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  1. RxCowboy

    The Ocasio-Cortez Thread

    As a general statement, "Local guitar shops are better than GC" yes, I'll fight about it, because GC has a much better selection than you're going to find in the vast majority of local guitar shops. If we're talking about specific local guitar shops and specific GCs, then there isn't much to...
  2. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    Which is exactly what we thought about tramadol when it first came on the market. My guess is that anything that acts at opioid receptors is going to cause all the problems of any other opioid, which is kind of the point of the conversation.
  3. RxCowboy

    Tweet of the Day

    Caution, NSFW:
  4. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    Probably because of the GI symptoms. The synthetics don't make people as sick from a GI standpoint. Just to point out, steross, "less likely to cause" and "currently causes fewer" are two different things. The former is a function of the pharmacology/pharmacodynamics, the latter is a function...
  5. RxCowboy

    Tweet of the Day

    Not buying it for a second. Playful dogs don't rip arms off.
  6. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    What I mean is that as heroin use became more common then heroin overdose became more common. As kratom use becomes more common kratom overdose will become more common. Codeine overdose isn't common because codeine abuse isn't common. People overdose on fentanyl because they often don't know...
  7. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    People aren't taking equipotent doses yet. It's just a matter of time. People didn't become addicted to tramadol when it first came onto the market, either. It took time for us to realize that it actually had that potential. But now we know it's true. People do not start out taking lethal doses...
  8. RxCowboy

    Tweet of the Day

    My grandma picked cotton in Arkansas.
  9. RxCowboy

    Tweet of the Day

  10. RxCowboy

    Tweet of the Day

    If you're talking about Beto, he calls himself a capitalist, but then he supports all the ultra-leftist stuff.
  11. RxCowboy

    Dumb/Sometimes LOL Political Pictures

    That's about the size of it. It is amazing at how quickly the small amount of power she has went straight to her head.
  12. RxCowboy

    Dumb/Sometimes LOL Political Pictures

    It just hasn't been done right yet...
  13. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    There are restrictions on buying Everclear, are there not? Still have not heard a lucid reason why kratom would not cause respiratory depression and addiction.
  14. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    Why would it be better than heroin? It acts at the same receptors to produce the same effects. Tramadol has taught us that an opioid is an opioid, regardless of the chemical structure.
  15. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    Which is clinically irrelevant. We convert equi-analgesic dosages between opiates all the time. Morphine is mg per mg more potent than codeine, but if you give 6.7 mg of codeine you have the equivalent of 1 mg of morphine. Fentanyl 1 mcg is equal to morphine 2.4 mg. Take enough of the kratom...
  16. RxCowboy

    Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality

    Not a problem, this is my area of expertise. I enjoy talking about it.
  17. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    So, @StillwaterTownie , I ask again, kratom acts at opioid mu receptors. Mu receptors are responsible for causing respiratory depression which is what causes death in opioid overdose. Why would kratom be any safer than anything else that acts at opioid mu receptors. Please back up what you say...
  18. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers - United States, 2010-2015. Anwar M1, Law R, Schier J. MMWR Morb Mortal Wkly Rep. 2016 Jul 29;65(29):748-9. doi: 10.15585/mmwr.mm6529a4. Abstract Kratom (Mitragyna speciosa) is a plant consumed throughout...
  19. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    A drug fatality involving Kratom. Neerman MF1, Frost RE, Deking J. J Forensic Sci. 2013 Jan;58 Suppl 1:S278-9. doi: 10.1111/1556-4029.12009. Epub 2012 Oct 19. Abstract A 17-year-old white man who showed no obvious signs of trauma was found unresponsive in bed and was pronounced dead at the...
  20. RxCowboy

    Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis

    From NEJM: Deaths in Colorado Attributed to Kratom N Engl J Med 2019; 380:97-98 DOI: 10.1056/NEJMc1811055 TO THE EDITOR: Kratom (Mitragyna speciosa) is an herbal drug identified by the Food and Drug Administration (FDA) as an opioid for which there is “no evidence of safety or effectiveness...