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Why is there such a big thing about prescription opioids when the addiction rate in less than 1% for those who have been prescribed for pain?

Is it really just because of the fentanyl situation? I know there is a huge disagreement with how the strict rules for prescribing opioids are so tight even for chronic pain patients like myself who can’t participate in life without em struggle to find a provider who is willing to prescribe us them.

33 comments
  • Because it's low hanging fruit. Politicians can be "tough" on chronic pain patients and frame it as furthering the battle against the "opioid epidemic" without having to address the actual kraken in the bathtub, which is shady, Chinese bootleg fentanyl flooding the US through our leaky International mail system. The opioid crisis and epidemic of overdoses isn't fueled by Grandma selling off her "extra" 5mg percosets, its coming from illegally smuggled fentanyl being sold illegally on the streets. Chronic pain patients are just a convenient sock puppet for the constant campaign mode our politicians are in, and they don't care who they hurt to get elected or stay in power. Imho.

    • I agree with everything you said here, but just came by to say, "Kraken in the bathtub" is one of my favorite new idioms.

  • opioids were over prescribed for years and years with no thought to the consequences - mainly because the person writing the scrip was compensated for it by the drug manufacturers.

    this led to tens of thousands of people who became addicted to opioids and lacked the willpower to fight being dope sick to get clean. even once you're clean, relapse is common. the reality is that many people are weak willed - but no one wants to discuss that.

    now cheap synthetic opioids are easily mass manufactured in China and Mexico and they are widely available & flood the streets. examples: https://www.youtube.com/@talesfromthestreets/videos & https://www.youtube.com/@examiningportland/videos (there are others but those are the ones I've seen recently).

  • Your 1% figure comes from misrepresentation of a 'study', pushed by Purdue and others for criminal gain.

    The One-Paragraph Letter From 1980 That Fueled the Opioid Crisis

    Purdue Pharma, which makes OxyContin, starting using the letter’s data to say that less than one percent of patients treated with opioids became addicted. Pain specialists routinely cited it in their lectures. Porter and Jick’s letter is not the only study whose findings on opioid addiction became taken out of context, but it was one of the most prominent. Jick recently told the AP, “I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did.”

    Don't get me wrong, pain is miserable and treatment needs to be better. But around 80% of opioid addictions start with prescriptions for people in genuine pain. What percentage of prescriptees that is, I don't know. But it's not a trivial issue, and it is a very difficult problem to solve.

    • I have a friend who is in school for being a nurse and she had an exam and one of the questions was about this percentage which is why I brought this up because less than 1% was the correct answer. She told me this figure since she knows I’m on em. Is this school just completely in the wrong then for teaching this to nursing students and I’m sure doctors etc?

      • I linked an article about how that stat became widely cited, based on almost nothing. It's not uncommon in medicine, especially when it suits Pharma. I teach medical students and the first thing we teach them is that half the course will be out of date by the time they graduate and the other half is already out of date.

        That's not to say that addiction rates can't be kept very low with responsible prescribing and there's nothing wrong with reassuring patients who may be concerned about swapping one problem for another. But this particular factoid was cultivated by drug companies wanting to encourage irresponsible prescribing. And they succeeded.

        There's a brilliant drama on Disney/Hulu called Dopesick which tells the story (including of this statistic). It's an excellent, and enraging, watch.

  • It may be low, but it's still thousands. I had knee surgery last year and didn't take opiates because I'm at higher risk for addiction.

33 comments