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How best to fight the opioid crisis? (1 Viewer)

timschochet

timschochet

Footballguy
So far as I can see, our current administration has done little except blame Mexico and threaten them with trade penalties. And Trump has appointed Jared Kushner to take charge of this issue, while at the same time his budget cuts down what little federal spending is already devoted to it. 

So much for what we should not do. But I didn’t start this thread as yet another means to attack Donald Trump- he’s the President so his involvement is always going to be a big part of the discussion. But I’m more interested in what we should do. Over the last several years this problem has reached catastrophic proportions. There’s probably not a single person reading this who doesn’t know somebody who has been personally affected- and as for me, since I became involved in substance abuse programs due to my wife joining AA, I have met a whole lot of people over the last year who are struggling with this. Some of those that I have met are already dead. 

Any ideas? 

 
You should be prohibited from meeting anyone else until the causal link between your meeting addicts and them dying can be studied further and is better understood.

 
There has to be some reporting of doctors that is better monitored.   "X" number of prescriptions / number of patients.   Is this type of data centralized   and monitored in the first place to flag potential abuse?  I have no clue.

Oh...also...####### legalize cannabis.  States that have done so have seen a 25% decrease in opioid-related deaths.

 
I don't know if anything can be done. We live in a very pro-drug society

We give drugs early and often in the United States. 7 in 10 are are on at least 1 prescription drug. We give kids drugs to make them pat attention, to help them stop puberty ... the older people get, the more drugs are used for everything to help them sleep or stay away, to get sexually excited, to just get high, to help lose weight, gain weight, to help or stop dang near anything you can imagine

We are a drug loving society. I think the negatives of addictions are just part of it, its acceptable for everyone to have easy access to drugs although I agree its a massive problem.

 
timschochet said:
So far as I can see, our current administration has done little except blame Mexico and threaten them with trade penalties. And Trump has appointed Jared Kushner to take charge of this issue, while at the same time his budget cuts down what little federal spending is already devoted to it. 

So much for what we should not do. But I didn’t start this thread as yet another means to attack Donald Trump- he’s the President so his involvement is always going to be a big part of the discussion. But I’m more interested in what we should do. Over the last several years this problem has reached catastrophic proportions. There’s probably not a single person reading this who doesn’t know somebody who has been personally affected- and as for me, since I became involved in substance abuse programs due to my wife joining AA, I have met a whole lot of people over the last year who are struggling with this. Some of those that I have met are already dead. 

Any ideas? 
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I have no idea, and I am in the minority where thankfully nobody I know has had any issues with this.  

 
urbanhack said:
There has to be some reporting of doctors that is better monitored.   "X" number of prescriptions / number of patients.   Is this type of data centralized   and monitored in the first place to flag potential abuse?  I have no clue.

Oh...also...####### legalize cannabis.  States that have done so have seen a 25% decrease in opioid-related deaths.
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Is that true? I had no idea of this. That is interesting.

 
Ditka Butkus said:
The Federal legalization of medical marijuana...In many cases marijuana could replace opioids.
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To me that is like saying that reading Heavy Metal can replace sex.  Of course lots of things don't make sense to me, so perhaps my own experiences are irrelevant here.

 
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Ditkaless Wonders said:
To me that is like saying that reading Heavy Metal can replace sex.  Of course lots of things don't make sense to me, so perhaps my own experiences are irrelevant here.
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It's my understanding that marijuana has the ability to lessen pain....Doctors seem to be very conservative when diagnosing, why not be conservative when prescribing.

 
Most heroin and fentanyl addicts are loathe to switch to marijuana before it goes through the proper state legal channels.

 
jonessed said:
Most heroin and fentanyl addicts are loathe to switch to marijuana before it goes through the proper state legal channels.
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I'm guessing the statistics that urbanhack quoted has to do with newcomers. If by making pot legal, we attract new people to it rather than the opioids they might choose instead, would that trade-off benefit society?

 
timschochet said:
I'm guessing the statistics that urbanhack quoted has to do with newcomers. If by making pot legal, we attract new people to it rather than the opioids they might choose instead, would that trade-off benefit society?
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Possibly.  I would have to look at the study he took the numbers from.

 
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Ditka Butkus said:
It's my understanding that marijuana has the ability to lessen pain....Doctors seem to be very conservative when diagnosing, why not be conservative when prescribing.
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I think it alleviates certain kinds of pain. I'm not sure it would be effective for the sort of serious pain that doctors prescribe pain-killers for. But I don't know.

 
jonessed said:
Possibly.  I would have to look at the study he took the numbers from.
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It's not that I'm looking forward to a society in which there are more people on pot. Marijuana is not harmless. I have come to learn in AA that the strains of it commonly used today are far more dangerous than the stuff I took in my youth- it's apparently lined with chemicals that makes it stronger. Moreover, for people with chemical imbalances it can have a permanent destructive effect, and I have seen this personally. And not everybody who is chemically imbalanced knows they are.

Still, if it reduced the opioid crisis, I suppose it's a positive.

 
timschochet said:
I think it alleviates certain kinds of pain. I'm not sure it would be effective for the sort of serious pain that doctors prescribe pain-killers for. But I don't know.
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I’ve never been prescribed an opioid for anything but massive pain for a very short duration (like kidney stones).  I’m sure there are some with chronic pain that marijuana could help, but I doubt anyone being prescribed opioids for that chronic pain would be able to replace them with marijuana.  

Not unless these areas just have massive amounts of irresponsible doctors who prescribe opioids on a whim.  I know these doctors exist, but I can’t believe it’s a large number.  Especially given the current scrutiny this is getting.

 
timschochet said:
It's not that I'm looking forward to a society in which there are more people on pot. Marijuana is not harmless. I have come to learn in AA that the strains of it commonly used today are far more dangerous than the stuff I took in my youth- it's apparently lined with chemicals that makes it stronger. Moreover, for people with chemical imbalances it can have a permanent destructive effect, and I have seen this personally. And not everybody who is chemically imbalanced knows they are.

Still, if it reduced the opioid crisis, I suppose it's a positive.
Click to expand...
I have zero problem with medicinal marijuana and only moderate issues with complete legalization (mass transit cars now horribly reek).  I just don’t see how it would do much for curing an opioid epidemic where people are largely dying from heroin and fentanyl.

 
jonessed said:
I’ve never been prescribed an opioid for anything but massive pain for a very short duration (like kidney stones).  I’m sure there are some with chronic pain that marijuana could help, but I doubt anyone being prescribed opioids for that chronic pain would be able to replace them with marijuana.  

Not unless these areas just have massive amounts of irresponsible doctors who prescribe opioids on a whim.  I know these doctors exist, but I can’t believe it’s a large number.  Especially given the current scrutiny this is getting.
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I agree, and my personal experience is the exact opposite. The one time I suffered great pain was, in fact, kidney stones, and the doctor was cautious and did not give me enough medicine to deal with it and I had to request more.

 
timschochet said:
I think it alleviates certain kinds of pain. I'm not sure it would be effective for the sort of serious pain that doctors prescribe pain-killers for. But I don't know.
Click to expand...
Anecdotal.  It is effective for arheumatoid arthritis sufferer I know.  She won't take opioids for RA - they aren't indicated anyway.  Hates to take the normal RA drugs because they damage liver, eyesight, etc.  Awful drugs - some are old chemotherapy drugs that found a new use.  She stays active and eats healthily and has kept it under reasonable control without the massive RA drug program.

Her rheumatologist tries to push the normal cocktail on her.  But is very hostile to cannabis when asked - she's well indoctrinated, and probably well compensated for pushing big pharma's line of products.  Her office looks like a chemotherapy center with folks taking infusions.  She's looking for a new doctor.

Amazing what a pain-reduced day followed by a good night's sleep can do going forward as well - breaks that cycle of pain.  Hard to sleep well when your hip and shoulder are hurting you.  Hard to heal and generally feel good when you can't sleep.

Our state legalized medical a few years back, but it has taken until now for them to get the licensing and logistics sorted out.  In that past it was tried during a visit to Colorado.  Went for the varietal that was low in the ingredient that makes you high but high in the ingredient that promotes pain relief.  Impressive relief was achieved.  This becomes another tool in the toolbox, along with diet, exercise, and certain traditional RA drugs in moderation.

 
timschochet said:
I agree, and my personal experience is the exact opposite. The one time I suffered great pain was, in fact, kidney stones, and the doctor was cautious and did not give me enough medicine to deal with it and I had to request more.
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I didn’t just have to request.  I had to get flat out angry.  They wanted me to sit around for a week to try and naturally pass a stone with little more than a supped-up Tylenol.  Screw that.

 
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timschochet said:
It's not that I'm looking forward to a society in which there are more people on pot. Marijuana is not harmless. I have come to learn in AA that the strains of it commonly used today are far more dangerous than the stuff I took in my youth- it's apparently lined with chemicals that makes it stronger. Moreover, for people with chemical imbalances it can have a permanent destructive effect, and I have seen this personally. And not everybody who is chemically imbalanced knows they are.

Still, if it reduced the opioid crisis, I suppose it's a positive.
Click to expand...
You have a very limited understanding of the current state of marijuana.  I would encourage you not to let your incomplete understanding make you afraid of it.  Learn more, then make a decision.

 
jonessed said:
I have zero problem with medicinal marijuana and only moderate issues with complete legalization (mass transit cars now horribly reek).  I just don’t see how it would do much for curing an opioid epidemic where people are largely dying from heroin and fentanyl.
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In the short term not much, but down the road it could possibly prevent future addictions.

 
jonessed said:
I didn’t just have to request.  I had to get flat out angry.  They wanted me to sit around for a week to try and naturally pass a stone with little more than a supped-up Tylenol.  Screw that.
Click to expand...
Had the opposite experience....My 28 year old son had gall bladder surgery...Surgeon prescribed 50 hydrocodone...Son took 4 the first 24 hours or so and that was all he needed...I had him give me the other 46 and eventually flushed them....

 
Ditka Butkus said:
In the short term not much, but down the road it could possibly prevent future addictions.
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It could, or it could just create other addictions.  It’s hard to know without extensive study.

Looking at the areas hit hardest by the opioid epidemic I have a hard time seeing how it can be solved by anything other than an economic revitalization plan.  

I think the opioids were just the easiest and cheapest thing to turn to when everything else fell apart.

 
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jonessed said:
It could, or it could just create other addictions.  It’s just hard to know without extensive study.

Looking at the areas hit hardest by the opioid epidemic I have a hard time seeing how it can be solved by anything other than an economic revitalization plan.  

I think the opioids were just the easiest and cheapest thing to turn to when everything else fell apart.
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To me it is sort of like gun control....If there is a chance it can make a difference...give it a try...You are right though, there is not just one solution...much like gun control.

 
Kratom seems to be a good start.  Of course the drug companies can't make a ton of money off of it, so it seems that they are waging war on it and trying to get it labeled an "illegal substance" via their pals in Washington DC.  It's really shocking how blatantly disgusting the pharma industry is in this country.

 
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The Commish said:
Kratom seems to be a good start.  Of course the drug companies can't make a ton of money off of it, so it seems that they are waging war on it and trying to get it labeled an "illegal substance" via their pals in Washington DC.  It's really shocking how blatantly disgusting the pharma industry is in this country.
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TBH I’ve never heard of this. Got some good reading material I could look at? 

 
timschochet said:
TBH I’ve never heard of this. Got some good reading material I could look at? 
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On the supplement or the politics of it all?  There's not a ton on the politics.  They try to keep these railroad jobs as quiet as possible.  But just google Kratom and there's a ton of stuff.  It's a tropical evergreen in the coffee family.  The key to your research is paying attention to the sources.  As I said before, it's not a drug yet and some want it to be a drug so it can be banned.  It's relatively new in terms of discovery and major studies haven't been done on it.  I have a friend with chronic fibromyalgia.  She's battled it since she was 13.  She was on opioids starting at 15.  Government took those away a year or so ago I believe?  Withdrawals from use for that period of time almost killed her.  Now she's working through replacements and this is the only light of hope she sees.  It's helped her like she could never have imagined.  

 
they need to attack the drug companies to start...I saw some incredible pieces on how the DOJ just let some of these drug companies off the hook when they knowingly and continue to deal an ungodly amount of pills with no red flags in their processes.  It starts with the drug companies because that's how most are hooked and stay hooked...they intentionally turn a blind eye while they line their pockets with enormous profits. 

https://www.vox.com/science-and-health/2018/1/30/16951316/opioid-epidemic-painkillers-west-virginia-shipments

 
Banger said:
they need to attack the drug companies to start...I saw some incredible pieces on how the DOJ just let some of these drug companies off the hook when they knowingly and continue to deal an ungodly amount of pills with no red flags in their processes.  It starts with the drug companies because that's how most are hooked and stay hooked...they intentionally turn a blind eye while they line their pockets with enormous profits. 

https://www.vox.com/science-and-health/2018/1/30/16951316/opioid-epidemic-painkillers-west-virginia-shipments
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Interesting that we're back to West Virginia again.

 
The Commish said:
Kratom seems to be a good start. 
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This kind of stuff goes back a long way.  Both MJ and absinthe were casualties of, largely, the alcohol industries.   For a long time stevia wasn't allowed thanks to sugar interests (funny how the health related concerns evaporated when natural sweeteners became in vogue).  Nothing new, nor a particular uniqueness to big pharma.

urbanhack said:
There has to be some reporting of doctors that is better monitored.   "X" number of prescriptions / number of patients.   Is this type of data centralized   and monitored in the first place to flag potential abuse?  I have no clue.
Click to expand...
This does have some big drawbacks.  If you're an oncologist who treats a lot of end stage patients those stats will look immediately fishy (though likely legit).  I distrust the government to handle this properly - they're largely just not competent to handle a database that has criminal consequences at the end of it.

 
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proteus126 said:
Anecdotal.  It is effective for arheumatoid arthritis sufferer I know.  She won't take opioids for RA - they aren't indicated anyway.  Hates to take the normal RA drugs because they damage liver, eyesight, etc.  Awful drugs - some are old chemotherapy drugs that found a new use.  She stays active and eats healthily and has kept it under reasonable control without the massive RA drug program.

Her rheumatologist tries to push the normal cocktail on her.  But is very hostile to cannabis when asked - she's well indoctrinated, and probably well compensated for pushing big pharma's line of products.  Her office looks like a chemotherapy center with folks taking infusions.  She's looking for a new doctor.

Amazing what a pain-reduced day followed by a good night's sleep can do going forward as well - breaks that cycle of pain.  Hard to sleep well when your hip and shoulder are hurting you.  Hard to heal and generally feel good when you can't sleep.

Our state legalized medical a few years back, but it has taken until now for them to get the licensing and logistics sorted out.  In that past it was tried during a visit to Colorado.  Went for the varietal that was low in the ingredient that makes you high but high in the ingredient that promotes pain relief.  Impressive relief was achieved.  This becomes another tool in the toolbox, along with diet, exercise, and certain traditional RA drugs in moderation.
Click to expand...
I just hope your friend understands that while the MJ may improve symptoms of her RA, as far as I know it does nothing to treat her RA. The ‘cocktails’ her rheumatologist prescribes are disease-directed.

 
My state has an online prescriber tool for controlled substances that allows them to see what was prescribed, who prescribed, and how many pills were dispensed. EMRs require you click a box that this report is reviewed prior to a controlled substance order. I know several other states also have this.

 
D_House said:
I just hope your friend understands that while the MJ may improve symptoms of her RA, as far as I know it does nothing to treat her RA. The ‘cocktails’ her rheumatologist prescribes are disease-directed.
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Yeah, that is understood.  RA is autoimmune-related and MJ won't fix that.

 
jonessed said:
Most heroin and fentanyl addicts are loathe to switch to marijuana before it goes through the proper state legal channels.
Click to expand...
lol 

but many people become addicted to opiods because it was prescribed to them by a doctor, they got hooked and then had to either fake problems to keep their script going or going to buying them illegally.

The reason legalized marijuana and medical marijuana can be important is that doctors can prescribe it instead of opiods in the first place. Certainly this won't end the problem but could lessen it. 

 
The Commish said:
On the supplement or the politics of it all?  There's not a ton on the politics.  They try to keep these railroad jobs as quiet as possible.  But just google Kratom and there's a ton of stuff.  It's a tropical evergreen in the coffee family.  The key to your research is paying attention to the sources.  As I said before, it's not a drug yet and some want it to be a drug so it can be banned.  It's relatively new in terms of discovery and major studies haven't been done on it.  I have a friend with chronic fibromyalgia.  She's battled it since she was 13.  She was on opioids starting at 15.  Government took those away a year or so ago I believe?  Withdrawals from use for that period of time almost killed her.  Now she's working through replacements and this is the only light of hope she sees.  It's helped her like she could never have imagined.  
Click to expand...
I have a relative who's in the middle of this battle and I've somehow never heard of this stuff.

Does it actually work?  Like, in conjunction with medical cannabis, could it fully replace the opioids? In your opinion, obviously, not going to hold you to it.

 
Henry Ford said:
I have a relative who's in the middle of this battle and I've somehow never heard of this stuff.

Does it actually work?  Like, in conjunction with medical cannabis, could it fully replace the opioids? In your opinion, obviously, not going to hold you to it.
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I haven't talked to her in a while.  I've just followed her on facebook the last few months, but she is not on opioids anymore.  She's been off over a year and still has days where withdrawals are unreal, but with this stuff, they are many fewer in number.  I can ask her what other meds she's on, if any.  I know what they gave her in place of the opioids did absolutely nothing for her.  She described it like a person being cut from head to toe for surgery and then giving them Tylenol to manage the pain.  Let me see if I can get more details.  

 
The Commish said:
I haven't talked to her in a while.  I've just followed her on facebook the last few months, but she is not on opioids anymore.  She's been off over a year and still has days where withdrawals are unreal, but with this stuff, they are many fewer in number.  I can ask her what other meds she's on, if any.  I know what they gave her in place of the opioids did absolutely nothing for her.  She described it like a person being cut from head to toe for surgery and then giving them Tylenol to manage the pain.  Let me see if I can get more details.  
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Thanks.  Relative is currently trying to use ibuprofen/acetaminophen combinations, and just in searing pain all the time.  I can't imagine some plant from Asia is going to seriously help, but if there's a chance I'll get it delivered to her tomorrow. 

 
Henry Ford said:
Thanks.  Relative is currently trying to use ibuprofen/acetaminophen combinations, and just in searing pain all the time.  I can't imagine some plant from Asia is going to seriously help, but if there's a chance I'll get it delivered to her tomorrow. 
Click to expand...
Fibromyalgia is a neuropathic pain disorder, so I’d research CBD over Kratom, since it would be a permanent medication for your relative.  The important compound in Kratom is mitragynine, which works utilizing opioid receptors so, based on my basic reading and understanding, there is still an addiction risk.  It appears it's not the huge addiction risk of other opioids, but considering the ongoing nature of her medication needs, CBD could be a better long-term choice. I can’t personally speak to the efficacy of both, but anecdotally, I find CBD very effective, if for much less serious pain, than what you two were discussing. I'm no expert, though, so take what I say with a grain of salt.

Basic info comparing the two. I don’t know the site, but the info seems legit

 
The Football Freak said:
Fibromyalgia is a neuropathic pain disorder, so I’d research CBD over Kratom, since it would be a permanent medication for your relative.  The important compound in Kratom is mitragynine, which works utilizing opioid receptors so, based on my basic reading and understanding, there is still an addiction risk.  It appears it's not the huge addiction risk of other opioids, but considering the ongoing nature of her medication needs, CBD could be a better long-term choice. I can’t personally speak to the efficacy of both, but anecdotally, I find CBD very effective, if for much less serious pain, than what you two were discussing. I'm no expert, though, so take what I say with a grain of salt.

Basic info comparing the two. I don’t know the site, but the info seems legit
Click to expand...
Cbd doesn’t seem to do the trick alone.  Cbd plus norco does though. 

 
Henry Ford said:
Cbd doesn’t seem to do the trick alone.  Cbd plus norco does though. 
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Oh. I'm sorry. There are terpenes that work synergistically with CBD and THC, that can increase the pain killing effects, if your family hasn’t already researched them. I don’t think it could replace norco, but maybe it could help on dosage.

 
The Football Freak said:
Oh. I'm sorry. There are terpenes that work synergistically with CBD and THC, that can increase the pain killing effects, if your family hasn’t already researched them. I don’t think it could replace norco, but maybe it could help on dosage.
Click to expand...
Thanks, she had picked up a jar from Amazon or some such. Without cannabinoids she takes 4-5 norco a day. With them she takes 1.  Just seeing if there’s an alternative. 

 
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