Tuesday, January 10, 2012

Up Chuck.

Drug seekers are one of the biggest annoyances to the medical profession. Get any EMT, ER nurse, or doctor going long enough, and you'll hear horror stories of the yahoos who clog their days, claiming fanciful-yet-vague maladies in the hopes of getting a scrip.

On the other hand, when you're recovering from massive trauma, aspirin just doesn't cut the mustard, and the roadblocks that the War on (Some) Drugs has thrown up around some of the more effective painkillers can become an annoyance in their own right.

A recent move to reorganize the regulations surrounding some hydrocodone-based drugs is finding a roadblock of the legislative variety in Chuck Schumer, who claims that it will lead to a murderous crime wave of pharmacy robberies.

Ah, Chuck, we can always count on you to do the wrong thing. Perhaps if you hadn't made it your mission in life to make it so hard for pharmacists to shoot back effectively, we wouldn't find ourselves in this pickle, now would we?

26 comments:

Tango Juliet said...

The Liberal Left has always had a problem with properly identifying the correct target. This is why the NRA receives harsher criticism from the Left than does Al Queda.

Roberta X said...

Wow, like treating chronic pain wasn't screwed up enough already...!

When my severe migraines and the dental/bone problems that triggered them first hit, I had to ride that merry-go-round for nearly a year while specialist dentists and ENTs argued about fixing it.

It's genuinely sucky, so much so that you're liable to be given a 'scrip for powerful anti-depressants instead of Vicodin. "It's not so much that they dull the pain," one pain doc said, "as it is you just won't care that it hurts." Or about anything else, either, he forgot to mention. But hey, patient stops griping and Doc isn't hunted down by DEA, so it's a win, right? Right?

Anonymous said...

I'm surprised Chucky didn't advocate making robbery and murder NOT a crime if you're doing it to get these new, powerful painkillers. After all, if the pharmaceutical companies are going to tempt addicts by making this stuff, you shouldn't blame the addicts for trying to get it, right?

perlhaqr said...

As an EMT...

Yes, drug seekers are annoying. Which is why we should just make oxycodone an OTC, and require drug companies to include Narcan syrettes in every box.

The addicts would get what they want, the people who whine that it'd lead to a rash of overdoses would be sated, and the medical professionals would stop having their days clogged up by people who don't really need their services. Throw in a mandatory minimum $10 co-pay at the ER to discourage the lady who comes in complaining of "stomach pain" because she knows it'll get her a pregnancy test, and the wait times should drop through the floor.

Divemedic said...

@perlhaqr: Not bad, except for the Narcan part. Narcan is not the harmless drug that many seem to think that it is.

Narcan use can cause nausea, vomiting, sweating, tremor, tachycardia, increased BP, seizures, ventricular tachycardia and fibrillation, pulmonary edema, and cardiac arrest. Not to mention the fact that Narcan has a significantly shorter half life (15 minutes)than does oxycodone (4.5 hours), meaning that it really won't help as an OTC cure for overdose.

Pakkinpoppa said...

War on Drugs. Will there be a Nuremburg for Crack one day when (ha!) we win this war?

We went to war with poverty, that sure worked out too. Maybe "War on (X)" should be reserved for, oh, I don't know, an actual war?

CalmGun said...

Schumer is addicted to brain killers.

Nathan said...

When Chuck Schumer is outlawed, only outlaws will care.

rickn8or said...

Ol' Up-Chuck sure is an authority on what people need / don't need isn't he?

Oleg Volk said...

I know people who had to leave the US just to get adequate pain management. When Holland is better than the US for libertarians, I think that's a problem.

Bubblehead Les. said...

Gee, so in Chuckie's world, just because there's no new Pain Killer out there, all the Drug Stores must be safer than Disneyland at this moment? Pull the other finger.

Able said...

I'm a nurse and yet here (UK) even I can't buy more than 32 (500 mg) paracetamol tablets. Why? Because a few people a year attempt suicide with paracetamol (sorry is that acetaminophen to you colonial types?).

As Tango Juliet said the left always had a "problem with properly identifying the correct target". So 65 million people are prevented from buying a mild analgesic for a headache all to save a few people who... Go out and use something else instead.

Personally (and professionally) I favour deregulation of all drugs. If you're too damn stupid to use them correctly (will you do any better with a prescription) then let's just let Darwin do his work, because whilst I have to suffer pain the people I treat daily don't seem to have any trouble obtaining heroine/cocaine/temazepam/pcp whenever they want. the war on drugs sure seems to be working here!

Anonymous said...

I'm old enough to remember when we could get Terpin hydrate with codeine over the counter. Now I can't even get pseudoephedrine without asking my pharmacy assistant. And yet I believe there is more drug crime now than when I was young. No, more regulation is NOT the answer.

Kristopher said...

Able: They succeed in suicide, not merely attempt.

Liver failure is a painful way to get there, but it is certain. It's why I don't have Tylenol in the house ... that shit is really dangerous.

Rick C said...

Divemedic: think of it as evolution in action.

Grumpyunk said...

The whole Pain Management problem is huge.
As a long time ER nurse I bitch about, "The Zombies" as I call 'em, clogging up the ER and sucking the life out of our national treasury. And it's only one part of the healthcare problems that politicians like, Chuck Shumer created in the first place. ObamaCare ain't gonna fix this system or make things any more affordable either.

The Joint Commission on Heathcare came out with a mandate 6-7 years(?) ago that required MD's to treat pain more aggressively. Capitalism, being what it is, saw a growth market and we've seen the "Pain Management Clinics" sprout up everywhere. This has helped the growth of, part time abusers in becoming full blown addicts. Law of unintended consequences +1! There are real people with real pain problems out there. But there are more legally created Zombie Addict Drug seekers than ever now.
Maybe that should be what Mr Shumer should be focusing on.

Personally, I'd like to see Shumer study "Air Quality Issues" inside of a closed garage with a 60's vintage big block Mopar idling in it.

Sorry for the length here. This shit just gets me torqued.

perlhaqr said...

Divemedic: I was thinking of the Narcan not as a cure-all for OD, but more as a stopgap until they get to a hospital.

Suz said...

Hmmm. I remember Terpin hydrate. That was a long bus ride home from college. I don't remember much of it...

Justthisguy said...

I sometimes correspond with an autistic gal, an electrical engineer out in Kali somewhere. She is always bitching about the flaming hoops she has to jump through to get her prescription speed, so that she can at least try to simulate being normal.

Yes, ADHD is quite often co-morbid with autism.

Oh, she likes cats, too, and has a couple or three.

Tam, you too are an outlier, and that's why I keep coming back here every day.

The fiftieth-percentile people are BO-RING!

Will said...

Justthhisguy:

"Yes, ADHD is quite often co-morbid with autism."
And with Asperger's, from my experience and observation.

Able said...

Kristopher

Sorry but no! I have worked A&E, ITU, HDU and acute Medical Admissions for twenty-mumble years and in all that time I have seen not one death attributable to paracetamol OD.

The treatment with N-acetylcysteine is proven. Should it, in the most unusual case cause liver damage - they are given a transplant. The point is it does not kill you immediately (ie. as an OD of other substances/other method of suicide).

The one case, in all my personal experience, where transplant was needed was due to an error by a doctor in deciding that the acetaminophen levels were below the treatment thresh-hold, by misjudging the time of ingestion.

As an idea, the minimum toxicity is assumed to occur at ingestion of 150 mg/kg, hepatotoxicity is a severe concern at 250 mg/kg and is severe at 350 mg/kg. So if you, as a 70kg average adult, 'accidentally' ingested 21, 35 or 45 500mg tablets in one session you would be at risk - if you did not receive treatment! Children are at risk, but they are from any number of household chemicals, that's not an excuse to ban them also is it?

The point remains, should everyone be banned from access to a drug because a tiny minority 'may' misuse it? And has banning them from accessing paracetamol prevented them attempting suicide? The answer to both is no and not once.

Tam said...

Justthisguy,

"Tam, you too are an outlier, and that's why I keep coming back here every day."

Everybody is an outlier. Normality is a mathematical descriptor, not a picture of reality.

We are each of us a species of one.

Justthisguy said...

Able, if you are like me and prefer to do your liver damage with ethyl hydroxide, acetaminophen can too be deadly. Aspirin works better, anyway.

Will, Aperger's is a subset of autism. When somebody says his kid is autistic, I ask if he is the kind who can't talk, or the kind who just won't shut up, maybe about band music...

WV: porite. In Nippon, we are very porite, and border-rine autistic.

Able said...

Justthisguy

Granted, but only if your consumption of Etoh is 'chronically excessive'.

But saying that, aspirin effects the clotting cascade as does alcohol greatly increasing the risk of ulceration and bleeding -so that's a no, no too. And then there's evidence that caffeine is as dangerous as alcohol in potentiating the liver-damaging effect of paracetamol.

I take the view that all medications are potentially dangerous, but used correctly the benefits generally outweigh the risks. Paracetamol is a wonderful and under-rated drug, it's used as a basis for the analgesic ladder for a reason. Research has shown that regular paracetamol can reduce the need/dose for stronger (opiate) analgesia, in those requiring such strong pain relief, by up to a third.

Oh and I hope you're not adulterating that ethyl hydroxide with any of that nasty dihydrogen oxide stuff - sacrilege ;-)

Justthisguy said...

Able, actually I do that. My liver may hate me, but I try to keep a good flow through the kidneys.

Able said...

Justthisguy

But, but.. that's what beer is for!

Gentlemen have been black-balled for less than watering the single malt you know? You'll be telling us next that you don't dress for dinner.

I tried desperately to come back with a quick rejoinder about which of my organs might not hate me but for the life of me I can't think of one (and that's from somebody whose studied anatomy at Masters level). Ah well, despite my age I'm well preserved - in other words pickled and smoked.