from the getting-sick-is-hazardous-to-your-health dept.
Seamus O'Mahony, a gastroenterologist from Cork, has written the most devastating critique of modern medicine since Ivan Illich in Medical Nemesis in 1975. O'Mahony cites Illich and argues that many of his warnings of the medicalisation of life and death; runaway costs; ever declining value; patients reduced to consumers; growing empires of doctors, other health workers, and researchers; and the industrialisation of healthcare have come true.
[...] Unlike Illich, who believed that modern medicine counterproductively created sickness, O'Mahony does see what he calls a golden age of medicine that began after the Second World War with the appearance of antibiotics, vaccines, a swathe of effective drugs, surgical innovations, better anaesthetics, and universal health coverage for most of those in rich countries. It ended in the late 1970s, meaning that O'Mahony, who graduated in 1983 and is still practising, enjoyed little of the golden age. We are now "in the age of unmet and unrealistic expectations, the age of disappointment."
[...] O'Mahony begins his dissection with medical research, "the intellectual motor of the medico-industrial complex." Governments see life sciences as a saviour of economies, and charities urge us to give more to cure every disease. Big Science, which appeared after the golden age, has provided jobs and status but "benefits to patients have been modest and unspectacular." A study of 101 basic science discoveries published in major journals and claiming a clinical application found that 20 years later only one had produced clinical benefit. Big Science is corrupted by "perverse incentives, careerism, and commercialisation."
[...] No disease is better marketed than cancer, and after Richard Nixon's War on Cancer, Barack Obama launched his Cancer Moonshot, which is now renamed Cancer Breakthroughs under Donald Trump. As O'Mahony writes, the language around cancer "is infected with a sort of hubristic oedema." For Big Science cancer is a blessing, leading to huge investments in molecular biology and genetics, but, as cancer researcher David Pye put it: "How can we know so much about the causes and progression of disease, yet do so little to prevent death and incapacity."
[...] "The medical profession," he writes, "has become the front-of-house sales team for the [drug] industry." He argues that "doctors' professional culture obliges them to do something—anything," but he is too easy on doctors, who could push back. Society, he says, displays "childishness" in going along with these expensive treatments: "we must have higher, and better, priorities than feeble, incremental and attritional extension of survival in patients with incurable cancer."
[...] The first thing that I ever had published in a medical journal was a letter to the Lancet in 1974 asking why there had been no response to an article in the journal by Ivan Illich describing in detail how modern medicine was a threat to health. (It would cost me $35.95 today to access the letter, about 50 cents a word from memory.) As a medical student I expected that the leaders of medicine would carefully dissect Illich's argument and with evidence show him to be wrong. But such a response never came. I was naive: I know now that it's easier simply to ignore cogent criticisms. I hope that O'Mahony's book, a Medical Nemesis for 2019, will not be ignored. It deserves to be taken very seriously.
(Score: 2, Interesting) by Anonymous Coward on Monday February 18 2019, @05:37AM (1 child)
Like this:
(Score: 0) by Anonymous Coward on Wednesday February 20 2019, @06:18PM
What they call "careerists" we would probably call MBA types now.
Doesn't sound like a critique of medicine rather than the spread of bullshit-merchants out of sales and marketing and into areas that traditionally require hard knowledge and honest work. I currently work in a medical field and The Dream seems to be to get out of doing any actual labor and into having the vision. Let others get bogged down fulfilling the vision, it's just details. Sell sell sell!
(Score: 5, Interesting) by The Mighty Buzzard on Monday February 18 2019, @05:43AM (44 children)
He's not entirely wrong but he's significantly off the mark as well. We've all but cured HIV/AIDS, created the HPV vaccine, and there are cancer treatments in early testing that appear to be very nearly a safe and completely effective universal cure. So, it's clearly possible for us to still make serious advances in medicines. Mind you, we've also declared nearly every minor abnormality under the sun a disease so we can sell pills to treat but never cure it. That needs curtailed at the very least.
Me, I'd put conditions on drug patents demanding one cure for every four (or whatever ends up being the most efficient number) treatments patented or you can't patent anything else until you provide one. Or something along those lines. I'd also put an end to evergreening drug patents by putting two commonly paired medications together in a new pill and receiving a new patent as they're about to lose their original patents. Medical equipment patents also need looked into but I haven't given the matter much thought yet.
My rights don't end where your fear begins.
(Score: 1, Insightful) by Anonymous Coward on Monday February 18 2019, @05:46AM (9 children)
I would bet anything against this becoming true. There is just zero actual chance of this if you know what is actually going on. Source?
(Score: 0) by Anonymous Coward on Monday February 18 2019, @05:56AM
I mean really if I can find someone who really believes this I will bet everything I have on it not happening even without seeing the source.
A lawyer will need to be involved because I expect there may be an attempt to do it in some weasely way like redefining "cancer" or "cure". N.B. Medical researchers have a history of this, like how they redefined "we sequenced the complete human genome" to mean "we tried really hard to sequence the complete human genome but couldn't get that last 10%".
(Score: 3, Interesting) by The Mighty Buzzard on Monday February 18 2019, @07:10AM (7 children)
Sources for this type of announcement pop up every year or so. Pick a search engine and look. The last one I saw was last fall out of Israel.
I'm not saying bet your life savings on it. I'm saying with this many people trying this many different approaches, it's going to happen sooner or later no matter what skeptics think.
My rights don't end where your fear begins.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @07:17AM (4 children)
No, it is no more likely to happen than if a bunch of monks were praying and waiting for a heavenly revelation about what to do. You can keep adding more monks all you want, it's never gonna happen.
But I don't want you to believe me, I want to know how to bet against people like you who believe this stuff.
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @07:27AM (1 child)
I'm not saying the announcements are going to cause anything. I'm saying that many scientists looking into it eventually will no matter what you or I believe.
My rights don't end where your fear begins.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @07:58AM
I'm saying I know the current state of cancer research and the idea they could accomplish what you are claiming (I assume based off the marketing materials universities are pumping out) is laughable.
There's not a chance in the world. Monks just making shit up would probably have a better chance since at least they are thinking rather than doing the bio equivalent of string of together a bunch of poorly run AB tests.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @08:45AM (1 child)
None of those anouncements are about "cancer", they're about specific forms of cancer. Helpful to some people, but not many and who knows how many are every fully developed and actually create a tangible benefit?
(Score: 2) by HiThere on Monday February 18 2019, @05:49PM
To an extent you're definitely correct. Cancer is not a disease, it's a syndrome. A collection of similar symptoms that are called by a common name. So curing one variety doesn't necessarily, or even probably, cure the others. Another example of that is the common cold, which is sometimes one of a number of different viruses, and sometimes an allergy.
But curing one kind of cancer cures that kind of cancer, and then you can address the next kind. Some kinds are known to be "caused" by viruses. (It's not clear whether the virus actively causes the cancer, or whether it just acts as an initiating agent, but if you could eliminate the virus, you'd eliminate the cancer, or at least retard its initiation by decades. And again, don't assume all of the viral cancers are identical. For that matter there's a couple of animal cancers that are known to be directly contagious. A genital one in dogs and a facial one in Tasmanian Devils. So there may be human cancers that are also directly contagious.)
As a result, all this "War against Cancer" stuff is drastically oversimplified. Try to explain it in detail and people go to sleep on you, even though it's a matter of life and death. But the clear implication is that if you want to model it with a war, a closer model is a guerrilla war than one with formal armies. And even so it's a lousy model. But progress has been made, and is being made. And it's almost guaranteed to continue to not be better than incremental.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2, Insightful) by Anonymous Coward on Monday February 18 2019, @08:51AM (1 child)
I'm not saying you're wrong, but I am saying that this type of breakthrough is nowhere near as close as it may appear if you read just the research announcements.
To put it into computer terms, today's biomedical/cancer research is basically trying to support legacy code, that is
* about 4 billion years of basically randomly generated spaghetti code with zero documentation
* operating in an environment that is quite different from what the code has (new chemicals unseen before, new types of radiation, new types of social and physical stresses, etc.)
* barely figured out.
In other words, we're trying to fix catastrophic (GPF/OS) crash bugs in a very complicated legacy Excel 97/VBA app, running in Wine or Windows 10 Home Basic, and our level of skill so far has only reached knowing how to open a hex editor and edit the binary code directly (no "source code" to speak of.) Oh, and one catastrophic crash means we can't practice on that install anymore, can't really debug what happened, and we have to start over on a completely separate, differently configured/corrupted install of the same app.
It may work sometimes, and this can feel very empowering and encouraging to someone who's never used a computer before, but it's nowhere near knowing what the fuck is going on and having a god-like power of full control/understanding that some specialists may give the impression of.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @05:24PM
No, it is wrong. If you think there is any chance of this whatsoever tell me the odds and I will bet on it.
(Score: 3, Interesting) by c0lo on Monday February 18 2019, @06:12AM (9 children)
Wrong [wikipedia.org]: "HIV/AIDS has become a chronic rather than an acutely fatal disease in many areas of the world"
---
But didn't eliminate yet the HPV infections or eradicate the virus and, based on the effectivity of the current vaccine alone [theconversation.com], we may never will
---
That's wishful thinking, marketdroid speak and/or the brainwashing result of the latter.
---
Theoretically, yes.
In practice, this is yet to happen.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 0) by Anonymous Coward on Monday February 18 2019, @06:19AM (3 children)
In other words, we've all but cured it! (and then some?)
---
Please fund herpes cure. Make America Kiss Again.
(Score: 4, Informative) by c0lo on Monday February 18 2019, @06:23AM (2 children)
In other words, we made it almost non-lethal, provided that you take medication all your life. And no strong warranty offered:
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 0) by Anonymous Coward on Monday February 18 2019, @12:01PM (1 child)
FTFY.
Like with cancer treatments, life expectancy flats out on HIV/AIDS. Some make it longer. Some don't. Averages under 10 years. Diet and other "healthy life style choices" barely add a couple of years over the average.
It's why they charge so much for the drugs: They're priced for how many years the insurance covers and how many years you'd last. So many dollars for so many years you're expected to last. Average dosage and presto.
(Score: 1) by shrewdsheep on Monday February 18 2019, @01:37PM
I think they are priced to maximize profit. With cancer drugs the societal pressure is high to re-reimburse these. There are cost-benefit calculations made and (in Europe) the acceptable cost seem to be around 50k Eur/yr. That's what the drug companies aim for no matter the actual cost (cost per QALY).
(Score: 3, Insightful) by The Mighty Buzzard on Monday February 18 2019, @07:05AM (2 children)
A study [hjf.org] ten years ago in Thailand had an HIV vaccine that managed a 32% success rate. That's still not good odds but you don't even get bad odds on something this complicated unless you're on to something.
And I expect you'll keep thinking that right up until we finally get one out of trials and being used regularly. You're a pessimist. Me, I'm happy that it's being looked at hard enough that we get false alarms so often. Eventually one of them will turn out not to be false.
My rights don't end where your fear begins.
(Score: 2) by c0lo on Monday February 18 2019, @08:35AM (1 child)
Cynical, to be more precise
'Pictures or it didn't happen. And, until someone shows pictures, it just won't happen'
Liitle chance to be negatively surprised with such a position.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @09:45AM
I prefer hopeful but not expecting it to happen tomorrow. It'd be nice if it did but I'm good just as long as it eventually gets taken care of.
My rights don't end where your fear begins.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @11:43AM (1 child)
There are 50+ strains of HPV. The vaccine is against 2.
(Score: 2) by HiThere on Monday February 18 2019, @05:56PM
Actually, with a virus, what counts as "a strain" is a bit artificial. And with the rate of mutation of the HIV virus, whatever definition you use there are probably strains you haven't noticed.
But that doesn't mean that working toward vaccines isn't a good idea.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by exaeta on Monday February 18 2019, @06:58AM (14 children)
The Government is a Bird
(Score: 1, Troll) by The Mighty Buzzard on Monday February 18 2019, @07:11AM (13 children)
No need. Darwin cures those eventually if you allow him to.
My rights don't end where your fear begins.
(Score: 1, Informative) by Anonymous Coward on Monday February 18 2019, @08:01AM (9 children)
sorry, but you're wrong. there are two cases for genetic diseases:
1. death before reproduction: recessive genes will survive in the population, unless you activate a eugenics program. Darwin will not help.
2. death after reproduction: Darwin will not help, unless you activate a eugenic program for it.
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @09:48AM
That was a what those of us with a sense of humor like to call a "joke". Gallows humor [wikipedia.org] to be specific.
My rights don't end where your fear begins.
(Score: 1) by shrewdsheep on Monday February 18 2019, @01:44PM (5 children)
1. You are wrong in this case. A recessive allele will have negative fitness meaning it disappears from the population (look up fitness).
2. This is debatable and probably wrong. Why are we not dying directly after leaving reproductive age? There is cross-generational care, transfer of knowledge and other interactions in many-generation groups. This again means, that early death leads to negative fitness and elimination of alleles (look up group-selection, inclusive fitness).
(Score: 2) by c0lo on Monday February 18 2019, @10:43PM (4 children)
Blue eyes is recessive, with the brown eyes dominant. Not seeing any sign that the blue eyed humans will disappear soon.
Point: what is negative fitness in one env may be a survival advantage in others. Case at point, one of the hypotheses [abc.net.au] is that blue eyes allow a better perception of blue light, with advantages in being more resistant to "seasonal affective disorder, a major depressive illness that occurs when there are long periods of low light."
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 1) by shrewdsheep on Tuesday February 19 2019, @09:19AM (3 children)
Sure thing. We were talking about disease alleles. The point was about the misunderstanding that a recessive allele can somehow escape selection. It is important to stress that there is another nuance. Alleles present in the population for longer times cannot have negative fitness (otherwise they would have disappeared). They convey a disadvantage in certain situations (let's say the homozygous state) but do convey an advantage in other ones (e.g. hemoglobin mutation vs. malaria).
(Score: 2) by c0lo on Tuesday February 19 2019, @09:40AM (2 children)
Sure, but it does not mean a negative-fitness allele is guarantee to disappear during evolution.
Being recessive, they can carry negative fitness for long time. And the reason is exactly what you pointed: they manifests only in homozygous state (and eliminate the individual), while in heterozygous state their activity is suppressed by the dominant and it can be passed to the new generation.
I wonder if the communism could have got a hold in Russia if not for the royal disease [wikipedia.org] (tangent: maybe a recessive can be deadly to millions of otherwise healthy individuals)
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 1) by shrewdsheep on Tuesday February 19 2019, @10:05AM (1 child)
Depends on how you define "long time". Under the assumption of no heterozygous advantage even a small fitness disadvantage leads to quick loss of allele, say 1000 generations (do .99^1000).
(Score: 2) by c0lo on Tuesday February 19 2019, @12:57PM
How about 0^1000? 'Cause the very definition of recessive alleles is that they do not show effects unless homozygous.
The cases in which an allele show effects in heterozygous situation:
1. is dominant
2. is codominant (e.g. the AB blood type)
3. is recessive but the other allele is incomplete dominant - does not completely suppress the activity of the recessive
In the case of pure dominant/recessive heterozygous combination, no matter how deadly the recessive, its activity is absolutely null.
Besides, even with a negative fitness homozygous combination, there exist cases in which the individual suffer the effects past the reproduction age - thus the negative fitness allele is passed into future generations (Becker's muscular dystrophy sufferers can live to old age, while the onset of distal muscular dystrophy is between 20 and 60 yo [wikipedia.org]).
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by HiThere on Monday February 18 2019, @06:01PM (1 child)
You misunderstand evolution. Even the late appearing genetic diseases generally count as disadvantageous. They just aren't as strongly selected against. But among humans disadvantaging the grandparents usually disadvantages the current children.
And you missed a few classes of genetic diseases that are actively maintained by evolution. The classic example is sickle cell anemia, but it's only one of several. And I'm not sure how you would count blood types, which slightly protect against one disease while making you slightly more susceptible to another.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Tuesday February 19 2019, @08:17AM
The trouble is that many of the late appearing diseases are outcomes of young advantages. Burn fast, leave lots of kids, and die young can be a successful evolutionary strategy.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @12:44PM (2 children)
Not quite. As long as it is a recessive gene (and they all are, or else they "cure" themselves out) , it will always be there, as only up to 25% of population would be "cured", in absence of means of treatment, while of the remaining rest, up to two thirds will be carriers of the faulty gene.
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @02:59PM
See above re: joke. It'd take a much bigger asshole than I am to advocate eugenics.
My rights don't end where your fear begins.
(Score: 2) by HiThere on Monday February 18 2019, @06:09PM
Sorry, but even at low frequency levels there's continued pressure against disadvantageous genes even if they are recessive. It's just a lot lower, and keeps getting lower as the frequency decreases until it's swamped by the noise level.
OTOH, many disadvantageous genes are actually advantageous in certain circumstances, especially in the heterozygous form. And in that case the question may turn out to be "how often does the advantageous circumstance present itself" as well as "how helpful?" and "how harmful?". And do you think a population should eliminate a gene which is sometimes helpful just because the condition under which it was helpful has become rare? So some people are hairier than others, despite that giving aid and comfort to body lice, because it sometimes gets really cold for a few centuries. (OK, the attribution of insight to the evolutionary process is wrong. But it's the effect that would be seen if there were insight, being achieved through partial dominance and weak selection pressure.)
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by loonycyborg on Monday February 18 2019, @09:01AM
Doctors prescribing cures just for bribes from patent holders or based on patient's ignorance(antibiotics for flu etc) violate the Hippocratic Oath. There aren't any more regulations needed here. If they refuse to honor even foundational ethical principles of medicine then they'll ignore any regulation too.
(Score: 2) by Runaway1956 on Monday February 18 2019, @09:15AM (1 child)
Damn, you're harsh. Just think about all those kids who might go hungry if the snake oil salesmen are put out of work!
(Score: 3, Touché) by The Mighty Buzzard on Monday February 18 2019, @09:49AM
Think of all the snakes having to slither around with dry skin due to lack of oiling too.
My rights don't end where your fear begins.
(Score: 2) by physicsmajor on Monday February 18 2019, @11:50AM (3 children)
If by all but cured you mean be on a lifetime cocktail of expensive medications with significant side effects, then sure.
We haven't cured HIV. It's not an imminent death sentence, quality of life with the disease can be improved, but it's still very bad.
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @03:01PM (2 children)
I was thinking that as well as there being some very good work being done, if slowly, on bringing a vaccine up to useful effectiveness.
My rights don't end where your fear begins.
(Score: 2) by deimtee on Tuesday February 19 2019, @08:23AM (1 child)
I knew a guy on the AIDS pill regime. They worked, but the side effects were so bad that after a couple of years he took the option to stop taking them and die.
If you cough while drinking cheap red wine it really cleans out your sinuses.
(Score: 2) by The Mighty Buzzard on Wednesday February 20 2019, @06:10AM
That's up to him. I won't ever shout anyone down for saying they've had enough. The vaccine should make that a non-issue within my lifetime though.
My rights don't end where your fear begins.
(Score: 2) by SpockLogic on Monday February 18 2019, @01:30PM (1 child)
Continuing treatment = constant corporate income stream (the MBA wet dream) = Capitalism. One shot cure = OMG, Socialism !!!!!
Glory, glory, hallelujah ! TMB has seen the light.
;-)
Overreacting is one thing, sticking your head up your ass hoping the problem goes away is another - edIII
(Score: 2) by The Mighty Buzzard on Monday February 18 2019, @03:03PM
Nope, capitalism still. Government granted monopolies (patents, copyright, etc...) work against capitalism and need reform badly.
My rights don't end where your fear begins.
(Score: 1) by fustakrakich on Monday February 18 2019, @06:13AM (16 children)
Pain relief... It's what they ration more than anything else.
La politica e i criminali sono la stessa cosa..
(Score: 2) by krishnoid on Monday February 18 2019, @06:26AM (7 children)
Then why the opioid epidemic? It seems like they can't get enough of prescribing pseudo-opioids to their trusting patients.
(Score: 4, Insightful) by sjames on Monday February 18 2019, @09:28AM (6 children)
In some cases, the rationing creates the crisis. Patient gets necessary opoids. Patient gets cut off because the pain "should" be gone. Maybe it is and maybe it isn't, but the patient is definitely addicted. So the patient resorts to street drugs and eventually ends up in jail, in the gutter, or dead. Addiction is a medical problem and should have been treated medically. But then some federal supercop with no medical training might decide the doctor needs to go to jail.
Some of the "crisis" is hysteria. Terminal patient has pain. A lot of pain. The doctor can either offer unlimited pain killers knowing the patient will probably OD sooner or later and die or the patient can die a month later in screaming agony. Since opoids were involved we all yell that the sky is falling and nobody notices that not dying wasn't among the available outcomes. Those deaths used to be officially attributed to the underlying disease, now they're counted as oppoid deaths.
There have been some excess deaths due to opoids. It seems a pharmaceutical company fudged some research and advertised a particularly addictive opoid as less addictive. Nobody went to jail but the patients that got hooked and a few of their doctors.
Another way rationing leads to addiction is when the patient gets inadequate pain relief such that they end up counting the minutes until they get their next dose (which will not effectively relieve pain until the next dose). Keep them like that for a week and they get so busy counting the minutes until their next dose that they don't notice that the pain is no longer that bad.
A final more speculative possibility. The last time I was prescribed a significant dose of opoids, I found them obnoxious. I hated feeling like I might fall asleep any minute. I resolved to take them as little as possible. It turned out that was zero times, and that was fine by me. Perhaps we simply have more people feeling like they need to escape more than they need to stay in the moment now. We know that rats provided a stimulating and pleasant environment will voluntarily consume less opoids than rats in a barren and unpleasant environment.
Pain is hard to guess. Some people won't complain even if the pain is severe, others will claim terrible pain when they have none just to get high. The same injury is very painful to some, barely noticeable to others. We don't have a device that can objectively read out how much pain the patient feels but for some reason we expect doctors to provide "just enough". We do know that recovery is faster and complications fewer if pain is adequately managed.
(Score: 4, Insightful) by Runaway1956 on Monday February 18 2019, @09:41AM (5 children)
Very good analysis, but you got one point wrong, or at least off target. The sons of bitches outright LIED TO CONGRESS, and the lie was repeated often enough that it became "truth". The lie was that "only 1% of opioid prescriptions lead to addiction". I really don't know what the real percentage was BEFORE the opioid crisis (can find it if I really want to), but it has been documented that this particular lie resulted in the relaxation of the law.
Without that lie, without the relaxation of laws and regulations, the number of opioid addicts created by the medical profesion would have remained relatively stable over the past 20 or 30 years. Depending on the definitions of "crisis" being used, we could still be said to have a crisis. But, it wouldn't be nearly as great a crisis as we have today.
Even with the lie, even with the relaxation of laws, if the drug pushing sales droids hadn't been out there rewarding doctors for over prescribing, the crisis would be considerably smaller than it is.
All the salesmen, all the CEO's who pushed those salesmen, need to sit in prison for a long time. They are no better than the punk on the street corner pushing drugs to school kids.
(Score: 2) by sjames on Monday February 18 2019, @10:15AM (4 children)
The laws surrounding medical use of opoids need to ho away entirely. None of them are written by doctors and none of them are enforced by doctors (I'm not convinced any of the writers or enforcers have ever experienced more pain than a paper cut).
Some of the salesmen need to go. Especially the ones that claimed Oxycontin was less addictive than other opoids. The classic Dr. Feelgood is a problem, but we need to be careful there. Some doctors prescribe a lot more opoids than others because they specialize in conditions that are more painful. The DEA doesn't seem to know that (because as I said, they're not doctors and have no business making medical decisions).
All in all, I suspect we would have less addicts if we had less laws and more low cost /no cost treatment for addiction. How likely would you be to seek treatment if even admitting you have the disease is tantamount to admitting to committing a felony? Especially when it's the kind of felony where the cops kick in your door, throw grenades around and steal everything you own?
(Score: 2) by Runaway1956 on Monday February 18 2019, @10:55AM (3 children)
I can agree that law enforcement are often a bunch of heavy-handed thugs. But, no laws? Not even laws or regulations administered by the medical profession? With no laws and regulations, it would be a free for all, with rogue doctors intentionally over prescribing stuff that the patient doesn't even need. The same doctor can create an addict, intentionally, then "cure" that addict, all the while making money.
I'm all for making dangerous drugs difficult to get, unless some need is demonstrated. Once that need is demonstrated, then they should be readily available. A lot of that has to be the doctor's judgement - he might be wrong sometimes. But, that seems more a matter for professional organizations to deal with, than for general law enforcement.
But, IMO, Patient Sixpack should not be able to wander into a doctor's office, and demand a script for whatever drug is fashionable this week/month/year. There have to be some kind of guidelines, don't there?
(Score: 2) by sjames on Monday February 18 2019, @06:19PM (2 children)
We would still have the usual professional standards, ethics, and liability. Also the same body of laws that in general would punish a doctor for deliberately making the patient sick(er) in order to cure them or otherwise through a procedure or prescription. There's no need to single out "fun" drugs there.
Patients go into doctor's offices or online demanding a prescription for Viagra all the time. The doctor is obligated to meet at least minimal professional standards and make sure the patient doesn't have any likely conditions that would make viagra a bad idea and to do followups to make sure the patient isn't being harmed by side effects. Failure to meet those minimum standards could cause a doctor to lose his license to practice medicine as well as significant civil liabilities. If the patient dies or is seriously injured from a reasonably forseeable exacerbation of an existing medical condition the doctor could face criminal penalties as well.
The same would apply for opoids. Doctors would have to weigh risk vs. benefit like any other drug.
(Score: 2) by urza9814 on Tuesday February 19 2019, @07:58PM (1 child)
In order to even have the doctors be involved, you still need laws regulating what drugs can be prescribed for what conditions and under what circumstances. You still need the Controlled Substances Act, which is written by non-doctors and is not written from the perspective of patient care but instead focuses almost exclusively on criminal justice and maintenance of existing power dynamics. But without that, everything is just over-the-counter and some people will take what their doctor recommends while others will start popping every pill that gets mentioned on Oprah. Which wouldn't necessarily be worse than the current system, but it's not likely to fix this particular problem.
You can't just revoke a couple laws and assume that standard negligence/malpractice will cover it. You've gotta build a whole new system, built on a foundation that is actually based on medical science rather than politics and profit. That's an interesting challenge....
(Score: 2) by sjames on Wednesday February 20 2019, @03:15AM
There are no laws saying what condition a doctor can prescribe what drug for or under what conditions other than the general professional standards. Drugs cannot legally be advertised off-label but they can be prescribed off-label.
But my point was that we don't need special laws and handling of opoids.
(Score: 2) by HiThere on Monday February 18 2019, @07:03PM (7 children)
I wish you were right. Unfortunately, all the things that produce pain relief have significant drawbacks. Every single one of them. Among drugs, you can say that different drugs have different drawbacks, but there are none without any, and chronic use makes them worse, sometimes much worse.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 1) by fustakrakich on Tuesday February 19 2019, @12:05AM
all the things that produce pain relief have significant drawbacks
Not for the people that sell them. And we can thank the Controlled Substances Act for protecting their business model.
La politica e i criminali sono la stessa cosa..
(Score: 2) by dry on Tuesday February 19 2019, @03:53AM (5 children)
What are the significant drawbacks of heroin? Not counting the artificial ones caused by the law and society being down on certain behaviours such as addictions.
(Score: 2) by takyon on Tuesday February 19 2019, @04:11AM (3 children)
https://en.wikipedia.org/wiki/Heroin#Adverse_effects [wikipedia.org]
https://en.wikipedia.org/wiki/Opioid_overdose [wikipedia.org]
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 2) by dry on Tuesday February 19 2019, @04:24AM (2 children)
OK, I should have included when used as directed and purity is known, needles are clean, which I hinted at, as most OD's are due to unknown strength of street drugs or impurities. Interesting about the brain damage though, wonder how it compares to other common drugs such as alcohol
(Score: 2) by takyon on Tuesday February 19 2019, @04:46AM (1 child)
I refer to this: http://www.ias.org.uk/uploads/pdf/news%20stories/dnutt-lancet-011110.pdf [ias.org.uk] when comparing drug safety. I don't think it gets into "this drug causes more brain damage than this other drug" but you can probably find info to that effect if you look around.
At the end of the day, you want to avoid opioids unless you have some severe pain issues. I'm sure some people could benefit from a clean, 100% pure source, but you aren't likely to find that on the illicit market unless you know wtf you are doing.
It would be interesting to see people with pain issues (not addicts... yet) getting cheap/free supply from supervised injection sites.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 2) by dry on Tuesday February 19 2019, @06:30AM
Personally I don't like opioids but some people sure do, and some seem to be in mostly mental pain.
They've been doing a small test of giving addicts clean heroin here, stop at clinic, get fix twice a day and it seems fairly successful. Junkies actually working rather then struggling for their next fix, maintaining a home kind of success. Listening to one, it was just so much of a relieve not to be living life wondering how to get the next fix.
Be nice if the supervised injection sites could supply drugs to go with the needles, but they've been pretty successful about preventing OD deaths. Helps too that the cops will just herd the junkies the the supervised injection site instead of busting them.
Unluckily there is a good chunk of the population who thinks it is just enabling giving out clean needles or worse, clean drugs.
(Score: 2) by HiThere on Tuesday February 19 2019, @05:15AM
All opioids have problems with habituation requiring continually stronger doses until you reach the LD-50 or higher. Some are faster than others.
Additionally, the use of opiods for chronic pain becomes useless. Reportedly less effective than aspirin. It is supposedly excellent for acute pain if used as directed, but NOT for chronic pain. Only partially because of habituation. Partially because it just becomes less effective as the body adapts. (I'm not speaking from personal experience, so I don't know what the difference between the decreased effectiveness and the habituation is, but they are reportedly separate considerations.)
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @06:18AM (1 child)
I'm guessing Ivan Illich is an alias???
https://en.wikipedia.org/wiki/The_Death_of_Ivan_Ilyich [wikipedia.org]
(Score: 2, Informative) by Anonymous Coward on Monday February 18 2019, @06:24AM
https://en.m.wikipedia.org/wiki/Ivan_Illich [wikipedia.org]
(Score: 3, Interesting) by krishnoid on Monday February 18 2019, @06:29AM (21 children)
It makes great fodder for the news cycle, but how about not-even-recent medical progress that's actively being rejected by anti-vaxxers? If he wants to complain about how modern medicine sucks, maybe he could start with just getting these people vaccinated?
(Score: 0, Troll) by Anonymous Coward on Monday February 18 2019, @06:37AM (20 children)
See the second paragraph. Vaccines fit perfectly with what is described. The promise was that measles would be eradicated by 1967 then vaccinations could be stopped. Promise not kept.
Now when is the last time you heard a vaccine promised to eradicate a virus? That was the original purpose, it has since morphed to "get society addicted for the indefinate future to vaccines out of fear for an epidemic."
(Score: 2, Disagree) by ants_in_pants on Monday February 18 2019, @08:11AM (12 children)
smallpox was eliminated with vaccines.
-Love, ants_in_pants
(Score: 0) by Anonymous Coward on Monday February 18 2019, @08:45AM (3 children)
Yep that campaign was run earlier.
(Score: 3, Informative) by sjames on Monday February 18 2019, @09:33AM (2 children)
We were well on our way with polio but then the CIA got involved.
(Score: 3, Funny) by The Mighty Buzzard on Monday February 18 2019, @09:51AM (1 child)
I like water polio better. It's more entertaining when a participant poops in the playing area in the water version.
My rights don't end where your fear begins.
(Score: 1, Troll) by realDonaldTrump on Monday February 18 2019, @01:04PM
That, actually, that's how it used to be passed. They didn't call it water polio. But, that's what it was. When the sick kid "poops" and the "poop" gets into the drinking water. Folks drink that "poopy" water, now they're getting sick too. And they're "pooping" too. Sounds so horrible, right? Disgusting. And it was. Except, very important, everybody got the polio when they were very young. I'm talking about, when they were babies. And it barely affected them. Except, they would never get it again -- NO SHOTS but they were IMMUNE!!!
(Score: 2) by Runaway1956 on Monday February 18 2019, @09:57AM (7 children)
Was it, though? I read of campaigns in India often enough to cast doubts on that claim. Polio is the one that most often makes the news. Volunteers wander through the villages, trying to get every last child, because - obviously - polio is still a thing. In 2012, WHO published an article that India had not recorded a new polio case for one year - https://www.who.int/mediacentre/news/releases/2012/polio_20120113/en/ [who.int]
Browse this map, and you'll find that polio still exists, not only in Asia, but in much of equatorial Africa, and Indonesia. Let's call them "underdeveloped countries". http://polioeradication.org/polio-today/polio-now/ [polioeradication.org]
Bottom line, IMO, we still have a genetic pool of all of our worst diseases, waiting for the opportunity to spread around the world again.
(Score: 2, Informative) by Anonymous Coward on Monday February 18 2019, @10:34AM
Other diseases with the exact same symptoms of polio are rising as polio falls, sounds like a measurement issue to me.
http://pediatrics.aappublications.org/content/135/Supplement_1/S16.2 [aappublications.org]
(Score: 4, Interesting) by realDonaldTrump on Monday February 18 2019, @01:36PM (5 children)
Ants in Pants was saying, no more smallpox. But you're talking polio, it's not the same. Polio is the one where you see these guys and they have one leg much shorter than the other, one arm much shorter. They're crippled, so ugly. Smallpox is the one where they have the pock marks all over the face, their face looks like an orange. Like the skin of an orange. Except for the color. And frankly, it would look better if they did the color too.
And we have the Smallpox Pill now. Which, maybe that one works. And maybe it doesn't. We need to find some people, give them the Pill and try to give them smallpox. So we'll know.
And we can do that, very easily. Because we kept the smallpox, from when it was going around a lot, in little bottles. And my Generals say it's very easy to crank up the production from there. Just from a few little bottles.
And if those bottles get lost, if somebody drops them and they break, if somebody steals them, that's O.K. Because, here's the most amazing part. Have you ever seen Star Trek? If you ever see it, they have the very special Computer. They say, "oh Computer, make me a steak & fries -- with a Coke." And by the way, they didn't say Coke because Coke didn't pay them. But they could have any drink you can imagine, just by asking. Which at the time was make-believe. It's make-believe no longer. Because we have that. We're getting that. It doesn't make steaks, doesn't make fries or drinks. But it makes diseases, very beautifully. Including smallpox. We have smallpox -- the digital of smallpox -- on a Cyber Chip. We checked the Copyright on that one (so important). And maybe we'll do super duper smallpox or something even better. I like thinking big. If you’re going to be thinking anything, you might as well think big!
(Score: 2) by Runaway1956 on Monday February 18 2019, @02:05PM (3 children)
My whole point was, diseases that we thought were eradicated still show up.
https://www.who.int/csr/disease/smallpox/faq/en/ [who.int]
Declared eradicated doesn't mean it won't crop up from somewhere again. I'm pretty sure that polio was also declared eradicated a couple of times.
(Score: 2) by realDonaldTrump on Monday February 18 2019, @03:54PM (1 child)
Sorry, but the U.K. is in many ways a very backward country. They had an "accident." It wasn't an accident. It was BAD PEOPLE & BAD INFRASTRUCTURE. And they gave away their smallpox bottles after that one. Trust me, the U.S.A. won't have any accidents. Because we have the best people. Working with the most modern digital. Our smallpox won't be getting out until we want it to.
The Eradication, you have to look at the small print on that one. The asterik. They say, "oh we eradicated Polio." But, look for the asterik. And it's going to say, "oh by the way, there are many kinds, or types, of Polio, now there's one less." It's like the H.P.V. So many kinds, also referred to as types. And maybe they eradicate some. But the others are still going around!!
(Score: 0) by Anonymous Coward on Wednesday February 20 2019, @06:00PM
Not just smallpox, Birmingham is effectively a no-go zone thanks to Mooslim breeding terrorists.
(Score: 2) by ants_in_pants on Tuesday February 19 2019, @04:50AM
I was pointing out that you can't get smallpox no matter how filthy of a hole you live in. You're free to try, you'll die of something else before you get a whiff of smallpox. All because of vaccination. I'd call that eradication of the disease, even though it's now a WMD.
-Love, ants_in_pants
(Score: 2) by takyon on Tuesday February 19 2019, @04:15AM
Fast forward 20 years, and people will be able to download polio/etc. and make it in the basement.
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(Score: 1, Interesting) by Anonymous Coward on Monday February 18 2019, @12:56PM (6 children)
Perhaps we need to create an annoying dumber sibling of the deadly pathogen, able to spread around and infect people, but too weak to knock patients out, so it just gets patients' immune systems angry and spreads bad name for all its kin, including the deadly one.
That would be a sort of involuntary vaccination, if you will. The milder variant (dumb sibling) outcompetes the deadly one, because due to a lighter clinical image it gets to spread faster, staying a step ahead and "burning the dry grass" leaving immunity in its wake.
Upside: none skims vaccination. Downside (for pharma): patients don't explicitly pay.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @05:28PM
Great idea, I'll pass it on to the "Green New Deal" team.
(Score: 2) by HiThere on Monday February 18 2019, @07:07PM (4 children)
Well, but cowpox didn't eliminate smallpox except among milkmaids. Getting something to do just what you want would be extremely tricky. And viruses mutate.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by dry on Tuesday February 19 2019, @04:16AM (3 children)
A lot of these diseases seem to have been less destructive when people were routinely exposed and got the diseases when young. By the time I was around 4, I had had the measles, chicken pox and the mumps, none of which did more then make me sick for a week or so. The only thing that came close to killing me was tonsillitis at an older age, and that was bacterial rather then virus. Another example was polio, which used to be common enough that most were exposed to it when young and few had the bad reaction, though sadly some did. Once hygiene became more common, we had the big outbreaks about a hundred+ years back with people being exposed at an older age.
Now if we can eliminate these viruses, great, but we seem to be failing and most of them have way worse actions on older people. It's a complex problem.
Other diseases such as smallpox seem to have been just plain old destructive.
(Score: 2) by HiThere on Tuesday February 19 2019, @05:26AM (2 children)
I think you've never met anyone who had a severe case of polio. Among Europeans, and probably asians, the bad effects of measles are rare except when a pregnant woman is exposed, but occasional severe reactions occurred. Just because you didn't meet them doesn't mean they didn't exist. These would be the kids who dropped out of school because they were sick and never came back. Disabled children were not mainstreamed. (Are they now?) Etc.
Also among the polynesians and AmerInds the effects of measles was *much* more severe.
FWIW, I've known a person who had a bad case of polio. He considered himself extremely lucky to have only ended up with a bad limp and the inability to stand in place. He was treated by a method that the AMA called "witchcraft". Today it's generally called the Sister Kenny method https://www.google.com/search?q=sister+kenny+method [google.com] but most people at that time who had a bad case of polio ended up either dead, in an iron lung (and short life), or permanently seriously crippled.
So I think you've formed your ideas out of a small biased sample. Most people survived most diseases without permanent harm. The exceptions, however, were numerous.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by dry on Tuesday February 19 2019, @06:44AM (1 child)
I'm not suggesting that we shouldn't be vaccinating, just that it is complex. Polio is an example of a disease that actually became worse when we got clean water, due to the age that people were exposed to it though it had always affected some kids negatively. https://en.wikipedia.org/wiki/Poliomyelitis#History [wikipedia.org]
And yes, I was going to mention the populations where measles etc were unknown, though once again, older people were more negatively affected.
It's a complicated thing, disease and vaccination, with as is often the case a spectrum from where it is obviously good to more questionable. So far it hasn't really entered the questionable area though the flu vaccine is close, but I do wonder if in the future there will be vaccinations, perhaps for the common cold or similar, where vaccination is a worse choice, but is still pushed in the name of profits, I mean public health.
(Score: 0) by Anonymous Coward on Wednesday February 20 2019, @06:09PM
I love your high moral standard on profit-making for things that are actually good for you. Just keep your darn goody toochoos hands off my Double Super Gulp.
(Score: 4, Funny) by MichaelDavidCrawford on Monday February 18 2019, @12:09PM
She is an ex-girlfriend; while we had some tension between us for the two years we were both at the Institute, even then she and I remain close friends.
She regards herself as a "Scientific Anti-Vaxxer".
I Cried Bullshit when she posted a graph of year vs. average ago of first female fertility or so; without even reading the linked article - which really _would_ have saved our _always_ argumentative relationship! - I said "Cool, that's clearly due to the rising costs of college education, the declining rate of Real Pay among the young people" and the like.
This because Student Loan Debt as well as steadily-decreasing Inflation Adjusted Hourly Wages ARE WELL DOCUMENTED TO DELAY PARENTING.
My, fuck does it have to _be_ so hard.
She got all Road Rage at me to say "It's clearly due to vaccines".
Now, she _did_ vaccinate her two kids with just _some_ carefully-researched Vaccines. I do _not_ fault her for that.
But I went TOTALLY BALLISTIC at the poor girl by point out that, as a Caltech Alumna, she knew _damn_ well that Correlation Is Not Causation; further, that IT IS THE FUCKING DUTY OF THE SCIENTIST TO BE NON-BIASED WHEN INTEPRETING FUCKING EVIDENCE!!!!!!MG PONIES!11111
Maybe I Shoulda Oughta Not Done That.
Really, she and I had established an uneasy truce, but then she posted Correlation Is Causation When It Comes To Poisoning Your Beloved Babies on Facebook.
KILL ME.
I've got her husband's number and work address. I Shall Wait A Good Long Time, then send him a Snail Mail with a letter for him, and an _unsealed_ envelope with a letter for his wife and my - long long ago - ex.
Yes I Have No Bananas. [gofundme.com]