Armed Polite Society
Main Forums => The Roundtable => Topic started by: MillCreek on March 15, 2016, 06:02:48 PM
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http://jama.jamanetwork.com/article.aspx?articleid=2503508
A lot of patients are not going to like these.
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There they go painting with that very wide brush again with their recommendations.
Not all opioid users are abusers. I know quite a few that are very compliant with their dosing regime. I also know some abusers. The abusers will find the docs that won't follow the guidelines and will end up getting their opioids and the docs will get rich.
As the opioids are tapered away from society you will see a resurgence of heroin abuse and an uptick in deaths due to ODs and possibly suicides due to people who believe death is preferable to constant pain. We have already seen tapering of opioids as a trigger to SI in the VA. We had 3 people make the celestial transfer last week in town due to some new heroin hitting the streets.
There is not a good solution but cutting people off from opioid therapy after years of allowing it will have to be managed very carefully. I can already see the increased pharmacy robberies as people look for their drugs.
bob
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Over on this side of the mountains, we have seen quite the uptick in heroin use as prescription opioids get harder and much more expensive to obtain illicitly. Heroin is much cheaper and more available.
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There they go painting with that very wide brush again with their recommendations.
Not all opioid users are abusers. I know quite a few that are very compliant with their dosing regime. I also know some abusers. The abusers will find the docs that won't follow the guidelines and will end up getting their opioids and the docs will get rich.
As the opioids are tapered away from society you will see a resurgence of heroin abuse and an uptick in deaths due to ODs and possibly suicides due to people who believe death is preferable to constant pain. We have already seen tapering of opioids as a trigger to SI in the VA. We had 3 people make the celestial transfer last week in town due to some new heroin hitting the streets.
There is not a good solution but cutting people off from opioid therapy after years of allowing it will have to be managed very carefully. I can already see the increased pharmacy robberies as people look for their drugs.
bob
I think they are deliberately creating a problem so they can get additional funding or police power to fight it. They really couldn't care less about people in chronic pain, or acute pain that last a month or so.
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Heroin substitution and the upswing in related overdoses have resulted in beat cops being issued naloxone around here. Apparently a significant percentage of ODs saved with it come up swinging. A higher percentage than training suggested.
Opiate abuse is huge, but making them hard to get doesn't solve the problem.
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You can get naloxone OTC here if you take a class. I wanna take it keep some at home and in car.
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There they go painting with that very wide brush again with their recommendations.
Not all opioid users are abusers. I know quite a few that are very compliant with their dosing regime. I also know some abusers. The abusers will find the docs that won't follow the guidelines and will end up getting their opioids and the docs will get rich.
As the opioids are tapered away from society you will see a resurgence of heroin abuse and an uptick in deaths due to ODs and possibly suicides due to people who believe death is preferable to constant pain. We have already seen tapering of opioids as a trigger to SI in the VA. We had 3 people make the celestial transfer last week in town due to some new heroin hitting the streets.
There is not a good solution but cutting people off from opioid therapy after years of allowing it will have to be managed very carefully. I can already see the increased pharmacy robberies as people look for their drugs.
bob
So much truth and reality.
Bet you dollars to donuts the "officials" making the recommendations have better political knowledge than understanding of pain management and addiction
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Antibiotic abuse and misuse is a bigger threat to mankind than people overdoing opioids, but you don't see any restrictive guidelines on those.
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"As the opioids are tapered away from society you will see a resurgence of heroin abuse and an uptick in deaths due to ODs..."
Too late. Heroin abuse and ODs are up dramatically all over the country, and have been rising as the price of heroin has been plunging.
Many people who have been addicted to pain medications long term are finding heroin cheaper and more potent.
The situation has gotten so bad in the DC metro area that more and more police and other first responders, and even schools and other public facilities, are being outfitted with Narcan.
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^^^I rarely see people overdosing and dying on antibiotics, nor do I see people committing property crimes, robberies or prostitution to buy antibiotics. 44 people per day in the US die from opioid overdose, according to CDC and NIDA statistics.
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^^^I rarely see people overdosing and dying on antibiotics, nor do I see people committing property crimes, robberies or prostitution to buy antibiotics. 44 people per day in the US die from opioid overdose, according to CDC and NIDA statistics.
I have to agree with Blakenzy.
While antibiotic abuse doesn't cause the kinds of social distress that opiates do, the potential for a return to the time when common, minor infections resulted in death is very real, and will reach a FAR wider swath of the population. It's made even more frightening by the rise of the anti-vax movement.
Antibiotics were the single greatest factor in the rather incredible jump in average life expectancy post World War II. Many now believe we stand a very good chance of having that reverse.
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Antibiotic abuse and misuse is a bigger threat to mankind than people overdoing opioids, but you don't see any restrictive guidelines on those.
Funny; people have been gulping down all the allicin they want for centuries, but it still works pretty darn well. Guess the magic superbugs that will kill us all if everyone has access to azithromycin on a Saturday night without a $750 ER bill somehow can't build up a resistance to plain old raw garlic.
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So, you're saying garlic is the cure all for all bugs, and that people didn't die of infections if they ate it?
Bull.
Garlic is an effective TOPICAL antimicrobial but its efficacy has never been established/proven in an ingested for.
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Sure helps against vampires, though.
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So, you're saying garlic is the cure all for all bugs, and that people didn't die of infections if they ate it?
People die of infections while eating and/or being injected full of every modern antibiotic.
Garlic is an effective TOPICAL antimicrobial but its efficacy has never been established/proven in an ingested for.
As in most cases, because there's not enough money to be made in trying to market milligrams of something folks can buy 100 grams of for a buck, so the research to "prove" effectiveness is a waste of money to anyone with the resources to do it.
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"People die of infections while eating and/or being injected full of every modern antibiotic."
Who ever said that they didn't?
What I said is that antibiotics were pretty much solely responsible for the biggest leap in life expectancy, EVER.
Yes, even when penicillin and the various sulfa drugs was the new wonders of the world, and antibiotic resistance wasn't even a thing, people still died from infections, for myriad different reasons. But far FEWER people died of infections than before.
"As in most cases, because there's not enough money to be made in trying to market milligrams of something folks can buy 100 grams of for a buck, so the research to "prove" effectiveness is a waste of money to anyone with the resources to do it."
:facepalm:
You do realize where virtually all early antibiotics came from, right?
From nature.
Garlic was investigated for years as a potential source of new antibiotics (as were literally thousands of other plants, and especially the molds that grew on plants. Lincomycin, for example, came from a moldy cantaloupe found at a fruit stand in Lincoln, Nebraska, in the late 1940s).
People understood its properties even back then, and the Russians, during WW II, used large amounts to treat wounds. Garlic's active mechanism against microbes is little to no different than the increasingly common sulfa drugs of the period. It made no sense, and still makes absolutely no sense, to grow and process millions of tons of raw material to get the same effectiveness of something that can be synthesized quickly and easily via a chemical process.
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You do realize where virtually all early antibiotics came from, right?
You do realize how all modern antibiotics came about, right? Economic incentives. There's a strong disincentive to prove that eating $3 worth of raw garlic would have the same effect as eating $30-$3000 worth of pills your company holds the patent on.
Garlic was investigated for years as a potential source of new antibiotics (as were literally thousands of other plants, and especially the molds that grew on plants. Lincomycin, for example, came from a moldy cantaloupe found at a fruit stand in Lincoln, Nebraska, in the late 1940s).
But not as an antibiotic in itself. Patent a process to make it into something else, and you have a viable product with a dirt cheap precursor. Not so if you release research showing that your process really isn't necessary for efficacy.
People understood its properties even back then, and the Russians, during WW II, used large amounts to treat wounds. Garlic's active mechanism against microbes is little to no different than the increasingly common sulfa drugs of the period.
And yet those all still work in the vast majority of cases. How is that, if resistance is such an issue?
It made no sense, and still makes absolutely no sense, to grow and process millions of tons of raw material to get the same effectiveness of something that can be synthesized quickly and easily via a chemical process.
Millions of tons? Synthesized quickly and easily? What's easier than growing garlic in 95% of the US, and just how much do you expect to use at a normal dose of 10-20 grams/day? 16 pounds would keep someone on 20 grams/day every day for a solid year. Processing is just breaking the bulb apart and shucking the cloves, which pretty much anyone with .05% or more Greek or Italian ancestry can do purely by instinct.
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"You do realize how all modern antibiotics came about, right? Economic incentives. There's a strong disincentive to prove that eating $3 worth of raw garlic would have the same effect as eating $30-$3000 worth of pills your company holds the patent on."
Wrong.
First, you need to define your terms. What's a "modern" antibiotic?
Penicillin? Streptomycin? Clindicin? Vancomycin?
Given that ALL antibiotics are under 100 years old, all are "modern" unless you start defining arbitrary terms and exceptions.
"But not as an antibiotic in itself."
Wrong. It was well understood that simply eating a shitload of garlic (even quantities that would gross out an Italian) would provide success much different from a placebo. The compounds IN garlic that provide the antimicrobial effect don't work that way because the human digestive system rips them apart into component pieces that have no use. Thus, your argument of IT'S ALL MONEY GRUBBING WHORES!! is as invalid as it is silly.
"And yet those all still work in the vast majority of cases. How is that, if resistance is such an issue?"
Are you really that dim? It's because we're in the BEGINNING phase of the rise of resistant bacteria, NOT the end.
Many antibiotics will remain effective in many cases for many years to come, but on a downward slope as the resistant bacteria spread and as more and more strains of once non-resistant bacteria become resistant.
The reason this is becoming more and more urgently discussed is one of prudence. It's the same reason you don't wait for the fire in your house to burn it to the ground before you call the fire department.
"Millions of tons? Synthesized quickly and easily? What's easier than growing garlic in 95% of the US, and just how much do you expect to use at a normal dose of 10-20 grams/day? 16 pounds would keep someone on 20 grams/day every day for a solid year. Processing is just breaking the bulb apart and shucking the cloves, which pretty much anyone with .05% or more Greek or Italian ancestry can do purely by instinct."
The active ingredient, the antimicrobial part of the average bulb of garlic, is roughly 0.05% of its weight, if that much. You're assuming that the supply would be constant, that the quality would be constant, and once again, that the effective ingredients in the garlic would somehow magically take on antibiotic properties when ingested that they do not, and will never, have.
Your arguments show an incredible lack of understanding of what's going on with the rise of resistant bacteria, where we are currently headed, and what the potential outcome might well be in our lifetimes.
You're also arguing from the naturopath's perspective, but totally ignoring the work that's already be done and which completely disproves your theories.
I'd say try again, but you've got no basis from which to try.
Garlic is great, but it's not a *expletive deleted*ing wonder drug in disguise that no one ever though to trying out before because BIG PHARMA CORPORATE GREED!!!!!
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Garlic is great, but it's not a *expletive deleted*ing wonder drug in disguise that no one ever though to trying out before because BIG PHARMA CORPORATE GREED!!!!!
On to the tangent we go!
In this instance (the need for new antibiotics), I am firmly in favor of government intervention.
Here is a situation that promotes the general welfare (meaning it benefits EVERYONE in the country), where the economic incentives for the private market are lacking.*
A prize for ANY new antibiotics that deal with the resistant strains (sufficiently large to offset development costs + a profit) provided by the Federal Government would be appropriate.
One of the few areas I can see a need for government. And what is the government doing?
It is proposed that:
-More than $650 million across the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority (BARDA) to significantly expand America’s investments in development of antibacterial and new rapid diagnostics, and to launch a large scale effort to characterize drug resistance. Earlier this year, NIH-supported scientists developed a novel technique for extracting powerful antibiotics from soil, including teixobactin: the first new antibiotic to be discovered in more than 25 years. The FY 2016 investment increases support for this kind of innovative research and discovery.
-More than $280 million at the CDC to support antibiotic stewardship, outbreak surveillance, antibiotic use and resistance monitoring, and research and development related to combating antibiotic resistance.
-$47 million at the Food and Drug Administration (FDA) to support evaluation of new antibacterial drugs for patient treatments and antibiotic stewardship in animal agriculture
Nearly quadruples antibiotic research and surveillance funding at the Department of Agriculture (USDA) to $77 million.
So, almost $1 Billion for studies and other items, mainly for government itself.
Hey, what's the average cost to develop a new drug (http://csdd.tufts.edu/news/complete_story/pr_tufts_csdd_2014_cost_study)? Oh... $2.6 BILLION.
Well, I see the government is taking this seriously...
*(Development of new antibiotics are unlikely to be rewarded with remuneration sufficient to cover investment within the patent period as they would be competing with the existing ones that are still effective in the vast majority of infections.)
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I like pancakes.
Brad
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I like pancakes.
Brad
With garlic?
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^^^I rarely see people overdosing and dying on antibiotics, nor do I see people committing property crimes, robberies or prostitution to buy antibiotics. 44 people per day in the US die from opioid overdose, according to CDC and NIDA statistics.
I suspect that number is low. Often see suicides covered up
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With garlic?
http://www.fieldsofflavor.com/korean-green-garlic-pancakes/
I was about to call it an abomination, but now I'm intrigued by the idea.
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Over on this side of the mountains, we have seen quite the uptick in heroin use as prescription opioids get harder and much more expensive to obtain illicitly. Heroin is much cheaper and more available.
I still have trouble believing that street heroin is more easily attainable, and cheaper, than a bottle of 5/325 Oxy.
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I still have trouble believing that street heroin is more easily attainable, and cheaper, than a bottle of 5/325 Oxy.
It is.
I have a good friend with a chronic pain issue. There is a surgical treatment available, but it's dangerous and has a fairly low success rate. Every month he's incredibly stressed over whether or not his prescription will go through properly, or if he'll be detoxing and in incredible pain because the pharmacy screwed up his paperwork or something. He has to see the doctor monthly, gets drug tested to make sure he's not suing any other drugs etc etc. It's expensive, invasive, and dehumanizing. He's seriously considered heroin as an alternative.
So much pain and misery caused to innocent people because a bunch of fcking busybodies want to tell people what they can put in their bodies. I hope every single DEA employee gets a chronically painful condition and dies a slow painful death.
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I still have trouble believing that street heroin is more easily attainable, and cheaper, than a bottle of 5/325 Oxy.
Know any chronic pain patients? The BS they have to go through, as Balog points out, is insane. And switching doctors can be pure torture as most docs are going to want to play the "well, lets start you off here" game instead of just continuing what worked before you moved or your last doc retired or what not.
Meanwhile, in much of America for less than a lot of folks pay out of pocket for everything, that same patient could have all the heroine they want in 15 minutes or less. Hell become a regular and your dealer will likely even deliver faster than Dominoes. The only down sides are the typical ones of street drugs.
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Been a couple decades but in the late 90's I would often struggle to buy weed but could find as much heroine or coke as I wanted
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And switching doctors can be pure torture as most docs are going to want to play the "well, lets start you off here" game instead of just continuing what worked before you moved or your last doc retired or what not.
Where are these docs? Every one I've been to in the last decade, if they even suspect my pain to be over about a 2, includes 15-30 days worth of Norco 5mg on the script. It's almost like it's pre-printed on each sheet of their pad.
Pharmacists look at me funny because I'll get the full amount of everything else, but then (unless I'm restocking the emergency part of the cabinet) ask them to only fill 6-10 tablets of Norco. Even then I'll often have a couple left over when whatever problem is no longer painful.
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Where are these docs? Every one I've been to in the last decade, if they even suspect my pain to be over about a 2, includes 15-30 days worth of Norco 5mg on the script. It's almost like it's pre-printed on each sheet of their pad.
Pharmacists look at me funny because I'll get the full amount of everything else, but then (unless I'm restocking the emergency part of the cabinet) ask them to only fill 6-10 tablets of Norco. Even then I'll often have a couple left over when whatever problem is no longer painful.
You apparently missed the pain management part.
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Been a couple decades but in the late 90's I would often struggle to buy weed but could find as much heroine or coke as I wanted
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I actually had all the heroin and coke I wanted at breakfast this morning.
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It is.
I have a good friend with a chronic pain issue. There is a surgical treatment available, but it's dangerous and has a fairly low success rate. Every month he's incredibly stressed over whether or not his prescription will go through properly, or if he'll be detoxing and in incredible pain because the pharmacy screwed up his paperwork or something. He has to see the doctor monthly, gets drug tested to make sure he's not suing any other drugs etc etc. It's expensive, invasive, and dehumanizing. He's seriously considered heroin as an alternative.
So much pain and misery caused to innocent people because a bunch of fcking busybodies want to tell people what they can put in their bodies. I hope every single DEA employee gets a chronically painful condition and dies a slow painful death.
10-4 that. Add the CDC to the list, too. Every bureaucrat who writes rules about how doctors/patients can control chronic pain, should have chronic pain applied to them for at least 6 mos. Then go write your rule, *expletive deleted*hole.
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10-4 that. Add the CDC to the list, too. Every bureaucrat who writes rules about how doctors/patients can control chronic pain, should have chronic pain applied to them for at least 6 mos. Then go write your rule, *expletive deleted*hole.
I'd settle for just having them smacked with a mesquite limb about the middle of day one of a four day backcountry hike, then have the deepest puncture start showing real signs of infection a couple miles from the farthest-from-civilization point on the trip. No antibiotics, and no effective pain relief because those require a script, which requires having the injury at a time when medical care is convenient.
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I still have trouble believing that street heroin is more easily attainable, and cheaper, than a bottle of 5/325 Oxy.
A point of heroin is about $10 around here. 5/325 Oxy is around $5 per pill, but most users would need at least three for recreational purposes. So, $10 vs $15 for a single dose.
That's ignoring the fact that 5/325 isn't particularly desirable for recreational purposes as it is less suited to snorting than pills with higher concentrations of opiate and with less acetaminophen.
I'd settle for just having them smacked with a mesquite limb about the middle of day one of a four day backcountry hike, then have the deepest puncture start showing real signs of infection a couple miles from the farthest-from-civilization point on the trip. No antibiotics, and no effective pain relief because those require a script, which requires having the injury at a time when medical care is convenient.
They'd probably find some wild garlic.
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I actually had all the heroin and coke I wanted at breakfast this morning.
Oddly enough, so did I:
(https://armedpolitesociety.com/proxy.php?request=http%3A%2F%2Fs3.amazonaws.com%2Fkym-assets%2Fphotos%2Fimages%2Foriginal%2F000%2F121%2F710%2FIFLCocaine.jpg%3F1304979998&hash=d4c81d7693187e44dc8b6412aec7093381bebac6)
Now, on to the opiate vs antibiotics debate:
Okay, I look at it this way:
Somebody using heroin isn't going to affect me, short of them committing crimes to feed their habit. Without the illegality, Heroin is a rather cheap drug. How cheap? Remember that bottle of aspirin? Under the same regulation scheme, the heroin bottle of equal size would be about the same price. In short, in a legal scenario, somebody will probably kill themselves before descending so far as to have to steal to feed their habit. Hell, it wasn't disclosed until 20 or so years later that one of the founders of the Johns Hopkins hospital was a lifelong heroin addict - with medical grade stuff and careful metering, he fed an addiction for a lifetime without serious harm.
On the other hand, antibiotic abuse does potentially affect me. Heroin use is contained to the user, more or less. Drug resistant bacteria go where they want. So people abusing antibiotics increases the chances that I'll get sick with something that can't be treated because of the abuse. It's the same line of thinking I use with vaccination. If you don't want to be vaccinated, that would be great if the disease was confined to you, but in most cases not being vaccinated means that if you get sick, you're a carrier. Meanwhile, vaccines themselves are only about 85-99% effective.
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How has no one posted this?
https://youtu.be/io1N6A66QOg?t=52s
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Know any chronic pain patients? The BS they have to go through, as Balog points out, is insane. And switching doctors can be pure torture as most docs are going to want to play the "well, lets start you off here" game instead of just continuing what worked before you moved or your last doc retired or what not.
Meanwhile, in much of America for less than a lot of folks pay out of pocket for everything, that same patient could have all the heroine they want in 15 minutes or less. Hell become a regular and your dealer will likely even deliver faster than Dominoes. The only down sides are the typical ones of street drugs.
God help ya if ya leave yer state on vacation and need a refill! You are well and truly SCREWED! Ask me how I know this...
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I have a good friend with a chronic pain issue. There is a surgical treatment available, but it's dangerous and has a fairly low success rate. Every month he's incredibly stressed over whether or not his prescription will go through properly, or if he'll be detoxing and in incredible pain because the pharmacy screwed up his paperwork or something. He has to see the doctor monthly, gets drug tested to make sure he's not suing any other drugs etc etc. It's expensive, invasive, and dehumanizing. He's seriously considered heroin as an alternative.
So much pain and misery caused to innocent people because a bunch of fcking busybodies want to tell people what they can put in their bodies. I hope every single DEA employee gets a chronically painful condition and dies a slow painful death.
Thanks bud... wait, ya didn't mean me? Oh, my bad. Moving on...
THIS is why I got off all that *expletive deleted*it and quit taking it on a steady basis! Screw Methadone and Hydrocodone 10/500 when that wasn't enough! Now I limit what I do (even more) and when I just HAVE to, I dip into the Hydrocodone which isn't too damned often.
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AND in this drug test every worker world, 7 of the drugs I take DAILY are on this list. Gee, why am I classed as unemployed and unemployable again?
http://www.askdocweb.com/falsepositives.html
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We had 3 people make the celestial transfer last week in town due to some new heroin hitting the streets.
Ummmmm.....make that 4 most likely.
Police are looking into the possibility that the death in East Spokane today was connected to three other deadly overdoses from last week.
My wife is one of those people who gets opioid pain meds. She normally uses a couple of Tramadol a day, which recently became a scheduled drug and for when that doesnt work she gets oxycodone. Her last bottle of 30 oxycodone lasted her nearly a year. But because of bureaucrats who don't know shyte about chronic pain she has to worry every time she gets low about whether or not she can get more. Her cardiologist was prescribing them but he said he wouldn't do any more. She is a congenital heart with two open heart surgeries behind her and a pacer along with frequent PVCs. I would like to take the dipshits that make these rules and jab a knife into their chest at random intervals throughout the day and night.
bob
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Regarding government and its role in the development of antibiotics...
The earliest compound generally classed as an antibiotic (sort of, but not really, as an organarsenate that primarily targeted only a very specific critter) was Salvarsan, developed in Germany in the early 1900s and the first effective treatment against syphilis. That was developed over a period of years, privately in Germany.
The first of the sulfa drugs, prontosil, was developed successfully in the 1930s, in Germany, by Bayer, also developed privately.
Then came penicillin, which was discovered in 1928 and developed slowly through the 1930s, with the first successful tests being carried out just before World War II.
All three of those drugs were developed independent of government support.
That changed with World War II. Pretty much every government in the war made developing and manufacturing antibiotics a priority. The British and Americans developed the first processes to grow penicillin in industrial quantities. By 1945 a gram of penicillin cost 1/10,000 or so what it had cost in 1939.
In the United States, government support of antibiotic research continued well into the 1960s, primarily to find ways of countering germ warfare. Government and private company scientists literally fanned out across the world sampling just about everything they could -- soil, plants, molds, even some animals -- trying to find a new wonder drug. A few years ago I ended up in the ER with cellulitis on my one leg. The first thing they did was, after ruling out things like DVT, was to hang a bag of vancomycin, which was developed in the 1950s from the soil bacterium Amycolatopsis orientalis. (From wikipedia, believe it or not). Judging by the name, it sounds as if it were discovered somewhere in the Orient.
After Vietnam began to wind down, and with successive treaties outlawing biological warfare and research (right), most leading officials felt that the arsenal of antibiotics then in existence was more than enough to ensure that bacteria would be kept at bay.
Because of the cost of development, and with the low expectation of returns, many drug companies scaled back or even eliminated development of new antibiotics in favor of drugs to treat other diseases and conditions.
Then, in the late 1970s, the first hints of antibiotic resistant diseases began to crop up. One of the first I recall seeing on the news (late 1970s, early 1980s, IIRC) was American sailors in the Philippines contracting penicillin resistant venereal disease. Not long after that, resistant TB began to crop up. And now we have things like MRSA.
A friend's dog even had issues with multi spectrum resistant ear infections that's been a chore to keep in check.
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We have already seen tapering of opioids as a trigger to SI in the VA.
"SI"?
Remember, one or two of us here aren't medical professionals ...
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"SI"?
Remember, one or two of us here aren't medical professionals ...
Suicidal ideation.
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The VA HAS been rather "generous" in providing me with Hydro and even Ovy for the really "fun" times but I am also real good at not looking for refills till WAY later than I am allowed to and my piss tests always come back "in range." Hell, I've been sitting on a bottle of 10mg Oxy since my last stone, that 8mm rascle, and have PLENTY of them left and that was back in the first of October of last year.
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http://www.nytimes.com/2016/03/17/health/er-pain-pills-opioids-addiction-doctors.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region®ion=top-news&WT.nav=top-news&_r=0
This is a very accurate story of what it is like for a primary care physician to prescribe pain meds in today's regulatory environment.
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It isn't just the primary care physicians, most specialists have stopped prescribing narcotics. Now would be the time to be a pain doc, everyone will be beating a path to your door.
This climate has also opened up the field of alternative medicine such as acupuncture and other "questionable" modalities. One of them that is being embraced by the .mil and the VA is "Battlefield Acupuncture". Depending on what you read it is either a god send or quackery at its worst. I tend to think quackery but I have not had it done so all of my bias is from reading studies and articles.
I am not looking forward to when my wife has to go in to talk to the doc about pain meds for her chronic chest pain. I will have to be the mediator because she may get just a little peeved if what I think is going to happen does happen.
bob
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I actually had all the heroin and coke I wanted at breakfast this morning.
Dollars to pancakes it's gonna take a little more tomorrow.
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One of them that is being embraced by the .mil and the VA is "Battlefield Acupuncture".
Battlefield acupuncture sounds like something we should be doing to the enemy not our own troops.
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Why "ideation," instead of just "thoughts," or some other one or two-syllable word?
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Why "ideation," instead of just "thoughts," or some other one or two-syllable word?
Because ideation can be coded higher and you get more money!!!! j/k or maybe not........
Ideation covers the entire spectrum of the thought process from innovation to development to actualization.
I am in the camp that it is some psycho-babble made up and has become common usage for homicidal and suicidal (thoughts). It is truly meaningless especially for both HI and SI (homicidal and suicidal ideation) because most of the time the actualization part is not there.
And that is my 2p (IEP) worth.
bob
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I am in the camp that it is some psycho-babble made up and has become common usage for homicidal and suicidal (thoughts). It is truly meaningless especially for both HI and SI (homicidal and suicidal ideation) because most of the time the actualization part is not there.
This; it lets them overreact to a normal passing thought by saying it's on the same spectrum as one carried out.
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Hell, I've been sitting on a bottle of 10mg Oxy since my last stone...
THAT'S NOT HOW YOU TAKE THE PILLS! No wonder you're in pain!
Joking aside, the thread has been eye opening for me in seeing what it takes to get decent pain meds for a chronic problem. Given my political bent I'm not at all surprised that street heroin is a cheaper/faster/better option but I'm not happy about it.
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Methadone, synthetic Heroin light. Reduces pain and makes ya fall asleep pretty much anywhere, anytime.