Monday, November 30, 2015


The war on drugs. 
It sounds good. 
Countless lives have been ruined because of them.
But, as usual, things go awry.

It's very irritating to me when I hear that in order to get a prescription at some of the chain pharmacies you have to go through some song and dance and convince the pharmacist that you actually need them. 

Oh, and I'm not talking about the patient.
I'm talking about the doctor.

It's ridiculous when the pharmacists puts your doctor through an interrogation. They want to know if they've tried every other remedy before prescribing opiates. This is absolutely unbelievable to me. When can a pharmacist override the doctor? Who went to medical school??

Why isn't more research being done to bring about pain relief than can block the addictive properties of the drug? Heroin and morphine bind to a specific immune receptor TLR4.  This receptor then becomes an amplifier for addiction. 

Why isn't naloxone being used more? Naloxone reverses the effects of the opioid and could save thousands of lives due to accidental overdose.  Naloxone alters brain chemistry to stop the production of dopamine. So, if it blocks the production of Mr. Feelgood (dopamine) doesn't it stand to reason it would block the craving for the drugs?

You can't tell me that the research isn't there.

There was one published in 2012. Opioid activation of toll-like receptor 4 contributes to drug reinforcement.

They talk about Naloxone in emergency rooms and taking it off prescription and being available to anyone to be used to prevent death from opioid overdose. If it can be used as a stand alone why can't it be used to create pain relief that won't be addictive. 

In October of 2013 the FDA drew huge praises from the addiction community by moving hydrocodone with acetominaphen to a Schedule 2 narcotic. The doctor cannot call in your refills. You must hand the prescription to the pharmacist personally. They have made it harder to get Lortab, Vicodin and other addictive painkillers. They are supposed to make painkillers harder to abuse. For example, they inject Oxycontin with a gel that makes it harder to crushed and snorted. This kind of abuse deterrent is supposed to be a public health priority. 

So what did they do?
They approved Zohydro. 

Zohydro is a long acting opioid. This drug is not intended for as-needed use. This is for patients who need long term, around the clock treatment. This drug is not messing around. You can't drink alcohol. Let's face it, you're not supposed to drink with any pain medication but alcohol with this medication can result in fatal hydrocodone plasma levels in the blood. You even have to be careful taking anything that contains alcohol. This can even mean cough syrup.

I love the insert on this drug. When addressing who should be prescribed this drug they talk about the opioid "naive."  Excuse me??? Zohydro is five to ten times more powerful than the currently available hydrocodone that's on the market. What the heck does opioid naive mean? To my mind? These pills shouldn't be available to everyone. It should be for terminal pain patients. If you're walking around, you shouldn't need Zohydro. It's that simple. The Attorney Generals of 28 states sent a letter to the F.D.A. protesting the approval of this drug. To be fair, the makers of Zohydro have contracted with a Canadian company to come up with an abuse deterrent formula but who knows how long that will take. This drug was meant for cancer patients but everyone knows it will be on the street soon enough. Pill mills will push these babies out and they can be crushed, snorted and will kill people.

So we are back to the problem.

Why can't we have pain relief that helps moderate to severe pain without the addictive properties? 

It's not out of the question.

When you look at all the commercials ....

And the outrageous side effects.........

And it still is approved........

You're telling me it's impossible to get adequate pain relief.....

Without the additictive properties......

I don't believe it.


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