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)

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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I was talking to a gal this week that I have known for 3+ decades and she is involved with a local recovery center because her Nephew also had a fatal OD. She was telling me that the judges in the drug courts are getting really pissed because people assigned to the drug court are not able to obtain or maintain sobriety because of the erratic available of all controlled meds, just like a lot of chronic pain pts are dealing with.  Here is a hyperlink to the nearly 600 page agreement between the 45 state AG and the three major drug wholesalers https://www.pharmaciststeve.com/?attachment_id=49645 

where they agreed to reduce the amounts of controlled meds that are sold to community pharmacies, and not share with those pharmacies what the amount of controls they are being allotted to each community pharmacy.

If anyone is interested, each wholesaler is licensed by the state board of pharmacy in each state, and

Telemedicine patients with opioid use disorder struggle to fill prescriptions

https://stateline.org/2025/08/22/telemedicine-patients-with-opioid-use-disorder-struggle-to-fill-prescriptions/

Nearly a third of patients surveyed had a hard time getting buprenorphine.

Nearly a third of telemedicine patients with opioid use disorder had to go without buprenorphine because they had trouble filling their prescription at a pharmacy, according to a new study.

The study, published in the medical journal JAMA Network Open this month, surveyed 600 telemedicine patients across five states: Florida, Michigan, New Jersey, Ohio and Texas. The U.S. Food and Drug Administration has approved buprenorphine for treatment of opioid use disorder. The drug reduces a patient’s cravings for opioids and reduces the likelihood of a fatal overdose.

The most common reason that patients had trouble was that buprenorphine was unavailable at the pharmacy, followed by coverage-related issues and the pharmacy’s hesitancy in filling a telemedicine prescription.

Previous research has shown that some pharmacists, fearing scrutiny, hesitate to dispense buprenorphine, which is a controlled substance. The U.S. Drug Enforcement Administration and the U.S. Department of Health and Human Services say people with opioid use disorder “who need buprenorphine [should be] able to access it without undue delay,” the authors note.

Roughly half of the patients who participated in the survey were covered by Medicaid. A majority of patients had been in treatment for at least six months, and half lived in rural areas.

The analysis didn’t find statistically significant differences between patients in rural and non-rural areas. But the authors noted that the study only surveyed participants from those five states, and results might be different in other ones.

In general, they noted, patients living in rural areas might have a harder time finding buprenorphine and other opioid use disorder drugs at a pharmacy because there are fewer pharmacies in rural areas.

The study underscores recent data suggesting a lack of access to opioid use disorder medication. An analysis released last year by the federal Centers for Disease Control and Prevention found that in 2022, only a quarter of people with opioid use disorder received recommended medications. About 4% of U.S. adults have opioid use disorder.

Other research has shown many pharmacies lack buprenorphine. Two studies found that between 42% and 51% of U.S. pharmacies did not have buprenorphine in stock, and availability varied widely across states.

The JAMA Network Open study was led by Workit Health, a telemedicine addiction treatment app that operates in four of the states included in the survey. Researchers from the University of Pittsburgh, Johns Hopkins University, and Geisinger Commonwealth School of Medicine in Pennsylvania also contributed. In their conflict of interest disclosures, some of the authors reported holding equity in Workit Health.

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Walgreens’ chief pharmacy officer proposes fixes to a system that broke long ago

https://www.statnews.com/2025/08/12/community-pharmacy-crisis-rite-aid-bankruptcy-walgreens/

Earlier this year, the second largest independent pharmacy chain in America, Rite-Aid, filed for bankruptcy. While many were caught off guard, I wasn’t. After 30 years in community pharmacy, I saw this coming. Financial pressure has been building for years. Burnout among pharmacists exploded during the pandemic. Now, access to care is deteriorating before our eyes.

This isn’t just an industry trend; it’s a system failure. The alignment of incentives around generics that once benefited the entire health care system is no longer in place. And the industry left holding the bag is community pharmacy.

Pharmacists are the most accessible health care providers in America. Nearly 90% of Americans live within 5 miles of a pharmacy. Patients interact with their pharmacist 12 times more often than their primary care provider. Chronic care patients, who account for 90% of U.S. health care spending, often engage with their pharmacy 35 to 50 times per year.

If we don’t act now, we won’t just lose pharmacies. We’ll lose one of the most efficient, cost-effective access points in the U.S. health care system. Here’s where the change must start:

1. Reimburse for care, not just pills

Let’s be blunt: Pharmacies are regularly reimbursed below cost. In some states, Medicaid pays less than $1 per prescription, not even enough to cover the label and bottle, let alone a licensed professional’s time.

Meanwhile, pharmacists deliver care every single day: immunizations, test-and-treat services (where a provider conducts a diagnostic test and provides treatment in the same visit, often without requiring a separate doctor’s appointment or lab processing), chronic disease management, medication adherence programs. But the current payment model only recognizes pills, not the professional judgment or clinical expertise behind them.

Between 2009 and 2015, roughly one in eight pharmacies closed, with closures disproportionately impacting independent pharmacies and low-income neighborhoods, according to a study published in the Journal of the American Medical Association. Within a matter of weeks, Rite-Aid closed at least 150 stores in Pennsylvania — a sizable percentage of the state’s approximately 2,600 licensed pharmacies.

Fixing this problem means establishing:

• Minimum dispensing fees that reflect pharmacies’ actual operating costs
• Patient freedom to go to the pharmacy of their choice without interference by PBMs who steer them toward affiliated pharmacies.

The economics of pharmacy are upside down. Without structural reform, we’ll lose the infrastructure that fills more than 6 billion prescriptions each year.

2. Build smarter systems that actually support pharmacy

Today’s pharmacy model is labor-intensive, fragmented, and inefficient. Pharmacists spend 40–60% of their day on administrative tasks: prior authorizations, insurance paperwork, chasing down refills.

That’s not a workforce problem. That’s a systems problem.

It’s time to scale clinical pharmacy and offload the rest. That means:

• Micro-fulfillment and central fill for high-volume scripts
• Remote verification and centralized operations across enterprise systems
• AI-driven tools to handle refill reminders, adherence programs, insurance adjudication, and even inventory optimization.

Technology isn’t a threat; it’s the only way we scale personalized care without burning out the people delivering it.

3. Let pharmacists practice — everywhere

Pharmacists are health care providers. They complete six to eight years of clinical training, yet outdated state laws and federal policies often tie their hands.

Some states allow test-and-treat. Others don’t. Some payers offer reimbursement for care. Others don’t. The result is a fragmented system where access depends more on ZIP code than need.

Other countries like the U.K. and Canada already empower pharmacists to test, treat, and prescribe for common conditions such as strep throat, urinary tract infections, and seasonal allergies — resulting in clear benefits to access and outcomes. The U.S. is falling behind.

Fixing this requires:

• Federal recognition of pharmacists as health care providers and reimbursement consistency across state lines
• Full integration of pharmacy into care teams under value-based models and accountable care organizations.

Some states — like Alaska, Florida, Idaho, Iowa, and New Mexico — are moving forward, but federal policy must catch up, especially in programs like Medicare.

And it must catch up soon.

According to the American Association of Colleges of Pharmacy, pharmacy school applications have dropped nearly 60% over the past decade. Loan debt is up. Morale is down. And students are being told, explicitly or implicitly, that community pharmacy is dying. If we don’t fix the system, that prophecy will fulfill itself.

This isn’t just about the profession. It’s about public health. Who’s going to administer flu shots, manage blood pressure, or help patients stay on track with their diabetes medications if half the nation’s pharmacies shut their doors? Who will manage chronic care for aging Americans if we decimate one of the only health care access points they consistently rely on?

And yes — pharmacists are asking: What are pharmacy chains doing about it? What’s Walgreens doing?

We hear you.

At Walgreens, we know we have to lead differently. That’s why we’re investing in programs like PharmStart, which helps pharmacy technicians become pharmacists — with fully funded education and real career pathways. We’ve expanded centralized services and micro-fulfillment centers to reduce operational strain in stores. And we’re advocating for payment reform that finally reimburses pharmacists for care, not just pills.

Are we where we need to be yet? No. But we’re making changes because the profession — and the people in it — deserve better.

I’ve seen the soul of this profession. Pharmacists stay late to help patients. They deliver meds to homebound seniors. They do more than they’re paid for, because it matters. We can’t afford to lose that.

Fix the system. Fund the care. Let pharmacists deliver care to their patients.

States have made real progress modernizing pharmacy practice and advancing some pharmacy benefit manager reforms. But at the federal level, we’ve been here before, almost crossing the finish line on critical reforms only to see key provisions stripped from broader legislation and postponed once again.

We can’t keep kicking the can down the road and hoping this crisis will solve itself. Policymakers need to act now to recognize pharmacists as health care providers, reform the broken reimbursement system, and protect community pharmacies.

If we don’t act now, the next community pharmacy to close might be the one your family depends on.

Rick Gates is chief pharmacy officer for Walgreens and chair of the National Association of Chain Drug Stores.

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https://www.fox9.com/news/pharmacist-prescription-refusal-lawsuit-highlights-human-religious-rights

(FOX 9) – Two Twin Cities pharmacists say they lost work when they refused to fulfill prescriptions for gender transition and emergency contraception.

Refusal on faith

Pharmacists won’t fulfill:

They cited religious objections, but one of them says she was fired and the other had hours reduced. 

So now they’re suing Walgreens and the Minnesota Board of Pharmacy.

Walgreens pharmacists Dora Ig-Izevbekhai and Rachel Scott say their Christian religion guides them against filling doctor’s prescriptions for gender transition and abortion medications.

For years, they say Walgreens let them hand off those patients to other pharmacists.

“Both Minnesota and the federal government of the United States have statutes that require employers to accommodate the religious practices of their employees if it can be done so without posing an undue hardship on the employer’s business,” said plaintiff’s attorney Nicholas Nelson of the Upper Midwest Law Center.

Can they or can’t they?

An evolving law:

But in 2022 and 2023, the pharmacists say Walgreens told them their religious accommodation was illegal under Minnesota law.

By that time, state courts had ruled against a Minnesota woman who claimed discrimination when an Aitkin County pharmacist denied her emergency contraception when her nearest option was at least an hour away through a snowstorm.

But the state appeals court ruled in her favor in 2024 and the ruling has stuck. She was awarded about $673,000 in attorney’s fees in June 2025.

Rights rivalry

Who would be hurt?:

Transgender advocates say when a pharmacist refuses to fill a prescription, it can be dangerous.

“It can delay necessary care, put a patient’s health at risk, and send the harmful message that they don’t deserve to be treated with dignity,” said Ash Lazarus Orr, press relations manager at A4TE.

Attorneys who fought the contraception case tell FOX 9 the state’s Human Rights Act would also apply to gender transition drugs.

“People deserve access to the healthcare they need, including prescriptions, and should be able to fill those prescriptions free from discrimination or bias,” said a statement sent to us by Gender Justice, which helped in the discrimination case. “We will continue to stand for the rights of all patients to receive respectful, unbiased care.”

But Nelson says the new case he filed on behalf of the pharmacists isn’t quite the same.

“They were not telling people, no you can’t have these drugs,” he said. “They were just handing the prescription to another pharmacist or otherwise making arrangements for the prescription to get filled.”

So the potential conflict between the state’s Human Rights Act and the constitutional freedom of religion isn’t necessarily put to the test here.

Nelson acknowledged there could be a situation where it’s a one-pharmacist town or there’s a snowstorm again, but that’s not what happened with his clients.

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Below is number of videos from various parts of our bureaucracy. Also below is just a few of the videos that I was able to find where our bureaucrats are not happy about the path we are on… a number of the citizens of our country apparently feels the same. The head of our FDA , Dr. Marty Makary, head of the FDA, states that the GOVERNMENT IS NOT YOUR DOCTOR. There is a law on the books from 1935 basically states the same. It seems that in the 162 yrs since Lincoln gave his Gettysburg address, we are no longer a government of the people, by the people, for the people. Unless you only count the 535 members of Congress.  Below is a list of the current Congress, their number of years in Congress and their age. Note the YOUNGEST is 72 y/o and the oldest is 91 y/o.

Congress formally limited the number of terms of our President may serve by proposing the Twenty-second Amendment to the Constitution on March 21, 1947; this amendment was ratified on February 27, 1951, establishing a two-term limit for U.S. Presidents.

But apparently Congress has never seen the need to impose term limits on themselves. Below is a list of the longest serving members of our current Congress and their age and years in Congress.

Part of Abraham Lincoln’s Gettysburg address: November 19, 1863

that this nation, under God, shall have a new birth of freedom—and that government of the people, by the people, for the people, shall not perish from the earth.”

42 USC 1395: Prohibition against any Federal interference

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

BELOW is a HELP WANTED AD  from DEA from a couple of days ago:

We’re Hiring: Diversion Investigators at the DEA 🚨

The Drug Enforcement Administration (DEA) is seeking highly motivated professionals to join our team as Diversion Investigators. This critical role is at the forefront of protecting public health and safety by preventing the diversion of controlled substances from legitimate channels into illegal distribution.

As a Diversion Investigator, you will:
✅ Conduct regulatory investigations and compliance inspections of manufacturers, distributors, pharmacies, and practitioners.
✅ Develop cases against unlawful handlers of controlled substances.
✅ Partner with law enforcement and healthcare stakeholders to safeguard our communities.
✅ Contribute directly to DEA’s mission of combating the opioid crisis and protecting lives.

Why Join DEA?
✔️ Impactful mission work protecting communities nationwide
✔️ Professional growth and specialized training opportunities
✔️ Federal benefits and career stability
✔️ A chance to serve at the intersection of healthcare, regulation, and law enforcement

📢 Apply today and take the next step toward a career that makes a difference.
👉 https://lnkd.in/d43jdsVy

Dr. Marty Makary, head of the FDA, states that the GOVERNMENT IS NOT YOUR DOCTOR

Wenstrup: COVID-19 Pandemic Eroded the Doctor-Patient Relationship, Severely Harmed America’s Healthcare System

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Make America free of drug addicts

Another article and another group that is not  smart enough to find out that there is more that just one Fentanyl analog. Article and group that if their kid, friend, relative that is not smart enough to question that buying drugs on the street and they are upset because they died for buying basically some substance off of someone selling it on the street – what could go wrong?

list of all the 100-200 different Fentanyl analogs – only FOUR have been approved to be safe for use in humans.  https://en.wikipedia.org/wiki/List_of_fentanyl_analogues

FIRST ON FOX: A new campaign launched on Monday to help fulfill President Donald Trump’s pledge to reduce fentanyl overdose deaths, which are one of the nation’s deadliest public health crises.

The campaign, titled Make America Fentanyl Free, is described as a privately-funded multi-million-dollar ad blitz on national and local television, and across all major social media platforms, including X, Instagram, YouTube, TikTok and Facebook.

The effort, which was first shared with Fox News Digital on Monday, aims to reduce the number of Americans killed by fentanyl, a highly potent and extremely dangerous synthetic opioid. Fentanyl and fentanyl-related drugs have been responsible for most drug overdose deaths in the U.S. for nearly a decade.

“The Make America Fentanyl Free ad campaign was launched to support President Trump’s efforts to save American lives from deadly fentanyl, which continues to be a leading cause of death for Americans between the ages of 18 and 45,” organizers said in a statement.

DRUG DEADLIER THAN FENTANYL SPREADS ACROSS THE AMERICAS

President Donald Trump speaks during a bill signing ceremony in the East Room of the White House in Washington, D.C., on July 16, 2025. Trump signed legislation that strengthens criminal penalties for fentanyl, hailing it as a historic step toward justice in his latest effort to address the public health crisis spurred by the deadly drug. (Al Drago/Bloomberg via Getty Images)

Organizers emphasized that the mission of the campaign, which is also online at MakeAmericaFentanylFree.com, is to inform Americans about the devastating effects of fentanyl, and pointed out that “ingesting as little as three grains of fentanyl can be lethal within minutes.”

The campaign is also intended to educate the public about the hidden dangers of fentanyl, which is frequently disguised in other substances, such as cocaine and marijuana. 

TRUMP SIGNED FENTANYL LAW WILL END ‘CAT AND MOUSE’ WITH TRAFFICKERS

“Make America Fentanyl Free is working with President Trump to aggressively make sure every American understands the danger of fentanyl,” the narrator in the ad says.

A new campaign titled Make America Fentanyl Free launched on Monday to help fulfill President Donald Trump’s pledge to reduce fentanyl overdose deaths, which are one of the country’s deadliest public health crises. (Make America Fentanyl Free)

The effort also intends to “send a strong unequivocal message to Mexican drug cartels that actions leading to American deaths or harm will result in serious consequences.”

The Trump administration says it has lowered fentanyl deaths in the U.S. by beefing up security along the nation’s borders, emphasizing law enforcement, and raising tariffs against China and Mexico to keep fentanyl and other lethal drugs out of the country.

Organizers touted that “on day one in office, President Trump shut down the dangerous, open border and stemmed the flow of deadly fentanyl through our country. As a result, fentanyl traffic at the border fell by 54% in the first months of the Trump Administration.”

FATHER WHOSE SON DIED FROM FENTANYL WARNS ‘OVERDOSES CAN HAPPEN TO ANYONE’

But organizers said their effort is needed to “continue eradicating deadly fentanyl from our communities.”

Trump last month signed into law a bill permanently placing street versions of fentanyl on the list of controlled substances, which should make it easier to prosecute fentanyl traffickers and put them behind bars.

President Donald Trump listens as a man who lost his son to fentanyl speaks before the signing of the “Halt All Lethal Trafficking of Fentanyl Act,” which strengthens prison sentences for fentanyl traffickers, at the White House in Washington, D.C., on July 16, 2025. (Andrew Caballero-Reynolds/AFP via Getty Images)

But the Trump administration has also been criticized when it comes to battling fentanyl deaths, for seeking major cuts to domestic programs that work to reduce drug demand.

And Democrats in California, taking aim at what they call Trump’s “unlawful deployment of military personnel to Los Angeles,” say the effort has slashed the California’s National Guard’s fentanyl and drug interdiction force by 32%, “directly harming California’s ability to fight the flow of illegal drugs into our communities.”

Organizers of the new effort highlight that Make America Fentanyl Free is a privately funded campaign “launched without taxpayer dollars.”

Some of the major contributions to fund the campaign have come from a number of the president’s major donors and allies, according to sources in Trump’s political orbit.

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aren’t drug wholesalers licensed by the state pharmacy board?

Yes, drug wholesalers are generally licensed by the state pharmacy boards in the United States. State Boards of Pharmacy are responsible for issuing, renewing, and regulating wholesale drug distributor licenses within their respective states, ensuring compliance with both state and federal laws.

Regulation Details

• Each state requires wholesale drug distributors to obtain a license from its Board of Pharmacy before engaging in distribution activities within or into that state.

• This licensing applies to wholesalers located both inside and outside of the state if they transport or sell drugs into the state.

• In addition to state licensure, wholesalers often need to meet federal requirements—especially if distributing controlled substances—and may need special accreditation from the National Association of Boards of Pharmacy (NABP).

Purpose of Licensing

• The primary goal is to safeguard the drug supply chain, preventing the introduction of counterfeit, diverted, or otherwise unsafe drugs and protecting public health and safety.

In summary, state pharmacy boards hold the authority for licensing and regulating drug wholesalers, and distributing without proper licensure is unlawful in every state.

state AGs suing drug wholesalers and wholesalers signed an agreement to ration controlled meds sold community pharmacies, resulting in pharmacies are not able to provide controlled meds – especially opioids and Buprenorphine and pts are not being able to get their medically necessary meds sporadically causing some pain pts being thrown into cold turkey withdrawal and torturous level of untreated pain and putting pts in recovering from possibly compromising their progress in reaching sobriety. Is the part of the BOP primary charge of public safety being compromised and are they obligated to take some sort of legal action to correct this potentially illegal rationing and harm to those pts. who would/should the BOP hire to seek a legal remedy?”

Yes, current and recent enforcement actions and agreements are causing wholesalers to ration controlled medications to community pharmacies—resulting in sporadic and sometimes complete restriction of access to medically necessary opioids and buprenorphine for patients, including those with severe pain or opioid use disorder. This has resulted in some patients experiencing untreated pain or withdrawal, which can compromise their recovery and lead to serious, even torturous, health consequences.

Board of Pharmacy’s Responsibility and Obligation

State Boards of Pharmacy (BOPs) have a primary legal charge to protect public health and safety by ensuring safe access to medications. When access to controlled substances is compromised for legitimate medical need, the mission of public protection may be undermined, particularly when actions result in harm to otherwise legitimate patients. While BOPs primarily regulate pharmacies and pharmacists, they also license and oversee wholesalers within their states.

Potential Board Actions in Response

• Legal Action Against Wholesalers: There is precedent for litigation when wholesalers abruptly or unfairly cut off or severely ration controlled substance supplies to pharmacies without clear evidence of diversion or improper dispensing. Courts have sometimes ruled against wholesalers in these circumstances, ordering them to resume supplying medications when no unlawful conduct by the pharmacy was demonstrated.

• Regulatory Complaints: Boards could initiate disciplinary investigations or refer cases to state attorneys general or the Drug Enforcement Administration (DEA) if there is evidence that a wholesaler’s practices violate public health statutes or constitute unfair/illegal rationing that causes patient harm.

• Advocacy and Policy Action: Boards may also advocate for regulatory clarity and reasonable thresholds, and in some cases have issued formal guidance or endorsed calls for distributors to re-examine purchasing thresholds so that legitimate patient needs are met.

Who Would the Board Hire for Legal Action?

• Specialized Legal Counsel: Boards would typically hire or assign state government attorneys with experience in health law, pharmacy regulation, or administrative law to pursue legal remedies. In some cases, they may work with the state Attorney General’s Office—which already leads major enforcement and public protection lawsuits, including those involving the drug supply chain.

• Subject Matter Experts: The Board may also rely on pharmacy regulatory experts, compliance officers, or external consultants to build a case demonstrating patient harm or procedural violations by wholesalers.

Summary Table: Board of Pharmacy Actions

State Boards of Pharmacy are obligated to respond and may pursue legal or regulatory remedies if wholesalers’ actions violate their core mandate of protecting patients and ensuring proper medication access.

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What should be asked is why back in 1973, that Congress put two legal drugs (Nicotine & Alcohol)  Into a separate and distinct sub-agency under the DOJ while putting all the other potentially abused/addicting drugs in and under the control of the DEA? Could we see some sort of tracking (PDMP) and daily limits (Ounces of grain alcohol equivalents per day) on how much alcohol & nicotine (Mgs of Nicotine/day) a person can purchase? An estimated 600,000/yr deaths from the use/abuse of alcohol & Nicotine. Six to EIGHT times the deaths from the use/abuse of  illegal Fentanyl/yr. Also, what does GUNS have any business being managed/controlled by the DEA?

What Should Be Done About the ATF?

https://www.americas1stfreedom.org/content/from-the-editor-what-should-be-done-about-the-atf/

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