Indianapolis to pursue legal action against opioid manufacturers

[rob63]

The next step will be to sue the oil companies for not stopping global warming by limiting the amount of gasoline they make.

https://www.theguardian.com/sustain...-climate-change-carbon-majors-sea-level-rises

https://www.huffingtonpost.com/entr...on-climate-change_us_57ec1512e4b024a52d2c5ae5

https://www.reuters.com/article/us-...led-investors-on-climate-change-idUSKBN18T1XK

https://insideclimatenews.org/news/...ge-research-ny-attorney-general-investigation

 

[Vigilant]

If he goes after the bourbon distilleries I'm launching a REVOLUTION.

As long as it's not MY brand, meh!

 

[Liberty Sanders]

This morning I held up the front page of the Indy Birdcage Liner so my wife could see the headline about this.

I said, "What do I always tell you is the hallmark of government?"

She didn't miss a beat. She replied, "To pretend to be doing something about a problem while in reality not doing a f**king thing, or making it worse."

I'd say this is a textbook case.

 

[T.Lex]

This morning I held up the front page of the Indy Birdcage Liner so my wife could see the headline about this.

I said, "What do I always tell you is the hallmark of government?"

She didn't miss a beat. She replied, "To pretend to be doing something about a problem while in reality not doing a f**king thing, or making it worse."

I'd say this is a textbook case.

Along those same lines...

https://www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html

What is it with Republican presidents and Wars on Drugs.

 

[BehindBlueI's]

Why doesn't screening test requirement include bringing your prescription in for an audit to show you still possess the proper quantity of the remainder of your prescription? Got 30 pills 10 days ago, take one a day, you should still have 20 pills when you show up for your audit/ pee test.

Hopefully Doc can correct me if I'm wrong, but I don't think there is any central repository for prescriptions. Hence "doctor shopping" and getting meds from multiple doctors. Pharmacies are more hooked together now, so that might realize you're filling multiple scripts but I don't know. My experience is limited to the EMT level/beginning nurses training and that was almost 20 years ago. (Yeah, I was considering being a murse at one point...)

Even then, though, I remember the big push for "zero pain" and how important pain management was. As an intern at a nursing home, I was supposed to constantly ask what their level of pain was, if it was manageable, etc. At the time I thought it was really nice. It seemed like it was about caring for and comforting the patient, whereas it was cruel before to make them tolerate a certain level of pain. Knowing now what I didn't know then, that was the beginning of the big push to get more pill sales.

I know many look at this like the drug companies just make a product and whoever wants it buys it, but that's not really how the drug industry works. There's a reason pharmaceutical sales rep is a six figure salary if you are any good at all. Some meds are more...optional, than others.

 

[craigkim]

Hopefully Doc can correct me if I'm wrong, but I don't think there is any central repository for prescriptions. Hence "doctor shopping" and getting meds from multiple doctors. Pharmacies are more hooked together now, so that might realize you're filling multiple scripts but I don't know. My experience is limited to the EMT level/beginning nurses training and that was almost 20 years ago. (Yeah, I was considering being a murse at one point...)

Even then, though, I remember the big push for "zero pain" and how important pain management was. As an intern at a nursing home, I was supposed to constantly ask what their level of pain was, if it was manageable, etc. At the time I thought it was really nice. It seemed like it was about caring for and comforting the patient, whereas it was cruel before to make them tolerate a certain level of pain. Knowing now what I didn't know then, that was the beginning of the big push to get more pill sales.

I know many look at this like the drug companies just make a product and whoever wants it buys it, but that's not really how the drug industry works. There's a reason pharmaceutical sales rep is a six figure salary if you are any good at all. Some meds are more...optional, than others.

We do have a database to check patients controlled medication history. It's been a godsend to help us prescribe responsibly over about the last 10+ years, IMO. Patients used to be VERY creative about how to seek out opioids and our database, Inspect, has largely eliminated that behavior as far as I can tell. I think a lot of the opioids, prior to Inspect, were prescribed by well meaning and law abiding practitioners who fell for the multiple scams of patients illegally seeking medications. They would get very good at faking symptoms, they would go to multiple offices in one day, fill at multiple pharmacies, and pay cash for the drugs. After we gained access to the data, I bet it shut off this "pipeline" and forced patients to resort to finding prescribers who were not law abiding or other drugs like heroin.

I am really quite thankful for the recent changes in the law, but I was always as careful as I could be about who I prescribed to and how many tabs, etc. Now, we can't "call in" prescriptions, we can't write for more than 7 days worth, and we are limited to one script. It's nice really, because I don't have to be the bad guy. I can just say, "well, it's the law." I do also think that opioids are a valuable medication for very short term use, but I also want to make sure that I am responsible with their use by my patients.

 

[printcraft]

Kokomo has also thrown it's hat in the lawsuit ring.
Update: Kokomo to join Indiana cities in lawsuit against opioid distributors | Local news | kokomotribune.com

 

[hoosierdoc]

They better hurry, the Feds already got OxyContin manufacturer for billions. And opana maker is down 90% in last two years

 

[printcraft]

They better hurry, the Feds already got OxyContin manufacturer for billions. And opana maker is down 90% in last two years

It's nuts. It's like suing Exxon for making gasoline that a drunk driver put in his car and killed someone with.

 

[hoosierdoc]

Well I think there was some intentional misleading done regarding addiction potential. But duh, they're narcotics...

they all work on the same receptor. They just push harder or softer than some others

 

[Tombs]

Prohibition 2.0.

This is absolute absurdity at its worst. I have a neck and back injury that makes driving more than a few miles torturous, tried absolutely every pain management option out there.
Doctors just straight up tell me that I have to live in pain because the government no longer allows them to give me anything that would work for me. The alternative is being unable to move my neck or back more than a few degrees, which at my age I'm not ready to deal with.

Can't even experiment with CBD in this state thanks to the laws.

Why not, you know, send criminals to jail instead of punish me for something that's no fault of my own?

 

[T.Lex]

Prohibition 2.0.

This is absolute absurdity at its worst. I have a neck and back injury that makes driving more than a few miles torturous, tried absolutely every pain management option out there.
Doctors just straight up tell me that I have to live in pain because the government no longer allows them to give me anything that would work for me. The alternative is being unable to move my neck or back more than a few degrees, which at my age I'm not ready to deal with.

Can't even experiment with CBD in this state thanks to the laws.

Why not, you know, send criminals to jail instead of punish me for something that's no fault of my own?

Do you think Trump's efforts in this regard are laudable? I mean, as you note, everyone is looking at the criminal side of this equation but there is a medical side that is completely legitimate.

 

[Tombs]

Do you think Trump's efforts in this regard are laudable? I mean, as you note, everyone is looking at the criminal side of this equation but there is a medical side that is completely legitimate.

Well of course not.

The government has been doing this trash for the past 3 administrations though. The doc gave me some sort of pain killer a few years ago that he was legally allowed to prescribe, then a mere week later the government came out and put it on some destructive controlled substance list and the doctor was forced to take me off it.

Does make me wonder if the doctor is just lying through his teeth or doesn't want to deal with the effort involved though.

 

[MarkC]

Do you think Trump's efforts in this regard are laudable? I mean, as you note, everyone is looking at the criminal side of this equation but there is a medical side that is completely legitimate.

As a now-retired former "warrior" in the "war on drugs," my views have evolved from the simplistic "arrest them all!" to realizing that I'm not smart enough to have all the answers.

However, I do understand that we cannot arrest our way out of this problem. On the other hand, in some cases a major life event, such as an arrest or loss of a professional license, is the nudge some need to finally seek the help they need.

Unfortunately, between being unusually busy at work and an ER trip with the in-laws, I haven't had time to closely examine the specifics of the President's latest declaration and what all it entails.

Lastly, at last night's rather lengthy ER visit (F-I-L is now an inpatient), I had the opportunity to do something I don't often get to do since my retirement: watch the wide variety of people who present themselves to the emergency department. Many of the folks there were visibly ill or injured or clearly distressed; others, well, their issues were not so apparent. Also, it is NOT necessary for all four generations of the extended family and the pet, not service, dog on a leash to accompany mee-maw and pe-paw to the ER.

 

[T.Lex]

Well of course not.

The government has been doing this trash for the past 3 administrations though. The doc gave me some sort of pain killer a few years ago that he was legally allowed to prescribe, then a mere week later the government came out and put it on some destructive controlled substance list and the doctor was forced to take me off it.

Does make me wonder if the doctor is just lying through his teeth or doesn't want to deal with the effort involved though.

I know you and I have differed, but at a personal level, I'm very sorry you're stuck with this. Family members of mine have had similar issues.

If you think the doc is perhaps not being diligent, there are resources to help figure it out. Of course, going to a different doc is risky because then it starts to look like doctor shopping.

Heck, some of us could help crowdsource whether the drug is actually regulated like that or help find alternatives.

Back on topic though (by INGO standards), my concern is that this is yet another distraction and effort to look like action is being taken without real action being taken. Because that's difficult. And expensive.

 

[Route 45]

Can't even experiment with CBD in this state thanks to the laws.

If one of my loved ones had a condition where CBD might be the only option left, this is where the law and I would part ways.

 

[Tombs]

If one of my loved ones had a condition where CBD might be the only option left, this is where the law and I would part ways.

And there's not a day that goes by with how bad my back hurts at times that makes me wonder if all this nanny state nonsense hasn't driven those with less concern with the law into drug abuse.

 

[hoosierdoc]

Tombs, you have at least admit there's a massive problem with opioid pain pills in our country, right? How would you propose dealing with it?

and your doctors are lying to you. They could put you on a pain management regimen, they are choosing not to. What pill did they put you on? darvocet was removed but it sucked anyway

Well of course not.

The government has been doing this trash for the past 3 administrations though. The doc gave me some sort of pain killer a few years ago that he was legally allowed to prescribe, then a mere week later the government came out and put it on some destructive controlled substance list and the doctor was forced to take me off it.

Does make me wonder if the doctor is just lying through his teeth or doesn't want to deal with the effort involved though.

 

[hoosierdoc]

Also, it is NOT necessary for all four generations of the extended family and the pet, not service, dog on a leash to accompany mee-maw and pe-paw to the ER.

THANK YOU! Please put this on a bumper sticker. It's soooo annoying to walk into a room with seven family members. Especially when some other doc gave them a bogus reason to go to the ER. When I told you death is imminent, call everyone. But when little Timmy vomited once, please respect the two visitor rule

and usually with 4+ family members there's going to be one who knows grandma has cancer and is dying and she has GOT to be admitted or else the fury of hell will be unleashed. Usually I try to find out who that person is before they expose themselves to me. Often they are the family medical expert because they are a medical coder

 

[JAL]

It's nuts. It's like suing Exxon for making gasoline that a drunk driver put in his car and killed someone with.

Not quite the same. The opioids are addictive. How addictive depends on dosage and the individual. A couple observations having been through cancer twice now, the first time around was Stage IV Head & Neck not quite eight years ago, and then Melanoma not quite five years ago. Woke up from surgery on an opioid drip and was prescribed Hydrocodone. May still have them somewhere as I think I took one, looked it up, realized what it was and stashed the bottle. All the time I was being asked for a pain level on a scale of 0-10. Pain management was frequently discussed, and I was continuously asked if I was certain that it wasn't that bad. Then came the radiation therapy and anyone who's had head/neck rads can attest to its morbidity at about the third week. More Hydrocoone . . . in a bottle . . . and I think that one is still in the back of the reefer, untouched, for the same reason as before. Then the Melanoma surgery and I declined the offer for yet more Hydrocodone. Not hard for me to see how someone can get hooked on an addictive drug. It was all but thrown at me along with lectures about not "toughing it out" because it would take longer to heal.

The Tylenol and Acute Liver Failure Kicker:
Every one of those prescriptions were annotated with "APAP" which means they're laced with acetaminophen, aka "Tylenol", to amplify pain relief. It's typically not a small amount either. Take it in high enough quantities and you're not only risking OD on the opioid, you're also potentially killing your liver, especially if you're taking anything else with "Tylenol" in it which is a host of OTC cold and flu medicines . . . or taking it in combination with alcoholic beverages. A few years ago, Tylenol OD was the leading cause of acute liver failure (ALF) in the US and UK, and a leading cause in Australia and New Zealand. AFAIK it still is. There's no recovery from ALF I'm aware of beyond transplant.

I've seen some effort to shut down pain clinic prescription mills, but as others already mentioned, it's not easy to do. I know of one that went down and it was a while ago. Script for opioids was their only business. From what I understand, the trail of a mountain of opioid script from them was their eventual undoing. This becomes, however, akin to the circus clown that makes the balloon figures. Sqeeze the balloon in one place and it bulges in another. Squeeze it there, and it bulges out somewhere else. Shut down the illegal mail-order pharmacies and pain clinics specializing in scripts for it pop up like mushrooms in the shade feeding on fecal rot. Shutting down pain clinic script mills pushes demand to other sources with pharmacy robberies and burglaries, and the growing demand for street heroin, plus Fentanyl smuggled in from China. It will continue so long as people become and remain addicted to opioids, whether it's heroin, morphine, Oxycodone, Hydrocodone, Fentanyl or some other man-made opiate. Until the demand to feed addiction is successfully reduced, all the other efforts will simply push the bulge in the balloon around.

My on the epidemic.

I've carefully noted they're going after the distributors, not the pharmacies that legitimately fill what appear to be legitimate script, or the manufacturers. I don't know enough about their role in pushing opioid use as the middle-man between the manufacturer and the prescriber or the pharmacy, but someone has been providing enormous incentive to prescribe opioids in large quantities for pain management. Its addictiveness is lucrative. Every time a patient gets addicted, it requires either continuation or medical intervention with other treatment. Pharma in particular benefits either way. They're minting money with it. As a former smoker, the addictiveness of cigarettes and the tobacco industry's effort to enhance their addictiveness has some strong parallels.

Regarding Fentanyl and China:
I'm reminded of the two Opium Wars between Great Britain and China during the 19th Century and then the Boxer Rebellion from 1899-1901, which was a direct consequence of the two earlier wars. Great Britain had a trade imbalance as China would only accept silver for the tea. In retaliation, Great Britain used their East India Company that became the British Raj to squelch rice crops and grow poppies for opium (resulting in massive famines there; another story). The opium was exported to China, hence the two Opium Wars to force China to accept the opium importation. At one point, 20-25% of the Chinese males were addicted to opium. British trade imbalance mostly solved. However the forced opium import into China along with other causes related to the unequal treaties rammed down the Qing dynasty's throat at gunpoint eventually resulted in the Boxer Rebellion. It was crushed by not just the British, but every other Western European power with them, plus Imperial Russia, Japan and the U.S. China remains in turmoil with the fall of the Qing Dyansty in 1911; suppression of local crops and dealers is no longer pursued. Japan invades Manchuria in 1931 under pretext of the false flag Mukden Incident (bombing of a protected railway). Hitler's false flag pretext to invade Poland eight years later has similar parallels. WWII intervenes from 1939-1945. It wasn't until Mao Tse-tung's communist revolution succeeded in 1949 and Chiang Kai-shek's exile to Formosa (Taiwan) that real suppression of opium crops and usage began in both mainland China and on Formosa. Mao took extreme action to suppress growers, distributors and addicts to finally get the problem under control although it's never been completely eliminated. Now we have Fentanyl pouring out of China into the U.S. just like Great Britain was pouring chests of opium into China in the 19th Century.

John