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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 16:29:10 »

If you want to talk about inhumane treatment of pain patients:

My friend, having been diagnosed as having Weigners disease, was told she had 2 years to live.

16 years later, having been inadvertently infected with Hep C 10 years earlier by the hospital conducting her care for all those years, and having been prescribed a steadily increasing dose of opiates for the pain associated with her crumbling facial bones and neck vertebrae - guess what?
NHS brings in a zero tolerance policy regarding long term opiate prescription and during a hospitalization for a minor fall decided to put their Hep C patient into forced opiate withdrawal.

For those of you who are not familiar, a forced opiate withdrawal is life threatening for a Hep C patient.  Withdrawal exacerbates the Hep C.  The exacerbated Hep C causes damage to the liver, and my friend 'the Weigners patient' that was requiring the pain killer was left unable to ingest opiates.

I've never been so angry in all my life.  I printed the Hep C info off the net and gave it to the doctor responsible for the decision who couldn't find enough nurses to put between us before he slunk off.  I daresay he hadn't bothered to read my friends file that had built up over 16 years to require a trolley of it's own...
...but why would a trained doctor put a regular Hep C patient into forced withdrawal from a 16 year opiate prescription anyway?
Based on the fact that a forced withdrawal will exacerbate Hep C and destroy the liver, what benefit could there be in forcing an opiate withdrawal on a Hep C patient?

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 16:13:03 »

It may also have something to do with $$$$$$$$$$$

Drug testing in the US is a multi-billion dollar industry, and the handful of companies in charge spend an awful lot of money lobbying and contributing to campaigns of politicians (federal, state, and local), with the purpose of increasing compulsory drug testing. A large number of jobs will drug test before hiring, or will have "random" unannounced drug tests of employees. Some high schools in the US have implemented drug tests for their sports teams and clubs (not for deterring use of performance enhancing drugs, but for "keeping the children safe" from recreational drugs)--my understanding is that this has been shown to have no effect on drug use among high-schoolers, but it has deterred drug-using students from being members of sports teams and school orchestras etc. Some states require drug testing for welfare (again, likely not having much effect on drug use, just making users more desperate)

Another unanticipated effect of drug screening is that it pushes people to switch from relatively harmless drugs like cannabis, which can be detected for several weeks after the last use, to more dangerous drugs like alcohol, benzodiazepines, cocaine, and amphetamines, all of which can only be detected within a few days after the last use. (at least by tests of urine or saliva--more expensive hair tests can detect essentially everything that a person has used while the hair was growing)

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 15:41:59 »

opiate-cocaine combo is a specific synergistic thing which people are known to indulge in.

What does that have to do with chronic pain patients use of opiates? In any case that doesn't address my question  which is why doctors care about that? I.e. does it mean a lower quality of life than living with no opiates and having the pain?

Besides, a visiting nurse can make sure that the opiates are taken exactly as prescribed.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 15:40:17 »

I have a neighbor with severe chronic pain, who takes large amounts of very powerful opiates every day, and she gets drug tested routinely. But she ascribes this to her Dr. wanting to verify that she is in fact taking the drugs (instead of selling them), not necessarily to screen for other drugs in her system.

Pain contracts require patients to refrain from alcohol and recreational drugs. Violation means being taken off opiates.

Note: All opiates are powerful. Being on a high dose only means that their body has adapted to the lower dose and only a higher dose will work. I does not mean the patient is experiencing euphoria from them or is high. That's from personal experience and my "patients education" in opiates.

I'm concerned that this line of discussion is detracting from the real issue which I wanted to discuss. The refraining of giving opiates to chronic pain patients because a few of them abuse them.

What almost all doctors refuse to understand is that they can always require the opiates be distributed by a visiting nurse who keeps them in a safe and gives you one days worth. Or they can visit in the morning and night and watch you take the extended relief opiates like oxycontin or mscontin. Or even a pain pump.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 15:36:12 »

... why put opiate users on a pain contract requiring urine screening?
Patients are never placed on pain contracts when taking meds like Xanax and you can die from a Xanax overdoes.

opiate-cocaine combo is a specific synergistic thing which opiate-users have been known to indulge in.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 14:31:08 »

I have a neighbor with severe chronic pain, who takes large amounts of very powerful opiates every day, and she gets drug tested routinely. But she ascribes this to her Dr. wanting to verify that she is in fact taking the drugs (instead of selling them), not necessarily to screen for other drugs in her system.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 14:12:22 »

Pete, cocaine and opiates are quite different types of drug; totally different family and mechanism.

Yeah. I know. But that doesn't address my question. I.e. why put opiate users on a pain contract requiring urine screening?

Patients are never placed on pain contracts when taking meds like Xanax and you can die from a Xanax overdoes.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 13:24:29 »

What I want to know is what the danger is of being on opiates when using cocaine ...

Opiate-users add cocaine to combat its sedative effects : more euphoria, less unconsciousness.
The cocaine allows higher doses of opiate to be taken without losing consciousness,  but it wears-off quicker than the opiate,  then the user is particularly vulnerable to respiratory arrest via the opiate.

[ I read Carrie Fisher, whose cause of death was sleep-apnea, was positive for cocaine & heroin & more ]. 

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 09:57:07 »

I listened to a podcast about the effects of medical marijuana on opiate consumption. They suggested that:
- For heroin, 5 times the effective dose will kill you
- For alcohol, 10  times the effective dose will kill you
- For marijuana, the ratio is even higher, ie death from overdose is very unlikely

In US states legalising medical marijuana, there has been a slight reduction in deaths from opiates - but this is a trend reversal, so this is promising.
- The main benefit seemed to be in substituting marijuana for the more dangerous (and more addictive) prescription opioid painkillers.
- They didn't have enough evidence from US states legalising recreational marijuana

When I raised the topic with some people who work in the pharmaceutical industry, they were very tight-lipped about it. I imagine that they have a very powerful economic incentive to fight medical marijuana as being "dangerous".

I have a relative who suffers from chronic pain, and has been on strong opiates for some time. I am in favor of doctors prescribing less dangerous medication, if it is effective.

Listen to the podcast (12 minutes), or click to read the transcript at: https://www.sciencefriday.com/segments/do-we-need-pot-to-fight-the-opioid-epidemic/

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 09:20:47 »

Pete, cocaine and opiates are quite different types of drug; totally different family and mechanism.

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Just Chat! / Re: ‘inhumane treatment’ of pain patients

« on: 30/06/2017 08:06:36 »

Something that I've never understood is the reason for urine screens to test for cocaine when a person is being prescribed opiates. What I want to know is what the danger is of being on opiates when using cocaine. And please don't bore me with anecdotes about people dying from overdoses of the combination since I can provide just as many anecdotes about people who have used both at the same time a huge number of times and were fine.

I'm thinking about cocaine users with chronic pain who aren't prescribed pain-killers for that reason. It's inhumane to do nothing about the pain. Why? Because some people will kill themselves because the pain is intolerable. That's something I have first hand experience in. And I'm referring only to those situations when all else has failed. Thanks.

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Just Chat! / ‘inhumane treatment’ of pain patients

« on: 30/06/2017 05:37:20 »

I noticed that one of my fellow moderators suffers from chronic pain like I do. I thought she'd appreciate this article

https://www.statnews.com/2017/02/24/opioids-prescribing-limits-pain-patients/

It makes two excellent points

In effect, pain patients currently taking opioids long-term have become involuntary participants in an experiment, with their lives at stake.

To its credit, the guideline endorsed treating patients as individuals, not numbers.

Unfortunately doctors don't in general have a solid understanding of pain meds nor do they understand the meaning of statistics.

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Just Chat! / Re: A Poem I wrote for those who might fear death!

« on: 11/07/2016 02:09:47 »

Your welcome Alan..and no, I do not mind! 

Those are beautifully written and very enlightened. How long have you been writing poetry of this nature?

For a long time Karen , it reflects the artistic creative pat of me? After all, come 23rd December this year I will turn 76 years young!

Karen did you notice that one of the poems of mine had almost the same wording as your signature "come fly with me"
""Come fly"" towards majestic Orion ""with me""
At great speed to our majestic god we flee
Through a great wide river, at last, we fly
Reaching out to a great light beyond the sky

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General Science / Re: Why does unhealthy food taste so good?

« on: 22/06/2016 22:10:32 »

The things we like -broadly fatty, sweet, salted foods are only unhealthy because we can easily get too much of them.
In moderation they are actually very good food. If you were starving these sorts of things would exactly what you needed.

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General Science / Re: Is accidentally eating rust bad for you?

« on: 22/06/2016 08:08:51 »

Run a strong magnet over a packet of cornflakes and you'll pick up lots of little pieces of iron.

The amount of iron you'll have ingested from an average muffin tray will be trivial. But, to avoid falling into the obvious trap of making assumptions, are you sure it's iron?

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General Science / Re: Why does unhealthy food taste so good?

« on: 21/06/2016 20:08:03 »

Would it be wrong to state that maybe it's because it's meant to be good?  That as far as evolution goes, that maybe we've developed a liking towards it BECAUSE it's unhealthy?  That maybe we're meant to indulge in some unhealthy behaviors, that maybe nature intends us to only live to 50?  We must understand that it is our technology and medical advances that enable us to live so much older than we're meant to.  We're doing that on purpose; possibly in spite of evolution and nature.

Species evolve to survive as a species.  But by doing as much as we are to increase our life span we are also overpopulating the planet.  We're healthier, so we're living longer.  We're healthier, so we're having more offspring.  More born, less dying, overpopulated planet.  Eventually we will not be able to sustain ourselves, and our species as an entirety will be put at risk.  This goes squarely against what evolution and nature itself call for; which is for us to strive to survive as a species.

So maybe we like it cause we're meant to.  Maybe we're meant to die younger, meant to have diseases and ailments that keep our populations in check.  Maybe we're meant to have lower sperm counts and reproductive rates and all the other things that can come from unhealthy behaviors.  Maybe, all the health nuts and all the health food industry are actually doing is hurting our species in the long run, actually creating an unsustainable system that some day will come crashing down on the species as a whole, no matter how much red meat you avoided.  Maybe it's the ones who love unhealthy stuff and have no qualms eating it such as I do, who are the ones that are ultimately helping humanity and the planet.  Ehhh, i dunno lol.  Heck, I have no idea if I even believe whatsoever any of what I just wrote and it was more a mental exercise than anything... Just an impulsive top of my head answer to your question that popped in after I read it.  But hey, it is kinda food for thought... (no pun intended!)

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Just Chat! / Re: Jokes thread. :)

« on: 29/12/2015 08:52:10 »

Q: What kind of shoes do frogs prefer?

A: "Open-toad" sandals...

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Just Chat! / Re: Punning is hard(ly) work! Is groaning aloud here?

« on: 24/11/2015 00:58:44 »

Did you spock the pun in my last post?

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Just Chat! / Re: Punning is hard(ly) work! Is groaning aloud here?

« on: 19/11/2015 12:19:44 »

November 19th.

Today is National Blow Bagpipes Day Coincidentally it is also National Have a Bad Day Day.

What’s more today is also Nouveau Beaujolais Day and World Toilet Day, another coincidence???

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Just Chat! / Re: What do we think of the medals next to your name?

« on: 31/10/2015 10:33:18 »

I quite like this idea, but where is my personal medal?
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