
The more opioids doctors prescribe, the more money they make - fahd777
https://edition.cnn.com/2018/03/11/health/prescription-opioid-payments-eprise/index.html
======
gesman
I've done study of these exact datasets with Splunk and applied machine
learning to detect anomalies in prescribed drugs comparing each
doctor/provider behavior to his peer group.

Doing this on a past HHS/CMS datasets - i was able to discover anomalies that
was proven to be actual fraud/crime:

Was interesting to discover anomaly in 2015 provider behavior data and then
read about that same provider just being raided by DEA in 2018.

Interesting data!

[https://imgur.com/a/eIySC](https://imgur.com/a/eIySC)

[https://imgur.com/a/5BTo6](https://imgur.com/a/5BTo6)

~~~
tshanmu
why cant this be used by the law enforcement as probable cause for shutting
down dodgy providers?

~~~
openasocket
Because some statistical analysis showing a particular entity is an outlier
isn't sufficient evidence to prove they are drug dealers. It is enough to
start an investigation, of course.

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ScottBurson
It occurred to me, reading a few days ago that Trump had suggested that some
drug dealers should face the death penalty, that maybe that should apply to
some of these pharma executives.

I don't actually support the use of the death penalty, at least not in cases
like this, but it is astonishing that we allow thinly-disguised kickbacks to
doctors for prescribing addictive drugs. That's as much pushing as what the
neighborhood drug dealer does — and more effective. This scam needs to be shut
down yesterday.

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cassowary37
Apparently we can only have one conflict-of-interest story on the front page
at once per mods, but some readers might be interested in further reading on
the topic from last year:
[http://journals.plos.org/plosone/article?id=10.1371/journal....](http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155474)
(Methods may also be useful to folks wondering how/where to get the data, and
what a pain it is to link it...!)

We were interested in how physician payments drive prescribing costs across
specialties, rather than for specific meds.

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gt_
I can’t help but wonder about the overlap between US regions with high opioid
use rates and US regions with high suicide rates.

I don’t doubt the incentives in the article contribute to the issue, but I
wonder how we can account for the regional discrepancies.

~~~
lsc
I would assume there's a high correlation between experiencing long term pain
and opioid use.

It also seems there would be a large degree of overlap between people
experiencing difficult to treat long-term pain and people who commit suicide.

therefore, while it's certainly not an advertisement for the effectiveness of
opioids for the treatment of long term pain, it seems unsurprising that there
would be a great deal of correlation between opioid use and suicide, even if
opioid use didn't cause suicide.

I mean, there are several mechanisms wherein opioid use could be the causative
factor, sure; I'm just saying that even if opioids mostly worked as designed
and never made anything worse, I would expect there to be a lot of overlap
between the people who are prescribed opioids over long periods of time and
people who commit suicide.

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snowpanda
You can look up your doctor here to see if they've "Received Drug or Device
Company Money"

[https://projects.propublica.org/docdollars/](https://projects.propublica.org/docdollars/)

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cf498
>As tens of thousands of Americans die from prescription opioid overdoses each
year

The number of people apparently come from the CDC
[https://www.cdc.gov/nchs/data/databriefs/db294.pdf](https://www.cdc.gov/nchs/data/databriefs/db294.pdf)

Is there some data about the circumstances? I was formerly under the
impression, that overdoses can generally be categorized into two. Cut drugs
and this no information about the dosage and intentional overdoses.

How are tens of thousands of people overdosing with a product with a known
content? Are all of those first time users?

~~~
mirimir
Sometimes, people addicted to prescribed opiates get cut off by programs to
fight opiate addiction. And some of them eventually turn to illegal drugs, and
have no clue how to use them safely.

~~~
cf498
Yes sure, but those arent listed under "die from prescription opioid
overdose".

~~~
mirimir
Maybe, maybe not. I mean, Teva oxycodone HCl is arguably still a prescription
opioid, even if it's been obtained without a prescription.

~~~
cf498
I have to blame the language barrier, thanks for pointing this out. I assumed
prescription drugs as being prescribed.

~~~
mirimir
It _is_ an ambiguous construction. And abuse can include doctor shopping to
get multiple concurrent prescriptions.

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dahdum
Outside of the top few, the amounts those doctors are receiving from drug
companies is barely consequential (<25k) compared to the stable, huge incomes
they can pull from their “patients” in a pain clinic.

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ta76567656
[https://www.theguardian.com/commentisfree/2017/nov/07/truth-...](https://www.theguardian.com/commentisfree/2017/nov/07/truth-
us-opioid-crisis-too-easy-blame-doctors-not-prescriptions)

------
sova
"Do no harm! unless of course you can sedate your clients forever... then it's
a gray enough area that we'll just all get rich!" My heart curls into strange
shapes when I think of all the friends I've lost to opiates.

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throwa_way_
The more wet streets that doctors walk through, the more it rains.

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md224
Really curious how previous societies dealt with opioid misuse when opium and
related products (e.g. laudanum) were far less regulated. I’m just confused
why a substance that’s been a cornerstone of medicine for centuries
(millennia?) is causing so many problems now. Is it less about the drug itself
and more about the state of society? The cultural or legal context?

~~~
BigJono
How many opiate addicts does the average person know today (sans internet
access)? I know for me it's 0, and I don't exactly run in the most wholesome
friend groups.

My guess is it's always been a problem to the same extent, but the extent is
exaggerated today, due to increased visibility (internet and media), and
fairly recent (since the start of the war on drugs in the U.S.) incentives for
bad news to spread.

~~~
YouKnowBetter
I knew quite a few pretty well, called them friends: they're all dead but one.

Some of them kept it well hidden, till the HIV struck (far less an issue now),
or they O.D.ed. I guess you might know one or two but maybe not as friends,
but as familiar faces or friends of friends.

As to the size of the problem, I can not tell if it's the same or larger or
less, since my observations are based on my age group (old) and survivor bias.
I have seen two towns suffer under the epedemic it was in Europe in the 80's
and 90's. These same towns now do not display the same issues with the 13 to
30 year old zombies.

The issues I read about in the US seem rather distant to me here in Europe.

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Mononokay
Related:

[https://news.brown.edu/articles/2017/08/opioids-
influence](https://news.brown.edu/articles/2017/08/opioids-influence)

