Friday, 25 October 2013

08:08 – I see that the FDA is proposing to reschedule Vicodin, Oxycontin, and other drugs that contain opioids in combination with acetaminophen from Schedule III to Schedule II. Now, granted, acetaminophen is an extraordinarily dangerous drug. I won’t have it in the house. But hydrocodone and oxycodone? Come on. They’re benign, and shouldn’t be subject to any controls at all. In fact, nothing should be subject to any controls. We should be able to walk into a drugstore and buy a kilo–or a metric ton–of heroin, cocaine, methamphetamine, or whatever we want. It’s our business, not the government’s. And if you doubt that, just look how well their “war on drugs” has worked out, not just for them but for all of us.

I just got a query from someone who wanted us to ship a science kit to Bolivia, and asked if we could do it via DHL. Apparently, theft is rampant in the Bolivian postal service, and any kit we shipped by USPS Priority Mail would likely be pillaged by Bolivia Post and arrive empty. I told the guy that unfortunately we can’t ship via DHL, UPS, FedEx, or other private carriers, both because it’s an administrative nightmare and because of the extremely high shipping charges and additional fees charged by all of the private carriers for international shipments.


26 thoughts on “Friday, 25 October 2013”

  1. We used to have an acetaminophen-free house, but then I discovered Excedrin. So, when I get a severe headache (which, thankfully, is very rare) that combo of acetaminophen, aspirin, and caffeine does wonders. Outside of that, I pretty much use ibuprofen for pain. In fact, I’ve had a couple of dentists over the years try to prescribe me acetaminophen/hydrocodone (Lortab) for severe toothaches and I usually hand the prescription back to them and make them change it to ibuprofen/hydrocodone (Vicoprofen).

    I was raised in a mostly medicine-free household. So, for most of what ails me, I just suck it up like I was raised to. I hate taking medication unless my symptoms are seriously impairing me from being productive.

  2. Right, and 30 years ago the outlaw bikers were buying Sudafed
    http://www.sudafed.com/products?utm_source=google&utm_medium=cpc&utm_campaign=Branded+-+General&utm_term=sudafed&utm_content=General|mkwid|sYDnpUnN6_dc|pcrid|30915863120
    in large amounts at local drugstores to make methadone.

    Nowadays, the raw material comes to Mexico in former crude oil tankers where the meth is made in former tequila distilleries.

    Nevertheless, in order to protect me with my tax dollars working for me, I still have to have my driver’s license scanned when I want to buy a packet of tablets.

  3. “…acetaminophen is an extraordinarily dangerous drug. I won’t have it in the house.”

    That’s just Paracetamol, isn’t it? I’ve been taking it (occasionally) for over 30 years.

  4. Yeah, paracetamol is one of the trade names for acetaminophen. The problem is that the therapeutic index (for humans, TD50/ED50) is very close to unity. In other words, if you take enough to be effective, you’re very close to the toxic dosage. The stuff is lethal, normally via hepatotoxicity. Many people have died because they wrongly assumed that one more extra strength tablet than recommended would be safe. Many others have died because they overdosed accidentally, not realizing that many different OTC medications contain acetaminophen. So they’ll pop the recommended maximum dose of acetaminophen tablets, then drink a slug or two of some nighttime cold medication liquid, and wake up dead.

    It’s absolutely insane to use the stuff when there are so many other much safer alternatives. Idiopathic adverse reactions to normal dosages of acetaminophen are also pretty common. You can take the recommended dose and still suffer severe reactions up to and including death. Acetaminophen is responsible for tens to hundreds of thousands of emergency room visits every year. And it’s probably also responsible for many or most of the people on lists awaiting liver transplants.

  5. I just got a query from someone who wanted us to ship a science kit to Bolivia, and asked if we could do it via DHL. Apparently, theft is rampant in the Bolivian postal service, and any kit we shipped by USPS Priority Mail would likely be pillaged by Bolivia Post and arrive empty.

    And we thought the US Postal service had problems.

  6. Well, thanks for the information about acetaminophen. I rarely get headaches or toothaches, and when I do they’re not usually bad, so I rarely take more than two tablets per day. I never knew it was this dangerous.

    Can you suggest alternatives that are safe?

  7. You are preaching to the choir here. The wife is afraid that we will have druggies all over the parks here in the USA if drugs are deregulated but I think that we are already there. Although, I do not see pot smokers as much as I used to but that is probably a reflection of my age and the war on tobacco.

  8. Saw a good political cartoon this morning. How about renaming the Redskins to the “Washington Lobbyists”?

  9. Can you suggest alternatives that are safe?

    I take Advil for headaches. My doctor said up to four at once but I only take up to three.

  10. I’m currently on asthma/bronchitis inhalants and blood pressure meds. Once in a blue moon I take Ibuprofen or a Tylenol. Other than that, I’m as pure as the driven snow.

  11. Advil is ibuprofen. But any of the NSAIDs should be OK. I’ve never acetaminophen found to be very effective. I’m currently using naproxen for my osteoarthritis with some effect. For headaches, I’ve never found anything better than 222s (co-codaprin with 7.5mg codeine). These are available in Canada (and many other countries) without a prescription.

    The only time I don’t use NSAIDs is when I am getting a prostate biopsy. I am specifically warned not to take any NSAIDs starting a week before the procedure. I was also given Tylenol 3s when I had the work done for my dental implant. Again, it was because the NSAIDs interfere with clotting.

    It is far to easy to overdose on acetaminophen. If you take a daytime cold capsule, a night-time capsule, maybe one or two hot lemon cold drinks, and then a couple of acetaminophen tablets as well for fever, its very easy to go well over the safe level. Especially if you get an “Extra Strength” variety. Extra Strength almost always means more acetaminophen not more decongestant or whatever. You really need to look at the labels and the contents.

    Given the toxicity of acetaminophen, I suspect the reason that it is so common is over the counter medications is the fear the manufacturers have of being sued as the result of some one developing Reye’s Syndrome, possibly the only reason for not using NSAIDs.

  12. I’d probably support government regulation and restriction of antibiotics as a public health risk, though only if use on animals was just as restrictive. And if we screened the hell out of anyone entering the US, especially from countries like the PRC, which sell antibiotics over the counter and which consequently are a vast reservoir of drug-resistant bugs.

    Aside from that, fuck you, Uncle Sam. Moral issues aside, where is it specifically authorized in the US Constitution for the federal government to regulate drugs?

  13. LOL, the fuckers do a ton of shit that ain’t in the USC. But rest assured, the tame pets at SCOTUS and other courts can find it there, or if not, just make it up out of whole cloth and make it fly. If one of them, like the Chief Justice, balks, send someone round to his crib the night before the vote to have a little chat and presto! The right vote is rung up the next morning.

    These people better hope like Hell that I don’t somehow, by some crazed miracle, get into power in this country. After the executions we’re going back to the Articles of Confederation. Assuming, which is wrong, that the whole thing stays together.

  14. Around here we have an enormous problem with people who are addicted to the various oral opiates. They slowly (and expensively, thanks to the War On Drugs) turn themselves into zombies, staying increasingly incoherent throughout the day. The most popular one seems to be OxyContin, (a time release form of oxycodone, for those who don’t know). But the addicts crush the pills, snort them, and get the full effects in one blast; it’s colloquially known as Hillbilly Heroin. Vicodin / Lortab (hydrocodone + acetaminophen) is also a huge problem, because it’s considered a first line treatment and is therefore readily available. A couple of years ago it was reported that a pharmacy at a Wal Mart in a small town north of here was issuing the expected amount of OxyContin for a town of 50,000 people.

    As our host notes, restricting access doesn’t seem to keep the junkies from getting hooked, it just keeps people who have a therapeutic need from getting what they need. Earlier this year I injured my left leg, and wound up in the local ER. When they discharged me (having assumed all along that I was a pill head looking to get high) they gave me a scrip for Vicodin. When I protested that Vicodin has no effect on me, and that they were free to examine all the surgical scars on my legs to see that I’m no stranger to pain, I was told “Tough. If you want something else you have to go to your regular doctor.” So later that day I hobbled to my regular doctor, and then to the pharmacy, to get some Percocet (oxycodone + acetaminophen).

    [snip] And it’s probably also responsible for many or most of the people on lists awaiting liver transplants. [snip]
    Pardon the pun, but I take a jaundiced look at that claim. I think rather it’s long term alcoholism. But I can certainly see that an alcoholic who takes too much acetaminophen is doing double the damage, or even worse.

    And Ray, the phrase ‘woke up dead’ is a very common idiom in the American South, to indicate that a person, who may or may not have had some terminal illness, passed away peacefully, at home, in his or her sleep.

  15. Ray lives in the South, doesn’t he?

    Good one on the jaundice pun; I’m a sucker for puns.

    Yeah, I’ve found the same thing over the years; actual junkies have no major hassle getting hooked and staying that way but Lordy, try and get a decent level of pain meds when you really need them as a regular citizen; they’re terrified you’re gonna get hooked or sue them or something. I routinely got meds designed, I assume, for the average-sized Western male; I’m a bit larger than that and had/have a very high tolerance for dope. Gimme the fuckin drugs!

    The pills are a big thing here in VT and also the meth; periodic busts with full media photo-op gigs for the cops. But they still seem to spend an inordinate amount of time and effort on pot busts. What a joke.

  16. I manage a website for a medical supply company that sells medical devices and supplies online. When I took over, they were also not doing international orders due to costs, hassles, etc.
    My thought was “figure out how much it would take for you to put with those ‘costs, hassles, etc.”, and quote the customer those charges, and let them take it or leave it.
    And as it turns out, more often than not, they take it, because all of your competitors feel the same way about the ‘costs, hassles, etc.”, and won’t ship to them either. So if you’ll ship to them, you’ve got their business.
    Five years later, international orders are a major source of revenue for the company.

  17. Ray lives in the South, doesn’t he?

    Tennessee. But I growed (sic) up in Oregon.

    And Ray, the phrase ‘woke up dead’ is a very common idiom in the American South, to indicate that a person, who may or may not have had some terminal illness, passed away peacefully, at home, in his or her sleep.

    I have never heard that phrase used around here. I have lived here 28 years. Guess no one I know in the south has had a terminal disease, yet.

    So what do they say if they die during the day time?

  18. So if you’ll ship to them, you’ve got their business.

    It’s an economy of scale thing. The vast majority of our customers and potential customers are in the US. Of the tiny fraction remaining, the vast majority are in Canada, the UK, and Australia, which we already ship to.

  19. And Ray, the phrase ‘woke up dead’ is a very common idiom in the American South, to indicate that a person, who may or may not have had some terminal illness, passed away peacefully, at home, in his or her sleep.

    New term for me too. And I have spent 50 years in Texas and Oklahoma. We won’t talk about those three years in New Jersey when Dad was working on his PhD.

    I always heard and used the term, “passed away”.

  20. I’d never heard it before, either. I thought it was an on-the-fly construct I’d made while writing that post.

  21. “Passed away,” “woke up dead,” “checked out,” and on the local FM radio “album station,” “passed through the veil.” I always just used and still prefer, simply, “died.”

    Old mil-spec terms were “smoked,” “wasted,” and “embarrassed.”

  22. I thought DHL was mainly an international shipper, and the hassles would be less than with other courier services.

  23. As mentioned in earlier threads, the big problem with DHL (and UPS, for that matter) is that they insist on getting paid twice for international shipments. They charge the shipper an “international” charge. Then, when they deliver, they charge the recipient for clearing customs.

    Which, somehow, you might think ought to be part and parcel of international shipping – it’s not like customs clearance is a surprise. I can’t speak for other countries, but here in CH, the charge is usually more than the original shipping costs.

  24. So if you’ll ship to them, you’ve got their business.
    ————————————–
    It’s an economy of scale thing. The vast majority of our customers and potential customers are in the US. Of the tiny fraction remaining, the vast majority are in Canada, the UK, and Australia, which we already ship to.
    ————————————–

    But the idea is, surely there is some amount that you feel would make it worth your while to put up with the ‘cost, hassles, etc.’. Figure out how much it would take for you to drop everything and ship a package to Bolivia, and that’s what you quote the guy.

    What have you got to lose? You never know.

    That’s essentially what we did, and we now have regular overseas customers who buy 10’s of thousands of dollars a month from us.

    Back in the late 50’s my parents owned a large motel on the Gulf Coast. One day a regular guest ask my father how much he would take for the place. After thinking a little bit, my father laughing gave him a figure that was about 10 times what he had in the place, and about 30 times what he thought it was worth. The guy stuck out his hand and said “Sold”.

    After talking a few minutes, my father found out that the guy was a multi-multi-millionaire who owned a chain of large department stores and had a hankering to get into the motel business, and was serious. So suddenly my parents were out of the motel business. They lived very well for the next 30 years on the proceeds and started two more successful businesses from it.

    Pick a figure and take a shot. You might open up a whole new market.

  25. Pardon the pun, but I take a jaundiced look at that claim. I think rather it’s long term alcoholism. But I can certainly see that an alcoholic who takes too much acetaminophen is doing double the damage, or even worse.

    IIRC, if you have more than three alcoholic drinks per week (a drink being a 12oz beer, 5oz glass of wine, or 1.5oz shot) you are not suppose to take acetaminophin at all. Your liver cannot handle both the ethanol and the acetaminophin.

Comments are closed.