Heroin now kills more people than guns:

[The Nature Boy 7,659]

4 hours ago, Il Mango Dulce said:

I am not really sure why we are comparing heroine and guns but Japan had one gun murder last year and 1/5 the murder rate of the US. 

and a way higher suicide rate

 

 

[Voice of Reason 10,298]

2 hours ago, spookyturtle said:

Yet Japan had over 20,000 suicides. 

Less than half the population of the US, their population is shrinking, and almost half the number of suicides.  Ends up being somewhere close to double our US rate.

Edited March 10, 2018 by IDWAF

[Voice of Reason 10,298]

7 minutes ago, Nature Boy Flair said:

and a way higher suicide rate

 

 

Roughly double the suicide rate in Japan, though their numbers have been declining in recent years (but not greatly).

 

Edited March 10, 2018 by IDWAF

[Neonred 3,563]

20 hours ago, bcking said:

Addiction will always exist, until we develop a cure or a way to prevent it. Promotion from pharmaceutical companies hasn't created chemical addiction, it has just increased the pool of patients prescribed them, which in turn increases the number addicted.

 

Can you elaborate more on your second sentence? People receive narcotics from the black market in their mail box? How exactly does that work? I wasn't aware of that, to be honest.

 

This isn't a subject that impacts my career very often since my patients are newborns, so I admit I'm not completely knowledgeable in the area. It comes up with mothers who are addicted, but that's about it.

I've had some exposure to addiction.  My ex-wife, also a doctor, developed a problem with opiods.  I clearly remember when she hurt her hip while waterskiing.  I encouraged her to see her physician but she refused.  She was taking ibuprofen, or so I thought, to help.  Turns out, after some time. she started self prescribing Vicodin.  At that time it was easy to obtain as we could order it along with other medical supplies for the office.  She was very discrete about ordering and no one knew.  One day I found a prescription bottle she had with my name on it as if I were the patient.  She had called it in and picked it up for herself.  That was the day the "stuff" hit the fan.  Further checking revealed thousands, yes thousands of Vicodin tablets ordered that year, along with hundreds of valium tablets all for her own use. 

 

Last time I saw her , a couple of years ago, it appeared she had beaten the addiction.

Edited March 11, 2018 by Neonred

[Voice of Reason 10,298]

House made it all too painfully aware that narcotics are far too easy to obtain.

[yuna628 9,676]

23 hours ago, spookyturtle said:

Yet Japan had over 20,000 suicides. 

I think that there is a cultural and somewhat spiritual reason for the high suicide rate there, that we in the western world wouldn't necessarily understand.

 

With regard to addiction: It is clear that there are many, often effective ways to treat and manage pain. However we know that often involved therapy - both physical and sometimes mental. These treatments can be a lengthy and ongoing process.... so long that very often insurance companies and Medicare will not cover. They are more than happy to cover the opioids, but not things that can really help heal the entire person. I know this from experience with my mom. First it was the cancer, then it was RA and other conditions which has twisted her hands and made her very immobile. Then she fell and badly injured herself, leading to most of one side being unable to function. She has been on a painkiller, not anything like oxy or the higher tier stuff, but still a painkiller for quite some time now. It must be approved every single month and reassessed by several doctors and they still continue to run other tests to find out if the deterioration of her hands is something more rare and genetic based (my grandfather had the same problem). For a time she was in PT, and this improved her mobility greatly... but eventually Medicare no longer wanted to cover it beyond a few weeks. The PT said they will refuse to cover anything continually if your progress is too slow even if you improve over time. Other suggestions have been to put her on heavy drugs for RA, which she has refused. She doesn't like the risk or the side effects. Ideally I'd like to reach the point where she has no need of these drugs. In this town.. addicts are everywhere, as are 'treatment' locations that are often very shady. It's unbelievable the things you see here every day, and honestly, it's worse than what I ever saw in the city. Narcan is being given to as many people as possible.. but some fear while it saves lives, it's providing a safety net.

 

My uncle was an addict for a good part of his youth, just as my dad was an alcoholic. But both turned their lives around. Genetically I suppose this predisposes me in some way.. but I have never had a desire bar a very rare occasional drink - for cigs, excessive alcohol, or drugs. People need help. Really long-lasting treatment for mental and physical problems, because we are in a world now where a large chunk of the population simply cannot cope anymore. What we're doing just isn't working.

 

@bcking My husband handles events for the PD, social services, and other department agencies for the governor. One of them recently was about the devastation addiction is causing and how they PD is trying to tackle it. The biggest increasing killer from fentanyl. Yes some items are being shipped directly to individuals. There was an investigative report recently just how a person could do it. Glossy websites, tech support, ways how the drugs are hidden, and a free reshipment if inspections catches it. Some of it is tainted.

[Voice of Reason 10,298]

1 hour ago, yuna628 said:

I think that there is a cultural and somewhat spiritual reason for the high suicide rate there, that we in the western world wouldn't necessarily understand.

Now, imagine yourself sitting in Japan, and saying the same thing about gun homicides.

[-Trinity- 513]

2 hours ago, yuna628 said:

I think that there is a cultural and somewhat spiritual reason for the high suicide rate there, that we in the western world wouldn't necessarily understand.

 

With regard to addiction: It is clear that there are many, often effective ways to treat and manage pain. However we know that often involved therapy - both physical and sometimes mental. These treatments can be a lengthy and ongoing process.... so long that very often insurance companies and Medicare will not cover. They are more than happy to cover the opioids, but not things that can really help heal the entire person. I know this from experience with my mom. First it was the cancer, then it was RA and other conditions which has twisted her hands and made her very immobile. Then she fell and badly injured herself, leading to most of one side being unable to function. She has been on a painkiller, not anything like oxy or the higher tier stuff, but still a painkiller for quite some time now. It must be approved every single month and reassessed by several doctors and they still continue to run other tests to find out if the deterioration of her hands is something more rare and genetic based (my grandfather had the same problem). For a time she was in PT, and this improved her mobility greatly... but eventually Medicare no longer wanted to cover it beyond a few weeks. The PT said they will refuse to cover anything continually if your progress is too slow even if you improve over time. Other suggestions have been to put her on heavy drugs for RA, which she has refused. She doesn't like the risk or the side effects. Ideally I'd like to reach the point where she has no need of these drugs. In this town.. addicts are everywhere, as are 'treatment' locations that are often very shady. It's unbelievable the things you see here every day, and honestly, it's worse than what I ever saw in the city. Narcan is being given to as many people as possible.. but some fear while it saves lives, it's providing a safety net.

 

My uncle was an addict for a good part of his youth, just as my dad was an alcoholic. But both turned their lives around. Genetically I suppose this predisposes me in some way.. but I have never had a desire bar a very rare occasional drink - for cigs, excessive alcohol, or drugs. People need help. Really long-lasting treatment for mental and physical problems, because we are in a world now where a large chunk of the population simply cannot cope anymore. What we're doing just isn't working.

 

@bcking My husband handles events for the PD, social services, and other department agencies for the governor. One of them recently was about the devastation addiction is causing and how they PD is trying to tackle it. The biggest increasing killer from fentanyl. Yes some items are being shipped directly to individuals. There was an investigative report recently just how a person could do it. Glossy websites, tech support, ways how the drugs are hidden, and a free reshipment if inspections catches it. Some of it is tainted.

I still can't wrap my mind about how many people are addicted in the area we live in.

 

And the many over doses, young people with their entire life ahead of them dying from overdoses. 

 

I wonder if there a direct correlation between addiction, and how easy people use medication for minor things like a simple cold.

Also, how do doctors guide patients who are on some sort of painkiller like morfine.

 

For example, my sister had to use morfine during her pregnancy because she hardly couldn't walk. But because of the side effects for the baby and to prevent addiction she had to see a doctor multiple times a week.

 

 

[Amica Nostra 4,803]

On 3/10/2018 at 10:46 AM, Nature Boy Flair said:

and a way higher suicide rate

 

 

Is there some sort of trade off you are like Japan has chosen lower heroin and gun murder deaths in exchange for higher suicide rates? 

[yuna628 9,676]

2 hours ago, IDWAF said:

Now, imagine yourself sitting in Japan, and saying the same thing about gun homicides.

I can't frankly, as it is two entirely different things. Suicide is a very significant spiritual and cultural thing for Japan, along with the normal reasons one kills themselves (if it can be called normal at least to the western world). Suicide in Japan can be seen as almost responsible and honorable. It's not seen as a sin or an insult. Gun ownership is in our culture, yes. But murdering people with them and mass shooting them isn't. That isn't normal. That is not seen as honorable or normal to Japan. That has nothing to do with inherent spirituality or sincerely held beliefs regarding suicide. Some in Japan do own guns, but like many other countries that do allow gun ownership, there is a different attitude of responsibility, healthy respect and knowledge in that ownership. Sort of akin to how I think our attitude towards guns used to be. Taking a life is a grave thing, using a gun to do so can be seen as cowardly. Even if Japan had more lax gun laws, I don't necessarily feel that they would be the weapon of choice - as it could be seen as dishonorable. Gun control laws are more modern history for Japan, but the concept for them is far older, well beyond the age of this nation.

[Voice of Reason 10,298]

2 hours ago, yuna628 said:

I can't frankly, as it is two entirely different things. Suicide is a very significant spiritual and cultural thing for Japan, along with the normal reasons one kills themselves (if it can be called normal at least to the western world). Suicide in Japan can be seen as almost responsible and honorable. It's not seen as a sin or an insult. Gun ownership is in our culture, yes. But murdering people with them and mass shooting them isn't. That isn't normal. That is not seen as honorable or normal to Japan. That has nothing to do with inherent spirituality or sincerely held beliefs regarding suicide. Some in Japan do own guns, but like many other countries that do allow gun ownership, there is a different attitude of responsibility, healthy respect and knowledge in that ownership. Sort of akin to how I think our attitude towards guns used to be. Taking a life is a grave thing, using a gun to do so can be seen as cowardly. Even if Japan had more lax gun laws, I don't necessarily feel that they would be the weapon of choice - as it could be seen as dishonorable. Gun control laws are more modern history for Japan, but the concept for them is far older, well beyond the age of this nation.

No.  The primary reason for suicide in Japan is bullying.  Not much honor in that, nor is there in avoiding it by killing oneself.  (Personal failure is another motivating factor, though less so today than in the past.)

 

Suicide in Japan is considered “normal”.  Just as gun crime is in America.  No one wants it, no one is proud of it, but it exists.  Their suicide rate is twice ours, roughly.  That’s a LOT of self-killing.  And it’s sad, no matter what culture it is in.  

 

I don’t understand how anyone, in any country, can see suicide as “honorable”.  

[bcking 3,157]

On 3/10/2018 at 11:13 AM, Il Mango Dulce said:

Focusing on the gateway to addiction,  I read somewhere that 1/10 of us should never take that first drag of tobacco because our genes have determined 1/10 cannot stop. If this extends to opiods, shouldn't we invest in determing who should not be perscribed and mitigate the risk?

 

 

Battling addiction to opioids is far more challenging than cigarettes.

 

You could argue no one should take that first drag of tobacco. Tobacco is a carcinogen and serves no purpose.

 

Opioids, unfortunately, serve a purpose. Even if you could identify the 10% who are sensitive to addiction, some of those will still truly need the medication. How do you weigh risk of addiction with the potential benefit? 

[TBoneTX 45,292]

Even something like oral prednisone can be "addictive" for people who are in pain.

Then, unless they taper off, they end up hosing their adrenal glands or something, which apparently leads to serious trouble.

I know someone with back pain who actually went doctor-shopping for more and more methylprednisolone injections.

This has caused me to wonder about the psychological aspects underlying the need for relief of physical pain.  Insights?

[Voice of Reason 10,298]

30 minutes ago, TBoneTX said:

Even something like oral prednisone can be "addictive" for people who are in pain.

Then, unless they taper off, they end up hosing their adrenal glands or something, which apparently leads to serious trouble.

I know someone with back pain who actually went doctor-shopping for more and more methylprednisolone injections.

This has caused me to wonder about the psychological aspects underlying the need for relief of physical pain.  Insights?

Personally, I avoid meds as much as possible.  Using the concept that they are man-made, and therefore not natural nor good for us.  I take ibuprofen or acetaminophen for headaches after a few hours of trying to deal with it.  I took hydrocodone for kidney stones, but was actually scared by how much they erased the pain, and only took them for three or four days.  Have always been paranoid about getting hooked, even though I haven’t found the attraction.  But for someone in constant pain, I can understand why they would persist in using the drugs.

[Póg mo 1,749]

37 minutes ago, bcking said:

Battling addiction to opioids is far more challenging than cigarettes.

 

You could argue no one should take that first drag of tobacco. Tobacco is a carcinogen and serves no purpose.

 

Opioids, unfortunately, serve a purpose. Even if you could identify the 10% who are sensitive to addiction, some of those will still truly need the medication. How do you weigh risk of addiction with the potential benefit? 

The way I understand it is, a lot of people who use heroin etc, start out on prescribed legal drugs, but are forced to buy illegal drugs because they get cut off. I feel that decriminalizing drugs is probably the best solution. Why make people with a natural tendency to abuse drugs into criminals, especially when drug addiction can be managed, or even helped. Also, marijuana may not be a silver bullet for everything, but it seems to me that allowing doctors to prescribe it might be a better option than prescribing pharmaceutical grade heroin. I agree opioids have a use, but perhaps they should be reserved for certain situations where they are truly needed, and like a couple of years ago when my wife's doctor hander her a script for sixty hydrocodone pills with little or no questions asked.