"And then she was gone"
April 29, 2019 8:29 AM Subscribe
Saige Earley was gone in stages.
To her mother, Ellen, the 22-year-old grew increasingly detached within weeks of returning from the dentist with a fateful prescription for opioid painkillers. The young woman with long dark hair and a broad toothy smile was gone physically a few months later when she walked out on her young son and left Ellen wondering if her daughter was even alive.
Then last September, Saige was gone for good, found dead of a heroin overdose in a toilet stall at Syracuse airport, clutching a plane ticket to drug rehab in California. (Chris McGreal, Guardian)
“Whether she escaped in her insatiable appetite for books, dancing till exhausted, headphones blaring music, walks upon walks, or the drugs that cut her life so terribly short, she simply needed to run,” Saige’s father, Jason, wrote in a moving and frank obituary. “But she always wanted to return, to make us laugh, to love her baby, to show us this cruel yet fascinating world through her eyes.”
The obituary caught the eye of the New York attorney general’s office as it built a sweeping lawsuit filed against the opioid industry last month. The legal action singled out Saige Earley as the face of “real people” devastated by the worst drug epidemic in American history.
In 2012, doctors and dentists wrote 255m opioid prescriptions – enough to supply every US adult with a month of pills
Yes the Sacklers need to be brought to justice but to reduce this epidemic to the evil deeds of one family is as counter-productive as the "Just Say No" campaign.
posted by gwint at 8:45 AM on April 29, 2019 [21 favorites]
Yes the Sacklers need to be brought to justice but to reduce this epidemic to the evil deeds of one family is as counter-productive as the "Just Say No" campaign.
posted by gwint at 8:45 AM on April 29, 2019 [21 favorites]
Yes the Sacklers need to be brought to justice but to reduce this epidemic to the evil deeds of one family is as counter-productive as the "Just Say No" campaign.
They were, in a very literal sense, the architects of this epidemic. You bring up all the scripts written by doctors, but ignore that the reason doctors did so was because of "education" campaigns that told them that opioid pain relievers were safe and non-addictive - campaigns that were executed at the behest of Richard Sackler.
posted by NoxAeternum at 8:53 AM on April 29, 2019 [25 favorites]
They were, in a very literal sense, the architects of this epidemic. You bring up all the scripts written by doctors, but ignore that the reason doctors did so was because of "education" campaigns that told them that opioid pain relievers were safe and non-addictive - campaigns that were executed at the behest of Richard Sackler.
posted by NoxAeternum at 8:53 AM on April 29, 2019 [25 favorites]
Lots of documentation out there about how Purdue relentlessly persuaded the entire medical establishment that opioids are not addictive. The book Dreamland, by Sam Quinones, is a good place to start.
Speaking as someone who lives in a city that has, at times over the past five years, witnessed the highest per capita number of OD deaths in North America (the sheer death toll here is shocking and underreported), the State of New York should be channeling its considerable legal resources into legalizing the distribution and possession of opioids, rather than suing one family.
posted by JamesBay at 9:06 AM on April 29, 2019 [2 favorites]
Speaking as someone who lives in a city that has, at times over the past five years, witnessed the highest per capita number of OD deaths in North America (the sheer death toll here is shocking and underreported), the State of New York should be channeling its considerable legal resources into legalizing the distribution and possession of opioids, rather than suing one family.
posted by JamesBay at 9:06 AM on April 29, 2019 [2 favorites]
It doesn't have to be either/or. The Sacklers absolutely need to be made to pay for their outsized role in all this. This can be done while also pursuing policy changes.
posted by Hairy Lobster at 9:12 AM on April 29, 2019 [15 favorites]
posted by Hairy Lobster at 9:12 AM on April 29, 2019 [15 favorites]
Thank you for posting. I am active in a recovery group and see younger people come to the program as part of their in-patient rehab. It has shocked me that there are so many. They seem stunned that this has happened to them. That they are where they are. That they have become addicted and now are trying to pull the pieces back together.
They were children just a few years ago and now, as adults, they are facing a complicated menace. Many still deal with their heartbreak as children, understandably. It is personally painful to witness as they wrestle with what has happened to them. They fear relapsing. Some do and return. Some don't. Some end up out on the streets.
This drug epidemic has an origin. I hope that justice will be served.
So much pain.
posted by zerobyproxy at 9:13 AM on April 29, 2019 [7 favorites]
They were children just a few years ago and now, as adults, they are facing a complicated menace. Many still deal with their heartbreak as children, understandably. It is personally painful to witness as they wrestle with what has happened to them. They fear relapsing. Some do and return. Some don't. Some end up out on the streets.
This drug epidemic has an origin. I hope that justice will be served.
So much pain.
posted by zerobyproxy at 9:13 AM on April 29, 2019 [7 favorites]
Opioid Crisis: No Easy Fix to Its Social and Economic Determinants (American Journal of Public Health paper):
The accepted wisdom about the US opioid crisis singles out opioid analgesics as causative agents of harm, with physicians as unwitting conduits and pharmaceutical companies as selfish promoters. Although invaluable for infection control, this vector model of drug-related harm ignores root causes. Eroding economic opportunity, evolving approaches to pain treatment and limited drug treatment have fueled spikes in problematic substance use, of which opioid overdose is the most visible manifestation. By ignoring the underlying drivers of drug consumption, current interventions are aggravating its trajectory. The structural and social determinants of health framework is widely understood to be critical in responding to public health challenges. Until we adopt this framework, we will continue to fail in our efforts to turn the tide of the opioid crisis.posted by gwint at 9:18 AM on April 29, 2019 [20 favorites]
Yes, if you strand a rat in a cage without hope it will pop opioids until it kills itself. It's the fault of the society that built the cage, the people that jailed the rat, the person who put the opioid in the cage, and the company that made and markets it.
There's lots of blame to go around. And just because the problem isn't simple, doesn't mean there aren't some low hanging fruit. Like the [financial] balls of the Sacklers. It's a good start.
posted by seanmpuckett at 9:23 AM on April 29, 2019 [27 favorites]
There's lots of blame to go around. And just because the problem isn't simple, doesn't mean there aren't some low hanging fruit. Like the [financial] balls of the Sacklers. It's a good start.
posted by seanmpuckett at 9:23 AM on April 29, 2019 [27 favorites]
I had a very serious surgery when I was 20. They gave me a bucket of pain pills, a whole damn bucketful; I've never seen a prescription bottle so tall and so fat. Hundreds of the fuckers, seriously. I did not need that many percs to recover, I promise. I also had a bottle of oxy, maybe from a different doctor? I don't know, but they were really tiny pills, orange.
A friend from college visited me at my parents' house during my recovery and took a bunch of those small orange pills from the bathroom. She left me some, but she took a lot. I noticed. As for that giant bottle, well, I took them back to college with me and someone, maybe that friend, broke into my room and took them all.
She died of an overdose about five years ago and one of my most vivid memories of her from college is of her dropping her purse in the snow and somehow losing a pill that was floating around in there in the snowdrifts. She dug through the snow for a good long while before giving up, but, like a faithful dog (and yes, that is an unkind comparison), every time we would walk past that spot during our remaining years of college she would stop and snoop around in the rocks and grass for a few minutes, hoping to find that long-gone pill. Maybe it never even existed in the first place, although I have a suspicion that she knew exactly how many pills she had and where they all were at all times, so she was probably right.
They did not need to give me that many painkillers. They handed them out like fucking candy, all to make a buck, and now a lot of people are dead.
.
posted by sockermom at 9:25 AM on April 29, 2019 [61 favorites]
A friend from college visited me at my parents' house during my recovery and took a bunch of those small orange pills from the bathroom. She left me some, but she took a lot. I noticed. As for that giant bottle, well, I took them back to college with me and someone, maybe that friend, broke into my room and took them all.
She died of an overdose about five years ago and one of my most vivid memories of her from college is of her dropping her purse in the snow and somehow losing a pill that was floating around in there in the snowdrifts. She dug through the snow for a good long while before giving up, but, like a faithful dog (and yes, that is an unkind comparison), every time we would walk past that spot during our remaining years of college she would stop and snoop around in the rocks and grass for a few minutes, hoping to find that long-gone pill. Maybe it never even existed in the first place, although I have a suspicion that she knew exactly how many pills she had and where they all were at all times, so she was probably right.
They did not need to give me that many painkillers. They handed them out like fucking candy, all to make a buck, and now a lot of people are dead.
.
posted by sockermom at 9:25 AM on April 29, 2019 [61 favorites]
I wonder how much she was prescribed? When I had extractions, I was given a limited quantity of three different painkillers, the strongest being a relatively weak oral narcotic, like Percocet. They lasted, taken as directed, about three days, and by then, Advil was enough. If I needed more, I would have had to call the office and they probably would have had me come in first for an exam.
I have heard stories, though, of people being given huge prescriptions of narcotics after relatively minor surgery, like tooth extractions, which can be dangerous.(On preview: a poster describes this). I don't know if my case was just handled the way the office always does it, or if I was treated differently because I had disclosed a history of alcohol abuse.
I was very grateful for the pain meds, and didn't attempt to abuse them. I needed them, and I took them exactly as directed. In previous threads on this topic, people have spoken bitterly of being deprived of needed pain meds because of this new-found concern for the "opioid epidemic", lumping chronic pain patients in with addicts buying street drugs, and that seems totally unacceptable to me.
posted by thelonius at 9:32 AM on April 29, 2019 [8 favorites]
I have heard stories, though, of people being given huge prescriptions of narcotics after relatively minor surgery, like tooth extractions, which can be dangerous.(On preview: a poster describes this). I don't know if my case was just handled the way the office always does it, or if I was treated differently because I had disclosed a history of alcohol abuse.
I was very grateful for the pain meds, and didn't attempt to abuse them. I needed them, and I took them exactly as directed. In previous threads on this topic, people have spoken bitterly of being deprived of needed pain meds because of this new-found concern for the "opioid epidemic", lumping chronic pain patients in with addicts buying street drugs, and that seems totally unacceptable to me.
posted by thelonius at 9:32 AM on April 29, 2019 [8 favorites]
Both of my parents were alcoholics, and so were their parents. There were a few years when I was around 11 that they mostly kicked it, at least my mother did and my dad greatly cut back. A few years later both of them got addicted to Oxy. My dad worked 50+ hours a week in construction and had to have a hip replacement in his late forties. When I was in 9th grade, at 14, my house burned down and my parents received a bunch of insurance money. They used most of this on drugs. I was 17 when they decided to sit us down and tell us they were going to a methadone clinic for it. The addiction lasted several years after that. My entire family started to tear apart and didn't stop. My father contracted a very drug-resistant and unusual strain of MRSA, and was hospitalized. He was in a coma for weeks. (oddly enough, it was the titanium in his hip replacement that slowed the infection down long enough for the doctors to get a lead and eventually beat it.) He'd had most of his thigh muscle removed, parts of his lower organs, etc. They gave him oxy for the pain. My mother walked out on him just before he got sick (I don't blame her too much, he was a mean asshole most of the time). And that sent him into a deep depression that only exacerbated the use. By then I'd used college as an excuse to run away from home and started estranging myself from the family. Other than the day that I left for college, I only saw him one other time, a thanksgiving dinner my sister hosted about 8 years ago. I'm not entirely sure when he stopped using, or if he's entirely stopped, but I'm finally going to see him for the first time tomorrow. I'm not entirely ready.
I grew up mostly without parents due to addiction. As a child I was delusional and in denial. As a young adult i was furious and jaded and thought they were selfish. As an adult I have a more nuanced view. Both of my parents grew up poor, and in broken homes. Capitalism destroyed every opportunity they could have had to turn their lives around. Abuse of the lower class meant my father had no other choice than to run his body into the ground. My mother, with a moderate learning disability, was discarded even before she was an adult, and never graduated high school. All of this is on purpose. People like the Sacklers don't make mistakes, they make plans. Poverty, prisons, these are the kinds of things our country runs on.
posted by FirstMateKate at 9:36 AM on April 29, 2019 [89 favorites]
I grew up mostly without parents due to addiction. As a child I was delusional and in denial. As a young adult i was furious and jaded and thought they were selfish. As an adult I have a more nuanced view. Both of my parents grew up poor, and in broken homes. Capitalism destroyed every opportunity they could have had to turn their lives around. Abuse of the lower class meant my father had no other choice than to run his body into the ground. My mother, with a moderate learning disability, was discarded even before she was an adult, and never graduated high school. All of this is on purpose. People like the Sacklers don't make mistakes, they make plans. Poverty, prisons, these are the kinds of things our country runs on.
posted by FirstMateKate at 9:36 AM on April 29, 2019 [89 favorites]
In previous threads on this topic, people have spoken bitterly of being deprived of needed pain meds because of this new-found concern for the "opioid epidemic", lumping chronic pain patients in with addicts buying street drugs, and that seems totally unacceptable to me.
And guess who pushed that narrative as hard as he could to stop people from looking at his own guilt in the matter, saying this in an email now revealed thanks to lawsuits:
posted by NoxAeternum at 9:44 AM on April 29, 2019 [12 favorites]
And guess who pushed that narrative as hard as he could to stop people from looking at his own guilt in the matter, saying this in an email now revealed thanks to lawsuits:
They get themselves addicted over and over again. They engage in it with full, criminal intent. Why should they be entitled to our sympathies?Why yes that would be, once again, Richard Sackler. It seems that everywhere you look in the opioid epidemic, there he is.
posted by NoxAeternum at 9:44 AM on April 29, 2019 [12 favorites]
They get themselves addicted over and over again. They engage in it with full, criminal intent. Why should they be entitled to our sympathies?
corrupt business executives addicted to that cold hard cash
triggered by those rising quarterly profits
posted by otherchaz at 9:54 AM on April 29, 2019 [2 favorites]
corrupt business executives addicted to that cold hard cash
triggered by those rising quarterly profits
posted by otherchaz at 9:54 AM on April 29, 2019 [2 favorites]
"I have heard stories, though, of people being given huge prescriptions of narcotics after relatively minor surgery, like tooth extractions"
I was once prescribed Vicodin after a cleaning. Seriously.
posted by kevinbelt at 9:58 AM on April 29, 2019 [6 favorites]
I was once prescribed Vicodin after a cleaning. Seriously.
posted by kevinbelt at 9:58 AM on April 29, 2019 [6 favorites]
The danger of this talk about too many prescriptions is that we don't know how to exercise balance & restraint and already we're going in the other direction of no painkillers for anyone ever which is equally as bad. Making them too hard to get legally for legit pain also fuels addiction. It's like throwing water on an electrical fire. This topic just makes me crazy to hear about because it's like knowing about your own death in advance. Someday I'm going to get surgery and I'm not going to be given painkillers because this one woman died. It's terrifying.
posted by bleep at 10:15 AM on April 29, 2019 [42 favorites]
posted by bleep at 10:15 AM on April 29, 2019 [42 favorites]
At least one person here understands the difference between addiction and dependence. Unfortunately, the DEA has ensured that such misapprehensions are widely held, to the point that many doctors choose to ignore the difference and actively harm their patients as a result.
I have zero hope of this problem ever really being resolved, though it will abate in the same way the heroin epidemic after Vietnam did. People refuse to confront the hard reality that all these dead people are the result of the policies enacted to enforce their own moral beliefs. See, friends, taking away the drugs isn't actually the best way to keep people from keeling over in a bathroom somewhere. Appropriate maintenance therapy, on the other hand, works wonders. It's just too bad that the only drugs doctors can legally prescribe for that purpose are chosen specifically to be.. unpleasant. Not "not pleasant," but actively unpleasant. Plus, just like the Sackler's recommended dosing schedule, the dosage prescribed is one that increases the chance of increased consumption.
Regardless of how any of us feel, we could cut the death rate by 90% overnight if we wanted to. All we have to do is be willing to sell people drugs of known purity. Most people aren't dying en masse because they are rapidly escalating their doses. Some do, but at the much lower rate we saw 10-15 years ago. The reason people are dying is because they are buying "heroin" that actually contains fentanyl because they can't get pharmaceuticals any more.
Heaven forbid we just let people buy the damn pharmaceuticals that are of known strength and purity and not kill themselves.
posted by wierdo at 12:09 PM on April 29, 2019 [35 favorites]
I have zero hope of this problem ever really being resolved, though it will abate in the same way the heroin epidemic after Vietnam did. People refuse to confront the hard reality that all these dead people are the result of the policies enacted to enforce their own moral beliefs. See, friends, taking away the drugs isn't actually the best way to keep people from keeling over in a bathroom somewhere. Appropriate maintenance therapy, on the other hand, works wonders. It's just too bad that the only drugs doctors can legally prescribe for that purpose are chosen specifically to be.. unpleasant. Not "not pleasant," but actively unpleasant. Plus, just like the Sackler's recommended dosing schedule, the dosage prescribed is one that increases the chance of increased consumption.
Regardless of how any of us feel, we could cut the death rate by 90% overnight if we wanted to. All we have to do is be willing to sell people drugs of known purity. Most people aren't dying en masse because they are rapidly escalating their doses. Some do, but at the much lower rate we saw 10-15 years ago. The reason people are dying is because they are buying "heroin" that actually contains fentanyl because they can't get pharmaceuticals any more.
Heaven forbid we just let people buy the damn pharmaceuticals that are of known strength and purity and not kill themselves.
posted by wierdo at 12:09 PM on April 29, 2019 [35 favorites]
I had surgery last year and was in agony, but the only painkiller I was given was basically strong ibuprophen that didnt help at all. I couldn't sleep due to the pain, and begged the doc to give me something, anything, and was told no because 'drug seeking behavior'. Luckily I live in a state with legal weed, so I tried that... 50 mg in edibles was at least enough to detach me enough to sleep.
posted by Pastor of Muppets at 12:11 PM on April 29, 2019 [15 favorites]
posted by Pastor of Muppets at 12:11 PM on April 29, 2019 [15 favorites]
I've had two tooth extractions and the most I ever got was the dentist saying "Take some Advil". Thank god for that I guess!
posted by aclevername at 12:26 PM on April 29, 2019
posted by aclevername at 12:26 PM on April 29, 2019
A few months ago I broke my leg (thanks for all the entertainment, incidentally). When I broke it, I was offered opioids but I said I wasn't in pain, so no thanks. Then I had surgery and I was again offered opioids, and again said I wasn't in pain, but the nurses insisted that I was going to be in pain, so I took them. I was not in pain. I feel very bad for people who are refused painkillers when they are genuinely in pain, but I'm weirded out by this insistence on giving me painkillers I don't need and shouldn't have.
posted by acrasis at 12:56 PM on April 29, 2019 [1 favorite]
posted by acrasis at 12:56 PM on April 29, 2019 [1 favorite]
I think having broke your leg and not feeling any pain at all for the duration is pretty unusual no?
posted by bleep at 1:00 PM on April 29, 2019 [13 favorites]
posted by bleep at 1:00 PM on April 29, 2019 [13 favorites]
I started commenting on MeFi a little before the peak of my opiate dependence (I'm doing pretty well now!) and boy do I have a lot of opinions about this topic and this thread. Unfortunately it's really not a day that I have a lot of time to write about this stuff but I'll see what I can get to.
It's just too bad that the only drugs doctors can legally prescribe for that purpose are chosen specifically to be.. unpleasant. Not "not pleasant," but actively unpleasant.
Not quite sure what you're talking about? Maintenance drugs have traditionally been hard to get in the U.S., though.
Heaven forbid we just let people buy the damn pharmaceuticals that are of known strength and purity and not kill themselves.
To be fair a lot of people manage to accidentally kill themselves with pills that do offer a known dosage, in theory. It's not quite as simple as that. But I think a lot of this risk - especially people overdosing on low-dosage medications like hydrocodone/APAP - does have to do with people mixing them with benzos and alcohol as well.
posted by atoxyl at 1:06 PM on April 29, 2019 [4 favorites]
It's just too bad that the only drugs doctors can legally prescribe for that purpose are chosen specifically to be.. unpleasant. Not "not pleasant," but actively unpleasant.
Not quite sure what you're talking about? Maintenance drugs have traditionally been hard to get in the U.S., though.
Heaven forbid we just let people buy the damn pharmaceuticals that are of known strength and purity and not kill themselves.
To be fair a lot of people manage to accidentally kill themselves with pills that do offer a known dosage, in theory. It's not quite as simple as that. But I think a lot of this risk - especially people overdosing on low-dosage medications like hydrocodone/APAP - does have to do with people mixing them with benzos and alcohol as well.
posted by atoxyl at 1:06 PM on April 29, 2019 [4 favorites]
Maintenance drugs have traditionally been hard to get in the U.S., though.
A friend of mine had a hard time getting in to a methadone program, because she still had a job and a house, and the people running at the program were sure that you have to be at rock bottom to get into recovery. It's idiotic - as if it's impossible for someone to look around and go "I have to do something, before I destroy what's left that's good in my life".
posted by thelonius at 1:20 PM on April 29, 2019 [10 favorites]
A friend of mine had a hard time getting in to a methadone program, because she still had a job and a house, and the people running at the program were sure that you have to be at rock bottom to get into recovery. It's idiotic - as if it's impossible for someone to look around and go "I have to do something, before I destroy what's left that's good in my life".
posted by thelonius at 1:20 PM on April 29, 2019 [10 favorites]
Jesus, the wisdom teeth. I'm beginning to think no one should have them out unless they're already suffering as badly as they would otherwise. I had dry socket last summer after an extraction, and they had given me a palmful of Percocet. I thought I would be too good to take it, but of course I could not be.
What amazed me about the Percocet was not that it relieved the pain, but that it made me feel ... okay. I was expecting that it would either be heavy sedation or make me loopy, ethereal, drugged. But no: I felt okay. For reference, I have struggled with major depression, OCD, and GAD for years, and that was before the Trump administration. I do not, as a general matter, feel okay. It was amazing.
I was certain that I was a safe, reasonable person with safe, reasonable, non-drug-abusing habits who could entirely be trusted with more Percocets. But all I did was say that I'd run out and look at my dentist with big eyes before she said no. I couldn't blame her, but I dearly wanted to argue about how reasonable I was and how reasonable the Percocets made me feel. Only once I was healed did I realize that that, as Carl says, is how they get you. And yet, if this had been a chronic pain issue instead of a limited problem with a resolution, would it not have been worth taking the chance?
posted by Countess Elena at 1:48 PM on April 29, 2019 [16 favorites]
What amazed me about the Percocet was not that it relieved the pain, but that it made me feel ... okay. I was expecting that it would either be heavy sedation or make me loopy, ethereal, drugged. But no: I felt okay. For reference, I have struggled with major depression, OCD, and GAD for years, and that was before the Trump administration. I do not, as a general matter, feel okay. It was amazing.
I was certain that I was a safe, reasonable person with safe, reasonable, non-drug-abusing habits who could entirely be trusted with more Percocets. But all I did was say that I'd run out and look at my dentist with big eyes before she said no. I couldn't blame her, but I dearly wanted to argue about how reasonable I was and how reasonable the Percocets made me feel. Only once I was healed did I realize that that, as Carl says, is how they get you. And yet, if this had been a chronic pain issue instead of a limited problem with a resolution, would it not have been worth taking the chance?
posted by Countess Elena at 1:48 PM on April 29, 2019 [16 favorites]
I’ve had two back surgeries and all my wisdom teeth removed, and was given truckloads of pain killers, and the only ones I came close to having a serious jones for were the percs. As Countess Elena says, they make you feel...okay.
Opioids, on the other hand, always have that attendant “you’re taking some serious drugs now” stupor that always reminded me to be very, very cautious with them. Percs, though...man...scary clean stuff.
posted by Thorzdad at 2:06 PM on April 29, 2019 [2 favorites]
Opioids, on the other hand, always have that attendant “you’re taking some serious drugs now” stupor that always reminded me to be very, very cautious with them. Percs, though...man...scary clean stuff.
posted by Thorzdad at 2:06 PM on April 29, 2019 [2 favorites]
But Percocet is an opioid--half and half, anyway, oxycodone and acetaminophen.
posted by Countess Elena at 2:11 PM on April 29, 2019 [5 favorites]
posted by Countess Elena at 2:11 PM on April 29, 2019 [5 favorites]
I've had two tooth extractions and the most I ever got was the dentist saying "Take some Advil". Thank god for that I guess!
No, not thank God for that; it's not like you take one and become an instant addict. The antidote to the opiod addiction crisis is not to make patients suffer unnecessarily.
Risk for developing dependence is higher among cocaine users and opioid users than cannabis users (Anthony, Warner, & Kessler, 1994; Tsuang et al., 1999; Wagner & Anthony, 2002), but about equal to the risk for alcohol dependence among drinkers and far lower than nicotine dependence risk among tobacco users. [Source]
These drugs can be both prescribed responsibly and taken appropriately when needed. Not long ago I was on both Oxycodone and morphine for days on end, which I didn't even know you could take at the same time. The drugs prescribed to me were required for my pain but my drugs were also well managed. It's not like my doctors just gave me 300 pills in a bottle and wished me well.
posted by DarlingBri at 2:27 PM on April 29, 2019 [12 favorites]
No, not thank God for that; it's not like you take one and become an instant addict. The antidote to the opiod addiction crisis is not to make patients suffer unnecessarily.
Risk for developing dependence is higher among cocaine users and opioid users than cannabis users (Anthony, Warner, & Kessler, 1994; Tsuang et al., 1999; Wagner & Anthony, 2002), but about equal to the risk for alcohol dependence among drinkers and far lower than nicotine dependence risk among tobacco users. [Source]
These drugs can be both prescribed responsibly and taken appropriately when needed. Not long ago I was on both Oxycodone and morphine for days on end, which I didn't even know you could take at the same time. The drugs prescribed to me were required for my pain but my drugs were also well managed. It's not like my doctors just gave me 300 pills in a bottle and wished me well.
posted by DarlingBri at 2:27 PM on April 29, 2019 [12 favorites]
DarlingBri: The drugs prescribed to me were required for my pain but my drugs were also well managed. It's not like my doctors just gave me 300 pills in a bottle and wished me well.
And there you go. You had doctors who cared, who checked in with you, who followed up, who had time to actually practice responsible medicine. One of the (too numerous to list) failings of the American medical system is that it's assembly-line, battery-chicken medicine: no time to do anything but either 1) chuck a bottle of opioids at the patient with a "Good luck!" or 2) say "You're in pain? Too bad! Take Advil! Suffer!"
The Sacklers were just taking advantage of the fact that doctors don't have time to spend with their patients anymore so they are reduced to throwing drugs at them hoping something will work - and then when people wind up dying, rather than suggest responsible medicine, the DEA steps in with prohibition policies.
People are still going to need opioid painkillers (and anyone in hospice should have as much as they want - after all, they are dying!) - but if we had a system where a doctor could sit down with a patient and talk about the potential for dependence, what are the warning signs, and make the patient feel safe going to the doctor and saying "I like these drugs a little too much, what can we do?" Some conditions call for physical therapy; medical weed might help other people. But we shouldn't be shocked, yes, shocked! that a predatory pharmaceutical industry with profit and only profit on its mind has taken advantage of a terrible medical system and vulnerable people.
posted by Rosie M. Banks at 2:49 PM on April 29, 2019 [11 favorites]
And there you go. You had doctors who cared, who checked in with you, who followed up, who had time to actually practice responsible medicine. One of the (too numerous to list) failings of the American medical system is that it's assembly-line, battery-chicken medicine: no time to do anything but either 1) chuck a bottle of opioids at the patient with a "Good luck!" or 2) say "You're in pain? Too bad! Take Advil! Suffer!"
The Sacklers were just taking advantage of the fact that doctors don't have time to spend with their patients anymore so they are reduced to throwing drugs at them hoping something will work - and then when people wind up dying, rather than suggest responsible medicine, the DEA steps in with prohibition policies.
People are still going to need opioid painkillers (and anyone in hospice should have as much as they want - after all, they are dying!) - but if we had a system where a doctor could sit down with a patient and talk about the potential for dependence, what are the warning signs, and make the patient feel safe going to the doctor and saying "I like these drugs a little too much, what can we do?" Some conditions call for physical therapy; medical weed might help other people. But we shouldn't be shocked, yes, shocked! that a predatory pharmaceutical industry with profit and only profit on its mind has taken advantage of a terrible medical system and vulnerable people.
posted by Rosie M. Banks at 2:49 PM on April 29, 2019 [11 favorites]
the nurses insisted that I was going to be in pain, so I took them. I was not in pain.
You took painkillers intended to prevent you feeling pain and you did not feel pain. That is not a rock solid argument for not having needed painkillers.
posted by the agents of KAOS at 3:01 PM on April 29, 2019 [22 favorites]
I have come to really dislike the tendency of reporters to focus on opioid casualties who they can paint as having had no idea what they were getting into until they received a fateful prescription for a minor injury and it destroyed their life. Feels like another way to sort out the innocents from the rest of us who just wanted to get high. I was afraid this article would be that but (only having skimmed it) it seems like it's probably not? Or at least they do acknowledge Earley's mental health struggles and prior interest in intoxication. I still have a sense that the focus on the routine prescription of painkillers for... pain, may be misleading, though? There's a legitimate case against Purdue for deceptive marketing of OxyContin etc. and it should be pursued as such, but to the extent that the "opioid epidemic" is a problem of supply - I think it's only partly a problem of supply - does that really mean overprescription in the course of normal medical practice, or the large-scale diversion, to which manufacturers also turned a blind eye? I really have no data on this but from where I stand and from what I've seen it feels like the latter has been underplayed.
There are reasons for the explosion of opioid use starting in the 00s, but also reasons it was so severe in certain places, and reasons it's turned more lethal in some of those places than in others.
posted by atoxyl at 3:18 PM on April 29, 2019 [5 favorites]
There are reasons for the explosion of opioid use starting in the 00s, but also reasons it was so severe in certain places, and reasons it's turned more lethal in some of those places than in others.
posted by atoxyl at 3:18 PM on April 29, 2019 [5 favorites]
And there you go. You had doctors who cared, who checked in with you, who followed up, who had time to actually practice responsible medicine.
Oh fuck no. I waited 25 minutes for an ambulance and spent 3 days in A&E waiting for a bed in a public ward in an under-funded medical system ranked 24th in Europe, with overworked striking nurses and doctors I saw for approximately 120 seconds on daily rounds. Yet despite all of these deficiencies, my drug management was, as a matter of policy, sufficient to my needs, neither profligate nor parsimonious.
posted by DarlingBri at 3:28 PM on April 29, 2019 [11 favorites]
Oh fuck no. I waited 25 minutes for an ambulance and spent 3 days in A&E waiting for a bed in a public ward in an under-funded medical system ranked 24th in Europe, with overworked striking nurses and doctors I saw for approximately 120 seconds on daily rounds. Yet despite all of these deficiencies, my drug management was, as a matter of policy, sufficient to my needs, neither profligate nor parsimonious.
posted by DarlingBri at 3:28 PM on April 29, 2019 [11 favorites]
It's very sad that this young woman died, but I was prescribed opiates when I was in radiation-slash-chemotherapy and honestly if I had had to kill a person to make the pain go away, I would have done it.
posted by kittens for breakfast at 4:59 PM on April 29, 2019 [6 favorites]
posted by kittens for breakfast at 4:59 PM on April 29, 2019 [6 favorites]
I am a person with a history of alcohol and drug abuse. I have not written any new history with alcohol and/or drugs in many years. Eight or ten years ago, when the pain in my shoulder from shredded rotator cuff was unbelievably agonizing, my doc wrote for me, and he wrote large. I am a grown-up. Had he not written for me I'd have jumped down his throat, then fired his ass. I was in agony.
I was and am well aware of the dangers I faced. I loved how the stuff felt, everything softened, most especially the pain but everything else, also. I kept all of my cards face up on the table* with my doctor, with my shrink, with my mentor, with the young men that I mentor, with my psychologist at the time. Every time that it was time to take another pill, I would ask myself "Can you get by with 1/4 less of that second pill? OK, how about 1/8 less?" and I went with the answer, whatever answer came up.
*In my experience it's good to be accountable to ppl, as I can bullshit myself much more easily if I don't have to look someone in the eye. Addiction grows in the dark, doesn't at all like the light shined on it.
A few years after that I had The Bicycle Wreck From Hell, didn't just shred that rotator cuff more but instead actually ripped it right off the bone, broke a bunch of bones in my face. The doc at the hospital wrote me large, and I damn sure needed it, and I did the same thing -- "Can I take less?" and went with whatever answer came. I think I was on that stuff maybe ten days that time, or twelve, maybe seven days on the other one.
If some doc had said that they weren't going to write they'd have had a psycho in their office, we'd have had words. More like *I* would have words. Because fuck them. I'm not playing silly games, I'm in real pain. My mother was in her late 80s and early 90s, she's got no cartilage in her shoulders, it's bone on bone and these morons want to take away the pain relief? My mother didn't stand up to everyone in her long life but when faced with this unbelievable pain she told them "No way." and they knew that her kids* when bark at them also so they played nice. God love you if you don't have someone looking out for you.
*It got to where my mother was cautious about telling me things, because I'd say "Hey, I'll call you right back." and call whatever doc or hospital or whoever and make them quiver, get flags running up and down poles -- it was fun! I'm a lot of things but shy isn't one of them.
~~~~~
It's pretty much just a matter of time before I get a phone call about a nephew who is now a junkie. Always he's loved drugs, hallucinogens and smoking pot, and he's a gambler, and somehow or other he got into another rehab program and met a woman there -- you know where this is going, right? She likes opiates, he likes her, they're living the hard life now, living in no-tell motels, living in his van, living where they can. One nice thing is that he'd gotten to the point in life where he was carrying a few more pounds than he ought to be carrying, but now, The Junkie Life has got him thin as a rail. Where he was always alive and alert and rather festive -- so much like my father! -- he is now on the nod. All of this is of course bad news, but the *real* bad news is fentenyl, and even worse than that is carfentenyl, junkies play Russian Roulette every time they poke a spike in their arm. I have not told my sister about that piece and I'm pretty sure she hasn't looked, she's terrified and horrified and can't see how this can happen, and of course completely powerless to turn course of events in any way. I look at photos of him as a child and he was the most darling boy, innocent as puppies, perfectly willing to believe me when I told him that Harvard was named after our Uncle Harvey, and not just for his academic achievements but also his prowess on the football field, in baseball, and track, swimming, Parcheesi, tennis, volley ball, figure skating, synchronized swimming, rowing, and skiing, and of all the women would coo and bill and who could blame them? And now that beautiful boy is a phone call waiting to happen, because we won't give him accurate dosages, a place to shower, three hots and a couple of cots.
~~~~~
The answer? Every drug completely legal. No such thing as illicit drugs. Ever since man first crushed grape we've known that we're going to lose a number of ppl to alcoholism. They aren't wrong, or bad, or weak -- they suffer an illness. Let them know that if they drive drunk society will incarcerate hell out of them, including lifetime removal of driving privilege, and no second chances. (We seem to forget that driving is a privilege, and not a right.) But other than that, drink and drugs free, or damn near, and given with known dosages.
This shuts down the whole prison industry. This also stops all of the cartels etc but that's not the aim -- the aim is to keep ppl from ODing in a stall in an airport john, sprawled next to a toilet. Also, yeah, do bust this family of scum beings, leave them with a couple of two year old economy size Ford cars, a $100,000 house in some horses-ass Indiana town, give them jobs cleaning airports, jobs cleaning the john at starbuc coffee shops, jobs where they have to wear stupid hats with the company name emblazoned upon them. And, of course, give them all the pills they want.
posted by dancestoblue at 5:12 PM on April 29, 2019 [12 favorites]
I was and am well aware of the dangers I faced. I loved how the stuff felt, everything softened, most especially the pain but everything else, also. I kept all of my cards face up on the table* with my doctor, with my shrink, with my mentor, with the young men that I mentor, with my psychologist at the time. Every time that it was time to take another pill, I would ask myself "Can you get by with 1/4 less of that second pill? OK, how about 1/8 less?" and I went with the answer, whatever answer came up.
*In my experience it's good to be accountable to ppl, as I can bullshit myself much more easily if I don't have to look someone in the eye. Addiction grows in the dark, doesn't at all like the light shined on it.
A few years after that I had The Bicycle Wreck From Hell, didn't just shred that rotator cuff more but instead actually ripped it right off the bone, broke a bunch of bones in my face. The doc at the hospital wrote me large, and I damn sure needed it, and I did the same thing -- "Can I take less?" and went with whatever answer came. I think I was on that stuff maybe ten days that time, or twelve, maybe seven days on the other one.
If some doc had said that they weren't going to write they'd have had a psycho in their office, we'd have had words. More like *I* would have words. Because fuck them. I'm not playing silly games, I'm in real pain. My mother was in her late 80s and early 90s, she's got no cartilage in her shoulders, it's bone on bone and these morons want to take away the pain relief? My mother didn't stand up to everyone in her long life but when faced with this unbelievable pain she told them "No way." and they knew that her kids* when bark at them also so they played nice. God love you if you don't have someone looking out for you.
*It got to where my mother was cautious about telling me things, because I'd say "Hey, I'll call you right back." and call whatever doc or hospital or whoever and make them quiver, get flags running up and down poles -- it was fun! I'm a lot of things but shy isn't one of them.
~~~~~
It's pretty much just a matter of time before I get a phone call about a nephew who is now a junkie. Always he's loved drugs, hallucinogens and smoking pot, and he's a gambler, and somehow or other he got into another rehab program and met a woman there -- you know where this is going, right? She likes opiates, he likes her, they're living the hard life now, living in no-tell motels, living in his van, living where they can. One nice thing is that he'd gotten to the point in life where he was carrying a few more pounds than he ought to be carrying, but now, The Junkie Life has got him thin as a rail. Where he was always alive and alert and rather festive -- so much like my father! -- he is now on the nod. All of this is of course bad news, but the *real* bad news is fentenyl, and even worse than that is carfentenyl, junkies play Russian Roulette every time they poke a spike in their arm. I have not told my sister about that piece and I'm pretty sure she hasn't looked, she's terrified and horrified and can't see how this can happen, and of course completely powerless to turn course of events in any way. I look at photos of him as a child and he was the most darling boy, innocent as puppies, perfectly willing to believe me when I told him that Harvard was named after our Uncle Harvey, and not just for his academic achievements but also his prowess on the football field, in baseball, and track, swimming, Parcheesi, tennis, volley ball, figure skating, synchronized swimming, rowing, and skiing, and of all the women would coo and bill and who could blame them? And now that beautiful boy is a phone call waiting to happen, because we won't give him accurate dosages, a place to shower, three hots and a couple of cots.
~~~~~
The answer? Every drug completely legal. No such thing as illicit drugs. Ever since man first crushed grape we've known that we're going to lose a number of ppl to alcoholism. They aren't wrong, or bad, or weak -- they suffer an illness. Let them know that if they drive drunk society will incarcerate hell out of them, including lifetime removal of driving privilege, and no second chances. (We seem to forget that driving is a privilege, and not a right.) But other than that, drink and drugs free, or damn near, and given with known dosages.
This shuts down the whole prison industry. This also stops all of the cartels etc but that's not the aim -- the aim is to keep ppl from ODing in a stall in an airport john, sprawled next to a toilet. Also, yeah, do bust this family of scum beings, leave them with a couple of two year old economy size Ford cars, a $100,000 house in some horses-ass Indiana town, give them jobs cleaning airports, jobs cleaning the john at starbuc coffee shops, jobs where they have to wear stupid hats with the company name emblazoned upon them. And, of course, give them all the pills they want.
posted by dancestoblue at 5:12 PM on April 29, 2019 [12 favorites]
I have come to really dislike the tendency of reporters to focus on opioid casualties who they can paint as having had no idea what they were getting into until they received a fateful prescription for a minor injury and it destroyed their life. Feels like another way to sort out the innocents from the rest of us who just wanted to get high.
This isn't new. See Ryan White.
posted by fluttering hellfire at 5:27 PM on April 29, 2019 [6 favorites]
I’m trying to get an understanding of how this works. I’ve had opiods after a c section and it took away the pain - but that’s all. Don’t get me wrong, I’m very grateful that it took away the pain but I was surprised because the way people spoke about them I expected to feel some kind of, I don’t know, high or euphoria.
So my question is for people who come in needing pain relief and are given it, once the injury has healed and the pain has gone, if there is no euphoria why do they keep seeking the drug? Does it give them some additional high or experience that I just didn’t have?
(And I recognise that for people with chronic pain that’s the reason they keep seeking it - the pain never goes away. I understand why these people are addicts, the drug actually has a beneficial effect on them. I’m talking about people who aren’t in any pain.) So for someone whose not in pain, why do they continue to seek opiods?
posted by Jubey at 6:08 PM on April 29, 2019
So my question is for people who come in needing pain relief and are given it, once the injury has healed and the pain has gone, if there is no euphoria why do they keep seeking the drug? Does it give them some additional high or experience that I just didn’t have?
(And I recognise that for people with chronic pain that’s the reason they keep seeking it - the pain never goes away. I understand why these people are addicts, the drug actually has a beneficial effect on them. I’m talking about people who aren’t in any pain.) So for someone whose not in pain, why do they continue to seek opiods?
posted by Jubey at 6:08 PM on April 29, 2019
It's not just physical pain, Jubey. It makes all of the pain go away. Angst, depression, anger, sadness, grief, regret. And if you've been living a life like where you can't get a job, have nowhere to sleep, people sneer at you on the street, curse you for your skin colour or religion, where the only friendly face is your dealer or another user who could share with you... all it takes is making the pain go away. Just a few hours, even just a few minutes of peace.
posted by seanmpuckett at 6:27 PM on April 29, 2019 [11 favorites]
posted by seanmpuckett at 6:27 PM on April 29, 2019 [11 favorites]
I had to go to the ER five and a half years ago with pain so severe, radiating out from my chest, that I couldn't breathe. I legitimately thought I was having a cardiac event of some sort. Nope! Just compressed a nerve in my back and so I was hooked up to a morphine drip.
It. Was. Amazing. Not only was I pain-free physically, the dozens of spinning plates in my head all synced up and spun themselves without my active attention or interference. I felt calm, benevolent, utterly sure that no matter what came next, I'd be just fine. To be pain-free and untroubled is so rare as an adult in the United States -- and I say this as someone who is luckier than most.
I have not been prescribed any opiates since, nor have I looked for them on my own. But let me tell you, I think about that serene blue afternoon with wistful longing at least once a week. To be able to feel like that again?
I get it. I get why people take opiates.
posted by sobell at 6:50 PM on April 29, 2019 [33 favorites]
It. Was. Amazing. Not only was I pain-free physically, the dozens of spinning plates in my head all synced up and spun themselves without my active attention or interference. I felt calm, benevolent, utterly sure that no matter what came next, I'd be just fine. To be pain-free and untroubled is so rare as an adult in the United States -- and I say this as someone who is luckier than most.
I have not been prescribed any opiates since, nor have I looked for them on my own. But let me tell you, I think about that serene blue afternoon with wistful longing at least once a week. To be able to feel like that again?
I get it. I get why people take opiates.
posted by sobell at 6:50 PM on April 29, 2019 [33 favorites]
The first time I had a narcotic it was IV Dilaudid, for gallstones. I thought I had achieved enlightenment. I was perfectly liberated from desire.
That said, I always squint a little bit at these stories. Legit doctors don't give out vats of these pills anymore. It takes a LOT of effort to go from "completely clean and sober" to "hopeless junkie" on thirty Percocet. Even if you're taking the recommended max, that's a little over three days' supply. There's got to be a severe underlying pathology already at play.
posted by praemunire at 7:42 PM on April 29, 2019 [4 favorites]
That said, I always squint a little bit at these stories. Legit doctors don't give out vats of these pills anymore. It takes a LOT of effort to go from "completely clean and sober" to "hopeless junkie" on thirty Percocet. Even if you're taking the recommended max, that's a little over three days' supply. There's got to be a severe underlying pathology already at play.
posted by praemunire at 7:42 PM on April 29, 2019 [4 favorites]
So my question is for people who come in needing pain relief and are given it, once the injury has healed and the pain has gone, if there is no euphoria why do they keep seeking the drug?
Because the chemicals the drugs provide bind to certain receptors in the brain which the brain demands to have something bound to when the drugs aren't taken, so they try to find a way to take more drugs that will fulfill the needs of those receptor sites. These are receptor sites which very often the brain will create its own chemicals to bond with, but obviously it's going to produce those at a much lower level than the drug provides. Otherwise, you wouldn't need the drug to act as a flood on those sites to get them to activate in the way that creates therapeutic results.
Addiction isn't about what makes you feel good. It's about your brain demanding a chemical that it wants that it isn't having and is making you go out and find.
Ever seen any of those videos about a rain forest ant which is infected with a fungus that makes it shake and walk strangely up to the top of a leaf of grass or the stem of a plant and then it kills the insect and this spike grows out through its head and it gives off spores hoping to land on other ants to begin the infection cycle again?
Addiction is like this. Your brain has levels that control you that you aren't even aware of. Some say we don't have ANY free well at all because it's all just the interaction of chemical processes which lead to outcomes in pathways which drive our behavior.
I'm not saying addicts are going to have a spike grow out through their head or that they're infected with a fungus or any of that. But the addiction can be just as controlling to the addict as that fungus is to that ant.
There are oceans of literature on this if you decide to do the research.
posted by hippybear at 7:43 PM on April 29, 2019 [6 favorites]
Because the chemicals the drugs provide bind to certain receptors in the brain which the brain demands to have something bound to when the drugs aren't taken, so they try to find a way to take more drugs that will fulfill the needs of those receptor sites. These are receptor sites which very often the brain will create its own chemicals to bond with, but obviously it's going to produce those at a much lower level than the drug provides. Otherwise, you wouldn't need the drug to act as a flood on those sites to get them to activate in the way that creates therapeutic results.
Addiction isn't about what makes you feel good. It's about your brain demanding a chemical that it wants that it isn't having and is making you go out and find.
Ever seen any of those videos about a rain forest ant which is infected with a fungus that makes it shake and walk strangely up to the top of a leaf of grass or the stem of a plant and then it kills the insect and this spike grows out through its head and it gives off spores hoping to land on other ants to begin the infection cycle again?
Addiction is like this. Your brain has levels that control you that you aren't even aware of. Some say we don't have ANY free well at all because it's all just the interaction of chemical processes which lead to outcomes in pathways which drive our behavior.
I'm not saying addicts are going to have a spike grow out through their head or that they're infected with a fungus or any of that. But the addiction can be just as controlling to the addict as that fungus is to that ant.
There are oceans of literature on this if you decide to do the research.
posted by hippybear at 7:43 PM on April 29, 2019 [6 favorites]
It. Was. Amazing. Not only was I pain-free physically, the dozens of spinning plates in my head all synced up and spun themselves without my active attention or interference. I felt calm, benevolent, utterly sure that no matter what came next, I'd be just fine.
Opiates throw me into a black hole of existential and physical despair so deep that it seems to be a well seeking to swallow me whole even while I struggle in vain against it. They are suicide drops for me, even at low levels.
I feel fortunate to have this kind of reaction to them. Although I will tell you if you take enough naproxen to cover the pain of having 5 broken ribs (and you can take enough, it's about 8 tabs across 24 hours), it gives you the shits.
posted by hippybear at 10:03 PM on April 29, 2019
Opiates throw me into a black hole of existential and physical despair so deep that it seems to be a well seeking to swallow me whole even while I struggle in vain against it. They are suicide drops for me, even at low levels.
I feel fortunate to have this kind of reaction to them. Although I will tell you if you take enough naproxen to cover the pain of having 5 broken ribs (and you can take enough, it's about 8 tabs across 24 hours), it gives you the shits.
posted by hippybear at 10:03 PM on April 29, 2019
Thank you all for your very thoughtful, detailed answers, it’s helped me understand it a bit better.
posted by Jubey at 10:04 PM on April 29, 2019 [1 favorite]
posted by Jubey at 10:04 PM on April 29, 2019 [1 favorite]
And a FUCK YOU to the doctor who with my broken ribs had a conversation with me about my "allergy" to opioids and then prescribed me Tramadol, which I took blindly because we'd had THAT CONVERSATION and so I spent a night struggling with having broken ribs AND with trying not to break out into hysterics and want to kill myself, because I'd already literally JUST CHEATED DEATH. Because my broken ribs were because I was parked on the side of a black ice highway in the middle of the night and was standing on the road side of my delivery van smoking a cigarette when a semi truck came to a sliding halt and then slid sideways down the bank of the curve we were parked on and sandwiched me against my delivery van. And the scope of this happening from my perspective was exactly long enough to think in my brain "oh shit I'm dead". And then when I seek treatment, and I discuss how opioids make me want to kill myself, the doctor GIVES ME FUCKING TRAMADOL??? /end rant
posted by hippybear at 10:09 PM on April 29, 2019 [5 favorites]
posted by hippybear at 10:09 PM on April 29, 2019 [5 favorites]
if there is no euphoria why do they keep seeking the drug?
There is, but it's more subtle than you expect it to be, which is actually one of the insidious things about opioids.
(People also get addicted to benzos, which to be are really not euphoric per se but do a very very good job making you feel not anxious.)
posted by atoxyl at 10:11 PM on April 29, 2019 [2 favorites]
There is, but it's more subtle than you expect it to be, which is actually one of the insidious things about opioids.
(People also get addicted to benzos, which to be are really not euphoric per se but do a very very good job making you feel not anxious.)
posted by atoxyl at 10:11 PM on April 29, 2019 [2 favorites]
Also there's a wide range in physiological and psychological response. I'd say a minority of people are born to love opioids, another minority can't stand them (get nauseous etc.) and most people can probably get used to them. And it depends on the exact drug, too - hydrocodone barely even ever worked on me.
posted by atoxyl at 10:15 PM on April 29, 2019 [1 favorite]
posted by atoxyl at 10:15 PM on April 29, 2019 [1 favorite]
I'm pretty mystified, too. Opioid painkillers are an old thing, when I was a kid Tylenol 3 was the go-to pain for serious but not extreme pain, codeine and Tylenol. I much prefer the modern generation as they don't make me feel high, unlike codeine, they just silence the pain. And the presentation of "JUST ONE PRESCRIPTION AND YOU'LL BE A JUUUUNNNNNKIE!" pisses me off, as it probably explains why my dentist acted like I was a evil drug seeker when I had an infected failed root canal that had filled half my face with pus and left me in agony.
People who get addicted from one prescription of pain killers probably had some pretty serious existing issues.
posted by tavella at 10:28 PM on April 29, 2019 [1 favorite]
People who get addicted from one prescription of pain killers probably had some pretty serious existing issues.
posted by tavella at 10:28 PM on April 29, 2019 [1 favorite]
People who get addicted from one prescription of pain killers probably had some pretty serious existing issues.
People who get addicted from one prescription of pain killers are people. And there's this thing in their brain that goes "oh, I want more of that".
You don't have that thing in your brain.
Lucky you.
posted by hippybear at 10:38 PM on April 29, 2019 [13 favorites]
People who get addicted from one prescription of pain killers are people. And there's this thing in their brain that goes "oh, I want more of that".
You don't have that thing in your brain.
Lucky you.
posted by hippybear at 10:38 PM on April 29, 2019 [13 favorites]
It takes a LOT of effort to go from "completely clean and sober" to "hopeless junkie" on thirty Percocet.
Perhaps. But the woman in the article was given a one week supply of hydrocodone that included a refill.
I suspect that's a sufficient amount to jump start a drug habit for someone dealing with more than their share of life issues (e.g., poverty, illness in the family), i.e., things that fall short of being "severe underlying pathology".
posted by she's not there at 10:42 PM on April 29, 2019 [2 favorites]
Perhaps. But the woman in the article was given a one week supply of hydrocodone that included a refill.
I suspect that's a sufficient amount to jump start a drug habit for someone dealing with more than their share of life issues (e.g., poverty, illness in the family), i.e., things that fall short of being "severe underlying pathology".
posted by she's not there at 10:42 PM on April 29, 2019 [2 favorites]
Also, some people really hate avocados or tomatoes or find cilantro tastes like soap, and some people are ticklish and some like stroking on their skin and others hate it.
Brains come in all sorts. Accept that. Accept the addict as a person. You don't have to have "pretty serious existing issues" to become an addict. That language is, exactly, blaming the victim/addict. It's no different from "if she hadn't been wearing that outfit..." Except in this case, the marauding party was a drug company salesman training session which told the company representatives to lie to doctors about their drugs ability to addict people, rather than some sleazy guy in a bar following a woman out of the bar.
posted by hippybear at 10:45 PM on April 29, 2019 [10 favorites]
Brains come in all sorts. Accept that. Accept the addict as a person. You don't have to have "pretty serious existing issues" to become an addict. That language is, exactly, blaming the victim/addict. It's no different from "if she hadn't been wearing that outfit..." Except in this case, the marauding party was a drug company salesman training session which told the company representatives to lie to doctors about their drugs ability to addict people, rather than some sleazy guy in a bar following a woman out of the bar.
posted by hippybear at 10:45 PM on April 29, 2019 [10 favorites]
I had wisdom teeth taken out and was given some pain meds - something in me said just tough it out so I did. I didn’t need them actually.
Then I had horrible back pain like 15 years later (they thought I had kidney stones it was so bad) and finally agreed to give me morphine... I was looking forward to see what it’d be like.... the bliss
I felt nothing. Nothing!
I was so disappointed. Apparently there’s some sub category of people for whom morphine does nothing and I belong in it.
posted by St. Peepsburg at 10:51 PM on April 29, 2019
Then I had horrible back pain like 15 years later (they thought I had kidney stones it was so bad) and finally agreed to give me morphine... I was looking forward to see what it’d be like.... the bliss
I felt nothing. Nothing!
I was so disappointed. Apparently there’s some sub category of people for whom morphine does nothing and I belong in it.
posted by St. Peepsburg at 10:51 PM on April 29, 2019
That language is, exactly, blaming the victim/addict. It's no different from "if she hadn't been wearing that outfit..."
Not sure I completely agree with this - I think that original comment could have been phrased more charitably, but I think reporting on the most sudden and shocking downward spirals and the danger of instant addiction posed by even relatively weak opioids doesn't necessarily help everyone think clearly about the big picture and the way out of this mess.
I don't mean to say this woman's story shouldn't be told, either - it's just sorta like my earlier comment about what kind of addiction stories get written about.
posted by atoxyl at 12:19 AM on April 30, 2019 [4 favorites]
Not sure I completely agree with this - I think that original comment could have been phrased more charitably, but I think reporting on the most sudden and shocking downward spirals and the danger of instant addiction posed by even relatively weak opioids doesn't necessarily help everyone think clearly about the big picture and the way out of this mess.
I don't mean to say this woman's story shouldn't be told, either - it's just sorta like my earlier comment about what kind of addiction stories get written about.
posted by atoxyl at 12:19 AM on April 30, 2019 [4 favorites]
People who get addicted from one prescription of pain killers are people. And there's this thing in their brain that goes "oh, I want more of that".
With respect, that's not really how it works. I've known more than one person who had occasional opioid prescriptions for acute pain with no problems whatsoever who only later began using and abusing opioids recreationally.
My naive suspicion is that individual perception of withdrawal symptoms and the availability of the supply plays a large role in determining who will develop addictive behaviors. People don't necessarily take drugs to feel good, at least not after a certain point. They take them so they don't feel bad. (Relapse after a period of abstinence is an entirely different thing)
posted by wierdo at 12:53 AM on April 30, 2019 [4 favorites]
With respect, that's not really how it works. I've known more than one person who had occasional opioid prescriptions for acute pain with no problems whatsoever who only later began using and abusing opioids recreationally.
My naive suspicion is that individual perception of withdrawal symptoms and the availability of the supply plays a large role in determining who will develop addictive behaviors. People don't necessarily take drugs to feel good, at least not after a certain point. They take them so they don't feel bad. (Relapse after a period of abstinence is an entirely different thing)
posted by wierdo at 12:53 AM on April 30, 2019 [4 favorites]
I had a shot of morphine, not a pill. Granted it was not a huge dose but still.
posted by St. Peepsburg at 9:08 AM on April 30, 2019
posted by St. Peepsburg at 9:08 AM on April 30, 2019
I mean, this isn't guesswork, people in the field studying this and harm reduction know that at the heart of the opioid crisis is people who were already using and who got the drugs illegally. And doctors are cracking down on the ability to get both MAT and proper pain control for chronic pain (don't even know where to begin linking for this, it is an ongoing conversation among recovery and chronic pain communities on twitter, though, and the stigma of opioid use for chronic pain kills too). We know that. We've known it for a while.
They're separate and equally important conversations but every time we pretend they're not already being had or operate from popular myth more people die. Yes, the Sacklers were evil. But not, as with most public health crises that affect people who are suffering on different ways on different axes, and this DOES include people who DO develop use disorders from prescribed drugs, they don't not exist, it's a lot more complex than the mainstream press wants to either talk about or use that information to pursue drug policy that's actually useful and not worsening the lives of already suffering and marginalized folks who are marginalized in more ways than just this.
posted by colorblock sock at 9:16 AM on April 30, 2019 [10 favorites]
They're separate and equally important conversations but every time we pretend they're not already being had or operate from popular myth more people die. Yes, the Sacklers were evil. But not, as with most public health crises that affect people who are suffering on different ways on different axes, and this DOES include people who DO develop use disorders from prescribed drugs, they don't not exist, it's a lot more complex than the mainstream press wants to either talk about or use that information to pursue drug policy that's actually useful and not worsening the lives of already suffering and marginalized folks who are marginalized in more ways than just this.
posted by colorblock sock at 9:16 AM on April 30, 2019 [10 favorites]
This one time thanks to somebody's surgery I had limited and brief access to pink bliss, which was a big jug of liquid oxy. I "made sandwiches," which meant I drank half a beer, slugged back a shot of the bliss, then drank the other half of the beer. I did that twice. This: everything softened, most especially the pain but everything else, also. and this: the dozens of spinning plates in my head all synced up and spun themselves without my active attention or interference. I felt calm, benevolent, utterly sure that no matter what came next, I'd be just fine. and this: it made me feel ... okay. I was expecting that it would either be heavy sedation or make me loopy, ethereal, drugged. But no: I felt okay. ... I do not, as a general matter, feel okay. It was amazing. Yes. All of that. It doesn't feel WRONG, like other intoxicants. Alcohol, coke, hallucinogens, pot, even cigarettes, you feel like you've done a thing to yourself. Opiates you feel you've made an excellent addition to your regimen and are now healthy and fine. I very much would not ever want to have a jug of pink bliss in my house. I wouldn't want to make more than about two blissy sandwiches in a single year. My friend was a pill head and it nearly killed her. It kills tons of people. How many PSHs and Tom Pettys do you need to watch die before you can get your head around the notion that yes: you did fine when you had your wisdom teeth out, and yes: once your friend gave you a couple of oxys and nothing bad happened, but that was because you were a luckylucky fuck and in fact given time and access you, too, would be Dr. House because the shit is insanely dangerous?
anyone in hospice should have as much as they want - after all, they are dying!
Anyone in hospice who lives alone, maybe. Not the ones who live with other people. You wouldn't believe. Well, you would. Hospice social workers regularly have to "waste the meds" of the dead. Picture it! You're the on-call social worker, you get woken up out of a deep sleep at 2 a.m. and told that your patient has died and that you therefore must immediately motor out to some bump in the road near Palatka, Florida, and drive down a long unlit limerock road to a woodsy retreat and knock on the door and compel the family of the deceased to give you back all Granny's oxys so you can drive them back to town and bag them and trash them. So many many ways opioids can get you killed.
posted by Don Pepino at 9:27 AM on April 30, 2019 [2 favorites]
anyone in hospice should have as much as they want - after all, they are dying!
Anyone in hospice who lives alone, maybe. Not the ones who live with other people. You wouldn't believe. Well, you would. Hospice social workers regularly have to "waste the meds" of the dead. Picture it! You're the on-call social worker, you get woken up out of a deep sleep at 2 a.m. and told that your patient has died and that you therefore must immediately motor out to some bump in the road near Palatka, Florida, and drive down a long unlit limerock road to a woodsy retreat and knock on the door and compel the family of the deceased to give you back all Granny's oxys so you can drive them back to town and bag them and trash them. So many many ways opioids can get you killed.
posted by Don Pepino at 9:27 AM on April 30, 2019 [2 favorites]
Way back when, I was prescribed Percocet for my quadruple wisdom teeth extraction. A couple years ago, I was prescribed Vicodin for a root canal. In each case, I needed one of each. Just one.
posted by emelenjr at 9:35 AM on April 30, 2019
posted by emelenjr at 9:35 AM on April 30, 2019
Way back when, I was prescribed Percocet for my quadruple wisdom teeth extraction. A couple years ago, I was prescribed Vicodin for a root canal. In each case, I needed one of each. Just one.
I mean, good for you? Your experience isn't indicative of anyone else's and I'm not sure you understand how holier-than-thou this sounds. I'm also unclear what conclusion you're expecting reader to draw from this conclusion, or what health guideline you think it illustrates. Three days worth of opiates is the guideline. It's a safe guideline. The problem isn't that doctors are not dispensing three days worth of drugs; they are writing 30 days, with refills.
posted by DarlingBri at 10:03 AM on April 30, 2019 [4 favorites]
I mean, good for you? Your experience isn't indicative of anyone else's and I'm not sure you understand how holier-than-thou this sounds. I'm also unclear what conclusion you're expecting reader to draw from this conclusion, or what health guideline you think it illustrates. Three days worth of opiates is the guideline. It's a safe guideline. The problem isn't that doctors are not dispensing three days worth of drugs; they are writing 30 days, with refills.
posted by DarlingBri at 10:03 AM on April 30, 2019 [4 favorites]
"I felt nothing. Nothing!"
The literal interpretation of this is what happened to me when I was given Vicodin following wisdom teeth extraction. I took one. It made the physical pain go away but it also made everything else go away. I literally felt nothing. Someone could've fallen and broken bones in front of me and any concern would've been purely rational with no real compassion. I hated being in that cold state but I also immediately realized how very tempting this could be if your circumstances were such that you wished you could stop feeling things for a while.
I never took another pill after that experience.
posted by Hairy Lobster at 10:13 AM on April 30, 2019
The literal interpretation of this is what happened to me when I was given Vicodin following wisdom teeth extraction. I took one. It made the physical pain go away but it also made everything else go away. I literally felt nothing. Someone could've fallen and broken bones in front of me and any concern would've been purely rational with no real compassion. I hated being in that cold state but I also immediately realized how very tempting this could be if your circumstances were such that you wished you could stop feeling things for a while.
I never took another pill after that experience.
posted by Hairy Lobster at 10:13 AM on April 30, 2019
I've known more than one person who had occasional opioid prescriptions for acute pain with no problems whatsoever who only later began using and abusing opioids recreationally.
Per my above comments this can be as simple as they didn't actually like Vicodin but they did like heroin. But also I know a lot of people who messed around with opioids for years before something changed about their circumstances or mindset and they made the leap to daily use. Or of course also people who messed around with opioids for a while and stopped before it got out of hand. People who immediately fall in love with pills and dive in headfirst definitely exist but I'm not sure they're the most typical case.
posted by atoxyl at 1:12 PM on April 30, 2019 [2 favorites]
Per my above comments this can be as simple as they didn't actually like Vicodin but they did like heroin. But also I know a lot of people who messed around with opioids for years before something changed about their circumstances or mindset and they made the leap to daily use. Or of course also people who messed around with opioids for a while and stopped before it got out of hand. People who immediately fall in love with pills and dive in headfirst definitely exist but I'm not sure they're the most typical case.
posted by atoxyl at 1:12 PM on April 30, 2019 [2 favorites]
The problem isn't that doctors are not dispensing three days worth of drugs; they are writing 30 days, with refills.
Both things seem to be problems, depending upon where (and who) you are. In some places, good luck getting a script for any opiate, whether you're a chronic pain patient or someone who needs three days' worth post-procedure. Overprescribing may still be happening -- hell, some years back I was handed a 100ct bottle of Vicodin with two refills -- but unfortunately the general reaction to overprescribing's now-manifest problems seems to be a pendulum swing toward "okay no pills for anybody EVER" which is... non-optimal, to say the least. (And then there's the increasing trend toward people on maintenance opiates having to submit to drug testing to prove that they are taking their pills, which sometimes compels people to take meds even when they don't need them, lest they come up clean on their test and get accused of selling, and wreaks merry hell on those who also find medicinal marijuana helpful for their conditions. And of course it's a profit centre for US-based insurers, since you have to pay a visit fee and pay for the drug test, because of course you do...)
Although I will tell you if you take enough naproxen to cover the pain of having 5 broken ribs (and you can take enough, it's about 8 tabs across 24 hours), it gives you the shits.
as someone who can't take opiates but had to deal with a pain management issue over the weekend using a similar protocol, uh, thank you for mentioning this. uh, not to get too detailed but, uh, it explains a thing that i was pretty darned concerned about
posted by halation at 6:29 PM on April 30, 2019 [8 favorites]
Both things seem to be problems, depending upon where (and who) you are. In some places, good luck getting a script for any opiate, whether you're a chronic pain patient or someone who needs three days' worth post-procedure. Overprescribing may still be happening -- hell, some years back I was handed a 100ct bottle of Vicodin with two refills -- but unfortunately the general reaction to overprescribing's now-manifest problems seems to be a pendulum swing toward "okay no pills for anybody EVER" which is... non-optimal, to say the least. (And then there's the increasing trend toward people on maintenance opiates having to submit to drug testing to prove that they are taking their pills, which sometimes compels people to take meds even when they don't need them, lest they come up clean on their test and get accused of selling, and wreaks merry hell on those who also find medicinal marijuana helpful for their conditions. And of course it's a profit centre for US-based insurers, since you have to pay a visit fee and pay for the drug test, because of course you do...)
Although I will tell you if you take enough naproxen to cover the pain of having 5 broken ribs (and you can take enough, it's about 8 tabs across 24 hours), it gives you the shits.
as someone who can't take opiates but had to deal with a pain management issue over the weekend using a similar protocol, uh, thank you for mentioning this. uh, not to get too detailed but, uh, it explains a thing that i was pretty darned concerned about
posted by halation at 6:29 PM on April 30, 2019 [8 favorites]
Heartbreaking Twitter video of a woman with bone mets describing the bullshit she has to put up with when trying to refill her pain meds.
posted by Johnny Wallflower at 10:33 PM on April 30, 2019 [3 favorites]
posted by Johnny Wallflower at 10:33 PM on April 30, 2019 [3 favorites]
It sure seems like we have a generally inconsistent and fucked up relationship to painkillers.
Folks like Radley Balko have been yelling about the DEA fishing for prosecutions of over-prescribing in chronic pain cases for a long, long time, but we still see examples of people ending up with almost comically large supplies of dangerous opiods for innocuous procedures, too. (If I had to guess, I'd bet there was a class difference between the folks being denied care they need and the folks being given oversupplies, but that's a whole other thing.)
I broke my hip cycling in November of 2014, and it hurt like a motherfucker. It hurt after morphine, and it hurt less (but I didn't care as much) after dilaudid. Only after versed and traction was I able to doze until the surgical repair the next morning. (Turns out, broken bones aren't the most interesting thing in a Tier 1 trauma center. Once I was stabilized, it was 10 or so hours before I was actually fixed.)
Here's the thing, though: that's the last pain I felt. Obviously I was out for the surgery, and that came with a nerve block that lingered for many hours afterwards. Once awake, they had me on tramadol and Norco and ibuprofen for a long time after. I kept taking what they gave me when I was in the hospital, because everyone I know who's had trauma told me that it was easier to keep big pain away than it was to banish it once it comes back. This SUCKED because the Norco -- which is, I'm told, basically Vicodin by another name -- just make me sweaty and queasy.
But I wasn't hurting, and I knew the kind of ortho repair I'd had was by no means gentle, so it didn't take much to convince me to comply.
When I was discharged, they gave me a big ol' bottle of the Norco. I still have it. I never took any more of them. But if I were the sort of person wired for opioid abuse, that bottle could've been doom.
(The Tramadol I tolerated fine. I wasn't really sure it was doing anything, but it didn't make me feel weird or drunk or high (or, critically, queasy or sweaty), so I kept taking it. The funny thing about it was that I was pretty sure it wasn't imposing a cognitive burden -- until, late in my recovery, I opened my laptop and tried to troubleshoot something for a co-worker. It was code I'd written. It may as well have been in high Valyrian. "Oh, yeah, I *am* on opiates," I remember thinking. It's still really strange to me that it was costing me that much brainpower without me noticing until I tried to USE my brain seriously.)
posted by uberchet at 2:50 PM on May 1, 2019 [3 favorites]
Folks like Radley Balko have been yelling about the DEA fishing for prosecutions of over-prescribing in chronic pain cases for a long, long time, but we still see examples of people ending up with almost comically large supplies of dangerous opiods for innocuous procedures, too. (If I had to guess, I'd bet there was a class difference between the folks being denied care they need and the folks being given oversupplies, but that's a whole other thing.)
I broke my hip cycling in November of 2014, and it hurt like a motherfucker. It hurt after morphine, and it hurt less (but I didn't care as much) after dilaudid. Only after versed and traction was I able to doze until the surgical repair the next morning. (Turns out, broken bones aren't the most interesting thing in a Tier 1 trauma center. Once I was stabilized, it was 10 or so hours before I was actually fixed.)
Here's the thing, though: that's the last pain I felt. Obviously I was out for the surgery, and that came with a nerve block that lingered for many hours afterwards. Once awake, they had me on tramadol and Norco and ibuprofen for a long time after. I kept taking what they gave me when I was in the hospital, because everyone I know who's had trauma told me that it was easier to keep big pain away than it was to banish it once it comes back. This SUCKED because the Norco -- which is, I'm told, basically Vicodin by another name -- just make me sweaty and queasy.
But I wasn't hurting, and I knew the kind of ortho repair I'd had was by no means gentle, so it didn't take much to convince me to comply.
When I was discharged, they gave me a big ol' bottle of the Norco. I still have it. I never took any more of them. But if I were the sort of person wired for opioid abuse, that bottle could've been doom.
(The Tramadol I tolerated fine. I wasn't really sure it was doing anything, but it didn't make me feel weird or drunk or high (or, critically, queasy or sweaty), so I kept taking it. The funny thing about it was that I was pretty sure it wasn't imposing a cognitive burden -- until, late in my recovery, I opened my laptop and tried to troubleshoot something for a co-worker. It was code I'd written. It may as well have been in high Valyrian. "Oh, yeah, I *am* on opiates," I remember thinking. It's still really strange to me that it was costing me that much brainpower without me noticing until I tried to USE my brain seriously.)
posted by uberchet at 2:50 PM on May 1, 2019 [3 favorites]
I was talking to my mom, who’s a doctor, and she said that one thing complicating this is that doctors simply don’t understand pain very well and the experience of pain varies so much from person to person.
posted by pelvicsorcery at 11:50 AM on May 2, 2019 [1 favorite]
posted by pelvicsorcery at 11:50 AM on May 2, 2019 [1 favorite]
I’m also wondering, based on the Vice article linked by colorblocksock, if doctors that now underprescribe opioids to patients are doing so not to keep the patient from getting addicted but to keep people in the patient’s orbit from getting their hands on the medication. (Which would be... fucked up, if true.)
posted by pelvicsorcery at 11:55 AM on May 2, 2019 [1 favorite]
posted by pelvicsorcery at 11:55 AM on May 2, 2019 [1 favorite]
Someday I'm going to get surgery and I'm not going to be given painkillers because this one woman died. It's terrifying.
I certainly hope this isn't the case. It's definitely not right now, at least in the UCSF system. I had 3 very-not-minor surgeries in the last 2 years (a hip AFI and then emergency surgery when I had an open fracture to my right tib/fib, and then about a year later a second surgery to remove all my tib hardware).
With each of these surgeries, I was discharged with a prescription for pretty strong opiods (Oxycodone for the first 2 and Norco for the last one). After the hip surgery I probably took 5-6 pills total.
The emergency surgery aftermath was a whole new universe of pain for me, from the accident straight through to the recovery. While I was still laying on the street in pieces, I knew I was going into shock but was able to stay present for the 7.5 minutes it took the EMTs to show up. My GoPro was on so I had video of the whole thing. You can see me offering them my left arm for the IV while you hear me explain the accident to them, give them my verbal vitals, and then kindly inform them that I'm going to lose it now. Then I just start screaming for the next 5 minutes. It was probably only 3 minutes after the first vial of morphine that they realized I felt nothing and started running my vitals again for another one. Maybe 3 minutes into the 2nd vial I tell them that they got me from a 14 to a 10, 10 being the worst pain I had ever experienced in my life.
They said, "Well that's good, cause now we have to splint you, move you onto the board, and into the ambulance."
I eventually passed out in the ambulance, and when I woke up in the ER, I was already on my way down a very dark Ketamine-hole. That's a story for another time.
~12 hours post surgery, the doctor told me I needed to get home ASAP because my chances of getting an infection were higher in the hospital and that meant a not-insignificant chance of an infection, which could lead to loss of limb. I told them to pull out the IV right then and there, and they laughed and told me we could talk about that the next day.
I convinced my night nurse that night to get me off the IV and onto the pills. Normally the nurses are only allowed to bring you the pills when you ask for them, but my guy told me that there was a set schedule at which he couldn't give me the pills before the set times, and he told me he would show up with the pills at those times. Even though he did me that kindness, I spent the whole night holding the sides of the bed completely white-knuckled, sweating bullets, moaning most of the time and screaming the rest. Eventually morning came and it was getting to where I could lay there relatively quietly.
I got home ~48 hours after my accident and about 24 hours after that I quit taking the Oxy they gave me and had another 24 hours of misery until I was able to wrestle quietly enough with the pain for the duration of the time in the post-surgical cast.
After the surgery a couple months ago to take the tib hardware out and put a bone graft in my fib, I got to go home the same night and I never took a single Norco, still have the full bottle.
I've told my doctors and anyone else I've talked to, I have no understanding of why we have an Opioid epidemic - I mean, I know that we do, but I don't understand personally what the attraction is. With my hip oxy, they had to give me an anti-nausea pill to take 30 mins before taking the oxy, and even then I still puked it back up. My buddy's GF's medical marijuana saved my ass that time. And then they have to give you a stool softener too because they super constipate you. And I didn't even get anything approaching even a mild buzz from them. Maybe some blunt dulling of the pain, at best. No high whatsoever. I have all of these bottles of pills at home now that probably have a not-minuscule street value.
In my cursory research online, I get the impression that the doctors are giving me the types of opioids that are much less likely to lead to addiction than certain other types. I also suspect people who get hooked probably take them in a lot greater volume than what I was prescribed. I hope I never have to take that much to manage pain, because I'm quite certain I would fit the addict profile very well.
I asked my doctor a few months after the emergency surgery why I wasn't in more chronic pain with the half-pound or so of metal they had bolted me back together with. He told me that pain is a completely user-specific experience. He said he could have a guy my same age, health, etc. with the exact same injury and repair surgery, and he'd have to pop pills every day the rest of his life just to hobble around. Told me to knock wood if I never needed the pharmaceutical assistance. You better believe I do every time I think of it.
posted by allkindsoftime at 4:23 PM on May 2, 2019
I certainly hope this isn't the case. It's definitely not right now, at least in the UCSF system. I had 3 very-not-minor surgeries in the last 2 years (a hip AFI and then emergency surgery when I had an open fracture to my right tib/fib, and then about a year later a second surgery to remove all my tib hardware).
With each of these surgeries, I was discharged with a prescription for pretty strong opiods (Oxycodone for the first 2 and Norco for the last one). After the hip surgery I probably took 5-6 pills total.
The emergency surgery aftermath was a whole new universe of pain for me, from the accident straight through to the recovery. While I was still laying on the street in pieces, I knew I was going into shock but was able to stay present for the 7.5 minutes it took the EMTs to show up. My GoPro was on so I had video of the whole thing. You can see me offering them my left arm for the IV while you hear me explain the accident to them, give them my verbal vitals, and then kindly inform them that I'm going to lose it now. Then I just start screaming for the next 5 minutes. It was probably only 3 minutes after the first vial of morphine that they realized I felt nothing and started running my vitals again for another one. Maybe 3 minutes into the 2nd vial I tell them that they got me from a 14 to a 10, 10 being the worst pain I had ever experienced in my life.
They said, "Well that's good, cause now we have to splint you, move you onto the board, and into the ambulance."
I eventually passed out in the ambulance, and when I woke up in the ER, I was already on my way down a very dark Ketamine-hole. That's a story for another time.
~12 hours post surgery, the doctor told me I needed to get home ASAP because my chances of getting an infection were higher in the hospital and that meant a not-insignificant chance of an infection, which could lead to loss of limb. I told them to pull out the IV right then and there, and they laughed and told me we could talk about that the next day.
I convinced my night nurse that night to get me off the IV and onto the pills. Normally the nurses are only allowed to bring you the pills when you ask for them, but my guy told me that there was a set schedule at which he couldn't give me the pills before the set times, and he told me he would show up with the pills at those times. Even though he did me that kindness, I spent the whole night holding the sides of the bed completely white-knuckled, sweating bullets, moaning most of the time and screaming the rest. Eventually morning came and it was getting to where I could lay there relatively quietly.
I got home ~48 hours after my accident and about 24 hours after that I quit taking the Oxy they gave me and had another 24 hours of misery until I was able to wrestle quietly enough with the pain for the duration of the time in the post-surgical cast.
After the surgery a couple months ago to take the tib hardware out and put a bone graft in my fib, I got to go home the same night and I never took a single Norco, still have the full bottle.
I've told my doctors and anyone else I've talked to, I have no understanding of why we have an Opioid epidemic - I mean, I know that we do, but I don't understand personally what the attraction is. With my hip oxy, they had to give me an anti-nausea pill to take 30 mins before taking the oxy, and even then I still puked it back up. My buddy's GF's medical marijuana saved my ass that time. And then they have to give you a stool softener too because they super constipate you. And I didn't even get anything approaching even a mild buzz from them. Maybe some blunt dulling of the pain, at best. No high whatsoever. I have all of these bottles of pills at home now that probably have a not-minuscule street value.
In my cursory research online, I get the impression that the doctors are giving me the types of opioids that are much less likely to lead to addiction than certain other types. I also suspect people who get hooked probably take them in a lot greater volume than what I was prescribed. I hope I never have to take that much to manage pain, because I'm quite certain I would fit the addict profile very well.
I asked my doctor a few months after the emergency surgery why I wasn't in more chronic pain with the half-pound or so of metal they had bolted me back together with. He told me that pain is a completely user-specific experience. He said he could have a guy my same age, health, etc. with the exact same injury and repair surgery, and he'd have to pop pills every day the rest of his life just to hobble around. Told me to knock wood if I never needed the pharmaceutical assistance. You better believe I do every time I think of it.
posted by allkindsoftime at 4:23 PM on May 2, 2019
Elizabeth Warren has begun rolling out her plan for combating the opioid crisis, called the CARE Act. In addition, she's also called on museums and Harvard to pull a damnatio memorae on the Sacklers as well.
posted by NoxAeternum at 3:48 AM on May 11, 2019 [1 favorite]
posted by NoxAeternum at 3:48 AM on May 11, 2019 [1 favorite]
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posted by NoxAeternum at 8:39 AM on April 29, 2019 [19 favorites]