Friday, August 11, 2017

Quick observations about health care, pain meds, and getting older

I didn't know this. Big corporations that provide health insurance to their employees, mostly through self insurance, want us to understand::

We and our employees spend more than $5 billion each year on four procedures and ailments: knee replacements, hip replacements, back pain and diabetes. These common problems account for 20 percent of the money our companies spend on treatment.

The first two were extreme rarities twenty-five years ago, now commonplace. They work very well for many. All these maladies respond positively to that which people in this country often do not do: keep moving. But you can't expect people to move when their lives are organized (and disorganized) in patterns that preclude exercise.

From a discussion of why U.S. doctors prescribe so much more pain meds than docs in other countries,

“A bit of this is cultural expectations about how fixable is life,” said Stanford psychiatry professor and addiction researcher Keith Humphreys. “America is still young and thinks life can be perfected.”

This rings true and points to a corollary: no wonder we are such an ageist society. Ageing a personal failing, or perhaps our doctors' failing, when we can no longer pretend we haven't suffered wear and tear. Yet we live longer and longer. Aging can't be "fixed." Is ageism a contributor to opioid overuse? Seems likely. Age must be shameful and should be hidden away ... no wonder we like our drugs.

The pic is from a rally in 2010, but like so much, still remains pertinent.


Rain Trueax said...

I keep hearing how the opioid problem is due to over-prescription but is it? Or is it illegal purchases? They are on the black market coming in from foreign countries and sold on the street. I'd like to know how many of the overuses are from that source and how many from doctors. I've heard a few doctors have overdone it but my experience with doctors is they are leery of prescribing any painkillers without careful consideration. In this state, the pharmacies also are apt to question the prescriptions.

Damon said...

A lot of it is on US doctors, but it's a regional thing.

As a cancer patient who will likely be on pain meds for the rest of my life, I'm fairly lucky. We have a draconian new law in VT that really handcuffs providers at times. Cancer patients are exempted from most of the law, and it's had only a minor impact on me so far. But, it took a lot of decision making away from doctors, and basically prohibits them from giving out opioids in some situations where there is a legit need.

My guess is that this law will just make our heroin problem worse. Neo-prohibition isn't the answer. Letting lawmakers make medical decisions isn't the answer either. We can afford to jail criminals but not kelp people who are sick. Basically, we are criminalizing a health issue.

My two cents...

janinsanfran said...

I found this pretty persuasive about opioids: The opioid epidemic, explained. Patients wanted and needed more pain meds than they were sometimes getting; pharma companies saw an opening and didn't care if some docs abused it if it raised sales; dealers in illegal heroin and fentanyl saw an even bigger opportunity. It sure does seem to be regional. When we were in tribal areas of Montana a few years ago, there were huge billboards warning about drug abuse; you wouldn't find that in coastal California ...

Damon: The article I linked to has a map of where the problem is worse -- though Vermont is right next to New Hampshire, it looks from this as if the latter is far more plagued by drug abuse than the former.

Hattie said...

I need hydrocodone to dry up mucus secretions in my lungs. I was coughing myself to death before I got them. I never up my dosage. But I don't seem to be the kind of person who gets hooked on drugs.
The drug situation has been handled so badly that I'm not sure we will ever be able to improve matters much. I can't even begin to think about what could help.

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