Not that pharma is angelic here, but don't the doctors have the largest measure of blame for writing unnecessary scripts, failing to monitor for abuse, and failing to encourage alternate options?
I'm in favor of maximum MD power. I think they should be allowed to prescribe everything from cocaine to bleach, or any other chemical compound, as suits the patient care, if they know what they're doing.
But they should also bear maximum accountability for what they prescribe, including abuse potential.
A more helpful line of inquiry to me is the culture of Rx usage. As a society, our patients expect drugs when they go to a doctor and a doctor's average time per patient is around 10-15 minutes. Does not seem like enough time to understand the patient's needs and create an individualized solution. Further, RX medicine is highly profitable and encouraged from the pharma.
In this case it looks like they are incentives for pain pills to be issued on both sides -- money maker for pharma and time saver for doctors (a third side -- convenience and feel good for the patient).
It is not as useful to find so-called bad actors but instead we should evaluate the medical system as a whole and put in safeguards to do less harm. Patients have generally too much influence on doctors for their treatment (otherwise why would direct to consumer marketing exist?), that doctors are not educating patients enough on the risks of narcotics and that pharma has $$ incentive to push medicine. That things like physical therapy and lifestyle changes will better deal with root causes than drugs that only address the symptom (but feel better and are easier to swallow). It's a recipe for a disaster.
I was in a motorcycle accident a few years ago and broke over 10 bones. The worst part of my recovery was kicking my addiction to narcotics. I did not understand what I was getting into and I was never given a path to get off them (not in a coherent way, not until I called to say I was going through withdrawals). This should not be.
Well, there is also information asymmetry at play here. Patients could have legit pain, and then go to multiple doctors, without the others finding out. Then they could sell those to other people, or use them all themselves.
On the other hand, the pharmacies might know, but that could be worked around by a motivated pill-obtainer.
The pharma companies, however, definitely know that they sent 780 million painkillers to a state with only 1.8 million men, women, and children.
I am not saying it is their duty to do something about this, but maybe they have some high-level information that others do not.
I really don't see a way this could be fixed without giving every doctor in the US access to some huge database of every prescription of every person in the country -- which I would not be cool with, nor would anyone else, other than maybe law enforcement agencies.
I had a friend who was a pharmacist and worked at several places like CVS. He said they routinely refused to fulfill prescriptions to people they felt were either gaming the system or were using outright fraud to get their meds.
He said after a while it became a game. User would get a script and come in totally strung out. My buddy would refuse to refill their meds. User would call doctor and yell and them. Doctor would call Pharmacy and yell at my friend, who would then have to tell the Doctor what was going on. Most of the time, he said the Doctors had no idea this person had 15 different scripts for pain killers.
For me, there's still too many loopholes to exploit in the process.
I think the drug dealers could learn a thing or two from our pharma industry.
When I had back pain, the doctor handed me a prescription for 100 hydrocodone tablets. I took none; just some physical therapy and stretching gave me immense relief. Later, I was shocked to find out from a friend that the street value of these tablets was $5/each.
Probably more a fault of your doctor or the laws. There should be limits on that kind of painkillers, especially if you use it first time. If the doctor restricts the amount to a few days' usage, potential misuse is much easier to detect.
These are rational people making a decision for themselves if the pain relief is worth and side effects or other Iissues. Let the people of WV make up their own minds and let the market speak for itself.
Seriously though, 'rational' people can also be misinformed by a large corporation and a system which does not necessarily incentivize getting people healthy, and only wish to make their shareholders happy. The 'market' will always try to optimize for profits even at the expense of everything else.
[+] [-] imglorp|9 years ago|reply
I'm in favor of maximum MD power. I think they should be allowed to prescribe everything from cocaine to bleach, or any other chemical compound, as suits the patient care, if they know what they're doing.
But they should also bear maximum accountability for what they prescribe, including abuse potential.
[+] [-] chillwaves|9 years ago|reply
In this case it looks like they are incentives for pain pills to be issued on both sides -- money maker for pharma and time saver for doctors (a third side -- convenience and feel good for the patient).
It is not as useful to find so-called bad actors but instead we should evaluate the medical system as a whole and put in safeguards to do less harm. Patients have generally too much influence on doctors for their treatment (otherwise why would direct to consumer marketing exist?), that doctors are not educating patients enough on the risks of narcotics and that pharma has $$ incentive to push medicine. That things like physical therapy and lifestyle changes will better deal with root causes than drugs that only address the symptom (but feel better and are easier to swallow). It's a recipe for a disaster.
I was in a motorcycle accident a few years ago and broke over 10 bones. The worst part of my recovery was kicking my addiction to narcotics. I did not understand what I was getting into and I was never given a path to get off them (not in a coherent way, not until I called to say I was going through withdrawals). This should not be.
[+] [-] mhuffman|9 years ago|reply
On the other hand, the pharmacies might know, but that could be worked around by a motivated pill-obtainer.
The pharma companies, however, definitely know that they sent 780 million painkillers to a state with only 1.8 million men, women, and children.
I am not saying it is their duty to do something about this, but maybe they have some high-level information that others do not.
I really don't see a way this could be fixed without giving every doctor in the US access to some huge database of every prescription of every person in the country -- which I would not be cool with, nor would anyone else, other than maybe law enforcement agencies.
[+] [-] jacobsievers|9 years ago|reply
[+] [-] at-fates-hands|9 years ago|reply
He said after a while it became a game. User would get a script and come in totally strung out. My buddy would refuse to refill their meds. User would call doctor and yell and them. Doctor would call Pharmacy and yell at my friend, who would then have to tell the Doctor what was going on. Most of the time, he said the Doctors had no idea this person had 15 different scripts for pain killers.
For me, there's still too many loopholes to exploit in the process.
[+] [-] gwbas1c|9 years ago|reply
[+] [-] 1024core|9 years ago|reply
When I had back pain, the doctor handed me a prescription for 100 hydrocodone tablets. I took none; just some physical therapy and stretching gave me immense relief. Later, I was shocked to find out from a friend that the street value of these tablets was $5/each.
[+] [-] dx034|9 years ago|reply
[+] [-] seibelj|9 years ago|reply
> The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia.
That is incredible. What a damning article.
[+] [-] snrplfth|9 years ago|reply
I mean, what is supposed to be done about this? Cut off WV from painkillers? Have the DEA raid a bunch of pharmacies?
[+] [-] commentzorro|9 years ago|reply
[+] [-] kelvin0|9 years ago|reply
Seriously though, 'rational' people can also be misinformed by a large corporation and a system which does not necessarily incentivize getting people healthy, and only wish to make their shareholders happy. The 'market' will always try to optimize for profits even at the expense of everything else.
[+] [-] wf|9 years ago|reply
[+] [-] burkaman|9 years ago|reply
[+] [-] gech|9 years ago|reply