Comment by mgkimsal | Hacker News Reader

Comment by mgkimsal | Hacker News Reader

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> but if only we had draconian DEA policies aggressively stopping overprescription now.

Not sure what the policies are now, but around me, I can not go get any prescription for any back pain (have really needed it twice in the past 3 years). "Nope, go see your GP" (vs going to a walk-in clinic). The walk-ins around here all have signs on the front door saying "no prescriptions for oxycontin, etc"

Now... yes, I could try to "see my GP", which generally means waiting a few days. (and, I don't really have a GP anymore, because I can never get in to see him).

What's strange is that about... 6 years ago, going to one of the same clinics, my wife went with an eye problem. Specifically, she'd had a small piece of sand get in her eye, and it was really sort/irritated. Home flushing wasn't working, so we went to the clinic. As she was leaving, they asked if she felt she needed any pain medication. "Well, not really, but it's a bit sore, and I do have a headache". They gave her a script for 14 oxycontin on the spot. Same place last year would not even talk to me about pain medication ("go see your GP").

Those practices (handing out oxy) are a major contributor to the current epidemic, if not the root cause.

I've gotten opiate prescriptions I had no business having without asking. I get that some people need pain medication or will suffer, but there's a whole lot of suffering that opiate addiction causes and that is not really factored into the 'do no harm' calculation doctors are supposed to be doing.

It really is a great thing to see legitimate restrictions on these prescriptions, as that should cut down on new addicts at the very least.

I guess part of this is doctors overprescribing to prevent patient complaints, based on how much patient satisfaction surveys are used to rate their year over year performance.

I don't know if its the AMA to blame for that or not, but everyone in the system seems to think its an upstream problem.

I'm hearing on the one side that these legal prescriptions are causing the problems but on the other had others say that these drugs being illegal is causing the problem and if we made them legal that people will use them in a safe manner. If people get addicted them when prescribed legally then how can making them legal have any hope?

Making them legal at least keeps the problem out in the open, where it can be regulated. Notice that the response to the opioid epidemic, as described in this thread, is that clinics have stopped giving out oxycontin. When we had a crack epidemic in the 80s or a heroin epidemic in the 60s and 70s, the response was to send troops into the regions that produced those drugs. This was both expensive and ineffective, and in many ways just made the problem worse: with the whole distribution chain being completely illegal, street prices went up, more money was made by a few outlaw kingpins, and that gave them more resources to buy arms and escalate violence.

These are highly addictive substances. If doctors can't stop the abuse now on prescribed medicines who in the regulatory agencies can do better?

If you go into a walk-in (or even GP office) asking for pain meds, that sets off all kinds of alarms.

If you go in with an obvious injury and they offer the painkillers without you asking, they probably feel a lot more confident that you are not drug-seeking.

And so the people that got addicted to those opiates 6 years ago that are now unable to get new ones turn to heroin.

> but around me, I can not go get any prescription for any back pain

Can I check: have you sought treatment for back pain, and not got it?

Have they offered physiotherapy or exercise?

(these might be relevant to your type of pain).

clarification - my back pain episodes were 2x in ... about 3 years. in both cases this was a sudden onset - like, standing up from a seated position, some sort of switch was flipped, and I had immediate massive pain.

In both cases, talking to a local "urgent care" clinic, "go to your GP for a referral for physical therapy" was the standard line. "we don't treat back pain".

I get it, in some sense, like... yeah, I may be an addict, etc. But in both cases, I'd been to the clinic multiple times before for other things. I had a history with them. Actually, the last time I'd been there I said I had no primary care physician, and wanted to use them as primary (3 miles from house vs 11 miles to previous dr).

In both cases, the back pain episode lasted more than a week, was debilitating to the point of not being able to walk without massive pain or sleep normally for several days. And then, it wore off, and ... 'back to normal'. Historically, I'm learning, we have some back issues in the family, but I can't get much info from anyone on specifics yet.

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