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whitequark's profile
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@whitequark

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whitequark

@whitequark

http://whitequark.org  · http://llvm.moe  · http://powerlinesinanime.tumblr.com  · working on quantum computers for a living · DMs open · she

Joined July 2010

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    1. Kia‏☆‏ @alt_kia Sep 22

      Kia‏☆ Retweeted Keith Humphreys

      you're right, all tackling drug supply has done is...*looks up what happened* shift commonly used opioids from laudanum/opium, to heroin, to fentanyl, to carfentanil, whilst also *subsidising* boundlessly violent transnational criminal organisations and fucking up Central Americahttps://twitter.com/KeithNHumphreys/status/1043161484035993600 …

      Kia‏☆ added,

      Keith Humphreys @KeithNHumphreys
      The most common market reality that journalists, activists, and analysts in drug policy overlook is "supplier-induced demand". Once you know that literature, you will never again write sentences like "tackling supply does nothing to change the demand for drugs".
      3 replies 14 retweets 80 likes
    2. hedge.bat  🦇 🦇 🦇‏ @hedgeberg Sep 22
      Replying to @alt_kia

      I mean, from the perspective of the prescription opioid market though, he does have a point. We enabled pfizer and others to market opioids for things other than EoL care direct to consumers. That absolutely falls under supplier induced demand.

      3 replies 0 retweets 0 likes
    3. hedge.bat  🦇 🦇 🦇‏ @hedgeberg Sep 22
      Replying to @hedgeberg @alt_kia

      Also "pain is the fifth vital sign" was one of the worst pieces of marketing propaganda for an addictive substance imaginable

      1 reply 0 retweets 2 likes
    4. hedge.bat  🦇 🦇 🦇‏ @hedgeberg Sep 22
      Replying to @hedgeberg @alt_kia

      That being said I doubt anyone has any intent to "reduce supply" by shutting down prescription opioid suppliers thanks to lobbyists, so point is moot.

      1 reply 0 retweets 0 likes
    5. Kia‏☆‏ @alt_kia Sep 22
      Replying to @hedgeberg

      they absolutely have, plenty of people with legit chronic pain are finding it much harder to get prescriptions for opioid medications that they've been on safely for a while

      1 reply 0 retweets 6 likes
    6. hedge.bat  🦇 🦇 🦇‏ @hedgeberg Sep 22
      Replying to @alt_kia

      So, there's an issue there, which is that opioids are not a good solution for long-term chronic pain treatment. They lose efficacy as they build addiction. Opioids were introduced purely for end-of-life treatment or pain which is untreatable by any other means.

      2 replies 0 retweets 0 likes
    7. whitequark‏ @whitequark Sep 22
      Replying to @hedgeberg @alt_kia

      this is not true. we do not have evidence that opioids are not a good solution for long-term chronic pain treatment because we have never properly studied it.

      1 reply 0 retweets 2 likes
      whitequark‏ @whitequark Sep 22
      Replying to @whitequark @hedgeberg @alt_kia

      all that we do know is that there is a limited evidence of dose-dependent risk of adverse effects. e.g. see https://www.ncbi.nlm.nih.gov/pubmed/25581257  (2015)

      11:21 PM - 22 Sep 2018
      • 1 Like
      • hedge.bat 🦇🦇🦇
      1 reply 0 retweets 1 like
        1. New conversation
        2. hedge.bat  🦇 🦇 🦇‏ @hedgeberg Sep 22
          Replying to @whitequark @alt_kia

          Interesting, but definitely does not jive with what I've heard from other folks who are medical professionals. I'll need to review, appreciate the reference. Worth noting that I am not a medical professional, so if you have more information than I do then I can't really argue.

          2 replies 0 retweets 0 likes
        3. whitequark‏ @whitequark Sep 22
          Replying to @hedgeberg @alt_kia

          unfortunately, bias and ignorance in medical professionals is widespread. to give you an example you are probably familiar with, consider trans healthcare in the US. opioids aren't a cure-all, but they are safe and effective when used appropriately, including for long-term pain.

          2 replies 1 retweet 3 likes
        4. Kia‏☆‏ @alt_kia Sep 22
          Replying to @whitequark @hedgeberg

          ("used appropriately" includes "not using with alcohol or benzodiazepines", and the overwhelming majority of "opioid deaths" in US involved benzos and/or EtOH as well)

          2 replies 0 retweets 2 likes
        5. Kia‏☆‏ @alt_kia Sep 23
          Replying to @alt_kia @whitequark @hedgeberg

          (US prescribing practices are bad, lots of doctors/surgeons like to prescribe them as a way to fob off patients or avoid repeat/complicated visits or w/e, but the flip to "opioids are now hard to get even for patients who legit need them and use them without incident" is bad too)

          1 reply 0 retweets 3 likes
        6. Tweet unavailable
        7. ~v‏ @__vba Sep 23

          The most important thing that you can get from reading handbooks on healthcare economics is that people often don't care about effective and "good" healthcare and medicine. Neither usual consumer nor doctors.

          0 replies 1 retweet 3 likes
        8. End of conversation

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