Published May 5, 2016.
Article argues that OxyContin caused strong withdrawal symptoms when used as directed. Important, imo, because at a societal level we substantially blame addiction on "drug abuse" which is not always an adequate model.
Article argues that OxyContin caused strong withdrawal symptoms when used as directed. Important, imo, because at a societal level we substantially blame addiction on "drug abuse" which is not always an adequate model.
The crux of this article was that Purdue knew their dosing schedule was problematic but pursued it despite growing evidence it was reducing efficacy and increasing addiction. Then they hid behind their FDA certification as if that exempts them from acting on evidence that their shitty drug doesn't work right.
In general, no drug for acute _anything_ will last as long as the manufacturer advertises. They are incentivized to push an idealized dosing schedule, even when that makes the drug less effective for a significant number of patients. This is kind of a big deal when a drug causes severe physical withdrawal symptoms.
While I agree that this model is not accurate, I'd also point out that just because you're taking a drug as directed doesn't mean you're not abusing it.
For whatever reason most people in the U.S. seem to have a wildly unjustifiable level of faith in western medicine, either way too much or way too little. Belief and disbelief in various forms of medicine have been successfully marketed as personal identities, which is easy to see from reading most HN comment threads on health issues.
Yes. I put "abuse" in scare quotes, because I think it's definition should be better aligned with buisiness incentives, medical advice, and actual human behavior, especially if we put people in jail for it.
I tend to think about drug misuse, rather than drug abuse, since not taking certain drugs can be just as irrational and damaging as taking too many drugs.
But basically I think people should use drugs as tools to maximize their utility based on their needs and values. And I think that drug misuse is anything that leads to significantly suboptimal utility that's clearly not justifiable by any sort of internally coherent reasoning.
Drug abuse seems straight forwardly defined as using a drug for purposes other than as prescribed. Not following the schedule or following it when it is unwise to shouldn't be considered abuse as long as you are still using it to manage pain. Of course that boils down to intent, which is hard to determine.