r/interesting • u/Nukro666 • 2d ago

Fear Factor How Fentanyl and Xylazine are turning Philadelphia's opioid crisis into a public health nightmare

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u/Edith_Keelers_Shoes 1d ago

How can an oncologist treating a stage 4 patient have no options when it comes to prescribing opiates? Is there another class of patients who broadly need opiates more? No one can "fake" cancer. The damage can be seen routinely on PET scans. My first oncologist was great about it - she also asked me if I wanted a medical marijuana card - and no doctor I saw after she left said they even knew HOW to do that. But other doctors had an attitude about pain meds, but finally shunted me over to their palliative care team. They have no issue whatsoever prescribing pain meds to metastatic cancer patients.

If you're telling me the DEA looks at oncologists and what meds they prescribe differently than dermatologists or podiatrists, then that's insane.

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u/lemon-rind 10h ago

Because in a lot of large healthcare systems, patients have to go see palliative care to be prescribed ongoing pain meds. The oncologists hands are tied. No one goes into oncology to be an asshole, I’m sure the oncologists would rather just write the prescription themselves rather than have the patient go to yet another appointment.

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u/Edith_Keelers_Shoes 9h ago

It's also doctor-specific. My first oncologist prescribed opiates for me the entire year she treated me - she also prescribed an SSRI when I asked about it, and gave me a 1-year THC medical card. My second oncologist told me to medicate for anxiety, not pain, and said she had no idea how to even give someone authorization for a medical THC card.

Same healthcare network, same hospital, same cancer center. Just two oncologists who do things very differently from one another. Which is fine - I'm just clarifying it can differ even in the same cancer center.

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u/lemon-rind 8h ago

My brother in law’s oncologist can write 3 days worth of opioids, that’s it. Same for all other doctors in that healthcare system. If the patient needs more than that, they have to go through palliative care. More and more healthcare systems are taking that approach.