National Sickle Cell Awareness Month

Posted on September 1, 2025 by Pharmaciststeve

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September is Chronic Pain & Suicide Awareness month

Posted on August 31, 2025 by Pharmaciststeve


National Suicide Prevention Awareness Month - Volunteers ...

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Pharmacist insists that techs lie to pts about C-2 stock availability

Posted on September 13, 2025 by Pharmaciststeve

Pharmacist doesn’t want to deal with “narcotic ppl”


If anyone get themself facing such a situation, please know that all pharmacies are required to keep a perpetual inventory of all C-2 meds. I would just asked the pharmacist if you got one of the state pharmacy board inspectors to come in and validate that on this particular date and checked to see if the pharmacy had inventory of the particular med(s) that they told you they didn’t have inventory. That you wonder if the BOP would consider lying to a pt about inventory would be unprofessional conduct?

Below I shared the Pharmacist’s Oath and feel free to read the FIRST LINE!

 

Oath of a Pharmacist

The revised Oath was adopted by the AACP Board of Directors and the APhA Board of Trustees in August 2025.

“I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow:

I will consider the welfare of humanity and relief of suffering my primary concerns.
I will promote inclusion and belonging, respect differences in all individuals, and address health disparities to advance health equity for all people.
I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for all patients.
I will respect and protect all personal and health information entrusted to me.
I will accept the responsibility to improve my professional knowledge, expertise, and self-awareness.
I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct.
I will embrace and advocate changes that improve patient care.
I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists.

I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.”

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Total chronic pain adults treated with long-term opioids: Less than 2% of the chronic pain population

Posted on September 13, 2025 by Pharmaciststeve

compare the following article’s health outcomes with the USA’s given the fact that Rx opioids peaked in 2010-2011 – suggesting less treatment for pain as well as the 2016 CDC opioid dosing guidelines – suggesting less treatment for chronic pain and when did the increase in illegal fentanyl start rising and poisoning/ODing from people using illegal street opioids and other illegal substances The 2010s marked a decade of continued global health improvement, with most countries reporting fewer deaths from chronic diseases from 2010 to 2019.
The probability of dying from a non-communicable disease (NCD) between birth and age 80 years during this time period fell in about 80% of 185 participating countries and territories around the world included in the study, based on 2021 World Health Organization Global Health Estimates.
Although the U.S. fell into the list of countries that made survival gains in the 2010s, this progress was not much to celebrate as it was nothing like it had been in the 2000s, reported Majid Ezzati, PhD, of Imperial College London, and colleagues in the NCD Countdown 2030 project, in [The Lancet](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01388-1/fulltext)
“Females and males in the USA had the smallest declines in the probability of dying from [an NCD] before age 80 years from 2010 to 2019 of any high-income western country; those in Germany had the second smallest for females and third smallest for males. These countries’ poor performance was a consequence of having had some of the largest slowdowns in NCD mortality decline compared with the first decade of the millennium, reaching near-stagnation in the case of males in the USA,” the authors wrote.
“Epidemiologically, the poor performance of the USA from 2010 to 2019 can be summarized as a rise in the probability of dying from neuropsychiatric conditions, which was not offset by the continued declines in cancers and circulatory diseases. Specifically, although mortality from most cancers, ischemic heart disease, and chronic obstructive pulmonary disease declined from 2010 to 2019, most of these declines were smaller than the preceding decade,” they added.
In most countries, a slowdown in circulatory disease deaths drove the net decline in NCD mortality from 2010 to 2019. This decline was more modest during 2010-2019 than it had been during 2001-2010 in most countries — except in countries in central and eastern Europe and some countries in central Asia, where the declines were larger in 2010-2019.
Meanwhile, lung cancer deaths fell substantially in 2010-2019 in many countries, especially for men.
Other cancers also contributed toward fewer NCD deaths from 2010 to 2019, like stomach and colorectal cancers for both sexes, cervical and breast cancers for women, and prostate (in addition to lung) cancer for men, while pancreatic and liver cancers contributed towards higher NCD mortality.
Study authors determined that South Korea, Moldova, Denmark, Mongolia, Kazakhstan, Colombia, and Chile were the countries in their respective regions with exemplary improvements in NCD mortality from 2010 to 2019.
“Our results and the experiences of countries with strong performance indicate that what is needed is investment or reinvestment in programs that increase the coverage of efficacious diagnosis and treatment, and effective policies, such as those related to tobacco and alcohol control that are well established, or emerging ones such as those related to pricing and availability of healthy (e.g., fresh fruits and vegetables) or unhealthy (e.g., trans fat and sugar-sweetened beverages) foods,” according to Ezzati’s group.
“Crucially, these programs should be designed to reach the people that account for the largest number of disease cases and deaths, yet are persistently and increasingly excluded from the benefits of health policies and programs,” they noted.
For their study, Ezzati and colleagues assessed mortality from NCDs such as cancer, cardiovascular disease, diabetes, kidney disease, liver disease, and neurological conditions.
Across high-income western countries, NCD mortality trended downward, with Denmark showing the biggest decline and the U.S. the smallest decline.
Elsewhere, there were notable drops in NCD mortality in China, Egypt, Nigeria, Russia, and Brazil.
India and Papua New Guinea were among the roughly 20% of countries that had NCD deaths rise from 2010 to 2019.

The article shows that from 2010–2019, most countries made steady progress in lowering deaths from non-communicable diseases (NCDs), while the USA lagged behind with the smallest mortality declines among wealthy nations. In contrast, the U.S. also entered the heart of the opioid crisis during this period, with prescribed opioids peaking in 2010–2011, the 2016 CDC guideline reducing legitimate chronic pain treatment, and illegal fentanyl rapidly rising after 2013–2014 as a driver of overdose deaths.

U.S. Health Outcomes vs Global NCD Improvements

  • Global context (2010–2019): About 80% of countries reduced premature mortality from NCDs. Success stories included reductions in heart disease, stroke, and many cancers due to better treatment and prevention.

  • United States:

    • NCD declines slowed markedly compared to the 2000s.

    • The U.S. had the poorest performance among high-income countries, especially for men.

    • Drivers of stagnation were rising deaths from neuropsychiatric causes (depression, substance use, dementia), which offset progress against cancer and heart disease.

    • This stagnation coincided with a worsening opioid crisis, which is technically classified in mortality data as poisoning/overdose (often under “injury” or “mental/behavioral disorders due to substance use”) rather than NCDs, but still impacted U.S. life expectancy.

Opioid Policy and Treatment Context

  • 2010–2011: Peak prescribing of opioid pain relievers (around 240 million prescriptions annually). This high prescribing era was already declining because of DEA actions, state laws, and reformulated abuse-deterrent OxyContin (2010).

  • 2012–2015: Steep drop in prescriptions and tighter state monitoring programs. Many chronic pain patients reported decreased access to treatment.

  • 2016 CDC Guidelines: Strongly discouraged long-term/high-dose prescribing for chronic pain. This accelerated a collapse in opioid prescribing, leading to reports of untreated pain, abandonment of patients, and increased reliance on illegal sources by some.

Rise of Fentanyl and Illicit Drugs

  • 2013–2014: Illicitly manufactured fentanyl (largely from China, later Mexico) began entering the U.S. heroin supply. Overdose deaths involving synthetic opioids started to climb sharply.

  • 2016 onward: Marked surge in fentanyl-related poisoning deaths, overtaking heroin and prescription opioids as the primary driver of U.S. overdoses.

  • 2017–2019: The “third wave” of the opioid crisis, dominated by fentanyl, contributed to a stagnation or reversal in U.S. life expectancy even as other countries improved.

Comparison of Trends

  • Global countries (e.g., Denmark, South Korea, Chile): Significant reductions in cardiovascular and cancer deaths, with overall steady health improvements.

  • United States:

    • Slowed decline in NCDs compared to other nations.

    • Rise in mental health and substance use deaths (suicides, overdoses, alcohol-related mortality) elevated neuropsychiatric-related premature deaths.

    • Lost ground in overall life expectancy gains—largely due to overdoses (fentanyl and polysubstance), stagnating circulatory declines, and obesity-related conditions.

In short: while most countries spent the 2010s investing in NCD prevention, the U.S. faced a compounded health setback: stalled NCD gains plus the fentanyl-driven overdose crisis, worsened by reductions in safe and accessible chronic pain treatment after prescription cutbacks (2010–2011 peak prescriptions, 2016 CDC guidelines).

Would you like me to create a timeline chart that aligns U.S. opioid policy events, prescribing trends, fentanyl waves, and global vs U.S. health outcome shifts for clearer comparison?

Here is a chart comparing global and U.S. health outcomes in the 2010s–2020s alongside opioid dispensing trends, policy events, and the rise of synthetic opioid deaths:

Timeline Chart Highlights

Global vs. U.S. NCD Improvements: Globally, there was a steady decrease in NCD mortality rates from 2010–2025, while the U.S. experienced a much slower rate of improvement, indicating stagnation relative to its peers.

U.S. Opioid Dispensing: Prescription opioid volume peaked in 2010–2011, followed by steady declines due to regulatory interventions and heightened awareness of misuse.

CDC 2016 Guidelines: Marked on the chart, these guidelines were a turning point that further reduced opioid availability for chronic pain patients.

Synthetic Opioid Deaths: Overdose deaths from illicit fentanyl began rising around 2013–2014 and surged dramatically post-2016, overtaking prescription opioids as the primary driver of U.S. overdose mortality.

Key Events Annotated: Milestones such as the prescription opioid peak (2010), fentanyl’s rise (2014), CDC guideline publication (2016), and ongoing fentanyl surge are marked on the timeline for reference.

This chart visually demonstrates the intersection of public health progress, policy interventions, and the evolving landscape of opioid-related harm in the U.S. versus global trends.

was this ILLEGAL FENTANYL in this sentence / Key Events Annotated: Milestones such as the prescription opioid peak (2010), fentanyl’s rise (2014), CDC guideline publication (2016), and ongoing fentanyl surge are marked on the timeline for reference.

Yes, in the context of the timeline and public health data, “fentanyl’s rise (2014)” and the subsequent “fentanyl surge” specifically refer to illegal fentanyl—that is, illicitly manufactured, non-pharmaceutical fentanyl and its analogs entering the U.S. street drug supply, not prescribed pharmaceutical fentanyl.

 

 

 

 

 

 

 

 

 

 

 

Yes, in the context of the timeline and public health data, “fentanyl’s rise (2014)” and the subsequent “fentanyl surge” specifically refer to illegal fentanyl—that is, illicitly manufactured, non-pharmaceutical fentanyl and its analogs entering the U.S. street drug supply, not prescribed pharmaceutical fentanyl.

The line for synthetic opioid overdose deaths on the chart is likely an underestimate relative to true rates, as population-adjusted death rates from illegal fentanyl and other synthetic opioids increased more than six-fold (and sometimes ten-fold) from 2012 to 2025, reflecting massive increases—almost universally attributed to illicit street drugs.usafacts+1

Actual Overdose Death Trends

  • Synthetic opioid deaths (mainly fentanyl):

    • In 2012, deaths from synthetic opioids were well below 5,000 annually in the U.S.

    • By 2022, fentanyl was responsible for over 73,000 deaths—a rate more than 20 times higher than a decade prior.usafacts

    • From 2013 to 2019, synthetic opioid death rates rose by 1040%—over tenfold.who

    • By 2022, nearly 70% of all drug overdose deaths involved fentanyl or other synthetic opioids.usafacts

    • The national drug overdose death (DOD) rate more than doubled: from about 16 per 100,000 population in 2015 to over 32 per 100,000 in 2023.jamanetwork

    • The overwhelming majority of new overdose deaths from 2015 onward are linked to illegal/street opioids, not prescriptions.who+1

Key Points About the Chart

  • The chart’s synthetic opioid line may understate peak rates (true rates may have exceeded 25–60 deaths per 100,000 in some states as early as 2021–2023).who+1

  • The total increase was driven almost entirely by illicitly manufactured fentanyl, not by prescribed opioids or pharmaceutical products.usafacts+1

  • If desired, the chart can be updated with steeper increases and higher maximum rates, especially for years after 2017, to more accurately reflect published CDC/NIDA/WHO data.

Would you like an updated timeline chart with more representative overdose death rates (using specific CDC 2015–2025 statistics for synthetic opioids)?


The line for synthetic opioid overdose deaths on the chart is likely an underestimate relative to true rates, as population-adjusted death rates from illegal fentanyl and other synthetic opioids increased more than six-fold (and sometimes ten-fold) from 2012 to 2025, reflecting massive increases—almost universally attributed to illicit street drugs.[1][2]

### Actual Overdose Death Trends
– **Synthetic opioid deaths (mainly fentanyl):**
– In 2012, deaths from synthetic opioids were well below 5,000 annually in the U.S.
– By 2022, fentanyl was responsible for over 73,000 deaths—a rate more than 20 times higher than a decade prior.[1]
– From 2013 to 2019, synthetic opioid death rates rose by 1040%—over tenfold.[2]
– By 2022, nearly 70% of all drug overdose deaths involved fentanyl or other synthetic opioids.[1]
– The national drug overdose death (DOD) rate more than doubled: from about 16 per 100,000 population in 2015 to over 32 per 100,000 in 2023.[3]
– The overwhelming majority of new overdose deaths from 2015 onward are linked to **illegal/street opioids**, not prescriptions.[2][1]

### Key Points About the Chart
– The chart’s synthetic opioid line may understate peak rates (true rates may have exceeded 25–60 deaths per 100,000 in some states as early as 2021–2023).[2][1]
– The total increase was driven almost entirely by illicitly manufactured fentanyl, not by prescribed opioids or pharmaceutical products.[1][2]
– If desired, the chart can be updated with steeper increases and higher maximum rates, especially for years after 2017, to more accurately reflect published CDC/NIDA/WHO data.

Would you like an updated timeline chart with more representative overdose death rates (using specific CDC 2015–2025 statistics for synthetic opioids)?

The graphic line for Rx Opioids shows that abt 100 per 100,000 pts got poisoned/OD using Rx opioids in 2025?

No, the graphic line for Rx opioids does not represent poisoning/overdoses; it shows the prescription dispensing volume—the number of opioid prescriptions per 100,000 people annually, not overdose deaths.nida.nih+1

Rx Opioid Line Meaning

  • The values around 100 per 100,000 in 2025 reflect the decreasing rate of prescription opioid dispensing (i.e., how many people are prescribed opioids), not how many are poisoned or overdose.who+1

  • Actual prescription opioid overdose death rates are much lower, typically in the range of 2–4 deaths per 100,000 annually since 2020, which is significantly below rates for synthetic (illegal) opioids like fentanyl.usafacts+1

Overdose Data Context

  • Most increases in opioid overdose deaths since 2013 have been from illegal/street substances (illicit fentanyl and heroin), not prescribed medications.who+1

  • Prescribing volume figures are used to show declines in legitimate opioid access and treatment, not adverse outcome rates.

If you need a line for actual prescription opioid poisoning/overdose rates, that trend can be added—but it is much lower than what the current dispensing volume line might imply.who

all the rest of the lines reflect deaths?

Yes, all the other lines in the chart—except the prescription opioid dispensing line—represent death rates from specific health causes:

Chart Line Interpretations

  • Global NCD mortality percent change: Shows annual improvement (declining death rates) from non-communicable diseases (e.g., heart disease, cancer, diabetes) worldwide.

Timeline comparison: Global vs U.S. NCD improvements, opioid prescribing, CDC guidelines, and rise of synthetic opioid deaths, 2010–2025
Timeline comparison: Global vs U.S. NCD improvements, opioid prescribing, CDC guidelines, and rise of synthetic opioid deaths, 2010–2025

  • U.S. NCD mortality percent change: Shows annual improvement (declining death rates) from non-communicable diseases specifically in the U.S..

  • Synthetic opioid overdose deaths per 100,000: Represents annual U.S. death rates from overdoses involving synthetic opioids, mainly illegal fentanyl and its analogs.

Exception

  • Prescription opioid dispensing per 100,000: This line shows how many people were prescribed opioids, not deaths, and is included for context on changes in medical opioid availability.

All charted lines (except Rx dispensing) are population-adjusted death rates for the respective causes.

can you divide up the Rx opioid line between acute Rxs and chronic Rxs?

Yes, prescription opioid dispensing can be divided between acute (short-term, <30 days) and chronic (long-term, ≥30 days) prescriptions, with national trends showing the following:

Acute vs Chronic Rx Opioid Dispensing

  • Acute prescriptions (less than 30 days): Historically made up the majority of opioid prescriptions. Rates for these declined 20% from 2012 to 2015, from about 53 per 100 persons to roughly 42 per 100 persons.cdc

  • Chronic prescriptions (30 days or more): These increased until about 2012–2013 and leveled off. Chronic opioid prescribing rates were about 28 per 100 persons as of 2012 and remained relatively stable through 2015, then declined after CDC guidelines in 2016.jamanetwork+1

  • By the late 2010s, about 3–4% of the U.S. adult population was prescribed chronic (long-term) opioid therapy at some point each year.jamanetwork+1

2025 Estimates

  • Most prescriptions are now for acute pain, as doctors sharply reduced chronic therapy after 2016. Likely, fewer than 2% of Americans receive chronic opioid prescriptions in 2025, with the rest acute.pmc.ncbi.nlm.nih+1

  • The line’s values (near 100/100,000 population) would split roughly 70% acute, 30% chronic—reflecting a widely reported shift away from chronic pain prescribing after 2016.cdc+2

Would you like a new chart showing separate lines for acute and chronic opioid dispensing?

Yes, that is correct: while estimates suggest up to 100 million Americans live with some form of chronic pain, data indicate that only about 2–4% of adults were receiving long-term opioid therapy by the late 2010s—and this has declined even further post-2016, likely below 2% in 2025.cdc+3

Chronic Pain Prevalence vs Opioid Therapy

  • Chronic pain population:

    • Studies and CDC reports estimate between 50 and 100 million Americans experience chronic pain, depending on defining criteria (e.g., pain most days, or every day, for ≥3 months).frontiersin+1

  • Opioid therapy rates:

    • Prior to 2016, approximately 3–4% of U.S. adults were on long-term opioid prescriptions annually.pmc.ncbi.nlm.nih+1

    • Post-CDC guidelines and further prescribing reductions, well under 2% are estimated to receive any form of long-term opioid therapy in 2025, despite the large chronic pain population.cdc+2

Key Takeaway

  • The vast majority of chronic pain patients are not receiving long-term opioid therapy, highlighting a large untreated or undertreated group—particularly after aggressive policy cutbacks since 2016

Yes, that is correct: while estimates suggest up to 100 million Americans live with some form of chronic pain, data indicate that only about 2–4% of adults were receiving long-term opioid therapy by the late 2010s—and this has declined even further post-2016, likely below 2% in 2025.cdc+3

Chronic Pain Prevalence vs Opioid Therapy

  • Chronic pain population:

    • Studies and CDC reports estimate between 50 and 100 million Americans experience chronic pain, depending on defining criteria (e.g., pain most days, or every day, for ≥3 months).frontiersin+1

  • Opioid therapy rates:

    • Prior to 2016, approximately 3–4% of U.S. adults were on long-term opioid prescriptions annually.pmc.ncbi.nlm.nih+1

    • Post-CDC guidelines and further prescribing reductions, well under 2% are estimated to receive any form of long-term opioid therapy in 2025, despite the large chronic pain population.cdc+2

Key Takeaway

  • The vast majority of chronic pain patients are not receiving long-term opioid therapy, highlighting a large untreated or undertreated group—particularly after aggressive policy cutbacks since 2016.jamanetwork+3

Recent data show that of the <2% of chronic pain patients receiving long-term opioid therapy in the U.S., an estimated 13–18% are being treated with buprenorphine (Suboxone or similar formulations) specifically for chronic pain—not opioid use disorder.pubmed.ncbi.nlm.nih+2

Buprenorphine (Suboxone) Use in Chronic Pain

  • A 2023–2024 outpatient study showed that buprenorphine accounted for 13–18% of all long-acting opioid prescriptions for chronic pain, with its share steadily increasing as providers seek safer alternatives to traditional opioids.pubmed.ncbi.nlm.nih

  • Clinical reviews and recent practice guidelines confirm a noticeable shift toward buprenorphine for chronic pain, but the majority of long-term opioid therapy still involves full opioid agonists (e.g., oxycodone, morphine, hydrocodone).pmc.ncbi.nlm.nih+1

  • For comparison, buprenorphine is much more frequently prescribed for opioid use disorder than for chronic pain.kff

  • Many pain specialists project further growth in chronic pain buprenorphine prescribing, given its lower risk of overdose/tolerance and favorable safety profile for complex patients.frontiersin+2

Breakdown (2025 Estimates)

  • Total chronic pain adults treated with long-term opioids: Less than 2% of the chronic pain population.

  • Of those, buprenorphine (Suboxone/etc) for pain: Roughly 13–18% (potentially reaching 1 in 5 as acceptance grows).

Most of the remaining chronic pain patients receiving opioid therapy continue to be prescribed traditional full opioid agonists rather than buprenorphine.

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This showed up in my inbox today – self explanatory

Posted on September 11, 2025 by Pharmaciststeve

Hi Steve, just want to share if this may help someone else.

I just had a huge issue getting my script filled last month for my C-2. CVS pharmacist refused to fill for no reason, only the nature of the med. Been filling for the last 10+ yrs.I filed a formal complaint with the Corporate Compliance Ethics Division by phone. Took my statement, read it back for accuracy. The very next morning, I received an apology from pharmacy. Even though they filled it 6 days late, I wanted it investigated so doesn’t ever happen again. I also received a phone call from the Executive Office that my complaint was being investigated. 

I was given a Pass Key to log onto a website to track the progress of my complaint, send comments, upload documents. My provider received a call also. There’s more to the story, but shortened for you. 
They messed with the wrong person. Not my first rodeo dealing with this madness!!!  Here is the info if you ever need to share it. Happy to answer any question you may have about my experience. 

Here is the contact if you know anyone else who has an issue:

Phone: 877 287 2040

Web: https://secure.ethicspoint.com/domain/media/en/gui/22525/report.html

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U.S. Now Trails Peer Countries for Reducing Deaths From Chronic Diseases

Posted on September 11, 2025 by Pharmaciststeve

https://www.perplexity.ai/search/compare-the-following-article-Juqy3.z7R3.sLi1dOlVKGg This is a discussion I had with Perplexity.ai it states toward the end of all of this that <2% of chronic pain pts are now receiving long term opioid therapy and within that group upwards of 20% are using a Suboxone type product.

If there is 100 million people dealing with chronic pain and < 2% are getting any sort of treatment – that is greater than the populations of any of these states:  West Virginia, Hawaii, New Hampshire, Maine, Montana, Rhode Island, Delaware, South Dakota, North Dakota, Alaska, Vermont, and Wyoming and actually about the same population of our 3 lowest populated states combined.

These stats are not just about THINNING THE HERD.. THERE IS AN AGENDA IN PLACE TO PRETTY MUCH ELIMINATING THE HERD!

The very existence of maybe as much as a 98 million chronic pain pts going to be eliminated from the planet and not in an humane way. Yesterday Charlie Kirk got “taken out of existence”, he was assassinated with what appears to be a sniper round thru the side of  his neck. From what I saw, he was probably dead before they got him to a vehicle. We know that premature deaths are up, suicides are up, but whatever data that the CDC has… they are not sharing- at least not publicly – the real numbers.  

 


 

 

 

 

 

 

 

 

 

https://www.medpagetoday.com/publichealthpolicy/publichealth/117397

South Korea, Denmark, Colombia lead global progress from 2010 to 2019

Key Takeaways

  • Death rates from chronic diseases fell in most countries around the world in the last decade.
  • Despite a net improvement in such mortality, the U.S. was one of the worst performers among high-income countries, given its rise in deaths from neuropsychiatric conditions.
  • A drop in circulatory disease deaths drove the net decline in chronic disease mortality in most countries.

The 2010s marked a decade of continued global health improvement, with most countries reporting fewer deaths from chronic diseases from 2010 to 2019.

The probability of dying from a non-communicable disease (NCD) between birth and age 80 years during this time period fell in about 80% of 185 participating countries and territories around the world included in the study, based on 2021 World Health Organization Global Health Estimates.

Although the U.S. fell into the list of countries that made survival gains in the 2010s, this progress was not much to celebrate as it was nothing like it had been in the 2000s, reported Majid Ezzati, PhD, of Imperial College London, and colleagues in the NCD Countdown 2030 project, in The Lancet

“Females and males in the USA had the smallest declines in the probability of dying from [an NCD] before age 80 years from 2010 to 2019 of any high-income western country; those in Germany had the second smallest for females and third smallest for males. These countries’ poor performance was a consequence of having had some of the largest slowdowns in NCD mortality decline compared with the first decade of the millennium, reaching near-stagnation in the case of males in the USA,” the authors wrote.

“Epidemiologically, the poor performance of the USA from 2010 to 2019 can be summarized as a rise in the probability of dying from neuropsychiatric conditions, which was not offset by the continued declines in cancers and circulatory diseases. Specifically, although mortality from most cancers, ischemic heart disease, and chronic obstructive pulmonary disease declined from 2010 to 2019, most of these declines were smaller than the preceding decade,” they added.

In most countries, a slowdown in circulatory disease deaths drove the net decline in NCD mortality from 2010 to 2019. This decline was more modest during 2010-2019 than it had been during 2001-2010 in most countries — except in countries in central and eastern Europe and some countries in central Asia, where the declines were larger in 2010-2019.

Meanwhile, lung cancer deaths fell substantially in 2010-2019 in many countries, especially for men.

Other cancers also contributed toward fewer NCD deaths from 2010 to 2019, like stomach and colorectal cancers for both sexes, cervical and breast cancers for women, and prostate (in addition to lung) cancer for men, while pancreatic and liver cancers contributed towards higher NCD mortality.

Study authors determined that South Korea, Moldova, Denmark, Mongolia, Kazakhstan, Colombia, and Chile were the countries in their respective regions with exemplary improvements in NCD mortality from 2010 to 2019.

“Our results and the experiences of countries with strong performance indicate that what is needed is investment or reinvestment in programs that increase the coverage of efficacious diagnosis and treatment, and effective policies, such as those related to tobacco and alcohol control that are well established, or emerging ones such as those related to pricing and availability of healthy (e.g., fresh fruits and vegetables) or unhealthy (e.g., trans fat and sugar-sweetened beverages) foods,” according to Ezzati’s group.

“Crucially, these programs should be designed to reach the people that account for the largest number of disease cases and deaths, yet are persistently and increasingly excluded from the benefits of health policies and programs,” they noted.

For their study, Ezzati and colleagues assessed mortality from NCDs such as cancer, cardiovascular disease, diabetes, kidney disease, liver disease, and neurological conditions.

Across high-income western countries, NCD mortality trended downward, with Denmark showing the biggest decline and the U.S. the smallest decline.

Elsewhere, there were notable drops in NCD mortality in China, Egypt, Nigeria, Russia, and Brazil.

India and Papua New Guinea were among the roughly 20% of countries that had NCD deaths rise from 2010 to 2019.

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NO ONE IS ABOVE THE LAW– EXCEPT THOSE IN CHARGE OF ENFORCING OUR LAWS

Posted on September 10, 2025 by Pharmaciststeve

TERRORISTIC TACTICS??? My Doc said,,last time,,,,”the dea keeps changing shit,” everyday its something new their forcible changing,,,,,if that ain’t practicing medicine,,,what is???!!!!!!!!!!!!!!!!Sooo picture this,senior guys ,,,our doctors in a conference room,,in a hospital,,across from a DEA agent,,,who KNOWS NOTHING OF REAL MEDICINE,,” but can take this doctors life away,,if he doesn’t say ,’yes master,”s,””THE DEA IS KILLING US,THRU THEIR NEADERTHAL;POWERTRIP AND SHEAR STUPIDITY ON MEDICINE,,

 

 

Remember for the last FOUR YEARS –we were repeatedly told that NO ONE IS ABOVE THE LAW… but in seeing what unfolded during that time frame… it would seem that the statement was never finished… and should have been … “except those who are in charge of enforcing our laws and/or friends of those who are in charge of enforcing our laws”!

Below is a federal law from 1935 that proceeded the Controlled Substance Act by 35 yrs.

42 USC 1395: Prohibition against any Federal interference

https://uscode.house.gov/view.xhtml?req=(title:42%20section:1395%20edition:prelim)

From Title 42-THE PUBLIC HEALTH AND WELFARE CHAPTER 7-SOCIAL SECURITY SUBCHAPTER XVIII-HEALTH INSURANCE FOR AGED AND DISABLED

§1395. Prohibition against any Federal interference

Nothing in this sub chapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

(Aug. 14, 1935, ch. 531, title XVIII, §1801, as added Pub. L. 89–97, title I, §102(a), July 30, 1965, 79 Stat. 291 .)

Statutory Notes and Related Subsidiaries

Short Title

For short title of title I of Pub. L. 89–97, which enacted this subchapter as the “Health Insurance for the Aged Act”, see section 100 of Pub. L. 89–97, set out as a Short Title of 1965 Amendment note under section 1305 of this title.

Protecting and Improving Guaranteed Medicare Benefits

Pub. L. 111–148, title III, §3601, Mar. 23, 2010, 124 Stat. 538 , provided that:

“(a) Protecting Guaranteed Medicare Benefits.-Nothing in the provisions of, or amendments made by, this Act [see Short Title note set out under section 18001 of this title] shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].

“(b) Ensuring That Medicare Savings Benefit the Medicare Program and Medicare Beneficiaries.-Savings generated for the Medicare program under title XVIII of the Social Security Act under the provisions of, and amendments made by, this Act shall extend the solvency of the Medicare trust funds, reduce Medicare premiums and other cost-sharing for beneficiaries, and improve or expand guaranteed Medicare benefits and protect access to Medicare providers.”

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updated 09092025 This is going to be an evolving story of a Disabled Female chronic pain pt

Posted on September 9, 2025 by Pharmaciststeve

Pt’s statements in RED: My words are in Green

Remember she is doing speech to text

This disabled female pt reached out to me Aug 4th and her doc had just abruptly cut her oral opioids she had been taking for ~ 10yr from 90 MME/day to 30 MME/day and put a Buprenorphine patch on her the next day. This is just starting to evolve but I am going to leave this post at the top of the first page and update as things happen – STAY TUNE

This is Aug 5th:

My. Primary. Just upped my blood. Pressure meds he said. It could ending up having. A stroke    Could it be the patch. Causing my blood. Pressure. Going. Up. So. High

Is your doctor just an employee of a large hospital system. I would like to put a spot light on his employer – let me know

 

 

 

A day or two after she put the buprenorphine patch on she was scheduled to have a treadmill cardiac stress test. Before the test, they took her blood pressure and it was 240/120 – what the American heart Association claims is a hypertensive crisis level. This test was done in part of a hospital system. Of course the stress test was cancelled, and the staff just SENT HER HOME. Before she had the patch on, her blood pressure was more normalish. Here is the American Heart Association on its definition of blood pressure. You may have to click on the graphic TWICE to make it enlarge and more readable

 

 

 

 

 

 

 

09-09-2025 This pt and her story has fallen off my radar – but today she told me that they had cut her opioid from 15 mg QID to either 10 mg 1-2 X daily.  Her BP is ONLY 230/120.  Within 20 minute of taking a dose.. she starts feeling better and two hrs later, she appears to be going into some level of withdrawal again..  IMO… this suggests that she is a fast/ultra fast metabolizer. I have suggested that she get a pharmacogenomic DNA test (PGx) to determine her metabolism of opioids. Will the practitioners involved even believe in this test. I have found that some practitioners are still practicing with the knowledge they obtained during their time in college.

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CVS Caremark ordered to pay $290M after Medicare fraud scheme exposed by former Aetna whistleblower

Posted on September 6, 2025 by Pharmaciststeve

What could go wrong? When the same company owns abt a 10,000 store community pharmacy, a mail order pharmacy, one or more “specialty pharmacy(s),  the largest nursing home pharmacy and also owns the largest PBM.

A $290 million fine after a whistleblower accused the business of overcharging Medicare on prescription drugs in 2013 & 2014, more than a decade ago. a former Aetna actuary, alleged Caremark defrauded Medicare Part D by causing false drug cost reports to be submitted in 2013 and 2014.

Generally, a pt residing in a nursing home is easily persuaded to use the nursing home’s preferred pharmacy.

https://www.doximity.com/collections/3ceb59b3-1782-4a09-9d7b-d0aa1a833393

A federal judge has ordered CVS Health’s pharmacy benefit manager, Caremark, to pay nearly $290 million after a whistleblower accused the business of overcharging Medicare on prescription drugs more than a decade ago.

Sarah Behnke, a former Aetna actuary, alleged Caremark defrauded Medicare Part D by causing false drug cost reports to be submitted in 2013 and 2014.

Caremark was found liable in June, and Philadelphia federal court Chief Judge Mitchell Goldberg ordered the company to pay $95 million in damages, deferring final rulings on penalties.

Goldberg, who was appointed by former President George W. Bush, tripled the damages on Tuesday, finding Caremark Rx, CaremarkPCS Health and CVS Caremark Part D Services should pay a total of $289.9 million in damages and penalties, according to court documents. Goldberg also imposed $4.87 million in civil penalties.

“We are pleased that the Behnke ruling in June was in our favor as to certain issues for CVS Pharmacy and CVS Health Corporation’s liability and disappointed the court found against Caremark on other issues. We plan to appeal,” CVS wrote in a statement to FOX Business.

In 2014, Caremark was accused of manipulating how drug costs were reported, prompting Aetna and SilverScript to submit false direct and indirect remuneration reports in 2013 and 2014, according to court records.

The scheme, which was allegedly designed to hide profits, led to Medicare Part D being overbilled by $95 million.

While Goldberg did not find “actual knowledge” of the fraud, he found reckless disregard and deliberate ignorance warranting the steep penalties, according to a memorandum.

Caremark argued that the 513 false reports submitted did not justify penalties exceeding the $95 million overcharged, citing the excessive fines clause of the Eighth Amendment and the due process clause.

However, Goldberg found a $95 million fraud loss was “certainly significant.”

Citing precedent from a State Farm insurance case in 2003, Goldberg noted due process was not violated because the ratio of penalties to actual damages was substantially lower than previous decisions, according to court documents.

Goldberg also awarded post-judgment interest, which means interest began accruing on the $289.9 million on Tuesday and will continue to accrue until Caremark pays in full.

The interest will compensate Behnke and the government until CVS pays fully, preventing the company from delaying action.

It is unclear how much of the total award Behnke will receive.

Aetna, Sarah Behnke and U.S. Attorney David Metcalf did not immediately respond to FOX Business’ requests for comment.

Full disclosure: for about 5 +/- years I worked for a Pharmacist temping service and worked a number of days/weeks/months at one of Omnicare’s LTC pharmacies, but I ceased working as a temp pharmacist in mid-2013. When working as a temp pharmacist, temp Pharmacists have little to nothing to do with the billing of medications. Omnicare had a whole dept to manage the Rx billing services to the various insurance/PBM entities.

 

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Now what do we do about all the laws/rules that are being broken

Posted on September 5, 2025 by Pharmaciststeve

Now that we know how many laws/rules that are being broken 

How many laws are their violating – let me count the ways

The DOJ/DEA falls under the saying we heard on a regular basis during the last Presidential administration. No one is above the law, except those who enforce our laws and/or friends with someone who enforces the law.

Lets start with the three major drug wholesalers who agreed to sell fewer controls – not just opioids – to all community pharmacies.

The primary charge of the various state boards of Pharmacy is:The primary function of state boards of pharmacy is to protect the public health, safety, and welfare by regulating the practice of pharmacy within each state.

They are all licensed by the various state Boards of Pharmacies and the scope of state boards of pharmacy authority explicitly covers drug distribution by wholesalers, ensuring these entities meet strict standards that protect the integrity and safety of the pharmaceutical supply chain.

So if 3 major drug wholesalers that control abt 85% of the Rx wholesale market place or rationing all controlled meds to all community pharmacies, resulting in shortage and causing chronic pain pts to be thrown into cold turkey withdrawal and enduring a torturous level of untreated pain and people who are trying to become sober or maintain their sobriety are set up for a failure.

The question needs to asked? Is this rationing of these wholesalers compromising the public health, safety, and welfare? and are the various state boards of pharmacy turning a blind eye to what is going on – and not DOING THEIR JOB?

Here is a website to locate all the state boards of pharmacy by state  https://nabp.pharmacy/about/boards-of-pharmacy/  where patients can find a complaint form to file a complaint with the BOP.

However, there might be a slight “rub” here. In most states, the attorney for all the licensing boards in a given state is THE ATTORNEY GENERAL for the state. But since 45 AGs signed the agreement with the major drug wholesalers…. Could there be a conflict of interest here?

Of course, the pt could go to the state Governor, but the state is going to share in the 21 billion that is coming from the 3 major drug wholesalers over the next 18 yrs.

Some may want to talk to their state legislators, after all these are the people who created these rules/law and you could ask them why did they spend all that time and trouble creating these laws, if the various people within the state’s bureaucracy is reluctant to enforce them?

IMO, there is a risk that there is so much money being paid into the states because of this agreement that with no corrective actions and if no pt files a complaint and maybe bring in the media, that will end up with nothing being done … nothing will change.

Conclusion: does this describe an intentional covert GENOCIDE?

Chronic pain and addiction are closely linked to increased suicide risk, frequent premature deaths, and measurable reduction in life expectancy, backed by large-scale studies and systematic reviews. These findings underscore the urgent need for integrated pain management and addiction treatment programs to address both physical and psychological risks for this vulnerable population.

 

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CVS Caremark Faces Lawsuit for Favoring Wegovy Over Zepbound – medically apples & oranges

Posted on September 5, 2025 by Pharmaciststeve

Remember the primary basis of the practice of medicine is the starting, changing, stopping a pt’s therapy.

Zepbound (tirzepatide) is the only GLP-1 product that activates GIP and GLP-1 receptors, which regulate appetite, insulin response, and digestion. All the other “GLP-1” only activates ONE RECEPTOR. There is a third receptor glucagon receptor (GcgR), which will most likely be in the next GLP-1 injection. They are also working on a oral tablet, that the pt will be taken daily but the weight loss in clinical trials is showing only a 10% of body weight loss where Zepbound has demonstrates up to a 25% of body weight loss.

CVS Caremark Faces Lawsuit for Favoring Wegovy Over Zepbound

https://news.bloomberglaw.com/employee-benefits/cvs-caremark-sued-by-patients-for-favoring-wegovy-over-zepbound

CVS Caremark was sued Wednesday by two health plan participants who say the pharmacy benefit manager wrongly refuses to cover weight-loss drug Zepbound because of its arrangement with Wegovy maker Novo Nordisk A/S.

The proposed class action says the company—formally known as Caremark RX LLC—stopped covering Eli Lilly & Co.’s Zepbound earlier this year, after it entered into a rebate agreement with Novo Nordisk that caused it to favor Wegovy. The plaintiffs, two patients who were prescribed Zepbound to treat obesity and other symptoms, say this violates the terms of their employer-sponsored health plans, which include coverage for medically necessary prescription drugs.

Both Wegovy and Zepbound cost more than $1,000 for a one-month supply. The medications received approval from the US Food & Drug Administration in 2021 and 2023, respectively.

Caremark’s decision to favor Wegovy overlooks important differences in the two drugs, including Zepbound’s ability to effectively treat sleep apnea, the patients said.

“Because of their different methods of action, different clinical outcomes, and different side effects for individual patients, Zepbound and Wegovy are not clinically interchangeable,” the patients said in a complaint filed in the US District Court for the Southern District of New York. “And as studies have proven, Zepbound is more effective than Wegovy in achieving weight loss, and only Zepbound has been proven effective and approved by the FDA for treating sleep apnea in patients with obesity.”

Plaintiffs Dennis Larkin and Danielle Gosline bring claims under the Employee Retirement Income Security Act on behalf of a proposed class of thousands of health plan participants whose requests for Zepbound coverage have been denied since July.

“This suit is without merit, and we’ll defend ourselves vigorously against these claims,” a CVS Health spokesperson said in an emailed statement.

Larkin and Gosline are represented by Berger Montague PC and Hufford Law Firm PLLC.

The case is Larkin v. Caremark RX, LLC, S.D.N.Y., No. 1:25-cv-07307, complaint 9/3/25.

(Updates Sept. 3 story with company’s response in seventh graph.)

To contact the reporter on this story: Jacklyn Wille in Washington at jwille@bloombergindustry.com

To contact the editor responsible for this story: Carmen Castro-Pagán at ccastro-pagan@bloomberglaw.com

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How many laws are they violating – let me count the ways

Posted on September 5, 2025 by Pharmaciststeve

One of the primary basics of the practice of medicine – starting, changing or stopping a pt’s therapy.

The DEA started creating production quotas of control meds  abt 2015 and ended up overall reducing the availability of control meds by > 50% over the following years.

How many pts have a valid medical necessity for many of those controlled meds that were no longer in the distribution system? Isn’t that changing or stopping some pt’s therapy?

In 2016 the CDC – outside of its normal focus on contagious diseases and vaccines – decided to establish their Opioid dosing guidelines. Their committee published guidelines that ignored the pharmacogenomic (PGx) testing that can justify higher doses and more frequent doses based on their liver enzymes. The adopted the (MME) Morphine Milligram Equivalent system that has no double blind clinical studies without a control group and just picked a arbitrary number of a max of 90 MME/day for any all diseases, post surgery, pain resulting from any accident.

The CDC has no ability to create any law or regulation, nor any authority to enforce anything that they create, because all they produced was GUIDELINES.

Shortly after those guidelines were releases, the DEA and Veteran Admin adopted those as the new standard of care and best practices and some 35+/- states used the guidelines to create statutory limits of opioid doses for all painful health issues.

Imagine what kind of a uproar we would have if the same bureaucrats that have created the opioid guidelines, did the same thing for diabetic type -1 , insulin dependent- if they came up with that all type 1-diabetic could only have 10 units on a particular insulin/day. Never mind some would die, at least they wouldn’t get addicted to “shooting up every day”.

Then we moved on to the fact that the DOJ/DEA could no longer find any “dead bodies” to attached to some practitioners to take them to court and accuse of being the reason that a person over dosed no matter the time frame between the first opioid Rx provided nor the time since the last Rx opioid provided by the practitioner nor the number of opioid Rxs were provided – even just one. 

The DEA/DOJ moved on to any practitioner prescribing Rxs of opioids >90 MME to any pt and/or prescribing concurrently to the same pt a Rx for a benzodiazepine and a muscle relaxant.   It was determined that violated the Control Substance Act which the DEA determined that those 3 meds concurrently prescribed to a pt was technically illegal.

Then as the 1999 Tobacco settlement was coming to the end, 45 state AGs decided to sue the three major 3 drug wholesalers – that control abt 85% of the drug wholesale market place. It did not even go to trial, the 3 drug wholesalers mediated an agreement where the three wholesalers, while admitting no wrong doing in concerns of contributing to the opioid crisis, but agreed to collectively paid 21 billion dollars over 18 yrs.  Also, they agreed to sell fewer control meds to community pharmacies. Disregarding if any patients that have a valid medical necessity and prescription for the controlled medicine.   The wholesalers even created rations for each pharmacy and the pharmacy could not find out what their ration for each Rx controlled med/strength.

No consideration if a lack of inventory would throw a chronic pain into cold turkey  withdrawal and uncontrolled pain  for days, weeks or a couple of months or a person that is trying to get sober or stay in sobriety and it would all fall apart. 

Then there is this law from 1935, 35 years before the CSA was signed into law

42 USC 1395: Prohibition against any Federal interference

https://uscode.house.gov/view.xhtml?req=(title:42%20section:1395%20edition:prelim)

From Title 42-THE PUBLIC HEALTH AND WELFARE CHAPTER 7-SOCIAL SECURITY SUB CHAPTER XVIII-HEALTH INSURANCE FOR AGED AND DISABLED

§1395. Prohibition against any Federal interference

Nothing in this sub chapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

(Aug. 14, 1935, ch. 531, title XVIII, §1801, as added Pub. L. 89–97, title I, §102(a), July 30, 1965, 79 Stat. 291 .)

Statutory Notes and Related Subsidiaries

Short Title

For short title of title I of Pub. L. 89–97, which enacted this sub chapter as the “Health Insurance for the Aged Act”, see section 100 of Pub. L. 89–97, set out as a Short Title of 1965 Amendment note under section 1305 of this title.

Per perplexity.ai:  Does this suggested that this is a planned covert genocide? A sort of thinning of the herd?

There is well-documented evidence of a significant increase in suicides, premature deaths, and reduced life expectancy among chronic pain patients and people dealing with addictions.

Suicides in Chronic Pain and Addiction

  • Chronic pain patients have about twice the risk of suicide compared to those without chronic pain.

  • Meta-analyses report lifetime suicidal ideation rates near 29% and suicide attempt rates near 11% among chronic pain sufferers.

  • More than 8% of U.S. suicide decedents had a history of chronic pain—a major risk factor for suicide, independently from mental health disorders.

  • Catastrophizing about pain, mental defeat, and lack of coping skills all contribute to heightened suicide risk.

  • Patients abandoned to untreated pain or rapid opioid withdrawal have a nearly 300% increased risk of overdose death and markedly higher suicide risk.

Premature Deaths in Chronic Pain and Addiction

  • People with opioid addiction (many with chronic pain) are over ten times more likely to die within a four-year period compared to those without substance abuse problems.

  • Among opioid-related deaths, over 60% had a chronic pain diagnosis in the year before death.

  • Opioid-related deaths represent up to 12% of deaths among 25-34 year-olds in the U.S..

  • Chronic pain directly contributes to both fatal and nonfatal overdoses and sudden unexpected deaths, including cardiac arrest in severe cases.

Reduction in Life Expectancy

  • Both opioid addiction and long-term painkiller use are linked to reduced overall life expectancy and welfare.

  • Opioid overdose deaths, often seen in addiction and chronic pain populations, surged 292% between 2001 and 2016 in the United States, reflecting dramatic impacts on life expectancy at the population level.

  • Chronic pain is strongly associated with decreased healthspan and lifespan due to behavioral health comorbidities (e.g., anxiety, depression, opioid misuse) and unmet mental health needs.

Conclusion

Chronic pain and addiction are closely linked to increased suicide risk, frequent premature deaths, and measurable reduction in life expectancy, backed by large-scale studies and systematic reviews. These findings underscore the urgent need for integrated pain management and addiction treatment programs to address both physical and psychological risks for this vulnerable population.

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