They don't call them drugstores for nothing
March 26, 2020 6:38 PM Subscribe
Walmart was almost charged criminally over opioids. Trump appointees killed the indictment.Walgreens, Rite-Aid, and CVS are also being sued.
Please don't. The sick and disabled are going through enough right now with the rich salivating over their deaths. We don't need to reopen this "Big Pharma are drug pushers" line right now further harm people who need access to these meds.
1 war front against the disabled is enough, thx.
posted by symbioid at 7:28 PM on March 26, 2020 [15 favorites]
1 war front against the disabled is enough, thx.
posted by symbioid at 7:28 PM on March 26, 2020 [15 favorites]
Yeah- my dad was in the hospital over Hannukah due to a fall- yadda yadda yadda-needed 5 bags of blood- yadda yadda yadda- kinda a big deal- he came home, and in January while recovering he threw his back out- happens from time to time, he has a shit back with some shit vertebrae. Getting fucking 7 goddamn tramadol as prescribed by his doctor was a fucking nightmare. He couldn't go to the pharm- he just got back from the frigging ICU- mom has a cataract and can't drive- I had to stop by after fucking work for 7 measly pills for an elderly disabled man and was treated like a fucking criminal for the 7 pills that would keep my fucking father from having to go back to the ER. There has to be a middle ground between "oh you stubbed your toe here's 100 pills" and "Oh you've been shot? well you look like a dirty pill head to me (because of your class or color) - take a tylenol and if you complain I'll blacklist you from every ER."
2nding symbioid here.
posted by Homo neanderthalensis at 7:41 PM on March 26, 2020 [31 favorites]
2nding symbioid here.
posted by Homo neanderthalensis at 7:41 PM on March 26, 2020 [31 favorites]
Mod note: One deleted. If you want to be here, just make your points, don't frame them as digs at other people in the conversation or putting words in other people's mouths.
posted by LobsterMitten (staff) at 7:44 PM on March 26, 2020 [1 favorite]
posted by LobsterMitten (staff) at 7:44 PM on March 26, 2020 [1 favorite]
My wife needed heavy opioid doses to get through many years of chronic pain, and still does on occasion. With that said, both she and I agree that big pharma are, quite literally, drug pushers. That's not all they are, but they are that. There is no tension between the beliefs that (a) these are important drugs that can help alleviate pain when most other things don't, and (b) there are people involved with the production and distribution of these drugs who are happy to over-prescribe them to make a buck.
I personally had to deal with being treated like an enabler with all of the escalating requirements / restrictions when I would pick up my wife's scrips until I could no longer do so, and then she had to, and then she had a much harder time getting them... All of this despite a great and compassionate physiatrist and nursing staff who knew for certain she wasn't abusing them.
And yet, these companies, and some doctors, are complicit in a monstrous conspiracy to harm people in pursuit of profit. Both topics are worthy of discussion, and both should be acceptable to discuss in this thread.
posted by tonycpsu at 8:42 PM on March 26, 2020 [11 favorites]
I personally had to deal with being treated like an enabler with all of the escalating requirements / restrictions when I would pick up my wife's scrips until I could no longer do so, and then she had to, and then she had a much harder time getting them... All of this despite a great and compassionate physiatrist and nursing staff who knew for certain she wasn't abusing them.
And yet, these companies, and some doctors, are complicit in a monstrous conspiracy to harm people in pursuit of profit. Both topics are worthy of discussion, and both should be acceptable to discuss in this thread.
posted by tonycpsu at 8:42 PM on March 26, 2020 [11 favorites]
Please don't. The sick and disabled are going through enough right now with the rich salivating over their deaths. We don't need to reopen this "Big Pharma are drug pushers" line right now further harm people who need access to these meds.
Seconding this. I still feel a hole in the pit of my stomach when I think about having had major surgery and bumping up against a level of paranoia from staff that would surface when I would request lower level opioid pain meds while in the hospital. All of the literature that the hospital sent me beforehand talked about how their primary goal was to make sure that their patients were as pain-free as possible during their stay. It was a relief to me, as I had a major fear of surgery. After surgery and in the hospital, I was in pain. I asked for a pain pill. They asked me how bad my pain was. Knowing the accuracy of the scale somewhat and how people exaggerate it, I said something like 7 (as I lay there right after surgery with a major neck incision). They said that if I didn't report at last an 8, they were not authorized to give me anything. And I was seriously like W.T.F. How is that even close to a pain free philosophy? I'm realistic about whether that's even possible, but I was pissed. And I reported an 8 so that I didn't have to suffer, and it was one pill every four hours, even though it was not fully effective. EVERY TIME they gave me one, they had to access a locked cabinet and dispense them like communion wafers, and I could TELL that they were hesitant every time they had to give me one. So now instead of feeling as if I had a great deal of respect for how my primary hospital said that they were going to handle pain management, I think they are lying liars who say one thing in their literature, and practice something else entirely when it becomes vital. If I ever need surgery again, I'm going to view this hospital as being stingy and fearful of litigation to the extent that they compromise the comfort of their client . I have no idea how to balance all of this with the opiod epidemic, but the very real result is that I am going to avoid surgery at all cost rather than do it with this network (and maybe others, as it seems like the whole world is going crazy) again, and I'm pretty sure that isn't what they had in mind when they started limiting pain meds.
posted by SpacemanStix at 9:18 PM on March 26, 2020 [23 favorites]
Seconding this. I still feel a hole in the pit of my stomach when I think about having had major surgery and bumping up against a level of paranoia from staff that would surface when I would request lower level opioid pain meds while in the hospital. All of the literature that the hospital sent me beforehand talked about how their primary goal was to make sure that their patients were as pain-free as possible during their stay. It was a relief to me, as I had a major fear of surgery. After surgery and in the hospital, I was in pain. I asked for a pain pill. They asked me how bad my pain was. Knowing the accuracy of the scale somewhat and how people exaggerate it, I said something like 7 (as I lay there right after surgery with a major neck incision). They said that if I didn't report at last an 8, they were not authorized to give me anything. And I was seriously like W.T.F. How is that even close to a pain free philosophy? I'm realistic about whether that's even possible, but I was pissed. And I reported an 8 so that I didn't have to suffer, and it was one pill every four hours, even though it was not fully effective. EVERY TIME they gave me one, they had to access a locked cabinet and dispense them like communion wafers, and I could TELL that they were hesitant every time they had to give me one. So now instead of feeling as if I had a great deal of respect for how my primary hospital said that they were going to handle pain management, I think they are lying liars who say one thing in their literature, and practice something else entirely when it becomes vital. If I ever need surgery again, I'm going to view this hospital as being stingy and fearful of litigation to the extent that they compromise the comfort of their client . I have no idea how to balance all of this with the opiod epidemic, but the very real result is that I am going to avoid surgery at all cost rather than do it with this network (and maybe others, as it seems like the whole world is going crazy) again, and I'm pretty sure that isn't what they had in mind when they started limiting pain meds.
posted by SpacemanStix at 9:18 PM on March 26, 2020 [23 favorites]
Before my psych had online prescriptions for Schedule II I had to go through the rigmarole of trying to get Adderall with an out of state prescription. It was a god damned wonder drug for helping with my antidepressants but going through the process of actually obtaining it was a nightmare.
I should find an in-state psych but I've had him for nearly 8 years. We have a really good working relationship and he's always about ideas and trying stuff to make my life better. One shouldn't ever move away from a psych that works for them but I was almost forced to choose between him and how much better I was doing with Adderall added to my antidepressant combination.
I long for the day when addiction is a public health issue instead of criminal. Yes, some people can't handle their medication and their addictions but a lot of these drugs do so much good for so many people. To deny that public good because our policymakers can't think of abuse as a public health issue rather than individual failings is cutting off our nose to spite our faces.
posted by Your Childhood Pet Rock at 9:31 PM on March 26, 2020 [8 favorites]
I should find an in-state psych but I've had him for nearly 8 years. We have a really good working relationship and he's always about ideas and trying stuff to make my life better. One shouldn't ever move away from a psych that works for them but I was almost forced to choose between him and how much better I was doing with Adderall added to my antidepressant combination.
I long for the day when addiction is a public health issue instead of criminal. Yes, some people can't handle their medication and their addictions but a lot of these drugs do so much good for so many people. To deny that public good because our policymakers can't think of abuse as a public health issue rather than individual failings is cutting off our nose to spite our faces.
posted by Your Childhood Pet Rock at 9:31 PM on March 26, 2020 [8 favorites]
Sorry, should have used a different title as the point really is more the Trump admin once again inserting itself into the justice system.
posted by blue shadows at 9:49 PM on March 26, 2020 [3 favorites]
posted by blue shadows at 9:49 PM on March 26, 2020 [3 favorites]
have some experience using opiates in healthcare setting and elsewhere.
am strongly in favor of their availability for treatment and management of pain.
am moderately in favor of occasional careful recreational use. ymmv.
would like to grow the flowers and make tea. carefully. in moderation.
as long as we're going after everyone in the supply-line with torches and pitchforks, i think we ought to spare some attention for the dea, who are in charge of annually authorizing the import of the manufacturers' raw materials, and, accordingly, had the best view into the magnitude of the available supply.
wapo had a story yesterday about j&j developing a "super poppy"; haven't managed to get past the paywall on that one though.
posted by 20 year lurk at 9:50 PM on March 26, 2020 [3 favorites]
am strongly in favor of their availability for treatment and management of pain.
am moderately in favor of occasional careful recreational use. ymmv.
would like to grow the flowers and make tea. carefully. in moderation.
as long as we're going after everyone in the supply-line with torches and pitchforks, i think we ought to spare some attention for the dea, who are in charge of annually authorizing the import of the manufacturers' raw materials, and, accordingly, had the best view into the magnitude of the available supply.
wapo had a story yesterday about j&j developing a "super poppy"; haven't managed to get past the paywall on that one though.
posted by 20 year lurk at 9:50 PM on March 26, 2020 [3 favorites]
all that said, this doesn't exactly describe unfounded moral panic:
The pharmacists who dispensed those opioids had told the company they didn’t want to fill the prescriptions because they were coming from doctors who were running pill mills. They pleaded for help and guidance from Walmart’s corporate office.posted by 20 year lurk at 9:56 PM on March 26, 2020 [6 favorites]
Investigators had obtained records of similar cries for help from Walmart pharmacists all over the country: from Maine, North Carolina, Kansas and Washington, and other states. They reported hundreds of thousands of suspicious or inappropriate opioid prescriptions. One Walmart employee warned about a Florida doctor who had a “list of patients from Kentucky that have been visiting pharmacies in all of central Wisconsin recently.” That doctor had sent patients to Walmarts in more than 30 other states.
In response to these alarms, Walmart compliance officials did not take corporate-wide action to halt the flow of opioids. Instead, they repeatedly admonished pharmacists that they could not cut off any doctor entirely. They could only evaluate each prescription on an individual basis. And they went further. An opioid compliance manager told an executive in an email, gathered during the inquiry and viewed by ProPublica, that Walmart’s focus should be on “driving sales.”
Because so many doctors are loathe to prescribe opiates, it's getting harder to differentiate between pill mills and one of the few physicians still prescribing them.
posted by Your Childhood Pet Rock at 9:57 PM on March 26, 2020 [13 favorites]
posted by Your Childhood Pet Rock at 9:57 PM on March 26, 2020 [13 favorites]
Anyone who's seen me posting on this topic here knows how I feel about the moral panic over addiction and the idea that it's better to torture chronic-pain patients than let an addict have a pill. But that is not incompatible with recognizing that certain companies chose to engage in very lax practices around medications that do carry meaningful risks and need to be used with care.
posted by praemunire at 10:44 PM on March 26, 2020 [16 favorites]
posted by praemunire at 10:44 PM on March 26, 2020 [16 favorites]
wapo had a story yesterday about j&j developing a "super poppy"; haven't managed to get past the paywall on that one though.
It's an interesting article, here's more coverage on how plant breeding and regulatory entrepreneurship made Tasmania the world's leading supplier of licit opioids.
posted by peeedro at 9:39 AM on March 27, 2020 [1 favorite]
It's an interesting article, here's more coverage on how plant breeding and regulatory entrepreneurship made Tasmania the world's leading supplier of licit opioids.
posted by peeedro at 9:39 AM on March 27, 2020 [1 favorite]
I also always have complicated feelings about this because as a former opioid addict myself I was never, and will never be, mad at somebody for selling me drugs. And the "fuck these pushers" response just rhymes too easily with the Wrong Ways people have gone about dealing with drugs as a societal problem before. On the other hand the people selling me drugs were people, with problems of their own. I do buy into the idea that pharmaceutical companies are given license by society to make hazardous substances to meet certain needs, and thus ought to be held to account for failing to live up to the responsibilities that entails.
posted by atoxyl at 11:46 AM on March 27, 2020 [2 favorites]
posted by atoxyl at 11:46 AM on March 27, 2020 [2 favorites]
The administration should not have blocked the indictment. Walmart corporate should not have ignored the evidence. However... I'm also not sure I want pharmacists making these decisions, overruling doctors. This seems like something to report to a medical oversight body.
posted by Belostomatidae at 9:30 AM on March 28, 2020
posted by Belostomatidae at 9:30 AM on March 28, 2020
Isn't that one of the reasons we license pharmacists, though? To act as a check on doctors doing the wrong thing?
posted by Joe in Australia at 6:05 PM on March 28, 2020 [1 favorite]
posted by Joe in Australia at 6:05 PM on March 28, 2020 [1 favorite]
I'm... actually not sure. That's a great question.
posted by Belostomatidae at 6:31 AM on March 29, 2020
posted by Belostomatidae at 6:31 AM on March 29, 2020
I know that historically - my information is based on old detective novels, so you may trust it implicitly - pharmacists originally sold pretty much anything thought to have a medicinal effect, and would do so without a doctor's prescription. People would buy arsenic from a pharmacist, for instance, to kill vermin.
Pharmacists were later required to keep a journal that recorded sales of poisons. This was to make it easier to track murders, and figured heavily in the aforementioned novels. But they still sold basically everything to everybody and had the usual commercial freedom to refuse a sale. More products (e.g., narcotics) got added to the poisons register and the rule became that these products were not sold without a doctors' prescription. That's the basis of today's system in which there are some "over the counter" products that can be purchased without a prescription and some that require a doctor's prescription. But the pharmacist is still a private operator who doesn't have to to sell anything to anyone unless required by some particular local law.
posted by Joe in Australia at 8:31 PM on March 29, 2020 [1 favorite]
Pharmacists were later required to keep a journal that recorded sales of poisons. This was to make it easier to track murders, and figured heavily in the aforementioned novels. But they still sold basically everything to everybody and had the usual commercial freedom to refuse a sale. More products (e.g., narcotics) got added to the poisons register and the rule became that these products were not sold without a doctors' prescription. That's the basis of today's system in which there are some "over the counter" products that can be purchased without a prescription and some that require a doctor's prescription. But the pharmacist is still a private operator who doesn't have to to sell anything to anyone unless required by some particular local law.
posted by Joe in Australia at 8:31 PM on March 29, 2020 [1 favorite]
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posted by poffin boffin at 7:05 PM on March 26, 2020 [24 favorites]