Current Events > Why is Big Pharma to blame for the opioid epidemic? (Serious post)

(+) Yeah! (+)

What are they doing to promote the use of opioids? Seems to me like if anything it would be doctor's fault for prescribing pain killers for silly things which leads people to get hooked. I had a kidney stone about 3 years ago and without painkillers I would have been in agony for about 3 straight weeks till I passed it. So to me simply making the medicine isn't enough to blame the, but I'm also not entirely knowledgeable on what big pharma has done so that's why I'm asking.
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justaguy3492 posted...

Seems to me like if anything it would be doctor's fault for prescribing pain killers for silly things which leads people to get hooked.

And guess what the root cause of that is...
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Big Pharma said opioids werent addictive and commissioned studies to say as much. They knew this was false.

Doctors relied on these and over prescribed them.
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I still don't understand how they convinced anyone they weren't addictive. I don't buy that line. They're called opioids, everyone knows opium/heroin is extremely addictive.
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Because it is the medicine that works and is readily available - it is just easy to become addicted too and is often little support to wean people off of it properly.
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Doctors are basically indoctrinated by Big Pharma. That's a huge chunk of the curriculum, while much less emphasis is put on things that really matter (such as proper nutrition and exercise).

Of course there's all the funding and kickbacks received for pushing certain drugs as well. Less morally sound doctors would certainly take advantage of that all they could. Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.
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KiwiTerraRizing posted...

Big Pharma said opioids werent addictive and commissioned studies to say as much. They knew this was false.

Doctors relied on these and over prescribed them.

Makes sense, though I have to wonder how any doctor could believe such a study. I mean opium has been historically addictive well before it was turned into a pill. Seems like the doctors would have to be willfully ignorant.

shockthemonkey posted...

get kickbacks for prescribing pills

This is beyond fucked up and any rep and doctor found guilty of this should sit in jail for a loooooooong time, but is there any evidence to suggest that this is a regular practice in the medical world?

Again I'm not trying to argue with anyone, I just want to understand the complete argument of why it's pharma's fault.
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Ultima Dragon posted...

Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.

That is true. It is often given out too freely - either from patients exaggerating their pain, or doctors simply being too indifferent to say no/try something else. Or just from targets they need to meet/whatever drug company related reason you want.
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Ultima Dragon posted...

Doctors are basically indoctrinated by Big Pharma. That's a huge chunk of the curriculum, while much less emphasis is put on things that really matter (such as proper nutrition and exercise).

Of course there's all the funding and kickbacks received for pushing certain drugs as well. Less morally sound doctors would certainly take advantage of that all they could. Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.

You've never suffered a real injury then. You try recovering from a broken back without opiods. Try recovering from an mcl or acl tear without them. Try recovering from an abscessed tooth or dry socket without them.

There are many, many legit reasons for them. I should be on them right now due to an mcl tear and as of yesterday a groin pull and whiplash but Thailand is insanely against opiods, especially things like morphine or percs. I was given tramadol which is probably one of the weakest pain killers in the opiod family and they are doing fuck all for the pain and that's combined with muscle relaxers, anti-inflammatories and self medication.
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MuayThai85 posted...

Ultima Dragon posted...

Doctors are basically indoctrinated by Big Pharma. That's a huge chunk of the curriculum, while much less emphasis is put on things that really matter (such as proper nutrition and exercise).

Of course there's all the funding and kickbacks received for pushing certain drugs as well. Less morally sound doctors would certainly take advantage of that all they could. Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.

You've never suffered a real injury then. You try recovering from a broken back without opiods. Try recovering from an mcl or acl tear without them. Try recovering from an abscessed tooth or dry socket without them.

There are many, many legit reasons for them. I should be on them right now due to an mcl tear and as of yesterday a groin pull and whiplash but Thailand is insanely against opiods, especially things like morphine or percs. I was given tramadol which is probably one of the weakest pain killers in the opiod family and they are doing fuck all for the pain and that's combined with muscle relaxers, anti-inflammatories and self medication.

I mean there are weak reasons too. I had a root canal done and the dentist, before asking me, prescribed me a painkiller (albeit a weaker one). I ended up not using them due to not needing it, but it's that level of carelessness that could have presented me with a problem.
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justaguy3492 posted...

This is beyond fucked up and any rep and doctor found guilty of this should sit in jail for a loooooooong time, but is there any evidence to suggest that this is a regular practice in the medical world?

Yeah: It's not illegal. Just a few years ago, a law was put into place that required disclosure of the kickbacks, but up until that point they didn't have to disclose it. And it's still not illegal for doctors to take kickbacks. You're getting into an issue that has had people concerned for a long time, to which there has been very little done about the problem.

You have uneducated people listening to the advice of someone who is more educated, and supposedly ethical, but doctors are allowed to be influenced by drug companies through money in order to push certain drugs to the consumer. This in turn creates massive profit for the drug companies, which then turn around and influence more doctors to prescribe their drugs.
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It was OxyContin that big pharma was pushing as a "non-addictive" substitute because it was a time-release formulation. They very heavily canvassed doctors with their new product, played up the abuse-resistance of the time-release formula, and strongly encouraged medical professionals to prescribe it for things previously considered too minor for opioids. They then completely ignored all the reports that started coming out shortly after that people were using multiple different methods to defeat the time-release mechanism, and the reports that came out shortly after those showing that it was still very abusable and addictive when taken normally. And now that millions of people are hooked, cheap Fentanyl ordered over the internet from labs in China is taking over to replace the demand for Oxys as they are finally becoming harder to get.
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justaguy3492 posted...

MuayThai85 posted...

Ultima Dragon posted...

Doctors are basically indoctrinated by Big Pharma. That's a huge chunk of the curriculum, while much less emphasis is put on things that really matter (such as proper nutrition and exercise).

Of course there's all the funding and kickbacks received for pushing certain drugs as well. Less morally sound doctors would certainly take advantage of that all they could. Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.

You've never suffered a real injury then. You try recovering from a broken back without opiods. Try recovering from an mcl or acl tear without them. Try recovering from an abscessed tooth or dry socket without them.

There are many, many legit reasons for them. I should be on them right now due to an mcl tear and as of yesterday a groin pull and whiplash but Thailand is insanely against opiods, especially things like morphine or percs. I was given tramadol which is probably one of the weakest pain killers in the opiod family and they are doing fuck all for the pain and that's combined with muscle relaxers, anti-inflammatories and self medication.

I mean there are weak reasons too. I had a root canal done and the dentist, before asking me, prescribed me a painkiller (albeit a weaker one). I ended up not using them due to not needing it, but it's that level of carelessness that could have presented me with a problem.

If you find yourself addicted to opiod painkillers in the amount a dentist would prescribe after a root canal (20 to 30 at absolute most) then you have problems already.

I broke my back. I was taking 150-180 percocets per month for over 6 months. That was near impossible to avoid becoming dependent on them.

But I've also been prescribed opiod pain killers for broken bones, wisdom tooth extractions, and a few other sports related injuries. I wasn't given an open prescription like I was with my back any other time was small prescriptions (largest I got was 30 with no refills). Never got hooked to them.

You're not going to get affected by taking them for a few days or even a few weeks, it'll take longer than that to build an addiction.
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synth_real posted...

It was OxyContin that big pharma was pushing as a "non-addictive" substitute because it was a time-release formulation. They very heavily canvassed doctors with their new product, played up the abuse-resistance of the time-release formula, and strongly encouraged medical professionals to prescribe it for things previously considered too minor for opioids. They then completely ignored all the reports that started coming out shortly after that people were using multiple different methods to defeat the time-release mechanism, and the reports that came out shortly after those showing that it was still very abusable and addictive when taken normally. And now that millions of people are hooked, cheap Fentanyl ordered over the internet from labs in China is taking over to replace the demand for Oxys as they are finally becoming harder to get.

I can't believe they said oxycontin wasn't addicting because of the extended release. Dumbest shit ever. Though oxycontin was never very easy for me to get. Roxicodone was the main.
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ChainedRedone posted...

synth_real posted...

It was OxyContin that big pharma was pushing as a "non-addictive" substitute because it was a time-release formulation. They very heavily canvassed doctors with their new product, played up the abuse-resistance of the time-release formula, and strongly encouraged medical professionals to prescribe it for things previously considered too minor for opioids. They then completely ignored all the reports that started coming out shortly after that people were using multiple different methods to defeat the time-release mechanism, and the reports that came out shortly after those showing that it was still very abusable and addictive when taken normally. And now that millions of people are hooked, cheap Fentanyl ordered over the internet from labs in China is taking over to replace the demand for Oxys as they are finally becoming harder to get.

I can't believe they said oxycontin wasn't addicting because of the extended release. Dumbest shit ever. Though oxycontin was never very easy for me to get. Roxicodone was the main.

Well, they did have studies that showed it to be a little less addictive that just straight oxycodone (the "Contin" is the time-release mechanism) which gave them just barely enough substantiation to make that claim
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Because they lobbied the FDA to keep it legal. Because they paid doctors to prescribe it even though it was WAY too strong. Because they lied to insurance companies to push through prior approvals.

Because they did lots of super shady shit like this to keep scripts up and addicts hooked.
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They have their part, but I'd blame doctors and lawyers before the drug makers.
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Funkydog posted...

Ultima Dragon posted...

Opioids have been prescribed for some pretty damn weak reasons. Should pretty much be used for cancer pain/to help dying patients cope a little easier and that's it.

That is true. It is often given out too freely - either from patients exaggerating their pain, or doctors simply being too indifferent to say no/try something else. Or just from targets they need to meet/whatever drug company related reason you want.

After my double hernia surgery I could barely even stand and the slightest shift caused pain. In addition I had severe shoulder pain as a side effect of the anesthesia. Also going to the bathroom was difficult. Literally took 30 minutes plus and anything more than the slightest muscle movement to urinate caused deep pain. I had to very gradually "coax the urine" with small movements until I was able to get a stream going and hopefully maintain it till my bladder was empty.

It was a painful and depressing process and no way Tylenol would've gotten me through the first few days.

Without the Oxycodone I definitely would not have been able to fall asleep and going up the stairs would have been more painful and dangerous. And sleep deprivation is not a good for recovering from surgery.

That said I took it for the absolute minimum time possible. About 5 days I took it.

As soon as I gauged I would be able to cope with the pain on normal pain killers (Tylenol/ibuprofen) I stopped taking that stuff because I know the dangers of addiction and also because they made me apathetic, tired and gave me on and off moderate to severe light headedness.

Use them after major surgery but rely on them to the minimum possible.
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justaguy3492 posted...

What are they doing to promote the use of opioids? Seems to me like if anything it would be doctor's fault for prescribing pain killers for silly things which leads people to get hooked. I had a kidney stone about 3 years ago and without painkillers I would have been in agony for about 3 straight weeks till I passed it. So to me simply making the medicine isn't enough to blame the, but I'm also not entirely knowledgeable on what big pharma has done so that's why I'm asking.

There were a bunch of peer reviewed studies published in the late 2000's with no alleged affiliation to Big Pharma that documented a major underprescribing of narcotic analgesics to patients. Doctors were essentially afraid of causing addiction and an epidemic, but pain was being severely undermanaged and resulted in numerous healthcare costs, especially for chronic issues like extended hospital stays, delayed recovery from surgeries, and recurrent visits for pain. And this was an actual thing. Doctors were really afraid to write opioids for anything outside of inpatient surgery because nobody wants to create or deal with an addict.

Then some reviews came out and there was a huge push to manage pain. Especially when medical literature and hospitals started treating "pain as the fifth vital sign" and there was this ridiculous push to treat pain aggressively. It's not just physicians or big pharma. It's a bit of everything, including peer reviewed medical literature and a massive push to remove the stigma of prescribing narcotics. It kinda backfired....
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MrPeppers posted...

justaguy3492 posted...

What are they doing to promote the use of opioids? Seems to me like if anything it would be doctor's fault for prescribing pain killers for silly things which leads people to get hooked. I had a kidney stone about 3 years ago and without painkillers I would have been in agony for about 3 straight weeks till I passed it. So to me simply making the medicine isn't enough to blame the, but I'm also not entirely knowledgeable on what big pharma has done so that's why I'm asking.

There were a bunch of peer reviewed studies published in the late 2000's with no alleged affiliation to Big Pharma that documented a major underprescribing of narcotic analgesics to patients. Doctors were essentially afraid of causing addiction and an epidemic, but pain was being severely undermanaged and resulted in numerous healthcare costs, especially for chronic issues extended hospital stays, delayed recovery from surgeries, and recurrent visits for pain. And this was an actual thing. Doctors were really afraid to write opioids for anything outside of inpatient surgery because nobody wants to create or deal with an addict.

Then some reviews came out and there was a huge push to manage pain. Especially when medical literature and hospitals started treating "pain as the fifth vital sign" and there was this ridiculous push to treat pain aggressively. It's not just physicians or big pharma. It's a bit of everything, including peer reviewed medical literature and a massive push to remove the stigma of prescribing narcotics. It kinda backfired....

So they didn't do enough for pain but they than overcompensated for that is the gist of it?
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justaguy3492 posted...

This is beyond fucked up and any rep and doctor found guilty of this should sit in jail for a loooooooong time, but is there any evidence to suggest that this is a regular practice in the medical world?

Again I'm not trying to argue with anyone, I just want to understand the complete argument of why it's pharma's fault.

I wouldn't listen too much to garbage like this. There has been so much crackdown on kickbacks. This isn't the 80's anymore. Doctors can't get away with shit like this and aren't allowed to get anything beyond a free lunch or something less than $50 in value whenever reps visit. And all of it's tracked to your DEA (unique prescribing number) so licensing boards know who receives compensation from a drug company. And if you think under the table stuff flies on any appreciable level, you're feeding into your delusions. Reps mostly give free samples which are invaluable for patients who have bad/no insurance and need some sort of medication (not just for pain). That's where their power in visiting lies nowadays: free samples.

And if you're a hospitalist or work at a university or research hospital (institutions that pushed for pain control the hardest) then there are no reps period that try to sell to you because you're autonomy as a physician is non-existent when it comes to administrative decisions.

Yeah, of course there are bad doctors who still in this day and age somehow manage to indulge in kickbacks and are added to payrolls of pharmaceutical companies to advocate their drug. But that information for the latter is public and it is by far the exception and no longer the rule.
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That's what you get for not having a free healthcare system in which the state are in control of what and how much drugs doctors are giving to patients.