute ago, Mr. WEO said: https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-8-29 (there are others). No matter how tragic any one incident may be (and I am sympathetic to the personal suffering you have shared with us here regarding this subject), in medicine, we don't base decisions on anecdotes. We use data to guide our decisions. Convincing, new data will always be used to change practice. But stories can't... Every provider should seriously consider non-narcotic alternatives before prescribing. My personal opinion is that every provider (MD, NP, PA) should NOT be able to prescribe narcotics (those who have a DEA number of course). I think all patients should have to go to a "Narcotic Provider" if they need more than 5 pills prescribed, just like in NYS where they have to really have to go out of their way to find a medical marijuana prescriber. That may be impractical, but it have an immediate profound impact. I read the first paragraph. With so many doctors refusing to prescribe OxyContin, it’s not anecdotal. It’s real life and death science, and how to make the most money. Period. Link to comment Share on other sites More sharing options...
Mr. WEO Posted June 30, 2019 Share Posted June 30, 2019 11 minutes ago, Augie said: I’m sure the numbers have exploded since 2012. As fentanyl is easier and more attractive to those “in the business”, things get even scarier. For those who don’t know, fentanyl is like 50 times stronger than heroin, but you never know what you’re getting. You can die from touching fentanyl. When you can’t get the pills, you do what you have to do. At one point about 85% of all OxyContin sold in the country was in Florida as laws allowed pill mills. People came from all over. OxyContin is the devil, and I agree with my buddy’s doctor.....it should be banned. It would be already if there wasn’t so much money involved. That’s the sad bottom line. No of that money goes to the providers. And pharmaceutical grade fentanyl, while never should be available outside of a hospital, it is safely used every day in nearly every ICU and OR in every hospital in the country. 1 minute ago, Augie said: I read the first paragraph. With so many doctors refusing to prescribe OxyContin, it’s not anecdotal. It’s real life and death science, and how to make the most money. Period. Read the second paragraph. And doctors aren't making money writing scripts. 1 hour ago, JohnC said: He was linking the two issues (football and family) when it wasn't necessary to make the point that he was trying to make. He could have just stated that the coach doesn't have a good record in bringing in troubled players and rehabilitating them. Was it necessary to bring up the family history to make the football point? I don't believe that it was a worthy comparison. In general, bringing up one's personal history to illustrate a point regarding one's job performance is very ill-advised and inappropriate. Well, the comparison WAS his point, so he would say "yes". Link to comment Share on other sites More sharing options...
Augie Posted June 30, 2019 Share Posted June 30, 2019 (edited) 3 hours ago, Mr. WEO said: No of that money goes to the providers. And pharmaceutical grade fentanyl, while never should be available outside of a hospital, it is safely used every day in nearly every ICU and OR in every hospital in the country. Read the second paragraph. And doctors aren't making money writing scripts. Well, the comparison WAS his point, so he would say "yes". They make money by having patients, many of whom are there for exactly what they prescribe. They are also courted to no end by the pharmaceutical companies who push the stuff. Get your head in the real world. Look, my wife’s immediate and extended family are almost ALL doctors (with a few lawyers sprinkled in). They agree with me, not some study you read. In fact, I had long discussion with one just last month. He has a nice practice in the Carolinas but has a specialty in addiction. He’s known throughout the mid-Atlantic states for his care and research. HE thinks OxyContin is evil. Copy and paste all the crap you want. People in the real world are on this side of the argument. Don’t read it, live it either in life or as a profession. Short of that, you are pointing out why I originally deleted my first post here. I’m out, not willing to argue against ignorance. . Edited June 30, 2019 by Augie Link to comment Share on other sites More sharing options...
Mr. WEO Posted June 30, 2019 Share Posted June 30, 2019 3 minutes ago, Augie said: They make money by having patients, many of whom are there for exactly what they prescribe. They are also courted to no end by the pharmaceutical companies who push the stuff. Get your head in the real world. Look, my wife’s immediate and extended family are almost ALL doctors (with a few lawyers sprinkled in). They agree with me, not some study you read. In fact, I had long discussion with one who has a nice practice in the Carolinas but has a specialty in addiction. He’s know throughout the mid-Atlantic states for his care and research. HE thinks OxyContin is evil. Copy and paste all the crap you want. People in the real world are on this side of the argument. Don’t read it, live it either in life or as a profession. Short of that, you are pointing out why I originally deleted my first post here. I’m out, not willing to argue against ignorance. This is my real world. I don't make more money on a patient visit by prescribing anything. Also, "sunshine laws" have made most of the pharma junkets for Docs a thing of the distant past. My university employer doesn't allow me to accept a slice of pizza for a minute with a pharmaceutical rep. I've already explicitly told you my thoughts about the presiding of narcotics. Any of these meds can be highly addictive. But every prescriber knows that the vast majority of single prescription patients will not become addicted to narcotics. No doctor can state this as fact because it's simply not true. I get your sensitivity on this issue. But those of us in this "real world" have to deal with this on a daily basis. I'll bow out here, because this is no longer a conversation. Cheers. 1 Link to comment Share on other sites More sharing options...
JohnC Posted June 30, 2019 Share Posted June 30, 2019 2 hours ago, Mr. WEO said: No of that money goes to the providers. And pharmaceutical grade fentanyl, while never should be available outside of a hospital, it is safely used every day in nearly every ICU and OR in every hospital in the country. Read the second paragraph. And doctors aren't making money writing scripts. Well, the comparison WAS his point, so he would say "yes". You missed my point. The comparison didn't need to be made to make his basic point about how Reid brings in renegade players and then has to deal with the messy aftermath. That's the point! Link to comment Share on other sites More sharing options...
Cripple Creek Posted June 30, 2019 Share Posted June 30, 2019 2 hours ago, Mr. WEO said: https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-8-29 (there are others). No matter how tragic any one incident may be (and I am sympathetic to the personal suffering you have shared with us here regarding this subject), in medicine, we don't base decisions on anecdotes. We use data to guide our decisions. Convincing, new data will always be used to change practice. But stories can't... Every provider should seriously consider non-narcotic alternatives before prescribing. My personal opinion is that every provider (MD, NP, PA) should NOT be able to prescribe narcotics (those who have a DEA number of course). I think all patients should have to go to a "Narcotic Provider" if they need more than 5 pills prescribed, just like in NYS where they have to really have to go out of their way to find a medical marijuana prescriber. That may be impractical, but it have an immediate profound impact. So, you're telling me that each resident of Ohio really needed 69 opoids? That's what was prescribed in one year. Your system, and your people are broken. 2 Link to comment Share on other sites More sharing options...
Mr. WEO Posted June 30, 2019 Share Posted June 30, 2019 46 minutes ago, JohnC said: You missed my point. The comparison didn't need to be made to make his basic point about how Reid brings in renegade players and then has to deal with the messy aftermath. That's the point! Yeah, but clearly that was not what the radio guy was saying. He wouldn't have commented at all if it was just to say "Andy Reid tolerates bad men on his team". He very clearly, specifically, wanted to link his tolerance for bad behavior in his roster with, in his mind, a permissive behavior with his sons. Not sure how you could have missed that. 15 minutes ago, Cripple Creek said: So, you're telling me that each resident of Ohio really needed 69 opoids? That's what was prescribed in one year. Your system, and your people are broken. No, I'm not telling you that. In your example, a very small number of prescribers prescribed a massive number of pills to a small number of Ohioans, many of which were then likely sold to others for money. Link to comment Share on other sites More sharing options...
Augie Posted June 30, 2019 Share Posted June 30, 2019 On 60 Minutes tonight (maybe a replay) about the possible future of opioid manufactures getting hammered in court. As they should. I want nothing, other than to force them to be responsible. Link to comment Share on other sites More sharing options...
JohnC Posted June 30, 2019 Share Posted June 30, 2019 1 minute ago, Mr. WEO said: Yeah, but clearly that was not what the radio guy was saying. He wouldn't have commented at all if it was just to say "Andy Reid tolerates bad men on his team". He very clearly, specifically, wanted to link his tolerance for bad behavior in his roster with, in his mind, a permissive behavior with his sons. Not sure how you could have missed that. I disagree how you are framing the issue. The central topic was Reid bringing in renegades and not being able to modify them. That was what he was getting at with the family reference. There was no need to go there. In fact, if he would made the simple argument about the players and not bring up the family his argument would have been more clearly made without the populace outraged by the personal issue. As it turned out the issue about the players was sidetracked by the explosive response over the family tragedies. 1 Link to comment Share on other sites More sharing options...
Mr. WEO Posted June 30, 2019 Share Posted June 30, 2019 Just now, JohnC said: I disagree how you are framing the issue. The central topic was Reid bringing in renegades and not being able to modify them. That was what he was getting at with the family reference. There was no need to go there. In fact, if he would made the simple argument about the players and not bring up the family his argument would have been more clearly made without the populace outraged by the personal issue. As it turned out the issue about the players was sidetracked by the explosive response over the family tragedies. That wasn't his intent. Just saying Reid brings in bad players is obvious. Why would anyone even comment on it? This guy sees it as a character defect with Reid. That's why he spoke out on this--because he thinks this is why Reid has these bums on his team---because he doesn't care about that stuff. Link to comment Share on other sites More sharing options...
Augie Posted June 30, 2019 Share Posted June 30, 2019 6 minutes ago, Mr. WEO said: That wasn't his intent. Just saying Reid brings in bad players is obvious. Why would anyone even comment on it? This guy sees it as a character defect with Reid. That's why he spoke out on this--because he thinks this is why Reid has these bums on his team---because he doesn't care about that stuff. Purdue pharma on 60 Minutes (interestingly enough timed) admitted in court they lied about your less than 1% stat. Just sayin’. Reading is nice, but living in the real world tells you a lot. 1 Link to comment Share on other sites More sharing options...
Mr. WEO Posted June 30, 2019 Share Posted June 30, 2019 Just now, Augie said: Purdue pharma on 60 Minutes (interestingly enough timed) admitted in court they lied about your less than 1% stat. Just sayin’. Reading is nice, but living in the real world tells you a lot. The stat wasn't produced by Purdue... I don't know how else to express this to you. You don't believe that the vast majority of patients prescribed a single script of narcotics escapes addiction. You call that the "real world", yet you base this on anecdotes and phone calls. If you don't believe in data, that's fine--because your real world clearly doesn't depend on it to function. In my world, we can't do that, obviously, because of the consequences. Link to comment Share on other sites More sharing options...
Augie Posted July 1, 2019 Share Posted July 1, 2019 6 minutes ago, Mr. WEO said: The stat wasn't produced by Purdue... I don't know how else to express this to you. You don't believe that the vast majority of patients prescribed a single script of narcotics escapes addiction. You call that the "real world", yet you base this on anecdotes and phone calls. If you don't believe in data, that's fine--because your real world clearly doesn't depend on it to function. In my world, we can't do that, obviously, because of the consequences. OK, put it this way. Big Pharma is getting sued, which they will lose, and they’ve already admitted to lying about their previous claims. You believe what you want. Oh, by the way, cigarettes are bad for you too. And to be clear, this is NOT personal, this is just obvious. It’s a reason that 1/3 of 60 Minutes was spent on it tonight and it’s a constant issue. Don’t be lame and think it’s a non-issue. I’m done, at least for now. Link to comment Share on other sites More sharing options...
Mr. WEO Posted July 1, 2019 Share Posted July 1, 2019 1 minute ago, Augie said: OK, put it this way. Big Pharma is getting sued, which they will lose, and they’ve already admitted to lying about their previous claims. You believe what you want. Oh, by the way, cigarettes are bad for you too. And to be clear, this is NOT personal, this is just obvious. It’s a reason that 1/3 of 60 Minutes was spent on it tonight and it’s a constant issue. Don’t be lame and think it’s a non-issue. I’m done, at least for now. Can you point to any post where I have even hinted it was a "non-issue"? You're straight up fabricating at this point. I've said the opposite over and over.. Go in peace and learn more. Link to comment Share on other sites More sharing options...
JohnC Posted July 1, 2019 Share Posted July 1, 2019 8 minutes ago, Mr. WEO said: The stat wasn't produced by Purdue... I don't know how else to express this to you. You don't believe that the vast majority of patients prescribed a single script of narcotics escapes addiction. You call that the "real world", yet you base this on anecdotes and phone calls. If you don't believe in data, that's fine--because your real world clearly doesn't depend on it to function. In my world, we can't do that, obviously, because of the consequences. WEO, The drug companies are being sued and settling law suits all over the country not because they are not culpable for the epidemic of addiction but because they know that the evidence proves otherwise. The carnage exists throughout the country sparing no segment of the society. It's not anecdotal evidence but rather a large body of evidence that addictive pain killer drugs were irresponsibly issued without the required caution. The underpinning reason for this recklessness was greed. https://www.washingtonpost.com/national/health-science/purdue-pharma-state-of-oklahoma-reach-settlement-in-landmark-opioid-lawsuit/2019/03/26/69aa5cda-4f11-11e9-a3f7-78b7525a8d5f_story.html?utm_term=.1fa74dec2449 1 Link to comment Share on other sites More sharing options...
Augie Posted July 1, 2019 Share Posted July 1, 2019 5 minutes ago, Mr. WEO said: Can you point to any post where I have even hinted it was a "non-issue"? You're straight up fabricating at this point. I've said the opposite over and over.. Go in peace and learn more. OK, underselling it to the point of not being rational. Link to comment Share on other sites More sharing options...
Augie Posted July 1, 2019 Share Posted July 1, 2019 26 minutes ago, JohnC said: WEO, The drug companies are being sued and settling law suits all over the country not because they are not culpable for the epidemic of addiction but because they know that the evidence proves otherwise. The carnage exists throughout the country sparing no segment of the society. It's not anecdotal evidence but rather a large body of evidence that addictive pain killer drugs were irresponsibly issued without the required caution. The underpinning reason for this recklessness was greed. https://www.washingtonpost.com/national/health-science/purdue-pharma-state-of-oklahoma-reach-settlement-in-landmark-opioid-lawsuit/2019/03/26/69aa5cda-4f11-11e9-a3f7-78b7525a8d5f_story.html?utm_term=.1fa74dec2449 WEO will not be a fan of the real facts, I’m guessing. Don’t give me a link to a company funded study....who won in and out of court. THOSE are the facts. And this is just the beginning. They are already talking bankruptcy. Link to comment Share on other sites More sharing options...
JohnC Posted July 1, 2019 Share Posted July 1, 2019 5 minutes ago, Augie said: WEO will not be a fan of the real facts, I’m guessing. Don’t give me a link to a company funded study....who won in and out of court. THOSE are the facts. And this is just the beginning. They are already talking bankruptcy. The world is upside down. Republican AGs suing giant drug companies. That's like mommas taking their own kids to court for misbehavior. Link to comment Share on other sites More sharing options...
Cripple Creek Posted July 1, 2019 Share Posted July 1, 2019 2 hours ago, Mr. WEO said: No, I'm not telling you that. In your example, a very small number of prescribers prescribed a massive number of pills to a small number of Ohioans, many of which were then likely sold to others for money. I'm glad you agree that your system is horribly broken. 1 Link to comment Share on other sites More sharing options...
Augie Posted July 1, 2019 Share Posted July 1, 2019 2 hours ago, Mr. WEO said: No, I'm not telling you that. In your example, a very small number of prescribers prescribed a massive number of pills to a small number of Ohioans, many of which were then likely sold to others for money. Duh? Do you feel embarrassed right now? Or do you STILL not get it? Link to comment Share on other sites More sharing options...
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