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Doctors and opioids, a troublesome connection.


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On 3/31/2018 at 3:29 PM, 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.

Could be less than what we are spending now trying to control this. Look at it this way, the next time you need an ambulance you might be able to get one that isn't dealing with a fentanyl overdose.

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A story that hit the headlines in NL last week: http://www.cbc.ca/news/canada/newfoundland-labrador/hollohan-drug-arrest-1.3783772 This is the same clinic as that used by Dr. Sean Buckingham, an ext

You're saying we shouldn't blame doctors because doctors say it's not their fault. Of course they are. They don't want to take accountability for getting people unnecessarily hooked on opioids. People

If there's one thing you can count on a junkie to do, its getting to a polling station.  /s

On 3/31/2018 at 7:59 PM, 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.

The cost of legal heroin might be about one tenth of the street price according to one study, even less in other studies:

https://www.nber.org/papers/w9689.pdf

There would be savings on the health costs per addict, the spread of infections like HIV and Hep C, and the organized crime side as well. One big unknown is how many more addicts we would end up with under such a regime. Use of the drug would have to be vigorously discouraged. The problem we already face with ultra-potent synthetics like fentanyl and carfentanil, which are designed for smuggling, is that they pose a serious risk to paramedics and police. This risk is only going to heighten when even more dangerous drugs are created. It's a tricky conundrum. 

https://www.cnn.com/2017/06/08/health/dea-first-responders-opioids/index.html

https://www.thestreet.com/story/12785354/1/legalizing-heroin-why-these-high-profile-politicians-want-it.html

Edited by SpankyMcFarland
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3 minutes ago, SpankyMcFarland said:

The cost of legal heroin might be about one tenth of the street price according to one study, even less in other studies:

https://www.nber.org/papers/w9689.pdf

There would be savings on the health costs per addict, the spread of infections like HIV and Hep C, and the organized crime side as well. One big unknown is how many more addicts we would end up with under such a regime. Use of the drug would have to be vigorously discouraged. The problem we already face with ultra-potent synthetics like fentanyl and carfentanil, which are designed for smuggling, is that they pose a serious risk to paramedics and police. This risk is only going to heighten when even more dangerous drugs are created. It's a tricky conundrum. 

https://www.thestreet.com/story/12785354/1/legalizing-heroin-why-these-high-profile-politicians-want-it.html

If you force addicts to register and carry specific ID, there should be no issue with new users.  From what I understand about addiction, it's strong enough to make people do some pretty drastic things, so I think the prospect of a steady, clean, safe supply of their drug of choice would make strict registration requirements a small price to pay.  Potential new users simply wouldn't be able to get a card.  Or at least, the effort required would be enough that they wouldn't bother.

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4 hours ago, bcsapper said:

If you force addicts to register and carry specific ID, there should be no issue with new users.  From what I understand about addiction, it's strong enough to make people do some pretty drastic things, so I think the prospect of a steady, clean, safe supply of their drug of choice would make strict registration requirements a small price to pay.  Potential new users simply wouldn't be able to get a card.  Or at least, the effort required would be enough that they wouldn't bother.

I'm not sure about no issue but I think it is the way to go. Even with state provision of the drug, there are many roles in life that should be off-limits to heroin users. A registry would mark a boundary for young people and would also make management of users much easier. 

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3 hours ago, SpankyMcFarland said:

I'm not sure about no issue but I think it is the way to go. Even with state provision of the drug, there are many roles in life that should be off-limits to heroin users. A registry would mark a boundary for young people and would also make management of users much easier. 

If it is done properly, illegal drugs should disappear along with the dealers.  The culture would no longer have the nihilistic cool that attracts the young who think they are being rebellious.

The problems would arise if it were done half-assed.

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On 10/3/2016 at 5:51 PM, drummindiver said:

I divide my time between Atlantic Canada and southern Ontario, and am well aware of the problems. However, cancer is not the only time opioids are indicated for pain.

The reason few Drs have been disciplined, is because they are doing their job of helping their patients. Should they not help a person in pain on the gamble that person may decide to misuse medication? How does a dr know? They are not psychic. As I've said, I've had three accidents and one oral surgery where I have required narcotics, and am thankful for them.

I do understand  you and respect your comments. That said the abuse of oxycontin in Ontario and elsewhere is real and is vey much part of what SM is talking about. There is a fine line between pain  control and enabling a drug addiction. I think many people have genuine pain but it then can evolve into drug addiction. I am not here to call you out. I am here to say we need to look at the over use of narcotics and no not with cancer patients. You have genuine concerns but the medical community has serious legal and addiction issues with narcotics use they have to address.

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On 12/1/2018 at 5:06 PM, SpankyMcFarland said:

I'm not sure about no issue but I think it is the way to go. Even with state provision of the drug, there are many roles in life that should be off-limits to heroin users. A registry would mark a boundary for young people and would also make management of users much easier. 

In theory maybe, in practice, I just don't know.

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On 12/1/2018 at 12:07 PM, bcsapper said:

If you force addicts to register and carry specific ID, there should be no issue with new users.  From what I understand about addiction, it's strong enough to make people do some pretty drastic things, so I think the prospect of a steady, clean, safe supply of their drug of choice would make strict registration requirements a small price to pay.  Potential new users simply wouldn't be able to get a card.  Or at least, the effort required would be enough that they wouldn't bother.

In theory yes. In  practical reality it may not work as intended. I also cringe at another government control system. 

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3 hours ago, Rue said:

In theory yes. In  practical reality it may not work as intended. I also cringe at another government control system. 

Certainly lots of funding would be required, but I'm talking about something that would take a generation to show real success.  By then, all the money for the program could come from the funds currently being spent on the war on drugs.  I understand your apprehension at another government control system, but the problem with this idea is that if you do it in half measures, it won't work.

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The thing is that our current policies are driving us inexorably to a point where ultra-potent opioids designed for smuggling will start killing first responders as well as addicts and casual users. We can’t allow that to happen. 

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On ‎12‎/‎1‎/‎2018 at 11:57 AM, SpankyMcFarland said:

The cost of legal heroin might be about one tenth of the street price according to one study, even less in other studies:

https://www.nber.org/papers/w9689.pdf

There would be savings on the health costs per addict, the spread of infections like HIV and Hep C, and the organized crime side as well. One big unknown is how many more addicts we would end up with under such a regime. Use of the drug would have to be vigorously discouraged. The problem we already face with ultra-potent synthetics like fentanyl and carfentanil, which are designed for smuggling, is that they pose a serious risk to paramedics and police. This risk is only going to heighten when even more dangerous drugs are created. It's a tricky conundrum. 

https://www.cnn.com/2017/06/08/health/dea-first-responders-opioids/index.html

https://www.thestreet.com/story/12785354/1/legalizing-heroin-why-these-high-profile-politicians-want-it.html

Well of course the Netherlands is used as the classic example of a nation that manages heroin addiction with methadone. Myself I prefer giving addicts methadone not needles. 

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On ‎12‎/‎9‎/‎2018 at 8:17 PM, bcsapper said:

Certainly lots of funding would be required, but I'm talking about something that would take a generation to show real success.  By then, all the money for the program could come from the funds currently being spent on the war on drugs.  I understand your apprehension at another government control system, but the problem with this idea is that if you do it in half measures, it won't work.

Can't argue with that.

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On 10/2/2016 at 6:57 PM, SpankyMcFarland said:

Here’s some follow-up on that case. The medical board has allowed the doctor to start practising again with restrictions.

https://www.cbc.ca/news/canada/newfoundland-labrador/brendan-hollohan-long-pond-medical-clinic-vikings-1.4425116

 

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Here’s some excellent news...for the Sackler family - a fine and they’re off scot-free:
 

Quote

Purdue Pharma, the maker of OxyContin, has agreed to plead guilty to criminal charges and face penalties of roughly $8.3 billion, the Justice Department announced on Wednesday, a move that could pave the way for a settlement of thousands of lawsuits brought against the company for its role in the opioids epidemic.

The company’s owners, members of the wealthy Sackler family, will pay $225 million in civil penalties. Federal prosecutors said the settlement did not preclude criminal charges against Purdue executives or individual Sacklers.

...Another objection to Wednesday’s settlement centers on the resolution of civil claims against individual Sacklers, raised by private families who are suing. A forensic audit last year by Purdue found that the Sacklers directed at least $10.7 billion in the company’s proceeds to family-controlled trusts and holding companies, even as Purdue was facing legal scrutiny.

According to the families’ letter, the Justice Department’s agreement is too soon and for too little. Massachusetts, for example, has scheduled depositions against some Sacklers in November, during which more information may come to light.

“The D.O.J. failed,” said Maura Healey, the Massachusetts attorney general. “Justice in this case requires exposing the truth and holding the perpetrators accountable, not rushing a settlement to beat an election. I am not done with Purdue and the Sacklers, and I will never sell out the families who have been calling for justice for so long. ”
 

https://www.nytimes.com/2020/10/21/health/purdue-opioids-criminal-charges.html?action=click&module=Top Stories&pgtype=Homepage


Like our banking chums at HSBC who laundered hundreds of millions for the Mexican cartels, the Sacklers are going to get a slap on the wrist with no prison time. 

 

 

 

 

 

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On 10/2/2016 at 2:27 PM, SpankyMcFarland said:

A story that hit the headlines in NL last week:

http://www.cbc.ca/news/canada/newfoundland-labrador/hollohan-drug-arrest-1.3783772

This is the same clinic as that used by Dr. Sean Buckingham, an extraordinary coincidence?

What strikes me is that the local medical board (CPSNL) has not been involved in disciplining many doctors for prescribing offences. In both these cases, it was left to the police to make the bust and, in Buckingham's case, the whole story was widely known long before anything happened. Canada has a very serious problem with opioid abuse and some doctors must be crossing the line but our regulators down here don't seem to be very pro-active.

More people are dying from the opioid crisis than from the Convid 19 virus. That should be the battle that the government should be fighting against, and quit with fighting this so called Convid 19 virus that has killed approx. 300 people in BC out of a population of approx. 5 million. Thousands of opioid users are dying every year from drugs.  But yet this Convid 19 farce is more important here in BC.

Maybe if the governments spent more money and made more of a big deal out of all the drug deaths going on in Canada and BC from opioids the less people would die. Why do governments always seem to want to do things ass backwards all the time anyway? The cost to society has been immense because of drug overdose just like this China virus scamdemic that has been a costly and immense problem on and for society. Both are a joke. Just saying. 

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