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The filthy little open secret of the industry is that long-term access to controlled medications is largely pay-to-play. Have watched low-income family & friends exhaust all their covered options trying to get the same meds concierge doctors offer wealthier friends “just in case”https://twitter.com/ccziv/status/1103885954933186561 …
![∃𝑋[∅∈𝑋∧∀𝑦(𝑦∈𝑋⇒𝑦∪{𝑦}∈𝑋)]](https://pbs.twimg.com/profile_images/976278603989168129/5nzgS7j4_normal.jpg)
Reality is that wealthier clients represent a dramatically better risk:reward ratio. They’re usually well-monitored, generally healthy, and strongly incentivized to remain functional. And they won’t draw attention by turning around & selling your script on the street
The situation is bad, and IMO the official recommendations to address the “epidemic” are stupid, but “be a gatekeeper who gives meds for conditions that can only be diagnosed based on self-report and never ever make a mistake” is not a real option
It's tempting to hoist the failed system onto complacent rich people + greedy doctors, but IMO the incentives suggest another story: risk-averse docs giving better-but-riskier treatments to patients who are less likely to be irrecoverably harmed by themhttps://twitter.com/StephenPiment/status/1104178389080977409 …
If Uncle Joe endures intolerable pain & ultimately attempts suicide as a result, he's probably less a legal liability to his doctor than if he's prescribed opioids for long-term pain management & suffers an impairment-related accident or any number of correlated health problems
Celebrity Joe has a driver who ensures he gets around safely, a personal trainer who monitors his physical condition on a near-daily basis, an assistant who checks on him every morning. Celebrity Joe has a *lot* of built-in safeties whether or not he always makes good choices
None of this makes it remotely OK that over the course of many soul-rending months of genuine torture Uncle Joe is driven to take his own life, especially in a world where risky-but-effective interventions exist but were withheld from him. I'm explaining, not justifying
Yep, seen the same. It's trash.
True.
I'm super lucky I don't happen to be susceptible to hydrocodone addiction. The constipation was enough to make me avoid them at all costs. Otherwise... yeah... my doctors have been pretty generous with them so far.
Perhaps at this point we need to just end prohibition on opiates. All the money we spend on the "war on drugs" can go to rehab, education, hospitals, and public awareness. This would also end massive civil rights violations and crazy prison for nonviolent possession offences.
How many more overdoses would such a policy create? Isn't the intent to prevent unnecessary deaths?
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