Heroin Parenting

[garbon]

So you never heard of people getting addicted to prescription painkillers?

Of course I have.

And apparently now my industry is gung ho about getting people addicted to them. Nevermind that we're not supposed to even look at off-label usage...

[Berkut]

See, that is a total bullshit response. Nobody said anything about eugenics.

Determining who can and cannot have children based on their perceived fitness is what Marty proposed. That's pretty close to Eugenics as I understand it.

I think that is strawmanning his argument. I am hardly Marty's cheerleader, but I think if you asked him "Hey, are you proposing eugenics?" he would pretty clearly say he was not making any such proposition.

My post, which you responded to (rather than responding to his) was an attempt to state what I thought he was saying in terms that we could all agree on - if you didn't disagree with my post, then please don't respond to my post and throw out words like "eugenics", which cannot possibly have any useful place in the discussion - certainly nothing useful in the point I was trying to make.

It is pouring gasoline on a fire to throw out that term.

[Barrister]

My understanding is the current opiate problem is directly connected to the massive over-prescription of opiates like oxycontin over the last decade, which was followed by a restriction on such drugs when we realized we had been over-prescribing them, addicts turned to the street.

That, plus the rise of chinese pharmaceutical labs which are turning out all kinds of synthetic opiates (such as fentanyl).  So an increase in both supply and in demand led to the current crisis.

[Jacob]

I think that is strawmanning his argument. I am hardly Marty's cheerleader, but I think if you asked him "Hey, are you proposing eugenics?" he would pretty clearly say he was not making any such proposition.

You have more faith in him than I do.

My post, which you responded to (rather than responding to his) was an attempt to state what I thought he was saying in terms that we could all agree on - if you didn't disagree with my post, then please don't respond to my post and throw out words like "eugenics", which cannot possibly have any useful place in the discussion - certainly nothing useful in the point I was trying to make.

I misunderstood your post.

It is pouring gasoline on a fire to throw out that term.

I agree, it was a mistake to respond to the sub-topic.

[Malthus]

My understanding is the current opiate problem is directly connected to the massive over-prescription of opiates like oxycontin over the last decade, which was followed by a restriction on such drugs when we realized we had been over-prescribing them, addicts turned to the street.

That, plus the rise of chinese pharmaceutical labs which are turning out all kinds of synthetic opiates (such as fentanyl).  So an increase in both supply and in demand led to the current crisis.

I wouldn't characterize the issue as "massive over-prescription". The problem is more difficult than that - it is that standards of medical pain management shifted, for some very good reasons (or at least reasons that appeared good): that physicians decided pain management was to have a higher priority than formerly.

The problem is this: patients have become conditioned to thinking that pain can be managed and "inadequate pain management" is simply unacceptable: it has been built into physician guidelines in some places as "pain is the fifth vital sign". Yet adequate control of pain apparently requires opiates in some cases (at least, so far). The use of opiates leads to a risk that a certain number of users, or those that have access to granny's pills, will develop addiction problems. The "reward" (superior pain management) comes with the "risk" (addiction).

Just this summer, the AMA has dropped "pain as the 5th vital sign" - to massive controversy.

Pain was first recognized as the fifth vital sign in the 1990's, giving pain equal status with blood pressure, heart rate, respiratory rate and temperature as vital signs. The policy encourages healthcare providers to ask patients about their pain.

But critics say pain is not a vital sign, but more of a symptom, and cannot be measured like a patient's temperature or blood pressure. They also claim The Joint Commission,  a non-profit that accredits hospitals and other U.S. healthcare organizations, sets pain management standards too high, which contributes to opioid overprescribing.

"Just as we now know (the) earth is not flat, we know that pain is not a vital sign. Let's remove that from the lexicon," James Milam, MD, an AMA delegate said in MedPage Today. "Whatever it's going to take to no longer include pain as a vital sign ... Let's just get rid of the whole concept and try to move on."

"I am astounded that physicians don't believe we should assess pain on a regular and ongoing basis. That is exactly what removing pain as a vital sign means," said Lynn Webster, MD, past president of the American Academy of Pain Medicine and vice president of scientific affairs at PRA Health Sciences.

Webster says dropping pain as a vital sign would setback pain care three decades.

"The problem is that too many physicians and policymakers equate assessing pain with giving opioids," he said in an email to Pain News Network. "It appears that advocates for removing pain as a 5th vital sign are suggesting that if we just ignore pain then we won't have to deal with pain and opioid abuse will disappear. That is not only fantastical thinking, it is harmful to millions of people in pain."

http://www.painnewsnetwork.org/stories/2016/6/16/ama-drops-pain-as-vital-sign

The issue: this is a problem without any good solution, until non-addictive methods of pain management become as good as addictive ones.

[Martinus]

I think Marty is NOT saying "Poors should not be allowed to procreate!"

Yup. To quote one of my posts again:

Nobody is calling for apalling "disappearance through abstinence". And nobody is also saying that people who are less well off than the average not to have children - often people who are poor can be some of the best and responsible parents.

Rather, the crux of the argument is simple - people should not have children (or more children) if they lack sufficient mental, financial and moral capacity to take care of them. Hopefully for most people such situation of deprivation is transitory. There are those, however, for whom it is permanent or semi permanent - such people should not be encouraged to have children.

Again, I will repeat - I am not calling for any legal or medical means of preventing this, but rather through encouraging responsible parenting. Isn't this what planned parenthood is all about?

I expressly said that I am not for imposition on any medical or legal bans and also said that it is not about poverty but rather general capability of taking care of a child. Thanks for sticking up for the truth - unfortunately, I am no longer interested in debating some posters here because they are quite shameless in their intellectual dishonesty.

[Valmy]

intellectual dishonesty.

Oh I haven't heard that one in awhile.

[Jacob]

I expressly said that I am not for imposition on any medical or legal bans and also said that it is not about poverty but rather general capability of taking care of a child. Thanks for sticking up for the truth - unfortunately, I am no longer interested in debating some posters here because they are quite shameless in their intellectual dishonesty.

I apologize for misreading your post and assuming you were saying something monstrous when you were not.

[Martinus]

I expressly said that I am not for imposition on any medical or legal bans and also said that it is not about poverty but rather general capability of taking care of a child. Thanks for sticking up for the truth - unfortunately, I am no longer interested in debating some posters here because they are quite shameless in their intellectual dishonesty.

I apologize for misreading your post and assuming you were saying something monstrous when you were not.

Apologies accepted. 

[Jacob]

Apologies accepted. 

[The Brain]

So do you agree or disagree with Mart on the issue?

[Jacob]

So do you agree or disagree with Mart on the issue?

We can probably find some nuance to argue about if we try, but I don't think it's worth the effort to be honest.

[The Brain]

[Jacob]

Feel free to step up to the plate

[The Brain]

Mart agrees with me.