The next pharma drug crisis in the US may be starting

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ViewsAskew
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The next pharma drug crisis in the US may be starting

Postby ViewsAskew » Mon May 07, 2018 7:07 pm

My eyes hurt tremendously, so I won't stay to write about it now. Click on this to find the article about gabapentin - now a scheduled drug in Kentucky and routinely being abused...
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

legsbestill
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Re: The next pharma drug crisis in the US may be starting

Postby legsbestill » Tue May 08, 2018 7:37 pm

Interesting that rls is specifically mentioned as a condition gabapentin is used to treat. I must say I’d have to be really desperate to resort to this drug for a ‘high’ - it’s so unpleasant. Also had a hollow laugh when I read that it is combined with opioids and marijuana for a more ‘intense’ high. It sounds so melodramatic but it doesn’t accord with my experience. Do people find gabapentin more intense when combined with an opioid? I take pregabalin with marijuana but I can’t say I notice any difference between the days when I take them mmj and the days when I don’t.

Rustsmith
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Re: The next pharma drug crisis in the US may be starting

Postby Rustsmith » Tue May 08, 2018 8:35 pm

I saw a similar article about six weeks ago that cited gabapentin use at the University of Ohio where they said a 300mg capsule was selling on the street for 50 cents. I am on the faculty at U of Ohio. I don't doubt that it is being abused, but I am pretty sure that most of it is with alcohol and not narcotics. These stories always seem to mix and match facts just to suit the desired message similar to the facts about deaths due to opioid abuse. The fact is that coroners only report the death due to opioids. They do not differentiate between prescription pills and heroin, but the media always makes it appear to be prescription pills that are responsible for the majority.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

QyX
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Re: The next pharma drug crisis in the US may be starting

Postby QyX » Mon Oct 22, 2018 11:45 pm

ViewsAskew wrote:My eyes hurt tremendously, so I won't stay to write about it now. Click on this to find the article about gabapentin - now a scheduled drug in Kentucky and routinely being abused...


The abuse potential for Gabapentin is rather low.

Lyrica is the same type of class, way more potent and is abused heavily here in Germany but it is not a controlled substance.

Gabapentin is too weak for proper abuse in my opinion. You need extreme doses of Gabapentin to get high and tolerance kicks in after using it only once or twice.

Making Gabapentin a controlled substance is just stupid and pointless but it would be a good idea if you want to sell more of the expensive Lyrica or Horizon.

Edit: Gabapentin and Lyrica are great drugs (if used properly) to manage withdraw from opioids. They are able to kill most of the possible withdraw symptoms associated with opioid withdraw symptoms. And with the current opioid crisis and so many patients suffering from losing their access to opioids, it is no surprise that Gabapentin and Lyrica get more popular.

Rustsmith
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Re: The next pharma drug crisis in the US may be starting

Postby Rustsmith » Tue Oct 23, 2018 12:50 am

Qyx, the issue with gabapentin isn't that it is being abused by itself. The idiots who are making things difficult for the rest of us are using it to add to the high that they are getting from other drugs and this appears to even include alcohol. The indications are that the high (or drunk) is even higher if it is combined with gabapentin.

So far, gabapentin is a Schedule 5 medication in only one state, Kentucky. As for Lyrica, the US government has it on Sch 5, so unlike gabapentin Lyrica is controlled in all 50 states. However, the UK is currently taking steps in the same direction with gabapentin.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

debbluebird
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Re: The next pharma drug crisis in the US may be starting

Postby debbluebird » Tue Oct 23, 2018 5:16 am

I take methadpne and gabapentin and have never felt "high". Like stated above, the tolerance comes on quickly.

QyX
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Re: The next pharma drug crisis in the US may be starting

Postby QyX » Wed Oct 24, 2018 3:32 am

Rustsmith wrote:Qyx, the issue with gabapentin isn't that it is being abused by itself. The idiots who are making things difficult for the rest of us are using it to add to the high that they are getting from other drugs and this appears to even include alcohol. The indications are that the high (or drunk) is even higher if it is combined with gabapentin.

So far, gabapentin is a Schedule 5 medication in only one state, Kentucky. As for Lyrica, the US government has it on Sch 5, so unlike gabapentin Lyrica is controlled in all 50 states. However, the UK is currently taking steps in the same direction with gabapentin.


Making Gabapentin a controlled substance is just stupid. Alcoholics and people who abuse narcotics and drugs in general will just take whatever they can get makes them high or sedates them. There are some well documented cases where people even abused antipsychotics, especially Seroquel.

Gabapetin has some weak sedative-hypnotic properties but tolerance will occur after only 1-3 days.

It is impossible to control every substance that can create a high or can increase the effect of other drugs.

Here in Germany, within the opioid addiction scene, there are quite a few people who abuse Lyrica but Gabapentin is way to weak to be popular.

This is just some drama that will improve nothing and change nothing.

The opioid addicts in the U.S. need access to proper treatment, especially opioid replacement therapy with Methadone & Buprenorphine. And it would probably best when the most severe cases get access to extended release Morphine and even medical Heroine like it is available in many European countries (Germany and Switzerland for example have such programs).

But from what I heard in the U.S. it is all about those 12 step programs where using a substitute is not an option. Sadly many people don't understand that opioid replacement therapy is the best option to save lives. I could write about this for ages but in short: in terms of treating addiction, the U.S. is twenty or maybe even thirty years behind Germany ... and even here many things are not good.

Rustsmith
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Re: The next pharma drug crisis in the US may be starting

Postby Rustsmith » Wed Oct 24, 2018 3:48 am

The opioid addicts in the U.S. need access to proper treatment, especially opioid replacement therapy with Methadone & Buprenorphine.


Methadone has been used for opioid replacement therapy in the US for many decades. In fact, the common reaction that you get if someone finds out that one of us is taking methadone is "Oh!!" and then they look at you and are thinking that you are a drug addict. I have even had pharmacists, who should know better, give me this reaction.

As for buprenorphine, the legislation that was passed just this last month has finally changed the regulations for that medication so that it can be used much more easily for this purpose than before. The limitations that were placed on it really didn't make a lot of sense considering everything else that has been going on.

Finally, the recent legislation also freed up a number of funding sources for opioid abuse treatment programs. Whether that will make a difference is something that remains to be seen. I know that in the town where I live, there simply are not enough beds in all of the hospitals to handle all the heroin addicts, even if they threw all the other patients out onto the street.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

debbluebird
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Re: The next pharma drug crisis in the US may be starting

Postby debbluebird » Wed Oct 24, 2018 11:50 am

The PT I saw today, said that Doctors are starting to band together to fight against what is happening. They are fighting for their patients. I know it's a big fight, but this made me feel a little better. My own PCP fought for my husband and I, against those who own our clinic. They were going to stop all opioid scripts. She won the fight. Granted we care a small town, but it was great. The pain Doctor we saw 2 weeks ago didn't make us feel like drug addicts. No pee tests. Another victory.

QyX
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Re: The next pharma drug crisis in the US may be starting

Postby QyX » Thu Oct 25, 2018 3:48 am

Rustsmith wrote:
The opioid addicts in the U.S. need access to proper treatment, especially opioid replacement therapy with Methadone & Buprenorphine.


Methadone has been used for opioid replacement therapy in the US for many decades. In fact, the common reaction that you get if someone finds out that one of us is taking methadone is "Oh!!" and then they look at you and are thinking that you are a drug addict. I have even had pharmacists, who should know better, give me this reaction.

As for buprenorphine, the legislation that was passed just this last month has finally changed the regulations for that medication so that it can be used much more easily for this purpose than before. The limitations that were placed on it really didn't make a lot of sense considering everything else that has been going on.

Finally, the recent legislation also freed up a number of funding sources for opioid abuse treatment programs. Whether that will make a difference is something that remains to be seen. I know that in the town where I live, there simply are not enough beds in all of the hospitals to handle all the heroin addicts, even if they threw all the other patients out onto the street.


From the outside and what I know about the situation in the U.S. ... it just seems like that those programs who offer treatment with Methadone and Buprenorphine are hard to access. For example not enough doctors and clinics who offer them, too many rules, laws that can lead to the loss of licence of the prescribing doctor when making only minor mistakes etc.

Another observation is that these programs seem to be underfunded and understaffed.

And when the U.S. is taking the opioid problem really serious, then they have to learn that Methadone and Buprenorphine are not enough treatment options. Some patients just need the needle. So we have special programs in some towns where patients can inject medical Heroine under supervision in special Heroine clinics.

About Methadone: Methadone comes with a lot of side effects and addicts who often need high doses are especially affected by them. Long QT-syndrome, weight gain, depression, impotence and fatigue are the most common problems. Or in short: while Methadone can treat the craving for Heroine very well, the side effects often make it impossible to work or have some kind of normal life which is a requirement when you want people to recover and integrate them back into society.

Buprenorphine is used as an alternative for those who have the side effects I mentioned. However for many people Buprenorphine is just not "satisfying". While it helps with the craving, it does not offer the effects addicts are looking for. In Germany it took us over 40 years to realize that we need to offer a third alternative which is now Morphine. We actually learned this from our austrian neighbours.

What we can see now is that for some patients Morphine is better, for others Buprenorphine and some Methadone. While Morphine seems to be the most popular opioid in opioid replacement therapy, it is impossible to predict which drug works best.

When I was prescribed opioids for RLS, I became super interested in opioid addiction, mainly because I was afraid I could end up as an addict. So I spent some years learning everything about opioid addiction that was possible. If the U.S. wants to reduce the deaths by opioids, they need to make opioid replacement therapy widely available and stop promoting those therapies that force people to stop opioids altogether because those people have the greatest risk of dying from an overdose. The reason is that most addicts don't know how fast they will lose the tolerance. After they stopped opioid, it will only take a couple of weeks and they almost have the same tolerance like somebody who never touched opioids.

And when they relapse and have a crazy craving for opioids, they totally underestimate how low their tolerance is ... and when they use doses similar to those they used before or even higher doses because they have that crazy craving, they are only a few moments away from a fatal overdose. An additional problem is the availability of fentanyl and fentanyl derivatives. While an addict who consumes daily would be okay when consuming a super high potent like opioid or one of its derivatives, he will most likely die when he lost his tolerance. So here in Germany most specialist agree that it is the safest option to keep addicts on relative high doses of opioids (like 600 to 1000 mg of Morphine per day) because that makes it hard to overdose and avoids the craving that will lead to illicit use of opioids.

In 2017, we only had about 2,000 deaths from opioids in Germany, in 2016 it was around 1,300 ... (in a country with about 81 million inhabitants).

If you compare this to the U.S. .. I would say our strategies work pretty good. I really wish the U.S. can learn from us (our Austria or Switzerland).

charles
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Re: The next pharma drug crisis in the US may be starting

Postby charles » Mon Nov 26, 2018 6:31 pm

Rustsmith wrote:I saw a similar article about six weeks ago that cited gabapentin use at the University of Ohio where they said a 300mg capsule was selling on the street for 50 cents. I am on the faculty at U of Ohio. I don't doubt that it is being abused, but I am pretty sure that most of it is with alcohol and not narcotics. These stories always seem to mix and match facts just to suit the desired message similar to the facts about deaths due to opioid abuse. The fact is that coroners only report the death due to opioids. They do not differentiate between prescription pills and heroin, but the media always makes it appear to be prescription pills that are responsible for the majority.


I have to say, I love reading posts like this that are spot on. If you listen to the LYRICA commercial on TV, it says that people with past alcohol & drug problems should avoid LYRICA.. (like that would ever happen). It's no wonder the spotlight is now on LYRICA. The wording is absolutely intentional to attract attention: and it certainly has !!
Drug companies know exactly what their doing . HOWEVER, in defense of drug companies, It's ironic that the most widely abused drug on the planet is ALCOHOL, and it's perfectly legal !
Alcohol is responsible for more deaths, auto accidents, injuries, family distress, etc, etc , but you rarely read about these statistics, and when you do, it's blamed on opioids..(the low hanging fruit). Legitimate RLS users of opioids are in a uphill battle for sure.

Charles
St Pete,FLA

charles
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Re: The next pharma drug crisis in the US may be starting

Postby charles » Mon Nov 26, 2018 6:36 pm

Please see reply to Rustsmith, Tue, May 18, 2018
Charles
St Pete,FLA


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