Sad or funny? "Tolerant San Francisco fed up with dirty, smelly streets"

[TFOGGER]

Opioids are indeed a problem. My lifelong best friend got hooked on them after going to the VA following a car wreck. After his prescriptions ran out, he started buying oxycontin on the street. He recognized he had a problem, got no help from the VA, and eventually tried to quit cold turkey. During the withdrawal, he lapsed into a deep depression, and eventually committed suicide. When I had my big bike wreck in 2013, they prescribed 120 Dilaudid when I left the hospital. I ended up taking 5. Part of addiction is psychological, a predisposition to addictive behavior, which is something that doctors should probably take into account before prescribing powerful opioids. Pain management in American medical practice has made a huge pendulum swing in the last 40 years or so from "don't give the patient anything until the pain is unbearable" to "do everything to ensure the patient feels no discomfort". I look at pain as a useful indicator of injury, and therefore choose not to eliminate it, personally. Others may not have the same tolerance, or the constitution to deal with pain. Either way, a cookie cutter approach to medicine doesn't yield optimal results for any patient.

[TheGrey]

The number of people I am acquainted with that have not been affected in some way by people using drugs can be counted on one hand.

I don't think the homeless situation and drug-abuser situation are so easily extricated from each other; nor do I think that there is one solution.

I wholeheartedly agree that something should be done about the garbage, the filth, the able-bodied that would rather be parasites than prideful; but the issue is that among the riffraff are people that genuinely need help. I think that until the causes are rooted out and addressed, this will continue to spiral out of control.

[cstone]

Until the government removes freedom from citizens, there is little that can legally be done to resolve the "problem."

Arresting people for vagrancy makes almost as much sense as putting debtors into prison until their debts are paid. Finding incentives to encourage desired behaviors and punishments to discourage undesired behaviors, and doing both with solutions that cost less than the original problems are the much sought after prize of public leadership.

[CoGirl303]

Hall pass for drug addicts? Say what?? My post was essentially advocating the right to suicide/euthanasia - e.g. the biggest right of all, the right to control ones own life. It is indeed off topic from the OP but responding to earlier posts on the same. AFAIK I did not mention drug addicts at all, my post was clearly of intentional suicide.

Chill. Pill.

Opioids kill 2x as many people as cars or guns now. You don't find me giving a hall pass, you find me cautioning people to never use them and bitch slap the people that offer them for every ailment.

Also, you can't lump "drug addicts" into one category. Many of your transients in San Fransisco may indeed be "drug addicts", but most of the 74,000 dying every year are employed right along side you, maintaining a home and have a family - you don't have a clue which of your coworkers and friends are addicted. Most of the people who are dying in the opiod crisis follow this vector:

1) Injury + debilitating pain
2) Doctor
3) Doctor prescribes opiods
4) They need to stay on opiods for a long time to deal with the pain
a) Some accidentally overdose here, simply by taking too much too soon by accident.
5) The doctor eventually ceases prescription for opiods
6) They go into serious withdrawl + debilitating pain
7) They try to find other sources for pain management
d) They end up with something like Fentanyl that can kill with a sniff of it, or Heroin, which is far stronger than anything in the 70's

You too can easily become a drug addict by beginning with step 1. And unless you've suffered true, debilitating pain for long periods of time, you've got no place to talk. Broadly inferring that "drug addicts" should generally "die" and society improves shows you are as educated on the topic as an African Bushman would be on exotic car repair, but not afraid to show ignorance.

The resulting addiction is caused by doctors. Ensares people who had no desire to ever use drugs in their life. Doctors force the change that leads to an OD; and these people are psychologically normal and treatable.

Contrast that to Cluster-B who have a permanent defect in their prefrontal cortext which prohibits them from ever feeling higher emotion, is untreatable, and is responsible for the majority of all of societys crime and ill's, including drug production and dealing, for that matter, vs the stereotypical typecast black transient drug addict that you must be envisioning the 74,000 annual dead to be.

PS: Most of the people involved in the crisis are not minorities, nor are they "inner city". Time for the stereotypes to end.

I'm not so sure there's truly an "opioid crisis" going on. had several surgeries in my adult life and been prescriped oxycodone, hydrocodone and tramadol as the most prevalent, never been hooked or addicted.

How many of these patients don't read the instructions on the bottle and take it as directed? How many think they're supposed to take it till it's gone? I personally know people that do this. If people would take them as directed...many wouldn't get addicted. I'm hard pressed to blame it all on doctors.

After each of my surgeries I maybe took mine for a week or two at most then transitioned over to 800 mg tablets of ibuprofen or naproxen. Narcotics cause constipation and that leads to nasty painful hemmorhoids, which is why I get off them as quick as possible.


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[cstone]

I'm not so sure there's truly an "opioid crisis" going on. had several surgeries in my adult life and been prescriped oxycodone, hydrocodone and tramadol as the most prevalent, never been hooked or addicted.

How many of these patients don't read the instructions on the bottle and take it as directed? How many think they're supposed to take it till it's gone? I personally know people that do this. If people would take them as directed...many wouldn't get addicted. I'm hard pressed to blame it all on doctors.

After each of my surgeries I maybe took mine for a week or two at most then transitioned over to 800 mg tablets of ibuprofen or naproxen. Narcotics cause constipation and that leads to nasty painful hemmorhoids, which is why I get off them as quick as possible.


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Congratulations!

Your story is one story and not necessarily representative of others. I have met very few people who choose to become addicts and most addicts I've known would do anything, except give up their monkey, to be free.

No simple answers. If there were, we would create more complex problems.

Be safe.

[Gman]

Whatever the disposition is to becoming addicted to opioids, I don't have it (thankfully). I take them for pain. I don't have the convenience of being able to take NSAIDs since they may interfere with my spinal fusion. I have "control issues" and hate the way they make me feel, so I only take them when I have to. Times that I "have to" are things like being able to sleep at night. If you're in so much pain trying to sleep that you can't, not only are you not sleeping, but you're not healing. If I'm awake, I pretty much just deal with it. I've had pain most of my life and don't expect to not have any. My pain management doc told me I wasn't really taking hardly anything compared to most of his patients. A monthly prescription lasts me several months. He didn't have to worry about me....but I was still required to have Narcan on-hand due to the "epidemic".

I also rarely drank alcohol for the same reason, but my current medications don't allow it. Which reminds me, I quit smoking in my early 20s. I decided one day that it was 'no longer fun' and just quit.

...but my wife reminds me regularly that I'm not like "most people".

[Gman]

I can say that being able to get opioids if you need them has become downright painful. The doctors that are willing to prescribe them for pain management require multi-page patient agreements. I remember having to agree to 48 separate clauses (would have been 49 if I were a woman due to pregnancy risk). I had to agree to pill counts and drug testing. I felt like I was being treated like a criminal.

...yet I understand that abusers get scripts from multiple doctors and get them filled at numerous pharmacies.

When I was reading articles about the epidemic, there were statements made that it was easier to find illegal drugs than prescription opioids. I wouldn't know the first thing about finding illegal drugs. That's an entirely different world of which I have no understanding.

Fentanyl on the streets is a big part of the problem, but prescription meds and illegal street drugs all get lumped into "the opioid epidemic".

In further study of the issue, there were some parts of the country where insanely huge quantities of opioids were being sold (like Florida and Kentucky). These were being funneled to the streets by doctors who had turned their backs on the Hippocratic Oath to make some bucks. Because some criminals were selling these legal drugs illegally, we must all be punished. Kind of like law-abiding firearm owners being punished by the acts of criminals.

[OtterbatHellcat]

had several surgeries in my adult life and been prescriped oxycodone, hydrocodone and tramadol as the most prevalent, never been hooked or addicted.

You could still drive OTR while under these prescriptions, and keep your CDL during the interim?...just curious.

[Jeffrey Lebowski]

Why is it considered entirely ethical for a pet owner to undertake euthanasia, but entirely unethical for a person to choose it? This one of society's moores is one of the most illogical, and it's not really rooted in *anything*.

It is rooted in religion and religious history. Several of them.

[Jeffrey Lebowski]

...yet I understand that abusers get scripts from multiple doctors and get them filled at numerous pharmacies.

PDMP should theoretically be helping this.

When I was reading articles about the epidemic, there were statements made that it was easier to find illegal drugs than prescription opioids. I wouldn't know the first thing about finding illegal drugs. That's an entirely different world of which I have no understanding.

Fentanyl on the streets is a big part of the problem, but prescription meds and illegal street drugs all get lumped into "the opioid epidemic".

Yep.
It is easier to get illicit than Rx drugs in some cases. Fentanyl has been very difficult for hospitals to get, but you can easily get heroin adulterated with it.

And, b/c of several of these measures, this is why there are legit strories of grandma going from pain meds to heroin. Truly sad.