Walgreens’ Priority Was Filling Drug Orders Fast, Judge Told

Walgreens’ Priority Was Filling Drug Orders Fast, Judge Told

A former Walgreens pharmacist felt pressured to “fill, fill, fill” prescriptions while working at a pace that made her fear making fatal errors, a California federal judge heard in recorded testimony Thursday in a multibillion-dollar bellwether trial over claims Walgreens and others illegally fueled San Francisco’s opioid epidemic.

The city of San Francisco has accused Walgreens, along with drugmakers Teva and Allergan and drug distributor Anda, of creating a public nuisance by marketing opioids with misleading messages about their safety and failing to prevent the ensuing flood of painkillers from being diverted for improper uses.

Thursday marked the second day of the bench trial in which the testimony focused on San Francisco’s case against the pharmacy chain. It included the recorded deposition of Rebecca Gayle, who worked at a San Francisco Walgreens as a staff pharmacist from 2012 to 2016, also holding the role of assistant store manager from 2014 to 2016.

“The most challenging part of working at Walgreens was I constantly felt there was the pressure to fill, fill, fill, and that was what the company cared about most,” Gayle said. “That’s the message I got.”

The demand to fill prescriptions quickly made it difficult for her to investigate suspicious prescriptions or talk to patients about their medications.

“I constantly got feedback to go faster, shave down on the things that were most important to me as a pharmacist like counseling patients,” Gayle said, later adding, “I ran into situations where I was afraid I made a lot of mistakes that could result in severe patient … harm or even death, depending on medication and the type of error.”

During Gayle’s cross-examination, a lawyer for Walgreens asked her if she believed she and her colleagues were doing their best on behalf of their patients and to make sure they prevented diversion.

“I feel like we, as pharmacists, could have had many more tools, and support from a staffing and time perspective, to do more due diligence to prevent diversion,” Gayle said. “We were doing our best, but it was limited given the volume of prescriptions we were filling and the pace at which we were expected to fill.”

Gayle said she would sometimes search doctors’ names on the internet if she felt something was fishy about them, as well as leave notes for her colleagues to warn them about doctors who appeared to be issuing excessive opioid orders.

If there was a strong red flag, Gayle said she and her colleagues would sometimes refuse to fill a prescription.

Brian Swanson of Bartlit Beck Herman Palenchar & Scott LLP, an attorney for Walgreen’s, asked Gayle if she was ever punished for refusing an order, and she said no.

Among doctors who had “fishy” prescribing practices was Collin Leong, Gayle said. He ultimately lost his license in 2013 and pled guilty to selling opioid prescriptions to homeless people with no medical justification, but not before Walgreens filled thousands of his prescriptions, according to a document the city filed with the court. 

An attorney for San Francisco showed Gayle a news article that said the homeless people would be given cash for the pills from a third party. Leong charged $80 to $150 for a prescription, taking in about $400,000, according to the news report.

“Did your district managers ever ask you to identify suspicious prescribers so they could warn others?” the attorney asked. Gayle said no.

Another former San Francisco Walgreens employee, Victor Lo, also testified that the store he worked at was inadequately staffed, making it difficult to do his job carefully.

“We always felt like we were behind, we always felt, at least I felt, I could potentially dispense something incorrectly,” Lo said.

Lo, however, testified that when he told his supervisor that he felt the pharmacy was dispensing a lot of narcotics from doctors who appeared to be “too free” in writing prescriptions, he was told the pharmacists couldn’t say no.

“We couldn’t categorically say flat out we’re not filling these prescriptions from a licensed prescriber. Those prescribers could sue Walgreens,” Lo said he was told.

In addition to Lo, live testimony was given Thursday from Carmen Catizone, who said Walgreens did not meet the standard of care legally required of pharmacies. Among concerns, from 2003 to 2012, Walgreens had a policy passed on to pharmacists to merely call the doctor who issued a questionable prescription as opposed to doing any other due diligence.

“This is especially true when the prescriber may be assisting the patient to inappropriately use controlled substances,” Catizone said.

In 2013, Walgreens introduced a checklist for pharmacists to use when dispensing some drugs, but it didn’t cover some commonly diverted opioids. Until 2020 the checklists were maintained only in hard copy at each pharmacy, and not electronically, so they could be shared with other stores, Catizone said.

During cross-examination, Swanson took aim at the list of “red flags” or warning signs that suggest opioid abuse or diversion that Catizone said pharmacists are required to be on the lookout for.

“You don’t cite any federal or state statute that discloses each of these specific red flags you identify, do you?” Swanson asked, later noting that they also don’t appear in the Controlled Substances Act.

Swanson also posed several hypothetical situations to Catizone that would result in a legitimate prescription being flagged. For example, if a patient obtained multiple opioid prescriptions from different prescribers.

“That would flag a patient who broke a leg and then gets an opioid script from the ER and then gets a second prescription from the orthopedist who treats them,” Swanson noted.

Walgreens’ lawyer also said pill volume wasn’t necessarily a red flag, for example, if a doctor was prescribing for an oncology patient or for pain management.

Catizone’s time on the stand was about 30 minutes, in keeping with Judge Breyer’s orders and a tight trial timetable, limiting direct witness examinations to written declarations with only a short live introductory summary.

Catizone, who served as the executive director and CEO of the National Association of Boards of Pharmacy from 1988 to 2020, also submitted a 35-page declaration to the court.

The Bay Area litigation is the first to rope together defendants across the pharmaceutical supply chain, from manufacturing to distribution and pharmacy dispensing.

San Francisco is represented by its city attorney’s office, Lieff Cabraser Heimann & Bernstein LLPRobbins Geller Rudman & Dowd LLPAndrus Anderson LLPWeitz & Luxenberg PCSimmons Hanly Conroy LLC and Levin Papantonio Rafferty.

Allergan and its affiliates are represented by Kirkland & Ellis LLP.

Teva and its affiliates are represented by Morgan Lewis & Bockius LLP.

Anda is represented by Foley & Lardner LLP.

Walgreens is represented by Bartlit Beck LLP and Gibson Dunn & Crutcher LLP.

The case is City and County of San Francisco et al. v. Purdue Pharma LP et al., case number 3:18-cv-07591, in the U.S. District Court for the Northern District of California. The MDL is In re: National Prescription Opiate Litigation, case number 1:17-md-02804, in the U.S. District Court for the Northern District of Ohio.

Record Numbers of Americans Are Dying of Overdoses. Instead of Justice, We Get Theater | Opinion

 

https://www.newsweek.com/record-numbers-americans-are-dying-overdoses-instead-justice-we-get-theater-opinion-1706231

The Guggenheim Museum in New York City announced this week that it would be removing the Sackler’s nameplate off of their arts center in response to pressure from activists. “The Guggenheim and the Mortimer D. Sackler family have agreed to rename the arts education center,” a museum spokesperson said in a statement on Tuesday. The Guggenheim was not alone; the Metropolitan Museum of Art in New York also removed the Sackler name from a gallery, as did the National Gallery in London this week.

The Guggenheim’s effort is timely, coming on the heels of another devastating statistic: Nearly 108,000 people died from drug overdoses in 2021. And yet, the sad truth is, embarrassing members of the Sackler family will not bring justice to the victims of the opioid crisis and their families, who are once again being offered busy work as though it were meaningful reform. Scrubbing the Sacklers’ name from museums, like suing them in court, amounts to little more than kabuki theater—and everyone but the victims knows it.

Real justice could not be more urgent. America remains mired in a protracted drug-overdose crisis, with over half a million people dead in just a decade. The crisis is being fed by the ubiquity of dangerous fentanyl in the black market. Despite illegal drugs being the culprit in almost every case, the focus of the media and politicians has been on punishing pharmaceutical companies, in particular, members of the Sackler family who own Purdue Pharma, for which a major case of civil litigation is ongoing.

But the calls for justice for the victims of opioid addiction rarely rise above the symbolic, things like the Guggenheim or the Metropolitan Museum of Art removing the Sackler name from their nameplates. And this is a far cry from meaningful consequences that would help the victims of the opioid crisis.

But the lawsuit is a far cry from what real justice would look like. “The whole thing is kabuki theater,” says Richard Ausness, a legal scholar and renowned opioid litigation expert from the University of Kentucky Law. He told me that while there is a high emotional charge to these proceedings, the actual bearing on the case is minimal. “It ought to be about money,” Dr. Ausness explained. “About who pays what. And instead, they want to make the Sacklers listen to people complain about them.”

It may surprise you to learn that instead of trying to bring the Sacklers to justice, the Department of Justice has done anything but. On multiple occasions, the family agreed to multi-billion-dollar settlements, like a widely-criticized bankruptcy agreement from September of 2021 which mandated that the Sacklers would forfeit Purdue ownership and shell out $4.3 billion to litigants. But it granted the Sacklers sweeping immunity from opioid lawsuits brought against their company Purdue Pharma and its drug OxyContin. The plan was killed last December by U.S. District Judge Colleen McMahon, after the DOJ publicly announced they didn’t like how the Sacklers would be immune to further shakedowns lawsuits.

Oxycontin
WHITE PLAINS, NEW YORK – AUGUST 9: Friends and family members of people who have died during the opioid epidemic protest against a bankruptcy deal with Purdue Pharmaceuticals that allows the Sackler family to avoid criminal prosecution and to keep billions of dollars in private wealth, on August 9, 2021 outside the Federal courthouse in White Plains, New York. For decades the Sackler family, which owned Purdue, knowingly marketed highly addictive painkillers, including Oxycontin. Andrew Lichtenstein/Corbis via Getty Images

So this March, the Sacklers made a new deal, with compensation coming to $6 billion—and immunity from further litigation. Once again, the DOJ pushed to have it overturned, though U.S. Bankruptcy Judge Robert Drain stood firm and overruled. (DOJ is still pushing for an appeal in the federal appeals court.)

Professor Ausness and others I spoke to believe the case will end up at the Supreme Court, and it’s anyone’s guess what happens then. But as it currently stands, the victims will never see a single cent from civil litigation. Unless specified otherwise by state law, litigation settlement funds are at the discretion of state attorneys general, who have historically allocated the vast majority of opioid litigation money to feed state budgets. What little funds go toward “anti-addiction” projects have been spent on ridiculous efforts that have very little do with addiction, like Michigan’s focus on helping new mothers or West Virginia’s emphasis on public education.

The media and prosecutors should have been honest with victims from the start and admitted that putting the Sacklers in jail was never an option. Remember, in the 1990s and 2000s, the hard push for prescribing opioids was at the behest of the federal government. These companies’ advertising strategies weren’t drastically different from those for any other drug. While Big Pharma’s behavior was unethical, that is not the same as it being illegal.

Meanwhile, Americans are still overdosing on illegal drugs in the hundreds of thousands.

Where are the calls for justice for them?

Nurse Vaught Sentenced for Deadly Medical Error

If healthcare providers start/keep getting thrown in jail for medical errors, pretty soon there will be no one to care for people need medical care. Many lethal medical errors that I have read about, most all the “system” contributed to the problem. Some of that is when licensing boards fail to take actions against a practitioner’s license who is a “frequent offender”, other times..it can be grossly understaffed/overworked staff, other times it can be contributed to by automation systems that are not working as designed … either from poor design or malfunctions that have failed to be corrected/fixed.

Nurse Vaught Sentenced for Deadly Medical Error

https://www.medpagetoday.com/special-reports/exclusives/98706

Former Vanderbilt nurse gets 3 years probation for negligent homicide, adult abuse

RaDonda Vaught, the Tennessee nurse convicted after a medical error led to a patient’s death, was sentenced to 3 years of supervised probation, evading a possible prison sentence of up to 8 years.

Today’s sentencing caps a years-long process, including delays caused by the COVID-19 pandemic, that brought to light Vaught’s medical error, led to her prosection, and sparked a national outcry from the medical community.

Vaught, 38, was convicted on March 25 of negligent homicide and impaired adult abuse over the medication error, which resulted in the death of 75-year-old Charlene Murphey at Vanderbilt University Medical Center (VUMC) in 2017. Vaught received concurrent sentences of 3 years probation for the adult abuse charge and 2 years probation for the reckless homicide charge.

The fatal error happened when Vaught, a nurse at VUMC at the time, was preparing Murphey for a PET scan on the day after Christmas. Murphey had complained of feeling anxious ahead of the scan and was ordered 2 mg of IV versed. Vaught mistakenly administered 10 mg of vecuronium to the patient instead, according to a CMS report on the incident. Murphey was transported to radiology for imaging, coded in the scanner, and died shortly after.

Vaught was fired from VUMC on Jan. 3, 2018. The hospital negotiated an out-of-court settlement with the patient’s family, one that required them not to speak publicly about Murphey’s death or the error, according to a report from the Tennessean. An anonymous tipster eventually reported the error to state officials in October 2018, and Vaught was charged by prosecutors in February 2019.

The case has stirred up a national conversation around the implications of criminal persecution for medical errors, an uncommon punishment for what many medical societies consider to be accidents born out of high pressure and high-risk environments.

Vaught’s case has also become a symbol of the policy problems that several experts say can lead to these kinds of errors.

“This is an excruciating case for nurses, because it is so abundantly clear that the conditions under which this particular nurse was working made it impossible for her to practice in a manner that ensured patient safety,” Patricia Pittman, PhD, of the Milken Institute School of Public Health at George Washington University, told MedPage Today via email. “It is a tragic example of what happens when nurse-to-patient ratios are too low. There is over twenty years of research showing this relationship, but policymakers and some healthcare leaders still don’t get it.”

“The case is also a horrifying example of how moral injury works — a situation in which health workers feel betrayed by those in authority and forced to practice in ways that violate their professional ethics,” added Pittman, who is also director of the Fitzhugh Mullan Institute for Health Workforce Equity. “This leads to shame and a sense of helplessness and is a major driver of nurses’ resignations.”

The nurse community has reacted with strong opposition since the verdict in late March. Both the American Nurses Association and the Tennessee Nurses Association released statements following the verdict questioning the original decision to prosecute medical errors.

“Health care delivery is highly complex,” the statement said. “It is inevitable that mistakes will happen, and systems will fail. It is completely unrealistic to think otherwise. The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent.”

State passes law to make legal off label Rxing – legal in the state

Missouri bill bars pharmacists from questioning Ivermectin effectiveness

https://www.kansascity.com/news/politics-government/article261400142.html

Missouri lawmakers this week passed legislation that appears to bar pharmacists from questioning doctors who prescribe the controversial off-label drugs ivermectin and hydroxychloroquine for patients. The measure, which passed the House on a resounding 130-4 vote this week, was tucked into a bill related to professional licensing. After passing both chambers, the bill now heads to Gov. Mike Parson’s desk. According to its language, the bill would prevent state medical licensing boards from punishing or taking away the medical licenses of doctors who “lawfully” prescribe the two drugs. And it prevents pharmacists from contacting a doctor or patient “to dispute the efficacy of ivermectin tablets or hydroxychloroquine sulfate tablets for human use” unless the doctor or patient asks about the drugs’ effectiveness. Sen. Rick Brattin, a Harrisonville Republican, told The Star Thursday he added the amendment after he spoke with doctors who worried they would lose their medical licenses for prescribing the drugs. Brattin, who said he previously bought ivermectin for COVID-19 but has never taken it, described the drug as “politicized.” “Unfortunately, because of the politicization of those two drugs, [doctors are] being targeted,” he said. “I wanted to protect them from that.” The bill, specifically Brattin’s amendment, swiftly drew criticism on social media from people who pointed to the fact that the Food and Drug Administration has not approved ivermectin for treating COVID-19. The drug is authorized for humans to treat infections caused by parasitic worms, head lice and skin conditions like rosacea. The agency has received multiple reports of people who have been hospitalized after taking ivermectin intended for livestock, according to its website. “The Missouri legislature has chosen to ‘own the libs’ by issuing a gag order against every pharmacist in this state from offering their medical opinion on taking either one of those medications—even if it could kill their patient,” former U.S. House candidate Lindsey Simmons wrote on Twitter. Rep. Patty Lewis, a Kansas City Democrat who served on the committee that handled the bill, told The Star Thursday that Democrats agreed to the language in the bill to satisfy a group of hard-right conservatives in the Senate. She said the parts of the bill relating to the two drugs will not change anything in the medical community. She said medical licensing boards already would not punish a doctor for prescribing a drug lawfully. “This language, with a few buzzwords, is to keep some difficult, obstinate, conservative senators quiet,” she said. “It’s not necessary, it’s not needed. It’s ‘do nothing’ language only to make sure the bill does not fail in the Senate.”

 

Woman files CLASS ACTION LAWSUIT against CVS – for refusal to fill C-II for directions > 90 MME



One of the basics of the practice of medicine is the starting, changing/limiting , stopping a pt’s therapy. So besides these Pharmacists violating the American with Disability Act & Civil Rights Act… which both makes it illegal to discriminate against disabled people. It would seems that these Pharmacists are practicing medicine without a license.

I wonder if an attorney would file a complaint with the state’s board of Pharmacy and the Medical licensing board on behalf of all the pts being involved in this class action lawsuit, could be ignored by those licensing boards.  Some states allow complaints against state licensing boards to be filed directly with the state’s Attorney General.

I have had some pts tell me recently that a CVS pharmacist told them that NO CVS PHARMACY will fill a particular controlled med in the immediate area.  I have also been told that ordering of stock for CVS Rx depts is now managed by the pharmacy computer system.  So it would seem that someone at CVS HQ could put a ZERO inventory to be maintained on certain meds at certain stores. Some state Pharmacy Practice Act, require a pharmacy to maintain inventory of meds routinely prescribed in their area. So if CVS HQ is prohibiting a CVS Rx dept to stock certain meds – even though the Pharmacist is regularly  being presented prescriptions to be filled.  Compounding the problem, C-II electronically sent, if they are not filled by the pharmacy/Pharmacist, basically become DEAD… because all paper C-II Rxs MUST BE SIGNED BY THE PRESCRIBER. I have read where the DEA has changed regulations that allows Pharmacist/Pharmacies to electronically transfer such electronic C-II to another pharmacy – HOWEVER – states would have to change their state control rules to allow this and pharmacy computer software would have to be changed.  I do not know  if any states and computer software companies have implement this.

This refusal to fill a pt’s controlled med Rx, seems that many different rules/regulations are being ignored and/or violated.

Here is a recent published article that shows that the MME SYSTEM has NO SCIENCE nor DOUBLE BLIND CLINICAL STUDIES behind it and/or supporting it.  Also, I have not seen any FDA professional prescribing information that mentions the MME SYSTEM regards to prescribing opiates. https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154  So what science or double blind clinical studies is CVS using in establishing this limiting pt’s opiate Rxs to 90 MME/day.  I was always told/taught that all clinical decisions has to be based on CLINICAL FACTS

Unsafe pharmacy conditions put patient safety at risk, spark resignations among pharmacy techs

Survey: Unsafe pharmacy conditions put patient safety at risk, spark resignations among pharmacy techs

https://drugstorenews.com/survey-unsafe-pharmacy-conditions-put-patient-safety-risk-spark-resignations-among-pharmacy-techs

The survey shows that a significant percentage of pharmacy technicians are leaving their roles due to poor working conditions that are creating concerns for patient safety.
Sandra Levy

Senior Editor
Sandra Levy profile picture

Under staffing, increased expectations and new COVID-19 era responsibilities are creating extreme burnout among pharmacy technicians, who are citing concerns about its impact on patient safety, according to a recent survey conducted by the National Pharmacy Technician Association.

The survey of 1,386 pharmacy technicians found that poor working conditions have driven 36% of respondents to plan to leave their jobs within the next three to 12 months. This is in addition to the record-setting 25.7% growth in job transition for pharmacy technicians observed from 2019 to 2021, according to NPTA.

[Read more: Pharmacist shortages are affecting the pharmacy industry]

When it comes to burnout, 91.4% of participants report experiencing burnout caused by unmanageable workloads due to under staffing and increased responsibilities, unrealistic expectations, low wages and even productivity quotas. On top of these demands, 44% of participants said their employers also do not provide legally required breaks.

Still, 91.6% reported that they have a passion for their work. That passion, coupled with concerns about the impacts of burnout, led 56% of respondents to report that these conditions are negatively affecting patient safety. Burnout in pharmacies can result in serious or even fatal medication errors, NPTA noted.

“As the largest organization of pharmacy technicians, our No. 1 priority has always been ensuring the quality and safety of patient care,” said Mike Johnston, CEO of NPTA. “We all have a responsibility to ensure pharmacies make significant changes to these working conditions, not only for the benefit of their employees, but also to protect their patients.”

To support these advocacy efforts to improve patient safety, NPTA has partnered with the Institute for Safe Medication Practices to invite pharmacy technicians to participate in a new, anonymous survey requesting specific accounts of how these working conditions are negatively impacting patient safety. Results from this survey will be shared with regulators, legislators, employers and industry organizations to provide the data needed to bring about change. Anonymous submissions can be made here.

The survey results come on the heels of news last month about a pharmacist shortage being the latest concern affecting the pharmacy industry. Currently, 80% of pharmacies are having trouble finding pharmacists, and many are offering huge sign-on bonuses of up to $50,000 to entice them.

Bridging the gap

The American Society of Health-System Pharmacists also is keeping tabs on the pharmacy technician employment situation.

A recent ASHP survey found that a majority of hospital and health-system pharmacy administrators reported turnover rates of at least 21-30% in 2021, and nearly 1 in 10 had lost 41% or more of their pharmacy technicians. The survey also showed that a growing number of health systems are responding to technician requests for professional development by implementing internal technician training programs.

In response, ASHP has launched PharmTech Ready, a resource to help bridge the professional development and training gaps that are among the drivers of the current nationwide shortage of pharmacy technicians.

PharmTech Ready provides healthcare organizations with tools to develop internal training programs to strengthen their ability to recruit, retain and advance the pharmacy technician workforce. The program aligns with the didactic learning requirements of the ASHP/Accreditation Council for Pharmacy Education Model Curriculum. Users can adapt the training program to a variety of settings and methods of delivery for technician training programs. The program features over 160 hours of entry- and advanced-level content on more than 70 topics and includes supplemental materials that will allow healthcare organizations to leverage their sites for experiential training.

“The growing shortage of pharmacy technicians poses a significant challenge to achieving optimal medication outcomes and protecting patient safety,” said ASHP CEO Paul Abramowitz.  “PharmTech Ready draws on ASHP’s extensive experience in developing education and practice resources for the pharmacy workforce and will help technicians build the skills needed to fulfill their essential role on the healthcare team.”

PharmTech Ready includes access to a range of exclusive ASHP continuing education, tools and other resources to bolster pharmacy technicians’ professional development and support their career advancement as critical members of the healthcare team.

Aspirin, ibuprofen and other pain-relieving drugs may actually make agony WORSE, study warns

Aspirin, ibuprofen and other pain-relieving drugs may actually make agony WORSE, study warns

https://www.newsbreak.com/news/2599808451704/aspirin-ibuprofen-and-other-pain-relieving-drugs-may-actually-make-agony-worse-study-warns

Taking aspirin and ibuprofen as painkillers could be completely pointless, a study suggests.

Experts have now warned the cheap drugs may actually leave patients in agony for longer.

The findings call into question the conventional practice of treating pain with anti-inflammatory drugs, taken by millions around the world.

Researchers today praised the ‘excellent’ study, which was based tests in the lab on human cells and mice.

However, they have urged people not give up their painkillers overnight because the drugs are proven to be effective in the short-term.

https://img.particlenews.com/image.php?url=45vvI2_0fadB7Si00
Taking aspirin and ibuprofen as painkillers could be completely pointless, a study suggests. Experts have now warned the cheap drugs may actually leave patients in agony for longer

The study by researchers in Canada and Italy suggests inflammation may not be the nemesis after all.

Instead, it could be protective in the long-term. One researcher said that it ‘may be dangerous to interfere with it’.

Popular anti-inflammatories include diclofenac, naproxen, and piroxicam.

The research, in the Science Translational Medicine journal, also looked at steroids like dexamethasone, which works in a similar fashion.

Anti-inflammatory drugs work by blocking neutrophils, white blood cells which help the body begin the healing process.

Experts analysed blood samples, taken on three occasions, from 98 people battling lower back pain.

Patients whose pain eventually went away had significantly more neutrophils in their blood, compared to those still struck down.

This inspired the researchers to test blocking neutrophils in injured mice with anti-inflammatory drugs dexamethasone and diclofenac.

https://img.particlenews.com/image.php?url=24Psgv_0fadB7Si00
Scientists have found blocking neutrophils, a type of white blood cell which causes inflammation as part of healing tissues, actually prolonged the duration of pain in studies  on mice. The experts were inspired to run the experiment after finding differences in genetic samples taken from people who suffered from ongoing lower back pain

HOW AMERICA GOT HOOKED ON OPIOIDS AND IS THE SAME HAPPENING HERE?

Research has shown hospital admissions for opioids has soared 50 per cent in the last decade in England adding to fears the UK could be facing a similar opioid crisis to the one in the US which has devastated thousands of families.

In the early 2000s, the FDA and CDC started to notice a steady increase in cases of opioid addiction and overdose. In 2013, they issued guidelines to curb addiction.

However, that same year – now regarded as the year the painkiller epidemic took hold – a CDC report revealed an unprecedented surge in rates of opioid addiction.

Overdose deaths are now the leading cause of death among young Americans – killing more in a year than were ever killed annually by HIV, gun violence or car crashes.

In 2019, the CDC revealed that nearly 71,000 Americans died from drug overdoses.

This is up from about 59,000 just three years prior, in 2016, and more than double the death rate from a decade ago.

It means that drug overdoses are currently the leading cause of death for Americans under 50 years old.

The data lays bare the bleak state of America’s opioid addiction crisis fueled by deadly manufactured drugs like fentanyl.

Most control mice stopped feeling pain within two months.

But rodents on the anti-inflammatory drugs experienced for pain for twice as long on average, with some in pain for 10 times longer than the control group.

Replicating the experiment with painkillers that don’t target inflammation, such as paracetamol (acetaminophen), did not produce the same extended pain response.

This suggested inflammation played a role in healing injuries and resolving pain, the authors said.

The findings were supported by a separate analysis of 500,000 people that showed that those taking anti-inflammatory drugs to treat their pain were more likely to have pain two to 10 years later.

Professor Jeffrey Mogil, author of the study from McGill University in Canada, said by interfering with this initial painful period medics could be doing more harm than good.

‘Neutrophils dominate the early stages of inflammation and set the stage for repair of tissue damage,’ he said.

‘Inflammation occurs for a reason, and it looks like it’s dangerous to interfere with it.

‘For many decades it’s been standard medical practice to treat pain with anti-inflammatory drugs.

‘But we found that this short-term fix could lead to longer-term problems.’

He added that while ibuprofen was not studied explicitly in the experiments, it would have been reflected in analysis of 500,000 Britons.

‘It is highly likely that a large percentage of those in the UK Biobank who reported taking non-steroidal anti-inflammatory drugs were in fact taking ibuprofen,’ he said.

Fellow author, Dr Massimo Allegri, from Monza Hospital in Italy, argued the findings could mean medics need to treat painful injuries differently.

‘Our findings suggest it may be time to reconsider the way we treat acute pain,’ he said.

‘Luckily pain can be killed in other ways that don’t involve interfering with inflammation.’

Experts called for further trails comparing anti-inflammatory drugs to other painkillers that don’t disrupt inflammation.

Chronic pain, and the medications prescribed to counter it, are one of the drivers of the prescription painkiller addiction crisis in both the US and Britain.

Dr Franziska Denk, an expert in chronic pain from King’s College London, said the study was a ‘wonderful start’.

But she claimed further research needed to be done before changing how medics treated patients.

‘It would most definitely be premature to make any recommendations regarding people’s medication until we have results of a prospectively designed clinical trial,’ she said.

‘In my opinion, this study should not generate a debate around the use of NSAIDs in low back pain – much more research is needed to confirm these findings first.’

Professor Blair Smith, an expert on pain from the University of Dundee, said the latest study was an ‘excellent’ piece of research but people should continue to take their medications as advised until further scientific work is completed.

‘It is also important to note that anti-inflammatory drugs are effective in short-term pain management,’ he said.

‘There is good quality evidence to back this up and they should not be withheld unnecessarily.’

Ongoing chronic pain has been blamed for fuelling a painkiller addiction crisis in both the UK and the US which has blighted thousands of lives.

A London School of Economics study published in February found hospitalisations for opioid overdoses in England have soared by 50 percent in a decade.

Experts have also warned prescription painkiller use is likely on the rise as millions of patients suffer in agony while trapped on record-high waiting lists for surgeries like hip replacements on the NHS.

In the US the opioid addiction crisis has resulted in 600,000 deaths from overdoses since 1999.

Around 5million people a year in England are given prescription opioids, and more than half-a-million taken them for at least three years, according to a 2019 Government report.

OK BOP showing concern about the temp meds exposed to being shipped by MAIL ORDER PHARMACIES

Oklahoma Board of Pharmacy Needs Volunteers

Posted: 09 May 2022 02:53 PM PDT

 Task Force/Committee Volunteers Needed 

The Board of Pharmacy is needing volunteers to create a Task Force/Committee for evaluating temperature excursions and the shipping of prescriptions by pharmacies to patients who are located in state and out of state.

This Task Force/Committee will more than likely need to evaluate the potential of creating rule changes to the existing rules.

All interested parties will need to submit the below items to Marty Hendrick via email at Mhendrick@pharmacy.ok.gov to be considered for this task force. 

 

  • Letter of interest on serving on the Task Force/Committee.
  • Resume of pharmacy work experience.
  • Past experience in a pharmacy practice that involves shipping prescriptions to patients.

 

535:15-3-11. Prescription drugs 

(f) Prescription shipping. The pharmacy shall maintain and use adequate storage or Cargo transportation services and use shipping processes to ensure drug stability and potency. Such shipping processes shall include the use of appropriate packaging material and/or devices to ensure that the drug is maintained at an appropriate temperature range to maintain the integrity of the medication throughout the delivery process. Visit this company for those looking for pallet suppliers in California.

 

(1) No prescription shipped to a citizen of Oklahoma should have a temperature excursion that exceeds the temperature storage conditions outlined within the package insert or by the manufacturer of the drug product. 

 

(2) A pharmacy or pharmacist shall refuse to deliver by mail or common carrier a prescription drug which, in the professional opinion of the pharmacy or pharmacist may be therapeutically compromised by delivery by mail or common carrier. 

 

(3) A mail order or non-resident pharmacy shall make available to the patient or patient’s caregiver the contact information for the Oklahoma State Board of Pharmacy.

#StopTheWHO: How You Can Take a Stand Against International Health Regulation Amendments

#StopTheWHO: How You Can Take a Stand Against International Health Regulation Amendments

https://worldcouncilforhealth.org/campaigns/stop-the-who/2022/05/stopthewho-oppose-international-health-regulation-amendments/73799/

#StopTheWHO

The WHO is making a power grab over our health sovereignty by changing the International Health Regulations

In May 2022, World Health Organization (WHO) intends to amend the International Health Regulations to give greater control to itself and Tedros Ghebreyesus, Director-General of WHO. This pushes our world towards a centralized governance model of worldwide health surveillance, reporting, and management, where the people have no say.

Background

The International Health Regulations (IHR) was adopted by 194 member states of the World Health Organization (WHO) in 2005. They enable the WHO to declare a Public Health Emergency of International Concern (PHEIC) if it decides that an infectious disease outbreak has occurred in a member state, but with the consent of the member state. The World Council for Health (WCH) acknowledges this aspect of the current regulations because it recognizes the sovereignty of nations that adopted the IHR. But that is about to change.

Key Issues to Understand

On January 18th 2022, the United States Department of Health and Human Services proposed amendments to the IHR. These amendments give control over the declaration of a public health emergency in any member state to the WHO Director-General – even over the objection of the member state. The Director-General communicated the text of the proposed amendments on 20 January 2022, via a circular letter to State Parties. 

The proposed IHR amendments also cede control to WHO “regional directors,” who are given the authority to declare a Public Health Emergency of Regional Concern (PHERC). Moreover, the proposed amendments allow the Director-General to ring an international alarm bell, by unilaterally issuing an “Intermediate Public Health Alert (IPHA).”

Properly understood, the proposed IHR amendments are directed towards establishing a globalist architecture of worldwide health surveillance, reporting, and management. Consistent with a top-down view of governance, the public will not have opportunities to provide input or criticism concerning the amendments. This, of course, is a direct violation of the basic tenets of democracy and can be compared to the separate new pandemic treaty.

Summary of Selected Proposed Amendments to the IHR

The WHO intends to amend 13 IHR articles: 5, 6, 9, 10, 11, 12, 13, 15, 18, 48, 49, 53, 59

  1. Increased surveillance: Under Article 5, the WHO will develop early warning criteria that will allow it to establish a risk assessment for a member state, which means that it can use the type of modeling, simulation, and predictions that exaggerated the risk from Covid-19 over two years ago. Once the WHO creates its assessment, it will communicate it to inter-governmental organizations and other member states.
  2. 48-hour deadline: Under Articles 6, 10, 11, and 13, a member state is given 48 hours to respond to a WHO risk assessment and accept or reject on-site assistance. However, in practice, this timeline can be reduced to hours, forcing it to comply or face international disapproval lead by the WHO and potentially unfriendly member states. 
  3. Secret sources: Under Article 9, the WHO can rely on undisclosed sources for information leading it to declare a public health emergency. Those sources could include Big Pharma, WHO funders such as the Gates Foundation and the Gates-founded-and-funded GAVI Alliance, as well as others seeking to monopolize power.
  4. Weakened Sovereignty: Under Article 12, when the WHO receives undisclosed information concerning a purported public health threat in a member state,  the Director-General may (not must) consult with the  WHO Emergency Committee and the member state. However, s/he can unilaterally declare a potential or actual public health emergency of international concern. The Director General’s authority replaces national sovereign authority. This can later be used to enforce sanctions on nations.
  5. Rejecting the amendments: Under Article 59, after the amendments are adopted by the World Health Assembly, a member state has six months to reject them. This means November, this year. If the member state fails to act, it will be deemed to have accepted the amendments in full.  Any rejection or reservation received by the Director-General after the expiry of that period shall have no force and effect.

The World Council for Health’s Position On Proposed IHR Amendments

The WCH opposes the unnecessary and dystopian move toward centralized control of public health. This proven harmful model assumes that only one entity, WHO, understands how to manage the health policy of every state – and by implication, the health of each and every individual. It also assumes, incorrectly, that Big Pharma’s controversial model of medicine which is the WHO’s preferred model – is the expert guide to better health and wellness. 

These proposed IHR amendments will be voted upon at the next World Health Assembly, which will take place in Geneva, May 22 to 28, 2022. The official agenda item is 16.2. It is not clear if the event will be broadcast for transparency. Thus, the WCH believes that it is essential to campaign against the proposed amendments and to build alternative pathways.

Why People Must Take Action Together

Due to the influence of private money at the WHO, a review in the Journal of Integrative Medicine & Therapy stated that the corruption of the WHO is the “biggest threat to the world’s public health of our time.” This is particularly true in relation to WHO drug recommendations, including its “list of essential medicines,” which a growing number of people believe is biased and unreliable. 

Moreover, even though WHO’s documents highlight voice, agency, and social participation as drivers of equity and democracy, it is unknown World Health Assembly delegates who get to make decisions for us. To date, 13 days away from the World Health Assembly 75, the secretive list of each country’s delegates has been not been published. This is censorship.

Given consistent evidence that WHO is heavily conflicted and controlled by various industries, its usefulness as a guide to public health must be critically re-evaluated, while alternative paradigms and models for ethical health guidance and human rights are built.

Global #StopTheWho Campaign Activated

It is going to take each and all of us to campaign against the power grab through the IHR Amendments, this May, and onwards to November – just six months away. In the best campaigns for human rights, multi-pronged strategies are effective. Here are some ideas:

  1. Speak: Raise awareness on the ground and online. Use articles, posters, videos 
  2. Act: Campaign through rallies, political mobilization, legal notices, and cases, etc.
  3. Collaborate with health freedom coalitions such as the World Council for Health
  4. Explore activist toolboxes such as: www.dontyoudare.info and stopthewho.com
  5. Engage global indigenous leadership to take a united stand against the WHO’s IHR
  6. Notify World Health Assembly country delegates to oppose the IHR amendments
  7. Activate people’s parliaments, legislatures or referendums to oppose power grabs

You will also find #StopTheWho campaign resources uploaded to the World Council for Health website in the next few days.

Collectively, we are in the greatest awakening in history. Given our experiences the last 2 years, we know that we are the ones we have been waiting for. If not us, then who? If not now, then when? Let us join hands in taking back our health, our freedom, and our power.

In Unity for Health, Freedom, and Sovereignty,

World Council for Health (www.worldcouncilforhealth.org)

Who said that the 50 MME’s in the proposed 2022 CDC guidelines wouldn’t replace the 90 MME/day limit ?


I’m not sure if you already know, but the State of Minnesota has been openly discriminating against chronic pain patients enrolled in Minnesota healthcare programs. Here in MN, people with lower incomes who are enrolled in programs like Medicaid and Minnesotacare (these are a population mostly comprised of low income, disabled and minority enrollees) has been limited SEPARATELY in opioid prescribing. State officials have admitted pressuring Medicaid/MnCare providers not to prescribe specifically to low income enrollees and they are doing so under threat of physician disenrollment from treating individuals in state programs. For many doctors and prescribers, this is the threat of financial ruin in return for their compassion.
Unfortunately, after almost 13 years of chronic pain, I have found myself enrolled one of these programs and experienced this discrimination personally. Recently, my diagnosis has worsened far beyond the herniated lower back that started my journey, and now I have fibro (possibly with fibro neuropathy in my feet, and they can’t seem to find the diagnosis for it). Very recently, after a fall, they discovered that my lower neck now has compressed discs and I have bone spurs and disc degeneration in my neck too. It burns so badly at night that it wakes me up and I can’t get back to sleep no matter what. Due to this new diagnosis, and also what I think have been really noticeable changes in medication potency of the hydro brand I’ve been taking for a long time (mallinckrodt hydrocodone 10/325), I respectfully requested a small increase in my pain medication to 70 mme (I’m currently at 65. I am a legacy patient with a very good record).

I was refused the small increase and told that I was at the “upper limit for my insurance”… I asked my provider with that meant and she said that under the kind of insurance I have (Minnesota Healthcare programs), I cannot be increased at all. I was also told that I can only be prescribed two kinds of medication…hydrocodone, and as she recently suggested Suboxone (I told her there was no way I would ever take Suboxone because I want to keep my teeth and I don’t want to be blackballed for the rest of my life). Schedule prescribe those two medications to me or nothing at all. Those are my options. Also, I found it frightening and insulting that she tried to throw me into Suboxone. After a short discussion I found she didn’t know anything about Suboxone AT ALL and that she was only considering prescribing that from a hyped up discussion she had with another PA practitioner. It was really kind of shocking that she would want me to take something that she didn’t know a thing about!

I did some research on her claims and I found that, yes…Minnesota Health Care programs are pushing doctors not to prescribe anyone beyond 50 MME of anything but Suboxone, and this was clearly designed to severely limit people like me who found themselves included with people from specific groups that the state decided were high risk. It was hard to accept that Minnesota, which likes to promote racial equity, was pigeonholing all of us together and discriminating against us all based on racial and income stereotypes. However I was not able to find where I was limited to only two different kinds of opioids, however, so that might also have been my provider fibbing, I’m not sure. Perhaps they were allowed to prescribe more hydrocodone? I don’t know.

But at any rate there are two articles that were published in the Minneapolis Star News Tribune that directly explains how the state is targeting people on Medicaid/Minnesotacare in Minnesota to be treated differently than people with private insurance. The people who initiated this were actually proud of blackmailing doctors to abuse low income people.

So this is where it’s at now. I’m not sure what I should do with this now, but I wrote a complaint of discrimination toward Minnesota Health Care programs. That was about a month ago now and I still have not received any reply.

Anyway, I was wondering if you knew anything about this and if you had any ideas to leverage this further for the cause. I do know that Kolodny has put up a remote office in Minnesota for PROP and we’re also dealing with the Steve Rummler Hope organization here too. I don’t have any other chronic pain allies in the state, unfortunately, which would be really helpful, but at this point I’ll take any help anyone can give me to move forward with this.