A potential BLACK SWAN EVENT for the chronic pain community

This is the definition of a Black Swan Event from ChatGPT

A black swan event refers to an unpredictable and rare occurrence that has a major impact. The term was popularized by Nassim Nicholas Taleb in his 2007 book, “The Black Swan: The Impact of the Highly Improbable.” The metaphorical black swan was used to describe an event that was considered impossible or highly improbable based on prior observations (as the conventional wisdom was that all swans were white), but that had profound consequences when it occurred.

In the context of finance and economics, black swan events are typically events that are unforeseen, have a major impact, and are often rationalized in hindsight. Examples of black swan events in history include the 2008 financial crisis, the 9/11 terrorist attacks, and the collapse of the Soviet Union. These events are characterized by their extreme rarity, the severe impact they have on systems, and the difficulty of predicting or preparing for them.

The concept of black swan events underscores the limitations of relying solely on historical data and statistical models for predicting future events, as it emphasizes the importance of being prepared for unexpected and rare occurrences that can have far-reaching consequences.

I have made a blog post before about the agreement between 41 state AG’s and the 3 major drug wholesalers to REDUCE the controlled meds that are sold to community pharmacies  Opioid Settlement Hinders Patients’ Access to a Wide Array of Drugs    Recently the DEA published proposals to cut Pharma opioid production quotas, as required by law, and had a period for interested parties to make comments, as required by law. I am not aware that the DEA had any requirement to give any serious consideration to the comments made, so it has been reported that they have posted the original proposed cuts as their final decision.

Earlier this year, the DEA stated that <1% of pharma opioids are being diverted, so for the DEA cutting of production quotas will almost guarantee further shortages of opioid meds. The “special twist” that the DEA has put into the process. They are moving from an annual production quotas to a QUARTERLY PRODUCTION QUOTA!

I have read that some of the Pharmas have stated that their cycle of ordering raw material to final production of the medication could be as long as SIX MONTHS!  This suggests that the availability of opioid meds could end up in a highly unpredictable availability.

If this comes to fruition, how many pts are going to be thrown into cold turkey withdrawals, because their meds are not available, and how many times is this going to happen to these pts?  If the DEA ignores the concerns of the pharmas about having quarterly production quotas, would suggest that the DEA has a dedicated purpose to disrupt the medical care of those in the chronic pain community. In no way can they claim that such a disruption has unintentional consequences/outcomes.

All of us can just imagine the anxiety levels of chronic pain pts as their refill date approaches.

Maybe it is time for all involved (pharmas, wholesalers, pharmacies, prescribers) in the treatment of pts dealing with medical issues that require being prescribed controlled meds, to challenge the CSA constitutionality and the DEA’s violation of a federal law that was on the books BEFORE the CSA was signed into law.

This may be an excellent example of our judicial system, where/how Congress can pass a bill and the President can sign it into law and there are no checks and balances if a new law is actually constitutional but can be enforced until some entity challenges it constitutionally in our courts. Some of us remember that the CSA was strongly supported by our then President “tricky dick” Nixon. Who was a known racist, and bigot and wanted to put all hippies and blacks in jail.

Here is the law that may apply:

42 USC 1395: Prohibition against any Federal interference



§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.”


3 Responses

  1. 42-1395,,,THEY ARE VIOLATIONG,,, also with ALLLL those comments AGAINST forcible taking our meds,,,,they could of and should of called for a public hearing,,,,,with sooo much public outcry against the dea practicing medicine,,jmo,,,thee director of the DEA can call for a public hearing based on thee concerns pointed out in the public comment peroid,,,,maryw

  2. […] case exposes the racket being perpetrated by Dr. Timothy King, a racket aided and abetted by rogue governmental agencies that have been coopted and are controlled by for-profit healthcare insurance […]

  3. This is unacceptable. We already have had shortages of methotrexate, used for RA. Even shortages of azalastine, a nasal spray for allergic rhinitis. Of course, that’s no comparison to shortages of the opioid meds that keep CPPs functioning.

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