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My dad recently retired after 30 years of practicing oncology and hematology in a private practice ran with a female colleague, located in an office building adjacent to a very large regional hospital. He also worked a supervising shift in the ER every Thursday night, simply because he found it easier to be in the ER since so many of his patients visited it while he was oncall, sometimes forcing him to go in anyway.

I guess you could say I enjoy recreational drugs and have done them all and my dad generally knows this and we've talked quite a bit about drugs, specifically the insane amount of opiates and benzos he used to prescribe to his cancer patients.

I've sort of gotten the impression the DEA was a hassle in his life and he would not want any attention gained by publicly saying anything but "drugs are bad" (aka the failed war on drugs). There would be no incentive for him to do this on a day to day basis; in fact, there would only be disincentives, at least in the short term.

One day in the early 00s, the DEA showed up at his practice unannounced and wanted to start auditing him on the spot. They told him he was in the top 10 opiate prescribers in his area and they were concerned. They had absolutely no paperwork, so my dad kicked them out of his office, and later the building via security. He told them to come back with a warrant. They never did.

What struck me about this story is how visibly upset he got at the idea of the DEA depriving people of comfort when they are in pain. When he told me this he said, very emotionally, "These people are dying and in pain and they want to look at paperwork?" I can only imagine how pissed off he was when it happened.

This anecdote is all to say I think that doctors probably take one look at any effort to delegitimize the war on drugs and say Nope. What's the point? To help society? Like they do every day as doctors? I just have never felt much of a "let's rock the boat" attitude from any doctors I've known personally regarding drug laws (keep in mind they live in a bubble where all of the drugs are available to them via an Rx pad -- this is very relevant to the enthusiasm drought IMO).

Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.



Having gone some surgery few months ago where a miscommunication (let's name it this way) from the nurses about my prescription left one day longer in the hospital, made my cry out of pain and made me afraid of even trying to stand up, I must say that I never understood the idea that "let's refrain giving so much opiates to these patients who have a life-expectancy of few months because it might get then addicted".


I didn't realise this was actually a thing? There's so much craziness out there that I guess it probably is.

However, don't get it confused with over-prescribing opiates to people with chronic but not life-ending pain, then suddenly restricting them again, which many point to as creating a ready market for illegal drugs.

Ideally they'd get less dangerous pain medication, and/or in a controlled manner that prevent accidental or intentional abuse, resale etc.


That's some interesting discussion. Not all drugs act the same on everybody, sometimes a stronger drug won't have any effect while a lighter one (or just slightly different one) might be enough. But there are cases that the lighter one can be eaten like cereals in the morning and won't give you any comfort.

Side effects are also a thing. Sometimes the lighter medication gives you the worst side effects, and I don't think (at least not anymore after my ordeal) that's human not to try and give all possibilities to your patient.

Of course abuse must be considered, resale should be prevented. Some drugs even have a special coating to prevent chewing and breaking so that the extended release drug isn't delivered to your body in some abusive way.

But preventing real, needed patients from getting a good drug because someone else might abuse it isn't fair for those who need.


> of few months because it might get then addicted

And thanks to Church, some would say "because it is a sin".


Actually, the RCC's position would probably be something akin to "feeling pain brings us closer to being like Jesus" or some other such nonsense.

I mean, after all, that was Mother Theresa's outlook (which is why so many suffered under her "care" in terrible conditions - despite her organization being extremely well funded. Mind you, though, that when it came time for her care, flying out to receive proper medical treatment in a first-world country was paramount).


Actually, Pope Francis just organized a workshop to try to address the issue.

http://www.catholicregister.org/faith/item/23678-drugs-a-new...


Peddle your propaganda elsewehere.


But that's one of the main driving forces of puritanism, which is what the war on drugs is mostly about.


To the contrary, to quote Nixon's aide (Nixon having started the war on drugs):

“You want to know what this was really all about?” he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. “The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”

[http://www.huffingtonpost.com/entry/nixon-drug-war-racist_us...]


And that caused black religious communities to join the war as they didn't want to be associated with drugs:

https://news.google.com/newspapers?nid=2199&dat=19860723&id=...

"Just as in the past we fought slavery and we fought racism, we are going to fight drugs and the total indifference of those in power"


If you can still edit, I recommend you move the last sentence to the start of your incredibly insightful anecdote:

Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.


I hope I am wrong, though!

Doctors are already fighting the good fight every day -- carrying the fire (the vast majority, at least). I have always mostly lived in a liberal bubble and over my life I'd say 90% of the people I have interacted with often over a long period were liberal, and this extends to 90% of my extended family too. Bubbled in all the way. All of these physicians in my bubbles throughout life have mostly fit the liberal label (except maybe fiscally) and would be more than happy with treating drug addiction like a health problem. And lots already do! Depends on the city, of course.

Things like "ending the war on drugs" are simply not on your average doctors' mind in the day to day (in my experience). They have other stuff to do, like maybe save a life or two, finish that big paper on immortality or w/e, and they simply go right ahead being doctors, knowing in the back of their mind they are largely "above" the drug war anyway, since they can and do dole out narcotics constantly.

To my dad, an 80mg oxycontin (the old ones, the holy grail of opiate pill abuse) lost its status as a "ooooh, awwww, look at this neat pill" thing probably within 60 seconds of becoming a doctor (that's a guess). My mom was/is a psychologist (retired) and doled out narcotic tranquilizers left and right as well (though at the VA, so she got left alone). It happens to pharmacists too, even a pharmacy tech friend of mine would go "meh" at a 1500 count bottle of perc 30s.

The drugs just become part of the day to day like, for lots of HN readers and myself at least, working on tens of millions of dollars with of computing infrastructure is business as usual.

I think the access to narcotics and constant distribution and "above it" feeling is relevant to why I think doctors won't be leading the anti-war on drugs movement. I don't know for sure about many other than my parents and a few others, but I'm guessing they would all end the war on drugs tomorrow and treat it as a health issue if they knew how to do it without making things infinitely worse. And I'd venture to say most doctors I've known over my (liberal-bubbled) life would agree without much thought put into it -- if they aren't already in some small (or big) way.


In my experience, a lot of doctors have already drank too much of the Kool-Aid. Of all my family physicians, only one was willing to have candid conversations about drugs. The rest would just shut down the conversation immediately and say all drugs are bad / we're not talking about this.


Given that the primary function of a physician these days creeps ever closer to "drug prescriber reacting to acute symptoms", this is just dripping with irony. Say no to drugs indeed.


Same experience here.. I come from a family of doctors, and not a single one of them is particularly against the war on drugs it's quite the opposite. This even seems to trickle down to nurses and it's probably as someone else described because they are biased from having to deal with all situations where something goes wrong. Of course you will find the occasional morphine junkie doctor but it's probably not even interesting to them either since they have all the drugs they need available.




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