If you can’t tolerate the heat…. stay out of the kitchen

Has anyone ever noticed that every state has a Medical Licensing Board and Pharmacy Board… whose primary charge is to protect the public’s health and safety and yet it is the judicial/legal system that goes after those prescribers and pharmacies for failing to protect the public’s health and safety… Is it appropriate that law enforcement and NOT MEDICAL PROFESSIONAL that are determining who is “bad docs”, “bad pharmacies/Pharmacists” ?

Right now we have numerous of cities, counties, states lining up to sue drug wholesalers…  The drug wholesalers just fill orders (Form 222 or electronic CSOS) that are sent in from licensed pharmacies.  These wholesalers have no idea who the prescriber that has written a prescriptions for these C-II’s, have no idea who the pt is that is getting a prescription filled.  But the boards of pharmacy have had access to the state’s PMP databases that some “data mining” could have isolated prescribers & pharmacies that are writing and dispensing a ton of C-II’s… but apparently they have not bothered to look at those reports ?

The DEA has had access to all the wholesaler reports as to which pharmacies have been buying tons of C-II’s … but apparently they have not bothered to look at these reports ?

So why are the wholesalers being sued ? Unless it is because there are three major wholesalers that control some 80%-90% of the market and have some very deep pockets.  Maybe the AG’s and attorneys are “striking now” as there is more and more evidence that legal opiate Rxs are lower than they were 10 yrs ago and more information coming out that all those OD”s are from ILLEGAL OPIATES from Mexico and China… as it gets reported in the media more and more may blunt all those lawsuits of being successful.

We now have all these state legislatures passing bills that are limiting opiates to pts… both acute and chronic… are they totally ignorant of the failure of their state pharmacy boards, or just turning a BLIND EYE to what is going on…and/or figures that once it all hits the fan that it will give them the opportunity to pass another bill/law that will give them more controls and/or tax revenues. After all some states are looking at a prescription opiate tax… tax one group of people suffering from a chronic disease to help pay for treating another group dealing with a chronic health issues (addiction).

Then we have the insurance/PBM industry that is imposing daily MME limits – using the prior authorization process to impose these limits. Could the insurance industry have a couple of different motives… Doing this now may blunt any attempts of various cities, counties and states suing the insurance industry for paying for all those opiate prescriptions and helping cause the opiate crisis and all those OD’s and they could also being using this period as a means to increase their profits… After all most insurance companies are publicly held FOR PROFIT businesses and they can claim that they are just following the CDC opiate guidelines.

Speaking of those CDC guidelines… does anyone really believe that the CDC had the legal authority to publish those guidelines after all they are THE CENTER FOR DISEASE CONTROL and according to our current and previous Surgeon General … ADDICTION – all addictions – are a mental health issue (addictive personality) and not a moral failing and isn’t their primary charge to deal with DISEASES..  contagious disease.. and addiction(s) are not contagious diseases… So where did they get – or did they never have – the authority to even convene the committee to put these opiate guidelines together ?

My little blog just started its 7th year … and the chronic pain community appears to be getting “more hostile”…  so hostile that some within some of the Face Book pages are attacking each other and some are “walking away”… there has always been a lot of whining, bitching and moaning…  Everyone wants change, but don’t ask most to “sign on the dotted line”, put their name, picture or fingerprints anywhere on the processes that might cause things to change.  It would seem that all too many are waiting for “george” to come and fix things or a knight on a white horse coming over the horizon to save their ass.  The TRUTH IS… neither is going to happen.

PETITIONS

How many dozens or HUNDREDS of petitions have put out there by someone in the chronic pain community… has any of them reached the number of signatures where the White House or others promised to “look at” what the petition was for ? and exactly does the promise to “look at” really mean ?

LEGISLATORS

How many have made phone calls, sent letter, faxes, emails concerning the denial of getting chronic pain medicine? and has anyone got back anything but a form letter talking about the legislator’s concerns about the opiate EPIDEMIC… they are so clueless that they don’t know the difference between a EPIDEMIC – which is normally about a contagious disease – and what MAY BE a crisis.  There are a lot of other societal issues that are causing more tombstones than opiates – especially legally prescribed opiates – but none of them have been labeled as a crisis, epidemic or some other descriptive word.

Has anyone asked or seen a legislator to introduce a bill and/or sponsor a bill that will make can changes in the status quo ? If a legislator has stated that they “feel your pain” but has done nothing to submit a bill that would address his concerns about your pain… then the legislator is just full of BULL SHIT.

THE ACHILLES HEAL

We are seeing a lot of employers of prescribers that are establishing opiate prescribing guidelines … these are generally hospitals that own numerous hospitals, urgent care centers , physicians practices and the like… I have been told of one such healthcare corporation in the mid west that has some 560 such outlets and I have been told that they have issued edicts/letters to their employed prescribers that if they prescribe ANY OPIATES .. they will be fired.  With that many outlets there are thousands or tens of thousands pts whose quality of life is being compromised. These corporations are rescinding the professional discretion that these prescribers have been granted by the state practice act.  These corporations don’t have a medical degree nor a license to practice medicine and typically these corporations have “deep pockets” and could be a great target by some class action law firms. Right off hand I can come up with a handful of laws that are being violated.

The above could also apply to insurance companies and PBM ( Prescription benefit managers) who are imposing dosing limits on pts. One of the basics of the practice of medicine is the starting, changing, stopping a pt’s therapy.  Again these corporations do not have a medical degree nor a license to practice medicine.  Pts are telling me that these companies are refusing to tell the pt who made the decision to reduce their dosage.  One huge “brick wall ” the pts are running up against.  Again thousands, tens of thousands or millions of pt can have their quality of life harmed. The law firms that may be interested is class action, civil rights, or personal injury.. if a pt runs into another brick wall… it might work by sending the legal dept and the medical director a certified letter stating that you are giving them one opportunity to correct (cease and decease) the discrimination of you – a person covered by the Americans with Disability Act and Civil Rights Act. They might just figure that stopping discriminating against a single pt that bother to complain, might be the least expense route to take.  May be the situation that the “Squeakie wheel” get their opiate prescriptions paid for ?

If the chronic pain pt becomes house, chair, bed confined by the actions of a number of these corporations – or any reason that their opiates are reduced and their quality of life deteriorates – and they have a spouse.. there is such a thing as loss of companionship and consortium and states have 300,000 – 400,000 limits on the damages… The last thing that these various entities would be expecting is a lawsuit from spouse and kids.

TO BE CONTINUED:

 

2 Responses

  1. Thanks Steve I found that to be interesting. My doctor is now a reader of your site. He is trying to do the Correct thing for his patients but as per his words”the DEA and the POWERS that be are putting slit of pressure on the DOSE size. Thanks again
    A long term CHronicpain sufferer!

  2. Than you Steve

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