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SpankyMcFarland

Doctors and opioids, a troublesome connection.

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11 hours ago, Penderyn said:

The UK used to do this until certain newspapers started squealing..   It was surprisingly cheap and, left alone, would have saved innumerable lives.   Newspapers prefer dramatic, squalid messes.  

I have thought on this one and will have to concede, this may be worth a try.  The government will have to keep an eye on the cost and if it is going to have serious impact on the costs of the medical system, they may have to re-consider how it is run.  But I'm all for saving lives and would certainly give it a try.  Good to hear the drugs are not that expensive.  Maybe it will work.

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3 hours ago, bcsapper said:

The only way to win the war on drugs is to give everyone what they want under government supervision. Might as well get on with it.  

I have re-thought this one and am willing to give it a try.   Someone said the drugs are not that expensive, which is good news.  Only concern is that this might discourage some from quitting altogether.   I hope they can find a way to use this system to also get people into treatment to quit completely.  That's the best solution but might not work for everyone.   It seems like society is plagued by one big problem after another.

Insert other media.url

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1 hour ago, blackbird said:

I have re-thought this one and am willing to give it a try.   Someone said the drugs are not that expensive, which is good news.  Only concern is that this might discourage some from quitting altogether.   I hope they can find a way to use this system to also get people into treatment to quit completely.  That's the best solution but might not work for everyone.   It seems like society is plagued by one big problem after another.

Insert other media.url

I can't access that link.  I don't have permission.

Now I'm all curious...

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44 minutes ago, bcsapper said:

I can't access that link.  I don't have permission.

Now I'm all curious...

 Must have accidently hit some key.   Oh I see the button on the bottom right I must have hit (insert other media).

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One concern about providing free heroine to addicts is the question about how long will this be done and how much will it cost?  Will it $50, $100 or $200 a day and how much a year?  Society could end up supporting thousands of addicts at a cost hundreds of millions of dollars (or billions?) for their lifetime.   This could break the public health care system if it was excessive.  There are many pressures on the health care system for various kinds of treatments.

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13 hours ago, blackbird said:

One concern about providing free heroine to addicts is the question about how long will this be done and how much will it cost?  Will it $50, $100 or $200 a day and how much a year?  Society could end up supporting thousands of addicts at a cost hundreds of millions of dollars (or billions?) for their lifetime.   This could break the public health care system if it was excessive.  There are many pressures on the health care system for various kinds of treatments.

Why pay the prices your War on Drugs have created?   

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On 25/03/2018 at 8:25 AM, Penderyn said:

 

Making health subject to private profit is a recipe for disaster, always and everywhere.

Yeah, drs  should be training for years and incurring hundreds of thousands in debt and not be paid.

A few chickens and the odd goat seem fair.

Companies spending billions in R and D then billions getting to market should also not be charging you. They should just be thankful for the chance to improve your life.

Those Basterds. We could still be experiencing early death rates and high child mortality rates but no.

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6 hours ago, Penderyn said:

Why pay the prices your War on Drugs have created?   

Are you advocating free hard drugs for all?  

Edited by blackbird

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11 minutes ago, blackbird said:

Are you advocating free hard drugs for all?  

Not free.  And not for all.  Some manageable price structure must be in place that helps cover the cost while making illegal drugs non-profitable for the criminal, and then they would only be available to registered addicts.  Registration would be free and easy.

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6 hours ago, bcsapper said:

Not free.  And not for all.  Some manageable price structure must be in place that helps cover the cost while making illegal drugs non-profitable for the criminal, and then they would only be available to registered addicts.  Registration would be free and easy.

...

Edited by blackbird

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2 hours ago, bcsapper said:

Registration would be free and easy.

The trouble is that governments usually insist on imposing a heavy dose of morality - the cost of which, I think, is just a little too galling for most. 

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1 minute ago, blackbird said:

With Trudeau's open borders and welcoming of illegal migrants, maybe thousands of drug addicts from all over the U.S. would flood into Canada for hard drugs and free social services.  They might even come from all over the world once the word gets out.

The same problem exists in Canada, Vancouver for example has to carry a disproportionate load due to the fact so much of Canada is leaving it up to others to carry their load.  Harm reduction needs to be universal to work.  As such, Canada needs to pressure other countries to get with the program.

This is the sort of morality the world needs a dose of.

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3 hours ago, eyeball said:

The same problem exists in Canada, Vancouver for example has to carry a disproportionate load due to the fact so much of Canada is leaving it up to others to carry their load.  Harm reduction needs to be universal to work.  As such, Canada needs to pressure other countries to get with the program.

This is the sort of morality the world needs a dose of.

..I don't think you as a liberal have any idea of the problem or how to solve it.  But the left/liberals are the same.  This country is sunk on this issue along with many other issues.

Edited by blackbird

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Just now, blackbird said:

Try it in Indonesia or the Philippines where suspected drug dealers get shot.  In Canada, we spend hundreds of millions of dollars to try save lives of addicts but how many of them are interested in quitting? 

Hey, have it your way and try the Indonesian/Philippine solution. Good luck with that btw.

Quote

 

What are the police and courts doing with the dealers?  With the fentanyl crisis,  why are these addicts still able to get their hands on drugs?  What are the police and courts doing about it?

 

Not much apparently.  Kinda what Ottawa is doing about the Chinese government looking the other way while their Big Pharma sector produces the fentanyl flooding into Canada.

https://globalnews.ca/news/4066845/chinas-fentanyl-production-called-out-by-port-coquitlam-councillor/

 

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3 hours ago, eyeball said:

Hey, have it your way and try the Indonesian/Philippine solution. Good luck with that btw.

Not much apparently.  Kinda what Ottawa is doing about the Chinese government looking the other way while their Big Pharma sector produces the fentanyl flooding into Canada.

https://globalnews.ca/news/4066845/chinas-fentanyl-production-called-out-by-port-coquitlam-councillor/

 

The drug problem is out of control.  Liberals are incapable of dealing with it.  It's not in their thinking to eliminate.  

Edited by blackbird

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17 hours ago, blackbird said:

Are you advocating free hard drugs for all?  

For addicts, obviously, until they are cured.   Cheaper than prison by a bloody long way.

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On 2018-03-27 at 1:18 PM, Penderyn said:

The UK used to do this until certain newspapers started squealing..   It was surprisingly cheap and, left alone, would have saved innumerable lives.   Newspapers prefer dramatic, squalid messes.  

And look who expanded that program in the UK:

m2m.pdf

 

Edited by SpankyMcFarland

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Here's an excellent recent article on how doctors were hoodwinked by some of their over-optimistic colleagues and unscrupulous drug companies:

https://www.theguardian.com/news/2018/nov/08/the-making-of-an-opioid-epidemic

The dream of a pain-free life turns out to be a dangerous one. 

 

 

 

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Some more info on one of those drug companies and the shenanigans they got up to:

Quote

A former opioid sales executive admitted Wednesday in Boston's federal court to participating in a nationwide conspiracy to bribe doctors to prescribe a highly addictive fentanyl spray for people who didn't need it and will cooperate with prosecutors targeting his co-workers

Alec Burlakoff, 44, pleaded guilty to racketeering conspiracy and is likely to be a witness for the government when billionaire founder John Kapoor and other high-level executives at the Arizona-based Insys Therapeutics go on trial in January.

They're accused of fueling the opioid epidemic by paying kickbacks to doctors willing to write large numbers of prescriptions for the powerful medication Subsys, which is meant for cancer patients with severe pain.

The kickbacks were disguised as speaking fees for events billed as opportunities for other doctors to learn about the drug, prosecutors say. Some doctors were paid more than $200,000, Assistant U.S. Attorney Fred Wyshak said.

http://www.wbur.org/news/2018/11/28/alec-burlakoff-insys-therapeutics-guilty-plea-opioid-kickback-conspiracy

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5 hours ago, dialamah said:

Hard to imagine docs prescribing dangerous drugs so heedlessly.  Will any of these doctors be prosecuted?

One of the biggest offenders has faced legal sanction which you can read about in the Senate report. Here’s an extract:

Quote

On June 23, 2015, the U.S. Attorney for the District of Connecticut charged Heather Alfonso, an Advanced Practice Registered Nurse and participant in Insys speakers programs, with receiving kickbacks in connection with Subsys prescriptions under Medicare Part D.107 According to the charging document, from January 2013 until March 2015, Ms. Alfonso “knowingly and willfully solicit[ed] and receive[d] remuneration [of] approximately $83,000, in return for recommending and ordering a pain medication [Subsys] used to treat cancer patients.”108

 

Here’s a link to the report:

Quote

The report is absolutely worth reading in full. It outlines allegations against Insys—whose founder, John Kapoor, was arrested last year over bribery charges—including a culture of protecting the bottom line via any means possible. (One sales manager literally referred to patients as “low-hanging fruit,” according to the investigation.)

At the very least, disciplinary proceedings should be intitiated against other health professionals by the relevant state medical boards. To knowingly endanger a patient for financial gain sounds like fairly serious misconduct. 

Edited by SpankyMcFarland

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One of the physicians mentioned in the Senate report has a fairly colourful past:

Quote

Simon, born in 1947, began his work life four decades ago in Missouri as a pharmacist, the family business. But he ran afoul of the Missouri Board of Pharmacy in 1976 after he pleaded no contest to federal drug charges, specifically distribution of methaqualone (quaaludes) and dl-amphetamines. He received a $5,000 fine and a suspended prison sentence.

In the recent interview with The Star, Simon said he “made a bad decision” and was fortunate the punishment was not harsher.

“A U.S. District judge not known for his leniency decided to give me a chance,” Simon said.

The Board of Pharmacy tried to suspend his license, but Simon sued. His attorneys argued that the no contest plea and the suspended sentence did not amount to a criminal “conviction,” and therefore the board had no grounds for suspension.

The case ultimately went to the Missouri Court of Appeals, which found in Simon’s favor. 

He then went to medical school at Ross University in the Caribbean, and after he completed his education, he returned to the Kansas City area and applied for a physician’s license with the Kansas State Board of Healing Arts in 1984.

Applications for those licenses now ask whether the applicant has been arrested or charged with a crime. But at the time, they only asked about felony convictions.

“There is no conviction, and that’s the way the board looked at it, as well,” Paul Katz, a lawyer who represented Simon at the time, told The Star.

 

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A rather eccentric denial of guilt:

Quote

“I also heard that if you had a good-looking female (sales rep), she would have sex with you if you would write the prescriptions," Simon said during the interview last year. "Torgny is not a good-looking female. Matter of fact, it’s one of the things he and I would joke about. He is a male with a big belly. He’s certainly not a good-looking female and so forth. 

"Sure, I heard those type of things (about kickbacks). Did Torgny ever, or did anybody in the organization ever, offer me anything like that? Absolutely not. So from my own experience, my relationship with Subsys or Insys the company was virtually the same as it was with any other company I dealt with. It was professional.”

Apparently, this physician is still practising in Kansas City. 

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