Chasing the Dragon: this country's heroin epidemic

I recall a lot of media coverage in the late 1990s and early 2000s about the surge in heroin use.
It seemed to get eclipsed by meth and oxy coverage in the race to report about the next thing.

 

Friend of mine had to have parts of both his feet amputated after a bout with meningitis. Got a bunch of pain pills to deal with the pain, then got addicted. He's clean now. But the lengths he'd go to score more pills from various pharmacies and the lies he'd tell were astounding. I watched a little of the doc linked in this thread and one woman was saying she was taking 50 pills a day just to keep from being sick. I can't even imagine how you'd get that many. Some of the doctors in this country blindly perscribing pills without giving much thought to the repercussions baffle me.

 

I walked into an urgent care clinic with food poisoning once, and walked out with a prescription for Lexapro. The doc there said, "You also look depressed. See if these help."

 

Did you think maybe you didn't need them? I had a cyst removed, got a shot of novacaine and it was cut off. Dr asked if I wanted oxy. Decided to just take advil or motrin. I realize it was nowhere near the pain some people go through, but sometimes the patient needs to question the Dr.

 

I sure as hell didn't need them. And I never took them. But he was insistent I do.

All because I admitted I was stressed out because I have two small children. You know, just like millions of other normal, non-depressed people.

 

The open handed way that Oxycontin, and to a lesser degree, Lortab, was prescribed, is the root of the heroin epidemic today. There was so much of it around that there began to be a serious problem with prescription drug addiction. The FDA cracked down on that, and the street prices for such drugs went up. At the same time, cheaper high quality heroin was becoming more available. The users went where the cheap high was.

Heroin is more addictive, more likely to cause a fatal OD, and does not care if the users are middle class.

 

When I had my back injury in 2012, I couldn't get my doctor to write me anything but naproxin and norco.
Stingy bastard.

 

Good job by you. Wonder how much the influence of pharmaceutical companies plays into doctors offering/pushing pain medication. I have a buddy who works for a pharmaceutical company (regional mgr making some good money) and he frequently is playing golf or going to Yankees or Mets games with doctors he is trying to sell to. His company is mostly dermatology medication, but I imagine it's the same with most pharmaceutical companies. Just from people I know, the patient also needs to take responsibility. It seems some people want to lay the blame soley on the doctors. Kid I used to work with pretty much lost his job as a result of pain pills. Had a car accident that resulted in back problems and he became addicted to whatever pills he could get. Had a pretty good job that he lost at 30 (3 yrs ago) and as far as I know hasn't worked since. People tried to talk to him, tell him to get help, but he downplayed his problem.

 

Don't over emphasize the drug reps. I was on the front lines, fifteen years in primary care. I saw reps come and go. In general, my doc did not have much time for them. If they were on his short list of favored reps they got a little more, depending on how busy things were. We ate (moderately decent) catered lunches probably four days a week because that was the only way for a rep to get any extended face time at all with him. He routinely turned down dinners at the high end steak houses in town because you had to listen to the hour and a half of propaganda to do so. He's a friggin doctor, he can afford a steak if he wants to go out. I've seen him run many of them right out of the office.

Oh, he'd take Alabama tickets if offered, but none of that stuff made much difference in what he wrote, including cute young blonde drug reps. He knew they didn't really like him, they were just trading in hormones to try to get their numbers up.

If a drug rep had a good drug, he'd write it... if it was on the BCBS and United formulary, and after it had been out three years or so. He wasn't big on dealing with Rx recalls due to side effects. The drug had to be clearly much better than what he was routinely writing, say a Lipitor sort of difference or he would not prescribe it.

He wrote pain meds, but he was pretty tight with them. If he knew that they had legit pain, he would, but he was pretty sharp about spotting the drug seekers, and if he had any doubt he'd pull the computerized profile of what they were getting, prescribed by who, and at what drug stores. Multiple doctors and drug stores would get them meds that were not controlled substances, and he'd have a nurse call the other doctors and squeal on the patient.

 

Wasn't trying to overemphasize them and I do realize doctors can afford steak dinners. I'm not familiar with the ethics laws and it varies from state to state. But I also know my buddy plays on PGA courses and gets the seats to the Yankees that only the corporatists buy. Even though every Dr in NJ and NY makes nice money they aren't paying for the season tix with the waiter service at Yankee Stadium and Citi Field. I'm not overempasizing, but just thinking it has to have some effect.

 

We all mocked Tom Cruise for his diatribe about how exercise was better for depression than medication, and he was wrong about DEPRESSION, but he wasn't really wrong about how frequently doctors prescribe stuff like LexaPro when people aren't really depressed. Feeling glum and stressed is not the same as real depression. Maybe docs think they can treat the symptoms before they get worse if you're headed in that direction, but I had a similar deal once. Took it for three days and thought: You know what? Fuck this. Go to the gym. Refocus your life.

 

http://www.nytimes.com/2016/08/05/h...-emergency-rooms-surveys.html?ref=todayspaper