You are by far the best explainer of drug addiction and I thank you for putting this out there.... my daughter is an addict, it helps me understand why she does what she does, and allow me to be more compassionate for all who suffer this brutally hard disease
Thank you for the video! Which studies are you referencing that suggest opioids used in the absence of pain have a stronger effect on the dopamine reward system? It makes sense, but I’m having a hard time finding data on it.
Informal. Understood. What do you do when a patient comes in for pain (over and over again for years) that is real and is effecting their well being and quality of life. Work, hobbies, sex, and all other points of their life. Of course mood as well. Being in pain everyday all day tends to bring on depression obviously. Never mind the added stresses from the consequences of not doing the things you are expected to… like give attention to your wife. That’s fading with time because the act itself is painful or painful after. Once the high of the act has left, they are now worse then they were before. The situation / issue has been agitated from the act. All variety of medications were tried. Most didn’t work, a few did. Like opioids. However the patient keeps returning and asking what is the next step to fix what’s causing me this pain. He or she gets no real answers. Not even a definitive cause, only vague responses. Only to get another script and the EXACT same other avenues suggested that were already tried, like physical therapy. Electric stimulation devices. Vitamins. And so on. What does that patient do? You might say “find a different doctor”. Well, suppose they did that. Being a new patient obviously they are not going to gain much traction at first. More hi nice to meet you this is my issue and this is the answers to your questions… Remember this patient has been living with this for years. 5+. Now they Come off very pushy. Very rude. Very drug seeking viewed from not knowing all the details or considering ok this patient is clearly fed up with all of it. Including me, a doctor (fed up with the entire system). This new doctor does much better when it comes to listening and testing theories. Pushing on points that hurt. So simple but nobody else did that… he must know what he’s doing. But after several visits the patient admits to depression because of going down this exhausting road. Include all the person problems that have unfolded. Now the new doctor focuses exclusively on the depression and ignores the initial reason for said patient coming in. Starts prescribing mental meds. Several. Saying it’ll help. No longer shows and interest in treating pain or giving an pain type scripts (after all your depressed you’ll surely abuse em). No evidence of this. Never asked for early fills. Never asked for higher doses with previous dr. But there’s no going back now. He admitted to depression. Even though it started bc of the pain. The person will give up and self medicate. For better or worse. Usually worse.
#1 You are not a doctor because you don't know the difference between affecting/effecting. And if you are then you are a doctor on the dumb end of the spectrum and need to keep that in mind. #2 By your intimate details of this "patient's" sex life it is clear you are describing yourself #3 He gives the answer to your problem IN the video. Anyone with behavior that causes them to continue to seek opioids, even after it's clear the opioids have not improved their quality of life, has opioid use disorder, REGARDLESS of if they were a pain treatment patient initially, and need to be treated for opioid use disorder #4 You have opioid use disorder. Watch his videos on the treatment for this.
Doctors don't think when they prescribe opioids. They make STUPID mistakes and the casualties of their mistakes make statistics of a few, so the result is blaming patients. At this point, patients are expected to suffer to save the those vulnerable to the doctors' mistakes! Specifically: I remember when dentists routinely prescribed Vicodin/hydrocodone after simple procedures. Personally, I refused these prescriptions and did OK. At a later time I got severe pain from dental work and opioids were not given, no matter what. I avoided dentists for a long time. Another instance of what I believe are doctos' faults: With me and others experiencing pain, doctors frequently prescribed oxycodone as a first choice. Oxycodone allegedly has a bad profile for addiction capabilities. Fortunately I cannot take it as I vomit uncontrollably and get no pain relief. Why are not doctors taught to prescribe the lowest dose of the mildest opioid first and move up to stronger drugs if needed? Added to this are people who deliberately, recreationally use opioids. Now, politically, doctors are supposed to let their patients suffer to save this group of people from opioids that might be 'misdirected', 'misused', etc. I am a very tolerant and kind person and I do feel sympathy for all suffering. However, I am sick and tired of the 'rotten apple spoils the batch' approach, that EVERYONE must be punished for the misbehaviour of the few. I am sorry for recreational drug users but there is plenty of effort to prevent this. Unfortunately, perhaps Darwin's Law needs to take over. Doctors must be able to treat patients as individuals, not as cogs in a 'population health' scheme!
You are by far the best explainer of drug addiction and I thank you for putting this out there.... my daughter is an addict, it helps me understand why she does what she does, and allow me to be more compassionate for all who suffer this brutally hard disease
Behind the 8 ball lol I laughed to myself and then saw you put "no pun intended" lol. Love these videos!
Brilliant presentation, thankyou (from a retired RN).
This video was ahead of its time. Love this guy’s videos.
some of the best information on addiction I've heard.
Really like the PT/yoga analogy; I think that complex persistent opioid dependence is "trendy" and getting overdiagnosed.
amazingly helpful videos from this doctor. Some of the best on RUclips!
This is a really great educational video.
Thank you for the video! Which studies are you referencing that suggest opioids used in the absence of pain have a stronger effect on the dopamine reward system? It makes sense, but I’m having a hard time finding data on it.
What this video does not talk about is trying to get away from mental pain and not being able to sit in the pain of trauma.
I listen to these videos at work with one AirPod so I don’t get in trouble
I wish I had plenty to go around. I'm running a little low today.
This video is for you
Informal. Understood.
What do you do when a patient comes in for pain (over and over again for years) that is real and is effecting their well being and quality of life. Work, hobbies, sex, and all other points of their life.
Of course mood as well. Being in pain everyday all day tends to bring on depression obviously. Never mind the added stresses from the consequences of not doing the things you are expected to… like give attention to your wife. That’s fading with time because the act itself is painful or painful after. Once the high of the act has left, they are now worse then they were before. The situation / issue has been agitated from the act.
All variety of medications were tried. Most didn’t work, a few did. Like opioids. However the patient keeps returning and asking what is the next step to fix what’s causing me this pain. He or she gets no real answers. Not even a definitive cause, only vague responses.
Only to get another script and the EXACT same other avenues suggested that were already tried, like physical therapy. Electric stimulation devices. Vitamins. And so on.
What does that patient do? You might say “find a different doctor”. Well, suppose they did that. Being a new patient obviously they are not going to gain much traction at first. More hi nice to meet you this is my issue and this is the answers to your questions…
Remember this patient has been living with this for years. 5+. Now they Come off very pushy. Very rude. Very drug seeking viewed from not knowing all the details or considering ok this patient is clearly fed up with all of it. Including me, a doctor (fed up with the entire system).
This new doctor does much better when it comes to listening and testing theories. Pushing on points that hurt. So simple but nobody else did that… he must know what he’s doing.
But after several visits the patient admits to depression because of going down this exhausting road. Include all the person problems that have unfolded.
Now the new doctor focuses exclusively on the depression and ignores the initial reason for said patient coming in.
Starts prescribing mental meds. Several. Saying it’ll help. No longer shows and interest in treating pain or giving an pain type scripts (after all your depressed you’ll surely abuse em). No evidence of this. Never asked for early fills. Never asked for higher doses with previous dr. But there’s no going back now.
He admitted to depression. Even though it started bc of the pain.
The person will give up and self medicate. For better or worse. Usually worse.
#1 You are not a doctor because you don't know the difference between affecting/effecting. And if you are then you are a doctor on the dumb end of the spectrum and need to keep that in mind.
#2 By your intimate details of this "patient's" sex life it is clear you are describing yourself
#3 He gives the answer to your problem IN the video. Anyone with behavior that causes them to continue to seek opioids, even after it's clear the opioids have not improved their quality of life, has opioid use disorder, REGARDLESS of if they were a pain treatment patient initially, and need to be treated for opioid use disorder
#4 You have opioid use disorder. Watch his videos on the treatment for this.
Well i dont think its fitting here but opiods are also amazing recreational drugs...
Doctors don't think when they prescribe opioids. They make STUPID mistakes and the casualties of their mistakes make statistics of a few, so the result is blaming patients. At this point, patients are expected to suffer to save the those vulnerable to the doctors' mistakes!
Specifically: I remember when dentists routinely prescribed Vicodin/hydrocodone after simple procedures. Personally, I refused these prescriptions and did OK. At a later time I got severe pain from dental work and opioids were not given, no matter what. I avoided dentists for a long time.
Another instance of what I believe are doctos' faults: With me and others experiencing pain, doctors frequently prescribed oxycodone as a first choice. Oxycodone allegedly has a bad profile for addiction capabilities. Fortunately I cannot take it as I vomit uncontrollably and get no pain relief. Why are not doctors taught to prescribe the lowest dose of the mildest opioid first and move up to stronger drugs if needed?
Added to this are people who deliberately, recreationally use opioids. Now, politically, doctors are supposed to let their patients suffer to save this group of people from opioids that might be 'misdirected', 'misused', etc. I am a very tolerant and kind person and I do feel sympathy for all suffering. However, I am sick and tired of the 'rotten apple spoils the batch' approach, that EVERYONE must be punished for the misbehaviour of the few. I am sorry for recreational drug users but there is plenty of effort to prevent this. Unfortunately, perhaps Darwin's Law needs to take over.
Doctors must be able to treat patients as individuals, not as cogs in a 'population health' scheme!