PHARMACIST STEVE

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I believe that state pharmacy boards license drug wholesalers and the primary charge of the pharmacy boards is pt safety, shouldn’t these boards take some action if nothing else to seek some legal action to nullify the wholesaler agreement because it is contra to public health safety

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And the states are going to benefit from the fines that the wholesalers are paying to the states over this wholesaler agreements.

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So this wholesaler agreement – could it considered nothing more – nothing less than a “money grab” some “free money” under the pretense that the wholesaler – at most only knew the legally licensed pharmacy purchased the control meds from them, Had no idea of the practitioner that wrote the Rxs that the pharmacy dispensed and knew nothing about the medical needs or the severity of the medical needs of the pt that ended up with the controlled meds. As I understand the wholesaler agreement, it did not go to trial, it was mostly a settlement based on some statistics of number of control meds that were sold to community pharmacies and those statistics may have been nothing more than some numbers that some bureaucrat pulled out of this ass and nothing that had something to do with reality of the need of various pts

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Since Opioid Rxs peaked in 2011-2013 and decreased significantly post 2016 CDC opioid dosing guidelines published and the Opioid poisoning/OD was shifting from Rx opioids to illegal opioids being produced/distributed by the Mex cartels using raw ingredients mostly from China – so could it be concluded that the stats that the AGs used in suing the wholesalers were inaccurate stats and Rx opioids were dramatically less involved in opioid poisoning/OD’d so all the $$$ agreed to and rationed required to community pharmacies were based on “false/inaccurate facts”

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According to Wikipedia they claim that there are 100-200 different Fentanyl analogs and only 4 are FDA approved as safe in humans. Please use illegal or illicit Fentanyl when addressing the “bathtub Fentanyl” that is coming from the Mex cartels. All John Q. Public hears out of the media is Fentanyl kills 80,000/yr. and they only know on Fentanyl the one the anesthesiologist wants to give them when they have surgery.

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The one that is legally used is Fentanyl citrate and it has been reported that the Mex cartels are selling on the street Fentanyl acetate – which has never when under any FDA clinical trials and now it is being reported that there maybe 1 or 2 veterinarian meds mixed in and some other things like methamphetamine, cocaine, Marijuana, etc, etc and Narcan will not reverse a poly-drug poisoning/OD

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I see this could be used to TV stations

BRIEF: The Real-World Consequences of Opioid Policy—Why Chronic Pain and Addiction Patients Are Being Left Behind

Overview:
Driven by the intention to mitigate opioid misuse, DEA production cuts and state Attorneys General (AG) opioid settlements with drug wholesalers are unintentionally creating a crisis for chronic pain sufferers and those seeking recovery from addiction.

Unseen Epidemic: Chronic Pain in America

• Over 51 million U.S. adults – more than 20% of the population – live with chronic pain. Of those, 17 million have “high-impact” pain, severely limiting daily life.

• Approximately 52,000 new chronic pain cases occur annually, stemming from birth defects, accidents, injuries, illnesses, and aging.

• As the U.S. population grows and ages, the chronic pain crisis only intensifies.

DEA/AG Policies: The Downside

• DEA opioid production quotas have been cut by more than 50% over the past decade.

• The AGs’ settlements require wholesalers to enforce secret order thresholds, resulting in pharmacies facing arbitrary, chronic shortages of vital pain and addiction therapies.

• The underlying lawsuit statistics failed to clearly distinguish pharmacy-based, licensed opioid prescribing from the rising surge of illegal fentanyl analogs now fueling the majority of opioid-related deaths. While prescriptions and deaths from medical opioids have steadily dropped, illicit fentanyl deaths have soared since 2014. However, CDC’s own data collection systems do not reliably distinguish whether an overdose came from a prescription opioid or an illicit one, due to limitations in toxicology and ICD coding. This “data fog” means the statistics behind the lawsuits relied on outmoded shipment numbers and ambiguous overdose data.

Who Pays the Price?

• Chronic pain patients – including victims of birth defects, catastrophic injuries, or age-related pain – are increasingly unable to receive effective medication, turning manageable conditions into daily suffering and disability.

• Patients in addiction recovery face difficulty accessing medication for opioid use disorder (MOUD) due to the same pharmacy rationing.

• Prescribers are retiring, leaving practice, or avoiding chronic pain patients to steer clear of regulatory risk and administrative obstacles.

• Naloxone (Narcan), while effective for opioid overdoses, often cannot reverse poly-drug poisonings now frequent in illicit fentanyl overdoses.

Ignored Realities

• Illicit fentanyl, not prescription opioids, now accounts for the vast majority of annual overdose deaths—but policy remains fixated on restricting doctors and pharmacies, neglecting illicit manufacturing by cartels.

• There are more than 1,000 fentanyl analogs; only four are FDA-approved for human use, the rest are part of the unpredictable illicit drug supply.

• State governments now stand to benefit financially—even as patients lose access—because billions in settlement funds are delivered to state coffers.

Human Toll

• Millions with chronic pain are being abandoned.

• Tens of thousands of new chronic pain patients join their ranks each year.

• Thousands of prescribers are leaving or cutting back chronic pain treatment entirely.

• The real toll of untreated pain—including possible deaths—remains untracked and ignored.

Bottom Line

Regulatory and legal actions rooted in outdated and ambiguous data, combined with a lack of clear CDC differentiation between prescription and illicit opioid sources, are causing widespread abandonment of some of the most medically vulnerable Americans—chronic pain sufferers and those seeking recovery.

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Filed under: General Problems