Elite Pharmaceuticals Inc (ELTP)

[WeeZuhl]

You do love the edge cases. Yes there are potential serious side effects with ibuprofen and acetaminophen but those people do make make up the majority of prescriptions written for opioids any more than end of life treatment does.

Pot calling the kettle black. This is exactly backwards. The number of people at risk for addiction or overdose when they get an Rx for #14 Norco due to an acute problem is very small. The number of people who start an NSAID regimen and have a substantial risk of heart attack or stroke due to their older age or history of prior cardiovascular disease is quite large. Same for people with A-fib or DVT/PE/clotting disorder who take Eliquis or Xarelto and have substantial risk of bleeding on NSAIDS. Same for PAD patients taking Plavix. Lots of people have CHF, and all of them would be at risk for fluid overload with NSAIDS. Lots and lots of chronic kidney disease out there, especially among diabetics, and any amount of NSAIDS can cause further damage. Many people have G.I. intolerance to NSAIDS and cannot take even one dose, not to mention for multiple days/weeks.

I am not advocating copious use of opioids, and I have never practiced that way. Nonetheless, I understand that opioids play an important (albeit diminished) role in the management of acute pain, and they had ought to be readily available when prescribed.

I can tell you why Percocet and Norco are still in the billion dollar range for annual sales because patients push their doctors to prescribe them ... and because of physicians not willing to refuse to prescribe them for people who can safely take available alternatives.

LOL billion dollar bullies! This is just silly. Who here really believes I can be bullied into writing a narc script?

Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency DepartmentA Randomized Clinical Trial
JAMA (2017)

The references you provide do an excellent job of supporting my point. In the above study, they looked at people who got extremity x-rays in the E.D., so a lot of contusions, sprains, and strains, with an occasional fracture. The total time of follow-up was **2 hours** (2 hours! LOL), and even with this very short time frame 1 in 5 patients required a dose of oxycodone for breakthrough pain. As I said, NSAIDS and Tylenol may be helpful to reduce the amount of opioids, but they are not appropriate for many patients and they are not effective for everyone. The management of acute pain is a complicated issue that requires a lot of consideration of multiple issues, including medical history, current medications, prior experiences, personal/family history of addiction, etc etc. It's not black and white NSAIDS good, opioids bad. The decisions that are made should be between the patient and their doctor, and dicks like Nasrat Hakim should have no role at all. And that is exactly what I said in the original post: if every pharmaceutical CEO had the same ethical judgment as Nasrat Hakim then there would be frequent shortages of pain meds and widespread pain and suffering for no reason.