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(Boston Herald)   Massachusetts governor: I'm banning this new drug because it's dangerous: Drug maker: You and what FDA?   (bostonherald.com) divider line 172
    More: Interesting, Massachusetts Governor, FDA, Massachusetts, new drugs, drug companies, state Department of Public Health  
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11027 clicks; posted to Main » on 08 Apr 2014 at 9:01 AM (37 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2014-04-08 11:15:17 AM  

MFK: are you suggesting that we should just say fark it and let the heroin dealers do whatever they want?


Well, we let the caffeine dealers do whatever they want & just look how that turned out:

a0.muscache.com

/ I shudder just thinking all the addicts getting their fix in this den of iniquity
 
2014-04-08 11:20:36 AM  

Tigger: 2) Decriminalise everything and provide treatment. We know this works. It's been tried. Prohibition doesn't work. We know because we've tried that too and it doesn't work.


I think you are right.  I read the story about Portugal upthread.  Decriminalize (instead of legalize), is a good policy.  It allows for some "light" form of enforcement to intervene in the hard cases (real addicts) while still allowing the recreational users to skate by.  I think decriminalize is better for the harder drugs like opiates and cocaine, whereas legalize makes more sense for cannabis derived products.  The middle ground like ecstasy (in one direction) and LSD (in the other) are tougher, but I would probably lean towards decriminalize for those rather than outright legalization..
 
2014-04-08 11:21:50 AM  

MFK: namegoeshere: Pangea:

http://news.yahoo.com/u-federal-judge-sentences-florida-pill-mill-do ct ors-230514610.html


And when the sort-of-legal pill mills in Floriduh were shut down, heroin addiction blossomed.

exactly. because heroin is cheaper, more potent, and extremely similar to the pills. By the time you are addicted to opiates, you do not have the same control of your faculties as you once did. So when a user might have been appalled at the thought of shooting up, "pills are totally safe - the doctor gives them out and he wouldn't if they weren't totally safe, right?" Take the pills away however and the user is still left with an opiod addiction. At that point, they'll do anything as long as it makes them "not sick".


No.  Just on the why part.  One drug dealer went to jail, another one took his business.  At least the new one wasn't perceived to be legal.
 
2014-04-08 12:10:27 PM  

mike_d85: Betep: bborchar: somedude210: This is the one that should've never gotten through the FDA and is very very very easy to overdose on, right?

I have no problem with Patrick doing this, if that's the case. New England is facing a massive opiate problem

My problem is where does governor have the power to do such a thing?  And if he's allowed to do it, what's stopping other conservative governors from banning drugs like birth control?

He overstepped his bounds and needs to leave this up to the correct authorities.

Pay attention kid.
It seems you have an axe to grind being a liberal and all, but we're talking about Obama Lite here.

Oh, you missed the point.  He meant that it's awesome this governor is doing this, but it would be terrible if those stupid conservatives started forcing children on the population.  Therefore, for the greater good, the Mass.ter race must be held back.


Or maybe I wouldn't give a crap what party he is, I just don't want politicians making arbitrary decisions about banning medications simply because they think it's 'bad'.  I said 'conservative governors' because it seems those states are hell-bent and determined to undermine doctors' and patients' rights to make their own decisions about drugs, and birth control in particular.  If a democrat, libertarian or republican were doing it about any drug, I would be equally against it.  It sets bad precedent.
 
2014-04-08 01:27:41 PM  
 
2014-04-08 01:35:27 PM  

beefoe: good article about this drug in Forbes:   http://www.forbes.com/sites/johnlamattina/2014/03/20/the-fdas-dilemma - with-the-opioid-pain-medication-zohydro-er/

Includes this gem:

"Was the FDA asleep at the wheel on this one? What were they thinking when they approved such a dangerous drug?
Actually, they were probably thinking about the patients, the ones who are suffering constantly and for whom nothing works to alleviate their pain."


Dilaudid
 
2014-04-08 01:35:44 PM  

hardinparamedic: That's one of the most moronic and out of touch statements I've ever read on FARK. In reality, we have a problem with under-treating and mistreating pain in the United States. Physicians are too apt to throw what are supposed to be short term opiates that have a huge abuse and harm potential at patients, rather than refer them to pain management specialists for proper treatment with opiate and non-opiate medications.

It has absolutely nothing to do with politics.


Yeah, I think the real answer should be with who can prescribe them.  What I'd like to see:

1)  A registry of all level 2 scripts issued.  A pharmacy can only fill a script that's in the database.  This ensures the doc must check the database before issuing it--he will see all other recent (say, 1 or 5 years) level 2 scripts issued.

2)  Level 2 drugs are limited to being prescribed by those who normally deal with or cause pain (ie, surgeons), oncologists, those providing end of life care and pain management docs.  Only the latter two can continue to write scripts for the same initial cause.  After the first script it's not an emergency situation, they can go to the specialist.  I'm exempting those providing end of life care because in that case it doesn't matter if the patient ends up hooked.  Let the hospice docs do what the patient wants.

RyansPrivates: I too have known my share of heroin/opiod addicts, and I blame the pushers: the doctors that prescribed the medicne to begin with without proper oversight/patient interaction. I also have known 2 people that may or may not be addicted, but have a good medical reasons for opioid use, both related to spinal injury problems. Banning these substances would reduce their quality of life. Both hold full time jobs that they are able to actually function in because of prescription opioids.


Yeah.  I used to have a coworker that was on something heavy because of shrapnel he caught in Iraq.  His personality wasn't exactly ideal but I suspect Iraq had more to do with that than the drugs did.


That being said, I think we need a new class of docs also:  Addiction management.  They would be allowed to prescribe even the stuff that's currently class 1, the objective being to keep the patient as a functional member of society.  While I support legalization for the non-addictive stuff I think the addictive stuff is better handled by making addiction a valid reason to prescribe them.
 
2014-04-08 02:41:20 PM  

hardinparamedic: OscarTamerz: The reason there is an epidemic of addiction to pharmaceuticals in this country is because the left wing pushed for reeducation of physicians to make sure they were available to the patients more easily.  Of course all that was needed was a prescription but the left wingers went so far as to require Continuing Medical Education courses about why you should give your patients pain relievers.  In California the requirement was for 12 hours of CME time and many states followed suit.  Now in the OC more people die of pharmaceutical overdose than die in motor vehicle accidents.  The left wing never anticipates the consequences of their actions like why it's a bad idea to pay teenagers to have babies.

[upload.wikimedia.org image 300x163]

That's one of the most moronic and out of touch statements I've ever read on FARK. In reality, we have a problem with under-treating and mistreating pain in the United States. Physicians are too apt to throw what are supposed to be short term opiates that have a huge abuse and harm potential at patients, rather than refer them to pain management specialists for proper treatment with opiate and non-opiate medications.

It has absolutely nothing to do with politics.


Absolutely spot on, man. As an MS patient, i had to roll through several doctors because the first several were throwing opioids at nerve pain... it does nothing for nerve pain... it kind of makes me not care, it makes me lethargic, and it makes me unable to work, but it doesn't actually address the problem. Gabapentin, Amitryptiline do way better, have way fewer side effects, and on good days, I can cut way back and not feel shiatty. Once a month or so, on really bad days, I'll still have a pot brownie... but none of that stuff is anywhere near as rough on me as some of the stuff I was with the first few doctors. That said, neurologist number three was a total dick who was convinced everyone was trying to work him for drugs... I had a spasm bad enough that I broke my foot (and some drywall)... when I asked him if there was anything he could do to at least slow the spasms down so I wouldn't get hurt any more, his response was "we're reluctant to give out any kind of muscle relaxers because, you know, people abuse them."

It isn't always a function of just more painkillers or less painkillers, but having a doctor take the time to actually figure out why the pain exists, and addressing that problem directly. While I'll concede there are certainly "pill mill" doctors out there, especially those in shady buildings marketing themselves as "pain clinics"... I'd still say the overall lean of doctors I've met has been to either treat it hastily (throw the wrong drugs at it) or under-treat pain, even if it means leaving a patient unable to complete activities of daily living. The issue isn't availability, it is one of competence.
 
2014-04-08 02:47:11 PM  
Federal preemption, right?
 
2014-04-08 02:48:00 PM  

namegoeshere: Pangea:

http://news.yahoo.com/u-federal-judge-sentences-florida-pill-mill-do ct ors-230514610.html


And when the sort-of-legal pill mills in Floriduh were shut down, heroin addiction blossomed.


That link was posted in response to someone who said:
"You get caught selling it you get to see a Judge. Judge should grant as much bail as if they had been selling ricin or anthrax. And charged the same. And put away the same."

"You get caught dealing, you get the max."


Are you saying keeping the pill mills open would be a better solution? A license to make new addicts and keep them addicted?

We'll have to disagree.
 
2014-04-08 03:08:13 PM  

Pangea: namegoeshere: Pangea:

http://news.yahoo.com/u-federal-judge-sentences-florida-pill-mill-do ct ors-230514610.html


And when the sort-of-legal pill mills in Floriduh were shut down, heroin addiction blossomed.

That link was posted in response to someone who said:
"You get caught selling it you get to see a Judge. Judge should grant as much bail as if they had been selling ricin or anthrax. And charged the same. And put away the same."

"You get caught dealing, you get the max."

Are you saying keeping the pill mills open would be a better solution? A license to make new addicts and keep them addicted?

We'll have to disagree.


Disagree with what? The opinion that you're apparently assigning to me?
 
2014-04-08 03:11:04 PM  

firefly212: hardinparamedic: OscarTamerz: The reason there is an epidemic of addiction to pharmaceuticals in this country is because the left wing pushed for reeducation of physicians to make sure they were available to the patients more easily.  Of course all that was needed was a prescription but the left wingers went so far as to require Continuing Medical Education courses about why you should give your patients pain relievers.  In California the requirement was for 12 hours of CME time and many states followed suit.  Now in the OC more people die of pharmaceutical overdose than die in motor vehicle accidents.  The left wing never anticipates the consequences of their actions like why it's a bad idea to pay teenagers to have babies.

[upload.wikimedia.org image 300x163]

That's one of the most moronic and out of touch statements I've ever read on FARK. In reality, we have a problem with under-treating and mistreating pain in the United States. Physicians are too apt to throw what are supposed to be short term opiates that have a huge abuse and harm potential at patients, rather than refer them to pain management specialists for proper treatment with opiate and non-opiate medications.

It has absolutely nothing to do with politics.

Absolutely spot on, man. As an MS patient, i had to roll through several doctors because the first several were throwing opioids at nerve pain... it does nothing for nerve pain... it kind of makes me not care, it makes me lethargic, and it makes me unable to work, but it doesn't actually address the problem. Gabapentin, Amitryptiline do way better, have way fewer side effects, and on good days, I can cut way back and not feel shiatty. Once a month or so, on really bad days, I'll still have a pot brownie... but none of that stuff is anywhere near as rough on me as some of the stuff I was with the first few doctors. That said, neurologist number three was a total dick who was convinced everyone was trying to work him for drugs... I had a spasm bad ...


That's what I hate about our medical system right now.  It's easier (and more profitable) to treat a patient's symptoms that it is to treat the disease.  I have addison's disease and grave's disease, and I went to 5 different doctors in 2 months when I got very, very sick.  I couldn't keep my food down, could barely stand up and couldn't even walk a block before nearly fainting.  I also had a goiter in my neck that was scaring me to death.

Every doctor I went to diagnosed it as 'the flu', gave me medication for the nausea and a round of antibiotics.  It was only when I went into the ER that the doctor there was able to just look at me and diagnose me.  Addison's disease causes uneven tanning and tanning on places that don't normally tan, like the palms of your hands or your lips...and this doctor saw me and knew immediately what I had, and suspected the thyroid disease (because I had a goiter).  But it was easier for the other doctors to write me off and hope that I didn't come back than it was to refer me to someone or do a little bit of research.
 
2014-04-08 03:50:54 PM  
I suppose there's a weird logic to this.  Death is an instant and 100% effective cure for drug addiction.
 
2014-04-08 04:38:27 PM  
It's really obvious to me that most of you have never worked in health care. Here's a few insider tips:

1. It actually IS the physician's responsibility to make sure the patient is not going to abuse the drug. It's also the pharmacist's responsibility.

2. There is no need for this drug. There are many better pain medications already available (that are less easy to snort or inject) and this drug will not - I repeat, WILL NOT - bring pain relief to patients who have failed Oxycontin, MS Contin, Opana, and transdermal fentanyl. Those (very few) patients will be on intrathecal therapy.

3. This drug was approved despite the panel voting against it. That's shady and I foresee a good chance that this drug is recalled by the FDA. It does not meet an unmet need, which is required for new drugs on the market.

4. This drug will not prevent Tylenol overdoses. For one thing, it's long acting; patients will still have breakthrough pain meds (possibly with acetaminophen) available. For another, it's for chronic pain ONLY. Patients who are taking 12+ Norcos a day and are therefore at risk of liver toxicity have bigger problems. They need to tell their doctor what they're taking (and stop pestering me for early refills; the answer is no, bub) and have a new stronger drug prescribed. Norco is not meant to be taken at the max dose for long periods of time. To have liver damage, one would have to either take a LOT more than prescribed (at least double the max daily dose, and probably triple) or take more than the max dose every day for a long period of time. There is NO reason for either of those things to EVER happen. None. If your pain is bad enough that you need to take 5 Norcos every 4 hours, then you need to go to the ER, because no way in hell was it that bad in the doctor's office or you would have been admitted to the floor. If you're taking more for months and months, then you need to get on a different drug. And trust me, we'll know you're taking more because you'll be lying to us about why you always run out 10 days early on your script.


This drug is bad news. Not sure that MA should ban it because of what others have stated about other states banning birth control, etc, but it needs to go away and go away fast.
 
2014-04-08 05:30:25 PM  

Suflig: http://www.huffingtonpost.com/andrew-kolodny-md/zohydro-the-fdaapprov e d-p_b_4855964.html

This here is an interesting link about the drug. It's 50mg of hydrocodone, ten times as potent as vicodin. An FDA advisory committee voted 11-2 against releasing it but it was approved anyway.


How the heck did that happen?

I'm pretty cynical, but that seems...unusual.
 
2014-04-08 06:16:33 PM  

jtown: MFK: jtown: wyltoknow: Even if there is a huge problem with opiads in the state, what does banning this one drug do? Absolutely nothing. Even if patrick banned every opiad, which would be insane, it still would hardly dent the problem. Just another politician pretending that theyre fixing the problem. How about some actual solutions? Why is opiate abuse so heavy in the state? What is causing people to turn to this drug? Where are the efforts to rehabilitate?

I'm guessing if you dig down, you'll find that the governor has close ties to some other opioid manufacturer.  A friend or relative, a significant investment, big campaign donor, etc.

I'm guessing that you have no idea how bad the heroin problem in New England is. In Vermont, the governor devoted most of the State of the State speech to it. It's seriously "that bad".

I don't need to know how bad it is to know that banning one (1) prescribed opioid does not address a drug abuse problem.  To have an effect, they must  all be banned.  If only one is banned, the reason it was banned can't be to address a drug abuse problem.  ?Comprende?


"My drugs are better than your drugs because I like my drugs. Nya"

So sick of pothead condescension of drugs they don't like. Personally I think Opium should be legal too. Can it kill you? yes it can, so can alcohol and cigarets.
 
2014-04-08 07:05:58 PM  

Private_Citizen: I came to be snarky about a mere State Governor challenging the authority of the corporate overlords, but the point about conservative governors banning birth control is well taken.

This would set a bad, bad precedent. Fight it at the FDA level.


The precedent was already set in Arizona.  The message was that states cannot infringe on the enforcement power of the feds.  At least that's what the Fark Libs told us.
 
2014-04-08 07:07:55 PM  

beefoe: bborchar: somedude210: This is the one that should've never gotten through the FDA and is very very very easy to overdose on, right?

I have no problem with Patrick doing this, if that's the case. New England is facing a massive opiate problem

My problem is where does governor have the power to do such a thing?  And if he's allowed to do it, what's stopping other conservative governors from banning drugs like birth control?

He overstepped his bounds and needs to leave this up to the correct authorities.

Don't be silly. Democrats only do good things and evil Repukelicans only do bad things.


I don't think anyone's ever said that Democrats only do good things ever.
 
2014-04-08 07:43:06 PM  

RyansPrivates: That is reasonable. (Not readily available.) Maybe tighter regulations around administration. Maybe clinic only adminstration? Or in the case of a pill, you have to go to the same pharmacy on some regular basis (i.e. once a week). But I think the root of the problem is overprescription. Recently broke my 5th metarsial. Not pleasant mind you, but far from the most painful thing in the world. But the doctor wrote a script for hydrocodone. I never filled it. I could manage my pain to a reasonable level with tylonol and cold/ice. The doctors need to get out of the business of writing scripts for this stuff so much.


And that was enough for you - good for you. However all people do not feel pain the same. Some people get pleasure from pain - real identifiable by CT scans pleasure, others don't. Just because YOU can deal without opiate pain killers doesn't mean everyone else can or should. Just because YOU will get addicted from taking them doesn't mean others will.

Pain and pain meds affect EVERYONE differently. Case and point my brother and I. My brother has a VERY high pain tolerance, he can break fingers and not even really notice, whereas I can stub my toe and feel it for hours. He however has a problem with "nagging" pains like papercuts whereas I am so used to pain 'nagging' me that rashes/papercuts don't bother me at all.

Step that up to a tiny bit of pain killers will throw him for a loop - and he's done hard drugs. I however, who have had 3 kidney stones am barely affected by tramadol and when my arthritis gets really bad I can feel it even through vicodin.

Pain killers affect different people with different brain chemistries in different ways. Pain killers have *always* made me hyper/wanting to stay busy and are better than caffeine at keeping me awake. Other people just fall asleep instantly.

Why is this all important? Since pain killers affect everyone differently, doctors need the flexibility to prescribe differently for different people in a variety of ways and situations. When your little snowflake is screaming and crying in pain because of that broken bone, the same one that you had no problem with, are you going to just say "man up, wimp" or are you going to fill that RX?

Doctors have degrees. Unless you have a medical degree, and specifically a degree in neurobiology you probably shouldn't be making any decisions regarding regulation of pain killers. Opiate, synthetic, or otherwise.
 
2014-04-08 09:35:21 PM  

Private_Citizen: I came to be snarky about a mere State Governor challenging the authority of the corporate overlords, but the point about conservative governors banning birth control is well taken.

This would set a bad, bad precedent. Fight it at the FDA level.


Agreed.  And use this platform as a means to improve the FDA and bring more transparency.

Panatheist: So sick of pothead condescension of drugs they don't like. Personally I think Opium should be legal too. Can it kill you? yes it can, so can alcohol and cigarets.


Calling people potheads is pretty condescending too.  But of the pro-pot people I know, they are against any prohibitions and dont single out things they "dont like".  You mileage (or awareness) may vary.
 
2014-04-08 10:50:34 PM  
zimbomba63:

Pretty sure you can get addicted to Tramadol, too.  Tried it once and it was like a trip to the magic kingdom of happiness.  It was so nice, I said to myself, "You can never touch that again!"

Wtf? I've been taking Tramadol for three years for a herniated disc and never had that effect.  I wanted to buy whoever invented it all the beers because 1) it was the only thing that worked 2) never felt even the slightest bit loopy our out of it. And it's not like I've developed a tolerance - no reaction, ever, from the very beginning.
 
2014-04-09 08:47:17 AM  

brax33: RyansPrivates: That is reasonable. (Not readily available.) Maybe tighter regulations around administration. Maybe clinic only adminstration? Or in the case of a pill, you have to go to the same pharmacy on some regular basis (i.e. once a week). But I think the root of the problem is overprescription. Recently broke my 5th metarsial. Not pleasant mind you, but far from the most painful thing in the world. But the doctor wrote a script for hydrocodone. I never filled it. I could manage my pain to a reasonable level with tylonol and cold/ice. The doctors need to get out of the business of writing scripts for this stuff so much.

And that was enough for you - good for you. However all people do not feel pain the same. Some people get pleasure from pain - real identifiable by CT scans pleasure, others don't. Just because YOU can deal without opiate pain killers doesn't mean everyone else can or should. Just because YOU will get addicted from taking them doesn't mean others will.

Pain and pain meds affect EVERYONE differently. Case and point my brother and I. My brother has a VERY high pain tolerance, he can break fingers and not even really notice, whereas I can stub my toe and feel it for hours. He however has a problem with "nagging" pains like papercuts whereas I am so used to pain 'nagging' me that rashes/papercuts don't bother me at all.

Step that up to a tiny bit of pain killers will throw him for a loop - and he's done hard drugs. I however, who have had 3 kidney stones am barely affected by tramadol and when my arthritis gets really bad I can feel it even through vicodin.

Pain killers affect different people with different brain chemistries in different ways. Pain killers have *always* made me hyper/wanting to stay busy and are better than caffeine at keeping me awake. Other people just fall asleep instantly.

Why is this all important? Since pain killers affect everyone differently, doctors need the flexibility to prescribe differently for different people i ...


I have peppered my posts throughout this thread with the caveat that I am NOT a doctor.  However, I am a concerned citizen who has seen my share of addicts that got hooked (at least initially) on prescription painkillers, (leading to heroin in at least one case). This post was in response to a discussion that about what to do about this problem.  And as far as regulation is concerned: as a citizen I absolutely have a vested interest what regulations are on the books whether it is my area of "expertise" or not. That is because we (ostensibly) live in a republican democracy, not an oligarchy.  That being said, doing a Google search I found that there are multiple medical boards (California, Nevada, etc) that voiced public concerns about this problem (overprescribing), so obviously, this "not a doctor" isn't alone in his thoughts.

As I stated before in a previous post, there is a place for these drugs:
My case (of the broken foot) was my case.  My pain was manageable.  My doctor didn't even ask if I wanted pain medication; he just prescribed.  That is a problem. If need pain meds, you should get them, opoid or othewise.  We have these medicines and they should be used; they shouldn't, however, be the default script after every injury you see the doctor about.

If doctors aren't doing the right thing (and are overprescribing) are we just to leave it to them? or do we as a society have a vested interest in additional regulations?  The governor in TFA had his heart in the right place, but banning a drug that the FDA has approved I don't think is in his powers.   Doctors need just about any medicine in their arsenal they can get their hands on, because of the reasons you stated.  That doesn't, however, preclude our society from having additional regulations around certain meds.
 
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