It's started...

Dear Purple,
I'm not sure but I think you were the one I read that was taking 10 percs/day. If that's so, it's way above the MDD (Maximum Daily Dose) because of the acetomenophen. The recent actions by the FDA in that area I don't believe are related to MJ. There will be plenty of that to come later, I'm sure. But you probably should have been on a combination of medications to limit you to 6/day. I limit myself to 6 percocets/day for that reason. And even though I was able to get an Rx for 200 pills in the past, that will likely change. Fortunately, I just got my 90 day supply, but having the 200 means I have extra and since I no longer have insurance I can stretch these scripts probably to nearly 4 months. I'll need it until I find someone else who will prescribe to someone with no insurance!

Anyway, I'm getting off track. I just don't think we can blame everything on MJ's death.

Investigating doctors who overprescribe, or patients who doctor shop, or celebrities who can pay for their house doc who will Rx anything, isn't a problem with me. Unfortunately, a wider net is usually cast.

PaLady

PurpleDaisy, I just read a lengthy article from National Pain forum called "How to take Acetomenophen correctly wthout causing liver damage." The gist of it relates to people taking way too much per day in their orals meds. This has been a long standing problem that goes back to the OTC meds. My daughter once was having extensive dental work done, she took way too much OTC per day and she ended up with liver damage. They were not trying to stop the meds just want people to take that take pain meds containing the Acetomenphen on the correct max daily dosage.

Susie,
From what I understand one option being considered right now by the FDA is removing percocet and vicodin from the market. Another is decreasing the amount of acetamenophen in OTC products. Maybe if they just educated people it would help.

I did hear today that the difference between the maximum amount of acetamenophen that's recommended and the amount needed to cause liver damage is quite small. I was surprised at that.

But I'll bet lots of people don't know what the "APAP" stands for on the Rx bottle. Maybe they just need to label things in a different way to make it easier for people to count up the amount they're taking each day - and clearly note the dose that can begin to cause liver damage.

It's probably easier for them to just add more restrictions rather than educate.

PaLady

PA, I think people also don't recognize how many other products contain Tylenol.

If someone is getting the MDD of tylenol from their pain meds alone, it may not even cross their mind that drinking one of those Theraflu hot drinks because they have a cold or taking Midol because they're having period cramps will give them another 1000mg of Tylenol per dose. The instructions on those OTC products are written to assume you're not getting any Tylenol from any other source, so if you take one of those two products every 6 hours, following the directions on the box to a perfect T, you'll take 4000mg of Tylenol from them. Add that to the Tylenol you get from your pain medications and you're suddenly taking 8000mg of Tylenol per day. Since colds and period cramps rarely last 1 day, a person could possibly take that dose daily for 3-7 days and not even realize they're dropping an atomic bomb on their liver.

With 200+ OTC medications on the market that contain Tylenol, it's almost impossible for an average person to know which are safe and which are not.

Freinds, as you know I work on the end where people abuse their medications and not for the acetamenophen but the narcotics. The problem seems to lie in two areas of abuse. The first being people that are taking either more prescription meds than they should or a combination of prescription meds and OTC which leads to an excess of the acetamenophen which causes liver damage. That is a real concern. The other issue is the number of people that are misusing prescription drugs and the elevated level of acetamenophen simply because they are looking for a high. I am not sure what the figure is as I have seen two seperate reports one shows 14 million Americans are in that class of misuing drugs. The other figure is as high as 50 million. When it is viewed from that perspective it is a major problem. Those who are using illegal drugs amount to about 20 million Americans. I believe the problem lies not with people who need the meds and take them responsibly. It lies with the major problem of those who are abusing the prescription drugs. Our government has proven that they are not that effective dealing with the drug problem. Simply making them harder to get, taking some off the market or even substituting others is not dealing with the problem. That is the only way it seems that the powers to be know how to address the problem. There will always be those who misuse or abuse their medications. Unfortunately that is the sad part. But when they take the steps that end up hurting the people that depend on the medications to function, work and have some level of life that is possitive, they need to look at other ways of dealing with the problem. I personally don't have a problem with them taking the acetamenophen out of the medications but from many peoples view, decision makes, that does not address the issue with the 15 or 50 million who are taking the meds to get high and taking the meds off the market is their attempt to deal with the problem. That seems the main way they have tried to deal with these kinds of problems. There is an old saying that insanity is doing the same thing the same way and expecting different results.

Bionic hit it on the head. Another problem that arises is many people do not read info on labels, this is not limited to OTC meds either. We get lots of questions here from people starting a new med, that if they would read the insert they woud know about potential side effects. To the best of my knowledge all rx's come with a complete print-out telling you important info about the drug. This is a bigger problem than many will admit to. Also, lets face it, some folks do not know how to read or their reading skills are limited. many are too embarrassed to ask a pharmacist questions, I think that is so sad too.

I feel quite sure the numbers are high out there on the amounts being used by folks unknowingly.

PAlady, I agree with you that them taking the meds off the market does not solve the problem for the illigal or misuse and it causes more problems with those who need the meds. It is difficult to understand the reasoning that these decision makers use. They try to solve one problem by creating more.  

Susie, Are we supposed to read those papers that come with our pills? I hear you and Bionic very clearly. I wonder how frustrating it is to our doctors when they have patients who don't follow directions or advise. I have problems with our students at times not using things like tylenol pm correctly.

 Mellisa, It does make you wonder. Here is another aspect that I deal with. In the state where I live, young people between the ages of 12 and 17 who are seeking treatment for drug abuse has risen 270% in the last 10 years. They are known as poly drug users, meaning they abuse more that one drug. The major abuse is in the form of prescription drugs that are taken, stolen from parents, grandparents etc. It is a major problem and it is sad that people who are not misusing or abusing have to pay the price.

I don't even pretend to be an authority on the issue but I get calls every day from parents, wives/husbands, grandparents etc wanting help for family members. Ut is so sad that we get lumped with the groups that are messing up. 

Michael Jackson is a bad example of many situations: this one is no different. Also, does anyone else dislike the heavy celebrity worship/fascination seen today?

hellokitty,

I also wanted to say that you'd be hard-pressed to find any recreational drug users that go to the length of cold water extraction to use higher doses of oxy or hydrocodone. They will most likely just take the liver damage knowingly/unknowingly, or get the higher-dosage pills of oxycodone as OxyContin or a generic brand name of the same concoction. Many "street pharmacists" only deal with high-dosage (40-80mg) oxycodone pills, high dosage morphine, sometimes the roxy or hydromorphone, and fentanyl. Where this situation will go from here is anyone's guess - your prediction seems quite valid, but I think we're all agreed that these illegal users, or the very illegality of recreational usage, is the thing that is making it harder for you and similar sufferers to get their needed medication.

Logan

ALSO, I guess now they found some very strong sedative in MJ's place that is only suppose to be used in operating rooms, very scary....

-hellokitty