What’s am I missing? Johnson and Johnson judgement.

shut a company down, people will die or get sicker because they can't get OTHER drugs that company produces.   No company only produces one drug or one classification of drugs.   Shut a company down, the medical industry and insurance industry would fall all over themselves in confusion over trying to switch the patients to Rx from another company.   And there are certain medication inactive ingredients that some people can't take, will act differently, etc.  I really don't think you could do something like that; it could create chaos. 

Don't you remember the debacle that happened earlier this year when there was a particular blood pressure medication ingredient that was contaminated? Imagine that, only on an exponential scale. Other companies would take literally YEARS to backfill that void.  What do those patients do in the meantime?

How/where does "second guessing" come into any of this?
There is no guess work, pretty much every order I've seen for pain killers contains the words "as needed"
Also if you don't understand your doctor/nurse/pharmacist instructions, then ask them...don't "guess"

but hey, it's easier to blame medical personal then those who voluntarily shove handfuls of tablets into their mouths I "guess".

Surely you recognize that some people needed the maximum amount for the maximum amount of time because everyone has different pain tolerances? And some people became addicted at smaller doses? And some doctors didn’t warn people to take the minimum and some people actually didn’t know? It’s great you were able to manage your pain with less medication, even better that you didn’t become addicted, and it’s great that you were aware of the dangers. Not everyone was. A lot of people were mislead by their doctors. We don’t all work in the medical field and weren’t all aware of the dangers. When your doctor simply says “take as needed” and sends you on your way with no warning well then that is what most people are going to do. And when your doctor tells you “don’t worry you aren’t going to become addicted” then a lot of people are going to trust that the doctor knows more than they do. And when you are still in pain and the doctor prescribes more...

Perhaps consider that it may have been handled differently there and not everyone has the bemefit of the medical knowledge you have. Your doctors order may have specified severe pain. Here? They weren’t just handed out for severe pain (I think even now my hydrocodone prescription simply says “take every 8 hours as needed for pain”) and doctors treated them like candy. There were no verbal warnings. No advice to wean off of them as soon as you could and go to Tylenol or Advil.  

In this day and age people know more, but when they first came out and for years later that wasn’t the case. I know my doctors treated them like Tylenol. I consider myself very lucky that I never became addicted. 

The label (in Australia at least) will say "take ONE (yes, capitalised just like that) tablet up to FOUR times per day when required for STRONG pain relief"

So following exactly what the label says, if you have STRONG pain, then you can take no more than 4 tablets per day.
If you start taking 10 tablets a day - then that's your choice and not what your doctor prescribed.
If you don't have "STRONG" pain, then you should be taking something else.
The labels are accurate. What people do when they get home is not under the control of medical personnel.

Our patients ALL get discharge information with all of this printed out for them, all about their choices for post op pain management, and we verbally go through this as well.
They aren't left "guessing" or not knowing what to take and how often and what their alternatives are.

However no matter what any label says if someone takes twice, 3 times or 10 times the amount of any standard drug dose...they already know they are taking too much and it is going to cause problems for them at some stage, no matter if that tablet is a narcotic or some other medicine. If they claim they don't know that, it's bullshit. They are just deciding to do it anyway.

OK so one minute I'm experienced professional who knows more than the average about medicines and how to take them and the next minute I don't know anything at all about addiction to those medicines?

OK
Keep arguing amongst yourselves then.

Another interview I listened to recently has more details more wrongdoing from the manufacturers and distributors:

Tales of Corporate Painkiller Pushing

Some key points:

- the DEA maintained a database that tracked all pills between 2006 and 2012. 76 billion pills went out on the market. This database was just made public in the last month, and together with also just released internal company emails, informed much of the reporting. The database shows manufacturers, distributors, and pharmacies and exactly how much went to what communities

- when overlaid with death statistics, there is a correlation between pill saturation in a community and deaths

- it's a closed supply chain between manufacturers/distributors/pharmacies and since pills were being tracked, it was documented when there were suspiciously large orders; these orders are supposed to be flagged (and legally so - Controlled Substances Act) and the companies weren't reporting as they should have been

- the DEA knew about the epidemic and had the data, but took little action (were more concerned with illegal drugs versus prescription drugs) - they fought to keep the data from going public. There was a small department that was tracking and trying to do right, but was understaffed with little resources and faced a lot of obstacles

- some pharmacies were diligent, many others weren't (CVS and Walgreens were fined), such as questioning prescriptions that didn't look legitimate

- manufacturers and distributors knew what was up and their compensation was often tied to how much drugs they could ship. Quote from the interview:

"But I guess, you know, one of the ones that really stands out and has got a lot of attention is a national sales director for Mallinckrodt, a big manufacturer, who was exchanging emails with one of his customers, KeySource, which was a distributor in Ohio. And the KeySource sales rep, you know, said, you know, send me more of these drugs. And he said, you know, it's almost like they're addicted to these things. Oh wait, they are. And he said in response just like Doritos. Keep eating. We'll make more.

And his title at - when he was at Mallinckrodt, his unofficial title that all of his coworkers jokingly called him ship, ship, ship. And he did ship a lot of oxycodone and hydrocodone. That was his job. And his bonus structure was tied to the amount of sales that he made. And that is something that happens throughout the industry."

- McKesson is the largest drug distributor and the DEA was trying to build a case against them as their pills were found in staggering amounts in pharmacies that could not be medically necessary. They believed they had the evidence and information, but the US Attorney and Justice Department declined to pursue a case.

- there is a large revolving door between the justice department, DEA, and the pharma industry - could explain why the justice department isn't very aggressive in these cases

- the DEA's most potent weapon in going after drug companies (suspension of operations due to imminent threat) was stripped by legislation written by the industry and they recruited representatives to bring the bill to Congress

- now any company wrongdoing can just be ignored if they file a "corrective action plan" so the DEA has been rendered largely ineffective



interview highlights

The amount of time it takes to become addicted is actually very, very low.  It can happen in less than a week, and doesn't necessarily mean that someone is misusing their meds.  

The Oklahoma Attorney General’s decision to bring this action as a public nuisance was a bold and brilliant legal move. There are lots of articles written about why the Oklahoma Attorney General sued under the state’s public nuisance statute, but basically the statute is written very broadly and the AG did not have to prove that a specific doctor was given false information which lead to the doctor prescribing opioids to a specific patient which caused that patient to become hooked on opioids. Under Oklahoma’s statute, the AG just had to prove that J&J marketed opioids in Oklahoma in a manner which lead to a public health crisis in Oklahoma. Plus, under Oklahoma law, there is no right to a jury trial for public nuisance, so that is why it was tried before a judge instead of a jury.

For those of you who are saying why not just shut these drug companies down instead of bringing civil actions against them, what would happen to all the patients who were using all the legitimate drugs J&J and other drug companies manufacture? Also, the companies would file bankruptcy if they were shut down and wouldn’t be able to pay the huge judgments already awarded against them.

I would just like to point out that every single time I visit any doctor (across all specialties for literally any reason) I get discharge papers. Regular docs, specialists, urgent care, and ER. Everything that we talked about is summarized on the paper. If I am to take meds they are listed with dosages. If I am to follow up somewhere that is also listed. Things to watch out for are listed. I am in MI.

I strongly suspect this is a hospital system policy. It did not used to be this way. All of the docs are part of our local hospital system, so it makes sense for them to be participating in this. I think this will become the norm across the country in the next few years.

It's a pittance compared to what opioids have cost this country in mental health crises, EMT shortages, homelessness, loss of livelihood. It's .6% of ONE YEAR REVENUES. It's 3.8% of J&J's ONE YEAR PROFITS.

Because people react differently? Just like with alcohol or any other drug. And even if a doctor is managing it, someone can still be/become addicted.

Did the liquor makers hire sales reps w/incentives to sell as much booze to docs as possible for docs to write scripts for booze to their patients? And lie to the docs about the clinical studies of the affects of alcohol consumption?

No?

Then not the same situation, is it?

i am grateful for opiods. i use them as needed for pain. never been addicted but several of my close friends live daily in pain because drs are scared to prescribe them now. i am sorry but if one must live in pain for live every minute of every day or have opiods i say let them have opiods. I do not abuse mine and in fact rarely use mine but have them for those extreme days. but I wish more drs felt they could prescribe them but with all the hype about the RX world right now, it is truly sad to see people in bed all day/night because of their pain. Should companies be held responsible for the misuse or overuse nope. patients and drs are well informed before taking meds. People need to wake up and learn before taking meds. become informed. stop being so sue happy and trying to get a free ride.