I wonder if some have a propensity towards addiction. It seems through some very unscientific observation that some people are prone to addictions whether they be physical such as smoking, alcoholism, drug addiction or psychological such as shopping, pornography etc. Others can engage in such behaviors on a limited basis and pretty much quit when they feel like it while those prone to addictions can become addicted with very little contact. If this is in fact the case has there been any studies to determine if this is measurable and predictable. It would sure help in knowing a persons propensity to becoming addicted when prescribing medicines.
I thought research had shown that to be the case.
It’s a tough issue . . . opiods serve a purpose for people who are in intense pain. Yet they can be extremely addictive for some people. Then when the rug is yanked they turn to heroin or other substances.
There has to be a good way to manage this from a public policy standpoint. I hate to see the pendulum swing too far either direction.
I agree but I also think the public and health care providers have been conditioned in the last few decades to believe that being pain free is an expectation. We’re inundated on TV, print ads with commercials, (eg have headache, backache, cramps, arthritis, etc, just take something). Oh sure the commercials list the common 57 side effects, but who reads or cares about side effects, at least you’ll be pain free. And so when one has a more invasive procedure, it just became over last several decades more routine for health care provider to write a script (if anything the patient won’t call at 2AM in pain), and a patient to expect a script for something stronger. I do think health care providers are becoming less inclined to write opiate scripts for large quantities, or okay refills, perhaps out of fear of litigation, so that’s a start.
Although drug companies will pay lip service to playing a role in helping to contain this problem, their push for profits and the fact that drug companies contribute heavily to politicians probably means some official ”War on Opiates” policy will be declared all the while opiate prescriptions will sadly just continue to be doled out like pez candy.
I think you see in this thread, how things happen, how many people keep these meds just in case? Just in case of what? It isn’t just the kids to worry about when hoarding meds. It is the very act of keeping stuff around just in case that might require some self reflection.
“It would sure help in knowing a persons propensity to becoming addicted when prescribing medicines.”
Most people have family members to reference. Assume the nature of humans is to seek reward, and that everyone has this propensity to addiction.
@Jugulator20 I agree on the expectation of being pain free. When I had my shoulder surgery I actively sough out non drug ways to help - ICE was my friend, big time and was actually at least if not more effective in pain relief after the first few days post surgery
One of my elderly family members keeps this type of medication around in case he or she gets a painful fatal disease and decides to engage in suicide.
I agree @Jugulator20. Pain is our body’s way of trying to tell us something.
On the other hand, I have known a couple of people in severe pain from chronic conditions not necessarily related to surgery (though one started out that way).
It’s a complicated situation. Have opiods been over-prescribed? Absolutely. Should there be an extreme swing the other direction - I don’t think that is good either. At some point we have to trust physicians and medical experts to know what is best for any one particular patient.
PS: Though back to the original point of the thread - maybe dentists should not be giving out a month’s worth of pain meds. Now that I think about it my H’s dentist gave him some pain meds last year after some work on a crown that went bad (?). Maybe dentists haven’t gotten the memo about opiods. 
“I think you see in this thread, how things happen, how many people keep these meds just in case? Just in case of what? It isn’t just the kids to worry about when hoarding meds. It is the very act of keeping stuff around just in case that might require some self reflection.”
In my situation I’m keeping the pills around (and not hoarding them) just in case the stitches come out too soon and create a painful problem for me. The weekend is coming up and I don’t want to be without painkillers. Once my stitches are gone the bottle of painkillers will be tossed in the trash. Their street value is $60, for what it’s worth.
@TonyK It sounds as if you are still actively working with a medical issue! I don’t think keep them around was meant in that way - more in the longer term when the issue has resolved.
^ ^ ^
Yup. Never had stitches inside my mouth before. It’s to minimize infections.
Does every surgeon automatically prescribe opioids after any kind of surgery?
why the piling on dentists?
http://www.nbcnews.com/politics/politics-news/u-s-combats-opioids-major-medical-fraud-crackdown-n782591
My son had his wisdom teeth out in May. I was stunned that they gave him a prescription for 20 hydrocodone tablets, as well as a prescription for some 600mg ibuprofen. He only needed one of the hydrocodones on the first day. I really think the prescription could have been limited to 4 tablets of hydrocodone opioids, not 20. It did seem excessive and unnecessary to me.
What is it about the US medical professions that has enabled the situation to get so bad (worse than in most other advanced economies, it seems)? Too little oversight, too much greed, wrongful financial incentives, poor ethical enforcement by professional bodies?
A lot of the rise in overdoses can be attributed to fentanyl.
http://abcnews.go.com/US/fentanyl-deaths-spiked-us-sign-slowing/story?id=44554601
But the fentanyl causing overdoses is made on the street not from legal manufacturers --it’s fairly easy to make. As opioids become harder to obtain the fentanyl use goes up–same with heroin and crack.
NYT just ran an excellent piece about babies born addicted to opiods . . . horrifying and sad. 
20 or so years ago, the government decided that too many patients were in too much pain and too many doctors were callously disregarding it. Therefore, they regulated “pain management” in the form or rating scales, “quality measures”, payment for opiates, etc. Do you wonder why everytime you see a doctor, a medical assistant asks you about pain and in the next sentence wonders if you are “safe at home?” The federal government, through the Joint Commission, Medicare, and other regulatory cudgels has catalyzed and addiction “crisis.”
Now, in a breakthrough discovery, the same regulatory bodies tell us we have an “opioid epidemic” caused my doctors. The doctors are too greedy and impatient to listen to their pain and manage it appropriately. Therefore, states like mine regulate mandatory physician training on “pain management.” Now we are told that the regulators are not trying to tell us how to practice, but by the way, it is tantamount to malpractice to prescribe opioids. On top of that, new regulations make it a major PITA and expensive for the doctor to prescribe opiates for longer than 3 days.
Primary care physicians will be getting out of the business of pain managment arguing that it is out of their scope, the “it” being compliance with regulations.
I am not arguing that there is no problem with opioids but I am making the point that the regulators are the catalysts and their interventions will create the next crisis. The next crisis will be problems with suboxone which they are promulgating as the “best practice” for treatment of opiate dependency. That is, until their next discovery about the abusability of suboxone and accusations that greedy drug companies mislead them. An easier fix would be for the regulatory bodies to be quiet and stop covering potent opioids on government insurance policies (Medicare and Medicaid). On top of that, they could start enforcing existing laws and prosecute criminal activity peripheral to opiate abuse. Then, stop pushing for “funding” for opiate treatment programs which don’t work very well and are very expensive (and we now hear rife with fraud (notice all those commercials).
Too little oversight, …yes
too much greed,…yes
wrongful financial incentives,…yes
poor ethical enforcement by professional bodies?..yes
but why just pile on medical professionals? What about drug companies? What about compliant political leaders who accept $$ from drug companies. It’s easier for politicians to stand up in front of microphones and attack Mexican/Columbian drug cartels (which are a big problem), but ignore, or write, or enforce legislation that hurts a US drug manufacturer. When the politician retires, he’ll probably become a very well paid drug company lobbyist. Unlike other advanced economies, profit is simply hard baked into our health care system, consequences are secondary.
Several posts above talk about experiences with dentists, yet in recent crackdown one MD has been charged with writing more than 14000 prescriptions for oxycodone for over 2.2 million pills and was able in the age of computers to do this for 5 years before someone noticed?
I’m sorry for getting so, so far off topic. It’s just one of those issues that bothers me, not because of any personal/family connection.
@Jugulator20 I think you are off the mark for the most part about doctors. There are a few, easily identified, that indiscriminately prescribe. But why not give some responsibility to malingering patients who are not victims but victimizers. They lie, cheat, and steal their addictions. They fraudulantly use insurance and Medicaid to pay for drugs. They steal massive amounts of opiates from elderly relatives prescribed the big guns for cancer pain both before and after the relative dies. They barter food stamp money for drugs. They are a scourge to emergency rooms, doctors’ offices, and pharmacies. You get the idea. When they manage to get admitted to the hospital they are behavioral nightmares for nursing staff and either manipulate their way to opiates, or more often, leave against medical advice with a wave of expletives.