Opioid Crisis in OK; Who’s to Blame?

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tRidiot

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Lose a Close Friend or Family member due to Chemothearpy Drugs and see how you feel about that. Who is responsible when CHEMO KlLLS the Patient???

Same principle-Different Drug

Wait... you do know that chemo is poison, right? Like... that's the intention of the drug. To kill the cancer before it kills the patient, if the patient is lucky. Sometimes it doesn't work out that way. Would it be better to ban chemotherapy?

Interested in your experience on the matter.
 

tRidiot

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I worked in Healthcare for nearly 39 years as a Registered Respiratory Therapist with the last 24 years as a Director of Respiratory Care Services. All of my time was spent in Acute Care Hospital settings. My duties ranged from clinical care to management with added assignments outside of my immediate area of responsibility like Medical Waste and HAZMAT Coordinator; Paperless Charting Development; Safety, Medical and Pharmacy Committees.

From 1981 to 2009, I was responsible for insuring that my service areas were compliant with standards of care, state and federal regulations, legal requirements, and quality of care standards as described by the JCAHO and HCFA (now CMS).

As I recall, in the late 1980s or early 1990s, JCAHO and HCFA jointly developed Quality of Care Goals and Quality Improvement Goals (later years adding Patient Safety Goals) with which Hospitals and Clinics were required to document their compliance and track their performance.

Well, I think around 1994-5 these agencies came up with a Pain Management Patient Care Goal. To achieve compliance with this goal, criteria were established that set standards that all medical records reviewed were expected to demonstrate. Patients were issued a Patient Bill of Rights on admission where they were informed ‘they had the right to be pain free’.

Physician Documentation of Pain Assessment was required in Medical Records in the ‘History & Physicaal’, ‘Initial Assessment’, ‘Patient Care Plan’, ‘Progress Notes’ and ‘Discharge Summary’.

Nurses were required to independently document Pain Assessment in their ‘Initial Assessment’, ‘Nursing Care Plan’, ‘Nurses Notes’-and ‘Discharge Notes’. Ancillary Services providing direct patient care had virtually the same charting requirements as Nursing.

JACHO and HCFA (CMS) inspect and grade Hospitals and Clinics for compliance with numerous standards. They can be ruthless on facilities that don’t measure up to their standards. Accreditation is awarded for passing institutions. It is important because Medicare/Medicaid Reimbursements are denied for facilities that fail Accreditation.

Patient Surveys to insure Patient Satisfaction were implemented. Pain Control was assessed from the patient’s perspective. Data from these documents was fed back to evaluate Physician/Nursing/Other Practitioners Performance. This feedback mechanism coupled with the emphasis on documenting Pain Assessments and Interventions drove Physicians to increase the use of narcotics and opioids because patient dissatisfaction with pain levels negatively impacted their performance evaluations and careers.

I went through this whole conundrum because before the beginning and of the Opioid Epidemic it was the idea of the government’s HCFA/CMS and the JCAHO to use patient perceptions of pain control as an Accreditation Standard that caused the increased prescription rate for narcotics and opioids by Physicians. And he crux of this is.....patients reporting of their pain levels are unreliable! I’ve seen patients that are laughing and moving around freely report Pain Levels of (10) on a (1-10) Scale.


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Thank you for posting this... this is an example of administration and bureaucracy dictating certain treatments, even though physicians often know it is detrimental. People think physicians hold the ultimate authority in the treatment of a patient, but nothing could be further from the truth - physicians hold the ultimate RESPONSIBILITY and BLAME if something goes wrong - but are far far far from dictating appropriate treatment.
 

filbert

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Please share more about the perks and kickbacks the doctors are getting. Really - specific examples would be helpful. I'm curious, because I am unaware of a single perk or kickback ANY physician receives for the prescribing of ANY particular drug. So, since you have definite and specific knowledge of these things (having made these claims multiple times), I would like to know more about it. I think the public deserves to know, don't you?

Thanks.
I second that tRidiot, show use the evidence Tanis143.
 

tRidiot

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I'm just saying.... there is a VERY common misconception out there in the public that doctors have some kind of incentive to prescribe certain medicines, when nothing could be further from the truth. With the exception of direct business from bringing people into the clinic for pain medication (i.e., the reimbursement of the cost of the visit itself), I know of NO form of kickbacks or incentives the pharmaceutical reps or drug companies can or do provide to prescribers. In fact, most of this is specifically prohibited by law. With the exception of the occasional steak dinner where they invite doctors out to listen to a specialist talk about the medicine - these specialists are paid for their time, yes, but that isn't for prescribing, just for speaking and answering questions about their experiences with the medication.

So I'm actually interested to hear if @Tanis143 has any actual experience with this or is just spouting off the misinformation commonly believed by anyone who wants to denigrate medical professionals and the pharmaceutical industry.
 

druryj

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Saying that Doctors or anyone is getting rich from taking "kickbacks" off opioids is silly. The stuff is CHEAP. Here's a link to a site that will give you pharmacy prices; just type in your medication and it pulls up pricing in your area, and most of the info is if you pay cash. I posted the link with morphine as the example. Morphine is like $20-25 for 60 30 mg tabs; how is anyone getting a kick back to prescribe that? Duh. Look at Percocet, Fentanyl, whatever...the stuff is cheap! Now on the street, well, that's a different story. But we are talking about prescriptions; nobody is making serious money prescribing opioids. I am sorry some people feel doctors are taking kickbacks or get perks to prescribe opioid medications; I just do not think that's a real problem, not at all. There's just no money in opioids people, it's too cheap to buy at your local pharmacy.

https://www.goodrx.com/morphine-er

Seriously, it costs much less to get a months supply of Morphine than it does to get Cable TV.

(I blame the cost of cable TV on unscrupulous cable guys about as much as I do unscrupulous doctors for the opioid crisis)
 

Fredkrueger100

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Man, my deal is nothing compared to yours. And yeah, opioids play hell on your digestive system; constipation sucks. If I do 2 pills a day for say 3 or 4 days, I gotta swill that magnesium sulfate stuff (like drano for your butt) or I’m in deep do-do.


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I have to drink two scoops of miralax every single day and drink a lot of water and I still have issues with constipation. Suboxone causes it extremely bad. But I also have a disease that affects my digestive tract and just about all the rest of my body so I’m pretty much up against a wall.
 

Fredkrueger100

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Saying that Doctors or anyone is getting rich from taking "kickbacks" off opioids is silly. The stuff is CHEAP. Here's a link to a site that will give you pharmacy prices; just type in your medication and it pulls up pricing in your area, and most of the info is if you pay cash. I posted the link with morphine as the example. Morphine is like $20-25 for 60 30 mg tabs; how is anyone getting a kick back to prescribe that? Duh. Look at Percocet, Fentanyl, whatever...the stuff is cheap! Now on the street, well, that's a different story. But we are talking about prescriptions; nobody is making serious money prescribing opioids. I am sorry some people feel doctors are taking kickbacks or get perks to prescribe opioid medications; I just do not think that's a real problem, not at all. There's just no money in opioids people, it's too cheap to buy at your local pharmacy.

https://www.goodrx.com/morphine-er

Seriously, it costs much less to get a months supply of Morphine than it does to get Cable TV.

(I blame the cost of cable TV on unscrupulous cable guys about as much as I do unscrupulous doctors for the opioid crisis)
Look up suboxone. If I didn’t have good health insurance I couldn’t afford to be on the stuff and I would probably either be dead or in prison from still being an addict. This is the biggest problem with pharmaceutical companies. They know people need a specific drug and they charge 10-20 times what they should. I get 90 suboxone films every month. Well now I get a generic that they finally released. But even it’s expensive. Just like my Androgel. But it just got a generic as well. For 90 suboxone films it would cost somewhere near $700-$900 a month!! My parents paid that for me for a few months until I got clean enough to get a job. My wife didn’t have the great job she does now she we couldn’t afford it. I know that a lot of people are poor enough to get assistance but I wasn’t. I would say a big majority isn’t. I see all walks of life in my doctors office. From low life’s to businessmen and women. My cousin works at tinker as a mechanic and he goes there too. The government could easily end the pharmaceutical companies from ripping people off but they don’t because I’m sure they have deals with them to make money. After all that’s all the government cares about. Well that and power. The opioid crisis could be significantly fixed if they actually wanted to. But they don’t. They want people addicted. That’s more money for them and their big Pharma donors. As a matter a fact, my doctor told me the DEA has been pushing them to get rid of long term patients like me and my cousin. They don’t care what happens to us.
 

druryj

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Tony, you said in an earlier post that your drug problem was 100% on you. You said you were saved by finding a doc who could/would give you suboxone. I believe it takes a specialist of some kind even. And surely you don't really believe the government is all bad? I think there's a lot of decent people who make up this thing called "the government".
I also don't think the corruption is as widespread as you make it out to be...come on; have some faith man! And to have the government control how much a company can charge for its product? Doesn't that smell a little like democratic socialism? Wait...you aren't a Bernie lover are you? An admirer of AOC? Oh say it isn't so! Tony! Noooooo!
 

Fredkrueger100

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Tony, you said in an earlier post that your drug problem was 100% on you. You said you were saved by finding a doc who could/would give you suboxone. I believe it takes a specialist of some kind even. And surely you don't really believe the government is all bad? I think there's a lot of decent people who make up this thing called "the government".
I also don't think the corruption is as widespread as you make it out to be...come on; have some faith man! And to have the government control how much a company can charge for its product? Doesn't that smell a little like democratic socialism? Wait...you aren't a Bernie lover are you? An admirer of AOC? Oh say it isn't so! Tony! Noooooo!
I am most certainly NOT a Bernie or AOC supporter. Not even in the slightest. I don’t know what the answer is. I just know it will probably never be fixed. As for the government. I don’t trust them. They are the enemy. The “government “ I am referring to is congress and the senate. But I could throw in some others too. They are after control over us. And they will do anything to get it. The only thing I have faith in is God and Jesus Christ. I know I always sound negative. I just see the world for what it is and what it is gonna be.
 

CHenry

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In my experience many Drs simply don't know alot about the drugs they are prescribing. Not saying they should because they are a MD and not a pharmacist but that seems to happen to me a lot.
 

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