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Comment by jschwartzi | Hacker News Reader

He's also blaming addicts for being addicts. At the end of the article he lays out a "rugged individualism" argument that addicts should just suck it up and quit being addicts. Well, they can't, and they've proven that they can't multiple times, so what does he propose we do, other than crack down even harder?

Doing the same thing over and over again and expecting a different result is how some define insanity.

Also, if these gangs are non-violent and their custom are non-violent, isn't that preferable to the kind of raw violence that is seen with other Mexican cartels?

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No he's not, he's blaming doctors for misunderstanding the medicines they are prescribing and overprescribing them, thus exposing a lot more people to addiction than otherwise would've been.

This may be the case in the US. However in the UK, doctors are scared to prescribe pain killers. As someone who suffers from chronic pain (accident early 2012), it took two years to get even close to adequate pain medication (from a pain specialist in the end).

I work hard and if there was a better option than pain killers, I'd happily pursue it. Being tarred with the same brush as addicts is quite offensive. Also, I have a BMI in the mid 20's so further exercise isn't going to help.

That's not being scared, that entirely appropriate prescribing.

https://news.ycombinator.com/item?id=9402507

Many people in the UK end up addicted to pain medication after inappropriate prescribing of opiate meds to treat long term pain.

You should be angry about the length of time it took to get you to a pain clinic, not about doctor's decision not to prescribe meds that are both addictive and often ineffective.

Also, "lose weight and do psysiotherapy guided exercise" might not have been right for you but it is good advice for many people with long term pain.

Hell, in the UK doctors often won't even prescribe addicts Methadone. For example, I had to go to a separate service, the CDPS (Community Drug Problem Service, says it all, really) where you are basically treated like criminal scum, no matter what your background is. I gave up on the scheme when my assessor didn't believe I wasn't homeless, had a real job and had never been in prison...

> Being tarred with the same brush as addicts is quite offensive

Actually, that attitude itself is offensive. Addiction is a serious mental health problem, and should not be stigmatized.

Agree wholeheartedly. Even beyond the acute condition itself, it's been shown that there are genetic factors that likely increase cravings for certain drugs, and may predict development of dependence. For alcoholism, OPRM1 A118G has some substantial evidence behind it. Shaming people for drug addiction isn't any different than shaming a diabetic IMO.

Yes, some may have a genetic disposition, but they still have choices. There is a difference between substance abuse and treating a medical condition.

Simply down voting people because you disagree with them isn't cool IMO.

edit: Myself (and many others) have also been stigmatised from getting the correct medication because of a fear becoming addicts.

You're being downvoted for your stigmatising ignorant comments about people with addiction.

Downvote to disagree is going to happen; it's not forbidden on HN (PG has a post somewhere talking about the acceptability of using downvote to disagree) although there are a large number of people who strongly dislike downvote to disagree.

People with depression have choices. People with OCD have choices. People with diabetes have choices. People with schizophrenia have choices. Having choices doesn't disqualify something from being a medical condition.

> Myself (and many others) have also been stigmatised from getting the correct medication because of a fear becoming addicts.

No. For most people with long term pain opiate meds are the wrong choice. Those people need rapid access to specialist pain clinics; cbt for pain; short term pain meds to enable them to take part in physiotherapist guided exercise; and possibly weightloss.

Opiate pain meds for long term use are not effective for most people; and are addictive. It is wrong to give someone a med that won't work and that has side effects and that carries a risk of addiction when there are less risky, non-addicting, better solutions to try first.

I've had chronic pain in the past that's probably far more minor than yours, and it sucks. But for what it's worth, I've found that the mental effects of exercise are far more dramatic than the physical ones – paradoxically, even running until I'm sore and exhausted seems to relieve more pain over the following two to three days than it causes. Maybe worth considering. Anyway, hope you're trending toward better.

Chronic pain is very tough and opioids shouldn't just be thrown at it. I've known two people with chronic pain that have gotten addicted to their pain medication... then they didn't even work anymore. So they ended up with addition in addition to their chronic pain. This outcome in a very very real (and very common) concern.

These people didn't want to become addicts and weren't taking Oxy for thrills...

Mid-20s is borderline overweight. A naturally skinny average height person who never exercises has BMI ~24. Varies by height and build of course.

http://www.vertex42.com/ExcelTemplates/Images/body-mass-inde...

That's definitely part of the problem – especially when it comes to the amount of a particular drug being prescribed. A lot of the addiction/dependence exposure involves diversion, i.e. the people using the prescription opioids are not necessarily the people who they were prescribed to. Often someone will start by buying leftover/extra pills from a friend/acquaintance, become physically dependent, find someone else when their friend runs dry, start running low on cash, and then finally break down and go for the cheaper option (heroin).

I don't think I've ever been prescribed less than 30 of an opioid pain reliever for an injury. Sometimes with refills. Five or ten, with the ability to call the doctor for a same-day script if I were still in pain after those, would be infinitely preferable.

>Well, they can't, and they've proven that they can't multiple times, so what does he propose we do, other than crack down even harder?

Or they don't really want to (getting clean sucks), they have proven again and again that they would rather be on drugs than of drugs, so what are you going to do, other than crack down even harder?

I am not saying that is necessarily the entire truth, but addicts do quit on their own and both narratives predict the behaviour.

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