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Last post 6 years ago by cacman. 186 replies replies.
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Opiate State of Emergency????
cacman Offline
#101 Posted:
Joined: 07-03-2010
Posts: 12,216
teedubbya wrote:
I’ll partially answer my own question. I do think oxy used to be advertised quite a bit in the 90s if I remember correctly.

A lot of advertising and propaganda was directed at doctors only, and not seen by the public.

Watch the full NatGeo episode. It shows some of the actual advertising and propaganda directed towards health care providers and insurance companies.
Speyside Offline
#102 Posted:
Joined: 03-16-2015
Posts: 13,106
Tim, I think prescription drug advertising is problematic. Right now we constantly see blood thinners being advertised with the provision of ask your doctor. Xarelto and Eliquis are certainly different than Coumadin, but are they necessarily better?

Thank you for the insight on opioids.
teedubbya Offline
#103 Posted:
Joined: 08-14-2003
Posts: 95,637
Cacman I’ll just say I see how docs are marketed, have spent a lot of time in the docs offices and with the RX reps. While I am in no way disputing your take on things I’d say it’s a smaller part then you know (specific to opioids) and works a little differently than I think you are stating, particularly the insurance company bit. And yes I’ve worked on both sides of the drug formulary (insurance company designing and implementing them, and network of docs offices attempting to manage and deal with them).

That said not specific to opioids I too find RX advertising, preferred drug formularies (usually set by pbms but not always), direct doc marketing and treats (I used to follow drug reps in after they treated the office to very nice lunches.... we stopped that)and much more garbage that goes on problematic. Even generic versus brand shenanigans and patent manipulation (for lack of a better term) are garbage. I thank massengill for a lot of the problems there and the resulting rules.

Specific to opioids though it’s tip of the iceberg. It’s a much deeper issue.

teedubbya Offline
#104 Posted:
Joined: 08-14-2003
Posts: 95,637
The sample practice is **** too. Just not under this topic.
teedubbya Offline
#105 Posted:
Joined: 08-14-2003
Posts: 95,637
I’ll shut up lol. Just been living this topic for awhile and it’s intensifying as of late. This, antimicrobial stewardship, diabetic education, medical harm, readmissions, nursing home issues (pressure ulcers etc), sepsis, data issues, etc keep me busy.
rfenst Offline
#106 Posted:
Joined: 06-23-2007
Posts: 39,323
teedubbya wrote:
I’ll shut up lol. Just been living this topic for awhile and it’s intensifying as of late. This, antimicrobial stewardship, diabetic education, medical harm, readmissions, nursing home issues (pressure ulcers etc), sepsis, data issues, etc keep me busy.

Hope you get better soon.
teedubbya Offline
#107 Posted:
Joined: 08-14-2003
Posts: 95,637
Lol.
frankj1 Offline
#108 Posted:
Joined: 02-08-2007
Posts: 44,221
teedubbya wrote:
I’ll shut up lol. Just been living this topic for awhile and it’s intensifying as of late. This, antimicrobial stewardship, diabetic education, medical harm, readmissions, nursing home issues (pressure ulcers etc), sepsis, data issues, etc keep me busy.

ask your doctor if cannabis is right for you.
cacman Offline
#109 Posted:
Joined: 07-03-2010
Posts: 12,216
teedubbya wrote:
I’ll shut up lol.

It's all been good info. Thanks.
DrafterX Offline
#110 Posted:
Joined: 10-18-2005
Posts: 98,551
What's everyone's opinion on the best over the counter drug for back pain..?? Cannabis would be cool if I didn't have to work... Mellow
teedubbya Offline
#111 Posted:
Joined: 08-14-2003
Posts: 95,637
Dilly Dilly

Have you tried a tens unit?
teedubbya Offline
#112 Posted:
Joined: 08-14-2003
Posts: 95,637
And I have no idea. I ain’t that smart.
DrafterX Offline
#113 Posted:
Joined: 10-18-2005
Posts: 98,551
I've got a burn on the lower left side of my new knee about the size of a quarter and 1/8th deep from a tens unit I got at physical therapy a couple weeks ago.. I'm a bit concerned... I told her it was burning but she just turned it down a little bit and walked off.. but other than that I've enjoyed them.. just not that often... Mellow
teedubbya Offline
#114 Posted:
Joined: 08-14-2003
Posts: 95,637
That’s unusual
DrafterX Offline
#115 Posted:
Joined: 10-18-2005
Posts: 98,551
Ya.. I'm kinda numb in that area but I knew somethin wasn't right... I can scratch the right side of my knee and feel it on the left side.. Mellow
Gene363 Offline
#116 Posted:
Joined: 01-24-2003
Posts: 30,817
cacman wrote:
A lot of times the insurance companies tell the doctor what meds have to be prescribed first, before any other options can be explored.



They also don't mind wasting your pain and the doctor's time trying out alternative drugs when they decide to drop one that work from their formulary. It happened to me for migraine fixer, MAXALT (rizatriptan benzoate) was removed after my provider was bought out by another company.
victor809 Offline
#117 Posted:
Joined: 10-14-2011
Posts: 23,866
Drafter.... back pain is tough. I've had ruptured discs on and off since my 20s. It's been bad enough to atrophy a leg at one time.

I've noticed opiates never helped that pain... I remember getting a morphine shot before they straightened my nose back and I was really hoping to get some relief from my back pain when they did that... nothing.

My best luck with back pain is lots of anti-inflammatories... ibuprofen at 800mg 4x a day. A tens unit running from my lower back down the trashed leg felt good... and hanging upside down in one of those inverters. Then tons of physical therapy...
DrafterX Offline
#118 Posted:
Joined: 10-18-2005
Posts: 98,551
I have an inversion table I used to use a couple times a week..of course I can't use it again until my knee is cool...
I've got 5 levels fused now and they want to another... I've just accepted pain..but I'm starting to think fighting it is futile... Mellow
bgz Offline
#119 Posted:
Joined: 07-29-2014
Posts: 13,023
Tai Chi (no I don't know it, just heard it can help with back pain).
dstieger Offline
#120 Posted:
Joined: 06-22-2007
Posts: 10,889
TW,
I appreciate your insight. I've read everything you wrote and understood some of it. However, while I get that the 'problem' is complicated, nothing I read convinces me that drug companies, health care complex and insurance industry aren't complicit. I take everything I see on TV with a huge grain of salt....but, I gotta say that watching Megyn Kelly's story on FLA rehab communities was downright alarming....takes a lot to get me outraged anymore, but holy ****...

https://www.nbcnews.com/feature/megyn-kelly/florida-s-billion-dollar-drug-treatment-industry-plagued-overdoses-fraud-n773376

This doesn't happen with some fringe ineptitude or a couple bad players....this is systemic ass **** by the same industries that everyone seems to feel needs government help and our tax dollars to keep us all safe, insured and healthy....


I fully agree that we've been WAY over antibacterialed and antimocrobed...to our huge detriment. But even that isn't purely slick marketing and healthy capitalism...if it is indeed a strategic health concern, then our providers and insurers failed to protect us ....with their silence or complacency or assistance, even.

Of course, all illegal drug addicts weren't directly hooked by our corrupted health care/insurance complex, but a lot are...and the market supply is aided by demand resulting from those we pay to keep a healthy society.

I don't want to assess 100% blame on health insurers and mega-health-provider systems, but I don't want to let them off the hook....and I want some accountability assessed....and I want some transparency in the system, especially with regards to costs before one more tax dollar goes into that corrupt meat grinder that spits out a few healthier people at great expense right along with addicts and other societal deficits
dstieger Offline
#121 Posted:
Joined: 06-22-2007
Posts: 10,889
BTW, my post 5 rant was (completely?) unrelated to my first post....I wasn't referring to advertising regarding opiates or anything related to that 'crisis'...I just meant consumer marketing of prescription medicine in general makes me queasy and likely does far more harm than good by corrupting patient care ....don't even give me any bull**** about how educating the consumer is a net positive in this case...I'm not buying that in this case...these aren't balanced documentaries that I'm watching every night
teedubbya Offline
#122 Posted:
Joined: 08-14-2003
Posts: 95,637
dstieger wrote:
TW,
I appreciate your insight. I've read everything you wrote and understood some of it. However, while I get that the 'problem' is complicated, nothing I read convinces me that drug companies, health care complex and insurance industry aren't complicit. I take everything I see on TV with a huge grain of salt....but, I gotta say that watching Megyn Kelly's story on FLA rehab communities was downright alarming....takes a lot to get me outraged anymore, but holy ****...

https://www.nbcnews.com/feature/megyn-kelly/florida-s-billion-dollar-drug-treatment-industry-plagued-overdoses-fraud-n773376

This doesn't happen with some fringe ineptitude or a couple bad players....this is systemic ass **** by the same industries that everyone seems to feel needs government help and our tax dollars to keep us all safe, insured and healthy....


I fully agree that we've been WAY over antibacterialed and antimocrobed...to our huge detriment. But even that isn't purely slick marketing and healthy capitalism...if it is indeed a strategic health concern, then our providers and insurers failed to protect us ....with their silence or complacency or assistance, even.

Of course, all illegal drug addicts weren't directly hooked by our corrupted health care/insurance complex, but a lot are...and the market supply is aided by demand resulting from those we pay to keep a healthy society.

I don't want to assess 100% blame on health insurers and mega-health-provider systems, but I don't want to let them off the hook....and I want some accountability assessed....and I want some transparency in the system, especially with regards to costs before one more tax dollar goes into that corrupt meat grinder that spits out a few healthier people at great expense right along with addicts and other societal deficits


Good. Because nothing I said was intended to do so. I’d never say they are not. But it’s just one (or more) facet and there is much more to the issue. I’m just saying it’s going to take a multi pronged approach. Don’t get too bogged down on one part of the problem or one approach, but don’t ignore it either. It’s a complicated critter.


Speyside Offline
#123 Posted:
Joined: 03-16-2015
Posts: 13,106
TW, you are much more knowledgeable than the rest of us on this subject I think. Would legalizing illicit drug use lessen or worsen the problem in your opinion? Also are there any checks in place to find the doctor feels goods that are out there?
Gene363 Offline
#124 Posted:
Joined: 01-24-2003
Posts: 30,817
victor809 wrote:
Drafter.... back pain is tough. I've had ruptured discs on and off since my 20s. It's been bad enough to atrophy a leg at one time.

I've noticed opiates never helped that pain... I remember getting a morphine shot before they straightened my nose back and I was really hoping to get some relief from my back pain when they did that... nothing.

My best luck with back pain is lots of anti-inflammatories... ibuprofen at 800mg 4x a day. A tens unit running from my lower back down the trashed leg felt good... and hanging upside down in one of those inverters. Then tons of physical therapy...


I had similar experience, age and bad genetics gave me crappy disks. I ended up getting some disks cleaned up and some relief cuts around the opening where the nerves are located. Back spasms are a mofo, I've been in the ER and had shots of demerol and morphine that didn't do a thing. But, once I learned my back pain was just muscle spasms and was not causing damage, I was able to deal with it and keep moving. I still get phantom pain in my legs, like someone is holding a hot iron on my leg. It's startling, but endurable because I know its just nerves. I haven't tried an inversion table, but avoiding things that piss off my back are the key to survival, best advice ever, "Never pick up anything heavier than a sixpack."
frankj1 Offline
#125 Posted:
Joined: 02-08-2007
Posts: 44,221
Gene363 wrote:
I had similar experience, age and bad genetics gave me crappy disks. I ended up getting some disks cleaned up and some relief cuts around the opening where the nerves are located. Back spasms are a mofo, I've been in the ER and had shots of demerol and morphine that didn't do a thing. But, once I learned my back pain was just muscle spasms and was not causing damage, I was able to deal with it and keep moving. I still get phantom pain in my legs, like someone is holding a hot iron on my leg. It's startling, but endurable because I know its just nerves. I haven't tried an inversion table, but avoiding things that piss off my back are the key to survival, best advice ever, "Never pick up anything heavier than a sixpack."

stenosis?
Gene363 Offline
#126 Posted:
Joined: 01-24-2003
Posts: 30,817
frankj1 wrote:
stenosis?


I do not recall that term, but after looking it up, yes. The doc did a laminectomy and some other things he described when all I was wanting to hear was success or something else.
Phil222 Offline
#127 Posted:
Joined: 10-01-2017
Posts: 1,911
dstieger wrote:
TW,
https://www.nbcnews.com/feature/megyn-kelly/florida-s-billion-dollar-drug-treatment-industry-plagued-overdoses-fraud-n773376


I wasn't aware that this was an issue. That definately needs to be addressed.

The government has access to the leading experts in every field, so they know what needs to be done in order to combat the opoid problem. They just have not done it. I think the difficult question that needs to be asked here is not what needs to be done, but is it Joe Taxpayers responsibility to pay for it?
cacman Offline
#128 Posted:
Joined: 07-03-2010
Posts: 12,216
Phil222 wrote:
I think the difficult question that needs to be asked here is not what needs to be done, but is it Joe Taxpayers responsibility to pay for it?

Said it before and will say it again.
If you ask for guberment controlled health care and insurance in cohoots with big pharma, then don't be surprised by a guberment and insurance created drug epidemic on prescription drugs with support of big pharma. They all make money on both ends of the candle - starting the addiction, then treating the symptoms. And tax-payers are footing the bill. All while being forced to buy into the broken system and supporting it.

Plus the guberment would rather have the sheeple stoned, drunk and stupid instead of questioning the guberment's decisions about their health care and life choices. As the guberment and insurance companies keep telling us, they know what's best for our health care.

https://www.youtube.com/watch?v=I8JfxP1Bv5c
offered with no disrespect to pain management or mental health issues. IMHO the song is still relevant today.
cacman Offline
#129 Posted:
Joined: 07-03-2010
Posts: 12,216
A wild conspiracy to consider:
The guberment supported crack cocaine being imported into the US to fund an illegal war. (Ask Gary Webb. Oh wait, he's dead)
Is it a far stretch to think the guberment is allowing the manufacturing and import of heroin/opiates to support those Middle Eastern countries.
Air America also come to mind.
Think
cacman Offline
#130 Posted:
Joined: 07-03-2010
Posts: 12,216
Great! Now all we need are the actual treatment centers instead of more prisons, and the Federally run health care system and insurance companies to cover the same services for those in need of treatment BEFORE they are incarcerated. And without more taxes or increased premiums.

Opioid commission: We need drug courts, not prisons, for abusers
http://www.cnn.com/2017/11/01/health/opioid-commission-final-report/index.html
bgz Offline
#131 Posted:
Joined: 07-29-2014
Posts: 13,023
Pretty sure crack cocaine is an American product.
teedubbya Offline
#132 Posted:
Joined: 08-14-2003
Posts: 95,637
Sitting in a collaborative right now. Heard an interesting statistic I need to verify.

In pain patients opioids only work 50% if the time. In the 50% they work on they provide 30% relief. That 30% relief deteriorates over time.

cacman Offline
#133 Posted:
Joined: 07-03-2010
Posts: 12,216
bgz wrote:
Pretty sure crack cocaine is an American product.

LMFAO!!!!
umm… NO!
DrafterX Offline
#134 Posted:
Joined: 10-18-2005
Posts: 98,551
Columbia... but I'm not sure they were first.. Mellow
DrafterX Offline
#135 Posted:
Joined: 10-18-2005
Posts: 98,551
teedubbya wrote:
Sitting in a collaborative right now. Heard an interesting statistic I need to verify.

In pain patients opioids only work 50% if the time. In the 50% they work on they provide 30% relief. That 30% relief deteriorates over time.





Sounds like I need to double my medication... Think
bgz Offline
#136 Posted:
Joined: 07-29-2014
Posts: 13,023
cacman wrote:
LMFAO!!!!
umm… NO!


Um ya, manufactured right here in our own ghetto and suburban kitchens across the good ol' USA.

You should know this, you got beat up in the hood for years!
cacman Offline
#137 Posted:
Joined: 07-03-2010
Posts: 12,216
bgz wrote:
Um ya, manufactured right here in our own ghetto and suburban kitchens across the good ol' USA.

You should know this, you got beat up in the hood for years!

NO. Wake up and quit stereotyping crack to the ghetto.
Crack is made and distributed world-wide. It is NOT a good ole USA thing only. Never was.
But it isn't worth arguing over. Become informed first.

Even the Wiki lists 3 other Countries (2 other Continents) including Australia, Canada, and Europe.
https://en.wikipedia.org/wiki/Crack_cocaine
bgz Offline
#138 Posted:
Joined: 07-29-2014
Posts: 13,023
cacman wrote:
NO. Wake up and quit stereotyping crack to the ghetto.
Crack is made and distributed world-wide. It is NOT a good ole USA thing only. Never was.
But it isn't worth arguing over. Become informed first.


LMFAO, even though I've never done cocaine myself (in any form), I've met a few chefs in my life.

Think about it logistically, what's easier to ship... raw powder or manufactured rocks.

It's stupid AF to ship rock when you can ship compact powder.

And I don't believe I stereotyped it just to the ghetto, re-read what I wrote.

Oh... and jokes!!! Learn to detect them ;)
DrafterX Offline
#139 Posted:
Joined: 10-18-2005
Posts: 98,551
Americans are the only ones smoking crack in da world..?? Huh
cacman Offline
#140 Posted:
Joined: 07-03-2010
Posts: 12,216
Love hearing the rhetoric from someone who has never used coke. let alone been involved in the import and distribution. LMFAO! That is a funny chef joke.

It's easier and less expensive to create crack than traditional powder. It also "compresses" more than powder, meaning that a kilo of crack is smaller than a kilo of powder. Crack is pure and faster to sell as it isn't "cut" before distribution. Crack can be made at home but is a PITA, especially when you've been up for 3 days. Ask Richard Pryor. But the USA probably is the biggest consumer.
bgz Offline
#141 Posted:
Joined: 07-29-2014
Posts: 13,023
Well, you sound like you're speaking from experience, so I'll defer to your expertise :D

I did try to find info on this, the only thing I could find is that recently they started shipping some product to Africa to be processed into rock before being smuggled in here.

I had a hard time finding anything other than that.

I never used it because my brain wouldn't let me... call me stubborn. You haven't seen paranoia until you've been the only one in a room full of crack heads not doing crack, lol.
cacman Offline
#142 Posted:
Joined: 07-03-2010
Posts: 12,216
At the end of the coke-boom during the 80's, it was easier to acquire crack than powder. The buzz from crack is more intense compared to powder. But not as intense as injecting coke. But you can't inject crack, only powder.

When you're raised in State institutions for being incorrigible, you learn a few things.
DrafterX Offline
#143 Posted:
Joined: 10-18-2005
Posts: 98,551
What puzzles me is the Meth heads... why in hell would anyone smoke or snort that chit... you may as well just drink antifreeze or somethin.. Mellow
RMAN4443 Offline
#144 Posted:
Joined: 09-29-2016
Posts: 7,683
DrafterX wrote:
Americans are the only ones smoking crack in da world..?? Huh

My crack used to smoke, but I cut back on the Habaneros and it's not so bad nowBlink
Phil222 Offline
#145 Posted:
Joined: 10-01-2017
Posts: 1,911
DrafterX wrote:
What puzzles me is the Meth heads... why in hell would anyone smoke or snort that chit... you may as well just drink antifreeze or somethin.. Mellow


It is the same reason people move on to heroin from opoid medications. It is cheaper than cocaine and easier to get.
RMAN4443 Offline
#146 Posted:
Joined: 09-29-2016
Posts: 7,683
DrafterX wrote:
What's everyone's opinion on the best over the counter drug for back pain..?? Cannabis would be cool if I didn't have to work... Mellow

Why would cannabis affect work?.......they have all the edibles now, so you don't even need to smoke it.......if your taking pain meds now and working, cannabis wouldn't be much, if any different.........unless it's the drug testing, I'm not sure how that works in your state.Think
DrafterX Offline
#147 Posted:
Joined: 10-18-2005
Posts: 98,551
RMAN4443 wrote:
Why would cannabis affect work?.......they have all the edibles now, so you don't even need to smoke it.......if your taking pain meds now and working, cannabis wouldn't be much, if any different.........unless it's the drug testing, I'm not sure how that works in your state.Think



just the testing... Mellow
bgz Offline
#148 Posted:
Joined: 07-29-2014
Posts: 13,023
Well, they wouldn't let you do it if you had a legit license for it?
DrafterX Offline
#149 Posted:
Joined: 10-18-2005
Posts: 98,551
not very likely... Mellow
delta1 Offline
#150 Posted:
Joined: 11-23-2011
Posts: 28,788
I'm sure glad that opiates exist. They are legitimate pain-killers. I had morphine for two days after knee replacement surgery, then a week of oxycodone, then a few days of novocodone.

But I remember the awful dreams I had after the first few doses of oxy at home, after the morphine wore off...can't imagine anyone wanting that side effect. But declaring war on opiates is useless...it basically is a narrowing of the "War on Drugs": a failed attempt to criminalize non-violent anti-social behavior. Maybe some form of treatment, including safer alternative drug therapy is the answer, but wasting money on putting people in jail for simple drug abuse aint it...
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