#abusing oxycontin | Explore Tumblr Posts and Blogs

mostlysignssomeportents · 8 months

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Brinklump Linkdump

Catch me in Miami! I'll be at Books and Books in Coral Gables on Jan 22 at 8PM.

Life comes at you fast, links come at you faster. Once again, I've arrived at Saturday with a giant backlog of links I didn't fit in this week, so it's time for a linkdump, the 14th in the series:

https://pluralistic.net/tag/linkdump/

It's the Year of Our Gourd twenty and twenty-four and holy shit, is rampant corporate power rampant. On January 1, the inbred droolers of Big Pharma shat out their annual price increases, as cataloged in 46Brooklyn's latest Brand Drug List Price Change Box Score:

https://www.46brooklyn.com/branddrug-boxscore

Here's the deal: drugs that have already been developed, brought to market, and paid off are now getting more expensive. Why? Because the pharma companies have "pricing power," the most reliable indicator of monopoly. Ed Cara rounds up the highlights for Gizmodo:

https://gizmodo.com/ozempic-wegovy-wellbutrin-oxycontin-drug-price-increase-1851179427

What's going up? Well, Ozempic and other GLP-1 agonists. These drugs have made untold billions for their manufacturers, so naturally, they're raising the price. That's how markets work, right? When firms increase the volume of a product, the price goes up? Right? Other drugs that are going up include Wellbutrin (an antidepressant that's also widely used in smoking cessation) and the blood thinner Plavix. I mean, why the hell not? These companies get billions in research subsidies, invaluable government patent privileges, and near-total freedom to abuse the patent system with evergreening:

https://pluralistic.net/2023/11/23/everorangeing/#taste-the-rainbow

The most amazing things about monopolies is how the contempt just oozes out of them. It's like these guys can't even pretend to give a shit. You want guillotines? Because that's how you get guillotines.

Take Apple. They just got their asses handed to them in court by Epic, who successfully argued that Apple's rule requiring everyone who sells through the App Store to use Apple's payment processor and pay Apple 30% out of every dollar they bring in was an antitrust violation. Epic won, then won the appeal, then SCOTUS told Apple they wouldn't hear the case, so that's that.

Right? Wrong. Apple's pulled a malicious compliance stunt that could shame the surly drunks my great-aunt Lisa used to boss in the Soviet electrical engineering firm she ran. Apple has announced that app companies that process transactions using their own payment processors on the web must still pay Apple a 27% fee for every dollar their process:

https://finance.yahoo.com/news/apples-app-store-rule-changes-draw-sharp-rebuke-from-critics-150047160.html

In addition, Apple will throw a terrifying FUD-screen up every time a user clicks a payment link that goes to the web:

https://www.jwz.org/blog/2024/01/second-verse-same-as-the-first/

This is obviously not what the court had in mind, and there's no way this will survive the next court challenge. It's just Apple making sure that everyone knows it hates us all and wants us to die. Thanks, Tim Apple, and right back atcha.

Not to be outdone in the monopolistic mustache-twirling department, Ubisoft just announced that it is going to shut down its driving simulator game The Crew, which it sold to users with a "perpetual license":

https://www.youtube.com/watch?v=VIqyvquTEVU

This is some real Darth Vader MBA shit. "Yeah, we sold you a 'perpetual license' to this game, but we're terminating it. I have altered the deal. Pray I don't alter it further":

https://pluralistic.net/2023/10/26/hit-with-a-brick/#graceful-failure

Ubisoft sure are innovators. They've managed the seemingly impossible feat of hybridizing Darth Vader and Immortan Joe. Ubisoft's head of subscriptions, the guillotine-ready Philippe Tremblay, told GamesIndustry.biz that gamers need to get "comfortable" with "not owning their games":

https://www.gamesindustry.biz/the-new-ubisoft-and-getting-gamers-comfortable-with-not-owning-their-games

Or, as Immortan Joe put it: "Do not, my friends, become addicted to water. It will take hold of you, and you will resent its absence!"

Capitalism without constraint is enshittification's handmaiden, and the latest victim is Ello, the "indie" social media startup that literally promised – on the sacred honor of its founders – that it would never sell out its users. When Ello took VC and Andy Baio questioned how this could be squared with this promise, the founders mocked him and others for raising the question. Their response boiled down to "we are super-chill dudes and you can totally trust us."

They raised more capital, and used that to create a nice place for independent artists, who piled into the platform and provided millions of unpaid hours of creative labor to help the founders increase its value. The founders and their investors turned the company into a Public Benefit Corporation, which meant they had an obligation to serve the public benefit.

But then they took more investment money and simply (and silently) sold their assets to a for-profit. Struggling to raise capital, the founders opted to secretly sell the business to a sleazy branding company called Talenthouse. Its users didn't know about the change, though the site sure had a lot of Talenthouse design competitions all of a sudden.

Finally, the company announced the change as the last founders left. Rather than announcing that the new owners were untrustworthy scum, warning their users to get their data and get out, the founders posted oblique, ominous statements to Instagram. The company started stiffing the winners of those design competitions. Then, one day, poof, Ello disappeared, taking all its users' data with it. Poof:

https://waxy.org/2024/01/the-quiet-death-of-ellos-big-dreams/

I'm sure the founders' decisions each seemed reasonable at the moment. That's every terrible situation arises: you rationalize that a single compromise isn't that big of a deal, and then you do the same for the next compromise, and the next, and the next. Pretty soon, you're betraying everyone who believed in you.

One answer to this is "Ulysses pacts": making binding commitments to do right before you are tempted. Throw away all your Oreos when you go on a diet and you can't be tempted to eat a whole sleeve of them at 2AM. License your software under the GPL and your investors can't force you to make it proprietary. Set up a warrant canary and the feds can't force you to keep their spying secret:

https://locusmag.com/2021/01/cory-doctorow-neofeudalism-and-the-digital-manor/

If the founders were determined to build a trustworthy, open, independent company, they could have published their quarterly books, livestreamed their staff meetings, built data-export tools that emailed users every week with a link to download everything they'd posted since the last week. Merely halting any of these practices would have been a signal that things were wrong. Anyone who says they won't be tempted in the moment to make a "reasonable" compromise in the hopes of recovering whatever they're trading away by living to fight another day is bullshitting you, and possibly themself.

The inability to project the consequences of your bad decisions in the future is the source of endless mischief and heartbreak. Take movie projectors. A couple decades ago, the studio cartel established a standard for digital movie distribution to cinematic exhibitors called the Digital Cinema Initiative. Because studio executives are more worried about stopping piracy than they are about making sure that people who pay for movies get to see them, they build digital rights management into this standard.

Movie theaters had to spend fortunes to upgrade to "secure" projectors. A single vendor, Deluxe Technicolor, monopolized the packaging of movies into "Digital Cinema Prints" for distribution to these projectors, and they used all kinds of dirty tricks to force distributors to use their services, like arbitrarily flunking third-party DCPs over picky shit like not starting and ending on a black frame.

Over time, the ability to use unencrypted files was stripped away, meaning every DCP needed to be encrypted, and every projector needed to have up-to-date decryption keys. This system broke down on Jan 1, 2024, and cinemas all over the world found they couldn't play Wonka. Many just shut down for the day and refunded their customers:

https://www.theverge.com/2024/1/1/24021915/alamo-drafthouse-outage-sony-projector

The problem? Something that every PKI system has to wrangle: an expired certificate from Deluxe Technicolor. The failure has been dubbed the Y2K24 debacle by projectionists and film-techs, who are furious:

http://www.film-tech.com/vbb/forum/main-forum/34652-the-y2k24-bug-major-digital-outage-today

Making everything worse is that Sony mothballed the division that maintains its projectors, so there's no one who can update them to accommodate Technicolor's workaround. Struggling mom-and-pop theaters are having to junk their systems and replace them. There's plenty of blame to go around, but Sony is definitely the most negligent link in the chain. Shame on them.

Big corporations LARP this performance of competence and seriousness, but they are deeply unserious. This week, I wrote, "we're nowhere near a place where bots can steal your job, we're certainly at the point where your boss can be suckered into firing you and replacing you with a bot that fails at doing your job":

https://pluralistic.net/2024/01/15/passive-income-brainworms/#four-hour-work-week

Score one for team deeply unserious. The multinational delivery company DPD fired its support staff and replaced them with a chatbot. The chatbot can't tell you where your parcels are, but it can be prompt-injected into coming up with profane poems about how badly DPD sucks:

https://twitter.com/ashbeauchamp/status/1748034519104450874

There once was a chatbot named DPD, Who was useless at providing help. It could not track parcels, Or give information on delivery dates, And it could not even tell you when your driver would arrive.

DPD was a waste of time, And a customer's worst nightmare. It was so bad, That people would rather call the depot directly, Than deal with the useless chatbot.

One day, DPD was finally shut down, And everyone rejoiced. Finally, they could get the help they needed, From a real person who knew what they were doing.

This is…the opposite of an AI hallucination? It's AI clarity.

As with all botshit, this kind of AI self-negging is funny and fresh the first time you see it, but just wait until 3,000 people have published their own versions to your social feed. AI novelty regresses to the mean damn quickly.

The old, good web, by contrast, was full of enduring surprises, as the world's weirdest and most delightful mutants filled the early web with every possible variation on every possible interest, expression, argument, and gag. Now, you can search the old, good web with Old'aVista, an Altavista lookalike that searches old pages from "personal websites that used to be hosted on services like Geocities, Angelfire, AOL, Xoom and so on," all ganked from the Internet Archive:

http://oldavista.com/

I miss the old, good internet and the way it let weirdos find each other and get seriously weird with one another. Think of steampunk, a subculture that wove together artists, makers, costumers, fiction writers, and tinkerers in endlessly creative ways. My old pal Roger Wood was the world's most improbable steampunk: he was a gay ex-navy gunner who grew up in a small town in the maritimes but moved to Toronto where he became the world's most accomplished steampunk clockmaker.

I was Roger's neighbour for a decade. He died last year, and I miss him all the time. I was in Toronto in December and saw a few of his last pieces being sold in galleries and I was just skewered on the knowledge that I'd never see him again, never visit his workshop:

https://pluralistic.net/2022/10/16/klockwerks/#craphound

A reader just sent this five-year-old mini documentary about Roger, shot in his wonderful workshop. Watching it made me happy and sad and then happy again:

https://www.youtube.com/watch?v=eqMGomM8yF8

The old, good internet was so great. It was a place where every kind of passion could live. It was a real testament to the power of geeking out together, no matter how often the suits demand that we "stop talking to each other and start buying things":

https://catvalente.substack.com/p/stop-talking-to-each-other-and-start

The world is full of people with weird passions and I love them all, mostly. Learning about Don Bolles's collection of decades' worth of lost pet posters was a moment of pure joy (I just wish more of it was online):

https://ameliatait.substack.com/p/the-man-who-collects-lost-pet-posters

That's the future I was promised: one where every kind of freak can find every other kind of freak. Despite the nipple-deep botshit we wade through online, and the relentless cheapening of words like "innovation" and "future," there are still occasional gleams of the future I want to live in.

Like the researchers who spliced a photosynthesis gene into brewer's yeast (a fungus) and got it to photosynthesize, and to display enhanced fitness:

https://www.cell.com/current-biology/fulltext/S0960-9822(23)01744-X

As Doug Muir writes on Crooked Timber, this is pretty kooky! Fungi – the coolest of the kingdoms! – can't photosynthesize. The idea that you can just add the photosynthesis gene to a thing that can't photosynthesize and have it just kind of work is wild!

https://crookedtimber.org/2024/01/19/occasional-paper-purple-sun-yeast/

As Muir writes: "Animals have no evolutionary history of photosynthesis and aren’t designed for it, but the same is true for yeast. So… no reason this shouldn’t be possible. A photosynthesizing cat? Sure, why not."

Why not indeed?!

OK, that's this week's linkdump done and dusted. It only remains for me to share the news with you that the trolley problem has been finally and comprehensively solved, by [email protected], of the IWW IU 520 (railroad workers):

Slip the switch by flipping it while the trolley's front wheels have passed through, but before the back wheels do. This will cause a controlled derailment bringing the trolley to a safe halt.

https://kolektiva.social/@sidereal/111779015415697244

I'm Kickstarting the audiobook for The Bezzle, the sequel to Red Team Blues, narrated by @wilwheaton! You can pre-order the audiobook and ebook, DRM free, as well as the hardcover, signed or unsigned. There's also bundles with Red Team Blues in ebook, audio or paperback.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/01/20/melange/#i-have-heard-the-mermaids-singing

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eve-was-framed · 17 days

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listen obviously I’m sure there are bad people who support Harris too but I don’t think it’s a coincidence that the only hardcore trump supporters in my family are my uncle who gets arrested like twice a year for DUIs and beating the shit out of his wife and kids or my nana who is in a cult and also abuses her OxyContin prescription

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makinggifsolson · 1 year

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TAYLOR KITSCH

— IN THE SOURCE LINK, you will find 545 hq gifs of TAYLOR KITSCH in PAINKILLER. All gifs were made by scratch by me for roleplaying purposes only. You may edit these as you please as long as you credit me, including crackships, gif icons. Please do not use these gifs to portray the actor/actress as themselves.

PLEASE NOTE: PAINKILLER is a series documenting the abuse of Oxycontin and contains graphic and explicit drug abuse depiction. This pack contains: drug abuse, drug use, hospital, overdose, blood, sex, and guns.

#taylor kitsch #taylor kitsch gif hunt #taylor kitsch gif pack #taylor kitsch gifs #rpt #rpc #gifpacksociety #gifpacknetwork

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luxe-pauvre · 4 months

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There is a notable absence of whistleblowers in the OxyContin story. This may be due to the fact that when people did attempt to blow the whistle, Purdue did its best to crush them, as company lawyers did to Karen White, the Florida saleswoman who lost her lawsuit against Purdue in 2005. But I came to believe that it was also a function of denial. I would spend hours talking with intelligent people who had worked at the company, and they could acknowledge all sorts of infirmities in the corporate culture and make astute observations about the personalities involved, but when it came to OxyContin’s role in the opioid crisis, they would do their best to explain it away. Even in the face of voluminous evidence, of guilty pleas to felony charges, of thousands of lawsuits, of study after study, of so many dead, they retreated to the old truths, about abuse versus addiction, about heroin and fentanyl. I wondered if, for some of these people, it was just too demoralising to take a sober measure of their own complicity, if it was simply too much for the human conscience to bear.

Patrick Radden Keefe, Empire of Pain: The Secret History of the Sackler Dynasty

#Patrick Radden Keefe #Empire of Pain: The Secret History of the Sackler Dynasty

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amphoterrible · 8 months

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some background information

What am I doing? Why, I'm re-watching House, M.D. as a whole-ass pharmacist and taking meticulous notes!

I’m only going to focus on when House, M.D. gets something about medication just wildly wrong. I’m not going to be like “why are the chest compressions so slow” or “would Chase really be inserting that temporary transcutaneous pacer at the beside wouldn’t they want to do that in the EP lab” or anything else along those lines. I am but a humble pharmacist.

Hydrocodone/acetaminophen (APAP), the U.S. Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA)

This is going to be interesting because House aired from November 16, 2004 to May 21, 2012 and there are two things that come to mind for me: 1) The U.S. Food and Drug Administration (FDA) asked drug manufacturers to reduce the strength of acetaminophen in combination acetaminophen products to 325 mg in 2011(1) and 2) hydrocodone combination products were still scheduled as schedule III by the Drug Enforcement Administration (DEA).(2) Hydrocodone combination products weren’t rescheduled to schedule II until 2014. Schedule III prescriptions are a lot easier to write and fill than schedule II prescriptions. A lot of the legal nuance varies by state and I am not going to read New Jersey pharmacy statutes, thank you very MUCH I barely passed every Multistate Pharmacy Jurisprudence Examination (MPJE) I’ve ever taken. Back to the Vicodin. So how am I going to know exactly what formulation of Vicodin House was consuming?

I really don’t care about the hydrocodone component of it. There is no ceiling to an opioid, it’s whatever the patient can tolerate it. (Well technically there is too much to give but you have to look at if the patient is used to taking opioids or not don’t just slam someone with 10 mg of IV Dilaudid you know what I’m saying.) And if they don’t tolerate it give them some naloxone. And patients with chronic pain can tolerate a lot of opioids. Was Vicodin an appropriate opioid for House? No! But it was less regulated! And the threat of liver failure is dramatic! But Oxycontin would make more sense – Wilson’s an oncologist, he would be prescribing it all the time! Cancer hurts! Antineoplastics hurt! Oxycontin was the most widely abused prescription opioid in the United States in 2004(3), right when House started airing. But no, it’s Vicodin. The writers chose Vicodin for a reason. I’m going to let the art flow over me. We’re sticking with Vicodin. Or, hydrocodone/APAP because Abbott isn’t paying me to do this.

I worked in an independent retail pharmacy my first year of pharmacy school (which was 2010 before I realized I do not have a poker face to deal with the general public and immediately started working in a hospital), and I vaguely remember there being way too many formulations of hydrocodone/APAP. Hydrocodone/APAP has a few brand names: Vicodin, Norco, and Lortab. I usually say Norco because it’s the easiest. (I actually say hydrocodone/acetaminophen because I’m an asshole.) I found this email(4) sent by Abbott in October 2012 that discussed the newly reformulated Vicodin®, Vicodin ES®, and Vicodin HP®, which is handy since it lists the old formulations too:

Vicodin®

Hydrocodone 5 mg/acetaminophen 500 mg

Vicodin ES®

Hydrocodone 7.5 mg/acetaminophen 750 mg

Vicodin HP®

Hydrocodone 10 mg/acetaminophen 660 mg

Who the fuck puts 750 mg of acetaminophen in one tablet? That limits the patient to five tablets in 24 hours. We’ve known the maximum dose of acetaminophen is 4000 mg since the 1970s. What the fuck, Abbott.

(Matthew Mercer Voice) How Do You Want To Do This?

So, like, I guess I’ll just count the tablets I see House consuming and then calculate the total daily dose of acetaminophen for each Vicodin formulation? I feel like I can do total acetaminophen dosage based on episodes versus trying to keep track of the days. The timeline of this show is wonky and like once you hit the toxic dose you’re there so? Also, sometimes he takes more than one and it’s hard to hear the tablets like, clink against his teeth or whatever. Sparkle on! We’ll do our best. I was going to put this in an Excel spreadsheet but I just remembered I am a pharmacist and I cannot function in Excel.

Let’s talk about the mechanism of liver toxicity and treatment of acetaminophen overdose if we hit significant toxicity. Wouldn’t it be funny if we didn’t?? That would result in me rambling about House M.D. for pages and pages and he doesn’t even get hypothetical liver failure. Is this fanfiction? Am I writing really weird fanfiction? Anyways significant toxicity occurs if you hit 150 mg/kg of acetaminophen.(5) How much does Gregory House weigh?? Let’s give him a range: 160-180 pounds (73-82 kg). Fairly average, actually. So House’s toxic dose of acetaminophen is likely 10,950 mg to 12,300 mg. Let’s say lower range is 22 tablets of Vicodin®, 15 tablets of Vicodin ES®, 17 tablets of Vicodin HP® and the upper range is 25 tablets of Vicodin®, 17 tablets of Vicodin ES®, and 19 tablets of Vicodin HP®.

References

Department of Health and Human Services. Food and Drug Administration. Prescription drug products containing acetaminophen; actions to reduce liver injury from unintentional overdose. Federal Register. 2011;76(10):2691-2697.

Seago S, Hayek A, Pruszynski J, Newman MG. Change in prescription habits after federal rescheduling of hydrocodone combination products. Proc (Bayl Univ Med Cent). 2016; 29:268-270.

Zee AV. The promotion of marketing of OxyContin: commercial triumph, public health tragedy. Am J Public Health. 2009;99:221-227.

Abbott. Newly reformulated Vicodin® launch announcement. https://www.uspharmacist.com/email/ecf1248.html. Accessed January 8, 2024.

Hendrickson RG. Acetaminophen. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Goldfrank's Toxicologic Emergencies, 11e. McGraw-Hill; 2019:486-499.

#house md #hate crimes md #house rewatch 2024 #I'm halfway through season 1 this is going to take A Bit #so please bear with me #but here's some background ramblings #I'll make a pinned post and have links to each season #so I am ~*~organized~*~

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your-space-brain · 1 year

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Narcan Dreams

Juan Carlos “Juice” Ortiz x Reader - One Shot

Gif does not belong to me.

Moved from @spacedbrainnn .

“I’m fine.” He would say.

“It just takes the edge off.”

“I’m not even doing that much.”

“It’s just a downer.”

“I’m not high.”

“Why are you asking so many questions?”

“What do you care?”

“It’s not even a drug.”

There were so many questions you’d ask and he would always have an answer. He always did. He was hidden behind brown eyes and a drug that suppressed the system that got nervous. It didn’t excite anything but the script was controlling his marionette strings.

Oxycontin.

He was becoming more and more apparent with it, and he knew that, but he needed it. He desired it, to the point he couldn’t control his eyes. They would get heavy and his mind would feel like it was crawling down his spinal cord. He was becoming too evolved in it.

Then, you found him.

He was laying there on the ground, his mouth open and he was hardly breathing. The sight alone, him there like a wax figure that had fallen over, sent a chill over you that felt like you were plunged into a dreadful ice bath.

“Shit.” The word fell out of your mouth as you collapsed on your knees beside him. His face was clammy and sweaty in your hands. Patting his cheek, you said his name.

“Juice.” It didn’t seem to do anything, so you popped him a bit harder as he didn’t have a response. Cradling his face, his body was dead weight, his head rolling in your hands before you saw the foam forming at the corner of his lips.

“Fuck, Juice. I told you to stop messing with this shit.” The words were to yourself to keep your mind from hitting fifth gear in manual overdrive. When you began to dig in your bag, your hands were shaking.

“Where is it? I know it’s in here.” Things shuffled around noisily but it didn’t matter. None of it did. None of the things in that bag were what you were looking for until you found it.

Narcan.

Popping the cap off, you shoved the nasal spray into his nostril and popped the plunger all the way in. The mist travelled his nose to his brain and hit the capillaries and nerves of his cerebral overdose. Then, like he was never down, his body jerked and his eyes opened.

“What’s happening?”

“Shut up.” You snapped as you tossed the vial away.

“What?”

“I said, shut up.” You repeated as you sighed. His brows knitted as if he didn’t know he just nearly ended his own life, and when you hauled him up by the leather that was almost desperately attached to his body, he nearly choked.

“Do you understand that you could’ve just died?” He swallowed when you got nose to nose with him, your breathing slightly labored because you were at your whit’s end. If you weren’t holding his cut, you’d have been trembling.

“Died, Juice. Dead. Gone. Without me. You’d leave me here with these fuckers." The realization made his brows lower as he sighed, his breath so dangerously close to your mouth as you sighed yourself.

“I can’t lose you, idiot. You’re a fucking idiot.” The verbal abuse spewed from your mouth out of fondness. You didn’t care.

“I need you. Do you not get that? I’ve questioned you for a reason—”

“[First name], breathe—”

“No.” The tears began to form. “Dammit!” You let him go to push them from your eyes, cussing more at yourself than at him.

“[First name]—”

“Dammit, Juice.”

“I’ll… I’ll work on stopping. I can’t see you like this.” He spoke honestly as he took you by the shirt this time, pulling himself up to stare you in the eyes with his large brown ones. “I promise.”

“Promise?”

“I promise.”

— end —

#juan carlos ortiz #Theo Rossi #juice ortiz #juice x reader #sons of anarchy imagines #sons of anarchy one shots #your space brain

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ausetkmt · 24 days

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Pain killer: an empire of deceit and the origin of America's opioid epidemic

In Pain Killer, Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic.

Between 1999 and 2017, an estimated 250,000 Americans died from overdoses involving prescription painkillers, a plague ignited by Purdue Pharma’s aggressive marketing of OxyContin. Families, working class and wealthy, have been torn apart, businesses destroyed, and public officials pushed to the brink. Meanwhile, the drugmaker’s owners, Raymond and Mortimer Sackler, whose names adorn museums worldwide, made enormous fortunes from the commercial success of OxyContin. In Pain Killer, Barry Meier tells the story of how Purdue turned OxyContin into a billion-dollar blockbuster. Powerful narcotic painkillers, or opioids, were once used as drugs of last resort for pain sufferers. But Purdue launched an unprecedented marketing campaign claiming that the drug’s long-acting formulation made it safer to use than traditional painkillers for many types of pain. That illusion was quickly shattered as drug abusers learned that crushing an Oxy could release its narcotic payload all at once. Even in its prescribed form, Oxy proved fiercely addictive. As OxyContin’s use and abuse grew, Purdue concealed what it knew from regulators, doctors, and patients. Here are the people who profited from the crisis and those who paid the price, those who plotted in boardrooms and those who tried to sound alarm bells. A country doctor in rural Virginia, Art Van Zee, took on Purdue and warned officials about OxyContin abuse. An ebullient high school cheerleader, Lindsey Myers, was reduced to stealing from her parents to feed her escalating Oxy habit. A hard-charging DEA official, Laura Nagel, tried to hold Purdue executives to account. In Pain Killer, Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic.

He takes readers inside Purdue to show how long the company withheld information about the abuse of OxyContin and gives a shocking account of the Justice Department’s failure to alter the trajectory of the opioid epidemic and protect thousands of lives. Equal parts crime thriller, medical detective story, and business exposé, Pain Killer is a hard-hitting look at how a supposed wonder drug became the gateway drug to a national tragedy.

From the Pulitzer Prize–winning New York Times reporter who first exposed the roots of the opioid epidemic and the secretive world of the Sackler family behind Purdue Pharma, Pain Killer is the celebrated landmark story of corporate greed and government negligence that inspired the Netflix limited series Painkiller. “This is the book that started it all. Barry Meier is a heroic reporter and Pain Killer is a muckraking classic.”—Patrick Radden Keefe, author of Empire of Pain New York Times Book Review Editors’ Choice

#Pain killer: an empire of deceit and the origin of America's opioid epidemic #In Pain Killer #Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic.#purdue pharma #sackler family #oxycontin

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bpdcodone · 5 months

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Relapsed hard after being offered shit I just couldn’t resist but now I feel incredibly bad is it really this? The addicts cycle is to much to handle

#cluster b #bpd life #system #borderline things #bpd tag #bpd vent #tw substance abuse #cw substance use #oxycontin 80mg #substance addiction #addiction #drug addikt #substance use disorder #polysubstance use #substance use #substance abuse #bpdcodone approved

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sourceblog · 2 years

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I met a kid a few years ago in Kentucky. And interviewing him was the moment I realised that there was something unique about [OxyContin]. He just died from an overdose.

↳ Dopesick (2021—) | 1.06 “Hammer the Abusers” dir. Patricia Riggen

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mlobsters · 6 months

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things i learned about the opioid crisis that truly shocked me

oxycontin (oxycodone) is more powerful than morphine (i thought i had a decent understanding of opiates, apparently not)

purdue (makers of oxycontin) claimed less than 1% of people got addicted based on a handful of sentences letter to the editor (link to letter in NEJM) in a medical journal about patients taking short term narcotics in a hospital environment and called it a study

the package insert said "Delayed absorption as provided by oxycontin is believed to reduce the abuse liability of a drug." no proof - just believed.

the medical officer at the FDA, curtis wright, allegedly drafted the medical review with purdue including claims about very limited rates of addiction and potential for abuse. a year later, he went to work for purdue

sales reps were paid commission by the number of milligrams their doctors prescribed, encouraging doctors to continue increasing dosages

purdue claimed oxy didn't have the peaks and valleys associated with opioids and used an extremely distorted graph that was incredibly misleading to prove their point (log scale that flattened the curves)

they created the concept of "pseudoaddiction" which meant drug seeking addiction behavior was actually untreated pain so the solution was to increase the dosage

the company who launched the fentanyl spray subsys were encouraging doctors to prescribe it offlabel for back pain and the like with the explantion "pain is pain" asking how is back pain different than end of life cancer pain

i knew fentanyl was a serious problem but i had no idea the overdose deaths increase after the launch of subsys and competitors in 2012 was this stark and terrifying

insys was investing $3-4 million dollars in speaker programs that were a cover for bribing doctors to increase prescriptions of their fentanyl product

in 2015, subsys was one of the top five most profitable opioid products in the US - something that was only indicated for breakthrough pain in cancer patients on around the clock pain management with high opiate tolerance levels as part of end of life care

medicare would not approve the prescriptions and pay for them (many thousands of dollars for one month of subsys) for offlabel uses, so insys created a system where their reps would pretend to be from the doctor's office (in collusion with doctors, dr office would give the private patient information so insys could have the information needed) and lie about the diagnosis to get it approved

actual promo video for sales reps to sell fentanyl

from burlakof, former vp of sales at insys: "the only way that i knew how to do it, to get that guarantee, is to bribe doctors." "you're saying bribery, like you're kind of--" "yes, i am" "that has a really kind of, big meaning, that word." "yes. i think to use any other word would be irresponsible of me at this point." "back then, did you think, 'oh, i'm going to bribe people'?" "yes."

90% of all hydrocodone production was going to pill mills in the late 2000s

at one point broward county alone (ft lauderdale, just a bit north of miami) had 150 pill mills

florida regulations were so lax, anyone could open a pain management clinic - including people with felony drug convictions

florida also did not track out of state people filling prescriptions that would throw up red flags like it did in other states

a retired dea agent, lou fisher, worked with large pill mills to make sure they followed requirements and could pass inspections by dea acting as their "compliance officer"

but fisher was being paid by the wholesaler, he maintains he didn't do anything wrong

by putting prescribing into the hands of corrupt doctors, they could technically be following the rules

once the pill mills were shut down, a large population had been addicted to opioids via pills now only had heroin to turn to

the george brothers and others in pill mills were indicted under the federal RICO act and it was the largest prescription drug trafficking case in US history

chris george maintains he just ran a business. he didn't create addicts, he gave them a safer way to get their drugs. and the people coming to florida to buy his pills were the actual problem. "The patients are the ones that caused whatever problems we have here."

(ps the george brothers are also white supremacists)

stuff i've watched/listened to

American Pain (HBO) - documentary on pill mills in florida, primarily about the George brothers

The Crime of the Century (HBO) - documentary directed, produced, and written by Alex Gibney. The film follows the opioid epidemic in the United States, and the political operatives, government regulations and corporations that enable the abuse of opioids, particularly the Sackler family and Purdue Pharma. Part two focuses on the rise of fentanyl by Insys Therapeutics.

Opioids, Inc by FRONTLINE (PBS) full film on youtube

Opioids in America by American Scandal (podcast by Wondery)

Dopesick (Hulu) - dramatized series based on nonfiction book Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy

Painkiller (Netflix) - dramatized series based on Patrick Radden Keefe's New Yorker article "The Family That Built an Empire of Pain" and Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic by Barry Meier

#opioid use disorder #opioid crisis #have had this sitting in my drafts for ages but i got so aggravated over that poll i finished up the alt text and here we go #addiction

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