When the DEA prefer OPINIONS over FACTS when filing charges violating the CONTROLLED SUBSTANCE ACT

Many many years ago … many as long ago as the Clinton Admin, some entity was hired/appointed to evaluate numerous agencies and how successful they were in meeting their goal(s)…  and I remember that the DEA GOT A SCORE OF ZERO.  I am sure that it was before the Decade of Pain Law (2001)… which was the end of the Clinton Admin.

since over the years – especially since the Decade of Pain Law expired and was not renewed in 2010…  It would seem that the DEA has stepped up their enforcement on “low hanging fruits’ … prescribers..  In 1980 the DEA estimated that the cartels were generating 12 Billion in illegal drugs and recently I have seen that estimate to be in the 100 billion range…  in FORTY YEARS the $$$ being generated by illegal drugs is up in range of EIGHT FOLD.  In 1980 our population was around 230 million and today it is around 320 million. So our population has grown 40% and illegal drug use – in $$$ – is up EIGHT FOLD ? Does this suggest how efficient the DEA has functioned in the last 40 years… or 80% of the total war on drugs years ?

I made this post a a few days ago about lawsuits in Ohio against pharmacies and quoting the “large number of opiates dispensed” over several years… I did some “reverse math” and reality and “DEA math” really doesn’t “compute”  http://www.pharmaciststeve.com/i-have-heard-something-about-a-new-math-but-the-dea-apparently-has-created-their-own-math-system/

This recent lawsuit http://www.pharmaciststeve.com/7-million-awarded-to-family-of-man-who-killed-himself-after-pain-medication-denied/ stands then it may be a very serious step forward a change in how chronic pain pts are being treated/mistreated by prescribers.  What I find interesting of the decision in this lawsuit is that this clinic is in Louisville, KY  – which has all four of the major TV channels and ONLY ONE reported on the outcome of this trial.  Metro Louisville Ky encompasses some 2+ million population.   Does this represent a bias of the three local channels or a policy coming from the national HQ of these TV channels ?

It was recently reported out of the 93,000 drug OD’s ….  abt 75% involved illegal fentanyl…  It would appear that the DEA is sticking to their original concept from when they were created in 1973… opiates are HIGHLY ADDICTING…. ANY PRESCRIBING OF OPIATES WILL CAUSE ADDICTION…. ADDICTS WILL END UP USING “STREET ADDICTS AND ODing”  The fact that Opiate Rxs peaked in 2011-2012 and DEA has cut opiate production quotas by abt 50% BUT… OD’s involving illegal opiates have have increased exponentially.

The DEA’s Long Game

https://daily-remedy.com/the-deas-long-game/

The canary in the coal mine is a metaphor alluding to the initial sign of an impending calamity.

An apt metaphor for what just transpired. Recently, the Drug Enforcement Agency (DEA) issued a public safety alert informing the public about a, “sharp increase in fake prescription pills containing Fentanyl and Meth[amphetamines]”.

The alert was the canary in the coal mine, but the impending calamity is not what we are led to believe. We knew of a rise in counterfeit prescription pills for many years. It was a rise induced directly by DEA policies inflicted upon patients.

The impending calamity is not the risks counterfeit pills pose to the public, but the legal liability the DEA faces for its failed policies.

For years federal agencies and physician advocacy groups remained in lockstep on the causes of the opioid epidemic. Lax prescription guidelines, overprescribing by willing physicians, and the addictive nature of opioids – we heard it all.

Unfortunately, these purported causes proved erroneous at best or deliberately misrepresented at worst. And implementation of policies based on these causes led to a rise in suicide and clinical stigmatization among chronic pain patients and patients with substance use dependencies.

An atrocity the DEA bears direct responsibility for.

The DEA orchestrated a culture of fear that can be described as medical McCarthyism, in which the fear of prosecution defined the quality of care for stigmatized patients. Accusations formed the basis of convictions as we saw physicians imprisoned for providing care and patients abruptly abandoned without legal recourse.

That is until now.

The American Medical Association (AMA) recently issued a report through its newly formed Substance Use and Pain Care Task Force recommending significant policy changes it believes would more effectively address the nation’s opioid epidemic. Stopping short of outright criticizing the DEA, the report proposes policy recommendations that run diametrically opposite to the DEA’s approach to the epidemic.

The report is simply the latest in a long line of published studies casting doubt on long held assumptions about the opioid epidemic. We know there is no correlation between opioid-related mortality and the number of opioid prescriptions. We know abruptly discontinuing opioids leads to adverse patient outcomes. And we know forcing physicians to reduce the number of opioid prescriptions leads to a rise in counterfeit prescription opioids.

All of which makes the public health alert by the DEA even more curious.

It is absurd to believe the DEA is not aware of the clinical consequences of its failed policies. And to issue a public health alert without acknowledging the basis for such an alert is deliberately deceptive – disrespecting the lives of the patients lost through these policies and conveying a lack of accountability on the part of the DEA.

But lacking accountability is different from lacking awareness. The DEA is clearly aware its aggressive approach to criminalizing the patient encounter has led to a rise in counterfeit prescription medications and adverse patient outcomes.

In Kentucky, a federal judge deemed a pain management practice liable for the suicide of a patient unable to receive adequate pain relief, who then committed suicide as a result of the untreated pain. The judge ruled that the physicians in the practice were liable for the suicide because they inappropriately reduced the patient’s opioid prescription dosage.

A ruling that implies patients have a right to be treated for pain, that when applied broadly to all chronic pain patients would hold the DEA liable for undue harms caused to patients based on its aggressive stance on opioid prescriptions.

Something the DEA is well aware of, but seems bent on assuming no accountability for, hoping the failed policies are seen as well-intentioned policy errors.

But in recently uncovered reports obtained through multiple FOIA (Freedom of Information Act) requests, it appears the DEA’s aggressive stance extends beyond erroneous policies and the specter of clinical fear – to something far more nefarious, far more deliberate.

For years the DEA colluded with major insurance companies to obtain data on prescribing practices for physicians who treated patients in pain with prescription opioids, contracting covert, third-party data-mining companies to troll medical records without the consent of patients or the knowledge of physicians.

In 2016, these data-mining companies modified the data analysis, changing the definition of a high risk opioid prescriber to encompass a majority of physicians who prescribed opioids. The adjustment was a blatant attempt to coordinate and speed the indictment of physicians, and to strengthen the likelihood of convictions.

It should come as no surprise that this is when we began to see a rise in physician imprisonments and a rise in counterfeit opioids. Both of which are direct consequences of deliberately misrepresenting the trolled medical data.

Now, years later, lacking the support of physician advocacy groups, or the protection of public perception, the DEA finds itself confronting the ugly reality of its failed policies – and the ensuing liability.

But liability comes in different forms. Liability can be characterized as a harmless mistake or as a deliberate misrepresentation. The behavior of the DEA elucidated through the FOIA documents would suggest the latter.

Yet the public health alert provides a convenient rebuttal. A plausible excuse for the DEA to claim its failed policies were an honest mistake. That when the DEA realized its policies were leading to a rise in counterfeit opioid prescriptions, it issued a public health alert, suggesting the adverse clinical outcomes – the suicides and stigmatizations – were nothing more than an unintended consequence, an honest mistake.

For the DEA to issue a public health alert for a crisis that began years ago through its own policies is certainly a curious course of action – something we rarely see from federal agencies.

But a broader analysis reveals that the timing of the alert is less curious, and more strategic. A canary in the coal mine – for the impending liability the DEA will soon face.

7 Responses

  1. An obvious observation to me is why……are the agents of DEA ,NOT at the southern border stopping the illicit, deadly drugs crossing the border in mass quantities instead of crippling our physicians of the ability to prescribe MEDICATION as per a so called “guideline” issued for the approximate 20 million patients that use our MEDICATION for a little improved “life”? Pisses me off but, that’s the new America I suppose.

    • Because stopping smuggling, open border or not, is an impossible task. That is not common knowledge because many would be shocked to hear it. Only %8 of any container ship can be searched, and now there are not enough workers to search that much, let alone off-load them.

    • More people want the drugs and THAT is why they are coming in. There is way, way too much money to be made just maintaining the smooth flow of supply and demand. You want it stopped and I want it stopped, but it is just not ‘real world’.

    • because they are too busy hanging around airports, bus station, train stations … waiting for staff to alert them to someone carrying some money that they can confiscate using the Civil Asset Forfeiture law… here is an example that the people the DEA was trying to confiscate their $$$ did not go so well http://www.pharmaciststeve.com/well-i-guess-that-i-cant-say-that-any-more/ it has been reported that the DEA will “share” some of the take with the employees that pointed out the person that had much $$$ on them It really cost the DEA money to confiscate ILLEGAL DRUGS… they have to do inventory of seized drugs, store them in a warehouse, move them to a location to be destroyed and document what has been destroyed… when they confiscate CASH… it is actually the CASH that is the guilty party – DEA presumes ill gotten gains… depending on the amount… it cost the person it is confiscated from just to let it go… the cost of legal fees may be more than the $$ confiscated.. and the DEA puts the $$ confiscated into their COFFERS and spend at they like

      • That’s right! They have money coming in guilty on ALL sides.
        A good report at the link Steve, Thank you.

  2. “…hoping the failed policies are seen as well-intentioned policy errors.”

  3. I am not a conspiracy theory believer, but there are certainly occasions when I truly wonder if the DEA, PROP, and other agencies are overseeing a long term solution to minimize those of us considered to be a “non-productive” member of our society. I am a retired person, but due to 3 severe auto accidents have been disabled since 1995, lost my career so have been below the poverty income threshold, and other than working when I was able and the generosity/love of my family have kept myself positive towards life. I did quite a bit of advocacy for pain patients between 2005 – 2010, before the social media boom but never dreamt there would one day be a concentrated effort to destroy both our ability to access our medications and to destroy/inhibut our physicians from treating our pain in a medical, ethical, and non-fact based scientific manner. I agree, it is almost as if all of this misery being inflicted on the poorest and most ill people in the United States of America, and in the case of physicians, low hanging, easily accessible, greed producing state and federal agencies. But, I will not submit to their wishes and fold under their lies.Imagine what we could accomplish if everyone wrote to their lawmakers bringing this to their attention. I am still able to type, spell, compose, and punctuate fairly well (having been a corporate secretary for 22 years) so if I can be of assistance to anyone whom would like to join in a letter storming campaign, I am available free of charge. Postage fees

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