Opioids, the Quiet Killer
There are no loud guns shots in the middle of the night. No screams for help or sounds of cars speeding away. No police sirens or flashing lights. It is pretty quiet when someone ODs on Opioids unless someone finds them before it is too late.
As I wrote earlier; “From 2006 to 2015, pharmaceutical companies spent $880 million in lobbying state and federal legislatures and contributing to campaigns to prevent laws restricting Opioid prescriptions. Opioid manufacturer lobbying expenditures has outstripped those such as STOPPNow advocating for greater controls on Opioids and prescriptions by 200 times at the state level.”
In comparison, only the NRA and its gun lobbying efforts in legislatures displays a similar capability to oppose and defeat any and all laws for bullet-spewing-weapons laws the same as the Opioid industry efforts to block legislation. Legislators pay attention when either industry or lobby calls on them.
Any particular article advocating greater regulation of Opioids or reporting of Opioid dangers on medical blogs such as Medscape, centers such as Public Integrity, news agencies such as Associated Press are met with a resistance (if they still have a comments section) the same as what is found on sites when they advocate for greater “gun control.” The evidence is overwhelming that there is an opioid epidemic in the nation resulting from usage and is similar to the epidemic of injury and deaths resulting from guns. Quietly, the industry and their lobbyists work the legislatures to stymie any effort to control opioids.
Latest Findings by the CDC
Today, Medscape reported:
Emergency department (ED) visits for suspected opioid overdoses rose by 30% throughout the U.S. in a year, according to the CDC.
“All five regions of the U.S. saw significant increases during this time period,” said Anne Schuchat, MD, acting CDC director, in a CDC tele-briefing Tuesday.
If you come back later to Medscape article, you will see the comments section flooded with what appears to be an organized opposition to what supported facts MedScape presents and consequently any and all suggested Opioid control. Many of the posters appear to be the same ones time and time again. It is pretty apparent the pharma industry is attuned to any medical backed article going up advocating for Opioid control.
The analysis backing the increase in Opioid ER visits can be found in a new CDC Vital Signs report. The basis of its findings are from ~91 million ED visits in 52 jurisdictions in 45 states from July 2016 to September 2017. The data is reported in the CDC’s National Syndromic Surveillance Program (NSSP) Biosense Platform. The 142,557 visits to the ER reported as suspected opioid overdose cases equate to a 29.7% increase from the previous 1-year period.
run75441 (Bill H)
Why do we care about these suicides?
Is this not “culling of the herd”?
Did I say suicide somewhere in my post?
It is one thing for companies to lie about their drugs to doctors to get them prescribed. It is something entirely different to eliminate pain medication for people with chronic pain. Treating the wrong problem usually doesn’t work.
Did I say something about Chronic Pain in the post; but, one study did which I will now mention. No, I did not. The use of Opioids for Chronic Pain is the fall back point for every argument against additional regulations for Opioids. It comes out every time and in every place where I have read. Why not the same argument as made for guns? It is my right to have guns (now substitute the word Opioids). I have read the multitude of anecdotal critiques of the numerous studies made about Opioids.
In 1980, a letter was written to the NEJM about how rare addiction was when using Opioids . . . which was a lie.
This particular short letter was cited more times than any other letter in support of studies (the median which is 11 times) in particular Opioids and it is false. Opioids are addictive (period).
In a more recent June 1, 2017 letter to the NEJM editor, the authors dealt with the broad based and undocumented assumption in the 1980 letter of Addiction Being Rare in Patients Treated with Narcotics and the realization of the addiction and deaths of many people using Opioids. “from 1999 through 2015, more than 183,000 deaths from prescription opioids were reported in the United States and millions of Americans are now addicted to opioids.” Signed by four researchers exploring the reasons why Opioid addiction and deaths have risen, one of the conclusions reached was doctors being told “the risk of addiction was low when opioids were prescribed for chronic pain.” Supplementary Appendix.
608 citations of the 1980 letter were identified (Figure 1) of the index publication. Also noted was a sizable increase in citations after the introduction of OxyContin (a long-acting formulation of oxycodone) in 1995. 439 (72.2%) authors of articles cited the 1980 letter as evidence addiction was rare in patients treated with opioids. 491 (80.8%) authors of articles did not note the patients described in the letter were hospitalized at the time they received the prescription and left readers to assume these were out-patients. As an aside to the citation of the letter, some authors grossly misrepresented the 1980 letter’s conclusion(s) in various comments as shown in Section 3, Supplementary Appendix. In comparison to the 1980 letter citations, the researchers also compared the number of times other letters published in the NEJM were cited: “11 other stand-alone letters taken from the same time period were cited at a median of 11 times.” To be redundant, the 1980 letter was cited 608 times.
The problem is Opioids and no one has advocated eliminating pain relief for people with chronic pain or for the final stages of cancer, etc. before death. They recommended other treatments for pain other then Opioids.
Mr. Barnes has an interesting point of view, which can be generalized to people self selecting for self-destruction. This is also known as “its their own fault.”
If we stopped providing welfare for people, then people without the means, because its “their own fault” for having “made all the wrong decisions” or “not having made the right ones” would suffer earlier deaths, including pre-reproductive youth, and thus not just “culling the herd” but from that point of view, changing the species to a “better” one” … where eventually only people who “make the right decisions” reproduce this “superior trait”.
Sounds just like advocating eugenics — to produce a superior race — according to whomever’s beliefs of “right” or “superior” among humans are able to hold sway.
Seems to me this is also no different than white supremacists — people who believe Northern European, Christian whites are the superior race..
“send (an inferior or surplus animal on a farm) to be slaughtered.”
Comparison to NRA:
“guns don’t kill people, people kill people”
“addictive drugs don’t kill people, people who use them kill themselves”.
I’m still trying to figure out how political/economic lobbies can be stopped in a democracy such as the one we promote & support n the US representative system — the one supported by our Constitution according to our Supreme Court interpretation & decision process?
How does a law get put on the books that doesn’t also stop any kind of political/economic lobby — for example, organized labor, women’s liberation, female enfranchisement, freedom of choice, NAACP, MADD, etc. ad-infinitum?
Constitutional “freedom of association & assembly” and “freedom of speech” (where speech also equals money) are pretty much the corner stones of any form of democracy (plus voting rights). Selective exceptions can be carved out of course (as Jim Crow did for example, and advocating the overthrow of the gov’t, or inciting to riot), but this is a double edged sword, no?
The Supreme Court says money get’s to talk with near unlimited (and to a large degree unenforceable restrictions) and it’s a general given that money talks and everybody else walks… sort of like a “human right” for all intents and purposes in any human organization and institution.
For those reasons we can “blame” the pharmaceutical lobby and “blame” the NRA lobby, and “blame” the religious white Christian organization lobby, but that doesn’t do anything to resolve the issues.
You can’t stop lobbying without turning the Constitution upside down (which I favor, btw) so that approach isn’t constructive.
It is entirely possible to create law which says that corporations have certain rights of persons, such as the right to execute and enforce contracts, but do not have other rights, such as the right of free speech and the ability to petition Congress.
Corporations are not literally persons. and it is up to law to establish what rights they have or do not have. In order for them to function it is necessary for them to be able, for instance, to make and rely upon contracts, but that does not mean that they need to have the ability to advocate for causes. All we need is a legislative body willing to create such laws, and a judicial system with the courage and reasoning ability sufficient to sustain such laws.
I am not generalizing.
I am referring specifically and only to people who overdose themselves on drugs.
Why do we care about these suicides?
Is this not “culling of the herd”?
My post did not include sucicide.
You know most of the OD are caused by Feyntanal (sp) and not the prescription for pain meds more commonly used and most of that is coming in from China.
People like me who live with chronic pain already have to jump through hoops to simply get the medications we need to live a fairly normal life. Next week since I am working in Florida I will have to drive 500 miles back home to GA to see my Dr and then turn around when the weekend is over and drive 500 miles back to S FL to work. Simply because my Dr already has zero flexibility to accommodate my work and lifestyle. Going a step further I have homes in GA and FL but will constantly every 30 days have to drive to one State or the other when I choose which State I am a “resident” of to get my medication.
I was in a wheel chair and with a lot of physical therapy was able to walk away from SSDI and go back work and be a functioning member of society with the aid of pain meds. I am SICK of hearing about this issue and I live with the current restrictions which are already draconian.
There is reaction to past occurrences and you are experiencing some of it. From a simple letter to the NEJM by doctors stating opioids are not addictive to enough prescriptions being filled to give every adult in the US a bottle of pills. It is difficult to pass any law in the US because the pharma industries lobbies the state and federal legislatures hard and prevents anything from ever being discussed. If you worked in Florida, then you must know about the 1000% increase in the numbers of babies being born addicted to Opioids. Not a pretty picture. The former ease of getting a prescription has led to people moving on to heroin and illegal opioids such as Fentanyl.
In the 1970s there was a study of veterans who were addicted to opioids in Vietnam. The study showed that the vast majority had stopped using opioids after they returned to the US. Apparently a large percentage accomplished the withdrawal on their own. Obviously these men were unusual for that ability, but they had been chosen from mainstream Americans.
That would seem to imply that some Americans are using opioids to deal with excessive stress and that when the stress is lessened the recovery can be accomplished somewhat easier than we have come to expect.
But if you give opioid prescriptions to enough people, you will give them to some of those who are more likely to become and stay addicted. (Just to escape from the stress of their reality.)
After 2010 death from prescription opioids seem to reach a sort of plateau. And death by heroin and other street drugs were rapidly increasing after 2010.
See Graph: https://www.cdc.gov/drugoverdose/data/analysis.html
Here is a link to a New York Times article.
I overlaid the graph from the New York Times article with a linear grid. Their graph was linear so I collected some information from it. This data obviously lacks some precision.
Here is a table with some of that data. I give the ‘Deaths per year’ for years when the slope changes. Then I give the ‘Increase in Deaths per year’ and last the ‘Average yearly increase over the period’ from that date back to the previous date.
Deaths due to drug overdose
Years_____Deaths __________Increase in_______Average yearly increase
________ per year________Deaths per year _______over the period
1990______ 8,500 ___________ 2,300 ______________ 230
2000_____ 17,500 ___________ 9,000 ______________ 900
2007_____ 36,200 __________ 18,700 ______________ 2671
2009_____ 37,200 ___________ 1,000 ______________ 500
2012_____ 41,500 ___________ 4,300 ______________ 1433
2017_____ 64,000 __________ 22,500 ______________ 4500
Note: The month for the year is January
The largest changes ‘Average yearly increase over the period’ occur after 2000.
The slower increases in ‘Average yearly increase over the period’ which began in 2007 were probably due to a tightening of access to prescription opioids. Which apparently caused more and more of the addicted to change to heroin.
My conclusion is that this economy is causing a lot of stress for some Americans. And that stress seems to be worsening after 2012. Or perhaps hope was diminishing.
It has been 10 years since the beginning of the Great Recession in 2008 and this economy is still in the doldrums!
An addendum to my last comment:
The changeover to heroin had occurred in 2010 and deaths due to heroin increased rapidly. And this graph indicates that deaths from fentanyl began to increase rapidly after 2013.
See graph: https://www.cdc.gov/drugoverdose/data/index.html
I think that the drug lords could not produce and move larger and larger amounts of heroin into the US. So they compensated by diluting the heroin and mixing it with a tiny amount fentanyl. (Probably after the heroin arrived in the US, since I am reading that fentanyl is being smuggled into the US via the postal service.)
So the very large number for the ‘Average yearly increase over the period’ in 2017 is a combination of the effects of that heroin/fentanyl mix and the continuing stress from the economy. (And the loss of hope.)
Thanks Jim H,
According to the CDC: ” Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl.”
Here start reading.
New Data on Opioid Use and Prescribing in the United States I had my bottle of “Oxy” too after they went 12 inches of my back and nicked the sheath while cleaning my spine out so I could walk again. The damn stuff gave me a headache and numbed my senses. Maybe my pain was not as great? I would rather have the pain. They cracked my chest with a Sears Best saw one time. That was pain and I was given Tylenol. Dilaudid for gall bladder initially and took myself off it and had the nurse give me one to help me sleep each night. She asked me why I did not need it after they cut into me. I just didn’t after a couple of days and was able to walk it off. Not everyone is me either. I look like a quilt. Getting shot was no fun either.
The overwhelming evidence is addiction started with uncontrolled prescriptions of Opioids and migrated to heroin and illegal opioids. Enough prescriptions for opioids have been written for opioids to give every adult in the US a bottle of pills. Prescription usage of opioids while it has decreased, it is still 3 times higher than what is used in Europe. 24 of 69 people who died from illicit Fentanyl in Rhode Island started with a legal prescription for Fentanyl. Within 90 deaths of their death, their prescription was refilled. You can catch one full page of this report at the link.
What has started this rise in the use of opioids can be traced back to a letter to the editor of the NEJM in 1980. It said Opioids are not addictive. That particular letter or note as signed by medical personnel was cited >600 times in promoting the usage of opioids in relief of pain. A lot of the citations never mentioned the study was done under the observation of medical personnel in a hospital and they controlled dosage.
Denying opioids were addictive and an over abundance of prescriptions for everything under the sun besides severe and chronic pain has fueled the epidemic of opioid legal and illegal addiction.
All the solutions to the opiate crisis seem to assume that other painkillers are available for everyone to use and that everyone who receives opiate painkillers will eventually become addicted and live for their drugs. That is not true. The rules restricting how much medication can be prescribed doesn’t consider that some patients don’t have other options to fall back on, or that someone with a 20 year tolerance won’t get the same relief as someone who has never taken opiates before.
Companies should not be allowed to lie about their products. The ones that did should be forced to pay for the damage, but that won’t happen.
Doctors who are just pillpushers need to be stopped, but most doctors know their patients and what they need and can take and will monitor their usage.
Addicts exist without opiates. They use alcohol or gambling or something else to give them some kind of feeling they need. Some of us want to not be in pain, but that isn’t allowed any more.
The drug addicted babies have increased by over 1000% in Florida. 92,100 children in the foster care system in the year 2016 were removed due to drug abuse. In the book STOPPNow the corruption and greed that caused the opiate epidemic and continue to fuel it are described.
In the 80’s I played a lot of Rugby and when I got hurt, which was a fair amount :), I would go to the ER to get fixed up and they would give me pain pills or a prescription for pain pills, even though I told them, repeatedly that I didn’t want them. It was like they were forcing them on me.
Now I am suspicious.
Like I said, tjey did not do much for me beyond giving me a headache.
Run – Good move on your part. The innocent looking doctor prescribed pain pill is not so innocent. They are highly addictive. The opiate epidemic was a well orchestrated brilliant plan by those that place no value on a human life. There is a lot more in the book STOPPNOW we need people to be aware and make change
Advocating greater regulation for opiods ignores the fact that there are those in chronic severe pain who DO need them, and more regulations means more hardship for them. As a pancreatic cancer survivor who suffers from severe chemo-induced neuropathy I know this first hand. Unless you’ve ever been in that position, you simply have no basis to know what it is like.
Opiod abuse is like mass shootings–both are epidemic ONLY in America, and neither happen because people are happy and satisfied with their lives. Instead of wantonly inflicting more suffering on those with severe chronic pain, a better discussion would be WHY are so many people so desperately unhappy? But that would require Americans to take a good hard look at who we are as a people and how unfettered capitalism is destroying us–something we will NEVER do.
I understand the position; but, this has been so abused by doctors who push pills and the pharmaceutical companies profiting big time from Opioids and blocking any control or limitation has caused far bigger issues. This is just like gun-controls and now people are angry and controls are going to happen. Everything I have read suggests there are other ways to mitigate the level of pain.
People become addicted to drugs and take them because of the way it makes them feel. Easy access makes it convenient. With guns, white men do not have any leeway because they are unhappy and go on a rampage.
Opioids – Europe v US
Western Europe regulates opioids more tightly
In Europe, the way patients and doctors view pain isn’t that different from attitudes toward pain in North America, according to Canadian researcher Dr. Benedikt Fischer. But Europe still has much lower rates of opioid prescription. Germany, the country that consumes the most opioids in Europe, prescribes pills at about half the rate of the US.
A few years ago, Fischer and a team of researchers at the University of Toronto set to explain the difference between opioid prescribing in North America and Western Europe. They found that pharmaceutical regulation (or lack thereof) plays a large role in how opioids are advertised, sold and prescribed in the US and Europe.
“In North America, health is much more of an industry than in Europe,” Fischer said. “Europe is generally much more regulated. That’s not universally the case, but in regards to medicine and health care, that’s probably more often the case than not.”
Western Europe is actually starting to catch up to the United States for rates of opioid prescribing, Fischer said. (Europe’s opioid problem has largely been restricted to heroin, although there are signs of prescription painkillers and synthetic fentanyl becoming a problem.)
But the two are very different when it comes to how the government regulates opioids, controlling where and how pharmaceutical companies are able to advertise, and also the setting where doctors can prescribe opioids.
One of the biggest differences is how centralized this regulation is across Europe, including limitations on how much doctors can prescribe and cost coverage. Comparatively, regulation in the United States usually happens on a case-by-case basis, with individual states running prescription drug monitoring programs where individual doctors upload information.
In Europe, opioids are generally dispensed by specialists, not primary care doctors. As in Japan, they are more frequently used when patients are in severe pain from a disease like cancer. They are also prescribed mostly in hospital settings, rather than in community-based clinics. There is also a strict ban on pharmaceutical companies advertising directly to patients in Europe.
Contrast that to the United States, where primary doctors write half of the nationwide prescriptions for opioid pain relievers, according to the CDC.
At the root of these differences in prescribing practices are even bigger differences among health care systems. For instance, nearly all European countries have national health systems where doctors are salaried, and don’t get paid depending on how much medical care they give, or how many pharmaceutical drugs they prescribe.
There’s much more private competition and fee-for-service medicine in both the US and Canada.
FDA has full control of all aspects of drugs included in the Controlled Substances Act of 1970 — frequently updated since. The Act establish[es] federal U.S. drug policy under which the manufacture, importation, possession, use, and distribution of certain substances is regulated.
Opiates are listed in the Schedule II drugs of this act.
See list here:
The DEA and FDA have enforcement and classification jurisdiction,
Penalties for violations are up to Congress however, as well as funding for enforcement activities and priorities of funding uses. This puts it directly in the hands of Congress which is where it becomes fully politicized. — and where the medical and pharmaceutical industries apply their lobbing.
Trump’s head of the FDA , Scott Gottlieb, has strong ties to the pharmaceutical industry.
As head of the FDA …”Gottlieb [is] an important player in the Trump administration’s plans to speed up the drug approval process and cut back on regulations and red tape, which the president has argued will bring down drug prices.”
“.Before being nominated, Gottlieb, served as a partner at a venture capital firm that worked with a number of leading drug companies. He also served on the boards or held advisory positions at companies including GlaxoSmithKline, Bristol Myers Squibb and Vertex Pharmaceuticals.”
” During his confirmation hearing, Gottlieb suggested that fighting opioid abuse would be a priority for the agency.”
“suggested” isn’t much of a commitment. I wonder what he’s done as a “priority”..
Whoops — wrong link to Gottlieb confirmation. Here’s the right one.
Here is a link to the paper on the men who served in Vietnam, became addicted to heroin and their remarkable recovery once they were back in the US.
From the right column of page 1045 in this article from Lee N. Robins :
“In the first year after return, only 5% of those who had been addicted in Vietnam were addicted in the US (Fig 4; Robins, Davis & Nurco, 1974b). This finding was totally unlike the outcomes of young men treated in Lexington, the Federal Narcotics Hospital at the time. When those young men were followed 6 months later, two-thirds were found to already be re-addicted (Stephens & Cottrell, 1972).”
[Skipped last of paragraph]
“It was not treatment that explained this remarkable rate of recovery. Only a third of the men addicted in Vietnam received even simple detoxification while in service and only a tiny percentage of Vietnam enlisted men went onto drug abuse treatment after return-less than 2% of those who used narcotics in Vietnam, 6% of those who were positive at departure, and 14% of those positive at departure who continued to use after return(Robins, 1975). Yet those who did enter treatment had relapse rates as high as the young civilian men in Lexington—two-thirds had relapsed by the time we interviewed them. Relapse often occurred the very day they left the hospital (Figure 6).”
Long tooth you are so right. Message to Karl Kolchak. Less than 1% of pancreatic patients survive so you are extremely fortunate to be a survivor. I’m suprised you are not aware that cancer patients are not forbade from receiving opiates. The opiate was originally approved for cancer and end of life patients. It’ greed and corruption that turned this into an epidemic. I was recently on a podcast – Underground Knowledge. An interesting question was posed by James Morcan, an australian. “How could this happen in America [opiate epidemic]?https://youtu.be/oXnzYUEpJSw
I was on hydrocodone for a solid month after I was released from the hospital after a bike accident. It was a godsend. Blunted the pain of four cracked ribs and a broken clavicle. After a month I just stopped. Let’s not throw the analgesic baby out with the bathwater.
I am sure you were in pain. They went 10 -12 inches up my back and I had issues for a while also. Not much fun. The oxy just numbed me up and gave me headaches. I stopped after a couple of days and stayed with Tylenol. Because most stuff can affect my platelets, I also to be careful of that also.
“All the solutions to the opiate crisis seem to assume that other painkillers are available for everyone to use and that everyone who receives opiate painkillers will eventually become addicted and live for their drugs.”
You lost me on this one…none that I have seen. Links??
Here’s a doctor speaking about chronic pain. Maybe this will help you.
I will listen to it probably early in the morning when no one will bother me. I am going to put up your PodCast with a commentary about you. What I do not get is that 1980 letter written by Medical people (MDs, etc.). How could they ever arrive at the conclusion they did, Opioids are not addictive? That is almost criminal. At MEDPAGE, the supposed doctors were washing their hands of it saying it was the patients fault if they become addicted. They said it would not, a know mind numbing drug, be addictive. How do you say that and walk away?
Another and CLTC certified person (Stephen) was saying a minority of people die from prescription Opioids. I guess 30% of the total OD deaths is a minority. I am not sure they will post my comment back to him.
Opioids are potentially addictive. So is alcohol. So is tobacco. I’ve used each of these in my life and became addicted to none of them. Per my post above, I spent a month on hydrocodone (having been on morphine for three days in the hospital). I quit cold turkey without any problem. There is no necessary link between opioid use and addiction.
Opioids are addicting. I do not remember reading about any doctors claiming tobacco or alcohol are not addictive in the NEJM. It was cited 600 times up till 2016 in support of opioids not being addictive or rare in finding such. Don’t be ridiculous.
On pain and pain killers:
I have a very high threshold of pain and stop pressing my hospital pain killer button within hours of recovery, and demand they remove the spinal I’ve been back in my room for about 12 hrs — arguing with my anesthesiologist. I have a 20 inch scar from by breast bone down one side to my waist … I can’ remember how many stalples there were… over 20 though.
I always want to know my level of pain without pain killers… if it get’s to the I’m nearly ready to pass out from I’ll relent — that’s never even come close. I adjust to whatever my pain level is and just deal with it… I don’t really even call it pain, but a high level of discomfort.
On the other end of the spectrum is my wife… the slightest ache and she’s downing ibuprofen like it’s going out of style. Anything beyond that and it’s a pain-killer (docs always presriber her at least a 7 day supply, refillable. She’s had each hip replaced… you’d think she was dying or something so she takes the max dosage of the heaviest opiods possible and then some. After 3 days I take the bottle away, an give her the min dosage while she calls me every foul name she can think of, threatens to divorce me, etc.
Amazing what happens then though She’s clear headed, & begins moving around in a fashion that minimizes her pain,, taking it slowly and causiously and within a week is taking a Tylenol occasionally. Her motto is “pain killers are your friend”, but she’s always told me that that she recovers faster and feels better sooner under my dosages for her. even though she wants to kill me at the time.
Over the nearly 50 years we’ve been married I’ve learned when she’s really in real pain and needs the pain killers and when she’s trying to feel nothing because it’s discomforting.
She does have one on-going occasional real pain though… from a rare condition (pseudo-gout) in one knee that comes to life once in a great while with no warning. A doc that knows what this condition is can fix it with one, well-placed cortisone shot — the shot’s as painful as the pseudo-gout because the needle has to wend it’s way into the right spot between moving parts. But pain is totally gone in 2 minutes, knee works and moves fine as if the pseudo-gout had never happened. The crystals dissolve on their own in a few more weeks.This occurred 3 times in 20 years It’s got nothing to do with diet or excess urea build-up .. there’s no known cure or preventive measures. It’s very hard to identify because there’s no infection of any kind — multiple bacterial tests show zero response even after two weeks in the petri dish. X-rays and CT-scans show nothing’s wrong at all. Normal microscopic examination of the fluid build-up are clear. BUT, at 250x magnification some tiny particles show up faintly and at 500x – 1000x they are identified as a crystal… a rare calcium crystal — it took a university a month to figure out what they were and how they can form..
tt took an entire team of specialists the first time two weeks to identify that it was caused by a crystal while she suffered to crying and not being able to even speak thru the pain…. pain killers helped but only a little bit so an anesthesiologist had to put her under three times.
Finally an old 65 year old doctor reviewed all the symptoms (or lack of them) and said use 250x or more magnification — you’ll see tiny little particles.. like a haze in the fluid. He was 99% sure. If so, it’s pseudo-gout… none of the team of specialists had even heard of it. Just luck that one doc was able figure it out and he wasn’t even part of the team of specialist. Oh, and this was a major well staffed hospital.
Anyway I know when my wife’s in real pain or approaching it… 90% of the time it’s not even like a bee-sting — more like a strained or pulled muscle, but her brain is telling her it’s really, really bad. That pain has to be treated of course…. but these varying degrees of pain thresholds among people is still self-assessed and docs or nurses don’t know patient’s well enough to know when it’s not really hurting them and when it is.
Someday docs will figure out what in the brain is interpreting pain and find a way to negate it or measure it at least on an objective scale and treat accordingly without addictive drugs. Someday, not soon.
Longtooth regarding your comment “addictive drugs don’t kill people” comparing to gun literature. You are quite wrong about that. The highly addictive opiate has in fact killed a lot of people. And do you acturally disagree with the drug dealers some of whom are doctors not being held accountable?