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Comment by gsdfg4gsdg | Hacker News Reader

The vast majority of heroin addicts today started with prescription painkillers. Many of them went into a doctor's office and took the pill that was prescribed to them by a trusted community member with a diploma on the wall. The problem was that these doctors were frequently either directly corrupt or under the unwitting influence of false advertising from Purdue Pharmaceuticals.

When I had my wisdom teeth pulled and was prescribed an entire bottle of Vicodin, when I didn't even need a single one, that wasn't a greater issue in my life. That was medical malfeasance and a just society would execute the principal architects of it.

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I think this is definitely the problem in the United States. In my country they don't just willy nilly prescribe opioids. The best you get is ibuprofen. For example, after a terrible shoulder injury or tooth extraction, that's all you get. It helps with the pain, but doesn't remove it 100%, doesn't get you hooked though. Of course they give IV opioids after surgeries and such, but even then something mild and in small doses, and only for a certain period time. I remember still feeling pain after an appendectomy, but they refused to give me any more tramadol and just switched to IV ibuprofen. It's just not a thing as a prescription medicine. Except maybe for terminal cancer patients or something equally drastic.

Going off on a tangent, what my country might have a problem with, is benzos, however. They're prescribed like psychiatric vitamins.

Please check "The Rat Park drug experiment" [1][2]

[1] http://www.stuartmcmillen.com/comic/rat-park/

[2] https://en.wikipedia.org/wiki/Rat_Park

What does the manufacturer of OxyContin (Purdue) have to do with you being prescribed Vicodin? And the world generally agrees that a just society wouldn't execute anyone. And the greatest issue in your life was that you were prescribed some pills you didn't need to take, just in case you had been in pain? That's a pretty good life.

A just society executing the principal architects sounds similar to Italy recently prosecuting the seismologists for incorrectly predicting earthquakes.

I agree that there is a problem with over prescription of opioids, but this problem isn't solely due to a simple conspiracy of drug makers. I think that sort of rhetoric is unhelpful.

What you fail to see in drawing your analogy is that seismologists aren't being incentivized to give specific readings. Pharmaceutical companies are loading the gun and they know it.

I see your point with the pharmaceuticals and they have a share of blame, but I would argue that the analogy has merit as the prosecution in the seismology case would not have pushed for punishment if the scientists were merely wrong.

https://www.google.com/amp/s/amp.theguardian.com/world/2013/...

From my reading (and I will admit I do not see the logical reasoning at all, which I think is why the case was later overturned) the judge thought that they were guilty not of failing to predict it, but of giving an inadequate message. Presumably, to me this implies some sort of laziness, or intent to not make more of an effort despite knowing better.

I will admit that I am biased being a doctor dealing with this daily, but I think that blaming this solely on the pharmaceutical companies is easier to do than looking at what is happening to our culture, expectations of pain, the way we deliver healthcare, how we grade healthcare (for example read about Press Ganey's Fifth Vital Sign).

Why do you think they kept taking them after they ran out?

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