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Wednesday, April 18, 2007 12:00 AM

Our benevolent surveillance state

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Wednesday, April 18, 2007 06:34 PM

Failure to follow prescribed treatment

Michmod:

One of the primary problems in our health system is people failing to follow prescribed treatment. Knowing when/if patient's fill their prescription is a key piece of information to determine the effectiveness of treatments and the interventions necessary to help patients and to reduce our national healthcare tab

I realize that your intentions here are entirely good, but I fear that down this path lies disaster. Your doctor gives you a prescription for some medication. You decide not to fill it. This might be for any number of reasons: you can't afford it; you do some research on the medication and discover that its side effects aren't ones you're willing to experience; your pharmacist looks it up and discovers that it's chemically related to a drug to which you have a known allergy; you get a second opinion from a doctor who disputes your need for the drug; gosh, you meant to fill it, but you just plain forgot; etc. etc.

Do you really want someone--your doctor, your pharmacist, some state agency, some federal agency, anyone--to decide that you're delinquent in filling this prescription after some period of time and...do what? Call you to remind/harrass you to fill your prescription? Mail you forms to fill out to justify your decision? Send the Medicine Police to tie you down and force-feed you the medicine? Put you on the No Fly list to protect you and/or others? Prosecute you for being a bad parent for exposing your children to your condition?

As to determining effectiveness of treatment, that's between you and your healthcare provider. If there's a question, he/she can always recommend a follow-up visit (or you can choose to schedule one yourself).

Just my opinion...

Wednesday, April 18, 2007 06:24 PM

"They'll have to pry my biscuits out of my cold dead fingers..."

The comments on this thread are hilarious.

"Let's just stop fucking around. You all know what we really need to do. This piece-meal bullshit has got to stop.

I propose that the government enact legislation forbidding you from leaving your home without the express permission of your local block captain. When attempting to leave your gated block, you are required to explain the purpose of your trip and why it is necessary. The block captain will then determine whether or not you are allowed to leave. This way, we can always make sure you really need to do whatever you're doing. This is America, why stop at mother fucking baking soda?"

http://www.reason.com/blog/show/119518.html

Wednesday, April 18, 2007 06:14 PM

If you can take it to get high..

...or use it to make something to get you high, they want you to sign away your first born child and all your rights to get it. If it's Sudafed it can be used to make crank. If it's baking soda, it can be used to make crack.

There is a guy in Missouri who wants to restrict the sale of baking soda. Sadly, he is a Democrat.

Balko: Reductio creep strikes again

http://www.reason.com/blog/show/119518.html

Baking Soda, the new illegal drug?

http://kmox.com/pages/338486.php?contentType=4&contentId=398985

Wednesday, April 18, 2007 06:10 PM

There are valid reasons to develop national databases on prescription drugs

Glenn, For the first time, I disagree with you. Or at least, I think you are missing a key point about tracking prescription drug usage. One of the primary problems in our health system is people failing to follow prescribed treatment. Knowing when/if patient's fill their prescription is a key piece of information to determine the effectiveness of treatments and the interventions necessary to help patients and to reduce our national healthcare tab (negotiating drug prices would help too, but that's another subject). That said, this information, like all medical records information, must never be made public or used for any purpose outside of patient care or anonymous research without a warrant.

Wednesday, April 18, 2007 06:08 PM

Meta

William Timberman:

The long and the short of it is that if we continue down our present path, we're going to subject more and more people to Kafka-like experiences, perhaps even life-threatening ones, before the powers that be realize what an awful chaos generator they've installed at the heart of our society. I wonder how long it will take....

Wired had an article a couple of days ago about how to get off your name off a watch list. Although the process may seem onerous,

DHS spokesman Darrin Kayser says the new system demonstrates the government's determination to stop inconveniencing Americans.

http://www.wired.com/politics/onlinerights/news/2007/04/watchlist2/

Wednesday, April 18, 2007 06:02 PM

Be Careful, Mr. Chippers

Not around the corner

I am hoping all of my serious depression is behind me. It's better to be chipper than have another 9/11.

If you get to happy and secure, the Bushitarians will put you on a regimen of depressants and paranoia inducing substances.

Like bad news and fear. It's the new normal.

Wednesday, April 18, 2007 05:51 PM

Antidepressants aren't "scheduled" at all

Schedule I is stuff that's always illegal -- heroin, marijuana, etc.

Schedule II is legal but in most states requires a special written prescription. Morphine and other heavy-duty pain medicines are Schedule II, and so are amphetamines and similar stimulants (including, perhaps inappropriately, some medicines used mostly to treat attention deficit disorder, like Ritalin).

Schedule III includes medium-duty pain medicines. Tylenol with codeine PILLS are Schedule III -- but Tylenol with codeine LIQUID is Schedule V. That's not quite as odd as it sounds, if the liquid is dilute enough that you'd have to drink huge amounts to get a dangerous buzz.

Schedule IV includes Darvocet, Valium, and Xanax.

Sometimes you'll find one drug that's been pushed up to Schedule II mostly because it has become a popular drug to abuse, while equally strong drugs that haven't happened to develop a 'street following' are still Schedule III.

Marinol, which is THC (the active ingredient in marijuana) is now Schedule III. I think it got 'demoted' from Schedule II out of boredom. Apparently it rarely gets sold illegally, perhaps because it seems to be more expensive than street marijuana.

Antidepressants, such as Paxil, Prozac, and Elavil, aren't 'scheduled' at all, though in the USA they do require a prescription. The same goes for most anti-psychotic medicines used to treat schizophrenia, like Thorazine and Haldol. The same also goes for antibiotics, blood pressure pills, pills for cholesterol like Lipitor, birth control pills, and Viagra.

As a doctor who worries about civil liberties, I'm happy somebody keeps track of the Schedule II prescriptions, ambivalent about any tracking program for Schedules III, IV, and V, and opposed to Big Brother poking his nose into the non scheduled stuff.

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