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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> US Govt Declares War on Doctors!
        
(Message started by: hdido on Jul 23^rd, 2005, 2:07pm)

Title: US Govt Declares War on Doctors!
Post by hdido on Jul 23^rd, 2005, 2:07pm

Does this scare you? It scares me-our government is out of control (from Today's NY Times)Op-Ed Columnist
Handcuffs and Stethoscopes

By JOHN TIERNEY
Published: July 23, 2005
The current zeal for sending doctors to jail for writing painkiller prescriptions may seem baffling, especially to the patients who relied on the doctors for pain relief. But if you consider it from the perspective of the agents raiding the doctors' offices, you can see a certain logic.
During the war on drugs in the 1980's and 1990's, federal and local agents risked their lives going after drug gangs on the streets. As their budgets for drug enforcement soared, they arrested hundreds of thousands of people annually and filled a quarter of American prison cells with drug offenders.
But what did they have to show for it? Drugs remained as available as ever on the streets - and actually got a lot cheaper. The street price of heroin and cocaine dropped by more than half in the last two decades. Dealers just went on dealing, not only lowering their prices but also selling stronger, purer versions of heroin, cocaine and marijuana.
Given this record, and the pressure from Congress to show results, it's understandable that the Drug Enforcement Administration and local police departments hit on a new strategy: defining deviancy up. Federal and local authorities shifted their focus to doctors and the new scourge of OxyContin and similar painkillers, known generally as opioids.
As quarry for D.E.A. agents, doctors offered several advantages over crack dealers. They were not armed. They were listed in the phone book. They kept office hours and records of their transactions. And unlike the typical crack dealer living with his mother, they had valuable assets that could be seized and shared by the federal, state and local agencies fighting the drug war.
I don't mean to suggest that the doctors were all blameless, or that OxyContin wasn't being diverted to the black market and being abused. But the problem wasn't nearly as bad as federal and local authorities made it out to be.
The D.E.A. announced that in two years, there had been 464 OxyContin-related deaths, but most of the victims had taken other drugs, too, so the cause of death was uncertain. Ronald Libby, a political scientist at the University of North Florida, notes that even that figure is a minuscule fraction (0.00008 percent) of the number of OxyContin prescriptions written, and that it's dwarfed by the more than 32,000 people who die in the same period from gastrointestinal bleeding from other painkillers, like aspirin and ibuprofen.
The OxyContin crisis was fanned by sensationalized press coverage and by popular fears that unsuspecting patients getting this painkiller were being turned into dangerous addicts. While it's true that chronic-pain patients taking opioids for a long time require higher and higher doses, the drugs typically don't give them a high or interfere with their lives. Instead, the drugs enable them to function.
But many doctors are now afraid to give painkillers to either kind of patient. The D.E.A. tried reassuring them by working with pain-management experts to produce a pamphlet setting out guidelines for doctors who want to avoid investigation. But last fall, the agency said it wasn't bound by the guidelines after all, and could investigate even when it had no reason to suspect a doctor. That shift prompted a letter from the attorneys general of 30 states, who complained that patients were not getting proper pain relief because the D.E.A. was confusing and scaring doctors. The state officials warned that "we cannot cast a broad net over all health care practitioners, hoping that a few criminals will be caught while the other cases are thrown out."
If enough doctors are jailed or scared into not writing prescriptions, it's conceivable that this drug war could have more impact than the ones against heroin and cocaine - doctors, after all, are harder to replace than crack dealers. But even if there's less OxyContin on the street, is that worth the suffering of patients who can't get the painkillers they need?
Maybe some OxyContin addicts would be helped, but consider the progress the White House's drug-policy agency found last year in a field survey on drug use in Cincinnati:
"Because diverted OxyContin is more expensive and difficult to purchase," the agency reported, "users have switched to heroin."

Title: Re: US Govt Declares War on Doctors!
Post by floridian on Jul 23^rd, 2005, 6:26pm

Yes, medical decisions are being made not by doctors based on their best judgement, but by doctors afraid of being singled out for writing too many prescriptions for a drug with abuse potential. That is a problem for people with chronic pain (opiates), and also for people with anxiety/panic (benzodiazepines).

There is a considerable movement (profitable for the pharmaceutical companies, of course) to push people with anxiety problems onto SSRIs instead of benzodiazepines. The SSRIs can often be helpful, but there is often weeks or months of 'adjustment' where the SSRIs are not helping with the anxiety, but are exerting negative side effects. Just google this board for paxil to hear some horror stories. And the SSRIs can be just as habit forming as valium or xanax (excruciating withdraw), The benzos work quickly, and most people with anxiety use only enough to function normally. but since there is abuse potential and a war against drugs, many patients are being steered clear of the best treatment option.

Fortunately, there are natural benzo alternatives that are reasonably effective and less habit forming (passiflora, skullcap) and an alternative to SSRIs that is equally effective but with fewer side effects (inositol). Inositol also inhibits the 5-ht2 receptors, which makes it of potential interest to people with a certain hypothalamus dysfunction.

The fact that oxycontin addicts are switching to heroin is a demonstration of the law of unintended consequences - pass a half arst law to help people who cant get up stairs such that every building over 3 stories must have an (expensive) elevator, and all of the sudden, almost every building built is exactly 3 stories tall, and 2/3 of the residents and visitors are SOL if they are in a wheel chair or on crutches.

Title: Re: US Govt Declares War on Doctors!
Post by Lizzie2 on Jul 23^rd, 2005, 6:38pm

on 07/23/05 at 18:26:50, floridian wrote:

The fact that oxycontin addicts are switching to heroin is a demonstration of the law of unintended consequences - pass a half arst law to help people who cant get up stairs such that every building over 3 stories must have an (expensive) elevator, and all of the sudden, almost every building built is exactly 3 stories tall, and 2/3 of the residents and visitors are SOL if they are in a wheel chair or on crutches.

I lived on the 3rd floor of a rickety old apartment building back in 2000-2001. It looked like a house from the outside, but it held 4 apartments per floor - the centre 2 apartments had no windows. I lived in one of those. The stairs were incredibly steep.

I learned after that to live on lower levels! I can't go up more than one (short) flight of steps... It makes me mad that things like what you wrote above happen... >:(

Title: Re: US Govt Declares War on Doctors!
Post by hdido on Jul 23^rd, 2005, 11:49pm

I think that there is the distinct possibility that legitimate users of prescription Oxycontin and other opiates might have to switch to buying heroin if the government threatens to or arrests doctors who prescribe the stuff for chronic pain patients. To make a point clear: there is a big difference between becoming dependent upon a drug and being an addict (see the article). Any long term use of opiates will result in dependence to control pain and higher doses will be needed as time goes by, but such patients don't use the drug to get high and don't abuse it and NEED it. Addiction involves illicit use of a drug to get high and behaviors such as doctor shopping (Rush Limbaugh), polydrug abuse, stealing to get money for drugs, using street drugs and generally has nothing to do with using the medication for a general medical reason (except to avoid withdrawal). 99.99% of legitimate users of narcotics have no problem when they don't need it anymore as they are no fun to take-you don't get high and the constipation is a bitch, not to mention the decrease in your libido. Legitimate users can function normally with the drug-depending on their medical conditon-and go to work and be productive; addicts cause trouble and the relapse rate for heroin addicts is around 90%....count the silverware if you have one over for dinner!

Title: Re: US Govt Declares War on Doctors!
Post by Topical on Jul 24^th, 2005, 6:14am

http://www.usdoj.gov/dea/pubs/intel/02017/02017fig2.gif

That's only through 2000, I bet the graph maintained the curve's slope until Limbaugh was busted. It does look a little out of control. I wouldn't call it a 'war', I'd call it an 'ahem'. Is it fair to say Limbaugh abused them? I think so. No doubt there are many others who are/were doing the same thing.

Title: Re: US Govt Declares War on Doctors!
Post by Jimmy_B on Jul 24^th, 2005, 8:17am

on 07/24/05 at 06:14:47, Topical wrote:

I had to laugh when I saw this graph...I'm sorry...Of course the graph curved upward from 1996 (That's when the drug was introduced)...you can't sell many oxycontin's when they're not for sale. ;) the other common opioids were on the market...hence the stable sales. Look at the total sales...even in the highest part of your oxycontin graph (at 2000) it's still only a little over 3 percent of the total opioid market. 160 million to 6 million.

It was also touted as a miracle drug (and still is) for cancer patients and the such. Previous they had to take a drug every 4 hours and would get peaks and valleys in their pain control. With time release preparations like oxycontin, M.S. Contin, Kadian and others...they were able to take 1 or two pills a day without the peaks and valleys (and also acetaminiphen poisoning) of the instant-release opioids.

Any drug that's gone to market...probably has a similiar graph...zero when it's not around...and up to a few million users in it's 1st. 3 to 5 years of production.

The fact that the DEA is even showing a laughable & biased graph...such as this...should give reason to wonder what the hell is going on.

Jimmy

Title: Re: US Govt Declares War on Doctors!
Post by Topical on Jul 25^th, 2005, 8:37pm

Ya no kidding! Here's the quote they had on their page.

"Law enforcement officials have been monitoring oxycodone products for abuse and diversion over the last 30 years."
http://www.usdoj.gov/dea/pubs/intel/02017/02017.html

It's a shame that it's supposedly a street drug now going for 30 bucks a tab. Some guy was paying off his place in exchange for the tabs and got busted for it.

Title: Re: US Govt Declares War on Doctors!
Post by Lizzie2 on Jul 26^th, 2005, 1:12am

I've had ER patients tell me that they get their drugs from people who had prescriptions....aka. they buy them off the street corner.

The first time someone admitted that to me, I had to stop my jaw from dropping to the floor. I mean, no kidding people do it...but I've never had someone just tell me straight out that that's what they do!

Last I heard, Oxycontin went for $10 on the street down in the city, but that may be old data from a couple of years ago. haha

Sad stuff...this really wrecks people in legitimate chronic (or even temporary acute) pain! I used oxycontin after my bilateral knee surgery in June. I only ever took it a few times, but it REALLY helped me get through the nights...I didn't want to wake up in extreme pain if I missed one of the 4 hour percocet doses!

Title: Re: US Govt Declares War on Doctors!
Post by mynm156 on Jul 28^th, 2005, 9:54pm

CRAZY Doesnt our goverment have BIGGER fish to fry?!

Title: Re: US Govt Declares War on Doctors!
Post by Cooked Brain on Jul 29^th, 2005, 5:29am

:o :o :o