Sunday New York Times - methadone for pain/deaths

[Suboxstitute]

Just wanted to let people know there's a long front page article on the risks of methadone when scripted by physicians who are not familiar with its use in pain management.... in a way, another "scare story" (they highlight a young man's death) but they do provide a bit of another perspective via a young woman who is on it for pain management and it has been very positive for her.

The scariest thing IMO in the article was a discussion about requiring providers to take a CLASS or have continuing eduation before scripting "strong narcotics" (fent was mentioned along with methadone, and I think oxy)... kind of like the 8 hour course for bupe treatment.

I will try to post a link to the article/I have the regular paper and didn't look online for it yet. But you may want to pick up a NY Times for your Sunday reading today.

Sue

[nick]

Yeah,I've seen this.The huge increase in 'done rxing,which is being cited as part of the reason for the increase of pharm related od's has lead the FDA to consider making prescribing docs take an additional course.

This is probably gonna be bad news for a lot of cp patients.

http://www.nytimes.com/2008/08/17/us/17methadone.html?_r=1@oref=slogin


There's another article by Barry Meier,but you have to log in for it.

[halfalien_s4]

interesting....ive been on done 4 PM several times. it always works pretty well, but fent is better...

[irish]

What's wrong with the docs taking another class? Better they fully understand the drugs than only having partial info.

[nick]

What's wrong with the docs taking another class? Better they fully understand the drugs than only having partial info.

In theory that would be great,but I suspect in practise some docs won't bother with the course and it will lead to a lot less docs rxing.Plus,who knows what they're going to teach in this class,I also suspect that rxing protocols will become much tighter and will this be retroactive and effect currant patients?

Then again it could lead to a land of milk and honey,but I wouldn't bet on it.

[irish]

In theory that would be great,but I suspect in practise some docs won't bother with the course and it will lead to a lot less docs rxing.Plus,who knows what they're going to teach in this class,I also suspect that rxing protocols will become much tighter and will this be retroactive and effect currant patients?

Then again it could lead to a land of milk and honey,but I wouldn't bet on it.



Good point, I'm just spoiled living here in Canada.

[nick]

However it must be said that I can't see big pharma(who'll lean on the government) going a long with this,if it was going to mean shifting less product and making less money.

Lobbying may come to the rescue........strange world.

[Synack]

I'm all for docs being required to take a class to rx done, and done only.. not the other stuff..

[nick]

Here's a handy link to the article about the FDA'S suggested requirement of an additional course to rx decent dope......Umm sorry,of course I mean reasonable medication.

http://www.nytimes.com/2008/08/17/us/17methside.html

[red26]

and then it gets thrown into the whole doctor only permitted a cirtain amount of patients at a time like bube and the costs of seeing that doc is outfuckinragous because it falls into the catagory of "opioid addiction treatment". I see where this could be heading.

[Suboxstitute]

[quote=nick;292376]Yeah,I've seen this.The huge increase in 'done rxing,which is being cited as part of the reason for the increase of pharm related od's has lead the FDA to consider making prescribing docs take an additional course.

This is probably gonna be bad news for a lot of cp patients.

http://www.nytimes.com/2008/08/17/us/17methadone.html?_r=1@oref=slogin


Nick thanks for finding and posting the link.

I do agree it is a good idea for doctors to be knowledgeable about the drugs they script (you know how many times WE have to educate THEM) but if something like a course or certification is implemented (which I don't think will happen 'cept maybe for 'done) ... some docs will just stop prescribing schedule II and maybe even schedule III pain drugs; esp. the generalists.

Just another thing for doctors to be scared about.

I assume most CP patients switching to done would have a decent tolerance to opiates at the start, depending on what theyve been on, length of time etc. ... apparently the people in the article didn't, or combined the methadone with other respiratory depressants either knowing the risks, or NOT knowing them.

Chronic pain treatment is so individualized, yet most (HMO) docs are not given adequate time to really spend with patients to titrate doses, monitor, etc. The have to meet "production goals" (and that is exactly what they are called.)

[pharmboy]

The media didn't use to roll over so easy when ever the Gov. wanted them

to in the past. There must be some threats being made some where.

The media is the gov. mouthpiece anymore. No Balls.

[Duckfeet]

Yeah, also the docs are *already* scared shitless of the gov't, as they *also* used to be independant: doctors used to feel outraged at the idea the gov't could tell them what to perscribe, but once again, online databases, and the ability to keep--and aquire--statistics and files, has made it very easy for the DEA to crackdown on docs, and since they failed at every other area of the drug war they are involved in, the gov't has *finally* found some "bad guys" they can prosecute/persecute, so pain perscribing docs--and us who need/like the opiates, are in big trouble...

Methadone was always good for addicts, for all the reasons everybody knows, but mostly because it was legal, while heroin wasn't...but anyway, methadone gets the blame, when it's almost always due to the fact that someone isn't *feeling* it, so they do more and more until they overdose.

I, being a good Ron Paul supporting libertarian, think the gov't just needs to get off the docs--and our--backs, and let the Darwinian weeding out process take it's course...but that won't happen, but I see more and more confused pain people, plowing into the methadone clinic, simply because it's the only place left they can get enough opiates...

Used to be a lot easier when it was just cranky old heroin addicts like me: hell they'd start you out at 100mg in the old days, and you be nodding out and drooling in front of the V.A. hospital in Houston until I could get it together to drive over to the 7-11 and get a quart of beer to "smooth off the edges"...ha ha...yeah yeah, I know, I'm the guy who keeps Mothers Agains Drunk Drivers grinding their miserable teeth...fuckem...