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Medicine Businesses United States

Drug Firms Shipped 20.8 Million Pain Pills To West Virginia Town of 2,900 (foxnews.com) 347

A congressional committee investigating the opioid crisis has discovered out-of-state drug companies shipped 20.8 million prescription painkillers over a decade to two pharmacies in a Southern West Virginia town with 2,900 people. From a report: Between 2006 and 2016, two drug wholesalers shipped 10.2 million hydrocodone pills and 10.6 million oxycodone pills to Tug Valley Pharmacy and Hurley Drug in the town of Williamson, in Mingo County, the Charleston Gazette-Mail reported. "These numbers are outrageous, and we will get to the bottom of how this destruction was able to be unleashed across West Virginia," the House Energy and Commerce Committee Chairman Greg Walden, R-Ore. and ranking member Frank Pallone Jr., D-N.J. said in a joint statement.
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Drug Firms Shipped 20.8 Million Pain Pills To West Virginia Town of 2,900

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  • by Anonymous Coward

    I would get high every day too.

    • by RavenLrD20k ( 311488 ) on Tuesday January 30, 2018 @10:44AM (#56033129) Journal
      20.8M / 2900 ~ 7,172
      7,172 / 10 (years) ~ 717
      717 / 12 (months) ~ 60 pills.

      Basically, everyone in town was given a standing prescription of take 2 pills per day as needed for pain. Up the script to 3 pills per day as needed and you've got a standing prescription for about 1,925 people. Consider that pharmacies often keep a stock of these pills for rapid fulfillment (Wal-greens will usually have whatever prescription my doc gives me ready within an hour; narc or not), and it's likely that not even that many people have standing scripts.

      Also, how long do pharmacies keep med batches on hand? They often have expiration dates slated for 90 days. They're supposed to dispose of unused portions of batches, right? Well, how are they going to keep the stock up to handle the medicated population when they get their next round of scripts? This is going to inflate the order that the drug companies are going to get.

      In short, this sounds like someone with an axe to grind trying to inflate emotional response by using a 10 year metric that only indicates how much opiates are getting shipped into community pharmacies, not how much is actually being doled out and prescribed to the community.

      • by plopez ( 54068 ) on Tuesday January 30, 2018 @11:07AM (#56033273) Journal

        realistically how many people per thousand actually need heavy opiates? How many would be in a town that size? 1 in 3 adults are getting prescriptions from the numbers I am finding. https://www.cbsnews.com/news/m... [cbsnews.com]

        Let's adjust by 50% to cover children, pregnant women, macho men (I can take the pain), masochists, etc. and divide by 3. That works out to about 483.

        483/60 = 8.05 which seems excessive.

        • Re: (Score:3, Insightful)

          by thegarbz ( 1787294 )

          1 in 3 adults are getting prescriptions from the numbers I am finding.

          Let me just say: WHAT THE FUCK!

          • Did you read the link? It says that 1 out of every 3 adults was prescribed opiates at some point in the previous 12 months. That's not particularly concerning if you ask me - I was prescribed them twice in that time period, once for a tooth extraction and once for a broken finger. What I thought was interesting was the amounts that were prescribed - for the teeth, the doc issued a prescription for 3 days worth. (12 pills total) For the finger, that doc issued 30 days worth, which seemed REALLY excessi
            • Where I live you wouldn't have gotten opiates in both cases. Ibuprofen in a slightly higher dosis then over-the-counter, if you're lucky. And then for a week max.

              So yes, I think it's quite excessive what you got.

              I live in the Netherlands by the way.

        • by rahvin112 ( 446269 ) on Tuesday January 30, 2018 @12:25PM (#56033947)

          Small towns like that are often 50% or more elderly. By my calculations that would offer 962 people in town a monthly supply of 180pills which is a fairly typical maintenance dose (2 pills 3 times a day). Given the size of the town and the likely high numbers of elderly I find nothing wrong with this other than rather obvious political scapegoating. The real political story in this number is the large number of people with chronic pain and/or cancer. Is this is town a cancer cluster?

          Short acting opiates take 20 minutes to affect you, require an hour to reach full potency and gradually fall off till the 4 hour point where they begin to drop off steeply until about 6 hours. Anyone that's taking pain meds for chronic pain is going to be taking doses 3-4 times a day minimum. Typically these people are also at least partly opiod tolerant and will need to take 2 pills at a time.

          I see nothing out of the ordinary here.

          • by amicusNYCL ( 1538833 ) on Tuesday January 30, 2018 @01:17PM (#56034367)

            Do you have any friends taking 2 opiate pills 3 times per day, at least that you know of?

            • I don't need friends taking that many, I do.

              I'm a chronic pain sufferer and I take significantly more than that, but that's what happens when your bones have so many bones spurs on them they look like steak knives. Yes, someone that twisted an ankle shouldn't be taking anywhere near that much but you people have NO IDEA how many people in this country are in chronic unrelenting pain for various conditions. Destroyed nerves, damages joints, blown out muscle groups, out of control immune systems. Pain is a co

              • My wife has chronic pain, as does a close friend. I realize the usefulness of opioids or any other pain relieving drug. But I don't think that it's likely that a majority of the people living in any one town all have chronic pain to the level that it requires opioids to treat. That's part of the problem. A doctor hears that someone has a toothache, so might as well give them some opioids because the pharmaceutical manufacturer will pay the doctor for every prescription. They are over-prescribed big tim

                • It's not the majority, it's the county seat and at 2600 people probably the only town in the entire county large enough to support pharmacy locations. When put in that perspective 900 people out of 26000 in the county isn't as bad and reduces the percentage by a factor of 10. You should also keep in mind that's averaging, a half a dozen stage 4 cancer patients would heavily skew the numbers because the volume of pills they'd be taking would skew the average and mean.

                  That's the point most of the rational pos

        • by sjames ( 1099 ) on Tuesday January 30, 2018 @12:45PM (#56034125) Homepage Journal

          Now include the people living in unincorporated areas (so not counted as part of the town's population) for whom the town has the nearest to them pharmacy. Include that coal mining and other physically demanding work is quite common in West Virginia.

          In many places, rural doesn't mean farms. It is more or less as dense as suburban areas but with no strip malls or corner stores. All of those people go into town for shopping, including the pharmacy.

          Williamson is the county seat of the surrounding county with a population of 30,000. Suddenly, the numbers don't look that out of line, just sensationalistic.

        • by amicusNYCL ( 1538833 ) on Tuesday January 30, 2018 @01:15PM (#56034349)

          realistically how many people per thousand actually need heavy opiates?

          According to drug manufacturers and wholesalers? About 1,000.

      • by careysub ( 976506 ) on Tuesday January 30, 2018 @11:50AM (#56033587)

        The presumption that everybody in town has a prescription for a very powerful narcotic (instead of say, codeine) is the presumption that this is a "pill mill", rather that proof to the contrary.

        National dispensing rates are something like 0.75 prescriptions per person per year, so this town would have had 22,000 units dispensed over the ten year period. People are not picking up bottles of 900 pills. Even assuming the rate for this town due to its composition is higher than normal, this is a factor of at least ten fold too high. And these opioid prescription rate are for all opioids not just these powerful and addicting ones. Most opioid prescriptions would normally be for less potent ones like codeine, propoxyphene (Darvon), and tramadol. So getting this much oxycodone and hydrocodone is something like a factor of 100 too high.

      • by nomadic ( 141991 ) <[moc.liamg] [ta] [dlrowcidamon]> on Tuesday January 30, 2018 @11:58AM (#56033683) Homepage

        The problem with your theory is that opioids are prescribed for extreme pain, and typically only for short periods of time following things like surgery. An entire town being prescribed them is beyond insane and there is no way you can feasibly make it out to sound like everyone in town -- every man, woman, and child -- needs them.

      • by amicusNYCL ( 1538833 ) on Tuesday January 30, 2018 @01:03PM (#56034255)

        Up the script to 3 pills per day as needed and you've got a standing prescription for about 1,925 people.

        That's quitter talk, every baby should also be on opiates. You'll shit your pants when you see what happens to stock prices and revenue when we get babies addicted as earlier as possible. Because that's literally the only thing that matters, stock prices, and revenue. In fact, the real story here is that these babies ONLY get 2 doses of neo-heroin per day. Those are rookie numbers.

      • Yep 7. No numbers on number of narcotics sent to the other 5.

    • West Virginia is an absolutely beautiful place to live. What isn't so great is the current epidemic. Personally I'd like to do away with all prescription opiates. The "chronic pain" they address cannot outweigh the suffering they inflict on communities. Next remove them and all forms of welfare. Keep it if you want in your large cities but over here, it would be better that men would have to struggle and work to get by again. The biggest problem in these regions is lack of purpose. Men need work. On
      • by gtall ( 79522 ) on Tuesday January 30, 2018 @11:36AM (#56033479)

        So, in your dog-eat-dog world, the children of the unemployed get squat which translates into a new generation of un-educated, malnourished sprogs who will be a burden when they turn to crime to make ends meet. Their parents might be able to give them pointers on how to do it well.

        You can either pay them now or pay for them later, either way, you will pay.

      • So now that cities are thriving and suburbs and rural areas are the center for welfare queen drug abusers, you want to cancel welfare in the rural areas so your rural degenerates will flee to the city and prop up your collapsing home prices. Do I have that right?

      • You do realize the vast majority of suffering inflicted by opiates is because of the War on Drugs right? Your solution would increase total suffering by at least a couple orders of magnitude. Education, prevention, and treatment are what minimize the harm caused by dangerous drugs. Prohibition maximizes it, and you take it further by inflicting suffering on people who aren't even abusing drugs.
        You're an ignorant sadomoralist of the worst kind, the kind that foolishly believes they're helping. Could you loo
  • by ColdWetDog ( 752185 ) on Tuesday January 30, 2018 @10:15AM (#56032921) Homepage

    What gets me about cases like this is how LONG it took to find the pharmacy pushing out 20E6 pills or the individual doctor prescribing hundreds of thousands a year. Yes, the do pop up now and again, but these drugs are tightly controlled. I have to fill out a triplicate form to get a couple of morphine ampules for our ambulances.

    Does anybody actually LOOK at those forms. If I ordered 5000 ampules would anyone notice?

    Asking for a friend.....

    • by 110010001000 ( 697113 ) on Tuesday January 30, 2018 @10:18AM (#56032939) Homepage Journal
      It wasn't detected until AI deep learning software was invented this year.
    • by jebrick ( 164096 ) on Tuesday January 30, 2018 @10:31AM (#56033033)

      Most of this came abut due to the Congress neutering the Law enforcement (DEA) on behest of the Drug Companies that product the opioids.

      https://www.cbsnews.com/news/e... [cbsnews.com]

      Look up Joe Rannazzisi. Former DEA chief prosecutor

      JOE RANNAZZISI: If I was gonna write a book about how to harm the United States with pharmaceuticals, the only thing I could think of that would immediately harm is to take the authority away from the investigative agency that is trying to enforce the Controlled Substances Act and the regulations implemented under the act. And that's what this bill did.

      The bill, introduced in the House by Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee, was promoted as a way to ensure that patients had access to the pain medication they needed.

      Jonathan Novak, who worked in the DEA's legal office, says what the bill really did was strip the agency of its ability to immediately freeze suspicious shipments of prescription narcotics to keep drugs off U.S. streets -- what the DEA calls diversion.

      • Re: (Score:2, Insightful)

        by Anonymous Coward

        I'm still having a hard time deciding which side of the fence I'm on here.

        When I'm presented with the choice of:

        A) Having access to the medications I'm legit prescribed by my surgeon or doctor, while abusers of the same drugs also have easy access to them
        and
        B) Not having access to the medications I'm legit prescribed and living in agony, while abusers of those drugs still maintain easy access to them

        I find it very difficult to support "B"

        As someone who recently had open heart surgery and could only get my

        • by swb ( 14022 )

          I think you have to look at the down side of extremely restrictive prescriptions in terms of what it does in the illegal drug market.

          Tightening of prescription opiates started happening BEFORE the current overdose crisis and I think drove a lot of more casual pill users to heroin as street prices for pills creeped up. A surge in heroin users and the short-term supply inelasticity of heroin means the market adapts -- hard-to-interdict synthetics from China get turned loose, either on its own or to pump up o

        • I got a prescription for hydrocodone after some dental work, plus an antibiotic. I headed to the drugstore, which I wasn't familiar with since I normally go to my medical foundation's pharmacy. Didn't have an "insurance card" and I wasn't in their system. So they looked at me suspiciously.

          However, the hydrocodone they were fine with, but I had to wait around a couple hours (in pain) while they phoned back and forth to see if I was allowed to get the antibiotic.

      • Re: (Score:3, Insightful)

        by gtall ( 79522 )

        Nothing Marsha Blackburn supports has a bright side.

      • According to your link, that bill didn't become law until 2016. Opioid overdose deaths began to skyrocket in 2013 [drugabuse.gov], long before the bill was even written.

        Based on your link, the more likely culprit was lobbying by pharmaceutical companies getting the bigwigs at the DEA to change enforcement policies.

        In 2011, more than 17,000 Americans died from opioid prescription overdoses. That same year Cardinal Health, the second largest distributor, started pushing back at Joe Rannazzisi. The companies' attorneys

      • by rahvin112 ( 446269 ) on Tuesday January 30, 2018 @12:32PM (#56034021)

        Nothing like a quote from the jack booted thugs in the DEA for how to ruin America.

        You know how you actually ruin America? You put law enforcement in charge of a medical issue. Then they do things like threaten people with jail which cuts the pharmaceutical supplies of a drug with physical addiction issues so the users have to immediately turn to street drugs to reduce withdrawl side effects.

        Then on top of that you stigmatize drug treatment so that seeking help makes you a looser, then add in a little random drug screening at employers so the person gets fired as well.

        Our war on drugs is the most fucked up thing you could EVER do to this country.

      • by hey! ( 33014 )

        In 2016. opioid overdoses claimed 64,000 lives. That's like a 9/11 attack every 17 days. It's like terrorists wiping out a city the size of Topeka KS every two years. It's amazing to me that anything else is news while something this big is going on, and our politicians are literally doing nothing about it.

        Oh, last year Congress allocated a billion dollars in block grants to be spent over two years, but I have seen what dropping these kinds of hot potato money bombs on state public health agencies does: i

        • by sjames ( 1099 )

          A real question though is how many of those opoid overdoses happened because users resorted to street drugs of unknown and poorly controlled strength rather than well regulated pharmaceuticals?

    • by pr0fessor ( 1940368 ) on Tuesday January 30, 2018 @10:56AM (#56033201)

      They were shipped to two pharmacies in the small town but is also county seat and has the only hospital in the county. They are forgetting that this town with the only hospital serves other communities inside and outside that county of 26,000+ people.

      • Speaking as a somewhat local, I wish you were correct, but majority of those pills were abused.

        • I'm not local to West Virginia but I do live in a small town that has the only hospital in the county and even for some small towns in neighboring counties it's still the closest hospital. It makes our hospital busy all the time.

      • by hey! ( 33014 )

        They were shipped to two pharmacies in the small town but is also county seat and has the only hospital in the county.

        208 million divided by a population of 26839 is 7750 pills per person.. Over the course of ten years that's two oxycodone doses per day for every man, woman, child and infant in the county, and that's assuming everyone in the county went to the county seat rather than closer pharmacies in adjacent counties, which include several Walmarts.

        There's really no way to make this even close to reasonable. West Virginia has the highest opioid death rate in the country, 52 deaths per 100,0000, but even so there prob

    • by DavidHumus ( 725117 ) on Tuesday January 30, 2018 @12:08PM (#56033787)
      > If I ordered 5000 ampules would anyone notice?

      Well, yeah, now they would. Thanks a lot, West Virginia.

  • Blockchain in the supply chain will fix that. My IBM commercial told me so.
  • by jellomizer ( 103300 ) on Tuesday January 30, 2018 @10:28AM (#56033005)

    Meds Per Person: 22800000.0/2900.0 = 7862.07
    Meds Per Person/Year: 7862.07/10.0 = 786.21
    Meds Per Person/Day: 786.21/365 = 2.15

    Now it is unlikely that the Town is all on these Meds and 2 of these meds a day is very high. I have family suffering from constant pain, and they only use these once a week, in case of extreme pain (And unlike the media, these meds do work), to bring the pain to a manageable level.

    However my main point is the news shoving people with big scary numbers, to really prove a point, but while there is still a problem, the real numbers are not as obvious as the article is lead to believe, as this is over 10 years. Not one big shipment.

    • However my main point is the news shoving people with big scary numbers, to really prove a point, but while there is still a problem, the real numbers are not as obvious as the article is lead to believe, as this is over 10 years. Not one big shipment.

      You are right. Without any comparison with other areas' usage it is impossible to draw any legitimate conclusion. If this rural area has the same drug usage as NYC that would mean one thing, however if all rural areas have statistically similar usage that means quite another.

    • And as I pointed out in more detail further down, Williamson is the only town of any size and thus has some of the only pharmacies in that part of the state, so they're serving a lot more people than just the ~3k inside the technical city limits. I'd guess you're looking at more like a pill or two per person per week once you factor that in. Back of the envelope, you probably can get to numbers like that with a fairly small population of heavy users on top of your normal, legitimate baseline volume.

    • by gweihir ( 88907 )

      There is also the possibility that the town is just 2600 numbers, but that this is the place to go to a pharmacy for significantly more people. The given numbers are dishonest.

    • by Mashiki ( 184564 )

      You're way off. My mom has the nerves in her feet destroyed from diabetes, she takes 50mg 3/daily of long-acting hydromorphone. On top of that she takes 325/5mg acet/oxy upto 5/day for breakthrough pain. This isn't uncommon for people who have severe nerve damage, that's even less then what most cancer patients at stage 2 or 3 take for pain control. Even in my case, I take 50-100mg of tramadol, up to 600mg/daily to control pain from when I broke my back. 600mg is where they switch you to long-acting, an

    • Comment removed based on user account deletion
    • Meds Per Person: 22800000.0/2900.0 = 7862.07
      Meds Per Person/Year: 7862.07/10.0 = 786.21
      Meds Per Person/Day: 786.21/365 = 2.15

      Now it is unlikely that the Town is all on these Meds and 2 of these meds a day is very high. I have family suffering from constant pain, and they only use these once a week, in case of extreme pain (And unlike the media, these meds do work), to bring the pain to a manageable level.

      It always amazes me how many experts there are in how much pain people are in and how much they should be able to tolerate.

      You're wrong.

  • Because it's all relative in West Virginia.
  • If you break down the numbers, it's far less outrageous, but hey, why bother with the math? 20.8 million sounds like a crazy, impossible number, right? 20.8 million over 3650 days and 2900 people is less than 2 pills per person per day. Some people may be taking 4~6 pills a day on a regular basis (not saying that is good, but it is in line with a typical prescription), while others won't have any at all. It doesn't seem that unreasonable, given how opioids are prescribed these days.

    • Yeah, hard math tends to hurt splashy headlines (as well as Congressional investigations looking for a silver bullet/whipping boy).

      On top of that, this part of WV is very sparsely populated and they don't have a pharmacy in every small town. Those pharmacies in Williamson are just about the only ones in that part of WV, so they're serving a much larger regional population than just those in the city limits. Total population in surrounding Mingo County in 2010 was nearly 27k [wikipedia.org]. The numbers start getting rea

      • when you take into account how that part of the country actually operates.

        But why do that, when we elitists in big cities know how to run things better than stupid hicks in WV? That's just a fact!

        (Please note, sarcasm)

      • I tend to be adversarial and will try to break things. A supportive approach when problem-solving tends to just create more problems. Therefor, I would like to hear more about the dynamics of pharmaceutical services in this area of WV, and pursue the hypothesis that this investigation is founded on bullshit.

        Should that line of argument prove indefensible, then we are left with stronger evidence of drug supplier, pharmacist, and prescriber reckless neglect, if not collusion. I'm certain we can deliberat

    • Comment removed (Score:5, Insightful)

      by account_deleted ( 4530225 ) on Tuesday January 30, 2018 @12:49PM (#56034163)
      Comment removed based on user account deletion
      • Given your interpretation of those figures, between 1/3 and half of all people in that county, including the children, are on prescription painkillers.

        That is completely unreasonable, and the story is absolutely right to suggest it's newsworthy.

        Yes, opiods are over prescribed. But not to extent almost half the population is on them.

        There are over 26,000 people in that county, with only one hospital. That hospital is in the town in question.

      • Sure, but how many counties and people does the hospital serve? It doesn't matter how many people are in the county if it's the only hospital in 50 miles.

    • So you are saying that you consider it normal that every
      single person in town takes opiates daily? Must be seriously painful living there. I mean, this is the kind of numbers pallative care facilities would have.

  • This is not a hotbed of economic progress. How are they affording to pay for it?
  • Is it that difficult to guess?
    Try check with delivery and parcel services and you'll get the confirmation.

  • Fake news! (Score:3, Funny)

    by OzPeter ( 195038 ) on Tuesday January 30, 2018 @10:48AM (#56033161)

    This is all the work of criminal latino gangs. These gangs forced the poor people of the great state of West Virginia into the offices of innocent Doctors and coerced those brave and hardworking Doctors into writing prescriptions for the drugs.

    It is only by building a great and yuge wall (the best wall, the most beautiful wall) that we can stop the spread of drugs affecting the little babies all over the country. And today great American companies like Purdue Pharma (real heroes of the economy I tell you) have come out a stated that a wall is the best thing we can do for our country.

    • by gtall ( 79522 )

      Since many of the illicit drugs are shipped from China, we'll be needing a wall there as well. Oh look, they have a nice yuge wall already there across the north. All we need to do is get our lovely construction companies to repair it...we'll charge...err...Mexico for the repair....now where's that fellow Ping's phone number. President Kelly, could you ping Ping for me?

  • by Jfetjunky ( 4359471 ) on Tuesday January 30, 2018 @10:59AM (#56033221)
    Hillbilly heroine (for a reason). My father has been addicted for a good portion of his later life.

    This is part of the reason I can't take people sheltered people seriously when they go off tangents about illicit drugs when people are likely addicted to synthetic opiates all around them. But that's totally fine because it came from a doctor. The older I've gotten, the more the line seems quite arbitrary, which makes it hard to believe in a system of enforcement of any kind.
  • by bobbied ( 2522392 ) on Tuesday January 30, 2018 @11:07AM (#56033275)

    The town's population is 3,100. This city is the largest city in the county which has a population of about 30,000.

    Surely these pills didn't get distributed only to those living in the city.... So Why do we discuss the size of the town only and not the county which the pharmacies obviously serve too? I'm pretty sure more than just city folks get their prescriptions filled in town.

    Somebody is being misleading here....Very misleading. I think on purpose.

    • Oh thank god. For a moment I thought the entire population was popping 2 pills a day rather than the entire population popping a pill every 5 days. I'm glad you cleared that up.

  • Community size (Score:3, Interesting)

    by Dan East ( 318230 ) on Tuesday January 30, 2018 @11:16AM (#56033325) Journal

    WV is a neighboring state, and I happen to know a good bit about its demographics. WV has extremely rural areas - one county has a few dozen zip codes and some only have a hundred people in them, and the entire county only has around 10k people (and it is not a huge county geographically). The fact that the exact town the pharmacy is in only has 2,900 people does not mean those are the only people served by that pharmacy. It may serve the entire county and portions of the adjoining counties as well. The number is very, very deceiving if intended to represent the total customer base of those pharmacies.

    • Re:Community size (Score:5, Informative)

      by DavidHumus ( 725117 ) on Tuesday January 30, 2018 @12:32PM (#56034015)
      Interesting how many of the comments here are fighting the numbers. It's not like West Virginia leads the nation in drug-related deaths - oh, wait, they do:

      In 2016, the five states with the highest rates of death due to drug overdose were West Virginia (52.0 per 100,000), Ohio (39.1 per 100,000), New Hampshire (39.0 per 100,000), Pennsylvania (37.9 per 100,000) and (Kentucky (33.5 per 100,000).

      [https://www.cdc.gov/drugoverdose/data/statedeaths.html]

      But that's probably a big coincidence.

  • It's only good for 20 years for all residents. Not enough.
  • by Joe_Dragon ( 2206452 ) on Tuesday January 30, 2018 @11:25AM (#56033399)

    coal miners are in pain and work rules say no to Medical Marijuana

  • I did the math...that's 7,172 pain pills per person, if every single resident was gobbling them down at ~20 pills a day.

    But there's nothing to see here, no siree, just move along. And whatever you do, don't say anything bad about the Sackler family, who almost single-handedly created this problem by deceptively marketing these opioids as being safe and manageable.

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