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Comment by lmg643 | Hacker News Reader

prescription opiates started the problem with heroin. the history of oxycontin is a sad one for the country. with the recent pharma/biotech explosion, lots of companies are trying to get in on the painkiller game as well. there's really no need for much of it. I've had multiple minor surgeries in the past few years and the doctors have never wanted to give me painkillers. Just take some tylenol.

We've probably had less of a need for legal painkillers than ever - surgery and medical technology keeps getting better and better - minimally invasive and the like - and yet we have more legal painkillers than ever. Something doesn't add up.

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> We've probably had less of a need for legal painkillers than ever - surgery and medical technology keeps getting better and better - minimally invasive and the like - and yet we have more legal painkillers than ever.

The vast majority of prescription painkillers go not to surgical patients, who usually take a week or two course and are done, but to patients suffering from crippling nerve disorders and cancers, who take the medication for long periods of time, and who are little helped by our advances in surgical technology. Absent narcotic painkillers, cancer and diseases like chronic shingles and trigeminal neuralgia ("the suicide disease") are just as painful as they were 100 years ago.

No, the DEA crackdown on pill mills started the problem with heroin. When your choices are expensive black market oxy and cheap black tar, that's when you switch to heroin.

Step 1. Folks in society can no longer tolerate even a little discomfort.

Step 2. These folks go to the doctor demanding pain relief. The doctor no longer bothers telling them to rest up and take some tylenol. Instead she hands out Oxy.

Step 3. Patient will never want to give up the Oxy (at best), or craves more as the drugs effects lessen over time. An addict is created.

Step 4. Patient looks to the blackmarket for supply of Oxy or alternatives.

You can solve the problem by either re-educating society to toughen up (eliminate step 1) or tell doctors to stop handing out opiates like candy (eliminate step 2).

Neither is going to happen. This has been going on since before opium was made illegal.

There are much better ways to deal with physical pain, the problem is they require a lot of effort ... and a pill is just an Rx away. This works for short periods of pain (such as immediately after surgery) but is very bad for chronic long term pain.

> This works for short periods of pain (such as immediately after surgery) but is very bad for chronic long term pain.

Do you have severe, chronic long-term pain?* Just curious on what basis you are making this remark.

I can tell you that since the DEA crackdown, no one is handing our narcotic painkillers for any condition that could be reasonably treated with rest and tylenol. Doctors value their licenses and freedom far too much, and so meticulously document their narcotic treatments, and give them only to patients with severe pain (and even then, they undertreat).

I've had two relatives die from cancer from in the past 5 years, who were terminal and over 70, and yet who were cruelly denied narcotic pain relief until their last week because doctors are scared shitless about getting arrested by the DEA. Far from what you're claiming (which was maybe the case with certain doctors a decade ago), doctors now undertreat most patients.

* "Bad back" and "aching knee" do not count. I mean things like cancer and severe nerve diseases.

Edit: By the way, I didn't downvote you.

Step 4 is the only part that hurts anyone. They could keep doing the legal oxy forever with minimal health problems to themselves and zero effect to you or me.

No, that's not true. People with long term pain often report tolerance to their opioid pain releif.

The problem is not the supply, it's the demand. Why do so many people feel the urge to abuse drugs?

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