Opioids: Last Week Tonight With John Oliver

Bobw235

Bobw235

Senior Member
Location
Massachusetts
Last year my wife had surgery on her spine and received Oxycodone for post-surgical pain. I can recall the doctor warning her about safeguarding the prescription and making sure she took the pills to stay ahead of the pain. Fortunately my wife didn't need them for more than about 45 days and recently discarded the remainder of her prescription. Never filled the last scrip they gave her.

I write all of this as an introduction to a 19 minute segment that John Oliver did last night on the subject of opioids and how the crisis got started. He takes a long look at the pharmaceutical industry (including Purdue Pharma) and how they were largely responsible for the current crisis in not only opioid addiction, but also the rise in heroin addiction. While some of this piece is funny, the segment is very serious and his team really brings to light a very serious problem. Highly recommend it if you have the time to watch.

It's also interesting to see this segment in light of the reading I'm doing for my upcoming volunteer program with a local hospice, where management of pain is such a huge part of what they do. As the reading is making clear, management of pain in the final stages of life is critical for a peaceful death in many cases.

 

Well done on volunteering for hospice. You are a good one, Bob. :)
 

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I'm a big fan of John Oliver's and I love how he can really nail serious issues. I don't have an HBO subscription currently, but fortunately his show is on YouTube.
 
We have talked about this a few times here on this forum. Up until three years ago, I counseled substance abuse (drugs and alcohol) addicts having been certified from Penn State University. I only watched a few minutes of the video and did not find anything funny about addiction, so I turned it off. Opioids, or opiates in this country as well as world wide has become pandemic. A lot of the addicts that I spoke with, especially those above the age of 35 told me that they got their start from doctors giving them pain pills for sprains, broken bones or a surgical procedure. I also took some after my surgeries. I found them to be very helpful with controlling pain, but also with giving me a euphoric feeling like I had never experienced. Because of my short term use with these drugs, I can understand how some people get hooked on these types of pain killers. Morphine, which is contained in most of these pills, has a very addictive effect.

There are two parts that have become the most dangerous to one's life that is connected with them. One is the fact that as people continue to take these drugs their body become immune to the potency and the user feels a need to increase the dosage to achieve the same effect as they first experienced when they began taking them. Soon, they are taking such a high dose that they actually can stop their heart. The more pills a person takes, the lower the blood pressure and the slower the heart rate until the heart just no longer beats and death occurs. The second part is when the user begins buying their pills off of the street. Like any other street drug, the more the user becomes addicted to their drug, the higher the price. It can literally bankrupt a family, not to mention destroy the family.

Entering a detox clinic is not easy for most middle or lower income Americans. The price of a long term rehab facility has increased tremendously over the last 20 years. An addict entering a long term rehab facility can expect to pay $30,000.00 and up. There are some free or low cost clinics, but the waiting line to be accepted is exhaustingly long and unfortunately, they are sometimes staffed by less than average therapists and counselors. Once a person has gone through the detox portion, the rehab comes next and that can last a minimum of another 28 days.

It's a long, slow process to get clean, but staying clean is the next step and not so easy for many addicts. Over the six years that I counseled addicts, I heard stories that broke my heart and when the day is over, it's very hard to put these unfortunate people out of your mind. It almost becomes a part of you and your life. On occasion, I would go home and find myself wondering what "John" or "Sue" is doing. Are they out on the street buying pills, are they at home getting high or are the really working at getting clean. I have been told by several addicts the main reason why they never wanted o get clean was because of all of the horror stories they heard about going through with withdrawals. Withdrawing from pills is one thing, but withdrawing from Heroin is definitely another and it can make a person wish that they were dead. Methadone is not really an answer. It's like putting a band aide on a cut that needs stitches.
 
While Oliver certainly injects humor and sarcasm into his pieces, I agree with Oldman above, that there's nothing funny about opioid abuse/addiction. The point that Oliver brings to light in the video however is the insidious marketing efforts by large Pharma to convince doctors and others that it was okay to dispense this stuff so freely. Much of the current epidemic is layed at the feet of the pharmaceutical industry, particularly Purdue Pharma and one other that he names in the piece. Purdue paid a heavy fine for their efforts, but the cat was out of the bag. This country does little in the way of helping those who are addicted, and now it's led to an ever-widening heroin crisis.
 
The distribution of opiates became so bad in Florida that pill mills were actually being able to do business. I remember one case in particular where two brothers were in the pill mill business and they had an on-site M.D. that would write the Rx and give it to the customer (not patient), who would then take it to the counter to have it filled. Of course, there was a premium that had to be paid to receive this service. These two jackasses made millions before the DEA caught up to them.

The last that I knew, Florida had established a database whereby patients that would take their Rx to a legitimate pharmacy would have their Rx recorded into the database that showed name, date of birth, date of issue and the prescriber of the Rx and number of pills distributed. Each patient was only permitted a certain number of pills per a 30-day period. This is good, but it's only a start. How does anyone contain the number of pills sold on the street?

I remember my surgeon issuing me an Rx for 100 pills of Hydrocodone, 7.5-500 (Vicodin) to be taken 2 every 4 hours. The 7.5 number is the amount of Hydrocodone and the 500 number represents the amount of Acetaminophen. This is above the suggested amount of Acetaminophen as suggested by the FDA. If taken according to the dosage, this would mean that the user would be taking 6 grams of Acetaminophen, which the FDA only recommends that the amount of Acetaminophen should not exceed 4 Grams per day.

Hydrocodone is the generic for Vicodin. Oxycodone is the generic for Percocet and Hydromorphone is the generic for Dilauded. All are considered very hazardous drugs and should not be used for recreational purposes.
 
Maybe I'm weird, but I took my fair share of opioids during the period directly before and after I had my hips replaced in 2013 (surgeries a month apart), and never once did any of them make me feel "good" or high. My doctor insisted I take them as directed and not "be a hero" because, he said, the body can't heal as well or as quickly if it is fighting pain. I even had to keep a little chart. The only thing they did was take the pain away, which they are supposed to do.

I never had the inclination to increase the dosage, nor to take them after the pain subsided. So I guess it's hard for me to imagine why people would take them when they don't need them for pain. I didn't feel any euphoria or anything like that at all, just a bit sleepy. The oxycontin made me feel a bit woozy (and not in a good way), but nothing from the others at all except, as I said, a bit sleepy sometimes. Maybe they affect some people differently??
 
Butterfly.... Not all opiates contain morphine. If you were given a drug that contained codeine for example, you may have just been a little fuzzy headed. Regardless, if you take any opiate and drive, be careful not to get stopped. If you do, you may be checked for alcohol or other substances and the penalties, at least here in PA are very stiff (expensive).
 
Butterfly said:
Maybe I'm weird, but I took my fair share of opioids during the period directly before and after I had my hips replaced in 2013 (surgeries a month apart), and never once did any of them make me feel "good" or high. My doctor insisted I take them as directed and not "be a hero" because, he said, the body can't heal as well or as quickly if it is fighting pain. I even had to keep a little chart. The only thing they did was take the pain away, which they are supposed to do.

I never had the inclination to increase the dosage, nor to take them after the pain subsided. So I guess it's hard for me to imagine why people would take them when they don't need them for pain. I didn't feel any euphoria or anything like that at all, just a bit sleepy. The oxycontin made me feel a bit woozy (and not in a good way), but nothing from the others at all except, as I said, a bit sleepy sometimes. Maybe they affect some people differently??
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I think that may be true, Butterfly. I have severe arthritis in my hands, neck, and knees, for which I have been taking two 10mg Hydrocodone per day for nearly three years. I get adequate pain relief, but no warm and fuzzy feeling and no desire to take more than needed/prescribed. I was prescribed oxycontin by one doctor but it made me feel woozy, so I asked my current doctor to put me back on Hydrocodone. I guess we are lucky that we aren't predisposed to addiction, if that's what's making the difference.
 
911 said:
Butterfly.... Not all opiates contain morphine. If you were given a drug that contained codeine for example, you may have just been a little fuzzy headed. Regardless, if you take any opiate and drive, be careful not to get stopped. If you do, you may be checked for alcohol or other substances and the penalties, at least here in PA are very stiff (expensive).
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Yeah, I got a big lecture from my doc about that. I wasn't allowed to drive for 6 weeks after each surgery, anyway.
 
Ummm, not an addict but I can appreciate comfortably numb. Hubby had a hideously bad reaction to codeine or narcotics in any form. Extreme vomiting etc, etc...certainly not pain relief. Me and Oxy? Meh...no difference really. Ativan is a good thing. All systems down. Xanax, they'll tell you it's addictive. If you need something for nights to turn it all off. Not every night but yes.
 
Did you know that the most addictive narcotic is "Nicotine?" This is why it is so hard for so many people to quit smoking. People will say it's hard to quit smoking because it's a habit, but so is shooting Heroin. Smoking is a habit, but above that, it is also an addiction. In this instance, there is a fine line between a habit and an addiction.
 
oldman said:
Did you know that the most addictive narcotic is "Nicotine?" This is why it is so hard for so many people to quit smoking. People will say it's hard to quit smoking because it's a habit, but so is shooting Heroin. Smoking is a habit, but above that, it is also an addiction. In this instance, there is a fine line between a habit and an addiction.
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I definitely agree with that. Quitting smoking is the hardest thing I've ever done. It's the nicotine + the psychological addiction.
 
I can remember back when we were able to smoke while flying. At one time, we had three pilots on the flight deck; Captain, First Officer and an Engineer (or Navigator). If all three would smoke, it was horrible. That only lasted for a short time on the flight deck before most airlines in the U.S. did not allow smoking on the flight deck. I did smoke at that time and I would step outside the cockpit and grab a few puffs to hold me over. Habit, addiction or whatever you want to call it, all I knew at that time was when I needed a smoke, I needed it now.
 
oldman said:
Did you know that the most addictive narcotic is "Nicotine?" This is why it is so hard for so many people to quit smoking. People will say it's hard to quit smoking because it's a habit, but so is shooting Heroin. Smoking is a habit, but above that, it is also an addiction. In this instance, there is a fine line between a habit and an addiction.
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I have had inmates tell me that nicotine cravings were worse than heroin's.
 
I don't know if I'm off topic on this but- I found out when my gall bladder was about to rupture that morphine had no effect on me whatsoever. I did not realize they had given it to me twice already in my IV so I complained to my nurse and said " Why haven't I received anything for pain yet when I'm in so much agony?" He said " I've already given you morphine twice and I can't give you anything else right now it would be an overdose." Here I am someone who has never done drugs or taken any pills habitually and morphine not only did not work on me, but may have even intensified the pain. The nurse came back in finally and gave me dilaudid which did work and told me that there are some people that morphine does not work for and that it has been known to intensify pain for some people. I thought that was so strange when it happened to me.
 
BlunderWoman said:
I don't know if I'm off topic on this but- I found out when my gall bladder was about to rupture that morphine had no effect on me whatsoever. I did not realize they had given it to me twice already in my IV so I complained to my nurse and said " Why haven't I received anything for pain yet when I'm in so much agony?" He said " I've already given you morphine twice and I can't give you anything else right now it would be an overdose." Here I am someone who has never done drugs or taken any pills habitually and morphine not only did not work on me, but may have even intensified the pain. The nurse came back in finally and gave me dilaudid which did work and told me that there are some people that morphine does not work for and that it has been known to intensify pain for some people. I thought that was so strange when it happened to me.
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That's really not as unusual as some people may think. Without going into all of the medical terminology about proteins and such, some people do not get an effect from morphine and in fact, some people may actually have their pain increased from the use of morphine. Dilaudid, also known as Hydromorphone, has its own set of problems. This is why most doctors will start out with small doses such as 1 cc and then increase it as necessary. Biggest issue with Dilaudid is breathing cessation. If you ever get an injection of Dilauded, take note if you begin to have an issue with breathing. I know we have a few R.N.'s here on the forum and they know more about this than me, but I have seen people overdosed on this drug and all but stopped breathing. On the other hand, I have also known addicts to use Dilauded pills, crushing them and then cook them for injections. Some people (addicts) will go to great lengths to get a high.
 
BlunderWoman said:
I don't know if I'm off topic on this but- I found out when my gall bladder was about to rupture that morphine had no effect on me whatsoever. I did not realize they had given it to me twice already in my IV so I complained to my nurse and said " Why haven't I received anything for pain yet when I'm in so much agony?" He said " I've already given you morphine twice and I can't give you anything else right now it would be an overdose." Here I am someone who has never done drugs or taken any pills habitually and morphine not only did not work on me, but may have even intensified the pain. The nurse came back in finally and gave me dilaudid which did work and told me that there are some people that morphine does not work for and that it has been known to intensify pain for some people. I thought that was so strange when it happened to me.
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I had one of those morphine pumps after my hysterectomy. I used the maximum allowed but still had pain.
 
tnthomas said:
I have had inmates tell me that nicotine cravings were worse than heroin's.
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I had a friend tell me that when he stopped smoking he was going through his trash to try to find a butt, so he could catch a drag or two to stop the withdrawals. I forget a lot since I no longer counsel addicts, but I believe that nicotine has a half life of about 2 hours, meaning that after that time, the user will begin to look for a cigarette, or a butt, or if he chooses to stay off of the smokes, he will start his withdrawals. I know that when I quit, I was a miserable person and anyone around me was also miserable, so I tried to stay clear of my friends. I quit when I went on vacation, so that I would be away from most everyone that I knew. Cold turkey, no gum, patches or anything. Just me and my madness.
 
oldman said:
That's really not as unusual as some people may think. Without going into all of the medical terminology about proteins and such, some people do not get an effect from morphine and in fact, some people may actually have their pain increased from the use of morphine. Dilaudid, also known as Hydromorphone, has its own set of problems. This is why most doctors will start out with small doses such as 1 cc and then increase it as necessary. Biggest issue with Dilaudid is breathing cessation. If you ever get an injection of Dilauded, take note if you begin to have an issue with breathing. I know we have a few R.N.'s here on the forum and they know more about this than me, but I have seen people overdosed on this drug and all but stopped breathing. On the other hand, I have also known addicts to use Dilauded pills, crushing them and then cook them for injections. Some people (addicts) will go to great lengths to get a high.
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I have a completely fear/phobia of addiction. I have sciatica and I don't take anything other than aleeve for the pain and I try not to even take that. After I fractured my neck last year I never took the oxycontin they sent me home with. I didn't notice any trouble breathing because right after that I was wheeled in for surgery & it was lights out after talking to the anesthesiologist for a couple of minutes.
 
oldman said:
I had a friend tell me that when he stopped smoking he was going through his trash to try to find a butt, so he could catch a drag or two to stop the withdrawals. I forget a lot since I no longer counsel addicts, but I believe that nicotine has a half life of about 2 hours, meaning that after that time, the user will begin to look for a cigarette, or a butt, or if he chooses to stay off of the smokes, he will start his withdrawals. I know that when I quit, I was a miserable person and anyone around me was also miserable, so I tried to stay clear of my friends. I quit when I went on vacation, so that I would be away from most everyone that I knew. Cold turkey, no gum, patches or anything. Just me and my madness.
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I'd say I had serious cravings after about 90 minutes. I knew when I quit I was going to be a miserable b*tch for at least 6 months and would wake every day wishing for a cigarette. I did use the 24 hour patches which did help (but also gave me very vivid dreams). The date I chose to quit was when I was moving to a new place, so it was somewhere I'd never smoked. Dumped my leather cigarette case, lighters and all ashtrays in the bin when I moved. Had a boyfriend that didn't smoke and didn't have any friends that smoked.
 

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