Hacker News Reader

Comment by refurb | Hacker News Reader

Oxycodone was always known to be addictive. It’s right on the label from day one.

“Also at the time of OxyContin’s approval, FDA product labeling warned of the danger of abuse of the drug and that crushing a controlled-release tablet followed by intravenous injection could result in a lethal overdose. There was no evidence to suggest at the time that crushing the controlled-release capsule followed by oral ingestion or snorting would become widespread and lead to a high level of abuse.”

https://www.fda.gov/drugs/information-drug-class/timeline-se...

View on HN

I remember with distinct anger that my friend told me information to the contrary. He probably got that phrasing from that doctor who got a free trip to Barbados to push it. I wasn't there but i remember him telling me that and it makes my blood boil.

I do share other people's skepticism of the medical industry as you might be able to tell. He should have done more research, agreed.

We license doctors to do the research for us. We can not be expected to experts in all fields. It's why we license professionals.

We license doctors you visit to practice medicine, not to do research. Unless they're working at a dedicated research hospital like the Mayo clinic, doctors don't do research on their own.

They'll stay up to date with what is standards of care, but even that is dictated to them by their EHR software or what they expect your insurance will cover.

When I've gotten prescribed a new medicine, I don't really recall a doctor ever even telling me what side effects to watch out for. At most, they've told me not to drink alcohol while on someone.

People are often taken in by the Big New Thing. That's why I have a default policy of skepticism towards pretty much everything.

> That's why I have a default policy of skepticism towards pretty much everything.

I’m convinced anyone who doesn’t do this is either too young to know better or too dumb to have been paying attention.

The Big New Thing at the moment seems to be a moral panic about oxycodone.

“Covid” or the constant breathless reporting about every possible little thing over 3 years did this to me. Not rehash any of it but now 3 years later people like Zuck coming out and saying things like “Woops maybe we censored the wrong things and promoted also the wrong things. Woopsies.”

I thought I was world worn and tough.

Then came AI and I was again on the doom and gloom train. Then I had a moment, realized this just the new thing and dropped it down a few degrees.

What’s next?

Yeah that was saying if you crushed n injected it would be addictive. No. It was addictive in literally any form. They knew that too, n it wasn't on the packaging.

You kind of have to be a monster to say something that callous.

As far as I understand it, crushing/injecting it makes it more likely to induce pronounced euphoria and other side effects that encourage abuse. But it was known from the start that it was addictive (causing a physical dependency) even if used as intended, simply because it is an opioid. Here's an older package insert:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/02...

Among other things, it says “Physical dependence and tolerance are not unusual during chronic opioid therapy.” I'm no expert, but I think that explains why warnings about dependence weren't more pronounced. The drug was supposed to be distributed in a tightly controlled fashion due to these risks, after all.

In retrospect, the warnings at the start, and the information for patients read like recipes for abuse, though.

Both sides benefit from the average Joe not knowing the facts. This is, in a nutshell, why so much FUD exists about drug addiction.

For dealers, it gets people through the gateway. For the anti drugs crowd, it's the equivalent of preventing teenage sex by not telling them how it's done

Reply on news.ycombinator.com