Pharmacy in the U.S. Is a graduate degree. It’s not a case of lower educational requirements, but perhaps different ones.
Incorrect. There are still bachelors of pharmacy, it’s the degree my late father held. It’s just that these days it’s hard to find a job in pharmacy unless you have either a graduate degree, a doctorate, or 30-40 years experience in the field like my dad did (actually, for him it was closer to 50 since he worked into his 70’s)
I think licensing varies by state, and educational requirements have been increasing in recent years. (I’ve been doing work visas for pharmacy professors at a local college.) i’m away from home and not on a real computer right now, but I will see if I can find details.
Yep, since 2003 a graduate degree is required. (I can’t figure out how to copy and paste chunks of text on this tablet, but scroll halfway down the page.)
Medical and Law school are also graduate over there, but as you say, it doesn’t necessarily mean lower requirements. Different ones yes, for sure.
I would not favor legalizing them but I would favor decriminalizing their use. I realise that only solves half the issue since they probably would have to go through some criminal behavior to obtain them. But it would make a good place to start.
Is there a way to pre-identify people who would be at risk for opioid addiction. I’ve seen in some documentaries that 80% of heroin addicts started out with legally prescribed opiates for pain. It’d be good if there was a way to know if someone had a strong potential for abuse and addiction and give them something else in those cases.
There are some pretty solid risk factors, and research continues. I’m going to assume the journal Addiction is behind a paywall, but here’s a summary of a great paper from a couple years ago. They identify four big ones: age, depression, psychotropic medication, and pain impairment. But of course, doctors don’t always have all the information when they prescribe, nor are most trained to look for risk categories. And the research isn’t super clear yet. But we’re heading there, slowly. Hopefully.
On the other hand, for certain types of horrible acute pain there really isn’t anything better. Even a drug addict should get proper and appropriate pain medication for, say, extensive burns or an amputation or something of the sort. Of course, people at high risk of addiction should be more carefully managed and monitored if such medications are required, but sometimes the addictive stuff is the best and the most appropriate stuff we have for a problem.
And while 80% of addicts might have started with prescribed medications MOST people take those drugs without becoming addicted.
Qadgop the Mercotan might be able to expand on that more.
People merit opioids for significant acute pain (post-operative, broken leg, and so on) and for malignant pain (from cancer, etc) no matter their opioid use history.
For chronic, non-malignant pain, opioids are generally not the best meds to use for people with a history of opioid addiction.
Most people get exposed to opioids in the course of their lives, for significant pain. For over 80% of them, it’s no big deal. For those who are predisposed genetically and/or via life events towards addiction, this can trigger the activation of the process towards chronic abuse/misuse. But that’s not a good reason to avoid giving opioids where appropriate.
It’s a challenging problem. Opioid deaths in this country skyrocketed after physicians were encouraged to prescribe more of them to deal with (a mostly non-existent) ‘untreated pain crisis’ in the US.
I could write much more, but I’ll resist the urge.
I love to talk about me.
I’m a really GREAT data point!
I have a life-long high tolerance for all CNS depressants.
Aspirin never did anything. The NSAIDs were effective only at megdoses and even then, only for brief times.
Over the course of the first 30 years, I had found exactly two drugs which worked for serious pain: Vicodin and Demerol (emergency appendectomy).
I must admit: the Demerol was a bit of fun - Wake up and hit the button. New shot, back to some really pleasant dreams. Vicodin never had the same effect.
I will never ask for Demerol just because I do NOT trust myself with it.
Anyway, this hard-to-medicate old boy now has osteoarthritis AND Stage III (by a whisker) CKD.
Oh yes - the puberty-onset insomnia. In a boy impossible to medicate (the last anesthesiologist stopped by after the surgery to tell me he had a Hell of a time keeping me down (I had warned him when he asked the Lithium question)).
Can’t use NSAIDs with CKD (they quite likely had a hand in creating the condition), even if they worked.
Gabapentin works - but only for the itching, not the pain.
So here I am with two opioids in my pocket and a nasty benzodiazepine on the nightstand.
And, since the DEA has yanked the cords, my allotment is 1/3 what it was.
I spend a great deal of time in bed, motionless to avoid pain.
Watch for the details of the next accidental(?) suicide - the combo is almost always opoid(s) + benzo + alcohol.
This is how people end up taking these combinations.
(I have dropped the etoh from the cocktail.)
p.s. - all meds prescribed by same MD, my PCP.