2017 in review … what killed us

Today is 12/12/2018.. who will not be here tomorrow

2016 in review … what killed us

6775 Americans will die EVERY DAY – from various reasons

2700 people  WILL ATTEMPT SUICIDE

140 will be SUCCESSFUL – including 20 veterans

270 will die from hospital acquired antibiotic resistant “bug” because staff won’t properly wash hands and/or proper infection control.

350 will die from their use/abuse of the drug ALCOHOL

1200 will die from their use/abuse of the drug NICOTINE

1400 will contract C-DIF from Hospital or Nursing home because staff doesn’t properly wash their hands are adhere to infection control  

80 WILL DIE mostly elderly.

850 will die from OBESITY

700 will die from medical errors

150 will die from Flu/Pneumonia

80 will die from Homicide

80 will die in car accidents

70 From ALL DRUG ABUSE

http://www.romans322.com/daily-death-rate-statistics.php

Here is the list from the end of 2016 if interested in comparing
United States of America
RealTime
CURRENT DEATH TOLL
from Jan 1, 2017 – Dec 31, 2017 (11:36:39 AM)


Abortion*: 1090465
Heart Disease: 613479
Cancer: 590862
Tobacco: 349505
Obesity: 306566
Medical Errors: 251098
Stroke: 132915
Lower Respiratory Disease: 142741
Accident (unintentional): 135861
Hospital Associated Infection: 98860
Alcohol: 99859
Diabetes: 76380
Alzheimer’s Disease: 93409
Influenza/Pneumonia: 55149
Kidney Failure: 42702
Blood Infection: 33417
Suicide: 42713
Drunk Driving: 33760
Unintentional Poisoning: 31713
All Drug Abuse: 24970
Homicide: 16775
Prescription Drug Overdose: 14979
Murder by gun: 11477
Texting while Driving: 5981
Pedestrian: 4993
Drowning: 3909
Fire Related: 3495
Malnutrition: 2768
Domestic Violence: 1458
Smoking in Bed: 779
Falling out of Bed: 598
Killed by Falling Tree: 149
Lawnmower: 68
Spontaneous Combustion: 0

Totals of all categories are based upon past trends documented below.


Sources:
http://www.cdc.gov/nchs/fastats/deaths.htm
http://www.cdc.gov/nchs/data/hus/hus15.pdf#019
http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_04.pdf
http://www.druglibrary.org/schaffer/library/graphs/graphs.htm
http://www.alcoholalert.com/drunk-driving-statistics.html
http://www.cdc.gov/nchs/fastats/suicide.htm
http://wonder.cdc.gov/wonder/prevguid/m0052833/m0052833.asp
http://www.cdc.gov/motorvehiclesafety/Pedestrian_Safety/factsheet.html
http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html
http://www.nfpa.org/categoryList.asp?categoryID=953
http://www.dvrc-or.org/domestic/violence/resources/C61/
http://www.time.com/time/magazine/article/0,9171,1562978,00.html
https://s3.amazonaws.com/s3.documentcloud.org/documents/781687/john-james-a-new-evidence-based-estimate-of.pdf

 

I am being completely weaned off my meds, & suspect I will kill myself with the amount of pain I am in, & will be by the time this is over (the wean that is). Already can’t function.


My husband committed suicide after being abandoned by his pain dr.


Please pray for me as I am on the brink of suicide! I don’t want to die but can’t handle the pain anymore! The doctor that I am currently seeing will not give me enough pills to last all month every month… I have to wait until Oct to get in with a pain management doctor whom I already know by others that I know sees this doctor that he will help me, need prayer to hold on until oct… I keep thinking of my family who needs me hear.


“We just lost another intractable member of our support group two nights ago. She committed suicide because her medications were taken away for interstitial cystitis (a horribly painful bladder condition) and pudendal neuralgia, both of which she had battled for years


D D., journalist and prescribed fentanyl patient for a dozen years joined me on air last weekend with her husband and spoke of her suicide plan should the only relief from constant agony be heavily reduced or taken away.


I was told last Friday that my Dr. will be tapering my meds again . When I told him I didn’t think my body could take another lowering he stated ” it wasn’t my
License on the line”, I stated ” no , but it’s my life on the line”!!!!! I can not continue to live this way . I can not continue to suffer in agony when my medications and dose where working just fine before and I was a productive member of society . I can no longer take this. I have a plan in place to end my life myself When I am forced to reduce my Medications again . I just can’t do it anymore .


On Friday at around 9 p.m. U.S. Navy veteran Kevin Keller parked his red pickup truck in the parking lot at the Wytheville Rite-Aid, walked across the grass and stood in front of the U.S. Veterans Community Based Outpatient Clinic next door.

Sick and tired of being in pain, he pulled out a gun, shot a hole in the office door, aimed the gun barrel at his head and ended his hurt once and for all.


As a longterm pain patient with a current unsupportive pain dr, I just thought I’d share the reality of the position I’m in right now…

I’m in very bad pain all the time for very legit and well documented reasons. My pain dr however never gives me enough meds to help me. He just keeps reducing them, which is causing me to be in even more pain and suffer so much more. My quality of life also continues to go downhill at the same time. I was just given a letter by him recently too about some study indicating an increase in deaths if you take opioids and benzos. It stated he’s no longer going to give pain meds to anyone who is taking a benzo. I take one, because I have to, for a seizure disorder, not because I want to. He told me to pick one or the other though, plus went ahead and reduced my pain meds some more. He doesn’t seem to care the least bit. I’ve looked hard and so far I can’t find another one to get in to see near me at this time, but I’m desperately still trying. Unfortunately, they’re few and far between here, in addition to the wait for an appointment being long. I’ve even called hospice for help. So far, they haven’t been of much help either, because I don’t have a dr who will say I have six months or less to live. I told them either choice my pain dr is giving me is very inhumane, so I’d rather just quit eating and drinking, to the point where I pass away from that, while I get some kind of comfort care from them. I don’t really want to though, although I do have a long list of some very bad health problems, including a high probability that I have cancer and it’s spread. Am I suicidal? No. Will I be if my pain and seizure meds are taken away. Highly likely. I never ever saw this coming either. I don’t have a clue what to do and the clock is ticking, but I’m still fighting for an answer. So far, I can’t find not even one dr to help me though. Not one. I know my life depends on it, but at what point will these drs let my suffering become so inhumane that I just can’t take it anymore. I just don’t know right now. It’s a very scary place to be in for sure. That I do know.


The patient was being denied the medicine that had been alleviating his pain and committed suicide because, “he couldn’t live with the pain anymore. He could not see a future. He had no hope. He had no life.”


I am a chronic pain patient who has been on fairly high doses of opiates for about nine years now. My dose has been forcibly reduced since the cdc guidelines. I moved to Oregon from Alaska and can’t find a doctor to prescribe my medication. I pray I have the strength not to take my own life!


Zach Williams of Minnesota  committed suicide at age 35. He was a veteran of Iraq and had experienced back pain and a brain injury from his time in service. He had treated his pain with narcotics until the VA began reducing prescriptions.


Ryan Trunzo committed suicide at the age of 26. He was an army veteran of Iraq. He had experienced fractures in his back for which he tried to get effective painkillers, but failed due to VA policy. His mother stated “I feel like the VA took my son’s life.”


Kevin Keller, a Navy veteran, committed suicide at age 52. He shot v after breaking into the house of his friend, Marty Austin, to take his gun. Austin found a letter left by Keller saying “Marty sorry I broke into your house and took your gun to end the pain!” Keller had experienced a stroke 11 years earlier, and he had worsening pain in the last two years of his life because VA doctors would not give him pain medicine. On the subject of pain medication, Austin said that Keller “was not addicted. He needed it.”


Bob Mason, aged 67, of Montana committed suicide after not having access to drugs to treat his chronic pain for just one week. One doctor who had treated Mason was Mark Ibsen, who shut down his office after the Montana Board of Medical Examiners investigated him for excessive prescription of opioids. According to Mason’s daughter, Mason “didn’t like the drugs, but there were no other options.”


Donald Alan Beyer, living in Idaho, had experienced back pain for years. He suffered from  degenerative disc disease, as well as a job-related injury resulting in a broken back. After his doctor retired, Beyer struggled without pain medicine for months. He shot himself on his 47th birthday. His son, Garrett, said “I guess he felt suicide was his only chance for relief.”


Denny Peck of Washington state was 58 when he ended his life. In 1990, he experienced a severe injury to his vertebrae during a fishing accident. His mother, Lorraine Peck, said “[h]e has been in severe pain ever since,” and his daughter, Amanda Peck, “said she didn’t remember a time when her dad didn’t hurt.” During the last few years of his life, Peck had received opiates for his pain from a Seattle Pain Center, until these clinics closed. After suffering and being unable to find doctors who would help with his pain, Peck called 911. Two days later, Peck was found dead in his home with bullet wounds in his head. A note found near Peck read: “Can’t sleep, can’t eat, can’t do anything. And all the whitecoats don’t care at all.”


Doug Hale of Vermont killed himself at the age of 53. He had experienced pain from interstitial cystitis, and decided to end his life six weeks after his doctor suddenly cut off his opiate painkillers. He left a note reading “Can’t take the chronic pain anymore” before he shot himself in the head. His doctor said he “was no longer willing to risk my license by writing you another script for opioids”  (see attachment A for details of the problem as relyed by his wife Tammi who is now 10 months without a husband as a direct result of the CDC guidelines to prevent deaths)Bruce Graham committed suicide after living with severe pain for two years. At age 62, Graham fell from a ladder, suffering several severe injuries. He had surgery and fell into a coma. After surgery, he suffered from painful adhesions which could not be removed. He relied on opioid painkillers to tolerate his pain, but doctors eventually stopped prescribing the medicine he needed. Two years after his fall, Graham shot himself in the heart to end the pain.


Travis Patterson, a young combat veteran, died two days after a suicide attempt at the age of 26. After the attempt to take his own life, Patterson was brought to the VA emergency room. Doctors offered therapy as a solution, but did not offer any relief for his pain. Patterson died two days after his attempted suicide.


54-year-old Bryan Spece of Montana  killed himself about two weeks after he experienced a major reduction in his pain medication. The CDC recommends a slow reduction in pain medicine, such as a 10% decrease per week. Based on information from Spece’s relative, Spece’s dose could have been reduced by around 70% in the weeks before he died.


In Oregon, Sonja Mae Jonsson ended her life when her doctor stopped giving her pain medicine as a result of the CDC guidelines.


United States veterans have been committing suicide after being unable to receive medicine for pain. These veterans include Peter Kaisen,Daniel Somers, Kevin Keller, Ryan Trunzo, Zach Williams, and Travis Patterson


A 40-year-old woman with fibromyalgia, lupus, and back issues appeared to have committed suicide after not being prescribed enough pain medicine. She had talked about her suicidal thoughts with her friends several times before, saying “there is no quality of life in pain.” She had no husband or children to care for, so she ended her life.


Sherri Little was 53 when she committed suicide. She suffered pain from occipital neuralgia, IBS, and fibromyalgia. A friend described Little as having a “shining soul of activism” as she spent time advocating for other chronic pain sufferers. However, Little had other struggles in her life, such as her feeling that her pain kept her from forming meaningful relationships. In her final days, Little was unable to keep down solid food, and she tried to get medical help from a hospital. When she was unable to receive relief, Little ended her life.


Former NASCAR driver Dick Trickle of North Carolina shot himself at age 71. He suffered from long-term pain under his left breast. Although he went through several medical tests to determine the cause of his pain, the results could not provide relief. After Trickle’s suicide, his brother stated that Dick “must have just decided the pain was too high, because he would have never done it for any other reason.”


39-year-old Julia Kelly committed suicide after suffering ongoing pain resulting from two car accidents. Kelly’s pain caused her to quit her job and move in with her parents, unable to start a family of her own. Her family is certain that the physical and emotional effects of her pain are what drove her to end her life. Kelly had founded a charity to help other chronic pain sufferers, an organization now run by her father in order to help others avoid Julia’s fate.


Sarah Kershaw ended her life at age 49. She was a New York Times Reporter who suffered from occipital neuralgia.


Lynn Gates Jackson, speaking for her friend E.C. who committed suicide after her long term opiates were suddenly reduced by 50% against her will, for no reason.  Lynn reports she felt like the doctors were not treating her like a human being (Ed:  a common complaint) and she made the conscious decision to end her life.


E.C. committed suicide quietly one day in Visalia California.  She was 40.  Her friend reported her death.  “She did not leave a note but I know what she did”.  The doctor would only write a prescription for 10 vicodin and she was in so much pain she could not get to the clinic every few days.   We had talked many times about quitting life. Then she left.  She just left.


Jessica, a patient with RSD/CRPS committed suicide when the pain from her disease became too much for her to bear. A friend asserted that Jessica’s death was not the result of an overdose, and that “living with RSD isn’t living.”


https://mobile.nytimes.com/2016/02/27/business/media/sarah-kershaw-former-times-reporter-dies-at-49.html?referer=https://t.co/qcSF8qOBp6?amp=1


http://www.news-press.com/story/news/crime/2014/09/08/death-investigation-at-groves-rv-park-in-fort-myers/15280035/


http://www.kpaddock.org/


https://m.facebook.com/FibroPrince/posts/948610075216801


http://www.pharmaciststeve.com/?p=14073


http://www.pharmaciststeve.com/?p=14574


http://www.pharmaciststeve.com/?p=15023


http://linkis.com/painnewsnetwork.org/7IoUl


http://linkis.com/whotv.com/2016/11/10/ibRof


https://articles.al.com/news/index.ssf/2016/12/alabama_pain_centers_troubles.amp


https://www.painnewsnetwork.org/stories/2016/12/22/chronic-pain-patient-abandoned-by-doctor-dies#.WFwJ5-Lk6Xg.twitter


http://linkis.com/painnewsnetwork.org/oKRZ5


http://linkis.com/www.seattletimes.com/tgyL7


https://edsinfo.wordpress.com/2017/04/20/%ef%bb%bfpain-and-suicide-the-other-side-of-the-opioid-story/amp/


http://www.bendbulletin.com/topics/5342867-151/opioid-crisis-pain-patients-pushed-to-the-brink


https://www.painnewsnetwork.org/stories/2017/5/26/patient-suicide-blamed-on-montana-pain-clinic


https://www.painnewsnetwork.org/stories/2016/5/27/are-cdcs-opioid-guidelines-causing-more-suicides?rq=suicide


http://www.pressofatlanticcity.com/news/breaking/man-who-set-himself-on-fire-at-northfield-veterans-clinic/article_b7a4a712-f04e-11e5-a39b-3f42b9138511.amp.html


Aliff, Charles


Beyer, Donald Alan


Brunner, Robert “Bruin”


Graham, Bruce


Hale, Doug


Hartsgrove, Daniel P


Ingram III, Charles Richard


Kaisen, Peter


Keller, Kevin


Kershaw, Sarah


Kimberly, Allison


Little, Sherri


Mason, Bob


Miles, Richard


Murphy, Thomas


Paddock, Karon


Patterson, Travis “Patt”


Peck, Denny


Peterson, Michael Jay


Reid, Marsha


Somers, Daniel


Son, Randall Lee


Spece, Brian


Tombs, John


Trickle, Richard “Dick”


Trunzo, Ryan


Williams, Zack


Karon Shettler Paddock  committed suicide on August 7, 2013  http://www.kpaddock.org/


https://www.facebook.com/photo.php?fbid=1616190951785852&set=a.395920107146282.94047.100001848876646&type=3&theater 

Jessica Simpson took her life July 2017


Mercedes McGuire took her life on Friday, August 4th. She leaves behind her 4 yr old son. She could no longer endure the physical & emotional pain from Trigeminal Neuralgia.


www.disabledveterans.org/2017/08/16/veteran-commits-suicide-front-amarillo-va-emergency-department/

Another Veteran Suicide In Front Of VA Emergency Department


 Depression and Pain makes me want to kill self. Too much physical and emotional pain to continue on. I seek the bliss fullness of Death. Peace. Live together die alone.


 Dr. Mansureh Irvani  suspected overdose victim  http://www.foxnews.com/health/2017/08/18/suspended-oral-surgeon-dies-suspected-overdose.html


Katherine Goddard’s Suicide note: Due to the pain we are both in and can’t get help, this is the only way we can see getting out of it. Goodbye to everybody,”   https://www.cbsnews.com/news/florida-man-arrested-after-girlfriend-dies-during-alleged-suicide-pact/  


Steven Lichtenberg: the 32-year-old Dublin man shot himself   http://www.dispatch.com/news/20160904/chronic-pains-emotional-toll-can-lead-to-suicide  


Fred Sinclair  he was hurting very much and was, in effect, saying goodbye to the family.  http://www.pharmaciststeve.com/?p=21743


Robert Markel, 56 – June 2016 – Denied Pain Meds/Heroin OD  http://www.pennlive.com/opioid-crisis/2017/08/heroin_overdose_deaths.html


 Lisa June 2016  https://youtu.be/rBlrSyi_-rQ


Jay Lawrence  March 2017  https://www.painnewsnetwork.org/stories/2017/9/4/how-chronic-pain-killed-my-husband


Celisa Henning: killed herself and her twin daughters...http://www.nbcchicago.com/news/local/Mom-in-Apparent-Joliet-Murder-Suicide-said-Body-Felt-Like-It-was-On-Fire-Grandma-Says-442353713.html?fb_action_ids=10213560297382698&fb_action_types=og.comments

Karen Boje-58  CPP-Deming, NM


Katherine Goddard, 52 –  June 30, 2017 – Palm Coast, FL -Suicide/Denied Opioids  http://www.news-journalonline.com/news/20170816/palm-coast-man-charged-with-assisting-self-murder


https://medium.com/@ThomasKlineMD/suicides-associated-with-non-consented-opioid-pain-medication-reductions-356b4ef7e02aPartial List of Suicides, as of 9–10-17


Suicides: Associated with non-consented Opioid Pain Medication Reductions


Lacy Stewart 59, http://healthylivings247.com/daughter-says-untreated-pain-led-to-mothers-suicide/#


Ryan Trunzo of Massachusetts committed suicide at the age of 26  http://www.startribune.com/obituaries/detail/18881/?fullname=trunzo,-ryan-j  


Mercedes McGuire of Indiana ended her life August 4th, 2017 after struggling with agony originally suppressed with opioid pain medicine but reappearing after her pain medicine was cut back in a fashion after the CDC regulations. She was in such discomfort she went to the ER because she could not stand the intractable pain by “learning to live with it” as suggested by CDC consultants. The ER gave her a small prescription. She went to the pharmacy where they refused to fill it “because she had a pain contract”. She went home and killed herself. She was a young mother with a 4 year old son, Bentley. Bentley, will never get over the loss of his mom.


http://greatamericans.world/suicides-associated-with-non-consented-opioid-pain-medication-reductions/


“Goodbye” Scott Smith: Vet w/PTSD committed murder/suicide. Killed his wife then himself today 11/27/2017


http://www.sfchronicle.com/news/crime/article/Ex-California-lawmaker-charged-with-aiding-wife-12405065.php

Pamela Clute had been suffering from agonizing back problems and medical treatment had failed to relieve pain that shot down her legs While California’s assisted suicide law went into effect a couple months before Clute’s death, the law only applies to terminally ill patients who are prescribed life-ending drugs by a physician. Clute wasn’t terminally ill


Kellie Bernsen 12/10/2017 Colorado suicide


Scott Smith: Vet w/PTSD committed murder/suicide. Killed his wife then himself today 11/27/2017


  Michelle Bloem committed suicide due to uncontrolled pain


John Lester shot himself on Jan. 8, 2014.


 Anne Örtegren took her life on Jan. 5  


 Debra Bales, 52 – Civilian – January 10, 2018 – Petaluma, CA – Denied Pain Meds/Suicide


 Aliff, Charles – Could not locate info!
He may be able to help! Charles Aliff – https://www.facebook.com/profile.php?id=100009343944744…


Brunner, Robert – Could not locate info!


Cagle, Melvin – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…


Chaney, Rocky – Denise Chaney – I WOULD LIKE YOU TO INCLUDE ROCKY WAYNE CHANEY HE WAS 70 YEARS OLD BORN MARCH 15 1946 DIE MARCH 24 2016 US ARMY VIETNAM. HE HAD PROSTATE CANCER WHICH SPREAD THROUGH OUT HIS BODY AND HE HAD LEWY BODY DEMENTIA HE DIE AT BEAUREGARD MEMORIAL HOSPITAL DERIDDER LOUISIANA OF BRAIN INJURY/DEATH AND CARDIAC ARREST DO TO ABNORMAL EEG BECAUSE OF SEVERE GENERALIZED SLOWING SUGGESTING DIFFUSE CEREBRAL DYSFUNCTION. HE HAD CEREBRAL BRAIN INJURY IT WAS ALL AGENT ORANGE CONNECTED


Harold Hamilton – http://www.dispatch.com/…/chronic-pains-emotional-toll…


Hartgrove, Daniel – http://www.legacy.com/…/name/daniel-hartsgrove-obituary…


Ingram III, Charles – http://www.pressofatlanticcity.com/…/article_b7a4a712…


Jarvis, Michael http://www.chicagotribune.com/…/ct-indiana-doctor…


http://www.nydailynews.com/…/indiana-man-kills-doctor…


Kevin Keller, 52 – US Navy – July 30, 2014 – Wytheville, VA
http://www.swvatoday.com/…/article_65866e4c-18f6-11e4…


Kershaw, Sarah – https://mobile.nytimes.com/…/sarah-kershaw-former-times…


Kimberly, Allison http://feldmanmortuary.com/…/Allison…/obituary.html…


Lane, Keith – Timothy Shields
August 8, 2017 · Colon, MI I would like you too include Kieth Lane . US Army , Vietnam in country , combat wounded . He died recovering from ulcers surgery of a stroke and heart attack in Battle Creek VA medical center in Michigan .
http://www.legacy.com/obi…/sturgisjournal/obituary.aspx…


Lichtenberg, Steven – http://www.dispatch.com/…/chronic-pains-emotional-toll…


Markel, Robert – http://www.pennlive.com/…/08/heroin_overdose_deaths.html


Miles, Richard – Could not locate info!


Murphy, Thomas – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…


Paddock, Karon http://www.kpaddock.com/


Denny Peck, 58 – Civilian – September 17,2016 – Seattle, Wa https://l.facebook.com/l.php…


http://www.seattletimes.com/…/the-whitecoats-dont…/…


Peterson, Michael – https://l.facebook.com/l.php…


Reid, Marsha – https://www.painnewsnetwork.org/…/daughter-blames…


Simpson, Jessica – https://www.facebook.com/photo.php?fbid=1616190951785852&set=a.395920107146282.94047.100001848876646&type=3&hc_location=ufi


Daniel Somers, 30 – US Army – June 10, 2013 – Denied Pain Meds/Suicide http://gawker.com/i-am-sorry-that-it-has-come-to-this-a…


Son, Randall – http://www.wpsdlocal6.com/…/woman-says-marion-va…/…


Bryan Spece, 54 – USMC – May 3, 2017 – Great Falls, Montana – Denied Meds/Suicide https://www.painnewsnetwork.org/…/patient-suicide…


Tombs, John – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…


 Jennifer E. Adams age 41 of Helena  December 20, 1976April 25, 2018


 https://youtu.be/0ACgV0aLIAk


Jay Lawrence  March 1, 2017  on the same bench in the Hendersonville, Tennessee, park where the Lawrences had recently renewed their wedding vows, the 58-year-old man gripped his wife’s hand and killed himself with a gun.


suicide due to pain video  https://youtu.be/CSkxF1DMQws


Eden Prairie Aug 2018 handwritten note, which stated she “could not endure any more pain and needed to escape it.” http://www.fox9.com/news/charges-eden-prairie-man-helped-wife-commit-suicide


Raymond Arlugo  August 29th 2018   https://hudsonvalleydoctorskilledmybrother.wordpress.com/2018/09/14/suicide-over-pain-telling-my-brothers-story-because-he-cant/amp/


Kris Hardenbrook   Oct 2018   What is the difference between patient abandonment and a FIRING SQUAD ? – NOT MUCH ?


Robert Charles Foster,65 Nov 3, 2018 Chronic pain pt …SUICIDE BY COP https://theworldlink.com/news/local/crime-and-courts/suspect-dead-after-officer-involved-shooting-in-bandon/article_182bfafd-5e6d-539f-b366-0f9a00b7dc85.html


Lee Cole 04/23/2018   http://www.pharmaciststeve.com/?p=27825


Peter A. Kaisen  76-year-old veteran committed suicide (Aug. 24, 2016) in the parking lot of the Northport Veterans Affairs Medical Center on Long Island, https://www.nytimes.com/2016/08/25/nyregion/veteran-kills-himself-in-parking-lot-of-va-hospital-on-long-island.html 


Paul Fitzpatrick, 56 Oct 2018, kills himself blaming 20 years of debilitating pain caused by laser eye surgery  https://www.dailymail.co.uk/news/article-6445427/Canadian-man-kills-suffering-20-years-pain-laser-eye-surgery.html


Your Rights in the Emergency Room


I reserve the right of editorial censorship

It looks like the political “mud slinging” has already started – IMO – worse than the national election two years ago… I am taking a stand – in particular – against “slanderous name calling”  directed toward specific politicians, particular political parties and/or specific people.  I don’t mind political debate – based on FACTS… when the debate drifts off the road based on FACTOIDS, FAKE NEWS, opinions stated as FACTS.. is where I am going to draw the “line in the sand” and delete comments that go down that path.

While personally, I am not a big fan of our political/bureaucratic system.. IMO.. it is too self serving… Admittedly, politically I tend to lean to the POLITICAL RIGHT but that is because the Libertarian party is seemingly always kept in their place by our dominating “two party system”.

I have belonged to a national pharmacy association for 35 yrs… that promotes the saying “get into politics … or get out of pharmacy ..” If you don’t attempt to influence politicians… someone else will…. and IMO this saying applies to those in the chronic pain community and/or pts who are dealing with subjective diseases.  Legislatures, bureaucrats are doing things that are adversely effecting the quality of life of those pts.  As long as those being affected continue to lack unity and/or a large segment chooses to stand on the sidelines, whoever is successfully “bending the ear” of these politicians … they will continue to do so because they have  little/no concern about the consequences and/or collateral damage that they cause to those suffering and dealing with subjective diseases.

I am sure that the vast majority of my readers will understand and cooperate…those who try to challenge this policy…  It is THREE STRIKES and you are out/banned… and WORDPRESS gives me your IP ADDRESS attached to your comment(s)… Once banned, just posting under a different name – WILL NOT WORK !  Everyone needs to “play nice “

Lastly, please do not post anything promoting a particular vendor or any entity or person selling a product/particular service. Because some may perceive/believe that they have my endorsement which may or may not be the case. Anyone posting a link to a professional selling a product/service will be edited out

Image result for Play Nice in the Sand Box

 

Trump: Pledge to Leave Social Security, Medicare Untouched – does this cover meds being cut/limited

Trump Doubles Down on Controversial Pledge to Leave Social Security, Medicare Untouched

https://www.foxbusiness.com/politics/trump-doubles-down-on-controversial-pledge-to-leave-social-security-medicare-untouched

President Trump delivered his first speech Tuesday night to a joint session of Congress, discussing his budget blueprint for the coming fiscal year which includes a $54 billion increase in defense spending, a large cut in funding for the Environmental Protection Agency– and “no changes” to Social Security and Medicare.

As of January, 66 million Americans were receiving Social Security, Supplemental Security Income payments, or both, according to the program’s website. As of 2015, there were 55.5 million Medicare beneficiaries, according to Centers for Medicare & Medicaid Services (CMS).

Meanwhile, the annual Social Security Trustees Report Opens a New Window. shows that by 2034, under current funding levels, Social Security will only be able to pay about 79% of promised benefits to recipients. After 2035, if left unchanged, the program will be able to deliver just 77% of benefits. The Trustees Report estimates Medicare “Part A,” or hospital insurance, will be officially bankrupt by 2028.

While Trump is following through on his campaign promise to leave entitlements untouched, his decision is likely to provoke ire among some fiscal budget watchers.

“It is utterly irresponsible to continue ducking the need for entitlement reform,” Michael Tanner, senior fellow at the Cato Institute, told FOX Business. “Medicare and Social Security alone constitute 38 percent of federal spending, and that percentage will only grow larger in the future. The unfunded liabilities of those two programs exceed $80 trillion.”

While Tanner says Trump is “playing to his base” by leaving entitlements unreformed, it could put him at odds with GOP leadership.

During an interview with Fox News in November, House Speaker Paul Ryan said “Obamacare rewrote Medicare, rewrote Medicaid, so if you’re going to repeal and replace Obamacare, you have to address those issues as well.”

In fact, Paul Ryan’s “Better Way” healthcare policy package included sweeping Medicare reforms, going so far as to propose overhauling the entire system into a “premium support” model; a fixed input for each beneficiary to purchase private insurance.

Health and Human Services Secretary Tom Price, who formerly chaired the House Budget Committee, said in November Republicans could use the budgetary process of reconciliation to begin reforming Medicare by summer, prior to being tapped for his new role.

In December 2016, Rep. Sam Johnson (R-TX), Chairman of the Social Security Subcommittee on the House Ways and Means Committee, introduced a bill to cut Social Security benefits, which Johnson told the Washington Examiner he hoped would serve as a starting point for reform discussions. So far, the proposal has been met with both praise and criticism.

Is the cutting/limiting of pain management meds and some other controlled meds…. for Medicare folks… TRUMP is breaking his pledge to leave MEDICARE UNTOUCHED ?  Because the meds are covered under Medicare Part D & Medicare Advantage !

One suspect hit a pharmacist over the head with a gun

Harrisburg police need help identifying these three suspects, accused of robbing a Rite Aid pharmacy of around 2,000 hydrocodone pills.

https://www.pennlive.com/news/2018/12/police-need-help-identifying-three-suspects-from-harrisburg-pharmacy-robbery.html

Police need help identifying three suspects from Harrisburg pharmacy robbery

Harrisburg police need help identifying three suspects they say got away with around 2000 hydrocodone pills in a pharmacy robbery on Saturday.

Officers were dispatched to the Rite Aid at 2103 N Third Street around 4:53 p.m. Saturday, for a report of a robbery.

Employees told police three people came into the store, with one staying at the front and the other two going to the pharmacy and jumping the counter, police said. One suspect hit a pharmacist over the head with a gun.

One robber demanded a pharmacist provide “Oxys,” but the pharmacist told the robbers they had none. Instead, the pharmacist gave the robber “around 2000 hydrocodone pills,” police said.

All three then fled the store, police said. A pharmacist suffered a minor injury to the back of his head, police said. There were about ten customers in the store at the time of the robbery.

All three suspects were wearing gloves, masks and carried firearms, police said.

The first robber was described by police as wearing a dark jacket, ripped and faded jeans and sky-blue Nike shoes with a white sole and white “Swoosh” symbol.

The second robber was described as wearing a dark jacket, ripped jeans and black and white running shoes.

The third robber was described as wearing a black short-sleeve T-shirt over a white long-sleeve T-shirt, black pants and black shoes.

Dauphin County Crime Stoppers is offering up to a $2,000 reward for information that leads to successful prosecution of the case.

Anyone with information is asked to call Harrisburg Bureau of Police at 717-255-3118, or submit a tip through Crimewatch.

Tonight (12/11/2018) 8PM EST– “The Doctor’s Corner” Dr Kline & Jonelle Elgaway

Image may contain: text that says 'You Dr. Kline has uncovered some interesting research about the number who actually overdose will revealing tonight's show! Truthfully, this will be earth shattering to the degree of ground breaking. This WILL appear elsewhere so come here here first! "The Doctor's Corner" with Dr. Kline Elgaway Tonight, December 8PM EST Call the studio at (415) to ask your questions LIVE! Tune in www.cawnation.com click "Listen" Or via YouTube by searching for "The Doctor's Corner" Don't forget, please send any questions you have that didn't get answered you just know for the "Mail Bag" See you there, everyone! #TheDoctorsCorner #CAW360Network'

 

Tune in at www.cawnation.com click “Listen”

Treating America’s Pain: Unintended Victims of the Opioid Crackdown, Part 2 – The Doctors

https://video.foxnews.com/v/5977750216001/?#sp=show-clips

Dec. 11, 2018 – 10:52 – As federal and state agencies respond to the staggering rate of drug overdose deaths — primarily involving illegal opioids like heroin and illicit fentanyl — doctors who maintain they are responsibly prescribing opioids are getting caught up in the crackdown. This is their side of the story to the opioid crisis and how it has impacted — and for some ruined — their lives.

Notice Kolondy in the video… he states that he has treated/dealt with thousands of ADDICTS…  apparently he has NEVER TREATED the first chronic pain pt..  and this is one of the authors of the CDC opiate dosing guidelines ?

 

 

Dr. Stephen Nadeau received a warning from the Gainesville, Fla., hospital where he worked.

Their policy on prescribing opioids was changing, to go beyond federal guidelines aimed at the national overdose crisis that has claimed hundreds of thousands of lives.

The hospital would stop treating pain with opioids. And every doctor, including Nadeau, had to stop prescribing them. Doctors otherwise risked losing hospital admitting privileges – and perhaps even their medical license.

In Helena, Mont., Dr. Mark Ibsen was feeling heat from the state medical board – and the U.S. Drug Enforcement Administration (DEA), for the high-dose opioids he was prescribing to patients in severe, chronic pain. An allegation made by what he described as a disgruntled employee charged Ibsen was overprescribing.

As a result, the state medical board suspended his license. The DEA visited five times, Ibsen said, suggesting he was risking his livelihood and could end up in jail if he kept prescribing.

Both doctors complied and stopped prescribing, affecting roughly 230 of their patients. Tragically, among those were several who committed suicide, the doctors said, when they couldn’t find another health care provider to relieve the pain.

That’s a scenario playing out across the country, as government agencies respond to the staggering rate of drug overdose deaths, involving primarily illegal opioids like heroin and illicit fentanyl. Doctors who maintain they are responsibly prescribing opioids are getting caught up in the crackdown, according to dozens of medical care providers interviewed by Fox News, leaving little room to both play by the rules and properly treat huge numbers of patients who legitimately suffer chronic and intense pain.

Some doctors like Ibsen and Nadeau are opting to simply stop prescribing legal opioids, as insurers, pharmacies, and authorities warn them about overstepping guidelines issued in 2016 by the Centers for Disease Control and Prevention (CDC).

Meanwhile, other doctors, nurses and medical associations accuse the federal government of interfering in the physician-patient relationship, and pursuing simplistic, politically expedient solutions that put tens of millions of Americans at risk.

“Not only is the government legislating the way we care for chronic pain patients,” said Nadeau, a professor of neurology at the University of Florida College of Medicine, “they are substantially taking away our ability to do it.”

CDC GUIDELINES CONTROVERSY

Critics of the way the 2016 guidelines have been applied note they were not intended as law, but as a means to advise primary care physicians. The CDC specifically cautioned against abruptly stopping or forcibly tapering opioid treatment for patients already taking them, because of the danger of withdrawals, or debilitation.

More than 300 health care professionals, including former drug czars in the Clinton, Nixon and Obama administrations, have signed an as-yet unpublished public letter to the CDC, warning of a brewing crisis among pain patients, despite the “laudable goals” of the guidelines.

“Within a year of (CDC) Guideline publication, there was evidence of widespread misapplication of some of the Guideline recommendations,” said the letter, written by three doctors and a pharmacist. “Soon, clinicians prescribing higher doses, pharmacists dispensing them, and patients taking them came under suspicion.”

“Patients with chronic pain, who are stable and, arguably, benefiting from long-term opioids, face draconian and often rapid involuntary dose reductions,” the letter continued. “Often, alternative pain care options are not offered, not covered by insurers, or not accessible … Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use. Others have experienced preventable hospitalizations or medical deterioration.”

Others argue many authorities have misunderstood, or outright ignored, the CDC’s disclaimer. Health care providers who don’t drop opiate painkillers are setting strict limits on dosage limits, even for chronic pain sufferers who require more medicine because of serious conditions, or the way they hyper-metabolize opioids. Many who do so cite the CDC guidelines, saying they were told to follow them — or took them up as a kind of pre-emptive strike.

Not only is the government legislating the way we care for chronic pain patients, they are substantially taking away our ability to do it.

— Dr. Steve Nadeau, a professor of neurology at the University of Florida College of Medicine

Dozens of pain patients have told Fox News they were dropped or forcibly tapered down by doctors who long treated them quite successfully, but who became fearful about losing their license after being formally admonished, or hearing about other doctors who ran afoul of the government.

Meredith Lawrence, who lived in Tennessee with her husband, Jay, while he suffered decades of pain following a tractor-trailer accident, recalled the helplessness she felt watching him suffer, while his dosage of opioids was being sharply reduced.

Lawrence said the doctor who had treated him successfully for years was very clear about his decision to taper down the dosage.

“He said ‘My patients’ quality of life is not worth risking my practice or my license over,'” she told Fox News. “I’ll never forget that.”

“Jay felt like they gave up on him,” she said, recalling what finally prompted her husband to kill himself. “That was the day Jay gave up. He felt the doctor gave up – and he gave up.”

Dr. Stephen Nadeau

Dr. Stephen Nadeau

DEA TARGETING ‘WORST OF THE WORST’

Much of the opioid overdose epidemic in recent years stems from illegal drugs, not legitimate prescriptions. But more than a decade of overprescribing – out of ignorance for some, and for others the chance to rake in big profits – played a significant part, according to federal authorities and others who have studied the issue.

Assured by what some charged were deliberately deceptive pharmaceutical companies insisting opioids weren’t very addictive, some health care providers prescribed liberally, even for minor procedures such as a pulled tooth, or non-serious orthopedic injuries. Overprescribing led to greater daily dosages or easy-to-get refills – more than were needed. That, along with the theft and resale of opioids from people who had prescriptions, laid the groundwork for the crisis.

Most prescribers say they recognize many health providers were not prudent enough when prescribing opioids. And many doctors noted they were previously criticized for undertreating pain. Medical schools devoted little time to the study of pain and to opioids, they also say.

“Physicians and particularly medical school residency programs should have been taking more responsibility. Pain is the most common condition, and it’s one of the most difficult to treat,” said Nadeau. “And there [have been] pill mills that have relied on physicians to prescribe and many have done so very irresponsibly. But I think many are compassionate physicians … it’s a reflection of the inadequacy of their training that they basically had to learn the ropes on their own.”

John Martin, the DEA’s Administrator of the Diversion Control Division, said an overwhelming percentage of prescribers followed the rules. Of 1.6 million registrants, he said, less than one percent “operate outside the law.”

But there are still unscrupulous prescribers.

“Remember, with the opioid epidemic, just one practitioner that’s operating outside the law can really have a lot of serious consequences. In a small community, it can wreak havoc,” Martin said. “They’re really going after the worst of the worst of the criminal violators.”

Martin said most prescribers have nothing to worry about.

“Doctors are writing less prescriptions. And that goes down to education with the CDC guidelines,” he said. “There’s a new and different way of looking at using opioids for chronic pain.”

But that’s not what prescribers and patients see.

“Doctors around the country are terrified because of what happened to me and other doctors,” Ibsen said. “We don’t arrest car dealers if someone drives a car and gets into a fatal accident.”

“Standards of care are being decided by a jury of people without medical training,” Ibsen added. “It’s a very bad situation. We’re playing Whack-a-mole with the wrong mallet.”

Remember, with the opioid epidemic, just one practitioner that’s operating outside the law can really have a lot of serious consequences. In a small community, it can wreak havoc…[the DEA agents] are really going after the worst of the worst of the criminal violators.

— John Martin, DEA Administrator of the Diversion Control Division

THE CHALLENGE OF PAIN MANAGEMENT

For many medical professionals, treating pain patients has become a thankless task. The stakes are too high, they say, as even those who try to responsibly manage opioid treatment for their sickest pain patients find themselves hounded by authorities or pharmacists.

Many doctors say they view opioids as a last resort. They are very strong medicines, which often come with strong side effects, ranging from constipation, nausea, liver damage and respiratory problems. Many pain patients said in interviews they were reluctant to take them initially, and eventually did only after other treatments and surgeries failed.

“If we had a good alternative to opioids, every physician would be at the front line of it to prescribe that,” said Dr. Lynn Webster, vice president of PRA Health Sciences, and the past president of the American Academy of Pain Medicine.

In a recent survey by the North Carolina Medical Board of its licensees, 43 percent of 2,661 respondents said they had stopped prescribing opioids. They attributed their decision to concern about getting into trouble.

Patients complained to the board doctors had cut them off, pointing to the CDC guidelines or an initiative by the board aimed at cracking down on health care providers who prescribed high doses of opioids, or who had two or more patients die of overdoses in a year.

And of 3,000 doctors responding to a recent nationwide survey by the SERMO physician network for BuzzFeed News, 70 percent said they had dramatically cut down or altogether stopped prescribing opioids. The main reasons were “too many hassles and risks involved,” “improved understanding of the risks of opioids,” and fear of “getting into trouble,” according to BuzzFeed.

Yet another survey, commissioned by The Physicians Foundation, showed about 70 percent of nearly 9,000 physicians nationwide were prescribing fewer opioids.

In Nevada, where so many doctors stopped taking pain patients after the state implemented strict opioid prescription rules – which increased required record-keeping – physicians like Dan Laird now have a six-month waiting list.

“We turn patients away every day,” said Laird, who last year could fit in patients soon after they called for an appointment. “It’s heartbreaking, but many can’t find doctors.”

Many pain patients told Fox News that after being forcibly tapered down or abandoned by their pain doctors, they have lost much of their ability to function. Many said they have made suicide plans.

“I have heard from — either through email or posts on my blogs — about 1,000 people over past two years who have been denied pain medicine or forced to dramatically reduce their dose who have expressed a desire to die or commit suicide,” Webster said.

Karen Nicholson, a former federal prosecutor who credits her opioid treatment with allowing her to function after years of being bedridden, said: “We’re looking only at the supply, and cutting off people who are not abusing the medication. It made all the difference in the world, I couldn’t sit or stand or walk because of nerve damage. I went from being bed-ridden and completely non-functional to doing my work as a prosecutor.”

WARNINGS, RAIDS AND ARRESTS

Health care providers who prescribe opioids, particularly to high-impact chronic pain patients, are finding themselves on the radar of any number of sources – pharmacists, state medical boards, insurers, and law enforcement.

In a speech about the national overdose deaths epidemic in March, President Trump said: “Whether you are a dealer or doctor or trafficker or a manufacturer, if you break the law and illegally peddle these deadly poisons, we will find you, we will arrest you, and we will hold you accountable.”

But the red line triggering disciplinary action often is inconsistent, and murky. The CDC considers an opioid’s benefits to outweigh risks if it improves pain and function by at least 30 percent. But, doctors say, those factors rarely are considered when authorities scrutinize prescribing patterns.

More often, it’s large amounts of opioids and high doses – statistics on a spreadsheet or chart, without the context of a patient’s medical condition — that can bring disciplinary action.

On Nov. 2, Dr. J. Julian Grove posted to Twitter a letter his Phoenix office had received from Walgreens. Grove said he wanted to provide chronic pain patients “an insight to the veiled threats” that health care providers treating pain are getting these days.

The letter said: “Walgreens has determined that you may have issued prescriptions for opioids that exceed the CDC guidelines.”

It said Walgreens had the right to refuse to fill a prescription that falls outside the guidelines, and added: “Walgreens pharmacists may notify appropriate regulatory agencies when prescriptions are refused.”

Grove blasted the letter.

“I am a double board-certified anesthesiologist and pain specialist, treating complex pain and cancer pain always w/comprehensive approach,” he said. “Insulting.”

Asked about Walgreen’s pressure on prescribers to follow the CDC guidelines, company spokesman Phil Caruso told Fox News in a statement: “As a key patient touchpoint in the nation’s healthcare delivery system, we regularly communicate with prescribers to help ensure the safe and effective dispensing of medications in the best interest of our customers … Fighting the opioid epidemic requires all parties, including leaders in the community, physicians, pharmaceutical manufacturers, distributors, pharmacies, insurance companies, PBMs (pharmacy benefit managers) and regulators to play a role and coordinate efforts.”

The U.S. Attorney’s Office in Atlanta announced in October that some 30 doctors were put on notice there for prescribing opioids in larger quantities and higher doses than others. Prosecutors enclosed the CDC guidelines with the warning letters.

U.S. Attorney B. Jay Pak called those doctors “outliers,” adding the warning letters were meant to point out “atypical practices.” Significantly, Pak said the doctors may not have done anything wrong.

“It is our plan to strategically reduce the impact of this crisis within our community by notifying outlier prescribers that their opioid prescribing habits are not in conformity with accepted standards, or the prescribing habits of their peers,” the agency said in a statement. “Through this initiative and others, it is the goal of the Department of Justice to reduce opioid prescriptions by one-third over the next three years.”

Prescribers particularly dread getting in the crosshairs of the DEA, which can revoke permission to manufacture, distribute and dispense controlled substances. The agency opens about 1,500 new opioid cases per year and makes more than 2,000 arrests. The arrests include DEA registrants, doctor-shopping patients, and prescription forgery rings.

Martin, the DEA administrator, said that actions against prescribers are not undertaken arbitrarily.

“When we are investigating something like a doctor that may be overprescribing, you know because we’re not doctors, in the course of our investigation we are going to solicit medical experts,” Martin said. “We’ll try to get what’s called prescription drug monitoring program information and that’s information that the states have at their level that shows how many prescriptions are being written by a doctor for a patient and being filled at a certain pharmacy.”

“So we’ll try to look at that stuff and then maybe go out to that pharmacy and do an inspection and look at their records and just see if there’s anything more there and then we’ll follow up with that,” he said.

Roughly 800 prescribers each year surrender their DEA registration – a kind of license – when the agency opens an investigation. DEA investigations can involve having assets and medical records seized. In some cases that can lead to bankruptcy, doctors said, prompting many to surrender their opioid prescribing rights, rather than fight a battle against a behemoth government.

Ibsen was an emergency room doctor in Montana when he became – as he puts it, an “accidental pain doctor,” taking “pain refugees” whose doctors had been arrested. Many patients were very ill and suffered severe chronic pain, said Ibsen, who added he was able to wean many patients down to lower doses.

Ibsen said he became a target of the state board of medical examiners after an employee he fired filed a complaint, saying he over-prescribed. His license was suspended but eventually reinstated – after four years. But he decided to stop prescribing opioids after five visits from the DEA.

“They were very vague,” he said of the DEA agents. “They said ‘You’re risking your freedom by prescribing to patients like these.’ I said ‘Patients like what?’ They said, ‘Patients who might sell the pills.’”

“Doctors are taking plea deals because they don’t want to go to prison,” said Ibsen, who was not charged. “Once they arrest a doctor, they seize all their medical records. A doctor can’t make any more income. They seize your assets, and can’t afford an attorney.”

Ibsen referred patients to a prominent pain doctor in California, Dr. Forrest Tennant, who became known for taking people cut off by other doctors. Tennant for years had been researching non-opioid alternatives.

Then the DEA raided Tennant’s office. The agency never charged him, but he, too, gave up prescribing opioids.

“It’s immoral and unsafe to forcibly taper down or abandon a patient,” said Tennant, whose patients included those with terminal illnesses. “Some doctors don’t give these patients any withdrawal medication. Who is the worst offender, then? The CDC, the DEA, the U.S. attorneys who are shutting down doctors, or the doctors who abandon patients?”

One Tennant patient, Jennifer Adams, a former Montana police officer who had been treated by Ibsen, died from a self-inflicted gunshot in April, after the California doctor’s office was raided by the DEA.

Tennant said he respects the idea “the DEA has a right and responsibility to investigate.”

“But since I used high doses, they said my patients were going to overdose and die,” Tennant said. “I’ve been practicing a long time, I’ve not had a single overdose. I’ve given patients thousands of opioid equivalents. I know how patients should be monitored.”

Dr. Lesly Pompy was one of a few pain physicians in a rural part of Michigan, serving as many as 1,500, the majority of them referrals from other doctors who could not treat their chronic conditions. A pain specialist since 1995, he kept long hours, sometimes going to hospital emergency rooms when he was summoned to help a patient in severe pain. Sometimes he would try nerve blocks, many other times opioids.

On Sept. 26, 2016, roughly 25 law enforcement officers raised Pompy’s office at the ProMedica Monroe Regional Hospital.

“There were DEA agents, county and local police, they had everybody in my waiting room and who worked in my office put their hands up. Children were crying. There was a helicopter over the building. It was like a scene from a Jason Bourne movie,” he said.

Pompy was charged with unlawful distribution of prescription drugs and health care fraud from 2012 to 2016. A federal jury indicted him this summer on 37 counts. The indictment maintained Pompy illegally prescribed some 10 million dosage units of controlled substances that fell outside the realm of standard practice. He was also accused of inappropriately filing claims to insurers.

Pompy denies the charges and claims that because he prescribed large quantities of opioids, some to severe pain patients who require high doses, he became a target.

“The damage that the proliferation of opioid distribution has done to our community, like many across the United States has been devastating,” U.S. Attorney Matthew Schneider said, according to published reports. “It’s particularly disturbing when the distributor is a medical professional.”

Pompy’s former patients and some former employees have stood by him, saying he is being scapegoated. Former patients have held rallies and started a Facebook group in support of him.

Janet Zureki, a former patient of Pompy, said that — as often happens after a prescriber’s arrest — patients were left in limbo, having to scramble to find another pain doctor. “After the raid and he could no longer prescribe, everyone was dangerously cut off of their medicines, including me,” she said. “It took me three months to find another pain doctor and they put me on a lower dose of medicine. During that three month period, I had to go without medicine and go through withdrawal.”

Zureki defends Pompy.

“As a doctor, I found him to be very compassionate and he also ran a tight ship,” she said. “I have been in his office and have heard him address someone who wasn’t taking their medicine properly, so I know he didn’t stand for that. He worked tirelessly to help the people in our community,” she said.

DOCTORS LAMENT WALKING AWAY

Nadeau is bewildered over having to stop treating his pain patients, at least one of whom died by suicide. And he said his hospital’s decision to stop working with opioids is by no means unique.

Hospitals increasingly see opioids as a liability; an overdose can land them in a lawsuit, he said. But he wrestles with the fact there are people he can no longer help.

“I can’t provide comprehensive care for my patients, meaning treatment of pain, depression, sleep problems, anxiety, and other problems,” Nadeau said. “In patients with chronic pain, there nearly always are a lot of problems.”

Nadeau reached out to fellow physicians to see if they would take his pain patients.

“It’s been extremely difficult to find physicians to provide comprehensive pain therapy,” he said. “I don’t blame physicians for being scared to death and for prescribing to CDC guidelines, but I do blame [some of] them for treating patients badly.”

For his part, Ibsen is treating patients with medical marijuana. Ibsen said he always strived to get patients on opioids to agree to taper down, and about 80 percent did, often using medical cannabis. For the others, opioids were the best treatment, Ibsen said. He understands the threat of the overdose epidemic all too well.

“My nephew died of a heroin overdose” in the summer, he said. “But incarcerating doctors is not going to solve the addiction crisis.”

“There are two things doctors do – we save lives and we relieve suffering. If we’re not willing now to relieve suffering, then what are we about?”

robbers became very agitated and nervous when the time delay safes wouldn’t open…threatened Pharmacist and physically hurt her

Police search for suspects in armed robbery of CVS Pharmacy

https://www.wndu.com/content/news/Police-search-for-suspects-in-armed-robbery-of-CVS-Pharmacy–502374401.html

 

 

 

 

 

 

 

 

 

 

 

 

Police are searching for three suspects in the armed robbery of a CVS Pharmacy in Michigan City.

It happened around 3:30 a.m. Monday at the store on Franklin Street.

An undetermined amount of money and narcotics were stolen.

The three suspects are described as black males, either juveniles or young adults. They were wearing all black.

If you have any information about the suspects, please contact Detective Corporal Michelle Widelski at 873-1465 ext. #1088 or email mwidelski@Emichigancity.com

 

 

 

 

 

The robbers became very agitated and nervous when the time delay safes wouldn’t open. The pharmacist, her name, ironically, is Patience. They threatened her and physically hurt her.
She has a possible broken rib, wrist, and a large cut on her head.
The District Leaders have refused to tell the other pharmacists what happened, standing by the company’s time delay C2 safe protocols.
I’m so pissed. I know these pharmacists. How do they dare not to let others know to be on alert!?!

Many pharmacies – mostly chains – are putting in “timed safes” to store their controlled substances… Pharmacist entering the combination and when the safe will actually open is highly variable.  This time – at 3 AM – the Pharmacist on duty was harmed because the safe would not readily open…  You notice that the MEDIA did not mention that anyone was harmed…  These timed safes were suppose to discourage robberies, apparently not do their job in this incident… how long before a CUSTOMER is held hostage – or threatened with harm – to get the pharmacist to open a save that they have no control over when it will open.

 

 

 

 

How the opioid crackdown is backfiring

https://www.politico.com/story/2018/08/28/how-the-opioid-crackdown-is-backfiring-752183

How the opioid crackdown is backfiring

Hundreds of chronic pain patients responding to a POLITICO survey describe being refused opioid prescriptions they had relied on for years with sometimes devastating consequences.

The former law enforcement officer was in constant pain after his doctor had abruptly cut off the twice-a-day OxyContin that had helped him endure excruciating back pain from a motorcycle crash almost two decades ago that had left him nearly paralyzed despite multiple surgeries.

“I came into the office one day and he said, ‘You have to find another doctor. You can’t come here anymore,’” Fowlkes, 58, recalled. The doctor gave him one last prescription and sent him away.

Like many Americans with chronic, disabling pain, Fowlkes felt angry and betrayed as state and federal regulators, starting in the Obama years and intensifying under President Donald Trump, cracked down on opioid prescribing to reduce the toll of overdose deaths. Hundreds of patients responding to a POLITICO reader survey told similar stories of being suddenly refused prescriptions for medications they’d relied on for years — sometimes just to get out of bed in the morning — and left to suffer untreated pain on top of withdrawal symptoms like vomiting and insomnia.

“I was pretty much thrown to the curb,” said Denise Pascal, 65, who had taken pain meds for decades after six back surgeries. Then her pain doctor cut her off and closed her practice without connecting her with another specialist.

Many of POLITICO’s respondents described being tapered off narcotics too quickly, or worse, turned away by doctors and left to navigate on their own. Some said they coped by using medical marijuana or CBD oil, an extract from marijuana or hemp plants; others turned to illicit street drugs despite the fear of buying fentanyl-laced heroin linked to soaring overdose death numbers. A few, like Fowlkes, contemplated suicide.

“I sat my wife down and told her life wasn’t worth it,” Fowlkes said after he had gone more than a month without pain relief while also suffering opioid withdrawal symptoms. “My pain exceeded my ability to handle it. We had a very frank discussion. … We even discussed what gun I would use.”

Fowlkes found another doctor willing to continue prescribe his medication. But he worries what will happen if the pills stop coming.

“Now there’s this ticking time bomb,” he said. “I don’t know when it’s going to go off again.”

That’s not an idle fear. Trump, who vowed during his campaign to combat the opioid crisis, has set a goal of cutting prescriptions by one-third over the next three years. He has also boasted of stepped-up prosecutions of doctors who prescribe inappropriately and sought tougher sentences for those who sell drugs illegally. While Trump has stressed a law enforcement approach — including broader use of the death penalty for traffickers — his administration has also invested billions in prevention, treatment and research, and last week authorized a respected science group to develop better guidelines for doctors about how to safely treat patients with severe pain.

Certainly, stories like Fowlkes’ and Pascal’s illustrate the unintended consequences of efforts to suddenly reverse years of loose prescribing practices that fueled an addiction crisis — and why so many of the estimated 25 million Americans suffering from chronic pain feel angry and forsaken. While studies suggest that other therapies are safer and more effective for many chronic conditions, large numbers of these patients are now hooked on the narcotics and on the relief they say they get from constant, grinding pain.

“I have a lot of anger, because I think there were a lot of things done wrong to all of us,” Pascal said.

Have you been treated for opioid abuse recently? Tell us your story.

Many doctors and pharmacists responding to POLITICO’s survey acknowledged such patients’ predicament. But they said they feel under enormous pressure to limit the powerful painkillers and fearful of consequences, such as losing their licenses or even prison time, for inappropriate prescribing.

The Justice Department has aggressively prosecuted doctors for improper prescribing or fraud — charging nearly 200 doctors and another 220 medical personnel for opioid-related crimes since January 2017, the DOJ said in a June press release.

Nonetheless, the toll of overdoses keeps mounting. Almost 70,000 people died of drug overdoses last year, according to the latest government numbers. About 49,000 were opioid-related, including legal and illegal painkillers, as well as street heroin and fentanyl.

“I will no longer treat chronic pain. Period,” said Sue Lewis, a primary care doctor who works in an urgent care clinic in Portland, Oregon. “There is too much risk involved,” she said, adding that if a patient doesn’t take the medications as she prescribes them, they could jeopardize her license.

Steven Henson, an emergency room doctor in Wichita, Kansas, described how his license was suspended after six patients illegally sold the medications he prescribed, without his knowledge.

“The DEA should be working with doctors when this happens,” as opposed to punishing them, Henson said.

Jianguo Cheng, president of the board for the American Academy of Pain Medicine, said that besides being scared, many doctors are also fed up with time-consuming requirements, including pill counting, where a patient brings her prescribed medication to the clinic so the doctor can make sure they aren’t being misused. Doctors also have to order regular urine tests to detect abuse.

And few are trained how to safely wean someone off opioids. Some patients told POLITICO their doctors failed to treat their withdrawal symptoms, and they were sick for weeks after being tapered off their painkillers.

Any doctor can prescribe a powerful painkiller like Oxycodone, but a physician has to go through special training and licensing to prescribe some drugs used to treat addiction. Only about 5 percent of U.S. physicians have been certified to prescribe buprenorphine, one of the main treatments for addiction, according to an NIH study published last fall.

Few saw the approaching wave. The effort to overhaul opioid prescribing began with little fanfare in March 2016, when President Barack Obama’s CDC issued controversial, first-of-their-kind guidelines, advising primary care doctors to prescribe opioids only as a last resort for pain, and then, in the lowest effective dose.

The guidance suggested a three-day limit for initial prescriptions for acute pain and recommended avoiding prescribing increasing large doses for those complaining of chronic pain. It was aimed at primary care doctors in an outpatient setting, not at specialists treating people with complex, chronic conditions, or those with advanced cancer. The CDC specifically excluded active cancer treatment, palliative care and end-of-life care, as well as the use of opioids in surgical and trauma settings.

Nonetheless, groups including the American Medical Association and the American Cancer Society Action Network raised concerns about unintended consequences for certain chronic pain patients, including cancer survivors who often deal with lifelong pain. AMA also raised concerns about the evidence underlying the guidelines.

Since then, at least 32 states have enacted laws related to limiting opioid prescriptions with exceptions for cancer and palliative care patients, according to the National Conference of State Legislatures. Most center on acute pain, but Oregon is considering a 90-day prescribing limit on many chronic pain patients in Medicaid. Those patients would have to go off the drugs within a year.

The guidelines have also served as a template for insurers like Anthem and pharmacy chains including CVS Caremark, that have capped initial opioid prescriptions. The Trump administration has also finalized opioid prescribing limits for initial prescriptions in Medicare Part D to take effect next year.

Sally Satel, a psychiatrist, Yale University School of Medicine lecturer and resident scholar at the conservative American Enterprise Institute, said the guidelines have been “systematically misinterpreted” as a blanket ban on opioids.

“Policies are being written as if to be in compliance with some mandate that we don’t have,” she said.

That misinterpretation, coupled with the crackdown on doctors and pharmacists under Trump’s Justice Department and growing alarm about opioid overdose deaths, has caused some doctors to stop prescribing opioids entirely.

Now, though, some patients are beginning to fight back.

“We thought we should be the ones being consulted because you’re talking about taking our medicine,” said Lauren DeLuca, president of the Boston-based Chronic Illness Advocacy Awareness Group, formed last November by DeLuca and another chronic pain patient to lobby state and federal lawmakers on behalf of those with chronic pain.

Some doctors are also questioning guidelines that they say tie their hands when it comes to chronically ill patients.

Thomas Kline, a general practitioner in North Carolina specializing in chronic and rare diseases who has garnered a large social media following for opposing the guidelines, argued the CDC shouldn’t tell doctors how to treat their patients. “It dawned on me that the CDC was going to sit in my office and try to tell me how to prescribe pain medicines, instead of tracking Zika,” he said.

Kline said he has not tapered any of his patients off opioids because he doesn’t believe that’s the right approach. He wants Congress to create an independent board to review the prescribing guidelines to prevent further unintended consequences.

Such efforts may be having an effect.

The Trump administration stands by the CDC guidelines, but officials say they are in early discussions about “expanding” upon them by providing specific examples of what doctors should prescribe for certain procedures. The FDA recently awarded a contract to the National Academies of Sciences, Engineering, and Medicine to develop new guidelines for treating acute pain that build on the CDC’s guidance, but lay out treatment recommendations for specific conditions and procedures.

“The goal is to strike a balance,” Vanila Singh, chief medical officer at HHS’ office of the Assistant Secretary for Health and the chair of an interagency Pain Management Task Force, said during a public meeting earlier this summer to discuss how to treat pain amid the opioid crisis. “We know there is a drug epidemic, and we know there are overdose fatalities happening all the time. But that has to be balanced against the issue of treating acute and chronic pain.”

Some doctors say they are also seeking better training in pain management. “Medical school certainly did not provide a solid basis for pain management or addictions,” said Henson, the Kansas emergency room doctor who said he has sought that out.

Many say one of their biggest problems is the dearth of good alternatives to opioids. Congress is working on legislation that includes provisions to encourage development of non-addictive pain treatments, but that won’t help the millions currently suffering from chronic pain.

Non-opioid pain therapies like acupuncture, which helps some conditions, can be expensive, and not all insurance plans cover them. Some people use medical marijuana, but insurance doesn’t cover that either. And some medical professionals caution against marijuana because there’s not a lot of research about its effectiveness and long-term safety for pain control.

Pascal, the Virginia back patient, says she has spent more than $5,000 in the past year treating her pain and withdrawal symptoms with alternatives such as acupuncture and CBD oil. She chose to go that route instead of medication-assisted treatment with a milder opioid called Suboxone (the brand name for buprenorphine). Although the treatment is considered the gold standard by doctors, she said she worried about remaining addicted.

Others say going off opioids entirely isn’t an option.

“The medication controls my pain to the point that I can function independently,” said Drew Pavilonis, 56, from Durham, North Carolina, who has relied on methadone to address chronic pain that developed following surgery to remove a brain tumor that left him wheelchair-bound. “Without it, I’m bedridden and pray for death.”

He blames “opioid hysteria” for the barriers at certain pharmacies.

“The longest I had to go without medication was four days,” Pavilonis said, blaming pharmacy issues for the gap. “I bought a pill splitter, and I started to split my methadone pills in half so I would at least have some medication for the four days. I suffered a great deal of pain during that time.”

Stigma around painkiller use is also an issue.

“You go in to fill your prescription and you’re treated like a second-class citizen … like you’re a drug addict,” said Melissa Brown of Helotes, Texas, who takes daily doses of OxyContin to cope with rheumatoid arthritis. “It’s like, wait a minute, I don’t abuse my drugs. I’m 51 and I’ve never had so much as a speeding ticket.”

Brown, and other chronic pain patients who responded to POLITICO’s survey, say they feel as if they’ve been pushed to the side in the larger response to the opioid crisis.

“President Trump in 2016 made it his mantra to represent the forgotten men and women,” Brown said. “I speak for a lot of chronic pain folks when I say we are now feeling like those forgotten men and women.”

The Feds Are About to Stick It to Pain Patients in a Big Way

https://www.vice.com/en_us/article/8qb4dg/the-feds-are-about-to-stick-it-to-pain-patients-in-a-big-way

Doctors are already getting spooked out of prescribing painkillers, and new rules could make life in some of America’s struggling communities even worse.

Before she turned 18, Anne*, a nurse, had endured at least five major surgeries, all without the use of post-op medication stronger than ibuprofen. As a child in Birmingham, Alabama, she had been diagnosed with cerebral palsy, but eventually learned that she actually has primary generalized dystonia, a genetic disorder that causes frequent painful muscle spasms and rigidity. By 19, she says, she had tried pretty much every treatment available, including a spinal implant that made matters worse.

Then she was given a prescription opioid.

Here is where your typical American news story might turn into a parable of addiction and dysfunction, even though the evidence we have suggests the vast majority of pain patients don’t become addicted. But Anne’s story is different, and there are millions of patients taking opioids for pain whose voices are rarely heard. 

Their ability to live and function well is now in danger because doctors and insurance companies have turned what were supposed to be voluntary guidelines issued last year by the Centers for Disease Control (CDC) into inflexible rules. Soon, Medicare plans to follow suit, with potentially massive implications for how pain is treated—or not treated—in America. This relentless focus on cutting medical use of opioids in the face of a real addiction crisis is starting to damage the middle- and working-class people it was intended to help. And because so many are also facing job loss and wage stagnation, we can’t really help until we recognize how economic, emotional, and physical pain are intertwined. 

In Anne’s case, opioids seemed like a godsend. Thanks to this class of drugs, she says, she was able to complete nursing school and become a hospice nurse. And even when her disease progressed and she could no longer work, opioids allowed her to live independently. When she decided at one point for herself to go for months without them, Anne tells me, she lost the use of her hands.

In a letter to a local medical board explaining why access to these medications matters, Anne wrote that during six months without opioids, “I was in the worst shape of my entire life—reliant on a power wheelchair, losing weight rapidly, with severe rigidity… unable to sit without support, with clenched fingers that rendered my hands useless.”

Now 36, Anne fears she will be forced to go back to that straitened way of life. Over the past few years, doctors who prescribe high doses of opioids for patients like her have been increasingly targeted by law enforcement and medical boards, leaving some physicians terrified that any unusual prescribing pattern will put them at risk of losing their license or going to prison. And interviews, news stories, blog entries, and emails from numerous pain patients—as well as surveys and social media posts—suggest Anne’s case is far from unusual.

After one of Anne’s doctors stopped prescribing, she says, she called more than 60 physicians before finding one willing to prescribe the medication that works for her, despite a documented medical history without signs of addiction. But the CDC guidelines—which were supposed to be flexible and to be used by primary care doctors (not specialists)—have increasingly taken on the air of law. To protect themselves, some pain specialists have stopped prescribing any opioids at all or cut back patient doses to fall within the guidelines, regardless of whether their current doses are helping their patients. 

Worse, just this month, the Center for Medicaid and Medicare Services (CMS) announced that it will soon apply the CDC guidelines to everyone insured via Medicare, which means that patients on high doses may find themselves cut off without much—or any—notice.

Doses outside the guidelines—except in end-of-life care—could soon trigger a process that prevents pharmacists from filling prescriptions. Yet that process for other exceptions is not yet clear, according to Stefan Kertesz, associate professor of preventive medicine at the University of Alabama, who has corresponded with the agency. (VICE reached out to CMS for comment, but the agency did not provide one prior to publication.)

“If a doctor could anticipate the need for special approval, and if he or she could obtain it in a rapid fashion, this process might not cause serious harm to patients,” Kertesz says. “However, we have no basis for expecting that kind of fluid rapid and clear communication in the history of managed care… I’m worried that the mechanics of how this will be implemented would result in patients being thrown into acute withdrawal, which would be medically risky.”

The Medicare plan seems to be based, at least in part, on a white paper written in collaboration between insurance companies and academic researchers. And according to Kertesz, insurers often extend policies that originate in Medicaid and Medicare to their private patients. What this means is that soon, anyone—either on Medicare, Medicaid, or privately insured—who takes a dose of opioids that is outside the CDC’s acceptable range may be pressured to cut down or stop the medications entirely, even if the same meds are keeping him or her functional and productive. 

“It’s like a runaway freight train,” says Pat Anson, a journalist who covers these issues for a specialist publication, the Pain News Network

Indeed, in every other area of medicine, “personalization” and “individualized care” are the buzzwords—but not when it comes to opioids.

Meanwhile, the crackdown isn’t curing people with addiction, even if it does seem to be shifting them to heroin. The result, among other things, has been more death: Just this past week, in fact, the CDC released data showing yet another jump in the overdose death rate, even though prescribing has continually fallen since 2012. According to the study, the proportion of overdose deaths involving heroin has tripled since 2010, while those involving prescription opioids have fallen. It’s not really in dispute at this point that being cut from medical opioids can send people in search of of riskier street drugs, sometimes cut with the super potent fentanyl and its derivatives.

But in the regions hardest hit by opioid problems—yes, these are some of the same areas that fell unexpectedly hard for Trump—opioid deaths are not the only kind of mortality on the rise. Deaths from suicide and alcoholism have risen, too—and the rise has been so large for whites that it has paused what once seemed like inevitable increases in lifespan in successive generations. Neither of these causes of death can be blamed solely or even mostly on increased opioid supply; instead, the trend points increasingly to an underlying common cause: the slow-motion economic collapse of these communities.

“These tend to be places that were once dependent on manufacturing or mining jobs and then lost a chunk of those,” explains Shannon Monnat, assistant professor of rural sociology at Penn State, who has published research on the Trump-voter-death-rate connection. “They tend to have experienced a decline or stagnation in median income. They have higher rates of poverty. It’s really that these are downward-mobility counties.”

Opioids seem to be hitting these communities hard for the same reason crack was so devastating in black neighborhoods in the 1980s and early 1990s. Basically, not only did the drugs themselves provide escape and relief from distress, but they also offered one of the few avenues of economic opportunity: jobs in the drug trade. 

Overwhelmingly, these rural addictions do not start with medical use, which reflects national patterns. However, a critical factor in their stories is childhood trauma, according to Khary Rigg, assistant professor in the Department of Mental Health Law and Policy at the University of South Florida. “These are folks who primarily are using painkillers, but also heroin,” he says before describing how the interviews he conducts with participants involve telling their stories chronologically. “They start talking about really, really intense traumatic experiences: rape, things like child abuse, molestation, witnessing someone die.”  

Traumatized people seeking emotional relief are not going to be fixed by cutting off one source of their drug supply. Nor are patients like Anne. To wit: When yet another doctor recently stopped prescribing and she was forced to lower her dose to near the CDC-recommended levels, Anne fell out of her wheelchair and broke two crowns she’d just had placed on her teeth.

“My whole body was like, one shaking, jerking mess,” she says.

The Medicare changes are open for public comment until March 3 at this email address. 

*Last name withheld to protect the patient’s privacy and to avoid undue scrutiny falling on her current doctor. 

Reporting for this column was supported by the journalism nonprofit the Economic Hardship Reporting Project.

Follow Maia Szalavitz on Twitter.

Treating America’s Pain: Unintended Victims of the Opioid Crackdown, Part 1 – The Suicides

https://www.foxnews.com/health/as-opioids-become-taboo-doctors-taper-down-or-abandon-pain-patients-driving-many-to-suicide

This is the first of a three-part series on the nation’s struggle to address a crippling opioid crisis, and the unintended victims left in its wake.

It happened slowly. The pain caused by a 1980 back fracture, the result of a tractor-trailer crash, crippled more and more of Jay Lawrence’s body and spirit.

By 2006, the Tennessee native and Navy veteran’s arms and legs were going numb. The excruciating pain reduced him to tears. Multiple surgeries, chiropractic adjustments, and physical therapy didn’t work.

He finally found solace in prescription painkillers – 120 milligrams a day of morphine. A high dose, but it dulled the pain enough for him to take walks with his wife, shop for groceries, even take in a few movies.

But last February, the pain clinic doctor delivered jarring news: He was cutting Lawrence’s daily dosage, first to 90 milligrams then, in short stages, down to 30 milligrams. The doctor said the reduced dosage was in response to the Centers for Disease Control and Prevention (CDC) prescribing guidelines released in 2016 as part of a national anti-opioid push, according to Lawrence’s wife, Meredith.

“The doctor said: ‘You know these guidelines are going to become a law eventually. So we’ve decided as a group that we’re going to take all of our patients down,’” she told Fox News in an interview.

Lawrence’s pain returned with a vengeance. He could barely move or sleep. He soiled his pants, unable to make the bathroom in time, Meredith said.

“It feels like every nerve in my body is on fire,” he told his wife.

Meredith said she and her husband went to their primary care physician and asked for a referral to another pain clinic. They were told it would take a minimum of six weeks.

That was too much for Lawrence. In March, on the day of his next medical appointment, when his painkiller dosage was to be reduced again, he instead went to a nearby park with his wife. And on the very spot where they renewed their wedding vows just two years earlier, they held hands.

He raised a gun to his chest and killed himself.

Jay and Meredith Lawrence

Jay and Meredith Lawrence (Savannah DeAnn Photography)

Lawrence, who was 58, became one of an undetermined number among the nation’s 20 million chronic pain sufferers who chose suicide after being cut back or denied prescriptions for opioids. The suicides have motivated many of those who continue to suffer from pain – and family members and advocates of those who took their lives – to call for a re-evaluation of the rush to reduce opioid dosages for those who most need them.

“We have a terrible problem. We have people committing suicide for no other reason than being forced to stop opioids, pain medication, for chronic pain,” said Thomas Kline, a North Carolina family doctor and former Harvard Medical School program administrator.

“It’s mass hysteria, a witch hunt. It’s one of the worst health care crises in our history,” said Kline, who has 26,000 Twitter followers, and a website where he publishes the names of those who he said committed suicide after having their opioids cut back or eliminated. “There are five to seven million people being tortured on purpose.”

The CDC doesn’t have numbers of those who commit suicide after having their pain medications cut. But most of the doctors who spoke to Fox News said they knew of between one and six patients who took their life after losing access to opioid treatment, and being turned away from other doctors who now see prescription painkillers as a hassle.

Several prominent doctors and pain patient advocacy organizations said they have heard from hundreds who say they have been left in debilitating pain and are considering suicide. The issue earlier this year came to the attention of Human Rights Watch, which launched an investigation.

“Clearly, there are patients now who feel like life is not worth living if they return to living in pain,” said Diederik Lohman, director of Health and Human Rights for Human Rights Watch. “Many of the patients we spoke to are very law-abiding, and would turn to suicide before going to the street to get illicit drugs. The government has a duty to respond to the overdose crisis but to do so in a way that is harming people who have a legitimate medical issue is a human rights issue.”

We have a terrible problem, we have people committing suicide for no other reason than being forced to stop opioids, pain medication, for chronic pain. It’s mass hysteria, a witch hunt. It’s one of the worst health care crises in our history. There are 5 to 7 million people being tortured on purpose.

— Dr. Thomas Kline, former Harvard Medical School program administrator, and publisher of list of pain patients who have died by suicide.

Many pain patients say they understand the urgent need of political leaders and government agencies to fight the drug overdose epidemic. But targeting the millions who legitimately suffer from chronic pain is grasping for a solution that doesn’t address the preponderance of illegal drugs, they argue – or the rate of overdoses caused by them.

The CDC released a report Nov. 30 showing that despite a drop in painkiller prescriptions over the years, the drug overdose rate continues to soar, with the growth driven by the illicit opioid fentanyl and its cousins. It is a trend that has held for several years.

“People with pain shouldn’t have to suffer because people without pain are abusing opioids,” said Cynthia Toussaint, a former ballerina from California, who has Complex Regional Pain Syndrome (CRPS), which left her bedridden for 10 years, and unable to speak for five. “Pain patients don’t want to take opioids any more than cancer patients want to use chemotherapy. However, many people with pain need opioids to function physically and pursue the joyful aspects of life.”

At a recent American Medical Association (AMA) meeting, the group’s president, Dr. Barbara McAneny, spoke of how an advanced prostate cancer patient of hers attempted suicide after he was denied opioids by an insurer. “The pendulum swung too far when pain was designated a vital sign, and now we are in danger of it swinging back so far that patients are being harmed,” she said, according to published reports.

ISSUES WITH CDC GUIDELINES

Federal officials have said the CDC guidelines weren’t intended to disrupt the proper prescribing and use of opioids. “We’re not telling any doctor that they can’t make a legitimate prescription,” then-U.S. Attorney General Jeff Sessions told Fox News, in an interview before he left office. “Maybe some doctors are getting too cautious. We don’t know.”

Sessions acknowledged “opioid prescribing can be essential for people,” and said, “it’s very clear that people with serious pain problems are in need of real significant pain relief and sometimes [opioids] are the only thing that will provide relief, and it is absolutely legitimate to prescribe it.”

We have heard about the suicides…It’s tragic that anyone takes their life for any reason, including that they had their opioids unilaterally stopped.

— Dr. Debbie Dowell, lead author of the 2016 “CDC Guideline for Prescribing Opioids for Chronic Pain”

CDC officials added they are also aware chronic pain sufferers have committed suicide in their struggle to get by with fewer or no opioids.

“We have heard about suicides,” said Dr. Debbie Dowell, a senior CDC medical advisor, and lead author of the guidelines on opioid prescribing. “We’ve heard the reports. It’s tragic that anyone takes their life for any reason, including that they had their opioids unilaterally stopped.”

Dowell said the scope of suicides caused by under-treatment of chronic pain “isn’t something that’s easy to measure. We’ve looked at how we might measure this. Sometimes patients or their families don’t report it.”

The CDC guidelines focused on primary care physicians and recommended extreme caution in prescribing opioids. It also suggested a maximum daily dosage of 90 morphine milligram equivalents for first-time painkiller patients.

But the guidelines also warned against forcibly tapering or abruptly cutting off severe pain sufferers who have responsibly have taken opioids, noting that a drastic change could lead to withdrawal, and serious illness.

Untreated pain, many health experts say, can also lead to hypertension, more serious pain conditions, and other problems. Health practitioners say this is a plight that could affect anyone — all it takes is a slip, a fall, or a botched surgery that could bring on intense and perhaps long-term pain.

Dowell said patients should be prescribed on a case-by-case basis.

“We believe everyone deserves effective pain management,” she said. “The CDC guidelines are not a regulation or a law – it’s guidance for providers.”

“It never made a recommendation to take people off medication involuntarily, or to taper down involuntary,” she said. “It was meant to provide updated guidance about the benefits and risks of opioids for chronic pain so that the provider and the patient – together – could make decisions.”

GUIDELINES BECOME ENFORCEMENT TOOLS

The CDC disclaimer was apparently lost among the headlines about the staggering number of deaths due to opioids. Political leaders and government officials often failed to note the bulk — at least 60 percent, according to the U.S. Department of Health and Human Services — of the overdose epidemic was caused by illicit drugs, not prescription painkillers.

And when officials did address the portion of deaths due to prescriptions, advocates of safe opioid use argue, they often lumped together pain patients and people with addiction who illegally obtained someone else’s prescribed opioids. That made for a perfect storm, which formed the basis for a slew of hardline state and federal policies, including a Trump administration vow to slash prescriptions by 30 percent over the next three years.

Either in response to the CDC guidelines or as proactive measure to deal with the opioid crisis on their own, at least 33 states have enacted some type of legislation related to prescription limits, according to the National Conference of State Legislators. Health care providers and pain patients who have Medicare prescription plans are bracing for January, when the federal insurance program will give its insurers and pharmacists the authority to reject prescriptions that deviate from CDC recommended dosage.

“The CDC guidelines were geared to primary care doctors, but they have been hijacked and weaponized as an excuse for draconian legislation,” said Michael Schatman, a clinical psychologist and director of research and development at Boston Pain Care, a multi-disciplinary pain clinic, and editor-in-chief of the Journal of Pain Research. “Illicit opioids, not prescription opioids, are driving overdose deaths.”

The CDC guidelines…have been hijacked and weaponized as an excuse for draconian legislation.

— Michael Schatman, editor-in-chief of the Journal of Pain

The disproportionate focus on prescription painkillers by officials responding to the overdose epidemic, pain specialists and public health researchers say, is in great part why the drug-related death rate continues to climb while legal opioids becomes less available to pain patients.

“We’re targeting the most vulnerable and sickest people who have been on opioids a long time,” said Dr. Stefan Kertesz, an addiction specialist and professor at the University of Alabama at Birmingham School of Medicine. “Insurers are issuing rules that say we won’t cover long-term opioids for anyone over 90 milligrams. Well, five percent of people who receive opioids account for 60 percent of the milligrams prescribed. With so many milligrams going to a tiny group of very sick people, if you can knock a few people off these opioids you can show a big numeric reduction.”

“What we’re really doing is dragging down the dose on the most disabled people,” said Kertesz, who sits on several state opioid safety committees. “Prescription control seems an easy answer to the epidemic, but that’s not stopping addiction.”

CRIES FOR HELP, AND GIVING UP

On social media, comments sections on news sites, and in emails to Fox News, numerous pain sufferers say they have made suicide plans because their health care provider has forcibly reduced their dose to a deficient level, or cut them off entirely. They speak of being treated like drug abusers, submitting to frequent urine tests and pill counts.

Jay and Meredith Lawrence

Jay and Meredith Lawrence (Courtesy of Meredith Lawrence)

“I have been on pain management since 2006,” said a man from Tampa in a Facebook message. “Have a crippling disease that there is no cure for, and can no longer get the medications I need.  A few months ago I was researching death with dignity and other options for assisted suicide if I wasn’t able to get the help needed down the road.”

Some posted comments about a loved one who died by suicide after losing access to a long-term treatment for pain, and finding it intolerable to continue suffering. Others said their spouse’s suffering, together with the frustration and anguish of being turned away or undertreated by doctors, was the reason they came around to accepting their loved one’s suicide plan.

In her new home in Georgia, its walls covered with pictures of her late husband, Meredith Lawrence recalled the helplessness she felt watching him suffer, as the pain worsened, and the drugs were tapered down.

“He said ‘I have three choices,’” Meredith recalled. “He said ‘I could do illegal drugs, I could suffer the rest of my life in pain, or I can end my life. I’m not going to do the first two.’”

Lawrence’s doctor did not respond to email and phone requests to comment for this story.

Meanwhile, hashtags on Twitter like #SuicideDue2Pain, #DontPunishPain, #PatientsNotAddicts have become common.

People with pain shouldn’t have to suffer because people without pain are abusing opioids.

— Cynthia Touissant, pain patient

“I think about suicide every day,” said Dawn Anderson, a former trauma nurse from Indiana, whose doctor cut her opioid dosage after his office was raided by the DEA.

“I recently wrote a suicide note to my family,” said Anderson, a diabetic whose legs were both amputated below the knee. “They have seen all I have gone through. I want to live. But not like this.”

Anderson, 53, now finds it too painful to stand on prosthetics because of what she says is undertreated pain, and is confined to a wheelchair.

“The pain feels like an electrical shock that happens every 30 seconds in some parts of my body,” she said, “and in the back it’s a stabbing pain, like a hot poker that is stuck and never coming out. The pain I endure on a daily basis is taking my will to live.”

Anderson’s doctor did not respond to requests for comment.

Anne Fuqua, a former nurse in Alabama who herself suffers from chronic pain, has logged records of 167 suicides since 2014 that she maintained were directly a result of patients who had their opioids reduced or cut and suffered uncontrolled pain.

Fuqua said she is in the midst of verifying more suicides that have been reported to her.

Caylee Cresta, a 26-year-old Massachusetts woman, has a rare disease, Stiff Person’s Syndrome, that causes muscle spasms and rapid convulsions that fracture her bones and often leave her stuck in an unnatural position for days. She has had the condition since she was 19.

“You’re in fear that your doctor will say that your next prescription is your last,” Cresta said, adding that when she has “a bad day” it means “I stop being a mother, a wife, a daughter.”

Ending the pain by ending it all has seemed, at times, like the way out.

Dr. Stefan Kertesz

Dr. Stefan Kertesz

CALLING FOR TOUGHER ANTI-OPIOID POLICIES

Not everyone agrees the problem is the cutting back of legal opioid prescriptions.

Dr. Andrew Kolodny, who directs opioid research at Brandeis University’s Heller School for Social Policy and Management, believes government policies on opioids need to be even tougher.

Kolodny, who also is executive director of the Physicians for Responsible Opioid Prescribing and one of the nation’s most vociferous critics of opioids, balks at the alarm sounding over the decreasing supply of prescription painkillers.

“The effects of hydrocodone and oxycodone produced in the brain are indistinguishable from the effects produced by heroin,” Kolodny said. “So my point is that when we talk about opioid pain medication, we’re essentially talking about heroin pills.”

Kolodny said opioids have an important role – in limited circumstances – such as ending suffering “at the end of life for some patients,” and “for a couple of days after major surgery.”

When we talk about opioid pain medication, we’re essentially talking about heroin pills.

— Dr. Andrew Kolodny, director of opioid research at Brandeis University’s Heller School for Social Policy and Management

Many pain experts and patients blame Kolodny for pushing the federal agencies, particularly the CDC, to treat opioids as if it were heroin, and pain patients as people who are one opioid away from being addicts.

Kolodny said that isn’t true.

“No role – none – zilch,” he said. “PROP was one of many organizations that was asked by CDC to offer them feedback on the guideline. Our letter is publicly available. CDC did not make the changes we requested.”

To Kolodny, “It’s a manufactured controversy … They’ll say with my opioid, I can at least get up from bed. For a heroin user it’s the same thing for them. They say they feel horrible, can’t do anything or function until they take their first dose of heroin in the morning.”

Former U.S. Attorney General Jeff Sessions

Former U.S. Attorney General Jeff Sessions (Reuters)

FEDS SAY THEY’RE AT WAR

Sessions appeared to view the issue as a war that needs to be fought, full-speed ahead.

“This is the greatest health hazard we’ve had,” he said of fatal overdoses.“Let me just say this to the suicide problem and other problems: They’re arising out of addiction to those drugs,” he said. “People don’t know how powerful these addictions are. So people get into a situation where they can’t keep taking the drugs, and some of them might conclude they can’t live without them.”

“We need to break that cycle,” Sessions said. “We’re making progress at it, but we still prescribe far more pain pills than in any country in the world … we as a nation need to face up to that fact.”

Federal and state officials at the agencies at the forefront of the fight against opioids – including the Drug Enforcement Agency (DEA) – were hard-pressed to provide details to Fox News about just how many overdose deaths involved those legitimately prescribed opioids. A report by the Massachusetts Department of Public Health, widely cited by many pain experts, said that among 477 people whose deaths were opioid‐related in 2018, 90 percent, or 423 of them, tested positive for fentanyl – a telltale sign of illegal opioid use.

Pain management experts said they share the concern and alarm over the terribly high percentage of drug overdoses.

“I share the nation’s concern that more than 100 people a day die of an overdose. But my patient nearly died of an under-dose,” said McAneny, the AMA president.

“My patient suffered, in part, because of the crackdown on opioids… When I visited my patient in the hospital as he was recovering from his suicide attempt, I apologized for not knowing his medication was denied,” McAneny said. “I felt I had failed him.”

If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the National Suicide Prevention Lifeline network is available 24 hours a day, 7 days a week, across the United States. The Lifeline is available for everyone, is free, and confidential — 1-800-273-TALK (8255)

The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. Nacional de Prevención del Suicidio –1-888-628-9454


New Opioid Pain Management Regulations Pharmacists Should Know

http://www.drugtopics.com/article/new-opioid-pain-management-regulations-pharmacists-should-know

As federal and other regulations on opioid pain relievers are changing, NCPA presented a panel discussion on “Opioid Pain Management and Your Pharmacy” on October 9 at the group’s Annual Convention in Boston.

The discussion centered on three aspects of opioid pain management: federal regulatory updates, work flow best practices for filling opioid prescriptions, and evaluating the abuse prevention policies in the community pharmacy.

Presenter Ronna Hauser, PharmD, vice president, Pharmacy Policy and Regulatory Affairs, NCPA, says the group has several recommended solutions for the opioid crisis, including establishing limits on maximum day supply for certain drugs, expanding electronic prescribing for controlled substances, encouraging alternatives to opioids for pain management, enhancing prescription drug monitoring programs (PDMPs), and increasing use and access to medication-assisted treatment for opioid abuse and addiction.

Policy Changes Coming

The presentation occurred within days of Congress’ passage of sweeping changes to federal rules related to the opioid crisis in Medicaid and Medicare programs. Many changes will start in 2019, though some won’t come into effect until 2021. “The main thing, I think, for our members is we’re going to move to a mandated system of electronic prescribing for controlled substances in [Medicare] Part D starting in 2021,” Hauser told Drug Topics prior to her presentation. Electronic prior authorization will be required for Part D drugs starting then as well, she adds.

Another change is that there will be a new drug management program or “lock-in program,” for Part D patients, where plans lock patients into using one or more specific pharmacies or healthcare providers for their prescriptions of frequently abused drugs, Hauser says. However, she adds, “It’s really the discretion of the [HHS] Secretary to determine what a frequently abused drug is. And then it’s up to the discretion of the Secretary to determine how you identify patients eligible for a lock in.”

There will also be hard safety edits for opioids, with seven-day limits on initial opioid prescriptions for acute pain under Part D. There will also be a real-time safety edit at 90 morphine milligram equivalents (MME) per day, which could be triggered when a beneficiary reaches a cumulative level of 90 MME per day across all their opioid prescriptions, she notes. Patients in hospice care, long-term care facilities, who are receiving palliative or end-of-life, or are being treated for cancer-related pain will be exempt from these rules.

NCPA believes that only a small number of patients will be affected by the 90 MME per day requirement, she says. “Nevertheless it’s going to be in existence and, I think, potentially grow in scope and size over time.” More federal legislation on opioids is expected in 2019, Hauser says.
 

How to Respond

After Hauser’s talk, Jordan Ballou, PharmD, BCACP, clinical assistant professor of pharmacy practice at the University of Mississippi School of Pharmacy, discussed policies that pharmacies should have in place when dealing with controlled substances. Policies should include what information to require from the patient; whether there should be a geographic limit to prescriptions, such as not filling those from providers outside a given distance from the pharmacy; when the PDMP should be checked; and what to do when patients request refills too early or too often.

Then Zach Forsythe, PharmD, a pharmacist with Hurricane Family Pharmacy in Hurricane, UT, looked back on how his pharmacy changed some of its practices after an armed robbery of the store. In southern Utah, where his pharmacy is located, there have been more than 20 night burglaries of pharmacies in 2017 and 2018. One independent store was hit three times in two months.

His pharmacy has added cameras, increased its employee training and counseling, put defined protocols in place, and added GPS trackers. It also added a sign in the window stating that the store was monitored by cameras and that Oxycontin and oxycodone are kept in a time-locked safe.

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