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Post by robeiae on Oct 26, 2017 8:26:16 GMT -5
www.npr.org/2017/10/26/560083795/president-trump-may-declare-opioid-epidemic-national-emergencyA good piece with facts and charts: www.bbc.com/news/world-us-canada-41701718From it: That's a big difference. Now, from the first story: From the second: It seems to me that there's a lack of critical thinking in the U.S. Expanding insurance coverage--which is not the same thing as expanding actual healthcare--would tend to incentivize increasing prescriptions for opioids. So even if there's more addiction treatment coverage available because of the ACA, it's the expansion of insurance that's partly creating the need for such addiction treatment. Someone is winning here and it's not the everyday citizen... It seems to me that the opioid problem points away from the ACA and more towards a single payer system (or in the exact opposite direction, though I'm now resigned to seeing that as a pipe dream, and thus am grudgingly supporting single payer).
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Post by Amadan on Oct 26, 2017 8:56:38 GMT -5
That depends on whether insurance coverage includes preventative care and physical therapy.
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Post by robeiae on Oct 26, 2017 9:07:01 GMT -5
I don't think so. Because even if it does, there's still the issue of the deductible, along with the issue of simple cost. If it's cheaper for the insurance company to allow prescriptions, that is what it is going to do, 99 times out of 100. Because insurance companies are not being run for the benefit of the patient. They never have been.
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Post by Deleted on Oct 26, 2017 9:33:29 GMT -5
I don't think so. Because even if it does, there's still the issue of the deductible, along with the issue of simple cost. If it's cheaper for the insurance company to allow prescriptions, that is what it is going to do, 99 times out of 100. Because insurance companies are not being run for the benefit of the patient. They never have been. Gotta agree. I also think too many patients demand pills they could do without, and too many doctors cave and issue the prescription. E.g., I know a couple of people who demand antibiotics every damn time they get the sniffles. Gaah, that is not how antibiotics should be used. And I know a couple of others who abuse sleep medications. As long as its covered, the pills get issued, and that's that for care. But then I look at how harried and busy my own doctor is (she's actually awesome, btw, and always explains the tradeoffs between treatments), and I get it. Insurance also provides an incentive to get the patient out the door as quickly as possible, and the prescription pad is often the way to do it, particularly if that's what the patient is demanding.
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Post by Christine on Oct 27, 2017 21:11:03 GMT -5
Opioids are not on par with antibiotics. I think "demanding pills" -- opioids -- is not at issue here. In fact, demanding opioids is a sign that the patient is an addict, afaik.
IME, there are doctors who voluntarily, enthusiastically give prescriptions for opioids, to make a buck. But there are also a lot of doctors who will not do so, and certainly not under pressure from patients.
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Post by Deleted on Oct 27, 2017 22:57:31 GMT -5
Yeah. No one said antibiotics were opioids.
My sister-in-law and a friend are doctors, and they've had patients try to demand prescriptions opioids. They don't comply with those demands unless they think they're called for. But I imagine some doctors do, just like my antibiotic-loving friends' doctors comply.
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Post by Christine on Oct 27, 2017 23:44:36 GMT -5
Yeah. No one said antibiotics were opioids. I said they were not on par with opioids. Doctors don't just hand out Vicodin like Amoxicillin. You implied as much, by talking about the over-prescription of antibiotics. You imagine. And there's the equivalency to antibiotics, again.
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Post by Deleted on Oct 27, 2017 23:49:06 GMT -5
Fine, Christine. It is impossible and never happens. Patients are far too wise and responsible for this ever to occur.
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Post by haggis on Oct 28, 2017 0:00:48 GMT -5
There are a lot of people with chronic pain. Some can be easily diagnosed, some not. But altogether too often, when doctors cannot determine a cause, they label the patient a drug seeker. I've seen it happen more than once. That doesn't mean our opioid epidemic isn't real, because of course it is. But I think it basically means our health care system is so screwed up we cannot differentiate between drug seekers and people in genuine physical pain. Perhaps if patient complaints weren't dismissed so readily simply because a physician can't figure out a cause, we'd have fewer addicts.
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Post by Deleted on Oct 28, 2017 0:15:25 GMT -5
Absolutely, the system is screwed up. I think Rob's OP on the messed-up incentives largely nails it. And I don't know a doctor who doesn't feel some pressure to rush through some appointments faster than they'd like. No doubt that results in some complaints not being diagnosed or treated as well as they might be.
I like my doctor a lot because she discusses alternatives with me when I have a medical issue -- lifestyle changes, treatments that aren't covered by insurance -- she doesn't just pull out a prescription pad. (She's a big reason I don't take sleep aids for my fairly chronic insomnia, but instead counter it with lifestyle adjustments.)
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Post by Christine on Oct 28, 2017 0:23:07 GMT -5
Fine, Christine. It is impossible and never happens. Patients are far too wise and responsible for this ever to occur. Not patients. Doctors. Like Haggis said, they're more likely to miss a real pain diagnosis than to treat a feigned one, what with the drug seeking behavior they are trying to circumvent.
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Post by Don on Oct 28, 2017 5:17:17 GMT -5
My wife was on opioids for years, and the increasing regulations are part of what made it impractical to travel. Thankfully, she's discovered that cannabis and diet changes relieve the pain, and she's no longer on opioids. Of course, where we live now, she's as illegal as if she were using a "pill mill" doctor, but at least she's clear-headed and in less pain than she ever was on opioids.
We do not have an "opioid crisis" in this country. We have a police-state crisis that has made access to excellent drugs illegal, and access to pharmaceutical crap nearly impossible for those who need it. Not to mention that cracking down on opioids has simply shifted the drug of choice to street heroin, racking up more healthcare crises and more easily-avoidable deaths.
The upcoming "war on opioids" is a fine example of a government crutch applied to people whose legs the government has broken in the first place.
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Post by Amadan on Oct 28, 2017 7:51:21 GMT -5
My wife was on opioids for years, and the increasing regulations are part of what made it impractical to travel. Thankfully, she's discovered that cannabis and diet changes relieve the pain, and she's no longer on opioids. Of course, where we live now, she's as illegal as if she were using a "pill mill" doctor, but at least she's clear-headed and in less pain than she ever was on opioids. We do not have an "opioid crisis" in this country. We have a police-state crisis that has made access to excellent drugs illegal, and access to pharmaceutical crap nearly impossible for those who need it. Not to mention that cracking down on opioids has simply shifted the drug of choice to street heroin, racking up more healthcare crises and more easily-avoidable deaths. The upcoming "war on opioids" is a fine example of a government crutch applied to people whose legs the government has broken in the first place. The government response may be flawed, but that does not mean that opioid addiction is not an actual problem. Just like heroin and crack and meth and cocaine actually are dangerous drugs, even if you think they should be legal. Every single problem in the world does not distill down to "da gummint" even if you can point to places where the government is exacerbating the problem.
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Post by Christine on Oct 28, 2017 21:00:38 GMT -5
My wife was on opioids for years, and the increasing regulations are part of what made it impractical to travel. Thankfully, she's discovered that cannabis and diet changes relieve the pain, and she's no longer on opioids. Of course, where we live now, she's as illegal as if she were using a "pill mill" doctor, but at least she's clear-headed and in less pain than she ever was on opioids. We do not have an "opioid crisis" in this country. We have a police-state crisis that has made access to excellent drugs illegal, and access to pharmaceutical crap nearly impossible for those who need it. Not to mention that cracking down on opioids has simply shifted the drug of choice to street heroin, racking up more healthcare crises and more easily-avoidable deaths. The upcoming "war on opioids" is a fine example of a government crutch applied to people whose legs the government has broken in the first place. I heard this on the news today--that medical marijuana can help with pain. Here's a confirmation from WebMD, of all places. The doctors are getting on board, hopefully. I'm so glad your wife has found some relief. But yeah, those pill mill docs are the ones who churn out the pain med prescriptions. Them, along with the pharmaceutical companies, are the culprits for all the pills circulating among the addicts, in my experience. It's been a while, but I lived it. My experience is that general practitioners do not hand out opioids willy-nilly. Addiction has been a serious concern for a long time.
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Post by Don on Oct 29, 2017 7:07:48 GMT -5
Let us not confuse addiction, which is a health issue, with the criminalization of addicts, which is most definitely a government problem. If anyone has any question as to which has done the most damage to society, one need only look at the highest incarceration rate in the world, the transformation of police forces to militarized, occupying forces, the growing disrespect toward those occupying forces, the destruction of family structure among the poor and minorities, and the hollowing out of our inner cities to see a very clear answer.
Today's society is NOT the result of addicts using drugs that are bad for them. Today's society is the result of the government declaring war on its addicted citizens.
We have a prohibition crisis, not an opioid crisis.
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