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Comment Archives: Stories: News + Opinion: Health Care

Re: “Vermont Fights Opiates With More Opiates. Is There a Better Way?

I was on 90mg of mscontin daily for pain management. In a sleep study I found I was experiencing central sleep apnea. I was having pauses in my breathing for up to 2 minutes. This was caused by the morphine. Dr told my wife that this would kill me. My wife asked about alternatives and medical marijuana came up. I skeptically tried and like turning a switch my morphine usage was reduced by 66% and within 6 months was opioid free. I went through withdrawals but believe that cannabis even made those more bearable. That was 3 years ago and I still use cannabis exclusively to manage my pain and opioids are now a medicine of last resort as it should be
.

2 likes, 0 dislikes
Posted by Jeff Marshall on 05/15/2017 at 11:08 PM

Re: “Vermont Fights Opiates With More Opiates. Is There a Better Way?

For our patients, loved ones, and for our state, for each other... we can do better. Hub & Spoke has its place and has maximized its usefulness at this point. OD rates have increased not decreased despite our "All-In" heroic efforts with MAT. The "not dead" argument only holds when OD rates decrease with MAT. Some argue vociferously that Methadone and Bupe and Naltrexone and Naloxone (Narcan) saves lives. Might these drugs also be contributing to death rates? Controversial statement for sure. Might anti-depressants and anti-anxiety and anti-psychotic meds contribute to depression, anxiety, and overall disease burden as much as they may relieve symptoms for many? Should any one form of treatment be promoted over all others? Population health approach fails to account for individual variability. Medicine - pharmacotherapy - is the quintessential example of this principle. Let's invest in diversity not uniformity.

https://vtdigger.org/2016/04/26/rick-barnett-maintenance-medication-madness/

Not Dead should not be end goal:
https://vtdigger.org/2017/04/03/not-dead-shouldnt-end-goal/

https://vtdigger.org/2017/03/05/rick-barnett-better-health-care-psychology/

1 like, 1 dislike
Posted by Rick Barnett on 05/14/2017 at 2:00 PM

Re: “Vermont Fights Opiates With More Opiates. Is There a Better Way?

MAT is marketed as though there is no other option for opiate addicts. There is - it is called abstinence-based recovery. I failed miserably on the methadone program; I used every day and found the withdrawal symptoms as bad, if not worse, than heroin. There are many folks like me, men and women who have achieved long-term recovery wo the use of medications. However, we are never invited to the table to discuss solutions. Why? Because we have no giant lobby behind us. MAT is not therapy. It is drug replacement. Time we give clients real choices in treatment. ANd not what is only endorsed by Big Pharma and their psychiatric minions. Show me a shrink who ever got an addict better....

9 likes, 1 dislike
Posted by Piers Kaniuka on 05/11/2017 at 1:39 PM

Re: “Vermont Fights Opiates With More Opiates. Is There a Better Way?

I owe my life to methadone. It let me become a productive member of society while I dealt with the issues that contributed to my heroin addiction. When I was strong enough to manage it, I left methadone behind. That was 46 years ago. I've led a good life, without opiates, and with purpose since then. Medically assisted treatment _can_ be a useful tool; I am proof of that.

9 likes, 1 dislike
Posted by Michael Poster on 05/11/2017 at 1:35 PM

Re: “Vermont Fights Opiates With More Opiates. Is There a Better Way?

Abstinence and long-term supports lead to true change and growth, not just harm reduction. The money behind medications to manage opiate addiction is astounding. I have 30 years of abstinence. If these medications were used when I got clean, I don't think I would have survived. I gave up my drug and alcohol counselor license because of the direction that treatment took.

15 likes, 2 dislikes
Posted by Lauren Bisson on 05/10/2017 at 6:51 PM

Re: “The Doctor Is Out: Lawmakers Seek 'Lifeline' for Independent Physicians

The subsidization for the academic medical center argument by Brumsted fails to recognize that independent physicians with hospital privileges are expected to teach medical students and residents as well, with no compensation.

1 like, 1 dislike
Posted by DerekP on 05/03/2017 at 12:36 PM

Re: “The Doctor Is Out: Lawmakers Seek 'Lifeline' for Independent Physicians

So they like independent practices because they represent competition, but don't want them to have to compete for reimbursement.

5 likes, 0 dislikes
Posted by Nate Awrich on 05/03/2017 at 10:34 AM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

"In 2015, enough painkillers were handed out in Vermont to give every man, woman and child a bottle of 100 pills," former governor Peter Shumlin said in his signing statement."

How many were given to post-surgical patients? How many were for hospice patients?

The vast majority of opiate users are not addicts. Opiates are becoming as stigmatized as psych meds.

4 likes, 1 dislike
Posted by Liz Leyden on 04/27/2017 at 5:43 PM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

i understand your concerns @David Skillman, however I think the same limitations in people that move them towards addiction also prevent them from being able to "take responsibility for their actions and bad choices". most people i've met who've made really bad life decisions didn't know at the time how bad those choices were. those who were able to take responsibility in terms of remorse or reparations had to have some kind of intervention, whether medical, psychological or reaching some kind of desperate situation where circumstances force them into a learning curve. but not everyone suffers. i've met 'functional' alcoholics and opiate users who don't bottom-out, don't commit robberies, earn a decent wage and live a productive life - as addicts, but not criminals in the sense of having to take responsibility for anything at all. addiction isn't by definition about depravity and desperation although it often is.

1 like, 0 dislikes
Posted by parallax on 04/27/2017 at 2:48 PM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

I have two comments. People always want to blame others for people's shortcomings. At some point, an addict, or someone moving towards addiction needs to take some responsibility for their actions and bad choices. It's not all the Doctor's fault. Also, nothing in these laws is going to keep an addict from getting what they want. It will only make it harder for responsible people to get medicine they need.

7 likes, 1 dislike
Posted by David Skillman on 04/27/2017 at 12:14 PM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

The worst part seems to be the idea that we have to trade painfree medical treatment for stringent controls. This isn't a zero-sum game and it's possible to obtain both as long as you're willing to accept the consequences. Pain perception is impossible to understand objectively so pain meds can't be presumed necessary or excessive. If the patient says they're in pain then presume they're in pain and experience should guide the proper prescribing, not the state. The idea that you can "go into a doctor's office and come out with a bagful." isn't about pain, it's about criminal activity on the part of the doctor, not the patient. The consumption or illegal resale of the pills is about very difficult socio-economic problems, not about surgical procedure aftermath or chronic pain and it's the price we pay for addictive pain meds. We made this tradeoff easily enough when adopted the automobile as a lifestyle improvement device and we quietly accept half a million deaths each year. We accept this easily with readily available nicotine and pay the price of cancer deaths and medical support for the adult addicts. It's so easy with cigarettes and cars and alcohol and a whole host of things. Painfree medical treatment is an incredibly awesome achievement and we're worried about a few deaths each year? We're complaining about decreased productivity and costs to society by supporting the medically needy addicts? Big deal. That's pennies compared to what we're already paying for due to cars, nicotine and alcohol. How about considering the question of *over* prescription and consumption outside of the context of the doctor-patient relationship and focus on standards of care instead of treating pain intolerance or even opium addiction as some kind of moral failing that doesn't deserve relief.

4 likes, 0 dislikes
Posted by parallax on 04/27/2017 at 11:38 AM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

Jimm the doctors and dentists that you are defending are the same people that helped create all the lovely addicts that we have in the state today. It's about time they were held accountable for the mess they created in order to line their own pockets when they prescribed opiates to people that did not need such strong drugs in the first place.

4 likes, 6 dislikes
Posted by citizen on 04/26/2017 at 3:36 PM

Re: “Do No Harm: New Rules Discourage Overprescribing Opiates

Aren't we lucky that Vermont politicians and bureaucrats are so knowledgeable in their craft that they are in a better position than the Physicians and Dentists with medical degrees to dictate to them how to practice Medicine and care for their patients.

10 likes, 4 dislikes
Posted by JimM on 04/26/2017 at 12:30 PM

Re: “UVM Study Explores a Fecal Transplant Cure

Has anyone looked into possible treatment of diverticulosis. Currently the only treatmentioned is removal of that section of the colon. It took three years before I received the correct diagnosis. In and out of the hospital but always in severe pain and diarrhea. Operation appears to have been successful, I have been pain free with normal stools since the operation.

Posted by stew1114 on 04/04/2017 at 10:55 AM

Re: “Under Supervision: Should Vermont Legalize Heroin Injection Sites?

http://www.emcdda.europa.eu/topics/pods/drug-consumption-rooms

Posted by Sara Moore on 02/08/2017 at 2:22 PM

Re: “Under Supervision: Should Vermont Legalize Heroin Injection Sites?

What idiot stayed up all night to think up this idiot idea?? What's next a safe place to go to rape someone, beat them or even kill them???Want to get "high" come to VT, bring your own drugs and they'll sit and watch as you shoot up!!!!..

2 likes, 2 dislikes
Posted by Donna Boutin on 02/01/2017 at 8:40 PM

Re: “Under Supervision: Should Vermont Legalize Heroin Injection Sites?

Anything to reduce the use of addictive drugs will be an improvement over the current thinking of how to best get a cut of the revenues they produce.

4 likes, 3 dislikes
Posted by Vermont Patriot on 01/30/2017 at 3:10 PM

Re: “Last Impressions: Recalling Final Conversations With Vermont Overdose Victims

The last conversation Jesse had was with his fiance where he told her like he did everyday "have I told you how much I love you" and as always she would say well...and Jesse would say I love you more than anything in the world baby. With her replying I love you always.

3 likes, 0 dislikes
Posted by thetruth on 01/27/2017 at 11:37 PM

Re: “Death by Drugs: Opiates Claimed a Record Number of Vermonters in 2016

Jesse was amazing Yetthey asked a woman who didn't know her son and caused him the most pain. She only callswhen she wants something he would say. He was so much more than she knew and I watched him hurt from the things she said. He always said she was the most selfish person he new. And struggled with this. He had gotten clean and yet a few weeks before he passed he was hurt again and my love wasn't enough to keep him from it. I am the one who knew him better than anyone yet was pushed aside and wiped away. But those who knew Jesse well know the truth about his childhood and adulthood. It's hurtful when people can't see how amazing their child is yet are two faced and amazing actors to strangers. But guilt can destry you if he were alive today he would still say she only calls when she wants something I'll call her back sometime or tell her I'm not here. I wish I could of mended that. He was amazing and this addiction does not solely define him.

1 like, 2 dislikes
Posted by thetruth on 01/27/2017 at 11:21 PM

Re: “Last Impressions: Recalling Final Conversations With Vermont Overdose Victims

How about before you post something about a family you actually ask the family members and not a boyfriend who fed addiction habits. Thanks.

5 likes, 4 dislikes
Posted by Don'tAsk on 01/27/2017 at 9:44 AM

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