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36 Responses to “Another Government Assault on Pain Patients”
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‘intensely cruel’ is a perfect description of most aspects of the drug hysteria, not just pain medication limitations.
When did “. . . pushed him off his bike” become an accident?
One can only hope they start banning prescription pain killers. Only when things get bad for patients, their families and, more importantly, the manufacturers will anything change.
But things need to get MUCH worse before there’s any real change.
There’s some legitimate concerns but this is BS. They are just separating the acetominophen from the other drugs so that people who need the pain killers can take them without damaging their liver. If you wish to take the pre-separation Vicodin, then just take some acetominophen beside the hydrocodone.
It’s just fearmongering crap. You should be calming people down not building up the hysteria, especially when there are legit problems like denying opiates for fear of addiction.
Its their fault I have to take it anyway. Now another dept. says you can’t have it.
Tyro,
Why should the government have any damn power to tell me what combination of drugs I use to treat my pain? If anything the call to action is not strong enough. Lamp posts and rope sounds like the proper way to deal with these government thugs.
Tyro, I think you may have skipped a minute or two of that video. The acetaminophen ban stems directly from the just-over 400 annual deaths from it every year. The FDA seems to think that this figure justifies a ban on it. Combine that with the conventional wisdom that opiate therapy almost always results in addiction (when the actual figure is one-fifth of one percent) and you don’t have to work hard to extrapolate what the video is getting at. Specifically, that the government will decide what’s in your best interests even if that means ignoring hard science in favor of deeply flawed public perception.
Fear mongering is insisting through publicly funded PSAs that your Percocet prescription will inevitably fall into your kid’s hands, who then will have no hope of avoiding a crippling addiction.
This video is whatever the opposite of fear mongering is.
Yeah, I’m gonna have to agree with Tyro. I don’t really think any drugs should be banned, but this is pretty close to the bottom of my libertarian freakout list.
People actually do suffer liver damage from taking too much acetaminophen. Its still possible to prescribe hydrocodone and oxycodone, and doctors are free to tell their patients to take acetaminophen with it. That way they can up the dose of the narcotics without the negative side effects of the acetaminophen.
That said, my points really only apply to chronic long term pain patients who take high doses of opiates. For a dude who breaks his leg and needs to take pain meds for a few weeks, percocet and vicodin are probably perfectly safe.
Mission creep is all that this is. Bureaucrats and other tax-funded bloodsuckers seeking to expand their little anti-drug empires out of sheer opportunism.
With a contracting economy, calls for cuts in the Federal budget are inevitable. Those bureaucracies and agencies that prosecute the DrugWar will soon face serious competition for the remaining Fed taxpayer revenues. That means they have to ‘stand out’ from the pack and that means they have to come up with something that legitimizes their continued existence. Hence the latest boogeyman of prescription drug abuse…which is in fact nothing new at all, as it was that same ‘abuse’ that partially created the impetus for the DrugWar almost a century ago, with the Harrison Narcotics Act.
Just like H. L. Mencken put it long ago: “The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.” The DrugWar is just one more example of those ‘hobgoblins’.
It’s a race: will the economy finally dictate sense when it comes to the issue of drugs in America by causing the dissolution of the DrugWar bureaucracy, or will we continue to bankrupt ourselves by funding a (GAO certified) wholly ineffective DrugWar?
Touch cop, get sent to jail
http://www.lewrockwell.com/blog/lewrw/archives/50610.html
The FDA seems to think that this figure justifies a ban on it.
No drug is being banned, that’s the hysteria talking. All of the drugs that were available and successful at combating pain are still available. The FDA is just saying that the drugs must be separated so that those people who are endangered by the extra acetominophen can manage their pain.
It will mean that some people will end up taking two pills instead of one and everyone will be better able to deal with side-effects. This is being spun as the government banning drugs which it is NOT doing. Pure fear-mongering. Maybe there’s some libertarian argument that companies should be able to bundle whatever drugs they want. Fine. But that’s not what these paranoid videos are saying and we need to speak up to calm it down. No one will be denied their pain meds because of this decision!
The DEA and FDA are too focussed on harm caused, rather than help given. People regularly kill themselves for lack of pain control. Do those show up in the numbers?
A few years ago I was in an accident with soft tissue injuries, cuts and four broken ribs. I needed opioids for a bit. Then I went onto Vioxx before that was withdrawn.
My doctor said Vioxx was dangerous and that she didnt want me taking Celebrex either, because there was a small risk of heart attack. I pointed out the risk to a fit young guy was minor, and that the alternative was for me to take massive amounts of ibuprofen, with a very real risk of a stomach ulcer. She eventually gave me Celebrex, but it couldnt do what Vioxx could do for my pain.
My pain then is nothing compared to the guy in this video, or the millions with cancer or arthritis etc. So WTF?
#11
Tyro,
When did hydrocodone become available without acetaminophen in it? I have been out of the practice pain medicine for five years, now. But I never encountered the drug you refer to.
Dilaudid is hydromorphone, the active metabolite of hydrocodone. It is available without Tylenol. It is also a class 2 drug, which makes it less prescribed in states where triplicate prescriptions are required. Thing is, with all of the fear mongering, from the other side, when science disproves it, I wonder why people like you keep parroting this crap! Even with what was presented, you go on and support your irrational fears, when doctors feel different! I guess that is what we get when we depend on government agencies to decide how doctors should treat their patients. Why even bother having doctors? Let the DEA and FDA make all the treatment decisions and we can save a lot of money on medical care!
The delusional person, appears to be you! Is the government (DEA?) out to destroy pain doctors and thus instill more suffering on the patients? Your lack of knowledge is showing! I am sure Frank Fisher was not delusional about this situation, when he was setting behind bars, after trying to treat chronic pain patients with compassion!
The government is wanting to take Vicodin and such off of the market? Where does that not turn into a ban? I have never seen, in any of the articles I reviewed, that the government was going to have the Tylenol taken out. Where did you read this? People are, already, denied pain treatment daily! You do not seem as knowledgeable as you would have us believe. If you want to judge the fear mongering on the part of Reason, maybe you should have to suffer like the chronic pain patients do, after being denied adequate pain control! You would have a whole new world of enlightenment, about chronic pain, to consider.
#9
Maybe I’m just feeling particularly pessimistic today, but I feel certain that the answer will be the latter and not the former.
I have a close family member that is seriously addicted to prescription pain medications. At first she did experience legitimate pain, but now she stumbles high through her life without a real pain problem.
She has committed insurance fraud, deceived multiple doctors to obtain multiple prescriptions, thousands of dollars from our family and has really ripped us apart. She desperately needs help and refuses to get it.
Nevertheless, I do think these medications should be banned. Nor do I think her doctors should be held accountable for her bad behavior. We have given her a choice, to get help, to pay for treatment, whatever she needs and she has refused. Her mistakes and bad choices should not make people who DO suffer from pain suffer even more. Her choice to continue to take pain medication and refusal to seek treatment is just that – a choice. I do not doubt her physical dependence on the drugs, but she knows she has a problem and refuses to accept any help, despite the fact that it has resulted in the loss of her job and complete and utter isolation from her family (we have agreed to cut off all communication and thereby all enabling behavior until she accepts treatment).
Further, she has had other addictive behaviors – other drugs, cigarettes, gambling – that have long been problems. Banning pain meds solves the physical issue but ignores the longstanding mental problems that have plagued this family member for years.
Its easy to ban pain meds, alcohol, gambling, or other so-called addictive behaviors. But it is an inappropriate response to a problem that is grounded in emotional and mental, not physical, problems. It is a problem that is deeply personal and cannot be tackled by the FDA. They just want to appear to be “doing something” to “fight addiction.”
UGH sorry the above post should read I DO NOT think this meds should be banned
Michael G,
When did hydrocodone become available without acetaminophen in it? I have been out of the practice pain medicine for five years, now. But I never encountered the drug you refer to.
Hycodan is hydrocodone without acetaminophen and of course oxycodone (the other painkiller in Percocet) is available as OxyContin. Vicodin is just 500mg of acetaminophen and 5mg of hydrocodone which can be taken as 1 extra strength Tylenol and one Hycodan. Patients will just take combinations of meds and if their liver is being impacted they will be able to reduce the acetaminophen easily.
Yes “Vicodin” – the forced combination of the two drugs – is being banned, but none of the active ingredients are affected. The pain killers are still available, all your bluster about removing pain management options is just panicy hot air.
Yeah guys I think you’ve misunderstood Tyro, and actually this entire situation. IIUC, opioids have been difficult to obtain WITHOUT acetaminophen for some time now. That is, if you needed to manage pain with opioids (and surely we can all agree that some people do legitimately need that; aren’t SOME of us still libertarians?), you HAD to get the acetaminophen along with it. The FDA-pharma regulatory-marketing complex had in its infinite wisdom removed the option of “opioid without acetaminophen” from the menu.
For chronic pain sufferers and their livers, this was a Bad Thing. Near as I can tell, some of the idiots who set drug regulatory policy have finally realized that. It’s at least possible that their reaction will be to certify drug products that include opioids and omit acetaminophen for the treatment of chronic pain. If that is the eventual result, arguing against it beforehand will make us appear to be idiots.
Also, anyone could have told you to watch out for those homeless dudes on the LA River bike path. It’s like Thunderdome down there.
Whoops Tyro it looks like I sort of misunderstood the menu of available analgesics as well. Bad post timing! Obviously I’m not a physician.
Although learning that OxyContin is the good stuff, opioid sans acetaminophen, goes some way toward explaining its vilification.
+1 to #18 Jess, who beat me to the punch: it was the FDA/DEA/fed.gov who mandated inclusion of acetaminophen in opiods, and made prescribing straight opiods a nightmare.
Their thinking at the time was that the risk of liver damage would limit abuse. Well, duh. How’d that work out, guys? Not to mention, anyone with access to Google and a freezer could figure out “cold filtering” easily enough, to remove the acetaminophen if they wished to use the opiods without the liver-killing additives.
Once again, Big Brother swoops in to solve a problem that Big Brother created in the first place.
The only thing I’m unclear about after watching this report: are the non-blended versions going to be more easily available through prescription, or just as unobtainable as they are today?
I have never seen, in any of the articles I reviewed, that the government was going to have the Tylenol taken out. Where did you read this?
Sorry, missed that.
Not sure why this is hard to find. In a google search for “Vicodin fda ban”, I get a NY Times article on the first page which explains:
I always thought they added the acetaminophen to discourage people from taking more of the pills for a more enhanced effect. In other words, vicodin (et al) has a self contained punishment system for people who decide to take it for recreational purposes in higher doses. It will destroy your liver. I have no idea if there’s any truth to that, but it sounds like the kind of sleazy logic the government would use as part of its crusade against drugs. You know, sort of like denying people easy access to clean hypodermic needles because it might encourage illegal drug use. Have I ever mentioned I don’t think much of government? I mean, after a while one can only wonder why people think the enemy lives in a different country.
I’ve taken Tylenol. I think it’s a placebo with a little liver killer added. It sure as hell has never relieved any pain I’ve ever had.
Look, I don’t think any drugs should be prescription only; but Tyro’s correct. AFAIK the Tylenol is only in there in the first place so you can tell the patient if they take too much they’ll die. Libertines (as opposed to libertarians) should be thrilled that the only drugs available now will be easily injectable and snort-able as opposed to the old style.
That’s one of the reasons that the street value of OxyContin, MSIR and Dilaudid is MUCH higher than percocet/percodan/vicodin, etc.
All of the common combination drugs are available generic narcotic only.
Ted Balaker needs a better haircut.
I’m not a doctor, but aren’t opiates without acetaminophen schedule II drugs while opiates mixed with acetaminophen are schedule III drugs? Banning these will mean no effective schedule III drugs available. Or am I wrong here?
Justin, that’s exactly right. That’s the point the Tyro is missing. Removing acetaminophen from Vicodin will likely result in it being rescheduled to schedule II, which means most doctors won’t prescribe it except in extreme cases. You sure as hell won’t get hydrocodone at the dentist following a root canal anymore. You won’t get it in most other cases either without a broken bone or something terminal.
Tyro points out Hycodan as an example of hydrocodone without acetaminophen. Bullshit. Hycodan is spiked with homatropine which can be just as nasty as acetaminophen. Pretty much every sched III opioid is spiked with something to discourage abuse.
If anything, this makes addiction all the more possible because you remove this limiter (acetaminophen overdose) from the opiate. Like most government action, it’s going to result in the opposite effect taking place. The negative side effects acetaminophen will most likely crop up before one can take a significant dose of opiate to OD or get addicted.
Doesn’t seem to be much of an issue in Florida…
http://www.cnn.com/video/#/video/bestoftv/2010/02/11/cb.prescrip.drug.abuse.cnn?iref=videosearch
We will save you from yourself.
At gunpoint, if necessary.
RP – not sure what I’m getting wrong. From the beginning I said that this is the wrong battle, the real problem is with the paranoid obsession with denying opiods to pain sufferers. That’s a real, immediate and serious fight that we should be focused on and you’re right that by taking a stance for the health of patients by separating these drugs, this classification scheme may make it harder to proscribe the right meds. They aren’t banned but like other drugs (and even like frigging cough medicine!), they can be hard to get.
What happened with Vicodin and Percocet is that some people found a way to sneak around loopholes in these assinine drug laws but the way around is hurting people and being plugged. But why was this loophole necessary?
So yes, let’s fight for humane treatment for pain, but when we say a drug is being banned when it isn’t, when we attack the FDA instead of the Federal drug classification, we are not only spreading falsehoods and attacking a group that is trying to help but we’re ignoring the real villain. If there’s a change on Vicodin, you know that some other problem will arise eventually. The drug classification system is fundamentally flawed and needs to be ovehauled.
KB Craig,
The drugs will probably be more limited! I am of that persuasion that sees the FDA and DEA as more government intrusion. It was just recently that the DEA was taken out of the decision making process that certified new opiates. I wonder, just, why they were thought to have a legitimate voice in the area of patient care for those many years.
And the comment about hot air added nothing to your point, other than dissing me, I guess. Pain patients, going untreated, may not think the same way you do. And, I guarantee you, you can find plenty of them on sites like The National Foundation for the Treatment of Pain. They tend to panic when told to “learn to live with it”.
KB Craig
I was having trouble with posting, so the thing about hot air is not in the right post. It does not refer to you.
Tyro,
Glad to see we are on the same page about pain patient’s treatment. Ironically, I now suffer from chronic neuropathic pain that is untreated. But, it would not surprise me if they took these drugs off the market and did not supply any new ones to replace them. I don’t trust the government! You might see my comments as hot air, and panicky, but I see yours as too trusting of the government hacks!
#27 Matt,
Don’t kid yourself. The Tylenol never kept anyone from abusing the drugs mentioned. And not all abusers are addicted. Addiction is a very complex problem. How many people do you know that have received pain treatment, during any time in their lives, that are actually addicted to drugs? True addicts give up their lives, family, and freedom for their drug.
Being physically dependent on a drug to provide you with enough pain control, to get a good quality of life back, is not addiction. I was really pleased with myself when one woman told me she was able to go fishing with her son for the first time, and he was 13 years old!
There is much misinformation on this topic. Acetaminophen in the doses prescribed almost never causes liver damage. It takes massive doses to overwhelm the liver’s normal mechanism for clearing acetaminophen. (Most acetaminophen-related fatalities are suicides.) Only people with moderately severe or severe liver failure are at significant risk of dying from acetaminophen/opiate combination drugs when used in typical dosages. There is no reason to ban any of the combo drugs, because, as noted by others, patients still are free to combine over-the-counter acetaminophen with any opiate.
The DEA and the FDA work hand-in-hand to demonize safe drugs. Look at the nonsense about the over-the-counter decongestant pseudoephedrine. Because some people chemically converted pseudoephedrine to amphetamines, the DEA convinced the FDA to require packaging changes (no pills in bottles, just blister packs). Then the FDA agreed to a second request to reduce the maximum pill count per box to 48. Then came the laws to take pseudoephedrine off the shelves, to require buyer IDs and signatures, to log sales at pharmacies, to track purchases per customer statewide, and to arrest those who buy “too much” pseudoephedrine. The FDA attempted to make this draconian system more palatable by issuing false information about the alternate decongestant phenylephrine (abbreviated PE so people would confuse it with PseudoEphedrine). The FDA claims that PE works as well as pseudoephedrine, despite the fact that studies submitted to the FDA decades ago show that phenylephrine is a mediocre decongestant with poor absorption, a short half-life, and little effectiveness.
Why the rant? Because the DEA, a law enforcement agency, uses the FDA (a regulatory and approval agency) to accomplish goals that have nothing to do with medical care or safe usage of pharmaceuticals. Depriving a few people of unprescribed opiates, amphetamines, or cannabinoids is more important to our federal government than helping sick people get the best possible treatments.
I have read so many wrong statements on here..let me clear some op this house crap. First of all, opiate therapy does not “almost always end in addiction.” This is where the hysteria starts. The true statistic here are less than one percent of chronic pain sufferers who are prescribe opiates ever develop a problem or become dependent. In case you missed that…less than one percent. This is a hyped hysteria..it always has been trumped up. If we continue down this road an enormous amount of people, most over 65, will suffer and question if they even want to live their current life. I’ve seen this over and over. I don’t know how anybody can consider such restrictions. Most of these complaints come from people who have some sort of judgmental process going on in their rationale. It’s sad and these people have no business interfering in a doctor’s relationship with their patient. There is going to be a need for a loud, screaming, noisy, “keep you nose out of our medicine cabinet!” ..campaign. You need to get vocal..get involved..get loud and stop government from controlling everything they think they have a right to. We have freedom in America and the nanny state has begun…stop this virus from spreading and stop bad legislation involving private information..keep them out and away!