For Our Own Good

Politicker, Jan 11 2013:

[Bloomberg: ] “The city hospitals we control, so … we’re going to do it and we’re urging all of the other hospitals to do it, voluntary guidelines. Somebody said, oh, somebody wrote, ‘Oh then maybe there won’t be enough painkillers for the poor who use the emergency rooms as their primary care doctor,’” the mayor said on his weekly radio show with John Gambling. “Number one, there’s no evidence of that. Number two, supposing it is really true, so you didn’t get enough painkillers and you did have to suffer a little bit. The other side of the coin is people are dying and there’s nothing perfect…

New York Times, Jan 26, 2013:

Trying to stem the scourge of prescription drug abuse, an advisory panel of experts to the Food and Drug Administration voted on Friday to toughen the restrictions on painkillers like Vicodin that contain hydrocodone, the most widely prescribed drugs in the country.

The recommendation, which the drug agency is likely to follow, would limit access to the drugs by making them harder to prescribe, a major policy change that advocates said could help ease the growing problem of addiction to painkillers, which exploded in the late 1990s and continues to strike hard in communities from Appalachia and the Midwest to New England.

But at 19 to 10, the vote was far from unanimous, with some opponents expressing skepticism that the change would do much to combat abuse. Oxycodone, another highly abused painkiller and the main ingredient in OxyContin, has been in the more restrictive category since it first came on the market, they pointed out in testimony at a public hearing. They also said the change could create unfair obstacles for patients in chronic pain.

Chronic pain? No matter. Just suffer a little bit.

And, no, this won’t achieve anything. There will just be something else. 

  1. The Mugwump

    This might be the only time in my life I agree with Mike Bloomberg.  I’ve picked up too many junkies in my cab (ride paid for by taxpayers no less) coming out of the emergency room after trying to cop a buzz at taxpayer expense.  It’s too bad the genuinely needy are denied the painkillers they need, but the system is being abused.  So are the taxpayers. 

  2. Goldgeller

    I don’t know enough about the facts to really comment.But much of medicine (apart from surgeries), I’m told, is about pain management. People will simply shop doctors until they get something to make the pain go away. Wouldn’t it be helpful if we allowed stronger pain killers in stores? I had a muscle spasm in my neck and it made moving very hard. I eventually went to doctor. Muscle spasm here is a pain killer and a muscle relaxer. Hey. That visit was pricey for what is basically a really strong tylenol. I think it is time to decrease regulation of drugs.

  3. Astonishing
    Al Sparks:  . . . First the government cracks down, and then the stories come out that terminally ill patients aren’t getting enough meds, and suffering needlessly. So the government eases up, and then the abuses start increasing. . . .

     

    Kozak:  . . . So, of  EVERY patient has 10/10 pain, even when they are sitting laughing and texting. 

    Whoever experiences pain as a regular daily feature of life gets an interesting education.

    The phrase “chronic pain” lost significance through overuse. Instead, think “constant pain.” Next time you burn your little finger on the stove, imagine feeling that teensy jolt every second of every minute of every hour of every day for for the rest of your life. Then magnify 10X. Living with pain can drain pleasure from life. It wears you down. And makes it tough to concentrate! Or do anything, except moan!

     I’m a constant three or four on the ten scale, with almost daily episodes to seven or eight, and spikes that go off the scale. I don’t abuse meds, but I see how it happens to people who aren’t druggies, like CJ Renquist.

    Regulations making it harder for me to get pain meds scare the crap outta me.

  4. Joseph Paquette
    ~Paules: This might be the only time in my life I agree with Mike Bloomberg.  I’ve picked up too many junkies in my cab (ride paid for by taxpayers no less) coming out of the emergency room after trying to cop a buzz at taxpayer expense.  It’s too bad the genuinely needy are denied the painkillers they need, but the system is being abused.  So are the taxpayers.  · 2 hours ago

    It’s the doctor’s duty not to provide these drugs when they are abused.  Leave it to the professional.  If we keep restricting things just because they are ‘abused’, we are feeding the nanny state. 

  5. PsychLynne

    Bloomberg had the power, because the city runs several hospitals and employees the staff.  Thus, as their “commander-in-chief,” he has chosen to implement this policy.  Other hospitals are going along voluntarily.  If they don’t state that they implementing the same policy, the junkies show up at their ER, where the EMTALA law prevents them from being turned away–thus, bankrupting them.

    Regarding additions, regulars use of pain killers brings on a host of symptoms that any chronic/constant pain sufferer can tell you about–the meds are system depressants, and depress all systems providing side helpings of constipation, slowed thinking and reaction time, and depresed mood.  In addition, their effectiveness typically decreases over time.  However, these things (including developing a tolerance), do not an addiction make. 

    Addiction has a psych component, a “must-have” at all costs component.  The vast majority of people will not become addicted to pain killers, the vast majority of people addicted to pain killers (the ones in the ERs) started out on something else. Pain was implemented at the fifth vital sign because a significant of body of research shows that poorly controlled leads to more post-surgical complications and re-admissions.

  6. Pilli

    A very close friend lives in FL. (notorious for “pill mills”)  He broke his back 10 years ago and has been on pain meds ever since.

    Last year, his pharmacist told him that he couldn’t have any more pain meds; that his MD was “over prescribing”.  He went back to the MD who told him there would be no more pain meds.  If the MD prescribed more, he would lose his license.  My friend is “suffering a bit more” to the point he often spends several daytime hours in bed because he can’t move.

    Unrelated.

    Another very close friend was a doctor.  He was very aware of which patients needed pain meds and which were abusing.  He was told he was “over prescribing” for those that needed the meds to control the pain.  He continued to prescribe.  He lost his license and is doing 3 years in federal prison because he continued to help those that needed help.

    Both these good people are suffering because some bureaucrat has too much power and no accountability.

    ~Paules, please rethink your position.

    ~Paules: This might be the only time in my life I agree with Mike Bloomberg.  I’ve picked up too many junkies in my cab (ride paid for by taxpayers no less) coming out of the emergency room after trying to cop a buzz at taxpayer expense.  It’s too bad the genuinely needy are denied the painkillers they need, but the system is being abused.  So are the taxpayers.  · 2 hours ago

  7. Nick Stuart

    Anybody think Bloomberg is going to lack for pain meds whenever he needs or wants them?

    Besides “what difference at this point does it make?”

  8. The Mugwump

    Let me be clear that I’m not opposed to licensed physicians prescribing painkillers for genuine cases of chronic pain.  I’m against drug addicts using the emergency room to get a fix.    

  9. Chris Campion

    There are ways to combat this at the hospital level, not at an office-in-the-clouds level of what amounts to restricting supply.

    ~Paules: Let me be clear that I’m not opposed to licensed physicians prescribing painkillers for genuine cases of chronic pain.  I’m against drug addicts using the emergency room to get a fix.     · 43 minutes ago

    Next up:  Bloomie will chide New Yorkers for causing deforestation due to their overuse of toilet paper.  No one will be able to spare a square in Bloomberg’s New Manhattan.

    soylent-latte.jpg

  10. tigerlily
    Franco: I’d like Merck or Lilly to create a drug that would cure Mike Bloomberg’s addiction to power. · 5 hours ago

    Exactly. Even if NYC has the power somewhere in it’s charter to regulate drugs, why wouldn’t this be something the City Council or Board oi Supervisors have to also vote on?

  11. Devereaux

    ED’s have had this problem for a very long time. Most doc’s give out scripts if the perp is reasonably polite and doesn’t make a pain of himself. Scripts written in the ED are generally for limited quantities so you get to see the repeats.

    Chronic pain is a serious issue. Unfortunately there are no simple solutions. Some people end up on pain meds forever. Others find other ways to cope. Certainly in the 1800′s one can make a case for people having no lass trouble with pain, but using a lot less pain medication. But then, you can also note that Laudenum was available OTC then, for any to use as they needed. Some got addicted – surprise. Rather like alcohol.

    Some ED’s have put a system in place wherein chronic abusers have their charts reviewed by a panel in the hospital, then if it is decided they are abusing the ED, they get a certified letter that they will no longer get pain medication unless in the opinion of the EDMD there is an acute need for them. The EDMD’s then can refuse to write and be protected by official policy.

  12. Randy Weivoda

    Hey, who knows best how much medicine a patient needs?  Some stupid doctor who’s looking the patient in the eye, or the mayor?  I know if I had a serious medical condition, I’d rather be treated by Bloomberg than some goof who has made medicine her career.

  13. Kozak

    The irony here is just too rich.  One of the reasons we are in the mess we are with prescription drugs is the meddling of government and progressives in health care to begin with.

    About 10 years ago a HUGE push was put on by academics and activists that we were undertreating pain, and should use powerful narcotics to help manage it ( the pharma companies which had come out with long acting meds helped too).  We were assured ( on what turns out to be little or no evidence) that only a small percentage would end up addicted.  Soon, pain became the “fifth vital sign” along with BP, pulse, temp, and oxygen saturation.  In the ER every patient is asked to rate their pain, on a 1-10 scale.   The Joint Commission began to scrutinize our pain management and woe to the ER or doctor who didn’t manage pain “appropriately”.  In addition to patient complaints, medical board censure and litigation.

    So, of  EVERY patient has 10/10 pain, even when they are sitting laughing and texting.  Thanks to this we are now at the point where the US has 5% of the world population and prescribe 85% of the narcotics.

  14. Al Sparks

    I’m actually amazed that a mayor has that kind of power.  Most cities can’t regulate drugs.  Usually state governments don’t delegate that to the cities.  And NYC may be an exception within the State of NY.

    As for the larger issue of pain killer access, I’ve seen it go back and forth. First the government cracks down, and then the stories come out that terminally ill patients aren’t getting enough meds, and suffering needlessly. So the government eases up, and then the abuses start increasing.

    Back and forth, back and forth.  And really, the government will never get it quite right.

    I myself agree with WFB’s stance.  Legalize them, but allow employers (including hospitals and their staff) to restrict and test.

  15. Franco

    I’d like Merck or Lilly to create a drug that would cure Mike Bloomberg’s addiction to power.

Want to comment on stories like these? Become a member today!

You'll have access to:

  • All Ricochet articles, posts and podcasts.
  • The conversation amongst our members.
  • The opportunity share your Ricochet experiences.

Join Today!

Already a Member? Sign In