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Ah, so it's the pharmaceutical industry's fault for getting folks hooked on opioids. You know, I'm starting to think that maybe most of the issues this country faces could be quickly resolved by eliminating capitalism.
No it's the opposite this time. Guy couldn't get pain medication literal days after back surgery. This is like the one case where giving someone opiates is appropriate.
Also opioid overdoses have gone up even though doctors are prescribing much less of them in the USA. Almost as if this is war on drugs all over again...
Oh, I totally agree, I must not have stated my point clearly.
I agree that not giving someone drugs for fresh surgical pain is fucking horrifying. I still see the root cause as the backlash to precious over-prescription
It's more that the capitalist system goes though cycles of over prescription of opioids, followed by under prescription, depending on various factors. Never settling on a working baseline. There was a good article about that, I'll try find it soon.
I’ve been thinking about this topic lately and am specially focused on the role of doctors in both the over-prescription and how the overly conservative in Rx.
To me it seems like doctors are typically treated like they are these irrelevant, mere cogs in the system who had little or no agency. I had accepted that was how it was and didn’t really think about it.
But these are the guys making hundreds of thousands of dollars, who supposedly are some of the most dedicated and brightest individuals out there, and who go through extensive training.
As far as I’m aware there wasn’t a massive academic fraud scheme showing that OxyContin was the best opiate, wasn’t addictive, etc All the scholarly/clinical research suggested it was pretty much like any other ol opiate
Which basically means doctors didn't and still don’t actually keep up with accurate knowledge. Instead they are swayed by some ‘attractive’ former college athlete who says they are not only the smartest person they’ve ever seen but the most attractive as well - now sell oxy. (This is how it was explained to me by an academic psychiatrist)
We are suppose to excuse doctors for being easily swayed by sandwiches and ass? :spray-bottle:
(Of course Purdue or whoever is also horribly evil and makes a great example of what pure capitalist drive leads to)
Which basically means doctors didn’t and still don’t actually keep up with accurate knowledge.
This is self-evident to anyone who's ever had any sort of complex medical problem. They are usually jerks about it as well. Shout-out to the one doc who actually went on UpToDate in front of me to confirm what I was saying about updated standard of care instead of telling me to "stop googling" like the rest of them.
Well, root cause as capitalism really; direct cause for not giving the drugs is the intersection of the backlash and a lack of empathy, presumably
Exactly. :illuminati: me thinks it's a way for the government to carry out eugenics on addicts and/or chronic pain patients, supply them with legal opiates, then cut it off so they go on fent and die. And keep repeating the cycle
Yeah idk the stat off the top of my head but the majority of heroin and fake oxytocin all have some level of fent in them. Some more than others but it's sadly a majority. It's extremely easy to OD off fent laced shit, especially when relapsing. There is currently no easy way to test for how much fent is in something without sending it to a lab which virtually no heavy or even casual user is doing because it's costly and takes weeks
Yeah because of the opiate crackdown people are buying bunk, pressed pills that typically have fentanyl in in it or its dozens of analogous and dying much easier because the people making that stuff can fuck up the ratio extremely easily. Or people take too many because they're use to popping like 5 percs and those pills are mostly all fent.
It's extremely fucking sad, and I'm almost certain I would have died if I didn't quit doing heroin and any opiate pill I could find. A lot of people are stuck and don't have any good resources to get clean. Just criminalized or forced to quit cold turkey which has an extremely low success rate. Plus the relapse deaths too.
Listen I'm not trying to start a fight but capitalism also brought us brilliant innovations like the beer hat so I can enjoy a couple of cold ones without even having to lift a finger. Can communism accomplish that????
In the commune, I will be the roving beer hat craftsman, peddling my humble wares for nothing but the love of mutual beer-related aid
Communism is when there's only one giant beer hat and we all have to wear it at the same time.
Hey, still the same root cause. Refusal to prescribe drugs is mostly a backlash to capitalism influenced over-prescription
Surely making guns cheaper and easier to obtain than medicine can't possibly backfire
This is the shit war on drugs 2.0, as in, the war on opioids, will lead to. I've been talking about it on here for over a year. You can't do this and not expect people to snap. The guy had back surgery on May 24, a week ago, and they were already not providing adequate treatment.
This is not to excuse the shooter or anything, going into a murderous rage over your own physical pain is inexcusable. Many people suffer such pain and don't do something anywhere near this.
Place your bets for a bank heist style hostage situation to get miscarriage care in a few months
This basically happened in the 70s but for the bank robber's trans wife's sex reassignment surgery: https://en.wikipedia.org/wiki/John_Wojtowicz
So a 2020s version for a miscarriage is totally plausible
This basically happened in the 70s but for the bank robber’s trans wife’s sex reassignment surgery
fucking BASED
I'm having a real hard time with this one because being in intense pain makes it really hard to think. Obviously he shouldn't have killed anyone, especially the people not responsible, but I don't think he was in a right state of mind. I hope ever executive involved in the drug wars gets back twice the pain they have caused in sound mind.
Half the comments are like "I'm not condoning it, but the doctors deserved some of it.", a quarter are like "fucking junkies" and a quarter are like "roast in piece doc".
Nobody likes doctors
Apparently the shooter was married to a doctor, as well. But anyways, this thread is doing wonders for my passive suicidal ideation, thanks everyone
Fuck me for burning over a decade of my life trying to learn enough information and how to use it in order to help people. Apparently it was all a lie and I'm just a sadist destroying people's lives
People not liking doctors isn't a factor of individual doctors being bad. Even if you're 100% dedicated to helping people, getting that help still means (at least in the US) dealing with our godawful healthcare industry and all the capitalist garbage that comes with it. Doctors are just the human face that gets blamed, what people really hate is capitalism.
If it makes you feel any better, the problems come from capitalism, not from you nor your co-workers
Chronic pain patients are such a pandora's box of nothing good. Realistically you can't cure most of its causes, especially spinal pain of some kind which might be a degenerative process. I've had countless pillseekers try to bullshit the emergency room and my veterinarian went off on them for intentionally injuring their pets so they could get veterinary narcotics. At best it'd be an endless succession of those calls where the receiving doc immediately discharges them with a pain clinic consult and then the pain clinic wouldn't give them more opioids because they signed a pain management contract.
Good job murdering two doctors. Now there are fewer doctors for the next patient. Hope it's real fucking hot down there and a lot more painful.
But this isn't a chronic pain patient or drug seeking behaviour. This is a medical facility not providing appropriate pain management for a guy that had back surgery on May 24. How can you cut into someone's spine, and ignore their pain literal days afterwards?
This is not to excuse the shooter, you can't kill someone because your doctor is ignoring you. That should go without saying
Depending on the surgery that can still be drug seeking. I'm not saying he feigned his injury or anything, but if it's a low-grade surgery that only calls for anti-inflammatories afterward I've seen that enrage patients who expect narcotics. Their history with that condition means previous times where they've been prescribed and built the addiction back when the goal of pain management was the Sackler-sponsored absolution of pain rather than getting it to a tolerable level without risky interventions. If it was a serious spinal surgery warranting the good shit, I doubt he'd be mobile enough to do the shooting so soon after. When I worked in an SNF downgrading surgical patients we'd have a lot of spinal ones from procedures like vertebral fusions. They could barely ambulate to the toilet with help usually. Something more minor with the unrealistic expectation of the pain ceasing entirely on drugs he can't get and that's a motive.
Sure, I'd also want the same. Pain sucks. Do you go to a hospital to feel good or to receive the most scientifically valid care under the most strictly developed protocols? A chiropractor will make you feel good and is much cheaper, but there's a reason you hopefully go to a doctor instead of a spine warlock.
Medicine's goals necessitate the bigger picture both for your health and public health. If the protocol says you get opioids because you want them and they'll mask the pain with significant side effects/addiction risk, sure that Russian roulette might work well for you but every other patient is treated under the same protocol. That's dozens or hundreds per day. Each a personal and public health risk, every day until enough of you die to change the protocol in the obviously sensible direction.
edit: The counter-example to that is when I went in for a vasectomy. Typical recovery time is like three days with the dull sensation of being kicked in the testicles. The urologist gave me ten hydrocodones without me even asking for narcotics, which I strictly avoid as someone with an addictive personality. Taking that many under the vague assumption that it's the sound medical advice of a doctor is probably enough to get me hooked. I controlled that pain just fine with ice, ibuprofen, and a CBD vape. That's a bad protocol that could get me killed if I didn't come from stricter ones.
That's a more convoluted way of treating COVID with antiparasitics for horses. We don't put medicine in the hands of the public because no matter how competent and informed and ontologically sound you are the idiots driving next to you would have access to the same drugs under the same logic. The authority of the medical system isn't arbitrarily established in this case. That's a decade of schooling and teams of experts and treatment standards informed by external research that's continuously updated. Even if you manage to correctly identify all the elements of your easily visually identified condition and treat it totally appropriately to the standard you'd receive in a hospital, what's that crystal mom in the next car over going to do? She goes into Walgreens, walks to the OTC medications aisle, and everything that used to be behind a glass panel and a PhD is now on the shelf. What's she going to buy and is it going to be the right thing when she's treating abdominal pain?
I had three after a dental procedure when I was a teen. That was enough to make me think "I like this feeling" and reach for the bottle to continue it in the same way that I'm never quite stoned enough. While I wouldn't jump to heroin after ten, if I still wanted that feeling or still felt the pain and had a cultural expectation/personal desire to not feel that pain I could probably score a different pill. If not physically addicted or mentally dependent, I'd have a positive association with the drug and its effects while knowing it's no big deal.
I'm sorry what kind of spinal surgery only requires anti inflammatory medication afterwards? Did I hear that right? Is the US medical system so afraid of opioid addiction that you can only get anti inflammatories after "minor" spine surgeries?
Also of course people with spinal problems were on opioids before surgery in certain cases, taking most anti inflammatories long term will destroy your kidneys. Or mess up your digestive system. It was also easier to get opioid prescriptions a few years ago. And they've probably been waiting to get operated on for years because of financial problems. Even if they were addicted before, is it right to let them suffer in pain because of a previous or ongoing addiction?
I am never, never, never, ever, going to get any medical care in the USA. Not like I would ever get the opportunity to anyways, but just reading that entire paragraph, it has me scared.
There's inappropriate pain management and there's pain management with realistic goals and protocols written in blood. If someome needs narcotics they're still widely used but the epidemic means the consequences of two decades of wanton prescription are forcing nuance. Patients don't see the clinical picture of their pain and living with it isn't a preferable option to drugging it at the risk of addiction.
Maybe this was a shitty surgeon oblivious to treatable pain out of stupidity or malice, but I'd expect he called the ward about the issue at least a time or two. If it were the appropiate decision to give him more pain management, there probably would have been at least one other opportunity for it even if he didn't have followups in that week.
I'm sorry I'm hearing about opioid free spine surgery in your first comment and I've noped out. No amount of writing is going to convince me that it's appropriate.
Also this guy had a 5 day impatient stay at the hospital according to the video, to me that sounds very serious. My hospital stay for back surgery was only a few days longer.
If he's in there for five days they've got a really good clinical picture of his pain and how it should be addressed. That's 12 hour rounds with the attending physician, hourly nursing checks, probably followups with the surgeon and/or multiple specialists. I'm really curious to see what surgery he had, what he was discharged with, what he wanted, and what his medical history/comorbidities are. When there's an inpatient stay there are so many people involved in the care that it's not just the incompetence of a single provider. That decision has a lot of data behind it.
Patients don’t see the clinical picture of their pain and living with it isn’t a preferable option to drugging it at the risk of addiction.
I love when doctors play god with other people's lives. It makes me feel really good about the standard of care I'm receiving.
Welcome to chronic illness 101.
Getting flashbacks to every doctors appointment I've had. At least my surgeon was good with pain management and post operative care. But other doctors, Christ.
Scientists play god with the laws and limits of the universe. Eventually they're even proven wrong as better scientists use the same process to form better conclusions. Do you reinvent physics to prove them wrong or do you see the basic value of expertise in their understanding of a field you don't work in? Feel free to be your own doctor but we've just seen that play out with the pandemic. None of those citizen-doctors seemed to outsmart the actual ones. They mistreated the disease they didn't understand and couldn't reliably digest information about. If they didn't die as a result, was their outcome better than what they would have received from those highfalutin doctors with their god complexes? Did they come to understand the virus more, treat it more effectively, or die less than they would have if they weren't libertarians about it?
You really took this opportunity to punch down on people with chronic pain. Honestly, fuck yourself. Your kind of attitude is the reason I can't get treatment for the pain I've suffered for the past 10 years after an accident. Your kind of attitude is why people with chronic pain kill themselves because they are treated like scum for daring to ask for some fucking relief. Fuck you .
Thank you for bringing the appropriate amount of anger to this discussion. God that comment pissed me off.
I don't get angry anymore, just sad.
Still can't believe the USA is trying opioid free spinal surgery, including fusions apparently.
https://pubmed.ncbi.nlm.nih.gov/32320863/
Conclusion: Opioid-free elective spine surgery, including lumbar fusions, is feasible and effective. We suggest that opioid-free spine surgery be offered to patients who are opioid-naïve or who can be weaned off before the operation.
I'm not punching anywhere. He shot up a hospital because he has unresolved pain. That's an issue worth examining and a demographic that needs to be critically understood because there are obvious consequences to the "satisfy the patient's every desire" approach that has been used until very recently. His pain complaint might have been just as valid as yours and the fuckup might have been on what now seems like a larger group than his target. It might have also been the same thing I saw half a dozen times a day either deliberately or out of ignorance, patients overstating their pain or having unrealistic expectations of it ending despite undergoing something more traumatic than we naturally survive. There isn't a solution which makes you happy and doesn't make a physician discharge patients who then become victims of something worse because the only drugs that make them happy are really bad. If your problem was chronic anxiety and you said "fuck you" because I don't think we should overprescribe drugs as effective and toxic as benzos, the solution isn't to prescribe more benzos. Fuck me but you'll still be alive to say that so I don't care.
Chronic pain patients are such a pandora’s box of nothing good
This is fucking dehumanizing. We're not Pandora's box of problems we're fucking people with lives.
"Pillseekers" is fucking derogatory. Yeah there's people that lie to try to get drugs. Because they're addicts. They need help and compassion not your smug judgement.
Fuck me but you’ll still be alive to say that so I don’t care.
Laugh in my face more asshole. Honestly I wish you could live a couple years in my position and then maybe you'd have some fucking empathy.
Work a couple years in an ER and try to resuscitate the patients you've previously discharged.
Live a couple years with debilitating pain that makes you unable to walk more than a few hundred feet at a time. Live a couple years getting ridiculed and harassed by doctors and nurses and pharmacists when you mention you are in debilitating fucking pain. Live a couple years in so much pain that you can't maintain a social life. Live a couple years knowing that the only thing that could end your pain is by blowing your own head off, or having to go to some sus dealer and buying shit that could be laced which would kill you anyway.
“satisfy the patient’s every desire” approach that has been used until very recently
As someone who has had pain issues for almost 2 decades and known others who have had it for even much longer, fuck you even more for saying this shit. I can't believe that first comment got any upvotes it's such priviliged fucking bullshit. You are part of the problem.
Aaaaand the medical God Complex shows its ugly face.
Medical god complex is when you say medicine isn't capable of curing pain and the tools we have to try are really bad for the patient and society so we should generally use the alternatives that kind of work over time and aren't surgical because we don't know how to do that in a way that doesn't cause more pain.
Medical god complex is when you declare that the only valid judge of pain and the utility of its treatment is the medical establishment and disregard the humanity of the patient altogether. Physicians are not moral arbiters. They have an obligation to informed consent, not dictatorial control. If a patient's pain is such that they cannot live with it and they have been given a reasonable and measured explanation of the danger of pain medication and how to use it in the least harmful way possible, it is then their choice what should be done. Not yours.
That patient went to that hospital for their staff's judgement. They can just as easily walk out at any time and go anywhere else under any other standards. I had a special AMA form just for it and gave them out routinely without any affront to my god complex. If multiple hospitals under multiple sets of protocols are denying the treatment that the patient wants, there's a reason for that which puts a wrench in using it the least harmful way possible. Using it might do more harm because of some set of factors not clear to me, you, or the patient themselves unless they're reading journals. Informed consent is so basically critical to routine medicine that I got it for everything I did. A dozen times repairing a wound. If they want to walk out at any point for any reason they can just do so and the only time they're stopped is when they aren't capable of forming informed consent. There is absolutely no disregard for their humanity, only the attempt to find the best path of restoring their functionality without risking extra damage unnecessarily. They have to fully consent to what's done and face no penalties for challenging what's declined and getting other opinions.
This did not, in fact, address my statement in any way. Your line is still 'if daddy medicine says no, then that's that', but with more steps. You should be honest with yourself about that fact. It will improve your ability to engage in self-criticism.
I learned a long time ago that trusting doctors is a terrible idea, after doing so nearly killed me because the infection that was increasingly risking my life was less important to the doctors seeing me (and giving me useless treatments repeatedly with zero effective communication at multiple hospitals ) than it was to me. The idea that the medical establishment can be trusted to make the right decision for an individual is, frankly, laughable. Instead, it is incumbent on the patient to go read those very journals and try to parse them for themself in order to reasonably be able to challenge physicians in order to ensure that they actually get the help they need. Hell, I need to have a discussion with my own neurologist about why I'm being prescribed a medicine that no studies I can find show effectiveness for in treating chronic sciatica (which, at least in my case, is effectively not treatable by fucking anything, it seems) next week.
Look, I have no idea what was going on with this guy's back. If this was nervous pain, odds are opiates would have done jack shit anyway. But if it was, he also wouldn't be likely to be very mobile. But medical privacy being what it is, we're never going to know that (and that's okay). Maybe this guy was a victim of legitimate malpractice. Maybe he was just unable to cope with pain and decided to take it out of his doctor. What we do know is that despite the incredibly toxic social stigma on opiate use, people are going to find and use opiates if they think they need them. If the hospital thinks that its procedure is safer than the patient going out and finding opiates where they can be found, I'd suggest that they are dangerously wrong about that. The hydrocodone that the Hospital prescribes is a hell of a lot safer than the shit you can get on the streets, which is almost universally cut with Fentanyl these days. But if I'm in unbearable pain and I can't get other relief, I'm sure as fuck not going to be concerned with a Doctor who thinks they know better than me what I can bear. I'm gonna buy that street shit and take the risk. Because that Doctor literally cannot know what I am able or unable to bear.
Have you ever been in so much pain that you seriously considered suicide to escape it? I have. Luckily, my current Doctor is a good one who actually understood my pain was unbearable for me, and she worked with me to get me short-term relief while we tried to find a long-term solution. If she hadn't, I'd have probably done it. The short-term relief was a higher-end anti-inflammatory injection on an annoyingly regular cadence, instead of opiates, because opiates would have done absolutely nothing for me (pain without Dilaudid? 10/10. Pain with Dilaudid? 10/10, but now with wooziness), but if I'd needed opiates to control the pain and she'd refused me, I'd be dead today, because I was well past what I could bear. Your argument leaves alternate universe me just as dead as if I'd overdosed.
:yikes-1::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-3:
I had a patient while I was in a nursing clinical who was on T4s following a hip surgery years ago and wasn't ready to give them up (she was addicted), honestly from a harm-reduction standpoint she would've been better off on just codeine in terms of her liver and that's what I told her... wonder how she is now.
Everyone here is talking about not getting opioids or whatever but if he was dealing with sciatica or other compressed nerves, odds are opioids would do next to nothing for him. Worse yet, there really isn't that much you can do for some cases (hi, it me). If so, I totally understand the rage and despair that can come from being in this pain and trying to come to terms with the fact that this awful pain is now just part of your life. But like, instead of saying "it was wrong, but they did wrong him" I want to emphasize that they may not have even wronged him.
How bad could his surgical pain have been if he was able to stand in line at a gun store, buy a rifle, then go across town and blow away two orthopedic surgeons, another patient in the lobby, and a receptionist? Let's say instead of a beloved surgeon, which is what people are claiming, he did deserve it. What on earth could those other three people have possibly done to deserve execution without trial?
Apparently Oklahoma only allows opiates to be prescribed up to a week in duration. I would bet that had a lot more to do with this over anything the surgeon did or didn't do.
Oh yeah for sure. But when the system fails things like this happen. Every hospital in my area has big signs up saying you will be removed if you are violent with the staff. The system doesn't work and everyone hates it.
Last I saw from portugal's numbers if you just gave eveyone all the popies they wanted it'd be fine. All this doesn't need to be.
