Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.
76 Billion Opioid Pills Manufactured in USA 2006-2012
Replies
-
I was prescribed opioids after my three joint replacement surgeries and also for ice pick migraines.
I don't have a genetic propensity for addiction, don't smoke, drink or do recreational drugs. I only took the drugs if the pain was obscenely over the top. I ended up with unused pills from every prescription.
I can't believe that I'm the only person on the planet with this experience with opioids.
you aren't. i had some for when my autoimmune gets out of hand. right now i don't need any. but i have even had dirty looks for taking my nonopiod medications. there are times when i can get by with 1 pill of 1 medication a day. but there have been times where i was taking 3-4 medications a few times a day.
i take as directed. i do have a mildly addictive personality but i've not ever felt addicted to any of my medications in the past 6 years2 -
sidcorsini wrote: »Where are these going? What percentage of the American population is addicted, and how many mgs does that equal on average per person?
I don't know your agenda or motive for posting this discussion here. However, with all the lawsuits and publicity campaigns against the Sackler family, I'll play along.
When my wife was in pain, opioids were prescribed abundantly, used occasionally, and never addictive.
She couldn't stand the skin crawling sensation. Watching her suffer was no fun at all.
The opioid manufactured tried to help. The doctors pretended to help.
The medical schools charge too much for pill pushers.
One of the 10 or 20, I lost track, doctors we saw for her quickly offered ACDF surgery, which she agreed to, and he did it perfectly, producing a pain-free not-addicted new lady. His school did a good job of training him.
I'll readily agree that the U.S. has lost too many (1 is too many) citizens to opioid abuse. There's a problem there.
However, the country has a huge portion of population suffering real pain who can, in fact, use the strongest opioids occasionally, as needed, without becoming addicted.4 -
USA USA USA LOL.
In most countries I know of Opiates are given in a medical environment(a hospital, post operation for a short period of time). The problem as I see it in the states is 1) you have little or no public health care so a knee that needs to be replaced cant be, 2) you have little or no employment protection, so you can really ring in sick. Therefore, you got to work to pay the bills and you an operation aint available, so you take whatever to get you thru. And then you have a business writing the rules for doctors etc
Perhaps one might have difficulty understanding a system one has only heard about second or third hand.
The majority of Americans - sadly, far from all - do have health insurance, and can have knee replacements when needed. Normally, they're scheduled quite quickly, too, once need is confirmed. Given my age (60s), many of my friends have had knee (and hip, etc.) replacements, covered by insurance, and we're all just regular working-class people.
Paid sick time, while unforunately far from universal, is not non-existent either. Mine, in a normal sort of office job, covered all of my needs for leave related to bilateral mastectomies, chemotherapy spread over 6 months, and 6 further weeks of daily radiation therapy. (I did have opiates prescribed after the surgery for a short time, but it really wasn't all that painful, so I didn't take many.)
But the larger point is that pretty much neither of those things - unmet medical needs or lack of paid sick time - are strongly related to the "opiate crisis". To put a finer point on it, here - just as in most other countries - legal opiates are given in a medical context (hospital, short course post-operatively, as you say). While that becomes an on-ramp to addiction for a small percentage of the people who initially take opiates via a legal and medically-justified prescription, mostly this situation is about use of illegally-obtained drugs.
Some of those illegally-obtained drugs were diverted from the legal supply by various means, ranging from people stealing from granny's medicine chest; to dishonest manufacturers, doctors, distributors, or pharmacies (likely a small percentage of the field, but accounting for large amounts of drugs in some cases); to industrial-scale theft (hijacked shipments, and that sort of thing).
All of which is a problem, and a serious one, of course.
9 -
Just a reminder:
Please keep your posts civil, and mindful of community guidelines. Violations of those guidelines may result in warnings, an explanation of which can be found here.
And a personal note: If you are 'debating' by taking swipes at other posters, you've already lost the debate.
Happy Thursday folks,
Em
8 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.2 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.2 -
Good piece that supports the use of the term "crisis" if anyone is disputing that: https://www.bostonfed.org/publications/communities-and-banking/2016/fall/drugs-death-and-despair-in-new-england.aspx0
-
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...1 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
To the bolded: Even though I'm personally a big fan of living a purposeless life, I think you have a point. The (limited) number of people I've known with a illegal-drug addiction problem were mostly either not seeing a point to their lives, or self-medicating some form of past or current trauma, or both. I see that many people around me (non drug addicted) seem to require a purpose to feel good about themselves (it's the reason some of my friends give for not retiring, though they could afford to and don't like their jobs much), even though I kind of don't get it.
In particular, I feel like our culture has missed some boat about rites of passage, and about a sense of belonging. (In some communities, gangs fill that gap, I gather.) Among younger people I know, there seems to be a level of rootlessness and undirection, and it seems to be worse among working-class/blue collar/traditional families' kids, and especially young men (don't know why, but wonder if there's a connection to the reasons so many traditional cultures had formal rites of passage for young men (young women at least have biology to usher them into womanhood)).
Maybe on average we've moved so far up the hierarchy of needs** that physiology and security are mostly OK (in a global and historical sense), some aspects of modern culture are interfering with belongingness (less neighborhood/extended family bonding, for example) and esteem (the photoshopped IG celeb phenomenon, among other things), and self-actualization seems out of reach (in the gig economy and worse).
** Using the Maslow scheme just because it's familiar, not because I think it's gospel. I'm not even remotely suggesting that the individuals affected by addiction parse their experience in these terms.3 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.1 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.1 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.
It's quite the eye opener for sure, and answers a lot of questions as to why meds are so expensive as well as why there's such an issue for US citizens being able (or not) to buy their medications over a national border.
How would we even begin to "clean" this up? Assuming it can be fixed in the first place.0 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.
And yet so many people believe these agencies are competent enough to run intentional large-scale conspiracies! (In my world, never posit a huge secret conspiracy when any of regular old human laziness, incompetence, short-sightedness or self-interest will suffice as an explanation.)
Sorry, that was a digression.4 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.
And yet so many people believe these agencies are competent enough to run intentional large-scale conspiracies! (In my world, never posit a huge secret conspiracy when any of regular old human laziness, incompetence, short-sightedness or self-interest will suffice as an explanation.)
Sorry, that was a digression.
A very accurate and truthful digression.2 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.
And yet so many people believe these agencies are competent enough to run intentional large-scale conspiracies! (In my world, never posit a huge secret conspiracy when any of regular old human laziness, incompetence, short-sightedness or self-interest will suffice as an explanation.)
Sorry, that was a digression.
I point to South Park - where the real conspiracy is getting the population to believe that the government is capable of pulling off a conspiracy.
In most cases it is simply gross incompetence followed up with CYA measures.1 -
This issue originated prior to most pharmacovigilance systems in the 1990s where people vastly underestimated the impact of psychological addiction and the damage to receptor sites over long periods of time (>7 years).
I've posted this before, but Jonathan Hari's TED talk is a must see on this topic:
https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong
I suspect the root cause of much of this is a lack of purpose. We're at the point where we must pursue a collective good and find a common purpose. Opioid (or any drug) use is simply a symptom of this.
I think the root cause is greedy manufacturers. That's in line with the info in the link I posted above.
Applying Five Why principles - does this lead to another cause?
Manufacturers are simply fulfilling a desire for product. This is a symptom of a larger cause.
The DEA has known about this for decades as each shipment of schedule II pharmaceuticals is done under their purview. This is a CYA measure trying to pass blame onto another entity. Like one criminal ratting a colleague out for a lighter sentence. Are there corrupt manufacturers? Absolutely and they should be charged to the limit of the law. The only reason government took action is because public opinion shifted from "We want our drugs" to "Greedy manufacturers" - this is based upon emotion and not logic.
What happened when the DEA began increasing the enforcement of narcotics? This resulted in an increase in heroin sales/use.
https://www.cdc.gov/drugoverdose/data/heroin.html
Wouldn't you agree that it's difficult to apply logic where all of the facts are not present at the time the decision is made?
From above:
https://www.biospace.com/article/release-of-federal-database-reveals-76-billion-opioid-pills-were-sold-in-the-u-s-from-2006-2012/The DEA database also revealed some surprising information about what the companies knew about the number of pills entering the market. The database provided information about the exact number of pills being dispensed, when the companies were made aware of the volume of pills being dispensed, as well as year by year and town by town information, the Post said. The evidence seems rather damning particularly as these companies are the subject of thousands of lawsuits from state and local governments. The Post noted that the companies “allowed the drugs to reach the streets of communities large and small, despite persistent red flags that those pills were being sold in apparent violation of federal law and diverted to the black market.”
The information in the database had long been held secret. However, a judicial order prompted the release of data up to 2013. U.S. District Judge Dan Polster said there is no basis for shielding older data, the Tribune Chronicle reported.
If the companies knew, yet kept that info secret and kept on pumping out pills....the math is rather suggestive to me.
I do understand your point, but the opioid crisis wouldn't be what it is today if manufacturers cut their quota to meet actual needs as opposed to profit margins. In my humble opinion of course...
The language used in these articles is purposefully misleading (disinformation) and absolves the three letter agencies of all responsibility - despite having complete oversight of sales and distribution.
The DEA and FDA knew this information - have always known as manufacturing of schedule II product requires a monthly reconciliation. Additionally reconciliation is required at every point along the distribution chain. Nothing was kept secret, other than to the public.
If you're going to place the blame on these manufacturers, then you must also place equal or greater blame on the government as they approved every transaction.
I bolded the relevant part which I assumed meant "released to the public ".
I do place partial blame with the agencies, but it is still the dollar driving the deals.
Oh we definitely agree, but I recognize the government at a bigger fish in this transaction. The manufacturers are simply doing the bidding of the government. All the federal and state agencies are responsible for this and everybody looked the other way even when the safety data was sending up signals everywhere. Then there is Medicare, Medicaid, and any insurance firms involved in the payment.
Unfortunately all that will likely happen is a few executive scapegoats and some fines, while the same government that created the manufactured crisis moves on to creating a new one.
It does sound like we agree on more than not, but doesn't the manufacturer have to submit something showing orders to justify the higher amounts being manufactured and dispersed? I thought the alphabet people only gave a thumbs up or down. How does gov determine how many, and what law authorizes the gov to dictate supply to private companies?
I am honestly unclear on that, unless I just missed your meaning re: the bolded.
The ordering process is absurdly and deliberately complicated. Orders are made in negotiations between the manufacturers, suppliers, distributors with oversight by various government agencies. To make issues more complicated the "price" is rarely the actual price due to the inclusion of charge-backs. This is a legal process where the suppliers and distributors channel charges off the original sales based upon volume - again all with government oversight. This is often how you see the 0.29 USD fentanyl jump to 300 USD on a hospital bill. This way it looks like the product costs way more than it does - then the bill is artificially lowered through insurance charges.
For schedule products there is a periodic reconciliation - if the counts are off this is a career ending situation. The period is based upon the product risk and time on market, but ranges from weekly to annually.
I'm not surprised at all by the chargebacks, but that convoluted, ridiculous (I'm assuming, safely I believe, that you've simplified it quite a bit here) process - I had no idea to be honest. Thanks for the explanation, and I really have no idea how to reply to that lol. Wow.
I just learned about this about 2 years ago and have been in the industry for over 15 years, but largely in the R & D or regulatory functions (I rarely if ever get involved in sales). Learning this was a tremendous eye opener and really shows exactly why medicine is so expensive - it isn't, but there a multiple middlemen in the game making a completed unnecessary profit.
What's really disturbing is that different departments within the larger three letter agencies are in conflict with one another - with the enforcement branch attempting to shut down a facility, while the product sustainability branch is telling the same facility to ramp up production.
It's quite the eye opener for sure, and answers a lot of questions as to why meds are so expensive as well as why there's such an issue for US citizens being able (or not) to buy their medications over a national border.
How would we even begin to "clean" this up? Assuming it can be fixed in the first place.
The clean up is simple - remove insurance and government from the transaction. The problem is that too many believe these bodies to be helping the situation, rather than the core problem.
The complexity of the transaction allows this to happen. There is no actual need for any of the middlemen, but fear keeps us shackled to them.1 -
A paper in the Proceedings of the National Academy of Sciences rates police use of force a greater public health problem than drug overdose, based on risk of death.
https://www.pnas.org/content/early/2019/07/30/1821204116
Because of the pay wall, here is a summary.
https://www.vox.com/identities/2019/8/14/20803872/police-violence-mortality-public-health-black-men-rutgers1
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 393.4K Introduce Yourself
- 43.8K Getting Started
- 260.2K Health and Weight Loss
- 175.9K Food and Nutrition
- 47.4K Recipes
- 232.5K Fitness and Exercise
- 426 Sleep, Mindfulness and Overall Wellness
- 6.5K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 153K Motivation and Support
- 8K Challenges
- 1.3K Debate Club
- 96.3K Chit-Chat
- 2.5K Fun and Games
- 3.7K MyFitnessPal Information
- 24 News and Announcements
- 1.1K Feature Suggestions and Ideas
- 2.6K MyFitnessPal Tech Support Questions