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Comment by alex_young | Hacker News Reader

Having spent the last year living is Switzerland, the major increase of drug overdoses in the US seems so preventable.

The Swiss have both decriminalized drug use (kills the black market, prevents people from getting an unknown dose of something) and highly restricted prescribing them.

I dislocated a shoulder and was never offered anything for pain, just physical therapy. This may sound harsh, but isn't setting someone up with an addiction that could lead to death pretty bad?

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> I dislocated a shoulder and was never offered anything for pain, just physical therapy. This may sound harsh, but isn't setting someone up with an addiction that could lead to death pretty bad?

Amazing what can happen when private profits aren't tied up in the healthcare system.

Neat theory but Canada is battling an opioid epidemic as well.

Yes, because apparently ibuprofen is BAD for you. To me, it sounds better to take care of the stomach rather than get hooked on opioids. When one then considers drug prices in the US and the need for prescriptions, it is not surprising people start going on heroin. From there, it’s a slippery slope. The dealer is already on the speed dial.

I find it odd that the US system (and presumably Canadian too) is so resistant to NSAIDs in paste form. Given they are more regularly killing their patients than Europeans, their arguments against patients handling imprecise dosing are as comic as morbid.

Yeah and doctors here regularly receive incentives from drug companies to push drugs on patients. My girlfriend gets free drug Rep lunch at least once every two weeks and has for years at the doctor's office she works at.

Interestingly, Swiss health care is actually provided by private, for-profit companies. It is highly regulated though and poor people’s health care costs are subsidised by the state.

It's basically like Obamacare. You have to buy from them and the insurers have to sell to you.

Is it normal to get pain killers for a dislocation? Never heard of that happening in the US. My friend dislocated his shoulder cliff diving last month. The doctor popped it back in and that was that.

From what I have experienced in the US doctors seem to believe that no amount of pain is acceptable. So they prescribe painkillers a lot. Definitely way more than I have experienced in Germany.

It certainly isn’t my experience or anyone in my family. The only time I ever was prescribed pain killers was after surgery for severely impacted wisdom teeth. They gave me 2. I’ve had broken bones where I was put to sleep, nasty dog bite where I still have a dent in my calf, multiple stitches from random accidents, and a somewhat major car accident.

Pain killers were not even an option and the doctors said deal with it. Here’s some Ibuprofen.

It could be anecdotal, the doctors in my area are good and they are very aware of opioid issues. I know of people driving to Florida to find favorable doctors.

Interesting. I have received and thrown away tons of Vicodin and muscle relaxers even for relatively minor injuries.

It could be my area. It is middle “upper” class and the opioid issues started much earlier. Doctors and pharmacies were aware of it in the early 2000s.

That's crazy.

I've been a pretty high level athlete, and have had some pretty bad injuries, and never once was I prescribed a pain killer?

Why is everything so non-uniform in this country? Because anyone with the resources to go to a doctor, you would think probably has insurance? So what is driving those differences? Just the doctors themselves?

You know how in your field, there is a wide variation in skill? Same in every other field.

Medicine is still more an art than science. We don't have clear evidence based practice guidelines for many conditions so doctors have to prescribe based on habit and intuition. Plus as with any profession, some are just incompetent.

> Pain killers were not even an option...Here’s some Ibuprofen.

Hmm...isn't Ibuprofen a pain killer?

https://www.nhs.uk/medicines/ibuprofen-for-adults/

"Ibuprofen is an everyday painkiller for a range of aches and pains, ..."

When I had a broken elbow, Ibu 600 was what I got a prescription for (Germany). In the hospital after the operation I got something stronger.

Yeah, but "painkiller" is often/mostly used to refer to opioid painkillers in the US these days.

This used to be true, that US doctors were taught to treat pain itself but now medical education is more aware of the dangers of addiction and abuse and hopefully new doctors don’t prescribe at the same rates or have the same falsehoods about painkillers being safe.

Idk about now, but for a long time in the not too distant past, you could get hydrocodone for virtually anything.

This is anecdotal, but not all dislocations are the same. I dislocated my thumb skiing (Colorado) some years back (10?), and the bone shredded the ligaments in my palm. I was pretty grateful for the hydrocodone the doctor gave me because I don't think I would have been able to sleep for the week after the incident without it.

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