APDF: advocating for 9 y/o cancer pt – Intractable chronic pain pt – another SOLID HIT for APDF advocate Bob Sheerin

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Today we advocated for a 9 year old boy named Tony. Tony suffers from BLS ,chronic pancreatitis, and severe low back pain from cancer related problems. “Today was a win for American Pain and Disability Foundation’s team as they pulled together to advocate for kids who suffer in chronic intractable pain,” said Bob Sheerin.
Bob Sheerin, APDF’s VPO stated that “Today I learned a valuable lesson, this lesson came to me in 3 different parts. One, doctors are obviously under contract with certain types of owners and insurance companies who breed policies. Two, by the end of this advocating session it came to my attention that it almost always takes an entity like APDF to allow these doctors to go to their administration in order to not get a bad name for themselves or their practices. Lastly, this doctor was more than willing to work with us to get this child the medicine he needs to manage the great pain he was in!”
The doctor from Methodist Hospital referred him to Vanderbilt to ask if their policies are going to change soon. It felt like he was hopeful they would. The doctor wrote the child’s prescription and asked me out to lunch where we discussed many issues like pain care in America. “I have 3 more children to see this doctor over the next 3 weeks. After today when we are through with Methodist we will move onward and upward with the children’s program and continue to take action like this wherever and wherever action is needed.”
Bob Sheerin and the APDF team!

Next Tuesday, the Colorado Pharmacists Society is holding a board meeting

Next Tuesday, the Colorado Pharmacists Society is holding a board meeting and will be discussing burnout and workplace issues! They are inviting pharmacists to attend and to share our perspectives.

I’m thinking we have their support

Chapman Law Group Wins for Doctors & Patients

Chapman Law Group Wins for Doctors & Patients

https://www.chapmanlawgroup.com/

https://doctorsofcourage.org/chapman-law-group-wins-for-doctors/

Kendall Hansen, MD, 66 y/o pain management specialist in Crestview Hills, KY, was indicted Nov 18, 2021.   But in the course of time since the raid on his office Feb 9, 2019, he was smart. He hired Chapman Law Group.This is something all medical professionals need to understand. Don’t waste your money with standard white collar lawyers in your area.  Reach out to Ron Chapman, II from the word go. This is a case to show you why.  In general, doctors who have been attacked visit Doctorsofcourage.org, but do not consult us. So they get snookered into hiring a standard white collar lawyer who has no idea how to approach the federal attack for prescribing opioids.  They pay a lot of money to these lawyers who do nothing to prepare the case, and then pressure the professional to take a plea. What we see is that, after losing all their money to these worthless lawyers, they then come to us asking for help. But by then it is too late. If they went straight to the Chapman Law Group, like Dr. Hansen did, then the work is done in preparation, and they are ready to fight whenever the government decides to proceed.

Check it out

When Dr. Hansen’s office was raided Feb 6, 2019, He was reported to say

“We welcome the scrutiny, we do a good job.”

As most practicing physicians do, he believed that once investigators got a look at his records, they’d realize he hadn’t done anything wrong. But he was smart enough to get a lawyer so that when the government struck, he was ready. It generally takes 2-3 years from the raid to the indictment, as in this case. Most doctors think, if the indictment doesn’t happen right away, that they are safe.  But that is not the case.

As part of the DOJ investigation of doctors, you are probably aware of the Narx score algorithm used against doctors and patients. Dr. Hansen was identified through the PDMP as a high prescriber of controlled substances. Obviously—he’s a pain management doctor. When the DOJ approached local pharmacies in their investigation, CVS decided to not fill any of Dr. Hansen’s prescriptions. Ron Chapman immediately took CVS to trial and won.

Then on November 18, 2021, indictments were filed against Kendall Hansen, MD and his associate, Michael Fletcher, MD in two separate cases. The indictment charges Dr. Hansen with one count of conspiracy to distribute controlled substance and two counts of distribution of a controlled substance. He is accused of getting other doctors to prescribe him controlled substances. They also accuse him of writing a prescription to his employees and instructing them to bring the pills back to him. The prescriptions were for 480 doses of tramadol in 2016 and 30 doses of phentermine in 2018.  Both tramadol and phentermine are schedule IV drugs which are defined as drugs with a low potential for abuse and low risk of dependence.

Five days later on Nov 23, the Kentucky Board of Medical Licensure (KBML) restricted his license, prohibiting both doctors in the practice from prescribing controlled substances. Because they were already informed on the case, Chapman Law Group asked the KBML for a hearing to explain the number of patients relying on Dr. Hansen, but the board denied it, based on their rule that indictment meant automatic license withdrawal.

So Ron Chapman immediately took action by filing an appeal. On January 4, 2022, The Hon Audra Eckerle of the Jefferson Circuit Court, Div 7 ordered a temporary injunction against the Kentucky Board of Medical Licensure, telling the board it is time to change their restriction policy in these types of cases. She basically stated that the KBML applied an incorrect rule of law. That rule of law was that Dr. Hansen’s license could be suspended simply based on an indictment. Instead, the court states that the KBML must carry out its burden to establish that Dr. Hansen’s practice constitutes a danger to the health, welfare, and safety of his patients or the general public. So Dr. Hansen, due to the work of the Chapman Law Group, was again permitted to begin prescribing controlled substances at his Crestview Hills clinic, and that ruling should now apply to all cases that go before the Kentucky Board of Medical Licensure. Following that decision, the medical board should set a date for a hearing to determine if Hansen can continue prescribing while his case is pending. The injunction by the judge allows him to prescribe until that hearing is over.

The Rest of the Story

The battle isn’t over.  While the KMBL matter was playing out, prosecutors attempted to utilize bond conditions to prevent Dr. Hansen from prescribing. At arraignment, Ron was successfully able to convince the judge that such a restriction should not be put in place because it would endanger the community and leave patients untreated. The judge agreed, refusing to advance the Government’s proposed restriction. So, the Government issued a superseding indictment with stale allegations and tried again. A hearing was recently held at which the judge took the matter under advisement but still has not restricted Dr. Hansen’s prescribing. 3000 patients in that clinic would be affected by any prescription restrictions and could go through withdrawal and end up seeking street drugs. It’s an interesting fact that the Cincinnati area, where Crestview Hills is located, is the nation’s No. 1 opioid overdose hot spot as of May, 2021 study by the University of Cincinnati.

Top 25 regions for opioid overdose

So Dr. Kendall has the best lawyer for the job. We will keep informed on the status of this case

 

Imagine this: Federal Decade of pain law … could have contributed to our perceived “opiate crisis”

Here is a conclusion of this study on opiate OD’s

The study also found a correlation between fatal overdoses and mental and physical distress using surveys of physically and mentally unhealthy days. Mental distress increases the relative risk of dying from a drug overdose by as much as 39%.

Here is a chart on all the comorbidity issues aggravated or caused by under/untreated pain.  Pay particular attention to line THREE CARDIOVASCULAR and the LAST LINE – QOL could under/untreated pain be a underlying issues of ODing?

Here is another poignant fact… At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.”

Does anyone remember what changed in 2010 ?  the Decade of Pain Law expired and was not renewed.  So after 10 yrs of pain being referred to as the 5th VITAL SIGN and practitioners being encouraged to treat pain and the Joint Commission making it a MAJOR STANDARD for hospitals to get credentialed.. each pt when discharged was asked on a survey “how was your pain treated” ?

The Joint Commission quickly disclaimed any ownership of THE FIFTH VITAL SIGN and was no longer a major standard for hospitals to meet.

In Jan 2009, we had two new attorneys in the White House and a new Governor & AG in Florida. All seemed to have an intent to tackle the “opiate epidemic ”  Florida was well known as having – it is claimed – a couple of hundred “Oxy docs”.

At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.” The ” pharma opiate epidemic ” had a 10 yr run up.  Over the next 5 yrs we had bureaucrats trying to – at least – slow down the prescribing of opiates and Rx opiates peaked in 2011-2012…  The DEA started reducing the pharma opiate production quota.. eventually reducing the opiate production quotas by 50%+.  Then in 2016, the CDC published their opiate dosing guidelines and the DEA and Veterans Hospitals jumped on those GUIDELINES with BOTH FEET and making statements that the GUIDELINES were ACTUALLY LAWS… and that 90 MME/day was the LIMIT FOR EVERYONE… even though there was provisions in the guidelines that exempt many chronic health issues from those daily limits.

UC opioid study identifies at-risk populations in America

Fatal overdoses are linked to high rates of mental distress

https://www.uc.edu/news/articles/2021/05/uc-opioid-study-identifies-at-risk-populations-in-america.html

The opioid epidemic is taking a deadly toll on people in disproportionate clusters, according to a new national study by the University of Cincinnati.

Fatal opiate overdoses are most prevalent among six states: Ohio, Pennsylvania, Kentucky, West Virginia, Indiana and Tennessee. But researchers identified 25 hot spots of fatal opioid overdoses nationwide using data from the Centers for Disease Control and Prevention.

Published today in the journal PLOS One, the study demonstrates how both widespread and localized the problem of substance use disorders can be, UC assistant professor and co-author Diego Cuadros said.

Diego Cuadros stands in front of a colorful projected map of America.

Epidemiologist Diego Cuadros is director of UC’s Health Geography and Disease Modeling Lab where he has studied HIV, malaria and COVID-19. Photo/Andrew Higley/UC Creative + Brand

Cuadros is director of UC’s Health Geography and Disease Modeling Laboratory, which applies geographical information, perspectives and methods to the study of health, disease and health care. As an epidemiologist, he studies the impacts of diseases such as malaria, HIV and COVID-19.

“Not everyone is similarly at risk,” Cuadros said. “We wanted to identify characteristics that put people at higher risk of a fatal overdose.”

Health interventions for opiates have focused largely on treatments such as the distribution of naloxone and other lifesaving remedies. But Cuadros said prevention could be effective if vulnerable populations can be identified. To that end, researchers found that white males ages 25 to 29 were most at risk of fatal opioid overdose followed by white males ages 30 to 34. The study also identified an increasing risk to black males ages 30 to 34.

What’s happening now is we’re more than a year into a pandemic. Mental health has deteriorated for the entire population, which means we’ll see a surge in opiate overdoses.

Diego Cuadros,UC’s Health Geography and Disease Modeling Lab

The study also found a correlation between fatal overdoses and mental and physical distress using surveys of physically and mentally unhealthy days. Mental distress increases the relative risk of dying from a drug overdose by as much as 39%.

“We saw a strong association with mental health and substance abuse disorders, particularly opiates,” Cuadros said. “What’s happening now is we’re more than a year into a pandemic. Mental health has deteriorated for the entire population, which means we’ll see a surge in opiate overdoses.”

Researchers are trying to understand why men are more likely than women to suffer a fatal overdose and what it is about the period of life between age 30 and 45 that makes people more susceptible to the epidemic.

“Maybe you have more responsibilities, financial responsibilities or stress at that time. Maybe there are physiological changes or changes in our brain that we don’t know yet,” Cuadros said. 

A map of the lower 48 states shows the spatial distribution of relative risk for death from substance use disorder in 25 clusters researchers identified.

A map of the contiguous United States shows the spatial distribution of relative risk for fatal overdoses from substance use disorder in 25 identified clusters. Graphic/UC

“This is a complex epidemic. For HIV we have one virus or agent. Same with malaria. Same with COVID-19. It’s a virus,” Cuadros said. “But with opioids, we have several agents. At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.”

Now states are seeing more overdoses from synthetic opioids such as fentanyl.

The study also tracked the migration of overdoses between 2005 and 2017 from Southwest states to the Northeast. Many of the clusters UC identified in the Southwest and Northeast had comparatively higher levels of physical and mental distress.

Andres Hernandez sits at a computer with a map of Ohio on the screen.

UC College of Arts and Sciences graduate Andres Hernandez identified national clusters where the opiate epidemic has had a disproportionate impact. Photo/Jay Yocis/UC Creative + Brand

Co-author Neil MacKinnon, former dean of UC’s James L. Winkle College of Pharmacy, said the analysis could help health policymakers and clinicians by identifying individual and community-level factors associated with an increased risk of death due to substance use disorder. He is provost now at Augusta University, Georgia.

“We hope the risk factors we identified in this analysis will be used by agencies like RecoveryOhio to plan proactive strategies and allocate resources to address this epidemic,” MacKinnon said.

Previously, UC researchers identified 12 regions in Ohio that had disproportionately high rates of fatal overdoses from opioids.

“We started in Ohio. We know that in this state we’re suffering one of the highest burdens of the problem,” Cuadros said.

Likewise, he said it would be worthwhile to study populations in the United States where opioids are not exacting a horrible toll on families to understand the problem.

“Sometimes we focus too much on where the problem is focused. It’s useful to look at the areas where the problem is not as pressing,” Cuadros said.

Rx dept staffing hours — are being cut – coming to a chain store near you

RA (Rite Aid) just announced they are cutting tech hours by about half!!! Every other industry is begging for help and pharmacies are just pissing it away!

Reason? Yes, it’s about 4 weeks out till end of fiscal year so big shots want to make their bonuses as high as they can get while the people making them their money get to work harder and NO BONUS!


Our 3 letter (CVS) hours are being basically cut in half over the next few weeks


we just lost half of our tech hours at 3 letter (CVS) bc of they are ‘forecasting a decrease in covid shots’…but still doing the same amount of work otherwise (even tho that doesn’t matter) like more scripts than last year but less hrs at this time vs last yr. It’s mind blowing


If those of you who are patronizing major chain pharmacies and service has not been good… looks like it possibly GET WORSE… these quotes are from Pharmacists/techs that work at these chains.
Anyone who wishes to find a independent pharmacy where you will most likely be dealing with the Pharmacist/Owner and staff turnover of staff is almost NOTHING. Where you know the staff and they know you … here is a link to be able to find one – or more – independent pharmacies by zip code.

 

PBS showing up for us now!!! Please fill out and share, fellow Pharmers!

PBS showing up for us now!!! Please fill out and share, fellow Pharmers! ❤️

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Are you a pharmacist or pharmacy technician? How has your work been affected by the pandemic?
We want to hear from you as part of our reporting: https://forms.gle/s1q3E5kvqf2kUpNm7

Let’s the LAW: PBM – can’t steer pts to their own mail order firm

Attention La State Group members: On

January 1 the PBM for your plan changed from Medimpact to Express Scripts. It has come to our attention that they have been contacting our patients and trying to persuade you to leave your home town pharmacies to use mail order. This is not legal. It’s called patient steering. You have the right to use the pharmacy of your choice. If you are an OGB member and have been contacted either by mail, phone, or email by someone who has implied or suggested that you should or need to change your pharmacy, please report it to the number listed below. Companies that are awarded state contracts must be held accountable for following the laws in the states that win the bids in.

Once they get their “claws” into you… nearly impossible to get away

When your insurance company insists or mandates that you must you a particular provider for some service/test/procedure that they are going to pay for… maybe you should check on who owns the company/provider that you are being mandated to use… Are you being referred to that particular provider because they are the best provider in the area or because their is a financial incentive to who is referring you ?  Like they own the provider ?

 

 

Neither the Constitution, 4 amendment nor HIPAA rules will interfere with the DEA getting your private health information

Neither the Constitution, 4 amendment nor HIPAA rules will interfere with the DEA getting your private health information.

 

US Appeals Court Rules: DEA Allowed Access to NH Opioid Database Without a Warrant

https://freekeene.com/2022/01/29/us-appeals-court-rules-dea-allowed-access-to-nh-opioid-database-without-a-warrant/

On January 27, 2022, the US Court of Appeals for the 1st Circuit, Chief Judge Jeffrey Howard, ruled in “US Dep’t of Justice v. Jonas, No. 19-1243,” that the DEA (Drug Enforcement Administration) can “legally” access New Hampshire’s prescription drug database via an administrative subpoena, not a warrant. This is despite New Hampshire and United States laws to the contrary.

While 48 states have submitted to maintaining a networked prescription database (Prescription Drug Monitoring Program / PDMP), most people would argue that their personal medical and prescription records are protected by the 4th amendment (“no warrants shall issue, but upon probable cause.”) Personal healthcare and medical information is generally protected under doctor-patient confidentiality laws and is regarded as almost sacrosanct in the healthcare world (think HIPAA.) In this case, confidentiality was further supported by the 4th amendment to the US Constitution.

Overwhelming Support From the Liberty Community

Michelle Ricco Jonas, manager of the New Hampshire PDMP in 2018, refused the DEA’s request to fork over 2.5 years’ worth of prescription data of a “person of interest.” After being subpoenaed she argued that the records belong to the state, not an individual person. Since March 12, 2019, when the notice of appeal was docketed, Michelle Jonas and New Hampshire state received an outpouring of support from the ACLU of California, Maine, Massachusetts, New Hampshire, New York, Puerto Rico, and Rhode Island – in other words, all the districts represented by the 1st Circuit Court.

Over the past two grueling years of appeal, the ACLU supported Jonas, and questioned whether issuing a subpoena to a state employee is within the bounds of the district court. They argued that medical records, for all intents and purposes, are considered private information. While the DEA has the ability to subpoena an individual, the ACLU asked if that gave them the right to subpoena a representative, or employee, of the state. They also argued that the 4th Amendment requires law enforcement “to obtain a warrant based on probable cause only to secure records over which there is a reasonable expectation of privacy.” The ACLU argued that medical records warrant an expectation of privacy.

The prescription records at issue in this case reveal intimate, private, and potentially stigmatizing details about patients’ health, including details of those patients’ underlying medical conditions. For that reason, as with other medical records, people have a reasonable expectation of privacy in them.” – Summary of Argument, US Dep’t of Justice v. Jonas, No. 19-1243

 

So What Was the Loophole?

In a nutshell, the “third-party doctrine” was the loophole the DEA used to secure a “victory” in this appeal. Basically, if you voluntarily share information with a third party (say a pharmacist at CVS who fills your prescription), you magically lose your right to the 4th amendment because you voluntarily shared your private information.

Now, I know what you’re thinking. You have to share that private information in order to receive your prescription medications through lawful means. If you wanna live, if you wanna beat that disease, you have to give your name, address, phone number, and all the information they need so you can just get your pills. Right? So what exactly is the alternative? The grey market? Street drugs? A life of crime?

The Feds Will Stop at Nothing to Support the Prison-Industrial Complex

It seems obvious that personal medical information is personal. We share that information with medical professionals with the expectation that their oaths of ethics and doctor-patient confidentiality will keep it that way. Everywhere we go we see “HIPAA” emblazoned there, telling us how seriously our personal medical information is treated, at the risk of sanctions, medical license removal, and prison time. Medical professionals have an entire course in this topic, and it’s included in their jurisprudence board exams.

There’s really no way to “logic” around this ruling; it’s pretty cut and dried. The DEA will stop at nothing to reach their quotas, to perpetuate the prison-industrial complex, and to erode our Constitutional rights. Unfortunately this is one of many similar rulings in the United States.

It’s up to us to continue fighting for freedom, liberty, and our Constitutional rights. It’s up to us to determine if this is acceptable or whether it’s about time we stand up against this onslaught and say, “I’m not gonna take this anymore!”

I want you to get up right now. Sit up. Go to your windows. Open them and stick your head out and yell – ‘I’m as mad as hell and I’m not gonna take this anymore!’ Things have got to change. But first, you’ve gotta get mad! You’ve got to say, I’M AS MAD AS HELL, AND I’M NOT GOING TO TAKE THIS ANYMORE! Then we’ll figure out what to do about the depression and the inflation and the oil crisis. But first, get up out of your chairs, open the window, stick your head out, and yell, and say it: I’M AS MAD AS HELL, AND I’M NOT GOING TO TAKE THIS ANYMORE!” – “Network” movie, 1976

 

Side Note

As of January 27, 2022, the exact date upon which this appeal was concluded, the presiding 1st Circuit Judge Jeffrey Howard announced his early retirement at the age of 66. This was the last case he will hear, and thankfully, the last case he will rule on.

In case people are missing my posts on FAKE BOOK

Some people have noticed that post from my blog… has not been showing up on FAKE BOOK and/or some have tried to share my posts on FAKE BOOK…  are getting a notice that their post share is against their community standards.  It would seems that a person who claims to be a chronic painer… got pissed at me… because I called him out back in Jan 2020 as a “virtual panhandler”, con artist, scammer…

In Oct of 2021, he demanded that I take down a post on my blog from Jan, 2019… that he believe was about him – while no names were mentioned in the blog post..

I was not sure what he was up to, so I turned the post from “public” to “private” and put a password on it… apparently not “destroying” the post… must have really pissed him off…  Either that, or I have been told that he went to some “legal aid group” – I guess because he is on Medicaid and food stamps – and wanted to sue me… and apparently he was told that “he had NOTHING !”

What I have been told, this “gentleman”  RICHARD MARK – stirred up his harem/tribe of minions to file untold number of complaints with FB that my blog was a SPAMMER…  Here is a link that claims that FAKE BOOK had to admit – while under oath in court – that their FACT CHECKERS is mostly THEIR OPINIONS https://www.facebook.com/pharmaciststeve/posts/10226586244631590

So apparently FAKE BOOK just took all those complaints that have no basis in fact, but apparently FACTS don’t really mean anything to FAKE BOOK. ONLY THE PERSONAL OPINIONS OF THEIR FACT CHECKERS !

To date, FAKE BOOK has removed at least 300 posts and comments with hyperlinks to my blog from FAKE BOOK.

I have been told that even at least one of the more visible female chronic pain advocates aligned herself with Mark in getting my blog labeled as a spammer.. 

My blog is still ALIVE AND WELL… because I own the domain that it is on and NO ONE can censor/delete my blog posts, for now, I am sharing my blog posts on Twitter and experimenting with some 2-3 minute videos