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OxyContin's 12-hour problem (2016)

124 点作者 nikunjk将近 8 年前

13 条评论

merraksh将近 8 年前
Previous discussion: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=11649195" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=11649195</a>
elipsey将近 8 年前
Published May 5, 2016.<p>Article argues that OxyContin caused strong withdrawal symptoms when used as directed. Important, imo, because at a societal level we substantially blame addiction on &quot;drug abuse&quot; which is not always an adequate model.
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waterside81将近 8 年前
For those interested in this topic and how the opiate epidemic has stretched across the US, read Dreamland by Sam Quinones (<a href="https:&#x2F;&#x2F;www.amazon.com&#x2F;Dreamland-True-Americas-Opiate-Epidemic&#x2F;dp&#x2F;1620402521" rel="nofollow">https:&#x2F;&#x2F;www.amazon.com&#x2F;Dreamland-True-Americas-Opiate-Epidem...</a>)<p>There are a multitude of reasons to explain how this happened but to quickly sum up an excellent book:<p>- Purdue created the whole &quot;sell-direct-to-doctor&quot; phenomena that is now the norm in the US medical profession<p>- One bad study that showed opiates for pain relief are NOT addictive and this study kept being cited by sales people<p>- Mexican drug dealers from a very tiny area in Mexico importing black tar heroin<p>- A prevailing idea in the US that people should never be in pain and managing it through lifestyle changes is not acceptable; a quick fix is needed<p>- economic depression in the Midwest and Appalachia regions<p>But really, read the book. It&#x27;s eye opening and well written.
politician将近 8 年前
Tldr: Oxycontin doesn&#x27;t last for 12-hours unless doage levels exceed thresholds known to induce addiction and higher risks of death. The 12-hour claim is a marketing gimmick that the company will go to war over regardless of the collateral damage. Moreover, the US court system has repeatedly permitted the company to continue, and works with the company to seal these findings.<p>Good to know.
mtdewcmu将近 8 年前
Doctors should be more skeptical of pharma companies&#x27; marketing claims, right? Who believes everything they read? There&#x27;s probably a case to be made that the FDA should have been more involved, too.<p>The data on how fast OC released its drug would have been available to the FDA, if not doctors.
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racl101将近 8 年前
I hope I never have to take this stuff.<p>Watching how dependent my mom has become on this has been painful to watch.
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passivepinetree将近 8 年前
Fantastic article, but this should have a [2016] in the title.<p>As noted elsewhere, this isn&#x27;t new content.
Spivak将近 8 年前
I&#x27;m sure this is an easy question to answer, but it was bugging me during the whole article.<p>What&#x27;s preventing a pill that releases a dose immediately and one after 6 hours? Or something like a diabetic pump that dispenses medication continuously? Surely such systems have the potential to be safer and more effective for patients?
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siliconc0w将近 8 年前
This is a dupe but Pursue should be prosecuted and held accountable for the total fucking disaster Oxycontin has wrought on our country. They should be considered enemies of the state. This shit is worse than any drug lord in Mexico or any ISIS leader as far as impact to US citizens and they knowingly perpetrated it.
panzer_wyrm将近 8 年前
Can somebody give some context on the root cause of the problem - the chronic pain epidemic in US. What caused it, why it is more than in other parts of the world and why so many painkillers?<p>Is it cultural?
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tommynicholas将近 8 年前
I just got ACL surgery and am doing the entire recovery (day 11) without any painkillers stronger than ibuprofin. This is not because I&#x27;m so brave, but because I know the pain associated with opioids to be so much than the physical pain in my knee. We&#x27;ve got to aggressively pursue alternatives.
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thriftwy将近 8 年前
The real problem here is that human pain gauge is ridiculously wide. xkcd was totally right on this part in <a href="https:&#x2F;&#x2F;xkcd.com&#x2F;883&#x2F;" rel="nofollow">https:&#x2F;&#x2F;xkcd.com&#x2F;883&#x2F;</a><p>Can we please fix something to add dynamic compression to pain signals? log(x) will be a good idea past some pain level.
merraksh将近 8 年前
Previous discussion has this top comment (<a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=11652159" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=11652159</a>) by cant_kant, which I believe is worth posting here:<p><i>Sensible doctors do not believe drug company marketing.<p>I get large amounts of ad-junk from drug companies that ends up unread in the bin. I refuse to meet with drug company representatives. I smile politely at them if I bump into them in the corridor and suggest that they leave their ad-junk with my secretary. My staff then file their ad-junk in the trash bin.<p>On Friday, I had a drug company representative attempt to tell me ( he was hanging around my coffee area ) about the joys of Targin, a fixed-dose combination of oxycodone and naloxone. I gently shook him off, and directed him to my secretary.<p>Drug company representatives are usually decent human beings with lives and families. However they are poorly educated, poorly informed salesmen and women with sales targets to meet and product managers to keep happy. Even worse, they and the drug company have no accountability if a patient dies because of their recommendations. If avoidable death supervenes or if there are non-lethal complications or even just therapeutic failure, I am accountable.<p>Instead of relying on marketing, I rely on information from good, well performed randomised controlled studies published in reputable peer reviewed journals ( I like the NEJM ) and on meta-analyses of these. I view the results of these through a filter of scepticism, cynicism, pragmatism and a modicum of hope.<p>Many of my colleagues do likewise. I trust that you do the same in your respective vocations. Regrettably, there is a bell curve. I am sure that the drug companies find enough gullible prescribers out in the wild for their purposes.</i>
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