1-ribboncryingeyevoteFirst they came for the mentally ill addicts, and I did not speak out—
Because I was not a mentally ill addict.

Then they came for the empathetic prescribers, and I did not speak out—
Because I was not an empathetic prescriber.

Then they came for the Pharmacists, and I did not speak out—
Because I was not a Pharmacist.

Then they came for me—and there was no one left to speak for me



Head of FDA (Doctor) doesn’t know that opiate addiction IS A DISEASE ?

Robert CaliffFDA’s Opioids Action Plan: A Midyear Checkup


By: Robert M. Califf, M.D.

As FDA works to address the opioid epidemic of abuse, misuse and addiction, it’s valuable to see firsthand some of the ways the crisis is affecting our communities.

This summer, I toured areas hard-hit by the opioid crisis in Tennessee, West Virginia, and Kentucky, visiting  with survivors of opioid addiction and overdose as well as community activists, government officials, and health care providers, all of whom are working diligently and creatively to address and overcome this crisis.

My visit to the nationally-recognized neonatal intensive care unit at East Tennessee Children’s Hospital was deeply moving and set the stage for the rest of my tour and underscored the urgency of fighting this epidemic. More than a third of the babies admitted to the NICU have neonatal opioid withdrawal syndrome (NOWS), a condition which can be life-threatening if not recognized and treated

Watching a nurse treat a fretful baby suffering from NOWS underscored the complexity of the opioid problem.  Many women taking opioids haven’t planned their pregnancy, don’t immediately know they are pregnant and may not be aware of the risk that opioids pose to their unborn child. This includes those women who are taking medication as part of medication-assisted treatment (MAT) which also includes counseling and behavioral therapies. For women on MAT, the risk of NOWS must be balanced against the additional dangers of untreated opioid addiction during pregnancy.

How best to prevent NOWS and treat opioids use disorder was a continued theme of my trip, and among the issues we grappled with during a roundtable at the University of Tennessee’s Medical Center hosted by Surgeon General Vivek Murthy, who is traveling the country to discuss solutions to opioid abuse as part of his TurnTheTideRx campaign. I’m pleased that expanding access to and the use of evidence-based MAT is a key focus area for the Administration, is a part of the HHS-wide opioid initiative, and is an approach supported by a recent FDA advisory committee.

In Charleston, WV, I met with several patients who are reclaiming their lives with the use of MAT including “Dave.” Like so many others, Dave became addicted to opioid pain medication after being treated for an injury. As a result of his addiction, his marriage failed and he lost contact with his children. But with treatment, he has reunited with his family and next spring will graduate from college and hopes to taper off of his treatment.

Throughout my tour, I heard that opioid education – including training during medical school and residency and greater public awareness far and wide – is a key component in fighting the opioid epidemic. At a roundtable in Charleston, Gov. Earl Ray Tomblin and U.S. Sen. Joe Manchin singled out their state’s model mandatory education program for prescribers and they told me the state is leading an effort to implement the CDC’s Guideline for Prescribing Opioids for Chronic Pain as a best practice for their state-run Medicaid program.

At a firehouse in the town of Williamson, WV, I met with those on the frontlines of the opioid epidemic – the firefighters and first responders who carry life-saving naloxone to help reverse an overdose. They told me more education about naloxone was needed and told me that they appreciate our efforts to help make naloxone more available to the general public.

My last stop this summer was to Kentucky where I toured the emergency room at the Pikeville Medical Center and participated in a roundtable with physicians, pharmacists, and state policy and community leaders brought together with the help of the regional organization Operation UNITE. UNITE coordinates treatment for those with substance use disorder as well as support for their families and friends, and educates the public about the dangers of drug use. These measures, combined with a recent state law requiring prescribers to register with a prescription drug monitoring program are working, we were told.

Throughout my travels, I listened and learned more about how FDA can help end this crisis. I also had the chance to share what FDA has been doing this year to implement a multipart plan to address the opioid epidemic.

Our milestones so far include:

  • Developing warning and safety information for immediate release opioids and requiring that prescription opioid analgesics and opioid-containing cough product labels include strengthened warnings about the risk of using benzodiazepines at the same time.
  • Working to better understand the long-term safety of using extended release/long acting opioids. Sponsors must now conduct a number of studies to generate postmarket data on these products.
  • Issuing draft guidance for industry to support the development of generic versions of approved opioids with abuse-deterrent formulations.
  • Seeking advice from the National Academy of Science Engineering and Medicine on how to balance both the needs of patients with pain and the need to address opioid misuse and abuse.
  • Supporting increased access to naloxone; for instance, by awarding a contract to conduct consumer behavior studies based on model product labeling for a potential OTC version of the antidote and by launching a competition to create a mobile app that could help find the closest available naloxone treatment in an emergency.
  • Approving the first implantable treatment for the maintenance treatment of opioid dependence.

The community-based successes I observed on my three-state tour reinforced my view that we are making important progress in addressing this crisis.  But continued hard work, creative ideas, and collaboration — across government, with the medical profession, health care providers, industry, and, most importantly, patients and their families, is still required.

We at FDA will continue to work with all of these groups, using all the resources at our disposal, to improve the judicious and responsible use of opioids and to help bring an end to this epidemic.

Robert M. Califf, M.D., is Commissioner of the U.S. Food and Drug Administration


Montgomery pharmacist facing malpractice suit

Montgomery pharmacist facing malpractice suit


A Montgomery pharmacist is facing legal action for allegedly revealing her customers’ private information.

The Alabama State Board of Pharmacy has also taken action against pharmacist Dee Parks.

According to court documents, Parks is the focus of a civil malpractice suit for allegedly giving patient information to a third party.

Attorney Virginia Lucci says Parks issued a lease to one of Lucci’s client. On the back of the lease were three dozen patients of Parks Pharmacy, along with their prescription information, doctor’s name and doctor’s number.

Lucci says it appears Parks decided to print the lease on the blank side of a paper that had been used for her pharmacy’s dispensing report log.

“The HIPAA law was created so that people wouldn’t know what kind of medication you are on. It’s an invasion of privacy,” Lucci said.

In the wrong hands, Lucci believes more than just HIPAA laws could have been violated. She says many of the prescriptions are controlled substances like hydrocodone.

“That information out there, it’s real easy to track these folks down. A lot of these people are older and could become targets for crime to steal their medication,” Lucci said.

Emily Nichols with the Attorney General’s Office says although personal information that can be used in identity theft, like social security numbers, wasn’t compromised, this still should serve as a reminder to be more careful.

“Keep an eye on things like our credit reports, credit card statements, prescriptions. Make sure when we go to the pharmacy to pick up a prescription, there’s not multiple prescriptions in our name. If you are there to pick up one and they say there is two here, find out why there is two there in your name. Be sure to ask questions,” Nichols said. “So many people are hesitant or shy about asking questions and being up front about their own identity and their information. There is no reason that you need to be shy about asking questions.”

We reached out to Parks for a comment, and she said she is waiting for her day in court.

After several violations from a different case, including operating a pharmacy without a permit, not having a valid DEA registration and State Controlled Substances registration, storing drugs in a warehouse and not in a pharmacy, the State Board of Pharmacy suspended Parks license to practice pharmacy and state controlled substance permit for five years.

One more reminder when it comes to protecting your personal information, the Attorney General’s Office advises you never to leave your mail sitting out in public view and invest in a shredder to destroy documents that you might have otherwise just tossed into the trash. 

Obamacare increases from NEGATIVE 14% to 145% INCREASE – depends on where you live

Feds: Most states to see steep ObamaCare rate hikes



The price of the most popular plan under ObamaCare will increase by an average of 25 percent on the federal marketplace next year, according to data released Monday.

This year’s increase — which is more than triple that of last year’s — is the sharpest jump yet since the launch of HealthCare.gov. 

The premium hikes will directly hit the 16 percent of people with ObamaCare plans who do not currently receive subsidies. The rest will be shielded from most or all of those price increases by ObamaCare subsidies, which increase alongside the rising premiums.

About 260,000 people could also become newly eligible for those subsidies, the administration said. About 22 percent of the 1.3 million people who currently buy ObamaCare plans without subsidies could qualify for subsidies next year.

Rates will vary widely by state, with steeper price hikes in rural areas like Arizona, which is facing a 116 percent. Indiana, however, will see a 3 percent decline. 

Despite the headlines, about 7 in 10 people will have ObamaCare plans available that cost $75 or less per month, according to the administration’s new report on the 2017 marketplace. The report includes data from the 38 states relying on HealthCare.gov.

In a call with reporters on Monday, officials with the Obama administration stressed that the new numbers don’t reflect what most people will end up paying.

“We think [consumers] will ultimately be surprised by the affordability of the product,” said Kevin Griffis, assistant secretary for public affairs for the Department of Health and Human Services (HHS).  

Griffis said most people on ObamaCare will see below-average increases, pointing to the median premium increase of 16 percent across plans — far lower than the 25 percent average.
Some states, such as New Hampshire and New Jersey, will see premium increases of 5 percent or less. The nation’s largest marketplace, California, is reporting just a 7 percent increase. That figure is not included in the federal marketplace average because the state runs its own marketplace, however.
Still, the price increases for some ObamaCare marketplaces are likely to become new fuel for the GOP’s attack against the healthcare law in the final two weeks before Election Day.

The White House’s report was released the same day as data from the Kaiser Family Foundation, which found that the cost of a benchmark plan will rise 145 percent in Phoenix, Ariz., to $507 per month for an average 40-year-old person.

That same plan will increase 71 percent in Birmingham, Ala., and Oklahoma City, Okla.

In other parts of the country, however, the cost of premiums is actually decreasing for people on the ObamaCare exchanges — even without subsidies.

Kaiser found that unsubsidized premiums in Providence, R.I., will drop 14 percent, to $286 per month, for a 40-year-old person. Indianapolis will see a 4 percent decline, and Cleveland will see a 2 percent drop.

Overall, the administration said this year’s premium increases will more closely match what the Congressional Budget Office (CBO) had initially estimated under the law.

“With these adjustments, premiums will end up roughly in line with the initial CBO projections,” Griffis said.

Republicans have fought back against that line, arguing that the 2010 projections also included far more people enrolling in the marketplaces to help offset the cost of the extra subsidies. About 10.4 million people were enrolled as of earlier this year, about half of the 21 million people initially projected to sign up by the CBO.

Switching plans could also save ObamaCare customers money, according to the report.

ObamaCare customers receive subsidies based on the second-lowest-cost silver plan available, and because that benchmark can change, they are encouraged to manually check for cheaper plans in their tier each enrollment period.

If every customer signed up for their cheapest option, the average premium would be about 20 percent less, the report states.


If you flood the streets with opiates the DEA has more bodies to arrest ? JOB SECURITY ?

Obama Floods US with Opioids; Kills DEA Enforcement Program


Looks like all of these attorneys from Obama/Holder on down… are more interested in job security for the DEA than anything else. Remember, Holder left office being held in contempt of Congress… there has been THREE MEMBERS of the Obama administration and/or affiliated with the Democratic Party/Clinton https://en.wikipedia.org/wiki/Contempt_of_Congress  that still have the charge of CONTEMPT OF CONGRESS  against them and no legal actions taken against them.

But the information in this article along with what we know about all those chronic pain pts having their opiates cut back or discontinued and/or their prescribers being charged with fabricated charges and hundreds or thousands of pts being “thrown to the street”.. and some have committed suicide or started using “street drugs”… and now we have so many ODing because of Acetyl Fentanyl or Carfentanyl being mixed with street Heroin and the DEA does not seem to be capable of stop the importing of these very lethal drugs into our country and on to our streets.

If you read/listen to all the DEA press releases it FOCUSES on all the OD DEATHS… which it seems that they may be the root cause of people being forced to turn to “street drugs” ?


Americans are dying from overdoses of opioid-based pain killers at alarming rates, and Obama is to blame. Since assuming office, he has acted to protect the producers and distributers, by hand-cuffing the Drug Enforcement Agency (DEA) in their enforcement efforts. An investigative report by the Washington Post over the weekend gives the details of how this happened.

Since 2000, deaths from opioids have increased steadily — overtaking those from drunk driving around 2010 — with over 14,000 people dying in 2014 (the last year which the CDC has posted statistics, which do not include deaths from heroin overdoses). The Post, as part of a series highlighting the human side of this new opium war, produced an investigative report on the take-down of enforcement efforts, begun shortly after Obama entered the White House. (In their coverage, the Post staff can’t bring themselves to actually name Obama, only mentioning (pot) Holder once, and this article, while appearing in print on Sunday, October 23, was not featured on the home page of their wider-circulation website.)

As the death-rate increased, in 2005 the DEA created the Office of Diversion Control (ODC), targeting the “diversion” of legally-produced drugs to the black market, focusing on the distributers, the middle-men between the producers and the pharmacies. After winning their first case against a small California distributer — eventually forcing it out of business — the ODC set its sights on two “biggies,” the Fortune 500 companies of McKesson and Cardinal Health. In 2008, the DEA won a $13 million conviction against McKesson, followed by a $34 million case against Cardinal Health. In 2010, according to court records, the agency had filed 115 “charging documents,” including 52 immediate suspension orders. That’s when the trouble began.

According to Joseph Rannazzisi, director of the ODC in 2011, the DEA was on the verge of going to court with what he called “the case of my dreams” — targeting Cardinal Health for huge over-shipments to four Florida pharmacies, including two CVS stores — when he received “an unexpected phone call” from James H. Dinan, then Eric Holder’s no. 2 man, chief of the Organized Crime Drug Enforcement Task Forces program at the DOJ (the official “parent” of the DEA). Eventually, Rannazzisi was summoned to a February 2012 meeting, where some of the administration’s highest enforcers — including Dinan; then-Deputy Attorney General James Cole; his chief of staff, Stuart Goldberg; and DEA chief counsel Wendy Goggin — just short of Obama, himself, tried to force him to cease and desist in his case against Cardinal Health.

While CVS was eventually forced to pay a $22 million fine in this case, Cardinal Health, although settling, has not been fined. For his tenacity, Rannazzisi lost his job in 2015. The Post says that court records have now identified 13 companies which “knew or should have known that hundreds of millions of pills were ending up on the black market.” Total filed cases began dropping immediately in 2011, and “surrender of licenses” which held steady through 2015, have dropped by 30% so far this year.

Assisted suicide being ENCOURAGED by INSURANCE COMPANY rather than TREATMENT ?

http://i1.wp.com/thefederalistpapers.integratedmarket.netdna-cdn.com/wp-content/uploads/2016/10/stephanie-packer.jpg?resize=300%2C157Insurance Company Would Rather Stephanie Packer Die Than Pay For Her Cancer Treatment


This is what leftist medicine has wrought:

A terminally ill woman in California had coverage for her chemotherapy treatment denied by her insurance company, but they’ll gladly pay for her to commit suicide.

The new California law permits physician-assisted suicide, and as a result, it appears that insurance companies have found a great cost-saving measure: kill their sickest patients.

Stephanie Packer, a wife with four children, was diagnosed with a terminal form of scleroderma. She said her insurance company initially told her it would cover but switching to a different chemotherapy drug at the advice of her doctors, The Washington Times is reporting.

For a while, five months or so, we’ve been trying to get me on a different chemotherapy drug for the infusions, because my doctor felt that it would be less toxic than some of the other drugs that we were going to be using,” Ms. Packer said in a video distributed by The Center for Bioethics and Culture Network on Monday.

But shortly after California’s “End of Life Option Act” went into effect – authorizing doctors to diagnose a fatal dose of medication with a prognosis of six months or less to live, Packer’s insurance company quickly reversed themselves and denied the request:

“And when the law was passed, it was a week later I received a letter in the mail saying they were going to deny coverage for the chemotherapy that we were asking for,” Ms. Packer said.

She said she called her insurance company to find out why her coverage had been denied. On the call, she also asked whether suicide pills were covered under her plan.

“And she says, ‘Yes, we do provide that to our patients, and you would only have to pay $1.20 for the medication,’” Packer said.


Packer said the doctors have twice appealed the decision, but to no avail. The new assisted-suicide law creates a huge incentive for insurance companies to deny expensive drugs to terminally ill patients. The cheapest option is to kill them.

All of this comes as other states and areas are considering their own “assisted suicide” bills. Oregon has a “Death with Dignity” act, and the D.C. City council is considering permitting physician-assisted suicide.

After the right-to-die movement began garnering national attention, Ms. Packer said she noticed a change in tone at her support groups for terminally ill patients. While the meetings were formerly positive and encouraging, she said the specter of suicide now hangs above them like a dark cloud.

“And people, once they became depressed, it became negative, and it started consuming people,” she said in the video. “And then they said, ‘You know what? I wish I could just end it.’”

Heroin Boom: Afghanistan Producing 25 Times More Opium Since U.S. Invasion

Heroin Boom: Afghanistan Producing 25 Times More Opium Since U.S. Invasion


The estimated opium poppy plant production and its cultivation area in Afghanistan have increased more than 25-fold over the course of the ongoing war in the country to 4,800 metric tons and 201,000 hectares (ha), respectively, according to the United Nations.

Meanwhile, eradication efforts appear to have collapsed this year despite the estimated $8.5 billion in American taxpayer funds that the United States has already spent on anti-narcotics measures in Afghanistan since the war started in October 2001.

Each year, the UN Office on Drugs and Crime (UNODC) issues the Afghanistan Opium Survey to show production and cultivation trends of the deadly drug in the country, considered the world’s top producer of opium and its heroin derivative.


“The potential opium production in 2016 might be an underestimation,” acknowledges the UNODC, noting that it had to rely on satellite images to calculate estimates due to the worsening security conditions in top opium-producing regions.

According to the latest UN survey, since the U.S. invaded Afghanistan on October 7, 2001, the area under opium cultivation has increased nearly 25 times from 8,000 ha in 2001, when the ruling Taliban regime had imposed an opium ban across the country, to 201,000 ha this year, which is equivalent to an area more than 11 times the size of Washington, D.C.


Both the increase in cultivation area and the decrease in eradication efforts were attributed to deteriorating security conditions across the country. Taliban jihadists, who use proceeds from the sale of opium and heroin to fund their terrorist activities, are primarily responsible for the crumbling security conditions in Afghanistan.


Meanwhile, estimated opium production shot up to 4,800 metric tons in 2016, from 185 tons when the U.S. invaded. The dramatic increase in opium production is reportedly not only the result of a larger area under cultivation but also due to the higher opium yield per hectare.

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Opium production and cultivation have increased dramatically since 2015 alone, notes the latest survey. The UN reports that estimated production jumped 43 percent and cultivation rose 10 percent this year compared with 2015 levels.

Areas under cultivation this year marked the third-largest in two decades, following historic highs in 2013 and 2014.

UNODC Executive Director Yury Fedotov indicated that the most recent survey shows “a worrying reversal in efforts to combat the persistent problem of illicit drugs and their impact on development, health and security.”

Eradication efforts appear to have disappeared this year with an area of 355 ha uprooted, marking a 91 percent drop when compared to 3,760 ha in 2015.

Most (54 percent) of the opium in Afghanistan is cultivated and produced in southern provinces that border Pakistan and have historically been Taliban strongholds, namely Helmand and Kandahar, the deadliest provinces for U.S.-led coalition forces of the ongoing war.

Opium is cultivated and/or produced in nearly two-thirds (21) of the 34 provinces that make up Afghanistan, the UN reveals.

U.S. government officials maintain Afghan heroin is not fueling the growing heroin overdose epidemic taking American lives on a daily basis in the United States.

In June, the DEA reported, “In 2014, 10,574 Americans died from heroin-related overdoses, more than triple the number in 2010.”

In its latest National Drug Threat Assessment, the DEA notes that only a small portion of Afghan heroin makes it into the U.S., smuggled primarily by Nigerian traffickers on commercial airlines.

In 2012, the latest year for which data is provided, Afghan heroin reportedly accounted for about four percent of estimated total weight of heroin seized in the United States.

The DEA acknowledges that most of the heroin flowing into Canada primarily originates in Afghanistan, but it maintains that Mexico and “to a lesser extent Colombia” are the top providers of the fatal drug in the United States.

Nevertheless, the White House and other government agencies have sounded the alarm on the Afghanistan heroin going into Canada, suggesting it may be flowing into the U.S.

Some American soldiers in Afghanistan have been investigated “on suspicion of using or distributing heroin, morphine or other opiates during 2010 and 2011,” the Associated Press (AP) pointed out in 2012.

Pentagon data analyzed by Breitbart News shows the number of U.S. service members testing positive for heroin has increased over the course of the war in Afghanistan.

In December 2014, the U.S. Special Inspector General for Afghanistan Reconstruction (SIGAR), reported that some U.S. taxpayer-funded reconstruction efforts, “such as improved irrigation, roads, and agricultural assistance,” may have contributed to the booming opium trade in Afghanistan.

In 2014, the DEA drug threat assessment shows, Mexico produced an estimated 42 metric tons of heroin. Afghanistan produced 6,400 metric tons of opium that same year.

Only ONE PERCENT of trauma pts are still taking opiates ONE YEAR LATER

If You’re Prescribed Opioids after Injury or Surgery, Will You Become Dependent?


We’ve all seen the massive media attention on the opioid epidemic and as the dust settles and changes are made to how opioids are viewed, we are left with a few takeaways.  One of them is that if someone is injured or has had surgery, prescribing opioids is a bad thing because many will become dependent.

A new study presented at the American College of Surgeons refutes this notion, reporting that up to one year after discharge from the hospital, only about 1 percent of trauma patients were reportedly still taking prescription opiates, or opioids, such as hydrocodone, oxycodone, morphine, and fentanyl.

“Our findings in patients who sustain traumatic injury contradict the popular narrative about the role that appropriate use of opioids may play in the rate of opioid abuse in this country,” said senior investigator Andrew Schoenfeld, MD, an orthopaedic surgeon at Brigham and Women’s Hospital and assistant professor at Harvard Medical School, Boston.


This new study is one of the largest investigations of prescription opiate use among patients who sustained trauma and may have the longest continued follow-up one year after hospital discharge.

Their research was conducted using the 2007 to 2013 database of TRICARE, the Department of Defense health care system that insures active-duty military, reserve members, retired veterans, and their dependents. Because most TRICARE plan members are currently civilians, Dr. Schoenfeld said the study findings are generalizable to the U.S. population.

Included in the study were patients aged 18 to 64 years whose injuries were severe, as indicated by an Injury Severity Score of 9 or higher.  Patients with major trauma could be expected to receive opiate prescriptions after their hospitalization.  In all, 15,369 patients were included and none of the patients had filled an opiate prescription within six months before their injuries.

Although more than half of the patients in the study, or 8,282, filled at least one opiate prescription soon after discharge, only 8.9 percent (1,371 patients) continued to fill opiate prescriptions three months later, the investigators reported.  Continued prescription opiate use reportedly dropped to 3.9 percent (597 patients) at six months and 1.1 percent (175 patients) at one year.

“We were really surprised by how low the numbers were for long-term opiate use,” Dr. Schoenfeld said.  “It appears that traumatic injury is not a main driver for continued opioid use in patients who were not taking opioids prior to their injuries.”

To identify predictors of continuing use of prescription opiates after hospital discharge, the researchers evaluated patients’ demographic and medical factors and found increased risk of continued opioid use among the following:

  • Patients ages 45 to 64 compared to those 18 to 24.
  • Lower socioeconomic status
  • Those who are married (although these finding probably cannot be generalized to the U.S. population, according to Dr. Schoenfeld, because military families tend to marry earlier than civilians do.)

“We wish to emphasize that health care providers should not withhold opiate painkillers because a patient has any of the identified risk factors from this study,” Dr. Schoenfeld said.  “At-risk patients can benefit from closer follow-up with their health care providers and, for those at high risk, a referral to the hospital’s pain management service.”

The study results were presented at the 2016 Clinical Congress of the American College of Surgeons.

Healthcare is just a business and “bodies” are just a revenue stream

The time a 28-year-old MBA told a physician where to round first


The last couple of decades have seen a dramatic shift of power and clout away from individual physicians and towards administrators and the business side of health care. In many ways, physicians have nobody but themselves to blame collectively; because for any large and respected group of people to surrender so much autonomy so quickly, a lack of strong leadership must always be a factor.

So many different reasons for this sea change can be discussed, but the consequences are very palpable. To name but a few, we’ve seen the relentless push towards consolidation and mass employment of physicians, a rise in mandates and bureaucratic requirements, and a general explosion in the number of administrative folks while the number of physicians appears to be shrinking! Then there’s the more subtle changes that the medical profession has also allowed to happen right under their noses, such as the refusal of many in the hierarchy to even call doctors by their true job title anymore — instead labeling them only as “providers” (a subject I’ve written about including an open letter to the AMA and all State Medical Boards).

Speaking as someone who maintains a large network of physician friends and colleagues across the country, some of the stories I’ve heard about what happens nowadays are astonishing. Fortunately, after a few bad experiences, I’m now part of an organization where the relationship between physicians and administrators is probably as good as it can be. But from what I see, this is a rarity.

I relate one recent story in particular. I have a very close friend in the Midwest who is quite a brilliant doctor. He went to a top US medical school and got stellar USMLE scores.  I’ve known him for years and am proud to have trained with him. He is sub-specialty board certified, but decided to practice hospital medicine.

He told me that his group, which is essentially run by non-clinicians, is completely (and unsurprisingly) focused on the bottom line only. Administrators aggressively monitor their physicians’ whereabouts and try to review all of their patient interactions (mostly how it pertains to billing). To cut a long story short, he told me that the administration for some reason or another wanted him to round first on a particular floor. He didn’t think it was the right thing to do for patient care (apparently another floor frequently had patients who required closer and more immediate attention), and it culminated in him basically being scolded by a 28-year-old MBA who informed him that he had to round on that particular floor first, like it or not. Needless to say, he didn’t take too kindly to this interaction and that particular experience persuaded him that the time was right to move on.

This story bothered me on multiple different levels, as I’m sure it would any self-respecting physician. First and foremost, how did the medical profession surrender so much to the business of medicine that a situation like this could happen? I wonder what our more esteemed colleagues in perhaps their 50s and 60s would have done twenty years ago if a 28-year-old MBA had dared tell them where to round first? Secondly, how did that young man feel so empowered to scold a highly qualified physician and feel so convinced that “he was the boss”? And thirdly, perhaps most worryingly, is this the future of medicine in the United States? If so, is there any way that physicians can wrestle back a bit of control over their own profession to avoid situations like this becoming the norm? Because if we can’t, and the practice of medicine is no longer led by doctors, it’s not only the doctors who lose.

Patients will too.

DEA’s Latest Ban Plan: Kratom

DEA’s Latest Ban Plan: Kratom


Kratom is an unusual, natural substance consumed in Asian countries including Thailand and Malaysia, since the early 1800s, to help treat anxiety and depression, alleviate fatigue, promote strength, relieve chronic pain, PTSD symptoms, diarrhea and combat lack of energy.

Kratom – thom, biak, ketum, kakuam or thang –  is mostly consumed orally in gel capsule form, but its leaves (from kratom trees) can also be crushed and chewed, smoked or brewed with tea. At low doses, it has a similar, stimulating effect one would get from drinking a strong cup of coffee. At higher doses it is a powerful sedative and painkiller, and arguably an addictive one.


Because of claims the substance can be addictive and abused, the US Drug Enforcement Administration (DEA) announced they intend to make Kratom a Schedule I drug – grouped with LSD, heroin, marijuana, and ecstasy.

Around the same time last month, the US Food and Drug Administration (FDA) alerted the public that it will be detaining supplements that contain Kratom without any physical examination.

The federal agencies are yet to evaluate the substance but claim there’s no legitimate medical use for Kratom in the United States, and that it has caused psychosis, hallucinations and other dangerous side effects in its users.

The DEA also linked 15 deaths to the use of Kratom in the last two years, but 14 of those 15 people who died also had other drugs in their systems. That’s a very small number when you take in consideration millions of doses are being consumed regularly around the US. The number of people who allegedly died after consuming Kratom doesn’t even come close to the number of kids who die every year from being trapped inside hot vehicles.

Pros vs. Cons

One of the best assessments available so far regarding the drug’s effects can be found in a study published last year in the Journal of Psychoactive Drugs. After stating that there hasn’t been any rigorous scientific research regarding Kratom and humans, the study analyzed hundreds of profiles from a popular website for drug users and drug researchers. Researchers then… 

gathered a list of negative side effects including stomach pain, headaches, itching, and nausea, alongside a list of positive effects like relaxation, increased energy, and enhanced sociability.

The study showed that Kratom alone has an extremely low overdose risk, which catches the attention of health care providers working to combat the  rising numbers of overdose deaths.

The most revealing information about Kratom in the study was its great ability to relieve pain, which gives a natural alternative to those who seek highly addictive and potentially deadly painkillers.

Proponents point to Kratom’s success as a method of treatment

The American Kratom Association was founded last year to protect the rights of Americans using the substance, to inform the general public about Kratom’s benefits and to raise awareness while representing a community of responsible consumers who share successful stories about using Kratom.

The increasing number of enthusiasts includes doctors, lawyers and law enforcement officers, and other professionals who found hope through the use of Kratom. Some use the new association as a platform to talk about how they’ve been cured from their lifelong addictions while others talk about how they’ve gained the ability to deal with depression, OCD, ADD/ADHD, migraines, debilitating cases of Lupus, Fibromyalgia, and Lyme Disease – among other serious illnesses – since they started using the natural analgesic. There’s still a lot to learn about Kratom, but it does seem to be a much better alternative than other popular maintenance medications for opiate addiction, such as methadone and buprenorphine, both known for causing death.

Many agree that banning Kratom would clearly affect many Americans who have  found it to be a good alternative to cure their addiction to heroin, among other opiates and legal narcotics.

Chronic pain advocate, consultant and licensed pharmacist for about 50 years Steven R. Ariens said he knows of a patient who has been on Kratom for six years and will be back on a wheelchair unable to move from pain after the federal ban. 

Best Interest (or not)

Kratom is legal in 44 states, but the ban could take place on the last day of September, although it is evident there isn’t a great deal of information or research regarding the medical benefits of the tree leaf product.

People using Kratom will not only be criminally charged if they continue to use it after the ban, but they would also have a hard time getting informed about the substance. Once the DEA lists a substance as Schedule I, medical research and scientific studies hardly ever take place since it becomes much more difficult for researchers to gain access to such substances – and that rarely changes.

“There’ll be no lift from the DEA because they profit from the ban,” Ariens said.

With the data gathered so far, and all the positive anecdotal evidence, one would wonder if banning the natural substance is potentially more harmful than beneficial. Is it in our best interest to have a regulating agency crippling its own need for scientific research? If we aim to protect people or aid recoveries, shouldn’t we be making room for more flexibility in the way that controlled drugs are studied?

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