The OxyContin family

[Bevo 13577]

4 minutes ago, Updawg said:

Kapoor and four other executives were found guilty last year of orchestrating a criminal conspiracy to bribe doctors to prescribe the company's medication, including to patients who didn't need it. They then lied to insurance companies to make sure the costly oral fentanyl spray was covered.

The law changed regarding pharmaceutical marketing in 1987 and 1992. Lots of the perks that sales reps and companies used to offer are no longer possible. Apparently, Kapoor was breaking the law and went to jail.

Opioids have been around since 3400BC. They were first used in modern medicine in 1853 and synthetic heroin was developed and sold by Bayer as a safer alternative to morphine in 1898. Oxycodone was approved by the FDA in 1950.

In 1969, the World Health Organization (WHO) abandoned the belief that the medical use of morphine inevitably led patients to dependence, stating that drug tolerance and physical dependence do not, in themselves, constitute “drug dependence.”

The American medical landscape in the 1980s was characterized by “opiophobia” – a fear of prescribing opiates and other opioids, with President Reagan asking Americans to join a national crusade not to tolerate drugs by anyone, anytime, anyplace. In response to the growing recognition of the need for pain management, the pendulum then swung the other way with a significant increase in opioid use for all types of pain. Then, in the 1990s, time-release prescription opioids hit the market, continuing into the 2000s.

In the 2000s, Purdue advertised Oxycontin as non-addictive because the drug was designed to be released within the body over a 12-hour period; however, recreational drug users quickly learned to get “high” by crushing or dissolving these time-release pills.

 

 

 

[DefinitelyNotHollywoodColt 12301]

1 hour ago, futureman said:

refute anything I said.  go ahead, I'll wait.

Virtually everything posted since your idiotic first take refutes it. Impressive level of ignorance, even for you.

[Augustus 3061]

On 8/26/2019 at 6:26 PM, Chad Fuck said:

The doctors weren’t organized into a conspiracy to addict vast swaths of the American people.

And surprising as it may be, a lot of doctors are, in fact, clueless about this stuff.  Back in 2003, a GP straight up told me in no uncertain terms that methadone was not addictive, and he absolutely believed that to be true, despite methadone being perhaps the most addictive opioid on the planet, due to its insanely long half life.  

And speaking of methadone, here's a cool story, bro.

When I moved to Scottsdale a few years ago I went to work for a substance abuse treatment facility that's one of the largest in Phoenix-metro.  After working there a while, I came to learn that the doctor who served as our clinical director and the owner of the facility were partners in a string of methadone clinics throughout the area.

Being a rehab, we always had a huge contingent of opioid addicts in the program, and their "detox" would begin with methadone or suboxone "tapers."  Only they weren't forced to taper.  They had the option of long-term methadone "maintenance," which meant every morning they'd be transported to one of the clinics owned by the doc and the facility owner, and quickly hooked on methadone--which is a metric fuckton harder to get off than short acting opioids like heroin or oxy, etc.

Once hooked on methadone, you can absolutely count on that patient coming back to your clinic either 1) Forever or 2) Until they run completely out of money and have no way of getting more.  I was on a high dose of methadone for 7 years and went through cold turkey withdrawals, the acute phase of which lasted for weeks.  I wouldn't sentence Hitler to something like that.  I'd just shoot him in the head.

That is hands down the most disgusting thing I've encountered in the treatment business, which is chock full of a lot of bad actors.

I work for a professional intervention company now, and will never work in treatment again, unless it's strictly homeopath/naturopath type deal.  Patients in just about any treatment center get so over medicated it's just heart breaking to witness.

 

[TwiceHorn 31470]

3 minutes ago, Augustus said:

And surprising as it may be, a lot of doctors are, in fact, clueless about this stuff.  Back in 2003, a GP straight up told me in no uncertain terms that methadone was not addictive, and he absolutely believed that to be true, despite methadone being perhaps the most addictive opioid on the planet, due to its insanely long half life.  

And speaking of methadone, here's a cool story, bro.

When I moved to Scottsdale a few years ago I went to work for a substance abuse treatment facility that's one of the largest in Phoenix-metro.  After working there a while, I came to learn that the doctor who served as our clinical director and the owner of the facility were partners in a string of methadone clinics throughout the area.

Being a rehab, we always had a huge contingent of opioid addicts in the program, and their "detox" would begin with methadone or suboxone "tapers."  Only they weren't forced to taper.  They had the option of long-term methadone "maintenance," which meant every morning they'd be transported to one of the clinics owned by the doc and the facility owner, and quickly hooked on methadone--which is a metric fuckton harder to get off than short acting opioids like heroin or oxy, etc.

Once hooked on methadone, you can absolutely count on that patient coming back to your clinic either 1) Forever or 2) Until they run completely out of money and have no way of getting more.  I was on a high dose of methadone for 7 years and went through cold turkey withdrawals, the acute phase of which lasted for weeks.  I wouldn't sentence Hitler to something like that.  I'd just shoot him in the head.

That is hands down the most disgusting thing I've encountered in the treatment business, which is chock full of a lot of bad actors.

I work for a professional intervention company now, and will never work in treatment again, unless it's strictly homeopath/naturopath type deal.  Patients in just about any treatment center get so over medicated it's just heart breaking to witness.

 

Yeesh, yeah, I can see that a lot of treatment outfits get overrun by the profit motive pretty quickly, but that's something else.

I understand that most methadone treatment is intended to taper.  I also understand that most does not.

 

 

[TwiceHorn 31470]

I think the Oxycontin story started innocently enough, but with a dose of profit motive.

But not long after, they went whole-hog-bananas profit and threw any legitimate medical objective out the window.  And in the process, they fucked up medicine for a couple of decades or more.  And a shit-ton of people.

It is my sense that as long is a person is actually in chronic or acute pain, the likelihood of addiction is relatively low.  But as soon as that pain becomes tolerable and opioid use continues, it's nelly bar the door.

I'm also not quite convinced that all the opioid addicts are addicted to them in the same way I was addicted to alcohol.  They just lack the fortitude to suffer withdrawal, which is no mean thing.  But once free of them, I suspect they could stay free.

Edited February 9, 2020 by TwiceHorn

[Augustus 3061]

20 minutes ago, TwiceHorn said:

Yeesh, yeah, I can see that a lot of treatment outfits get overrun by the profit motive pretty quickly, but that's something else.

I understand that most methadone treatment is intended to taper.  I also understand that most does not.

 

 

In my 7 years of patronizing the Huntsville Clinic (closest methadone clinic to where I lived in College Station) I don't recall meeting anyone there who was tapering their dosage.  Met tons of folks who, like me, were doing incremental increases.

The clinic doesn't make money if you get off methadone, and these aren't non-profits.  So there's no encouragement by them to lower your dosage or get off the medication altogether.

 

[Augustus 3061]

I should add, just so it doesn't sound like I'm condemning methadone maintenance for anyone/everyone:

I met more than a few people for whom I believe methadone maintenance was probably the only realistic alternative for them.  They were able to work, go about their lives in otherwise normal fashion, drive safely, etc.

But they weren't people who were likely to ever embrace a recovery program that required complete abstinence.

Whether because they were just so dopamine deficient, or just so unwilling or unable to process through their underlying issues... I don't know.  But I accept that it was better for them to be on methadone than the lifestyle they'd otherwise be living.

I'm very glad I'm not in charge of making that decision for them.  

But that's a far different issue from the ethical questions around treatment center clinicians owning methadone clinics.

Edited February 10, 2020 by Augustus

[futureman 22462]

1 hour ago, DefinitelyNotHollywoodColt said:

Virtually everything posted since your idiotic first take refutes it. Impressive level of ignorance, even for you.

your irrational hatred of cancer patients is shameful. 

[Serak The Preparer 3431]

1 hour ago, TwiceHorn said:

...it's nelly bar the door.

...

Where the hell did that come from? I have never heard that (in place of Katy bar the door) before, and only Google hit I find is from Michigan law blog. Is this some weird regional colloquialism?

[XYZ 2154]

The government of this country is so fucking beholden to corporate interests. What’s best for corporate America is best for America.

[Chad Fuck 17681]

16 hours ago, Augustus said:

And surprising as it may be, a lot of doctors are, in fact, clueless about this stuff.  Back in 2003, a GP straight up told me in no uncertain terms that methadone was not addictive, and he absolutely believed that to be true, despite methadone being perhaps the most addictive opioid on the planet, due to its insanely long half life.  

And speaking of methadone, here's a cool story, bro.

When I moved to Scottsdale a few years ago I went to work for a substance abuse treatment facility that's one of the largest in Phoenix-metro.  After working there a while, I came to learn that the doctor who served as our clinical director and the owner of the facility were partners in a string of methadone clinics throughout the area.

Being a rehab, we always had a huge contingent of opioid addicts in the program, and their "detox" would begin with methadone or suboxone "tapers."  Only they weren't forced to taper.  They had the option of long-term methadone "maintenance," which meant every morning they'd be transported to one of the clinics owned by the doc and the facility owner, and quickly hooked on methadone--which is a metric fuckton harder to get off than short acting opioids like heroin or oxy, etc.

Once hooked on methadone, you can absolutely count on that patient coming back to your clinic either 1) Forever or 2) Until they run completely out of money and have no way of getting more.  I was on a high dose of methadone for 7 years and went through cold turkey withdrawals, the acute phase of which lasted for weeks.  I wouldn't sentence Hitler to something like that.  I'd just shoot him in the head.

That is hands down the most disgusting thing I've encountered in the treatment business, which is chock full of a lot of bad actors.

I work for a professional intervention company now, and will never work in treatment again, unless it's strictly homeopath/naturopath type deal.  Patients in just about any treatment center get so over medicated it's just heart breaking to witness.

 

This is gottdam horrifying, but not surprising.  

It's the medical version of the the payday loan industry.

 

[Kyrie Eleison 9312]

22 hours ago, Augustus said:

And surprising as it may be, a lot of doctors are, in fact, clueless about this stuff.  Back in 2003, a GP straight up told me in no uncertain terms that methadone was not addictive, and he absolutely believed that to be true, despite methadone being perhaps the most addictive opioid on the planet, due to its insanely long half life.  

And speaking of methadone, here's a cool story, bro.

When I moved to Scottsdale a few years ago I went to work for a substance abuse treatment facility that's one of the largest in Phoenix-metro.  After working there a while, I came to learn that the doctor who served as our clinical director and the owner of the facility were partners in a string of methadone clinics throughout the area.

Being a rehab, we always had a huge contingent of opioid addicts in the program, and their "detox" would begin with methadone or suboxone "tapers."  Only they weren't forced to taper.  They had the option of long-term methadone "maintenance," which meant every morning they'd be transported to one of the clinics owned by the doc and the facility owner, and quickly hooked on methadone--which is a metric fuckton harder to get off than short acting opioids like heroin or oxy, etc.

Once hooked on methadone, you can absolutely count on that patient coming back to your clinic either 1) Forever or 2) Until they run completely out of money and have no way of getting more.  I was on a high dose of methadone for 7 years and went through cold turkey withdrawals, the acute phase of which lasted for weeks.  I wouldn't sentence Hitler to something like that.  I'd just shoot him in the head.

That is hands down the most disgusting thing I've encountered in the treatment business, which is chock full of a lot of bad actors.

I work for a professional intervention company now, and will never work in treatment again, unless it's strictly homeopath/naturopath type deal.  Patients in just about any treatment center get so over medicated it's just heart breaking to witness.

 

[BigHorn'13 3363]

On 2/9/2020 at 5:14 PM, Bevo said:

In the 2000s, Purdue advertised Oxycontin as non-addictive because the drug was designed to be released within the body over a 12-hour period; however, recreational drug users quickly learned to get “high” by crushing or dissolving these time-release pills.

Not saying this wasn't the case with a lot of people, but there are enough stories out there on people who were hooked on it and not doing this. 

Also that Netflix documentary is great at making you question law enforcement. At least 4 different agencies couldn't do what 1 state board did. Unbelievable. 

[MaybeACoordinator 8349]

On 2/9/2020 at 5:40 PM, Augustus said:

And surprising as it may be, a lot of doctors are, in fact, clueless about this stuff.  Back in 2003, a GP straight up told me in no uncertain terms that methadone was not addictive, and he absolutely believed that to be true, despite methadone being perhaps the most addictive opioid on the planet, due to its insanely long half life.  

And speaking of methadone, here's a cool story, bro.

When I moved to Scottsdale a few years ago I went to work for a substance abuse treatment facility that's one of the largest in Phoenix-metro.  After working there a while, I came to learn that the doctor who served as our clinical director and the owner of the facility were partners in a string of methadone clinics throughout the area.

Being a rehab, we always had a huge contingent of opioid addicts in the program, and their "detox" would begin with methadone or suboxone "tapers."  Only they weren't forced to taper.  They had the option of long-term methadone "maintenance," which meant every morning they'd be transported to one of the clinics owned by the doc and the facility owner, and quickly hooked on methadone--which is a metric fuckton harder to get off than short acting opioids like heroin or oxy, etc.

Once hooked on methadone, you can absolutely count on that patient coming back to your clinic either 1) Forever or 2) Until they run completely out of money and have no way of getting more.  I was on a high dose of methadone for 7 years and went through cold turkey withdrawals, the acute phase of which lasted for weeks.  I wouldn't sentence Hitler to something like that.  I'd just shoot him in the head.

That is hands down the most disgusting thing I've encountered in the treatment business, which is chock full of a lot of bad actors.

I work for a professional intervention company now, and will never work in treatment again, unless it's strictly homeopath/naturopath type deal.  Patients in just about any treatment center get so over medicated it's just heart breaking to witness.

 

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

 

 

[TwiceHorn 31470]

1 hour ago, BigHorn'13 said:

Not saying this wasn't the case with a lot of people, but there are enough stories out there on people who were hooked on it and not doing this. 

Also that Netflix documentary is great at making you question law enforcement. At least 4 different agencies couldn't do what 1 state board did. Unbelievable. 

Federal law enforcement agencies are fucked.  They're not so much interested in doing what's right as doing what covers them in glory and career advancement.  Sometimes that coincides with what's right.

As bad as state/local law enforcement is, they aren't political in this way, typically.

A huge part of it is that federal criminal jurisdiction almost entirely overlaps with that of the states.  Therefore, federal prosecution is mostly "optional" for the feds.  So they only take winners.

The DEA and FBI don't have any ability to prosecute a case.  They have to bring one to the local US Attorney.  As alluded to, the USA didn't want to bring the charges because trying a case based on medical judgment (or lack thereof) can be difficult.  Not insurmountably so, but they wanted someone else to take the potential loss.

Edited February 11, 2020 by TwiceHorn

[XYZ 2154]

1 hour ago, MaybeACoordinator said:

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

Daaamn.

[ChiTownDoc 21154]

1 hour ago, MaybeACoordinator said:

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

 

 

Last paragraph.  She was behind the 8 ball to start.  Sorry, man.   
 

So many docs gloss over ‘do no harm’.  As in, ‘of course I won’t’.  Easy to cross that line.  Damn shame.  

[Texas_Rocks 346]

Damn, Maybe! That is a tragic story, no other way to put it. Glad you escaped that trap and defied the odds.

[Newdoc 3440]

Props to those of you all that have broken the cycle of addiction or dependence. I'd like to throw my two cents in on drug addiction, abuse and treatment. I am certified and have a waiver for treatment of opioid use disorders. I work first hand with a drug dependence treatment program.

1) There is a a difference between addiction and dependence. Some have both. Addiction is defined more by a set of behaviors and motivations to obtain a drug, use said drug and accelerate use. Dependence is when you need the medication to prevent withdrawal or cannot bear the disease process the medication is treating (methadone treatment for previous addiction, chronic opioids for cancer pain, etc.).

2) Short acting opioid are more likely to cause addiction because of the intense high with release of dopamine, norepinephrine, etc. Long acting opioids can cause addiction more often than short IF the long acting is crushed or mutilated into a short acting form (crushing old oxy formulations, cutting into Fentanyl patches). Long acting opioids in unadulterated form like methadone are not more addicting but are harder to quit due to long half life and more intense withdrawal symptoms.

3) Y'all qualify but tend to throw methadone treatment centers under the bus and there are likely bad actors but in my experience, they are usually trying to do the right thing. With addicts and people dependent on opioids you are dealing with a population of people who tend to continue to make bad choices. A lot of these people are stuck in families with addiction, poor socio-economics and poor education so they have never been taught or shown there is another way. For those who take the programs seriously, the treatments can mean a productive and more fulfilling life.  There are no good proven studies that show homeopathy and naturopathy work for true drug addiction. 

4) There are many people who actively attempt tapers of their treatments at drug treatment centers. It is a very precarious process. Do not do it cold turkey. 90% of those who try cold turkey or even just counseling methods are back on opioids within 6 months.

5) Buprenorphine with naloxone would be my treatment of choice for most but it is limited in availability due to cost per day and lack of providers to supervise and dispense.

6) Until we have a better understanding of the genetics of drug addiction, you are playing potluck with taking opioids. It really doesn't matter if you take them for fun or for pain. 

7) The crack down on doctor provided opioid prescriptions (known doses) in the last 5 years has led to an increase in indiscriminate use of heroin and lab cooked fentanyl which has increased overdoses and deaths. This was easily predictable.  We haven't fixed the root causes of drug use in our society. 

[TwiceHorn 31470]

21 minutes ago, Newdoc said:

Props to those of you all that have broken the cycle of addiction or dependence. I'd like to throw my two cents in on drug addiction, abuse and treatment. I am certified and have a waiver for treatment of opioid use disorders. I work first hand with a drug dependence treatment program.

1) There is a a difference between addiction and dependence. Some have both. Addiction is defined more by a set of behaviors and motivations to obtain a drug, use said drug and accelerate use. Dependence is when you need the medication to prevent withdrawal or cannot bear the disease process the medication is treating (methadone treatment for previous addiction, chronic opioids for cancer pain, etc.).

2) Short acting opioid are more likely to cause addiction because of the intense high with release of dopamine, norepinephrine, etc. Long acting opioids can cause addiction more often than short IF the long acting is crushed or mutilated into a short acting form (crushing old oxy formulations, cutting into Fentanyl patches). Long acting opioids in unadulterated form like methadone are not more addicting but are harder to quit due to long half life and more intense withdrawal symptoms.

3) Y'all qualify but tend to throw methadone treatment centers under the bus and there are likely bad actors but in my experience, they are usually trying to do the right thing. With addicts and people dependent on opioids you are dealing with a population of people who tend to continue to make bad choices. A lot of these people are stuck in families with addiction, poor socio-economics and poor education so they have never been taught or shown there is another way. For those who take the programs seriously, the treatments can mean a productive and more fulfilling life.  There are no good proven studies that show homeopathy and naturopathy work for true drug addiction. 

4) There are many people who actively attempt tapers of their treatments at drug treatment centers. It is a very precarious process. Do not do it cold turkey. 90% of those who try cold turkey or even just counseling methods are back on opioids within 6 months.

5) Buprenorphine with naloxone would be my treatment of choice for most but it is limited in availability due to cost per day and lack of providers to supervise and dispense.

6) Until we have a better understanding of the genetics of drug addiction, you are playing potluck with taking opioids. It really doesn't matter if you take them for fun or for pain. 

7) The crack down on doctor provided opioid prescriptions (known doses) in the last 5 years has led to an increase in indiscriminate use of heroin and lab cooked fentanyl which has increased overdoses and deaths. This was easily predictable.  We haven't fixed the root causes of drug use in our society. 

From observations on the ground, sociological factors are huge.  It's hard enough for an alcoholic to get away from alcohol, but in all likelihood, most of the alcoholic's drinking acquaintances aren't abusers (some are, of course).

With what I have seen of meth and opioids, a person who gets clean often goes back to a milieu where just about everyone they know is an abuser too.  In some cases, this is a sort of stereotypical "crack den" environment, in others some people remain relatively functional (for the time being), but it's really a way of life.

None of this is to say that it's absolutely necessary to avoid other drinkers/users to get in recovery, but proximity like this makes early sobriety particularly difficult.

Edited February 11, 2020 by TwiceHorn

[hullabelew 3724]

I was in rehab for 28 days last May.  I got to know about 60 guys there on a first name basis and have kept up with about 30 of them.  About 2/3 were opioid guys.  6 of the 60 have died since June.  Talked with another guy recently who was at the same treatment center 4 years ago.  He told me 19 of the 40 guys he was there with had died.  One of the guys in my cabin had been on methadone for 15 fucking years.  He said no one ever tried to get him on maintenance until this stint in rehab.  

Don't know if it has been mentioned above but Harris Wittel's sister has a fantastic podcast called Last Day.  It is worth a listen.    

[MaybeACoordinator 8349]

2 hours ago, hullabelew said:

I was in rehab for 28 days last May.  I got to know about 60 guys there on a first name basis and have kept up with about 30 of them.  About 2/3 were opioid guys.  6 of the 60 have died since June.  Talked with another guy recently who was at the same treatment center 4 years ago.  He told me 19 of the 40 guys he was there with had died.  One of the guys in my cabin had been on methadone for 15 fucking years.  He said no one ever tried to get him on maintenance until this stint in rehab.  

Don't know if it has been mentioned above but Harris Wittel's sister has a fantastic podcast called Last Day.  It is worth a listen.    

Also recommend Dopey and Don't Die, the podcast from Bob Forrest, Drew Pinsky's right hand man on Celeb Rehab.

[hullabelew 3724]

One of the guys I met in rehab turned me on to Dopey. He was actually listening to it real time when Chris died. That guys name was Greg. Greg ODed at Christmas after 8 months sober.

[G650 14256]

On 2/10/2020 at 11:39 PM, MaybeACoordinator said:

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

 

 

Great googly moogly

[Augustus 3061]

On 2/11/2020 at 10:14 AM, Newdoc said:

There is a a difference between addiction and dependence. Some have both. Addiction is defined more by a set of behaviors and motivations to obtain a drug, use said drug and accelerate use. Dependence is when you need the medication to prevent withdrawal or cannot bear the disease process the medication is treating (methadone treatment for previous addiction, chronic opioids for cancer pain, etc.).

 

7 years on that stuff and got to know a lot others who were.  Now going on 8.5 years clean/sober and having worked with literally hundreds of others in recovery I vehemently dispute that methadone "treatment" is not "addiction." 

It is certainly dependence, no question about it. No one could endure those withdrawals if there's a means to stop them.  But methadone maintenance isn't just about preventing withdrawals for us, it's about making existence somewhat tolerable, and occasionally something that approaches enjoyable.

We're not just proactively medicating withdrawal.  We're medicating the same internal issues that made addicts out of us in the first place.  Methadone may not provide the same euphoria that a short acting opioid delivers, but it damn sure rewards the pleasure centers just the same.  

If that weren't the case, every clinic in the US could slowly taper every patient down to zero and then everything would be just fine.

Jesus Christ, the reason people stay on methadone forever, with ever increasing doses, is precisely BECAUSE it's an addiction.

You even said as much:  "Addiction is defined more by a set of behaviors and motivations to obtain a drug, use said drug and accelerate use."  Getting it from a clinic instead of a dealer changes nothing.

Edited February 18, 2020 by Augustus

[Newdoc 3440]

6 hours ago, Augustus said:

7 years on that stuff and got to know a lot others who were.  Now going on 8.5 years clean/sober and having worked with literally hundreds of others in recovery I vehemently dispute that methadone "treatment" is not "addiction." 

It is certainly dependence, no question about it. No one could endure those withdrawals if there's a means to stop them.  But methadone maintenance isn't just about preventing withdrawals for us, it's about making existence somewhat tolerable, and occasionally something that approaches enjoyable.

We're not just proactively medicating withdrawal.  We're medicating the same internal issues that made addicts out of us in the first place.  Methadone may not provide the same euphoria that a short acting opioid delivers, but it damn sure rewards the pleasure centers just the same.  

If that weren't the case, every clinic in the US could slowly taper every patient down to zero and then everything would be just fine.

Jesus Christ, the reason people stay on methadone forever, with ever increasing doses, is precisely BECAUSE it's an addiction.

You even said as much:  "Addiction is defined more by a set of behaviors and motivations to obtain a drug, use said drug and accelerate use."  Getting it from a clinic instead of a dealer changes nothing.

You’re lumping addiction in with dependence or vice versa. They’re two different ICD 10 codes and yes, it’s splitting hairs and technical. If you take out the use of “dependence” then you have to use “addiction” for everyone. But we don’t. Yes, you can become “addicted” to methadone. I never said you couldn’t.  Most of my patients however are dependent and it’s not great but it beats the pattern of addiction behaviors.

[52-80 19157]

On 2/11/2020 at 5:39 AM, MaybeACoordinator said:

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

 

 

 

[Augustus 3061]

10 hours ago, Newdoc said:

You’re lumping addiction in with dependence or vice versa. They’re two different ICD 10 codes and yes, it’s splitting hairs and technical. If you take out the use of “dependence” then you have to use “addiction” for everyone. But we don’t. Yes, you can become “addicted” to methadone. I never said you couldn’t.  Most of my patients however are dependent and it’s not great but it beats the pattern of addiction behaviors.

Happy to know I wasn't addicted to methadone for 7 years, increasing over that time from 30mg to 125mg per day, resulting in damage to my colon that resulted in a semicolectomy that resulted in sepsis, coma, kidney failure and paralyzing peripheral neuropathy that required 3 months of assisted living to allow me to walk again.  Hate to think what might've happened if I'd actually become addicted.  

I couldn't care less what codes people like yourself give to these behaviors or your attempts to codify them into categories that ultimately have no impact whatsoever on a solution to the problem.

I could have done what I did with heroin and everyone would have called it addiction.  I did it at a clinic with a prescribed "medication" and people like yourself want to me tell me there's some fundamental difference.  

I still believe there are plenty of people for whom methadone/suboxone maintenance is the best of all possible, realistic solutions.  But clearly I get angry when someone tries to define the addiction out of the equation.  Usually non-addicts.

I'll reiterate:  If dependence were the issue, then problem solved.  Taper everyone slowly down to zero.  In fact, if most of your patients are merely dependent, I assume that's what you're doing?

 

 

Edited February 18, 2020 by Augustus

[TwiceHorn 31470]

Thing is, you don't really know if it's "dependence" or "addiction" until you take it away.

[XYZ 2154]

19 hours ago, Augustus said:

Happy to know I wasn't addicted to methadone for 7 years, increasing over that time from 30mg to 125mg per day...

I don’t understand this. Why did the clinic increase your dose? I would assume that the protocol would be: use enough methadone so that patient doesn’t suffer too much withdrawal symptoms, and slowly decrease the methadone over time.

[Blotto 23508]

https://www.cnn.com/2020/10/21/business/purdue-pharma-guilty-plea/index.html

Quote

Purdue Pharma, the maker of OxyContin, has agreed to plead guilty to three federal criminal charges for its role in creating the nation's opioid crisis and will pay more than $8 billion and close down the company.

The money will go to opioid treatment and abatement programs. The privately held company has agreed to pay a $3.5 billion fine as well as forfeit an additional $2 billion in past profits, in addition to the $2.8 billion it agreed to pay in civil liability.

"Purdue Pharma actively thwarted the United States' efforts to ensure compliance and prevent diversion," said Drug Enforcement Administration Assistant Administrator Tim McDermott. "The devastating ripple effect of Purdue's actions left lives lost and others addicted."

The company doesn't have $8 billion in cash available to pay the fines. So Purdue will be dissolved as part of the settlement, and its assets will be used to create a new "public benefit company" controlled by a trust or similar entity designed for the benefit of the American public. The Justice Department said it will function entirely in the public interest rather than to maximize profits. Its future earnings will go to paying the fines and penalties, which in turn will be used to combat the opioid crisis.

That new company will continue to produce painkillers such as OxyContin, as well as drugs to deal with opioid overdose. Deputy Attorney General Jeffrey Rosen, who announced the settlement, defended the plans for the new company to continue to sell that drug, saying there are legitimate uses for painkillers such as OxyContin.

The plan is for the company to make life-saving overdose rescue drugs and medically assisted treatment medications available at steep discounts to communities dealing with the opioid crisis.

The Justice Department also reached a separate $225 million civil settlement with the former owners of Purdue Pharma, the Sackler family. Still, the Sackler family -- as well as other current and former employees and owners of the the company -- face the possibility that federal criminal charges will be filed against them.

So the Sackler family wealth is greater than $10 billion and they have to cough up $225 million. Poor bastards, I'm sure they learned their lesson, and I pray they can recover. 

[Updawg 2266]

https://www.cnn.com/2020/10/21/business/purdue-pharma-guilty-plea/index.html

Purdue Pharma, the maker of OxyContin, has agreed to plead guilty to three federal criminal charges for its role in creating the nation's opioid crisis and will pay more than $8 billion and close down the company.
The money will go to opioid treatment and abatement programs. The privately held company has agreed to pay a $3.5 billion fine as well as forfeit an additional $2 billion in past profits, in addition to the $2.8 billion it agreed to pay in civil liability.
"Purdue Pharma actively thwarted the United States' efforts to ensure compliance and prevent diversion," said Drug Enforcement Administration Assistant Administrator Tim McDermott. "The devastating ripple effect of Purdue's actions left lives lost and others addicted."
The company doesn't have $8 billion in cash available to pay the fines. So Purdue will be dissolved as part of the settlement, and its assets will be used to create a new "public benefit company" controlled by a trust or similar entity designed for the benefit of the American public. The Justice Department said it will function entirely in the public interest rather than to maximize profits. Its future earnings will go to paying the fines and penalties, which in turn will be used to combat the opioid crisis.
That new company will continue to produce painkillers such as OxyContin, as well as drugs to deal with opioid overdose. Deputy Attorney General Jeffrey Rosen, who announced the settlement, defended the plans for the new company to continue to sell that drug, saying there are legitimate uses for painkillers such as OxyContin.
The plan is for the company to make life-saving overdose rescue drugs and medically assisted treatment medications available at steep discounts to communities dealing with the opioid crisis.
The Justice Department also reached a separate $225 million civil settlement with the former owners of Purdue Pharma, the Sackler family. Still, the Sackler family -- as well as other current and former employees and owners of the the company -- face the possibility that federal criminal charges will be filed against them.

So the Sackler family wealth is greater than $10 billion and they have to cough up $225 million. Poor bastards, I'm sure they learned their lesson, and I pray they can recover. 

Total bullshit. Hopefully they find criminal charges but I’m sure it will only be against middle mgt

Some of them live here in Austin. Fuckers

[TwiceHorn 31470]

10 minutes ago, Updawg said:

So the Sackler family wealth is greater than $10 billion and they have to cough up $225 million. Poor bastards, I'm sure they learned their lesson, and I pray they can recover. 

Total bullshit. Hopefully they find criminal charges but I’m sure it will only be against middle mgt

Some of them live here in Austin. Fuckers

Only a couple of the Sacklers are actually culpable, AFAIK.  I guess you can argue that the entire family should be stripped of their ill-gotten gains, but  . . . . .

That the company is dismantled and an extremely large sum is being directed to public benefit seems like a fairly good outcome.

[Updawg 2266]

Only a couple of the Sacklers are actually culpable, AFAIK.  I guess you can argue that the entire family should be stripped of their ill-gotten gains, but  . . . . .

That the company is dismantled and an extremely large sum is being directed to public benefit seems like a fairly good outcome.

Then they can afford to visit them in jail.

 

It’s sad to think about how many are in jail right now because of them. Glad I never got hooked but many have

[HenryJames 66052]

 

[ztejas 43445]

On 2/11/2020 at 11:14 AM, Newdoc said:

7) The crack down on doctor provided opioid prescriptions (known doses) in the last 5 years has led to an increase in indiscriminate use of heroin and lab cooked fentanyl which has increased overdoses and deaths.

Bullshit conclusion jump. Provide a source.

[Newdoc 3440]

21 minutes ago, ztejas said:

Bullshit conclusion jump. Provide a source.

https://pubmed.ncbi.nlm.nih.gov/31468341/

If I had every frickin patient asking me to provide sources for my recommendations with each encounter then I would never get anything done. You must be a lot of fun in the doctor's office.

[ztejas 43445]

5 hours ago, Newdoc said:

https://pubmed.ncbi.nlm.nih.gov/31468341/

If I had every frickin patient asking me to provide sources for my recommendations with each encounter then I would never get anything done. You must be a lot of fun in the doctor's office.

Lol get off your horse, please. You're on a message board. You are not my doctor and I am not your patient. 

And I might have misinterpreted what you were getting at although I don't think your were very clear. I do not beleive that making it harder for Joe Drug-Curious to get an opioid prescription (or steal or buy someone else's) makes it more likely that Joe will wind up ODing and dead. In fact I beleive the opposite.

Long term opioid users suddenly being discontinued from their meds is a different story and I'm not sure where I would fall on that - but I am always going to advocate recovery and rehabilitation over turning people into Methadone and Suboxone zombies.

Edited November 19, 2020 by ztejas

[XYZ 2154]

On 11/18/2020 at 12:39 PM, HenryJames said:

 

How quaint. It couldn’t have ended any other way. Money changes hands and nobody goes to prison.

[Hefeweizen 5321]

4 minutes ago, XYZ said:

How quaint. It couldn’t have ended any other way. Money changes hands and nobody goes to prison.

The American legal system writ large.  Rich people don’t go to prison.

[BrazilHorn 6605]

3 hours ago, XYZ said:

How quaint. It couldn’t have ended any other way. Money changes hands and nobody goes to prison.

I just rewatched the "Chappelle Show" episode where the executive white collar criminal gets treated like a crack dealer and the crack dealer treated like the white collar criminal. Wish that would have happened to the Sackler family. Fucking scumbags.

 

[Blotto 23508]

And a hearty fuck you to Mckinsey as well. Here's another group of people that cashed in while Americans died.

Quote

When Purdue Pharma agreed last month to plead guilty to criminal charges involving OxyContin, the Justice Department noted the role an unidentified consulting company had played in driving sales of the addictive painkiller even as public outrage grew over widespread overdoses.

Documents released last week in a federal bankruptcy court in New York show that the adviser was McKinsey & Co., the world’s most prestigious consulting firm. The 160 pages include emails and slides revealing new details about McKinsey’s advice to the Sackler family, Purdue’s billionaire owners, and the firm’s now notorious plan to “turbocharge” OxyContin sales at a time when opioid abuse had already killed hundreds of thousands of Americans.

In a 2017 presentation, according to the records, which were filed in court on behalf of multiple state attorneys general, McKinsey laid out several options to shore up sales. One was to give Purdue’s distributors a rebate for every OxyContin overdose attributable to pills they sold.

The presentation estimated how many customers of companies including CVS and Anthem might overdose. It projected that in 2019, for example, 2,484 CVS customers would either have an overdose or develop an opioid use disorder. A rebate of $14,810 per “event” meant that Purdue would pay CVS $36.8 million that year.

CVS and Anthem have recently been among McKinsey’s biggest clients. Press officers for the two companies said they had never received rebates from Purdue for customers who had overdosed on OxyContin.

Though McKinsey has not been charged by the federal government or sued, it began to worry about legal repercussions in 2018, according to the documents. After Massachusetts filed a lawsuit against Purdue, Martin Elling, a leader for McKinsey’s North American pharmaceutical practice, wrote to another senior partner, Arnab Ghatak: “It probably makes sense to have a quick conversation with the risk committee to see if we should be doing anything” other than “eliminating all our documents and emails. Suspect not but as things get tougher there someone might turn to us.”

Ghatak, who also advised Purdue, replied: “Thanks for the heads up. Will do.”

It is not known whether consultants at the firm went on to destroy any records.

The two men were among the highest-ranking consultants at McKinsey. Five years earlier, the documents show, they emailed colleagues about a meeting in which McKinsey persuaded the Sacklers to aggressively market OxyContin.

The meeting “went very well — the room was filled with only family, including the elder statesman Dr. Raymond,” wrote Ghatak, referring to Purdue’s co-founder, the physician Raymond Sackler, who would die in 2017.

Elling concurred. “By the end of the meeting,” he wrote, “the findings were crystal clear to everyone and they gave a ringing endorsement of moving forward fast.”

McKinsey’s plan was accepted, even though Russell Gasdia, then Purdue’s vice president of sales and marketing, questioned the firm’s approach, writing Ghatak the night before the meeting to say that he had real concerns “on the need to turbocharge sales” of OxyContin.

Another Purdue executive, David Lundie, agreed with the strategy, however. Lundie said the proposal would catch the Sackler family’s attention, according to the documents. It did.

By 2017, Purdue’s chief executive, Craig Landau, wrote that the crisis was caused by “too many Rxs being written” at “too high a dose” and “for too long.” The drugs, he said, were being prescribed “for conditions that often don’t require them” by physicians who lacked “the requisite training in how to use them appropriately.”

When McKinsey was later called on to “disassemble” the aggressive sales campaign, according to the court filings, Landau was quoted as saying that it was something “we should have done five years ago.”

A press officer for McKinsey on Wednesday said the firm had been “cooperating fully with the opioid-related investigations” and had announced in 2019 that it “would not advise any clients worldwide on opioid-specific business.”

In a statement last month, the Sacklers said that family members “who served on Purdue’s board of directors acted ethically and lawfully.”

McKinsey’s involvement in the opioid crisis came to light early last year, with the release of documents from Massachusetts, which is among the states suing Purdue. Those records show that McKinsey was helping Purdue find a way “to counter the emotional messages from mothers with teenagers that overdosed” from OxyContin.

On Tuesday, Purdue pleaded guilty to criminal charges, including defrauding federal health agencies and paying illegal kickbacks to doctors. The company also faces roughly $8.3 billion in penalties. As part of the settlement, members of the Sackler family will pay $225 million in civil penalties.

In a statement issued after the announcement of settlement in October, Purdue said it “deeply regrets and accepts responsibility” for misconduct involving its marketing of OxyContin.

The federal settlement with Purdue comes as states and municipalities seek compensation from opioid makers for helping fuel a health crisis that has killed more than 450,000 Americans since 1999. Purdue is now seeking bankruptcy protection, as are other manufacturers.

“This is the banality of evil, MBA edition,” Anand Giridharadas, a former McKinsey consultant who reviewed the documents, said of the firm’s work with Purdue. “They knew what was going on. And they found a way to look past it, through it, around it, so as to answer the only questions they cared about: how to make the client money and, when the walls closed in, how to protect themselves.”

Giridharadas is a New York Times contributor who wrote a 2018 book that examined the power of elites, including those at McKinsey, for how they evade responsibility for social harm.

In recent years, McKinsey has attracted criticism and unwanted attention for its dealings around the world, including in authoritarian countries such as China, Russia and Saudi Arabia. Its business in South Africa was decimated after McKinsey worked with companies tied to a corruption scandal that led to the ouster of the country’s president. In the United States, McKinsey worked with Immigration and Customs Enforcement under President Donald Trump, proposing ways to cut spending on food and housing for detainees.

The documents released last week detail McKinsey’s work with Purdue going back to 2008, the year after the drugmaker pleaded guilty to misleading regulators. The Food and Drug Administration had previously told Purdue that OxyContin would face sales restrictions and that doctors prescribing it would require specialized training.

The Sackler family saw those rules as a threat and, joining with McKinsey, made a plan to “band together” with other opioid makers to push back, according to one email. McKinsey prepped Purdue executives for a vital meeting before an FDA advisory committee reviewing its proposed reformulation of OxyContin to make it less prone to abuse. The reformulation went on the market in 2010.

McKinsey put together briefing materials that anticipated questions Purdue would receive. One possible question: “Who at Purdue takes personal responsibility for these deaths?”

The proposed answer: “We all feel responsible.”

Dr. Richard Sackler, now the family patriarch, was pleased with the preparations, writing to his daughter in a January 2009 email: “Marianna, I am writing to tell you how impressed I was by the preparation for the FDA meeting. Both the method and process as well as the content was excellent and a major departure from efforts like this in the past.”

Purdue’s FDA meeting appeared to be at least partly successful. “Even to this day, the FDA has never required specialized training for OxyContin prescribers,” wrote the state lawyers who filed the documents last week.

This article originally appeared in The New York Times.

 

[XYZ 2154]

The Sackler family wins.

[DonkeyCigars 143]

7 hours ago, XYZ said:

The Sackler family wins.

Yea I saw that. 

—

OxyContin maker Purdue Pharma won court approval for a $4.5 billion bankruptcy settlement that shields its Sackler family owners from future lawsuits over their role in the opioid epidemic. 

[elfenix 34240]

[XYZ 2154]

18 hours ago, elfenix said:

Do severed heads leak that much blood? That seems exagerated.

[Harrison Stafford 3335]

On 9/4/2021 at 9:31 AM, XYZ said:

Do severed heads leak that much blood? That seems exagerated.

Quit while you’re a head.

[MaybeACoordinator 8349]

we need another unabomber...this one should take requests

[tomahawk dunk 338]

On 2/10/2020 at 10:39 PM, MaybeACoordinator said:

My mom was a heroin / codeine addict who maintained on methadone for years. 

It's a long story. When I was 8, she lost all custody of me because she was in active addiction and enlisting me in her scams. (Shoplifting -- we'd walk into supermarkets and toy stores and just walk right out with whatever we wanted. White privilege, I guess, and she played on that by her calculating that store employees would think that no mother would be so horrible as to do what they thought she might be doing with her kid in tow. I guess...and when she did get busted, I was not with her, so maybe it worked.

Anyway, she lost custody of me and headed back to Texas (we were living in Nashville at the time) with my half-brother and had two more kids with my stepdad. Those were the years she stayed on methadone. Then in the late '80s she came back to Nashville because Steve Earle hired my stepfather (his old running buddy from San Antonio) to be his guitar roadie. Mama and Steve were drug buddies, my stepfather was a pothead and a bit of a drinker but no kinda addict. Anyway, he worked for Steve from about 1986 until Steve hit the wall, went to jail, and got sober, but by the time he cleaned up, mama had driven my stepdad crazy.

Even when she was maintaining, it was a massive drain on the family financially. That shit ain't cheap, and mama would only work sporadically. So every now and then my stepfather would bring up her kicking, and man, she could go from smiling to a fucking door-slamming, cussing, screaming, breaking shit viper at the mere mention of her even thinking about quitting.

So he gave up. And then along about 1991 the state of Georgia started offering a much heftier dose than what was available in Tennessee, so some enterprising Georgia MD thoughtfully opened up a clinic on the state line, two hours down I-24 from Nashville. Mama and her junky buddies would pile in a van every weekend and go down there and stock up. They all thought they were gonna get rich selling off the excess, but you know how that goes.

I'd been renting an attic apartment from her and my stepdad during that time, and it was cool to get to know her as an adult. I saw her only two or three times for a couple of hours apiece from the time I was 18 until I was 19, so the couple of years I rented from them was my chance to get to know her and my brother and two little sisters, who were then about 5 and 3. And everything was going okay, I guess, when I moved out and headed off on a trip to Europe that was meant to be three months but lasted for three years. (Eloped with an Englishwoman.)

By the time I got back to Nashville, my stepfather had booted her out of the house. She had started trading off Methadone and malt liquor and vodka and quickly become as bad a worse a drunk as she had been a junky way back when. She had driven him to a suicide attempt in one of their fights -- he picked up a big bottle of her methadone and chugged it right in front of her. He told me later he did that because he saw it as the "instrument of my family's destruction."  He recovered, barely, and she ended up running off with an alcoholic guitar player who she soon wore out and there she was again, putting another set of kids in mortal and legal danger. Eventually my stepfather got her out of their lives. I tried to take her in but she was such a disaster in her 48 hours under my roof my wife told me it was her or mama, and by this time we had my son to think about too.

So we moved back to Texas and left her up in Nashville, where she died in the streets, horribly. (Run over by a car while trying to run across I-65 in the wee hours to get another beer.)

I don't know if there was ever any saving my mom. She was hard-wired to be a junky from the time she was two or three, when she got horribly burned in a BBQ accident in Port Arthur and the doctors pumped her little toddler brain with morphine for a month. Her synapses were re-arranged then and there, and when she and a friend got ahold of some heroin sent home from Nam by her friend's GI brother, wham, she was hooked, addicted from that first hit. So she was kind of a special case, but I still want to kill that Georgia crook for opening that fucking clinic on the Tennessee state line.

 

 

Thank you for sharing. Love and peace to you and yours.

[Hornius Emeritus 12461]

On 9/3/2021 at 6:48 AM, DonkeyCigars said:

Yea I saw that. 

—

OxyContin maker Purdue Pharma won court approval for a $4.5 billion bankruptcy settlement that shields its Sackler family owners from future lawsuits over their role in the opioid epidemic. 

Not so fast, my banned friend!