Due Diligence: Habit forming medications
<p>What responsibility do patients have to make informed decisions?</p>
<p>Opioids are known to be <a href="https://en.wikipedia.org/wiki/Opioid_use_disorder" rel="nofollow noreferrer">habit forming</a> throughout <a href="https://en.wikipedia.org/wiki/First_Opium_War" rel="nofollow noreferrer">history</a>.   Given the context of Purdue's Oxycontin.</p>
<p>Let us assume this <a href="https://www.addictioncenter.com/news/2021/12/purdue-bankruptcy-settlement-overturned/" rel="nofollow noreferrer">statement</a> is true:</p>
<blockquote>
<p>Purdue Pharma still led healthcare providers to believe that the
Opioid was a non-habit-forming solution to help patients manage their
pain safely.</p>
</blockquote>
<p>Let us also assume that <a href="https://%E2%80%9CWARNING:%20May%20be%20Habit%20Forming%E2%80%9D%20%20%E2%80%9COxyContin%20is%20a%20mu-agonist%20with%20an%20abuse%20liability%20similar%20to%20morphine,%20and%20is%20a%20Schedule%20II%20controlled%20substance.%E2%80%9D%20%20%E2%80%9COxycodone%20products%20are%20common%20targets%20for%20both%20drug%20abusers%20and%20addicts.%E2%80%9D%20%20%E2%80%9CPatients%20should%20be%20advised%20that%20OxyContin%20is%20a%20potential%20drug%20of%20abuse.%20%20They%20should%20protect%20it%20from%20theft,%20and%20it%20should%20never%20be%20given%20to%20anyone%20other%20than%20the%20individual%20for%20whom%20it%20was%20prescribed.%E2%80%9D%20%20%E2%80%9CPhysicians%20should%20be%20aware%20that%20psychological%20dependence%20may%20not%20be%20accompanied%20by%20concurrent%20tolerance%20and%20symptoms%20of%20physical%20dependence%20in%20all%20addicts.%20%20In%20addition,%20abuse%20of%20opioids%20can%20occur%20in%20the%20absence%20of%20true%20psychological%20dependence%20and%20is%20characterized%20by%20misuse%20for%20non-medical%20purposes.%E2%80%9D" rel="nofollow noreferrer">Oxycontin bottles are labeled</a>:</p>
<blockquote>
<p>“WARNING: May be Habit Forming”</p>
<p>“OxyContin is a mu-agonist with an abuse liability similar to
morphine, and is a Schedule II controlled substance.”</p>
<p>“Oxycodone products are common targets for both drug abusers and
addicts.”</p>
<p>“Patients should be advised that OxyContin is a potential drug of
abuse.  They should protect it from theft, and it should never be
given to anyone other than the individual for whom it was prescribed.”</p>
<p>“Physicians should be aware that psychological dependence may not be
accompanied by concurrent tolerance and symptoms of physical
dependence in all addicts.  In addition, abuse of opioids can occur in
the absence of true psychological dependence and is characterized by
misuse for non-medical purposes.”</p>
</blockquote>
<p>Did patients have any responsibility to research / read labels and understand the risk associated with opiates?</p>

<p>The question of a patient's legal responsibility would arise under a negligence lawsuit, where the patient &quot;should have known&quot;. The standard for determining what things a person &quot;should have known&quot; is fluid, but obviously you can start with &quot;could have known&quot;. If a patient's can't know a fact, they cannot be said to have negligently contributed to the damage. Doctors are given these warnings, but patients are not, uniformly. It is therefore possible that a patient was never warned of the effects of an opioid prescription (I can personally attest to that lacuna in the system). Your assumption about the bottle being so labeled is only valid for the original supply bottles from which the pharmacist dispenses.</p>
<p>However, there is also a rather compelling argument to the effect that no person in the US can in fact be unaware of the addiction risk of opioids. It is a defeasible argument, possibly applicable to a hypothetical person who has lived in complete isolation for decades.</p>
<p>A patient is not required to undertake independent research in order to validate the science that underlies statutorily-mandated FDA approval or drugs, instead, the burden is assigned to the manufacturers and distributors (primarily doctors and pharmacists) to convey the relevant information. Thus HR 1026 would, if enacted, mandate a different warning. But the bill does not assert a lack of liability on either side, therefore the question reduces to the &quot;simple&quot; matter of determining if a person knew or should have known.</p>

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