How judges added to the grim toll of opioids | Hacker News Reader

How judges added to the grim toll of opioids

reuters.com

104 pointsSolaceQuantum45 comments

> Judge Stephens was bound by West Virginia law to weigh secrecy against transparency and provide in the court record his reasoning. Like many judges in his position, he did neither. "This case was sealed because both sides agreed and asked me to seal it," he told Reuters.

As a practical matter, this is why it happens: the court system is inherently adversarial. If the two sides agree that something should happen in their case, the judge is likely to rubber-stamp it. Judges don't want to waste time litigating something that isn't actually disputed.

Thank you. I would add to this that prior to it coming before the judge there is the leverage of "We can get 600 mil now or go into years and years of litigation that we have a non-zero chance of losing, and all we have to do is agree to let them hide their documents." hindsight is 20/20, how many would really choose the years and years of litigation over the payout?

There are at least four sides when it comes to sealing documents though, the two parties in court, the state and the public.

edit - or maybe at least five, if you count the law.

If there were criminal charges as in the Perdue case then the court has a public interest to consider.

> If the two sides agree that something should happen in their case, the judge is likely to rubber-stamp it.

Except of course that isn't what happens in most cases. One side wants the details of the case kept secret, the other may not care but more likely (as in this case) would prefer the details to be made public so others can at least learn from their experience. But if there is a power imbalance (which there is this case because $X has far more effect on one side than the other), the side with the most money can simply buy their way out of the unwanted publicity. It's effectively a bribe, but since it's tied up with the settlement and the negotiations are also secret that's impossible to prove.

I can't see how this is the judges fault. If every case was forced to be public there would be all sorts of unpleasant consequences. If judges were forced to go through all the evidence in these cases and rule on which bits should be made public it would increase their work load considerably.

The judges aren't forced to make every case public. There are clear guidelines for when not to, where otherwise there are requirements to clarify the reasons. The judges aren't following the guidelines, because there's no repercussions and it makes their job easier. That needs to change. And also the judges are supposed to weigh up the secrecy vs public interest, which is clearly not happening.

> In fact, court records are presumed to be public as a matter of law. They can only be sealed for valid concerns about privacy, including personal medical records, and to protect company trade secrets.

Yet

> In practice, secrecy has become so ingrained in the system that judges rarely question it. In 85 percent of the cases where Reuters found health and safety information under seal, judges provided no explanation for allowing the secrecy.

Sounds like this needs oversight.

> Sounds like this needs oversight.

That's what the record is for. There needs to be consequences

Really dude? Semantic much.

There are no consequences. You don't need additional oversight. This is not semantics, at the core of the issue.

The idea that oversight (ie another layer of bureaucracy) is a solution to a problem is what the US legal system has to avoid, to stay effective.

How is this allowable? What law or procedure allows this to happen? Scrap it, unseal everything and let evidence wash away all the rhetoric and grand-standing

Meanwhile joe weed dealer on the corner got 20 years in prison.

The next story we’ll be hearing about is how adderall and Ritalin made a generation of kids addicted to speed.

> The next story we’ll be hearing about is how adderall and Ritalin made a generation of kids addicted to speed.

Didn't it though?

Oh, it did.

Big Pharma: Mind keeping those records private?

Judge: I would never...

Big Pharma: 'Hands judge 2mil'

Judge: ..consider anything but keeping them private. I meant to say.

^You don't believe this kind of thing happens, then your living in a dream world Alice:

https://www.justice.gov/opa/pr/texas-judge-arrested-and-char...

https://www.npr.org/sections/thetwo-way/2011/08/11/139536686...

https://www.seattletimes.com/nation-world/feds-judge-admitte...

just to name a few.

Weed might also be an effective pain killer but we’ll never know. The Reactionaries - God bless them - have already decided there’s no good use for it, there’s no need for controlled experiments and all that scientific devilry

We do know, and it is. Medical marijuana is legal in about half the states, and is commonly prescribed for cancer, glaucoma, and MS.

It is legal and commonly prescribed, but that doesn't mean it is effective. Anecdotes say it is, and the enjoyment of being high is worth it to some but no doctor should prescribe it until the alternatives we know work have been tried and found to not work. Proper medical treatments goes through many rounds of studies to prove that it works and is safe (which is unlikely in this case: smoke causes cancer in general).

If someone were to do a proper study (I'm not aware of any, but many countries don't have the US ban so I'd be shocked if none have been done) I'd change my position. For now it is a last resort though.

until the alternatives we know work have been tried

Oh, you mean the alternatives Big Pharma claims to be effective? Because as TFA shows, they can totally be trusted...

Two wrongs do not make a right.

> until the alternatives we know work have been tried and found to not work.

I mean, opioids clearly work; but they come at an extremely high in terms of addiction and risk of overdose. Morphine works; we just only prescribe it at EOL now because we know its so addictive it will kill.

Where if cannabis or cbd have even an anecdotal placebo effect, it is not currently leading to high risk of overdose.

This seems to ignore the incredible numbers of testimonials from very sick patients who say marijuana improves their quality of life by reducing anxiety, and/or increasing appetite, and/or reducing pain with few long term side effects.

It also conveniently ignores that you can ingest cannabinoids in a variety of methods besides smoking.

And the fact that there are an absolute ton of “FDA Approved” products which have barely gone through any of the rigor you’ve talked about which is why there are all those commercials on TV about “have you or a loved one suffered acute bronchitis as a result of taking prophylactyse?”

As well as the incredible lists of side effects even well studied drugs seem to have which is why all the other drug commercials end with “Side effects may include internal bleeding, gastrointestinal distress, ...”.

All that being said, I’d love to see more research, why not?

Antidotes are not science. I have seen plenty testimonials for homeopathic treatments.

>Antidotes are not science.

Sorry, but that is a great typo.

I think a lot more effort in public perception needs to be made in separating the actual drug from the most common method of absorbing it, which is recreationally smoking it. There has been a lot of advances in drug delivery over the past few decades, we probably should use one that doesn't fuck your lungs

> which is unlikely in this case: smoke causes cancer in general

You do understand that you can get the effects of marijuana without smoking it right? Edibles do exist.

The thing is, I'd be amazed if it had no medical effectiveness, but that's not because I'm some blown-out hippy who thinks it is a magical cure-all, but because I know researchers who specialise in the mammalian endocannabinoid system -

https://en.wikipedia.org/wiki/Endocannabinoid_system

I also know people who run medical drug trials and they are often busy running cannabis trials these days.

Here's a quick search for registered Sativex trials -

https://www.clinicaltrialsregister.eu/ctr-search/search?quer...

And here's an overview of evidence and research, hosted by the British Medical Journal -

https://www.bmj.com/sites/default/files/response_attachments...

> Proper medical treatments goes through many rounds of studies to prove that it works and is safe (which is unlikely in this case: smoke causes cancer in general).

And opioids cause addiction and death. All medicine is poison. There is no such thing as "safe medicine" there is only a "relatively safe dosage".

There are proper studies, and meta-analyses:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549367/

https://www.jpain.org/article/S1526-5900%2815%2900837-8/full...

http://jalm.aaccjnls.org/content/2/4/485

The current findings appear to be that cannabis is modestly effective at chronic pain management and ineffective at acute pain management. There's some contradictory evidence as well; I'd be remiss in not pointing out this Lancet article finding zero to negative effect on chronic non-cancer pain:

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...

I’d be surprised if anyone takes marijuana for medical purposes by smoking it. Try visiting somewhere like seattle where it’s legal - you can get it in useful forms like oils or tinctures that get dispensed out of a dropper, or you can buy e.g chocolates with a defined strength per piece.

It has no known medical uses, legally speaking.

Now, maybe one should question the value of a statement made by law and not by science. I personally do question it. But in other areas of law people treat statements by law as if it were scientific fact, so it doesn't surprise me that so many do in this case as well.

I was under the impression that there is clear evidence/consensus that CBD is a great anti-inflammatory / painkiller.

The comment may refer to the fact that the US federal government categorizes marijuana s a Schedule I drug, which explicitly states it has no medical uses whatsoever. But yes, there are mountains of scientific evidence that marijuana has medical benefits.

I sure know, I have chronic kidney stones and voted to legalize it in my state. It provides a great deal of pain relief for me. I utilize opiates for the most extreme cases of pain.

You probably heard of this treatment, my co-worker got kidney stone relief from extracorporeal shock wave lithotripsy.

Yeah, I have had two of these and two laser lithotripsies.

I know the people who ran the stage three MS trials comparing whole plant vs sativex vs established medication, here in the UK. Trials are going forward and evidence is mounting up for THC and whole plant. Other than for THC, mostly via sativex, right now there is less evidence either way for CBD and other isolated cannibanoids as they have had far fewer trials.

Somewhat related: there's apparently some question as to whether the availability of Naloxone actually increases risky behavior among drug users, based on a concept called 'moral hazard': https://www.annemergmed.com/article/S0196-0644(18)30457-8/fu...

There's so many people that get these drugs completely legally then get hooked on them and next thing you know their on heroin which is illegal. I really think we need to restore some balance and get rid of the legal stuff (like the so called harmless back-ache medicine, etc) people are getting addicted to in the first place.

This is the attitude that gets us in this mess in the first place.

It should all be legal, but the controls in place are harmful. Too much oversight in the wrong places, not enough in the right places.

Have you ever needed opioid pain killers to deal with either an acute or chronic pain condition?

I can answer that for you: no, they haven't.

If they'd witnessed someone they love, living for weeks in mind shattering pain, sobbing just getting up to go to the bathroom, unable to sleep or think through the pain, waiting on a doc to prescribe real painkillers, but the doc is too afraid of the DEA, maybe they'd change their minds. Or maybe they'd point to some random overdose in the newspaper and tell their spouse/mother/father/child to suck it up and stop crying, it's only major nerve branches slowly dying, and who can't rub some dirt on that?

Being addicted to heroin is even worse. You should see how the people addicted to drugs end up: they have all the pain you just mentioned but with the additional burden of having to buy 150$ worth of drugs everyday, just so they can function.

I haven't, but I have had surgery where they just automatically handed me a scrip for them even though I never had enough pain to bother using them. They hand out opioids like candy; it's no wonder so many people are addicted to them.

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