That's pretty insensitive, suggesting that Bruce buy heroin in your neighborhood. Oh, wait, that's a totally different issue.

More on this in Time magazine...

Here's how this would go: one suffering from intractable pain starves to death and dies while under the influence because the drugs also turn off appetite. One has a pedestrian accident while under the influence. One has an overdose incident.

In court, all three are the fault of the drug company and the doctors, without whom such tragedies would never happen. They have deep pockets, and so being kind costs them their entire company.

No deal. Say what you will about government heartlessness and/or crackdowns, but when people smell money, nothing can continue.

This is what happens when you turn the practice of medicine over to bureaucrats; this was the original argument against ObamaCare. On the flip side, there are enough Theodore Morells, George Nichopouloses, and Max Jacobsons in the world that turning the practice of medicine medicine over to individual doctors is also problematic.

Bureaucrats like one-size-fits-all solutions. If the patient presents with a headache, prescribe 100ml of Drug X one time only. Individual doctors are human and subject to human frailties and failures.

Unfortunately medicine is entirely individualistic. What works for one patient might not work for the next one hundred patients. Body chemistry, physiology, attitude, and emotional state can all play into the rehabilitation of a patient, and are dramatically different from patient to patient.

Some patients become addicted to opiates in small doses. Some need larger doses just to function. Dictating that every patient can only have X amount for X number of days dooms some patients to a life of chronic pain and others to a life of addiction.

While returning to the free-wheeling days when cocaine and LSD were regularly prescribed and bleeding with leeches was considered a valid cure is not the answer, locking medicine up in a rigid government bureaucracy (Palin's "death panels") is surely not the answer either.

To riff on what Conan said, our entire structure for regulating opioid use goes back to the Victorian era, when morphine and heroin were sold over the counter, and the hazards were poorly understood. Nothing about the medical industry's or the government's approach to regulation has changed since then, despite the fact that we know how to manage the risks now, and the drugs themselves have fewer of the really bad side effects.

The medical industry does not take chronic pain seriously. Part of this is because a lot of doctors are afraid of the DEA; they seem to have an arbitrary cutoff of what constitutes "too many prescriptions" that ignores what mix of patients the doctor is seeing, or what their conditions are. A doctor who specializes in pain management is going to prescribe more than a GP, because of the nature of his practice, but that's too subtle a distinction for the DEA. When you're a hammer, etc.

But the other part of the problem is that a lot of doctors act like dealing with pain, and mental health issues in general, is beneath them. I saw this quote in an article recently from a pompous doctor: "The patient needs to be told to not focus on the pain, but on their emotional reaction to the pain. If they learn to manage their emotional reaction, then the pain will not be a problem." Doctor, let me stick you in the arm with a hot needle, repeatedly, and then you can tell me about how you are managing your emotional reaction. They are all about "we must prevent deaths from addiction", but they seem to care nothing about suicides due to lack of treatment.

I saw this phrase recently: "invisible graveyards". The reference was in this context: the fact that we can count fatalities caused by side effects of drugs that have been approved, but nobody makes an attempt to account for deaths that occur because regulators drag their feet on approving life-saving drugs. It applies here too. How big is the invisible graveyard filled with people who died from the effects of untreated chronic pain? Does anyone care?

You can buy heroin and lots of other drugs about eight blocks from my house.

You have a bar around the corner, right? You can probably score some there. You'll just have to introduce yourself to the "undocumented pharmacist".

The other bureaucratic issue with such prescriptions is the artificial limits on the amounts of drug to be produced, as you have found with your ADHD drug.

https://www.dea.gov/divisions/hq/2016/hq100416.shtml

The United States Drug Enforcement Administration (DEA) has reduced the amount of almost every Schedule II opiate and opioid medication that may be manufactured in the United States in 2017 by 25 percent or more, according to a Final Order being published in the Federal Register tomorrow and available for public inspection today.

I'm lucky -- I don't have cancer or crippling pain. I'm very thankful for that. I do have chronic pain though due to three different back conditions and arthritic hips.

Originally I was put on Vicodin. It worked, but not well. Many days it barely touched the pain, and due to the Tylenol in it, I couldn't increase dosage to deal effectively with the pain levels on bad days. On top of this, Vidocin caused constipation (which was quite severe with me), nausea, dizziness, and slow digestion (which I have issues with already due to neuropathy). Vicodin reduced my activity levels as well.

A new doctor prescribed Hydromorphone for me. It was as different as night and day. The side effects are mild, so much so I rarely notice them. The effectiveness for dealing with pain meant I was often able to only use one tablet, or even half a tablet, per day. My activity increased as pain was controlled well. I was very satisfied and happy with the results.

Then the war on pain meds started. I had to jump through more hoops to get Hydromorphe despite not increasing the amount I needed per month and never having an issue with any substance addiction. My doctor, another new one as the last I lost due to Obamacare, Started pushing me to go back to Vicodin. Almost every time I see him he does this. Between the fear mongering over opiates and Kaiser pushing solutions that don't work well, I fear it won't be long before they refuse to prescribe Hydromorphone for me.

I have degenerative conditions that won't get better, only worse. This war on opiates concerns me greatly as this will be torture for me and many others if they're banned, or greatly reduced in use.

PS Does anyone find it coincidental that, as marijuana becomes more acceptable and legal, that dryg enforcement is eyeing opiates now? Perhaps job security is driving this as much as their lust for control.

Recently my 26 year old niece was having some health issues...lingering cold, and bronchitis. She couldn't shake it no matter what, so she went back to the doctor who decided to perform a chest x-ray to see if the bronchitis was in fact pneumonia. Well it turns out that she had a large sarcoma taking up nearly the entire left lung, and was pressing on the aorta. Within 2 weeks of this discovery she had surgery to remove the sarcoma, which necessitated the removal of her entire left lung, and then repairs to the aorta and the left side of her heart. When she got out of the hospital, she left without any pain meds...none, whatsoever. A week later, at a follow-up appointment, they still refused to give her any pain meds. My SIL literally had to beg several doctors before finding one with a brain who prescribe the meds to my niece. WTF is wrong with doctors and hospitals that they're unable, or unwilling to look at an individual and say "Oh shit, you had your chest cracked opened, had a lung removed, yeah you're probably in some serious pain."

On the whole intractable pain issue -- there is considerable material noting that surgery often produces numbness.

I suggest that people ask loudly before surgeries if continuing pain will be the result, and whether a surgical solution can be found.

You can't be loud enough asking about medical treatment. Even minor things can develop into permanent problems.

Well, then...

“One thing that’s always disturbed me: they come up with a new drug for a patient who’s terminal, and the FDA says we can’t … approve the drug, because we don’t want to hurt the patient. But the patient is not going to live more than 4 weeks, [anyway]. So, we're going to be changing a lot of the rules.”

Time to be horrified. That was President Donald Trump saying that. You know, the non-adult.

"You can buy heroin and lots of other drugs about eight blocks from my house."

Hell, Vancouver B. C. is giving away free heroin as a quality of life compassion program.

www.google.com/search?redir_esc=&client=ms-android-boost-us&hl=en-US&oe=utf-8&safe=images&q=vancouver+b.+b.+free+heroin&source=android-browser-type&qsubts=1485979692495

I say we take off and nuke the DEA from orbit.

It's the only way to be sure.

Mythspeak, when my wife died, I had a bizarrely hard time getting rid of the prescription drugs - including tablets of Hydromorphone (Dilaudid). The nurses wouldn't take the drugs, etc. I eventually disposed of them in coffee grounds, but I know a lot of people hold on to them with no intention of using them. They just sit there, for months or years, unused. I thought it was a shame I couldn't give them to someone who needed them.

Sara, I'm sorry your niece (and your whole family) went through, is going through, this. My wife had lung cancer and I remember what the surgeon said about the pain levels that result from thoracic surgery (which my wife did not have).

Here's what I wish we had known:

tell the surgeon/ doctor/ nurses you do not want to leave the hospital without pain medications to use at home; and

before you leave with those medications, use them in the hospital in the same form and in the same concentration.

IV Dilaudid worked well for my wife, but Dilaudid in pill form did nothing for her. Sometimes changing the form of the drug is all is takes to render it useless for you.

(The days she spent at home in pain before we got that handled - those days changed me. I agreed to them when we married, but it is a horror I cannot describe - seriously, whatever it takes, make sure to get pain meds that you have verified work for *you*, before you leave the hospital.)

It can be hard to get the doctor who is on call to get on the phone, or to do more or differently than what your doctor ordered.

Heed Sara's example - do not count on reason and mercy to prevail just because the person you love is screaming in pain. Get what you need and be sure it works for you before you leave the hospital. Discuss contingency plans with your doctor and nurses before you leave the hospital. Write down the names of the drugs, the doctors, the nurses, before you leave the hospital - so if you need to call from home, you have a head start in facilitating the conversation.