Dr Drew Pinsky pod cast (09/17/2019) on treating chronic pain

Licensing details for: G 55092

Name: PINSKY, DAVID DREW

License Type: Physician and Surgeon G

Primary Status: License Renewed & Current Primary Status Definition

School Name: University of Southern California Keck School of Medicine

Graduation Year: 1984

Address of Record:

2050 HUNTINGTON DR STE D
SOUTH PASADENA CA 91030
LOS ANGELES county

The following information is self-reported by the licensee and has not been verified by the Board.

Are you retired?        No
Activities in Medicine     Other – 10-19 Hours
Administration – 1-9 Hours   Teaching – 1-9 Hours
Patient Care – 10-19 Hours    Research – None
Telemedicine – 1-9 Hours       Patient Care Practice Location
Zip –                                        91030
County –                                  LOS ANGELES
Patient Care Secondary Practice Location      Not identified
Telemedicine Practice Location     Zip – 91105
County –                                    LOS ANGELES
Telemedicine                            Not identified
Secondary Practice Location    Not identified
Current Training Status            Not in Training
Areas of  practice                     Other – Not Listed – Secondary
Internal Medicine – Primary
Board Certifications                  American Board of Internal Medicine – Internal Medicine
Postgraduate Training Years     4 Years
Cultural Background                 White
Foreign Language Proficiency   French
Gender                                       Male
In listening to this program… two things seemed fairly odd…
Dr Drew repeated several times that he was not aware of any chronic pain pts having trouble getting their medication(s)
Dr Drew repeated several times that Suboxone DOES TREAT CHRONIC PAIN VERY WELL.
I guess that Dr Pinsky’s neighborhood or “circle of friends” live in a “utopia” in regards to ready access to adequate chronic pain treatment… or all the FB messages, emails, phone calls that I get every week are from chronic pain pts are just “unlucky” or lying about not getting proper pain management prescribed… or having Pharmacists refusing to fill the controlled substance Rxs and/or PBM/insurance companies refusing to pay for only some or none of the Rxs that their prescriber writes.
Suboxone may well work for some chronic pain pts …but… the only FDA approved use for Suboxone is for opioid dependence… of course this can be used/prescribed “off-label” for just about any health issue.
Where are the clinical studies that support the long term use of  Suboxone being effective in treating chronic pain… ?  Isn’t this what all the anti-opiate zealots use as a reason why opiates should not be prescribed long term to treat chronic pain  ?
Just imagine this… a pt is being given some Suboxone for chronic pain… maybe works a little bit… but the pt is offered no other medication options… the pt’s doc retires, leaves town, or stops treating chronic pain pts..
In searching out a new prescriber to treat the pt’s chronic pain… the pt gets routinely turned down in their search of new prescriber…  BECAUSE… these prescribers see SUBOXONE on the pt’s medication records… It is a controlled substance and would show up on a PMP report… and the prescribers “jump to the conclusion” that the pt is in REHAB for substance abuse…
May make no difference that the pt’s medical record does not have a ICD10 code for substance abuse.
After all, the only FDA approved use for Suboxone is for SUBSTANCE ABUSE.

Is this what you get when you elected a state AG who is married to a DEA agent ?

Atty Gen Moody Calls on DEA to Reexamine Opioid Prescription Quotas to Help Curb the Opioid Crisis

https://www.madisonfl.net/blog/atty-gen-moody-calls-on-dea-to-reexamine-opioid-prescription-quotas-to-help-curb-the-opioid-crisis/

TALLAHASSEE, Fla.—Florida Attorney General Ashley Moody joined seven states in pushing federal regulators to consider more information as they set manufacturing limits on prescription painkillers in hopes a more thorough review will lead to fewer overdose deaths as the fight against the opioid crisis continues. The coalition filed comments late Tuesday arguing Drug Enforcement Administration officials must do more to account for over-prescribing and expand its universe of information sources.

Attorney General Ashley Moody said, “Seventeen Floridians are dying every day from opioid abuse, as the national opioid crisis continues to ravage our country. To help reduce the excess supply of prescription opioids and save lives, I am calling on the DEA to reexamine the quotas that drug manufacturers have for specific painkiller production. This action could help reduce drug overdose deaths by limiting the amount of leftover pain medication that could fall into the hands of Floridians struggling with addiction.”

The coalition recognizes that current data sets make accounting for diversion difficult but argues such complexity cannot hinder progress. For instance, its members suggest that the DEA take into greater account data from its Drug Take Back Day as evidence of over-prescribing.

The states also suggest DEA officials should consider best practices developed by the medical community and state regulators, in addition to improving the usability of its reporting system and its suspicious orders database.

The DEA’s proposed limits for 2020 slash hydrocodone manufacturing by 19 percent and oxycodone by 8.8 percent in one year.

Florida’s attorney general joined six other states in the filing, including attorneys general in Arkansas, Idaho, Louisiana, Nebraska, West Virginia and the governor of Kentucky.

 

Floater Pharmacist and “just like to say no” ? could care less abt the consequences to the pt ?

Steve I have a CPP that is in a very bad place. Is there any way you can guide her through this. She was denied all of her meds. and now today is cold turkey. She said she wishes she was dead
she was denied her meds from prescriber or pharmacy ?
Pharmacy and now medicare pulled her prior approval
Now everyone has gone home knowing she has nothing
why was PA pulled
She has no idea
let me guess she is dealing with a chain … maybe CVS or Walgreen ?
CVS
I would bet that the pharmacist is opiophobic and called the Part D prgm and told them some sort of lie
Oh I am guessing same
She is in late 60’s to early 70’s
have her find a independent pharmacy http://www.ncpanet.org/home/find-your-local-pharmacy call CMS 800-MEDICARE and file complaint against CVS… have her go on line pharmacy board and file complaint with board of pharmacy unprofessional conduct, denial of care, pt abuse.. for starters… have her call the Part D and ask for reason PA was withdrawn – IN WRITING … file a complaint with CMS against them as well … tell me that it is not SILVER SCRIPTS Part D ?
Not Silver Scriots it’s the other one and I am beain dead
who is the PBM ?
She has an electronic script and they are refusing cash pay. It’s Express Scriots
Scripts
Paying cash when a pt has insurance is consider a RED FLAG by DEA
She tried that after pharmacy refused to fill
Dr. told them to let her pay cash
My understanding is that some chains … no insurance … no controls filled… even if the pt doesn’t have insurance… which means that they will not fill Rxs for about 10% of the population that doesn’t have insurance
She has Medicare Part D and I am pretty sure it is because Rx is ER
have doc to send new Rx to local indepenent and pay cash and argue about insurance covering when the sun comes up tomorrow
 
Dr. went home
doc could call in some Tylenol No.4 to hold her over for the night
Good idea. I even thought Clonidine
Clonidine MAY help with withdrawal issues but not pain…. Tylenol No.4 is still C-III and can be called in
I am letting her know
sorry couldn’t give you much more help tonight
I understand. I hate all of this
Once this is all straightened out… I would still file complaints with various oversight agencies
Ih I am making sure she does

She just sent me this Believe me, I realize that!!!!! Dr won’t call Tyl 4 in. He wants me to get thru til tom’w & see how it goes. So I don’t offend him, I gotta do what he asks. He really has been very good to me. He is the one who got me emergency surgery 10 mos ago after a Henry Ford Hospital neurosurgeon put surgical date 3 mos out. My MRI showed just millimeters away from severed spinal cord at C2 ( not conducive to life). PMP got me different Dr & surgery within 36 hrs!!! I owe him some respect
Also

My PMP called CVS pharmacist. Tonite’s “fill in” pharmacist absolutely REFUSES to fill my MS 60 at all!!!
Dr says the regular pharmacist will be there tom’w & he will fill it for cash. 🤞🏼. Those night time hours tick by so slowly under circumstances like this.
Both my sons are very upset because they feel so helpless. They remind me that this will only get worse & worse every month. They think I am at a crossroad – put up & shut up OR. Sign myself in & get off MS & pray I will be able to function

You know what is happening here
As if # dozen Tylenol No.4 could cause the his world to come to a end… i guess that his empathy is only good during office hours
Floater pharmacists are the worse… they don’t know the pt… they don’t know the prescriber… so … they just say NO
I fear tomorrow reality is gonna hit. I’m afraid she is losing her Dr. Will blame on DEA flag
Part D prgms don’t normally pull a PA without some outside “bad news” being pushed at them
They want her tapered
who is “they”
Medicare
This is her current dose MS Contin 60mg 3x/day. Plus MS Contin 15 mg 2x/day breakthru
one of the basics of the practice of medicine is starting, changing. stopping a pt’s therapy… Part D is NOT MEDICARE .. it is private FOR PROFIT insurance … so the private insurance company is attempting to practice medicine ?… no license… just interested in increasing their bottom line
Yes
Find out who the Part D medical director is… he/she is responsible for this… is the only one who has legal authority to practice medicine… but…doubt if he/she has a license to practice medicine in the state the pt lives – ILLEGAL… and according to the Controlled Substance Act… it is ILLEGAL for a prescriber to prescribe for a pt .. who they have not done a in person physical exam… call the Part D and tell them that she is going to file a complaint with the state he/she is licensed in and the state the pt lives in … as well as the DEA for violating the controlled substance act.. I have had to do that a couple of time with our Part D and they seem to quickly change their mind about PA
Thank you Steve
I have NEVER lost a PA nor a rejection with our Part D… I know too much… and it is easier just to approve the PA for me or wife… than to risk just how much trouble I could cause

she would like your email so she can update you on her status and thank you for your advice and compassion
Linda just heard from Exoress Scriotscand this is what they said You will NOT BELIEVE THIS!!!!! I just got a call from EXPRESS SCRIPTS PHARMACIST in approval Dept. He says my rxs were NOT DENIED. They continue to be approved thru Feb 2020. Those CVS pharmacists yesterday were called by him to tell them they were coding wrong AND how to fix it STAT so I could get my rxs. Both those pharmacists told him they refuse to fill them anyway! UNFUCINBELIEVABLE!

She just got her rx

This is an exchange with a chronic pain pt’s advocate/friend.   Once again this sort of scenario involves a “floater pharmacist” and one of the two major chain stores.

Pt can file complaints with the Pharmacist’s employer, the state board of Pharmacy, the PBM/insurance company and most likely the pt will get the response that “they” can’t force a Pharmacist to fill a Rx… which is true…

But we have a very serious and growing Pharmacist SURPLUS and if the Pharmacist’s employer was not happy with how their employee Pharmacist is treating pts who wish to patronize their pharmacy… They could fire them on the spot… but.. they don’t… so are they condoning this sort of denial of care ?

The Board of Pharmacy will tell the pt the same thing…  Is this because the pt has not filed a complaint about being lied to, denial of care, pt abuse – intentionally throwing a pt into cold turkey withdrawal… IMO … all involving UNPROFESSIONAL CONDUCT… it is normal for bureaucrats not to really look for trouble.

The PBM/Insurance company MAKES MONEY when they don’t have to pay for a prescription that they should have paid for… because Pharmacists deny filling legit prescriptions most of these are FOR PROFIT COMPANIES.

UNPROFESSIONAL CONDUCT is a very broad/vague concept and maybe it is time for pt denied appropriate care start filing complaints with the state board of pharmacy for all the UNPROFESSIONAL CONDUCT that I heard from pts every week…

One or two complaints are not going to get the BOP to take action… they will dismiss the complaints are “disgruntled substance abuser”… because they don’t know/understand that a substance abuser would never call attention to themselves with anyone in law enforcement.

Man is dead after CVS pharmacy medication mix-up

Man is dead after CVS pharmacy medication mix-up

https://www.fox13memphis.com/top-stories/man-is-dead-after-pharmacy-medication-mix-up/997776393

SOUTHAVEN, Miss. – One man is dead after a Southaven pharmacy allegedly mixed up the dosage of the man’s medication. 

Jeffrey Dale Simmons, of Clarksdale, died after a CVS pharmacist filled his prescription with four times the dosage that the doctor had prescribed.

Simmons’ family is suing CVS and the pharmacist in federal court, according to the lawsuit.

Content Continues Below

We spoke to a northern Mississippi pharmacist who told us it is easy to be your own advocate and to make sure you get the right medicines and use them properly.

The pharmacist said when a doctor prescribes you medicines, you need to ask the doctor questions at that point.

“Ask what are you writing for me,” said Mike Klepzig, a pharmacist at Mike’s Pharmacy. “What is it for and what does it do and what is its strength that way you are more educated on what he is giving you, versus you just taking it for granted.”

Klepzig is an Olive Branch, Mississippi, pharmacist. He tells us to not just ask questions at the doctor’s office. When you go to the pharmacy, ask the pharmacist questions about your medication. The pharmacist should be open to a consultation about the medication, especially if it is new. 

The important questions to remember include:

  • What is the dosage?
  • Medication interactions?
  • Does it need to be taken with food or shaken up?

Protesters voice concerns about lack of pain medication

Protesters voice concerns about lack of pain medication

https://www.nbc15.com/content/news/Protesters-voice-concers-about-lack-of-pain-medication–563249251.html

MADISON, Wis (WMTV) — Protestors voiced concerns surrounding policies that restrict access to pain medication during the 5th annual nationwide “Don’t Punish Pain” rally.

Protesters took to the streets with colorful signs and their voices to tell their stories of pain.

“I’ve been in pain… constantly,” Joanne Cocchiola, protester said.

She has degenerative disc disease among other health complications, and she said pain is all she knows.

“I have arthritis in my knee. I have a plate in my foot, and they take the pain medicine away,” she said.

She said she used to paint pictures and ride horses, but now that piece of her life is gone.

“I can’t go for a walk with my husband anymore because of my knee and my feet and my hips. So what do I do all day? I have to lay down. It’s either on the couch or the bed,” Cocchiola said.

In 2016, the CDC issued prescribing guidelines highlighting risks of addiction encouraging providers to lower dosages when possible.

Pain experts said after the CDC released those guidelines, prescribers reduced or completely stopped the availability of opioids to chronically-ill patients.

“The problem with that is that in many of these patients, on an individual basis, they do obtain a substantial amount of benefit in addition to other medications, but they still get a benefit out of opioids and safely, ” Paul Hutson, UW-Madison Pharmacy Professor said.

Health experts said the regulations don’t consider that there’s no “one size fits all” with medical care.

“We’re having negative consequences from rapid stopping of individuals with opioids who have legitimate needs for these prescriptions. So it’s finding that balance,” Cody Wenthur, UW-Madison Assistant Pharmacy Professor said.

State lawmakers have passed bills over the last three legislative sessions to combat the opioid epidemic.

Address Pain Management with Dr. Drew Pinsky OCTOBER 17TH (Thursday) 7:30 PST

OCTOBER 17TH (Thursday) 7:30 PST

Dr. Dan Laird, Dr. Vanila Singh, and Claudia Merandi Address Pain Management with Dr. Drew Pinsky

Medicare open enrollment period is now on going

Everyone who has a Part D prescription program needs to look at Medicare plan compare  to see what plans are coming in 2020.

Most all of the programs that I looked at now has DEDUCTIBLES UP TO $450 for 2020.

Using this website… one can sort the resulting Part D policies by several different options… default is lowest monthly premium.

BE CAREFUL.. if you go to a previous page and return to the list of policies the program goes back to the default sort

BE CAREFUL… one of the policies I checked on my wife showed that she her med costs would exceed and put her into the catastrophic level… but.. then also stated that she would not even get INTO the “donut hole” … in looking at the information… one of the very inexpensive meds – WAS NOT COVERED…. but did not PLAINLY STATE SO..

BE CAREFUL…. I called one of the programs – talking to a “insurance salesperson” and was told that the monthly premiums was $2+ more per month than stated on the website.

Medicare open enrollment ENDS DECEMBER 7th

How the elderly and frail are caught in the crosshairs of push to end hallway medicine

Hospitals are not the right place for them and their families can’t care for them at home. The elderly and frail are increasingly collateral damage in the drive to end hallway medicine in Ontario, say advocates and families.

Patients who occupy hospital beds but no longer need acute care, ALC — alternative level of care — patients are a key factor in hospital overcrowding. But with record waiting lists for long-term care beds and shortages of home care workers, patients and their families say they are caught in the middle and feeling pressured.

“This is a crisis,” said Melanie Dea of Rockland, who recently experienced that pressure first hand. Her husband Richard Martin, who has Huntington’s disease, was treated at Montfort Hospital for pneumonia in July. By August he had improved, but was on a waiting list for long-term care and Dea could not safely care for him at home.

She said the hospital suggested he go to an Alzheimer’s unit of a long-term care home. Rea refused because her husband does not have dementia. The hospital began charging him $62.18 a day, a co-payment she says she will not pay. He has since moved to a long-term care home.

Meanwhile, the wife of an elderly patient in the same hospital room was in tears after being told her husband was being discharged, said Dea. The man ended up in the hospital because he was wandering the streets at night and his wife could no longer care for him.

Trevor Mertz of Chesterville, says his mother-in-law felt pressured to move into an Ottawa long-term care home by staff at Winchester Hospital when she was there in 2017.

“They said, ‘You have two hours to decide or the spot will be gone.’” Her stay at the home, with a history of health and safety violations, was a “nightmare”, according to Mertz. She eventually moved to another home, but died soon after.

“You shouldn’t pressure people on a Friday, saying you have two hours to make a decision. If I had seen the place, I would have said no.”

Jane Meadus of the Toronto-based Advocacy Centre for the Elderly said her organization hears from families on a daily basis who are distraught about having to quickly find a solution for a frail relative being discharged from hospital.

“They come to us in tears. It is our biggest thing right now and it is just heartbreaking. It has always happened, but the pressure on people is worse now.”

Meadus said some patients are being illegally prevented from applying for long-term care from hospital or forced into retirement homes to wait until a less expensive long-term care bed becomes available. “We have got two-tier medicine on the backs of seniors,” she said.

Hospital officials, meanwhile, say the hospital is not where frail and elderly patients in need of chronic care should be.

Cholly Boland, CEO of Winchester Hospital, would not discuss individual cases, but said the hospital’s philosophy is that it is not good to be in a hospital if you don’t need to be.

“If you are a person within the ALC category, by definition you do not need to be in the hospital and in general, it is not a good place to be.”

Montfort Hospital spokesperson Geneviève Picard said patients are charged a co-payment when they are waiting in hospital for a long-term care bed, according to provincial policy. The preference, though, is for them to apply from home. “Research has demonstrated that it is easier for people to make important decisions for the next stage while they are in their regular environment and can validate if they can safely remain in their home.”

She said she is aware of cases in which people have felt pressured to leave, but added patients will get better care tailored to their needs at home with service providers, in a retirement home or long-term care home. “We know that situations such as these are stressful times for the patients and their loved ones.”

Leah Levesque, head of nursing at Queensway Carleton Hospital, acknowledged that the transition from hospital to home or institutional care can be hard on families.

“I think the bottom line for us is we think patients should be in the right bed getting appropriate care from the most appropriate providers.”

That can be easier said than done, though.

The average wait in the Ottawa area for long-term care was 186 days in 2017, above the provincial average of 146 days. In addition, support worker shortages and increasing demand mean home care is not always available or reliable.

Dr. Alan Forster, vice president of innovation and quality at The Ottawa Hospital, said making sure ALC patients get appropriate care is a societal issue.

“If we continue to use hospitals as the place of last resort for people and don’t figure out an alternative for people who are frail and in need of close attention, if we don’t make places for that part of the population, then it will get worse for individuals who are in that situation and increasingly difficult for folks not in that situation.”

There are currently between 150 and 200 ALC patients at The Ottawa Hospital on any given day. Montfort has seen a 75 per cent increase in ALC patients in the past three years.

Meadus, meanwhile, said her organization sees daily evidence that families and patients are bearing the brunt of the push to end hallway medicine.

“We see people being sent home, families being told to mortgage their house to pay for parents’ care in a retirement home,” she said. The Advocacy Centre for the Elderly also sees seniors being discharged to homeless shelters, motels and transitional homes.

“Everyone talks about hallway medicine and those taking up the beds should be in long-term care. But no one ever talks about the effects on those people.”

Fox 29 in Philadelphia covered our rally. They also got the correct message we are trying to share!

Fox 29 in Philadelphia covered our rally. They also got the correct message we are trying to share!

CVS: such a good working environment.. pharmacist has to use floor to give vaccinations ?

I’ve been trying to get this issue resolved since last week, but I guess since CVS doesn’t want to respond I’m guna post this.

You should get your flu vaccine. But maybe be careful getting it at CVS since they think putting clean gloves and syringes full of vaccines on the floor is acceptable. There were four people getting vaccines but when he put the stuff on the floor one person said never mind and walked away. I’ll make it public if CVS doesn’t respond by tonight. That’s just nasty, at least get a table.

Edit: I got an email from CVS apologizing for not reaching back out. They said the store manager reviewed video from surveillance and confirmed that what I said did in fact happen (since some people are saying he was just cleaning up a mess he dropped, which is not what happened).

However. Situation still not solved. They said, “He has spoken with the Pharmacy Manager about follow up and appropriate practices.” I still want to know what are appropriate practices and what was done to make sure this won’t happen again. I’ll update again when we get in touch again, I doubt they will reply before Monday so…

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