wrathtarw t1_j1m3ij4 wrote
Things like this are not the helpful tools they appear to be. They are only as good as the researchers and data used to train them, and they are significantly biased by both
The opiate crisis is a disaster but it also has created significant problems for people who never have abused their medicines and need them to be functional.
https://internationalpain.org/how-the-opiate-crisis-has-affected-chronic-pain-sufferers/
https://www.sapiens.org/biology/chronic-pain-opioid-crackdown/
carlitospig t1_j1m77qa wrote
Amen. It made a lot of established pain folks reduce or cease entirely their pain management protocols. Still left with their pain, they went to the street for help. And now they’re fent addicts.
This whole thing is such a mess.
bob0979 t1_j1nfe99 wrote
I was in an inpatient rehab with a d1 college soccer player in the US. Broke his ankle, got on opiates, took them as prescribed, never made it back on the field because his scripts ran out and he still hurt.
carlitospig t1_j1nfwon wrote
Aww poor kid.
bob0979 t1_j1ngeio wrote
The worst part is it's his fault sort of, but I mean that's just about an impossible situation to win. I know I'd have failed there. I don't know many people who'd have been capable of running their lives correctly like that. It's not really his fault, at least not entirely. He was failed by society and couldn't fix it himself.
carlitospig t1_j1ngmsl wrote
You’d think the uni would bend over backwards to make sure he could get on the field again, the best specialists, etc. That’s really sad. I wonder if it still pains him today.
pseudocultist t1_j1ohsgx wrote
I couldn't get even a short course of painkillers when I had a facial abscess last year. I wound up having to take my dog's medications for several days. The dentist was like, "see you didn't need me to prescribe you anything."
I am a recovering addict. I know how to get street drugs. Please, please, please don't leave me hanging when it comes to pain management. I need to be able to trust my doctors to do this for me.
Spacefungi t1_j1n8932 wrote
Yeah, if you want to reduce addiction, give everyone good healthcare so people don't self-medicate and give people a good standard of living so they don't turn to substances to forget about their hardships.
Puzzleheaded-Ad-5002 t1_j1nskx2 wrote
Agreed. Same with ADHD medications. A young person (even at 35), who has a history of ADHD can go to 2-3 doctors and be treated like I’m there to get something to compliment some iv meth.
I hate that my health records are electronic and shared everywhere. And it’s being backed up many times that by not treating people with ADHD, they are much more likely to develop a drug issue or to relapse.
juggles_geese4 t1_j1oe2hq wrote
I think I’m lucky that my doctor treats me with respect and not like a drug seeker or addict because I’m on meds for ADHD. It probably helps that I don’t ask for them early, or anything. She initially sent me to a psychiatrist to help. I thought they were the type of doctors you met with had therapy and they prescribed meds as appropriate. No. She only serves the purpose of prescribing me meds. She tried to prescribe me Klonopin at a high dose multiple times a day because I have bad anxiety too. I had actually tried that with my doctor and all of those types of drugs make me. Too tried drunk feeling and Im a funeral director that literally can’t take that type of medication every night since I do on call a few nights a week. She forced me to try them so I did. She suggested a different med for adhd at one point and I thought that her and my doctor were in communication, so I told my doctor her suggestion and she prescribed it agreeing with the reason. The psychiatrist got pissed that I had asked her to prescribe something and then went on a rampage about other meds I’m on. I’m on a med for restless legs and have been for like a decade. It has a benefits of quieting my brain at night but doesn’t make me groggy like Xanax and what not. It’s a Parkinson medication. She at that point decided that my dr wasn’t going to be prescribing any of my meds from now on. That the klonopin wasn’t making me so tired the meds I take for restless legs is and that I was going to stop them. Ok, lady. You want to take me off a medication that makes me physically I’ll when I miss a dose not to mention makes me go literally insane because my RLS kicks in full force because of withdrawal (it’s not a control substance but stopping it suddenly is not a good thing like many meds.) to put me on one that is that I say I can’t be taking if I’m going to keep my job? The klonopin actually made my Restless leg syndrome worse in itself for whatever reason. As someone with ADHD it might be best to not needlessly take controlled substances that aren’t doing what I need them to do? I never went back to her. I told my dr about it and she was really upset that that was her plan. I’m not even sure she can be making medical decisions like taking me off meds that I don’t take for mental health issues but because of my physical health? It was utterly insane. She actually made me feel like a drug seek not just for asking my doctor for Concerta but for the RLS meds I took. I was really baffled by her for so many reasons. Now I just see a therapist and my doctor and I went through a bunch of trial and error to find the best combo of meds for my ADHD and anxiety until we found what is currently working best. A lot of my anxiety comes from adhd anyway. Point being finding your doctor that doesn’t judge is most important. You’ll have to see other doctors along the way but their opinions only mean so much.
Puzzleheaded-Ad-5002 t1_j1s86gn wrote
You seem to have better communication skills and assertiveness with your doctors than I have had.
I have always had major issues with RLS as well! I’ve been on a pretty high dose of Gabapentin for about 10 years. It helps with insomnia / quieting my brain quite a bit as well.
I used to be on a high dose of Adderal for several years. External events lead to me stopping it and switching to kratom. Kratom worked fantastic for me for about a year but then the quality dropped and I started taking more than a moderate dose. After another 8 months I unfortunately became very physically dependent on it, and when I told my doctors, they cancelled everything except for Gabbapentin.
I haven’t taken Kratom for 2 years, but my doctors treat me like I’m trying to become a homeless in meth user and rob banks and lie to doctors to get ADHD meds. I had to “restart” the process of finding a workable med and dose. It took over a year before I was trusted with concerta. I just switched to Focalin and I’ve found it to be better for me and with less of the “edginess” I’d sometimes get with concerta.
I wish you the best on this journey. It sounds like we have shared a lot in common with our experiences with doctors!
juggles_geese4 t1_j1sg2x3 wrote
It’s interesting that Kratom gives doctors such a drug addict vibe when it’s a supplement. That doesn’t make it less addicting or ok for you but it does make it easier to stumble into. You’d think they’d be a little more willing to see that you aren’t necessarily an addict just because your dependent on it.
I’m glad they trust you again with different meds. It’s interesting that you also struggle with RLS. I wonder if that’s common in people with ADHD or what.
Puzzleheaded-Ad-5002 t1_j1snzg7 wrote
My relationship with doctors changed significantly for the worse once I opened up about taking Kratom.
I really appreciate hearing someone say that they would hope doctors would consider someone that started taking kratom as what they initiated thought was the healthier option, to not be the same as someone that was taking a drug with an totally different reputation. I wish my doctors felt the same way!
You are spot on about ADHD and RLS. Both RLS and PLM are known to be more common in those with ADHD, and the theory that I buy into the most is that it is due to how our brains have a harder time with supplying a consistent amount of dopamine.
juggles_geese4 t1_j1soxoc wrote
I’m sorry your relationship with your doctor changed so much. That sucks a ton. I have a hard time with new doctors so I’d struggle big time if something like that happened. I hope things get better, or at least that you don’t have to much of a struggle with your ADHD and other health issues mental or otherwise.
I’m going to have to look more into the connection. I don’t often talk about RLS so I never really heard anyone else mention it.
Hydrocoded t1_j1pe10e wrote
The opioid crackdown is one of the most cruel things I have witnessed in my lifetime. I’d rather see heroin legal and unregulated than deal with our current system.
pharmaway123 t1_j1ntu65 wrote
can you elaborate a bit? How would biases in the nationally representative claims data (or the researchers) here make this model less useful?
wrathtarw t1_j1ocd3y wrote
The same bias that is present in the medical system is then programmed into the algorithm- the way machine learning works is that it essentially condenses information from the source and then uses it to determine the output. Garbage in garbage out…
If the source is flawed so too will the algorithm: https://developer.ibm.com/articles/machine-learning-and-bias/
And the source is flawed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344207/
pharmaway123 t1_j1on8ck wrote
Right, and I'm asking in this specific instance, given the rank ordered feature importance from the study, how would bias impact the results from this model, concretely.
wrathtarw t1_j1onilg wrote
Sorry- reddit karma doesn’t pay enough to do that analysis for you;
pharmaway123 t1_j1oqzaz wrote
Yeah, I figured it was just a nice sound bite without any actual thought behind it. Thanks for confirming.
[deleted] t1_j1oz2l9 wrote
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