At First a Lifeline, Then a Noose

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February 4, 2014 | 6 Comments

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  1. It is difficult for me to talk about these pain meds without shivering. First, let me say that I have always been sensitive to Rx medications of all kinds. I also come from a family where pain meds were accepted because my father suffered chronic pain . No one likes to endure pain. However, my physical constitution could not tolerate the pain meds Drs. prescribed to me and the list included Vicoden, Kadian, Talwain, Oxycotin, Soma, …when I encountered pain from migraines, and surgery for a torn rotator cuff a few years back. The headaches were chronic and thought to be ‘occipital neuralgia’ according to the neurologist. I could not function daily on the course of treatment with pain meds. Sometimes my eyes would roll back in my head and I’d just momentarily collapse. Luckily this never happened while I was driving. My blood pressure became so low it was regarded as an unsafe level to exercise at a local gym. I developed a slightly leaking heart valve during this course of treatment. I experienced much “fantastical” non-reality thinking. I knew something was wrong, but I did not know what. I stopped taking the medication after the syncope events resulted in numerous ER visits. I was being tested with Cat Scans, MRIs, Heart Caths, and many other expensive procedures because of what I now believe were side effects I was experiencing from multi medications that I was sensitive to. I am lucky to be here without having experienced addiction that lead to death, or without more physical damage than I currently have. My headaches diminished after stopping the Rx prescribed to treat them. I still have chronic pain from some arthritic conditions but I no longer am on the pain med merry-go-round that could have resulted in death, or unending invasive tests and procedures to determine what was wrong with me. Side effects are experienced differently by everyone. When patients complain of strange symptoms, why is it that doctors don’t look at the pharmaceuticals the patient is taking, but opts to perform expensive, and sometimes invasively dangerous, procedures/tests to “look for the cause” ?? Well, there’s probably more money to be made that way would be my guess. I used to be naïve about how the health care system works, but no more. I feel that I was abused by the health care system in more ways than one. I could write a book as I have had hideous experiences with psych meds also. One thing I know is that the problem currently experienced could have been brought to the public’s attention if the Medical Boards wanted to highlight it years ago. I submitted numerous complaints about my care because I was fearful for public safety. I thought surely, someone needs to know what is happening. That was about 10 years ago. Even sent them copies of pharmacy records. The bottom line is, doctors stick together like glue and it’s called a “regional standard of care.” Hey, that’s just the way they roll in these parts, yeah? Well, as they say, good luck with that. I’ll never go back to any of them. I’m better now. Off Rx meds for 8 years and have a new hobby. I’m no longer just more fat for the wheels of the corporate greed machine called “health care” in the US. It was quite an education! With the opiate abuse or as it is called “hillbilly heroin” so prominent in Appalachia districts, and thanks to Insurance Laws, now, everyone can get an “education” except that it comes with a death certificate instead of a diploma usually. I’m very lucky.

  2. John Hempton of Bronte Capital posted the following on his blog two days ago and has given permission to add here

    Get your opiates for free: Capitalism meets the zombie apocalypse
    Posted: 02 Feb 2014 11:02 PM PST

    I think I have found a new low in the pharmaceutical industry: giving away a month’s free supply of potentially lethal high-grade opioids.

    This ambitious marketing strategy allows more than enough time and supply to create addicts.

    The company is Galena Biopharma and their product, under the marketing name of Abstral is sublingual Fentanyl.

    Fentanyl according to Wikipedia is a potent, synthetic opioid analgesic with a rapid onset and short duration of action. In other words you get really high, really fast and it doesn’t last long. Also according to Wikipedia it is “one of a small number of drugs that may be especially harmful, and in some cases fatal, with just one dose”.

    Fentanyl has a legitimate use – for intense “breakthrough” pain spasms for someone already being treated around the clock with a heavy opiod like morphine. The legitimate user is probably a terminal cancer patient with bursts of pain so intense that morphine just doesn’t cut it. In that case the seriously addicting properties of the drug are not particularly relevant and the benefit of use is indisputable.

    Outside that it is hard to think of a good use for this drug.

    The drug has killed plenty of people including a few notable rock-n-rollers. Read Wikipedia for the gory details.

    Galena’s hot new product is a sublingual version of an old drug. The marketing (on their website) argues this drug is really fast. To quote: “Patients preferred Abstral for speed”.

    However to give it that extra marketing pizazz they are giving it away. Here is the pitch – which I believe as a matter of policy should be criminalized.* [I note that tobacco companies are not allowed to give free samples of cigarettes – and it is curious that same does not apply here.]

    See Bronte Capital BlogSpot for the picture

    The advert has an irony of its own. It shows a new-age style woman completely blissed out (with a smiling kind) and the slogan “time better spent”.

    We have US corporations doing hippy alternative lifestyle drug marketing for drugs that are especially effective in turning you into a zombie. Capitalism meets the zombie apocalypse.

    It is as if Tim Leary was reincarnated as a cynical capitalist going for the mega dollars.

    • This post gave rise to a lot of informed comment – pointing out that the woman in the advert was almost certainly a cancer victim and mentioning some of the gimmicks companies use to sell new branded drugs in the face of generic competition and that JH might have been over-reading the degree of evil.

      But it seems likely as Steve Rummler’s case shows JH was not guilty of over-reading the evil but perhaps missed how banal it can be. There will always be a case for pain relief in cancer and related diseases and the free supply for a month or discounted coupons trick are ones that many companies marketing non-addicting drugs use, but as the story of the last 20 years have shown the real market for all these drugs is never the hard-core of patients who need them but the vast penumbra who don’t and who are positively harmed – like Steve Rummler.

      The banality lies in the fact that the company people and those commenting on JH’s blog post miss the bigger picture and bring the zeal of getting pain relief to the terminally ill to the marketing of dangerous opiates to people with minor complaints. “Turning” doctors is all too easily done.

  3. Oh, by the way, I still have chronic pain; I’ve learned to cope with it through art therapy, and natural alternatives, like melatonin and/or valerian herb to help sleep. My diet is healthier and I neither drink alcohol or smoke. My enjoyment of art/sketching diverts my attention away from chronic pain (arthritic conditions/fibromyalgia/PTSD) and allows me to feel better. The one thing I have learned from experience with pain, is that “the more your focus on pain; the greater the pain is.” I have had no training in art therapy and taught myself this coping strategy. If I had not, well, I don’t like the thought of just being another statistic. I don’t think we need more addictive pain meds. I think we need more inquiry into natural methods that one’s body may find more adaptive to living with and managing chronic pain as opposed to total eradication of feeling that can lead to death. This epidemic of pain medication abuse that seems too often to lead to heroin or death needs to HALT. It has consequences for ALL of society. I remember pills in the past that were widely prescribed and then taken off the frequent flyer market. “Diet Pills” in the past caused so many problems for whole families because of mood swings, addictive behaviors. Pills–any pills–used unwisely have consequences for children in homes where the Rx “abuse” occurs-often in more ways than one. Doctors who prescribe without forethought or suggesting alternative methods of alleviating pain to their patients, in my opinion, are guilty of abuse. They are abusing the privilege of trust and dignity of their profession. Shame on them.

  4. Actually the drug cos are not even giving it away – they’re getting paid. Here’s how it works:
    Abstral retails for a cool $2,495 a month or more. You think I’m kidding?

    http://www.goodrx.com/abstral

    My insurance company does NOT want to pay. You’d hope they’d control costs by making sure only “appropriate” patients get this drug (mainly folks with terminal cancer). And to be fair, some insurance cos take the time to screen ethically. But most will just slap an extremely high co-payment on the patient, from $100 to as much as $500. It’s pure financial “screening” which may put the drug beyond the reach of those who need it, while the well-to-do will get the stuff even if it kills them.

    So, if my insurance demands a copay of $300, Galena will step up & make my first few scripts “free” to me – then collect $2,200 from the insurance company! (Or a bit less, maybe, if they’ve negotiated a lower rate.) Of course, if this “compassionate” discount goes away after the first few scripts, what am I going to do, quit? Oh, I don’t think so. (When I worked on the railroad in the 70’s the dealers who hung around the yard used the same trick – minus the insurance angle of course…)

    Here’s another thing: If Fentanyl costs that much at the pharmacy window, how much do you think it fetches on the black market? And how big is the temptation for a broke disabled person (drowning in medical debt and facing foreclosure, maybe) to sell their script? Fentanyl is one of the scariest pharmaceutical drugs now being sold on the street, from Duragesic patches to heroin cut with Fentanyl, which has killed 22 people in Pennsylvania in the past few weeks with similar outbreaks in other areas.

    A small (but not that small!) number of doctors funnel these drugs onto the street knowingly and consciously; a larger number end up doing so inadvertently. But drug companies in the past decade or so have made millions, maybe billions, with the added luxury of not having to know where the money is coming from. Or, well, not exactly …

  5. My story is almost a mirror image of Barbara’s with one big difference…..I still take 30mg of morphine 4 times a day everyday. I have been searching for years for a non opiate and/or all natural alternative without success…..yet. My pain management doctor told me the FDA just approved a new medical device that is very similar to transcranial magnetic stimulation that we both hope might be the alternative answer I have been searching for. Now all we have to do is find out where you get the darned thing. I have tried so very many different medications and treatments in an effort to live an opiate free life with a tolerable pain level always to end up back on the emergency room merry go round within six or seven months. I even tried a 21 day inpatient lidocaine infusion treatment which left me with a tolerable level of pain for four months,,,,,but then it wasn’t tolerable anymore and I felt like my only choices were suicide or the emergency room. So here I am walking along the worlds most dangerous tightrope….suicide and intolerable pain on one side, addiction and all its associated trappings on the other, and hell underneath. I see a psychologist specializing in dealing with pain, I meditate and practice mindfulness everyday, I have a spiritual practice, I work with a nutritionist to optimize my diet to reduce inflammation, I practice yoga, and I still live on morphine everyday. All I want is to find a way to function daily without morphine and have a pain level that is tolerable. As of now, I’m still searching and praying that I can stay on top of that tightrope one more day.

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