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  #41  
Old 02 September 2017, 02:01 PM
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Originally Posted by Lainie View Post
In case the pain gets worse after they leave the medical facility, maybe.
Yeah, I could see that it some cases but not mine; there wasn't anything to cause pain.
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  #42  
Old 02 September 2017, 05:35 PM
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Originally Posted by Lainie View Post
In case the pain gets worse after they leave the medical facility, maybe.
I've had oral surgeries where I was under anesthesia for the procedure. My initial pain level afterward is low. The first time I had it done, I didn't take any meds, and then the pain built up over the next several hours, and was pretty bad for a day or two.

Since then, I know I need to take a couple of timed doses of the pain meds to stay ahead of the pain. But I usually only need 2-3 doses.
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  #43  
Old 17 September 2017, 11:21 AM
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A bit of a sensationalist article from The Enquirer in Cincinnati SEVEN DAYS OF HEROIN
THIS IS WHAT AN EPIDEMIC LOOKS LIKE


Associated article: Heroin addiction: Why we took on this 7-day project
Quote:
We undertook this work – spreading our staff throughout courtrooms, jails, treatment facilities, finding addicts on the streets and talking to families who have lost love ones – to put the epidemic in proportion. It is massive. It has a direct or indirect impact on every one of us. It doesn’t discriminate by race, gender, age or economic background. Its insidious spread reaches every neighborhood, every township, every city, regardless of demographics. And it is stressing our health-care systems, hospitals and treatment capacity.
This seems to be one of the case where the best answer is to not even start. Not even once, as the addiction is so strong.

For many, this means to find better solutions for pain management.
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  #44  
Old 17 September 2017, 04:34 PM
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I didn't find the article sensationalist at all. It's full of shocking things, but that's the nature of the topic.
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  #45  
Old 21 December 2017, 03:57 PM
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Here in Oregon (or at least my area), we have the opposite problem thanks to drug users whom have moved on to other drugs. Now, it would take a miracle and a six-car pile up to get anything stronger than ibuprofen (seriously, we can't even get codeine cough meds without begging).

It's impacting those of us with real pain issues (I've carried around the weight of a small family for almost two decades, I HURT and while I'm attempting to solve the base problem, it doesn't help the now and being in pain means less exercise). I really, really wish there was a giant neon sign that would pop up whenever you're in serious pain so that doctors could see who really needed it (and how much) vs frequent fliers. Or a Sims diamond that changed colour depending on pain level.

I understand the risks and problems associated with addiction (trust me, in my county everyone's addicted to somthing darn near) and my mother commited suicide via prescription morphine, but still, when my body is aching so badly it hurts to lay down, I really don't care.
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  #46  
Old 21 December 2017, 07:45 PM
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Saw this article and thought about the thread. "Life Expectancy Drops Again As Opioid Deaths Surge In U.S."
Quote:
"I'm not prone to dramatic statements," says Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics. "But I think we should be really alarmed. The drug overdose problem is a public health problem, and it needs to be addressed. We need to get a handle on it."
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  #47  
Old 21 December 2017, 09:01 PM
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I've been mostly reassured by the things posted in this thread that the magnitude of the problem is mostly not being overstated. I think some of the details, like what the connection is between prescribed drugs and addiction, are being misrepresented at times. Sometimes drastically.

The large majority of opioid addicts did not become addicted from using prescribed medication as directed for a medical condition, and then being unable to stop taking it. From the study I posted earlier, 75% of addicts got their first dose from friends, relatives, or a dealer. And 90% already had problems with addiction. And of course the drugs people are overdosing on as identified in the article just posted--heroin and fentanyl--are not being obtained by people going to the doctor and getting a prescription.

There may be reason to suggest that doctors perhaps should prescribe fewer pain pills at a time, and to educate people about (1) not filling prescriptions they won't use, (2) getting rid of unused prescription medication, and (3) not giving prescription medications to others, but this problem is not primarily being caused by doctors prescribing ordinary opioid pain meds to people who have medical conditions. It is primarily a problem of addicts turning to prescription medication, and being able to divert it from legitimate channels in various ways, and of people using an illegal drug.

From my understanding of the problem, it seems to me that getting a prescription for a small amount of pain medicine should be/stay relatively easy. This helps prevent a hoarding mentality for people who don't misuse it. The amount prescribed at a time should probably be reduced so that there is less chance of "extra" medication being diverted, and more contact with the doctor for someone who is using more medication. And, as I mentioned, education.

Also, much more study into what causes addiction, since it seems like a certain portion of the population may be much more prone to it.

Last edited by erwins; 21 December 2017 at 09:12 PM.
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  #48  
Old 22 December 2017, 04:37 PM
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Quote:
Originally Posted by Saitaina View Post
(seriously, we can't even get codeine cough meds without begging).
This has been an annoyance of mine for many years.

When I was a teenager, the stuff was over the counter. For a long time now, in NYState it's been prescription only, and IME doctors are very reluctant to write the prescription, even for patients who are coughing their heads off and who don't have a history of asking for opiates.

I live some distance from town, and am often the only one here. Even if I can get the prescription, I don't want to have to go into town -- possibly in terrible weather, driving myself while in bad shape, and spreading germs -- when I'm that sick. What I want is to be able to get one bottle of cough syrup that actually works and keep it in stock, so that if at three in the morning I can't sleep for coughing it's there and I can take it. One bottle every couple of years, or even less often if it keeps that long, would do it.

And we now have online computers in all the drugstores, and it ought to be possible to set up a system that could tell whether I was actually buying one bottle every couple of years, or whether I was trying to buy one each from every drugstore in six counties.

And the stuff they want you to take instead doesn't work. And not only does it not work, but people determined to get stoned can get stoned on it, also; and this is also not good for them. So they're not even substituting a non-hazardous drug for a hazardous one. They're substituting a potentially hazardous drug that doesn't stop the cough for a potentially hazardous drug that does stop the cough.

Sorry. End rant.
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  #49  
Old 22 December 2017, 05:13 PM
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Quote:
Originally Posted by erwins View Post
There may be reason to suggest that doctors perhaps should prescribe fewer pain pills at a time, and to educate people about (1) not filling prescriptions they won't use, (2) getting rid of unused prescription medication,
Quote:
Originally Posted by thorny locust View Post
For a long time now, in NYState it's been prescription only, and IME doctors are very reluctant to write the prescription, even for patients who are coughing their heads off and who don't have a history of asking for opiates.
We have twice received codeine tablets from our doctors because we were coughing our heads off. Doctors here have a supply of standard medicines in their office, so it's not even necessary to go to the pharmacy after a doctor's visit. At my former doctor's office the closet was often left open for convenience. At my current doctor's office the door is always locked and needs an electronic badge.

We didn't finish either of the packages and they are sitting in the closet. One expired on 2015 (9/20 tablets left), the other at the beginning of 2017 (all 20 tablets still there). To dispose of them is a simple case of taking them to the pharmacy - there's one just 5 minutes walk from here. Haven't done it.

According to various articles (example), the codeine is probably still good and will be for some time. We won't share them, but we might take them ourselves (the 2017, not the 2015), maybe even this weekend if I can't sleep, but most likely, they will stay in the closet until we move.
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  #50  
Old 22 December 2017, 07:43 PM
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We just adopted a dog a couple of weeks ago, and she developed kennel cough. The coughing was terrible, and often ended with her gagging. As part of the meds we got from the vet, there were some tablets with hydrocodone and another ingredient. (Looking it up, the other ingredient appears to be something intended to discourage abuse/overdose.) It had never occurred to me until I saw those tablets that taking hydrocodone tablets would cause the same suppression of the cough reflex as the Rx cough syrup. But of course it makes sense.
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  #51  
Old 22 December 2017, 08:52 PM
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Aw, poor puppers. Is she feeling better?
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  #52  
Old 22 December 2017, 09:12 PM
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Yes, she's all better now. She got antibiotics, and she stopped coughing on the second day.
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  #53  
Old 23 December 2017, 04:58 AM
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IMS, Tylenol is added to human hydrocodone to preclude abuse. Could be that for dogs too, but Tylenol is more toxic to dogs.
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  #54  
Old 23 December 2017, 03:48 PM
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My mother took low-dose codeine occasionally for pain. (She'd done this on and off most of her adult life, never became addicted, and never wanted to raise the dose. I've also taken it occasionally though not recently, and was never tempted to keep taking it longer than necessary for the specific short term problem.) Towards the end of her life it became difficult to get it without tylenol added -- but tylenol made her feel terrible.

Tylenol doesn't make me feel terrible; but it doesn't do anything at all to help me, either. On me it seems to have no effect whatsoever; though I suppose enough of it would ruin my kidneys (is it kidneys or liver?).

Can somebody by the way explain to me how adding tylenol would discourage addicts from taking hydrocodone? Addiction isn't known for making people concerned about their long-term health.
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  #55  
Old 23 December 2017, 03:59 PM
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Quote:
Originally Posted by GenYus234 View Post
IMS, Tylenol is added to human hydrocodone to preclude abuse. Could be that for dogs too, but Tylenol is more toxic to dogs.
She got Hycodan tablets, the same as the human medicine. The second ingredient is homatropine. Some sources say it is added at a sub-therapeutic dose to discourage abuse. I'm not sure how it is supposed to do that, unless you would reach an excessive dose of the homatropine quicker than the hydrocodone. When I looked up homatropine, it says that it is generally not abused because the experience tends to be unpleasant.

Last edited by erwins; 23 December 2017 at 04:07 PM.
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  #56  
Old 23 December 2017, 04:06 PM
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How would Tylenol preclude abuse?

TL, yes, taking too much Tylenol it can damage your liver and kidneys. I think that's true of most medications, but AIUI the risk threshold for Tylenol is significantly lower than for other OTC meds like ibuprofen.
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  #57  
Old 23 December 2017, 06:31 PM
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Quote:
Originally Posted by Lainie View Post
How would Tylenol preclude abuse?

TL, yes, taking too much Tylenol it can damage your liver and kidneys. I think that's true of most medications, but AIUI the risk threshold for Tylenol is significantly lower than for other OTC meds like ibuprofen.
Not that much difference, which is why some people alternate between acetaminophen and ibuprofen.

Maximum for acetaminophen: 6 pills per day (3,000 mg)

Maximum for ibuprofen: 3,200 mg per day divided into three or four equal doses
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  #58  
Old 23 December 2017, 07:31 PM
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Quote:
Originally Posted by Die Capacitrix View Post
Not that much difference, which is why some people alternate between acetaminophen and ibuprofen.
Does that reduce the risk of damage, though? Does the total amount of both do as much damage as that amount of only one would; or less damage; or possibly even more damage?
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  #59  
Old 23 December 2017, 07:44 PM
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Quote:
Originally Posted by Lainie View Post
How would Tylenol preclude abuse?

TL, yes, taking too much Tylenol it can damage your liver and kidneys. I think that's true of most medications, but AIUI the risk threshold for Tylenol is significantly lower than for other OTC meds like ibuprofen.
It's the same thinking that led to thousands of poisoning deaths during prohibition. Ethyl alcohol was still a useful solvent. To try to keep people from drinking it, the government ordered manufacturers to add poisonous solvents (that's what the denatured alcohol is that you can buy at the hardware store). So it still got diverted, people still drank it, and thousands of people died. Cite: http://www.slate.com/articles/health...mists_war.html

With hydrocodone, acetaminofen is added to the formulation because it is ostensibly also useful for the pain, and it makes it a schedule III drug, because scheduling is based on the potential for abuse, and having it be more dangerous to abuse probably does actually reduce abuse.

TL, ibuprofen is not as toxic to the liver, but has some danger of causing gastric bleeding if you take a lot. (IANAD this is just what I've read or been told about taking them).

Last edited by erwins; 23 December 2017 at 07:50 PM.
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  #60  
Old 24 December 2017, 01:40 AM
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Originally Posted by erwins View Post
and having it be more dangerous to abuse probably does actually reduce abuse.
Say what?

Do they have any actual evidence of that? that is, not evidence that it dissuades a few people, but evidence that the overall likelihood of its causing damage is reduced?

-- oh, silly me. The people deciding to put it in there are quite possibly only nominally interested in reducing the physical damage; they're primarily interested in 'but it's an opiate/it's illegal! killing a few extra druggies is worth it if it keeps a few different people from taking it at all!'

Quote:
Originally Posted by erwins View Post
TL, ibuprofen is not as toxic to the liver, but has some danger of causing gastric bleeding if you take a lot.
As does aspirin, of course. I'm careful with my dosages on both.

I'm not taking ibuprofen (when I need it, which is only occasionally) instead of tylenol because I think it's less toxic, though it may be slightly so; I'm taking it because, on me, ibuprofen actually works (at least on headaches) and tylenol doesn't do a thing.
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