Monday 8 PM EDT: communication campaign to end government overreach

Monday Webinar:

The Communication Campaign

Link: https://join.me/sevenpillars
How do we get information to the legislators and President that they can’t ignore and dismiss with a form letter?  Through coordinated mass emails/FB posts/tweets from hundreds of constituents at the same time.  DoctorsofCourage is spearheading such a campaign.

Major advocates in the work of stopping the attacks on patients and pain management providers met on the webinar Monday, June 24. We put our heads together, discussed what has been tried, but hasn’t worked, and are working on a coordinated effort to design effective communication. This is a start. We will be working every Monday on a communication campaign that hopefully all will participate in. If you have any ideas to share, please send them to me at lindacheek@doctorsofcourage.org. I will share with the group. If you are interested in becoming an active advocate in the campaign, please join us next Monday at 8:00 EDT.

To dial in by phone:

United States – Camden, DE
+1.302.202.5900

United States – Denver, CO
+1.720.650.5050

United States – Los Angeles, CA
+1.213.226.1066

United States – New York, NY
+1.646.307.1990

United States – Tampa, FL
+1.813.769.0500

United States – Washington, DC
+1.202.602.1295

More phone numbers

Conference ID:
848-079-407 #

2018 in review … what killed us

Today is 07/21/2019.. who will not be here tomorrow

2016 in review … what killed us

2017 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, 2018 – Dec 31, 2018 (6:27:30 PM)


Someone just died by: Death Box

Just the Data … Raw and Undigested


Abortion *: 1091318
Heart Disease: 613959
Cancer: 591325
Tobacco: 349779
Obesity: 306806
Medical Errors: 251295
Stroke: 133019
Lower Respiratory Disease: 142853
Accident (unintentional): 135967
Hospital Associated Infection: 98937
Alcohol *: 99937
Diabetes: 76440
Alzheimer’s Disease: 93482
Influenza/Pneumonia: 55192
Kidney Failure: 42735
Blood Infection: 33443
Suicide: 42746
Drunk Driving: 33787
Unintentional Poisoning: 31738
All Drug Abuse: 24989
Homicide: 16788
Prescription Drug Overdose: 14991
Murder by gun: 11486
Texting while Driving: 5985
Pedestrian: 4997
Drowning: 3913
Fire Related: 3498
Malnutrition: 2770
Domestic Violence: 1459
Smoking in Bed: 780
Falling out of Bed: 598
Killed by Falling Tree: 149
Lawnmower: 68
Spontaneous Combustion: 0
Your chance of death is 100%. Are you ready?

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 Örtegrentook 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


Jessica Starr   Dec, 2018 failed Lasik SMILE eye surgery resulting in chronic pain


Paolo Antonio Argenzio:  Passed away on Monday December 10th 2018, from a self inflicted gunshot wound


Rory G. Hosking, age 50, honorable Army Veteran, passed away Feb. 9, 2019 from his struggle with chronic pain


Sonya White has passed away on Thursday March 7, 2019 at 30 years old


Danielle Byron Henry 10th June, 2017


Kelly Catlin, the 23-year-old Olympic cyclist with debilitating migraines committed suicide 16th March, 2019


Dawn Anderson was 53 years old, and a former Registered Nurse died on March 11, 2019 in untreated agonizing pain


Adam Palmer Jan 20,2019    Family says Pleasant Grove man committed suicide after going off pain meds too quickly


Bobbi Fencl April 9, 2019 My wife Bobbi Fencl is one of the recent casualties of the insane Federal, State and Physician response to the Opioid Crisis. She committed suicide this last Tuesday. She is now out of pain and wrapped in His arms.


Post on FB 07/18/2019 – exact suicide date unknown: 

Remember The Fallen Pain Warriors.
Travis Patterson, a Texan, a decorated Staff Sergeant in the Army, combat veteran of Iraq and Afghanistan, was injured by a road side mine, and discharged from the army in 2016. He was in daily severe pain. He could not get pain treatment, and tried to commit suicide and was admitted to a Topeka Kansas VA hospital by his 26 year old wife. The VA refused to treat his war wounds with pain medicine and offered instead a stress ball. Two days later he made sure of his own method for treating his intractable pain by killing himself. He had a future with his wife and studying law but it did not matter. He showed no signs of mental illness, just the stress of failure to treat his underlying war injuries with long term daily pain. One other veteran remarked the US Government was finding other ways to “kill us”.

Additional information: Travis was denied pain medication for this combat wounds by the VA by law passed without knowledge of most 12–15, deep in a 2000 page budget bill. It is now federal law to forcibly taper wounded veterans with intractable pain to “prevent addiction and heroin overdoses” Traviswas a Texas native).


 

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

 

CHRONIC ILLNESS & RELATIONSHIPS

CHRONIC ILLNESS & RELATIONSHIPS

Having HEALTH INSURANCE is NO GUARANTEE of actually getting HEALTHCARE SERVICES

Study: 40% of Doctors Refuse New Chronic Pain Patients Using Opioids

 

 

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Many/most of the people who are running in the Democratic primary claim that healthcare is a RIGHT…. They are promoting “Medicare for all” but what they are describing is “Medicaid for all” because they are talking about services covered from “first dollar” which describes MEDICAID and no one is mentioning monthly premiums, deductibles and co-pays to be paid by the pt which is the norm for Medicare.

Shouldn’t these potential Presidential candidates be pressed to answer if they will make the DEA do their job of stopping illegal drug traffic because the illegal drugs (illegal Fentanyl, meth, cocaine) is what is causing the majority of the OD’s. They should also go after the diverters conning prescribers and does “healthcare for all” include that all substance abusers are entitled to treatment ?  What they are promising – in generalities – has a lot of components that should be inclusive.  Should those who are making these promises … should their feet be held to the fire to expand the details of what their version of “Medicare for all” really means ?

Study: 40% of Doctors Refuse New Chronic Pain Patients Using Opioids

Study: 40% of Doctors Refuse New Chronic Pain Patients Using Opioids

https://www.usnews.com/news/healthiest-communities/articles/2019-07-12/study-40-of-doctors-refuse-new-chronic-pain-patients-using-opioids

“Insurance status and whether the clinic provided for treatment of (opioid use disorder) were not associated with willingness to accept the new patient taking opioids,” according to the study, published in the online Journal of the American Medical Association.

In the national fight against opioid abuse, policymakers and politicians have deployed a range of strategies, including curbing access to the powerful prescription drugs. The logic: Stop addiction before it starts by restricting the amount of painkillers a patient can take.

But a new paper published Friday presents strong evidence that opioid users who take the drug for chronic pain — but show no signs of addiction — are suffering harmful, potentially deadly consequences of the crackdown, and are at risk of becoming “opioid refugees.”

Slightly more than 4 in 10 doctors’ offices refused to take on new patients who need opioids to control pain, according to the analysis, published in the online Journal of the American Medical Association.

That reluctance, the paper argues, could lead patients who use the drug responsibly as well as those who are addicted to seek out other ways to manage their condition — including illegal potentially dangerous substances like heroin — and increases their risk of suicide.

The results “are concerning not only because they demonstrate how difficult it may be for a patient with chronic pain to find a new primary care physician, but it also raises questions about what happens next,” says Dr. Pooja A. Lagisetty, an internist and researcher at the University of Michigan Institute for Healthcare Policy and Innovation. Lagisetty was the lead author of the paper, “Access to Primary Care Clinics for Patients With Chronic Pain Receiving Opioids.”

“Where will these patients find relief for their pain? Will they turn to more dangerous illicit opioids?” says Lagisetty. If those patients can’t get a primary care doctor, she adds, “who will manage their other medical problems such as their diabetes and hypertension?”

The situation is likely due to “a combination of factors,” Lagisetty says, including “new regulations (on opioid prescriptions) that are time-consuming (for doctors) to comply with” as well as medical liability, and “stigma against patients with chronic pain.”

Looking to examine whether medical practitioners were willing to take on patients who use opioids — and continue writing prescriptions for them — researchers contacted more than 190 doctor’s offices and clinics in Michigan between June and October of last year.

Following a script, the callers told the medical-care provider that they were the child of a woman who needed a primary-care physician, but “before we get too far, is it OK if my mother takes opioids for pain?”

Of 194 clinics, “40.7% stated that their practitioners were not willing to provide care for new patients taking opioids,” compared to 41% who were willing to schedule an initial appointment, according to the study. Seventeen percent of the clinics wanted more information before deciding whether to accept the patient, but after receiving the information only one agreed to treat her.

“Insurance status and whether the clinic provided for treatment of (opioid use disorder) were not associated with willingness to accept the new patient taking opioids,” according to the study. “However, larger clinics with more practitioners and community health centers were more than willing” to take on an opioid-using patient.

The results could reflect “practitioners’ discomfort with managing opioid therapy for chronic pain or treating patients with OUD as a result of pressures to decrease overall opioid prescribing,” the study says. Further, “our study found that a low number of clinics provided any medications for treatment of” opioid addiction, “and a large number of front-desk staff at clinics … did not know whether their clinic offered OUD treatment.”

Lagisetty found the results surprising “because I expected it to be around 25%” of clinics who wouldn’t take on opioid-using patients. “Forty percent was much higher than I thought it would be.”

For patients, “I think that is still really problematic,” she says. “It’s hard to build a trusting relationship with your doctor to treat your other medical conditions if you feel like your doctor is not willing to address your pain.”

“As a primary care physician, I will often see new patients who say that their previous doctor just stopped prescribing opioids for them,” Lagisetty says. “When I ask why, many will say that the doctor said it was a new ‘policy.’ We see stories about abandoned patients all over the news, and I also think we talk a lot about stigma against patients with addiction, but there is also stigma against patients with pain.”

FDA warning: non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke

FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes

https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-strengthens-warning-non-aspirin-nonsteroidal-anti-inflammatory

The U.S. Food and Drug Administration (FDA) is strengthening an existing label warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke. Based on our comprehensive review of new safety information, we are requiring updates to the drug labels of all prescription NSAIDs. As is the case with current prescription NSAID labels, the Drug Facts labels of over-the-counter (OTC) non-aspirin NSAIDs already contain information on heart attack and stroke risk. We will also request updates to the OTC non-aspirin NSAID Drug Facts labels.

Patients taking NSAIDs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech.

NSAIDs are widely used to treat pain and fever from many different long- and short-term medical conditions such as arthritis, menstrual cramps, headaches, colds, and the flu. NSAIDs are available by prescription and OTC. Examples of NSAIDs include ibuprofen, naproxen, diclofenac, and celecoxib (see Table 1 for a list of NSAIDs).

The risk of heart attack and stroke with NSAIDs, either of which can lead to death, was first described in 2005 in the Boxed Warning and Warnings and Precautions sections of the prescription drug labels. Since then, we have reviewed a variety of new safety information on prescription and OTC NSAIDs, including observational studies,1 a large combined analysis of clinical trials,2 and other scientific publications.1 These studies were also discussed at a joint meeting of the Arthritis Advisory Committee and Drug Safety and Risk Management Advisory Committee held on February 10-11, 2014External Link Disclaimer.

Based on our review and the advisory committees’ recommendations, the prescription NSAID labels will be revised to reflect the following information:

  • The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.
  • The risk appears greater at higher doses.
  • It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
  • NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
  • In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
  • Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
  • There is an increased risk of heart failure with NSAID use.

We will request similar updates to the existing heart attack and stroke risk information in the Drug Facts labels of OTC non-aspirin NSAIDs.

In addition, the format and language contained throughout the labels of prescription NSAIDs will be updated to reflect the newest information available about the NSAID class.

Patients and health care professionals should remain alert for heart-related side effects the entire time that NSAIDs are being taken. We urge you to report side effects involving NSAIDs to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.

en Español

Drug Safety Communication (PDF- 84KB)

Calling all civil rights and personal injury attorneys

This office practice seems to be making a public statement that they are going to segregate the care that all pts with chronic health issues are dealing with.. EXCEPT those who are dealing with chronic pain.

So are the prescribers in this practice … when dealing with a pt that has a health issue where chronic pain is part of the disease… think Lupus, MS, RA and other serious.. even life threatening diseases and these health issues are NOT CURABLE… at best .. they can only be managed and part of that management should be the pain associated with those health issues.

Whoever came up with this policy did not consult any attorney  – or consulted an attorney that has little/no knowledge about the Americans with Disability Act or the attorney advised the practice that no pt would file a complaint or file a lawsuit… as if the pts are NOT THAT SMART ?

I hope that the pts that patronize this practice that the practice is fairly large or owned by a large hospital corporation… because both of those entities are likely to have DEEP POCKETS .. and that is what attorneys look for… DEEP FINANCIAL POCKETS.

Not all criminals are alike – some carry BADGES

DEA Agents Sold Opioids, Stole Cash, and Falsely Identified Drug Suspects, Say Feds

Seize the drugs. Sell the drugs. Arrest the buyers. Repeat.

www.reason.com/2017/10/04/dea-agents-sold-opioids-stole-cash/

Four former Drug Enforcement Administration (DEA) operatives face federal corruption and conspiracy charges after allegedly engaging in all sorts of shady behavior, from selling drugs themselves to lying under oath, falsifying records, falsely identifying drug suspects, accepting bribes, and stealing cash and other property from the people they arrested. In at least one instance, their behavior led to someone being wrongly imprisoned for more than two years.

The dirty drug warriors—special agent Chad Scott, with the DEA since 1997, and former task force officers Rodney Gemar, Karl Newman, and Johnny Domingue—worked with the DEA’s New Orelans Division. Gemar and Newman also work for local law enforcement agencies.

In an indictment unsealed this week, Scott, Newman, and Gemar—a Hammond Police Department officer since 2004 and DEA Task Force Officer since 2009—are accused of seizing money and other property from those they arrested and then keeping it for themselves. (Notably, the feds do not frame this as theft from the suspects but as embezzling funds from the DEA.) This went on for at least seven years.

Scott is also accused of accepting $10,000 from a defendent in a federal criminal case in exchange for recommending that prosecutors seek a reduced sentence and, in another case, tampering with witness testimony.

Scott allegedly coerced Frederick Brown (a defendent in his own drug case) “to falsely testify that Jorge Perralta was present during drug transactions between Edwin Martinez and [Brown], when in fact Frederick Brown had never seen Jorge Perralta during his drug transactions with Edwin Martinez.” Scott reportedly offered his own false testimony in the case as well.

The DEA agent claimed that it was Brown who initially brought up Perralta when talking about people who were around during deals and might be Martinez’s supplier, referring to Perralta not by name but as “the little Mexican guy.” Scott said that he showed Brown a photograph of Perralta on his phone, and that Brown confirmed this was the dude he had seen during drug deals.

An arrest warrant was issued, and Scott went to Houston to help police there arrest Perralta for conspiracy to distribute heroin and cocaine. Perralta’s phone was seized, he was taken into custody, and—without even being allowed to contact his parents or girlfriend—he was whisked away to Louisiana. That was in March 2015.

After nearly two and a half years behnd bars, Perralta was released in August 2017 and all charges against him were dismissed.

Brown had never brought up Perralta on his own, say prosecutors in their indictment against Scott. And when shown a picture of Perralta, Brown said that he had never seen him.

Both Scott and Gemar were arrested on October 1 and released on bond the next day.

Newman and Domingue were arrested in 2016. According to federal prosecutors, Newman seized and sold thousands of dollars worth of cocaine and oxycodone. Some of these drugs he seized from a woman identified as R.G. “by means of actual and threatened force, violence, and fear of injury…to R.G.’s person and the persons of her family.”

Domingue is accused only of falsifying records related to this illegal drug seizure. His trial is set February 2018.

Newman has agreed to plead guilty to one count of “conspiracy to convert property” and one count of using a gun in furtherance of a crime of violence, in exchange for prosecutors dropping the other charges against him. He faces fines of up to $500,000 and possible life in prison, with a mandatory minimum sentence of at least five years.

 

What TWO DRUGS have killed 12 million people since 1996 – answer at end of post

Internal drug company emails show indifference to opioid epidemic

https://www.washingtonpost.com/investigations/internal-drug-company-emails-show-indifference-to-opioid-epidemic-ship-ship-ship/2019/07/19/003d58f6-a993-11e9-a3a6-ab670962db05_story.html

In May 2008, as the opioid epidemic was raging in America, a representative of the nation’s largest manufacturer of opioid pain pills sent an email to a client at a wholesale drug distributor in Ohio.

Victor Borelli, a national account manager for Mallinckrodt, told Steve Cochrane, the vice president of sales for KeySource Medical, to check his inventories and “[i]f you are low, order more. If you are okay, order a little more, Capesce?”

Then Borelli joked, “destroy this email. . .Is that really possible? Oh Well. . .”

Previously, Borelli used the phrase “ship, ship, ship” to describe his job.

Those email excerpts are quoted in a 144-page plaintiffs’ filing along with thousands of pages of documents unsealed by a judge’s order Friday in a landmark case in Cleveland against many of the largest companies in the drug industry. A Drug Enforcement Administration database released earlier in the week revealed that the companies had inundated the nation with 76 billion oxycodone and hydrocodone pills from 2006 through 2012. Nearly 2,000 cities, counties and towns are alleging that the companies knowingly flooded their communities with opioids, fueling an epidemic that has killed more than 200,000 since 1996.

The filing by plaintiffs depict some drug company employees as driven by profits and undeterred by the knowledge that their products were wreaking havoc across the country. The defendants’ response to the motion is due July 31.

In January 2009, Borelli told Cochrane in another email that 1,200 bottles of oxycodone 30 mg tablets had been shipped.

“Keep ’em comin’!” Cochrane responded. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are. . .”

Borelli responded: “Just like Doritos keep eating. We’ll make more.”

Borelli and Cochrane did not return calls for comment Friday night.

In a statement Friday night, a spokesman for Mallinckrodt sought to distance the company from Borelli’s email: “This is an outrageously callous email from an individual who has not been employed by the company for many years. It is antithetical to everything that Mallinckrodt stands for and has done to combat opioid abuse and misuse.”

The Controlled Substances Act requires drug companies to control against diversion, and to design and operate systems to identify “suspicious orders,” defined as “orders of unusual size, orders deviating substantially from a normal pattern, and orders of unusual frequency.” The companies are supposed to report such orders to the DEA and refrain from shipping them unless they can determine the drugs are unlikely to be diverted to the black market. The plaintiffs, in the filing, allege that the companies ignored red flags and failed at every level.

[76 billion opioid pills: An epidemic unmasked]

At Cardinal Health, one of the nation’s largest drug distributors, then-CEO Kerry Clark in January 2008 wrote in an email to Cardinal senior officials that the company’s “results-oriented culture” was perhaps “leading to ill-advised or shortsighted decisions,” the filing contends.

In the previous 18 months, Cardinal had been hit with nearly $1 billion in “fines, settlements, and lost business as a result of multiple regulatory actions,” the filing alleges, including the suspension of licenses at some of its distribution centers for failing to maintain effective controls against opioid diversion.

Cardinal Health did not immediately return a request for comment Friday night.

On Aug. 31, 2011, McKesson Corp.’s then-director of regulatory affairs, David B. Gustin, told his colleagues he was concerned about the “number of accounts we have that have large gaps between the amount of Oxy or Hydro they are allowed to buy (their threshold) and the amount they really need,” according to the filing, which cites Gustin’s statements. “This increases the ‘opportunity’ for diversion by exposing more product for introduction into the pipeline than may be being used for legitimate purposes.”

According to the filing, he had earlier noted to his colleagues that they “need to get out visiting more customers and away from our laptops or the company is going to end up paying the price . . . big time.”

Another McKesson regulatory affairs director responded: “I am overwhelmed. I feel that I am going down a river without a paddle and fighting the rapids. Sooner or later, hopefully later I feel we will be burned by a customer that did not get enough due diligence,” according to the filing.

McKesson is the largest drug distributor in the United States. It distributed 14.1 billion oxycodone and hydrocodone pills from 2006 to 2012, about 18 percent of the market, according to the DEA database.

The Post had made public a significant portion of a government database that records the flood of prescription opioid pain pills distributed across the U.S. View Graphic

The Post had made public a significant portion of a government database that records the flood of prescription opioid pain pills distributed across the U.S.

McKesson said that the DEA was responsible for setting the annual production quota of pills.

“For decades, McKesson has consistently reported opioid transactions to the DEA,” McKesson spokeswoman Kristin Chasen said in a statement. “We have also invested heavily in further strengthening our anti-diversion program.”

Until Friday, the documents had been sealed under a protective order issued by U.S. District Judge Dan Polster. The order was lifted a year after The Washington Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, filed a lawsuit for access to the documents and a DEA database tracking opioid sales, known as the Automation of Reports and Consolidated Orders System, or ARCOS.

The drug companies and the DEA strenuously opposed the release of the data and the documents, and Polster agreed with them. But a three-judge panel of the U.S. Court of Appeals for the 6th Circuit in Ohio ordered that some of the information should be released with reasonable redactions and the database should be made public.

By consolidating cases from around the nation, the Cleveland case, for the first time, provides specific information about how and in what quantity the drugs flowed around the country, from manufacturers and distributors to pharmacies. The case also brings to light internal documents and deliberations by the companies as they sought to promote their products and contend with enforcement efforts by the DEA.

The local and state government plaintiffs in the case argue that the actions of some of America’s biggest and best-known companies — including Mallinckrodt, Cardinal Health, McKesson, Walgreens, CVS, Walmart and Purdue Pharma — amounted to a civil racketeering enterprise that had a devastating effect on the plaintiffs’ communities.

[How have opioids affected your community? Share your story.]

The case is a civil action under the Racketeer Influenced and Corrupt Organizations (RICO) Act, making use of a law originally developed to attack organized crime.

In statements to The Post on Tuesday in response to the release of the DEA database, the drug companies issued broad defenses of their actions during the opioid epidemic. They have said previously that they were trying to sell legal painkillers to legitimate pain patients who had prescriptions. They have blamed the epidemic on overprescribing by physicians and also on corrupt doctors and pharmacists who worked in “pill mills” that handed out drugs with few questions asked. The companies also said they should not be held responsible for the actions of people who abused the drugs.

The companies said that they were diligent about reporting their sales to the DEA and that the agency should have worked with them to do more to fight the epidemic, a point former DEA agents dispute. The companies also note that the DEA set the quotas for opioid production.

“We report those suspicious orders to state boards of pharmacy and to the DEA but we do not know what those government entities do with those reports, if anything,” Cardinal Health said in a statement.

The companies issued statements rejecting the plaintiffs’ allegations.

McKesson said in its statement: “The allegations made by the plaintiffs are just that — allegations. They are unproven, untrue and greatly oversimplify the evolution of this health crisis as well as the roles and responsibilities of the many players in the pharmaceutical supply chain.”

Mallinckrodt said the company “has for years been at the forefront of preventing prescription drug diversion and abuse, and has invested millions of dollars in a multipronged program to address opioid abuse.”

Drug Enforcement Administration agents raid a pain management clinic in Delray Beach, Fla., in February 2011. A DEA database released this week revealed that drug companies had inundated the nation with 76 billion oxycodone and hydrocodone pills from 2006 through 2012. (Carline Jean/South Florida Sun-Sentinel/AP)

‘Kingpin within the drug cartel’

One of the biggest points of contention in the lawsuit is whether the nation’s largest drug companies did enough to identify suspicious orders of opioids. What exactly constitutes a suspicious order is at the heart of the case.

The DEA has long said there should be no confusion because the agency has given frequent guidance and briefings to the industry, and repeatedly defined what constitutes a suspicious order.

The plaintiffs argue that the companies failed to “design serious suspicious order monitoring systems that would identify suspicious orders to the DEA” and shipped the drugs anyway.

[As lawyers zero in on drug companies, a reckoning may be coming]

“Their failure to identify suspicious orders was their business model: they turned a blind eye and called themselves mere ‘deliverymen’ with no responsibility for what they delivered or to whom,” according to the plaintiffs’ filing.

Between 1996 and 2018, the plaintiffs alleged in the filing, drug companies shipped hundreds of millions of opioid pills into Summit and Cuyahoga counties in Ohio, filling orders that were suspicious and “should never have been shipped.”

“They made no effort actually to identify suspicious orders, failed to flag orders that, under any reasonable algorithm, represented between one-quarter and 90 percent of their business, and kept the flow of drugs coming into Summit and Cuyahoga Counties,” the plaintiffs’ lawyers wrote.

In 2007, the DEA told Mallinckrodt that the numeric formula it used to monitor suspicious orders was insufficient, the filing contended. It alleges the company’s suspicious order monitoring program from 2008 through 2009 consisted of solely verifying that the customer had a valid DEA registration and that the order was accurately logged into the DEA’s tracking database.

From 2003 to 2011, Mallinckrodt shipped a total of 53 million orders, flagged 37,817 as suspicious but stopped only 33 orders, the plaintiffs’ filing states.

A Mallinckrodt employee said in a deposition that the DEA had described the company as the “kingpin within the drug cartel” in a meeting with the agency in July 2010, according to a footnote in the filing.

In 2011, the filing cites a Justice Department document in which the DEA alleged that Mallinckrodt “sold excessive amounts of the most highly abused forms of oxycodone, 30 mg and 15 mg tablets, placing them into a stream of commerce that would result in diversion.”

According to the DEA, the filing states, “even though Mallinckrodt knew of the pattern of excessive sales of its oxycodone feeding massive diversion, it continued to incentivize and supply these suspicious sales,” and never notified the DEA of the suspicious orders.

In a settlement with the DEA, Mallinckrodt agreed that from Jan. 1, 2008, through Jan. 1, 2012, “certain aspects of Mallinckrodt’s system to monitor and detect suspicious orders did not meet the standards” outlined in letters from the DEA deputy administrator for diversion control.

Mallinckrodt was the nation’s leading manufacturer of oxycodone and hydrocodone, with 28.8 billion pills from 2006 to 2012, 37.7 percent of the market, according to the DEA database. It has since created a subsidiary for its generic opioids called SpecGx.

The Post reported in 2017 that federal prosecutors said 500 million of the company’s 30 mg oxycodone pills wound up in Florida between 2008 and 2012 — 66 percent of all oxycodone sold in the state. Pills at that dosage are among the most widely abused.

Prosecutors said the company failed to report suspicious orders, and Mallinckrodt that year settled the case by paying a $35 million fine.

“Mallinckrodt’s actions and omissions formed a link in the chain of supply that resulted in millions of oxycodone pills being sold on the street,” then-Attorney General Jeff Sessions said at the time.

McKesson Corp., the nation’s largest opioid distributor, doled out 14.1 billion oxycodone and hydrocodone pills from 2006 to 2012, about 18 percent of the market, according to the newly released DEA database. (Kris Tripplaar/Sipa USA)

‘Business as usual’

The same year that Mallinckrodt paid its fine, McKesson, the nation’s largest drug distributor, was fined a record $150 million by the Justice Department.

According to allegations in the new court filing, McKesson frequently increased the amount of opioid pills it sent to its pharmacy customers.

“McKesson has a long history of absolute deference to retail national account customers when it comes to [opioid] threshold increases,” the plaintiffs argue in their filing, citing a deposition of McKesson’s senior director of distribution operations.

McKesson had set limits on the amount of opioids its customers could order, the filing contends, but those limits were often lifted.

“In August 2014, DOJ noted that McKesson appeared to be willing to approve threshold increases for opioids for the flimsiest of reasons,” the filing contends.

For shipments to pharmacies in Summit and Cuyahoga counties, McKesson did not report a single suspicious order between May 2008 and July 2013, the filing says. During that time, McKesson filled 366,000 opioid orders in those two counties.

McKesson reached its settlement with the government in January 2017 for allegations of failing to report suspicious orders. It was the second time the company was fined over suspicious orders. Nine years earlier, it paid $13 million.

The government said in 2017 that McKesson “failed to design and implement an effective system to detect and report ‘suspicious orders.’ ” The company shipped more than 1.6 million orders of opioid pills between 2008 and 2013 but reported just 16 as suspicious, according to the Justice Department.

However, “before the ink of the settlement agreement was even dry,” the new filing argues , McKesson was already reassuring customers who were concerned that the flow of opioids would be curtailed that it would remain “business as usual” at the company. McKesson sent more than 68 million doses of oxycodone and hydrocodone to those counties between 2006 and 2012, according to DEA tracking data analyzed by The Post.

Gustin, McKesson’s former director of regulatory affairs, was recently indicted in federal court in Kentucky on a charge of illegally distributing opioids. His attorney wrote in a court filing that the allegations against his client stem from his job at McKesson and “seem to focus on the manner by which he performed his former position as Director of Regulatory Affairs.”

Gustin’s lawyer and the prosecutor in the case did not return calls for comment.

The southwest Virginia city of Norton, with a population of about 4,000, saw millions of prescription opioids arrive in seven years, with the city’s CVS pharmacy receiving 1.3 million opioids from 2006 through 2012, according to the DEA database. (Charles Mostoller for The Washington Post)

Pickers and packers

The plaintiffs in the Cleveland case alleged that CVS, the nation’s largest pharmacy chain, did not implement required controls to identify suspicious orders from 2006 until early to mid-2009.

The CVS compliance coordinator said that her title “was only for reference and not her real job position and that the only thing she ever did related to suspicious order monitoring was to update the [Standard Operating Procedures Manual],” the plaintiffs allege.

A system that CVS used to monitor suspicious orders was known as “Pickers and Packers,” according to the filing.

The pickers and packers were workers in the distribution centers who would pick and pack opioid orders. A CVS official testified that the company did not have any written policies, guidance or training programs to teach the pickers and packers how to detect suspicious orders, according to the filing.

“Instead, the Pickers and Packers would identify orders based on a gut feeling or a crude rule of thumb that essentially can be summarized that they believed the order was simply too large,” the filing states. “One of the Pickers and Packers . . . testified that she was trained by another Picker and Packer in 1996 and that as a rule a Picker and Packer should not send out more than 12 of the small bottles, six of the larger bottles and two or three of the largest bottles. She used this rule of thumb for her entire career.”

CVS’s system flagged few orders, the filing contends : A CVS distribution center in Indianapolis flagged two orders per year from 2006 through 2014.

CVS rejected the plaintiffs’ arguments.

“As part of our response in this case, we will be presenting the expert opinion of a former high-ranking DEA official who concluded independently that our systems were compliant and that the plaintiffs’ analysis is unfounded,” CVS spokesman Mike DeAngelis said.

‘Obvious signs of diversion’

Walgreens used a formula to identify thousands of pharmacy orders as suspicious but shipped them anyway, the filing alleges. The orders were reported to the DEA after they had been shipped, according to agency documents quoted in the filing.

“Suspicious orders are to be reported as discovered, not in a collection of monthly completed transactions,” the DEA wrote in an immediate suspension order issued against Walgreens in 2012. “Notwithstanding the ample guidance available, Walgreens has failed to maintain an adequate suspicious order reporting system and as a result, has ignored readily identifiable orders and ordering patterns that, based on the information available throughout the Walgreens Corporation, should have been obvious signs of diversion.”

In one case, Walgreens’s suspicious order report to the DEA was 1,712 pages long and contained six months’ worth of orders, including reports on 836 pharmacies in more than a dozen states and Puerto Rico, the filing alleges.

The filing also alleges that Walgreens stores could “place ad hoc ‘PDQ’ (“pretty darn quick”) orders to controlled substances outside of their normal order days and outside of the [suspicious order monitoring] analysis and limits.”

The Post has previously reported that Kristine Atwell, who managed distribution of controlled substances for the company’s warehouse in Jupiter, Fla., sent an email on Jan. 10, 2011, to corporate headquarters urging that some of the stores be required to justify their large quantity of orders.

“I ran a query to see how many bottles we have sent to store #3836 and we have shipped them 3271 bottles between 12/1/10 and 1/10/11,” Atwell wrote. “I don’t know how they can even house this many bottle[s] to be honest. How do we go about checking the validity of these orders?”

A bottle sent by a wholesaler generally contains 100 pills.

Walgreens never checked, the DEA said. Between April 2010 and February 2012, the Jupiter distribution center sent 13.7 million oxycodone doses to six Florida stores, records show, many times the norm, the DEA said.

Walgreens ranked second among distributors in the nation, with 13 billion pills and 16.5 percent of the market for oxycodone and hydrocodone from 2006 through 2012, the DEA database shows. It stopped distributing opioids to its stores in 2014, but continues to dispense controlled substances.

As part of a settlement with the DEA in June 2013, Walgreens said that its “suspicious order reporting for distribution to certain pharmacies did not meet the standards identified by DEA.” The company paid an $80 million fine to the government.

In a statement to The Post earlier in the week, Walgreens defended its operations, saying, “Walgreens has been an industry leader in combating this crisis in the communities where our pharmacists live and work.”

Aaron C. Davis, Jenn Abelson, Amy Brittain, Robert O’Harrow Jr., Shawn Boburg, Jennifer Jenkins, Andrew Ba Tran, Aaron Williams and Katie Zezima contributed to this report.

Since 1996, the two drugs: Nicotine & Alcohol have killed abt 12 million people – SIXTY TIMES OPIATES

 

I Will Not Be Shamed for Using Opioids to Manage My Cancer Pain

I Will Not Be Shamed for Using Opioids to Manage My Cancer Pain

I Will Not Be Shamed for Using Opioids to Manage My Cancer Pain

https://www.healthywomen.org/content/article/i-will-not-be-shamed-using-opioids-manage-my-cancer-pain

by April Doyle

The pain starts in my sit bones, radiates into my pelvic area and moves up and down my spine. When I’m having a good day, my pain is a 5 or 6 out of 10 on the pain scale. Some days, my pain escalates to an 8 or 9 and I can’t function. But when I take my opioids, the pain decreases. I can move again. I can breathe again. I can handle my full-time job. I can go to the park with my 8 year old son. I can manage my pain.

So when I went to the pharmacist in my hometown in California and the pharmacist again refused to fill my opioid prescription, I was frustrated and angry. Not only did he say that he couldn’t fill my prescription, but he made me feel like I was doing something wrong by trying to get my pain pills. I was made to feel less than human.

In order to stay alive, in order to function, I need to take 20 pills a day, four of which are opioids. It’s my only option. I have stage 4 metastatic breast cancer that is in my spine, my hips and my lungs. I don’t even take as much as is prescribed to me. But when you have metastatic cancer in your bones, the pain is so severe that you can’t even function.

It all started in 2009 at the age of 31 when I found a lump in my breast. Everyone kept saying to me, “I’m sure it’s fine.” But I instinctually knew something wasn’t right. After nothing showed up on the mammogram, I decided to go in for a lumpectomy and have it biopsied. All the doctors were surprised when it came back as breast cancer, stage 1B. I had a bilateral mastectomy with reconstruction, 4 months of chemotherapy and then I was declared cancer free!

Fast forward 5 years: I had some back pain, which I thought was sciatica. I wasn’t too concerned because otherwise, I felt great. I went into my oncologist for my 5-year check-up and he said, “Congrats! You are doing great!” But two days later, the nurse from the cancer center called and left me a voicemail saying, “Oops. We spoke too soon.” I was now told I was stage 4 and the cancer had metastasized to my bones and lungs. I had terminal cancer.

Pain management is now a major facet of my cancer treatment. I have had steady treatment for the past 5 years and am now on my 5th line of treatment. I have exhausted all my anti-hormonal treatments and am currently getting chemotherapy intravenously. I’ve also had two different rounds of radiation to help with the pain. Along with antidepressants, anti-nausea drugs, nerve blockers, supplements, and over-the-counter pain relief pills, I now take an opioid.

My oncologist prescribes the opioid and the insurance company covers it without any issue. But I’ve had numerous negative experiences with this particular pharmacist. They have told me they don’t have enough pills and they’ve told me to come back another day.

When my anger and frustration took over, I posted a video explaining what had happened. I had no idea that the video would strike such a nerve with a bigger population. But it did. Thousands of people reached out to me to share their experiences having trouble getting their prescriptions filled for much needed pain medications.

Watch the video here.

The anti-opioid movement has created difficulty for those of us who need opioids for pain relief. This is a problem that affects all sorts of people with many different chronic diseases. Although the pharmacy issued an apology to me, I have decided to go to a different pharmacy in my hometown and no longer give the other one my business. People with chronic pain want to be able to function, to sleep, to work, and to be able to have quality time with their families without hurting all the time. We have valid reasons for needing opioids and our stories need to be heard.

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