2018 in review … what killed us

Today is 01/20/2019.. 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


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



Here is the list from the end of 2016 if interested in comparing
United States of America
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.



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.”



















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/


Jessica Simpson took her life July 2017

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


Another Veteran Suicide In Front Of VA Emergency Department

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

 Dr. Mansureh Irvani  suspected overdose victim  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.


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


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

Kellie Bernsen 12/10/2017 Colorado suicide

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

  Michelle Bloem committed suicide due to uncontrolled pain

John Lester shot himself on Jan. 8, 2014.

 Anne Örtegren took her life on Jan. 5  

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

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

Brunner, Robert – Could not locate info!

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


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…


Kevin Keller, 52 – US Navy – July 30, 2014 – Wytheville, VA

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 .

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…


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


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

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


Saving Money For Medicaid in WV


In 2017, West Virginia was faced with growing Medicaid costs — particularly when it came to prescription drugs. So state government cut out the middlemen, pharmacy benefit managers, and turned to a streamlined system that utilizes West Virginia University’s School of Pharmacy to recommend drugs for patients, instead. The move saved the Mountain State $30 million in its first year.

Now Ohio is struggling under the $2.5 billion its Medicaid system must spend on prescription drugs, through its managed-care plans. State officials are looking for a solution. They may not have to look any farther than across the Ohio River.

At WVU, there are “clinical, well-informed individuals who make appropriate clinical decisions,” according to a report in the Columbus Dispatch, and they are interested in the best health outcomes, not corporate profits.

Of course, there is resistance to this idea from the pharmacy benefit managers, who have had the luxury of operating in a remarkably layered and opaque environment. One tactic is pointing out that Ohio has a much larger population than West Virginia’s.

True, the system in place in West Virginia would have to be scaled up. Dr. Robert Weber, chief pharmacist and assistant dean for medical center affairs at Ohio State, acknowledges there would have to be an increase in resources to duplicate the Mountain State model. But it is possible.

“Our committee is focused on how we can improve quality of care,” Weber told the Dispatch. “We do not have any influence from the drug industry, no significant conflict of interests, we do not allow manufacturers to come into the institution, and the cost of the drug is the last thing we consider.”

Vicki Cunningham, West Virginia Medicaid’s director of pharmacy services, agrees Ohio could take advantage of West Virginia’s model. “You have to provide the same things if you have one person or 100,000,” she said.

There are, as is always the case when bureaucrats dig in, other factors. Ohio might also need to look at unbundling other services provided by the benefit managers to provide greater transparency (which almost always leads to saving more money). West Virginia has done that, too.

Assuming careful analysis of the plan shows the West Virginia model can be scaled up and will save Ohioans money, Ohio’s Department of Medicaid should consider following the Mountain State’s lead.

why it takes so DAMN LONG to get your prescription filled at a chain pharmacy

Image may contain: 15 people, people smiling, text


How to find a local independent pharmacy/Pharmacist

They say you can’t buy a politician.. what about a LONG TERM LEASE ?

Image may contain: 1 person, text

study, could not differentiate between overdose deaths involving painkillers that are prescribed versus illicitly acquired

Study Links Drug Maker Gifts for Doctors to More Overdose Deaths


WASHINGTON — A new study offers some of the strongest evidence yet of the connection between the marketing of opioids to doctors and the nation’s addiction epidemic.

It found that counties where opioid manufacturers offered a large number of gifts and payments to doctors had more overdose deaths involving the drugs than counties where direct-to-physician marketing was less aggressive.

The study, published Friday in JAMA Network Open, said the industry spent about $40 million promoting opioid medications to nearly 68,000 doctors from 2013 through 2015, including by paying for meals, trips and consulting fees. And it found that for every three additional payments that companies made to doctors per 100,000 people in a county, overdose deaths involving prescription opioids there a year later were 18 percent higher.

Even as the opioid epidemic was killing more and more Americans, such marketing practices remained widespread. From 2013 through 2015, roughly 1 in 12 doctors received opioid-related marketing, according to the study, including 1 in 5 family practice doctors.

The authors, from Boston Medical Center and New York University School of Medicine, found that counties where doctors received more industry marketing subsequently saw an increase in both the number of opioids prescribed and opioid-related overdose deaths.

In response to the study, Dr. John Cullen, president of the American Academy of Family Physicians, said, “A limitation of the study, as acknowledged by the authors, is the many unknown variables that prevent drawing a direct causal link between pharmaceutical marketing and opioid-related deaths.”

He added, “We’re very much aware of the critical and devastating impact of the opioid epidemic and work every day, with every patient interaction, to fight it. At the same time, we must protect the physician’s ability to provide adequate pain management.”

The authors acknowledged several caveats in the study, including that it could not differentiate between overdose deaths involving painkillers that are prescribed versus illicitly acquired.

“We acknowledge that our work describes only one part of the very complex opioid overdose crisis in this country,” said the lead author, Dr. Scott Hadland, a pediatrician and researcher at Boston Medical Center’s Grayken Center for Addiction. “Even still, prescription opioids remain involved in one-third of all opioid overdose deaths, and are commonly the first medications that people encounter before transitioning to heroin or fentanyl. It is critical that we take measures now to prevent marketing from unnecessarily exposing new people to opioids they may not need.”

The study found that opioid-related spending on doctors was most highly concentrated in counties in the Northeast; the Midwest had the lowest concentration.

Areas with large numbers of payments and high overdose rates included four cities in Virginia — Salem, Fredericksburg, Winchester and Norton — as well as Cabell County, W.Va., which has one of the highest overdose death rates in the nation. Lackawanna County, Penn., which includes Scranton, also ranked high in both measures, as did Erie County, Ohio.

The authors said they were particularly struck by the fact that the number of marketing interactions with doctors — such as frequent free meals — was more strongly associated with overdose deaths than the amount spent.

“Each meal seems to be associated with more and more prescriptions,” Dr. Hadland said. He added that while pharmaceutical company payments to doctors seem to have started dropping, the practice of companies buying meals for doctors “remains alive and well.”

The study noted that while some states have sought to limit the total amount drug companies spend promoting their products to doctors — New Jersey, for example, recently adopted a new regulation limiting such spending to $10,000 per doctor, per year — what may matter more is for states or health systems to limit the number of interactions.

“I think what seems to be less important is the amount of money spent,” Dr. Hadland said, “compared with the number of interactions.”

The study linked information from 2013 to 2016 across three national databases: the Open Payments database, which includes all payments made by pharmaceutical companies to physicians, which companies are required to report under a section of the Affordable Care Act; drug overdose data from the Centers for Disease Control and Prevention; and C.D.C. data on opioid prescriptions dispensed at pharmacies.

It measured opioid marketing in three ways: the total dollar value of marketing received by doctors; the number of payments made by the pharmaceutical industry; and the number of physicians receiving any marketing.

The study builds on another that Dr. Hadland and his co-author, Dr. Magdalena Cerda, an associate professor of population health at the NYU School of Medicine, published earlier this year. It found that for every meal a doctor received related to an opioid drug in 2014, there was an increase in opioid claims by that doctor for Medicare patients the following year.

As the opioid epidemic reached crisis proportions over the past few years, more than 30 states have responded by passing laws that restrict opioid prescribing. Critics say these policies are misguided because most overdose deaths now are from illicit opioids like synthetic fentanyl, and because the restrictions hurt patients with chronic pain.

But the policies may be having an impact, as opioid prescribing rates overall have been falling. Still, Dr. Hadland pointed out, prescribing rates remain uneven, with some regions still seeing widespread prescribing of opioids.

One company, Purdue Pharma, the maker of OxyContin, announced last year that it would stop marketing its painkillers to doctors, including by no longer sending salespeople to medical offices to talk about the drugs. According to a newly public filing in a lawsuit brought by Massachusetts against Purdue, a member of the Sackler family, which owns the company, had boasted in 1996 that “the launch of OxyContin tablets will be followed by a blizzard of prescriptions that will bury the competition.”

An analysis last year by ProPublica found that payments to doctors related to opioid drugs dropped significantly in 2016 — a sign that public pressure on the companies in the wake of the opioid epidemic had begun having an effect. ProPublica found that in 2016, drug makers spent $15.8 million on doctors in the form of speaking and consulting fees, meals and travel related to opioid drugs. That was 33 percent less than in 2015, when they spent $23.7 million, and 21 percent less in 2014, when they spent $19.9 million.

Top California doctors group seeks legislation to ensure pain prescriptions get filled


Top California doctors group seeks legislation to ensure pain prescriptions get filled


The California Medical Association is working to get legislation introduced — perhaps as early as this week — that will alleviate a problem with prescription forms that has pharmacists across the state rejecting patients who bring doctors’ orders for pain medications.

Many doctors say the problems began Jan. 2 after a new law went into effect the day before. That’s when they started receiving emails from pharmacies telling them that they had used an incorrect prescription form and that pharmacists couldn’t fill their orders until they received the correct form.

“I just got my new prescription pads (Monday) at a cost of several hundred dollars, and the change is trivial,” said Dr. Richard Buss, a family practice physician in Jackson. “At the hospital here, I was next to a doctor who was trying to send a patient home after knee surgery, and the pharmacy wouldn’t honor his prescription because they were old forms.”

The new law, known as Assembly Bill 1753, is intended to help keep opioid medications and other controlled substances out of the illicit drug trade. Carried by Assemblyman Evan Low, the measure allows the California Department of Justice to restrict the number of companies authorized to print prescription drug forms, and it requires that each form has a unique serialized number for tracking. Legislation in 2017 required other security measures for prescription forms.

Buss said the changes in the forms seem more like a change in format to him than an addition of meaningful new security measures. The old forms, he said, had serial numbers as well.

Gov. Jerry Brown signed the measure in September, but the California Medical Association told Attorney General Xavier Becerra in a letter dated Dec. 21 that updated forms were not available to physicians until the week of Dec. 17. The professional organization, which represents 43,000 doctors, said in the memo that it had concerns that doctors would not have enough time to acquire the new forms and implement the new protocols before the Jan. 1 deadline.

The Jan. 1 implementation “would result in a serious barrier to patients who must access necessary medications in a timely manner,” said Janus Norman, senior vice president for the CMA’s Center for Government Relations. He urged Becerra to work with the Medical Board of California and the California Board of Pharmacy to establish a transitional period allowing pharmacists to accept forms that do not comply.

Buss said he was frustrated because this is the second year in a row where he felt doctors were not given proper notification of changes needed in their prescription forms: “They’re just changing a prescription requirements, and then the doctors have to jump through the hoops suddenly, and I’m left with thousands of prescription blanks that are unusable, and that’s probably true for a lot of other doctors.”

No transition period was included as part of the legislation. In an email to The Sacramento Bee, Low stated that he is “committed to seeing that any legislative solution is signed into law immediately.”

On Tuesday, Anthony York, a spokesman for the California Medical Association, said the organization hoped to have legislation soon that would ensure a smoother transition to new prescription pads. He didn’t have details on the measure under consideration.

Buss said he believes that legislation affecting prescriptions should include a grace period in which pharmacists and printing companies alert doctors of the date on which their prior forms will expire.

The Medical Board of California said it tried to get the word out. On Dec. 28, it sent an email blast to all licensees notifying them of the new prescription form requirement for many controlled substances, and the agency posted messages that day about the new prescription form requirement on its Facebook and Twitter sites. On Jan. 10, it issued a joint statement with the Department of Justice and the pharmacy board.

In that statement, issued via email blast and the web, the agencies said none of them wanted to see patients denied access to necessary medications in the transition to new forms. To that end, the pharmacy board said in the statement, it would not make a priority of investigating pharmacists who determine it is in the best interest of a patient or public health to fill a prescription using last year’s prescription forms.

“Pharmacies have the option of accepting the (prescription forms) but people are so wary now of running afoul of the Board of Pharmacy that they’re just refusing them,” Buss said. “Even the prescription printers had no warning of this. There’s probably 20 to 30 organizations that print security prescriptions, and they were all rushing to get these things done.”

The clampdown on opioid prescriptions is hurting pain patients

The clampdown on opioid prescriptions is hurting pain patients


In the summer of 1994, I was working at my desk at the Department of Justice when my back started to burn. Moments later, my body seized up, and I fell to the floor. Suddenly, at the age of 30, I was no longer able to sit or stand. I could barely walk short distances. These limitations, related to a surgical mishap, would continue for almost 20 years.

After dozens of failed treatments, I reluctantly tried prescription opioids. The pain medication enabled me to work despite my condition. I argued cases in federal court from a foldable reclining chair, negotiated settlements by video teleconference and, working remotely, managed litigation in U.S. attorney’s offices across the country.

When medical advancements led to an improvement of my health, I went off opioids without incident.

I was, as it turns out, incredibly lucky. A report released last month by Human Rights Watch paints a cautionary and at times harrowing picture of what pain patients are experiencing today.

The CDC needs to revise its guidelines to recommend that physicians not abandon pain patients or engage in “forced tapering.”
Share quote & link

Because of well-intended efforts to address the overdose crisis, many doctors are severely limiting opioid prescriptions. Patients who rely on opioid analgesics are being forcibly weaned off the medication or seeing their prescriptions significantly reduced. Other patients are unable to find doctors willing to treat them at all.

One such patient, Maria Higginbotham, has had more than a dozen surgeries to correct the collapse of her spine. She suffers from a painful condition in which the spinal cord fuses with adjacent membranes. Last year, her physician cut her pain medication by 75%, explaining that the reduction was to comply with federal guidelines.

In the past, Higginbotham could function. Now she needs assistance just to get out of bed and go to the toilet.

The federal guidelines Higginbotham’s doctor cited were issued in 2016 by the Centers for Disease Control and Prevention. They were intended as non-mandatory recommendations for primary care physicians.

Increasingly, the guidelines are treated not as recommendations, but as one-size-fits-all mandates. They are being misapplied by physicians, state legislatures, insurers and Medicaid programs.

Some physicians told Human Rights Watch researchers that they had taken patients off opioids, or reduced patients’ prescriptions, against their better clinical judgment. “You set yourself up for a liability, even when you know they’re not addicted and they’re benefiting from opioids,” one physician said.

Other doctors said that they had stopped treating pain patients altogether — even patients who don’t use prescription opioids.

It’s true that opioids were prescribed liberally in recent decades. Doctors began doing this in the 1990s. There were some bad actors, such as “pill mills” and wayward pharmacies. Opioid medication too often fell into the wrong hands.

Moreover, prescription opioids are not the magic bullet we once believed them to be. The evidence about their efficacy across a broad population is limited. Even when their use is appropriate, opioids carry risks, and the risks increase at higher doses. The CDC was right to encourage judicious, responsible prescribing.

But chronic pain is a large umbrella category, encompassing a wide range of injuries and diseases, some of which are incurable. A one-size-fits-all approach to treatment does not work.

The recent clampdown has had harmful consequences. Some patients told researchers that they were forced to quit working or go on disability when their medication was denied. Others are now homebound. Many mentioned the possibility of suicide.

Patients also said that they were turning to alcohol or illegal substances to treat their pain.

What began as an effort to protect patients may be morphing into one that is harming them. The CDC’s National Center for Health Statistics estimates that 50 million Americans have pain every day and nearly 20 million have pain that limits major life activities. If the experiences that patients described to Human Rights Watch are common, the harm to patients could be widespread.
Enter the Fray: First takes on the news of the minute »

The CDC’s own data show that fatal overdoses are driven largely by illegally produced fentanyl, its analogs and heroin — not by medically prescribed opioids.

For all these reasons, the CDC should address the misapplication of its guidelines, as the American Medical Assn. recently did. The agency needs to revise its guidelines to recommend that physicians not abandon pain patients or engage in “forced tapering.”

The CDC should also study and address any unintended consequences of its 2016 guidelines, as it promised to do.

Tackling the overdose crisis is a vital public policy goal. But chronic pain patients should not become casualties in that fight.

Kate M. Nicholson is a civil rights and health policy attorney. She served for 20 years in the Department of Justice’s civil rights division, where she drafted current regulations under the Americans With Disabilities Act. She gave a TEDx talk about chronic pain, “What We Lose When We Undertreat Pain.”

He is in jail.. he had put a photo of the DEA agents on his computer… the DEA agents.. in mortal danger of their lives

Doc, my son, has been in jail snce June 26, 2018. He will have to remain there until August of 2019, when the trial will begin. The DEA raided his office, his home and my home and stole jewellery of mine, without leaving a receipt. I consider them nothing but thieves, low life’s and liars. He is in jail, not because of any false charges they came up with, but because he had put a photo of the DEA agents on his computer to find out who had been telling the pharmacists he was under investigation. They, the DEA agent, convinced the judge that because doc had this photo of them, they were in mortal danger of their lives. It’s sickening how they lie and twist everything to suit themselves. The main reason for the raid I am convinced was to take all llhis assets, which they did, and left him with no assets to even hire a lawyer. Of course, this was intentional on their part, so that they may have a so called legal interest in clearing out his bank and investment account. The first thing on DEA web site that is what they are after is asset forfeiture. It is they who should be serving time in jail for theft.



Maybe this is why the DEA runs want ads like this:

Forfeiture Financial Specialist Supporting the DEA

When MASS Medicaid says that a pt should not have a opiate Rx … they mean it !!!

Rite Aid pays $177K to settle improper drug-dispensing allegations


Retail pharmacy chain Rite Aid will pay $177,000 to resolve allegations that it violated Massachusetts law by accepting cash payments from Medicaid recipients for controlled substances instead of billing the agency “in a limited number of instances,” according to The Boston Globe.

The lawsuit, brought by Massachusetts Attorney General Maura Healey, claims that in some cases Medicaid had denied a claim for a controlled substance like opioids, and a Rite Aid pharmacist dispensed the medication anyway for cash.

Rite Aid denied violating state law and told The Globe that the settlement  is to avoid the uncertainty and expense of litigation.

Under the settlement arrangement, Rite Aid also agreed to train all pharmacy staff about Medicaid regulations and require all pharmacists to consult the state’s prescription monitoring program before dispensing controlled substances.

A similar agreement was reached in 2016 and 2017 with CVS and Walgreens, which also were accused of violating controlled substance drug-dispensing rules.


#starburst lawsuit.. the explanation as to what it is

Too tired & suffering too much pain fog to share or even describe this video explaining #Starburst🚀 & the importance of all Americans filing the Motions to Join. Plz watch & share far & wide as it is appropriately named

SickOfSuffering😢  https://sickofsuffering.com/

Robert D. Rose Jr. — Teufelshunde

%d bloggers like this: