1-ribbonFirst they came for the mentally ill addicts, and I did not speak out—
Because I was not a mentally ill addict.

Then they came for the empathetic prescribers, and I did not speak out—
Because I was not a empathetic prescriber.

Then they came for the Pharmacists, and I did not speak out—
Because I was not a Pharmacist.

Then they came for me—and there was no one left to speak for me

There are so many people in the severe pain category that something has to be done

Pain by the Numbers


In one of the largest population studies on pain to date, researchers with the National Institutes of Health estimate that nearly 40 million Americans experience severe pain and more than 25 million have pain every day.

Those with severe pain were more likely to have worse health status, use more health care, and suffer from more disability than those with less severe pain.

There are so many people in the severe pain category that something has to be done,” said Richard Nahin, the lead author of the analysis and lead epidemiologist for the National Center for Complementary and Integrative Health, the arm of the NIH that funded the study. “If people are in the most severe category of pain, whatever treatment they are getting may be inadequate.”

Published in The Journal of Pain earlier this month, the study is an analysis of 2012 data from the National Health Interview Survey. It follows a comprehensive 2011 Institute of Medicine report on pain.

The analysis examined pain differences among ethnic groups. For example, Hispanics and Asians are less likely to report pain.

“If you are dealing with a minority group that doesn’t speak English, you need to pay greater attention to eliciting what they mean when they say they have mild pain or severe pain,” Nahin said.

The authors of the analysis hope their work will help inform greater research and better treatment options for people in pain.

“We’re doing a lot of research on the mechanism of pain and potential medications. The problem is there is no silver bullet,” said David Shurtleff, deputy director of NCCIH. “These data are giving us a better understanding of the pain conditions in the United States. We now can understand how sub-populations across age and across ethnic groups are experiencing pain.”

Shurtleff said that pain is a challenge to treat because it is not just about what happens to a person physically. Emotional and cognitive factors come into play as well. “Our major focus is on symptom management for pain,” he said. “It’s not necessarily [one] medication or behavioral intervention. It’s likely to be an integrative approach using multiple strategies to help patients alleviate their pain.”

Paul Gileno, who has had chronic pain since he broke his back 12 years ago, is doing just that. Gileno, who founded the U.S. Pain Foundation advocacy group, uses acupuncture, meditation, and changes to his diet to manage his pain. He is now able to take fewer painkillers, he said.

“You need to keep trying these different modalities because you never want to give up hoping that your pain can be reduced or go away,” he says.

Gileno endured multiple surgeries and has tried many different pain medicines, but he still lives with pain every day.

 “After I saw the last neurologist and the last doctor and they said, ‘Listen we’ve done everything we can do and I don’t think your pain is going to go away,’ I had to come to terms that I would have chronic pain for the rest of my life,” said Gileno. “Pain comes with a lot of baggage. It comes with depression. It comes with feeling judged and you feel less of a person. You become very isolated.”

Untreated pain is something Dr. Sean Morrison sees in many of his patients. He is a geriatrician and director of Palliative Care at Mount Sinai Hospital in New York.

“Pain causes a tremendous amount of suffering,” said Morrison. “It has huge economic costs, because of people who cannot work … And it has a significant impact on caregivers who are caring for people who have pain.”

As more effective treatments are developed for a greater number of diseases, a growing number of people will suffer from pain as a side-effect, he said.

“Many of the cancer drugs we use now result in permanent nerve injury and resulting neuropathic pain which is very difficult to treat,” he said.

Another of Morrison’s frustrations is the growing level of scrutiny physicians and pharmacists are under as they treat pain. The law enforcement crackdown on prescription drug abuse appears to be making it harder for legitimate pain patients to get the medicines they need.

“What’s happening is that the same drug is being used appropriately by group of patients and inappropriately in a large segment of the population,” Morrison said. “What we’ve seen is people in pain are the unintended victims of the war on drugs.”

NIH is in the process of finalizing a National Pain Strategy to coordinate efforts among different agencies to prevent, treat, manage, and study pain.

When does the PROTECT AND SERVE start for those with subjective diseases ?

I thought that the three stooges were dead but apparently two of them have been reincarnated as attorneys in MT. This Physician’s practice was “raided” in 2014 and shut down.. he just got his license back and reopened his practice a couple of week ago and now the local judicial system is going after him for the same issues that he was cleared of in 2014.

We have doctors and Pharmacists denying care to pts… but.. only to those pts that suffer from subjective diseases…  If they denied care to a pt with any other chronic disease.. the attorneys would be circling like vultures over a dead carcass suing for pt abuse and malpractice.

We have three different Florida Pharmacists http://www.wesh.com/news/pharmacy-rejects-pain-prescription-for-4yearold-with-cancer/34447400?utm_source=Social&utm_medium=FBPAGE&utm_campaign=WESH%202%20News&Content%20Type=Story refusing to fill pain medication for a four year old who just had a cancerous kidney removed and being discharged from the hospital. I would bet that if the parent had refused to get this child’s pain medicine filled CPS would be after them for child abuse or child neglect. The consequences to these Pharmacists.. apparently NOTHING !

Our judicial system is suppose to be PROTECT AND SERVE… but.. it seems to have evolved into ABUSE AND SELF-SERVE

HAMILTON -A controversial Ravalli County doctor has been arrested and is facing hundreds of charges.

Deputy Ravalli County Attorney Thorin Geist says that Dr. Chris Arthur Christensen was arrested Thursday without incident at his home in Florence.

A news release states that the Ravalli County Attorney’s Office has charged Christensen with 400 felony level offenses, including two counts of negligent homicide, related to the distribution of controlled substances in Montana.

Christensen is also facing felony Criminal Endangerment, felony Criminal Distribution Of Dangerous Drugs and felony Criminal Possession of Dangerous Drugs charges.

He is being held on a $200,000 bond in the Ravalli County jail and is slated to make his court appearance in Hamilton on Friday afternoon..

We will have more on this developing story as information becomes available.

FDA now allows “poor quality” manufacturers to produce your meds ?

Government wants to grade drugmakers, but keep grades secret


Federal regulators want to grade drug companies on the manufacturing quality of their product or factory, but don’t want to share that grade with the public.

Patients have become more empowered in their healthcare decisions, using websites like Yelp to determine the quality of a doctor or hospital. There are some tools for evaluating the quality of a drug maker. The Food and Drug Administration posts warnings to companies for egregious offenses and some inspection reports of facilities on its website.

But agency officials have said there isn’t a good picture of quality of pharmaceutical manufacturing as a whole, let alone where an individual drug maker fits in that picture.

The agency hopes to change that by implementing its quality metrics program.

The goal of the program is to help the FDA sort out the high-quality manufacturers from the poor quality ones. By doing so, the agency would be able to inspect the low-quality manufacturers more than the ones that don’t need as much oversight.

In July, the agency announced it intends to require four types of quality metrics from manufacturers and three optional ones. It held a meeting to get industry feedback on the metrics on Monday.

Each metric is intended to evaluate a specific part of how the drugs are made. For instance, one proposed required metric is the number of complaints a company has received about a specific product. Another is the number of batches of product that were rejected due to failing quality tests.

The agency would collect that data each year and give each manufacturer a grade that encompasses how they are on all the metrics. What the company does with that grade is up to them.

There is no plan to release the grades to the public, said Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. A big reason is context.

The metrics “certainly could be misinterpreted,” Woodcock said. “Because they can be gamed and are not straightforward to understand it would be a disservice to release them to the public.”

Take biologics, which are drugs made from a living organism. One example of a biologic is a vaccine.

A biologic differs greatly from a traditional drug, which is made up of chemicals rather than living organisms. Therefore a biologic can be harder to produce than a traditional drug since they are more susceptible to heat and contamination.

A biologic drug maker may have a higher score on a certain metric but that may not mean they are a poor-quality manufacturer, Woodcock said.

“If they have a higher [batch] rejection rate does that mean they are a bad production line or a good production line?” Woodcock said. “The public isn’t in a position to interpret all of that.”

Another reason is the agency itself needs to understand what these metrics mean. Woodcock said that a final list of metrics won’t be published this year and even then drug makers will need time to collect and report the data and the agency to analyze it.

“We have to understand them and give companies a chance to work with [the metrics],” she said.

Woodcock downplayed drug quality as a safety issue in the U.S.

“It is not common at all for a drug that somebody takes to have a quality problem,” she said. “Having a safety problem is usually an adverse event that is the inherent property of the drug or maybe it doesn’t work very well.”

Those issues are more of a problem with the design of the drug, and not the manufacturing of it, she said.

Though she said quality problems among regulated drugs are uncommon, there is still a problem with substandard products and counterfeits. There have been highly publicized incidents of counterfeit drugs reaching U.S. patients in the past couple of years, most notably involving fake botox and even some cancer meds.

Woodcock recommended that patients not buy any pharmaceuticals online unless they are from a certified online pharmacy or an insurer’s distribution network.

“We have had consumers given labels in Turkish,” she said. “You know that didn’t go through U.S. distribution channels.”

She added that sometimes a website will say they are peddling drugs from Canada but they may actually be counterfeit.

A 2013 law required the FDA and industry to set up a system to electronically track and trace pharmaceuticals as they go from the manufacturer to the pharmacy. The goal of the system is to ensure there is no chance of counterfeit drugs getting into U.S. markets.

Experts say that the FDA could provide more information on drug quality.

“The FDA is opaque,” said Roger Bate, a scholar with the think tank American Enterprise Institute. “There are numerous data that are important and I accept that much is proprietary to companies, but much is not and is still not disclosed.”

Bate gave an example of data that is supposed to show that a generic drug is equivalent to the brand-name drug it is copying.

“Showing where your product might be slightly different to another generic is important for doctors to know, since it is quite possible that a generic is bioequivalent to the innovator but two generics are not bioequivalent to each other,” he told the Washington Examiner Monday.

Corrupt cops in the news

This Week’s Corrupt Cops Stories


More jail guards in trouble, a DEA agent gets popped for child porn, and a Mississippi cop gets fired after getting caught in a major marijuana deal. Let’s get to it:

In Hattiesburg, Mississippi, a Hattiesburg police officer was fired last Wednesday amid allegations he is a target of a state and federal drug investigation. Officer Thomas Wheeler got canned after he was caught making a 600-pound marijuana deal earlier this month. Wheeler has yet to be charged, and his case will likely go before a grand jury in October.In McAllen, Texas, a DEA special agent was arrested last Friday on child porn charges. Special Agent James Patrick Burke had been the subject of a February raid in which FBI agents seized his laptop and discovered he was viewing and downloading child pornography. It’s not clear exactly what he’s been charged with, but he’s now on administrative leave from the DEA.

In Mobile, Alabama, a Mobile County jail guard was arrested Tuesday for allegedly selling drugs. David John Black Jr. is charged with four counts of distribution of marijuana, possession of marijuana, and possession of drug paraphernalia. The Mobile County Sheriff’s Office said there was no evidence he was dealing drugs at the jail.

In Memphis, four Shelby County jail deputies pleaded guilty last Thursday to trying to smuggle prescription drugs into the jail. Torriano Vaughn, Brian Grammer, Anthony Thomas and Marcus Green had participated in a scheme to smuggle what they thought were OxyContin pills into Shelby County Jail on multiple occasions between May and December 2014. But it was a sting, and the four have now pleaded guilty to attempted possession of a controlled substance with the intent to distribute. They’re looking at up to 20 years.

I hope that the “desperate robbers” can read signs

New safes installed in Walgreens stores to prevent pharmacy robberies

MILWAUKEE (TMJ) — Pharmacies have long been targets for criminals and drug addicts looking for their next fix. That has often put employees at risk of being robbed and customers in the crossfire.

According to the Drug Enforcement Administration, Wisconsin ranks just behind Indiana for the most pharmacy armed robberies in the nation this year. The majority of those took place in Milwaukee County.

Walgreens has a new tool to combat these pharmacy robberies and help improve the safety of customers and employees. They’re called “time delay safes” and they’re being installed throughout Wisconsin.

The new safes will be used to secure opiates and narcotics.

They’re designed to remain locked for a period of time before a pharmacist can open it: this takes away immediate access of drugs. The program has been successful in other states and now the technology is coming to Walgreens pharmacies in the greater Milwaukee metro area.

The program could be expanded to other drug stores in the future.

“Once activated by a pharmacist, the safe is designed to remain locked for several minutes,” said Telly Knetter, an asset protection manager. “Our safes will be used to secure commonly controlled substances that are often targeted by criminals.”

Walgreens corporate offices said there’s been a decrease in pharmacy robberies in retail stores since these safes have been installed.

Fined $20,000 by DEA for sloppy record keeping… no controls missing

Lanier Treatment Center responds to fine, DEA oversight

Department of Justice alleges narcotic treatment program kept incomplete records


Administrators of a Gainesville narcotic treatment program responded Wednesday to concerns that methadone was leaving the door unchecked.

The program, Lanier Treatment Center was fined $20,000 to settle allegations about not keeping complete and accurate records of the drugs sold and received. The center is an accredited agency specializing in opiate treatment.

According to a Department of Justice news release Tuesday, the center did not comply with regulations on controlled substances.

“Accountability audits conducted by the (Drug Enforcement Administration) revealed overages and shortages of methadone in 2010 and 2013,” according to the news release.

The center will have additional DEA oversight as a result.

“We completely agree with the DEA that the opiate epidemic has caused such heartache and pain to families in Georgia,” Matthew Mote, clinic administrator said in a statement. “We are glad to work with the DEA since clerical errors were brought to our attention.”

But it was an implication that treatment drugs might be “falling into the hands of dealers and addicts” that drew a response from the center.

“The diversion of prescription narcotics and painkillers feeds the market for abuse and addiction, and Georgia is experiencing an epidemic of prescription drug abuse,” Acting U.S. Attorney John Horn said in the news release.

Mote said the recordkeeping mistakes presented no danger of methadone and other treatment drugs going untracked.

“At no time has diversion ever been suspected, and we have been able to account for all medication,” Mote said. “We are always very cooperative with the multiple government agencies that help regulate our facility.”

Mote said the center is proud to continue its work locally. It is the only opiate treatment center of its kind in Hall County and the center regularly works with local hospitals, clinics, law enforcement and other agencies to educate about “evidenced-based practice with medication-assisted treatment.”

“We strive to work with not only the government agencies but also with our local community,” Mote said.


Can you trust anyone.. if you can’t trust a physician’s office’s word ?

This pt was moving from one state to another and had called ahead and made an appt with a new doctor explaining what meds she had been on… apparently one week before the appt and the pt would be out of meds and into withdrawal… the doctor’s office called and told the pt that she would not be accepted as a new pt.  A form of GENOCIDE in America ?

How long before someone gets hurt/killed

video platformvideo managementvideo solutionsvideo player

22 veterans commit suicide EVERY DAY.. no headlines here ?

Two people may have committed suicide after Ashley Madison hack: police


How many chronic painers commit suicide every day from DENIAL OF CARE ? NO ONE keeps tracks.. because NO ONE CARES ?

At least two people may have committed suicide following the hacking of the Ashley Madison cheating website, Toronto police said on Monday, warning of a ripple effect that includes scams and extortion of clients desperate to stop the exposure of their infidelity.

Avid Life Media Inc, the parent company of the website, is offering a C$500,000 ($379,132) reward to catch the hackers.

In addition to the exposure of the Ashley Madison accounts of as many as 37 million users, the attack on the dating website for married people has sparked extortion attempts and at least two unconfirmed suicides, Toronto Police Acting Staff Superintendent Bryce Evans told a news conference.

The data dump contained email addresses of U.S. government officials, UK civil servants, and workers at European and North American corporations, taking already deep-seated fears about Internet security and data protection to a new level.

“Your actions are illegal and will not be tolerated. This is your wake-up call,” Evans said, addressing the so-called “Impact Team” hackers directly during the news conference.

“To the hacking community who engage in discussions on the dark web and who no doubt have information that could assist this investigation, we’re also appealing to you to do the right thing,” Evans said. “You know the Impact Team has crossed the line. Do the right thing and reach out to us.”

Police declined to provide any more details on the apparent suicides, saying they received unconfirmed reports on Monday morning.

“The social impact behind this (hacking) – we’re talking about families. We’re talking about their children, we’re talking about their wives, we’re talking about their male partners,” Evans told reporters.

“It’s going to have impacts on their lives. We’re now going to have hate crimes that are a result of this. There are so many things that are happening. The reality is … this is not the fun and games that has been portrayed.”

The investigation into the hacking has broadened to include international law enforcement, with the U.S. Department of Homeland Security joining last week. The U.S. Federal Bureau of Investigation and Canadian federal and provincial police are also assisting.

Evans also said the hacking has spawned online scams that fraudulently claim to be able to protect Ashley Madison clients’ data for a fee.

People are also attempting to extort Ashley Madison clients by threatening to send evidence of their membership directly to friends, family or colleagues, Evans said.

In a sign of Ashley Madison’s deepening woes following the breach, lawyers last week launched a class-action lawsuit seeking some $760 million in damages on behalf of Canadians whose information was leaked.

Evans said Avid Life first became aware of the breach on July 12, when several employees booted up their computers and received a message from the infiltrators accompanied by the playing of rock group AC/DC’s “Thunderstruck.”

The company went to police several days later, he said, while the hackers went public on July 20.


The multi-million dollar federal marijuana eradication program may be on its last legs

Legal marijuana snuffing out eradication program


The multi-million dollar federal marijuana eradication program may be on its last legs as more states legalize the drug and results of the program decline.

Since 2010, funding for the program has been relatively stable, yet states receiving the money have reported 35 percent fewer arrests and 58 percent fewer marijuana plants seized. In Ohio, where voters will decide on marijuana legalization in November, those decreases are even larger — 86 percent fewer arrests and 75 percent fewer plants.

In June, the U.S. House approved a California congressman’s proposal to slash the Drug Enforcement Agency’s $18 million state marijuana eradication budget in half. While 183 members of Congress voted against the budget legislation where the proposal appeared, no one spoke against it in session.

Dan Riffle, director of federal policies for the Marijuana Policy Project, said it’s just a matter of time before the program is defunded altogether.

“The thinking is there’s just better things for the DEA to focus their resources on now,” Riffle said, noting the nation’s opiate epidemic.

Congressman Ted Lieu, R-California, brought forth the funding cut and has pledged to bring forward legislation to cut the program entirely next year.

“This is a ridiculous waste of precious federal resources, especially when multiple states and jurisdictions have already legalized marijuana,” Lieu said in a June news release. “It is time for the federal government to stop making marijuana use or possession a federal crime.”

Worth the cost?

The DEA began funding marijuana eradication efforts in Hawaii and California in 1979. By 1985, all 50 states had jumped on board to nab a bit of the money, even though not all of them do so now. How much a state gets is based on several factors including past performance, perceived threat and how well they cooperate with the DEA, agency spokeswomen Barbara Carreno said.

The eradication money comes from forfeitures of cash and property, such as vehicles, during drug cases. Between 2010 and 2014, the DEA set aside $104.8 million for marijuana eradication with 85 percent of that going to states and the remainder for the agency’s own eradication efforts.

States submit a request for money and are provided an allowance they can spend. If a state doesn’t use all of its money, the DEA gives it to someone else, Carreno said. Between 2010 and 2015, states didn’t use $4.1 million, about 5 percent of the approved budget.

Lieu’s state of California received the largest amount, about $27.2 million between 2010 and 2014. While the state has ret

urned the largest dollar amount between 2010 and 2014 — nearly $2.1 million — Maine has returned the largest percentage of its allocation: 39 percent.

Ohio’s Bureau of Criminal Identification and Investigation received about $500,000 each of the last five years. It forfeited money once — nearly $25,000 in 2013. The bureau works with law enforcement agencies around the state to fly over fields and forests to look for marijuana.

Over the past five years, Ohio spent more than $2 million — 80 percent of the DEA funds — on aircraft and nearly $361,000 on overtime. Ohio’s efforts resulted in the seizure of 228,204 marijuana plants over those five years, with nearly half of those discovered in 2010.

One of those finds came in August 2010 in Pike County where officials discovered 22,000 marijuana plants and abandoned camp sites where people had been stationed guarding the crop. The following month, hunters tipped off officials to another camp and grow site at the Coshocton/Muskingum county line where upwards of 6,000 plants were found and 11 men taken into custody.

Despite those large grow sites making 2010 a banner year, seizures since 2012 have been about half of what was seized in 2009 and 2011.

As for decreases in arrests, Del Greco said tracking down growers can be tricky.

“For example, if plants are spotted in a corn field, it’s typically not the farmer who put them there but someone who trespassed on the property. If the plants are found in someone’s backyard, an arrest could be more likely,” she said.

Del Greco speculated that in some cases, arrests after additional investigation may not be reported to the DEA.

The number of plants being seized and arrests made nationally has seen a similar decline, which Carreno chalks up to a “perfect storm of factors” and not a sign that the program needs to change to be more effective. Weather, such as the intense drought in California, tightening law enforcement budgets, and changing grow tactics, such as indoor cultivation, impact eradication efforts.

Waning interest?

Although marijuana seizure numbers fluctuate for various reasons, Riffle said law enforcement just isn’t as focused on marijuana.

“(The decrease) shows the failure of a law enforcement approach,” said Riffle, a former prosecutor in Vinton County.

The national decrease also is reflective of changing state laws. Nearly half of the nation has legalized marijuana to some extent and Ohio voters will be voting on ResponsibleOhio’s issue in November that would legalize the drug for recreational use.

Although marijuana remains illegal under federal law, Congress recently has begun examining changes — for example, an appropriations committee voted to allow federal banks to handle funds from legal marijuana businesses — that imply federal legality may be around the corner.

Legality also would mean less demand for illegal grows, Riffle said, and why the eradication efforts won’t be needed. He predicts that Lieu’s wish to eradicate the marijuana eradication budget may not happen this year, but within the next decade.

“It’s going to happen pretty quickly, that shift,” he said.

But for now, it’s still illegal and remains part of the DEA’s focus.

“(The) DEA has always focused its resources on large-scale drug trafficking organizations. Our field divisions prioritize the biggest, most important cases, and if those include marijuana cases, we don’t shy away from them,” Carreno said.

In the meantime, Del Greco contends Ohio law enforcement remains interested in marijuana eradication despite the drain on resources to attack the heroin problem.

“The efforts to legalize marijuana have not lowered participation in the program because marijuana cultivation is still illegal. And, although many local agencies are dedicating resources towards the opiate epidemic, participating in the eradication program does not cost the local agency anything besides manpower,” she said.

If that “free” money from the feds goes away, cash-strapped agency interest in eradication is likely to follow. And that’s OK, according to Riffle; because if marijuana is legal and regulated like alcohol, then people won’t be illegally growing it in large quantities in the nation’s parks and forests.

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