The Opioid Epidemic

Discussion in 'The Mainboard' started by steamengine, Jun 23, 2017.

  1. Bo Pelinis

    Bo Pelinis WE GO HARD ON EARTH
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    It all depends on how it's structured. If they've got a substantial amount of their wealth in common stock then it's certainly possible for them to lose it. I don't know enough about these folks but if you have that much money you can generally do a very good job of shielding it.
     
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  2. dblplay1212

    dblplay1212 Well-Known Member
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    Pretty fucked up that we have thousands of people in jail for selling a little weed while the Sacklers will never see jail and will still have a couple billion, at least.
     
  3. herb.burdette

    herb.burdette Meet me at the corner of 8th and Worthington
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    It depends upon the insurance policy. The larger manufacturers and distributors likely self insure up to $3-5 million and handle defense on their own. Excess coverage will not settle.

    The CGL carriers who got tagged for defense in WV litigation look like they have standard ISO forms. Defense does not erode limits under standard ISO and it is dollar one coverage.

    If you issued a $1 million primary, you are going to burn at least $1 million on defense, and still possibly owe the $1 million limit on indemnity.
     
  4. wes tegg

    wes tegg I'm a Guy's guy, guys.
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    I thought we were talking about the manufacturers. Your original post was amidst a discussion over the J&J verdict and potentially against Purdue. My point was that most of those verdicts won’t be covered losses.
     
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  5. Gunners

    Gunners Nicking a living
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    https://www.washingtonpost.com/heal...77f93a-cb71-11e9-a4f3-c081a126de70_story.html

    Under a novel plan to relinquish control of their company, Purdue Pharma, and resurrect it as a trust whose main purpose would be to combat the opioid epidemic, the Sacklers could raise most, if not all, of their personal share of the $10 billion to $12 billion agreement by selling their international drug conglomerate, Mundipharma, according to the documents and those close to the talks.
     
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  6. herb.burdette

    herb.burdette Meet me at the corner of 8th and Worthington
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    The folks with high SIRs will still seek coverage for settlements. It just raises a different set of issues.

    Polster orders the insurers to every mediation in the MDL case.
     
  7. Tony Ray Bans

    Tony Ray Bans Most Overlooked. Most Overbooked.
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    I am all for punishing these companies and their ownership but I worry that a focus on that won't have a tremendous effect on the issue as a whole.

    A big problem in our system is that people can effectively shop around until they find a doctor who is more liberal with handing out opioids. That aspect is much harder to reign in because it goes to the core of free market medicine. If you are a doctor or a free standing ER or a clinic, you rely on patient satisfaction to keep people coming in keeping the lights on. If a patient goes into a doctors office and is told "ok you have back pain. You need to do months of physical therapy, change your diet, exercise and take these steps to reduce inflammation" there are a lot of people who don't want to hear that. We have become a society that expects a problem to be solved immediately with a pill and so when a problem requires a ton of uncomfortable work for modest reduction in that problem, we are more likely to go to another doctor who will just hand out oxy like candy. Doctors who give people opioids get great reviews. Patients are happy. They "feel better" in the short term and get the immediate results they expect. The work it would take, at a societal scale, to change that attitude and approach to medicine is insane.

    The other aspect here is that even if we stop the flow of legal narcotics, we have already created a huge population of addicts or potential addicts. 17 million people misused prescription painkillers in 2017. Even if all of them were suddenly completely cut off from prescription opiates, many of them would seek out street drugs.

    So all that said, I am entirely in favor of punishing the drug companies for their irresponsibility and it would make me very happy to see the Sacklers go to jail but making actual progress on the epidemic itself is going to be a generational effort.
     
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  8. herb.burdette

    herb.burdette Meet me at the corner of 8th and Worthington
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    A big problem that Tug alluded to earlier is the inability to track individual prescription purchases. We track all the sales and know which pharmacies are selling, but we don’t track individual users shopping doctors and pharmacies.
     
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  9. Tony Ray Bans

    Tony Ray Bans Most Overlooked. Most Overbooked.
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    Agree completely. Additionally, we don't track the no's in addition to the yes'. If someone goes to 4 doctors in a row seeking painkillers and gets turned down and then a 5th doctor gives them oxy, we only see that last one. That 5th doctor has no way of knowing that he or she is treating a patient who has knocked on every door in town looking for oxy which could absolutely cause them to think twice about giving this person what they want
     
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  10. Pharm

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    That is being worked on. Each state as a contolled rx database requirement. They are working to get them all linked. Florida had pretty strict laws on writing for narcotics now. The databases have been around for a while, however it was up to the rph and doctor to police them. Which is a challenge in heath care because it takes few minutes to look up and we all know that us health care isn't about taking longer life.
     
  11. Pharm

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    You can flag a patient on the database as a doctor shopper or leave a note. It just doesn't get done
     
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  12. herb.burdette

    herb.burdette Meet me at the corner of 8th and Worthington
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    It needs to be a federal requirement to ensure it is coordinated across state lines. It would be very simple to incorporate it into what everyone already reports to the DEA.
     
  13. Tug

    Tug Well-Known Member
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    Are you admitting I was correct?

    And the capability is there. The nationwide PDMP is being prevented because of *states rights*. Ironically, by states that are most severely impacted
     
  14. Pharm

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    In theory yes, but every state developed there in rules (how often you have to report). They also all have their own system or program. So it would take a lot of laws being changed, a lot of IT work, and a lot of cooperations which states hate giving power away.
     
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  15. Tony Ray Bans

    Tony Ray Bans Most Overlooked. Most Overbooked.
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    Yeah thats another weak link: an unwillingness by some providers to pay attention to things like that. Last year I had a horrible sore throat and went to an urgent care near my place. When asked if I had any allergies to medicines, I told the doctor that I am an addict and despite being clean for 6 years, I cannot have any narcotics. The doctor proceeded to try and prescribe me codeine cough syrup noting that "its such a small amount it shouldnt cause any issues." Now luckily, even if I had decided to take that, my pharmacy probably would have flagged it and said no but the fact that even when someone is open about that problem someone will still try to give them that stuff is not great.
     
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  16. Pharm

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    Yeah fuck that doctor.
     
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  17. Pharm

    Pharm Right Handed
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    Yep largest hurdle is getting states to work together and having them redo how their reporting works. I used to have to have to report to 7 different states one time and each had their own requirement and way of doing things.
     
  18. duc15

    duc15 Hey Nong Man
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    Is this your first time understanding our justice system has different rules for the wealthy?
     
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  19. Bo Pelinis

    Bo Pelinis WE GO HARD ON EARTH
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    The opioid epidemic wasn't an issue until drug companies (the Sacklers primarily) started pushing these drugs for everything that exists, paying docs to push their product, and lying about how addictive the drugs are and how people can ingest them. This epidemic exists solely because of drug companies.

    There are always people looking to score good drugs and, while we obviously have to have a system that responds to how they're prescribed, the companies and people behind them need to be taken behind the woodshed. They're legal cartels.
     
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  20. dblplay1212

    dblplay1212 Well-Known Member
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    No. I can know it's par for the course and still think it's fucked up.
     
  21. Tug

    Tug Well-Known Member
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    We are working from different perspectives. The biggest issue I’ve noticed is privacy laws
     
  22. Bo Pelinis

    Bo Pelinis WE GO HARD ON EARTH
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    How can a registry be state specific and non-mandatory when our federal government has its stance on illegal versions of the same drugs? That's so stupid.
     
  23. Pharm

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    True, but you would think HIPAA would have that covered, but states don't want to give up control.
     
  24. Tug

    Tug Well-Known Member
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    There are some quirks with exchanging data related to substance abuse (and things like HIV/AIDS) that are really prohibitive
     
  25. Pharm

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    Makes sense it has been a while since I have worked in an actual pharmacy but that makes sense.
     
  26. Tony Ray Bans

    Tony Ray Bans Most Overlooked. Most Overbooked.
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    Privacy was Florida's reasoning for not having a prescription tracking database forever right? I remember there being a lot laughs around some official in florida saying that they didn't want a database for prescriptions because "terrorists could hack into it and steal personal information."
     
  27. Tug

    Tug Well-Known Member
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    I just look at the data flows. I’ve never been behind the counter at a pharmacy
     
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  28. Pharm

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    It was very very tough to mantain as an independent pharmacist reporting to multiple states. Some states required every day reporting, some required once weekly, some it was up for debate..I reported every day, but had a state tell me to stop.
     
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  29. herb.burdette

    herb.burdette Meet me at the corner of 8th and Worthington
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    Jesus Christ you are impossible to discuss this topic. You disputed that the federal government had pill data, to which I pointed you toward ARCOS.

    The DEA absolutely could have identified pill mill pharmacies and counties with problems based upon ARCOS.

    The issue you raised is different, and you acknowledged it was, individual prescription tracking of patients.
     
  30. Tug

    Tug Well-Known Member
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    No, I said there wasn’t a nationwide PDPM, which you disagreed with
     
  31. Bruce Wayne

    Bruce Wayne Billionaire Playboy
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  32. dblplay1212

    dblplay1212 Well-Known Member
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    What’s new. According to The Wall Street Journal on Wednesday, under the terms of the tentative deal, the Sackler family, which owns the company, would step down, and the company would file for bankruptcy. The Sackler family would pay plaintiffs at least $3 billion. According to the New York Times, Purdue would donate some drugs as part of the deal. A new company would take over the sale of OxyContin, and money from those sales would go to the plaintiffs in the case.
     
  33. fsugrad99

    fsugrad99 I'm the victim here
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    Sounds like a good step, but not the last one
     
  34. Capstone 88

    Capstone 88 Going hard in the paint
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    $3B of their $10B+ fortune. I feel terrible for them. Hope they have some boot straps.