Trump and Opioid Crisis

GermanSuplex

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Aug 26, 2009
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He mixed ad-libs and prepared speech with his thoughts on not just opioids, but also drugs in general.

He did a good job. He mentioned his brother, and maybe it’s the personal effect on him that was the source of sincerity. He may have been a good president if he could relate to everyone, rather than his rabid base, racists and his donors.

Great speech, but also a hole in veil of sincerity.

On topic, he hasn’t really handed any legislation for the opioid crisis. Every state, county, city and local PD should have the pen-drugs to revive overdose victims. It should also be as cheap as aspirin.
 

LIVEFRMNYC

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Oct 27, 2009
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Lets see if he actually implements everything he mentioned. Especially when speaking of non-opioid pain medication, which I'm 100% in favor of.

But he didn't declare a national public health emergency, which would have instantly gave him a budget of billions. So where is he going to get the money from?
 
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vrDrew

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All true.

But the reality is that the opioid crisis in the United States is a direct result of US health care policy. The health care system in the US chooses to treat pretty much any health issue with opioids, rather than the more holistic approach that the health systems in places like the UK, France, Germany, Japan, etc. do.

Middle-aged Americans don't get, or can't afford, decent primary care. When they finally present, their doctors cannot spend the time or the money to deal with their obesity, their Type-2 diabetes, or their crumbling bones and ragged joints. So they prescribe opioids to make the pain go away.

Is it any wonder that literally tens of thousands of them end up killing themselves. With oxycodone. With Fentanyl. If they don't blow their brains out with one of the dozen guns they've got stashed under their mattresses first.

Fox News has killed more middle-aged white Americans than al-Quaeda and Kin Jong-Un could dream of doing in a thousand years.
 

LIVEFRMNYC

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Oct 27, 2009
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All true.

But the reality is that the opioid crisis in the United States is a direct result of US health care policy. The health care system in the US chooses to treat pretty much any health issue with opioids, rather than the more holistic approach that the health systems in places like the UK, France, Germany, Japan, etc. do.
I been in plenty of accidents in my life time, some critical with long recoveries, and been through rough internal health issues as well. I know what pain feels like, and there's plenty of people that deal with far worst pain than I'll ever know. I've been prescribed opioid meds before but never took it, so I personally don't know how powerful they are.

Being that said ...Is there actually non-opioid pain treatments that work just as good? Because from the perceptive of many dealing with severe pain on a daily basis, taking away their opioid medications is not an option. I just don't want to see the ones that truly need now finding it near impossible to get.
 

vrDrew

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Being that said ...Is there actually non-opioid pain treatments that work just as good? Because from the perceptive of many dealing with severe pain on a daily basis, taking away their opioid medications is not an option. I just don't want to see the ones that truly need now finding it near impossible to get.
Opioid-based medications are remarkably effective at relieving severe pain. The pain from traumatic injury, as well as the chronic pain of diseases like cancer. There really aren't too many effective alternatives. And, if properly managed, opioids such as fentanyl and morphine needn't become addictive or pose a risk for overdose, especially in cases such as palliative cancer care.

The problem is, there are many medical conditions, such as chronic back and joint pain, that would have much better outcomes if average Americans had better, easier, and cheaper access to effective primary care. An annual physical, with a course of exercise, diet, and physical therapy, with regular follow-up care - at no out-of-pocket cost to the patient - is, in the long run, far cheaper and more effective, than waiting till the patient presents, in agony, with the spinal cartilage destroyed and the vertebrae crumbling.

Americans peculiar model of health insurance coverage, with very steep deductibles and co-pays, means that many ordinary people put off seeing a physician. Even people with "good" private health insurance will have to pay - out of pocket - a thousand or two thousand dollars for an office visit, a referral or two, a course of medication and a period of physical therapy. People in Germany, France, Britain, and just about every other advanced economy simply do not have that sort of out-of-pocket cost for treatment.
 

sim667

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Dec 7, 2010
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There was a great documentary shown about heroin use in the a US town shown recently on UK tv....... It was one of the new louis theroux series. Worth a watch. It seems a lot of the time usage stems for pain relief drugs perscribed in the US and wreckless use of opioids by US healthcare, thats not to say that there weren't other factors.

 

samcraig

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Jun 22, 2009
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For once, I thought he did an OK job speaking. However, unless real money is put towards this, some of it is just rhetoric. Treatment is not cheap and the budget allotted right now is small. He should be so condemning of other issues.
 

VulchR

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Jun 8, 2009
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Opiates are good for treating acute post-surgical pain and other forms of severe pain (in particular pain at the end of life from cancer etc.). They aren't so good for treating chronic pain because the patient becomes tolerant to them and also they have the obvious drawback of being addictive (and other side effects as well). I think the first step in combating this problem is to allow all the opiate addicts who became addicted from prescription opiates to sue the doctors, the drug companies, and the managers of those companies into the stone age for the harm that they wilfully caused. Go after them like you would if they were illegal drug dealers.

The second thing that needs to be done is to coordinate a government effort on a massive scale. Simply providing more treatment places won't do the trick, because treatment as it currently stands is only marginally effective. Thus, the government's response should include funding additional research (full disclosure: I am a neuroscientist who once did addiction research). The problem is that much of what we know about the brain processes in addiction arise from studies of psychostimulants like cocaine and amphetamine. This is because the US government funded huge numbers of studies during the cocaine epidemic (and also using psychostimulants in studies of animal model of addiction is more humane, since psychostimulants, unlike opiates, rarely result in overdose and also they do not cause physical withdrawal symptoms). We had assumed that the mechanisms of addiction boil down to the same neural pathway no matter what the drug (or activity, such as gambling). That is true to some extent, but there are differences in how different drugs change the structure and function of brain areas. It seems now that these differences are important, yet we know little about them. Hopefully, both Trump and Congress will get serious about this and do a little talking to NIDA.
 

Zombie Acorn

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Lets see if he actually implements everything he mentioned. Especially when speaking of non-opioid pain medication, which I'm 100% in favor of.

But he didn't declare a national public health emergency, which would have instantly gave him a budget of billions. So where is he going to get the money from?
Pretty sure that emergency budget is depleted from hurricane response.

https://www.google.com/amp/abcnews.go.com/amp/Health/wireStory/latest-trump-declare-opioid-public-health-emergency-50732977

Pelosi asked where the money is, apparently she forgot what her job is.

Democrats are still use to king Obama flowing cash without going through congress, here's how it works when the pre-existing funds dry up:

1) President sets a focus in his agenda.
2) Congress passes a bill to appropriate funds.
3) President allocates fund to his agenda.

Do your ****ing job.
 
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samcraig

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Jun 22, 2009
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Pretty sure that emergency budget is depleted from hurricane response.

https://www.google.com/amp/abcnews.go.com/amp/Health/wireStory/latest-trump-declare-opioid-public-health-emergency-50732977

Pelosi asked where the money is, apparently she forgot what her job is.

Democrats are still use to king Obama flowing cash without going through congress, here's how it works when the pre-existing funds dry up:

1) President sets a focus in his agenda.
2) Congress passes a bill to appropriate funds.
3) President allocates fund to his agenda.

Do your ****ing job.
Oh I don't know - I don't blame Rs or Ds in congress too much on trying to figure where money is going to come from since Trump's budget is a hot mess. It's a valid question regardless of who is appropriating. Perhaps the more semantically correct question is - where is the money going to come from. You know - since Trump was all about FEMA budget cuts..
 

oneMadRssn

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Note that the opioid crisis is the worst in coal mining areas. Coincidence that one of the the worst jobs imaginable produces a whole bunch of injured people that need pain killers? And these are the jobs Trump wants to save?
 

vrDrew

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Note that the opioid crisis is the worst in coal mining areas.
I noted in a prior thread: America just doesn't care that much about its people anymore.

If you are injured, or middle-aged and unemployed, or obese - then the Government doesn't really care about you. It'll pay you a disability or unemployment check to make you go away. And rather than give you access to a healthcare system that gets you fit again - because that would cost real money - it gives you a script for Fentanyl. Because that's cheap.

The Conservative Machine tells Americans in places like W. Virginia it "cares" about them. It cares enough to let them have as many guns as they want. It "cares" enough to kill thousands of Arabs and Muslims halfway round the world (spending a trillion or two in the process.) It "cares" enough to get tough on black people who live in cities. Or Hispanic people who live in Arizona. It 'cares" enough to make sure millionaire black athletes pay suitable patriotic respect at NFL games.

But for some strange reason, all that doesn't seem to be doing the people in Apalachia and the rest of flyover working class white America that much good.
 
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Zombie Acorn

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Oh I don't know - I don't blame Rs or Ds in congress too much on trying to figure where money is going to come from since Trump's budget is a hot mess. It's a valid question regardless of who is appropriating. Perhaps the more semantically correct question is - where is the money going to come from. You know - since Trump was all about FEMA budget cuts..
Trump's budget? You realize that Congress passes that too right?
 

poloponies

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May 3, 2010
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I been in plenty of accidents in my life time, some critical with long recoveries, and been through rough internal health issues as well. I know what pain feels like, and there's plenty of people that deal with far worst pain than I'll ever know. I've been prescribed opioid meds before but never took it, so I personally don't know how powerful they are.
I have an exceptionally high threshold of pain but had one experience where the pain was simply beyond "11." One shot of morphine made me immediately realize how people could get hooked. I went from agonizing, unbearable pain where I couldn't find a position that would make me comfortable to almost immediate comfort. I got 30 tablets of Norco after another incident, took 2 on the first day and then had my wife hide the bottle, just in case.
 
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Septembersrain

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It's frustrating because people like me with chronic pain can't even get opioids legally. So that's leading to many trying dangerous substances instead. This crackdown is only going to make the black market more lucrative.

We need an alternative to these medications and the only one I know of, it's not legal everywhere. Not yet anyways.
 

LIVEFRMNYC

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It's very good to have on hand if you've got anyone you know in drugs like heroin, fentanyl, etc.

My fiancee buys it from his own pocket because his department doesn't want to pay for that.

Oh okay, so it's a last resort measure, like a defibrillator. I was thinking for a moment it's was some sort of replacement drug like methadone.
 

Septembersrain

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Oh okay, so it's a last resort measure, like a defibrillator. I was thinking for a moment it's was some sort of replacement drug like methadone.
Copied from a website:

"Narcan (naloxone) is an opiate antidote. ... When a person is overdosing on an opioid, breathing can slow down or stop and it can very hard to wake them from this state. Narcan (naloxone) is a prescription medicine that blocks the effects of opioids and reverses an overdose. It cannot be used to get a person high."
 

A.Goldberg

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Walgreens to begin selling Narcan over the counter




Good or Bad decision? I know nothing about Narcan.
Oh okay, so it's a last resort measure, like a defibrillator. I was thinking for a moment it's was some sort of replacement drug like methadone.
No, Narcan is basically the opposite of an opioid and almost immediately reverses the effect of such drugs. Speaking literally now, if someone is overdosed on something like heroin or oxycoodne, a defibrillator would be of little use in resuscitating the person without also having Narcan on hand. It’s the most effective tool in combating acute overdoses and is responsible for saving thousands of lives every year. The greater accessibility, the better, in my opinion (which is why I volunteer training communities on Narcan administration).

Many states now allow for Narcan to be purchased without a prescription. For example, here in Massachusetts there’s basically a standing order so anyone can go to a pharmacy and automatically have a prescription available. Personally I think this is a better system than simply than selling it OTC. If it’s sold as a prescription then at least there is the chance of it being covered by private insurance (private insurance generally do not cover OTC drugs). Also, having to process it as a prescription hopefully ensures training/dialogue between the pharmacist and purchaser. If sold OTC, there’s also a greater chance of companies like Walgreens profit excessively... profit on OTC drugs tends to be quite high compared to Rx.

There’s 3 publicly available nalaxone products on the market- generic nalaxone with an atomizer kit (cheapest option but requires assembly and training- it’s a pretty crappy option), brand name a Narcan (much more expensive, I think around $120, but requires no assembly), and Evzio (most expensive $1000+, intramuscular autoinjector- much like an epipen). Insurance coverage increases the chances the better products will be obtained. That said, these products can be obtained for free from in a lot of states if you know where to go.

There is some controversy, granted from a small population, that increasing Narcan accessibility is “bad” because it somehow “encourages” drug use... supposedly creating an expectation that opioid abusers can be easily saved from overdose. This is an absurd argument. Drug abusers don’t tend to worry themselves with consequences of drug use- otherwise it would be a lot easier to stop. It’s not like Narcan is going to be self-administered either (kinda hard to administer it when you’re unconscious).
 
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Zenithal

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If I'm not mistaken, isn't the immediate reversal from the naloxone incredibly painful? I seem to recall cardiac arrest being a common issue with those who have innate health issues involving their cardiovascular system.
 

Septembersrain

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If I'm not mistaken, isn't the immediate reversal from the naloxone incredibly painful? I seem to recall cardiac arrest being a common issue with those who have innate health issues involving their cardiovascular system.
It's a risk that will be taken if the outcome is they'll die anyways.

That's what I think anyways.
 
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