Maker of dangerous pain pills is 'ghost' that can't be found [video]
usatoday.com
usatoday.com
> They are running a high risk: Dozens of Reumofan users have suffered serious and sometimes life-threatening health effects after taking the pills, including liver injury, strokes and severe episodes of bleeding, according to federal records obtained under the Freedom of Information Act.
On first reading it's easy to say these people are stupid, taking this ridiculous medication when there are proper meds around.
Pain control and pain medication is weird. People sometimes overdose with proper meds, leaving themselves open to similar very dangerous side effects.
Some of the meds are old, from a time when testing wasn't as good and understanding of pain was poor. See coproxamol as an example - this med contains 325 mg of paracetamol (therapeutic dose is 1000 mg per dose) and the weak opioid dextropropoxyphene. Coproxamol was widely used in the UK by people completing suicide. The dextropropoxyphene is very toxic, especially if combined with alcohol. And people taking the med long term would increase the dose because of tolerance to the opioid, thus risking liver toxicity from paracetamol overdosing.
But, despite clear evidence that this med is dangerous, and no more effective than a normal dose of paracetamol alone, there was a lot of campaigning around its withdrawal, with people worried that they would not find a suitable replacement.
We have better pain management now, but it's still tricky to get people the right pain relief.
Which is still full of APAP. The liver damage problems are possibly even more prevalent today with Vicodin being prescribed like Tic Tacs.
I've found Vicodin helped with the pain from my teeth (pulling) but didn't do anything (except make me drowsy) when I scratched my cornea. I know it's an anecdote but it always left me confused as to whether it was the pain being so much worse with the eye or myself reacting differently the medication. With how subjective pain is it's amazing that we find stuff that works for so many people really.
Here we have a highly addictive drug (codeine) that is otherwise reasonably safe in quite high doses, and that is regularly prescribed in substantially higher doses. E.g. prescription co-codamol is usually sold with 30mg codeine per 500mg paracetamol vs. 8 or 12.5 mg codein in over the counter, and you can get prescriptions for "neat" codeine at higher doses as well.
And we have a drug that causes liver failure in quite small doses, to the extent that the UK government put in place restrictions on it sale intended to reduce its use in suicides (you can only buy 16 pills at a time outside of pharmacies, and 32 pills at a time in a pharmacy). It's been widely reported to have cut suicide deaths using paracetamol by hundreds (total, not per year) since the restriction was put in place as just that slight little barrier of having to go to multiple places is apparently enough to make some people think twice.
So what do they do? Of course, since we all know addiction is bad (and we're talking religious/morally/tabloid style righteous "bad" here), why, when they decide to allow sales of tablets with codeine over the counter, they decide it should be mixed with paracetamol or ibuprofen, with the codeine content low enough that anyone left addicted after failing to get prescriptions renewed etc. faces the choice of suffering it out, or risking their liver.
Cue a couple of years, and the warnings about the danger of these pills are starting to emerge: Surprise, surprise, people with severe opiate addictions are sufficiently often not in a place where you should expect them to make rational decisions about whether or not taking products containing too much paracetamol is a good idea...
I get migraines sometimes, and the codeine/paracetamol pills are a great help, but I can't help but think that allowing the over-the-counter sale of them without a "safe" alternative for those addicted to codeine is tantamount to murder - the government knew all the risks, and in fact there'd be little reason to require those mixes over allowing plain codeine if it wasn't as a way of making the pills more dangerous to abuse. Yet they did it anyway.
After the doctor pulled the prescription, I had to come down off the stuff slowly and cocodamol was the only option. I decided to go cold turkey and was a grumpy asshole for a month in the end.
So fundamentally I agree entirely with you!
Also, Hydrocodone (derived from codeine) is a Schedule 2 drug in the US. But, when combined with another substance (most often with acetaminophen, like Percocet) the drug is reduced to Schedule 3. http://en.wikipedia.org/wiki/Hydrocodone
As far as addicts misusing OTC codeine/acetaminophen, it's apparently pretty easy to filter most of the adulterant in a basic kitchen.
Preventing sales of loose tablets (everything in blister packs) was more successful.
(I agree with everything else you say)
Doctors and the FDA began to get suspicious because the pills worked so well.
You know the risk just may be worth it if you can get the same drug at a fraction of the price. Some people can't afford the real thing.
Hacker instinct took over :)