Today is 11/25/2017

2016 in review … what killed us

2600 Americans will die EVERY DAY – from various reasons


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


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 himself 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.”

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

Karen Shettler Paddock  committed suicide on August 7, 2013 

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.

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

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,”  

Steven Lichtenberg: the 32-year-old Dublin man shot himself  

Fred Sinclair  he was hurting very much and was, in effect, saying goodbye to the family.

Robert Markel, 56 – June 2016 – Denied Pain Meds/Heroin OD

 Lisa June 2016

Jay Lawrence  March 2017

Celisa Henning: killed herself and her twin daughters...

Karen Boje-58  CPP-Deming, NM

Katherine Goddard, 52 –  June 30, 2017 – Palm Coast, FL -Suicide/Denied Opioids List of Suicides, as of 9–10-17

Suicides: Associated with non-consented Opioid Pain Medication Reductions

Lacy Stewart 59,

Ryan Trunzo of Massachusetts committed suicide at the age of 26,-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.

Suicides: Associated with non-consented Opioid Pain Medication Reductions


Meet the Doctor Who Refuses to Stop Prescribing Opioids to Pain Patients

How Jeff Sessions Plans to End Medical Marijuana Before the Year Is Over


Tears streamed down Claudia Jendron’s face this year as her doctor patted her hand and told her, after eight years of failed pain treatments for her spinal fusion-gone-wrong, “This is going to work, Claudia.” She was talking about medical marijuana.

For “eight years of hell,” Jendron tried opioids, epidural shots and acupuncture in the hopes that she’d be able to sit down or go to her grandchildren’s birthday parties without having to leave and lie down. None of it worked. At one point, she considered checking into an assisted living facility to receive morphine before she tried medical marijuana. 

Then, early this year, the 66-year-old upstate New Yorker got a prescription for medical marijuana to help what she called “excruciating pain.” To Jendron’s surprise, her doctor was right about the weed. Two days after starting a tincture (a liquid cannabis extract dropped under the tongue), her crushing pain subsided to something manageable.

“I can lean over and hug my grandkids without screaming anymore,” she said. “I went to a commitment ceremony in the park the other day, and I lasted all day long without any pain…It’s just, it’s amazing.”

New York is one of 29 states (plus the District of Columbia) that have legalized medical marijuana––a trend that 94 percent of Americans support, according to an August Quinnipiac poll. But on December 8, all of that could begin to change.

Congress has until that day to decide whether to include the Rohrabacher-Farr Act (also known as Rohrabacher-Blumenauer) in a bill that will fund the government through the next fiscal year. Right now, that law, made up of just 85 words, blocks the Department of Justice from using any money to prosecute medical marijuana in states where it’s legal.

11_21_Rohrabacher_Blumenauer_Farr_Act The text of the Rohrabacher-Farr (also known as Rohrabacher-Blumenauer) Act, which blocked the U.S. Department of Justice from spending any money to prosecute medical marijuana in states where it’s legal. H.R. 2029 – Consolidated Appropriations Act, 2016

In May, Attorney General Jeff Sessions pushed back against the bill when he sent a strongly worded letter to Democratic and Republican leaders in Congress, asking them to oppose protections for legal weed and allow him to prosecute medical marijuana. 

“I believe it would be unwise for Congress to restrict the discretion of the Department to fund particular prosecutions, particularly in the midst of an historic drug epidemic and potentially long-term uptick in violent crime,” Sessions wrote in his letter. 

The bill’s 2014 passage, with 170 Democrats and 49 Republicans in favor, was the first time Congress passed legislation that protected medical marijuana users and businesses. It meant that an attorney general could no longer send Drug Enforcement Administration agents (or use other government resources) to bust medical marijuana in states where it was legal. 

It was in line with the Obama administration’s 2013 “Cole Memo,” in which Deputy Attorney General James Cole said the Justice Department would refrain from prosecuting medical marijuana businesses and users in states where it was legal, and that it would prioritize more serious marijuana offenses, like drug cartels and sales to minors. The policy marked a change for the Obama administration, where medical marijuana busts were once rampant.  

With his letter, Sessions pushed Congress to end these protections. In a statement on Friday, Sessions announced that the Justice Department would halt the practice of guidance memos, and review Obama administration guidance memos on legal pot to see if they went too far.

Sessions is known for being one of the nation’s toughest critics of legal pot. He once said the KKK was “OK until I found out they smoked pot.” 

More recently, he said at a speech in March in Richmond, “I am astonished to hear people suggest that we can solve our heroin crisis by legalizing marijuana—so people can trade one life-wrecking dependency for another that’s only slightly less awful.”

In the early decades of his career, denouncing marijuana was an unprovocative viewpoint. In the days of DARE and abstinence-only drug education, marijuana was the bogeyman at the gateway to much more dangerous drugs. But despite new research praising medical pot and the skyrocketing approval ratings for the drug, Sessions has only budged ever so slightly in that view. 

11_21_JeffSessions U.S. Attorney General Jeff Sessions testifies before a House Judiciary Committee hearing on oversight of the Justice Department on Capitol Hill in Washington, U.S., November 14, 2017. REUTERS/Yuri Gripas

He nodded last week and said, “I think that’s correct” when Representative Steve Cohen, a Tennessee Democrat, said cannabis was not as dangerous as heroin. Sessions said he’d consider thorough analyses of medical marijuana, but that he was not optimistic. 

“He’s old fashioned and very conservative,” said Philip Heymann, a Harvard Law School professor and former Justice Department official for the Kennedy, Johnson, Carter and Clinton administrations.. “Literally seven years ago, maybe eight years ago, marijuana was thought to be a very dangerous drug. Why would he focus on this issue? Because he’s seven years out of date.” 

Even the attorney general who set the precedent for federal prosecution of legalized marijuana says Sessions would be remiss to put many resources, amid all of the country’s larger problems, into prosecuting medical marijuana.

“To prosecute an act that is otherwise lawful under state law, one could make the argument [that] as a matter of policy, we’ve got other priorities we ought to be spending our resources on,” Alberto Gonzales, the attorney general for President George W. Bush, told Newsweek. “With respect to everything else going on in the U.S., this is pretty low priority.” 

In theory, without Rohrabacher-Farr in his way, Sessions could send DEA agents into a medical marijuana dispensary or producer in any state to bust it. Experts say, if he did this, he’d likely prosecute a distributor or a producer with other violations, like tax or licensing mistakes, in addition to its violation of the CSA. 

“They can scream all they like that they haven’t violated state laws, but they violated federal law,” said Heymann.

Ilya Shapiro, a constitutional studies fellow at conservative think tank CATO institute and the editor of its Supreme Court Review, said law enforcement would likely first prosecute those in gross violation of federal laws before the average pot smoker––”the same way police go after rapists and murderers before they go after jaywalkers.” 

The Justice Department declined requests for comment on its medical marijuana agenda or on the aftermath of a Rohrabacher-Farr expiration. Representatives Sam Farr (D-Calif.) and Dana Rohrabacher (R-Calif.) introduced and passed the bill in 2014, after years of failed attempts, as part of the Commerce, Justice and Science Appropriations Bill for fiscal year 2015. It has been renewed twice since then, until House Republican leadership blocked a vote on it in September.

Under the bill, none of the funds appropriated by Congress to the D.O.J. can be used “to prevent [states] from implementing their own laws that authorize the use, distribution, possession, or cultivation of medical marijuana.” Congress has to vote on it every year.

Nicholas Vita, the CEO of Columbia Care, a medical marijuana healthcare company with dispensaries across the country, said Sessions “clearly has a bias.” His company owns five dispensaries in New York –– including the one in Rochester, where Jendron gets her weed. But, Vita said, “The toothpaste can’t be put back in the tube.” With such high support across the country, a full reversal seems extremely unlikely. 

11_21_ColumbiaCareDispensary Inside Columbia Care, a medical marijuana dispensary in Manhattan. Newsweek/Melina Delkic

Columbia Care’s Manhattan dispensary looks more like the lobby of a luxury hotel than a place to get weed, but with much more security. Its marijuana is mostly stored in a thick and ominous-looking steel safe, an extra-cautious precaution to make sure the dispensary complies with DEA standards. It comes in three, carefully measured formats –– capsules, a tincture (liquid cannabis extract) that patients take with a dropper, and a vape pen.



IMG_0765 A pharmacist at the Manhattan branch of Columbia Care, a medical marijuana dispensary chain, holds a vape pen. Newsweek/Melina Delkic

Vita said public perception on dispensaries like Columbia’s has changed rapidly.

“Five years ago, no one even talked to us,” Vita said. “I couldn’t even tell my mom and dad what I do for a living.” Today, he says leading research institutions reach out to him to partner on studies.

Despite the turnaround, strong dissenting voices remain. 

Kevin Sabet, president of the nonprofit Smart Approaches to Marijuana, an anti-marijuana legalization group led by former Representative Patrick Kennedy (D-RI), said legal weed was not as harmless as the recent hype has made it out to be. “A lot of people are being peddled this by an industry that wants to make money, like any other industry,” he said. “I have a really hard time with the very small handful of studies out. They’re just not something that the scientific community agrees upon.”

Studies are indeed limited, because marijuana is a Schedule I drug, making it hard to get DEA funding for that research. A recent study in Colorado found a reversal of opioid deaths following recreational legalization. Two August studies found, however, that evidence of its efficacy in chronic pain or PTSD treatment was lacking. While far from a consensus, its patients seem hopeful. 

For patients like Jendron, the proof is in lived experience. 

Chronic pain “manipulates your life,” she said. “I’m smiling because I don’t hurt anymore.” 


TN veteran sues VA for cutting off pain med prescription

TN veteran sues VA for cutting off pain med prescription


A Veterans Affair initiative to curb addiction by cutting back on opioid prescriptions is backfiring, according to some Tennessee veterans.

East Tennessee Marine veteran Robert Rose Jr. has filed a $350 million lawsuit that names several employees of the Mountain Home Veterans’ Affairs Medical Canter and U.S. Rep. Phil Roe, R-TN.

Rose said he has chronic pain in his back, spine and legs as a result of severe injuries while in the service.

He said he has been tormented since last November, when he was forced off pain medication.

According to the VA, more than 221,000 veterans have been weaned off opioids since fall of 2013.

Rose said the veterans who are not addicted, and have severe pain are being neglected.

“It is a death sentence for people like me who has documented issues from the Marine Corps all the way back to 1985. They just said, no more,” Rose said.

Rose said he isn’t the only one. He said he has spoken with more than 100 other veterans with similar concerns.

A spokesperson with the VA told News 4 this month that when a decision is made to wean a veteran off opioids, every individual situation is taken in to account.

Colorado kratom death: Bereaved woman says government could have saved her brother

Colorado kratom death: Bereaved woman says government could have saved her brother

Thirty-six people in the United States have died after using kratom, a largely unregulated drug sold in shops around Denver, according to the federal government. A young man in Boulder may be among them.

Jay Knaus, 25, died in his room this year after ingesting what his sister believes was a typical dose of the substance. The Boulder coroner directly linked his death to kratom’s active component. And his sister wants action.

“How many deaths are there going to be before you do anything about it?” asked Julie Knaus.

The death is one of the reasons that the city of Denver has placed new restrictions on the drug, which also is the subject of a new federal warning.

In response, city officials will require labels saying that the product is not for human consumption. They’ll also move to shut down kratom bars that serve the drug on site.

However, the city won’t use its power to ban the sale of the product.

“What we’re seeing is products being sold without any information about dosage. In some cases, very little labeling at all. It really leaves a lot of safety concerns,” said Danica Lee, director of public health inspections for the city.

Jay Knaus was a student at Metro State University.

“Jay was a very healthy, athletic, popular guy. Everyone loved him,” said Julie, his twin sister.

A family member discovered Jay unresponsive in bed at the family home in Longmont this February. They had no idea what was wrong with him, Knaus said, and they wouldn’t have an explanation for six more weeks.

“I was looking in trash cans, all over his room, anything for an answer. We all had no idea how and why,” she said.

When it finally arrived, an autopsy from the Boulder County Coroner’s Office listed the cause of death as accidental “mitragynine intoxication.” Mitragynine is a key active compound in kratom. Knaus’ body contained a “lethal level” of the substance, the autopsy reported.

“It was definitely a product we weren’t even aware he was taking,” Knaus said.

Jay Knaus also was found to have suffered pulmonary edema — fluid in the lungs — and that he had inhaled vomit, all related to mitragynine poisoning, according to the autopsy. The toxicology report found no other substances besides caffeine and drugs that are commonly used in medical treatment and rescue attempts, such as naloxone.

The family had to look at Jay Knaus’ bank statements for hints at what had happened.

“We believe he started the spring of 2016, but then he stopped because he had side effects like itchy skin, hair loss, irritability. We didn’t know this was the product,” said Julie Knaus, who works as a physical therapist aide in California.

While many people use kratom as an alternative to heroin and other opiates, Jay Knaus had no history with those drugs, according to his sister. She believes he was attracted to kratom because he saw it as a health product.

“It was mostly marketed as a health supplement. It’s marketed as a good source of extra energy — helps you focus,” Knaus said.

Kratom is derived from a tropical tree leaf. Its fans liken it to coffee, and it’s informally used to treat chronic pain and to replace other substances, especially opiate painkillers or heroin. A typical cup might cost $1.50 to $3.

Some users say that it saved their lives from hard drugs, and they point to the prevalence of alcohol-related deaths.

Bank records reviewed by the family show that Jay Knaus stopped buying it in the summer of 2016. He apparently started again late in January, making three purchases in the last week of his life. The purchases were of moderate size, his sister said.

His last purchase came from a Denver business, Julie Knaus said, but she declined to name the business.

The death reflects broader concerns.

In a statement issued last week, FDA Commissioner Scott Gottlieb warned that the administration was “aware of reports of 36 deaths associated with the use of kratom-containing products.” It’s unclear whether that figure includes Jay Knaus.

Chris McCurdy, a professor of medicinal chemistry at the University of Florida and leading expert on kratom, told Denverite that it’s “a total ‘buyer beware’ marketplace at this point.”

The drug has been used in Thailand and Malaysia “for centuries with no related deaths” reported, he wrote in an email. “However, in the USA this has obviously been a different story.”

A lack of regulation of dietary supplements is part of the problem, he continued. “This, unfortunately, means that it is impossible to tell what one is purchasing when they believe they are purchasing kratom,” he wrote.

It’s particularly concerning that kratom may be mixed with other substances, McCurdy added. A study found kratom-related deaths tended to involve other drugs too.

The Knaus family has consulted with medical experts who said that the level of mitragynine in Jay’s body was not atypical for kratom use, according to Julie Knaus.

What will Denver do next?

Denver’s new rule will require a label on each kratom package in large font, reading:

“This product is not intended for human consumption. Consuming kratom products may pose a risk, including death, to consumers and has addictive potential. Increased risk of injury or death may be posed by consuming with alcohol and other drugs.”

The city briefly went further than that, issuing a total ban on sales last fall. At the time, Denver was responding to the federal Drug Enforcement Administration, which had proposed a ban and suggested that kratom was an “imminent hazard” to public health.

However, the DEA reversed course. It withdrew its proposal to make the substance illegal and called for more research. One researcher said the change was “shocking.” And Denver followed suit, withdrawing its ban in October 2016.

Julie Knaus says that a different government decision could have saved her brother’s life. “I know if it was scheduled in September 2016 as a drug, he would not have died,” she said. Now, she wants Denver and other governments to go further. Instead of warnings, she wants a ban.

“Putting a label on every single package — I think that’s a step in the right direction,” she said. But she wants it to be restricted as a prescribed medicine, she said.

Lee, the Denver health official, said that instituting a total ban would be a difficult legal move, especially as higher levels of government haven’t banned the sale of the product either.

“At this point in time, we don’t feel it’s appropriate to implement a complete ban, given the fact that there are other uses (of kratom) and the state health department isn’t taking any action,” Lee said.

A local ban “would be using broad authority, and we would definitely have to make sure we’re taking a defensible position. This is what we feel comfortable with at this time.”

There Is No Determined Toxic Level Of Kratom

Confirming the subjective nature of that number, in a paper published by Forensic Science International, dated December 2014 and titled “An Accidental Poisoning with Mitragyna” it is stated, “ Toxicity of mitragynine in humans is poorly defined, and no toxic or lethal ranges have been established.  Kronstrand et al. [7] found mitragynine levels in nine cases that varied between 0.02 and 0.18 μg/g. Holler et al.[14] and Neerman et al. [15] found mitragynine concentrations of 0.39 mg/L and 0.60 mg/L in post-mortem blood samples”.


How many pieces are missing from the puzzle ?

I have been posting on this blog, now in my SIXTH YEAR…  Hardly a week that doesn’t go by that I get at least one notice that someone has added me to a NEW FACE BOOK PAGE CONCERNING CHRONIC PAIN.

Just how many THOUSAND(s) for Face Book Pages do we need that are focused on those in the chronic pain community and it’s issues ?

Does the old saying “United we stand… divided we fall ” … seem to apply here.

IMO, there is simply a SINGLE ISSUE that effects all of those in the chronic pain community – you are either getting adequate pain management or you are being denied adequate pain management… There are numerous players involved prescribers, pharmacists, insurance companies and various governmental agencies.

There are a number of sub-issues,  but helping getting optimized pain management for all chronic pain pts.. those other issues should go away or become basically non-issues.

It is estimated that there is about 230 million eligible voters and in the typical Presidential election… 106 million will fail to vote and more will fail to vote in “off-year” elections.

Generally speaking, 98% of politicians – especially Congress – will get reelected no matter what they do – or don’t do – when they are in office.

Congress and state legislatures generally function on a seniority basis… those who have been around the longest, get to pretty much control what bills get passed or even what bills even get to be voted on by the entire body.

Everyone should be able to register to vote BY MAIL and vote BY MAIL.. there is no reason for failing to vote… If you don’t know who to vote for… vote for the person challenges the current person holding the office.  Especially those who have been “in power” for decades.

The other issue is that all of these thousands of Face Book Pages either need to consolidate or their members consolidate around a SINGLE FACE BOOK PAGE… so that everyone can get a better picture of what is going on for/against those in the chronic pain community..   A clearer picture – unlike the above puzzle…

You can contact the media and politicians, but the DEA and other agencies have at least a couple of dozen decades lead in putting out anti-opiate propaganda pieces…

Here is a link to all the press releases from the 22 DEA offices across the country back to 2002

We also don’t know how many “behind closed door meetings” that upper level DEA agents have with members of Congress and members of city/county/state of law enforcement that can have “informal -off the record -meetings” with bureaucrats/legislators.

The chronic pain community doesn’t need a SINGLE SPOKESPERSON… but.. they do need a SINGLE MESSAGE… Until that happens, the chronic pain community will look like the above puzzle … no clear picture/message because a lot of pieces are missing.

the DEA can avoid potentially awkward questions about the legality of its evidence

DEA Reportedly Hiding NSA Data Used To Prosecute U.S. Citizens

The Snowden effect continued to roll today, with fresh revelations detailing how the pervasive surveillance of the National Security Agency (NSA) is in fact linked to domestic criminal prosecution. The idea, and the defense, that NSA activity only impacts non-United States citizens and terrorists, is now utterly specious.

The NSA is one of the member agencies of a DEA unit called the Special Operations Division (SOD). The SOD, according to Reuters who broke the story, is at work “funneling information from intelligence intercepts, wiretaps, informants and a massive database of telephone records to authorities across the nation to help” start, and win criminal investigations of United States citizens.

Therefore, there is a direct connection between the NSA and its surveillance efforts and regular criminal prosecution in the country.

The Washington Post read the Reuters piece as an indication the NSA is leaking phone record information to the DEA, through the SOD, but we’re not convinced that it’s a proper reading of the source. However, the SOD does operate the ‘DICE’ database, which the DEA told Reuters has around 1 billion records, both telephonic and digital. The majority, but not all, are sourced by the DEA itself.

What’s most surprising about today’s revelations is the process by which the DEA covers the tracks of its information. Using “parallel construction,” where information came from is hidden. Reuters tells a story in which a judge was told that a tip kicked off the investigation at hand. However, after pressing, it was admitted that the data had in fact been first captured by the NSA, and distributed by the SOD.

By creating new pasts for received data, the DEA can avoid potentially awkward questions about the legality of its evidence.

And the data that the NSA collects could be very useful to the DEA. The NSA, for example, collects metadata on every phone call placed in the United States. It is not clear what the NSA shares, or how often. However, it’s the fact that NSA data is being handed to the DEA through the secret SOD that is troubling prima facie.

This is not the last time that we will have a conversation similar to this one. According to the New York Times, other agencies inside the Federal government are clamoring for the information that the NSA has collected, and continues to collect.


It has also recently been reported that members of Congress are being denied access to information about the NSA’s activities, both by having requests ignored, or simply denied. Glenn Greenwald has primary source information, letters sent by members of Congress asking for specific information.

Others have reported similar issues in more pedestrian fashion, including Rep. Justin Amash, who tweeted that access to certain information was provided for a mere three hours, and that many Representatives missed the chance, and that those who did see the document in question were not allowed to discuss it with those that did not.

There is work afoot, as you might have expected, to keep information regarding the NSA’s activities out of the public eye. To some extent that is perfectly reasonable, given that such agencies are clandestine by nature. When Congress, tasked with oversight of American intelligence operations, is lied to, denied information, and then provided only select facts for limited periods of time, something is wrong.

And, given that the NSA is slipping the DEA information about domestic phone calls, we’ve never needed more stern hands on the NSA’s wheel.

FDA: Potentially Life-Threatening Adverse Events Linked to Limbrel

FDA: Potentially Life-Threatening Adverse Events Linked to Limbrel

The Food and Drug Administration (FDA) has issued an advisory regarding serious adverse events linked to the medical food Limbrel (flavocoxid; Primus).

Limbrel is indicated for the dietary management of the metabolic processes associated with osteoarthritis, and is available in 250mg and 500mg strength capsules. The capsules contain two types of flavonoids called bicalin (from Scutellaria baicalensis) and catechin (from Acacia catechu); both dosages contain zinc. 

A total of 194 adverse events have been reported regarding Limbrel, and an association between its use and the reported adverse events was determined in 30 of those cases. 

Specifically, there have been reports of two serious and potentially life-threatening medical conditions among these adverse events: drug-induced livery injury and hypersensitivity pneumonitis. Symptoms of drug-induced liver injury can include jaundice, nausea, fatigue, and gastrointestinal discomfort. Symptoms of hypersensitivity pneumonitis can include fever, chills, headache, cough, chronic bronchitis, shortness of breath or trouble breathing, weight loss, and fatigue.

While the FDA is reviewing the formula and manufacturing process for Limbrel, clinicians and consumers are recommended not to use the product. Consumers should immediately discontinue use and report any of the aforementioned symptoms if they occur. Healthcare professionals should advise their patients to immediately stop taking Limbrel and report any symptoms related to the product to MedWatch.

For more information call (480) 483-1410 or visit

Indiana: pharmacists would be required to dispense prescription drugs in lockable bottles.

Opioid bills will put focus on prescription reform

INDIANAPOLIS — After passing 15 bills last session in an attempt to stem the opioid crisis, the Indiana General Assembly will fine-tune some of those during the upcoming short session.

Among prescription reform efforts, pharmacists would be required to dispense prescription drugs in lockable bottles.

“These are vials that opioids will leave the pharmacy and have a pin number … where you put the vial in the medicine cabinet, you know no one can get into it,” said state Sen. Jim Merritt, R-Indianapolis.

 Randy Hutchens, executive vice president of the Indiana Pharmacists Association, said the association did not yet have a position on Merritt’s proposals.

But in a statement, Hutchens said, “Our Indiana Pharmacists Alliance is supporting the fight against the opioid crisis in Indiana. We support pharmacists serving as a primary resource as a medication expert to counsel patients about their medications and reduce opioid misuse; drug take back programs; and prescription drug monitoring.”

Both Indiana House Speaker Brian Bosma, R-Indianapolis, and Senate President Pro Tem David Long, R-Fort Wayne, said this week that the opioid crisis would be one of the two top legislative issues facing the 2018 session. The other issue is workforce development, they said.

The Indiana Department of Health says the three most commonly prescribed drugs that are abused include opioids, depressants and stimulants. Opioid pain relievers, including hydrocodone and oxycodone, contributed to 274 of the 1,236 drug overdose deaths in 2015 in Indiana.

Heroin overdoses, however, saw 40 percent increase in 2015 compared to 2014, a rise that the department attributed to heroin’s relatively cheap price and easier accessibility.

Merritt said he also planned to introduce legislation requiring pharmacies to initiate prescription take-back programs, as well as legislation requiring all licensees for controlled substances be registered in INSPECT, the state’s prescription monitoring program.

Some physicians have said that their rural offices do not have reliable access to the internet and, subsequently, to the INSPECT system.

 Merritt said his legislation would only require registration and not mandate use of the system  (INSPECT).

Donnelly bill increases shared data

A bill to address opioid abuse by veterans was signed into law this week by President Donald Trump.

The bipartisan bill was introduced by U.S. Sens. Joe Donnelly, D-Indiana, and Mike Rounds, R-South Dakota.

The Veterans Administration Data Accountability Act, Donnelly said, will enable the VA to share data with Indiana’s prescription drug monitoring program, INSPECT.

The VA is currently sharing prescription data only on veterans, not their dependents or others treated by VA providers, due to technical issues related to the VA’s health records system. As a result, a significant amount of VA prescription data is not being shared with the state’s prescription drug monitoring program, Donnelly said.

Apparently Senator Merritt has never heard of a hammer. 

See the source image

While a lockable bottle might prevent someone from taking a few tablets out of the bottle in a friend’s/relative’s medicine cabinet…  they will just TAKE THE ENTIRE BOTTLE.

And to require all prescribers to register to the state’s PMP system ( INSPECT).. BUT DON’T HAVE TO USE IT.

Changing One Word in Oklahoma Law Could Go a Long Way in Opioid Crisis

Oklahoma law currently says electronic prescribing may be used for controlled substances. A task force wants that “may” changed to “shall.”

The one-word switch would effectively end paper prescriptions for opioids, which are Schedule II drugs. Tulsa County Director of Governmental Affairs Terry Simonson said those are easily forged.

Nearly every expert on an opioid task force — from pharmacists to DEA agents — was fooled by a fake prescription. A real prescription was scanned and altered on a computer and printed on security paper readily available online.

The security paper simply can’t be photocopied.

“It was so easy. It was just kind of mind-boggling that that’s all it took,” Simonson said.

According to Surescripts, only 8 percent of the 14,000 prescribers in the state of Oklahoma are using e-prescribing for controlled substances. Meanwhile, 96 percent of the state’s pharmacies can receive electronic prescriptions.

Attorney General Mike Hunter said e-prescribing could be an important piece of a comprehensive solution the Oklahoma Commission on Opioid Abuse will recommend later.

“But I’m convinced that it will have a material impact on this leakage of opioids into the hands of addicts,” Hunter said.

Besides making it difficult to forge prescriptions, e-prescribing would make it easer for doctors to prescribe smaller amounts of opioids. The drugs are often given in larger amounts than needed so patients won’t be stranded with an insufficient supply for their pain. An electronic prescription could be easier for doctors to monitor and renew as needed.

The Tulsa County task force has the ear of state Rep. Glen Mulready for a bill to change the law saying electronic prescribing may be used for controlled substances to say it shall be used. Sen. AJ Griffin said she is interested in being a bill’s senate sponsor, and she has other legislation in mind.

“Our state is one of the very few that does not have a 911 Good Samaritan law. I have introduced that piece of legislation now for four years, and it’s been blocked every time,” Griffin said. “It will be my No. 1 priority as we move into 2018 session.”

There are 40 states with Good Samaritan laws to help protect people from drug possession charges when they call 911 for an overdose.

This change in the law could have MAJOR UNINTENDED CONSEQUENCES..

While the DEA has changed the law about if a pharmacy can transfer a electronic C-II to another pharmacy if the pharmacy that originally received the electronic C-II did not have inventory and/or the Pharmacist was “not comfortable” filling it… Before the law was changed… at this point the electronic C-II became DOA.

Because the DEA has changed the law… does not mean that the pharmacy’s software has been updated to be able to forward/transfer the electronic C-II to another pharmacy and/or the state’s laws have not been updated to agree with the Federal law..

As they say….

“The road to hell is paved with good intentions”

%d bloggers like this: