HELP — HELP — HELP

Every week, sometimes multiple of times a day… I get emails, FB messages, phone calls from chronic pain pts that are being denied care and their medically necessary medication… sometimes from a prescriber, some from a pharmacy/pharmacist, insurance/PBM.

I am about to take on the task of being CFO for the non profit American Pain & Disability Foundation, so there is going to be one more alligator in my swamp…and I am getting tired/bored with giving out the same/similar advise over and over… hopefully after I finish this post they will read it first and/or if they don’t read it first..  I can just answer their question with referring them to this post first with a hyperlink.

FIRST THE PHARMACY/PHARMACIST

I often get some cryptic message about them being denied their medication – and I am suppose to fill in the blanks and come up with a recommendation.  Often, I am just replying with the same/similar words that I have routinely typed to other pts.

If the pt is going to a chain store… and you have been getting your meds without problem for months or years and all of sudden they are getting stonewalled.. Most likely, there has been a change in the staffing in the Rx dept of that store or they have encountered  a “floating pharmacist” that is working there for a day or week… covering a sick employee, a vacation, a pregnancy leave.  Often these Pharmacists don’t know your prescriber, don’t know you and won’t bother to look at your Rx records at the store…  JUST SAY NO…

They know that the pt calls HQ, they will be told that they stand behind their pharmacist’s decisions – can’t make a pharmacist to fill a Rx… probably get the same answer from the board of pharmacy.  They could ask the Pharmacist to provide the clinical information that they made their decision on… but.. that would create a virtually Tsunami of paperwork.

Another “reason” … “I’m not comfortable”… maybe the pt should ask the pharmacist what clinical information that he/she is not comfortable about ? – IMO “I’m not comfortable” is an EXCUSE not based on few if any FACTS.

Then there is a “we are out of stock”… what the Pharmacist hopes that the pt doesn’t know that the DEA requires that every pharmacy keep a hard copy PERPETUAL INVENTORY… Maybe the pt should document the date/time of being told that the pharmacy is out of stock and send a request to the pharmacy board to ask the pharmacy to provide a copy of the perpetual inventory sheet for the particular medication/strength for the particular day/time…  Does the Board of Pharmacy consider LYING TO PTS UNPROFESSIONAL CONDUCT ?  If the Board won’t go as far as getting this information – then they apparently don’t.

The pt will probably be told that the Pharmacist has a “corresponding responsibility” which is in the control substance act of 1970…  Just have to make sure that the medication is being prescribed for valid medical reason…  IMO, corresponding responsibility should be a “two way street” … make sure that medication does not get into the hands of someone that really doesn’t have a valid medical necessity and make sure that the medication gets in the hands of someone that does have a valid medical necessity..  But Pharmacists don’t have access to the pt’s medical records – other than the Rxs they have filled at the store and/or pulled a state PDMP report…  Pharmacists don’t have the legal right, nor training, nor physical space,  nor time to do a physical exam…  If they have not called and talked to the prescriber.. the information that the Pharmacist has is fairly limited… so many use the term “corresponding responsibility” to JUST SAY NO. They turn this term into a ONE WAY STREET TO JUST SAY NO !!!

Other than the state of Alaska, I know of no pharmacists that have experienced any bad consequences for JUST SAYING NO !!

Perhaps, a pt – being denied their medication… share this chart with the Pharmacist… this chart shows the comorbidity complication of under/untreated pain and if a pt is intentionally thrown into cold turkey withdrawal those complications will come on very quickly and probably very intensively…  Think hypertensive crisis, stroke, death… how would that affect the pharmacist’s license ?

The quickest path for a pt to get their medication is to find a independent pharmacy … where the pt will be dealing with the Pharmacist/owner who tend to be less judgemental.. here is a website to locate one by zip code https://ncpa.org/pharmacy-locator

DENIAL FROM A PRESCRIBER

More and more prescribers are no longer in a private practice. Their practice has been sold to large hospital system and they are just an employee of that corporation and what they will/won’t prescribe is more likely being dictated by their corporate employer.

It is best if chronic pain pts are proactive when they are first told that they are going to participate in a involuntary forced reduction in their meds.  IMO… waiting until you are way down the path of reducing their doses… it is probably too late to back things up  Here is a post that I did a few months ago that should give the pt some direction of actions that they may be able to take http://www.pharmaciststeve.com/?p=35002

Insurance/ PBM problems/denials

Many insurance company will hire a PBM ( Prescription Benefit Manager) to handle the adjudication of Rx claims… they provide you the “drug card”. There are a handful of PBM’s that control the lion’s share of the market place.

If your insurance is thru your employer.. abt 50% of large employers are self insured that is referred to as an ERISA prgm – over seen by the Fed Labor Dept and insurance company is just an administrator to pay out your employer’s money for health claims for their employees and their families.  If you have this sort of “insurance” and you get denied…someone at your employer can just call up the insurance company and tell them to pay for your medications as your prescriber wrote for… after all it is your employer’s money that they are paying out.

If you are on Medicare or Medicaid… then you are probably dealing with a Part D Rx prgm… they have a three level appeal process.. they don’t have to tell you about the process unless you ask and then they have to give you the process in writing- today that is probably a website.  Be sure to meet the time limits of making the appeals… expect to get denied the first time because the same system/people that already denied it … is the one handling the appeal.. because a fair percent of pts getting denied will give up… after three denials there is a Administrative Law Judge (ALJ) again they have to tell you the process is writing… the very fact that you KNOW ABOUT the ALJ appeal level… may be enough to get them to cave… because they know that at least 50% get to this level will get approved.  Doesn’t cost the pt anything, and now a days… it is probably a ZOOM type meeting..  the pt doesn’t need an attorney… just needs to state way they need what was denied … it is a pretty straight forward process.

It is also good if the pt calls 800-MEDICARE or www.cms.gov and file a complaint against any provider for denying you care.

Any other kind of health insurance… you just have to ask what their appeal process is and if they don’t offer… ask for the details in writing… the more times you appeal … the more likely the pt will get a YES/APPROVED.

 

 

 

 

 

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

Pfizer COVID Vaccine Antibodies May Disappear in 7 Months, Study Says

Pfizer COVID Vaccine Antibodies May Disappear in 7 Months, Study Says

https://www.medscape.com/viewarticle/960214

Antibody levels may wane after 7 months for people who got the Pfizer-BioNTech vaccine, according to a new study published on the bioRxiv preprint server.

In the study, which hasn’t yet been peer-reviewed or formally published in a medical journal, researchers analyzed blood samples from 46 healthy young or middle-aged adults after receiving two doses, and then 6 months after the second dose.

“Our study shows vaccination with the Pfizer-BioNTech vaccine induces high levels of neutralizing antibodies against the original vaccine strain, but these levels drop by nearly 10-fold by 7 months,” the researchers told Reuters.

In about half of the adults, neutralizing antibodies were undetectable at 6 months after the second dose, particularly against coronavirus variants such as Delta, Beta, and Mu.

Neutralizing antibodies only make up part of the body’s immune defense against the virus, Reuters noted, but they are still “critically important” in protecting against coronavirus infections.

“These findings suggest that administering a booster dose at around 6 to 7 months following the initial immunization will likely enhance protection,” the study authors wrote.

BioNTech said a new vaccine formula will likely be needed by mid-2022 to protect against future mutations of the virus, according to the Financial Times.

“This year, [a different vaccine] is completely unneeded, but by mid-next year, it could be a different situation,” Ugur Sahin, MD, co-founder and CEO of BioNTech, told the news outlet.

Current variants, namely the Delta variant, are more contagious than the original coronavirus strain but not different enough to evade current vaccines, he said. But new strains may be able to evade boosters.

“This virus will stay, and the virus will further adapt,” Sahin said. “This is a continuous evolution, and that evolution has just started.”

If you want to share your #PatientStory please send to NationalPainCouncil.org.

https://www.linkedin.com/posts/jonelle-elgaway-86923315a_ama-patientstory-wer1-activity-6871571377493688320-gqRy

 

 

Vanderbilt Burn Center (Nashville) refused to provide the young patient sufficient pain medication for SIX WEEKS

Vanderbilt Burn Center (Nashville) refused to provide the young patient sufficient pain medication for SIX WEEKS

A Davidson County Court in Nashville Tennessee ruled in favor of a family whose minor child was denied proper treatment in January 2020. The ten-year-old victim had suffered severe burns in a tragic mishap. Staff at Vanderbilt Burn Center refused to provide the young patient sufficient pain medication while performing a procedure that requires cleaning and dressing burn wounds.
At the time of treatment, Bob Sheerin, a Chronic/Intractable Pain Advocate and Vice President of Operations with the American Pain and Disability Foundation, was himself receiving burn treatment in an adjoining room. He heard the agonizing screams of the victim and was compelled to help.
Sheerin, 52, Hopkinsville, Kentucky, stepped in to assist the 10-year-old patient at the burn unit of Vanderbilt Medical Center, Nashville. Sheerin was responsible for obtaining an attorney and securing funds to help the minor child and her mother navigate a system that is rigged against the poor and the uninsured.
“I have accomplished a lot advocating; not more than others, just my fair share.” said, Sheerin outside of the Tennessee courthouse. “This is something any of our great Chronic/Intractable pain advocates would have taken on.”
Mr. Sheerin has been advocating for chronic pain patients for nearly a decade and says this is his greatest accomplishment.
The family was awarded a settlement in court and money paid to the attorney was donated back to the family to establish a college fund.
Mr. Sheerin goes on to say, ”People in this country need to start opening their eyes to what the government is doing to people in need of life-saving pain medications. The way we can help children in the future is to get rid of this false narrative put forth by the CDC 2016 guidelines.”
HENRY TAYLOR/THE LEAF-CHRONICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bob Sheerin VP

Opioid Crackdown Leaves Pain Patients in Limbo

Opioid Crackdown Leaves Pain Patients in Limbo

https://doctorsofcourage.org/opioid-crackdown-leaves-pain-patients-in-limbo/

An article on Thehill.com by Mark Rothstein, J.D. and Julia Irzyk, J.D was published today. The Opioid Crackdown Leaves Chronic Pain Patients in Limbo includes some truths, but it’s a real shame they ended it with worthless recommendations.  They need to be informed of where the problem actually lies.

Interesting that Julia’s birth name is Rothstein. I wonder if they are related.  Also, the name Rothstein is of German Jewish ethnicity. So they should especially be informed, if they haven’t recognized it already, of the Hitlerist attacks on doctors, minorities, and the expendable populations of citizens.

In the beginning of their article they point out that prescription writing has been reduced by almost half since 2012, while overdose deaths have more than doubled and pain patients have been abandoned. But notwithstanding the impact of those truths, they then move into continuing the misinformation that won’t help bring pain management back.

The umbrella untruth that they still spread is that opioids are the basic cause of addiction, with phrases like “dangerous overprescribing of opioids” by doctors that are not pain management specialists.  Folks, you don’t have to be specialized in pain management to know how to prescribe opioids.

Then the coup de grace is that they then start talking CDC guidelines. Folks, the CDC guidelines are not the culprit, nor is changing them the solution. We have the solution here on DoC. They need to be informed and use their abilities to spread what WILL change the situation, not just chase the rabbit.

The REAL Solution

elephant in the room with 2 men sitting at a tableThe elephant in the room is the Controlled Substance Act. This MUST be repealed. And the truth is that NO DRUG CAUSES ADDICTION!!  Drugs have been the target simply for racist, monetary, government motives.  I would hope that, with the right information at their fingertips, that these two prominent people in the media would take this and run with it.  So get your emails and tweets going to these two people, and point them to Doctorsofcourage.org

Here’s a quick example:

Dr. ___,
I appreciate your recognizing the problem with the current government attacks on opioids. But your conclusion and solution are not the answer. Opioids are simply the current government drug target, as cannabis was in 1970. Your pointing to the CDC guidelines is a rabbit chase that will get us nowhere. The answer is on www.doctorsofcourage.org.  Drugs themselves do not cause addiction. And until we recognize the REAL cause, the rate of addiction will continue to climb exponentially. I suggest to you that you recognize the elephant in the room—the Controlled Substance Act—and get on board with Doctors (and Patients) of Courage to get the real solution out to the public.  Thank you.

Contact Information:

Mark Rothstein, J.D.: mark.rothstein@louisville.edu

Dr. Rothstein is the Herbert F. Boehl Chair of Law and Medicine and Director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine.

Julia Irzyk, J.D.:  https://twitter.com/juliairzyk

Dr. Irzyk, is an advocate for individuals with disabilities and coauthor of “Disabilities and the Law”

crackdown on opioid pain medications, experts have concluded the policy has been a miserable failure

https://www.8newsnow.com/news/local-news/i-team-pain-med-prescriptions-did-not-cause-opioid-epidemic-courts-rule/

LAS VEGAS (KLAS) — Five years after the Centers for Disease Control and Prevention initiated a crackdown on opioid pain medications, experts have concluded the policy has been a miserable failure. Overdose deaths have gone up, not down, and now, courts are starting to recognize the arguments used to justify the crackdown are largely bogus.

“So these numbers, they just push these false numbers and now you have courts of law calling them out,” said Dr. Dan Laird. 

As a Las Vegas physician, Laird has a unique vantage point from which to evaluate the great opioid crackdown.  Laird is a pain management doctor and an attorney who represented patients who suffered pain after being denied legal medications. 

Of the 50 million Americans plagued by chronic pain, about 20 million depend on prescription opioids to try and lead somewhat normal lives. Since 2016, those millions have suffered immensely because of a war on legal pain meds. 

“Chronic pain patients are basically in a fight for their lives,” Laird said. “They’ve been under attack for several years now with this. Anti-opioid sentiment and sort of the over-reaction to the opioid crisis.”

Laird says the campaign against opioids is largely about money. More than 1,500 civil lawsuits have been filed against drug companies by state and local governments, including in Nevada, as officials and trial lawyers eye multi-billion dollar settlements. but the lawsuits, most of which accuse big pharma of being a public nuisance for causing the opioid epidemic are starting to fall apart.

In California this month, a lower court tossed out a huge lawsuit with a scathing opinion that found the underlying facts don’t support the allegation that 25% of opioid patients get addicted. And in Oklahoma, the state’s supreme court reached a similar conclusion and held that the benefits of opioid meds far outweigh the risks.   

“But the litigation narrative, the narrative that the trial lawyers want to push is that it’s prescribed opioids that are causing all of these deaths. This huge upswing in opioid deaths has occurred because of fentanyl, yet they continue to pound this drum that it’s prescription opioids, causing the deaths and the reason they are is because this is being driven by litigation by the people involved in this. Aren’t talking about millions of dollars, they’re talking about billions and billions of dollars. So if it hurts a few chronic pain patients … and if they’re collateral damage, you know, I guess they look at it as you’ve got to break a few eggs to make an omelet,” Laird said. 

But prescription drugs are not the cause of a spike in overdose deaths. Ninety thousand overdoses were recorded in 2020, a huge increase, but 87% of those were caused by illegal street drugs, notably fentanyl and heroin, not a prescription medication. Cutting down on prescriptions hasn’t worked because legal pain patients are not the ones overdosing. 

One outspoken advocate for chronic pain patients, Red Lawhern, says the CC’s own statistics prove the crackdown on prescription opioids is unwarranted.

“So seniors, who get the most opioid prescribing have the lowest rates of opioid overdose-related deaths by a factor of three to one,” Lawhern told Mystery Wire. “Kids under the age of 19 have the lowest prescription rates for opioids. And they have a rate of opioid-related overdose death, that is three times that of seniors.
So what I’ve been telling people for the last roughly four years is that you can’t explain this inversion of demographics, by any model that proposes that prescribing is the problem or the cause of addiction. It’s not there, it has never been there. So what we are seeing is, statistics of the CDC itself demonstrate that the logic behind the 2016 guidelines is bogus. It’s flat not supported by the data that CDC itself has reported. But CDC has chosen to ignore the data, and instead to enlist the opinions of people who were hand-picked as anti-opioid advocates, who may even believe the nonsense that they talk. But they’re lying through their teeth.” 

Studies show less than 1% of them become addicted, not 25% as alleged in the lawsuits. Millions of patients who followed the rules and their doctors have been cut off altogether or had their dosages slashed. Suicides among those patients jumped 470%, many of them veterans in pain who were cut off by the Veterans Administration. Patients are starting to fight back by suing doctors and hospitals who deny legitimate medications.  

Also coming under scrutiny are the very same anti-opioid crusaders who crafted the CDC’s opioid crackdown in 2016. Several are now working as expert witnesses in lawsuits against big pharma. 

“One person, Andrew Kolodny, who is a psychiatrist with no formal postgraduate training and pain management is an expert witness for again, Oklahoma case against Johnson & Johnson Pharmaceuticals. His expert witness fee for that case reportedly is $500,000, so it’s pretty good work if you can get it,” Laird said.

Earlier this month, the U.S. Supreme Court agreed to hear arguments whether doctors should be criminally prosecuted for prescribing legal medications, so long as they use “good faith” standards in issuing prescriptions.

 

How many “dead bodies” does it take to really declare WAR ?

In Dec 1941 the Japanese bombed Pearl Harbor and killed about 2300 people and we declared war against the Japanese and ended up fighting Germany/Hitler as well…

In Sept 2011, when the Towers and the Pentagon was attacked abt 3000 people died and we declared war

During his administration President Nixon declared that “addiction is public enemy number one” and he declared a war on drugs. Actually Nixon was a racist and didn’t like Blacks or those “Hippie types”… and that was the focus of his “war”.  When this happened the NY Mafia controlled the vast majority of illegal drugs distribution.

I am binge watching Narco Wars on National Geographic and Congress has routinely passed laws that has pushed the production of illegal abuse substances out of the country… mostly to Mexico and for decades China has been a source for most of the chemicals that is used to make some of these illegal substances.

Today, it is claimed that abt 75,000/yr OD deaths from illegal drugs coming from China & Mexico…  so in about 10 days as many people die as did in the attach on Pearl Harbor and in about 15 days the number of people that died in the 911 attack. Realistically we can’t declare war on China or Mexico. China has declared the making illegal Fentanyl is ILLEGAL and the penalty is pretty stiff.. but they don’t seem to be doing a very good job in stopping these chemical labs.

See the source image Our Congress has been consistent in how they deal with things that the Puritanical thread in our societal fabric considers “evil”… they first try to ban it and then when that fails they legalize it and tax it.  They have done it with Tobacco, Alcohol, Gambling and now MJ.  Often the taxes and fees to those who sell the particular product is so high, that the “cartels” can sell the product much cheaper and still make “boat loads of money”.

Many understand that addictions – all addictions – have a mental health component – we have some 30-40 million people addicted/abusing to some substance or activity.  We could use the same tactics that Standard Oil used in the early 20th century to get rid of competition… under price the competition.  We could take the illegal substances that we confiscate from the cartels… get a pharma or chemical company to standardize the product and get a pharma or other company to produce a standardized potency product to be provided to those who are going to find a way to get their “drug of choice”

Take alcohol as an example, the use/abuse of alcohol contributes to abt 100,000/yr deaths, but only abt 1,000 die from alcohol toxicity (OD). Could that be because the person abusing/addicted to alcohol… knows their limits and is able to get their “drug of choice” in a standardized potency.

We can go back to 2015 when Scottsburg, IN had a 200+ breakout of  HEP B & C and HIV + http://www.pharmaciststeve.com/another-good-example-of-how-well-drug-prohibition-works/ because of sharing needles..  and the lifetime costs to treat each of these people could upward of $750,000 EACH… Scottsburg had a free needle exchange program until this year when the “local bureaucrats” decided that they were encouraging/condoning substance abuse. Of course, being a small, poor rural county it wasn’t their tax money that was going to pay for the medical treatment cost for those people.

How far could the 100 billion that we spend on the war on drugs go to provide – at low cost – to attempt to SHRINK the demand of illegal substances that some people like to abuse and perhaps put the cartels back on their heels

 

 

Complete government and insurance industry control over healthcare clear now in 2016 HFPP

Complete government and insurance industry control over healthcare clear now in 2016 HFPP

by | Nov, Sun, 2021 | Chronic Pain Patient, Convicted physician, government benefiting off street opiates, Government Misconduct, health insurance, healthcare reform, Licensed to Lie, opiates | 0 comments

https://doctorsofcourage.org/complete-government-and-insurance-industry-control-over-healthcare-clear-now-in-2016-hfpp/

 

Human rights and healthcare surrounded by raised hands

Doctors of courage, through the freedom of information act, were able to obtain close to 300 pages of information, considered classified and for “insiders” only, concerning the HFPP or Healthcare fraud and prevention partnership designed to address what has been considered the prescription opiate crisis, which was felt to be solely responsible for rising abuse and deaths from opiates. Keep in mind that there is now inequivocal proof that prescription opiates accounted for less than 1% of opiates abused. This was released October 20, 2021 the policies of which the federal government, in conjunction with government agencies, using agencies such as the FBI, DEA, state medical boards have been implicating to control what they called, “fraud, abuse and waste”. Through the enforcement of policies from the “white papers”, which were policies enforced though the Trump administration, through collaboration of Jeff Sessions, Qlarant (a high technology company that uses computer technology to obtain information about patients, doctors and pharmacies without consent violating their ourth amendment rights), the health insurance industry and an organization of physicians, PROP with no formal training in policies being addressed and who are opposed to use of opiates for long term pain management and who’s policies are now being scrutinized by the press.

The white papers utilize the 2016 CDC guidelines on opiate prescribing to justify classifying opiate use as “fraud, abuse and waste” by misinterpreting these guidelines as “laws” set forth by the CDC, which the CDC in it’s July 2021 meeting, which I attended and spoke at, adamantly deny that these were meant to be anything but guidelines. Emphasizing that the ultimate decision was between the doctor and the patient at this meeting. So in retrospect, the Trump administration “strong armed” policy to criminalize use of opiates which they felt was not appropriate. No input from chronic pain groups and organizations like the chronic pain society, the AMA, physicians with respected publications on chronic pain management or certification boards such as the American Academy of Psychiatry and Neurology or the ABEM (American Academy of Emergency Physicians) who provide certification of pain management for physicians. By using the “white paper” guidelines, this gives the government clout to define the misuse of opiates by whatever definition they feel is appropriate. By placing opiate “misuse” under the umbrella of fraud, waste and abuse, this allows for criminalization of prescribing of opiates and leaves physicians, pharmacists and other health care personal criminally liable for any prescribing of opiates for any use. Even medication assisted treatment (MAT) for drug addiction with use of methadone, naloxone or buprenorphine. The white papers are of the opinions that opiates should be used only for MAT, cancer patients but still criminalize use of opiates regardless.

The HFPP partnership includes mainly federal and local government agencies and insurance companies such the blues cross organizations such as Highmark, as well as Humana and Keiser Permanente and many others. No physicians, other healthcare workers, AMA, certification organizations or any other, non-biased well respected Healthcare organization were asked to be in the partnership. Clearly an example of its intention to maintain control of the health, well being of the American public strictly between the government and insurance industry. Including who lives or dies. The HFPP does not limit it’s regulation to opiate use, but it leaves open the definition of “fraud, waste and abuse” to any action they feel compromises their agenda. Which is unequivocally meant to maximize profit for the health insurance industry at the expense of American lives. A recent article published in the New England Journal of Medicine, dated October 28, 2021 emphasized how treatment of chronic disease, the cornerstone of healthcare, has been so compromised that our lifespan has once again fallen. Yet health insurance industry is making record profits, $500 billion in 2020 the highest ever by allowing Americans to get sick by avoiding chronic care and making money off expensive procedures and cancer care. Chronic pain falls under the umbrella of chronic disease and care. Unaddressed chronic disease is the number one cause of chronic pain through facilitation of central pain pathways https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750819/. Which is why the USA leads the world in chronic pain and thus, leading the world in prescribing of opiates.

The HFPP only emphasizes and condones opiate use for pain in cancer pain. They do acknowledge that their is concern in public opinion about “chronic pain’, but are of the opinion that the consequences of use of opiates for chronic pain outweigh the benefits. An opinion without scientific merit. Cancer is a multibillion dollar industry from which health insurance companies, pharmaceutical companies, Oncologists and large healthcare conglomerations like Keiser and UPMC benefit and make the emphasis of most of their advertising. Cancer is very very very serous, but so are chronic autoimmune disorder, neuromuscular disorders such muscular dystrophies, inherited diseases all of which lead to chronic. Yet, I have always struggled to find resources for these diseases and individuals with these conditions struggle for proper pain management. There has been an increase in suicides in these groups of over 470%. There are between 50 million and 100 million people in chronic pain. At it’s peak before the white papers, the HFPP or the PDMP (Physician drug monitoring program), there were only about 2000 chronic pain doctors to manage these people. Prescribing of prescription opiates has declined lethal levels. Leaving people to resort to reaching for the streets to manage their pain. Chronic pain patients have no choice but to use dangerous drugs which cannot be monitored. Mainly synthetic fentanyl and heroin. This has lead to a massive 1040% increase in misuse, over doses up to 2020. From 2020 – 20221, this has grown another 28%, with over 100,000 over dose deaths. The most ever.

In summary, the government, including the Trump administration purposely compromised the health of the American public, shunned chronic care and allowed pain, suffering and early death for benefit for profit for the health insurance industry. This not only constitutes extremes in inhumane behavior, akin to the Third Reich, but extreme criminal behavior which unlike Germany from 1933 to 1945, affects all citizens without boundaries for class, race or socio-economic status.

Here is the information the government released to us:  Released Records (1).pdf

About the Author Felix Brizuela

Born in Cuba, Felix moved to New Jersey when he was two years old. He played football and wrestled for Rutgers University. He graduated medical training at the now-named Rowan School of Osteopathic Medicine and did his residency in neurology. His medical practice was located in Morgantown, WV and Connellsville, PA. He has teaching experience, serving as department chair at Temple University and teaching attendant at the West Virginia school of Osteopathic Medicine. He has done investigative studies with epilepsy and multiple sclerosis and served as chief investigator for a study of postpolio syndrome and chronic fatigue. He was also a chief investigator in a study involving the use of intravenous gamma globin for the treatment of chronic inflammatory demyelinating polyneuropathy, entitled “Ivig and cidp, dose matters”. The paper was presented at a poster presentation in France. He has lectured overseas on the topic of cidp and immune neuropathy.

Felix will be teaching various health topics through our DoC course network. If interested in learning more, sign up below for our newsletter.

 

Medicare open enrollment period ending 12/07/2021

If you have a Medicare Part D prgm… you need to check what your plan is going to charge you using this link http://www.medicare.gov/plan-compare/#/?lang=en&year=2022

In checking our Part D plan… the total annual cost ( premiums, deductibles, med costs) ranged from the lowest cost/yr to about TEN TIMES that cost.  For the same meds & quantities.

I guess this is what is possible when you are dealing with FOR PROFIT INSURANCE COMPANIES – the same thing may apply to those companies providing Medicare Advantage prgm or what they are starting to call Medicare-C

 

CVS: to close abt 10% of their stores over the next 3 yrs – to beef up health services – creating healthcare deserts ?

CVS to close 900 drugstores in three years to beef up health services

https://www.reuters.com/business/healthcare-pharmaceuticals/cvs-health-close-stores-record-impairment-charge-2021-11-18/

Nov 18 (Reuters) – CVS Health Corp (CVS.N) will shut about 900 stores over the next three years, it said on Thursday as the company tries to adapt to changing consumer preferences by pivoting to new store formats that offer more health services.

Best known for its chain of drugstores in more than 9,900 locations, the company has been working to expand its services since it acquired health insurer Aetna in 2018.

CVS said that as part of its strategic review it would create an enhanced version of its health hubs that offer treatment for common ailments as well as chronic care to add more customers.

The reduction in stores will result in CVS taking an impairment charge of between $1 billion and $1.2 billion in the fourth quarter.

People walk by a CVS pharmacy store in Manhattan, New York City, New York, U.S., November 17, 2021. REUTERS/Andrew Kelly
People walk by a CVS pharmacy store in Manhattan, New York City, New York, U.S., November 17, 2021. REUTERS/Andrew Kelly

As part of the new strategy, the company also created a new position of chief pharmacy officer and appointed executive vice president of specialty pharmacy and product innovation Prem Shah to the role.

“We see this as consistent with our expected LT (long-term) strategy for CVS, moving to grow managed care and care delivery, while shrinking legacy bricks-and-mortar retail business,” said Bernstein analyst Lance Wilkes in a note.

Rival Walgreens Boots Alliance (WBA.O) also recently shifted focus beyond its drugstores, investing $5.2 billion in VillageMD and $330 million in post-acute and home care provider CareCentrix. read more

CVS cut its annual 2021 profit per share forecast to between $5.46 and $5.67 from $6.13 to $6.23, but stuck to its adjusted profit view saying there will be no impact from the store closures this year and the next.

It also said Neela Montgomery, president of CVS Pharmacy, would leave company at the end of 2021.

All addicts seem to get a break – even docs who are addicted and prescribe to addicts

https://doctorsofcourage.org/richard-morgan-do/

Richard Morgan, DO, was a physical medicine and rehabilitation (PM & R) physician in New York City.  He was also an addict, which led him to commit the crime of selling prescriptions for drugs. Literally, he is the first doctor in the 5 years that I have been researching, to actually be guilty of violating the Controlled Substance Act. And yet, unlike all of us who are innocent victims unable to work again, he is a clinical instructor at a medical school with a future of having his license reinstated.  How could this be, and how does it make you feel? I can honestly say my feelings sway like a pendulum.

 

Richard Morgan’s history as a physician

Richard Morgan, DO graduated in 1998 from the New York Institute of Technology College of Osteopathic Medicine. He completed his residency in PM & R in 2002. But from 1997 through 2007, he was addicted to opioids and benzodiazepines. To this day, he blames being treated with opioids following dental surgery as a medical student as the cause of his addiction.  Hopefully this article will get through to him and others who blame opioids for addiction.

History of his addiction

In 1997 while a medical student, he had his wisdom teeth pulled, developed an abscess and received a prescription for Vicodin. Taking it as prescribed, he began to notice a change in how the medication affected him. “It was no longer about the pain,” he said. “I really started enjoying how it made me feel.” Suffering from stress in school and with his wife, “it just gave me this feeling of empowerment that I could take on the world.” He would get prescriptions for fake patients from the hospital pharmacy to use himself.

After graduation from residency in 2002, he wasn’t happy in the job he began. With his resentment and frustration, Morgan’s addiction worsened. “I realized I was starting to take pills to boost my confidence,” Morgan says. Some young kids approached him at the urgent care center and offered him money to prescribe them pills. At first he said no. Then one of them threw down thousands of dollars in cash and he changed his mind. He also wrote himself prescriptions using about 15 different fake names, with false addresses and dates of birth. He went to dozens of pharmacies to spread out his prescriptions and refills, and he paid cash.

In early 2006, Morgan’s family staged an intervention. After two failed rehab attempts he finally participated in New York State’s PHP (physician health program) and was able to stay clean afterward. But the people who bought prescriptions from him tracked him down, threatened him, and he continued to write prescriptions for them.

Dr. Morgan’s Conviction and Imprisonment

In May 2007, at age 35, Dr. Morgan was arrested for conspiracy to distribute oxycodone. According to the indictment, Dr. Morgan sold more than1,500 prescriptions for OxyContin and other drugs, for individuals who were not patients, including one recipient who paid him roughly $6,000 per month for more than a year.

Although early in the attacks on doctors, DEA Special Agent-in-Charge John Gilbride already had the propaganda line taught by the DEA and said, “Trafficking OxyContin is no different than trafficking cocaine, but in this case, the source of supply wore a white doctor’s coat.”

Following his defense attorney’s recommendations, Dr. Morgan pleaded guilty. Over the next 2 years, while awaiting sentencing, he continued to practice medicine, but without the ability to write prescriptions. Despite the frequent drug testing and therapy sessions, he still had a “pill fixation,” he says. “I felt comfort in pills.” He bought Sudafed and took whole sheets of the pills to get a little bit of a high. “It would almost feel like I drank 10 cups of coffee at the same time,” he says. So in spite of his saying he was “clean”, he was still abusing. During one month, Morgan bought more Sudafed than was allowed by state law. He was arrested again in March 2009.

Dr. Morgan was sentenced to 14 years in prison. But lucky for him, after serving 8 years, he was rewarded with an early release in April 2017.

Post-incarceration

It’s amazing to me how thousands of innocent physicians have had their lives ruined, tried to get their stories to the public, and can’t because the media have an agenda against us.  But Dr. Morgan, an addict and a law breaker, gets an appearance on The Dr. Oz Show to tell his story.

Then he gets an invitation to speak at the New York Institute of Technology College of Osteopathic Medicine to students at the school about his experience with addiction. That was followed by becoming a full time clinical instructor at New York Institute of Technology of Osteopathic Medicine. With the help of New York State’s physician health program, he is working to regain his medical license.

Chances of relapse?

In the 4 years since his release from prison, Dr. Morgan says he has never come close to experiencing a relapse. But he knows it could happen. He hopes that constantly remembering what happened to him because of addiction will protect him from relapsing.

“So many positive things are happening,” Morgan says, “and they wouldn’t be happening if I ever picked up a pill.”

But addiction isn’t a case of mind over matter. Until he learns the REAL cause of addiction and does the 7 steps to healing, he is always at risk.

My thoughts on the good news/bad news of this case:

  1. Morgan broke the law. But it was caused by his addiction, just like all of the inmates in prison cells for drugs. So he does deserve a second chance. The fact that he is getting it when the rest of us aren’t might not be fair. But when is life fair?
  2. I hope Dr. Morgan will use his connections to bring justice to the rest of us. So my message to him is:

Dr. Morgan,
Learn the REAL cause of drug abuse. Use that when you teach to the residents, not that opioids or drugs cause addiction.  Become a member of Doctorsofcourage and help get our message out to the country through your connections.  Heal yourself with the Seven Steps to Healing and help promote the knowledge that you learn from us. It is in line with the philosophy of osteopathic medicine.

I wish you all the best, in healing and in your profession.

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