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As you all may have heard by now, heroin and especially opioid prescription abuse have become an epidemic in America in recent years and has been the subject of numerous news stories in American media as of late. Cases have been cited of doctors redosing patients on opioids even immediately after suffering an overdose, among other worrying concerns.This seems to be especially the case in the Midwest as billboard PSAs and reporting heroin dealers to authorities have been going up. What are the factors spurring a rise in prescriptions, abuse, and overdoses? I do not have the article and statistics on hand to construct a proper OP on the background of the contemporary opioid crisis but plan on revising this post in the future to make it so. In lieu of this, please discuss and debate the issues at hand with heroin intentionally cut with fentanyl, doctors overprescribing opioids, the effects of opioids on the workplace, the factors behind and effects of Florida's lax oxycodone pill-mill regulations, and etc. Teriyaki Koinku fucked around with this message at 20:35 on Jan 20, 2016 |
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Jan 20, 2016 20:28
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Jan 20, 2016 20:31
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So I keep seeing stories about how prescription rates in the US are really high compared to other nations so therefore patients are giant pansies who need to suffer through their pain. How do we know that pain meds are being prescribed too much rather than other nations simply not caring about pain? It seems rather cruel to tell a patient, "just suck it up, it's only terminal cancer". How much higher are these rates? Are doctors generally giving refills on these automatically? Or does this have to do with the lack of records that cross state lines?
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Jan 20, 2016 23:53
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This all has to do with the war on drugs starting to finally affect Middle/Working Class white people instead of poor minorities.
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Jan 20, 2016 23:58
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LionYeti posted:This all has to do with the war on drugs starting to finally affect Middle/Working Class white people instead of poor minorities. pangstrom posted:Is there a "heroin epidemic" thread? These numbers are in the car-crash-death range.  http://www.nytimes.com/interactive/2015/10/30/us/31heroin-deaths.html quote:Heroin-related deaths jumped 39 percent from 2012 to 2013, and the longer-term trends are equally disturbing: from 2002 to 2013, the rate of heroin-related overdose deaths nearly quadrupled, according to the Centers for Disease Control and Prevention.
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Jan 21, 2016 00:35
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LionYeti posted:This all has to do with the war on drugs starting to finally affect Middle/Working Class white people instead of poor minorities. So what changed such that it's affecting new demographic groups?
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Jan 21, 2016 00:47
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Solkanar512 posted:How do we know that pain meds are being prescribed too much rather than other nations simply not caring about pain? It seems rather cruel to tell a patient, "just suck it up, it's only terminal cancer". How much higher are these rates? Are doctors generally giving refills on these automatically? Or does this have to do with the lack of records that cross state lines? It's just as likely that other industrialized nations have better systems in place to manage chronic pain than to write a bottomless scrip for opioids, which doesn't help long term but is the least costly option. Solkanar512 posted:So what changed such that it's affecting new demographic groups? From what I've read, we've created a stealth class of opiate addicts through relatively generous pain pill policies, because these are powerful drugs just good drugs because they're legal and doctors said you could take them. Except if you start cracking down on how many pills an addict can get a month or how stringent perscription policies are (cracking down on pill mills) people suddenly can't get the pills anymore and since you're breaking the law anyway cheaper and easier to get heroin might start looking like a good option. fade5 posted:Now that Heroin affects middle class white people, it's suddenly an epidemic and we need to take a look at our drug laws and throwing people in jail for shitloads of time. Well it's not just "white people's lives are more valuable" but an actual increase in drug consumption. Especially as people end up falling backwards into addiction through the medical system rather than due to stereotypical methods of lowlife drug abuse. These images are as powerful as they are false, and can easily convince a middle class pillhead that they're not an addict because they get their drugs from a doctor. boner confessor fucked around with this message at 01:18 on Jan 21, 2016 |
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Jan 21, 2016 01:16
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It's also not just because it's whie people dropping H for the first time, its because H is too drat cheap thanks to Mexican cartel evolution into vertically integrated corporate structures.
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Jan 21, 2016 01:20
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Popular Thug Drink posted:From what I've read, we've created a stealth class of opiate addicts through relatively generous pain pill policies, because these are powerful drugs just good drugs because they're legal and doctors said you could take them. Except if you start cracking down on how many pills an addict can get a month or how stringent perscription policies are (cracking down on pill mills) people suddenly can't get the pills anymore and since you're breaking the law anyway cheaper and easier to get heroin might start looking like a good option. Yeah the article fade5 posted suggests it's just people that would traditionally get pain problems, like coal miners in Appalachia, being prescribed stronger opioid painkillers all of a sudden. Heroin-related deaths are more common in the Mid-Atlantic region and Illinois (which could be either due to crackdowns on people addicted to prescription opiates like you said, or just because PA/NY/IL have bigger cities where traditional illicit use is more common) while people are just dying from overdoses of the pills themselves in WV and the Midwest. Solkanar512 posted:How do we know that pain meds are being prescribed too much rather than other nations simply not caring about pain? It seems rather cruel to tell a patient, "just suck it up, it's only terminal cancer". How much higher are these rates? Are doctors generally giving refills on these automatically? Or does this have to do with the lack of records that cross state lines? Because of the geographic distribution of overdoses, it seems more likely that strong painkillers are being prescribed for things other than cancer. Workplace injuries related to manual occupations. No one is going to fault someone slowly dying of agonizing cancer for slapping a fentanyl patch on every day, but someone with a moderate strain injury should at least be given weaker options at first. You want to save drugs this powerful for when it's clear there is no other option, because pulling the rug out from under people's feet after prescribing them is probably just going to lead to street drug use.
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Jan 21, 2016 01:42
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Weldon Pemberton posted:Yeah the article fade5 posted suggests it's just people that would traditionally get pain problems, like coal miners in Appalachia, being prescribed stronger opioid painkillers all of a sudden. Heroin-related deaths are more common in the Mid-Atlantic region and Illinois (which could be either due to crackdowns on people addicted to prescription opiates like you said, or just because PA/NY/IL have bigger cities where traditional illicit use is more common) while people are just dying from overdoses of the pills themselves in WV and the Midwest. It's because IL is the railroad hub of the nation, and Mexican cartels are shipping heroin in by the boxcar.
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Jan 21, 2016 01:43
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As I understand it it was mainly these bastards.quote:From 1995 to 2000, Purdue conducted 40 "pain conferences" in resorts like Boca Raton, Florida, and Scottsdale, Arizona, focused on primary care physicians and doctors specializing in cancer care. Purdue lined up more than 2,500 physicians for paid speeches and presentations at health-care seminars, and in 2001 alone spent $4.6 million for OxyContin advertisement in medical journals.
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Jan 21, 2016 01:53
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The cause of the shift to heroin appears to be related to the closing down of the pill mills that were flooding oxy into communities in the first place. And the root cause of the pill mills was deliberate pressure by the people that stood to profit from sales. https://medium.com/@jasisrad/kingpins-1fa9331c705d#.hj1gb5ids That said, the rebound opiophobia among physicians is also a problem for people who are legitimately in pain. The US still seems to be better than a lot of other countries when it comes to pain management though, even though the DEA classes heroin as Schedule I with 'no medical use', which is patently absurd. Many other countries suffer highly rampant aversion to opiates even in terminal cases. http://www.npr.org/sections/goatsandsoda/2015/10/16/449243933/how-uganda-came-to-earn-high-marks-for-quality-of-death
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Jan 21, 2016 01:58
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Popular Thug Drink posted:
This is what happened to my sister after her dentist accidentally broke her jaw. After getting 120 count oxycontin prescriptions monthly the withdrawal for her was far worse than simply picking up a habit.
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Jan 21, 2016 01:59
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LionYeti posted:This all has to do with the war on drugs starting to finally affect Middle/Working Class white people instead of poor minorities. Doctors are less likely to prescribe opioids to minorities due to some combination of discounting their pain and believing that they are more likely to become addicts.
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Jan 21, 2016 03:24
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Guavanaut posted:The cause of the shift to heroin appears to be related to the closing down of the pill mills that were flooding oxy into communities in the first place. And the root cause of the pill mills was deliberate pressure by the people that stood to profit from sales. Maybe the best middle-ground solution would be to have one government-run pill mill for addicts looking to get a fix? Seems like a win-win-win all around.
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Jan 21, 2016 03:45
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Sure is weird that American communities were flooded with coke in the 80s when the CIA was fighting undeclared wars against the people of Latin America, and it is definitely weird today that American communities are flooded with heroin today, after a decade of sustained war in Afghaistan and the Middle East.
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Jan 21, 2016 03:59
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DOCTOR ZIMBARDO posted:Sure is weird that American communities were flooded with coke in the 80s when the CIA was fighting undeclared wars against the people of Latin America, and it is definitely weird today that American communities are flooded with heroin today, after a decade of sustained war in Afghaistan and the Middle East. Perfect avatar/post combo there.
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Jan 21, 2016 04:11
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Weldon Pemberton posted:Because of the geographic distribution of overdoses, it seems more likely that strong painkillers are being prescribed for things other than cancer. Workplace injuries related to manual occupations. No one is going to fault someone slowly dying of agonizing cancer for slapping a fentanyl patch on every day, but someone with a moderate strain injury should at least be given weaker options at first. You want to save drugs this powerful for when it's clear there is no other option, because pulling the rug out from under people's feet after prescribing them is probably just going to lead to street drug use. It's incredibly dangerous how the War on Drugs and "tough on crime" policies have lead to this ingrained reaction of "Oh, you're abusing your overprescribed pain meds that led you into addiction in the first place? Well, gently caress YOU, then, you dirty addict!" and yanking away support and leaving people to rot instead of providing a means to help people through the strains of physical and mental addiction. The former literally promotes deeper addiction and maladaptive behavior and only increases crime. It's a simple A to B cause and effect here that only serves to satisfy the emotional prejudices of society in shunning and isolating addicts from others. It's like cutting people off entirely from pain medication and their current primary doctor after turning up positive for marijuana or some other drug; it can only do massive amounts of harm to everyone involved. The cultural stigma around addiction as immoral criminality desperately needs to be changed to a compassionate medical perspective instead. It just takes an entirely different way of viewing things without that emotional baggage that continuous propaganda has built up. Teriyaki Koinku fucked around with this message at 04:30 on Jan 21, 2016 |
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Jan 21, 2016 04:26
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I was prescribed some opiates when I had my tonsils removed as a teen, and I didn't become a heroin addict. I don't see why the folk with oxycotin prescriptions can't give up their medication as well as teen me did.
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Jan 21, 2016 04:56
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Weldon Pemberton posted:because pulling the rug out from under people's feet after prescribing them is probably just going to lead to street drug use. This is pretty much it. The Oxy scourge made it 10x worse, but the problem simply comes down to people suffer chronic pain that Tylenol and Advil aren't going to touch, they get prescribed painkillers then the DEA scares their doctors and they get cut off. Except they are still in pain and if you can't get prescribed proper pain management drugs you'll turn to buying them illegally and when that fails heroin is next up. My wife worked with a guy who got in a motorcycle accident, lost his arm and his back and neck were destroyed. His neck so badly that his head was locked in position cocked so far to the side were his arm used to be his ear was on his shoulder. When his pain was being managed properly he was able to function just fine, hold a job and have a normal (for him) life. Then he got cut off because the DEA decided his doctor was writing too many pain scripts and the combined massive injury pain and withdrawal he ended up on heroin. He was never 'high' under the care of a doctor but you never know if the next batch of heroin is 50% baby laxative or almost pure. He lost his job, his heroin use went up until he OD'd twice. Luckily he got a morphine pump installed before his heroin use could kill him. Pharmacies contribute to it too, CVS can burn to the loving ground. I have the fun of a 'spastic colon'. My intestines are constantly writhing like a nest of snakes. Tack on getting internal and external cysts and there care days I feel like I swallowed a handful of nails. When I'm under the care if a doctor who manages the spasticity and pain I'm fine aside from the occasional days when even the drugs can't control it but even getting my scripts filled was a loving nightmare, luckily I have a insurance company that fills everything mail order now but before then I came drat close to hunting for smack just so I could stay employed. I don't ever mention it because the first reaction to finding out I take 40-50mg of oxycodone daily and the first reaction is Im some kind of junkie. I don't even get a buzz, he'll I don't even like the high from opiates but just being on painkillers regularly immediately marks you as just another addict abuser. Unless you have an obvious broken limb or visible injury people can't comprehend that yes, lots of people suffer chronic pain and it usually only gets managed by pure luck of finding a doctor and pharmacy willing to do it.
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Jan 21, 2016 05:45
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My Imaginary GF posted:I was prescribed some opiates when I had my tonsils removed as a teen, and I didn't become a heroin addict. I don't see why the folk with oxycotin prescriptions can't give up their medication as well as teen me did. Is this supposed to be a joke or meant seriously? I can't tell with MIGF. Maybe it started with Reagan and the "welfare queen" myth, maybe not, but in America we have this weird obsession with trying to root out addicts - real and imagined - and ignoring real suffering needing treatment. We'd rather leave a thousand people in genuine need out to dry rather than let one addict possibly abusing scripts go scot-free. 
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Jan 21, 2016 06:32
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Your Dunkle Sans posted:Is this supposed to be a joke or meant seriously? I can't tell with MIGF. The official line is that the cause of drug addiction is drugs, end of discussion. The only alternative research we have is things like Bruce Alexander's rat park, which isn't something that is marketed much to the public.
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Jan 21, 2016 11:44
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A comment on the pain angle. A lot of the pain that opioid medication is prescribed for is chronic pain. And if you look at the relevant statistics (http://www.painmed.org/patientcenter/facts_on_pain.aspx ), it's actually that the US does not only have an opioid epidemic. It has a chronic pain epidemic, it's just that it's trying to medicate it via opioids. The thing is, talking to doctors who specialise in pain research, for most people, chronic pain is like depression or emotional eating/obesity - it's like the physical bodily expression of chronic stress. Everyday grind. Women are twice as likely to report headaches and orofacial pain than men, for example. And it's not just that women and minorities find doctors to be less sympathetic to their pain - it's just that lower status and greater stress cause give one a greater probability of acquiring chronic pain in the first place. And, conversely, because it's a stress thing, chronic pain can be cured, or hugely mitigated, by physical therapy, massages, gentle exercise, better eating, better support nets, better workplace security, increased status and respect and so on. Just quality of life stuff. At some level, I'm pretty sure a case could be made that this pain-opioid epidemic is partly the result of [sanders]widening inequality[/sanders], although, like I noted, it's not just the inequality of income, it's also inequality of status. It's just that, similar to the obesity epidemic, the actual cure to the underlying pain epidemic is, well, transformation of the understanding of the connection between lifestyle, work conditions and pain. And, obviously, [sanders]the glorious workers' revolution[/sanders].
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Jan 21, 2016 14:34
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If you're doing a Marxist analysis of it, you could also blame the increased secularization of society. 
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Jan 21, 2016 14:37
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fade5 posted:Now that Heroin affects middle class white people, it's suddenly an epidemic and we need to take a look at our drug laws and throwing people in jail for shitloads of time. That's some impressive levels of selective reading to support a desired narrative, you sure its not an epidemic because of that part that said quote:Heroin-related deaths jumped 39 percent from 2012 to 2013, and the longer-term trends are equally disturbing: from 2002 to 2013, the rate of heroin-related overdose deaths nearly quadrupled
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Jan 21, 2016 14:53
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Guavanaut posted:If you're doing a Marxist analysis of it, you could also blame the increased secularization of society. I'm a chronic myofascial pain sufferer myself, so I had to acquire some understanding of how to deal with it, and what to avoid, because I needed to learn how to doctors so that they wouldn't be just 'here's a pill'. Part of it was attending this MOOC by James Fricton - https://www.coursera.org/course/chronicpain . The analysis comes all from there, and I'm pretty sure you can find more academic stuff if you start at the link I gave. Quarrel with the good doctors, not with me. For me, even though I'm post-surgical and the underlying cause won't ever go away, lifestyle changes worked. But, hey, anecdotes.
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Jan 21, 2016 14:53
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American doctors are way too free and easy with opioids. I had minor surgery in the UK, and got released from the hospital with nothing more than a "good luck." I had minor surgery in the USA a few years later and got a bottle of Percocet that could have kept me high for a week. I didn't need it, didn't use it (took one pill and found I didn't like it.) I have a pain issue (not all that bad, generally just nagging) and I feel like I really have to fight off a Percocet prescription every time I see anyone about it. I feel like I'm getting the message "If you are hurting, take Percocet, or else you aren't taking enough steps to control your pain." I don't want to take the nasty stuff. It constipates me and makes me loopy, plus, it's addictive and my pain isn't going to clear up soon, so I don't want to get addicted.
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Jan 21, 2016 14:58
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Are there any studies (non-Purdue funded) studies into how addictive opioid analgesics are when prescribed within a medical framework, as opposed for self medication of social malaise? Not an opioid at all, but doctors in California tried cocaine (under the brand name Esterene) as an insufflated arthritis treatment and found that it worked without anyone in the trial becoming addicted. It seems circumstance has a high correlation with likelihood of habituation and addiction. meristem posted:Heh, I thought I did, under 'support networks'. Churches often provide those. e: Maybe the reason they don't send you home with a bottle of percocet in the UK is because you can still buy Browne's Mixture OTC. Guavanaut fucked around with this message at 15:16 on Jan 21, 2016 |
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Jan 21, 2016 15:10
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Guavanaut posted:It was a "religion is the opiate of the masses" reference. Although it does raise some interesting questions about addiction and the collapse of traditional support networks in late capitalism. Catholicism has a lot of stories about saints who patiently endured endless pain, sometimes for many years.
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Jan 21, 2016 15:16
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My generous prescription story is when I was in Colorado I went to the clinic when my throat was really sore + swollen. Doctor ran tests, wasn't strep/mono, so he said it was probably viral and would go away on its own, in the meantime here's vicodin
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Jan 21, 2016 15:17
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Which is worse for the USA - funding giant pharmaceuticals or Mexican cartels?
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Jan 21, 2016 15:40
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Jarmak posted:That's some impressive levels of selective reading to support a desired narrative, you sure its not an epidemic because of that part that said Yes. Deaths are going up because it is infiltrating the white community, and thus is a problem. Please don't be willfully dense.
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Jan 21, 2016 15:42
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Your Dunkle Sans posted:Maybe it started with Reagan and the "welfare queen" myth, maybe not, but in America we have this weird obsession with trying to root out addicts - real and imagined - and ignoring real suffering needing treatment. We'd rather leave a thousand people in genuine need out to dry rather than let one addict possibly abusing scripts go scot-free. Having gone through decades of my issues people just have this bizarre mental block when it comes to pain. We have drugs for thousands of chronic problems, many of the drugs used for those make opiates look like candy when it comes to addiction and side effects. Every person I've known that's been on Paxil won't touch it with someone else's dick, getting off long term use makes opiate withdrawals seem like quitting coffee. Its maddening that people accept long term prescriptions for everything except pain. Lots of people also can't seem to grasp that taking opiates for pain management you're not getting high off them (besides things like 'going to die soon' levels of things like cancer). Even then I will never understand why taking any drug that brings you to normal is fine but no more, taking something to feel good is for some reason unthinkable. Unless it's alcohol or now weed. There are non-opiate options that will handle some chronic pain but like any other drug because it works for some does not mean it works for everyone, Nevermind that pure opiates are extremely non-toxic while some of the non-opiate alternatives have side effects a mile long. Pain meds are also the only drugs that it's acceptable to add enough poison to make sure God forbid nobody dares take extra and possibly feel good. I get prescribed 10mg percocets not because I take that much at once (I break them into halves or thirds) but because it keeps my acitominiphan intake below 1g/day so my liver doesn't fail. I have prescription strength diarrhea meds that are laced with deadly nightshade to make sure I don't try and get high (Lomotil, each pill has .025mg of atropine). At least I'm safe if I get nerve gassed! Yes, I know atropine has medicinal uses but it's added to these just so you feel like death if you take 'too many'. It's especially stupid because diphenoxylate doesn't cross the blood brain barrier very well so you'd have to take a handful to get high. The acitominiphan is also stupid because if you really want to get high and not destroy your liver extracting the opiate takes ice water and a coffee filter. BarbarianElephant posted:American doctors are way too free and easy with opioids. I had minor surgery in the UK, and got released from the hospital with nothing more than a "good luck." I had minor surgery in the USA a few years later and got a bottle of Percocet that could have kept me high for a week. I didn't need it, didn't use it (took one pill and found I didn't like it.) I have a pain issue (not all that bad, generally just nagging) and I feel like I really have to fight off a Percocet prescription every time I see anyone about it. I feel like I'm getting the message "If you are hurting, take Percocet, or else you aren't taking enough steps to control your pain." I don't want to take the nasty stuff. It constipates me and makes me loopy, plus, it's addictive and my pain isn't going to clear up soon, so I don't want to get addicted. One or even three scripts of Percocet is not going to make you addicted I wish this loving myth would die already. Great you didn't need it, some people do. Demonizing doctors who God forbid want to make sure you aren't in pain is exactly the problem. You don't get hooked on coke or even meth unless you use them regularly for weeks, opiates even less so if you take them as prescribed for pain and not just to get high. Toasticle fucked around with this message at 15:55 on Jan 21, 2016 |
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Jan 21, 2016 15:43
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There is a real lack of painkillers between "headache pills" and opioids. If medical science could create a painkiller as strong as percocet but non-addictive and not significantly dangerous long-term, a lot of people's lives would be improved.
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Jan 21, 2016 15:49
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BarbarianElephant posted:American doctors are way too free and easy with opioids. I had minor surgery in the UK, and got released from the hospital with nothing more than a "good luck." I had minor surgery in the USA a few years later and got a bottle of Percocet that could have kept me high for a week. I didn't need it, didn't use it (took one pill and found I didn't like it.) I have a pain issue (not all that bad, generally just nagging) and I feel like I really have to fight off a Percocet prescription every time I see anyone about it. I feel like I'm getting the message "If you are hurting, take Percocet, or else you aren't taking enough steps to control your pain." I don't want to take the nasty stuff. It constipates me and makes me loopy, plus, it's addictive and my pain isn't going to clear up soon, so I don't want to get addicted. I dislocated my shoulder in the UK, got IV morphine/midazolam by the doctors and then had my shoulder put back pain free and that was that. It happened in the US and they popped it back in with no pain relief then gave me a percocet prescription when the pain almost immediately went away lol
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Jan 21, 2016 15:51
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Your Dunkle Sans posted:Is this supposed to be a joke or meant seriously? I can't tell with MIGF. MIGF is a sociopath who thinks burning Palestinian children smell like victory so the fact that he would have no concern for opioid users goes without saying. BarbarianElephant posted:There is a real lack of painkillers between "headache pills" and opioids. If medical science could create a painkiller as strong as percocet but non-addictive and not significantly dangerous long-term, a lot of people's lives would be improved. It would cost far beyond what normal people could afford to pay for it, and when asked why the pharma company would just be "hurr durr gotta make money somehow this medication is 90% cheaper in Europe and we're ripping you off to compensate for the lost profits we believe ourselves to be entitled to". 
Woolie Wool fucked around with this message at 16:25 on Jan 21, 2016 |
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Jan 21, 2016 16:20
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I was prescribed Vicodin for a knee ache, and then for post-surgery from getting it scoped. They gave me 4 refills and when I went through those they called in 4 more without me ever seeing the doctor. It was a knee scope. poo poo stops hurting after like a week. Oh, and they upped my dosage from 5mg to 7.5mg to 10mg based on phone calls I made to the nurse. And the refills on all the 5mg doses and 7.5mg doses were still valid. I was basically drugged out for a full year until I moved and ended up quitting cold turkey and holy poo poo the shakes and sweats that accompanied that. I'll stick with Tylenol for the rest of my natural existence please and thank you.
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Jan 21, 2016 16:31
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Meh.
Kristov fucked around with this message at 18:45 on Jan 21, 2016 |
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Jan 21, 2016 18:40
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I have no doubt that opiates are the best option for some chronic pain patients, but I also have no doubt that they're not the best option for a lot of people who are taking that option. And that the pill mill closures are a good thing on the whole, even though things will probably have to get worse before they get better. Opiates are great for end-of-life stuff and (if you can shut the door) acute stuff. It's not really a bizarre mental block -- the efficacy/safety of other medicines for other conditions is a separate issue. You're right that opiates are actually pretty safe as long as you don't OD/mix with alcohol or benzos, don't infect yourself with a needle, etc. but addicts are at a risk for doing that and it's happening a lot. Not to mention just the usual non-health-related costs of addiction. I've seen you in addiction threads, before, I think? PRETTY sure you were an alcoholic, or addicted to something else, or at least were complaining about how the higher power part of AA was a dealbreaker for you at some point in the way distant past? Either way, you have to reconcile your personal struggle to get relief with the fact that some doctors were in fact pill mills and that people are in fact getting addicted. Well okay you don't have to reconcile anything you don't want to of course, I just mean as a society your story isn't the only one out there and policy has to reconcile these things.
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Jan 21, 2016 19:39
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One thing that pretty consistently forks opinion in people by the way is if you have visibility into (say) a well-run pain center versus if you have visibility into addiction/treatment centers. I have a lot more of the latter and a lot of people there think doctors are just total loving idiots with the opiate scripts, though it has gotten better.
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Jan 21, 2016 19:44
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