Opioids

Trump Says Pain Pills Are 'So Highly Addictive.' He's Wrong.

The president wants to sue pharmaceutical companies for telling the truth about the addictive potential of their products.

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White House

Donald Trump wants Attorney General Jeff Sessions to sue companies that make prescription pain medication because they "are really sending opioids at a level that it shouldn't be happening." Here is how the president summarized the issue at a Cabinet meeting yesterday:

It's so highly addictive. People go into a hospital with a broken arm; they come out, they're a drug addict. They get the arm fixed, but they're now a drug addict.

The implication—that people with fractured bones should not receive prescription analgesics, lest they become addicted—is rather alarming. But it is consistent with Sessions' view that patients suffering from severe pain should "take some aspirin" and "tough it out." So here is an issue where the president and his attorney general, long at odds over the latter's decision to recuse himself from the Russia investigation, see eye to eye. Trump and Sessions agree that opioids are "so highly addictive" that they should be avoided, even when they provide better pain relief than the alternatives.

Wall Street Journal reporter Rebecca Ballhaus seems sympathetic to this view. Reporting on Trump's litigation plans, she says the president is trying to "combat the highly addictive painkillers linked to tens of thousands of U.S. deaths a year." There are at least two problems with that statement: Pain pills are not "highly addictive," and they are not "linked to tens of thousands of U.S. deaths a year."

Let's take the second claim first, since it is refuted by the same data Ballhaus cites to demonstrate the magnitude of the problem that the lawsuit contemplated by Trump supposedly would address. "U.S. overdose deaths from all drugs," she says, "soared to more than 72,000 in 2017, a record, according to preliminary data released this week by the Centers for Disease Control and Prevention." How many of those deaths involved pain pills? About 15,000, according to the CDC. Is that "tens of thousands"? No, it is not. Furthermore, many of those deaths also involved other drugs, including illicit opioids such as heroin and fentanyl, so it's misleading to blame them all on prescription analgesics.

Nor does the evidence support the assertion that pain pills are "highly addictive." A BMJ study published in January looked at "diagnostic code[s] for opioid dependence, abuse, or overdose" in the records of 568?,612 patients who received narcotics after surgery between 2008 and 2016. The researchers found such evidence of "opioid misuse" in 5,906 cases, or 1 percent of the total. A JAMA study published last week looked at 56,686 patients between the ages of 13 and 30 who filled opioid prescriptions after they had their wisdom teeth extracted. The researchers found that 737, or 1.3 percent, were still getting opioids from pharmacies after three days, by which time the pain from the oral surgery should have subsided. According to the 2016 National Survey on Drug Use and Health, about 2 percent of the people who used prescription opioids that year, whether legally or illegally, experienced a "substance use disorder."

No doubt these studies missed some cases of addiction. Then again, their outcome measures—"opioid misuse," "persistent opioid use," and "substance use disorder," respectively—are not synonymous with addiction. A lot of the people who fell into those categories would bear little resemblance to the addicts portrayed in the government's anti-opioid ads, who are so desperate for more pain pills that they deliberately injure themselves. On the whole, the evidence indicates that addiction is a rare outcome among patients treated for acute pain, such as the guy with a broken arm in Trump's scenario.

The risk of addiction is obviously relevant to the choices made by doctors and patients, and it figures prominently in the lawsuits that a bunch of states have filed against opioid manufacturers, which Trump wants the Justice Department to imitiate. As Ballhaus notes, "The suits generally claim the companies misrepresented the addictive risk of their medicines in marketing materials."

That charge may be true on certain points, such as as the addictive potential of timed-release opioids that supposedly helped prevent nonmedical use but could easily be crushed for snorting or injection. But to the extent that pharmaceutical companies stated or implied that the risk of addiction among patients who take opioids for pain is low, they were telling the truth. It would not have been accurate for them to warn doctors that pain pills are "highly addictive." On that point, it's the government that is guilty of fraud.

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  1. Donald Trump wants Attorney General Jeff Sessions to sue companies that make prescription pain medication because they “are really sending opioids at a level that it shouldn’t be happening.”

    Most libertarian president evar!

    1. He is. Glad you agree.

    2. He is blaming drug companies for the opioid crisis. Drug companies need to educate the public about the true causes.

      Dr. Lonny Shavelson found that 70% of female heroin addicts were sexually abused in childhood.

      Addiction is a symptom of PTSD. Look it up.

      I fail to see how drug companies are responsible for child abuse or trauma.

      ===

      I think that this is a move to strengthen the Black Market.

      With Chinese fentanyl and analogs flooding the Black Market expect more overdose deaths.

      Not to mention suicides from a lack of pain relief.

  2. Who are you gonna believe, the President, or some researchers who probably don’t want to make America great again?

    1. Trump said it, I believe it, that settles it.

      1. As in everything, you can only be as good as your advisors. Most people in the drug war, and pushing the “opioid epidemic” scare, are there to spread propaganda, and not the truth, revealed by the stats available. He is getting bad advice from the “experts”! Most patients experiencing pain, that use opioids, will never have a problem. Addicts are the people killing themselves in search of the “high”! Most have mental disorders including PTSD, chronic depression, etc. And they are not using prescription pills! They are dying from drugs laced with Fentanyl. I think that happened to Prince! He had no idea that there were careless people out there, that would endanger others’ lives, by this type of deception. If it is not from a pharmacy, you cannot tell what you are getting! Be careful, people! You don’t know what is in that bag!

        1. “He is getting bad advice from the “experts”! ”

          I doubt it. He rejects the advice he gets and assumes that he knows better than experts on virtually any issue, including this one.

          1. He rejects his own advice.

            http://www.ocregister.com/arti…..-joke.html

            In a speech delivered at the Miami Herald’s Company of the Year Awards luncheon [April 1990], Donald Trump condemned the “war on drugs” as “a joke” and called for the legalization of drugs. “We’re losing badly the war on drugs,” he said. “You have to legalize drugs to win that war. You have to take the profit away from these drug czars.”

              1. Proving once again that it’s one thing to run your mouth when you are striving for attention (not to mention political office and quite another when you’re actually sitting in office. There’s no need to compromise your principles on the campaign trail.

        2. Stats, numbers, research figures, charts are not Empirical evidence. Empirical evidence is real life evidence. A patient debilitated with one of many terrible conditions, is relieved mostly with narcotics. Narcotics prevent pneumonia caused by painful constricted breathing.Some patients can do with less or none. Every patient has opiate receptor sites that respond to narcotics for a reason, improved breathing and promoting activity.Others treat their pain with alcohol which is another issue.One of the most important points missing in these articles is the need to teach patients how to successfully WEAN OFF narcotics.Every prescribing doctor should have an RN who teaches patients about weaning off. The action of hand writing prescriptions on multiple forms to please DEA, causes some doctors to ignore the pain issue.

  3. Those are my tacos. Mine!

    1. LOL, you watch Tucker Carlson?

      I generally like that show, but that thing about the tacos was just fucking weird.

      1. Tucker is a colossal douche. He is worse than the evil douche from Sausage Party. Bro.

  4. On that point, it’s the government that is guilty of fraud.

    Wait, a WSJ reporter says “10s of thousands”, you disprove the WSJ reporter’s statements and that makes the WH guilty of fraud?

    1. Furthermore, many of those deaths also involved other drugs, including illicit opioids such as heroin and fentanyl, so it’s misleading to blame them all on prescription analgesics.

      It would also be misleading to say that anyone said what you claim they’re saying when they didn’t.

      Jesus Christ I hate to defend the WH or the media for blowing this out of proportion and enacting legislation based on lies, but it’s not like the alternative is anything resembling the truth.

    2. Wait, a WSJ reporter says “10s of thousands”, you disprove the WSJ reporter’s statements and that makes the WH guilty of fraud?

      The previous sentence, to which “that point” refers, is “It would not have been accurate for them to warn doctors that pain pills are ‘highly addictive.'” It’s Trump and Sessions who made the “highly addictive” claim. Nice try bullshitting though.

      1. “It would not have been accurate for them to warn doctors that pain pills are ‘highly addictive.'” It’s Trump and Sessions who made the “highly addictive” claim.

        Show me where anyone besides Sullum makes the claim that they aren’t highly addictive.

        It’s exactly what Ken is talking about below. This story lithely slides over the fact that lots and lots of medical professionals, including doctors, do feel like they’ve been misinformed about the dangers of these medications only briefly mentioning that the states have legitimately filed charges. All of which would be relevant to what the WH is essentially saying and could be more carefully considered in well-plotted article. Instead we get an article reminding us that neither Trump nor Sessions is a medical doctor.

        1. Show me where anyone besides Sullum makes the claim that they aren’t highly addictive.

          Why does someone besides Sullum have to make that case? He’s got a bunch of data in the post. Do you actually want to dispute any of it?

          1. Why does someone besides Sullum have to make that case?

            So rather than ‘the government is guilty of fraud.’ he should’ve said ‘I think the government is guilty of fraud.’ or ‘I think the governments claims could be considered by some to be fraudulent.’

            He’s got a bunch of data in the post. Do you actually want to dispute any of it?

            First, the numbers don’t mean shit without explanations about what constitutes ‘low addiction’. Second, if you even skim Sullum’s sources, they’re rather overtly performed by people who think that opioid addiction is, or can be, a problem. Normally, if you’re going to assert fraud, you’d need to do better than ‘Well, I think 1% is a low number, so he must be wrong.’

            I don’t disagree with Sullum. I’m fairly certain Trump and Sessions are being deceptive. I actually think it’s worse in that many in the medical profession are being deceptive as well. And if I thought that were where the real problem lies, then his article using medical professionals who buy into the ‘highly addictive’ narrative in order to prove that the President doesn’t have a medical degree is shitty and misses the point.

        2. I don’t think that medical professionals are stupid enough to believe that drugs, known to cause dependence, magically stop doing it, all of a sudden. That is another one of the myths being spread by the haters, the ignorant in medicine, and the media. It is a scientific fact that true addiction, among chronic pain patients, is much lower than that of the general population. But, we can’t let the scientific research and the facts get in the way. (sarc) When I saw drug reps, I had more knowledge than they did about their drugs. All of the opioids can be addictive! I knew that since I was ten years old. I never had drug reps misrepresent the risks of opioids to me, either!

          1. And of that 1% who fill prescriptions past the time they’re needed, it’s already a low enough percentage that a large percent of that 1% were already drug addicts, further reducing the percentage of addiction caused by pain management.

        3. They over-prescribe because if you limit prescriptions to a non-lethal amount the patients get pist off they have to pay for another office call EVERY DAY to get another prescription (and in the case of, say, a broken leg, TWO people are missing work for those appointments), because idiots in congress changed the law so refills on opioid prescriptions are no longer allowed.

          1. Not so fast. I can refill my prescription for opioid narcotic painkiller, it just isn’t automatic like, say, my prescription for blood pressure medication. The pharmacy has to route it to the doctor who has to approve it. So the renewal is more like a new prescription, and can be denied. As it happens I went cold turkey on the opioid; I had 3 or 4 nasty days and that was it. I still have the supply I had when I quit and have not touched it in several weeks.

      2. Highly addictive pisses me off! It is either addictive or not! But, addiction has to do with the mental facilities of the patient, and not the strength of the medication. It would be more appropriate to talk about the potency of Fentanyl and the fact that even a small dose, to the opioid naive patient, could cause death. So can all of the other opioids, if they are taken at adequate doses. So far, there are many opioids, and other drugs, that can addict patients. Those can include antidepressants! Beta blockers, for the heart, and blood pressure can also cause a dependence! Acute withdrawal, from them, can also kill!

  5. Thank goodness for libertarians like Jacob Sullum. He’s as intellectually honest and devoted to reason as could be. He’s focusing on the issue at hand, and he’s right about this, of course.

    In the hockey world, there’s a saying about playing the man and not the puck, and it’s usually an indication that someone has become so distracted by the physicality and emotion of the game that they stop focusing on what’s important. Sullum played the puck. I’m about to play the man.

    There’s a midterm election in ten weeks, and it’s been turned into a referendum on Trump. The things Trump is saying, here, are probably turned with an ear towards the upcoming election. If there’s anybody in the country more unpopular than the press, it’s probably only the pharmaceutical companies. The Republicans aren’t about to lose the house because they ticked off the biotech industry in Silicon Valley and Biotech Beach. They make an excellent bad guy to pillory before the election, and I think that’s what this is really about.

    I hope reason prevails, as always, and I’m glad that Sullum and others are still out there fighting the good fight.

    1. The things Trump is saying, here, are probably turned with an ear towards the upcoming election. If there’s anybody in the country more unpopular than the press, it’s probably only the pharmaceutical companies. The Republicans aren’t about to lose the house because they ticked off the biotech industry in Silicon Valley and Biotech Beach. They make an excellent bad guy to pillory before the election, and I think that’s what this is really about.

      Right, so Trump is (once again) playing off the irrational fears of the public in a way that is likely to make life worse for vulnerable people.

      1. Yeah, this is why elected politicians can’t be trusted, why democracy should be closely circumscribed to its proper purview, and why the ultimate solution to our problems isn’t electing the right politicians.

        The problem with this country is that the American people don’t want freedom, and the solution is for us to convince them otherwise. The politicians we already have are the only politicians we need. Once the America people are on our side, politicians (like Trump) will fall all over themselves trying to be more libertarian than each other.

        1. Well, that’s a nice fantasy.

          1. Accomplishing it may be a fantasy, but that’s how things actually work – pols sees a parade (Obama sees gay marriage is becoming popular) and jumps in front, claiming he’s leading it.

          2. That’s how change happens.

            Segregation didn’t end because of the CRA. The CRA happened because private citizens were taking to the streets and the American people changed their minds. The “Segregation today, segregation tomorrow, segregation forever!” guy changed his mind when the American people changed their minds, and he ended up championing integration. That’s the normal way change happens.

            The liberal politicians of California, Washington state, Oregon, and Massachusetts didn’t jump out ahead of their constituencies and legalize recreational marijuana. Those happened with referendums over the top of the politicians’ heads and in some cases against their wishes.

            I’m trying to think of a time when change came because politicians stuck their necks out ahead of where the American people were and did the right thing. That’s a fantasy. Where’s ObamaCare now? If the preexisting condition exclusion hasn’t been gotten rid of yet, it’s only because the American people want to keep that part–so much that not enough Republicans would vote for a bill that got rid of it.

            A fantasy is the idea that electing the right politicians will give us a better society. That’s putting the cart before the horse. First, you persuade the American people to want change, and the politicians will almost always be the last on board. Change happens from the bottom up. Start with your friends and family. Treat it like a church. Jesus started with 12 guys, and one of them was a traitor.

            1. P.S. The alternative to persuading the American people to want change is to inflict change on them against their will. Persuading the American people to want change is, therefore, the libertarian alternative. Everything else is some form of authoritarianism.

              1. P.S. The alternative to persuading the American people to want change is to inflict change on them against their will. Persuading the American people to want change is, therefore, the libertarian alternative. Everything else is some form of authoritarianism.

                But the core difference between libertarianism and anarchism is that libertarians will (tend to) agree that the authoritarianism of a state is justified IF AND ONLY IF it uses that power to protect fundamental liberties.

                So for instance, when SCOTUS strikes down anti-flag burning laws, or gun control laws, I would hope that most libertarians would agree that these kinds of acts are justified even though they are about an authoritarian court telling a demos that they can’t do what they want to do.

                I totally agree with you that the BEST solution is if people can be persuaded to change their anti-liberty attitudes without invoking state power at all. But if the people are stubbornly resistant to change, how long should a good libertarian wait before attempting to use the authoritarian instruments of the state to protect liberty?

                1. “But the core difference between libertarianism and anarchism is that libertarians will (tend to) agree that the authoritarianism of a state is justified IF AND ONLY IF it uses that power to protect fundamental liberties.”

                  Small state libertarians like me believe that the government ultimately only has one legitimate purpose, and that is to protect our rights. We have police to protect our rights from criminals, criminal courts to protect our rights from the police, a military to protect our rights from foreign threats, civil courts to protect our property rights.

                  In no case do I justify the use of authoritarianism. The true purpose of a jury is to establish whether the accused willingly forfeited their rights. In a criminal case, this is what is really meant by “mens rea”. When you willingly violated someone’s rights, you willingly forfeit your own. In a civil case, we’re usually talking about contract law. Enforcing the terms of a contract to which bother parties willingly agreed is not authoritarian.

                  You need to rethink what it is you believe small state libertarians believe ’cause you’re way off.

                  1. Well I view the entire state as authoritarian when it acts. Perhaps we are not referring to the same concept. Let me use an example of, say, flag burning. In this case, a superior authority (the federal government) told inferior authorities (state governments) that they had to get rid of a law that presumably had the support of the people living in those states. How would you describe that action by the superior authority?

                    But the larger point is, suppose SCOTUS had declined to get involved with flag burning issues at all. In this case, it would be up to all of us in these several states to persuade the citizens there that banning flag burning is a bad idea. Right? And some of those will be completely unpersuadable. So at what point should a libertarian get tired of trying to persuade the unpersuadable, and instead say “well, we have this other option available to us, going to SCOTUS/federal government – it is not as good as trying to persuade the people, but it would result in protecting the liberty of those who are currently denied it, let’s do that”?

                    1. No one’s rights are violated when someone burns a flag. A crime is when one person violates another person’s rights.

                      Apart from that, I don’t understand what you’re talking about.

                      The only potentially coercive action I might sanction is compelling witnesses to testify at trial.

                      The only differences I see between myself and anarchists are theoretical, but I have plenty of theoretical differences with other small-state libertarians, too. Someday, if the government ever gets so small that we have to argue about whether to kill what little of it that’s left or keep it alive, we’ll be on the opposite side of things. In the meantime, we’re on pretty much the same side until then.

                      I should say, too, that having seen an anarchist society, you might find a small state libertarian government more tolerant and committed to freedom as evidenced here:

                      http://en.wikipedia.org/wiki/Z…..ZLN.01.jpg

                    2. No one’s rights are violated when someone burns a flag.

                      I agree. But, suppose the state of Texas decides that it wants to ban flag burning, and the people of Texas are firmly supportive of banning flag burning. You and I try to convince them otherwise, but they won’t listen. So people are marched to jail in Texas for the ‘crime’ of burning a piece of cloth. If you had the option of using SCOTUS to force Texas to repeal its law, would you do it?

                    3. “If you had the option of using SCOTUS to force Texas to repeal its law, would you do it?”

                      I’m not sure a higher court forcing a lower court to abide by its decisions is an excellent example of libertarians (anarchist or otherwise) condoning authoritarianism. The difference between anarchists and small-state libertarians, isn’t that what we were talking about?

                      Yes, small state libertarians think that the government protecting people’s rights is the proper role of government. I don’t believe anarcho-capitalists are in favor of the government throwing people in jail for burning flags either. We’re talking about different justifications for doing the same thing.

                      We’re not talking about doing different things.

                      If and when the government ever gets too small for a small-state libertarians then the anarcho-capitalists and the small state libertarians will be opposed to each other on what to do. Until then, I think we’re mostly just arguing about whys and hows–not what we should do.

                  2. “The true purpose of a jury is to establish whether the accused willingly forfeited their rights. In a criminal case, this is what is really meant by “mens rea”. When you willingly violated someone’s rights, you willingly forfeit your own”

                    That is not what is meant by “mens rea”. Mens rea is Latin for “guilty state of mind”, which must be in accord with the guilty act (actus reus). So, for example, if all you did was drive you car negligently and caused someone’s death you cannot be charged with first degree murder although it can be argued that you willingly (by drinking) violated that person’s rights.

                2. how long should a good libertarian wait before attempting to use the authoritarian instruments of the state to protect liberty?

                  For as long as one values liberty.

          3. Every change in human history started as a dream in one person’s head.

            1. I’ve been thinking about meditation a lot lately, which a way to help people accept the way things are.

              I’m not sure that’s a good thing.

              Depression is when people can’t stop ruminating about the way things used to be.

              Anxiety is when people can’t stop obsessing about the future.

              Change happens when people won’t accept the way things are and become fixated on the way they want things to be in the future.

              If meditation is a way to learn to accept the way things are, then it may make people adverse to change. In an authoritarian society where the dictator is concerned about his people wanting change, he might implement a meditation policy.

              The practice started off as a way to get second born sons to forget about wanting material things so as not to split up the family land and fortune. Empty yourself of desire and you can achieve contentedness in spite of an uncertain future? I’d rather learn how to achieve my ambitions. Thank God I found my circumstance unacceptable. You’ve gotta want change.

              1. Anxiety and depression are chemical disorders. They can be exacerbated by circumstance, but they are biological in basis.

                Meditation doesn’t mean that you don’t work for change. Different schools have different teachings, but most of them focus on not attaching to the feelings. That doesn’t mean that you don’t work for change. One quote is “Pain is inevitable. Suffering is optional”. That doesn’t mean you don’t work to lessen pain. It means you don’t let it cause suffering.

                As to your original question, many changes in attitude followed changes in law. Interracial marriages are now nearly universally accepted. School integration was done at literal gunpoint. Acceptance of gay marriage has jumped since the Obergefell ruling.
                Much of this is due to generational change. You can’t convince the old people to change, but the young people who never knew any different don’t need to be convinced.

                1. And George Wallace a decade and a half after the Civil Rights Act.

                2. Anxiety and depression are chemical disorders. They can be exacerbated by circumstance, but they are biological in basis.
                  This was a theory put forth in the sixties by, iirc, the company who were marketing Valium. It was not proven, and I would like to see your cites for this.

                  The brain is fascinating. It seems that we have yet to prove that anxiety and depression are even disorders or dysfunctions.

                    1. No, no, my bad. Let me clarify. I didn’t mean for you to cite the minimum to satisfy you, I meant I’d like you to cite the minimum to satisfy me. And there’s an unrelated cite about sheep in there, so it’s kind of saying insulting things about how low my scientific standards are. Bro, I’m not like that.

                  1. I tend to agree with you. Anxiety and depression can be exacerbated by chemical disorders, but most of the time they represent how people think. Circumstances have something to do with it but not entirely. Read Victor Frankl’s Man’s Search for Meaning.

                    1. Thoughts are electro-chemical reactions in our brains.

                      Meanwhile, what bout the suggestion that depression and anxiety are “chemical disorders” negates the idea that depression is ruminating about the past and anxiety is obsessing about the future?

                      Meanwhile, anxiety and depression aren’t even psychoses. Paranoia is a psychosis. Paranoia is not anxiety. Schizophrenia is a psychosis. Depression is not schizophrenia.

                      Anxiety is a perfectly healthy thing–when the future is authentically scary for whatever reason. Ruminating on the past is perfectly reasonable–when the present and future are dark and formidable. These are not chemical disorders–that can be cured with medication.

                      If your wife has left you because your business failed and you lost the house and she’s taking the kids and you have to go compete with 30-somethings for a new entry-level job to pay child support and you have to move into some shitty studio apartment and your life will never be as good as it was again, then ruminating on the past and obsessing about the future are not chemical disorders. They’re rational responses to your circumstances.

                    2. Medication doesn’t even cure these “disorders”. Antidepressants and anti-anxiety medications simply take the edge off. If your present and future were bleak and you didn’t feel depressed or anxious about that, then you might have a chemical disorder. Lots of anxious and depressed people are reluctant to take medication for precisely that reason–they think that it’s going to make them irrational, when the reasons they’re depressed or anxious are perfectly rational. It simply doesn’t work that way. Your circumstances are the issue, and medication doesn’t change that. It just takes some of the pain away–like taking a Tylenol can help treat the pain of a broken leg.

                      Meditation trains people to focus on the present–to get the upper hand on the forces that pull your mind to obsess about the future or ruminate on the past. It’s training your mind to prefer the present. There has been a lot of discussion about meditation in Silicon Valley recently, where many of the companies offer yoga and meditation classes to their employees. These companies are all about abhorring the present and wanting to change the future. The open question is why a company would want engineers and software people to learn to live with things as they are–when they’re supposed to be hating the present and changing the future.

                    3. The circumstances in this present? Happy Chandler is a buffoon, who think he’s here to enlighten us rednecks on science, truth, sophistication, and culture. He has no idea what he’s talking about, and he thinks he’s talking to people who are far beneath him, but he’s flailing about because what he’s finding here is far different than what he expected. He’s basically a slightly more informed version of Tony, like Tony he believes in the left, but he doesn’t really know why. He thinks the reason we’re not progressives is because we’ve been misinformed or because we’re uneducated, and it still hasn’t clicked for him that he’s either conversing with people who are far ahead of him or that the reasons libertarians believe what they believe isn’t for the reasons he thought. He’ll either morph into Shrike when he realizes what a fool he’s made of himself, or, like all the other lefty trolls, he’ll disappear eventually. His whole world view is based on a house of cards, and he doesn’t have the integrity necessary to be persuaded to change his mind. It’s both pathetic and typical.

                3. You’re a moron.

                  1. Above meant for HC, in case that wasn’t entirely obvious.

              2. This is quite a compelling line of thought, Ken.

                It’s kind of looking as if we all went to our respective corners to think. I like it.

  6. I’ve got to be completely honest here and admit that I approach this particular subject with more emotion than reason, because of the suffering my mother had to endure in the final years of her life due to government imposed limitations on how much pain medication she could get. But I’ll say it anyway: Trump and Session can go fuck themselves with a rusty chainsaw.

    1. Agreed! They are being ignorant because the information they get is not true! Nothing more stupid than calling something “highly addictive” Opioids can be an avenue whereas vulnerable people can become addicted. Since most people don’t abuse their pain pills, addiction, among them, is not at all common!! The intentional abuse, paired with occult mental disorders, brings on addiction. It does not automatically happen because people get a pain pill prescription! That seems what the ignorant want all of the rest of you to believe! I am a chronic pain sufferer, who was a pain practitioner in the past.

  7. That’s all fine and good, but the precautionary principle says fuck you drugs can hurt people sometimes.

    1. The drug war hurts people ALL the time.

  8. To be fair, Purdue did pay over a half a billion dollar fine for misleading patients and practitioners on the addictive potential of Oxycontin compared to previous formulations. This lead to misleading prescribing instructions and a long delay before the black box warning went on the label.

    The studies aren’t relevant to much of the way it was prescribed, concentrating on patients coming out of hospital trips who are more likely to be closely monitored rather than ones on long-term use, who are much less monitored.

    The addiction potential is much higher for the ER tablets than the IR tablets. I’m not sure the convenience of an ER formula is worth the risk.

    1. Then don’t take the risk.

      1. When the risk is hidden from the medical professionals and patients, one cannot accurately assess the risk.

        That’s why Purdue and it’s execs had to pay over half a billion dollars. Their lies contributed to this crisis.

        1. The addiction potential is much higher for the ER tablets than the IR tablets. I’m not sure the convenience of an ER formula is worth the risk.

          Then don’t take the risk.

        2. The risk is not the medicine. The risk is taking the medical professionals word that something will work out.

          If you dont trust the doctor, drug company, or other professional, dont risk it.

          Lefties love to get rid of moral hazard and let Government protect you. Government never does.

    2. The studies aren’t relevant to much of the way it was prescribed, concentrating on patients coming out of hospital trips who are more likely to be closely monitored rather than ones on long-term use, who are much less monitored.

      The second study, that Sullum claims as evidence of ‘low addition’ actually drives right to the heart of this. The longer the patients were on the opioids the more likely addiction becomes.

      Sullum cherry-picked the data to inform us that Trump and Sessions are being deceptive in giving their not-medically-informed opinions.

  9. Opiates can be addictive but the government needs to get out of the drug war business.

    1. In two sentences, you and Incomprehensible Bitching have written a better article than Sullum. Without a single citation no less.

  10. Yet another quote from the idiot in chief. His ignorance of everything is astonishing.

    Who cares what he thinks. The rest of the country is just working around it.

    No people with a “broken arm” do not come out of the hospital as “addicts”. That is ignorant on so many levels I do not know where to start. Neither are these drugs by any means benign. They are dangerous and it takes a professional to prescribe them under safe limits.

    We are listening to a fifth grader talk about neuroscience.

    1. Can you blame him? Trump does not use drugs. He’s a boomer, so his life consisted of Free Love 60’s and 1970s and then the War on Drugs started.

      Guys like Pence are drug warriors.

      Trump is doing surprising well with so many drug warriors whispering in his ear.

  11. You know what’s highly addictive?

    I’ll tell you what’s highly addictive!

    Government power – this is the most fucking addictive substance ever known…

    And it’s a fucking joke that the ideology which created the beast of the federal government – the fucking socialist ass hats, Woodrow Wilson, and FDR the socialist god…

    this ideology made the Executive Branch so Powerful with the fucking President as a Potentate – with fucking awesome powers to wage war without congressional consent, and even have a secret Kill List.

    This ideology is responsible for the power of the Trump.

    Yes, the socialist ass hole ass hats are those to thank for giving The Donald such awesome fucking powers.

  12. The author has never lost someone who OD’d …. and who got there using pain pills as a gateway drug. In these cases, opioid pills are not the cause of death. Genius!

  13. It’s not surprising. Trump and his associates probably get most of their information from TV news and the press, all of whom are just plain ignorant about this issue among others.

  14. As usual POTUS has a 10-year old’s explanation for things he doesn’t understand.

    A while back, I sat through a presentation on opoid abuse by a doctor from a major research university. Four takeaways stuck with me:

    1. There is no upper limit to the amount for opioid dosage. Over time higher and higher doses are required to obtain the same effect (whether it be pain relief or to get high). Overdoes happen if someone withdraws and returns to the previous dose, or gets some unexpectly potent street drugs.

    2. Longterm opioid use/abuse permanently rewires the brain, making withdrawal/abstinence very difficult, and nearly impossible for some people. It’s not a matter of lack of willpower.

    3. For some people, injecting opioids produces intestinal convulsions that are not unlike an orgasm. With a feedback mechanism like that, no wonder some people get addicted.

    4. Most people who use opioids, especially for short term use, do NOT get addicted.

    A few years ago I had surgery to repair 4 broken bones in my right foot. After the surgery, there was a port on the back of my hand. A nurse came by and asked how the pain was. I replied “Not so good.” Watching her pull the plug and insert a hypodermic filled with morphine and press the plunger. I thought to myself, “This is NOT a road I want to go down.” Fortunately, I got no joy (and not much pain relief) from morphine; I just didn’t care.

    Recovering from opioid-induced constipation was at least as painful as post-surgical pain.

    1. That is because most pain medicine has the mechanism of making one not care! Until we figure out a better avenue, we are stuck with those. I remember having a terrible response to Dilaudid IV in the post -op area. After I was in the room, the PCA (patient controlled analgesia) was not helping. I asked for Toradol, a strong anti-inflammatory, instead. It was a miracle! The pain stopped, completely! Sadly, since I had so much opiate in my system, I became overdosed! The pain is actually a good antidote to the narcotic affects of the pain medication. Once the pain was gone, my body read me as an opiate naive patient, and placed me in danger. It was an outpatient hernia procedure, yet, they kept me overnight, because I had to be placed on an apnea monitor to make sure I did not stop breathing from the respiratory suppression of the drugs. They can be a very complicated medication to use! I learned about the more modern techniques in pain management from Dr Peter Pan and his associates, as a general surgery resident. And, that is no joke, the anesthesiologists name was Peter Pan!!! My pain management mentor, Dr Amato, was an associate of Dr Pan. Sadly, the pain management education has not improved since I was in medical school and residency in the early ’80-s! The old guys like it that way. It makes them look less dumb because they don’t do a good job at keeping up. The old guys are still running the show.!

      1. Good for you that Toradol worked. People with longer pain crises have 16-20 dose limits of Toradol because it can cause bleeding and kidney damage.In prolonged hospitalization, patients requiring 16-20 doses of Toradol get lab draws to determine if their bleeding times, kidney values and platelet levels are OK. 2 years ago we finally realized how chronic Tylenol use can cause severe liver damage. Dosages for Tylenol [acetaminaphen] were cut by 35%.

  15. How do the figures within this article compare with alcoholic beverages and especially nicotine/cigarettes?

    Are not the issues related with addiction to those substances far more severe than with Opiates?

    Two matters notably unmentioned in all the media hyperbole about “opioids” is physicians prescribing them for continued usage (rather than on and off), and that such are available only in compact, thus more potentially easily abuse-able form. Recall how medications more than a century ago where generally far bulkier and dilute.

    Seems to me that the media hyperbole, especially since about 2010 when they started touting the phrase “opioid epidemic” is but a ruse to continue the drug war as Cannabis becomes legalized, as well as distracting from the medical profession ‘s unwise reliance on compact (greater profits per shelf space), and the regular use of such medications.

    Certainly if the concern were truly about “addiction” they would invoke against the OTC sale of cigarettes, which are generally by definition adulterated for lacking labeling as to their ingredients.

    1. Alcohol still kills more people per year than narcotics.Approximately half of narcotic overdose victims were also drinking.A part of that number were dosing on pain pills, drinking and taking muscle relaxer pills.

  16. I just dont see a problem with any of this. Other than the price of pain meds being too high.

  17. Wow. Trump opened his mouth a lie came out. Shocking.

  18. Wow. Trump opened his mouth a lie came out. Shocking.

  19. Remember Reefer Madness? The Opioid Epidemic is more of the same propaganda, except nobody ever died of a Marijuana overdose. I had opioid prescriptions from the VA for years. I might go months without taking any for a host of things causing chronic pain, but it was good that I had them when I needed them. No more. The VA is now so scared of being accused of overprescribing narcotics that they have taken them away from people who never abused them or became addicted to them. Now we can suffer, buy illegal ones to both deal with and become criminals, or we can take other inferior products with horrible side effects.

    End the War on Drugs. It is a travesty and a war on humanity.

  20. This president completely ignores thousands of children, teens and adults. who suffer severe pain crises with Sickle Cell Anemia, Cancer,Thalessemia, major bone surgery and more.I have been assigned as an RN to hundreds of cases of such patients over 30 years who require narcotics to breathe deep and prevent pneumonia. Children in crises to adults adults in crises, we managed their pain with a flexible plan from the beginning about WEANING OFF.Most of these patients equate narcotics with their hospital illness experience and prefer to live without the pain and the narcotics.These are the patients whose treatments will be immediately affected by a president who knows not what he is talking about.Pneumonia secondary to restricting breath because of pain is not a political issue.

  21. Kind of an understatement to offer one example of a government statement as fraud. Government is predicated on fraud. And relying on government is a dangerously addictive habit.

  22. It’s truly amazing that Reason again ipushing drug use. In the past Reason has promoted the extreme psychotropic drug – LSD. Now Reason is pushing pain killers, about which President Trump is absolutely correct that they are way over prescribed.

    Perhaps Trump used a poor example. when he spoke of a broken arm. Nevertheless the vast majority of people and their doctors don’t look for the cause of the pain being felt. Instead they use a drug to cover it up. Then not feeling the pain any longer, they think they’re cured.

    Reason is promoting the drug industry, which it should not be doing. Reason has taken a very shameful position in it’s support of the drug industry.

    1. That’s not really true, though. There are a few doctors out there jumping to medication first, but it’s certainly not the vast majority. The vast majority of patients on long-term pain medication went through years and years of testing to find a cause. For many of us, they did find a cause, but it’s a rare genetic disease that doesn’t have any treatments. Pain medication allows people like us to live normal lives even when we can’t be cured. It’s not “shameful support of the drug industry” to be in favor of that.

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