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  #21  
Old 04.11.2015, 22:49
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Re: Land of the free

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I've always taken those characters for gay, especially Robin. Who the hell else runs around in tights?
He also seems to have applied an unhealthy amount of fake tan.
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  #22  
Old 04.11.2015, 22:50
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Re: Land of the free

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Al jazeera, ahh. It must be 100% true then.
I find Al Jazeera to be a very good source, certainly better and more trustworthy than any US TV network. Everyone knows they have a gag order by his royal highness when it comes to their home country... but I frankly don't really care about news from there.

Any international news? I'd say less bias than CNN and even the BBC.
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Old 05.11.2015, 00:35
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Re: Land of the free

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You are right, generally speaking, that carefully supervised in a medical setting, many people do not become addicts. But there is still a lot of abuse. And perhaps not everyone is carefully monitored, and not all patients return for follow up, prescription etc. heroin is cheaper.
I think what's missing here is that opiates are not, or should not be, prescribed for any Tom, Dick or Harry. There are very few conditions, apart from recent trauma, that warrant their use.

The idea, that's being suggested, that it's prescription use that leads to wide scale addiction, is a complete fallacy. 99% of patients prescribed these drugs are either going to die very soon or recover from their injuries and become able to exist on non-opioid painkillers, or eventually none at all.

It's a myth, basically,and often used as a convenient scapegoat to avoid facing up to the real causes of social problems.
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Old 05.11.2015, 09:10
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Re: Land of the free

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In the decades before 1998 the USA death rate of middle aged whites was falling about 2 per cent per year; similar to other Western economies.
However after 1998 (in USA only) the death rate has risen around 0.5% per year due to drug related deaths (including prescription drugs), mostly amongst the poorer educated with limited prospects.
What inspired this thread? The article in The Atlantic?

http://www.theatlantic.com/health/ar...s-pnas/413971/

The article states the increase is due to poisoning (alcohol), suicides and liver disease:


Bad brews?
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Old 05.11.2015, 11:24
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Re: Land of the free

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I think what's missing here is that opiates are not, or should not be, prescribed for any Tom, Dick or Harry. There are very few conditions, apart from recent trauma, that warrant their use.

The idea, that's being suggested, that it's prescription use that leads to wide scale addiction, is a complete fallacy. 99% of patients prescribed these drugs are either going to die very soon or recover from their injuries and become able to exist on non-opioid painkillers, or eventually none at all.

It's a myth, basically,and often used as a convenient scapegoat to avoid facing up to the real causes of social problems.
Where did you get the 99%?
At any rate, no one is talking about appropriate opiate prescriptions for trauma, pain and end of life. There is, however, inappropriate opiate use, might be from inappropriate prescribing behavior or getting it on the street. There are, in the US, a number of people scamming opiates. Price goes up, people turn to heroin because it's cheaper.

Inappropriate opiate prescriptions are a problem in the US. Here's an abstract from an article here. You're right though - it's not the approriate use of opiates, it is very sloppy monitoring, drug seeking, and drugs falling through the cracks, making it that much harder for people who really need the meds.

http://www.ncbi.nlm.nih.gov/pubmed/26469747

Abstract
PROBLEM/CONDITION:
Drug overdose is the leading cause of injury death in the United States. The death rate from drug overdose in the United States more than doubled during 1999-2013, from 6.0 per 100,000 population in 1999 to 13.8 in 2013. The increase in drug overdoses is attributable primarily to the misuse and abuse of prescription drugs, especially opioid analgesics, sedatives/tranquilizers, and stimulants. Such drugs are prescribed widely in the United States, with substantial variation by state. Certain patients obtain drugs for nonmedical use or resale by obtaining overlapping prescriptions from multiple prescribers. The risk for overdose is directly associated with the use of multiple prescribers and daily dosages of >100 morphine milligram equivalents (MMEs) per day.


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What inspired this thread? The article in The Atlantic?

http://www.theatlantic.com/health/ar...s-pnas/413971/

The source is an article recently published in the Proceedings of the National Academy of Sciences. Interesting thing is that both the journal of the American Medical Association and New England Journal of Medicine rejected the article within hours of receipt, although the authors were careful with their research. The Atlantic picked up the PNAS article to distill to the public.


Here's a funny thing from the Onion - published in 1999, slightly different tone, but still....
http://www.theonion.com/article/long...n-soon-exp-647
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  #26  
Old 05.11.2015, 11:34
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Re: Land of the free

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Inappropriate opiate prescriptions are a problem in the US. Here's an abstract from an article here. You're right though - it's not the approriate use of opiates, it is very sloppy monitoring, drug seeking, and drugs falling through the cracks, making it that much harder for people who really need the meds.
A lot of people develop hard drug addictions after using prescription painkillers to ease a serious medical injury. When the prescription runs out, there is still that urge that is difficult to control, and some find it in cheap street heroin. There is a pathway to drug abuse through prescription drugs. I saw a friend go through this after a serious accident. He went through drastic personality changes, and he really had a hard time getting off the painkillers. He practically went through rehab for his addiction.
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Old 05.11.2015, 11:38
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Re: Land of the free

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A lot of people develop hard drug addictions after using prescription painkillers to ease a serious medical injury. When the prescription runs out, there is still that urge that is difficult to control, and some find it in cheap street heroin. There is a pathway to drug abuse through prescription drugs. I saw a friend go through this after a serious accident. He went through drastic personality changes, and he really had a hard time getting off the painkillers. He practically went through rehab for his addiction.

Yes... people need to be offered some sort of taper off the meds.

Oh and by the way, "Poisonings" might refer to drug poisonings - for example, deaths from bad heroin, and overdoses. When you overdose in the US, you call a poison center.
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Old 05.11.2015, 12:40
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A lot of people develop hard drug addictions after using prescription painkillers to ease a serious medical injury. When the prescription runs out, there is still that urge that is difficult to control, and some find it in cheap street heroin. There is a pathway to drug abuse through prescription drugs. I saw a friend go through this after a serious accident. He went through drastic personality changes, and he really had a hard time getting off the painkillers. He practically went through rehab for his addiction.
This is frankly alarmist rubbish. Yes, you may have seen a friend become addicted to the hard stuff; Yes, it's possible to become addicted to it; No, it's not possible to become addicted to it if you don't want to.

All it takes is the tiniest awareness that the feeling of blissful tranquility it brings is only temporary, and that sooner or later you're going to have to wake up and face real life. Those who become addicted are those who can't, or don't want to, face these realities, who implicitly accept that they would rather remain in that state.

For me, over several months of morphine use, I recognised that the "I don't give a shite about anything" feeling I was experiencing was masking me off from life, and that this was really not a good thing to continue, so I was diligent in ensuring that as the pain levels dropped, so too did my morphine usage. It wasn't in the least bit difficult, and the prescribing doctors I've spoken to have very few concerns about it, in that my experience was typical of what they see.

It's easy to confuse these addiction/dependency issues with the "rush" that's associated with Heroin use in particular. Medical, oral use of opiates doesn't give you this; not at all. So anyone looking for it has already been an IV or inhaling user to have experienced it, and probably of Heroin, since it gives much more of the high that morphine itself or most other derivative or artificial opiates. In other words it's not the medical use that started them down the road to addiction.

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Yes... people need to be offered some sort of taper off the meds.
Yes, people are offered a taper off the meds. It's called taking fewer and fewer over time as the need diminishes. As I just said, it really, really is not difficult to do if you want to.

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Where did you get the 99%?
I made it up, of course

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Inappropriate opiate prescriptions are a problem in the US. Here's an abstract from an article here. You're right though - it's not the appropriate use of opiates, it is very sloppy monitoring, drug seeking, and drugs falling through the cracks, making it that much harder for people who really need the meds.
Quite so. And as such it's a symptom of the problem, not a cause of it.
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Old 05.11.2015, 12:50
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Re: Land of the free

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This is frankly alarmist rubbish. Yes, you may have seen a friend become addicted to the hard stuff; Yes, it's possible to become addicted to it; No, it's not possible to become addicted to it if you don't want to.

All it takes is the tiniest awareness that the feeling of blissful tranquility it brings is only temporary, and that sooner or later you're going to have to wake up and face real life. Those who become addicted are those who can't, or don't want to, face these realities, who implicitly accept that they would rather remain in that state.

For me, over several months of morphine use, I recognised that the "I don't give a shite about anything" feeling I was experiencing was masking me off from life, and that this was really not a good thing to continue, so I was diligent in ensuring that as the pain levels dropped, so too did my morphine usage. It wasn't in the least bit difficult, and the prescribing doctors I've spoken to have very few concerns about it, in that my experience was typical of what they see.

It's easy to confuse these addiction/dependency issues with the "rush" that's associated with Heroin use in particular. Medical, oral use of opiates doesn't give you this; not at all. So anyone looking for it has already been an IV or inhaling user to have experienced it, and probably of Heroin, since it gives much more of the high that morphine itself or most other derivative or artificial opiates. In other words it's not the medical use that started them down the road to addiction.
Alarmist? Who is alarmed?

There is a psychological as well as a physiological aspect to addiction. People can get addicted to anything on a psychological level. There are people who are simply prone to addictions. There are people addicted to shopping, gambling, computer games, the Internet, sex, etc.

Drugs bring a physiological aspect to an addiction. There are drugs that alter body and mind chemistry in such a way that an addiction becomes physical, meaning there is a physical need for a chemical for normal functioning. Not all drugs do this, but painkillers certainly can.

Some people who have never had painkillers may never need it or become aware of it. But some certainly do develop an addiction after a prescription. This happens often. I think Michael Jackson claims to be another such case. There are people who fall into that, and what is your problem with them? You'd rather deny they picked up an addiction from prescriptions and are just what? Weak willed individuals? Why? Does that make you feel better about yourself?
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  #30  
Old 05.11.2015, 12:58
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Re: Land of the free

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Yes, people are offered a taper off the meds. It's called taking fewer and fewer over time as the need diminishes. As I just said, it really, really is not difficult to do if you want to.

No one is disputing your experience, nor are we disputing the need for opiates. However there is a good bit of literature reporting instances of inappropriate prescription, drug seeking and the like. And there is a rise in white, suburban Americans using both opiates and heroin. And some researchers see a link.

Believe me, I'm looking at 2 knee replacements in the next few years and I know I will likely require good pain control.
So I want them to be around.

It's not alarmist to see both good and bad in this.
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  #31  
Old 05.11.2015, 13:04
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Re: Land of the free

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I've always taken those characters for gay, especially Robin. Who the hell else runs around in tights?




At this rate, even James Bond may very well be gay sometime in some future release.
Bit late there. Go back and watch Skyfall again - the door is open, even if no one has looked inside yet.
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  #32  
Old 05.11.2015, 20:55
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Re: Land of the free

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Yes... people need to be offered some sort of taper off the meds.

Oh and by the way, "Poisonings" might refer to drug poisonings - for example, deaths from bad heroin, and overdoses. When you overdose in the US, you call a poison center.
Apparently an epidemic of drug overdoses, prescription and illicit. Drug overdose is the leading cause of death in the US, surpassing car accidents and gun deaths:

DEA:
http://news.yahoo.com/drug-overdose-...185554253.html
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Old 05.11.2015, 21:58
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Re: Land of the free

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Believe me, I'm looking at 2 knee replacements in the next few years and I know I will likely require good pain control.
I think you'll be pleasantly surprised. Knee replacements are - next to cataract surgery - enjoy the greatest success rates. Need to do the therapy religiously, of course, but I know several people who have gone through it and were astonished at how easy it was.
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Old 05.11.2015, 21:59
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Re: Land of the free

Apparently, there's some sort of epidemic in the Chicago area. It seems hard to believe and then this was in the news the other day ...
http://www.chicagotribune.com/news/l...002-story.html
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Old 05.11.2015, 22:36
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Re: Land of the free

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Apparently, there's some sort of epidemic in the Chicago area. It seems hard to believe and then this was in the news the other day ...
http://www.chicagotribune.com/news/l...002-story.html
Apparently heroin mixed with a prescription opioid. Addiction specialist, Dr. Joel Nathan, reports a lot of prescription users switching over to street heroin.
http://www.cbsnews.com/news/chicago-...ly-concoction/

NIH also reporting link and pathway from prescription use of painkiller to street heroin mixtures, as it is less expensive:
https://www.drugabuse.gov/publicatio...ion-drug-abuse
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Old 06.11.2015, 00:27
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Re: Land of the free

So first came Big Pharma, telling doctors that it is okay to prescribe opiate painkillers for long term pain issues, and misstating the potential for addiction:

http://theweek.com/articles/541564/h...utical-company

After the doctors had started prescribing this poison, and the culture of abuse began, it snowballed into a full blown epidemic. 'Pill Mill' doctors and medical practices popped up all over, and the bill was passed on to the average joe's insurance premiums. The doctors wrote the prescription, and charged the patient (to the insurance) for the office visit and prescription. The junkie now walks out of the pharmacy with bottle of pills for the $5 or $10 insurance co-pay fee, and the pills have a street value of $80. EACH!

In a former life I worked in a 5 star hotel, fine dining, and the whole kitchen staff was addicted to this shit. They could barely hold themselves together until payday.

Anyway, eventually the problem got out of hand - white suburban kids were knocking over pharmacies in Connecticut to the point that they had to put up 'we don't carry oxycontin' signs on their windows. The authorities then stepped in to regulate the prescriptions, and the obvious 'pill mills' have largely been shut down.

So that leaves us with a huge population of oxy addicts who are suddenly cut off from their supply. And the obvious answer - heroin from the streets. (well, many of these people never thought of themselves as junkies/druggies to begin with - they were just taking the little pills made by the pharma company and it all seemed so harmless...until they couldn't get their pills and tried the street heroin for the first time, realizing that it's basically the same as oxycontin at 1/5 th? the price..)

My old college flatmate is a junkie. It's painful to see him in such a state - and he never realized what he was getting into because of the false sense of trust in big pharma's product. Yes, it's a symptom of his problems to cultivate such an addiction, but was made much easier such strong addictive drugs.

I know/knew at least 2 other people who have died from oxycontin overdoses, both of whom's addictions initially started through doctor prescriptions for genuine injuries/pain.

It doesn't take long for rats to choose cocaine over food until they die from it. To think that humans are much different is crazy. Or is it the rat's fault for not making good decisions?

Ace, I agree with you in some regards but one can't claim that the drugs themselves aren't inherently dangerous and addictive.
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Old 06.11.2015, 10:20
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Re: Land of the free

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Ace, I agree with you in some regards but one can't claim that the drugs themselves aren't inherently dangerous and addictive.
A lot of drugs, used incorrectly, are dangerous. Drugs like oxycontin or fentanyl are cornerstones of pain therapy for cancer patients. Used properly, they're fine.
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Old 06.11.2015, 11:02
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Re: Land of the free

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Bit late there. Go back and watch Skyfall again - the door is open, even if no one has looked inside yet.
He certainly likes being tied to chairs.







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Old 06.11.2015, 12:38
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Re: Land of the free

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A lot of drugs, used incorrectly, are dangerous. Drugs like oxycontin or fentanyl are cornerstones of pain therapy for cancer patients. Used properly, they're fine.
I agree, but what does 'properly' mean? According to the manufacturer's guidelines?:

"In 2007, in United States of America v. The Purdue Frederick Company, Inc., Purdue and its top executives pleaded guilty to charges that it misled doctors and patients about the addictive properties of OxyContin and misbranded the product as "abuse resistant." "
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Old 06.11.2015, 19:30
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I agree, but what does 'properly' mean? According to the manufacturer's guidelines?:

"In 2007, in United States of America v. The Purdue Frederick Company, Inc., Purdue and its top executives pleaded guilty to charges that it misled doctors and patients about the addictive properties of OxyContin and misbranded the product as "abuse resistant." "
'Properly' means when used according to the latest medical knowledge by physicians. By 'latest' I mean taking Phase IV data sets into account. These databases are constantly updated - I doubt there is a single pharma product that has not benefited from such post-marketing surveillance. But when I speak of 'properly', I speak of first-hand observation of both products being prescribed and monitored by an excellent oncologist at Johns Hopkins. These products visibly eased the suffering of both patients (my nephew and my mother), who suffered from extremely unpleasant cancers. Really awful to witness.
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