Medical doesn't test for drugs; just like a flight physical doesn't. How he beat the random screening, don't know. My guess is just luck. Maybe his number never came up or maybe he always had a "doctors" prescription.. Dunno..
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NEWS Local Spirit Airline Pilot Dead of Heroin Overdose
- Thread starter ChuckMK23
- Start date
I agree 100%, but unfortunately for some there is no other option. Less addictive drugs, pain management counseling, and physical therapy don't always work as promised.
There are people out there that live with chronic, severe pain, and for some, opioids are the only thing that makes life bearable. You don't see them out and about because they are hunkered down in their homes, unable to live normal lives. They have bad days, terrible days, and days that they just want to end the suffering.
Regular, everyday use of opiods can be reasonably safe with close monitoring by doctors and pharmacists and self-discipline on the part of the patient. However, weak, asshole addicts that abuse the system have made getting these meds much more difficult for those truly in need and following the rules.
To add on to what you mentioned about the lack of effectiveness of other methods, there's somewhat of a cyclical nature to the prescription of opioid based pain relievers. Usually for a period of about a decade, someone gets the bright idea that reducing opioid prescription can reduce dependence, then someone else disproves it and it goes back in fashion for a period of time. Fact is, much like cutting dependence on gasoline, we've developed opiates for a long time and we're pretty darn good at it, so an elegant replacement solution is difficult.
This always brings me back to the House quote: "I don't have a painkiller problem, I have a pain problem." For many, a responsible dose is the only thing that allows them to function.
Addicts that are "functional" are experts at hiding their problems. If your only relationship with them occurs in a work environment, they prepare for that event and clean up/cover up/sober up as needed.
Years ago I had a pilot that worked for me who had a severe alcohol problem that no one knew about. My first clue was a change in his use of annual leave, followed by strange pattern of calling in sick but using annual leave instead of sick leave. Shortly afterwards he became somewhat evasive in answering my questions about his time off, citing privacy issues. He ultimately came clean about his alcoholism, took a leave of absence to go to rehab, and ultimately returned to flying.
http://www.msn.com/en-us/news/us/te...t-doctors-office/ar-BBysapu?OCID=ansmsnnews11
Relevant article to this discussion.
Relevant article to this discussion.
The misuse of opioids is one of the great self-inflicted wounds of medicine. In the 90's, the VA started socializing the notion that pain was undertreated. Other groups jumped on the bandwagon, including The Joint Commission (the organization that has become the de facto overseer for hospitals) and several professional societies. This emphasis on treating pain led to the infamous "pain scale", to which we're all subjected to every time we go to medical. Medicare then incentivized the process by linking patient satisfaction to reimbursement. One component of patient satisfaction was "How well was my pain controlled?". Predictably, this confluence of official emphasis and financial incentive (or lack of penalty) resulted in physicians prescribing the most effective pain control possible to minimize negative reviews and financial penalty.
Opiates are excellent medications for acute pain. However, tolerance to the analgesic effects develops rapidly. Tolerance to the other effects of opioids like respiratory depression doesn't develop as rapidly, making the already low margin of safety lower, as the dose of opioid has to be increased to achieve pain control, but the dose required for toxic effects doesn't change that rapidly.
Opioids for chronic pain are more controversial. All the recommendations were extrapolated from a study that lasted only a few months, nowhere near the duration of time that patients are commonly maintained opiates these days. There is also a substantial body of research that chronic opioid therapy actually lowers the pain threshold, paradoxically increasing susceptibility to pain when administered chronically. Compounding that problem is that patients on chronic opioid treatment often confuse withdrawal symptoms with pain, which leads prescribers and/or patients themselves to continue to escalate doses to avoid withdrawal, which is perceived as distinctly unpleasant.
At this point, I really don't see a way to stop this train. An entire generation of Americans has been conditioned to expect a life free from pain. We're at the point now where there were enough opiates prescribed in this country last year to give every man, woman and child a 30 day prescription of 5 mg of hydrocodone. And we're the only nation with a problem as large as this.
R/
Opiates are excellent medications for acute pain. However, tolerance to the analgesic effects develops rapidly. Tolerance to the other effects of opioids like respiratory depression doesn't develop as rapidly, making the already low margin of safety lower, as the dose of opioid has to be increased to achieve pain control, but the dose required for toxic effects doesn't change that rapidly.
Opioids for chronic pain are more controversial. All the recommendations were extrapolated from a study that lasted only a few months, nowhere near the duration of time that patients are commonly maintained opiates these days. There is also a substantial body of research that chronic opioid therapy actually lowers the pain threshold, paradoxically increasing susceptibility to pain when administered chronically. Compounding that problem is that patients on chronic opioid treatment often confuse withdrawal symptoms with pain, which leads prescribers and/or patients themselves to continue to escalate doses to avoid withdrawal, which is perceived as distinctly unpleasant.
At this point, I really don't see a way to stop this train. An entire generation of Americans has been conditioned to expect a life free from pain. We're at the point now where there were enough opiates prescribed in this country last year to give every man, woman and child a 30 day prescription of 5 mg of hydrocodone. And we're the only nation with a problem as large as this.
R/
http://time.com/4419003/can-medical-marijuana-help-end-the-opioid-epidemic/
"...they also found that when states legalized medical marijuana, prescriptions dropped significantly for painkillers and other drugs for which pot may be an alternative. Doctors in a state where marijuana was legal prescribed an average of 1,826 fewer doses of painkillers per year."
"If we could use cannabis, which is less addictive and harmful than opioids, to increase the effectiveness of pain treatment, I think it can make a difference during this epidemic of opioid abuse," says Abrams who has investigated the effect of cannabis on pain for over a decade."
"...they also found that when states legalized medical marijuana, prescriptions dropped significantly for painkillers and other drugs for which pot may be an alternative. Doctors in a state where marijuana was legal prescribed an average of 1,826 fewer doses of painkillers per year."
"If we could use cannabis, which is less addictive and harmful than opioids, to increase the effectiveness of pain treatment, I think it can make a difference during this epidemic of opioid abuse," says Abrams who has investigated the effect of cannabis on pain for over a decade."
While I wholeheartedly agree with you, it's only a matter of time before the kids fall victim to your scorn. Drug addicts aren't inherently bad people who emerge from the ether. They are commonly victims of childhood trauma (like those from drug addict parents, nevermind parents who overdosed). The key is finding a way to screen these people earlier and treating them instead of letting them self-destruct and shitting on them after the fact.
I can't agree with you more. Studies have shown opiates/opioids are INEFFECTIVE for treating chronic pain. In fact, one of the main side effects of opioids long-term is CREATING pain. Doctors who are ignorant about pharmacology and addiction medicine are responsible for the opiate (including heroin) addiction problem nowadays. TL;DR: If you are prescribed opiates for longer than 2 weeks... find a new doctor.
I don't think this is true for everybody. I did very bad things to my back and was on opioids (of gradually decreasing strength) for over three months. It kept me relatively functionally and probably helped me get into physical therapy sooner. After the obligatory YMMV disclaimer, I would maybe amend that to warn against using them to control chronic pain where there is no path to physical improvement.
exNavyOffRec
Well-Known Member
I am in a state where it is legal and we have had a boom in heroin addicts, I am also friends with several in LE and they are seeing a significant increase in those driving under the influence of MJ, of course they are not being classified as DUI since the threshold for the blood test is such that by the time they do the blood draw after the court order it has been hours so the level is often below, so instead they are getting a driving under impairment or reckless driving charge, so the state can still say they haven't seen much of a spike in MJ DUI's.
I believe there are medical benefits, but also believe the legalization is not due to those wanting to help those with medical issues but those that just want to get high.
RadicalDude
Social Justice Warlord
And the problem with that is...?
exNavyOffRec
Well-Known Member
driving high, crashing cars, etc...... there have been more injuries on the highway near me in the past few years due to people driving high than driving drunk, MJ overdoses are up, as well as those having other issues with it, the MJ of today is not the MJ of 40 years ago, by the reports it is around 5 times stronger, there is really no regulation, if there was they would regulate the THC content to a level that would limit issues.
RadicalDude
Social Justice Warlord
There is no real "overdose" like you think about with other drugs or alcohol with marijuana. It's just people getting paranoid or anxious. It's virtually medically impossible to ingest a lethal dose of marijuana.
The rest of your concerns, while valid, pale in comparison to the worst effects of prohibition. And I highly doubt the rate of injury due to high driving has exceeded the injuries due to drunk driving. That sounds anecdotal and would be unprecedented based on statistics I have seen.