Hacker News new | past | comments | ask | show | jobs | submit login
A hidden “credit score” for being prescribed opiates (wired.com)
43 points by ssklash 11 days ago | hide | past | favorite | 22 comments

I am not in the least surprised.

The government has been cracking down on opioids, such crackdowns are never nuanced and will of course hit the ones that stand out, justified or not.

Until the people collecting the data are made accountable for problems with the system this sort of garbage will occur--and it's far more harmful when it's medical rather than just credit scores.

The doctors & pharmacies don't really have a choice here--do the medically right thing and you risk your license and maybe even your freedom.

Some years back locally we had a case that obviously related to this, but the news reporting barely touched on it. Murder-suicide, a cancer? patient denied adequate pain management took his doctor with him. Of course the true perpetrators at the DEA don't face any such repercussions.

> Of course the true perpetrators at the DEA don't face any such repercussions.

It amazes me that an LEO agency sets medical policy for an entire nation - instead of an actual medical body. No one questions this from what I can tell.

Norms are a real bitch and we have had about a century of prohibition and were too damn lead poisoned to notice it wasn't working for entire damn generations.

The DEA is the precedent and even may order tests against patient will - doctors refusing makes the news.

I feel obligated to mention that we are not all that far away from a medical agency setting LEO policy for an entire nation. Maybe some cross training is in order.

Aside from the Big Brother factor this is terrible medicine. The best practice for an opiate addict is, very often, to get them on a stabilised prescription supply to minimise the risk of overdose. Rapid changes in effective dose should be avoided outside of an inpatient setting. (If you cold turkey an outpatient addict -- or even a non-addict in serious pain -- then don't be too surprised if they're dead from a heroin overdose within 48 hours.) This system creates the exact opposite outcomes.

The opaque algorithm from hell. I am quite glad that patient data is protected where I live ...

It feels like the legislators want to automate malpractice investigations, instead forcing doctors to do malpractice because the computer says no.

The War On Pain Relief sucks in so many ways. News orgs that parrot Gov/Leo anti-opioid narratives - w/o any analysis at all - aren't helping.

In FL, Opioid Rx are limited to 3 days and the politics behind that pushes Drs to not Rx opioids under any circumstances.

Cases in point: I was recently Rx'd Tylenol after emergency abdominal surgery - had to convince the Dr just to Rx Tramadol. This is everywhere now. Under-medicating patients with OTC analgesics is the new normal for hospitals/ERs.

I've a friend who responsibly took opioids for years to mitigate his (visibly) advanced rheumatoid arthritis. Within a year of the 3-day law passing, Drs in his network ended opioid Rxs. The (now fewer) pain management Drs are over capacity and not accepting new patients. What pain relief he can manage isn't thru Drs.

So, yeah. Thanks Opioid Hysteria for forcing desperate people in pain toward less safe alternatives.

> Appriss says that it is “very rare” for pets’ prescriptions to drive up a patient’s NarxCare scores.

What a bullshit response. There's not even an acknowledgement that this is a bad thing, let alone any attempt to fix it.

Unfortunately, people sometimes injure their pets and then take the drugs for themselves.

The basic problem is they have set up a system that is totally focused on avoiding false negatives that it inevitably produces a lot of false positives.

As compassionate for animals as they may be, adopting yet another end-of-life dog when they know what that will do to their score is exactly the sort of activity the algorithm will be looking for and mark against

Ok that sucks, and just lik credit scores, should be banned. Driving? Maybe. Theft? Maybe. But healthcare is present in the lives of everyone, and eventually someone has to take a pill. Discrimination by prescription.

> But healthcare is present in the lives of everyone

As far as the US goes, this part isn't very true.

Allow me to explain and clarify: The need and dependency for healthcare is present in everyone’s life. We all need it, want it, but only some get it. Why put up further roadblocks?

That's a good clarification

This is horrifying. When is the proliferation of these practices going to be stopped?

Only when the US government is reformed. Presently, we don't have any laws governing what can be done with people's data like the EU does (GDPR).

Collecting huge amounts of personal data for any purpose is allowed, whether that purpose is controlling people's choices at the store or maximizing profit of insurance companies by minimizing risk.

Sale of personal data is allowed, including selling data you collect on your customers' spending habits. Most companies in the US treat it as an extra revenue stream, and everywhere in the US where you can use a "loyalty card" is really just you opting in to them collecting more data on you and selling it.

Until things like aggregating personal data for corporate purposes are illegal here, this will continue, and corporations and government entities will continue to influence, control, and make judgements on individuals based on technology they don't themselves understand.

And it will all happen in silence and darkness, because there are no laws prohibiting doctors from choosing how they treat people based on services like NarxCare.

For profit health care is an abomination.

Probably not until we stop reelecting pols that legislate in response to major campaign donations.

When the DEA is nuked from orbit.

> When the DEA is nuked from orbit.

That does nothing. DEA is just the engine that turns outrage-driven laws from elected politicians i to concrete action. Destroying the agency won't remove the existence of such an engine, or reform the processes driving it.

True but the DEA provides critical services to help keep Americans in pain. A period where Drs have one less major threat could buy them a little breathing room - allow them to more fully practice medicine for a time.

Jesus, it's like every paragraph introduces a new case of "what the hell were they thinking?" Something like this being would have required thousands, maybe tens of thousands of people to all make a multitude of terrible decisions based off absurd assumptions.

Sounds like AI is influencing some medical decision here.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact