the Trump administration has been floating the idea of merging the ATF with the DEA:What could go wrong?

Posted on August 27, 2025 by Pharmaciststeve

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/

When a federal agency becomes corrupted by politics, especially unconstitutional politics, something must be done. Government agencies are supposed to treat all citizens equally. A free people should not have to contend with federal agencies being weaponized against them.

Nevertheless, a few administrations have weaponized the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) against our freedom.

The Obama administration’s Operation Fast and Furious gun-running scandal was perhaps the most shocking example of how far ATF leadership, as a sub-agency in the U.S. Department of Justice (DOJ), was willing to go to get the gun control they desired.

Well, the Biden administration’s creation and use of an ATF zero-tolerance policy to put as many federal firearms licensees (FFLs) out of business as they could is a close second.

ATF attempts, under the Biden administration, to reinterpret or write gun-control laws, as if this agency has the power the U.S. Constitution grants the U.S. Congress, offers a series of egregious examples on the weaponization of this law-enforcement agency against citizens.

So then, what is the Trump administration now supposed to do with the ATF?

Perhaps the best answers are in the details. President Donald Trump (R) began substantive change within federal agencies last February with an executive order titled “Protecting Second Amendment Rights,” in which he tasked Attorney General Pam Bondi with implementing changes to get the ATF, and other agencies, back in line with the U.S. Constitution.

Reforms to the ATF, as this was going to print, were reportedly coming fast. Indeed, the Department of Government Efficiency (DOGE) reportedly sent lawyers to assist the ATF with the goal of changing or repealing 47 regulations—a reference to President Trump as the 47th president.

Meanwhile, the Trump administration has been publicly floating the idea of merging the ATF with the Drug Enforcement Administration (DEA). This would likely require congressional approval, but the ATF has been beneath other agencies before—most notably, the Internal Revenue Service (IRS). Like the ATF, the DEA is also a sub-agency of the DOJ.

From a budgetary standpoint, it is easy to see how consolidating the ATF and DEA makes sense. But some worry that doing so could make the ATF even more powerful, and then, as a supercharged agency, it could be used by a future president with Joe Biden’s politics against American gun owners.

One way or another, however, reform is coming. Bondi’s establishment of a Second Amendment Task Force to advance, protect and promote compliance with the Second Amendment, as President Trump mandated via executive order, as well as changes in senior ATF leadership, indicate that change in the culture within the ATF is well underway.

Indeed, the ATF quickly announced an end to the Biden administration’s “zero-tolerance” policy. They are also reportedly reconsidering the last administration’s final rules regarding “engaged in the business”  and “stabilizing braces.” 

The ATF also recently issued two new rulings that allow for the importation of non-lethal training rounds, or “simunition” rounds. The training rounds were banned for import in 2023 by the Biden administration.

Indeed, an ATF announcement last May said, in part, that the ATF is “ushering in a new chapter—marked by transparency, accountability, and partnership with the firearms industry. This is not the same ATF of the last four years.”

Filed under: General Problems | 1 Comment »

UPDATED 08-27-2025: I NEED/WANT YOUR OPINION

Posted on August 27, 2025 by Pharmaciststeve


you will need either a laptop computer or desk top computer to do this

This blog post will be my 11,011 blog post since I started in 2012 and my blog is approaching THREE MILLION PAGE VIEWS.

I have been around the chronic pain community since 2012. There are a few things that have remained common over all those years. 

1. Here are some people who want to be a advocate and come into the community and after a few months, they discover that the community has segregated into hundreds or thousands of different groups/tribes.

2. There seems to be a lot of in-fighting within the various communities. Often resulting of a few self proclaimed pain advocates that splinter off and create a new group to advocate for the community.

3. There is a lot of what is referred to as “keyboard warriors” that do a lot of whining, bitching, moaning to others on FP and other websites. They are seemingly the same chronic painers that are waiting for some White Knight on a White Horse to come over the horizon to save their ass.

Would anyone be interested on a fairly simple process to generate letters to send to members of Congress.  The letter head at the left I just asked AI  to generate a letterhead

I asked AI to find all the members of Congress that represents my zip code. took it about 1-2 minutes to get all the contact info on my two Federal Senators and the House member for the district I was in.

You put the contact info to your 2 senators and 1 house member and you go to AI. load the letterhead as an attachment to the AI. You then tell AI that you want a letter to send those Senators and House member and you tell what the subject matter is and the “catch words” that you want to be in your letter. 

You copy the text of the letter and paste it into your letter head that the AI created.

I have found a few free fax programs that you can send at fax from your computer over the internet.

If you don’t have a word processor, there is a free word processor that is compatible with Windows’ suite  of  office software

Say.. you set up to contact your 2 Senators and 1 Representative  to send them letters. After you get it all set up. you could “pepper” them with letters EVERY WEEK, ONCE A MONTH. All you have to do is create a new text for the letter. If you email or fax your letter(s), Other than your time, the cost is ZERO. There is an estimated 100 million chronic pain pts. if 10% of those chronic pain pts could send a letter once a week. My money on is that if all those 535 members got TEN MILLION LETTERS/EMAILS A WEEK,  The community could get their attentions, especially if most of the letters state that they are going to vote for whoever that is running against the incumbent. After 53 years of the DEA overseeing the war on drugs, how much worse could it be, if we KICKED ALL THE INCUMBENTS OUT OF OFFICE – that would be 435 House members and 33-34 Senators. That is 87% of Congress that would be GONE in Jan, 2027!

Let me know if you want this “tool” to help you express your concerns to Congress. If I get little/no response, I will presume that most of the community is happy with the outcomes/changes to their access to pain management with all their whining, bitching, moaning to others on the FB pages.

 

This is where things start:

  https://www.pharmaciststeve.com/communications/

 

Filed under: General Problems | 23 Comments »

What is Patient Abandonment? this is a old blog post from 2016

Posted on August 26, 2025 by Pharmaciststeve

What is Patient Abandonment?

https://www.nolo.com/legal-encyclopedia/what-patient-abandonment.html

What is Patient Abandonment?

When a doctor doesn’t end the provider-patient relationship properly, it could amount to malpractice.

Need Professional Help? Talk to a Lawyer.

Please answer a few questions to help us match you with attorneys in your area.

 
 
Injury from malpractice can be short/long term loss of Physical ability . This website is suppose to  help someone find an attorney. One must ask what is “loss of physical ability”.. is the reduction of opiate therapy which causes the pt to no longer to routinely do personal care tasks?  If your prescriber has reduced your dose and claims that they are going to follow the CDC guidelines.. these guidelines end goal is to eliminate all pts from taking pt’s opiates long term. It is important to audio/video all interactions with practitioner and the office staff. Because you may never know what they have documented in your medical records that are untruths.
 

Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.

In this article, we’ll look at the elements that typically define patient abandonment, and we’ll explore a few scenarios that could qualify as patient abandonment in the health care setting.

The Elements of Patient Abandonment

Let’s start by pointing out that whether or not patient abandonment has occurred is a very fact-specific issue, and a doctor’s potential legal liability can vary from state to state. Having said that, there are certain common elements among patient abandonment cases:

  • First, the doctor-patient relationship must be established. This means that the physician must have agreed to treat the patient, and treatment must be underway.
  • Second, the abandonment must take place when the patient is still in need of medical attention — this is known as a “critical stage” of the treatment process.
  • Third, the abandonment must have taken place so abruptly that the patient did not have enough time or resources to find a suitable replacement physician to take over treatment.
  • Finally, the patient must suffer an injury as a direct result of the patient abandonment.

Examples of Patient Abandonment

There are many real-world situations in which a doctor might terminate a relationship with a patient without a reasonable excuse.

For example, if a doctor intentionally refuses to treat a patient who has failed to pay his or her medical bill, that is often considered unjustified. And if a doctor is unavailable for an unreasonable amount of time when a patient needs medical care — and so is the backup (or “on call”) doctor — that could amount to patient abandonment if the patient ends up suffering harm as a result.

It should be noted that patient abandonment can also occur between other kinds of health care providers and the patient — not just between the physician and the patient. For example, if a nurse-patient relationship has been established, and the same legal elements we discussed above are present, then the patient may have a valid medical malpractice claim based on patient abandonment.

Patient abandonment can also occur when:

  • the hospital has inadequate staffing
  • the medical staff fails to reach out to a patient who has missed an important follow-up appointment
  • the medical staff fails to communicate an urgent question from the patient to the doctor, or
  • the medical staff schedules an appointment too far in the future, resulting in preventable harm to the patient as their condition worsens.

When It’s Not Patient Abandonment

Not every situation where a doctor stops treating a patient leads to an actionable claim for medical malpractice. Most don’t, in fact.

Valid reasons to end a doctor-patient relationship include:

  • the doctor has insufficient skills to provide adequate treatment to the patient
  • If the pt has been seeing the practitioner for a while this could be considered a LAME EXCUSE
  • there are insufficient supplies or resources to provide adequate treatment to the patient
  • ethical  or legal conflicts arise during the treatment process
  • If the practitioner has been treating a pt’s chronic pain.. did the practitioner’s ethics change ?
  • the patient violates the physician’s policies
  • Is the physician’s policies unethical or illegal – like mandating services that have proven of no benefit to the pt which is insurance fraud
  • the patient has numerous cancelled or missed appointments
  • the patient refuses to comply with the physician’s recommendations
  • Is the physician’s policies unethical or illegal – like mandating services that have proven of no benefit to the pt which is insurance fraud
  • the patient demonstrates inappropriate behavior, such as making sexual advances or engaging in verbal abuse.
  • It may be important for the pt to audio/video visits with the practitioners to prove/refute what is being claimed

If a valid reason exists, then the physician can take steps to terminate the relationship in an appropriate manner, and attempt to avoid liability. That means, the physician should provide the patient with written notice of the termination along with a valid reason for the decision. The physician should continue to treat the patient for a reasonable period of time to allow the patient to arrange for alternative care from another competent physician. The physician should also recommend another qualified physician. Finally, once the patient has secured another physician, and has signed an authorization, the physician must transfer the patient’s medical records to the new physician in a reasonable and timely manner.

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C.1

Posted on August 26, 2025 by Pharmaciststeve

Could find some stats on I read that the production quotas established on controlled substance by the DEA has dropped > 50% over the last 10 yrs +/- can you find actual stats on this

how much has the lawsuit by the 45 state AG’s against the 3 major drug wholesalers reduced the availability of controlled meds at the community pharmacy level

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

that being said if the BOP was to take any legal action, wouldn’t that be turned over to the state AG to handle such violation by a BOP licensee, but the AG is probably be one of the AGs that was involved with wholesaler agreement that is causing the problem

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

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

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

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

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

I know that I have been throwing a lot of factual data out – over the last 30-45 minutes. Any way that you could condense all of this data into something that could be sent to the media outlets. IMO… the bottom line of all of DEA cut in production quotas and the AG’s agreement is causing a lot of pts – both pain pts and addicts trying to get sober – to be basically being abandoned. I read where “we” create 50K-55K new chronic painers every year – birth defects that are painful, we have 45K vehicle accidents that cause deaths – I don’t know the survivors that end up with life time chronic pain. I can vouch that growing old can cause some progressing chronic pain. How many prescribers are leaving practice – retiring or just throwing their hands up, how many are just stop treating chronic pain pts or won’t accept new pts dealing with some chronic pain issues. What is the increase in our population in the last decade, presuming that 20%-30% of that populations will be chronic painers. How many chronic painers have died over the last decade? IMO, there are too many numbers/statistics that seem to be swept under the rug, to “hide reality”

I see this could be used to TV stations

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

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

Unseen Epidemic: Chronic Pain in America

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

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

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

DEA/AG Policies: The Downside

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

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

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

Who Pays the Price?

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

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

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

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

Ignored Realities

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

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

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

Human Toll

  • Millions with chronic pain are being abandoned.

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

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

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

Bottom Line

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

Contact: [Your Name, Credentials, City/State, and optional contact info]

Filed under: General Problems | 3 Comments »

Interesting concept – opioid free surgery – pt’s choice & can always drop out of the program

Posted on August 24, 2025 by Pharmaciststeve

Filed under: General Problems | 1 Comment »

PROGRAMS TO BE USED

Posted on August 24, 2025 by Pharmaciststeve

AI PROGRAMS:

www.perplexity.ai

https://claude.ai/new

https://chatgpt.com/

https://x.com/i/grok

Send Faxes using a computer

https://www.pcmag.com/picks/the-best-online-fax-services#

OPEN OFFICE software

https://www.openoffice.org/

Open Office software refers to a free and open-source office productivity suite developed as an alternative to commercial office software like Microsoft Office. Originally known as OpenOffice.org, it was created from the StarOffice suite and was open-sourced by Sun Microsystems in 2000. Today, its main version is Apache OpenOffice, run by the Apache Software Foundation.wikipedia+2

Main Features

Apache OpenOffice includes six main applications:

  • Writer: A word processor (similar to Microsoft Word)

  • Calc: A spreadsheet program (similar to Excel)

  • Impress: Presentation software (like PowerPoint)

  • Draw: Vector graphics editor

  • Base: Database management program

  • Math: A formula editor for mathematical equationsopenoffice+2

Key Advantages

  • Completely free to download, use, and distribute—no purchase or license fees.

  • Cross-platform: Works on Windows, Mac, Linux, and more.

  • OpenDocument file format (ODF): Uses an open standard for storing data, and can read most Microsoft Office files.

  • Open-source development: Anyone can contribute or report bugs, leading to a transparent development process.

  • Multilingual and widely supported: Available in over 100 languages.openoffice+2

Usage

OpenOffice is used for everyday office tasks: writing documents, creating spreadsheets, making presentations, drawing diagrams, managing databases, and writing mathematical formulas. Its familiar layout makes it easy for users coming from other office suites to adapt quickly.

Note

Active development of Apache OpenOffice has slowed, and an offshoot called LibreOffice is now more frequently updated and is widely recommended for those seeking the latest features.wikipedia+2

In summary, Open Office software provides a comprehensive, no-cost solution to everyday office tasks, with full compatibility for common file types and wide community support.techtarget+2

  1. https://en.wikipedia.org/wiki/OpenOffice.org
  2. https://www.openoffice.org/why/
  3. https://www.openoffice.org
  4. https://en.wikipedia.org/wiki/Apache_OpenOffice
  5. https://www.openoffice.org/product/
  6. https://www.techtarget.com/searchenterprisedesktop/definition/Apache-OpenOffice
  7. https://openoffice.apache.org
  8. https://www.youtube.com/watch?v=6iUJPy1cj7E
  9. https://www.youtube.com/watch?v=XnUsTyQtZ20
  10. https://www.reddit.com/r/computers/comments/1e66n6t/which_one_is_better_microsoft_office_or_open/

 

Filed under: General Problems | Leave a Comment »

This is a good example of BUYER BE WARE!

Posted on August 21, 2025 by Pharmaciststeve


Lilly has a mail order pharmacy that will fill prescriptions for all strengths of Zepbound in vials for < $500 for 4 weeks.

https://www.lilly.com/lillydirect/medicines/zepbound

You only have one LIFE and one QOL!  As soon as the lawsuits start stacking up because they are basically selling an illegal compound product. They will file bankruptcy and close their doors and VANISH.

 

FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss

https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss

Understanding unapproved versions of these drugs

FDA is aware that some patients and health care professionals may look to unapproved versions of GLP-1 (glucagon-like peptide-1 (GLP-1) receptor agonists) drugs, including semaglutide and tirzepatide, as an option for weight loss. This can be risky for patients, as unapproved versions do not undergo FDA’s review for safety, effectiveness and quality before they are marketed.  

FDA recommendations for patients 

  • Patients should obtain a prescription from their doctor and fill the prescription at a state-licensed pharmacy.  
  • Visit FDA’s BeSafeRx campaign for resources to safely buy prescription medicines online.  
  • Talk to your doctor if you have questions about your medicines.  

Concerns with compounded versions of these drugs 

A compounded drug might be appropriate if a patient’s medical need cannot be met by an FDA-approved drug, or the FDA-approved drug is not commercially available. However, compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed.   

The agency has identified some areas of concern for compounded GLP-1 drugs. FDA is working with its state regulatory partners and will continue to communicate with compounders regarding these concerns.

Fraudulent compounded GLP-1 drugs 

FDA is aware of fraudulent compounded semaglutide and tirzepatide marketed in the U.S. that contain false information on the product label. In some cases, the compounding pharmacies identified on the labels of the products do not exist. In other cases, the labels of the fraudulent compounded medicine contain the name of a licensed pharmacy that, based on information FDA has gathered, did not compound these products.

FDA is aware of one reported adverse event associated with a product labeled as compounded tirzepatide from a pharmacy that did not actually compound the product. The adverse event report included symptoms such as redness, site swelling, pain, and a red lump at the injection site.

Recommendations for consumers

The agency encourages patients to be vigilant and know the source of their medicine. 

  • Carefully check labels of compounded GLP-1 drugs for warning signs such as spelling errors or incorrect addresses and ensure your medicine is provided by a licensed pharmacy and prescribed by a licensed health care provider.
  • If you receive a product with a licensed pharmacy name on the label that you think might be fraudulent, contact the pharmacy to ask if it is their product. 
  • Talk to your doctor if you have questions about your medicines.

Dosing concerns with compounded semaglutide and tirzepatide 

FDA received multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products. These dosing errors resulted from patients measuring and self-administering incorrect doses of the drug, and in some cases, health care professionals miscalculating doses of the drug.  

Additionally, the agency has received adverse event reports that may be related to patients prescribed compounded semaglutide or tirzepatide products in doses beyond what is in the FDA-approved drug label. This could mean using more product in a single dose, taking doses more frequently or increasing the amount more quickly (titration schedule). Some of the adverse events are serious and some patients reported seeking medical attention for their symptoms, including nausea, vomiting, diarrhea, abdominal pain and constipation. 

Health care providers should be vigilant when prescribing compounded semaglutide or tirzepatide products and determining appropriate doses and titration and dosing schedules for patients. The agency also encourages patients to talk with their health care provider or compounder about how to measure and administer the intended dose of compounded semaglutide or tirzepatide. 

Retatrutide and cagrilintide cannot be used in compounding

Retatrutide and cagrilintide cannot be used in compounding under federal law. Additionally, these are not components of FDA-approved drugs and have not been found safe and effective for any condition.

Salt forms should not be used to compound semaglutide 

The agency is aware that some semaglutide products sold by compounders may be the salt forms. These salt forms, including semaglutide sodium and semaglutide acetate, are different active ingredients than are used in the approved drugs. The agency does not have information on whether these salts have the same chemical and pharmacologic properties as the active ingredient in the approved drug, and we are not aware of any lawful basis for their use in compounding.  

Adverse events related to compounded versions of semaglutide and tirzepatide  

FDA has received reports of adverse events related to compounded versions of semaglutide and tirzepatide. However, federal law does not require state-licensed pharmacies that are not outsourcing facilities to submit adverse events to FDA so it is likely that adverse events from compounded versions of these drugs are underreported. Many of the adverse events reported for compounded products appear to be consistent with adverse events related to the FDA-approved versions of these products.  

As of July 31, 2025, the FDA has received: 

  • 605 reports of adverse events associated with compounded semaglutide.
  • 545 reports of adverse events associated with compounded tirzepatide.

It is not always possible to determine if the adverse event directly resulted from use of the drug or if other factors may have contributed to these adverse events. 

Illegally marketed versions of these drugs 

Counterfeit Ozempic

FDA is aware of counterfeit Ozempic marketed in the U.S. Counterfeit drugs claim to be authentic, but could contain the wrong ingredients, contain too little, too much or no active ingredient at all or other harmful ingredients, and are illegal. 

The agency investigates reports of suspected counterfeit drugs to determine the public health risks and the appropriate regulatory response. FDA remains vigilant in protecting the U.S. drug supply from these threats.   

Illegal online sales of these drugs

FDA monitors the internet for fraudulent or unapproved drugs and has issued warning letters to stop the distribution of illegally marketed semaglutide and tirzepatide. These illegally marketed drugs:

  • may be counterfeit
  • could contain the wrong ingredients or harmful ingredients
  • could contain too little, too much or no active ingredient at all 

The agency urges consumers to be vigilant when purchasing drugs online and only purchase from state-licensed pharmacies.  

Versions sold falsely for research purposes or not for human consumption 

FDA has warned companies that have illegally sold unapproved drugs containing semaglutide, tirzepatide or retatrutide that are falsely labeled “for research purposes” or “not for human consumption.” These products have been sold directly to consumers for human use with dosing instructions. The agency urges consumers not to purchase these products which are of unknown quality and may be harmful to their health.  

Reporting issues to FDA

FDA encourages health care professionals, patients and compounders to report adverse events or quality problems with these or any medications to FDA’s MedWatch Adverse Event Reporting program:

  • Complete and submit the report online, or
  • Download and complete the form, then submit it via fax at 1-800-FDA-0178.

You also may contact the CDER Division of Drug Information at druginfo@fda.hhs.gov or 855-543-3784.

Filed under: General Problems | 2 Comments »

There are NO LEGAL FENTANYL TABLETS THEY ARE ALL ILLEGAL FENTANYL TABS

Posted on August 20, 2025 by Pharmaciststeve

I count EIGHT TIMES that the word FENTANYL is mentioned in this pretty short press release by the DEA. AND NOT ONCE do they state that they are talking about ILLEGAL/ILLICIT Fentanyl analogs. That could  contain not only an illegal Fentanyl analog but could also contain various other drugs, a couple of veterinarian meds, illegal Cocaine, Methamphetamine, Marijuana, etc, etc.  If they are showing illegal Fentanyl tablets that they confiscated – there is no Fentanyl tablets produced by our legal Pharmaceutical companies and so any/all substances that is claimed to be a Fentanyl product, could contain a cornucopia of various illegal drugs. 

Also, I have read that all the illegal drugs that the DOJ/DEA confiscate, is only 12%-15% of what actually gets to our streets and the number of people lives they claimed that they have saved by confiscating all the illegal drugs they did. You can multiply that number by 7 to 8 as the potential real numbers of people that could get poisoned/OD’s by what got to our streets.

The DEA has been fighting the WAR ON DRUGS since 1973, and the real numbers seem to be that they have successfully denied more chronic pain pts from getting their necessary medications, than the number of illegal drugs that are killing our fellow citizen on our streets.

 

Filed under: General Problems | 1 Comment »

CVS Caremark continues to flout West Virginia law

Posted on August 19, 2025 by Pharmaciststeve

Maybe this explains why the CVS Health net profits are substantially increasing each year when other pharmacies are having trouble just paying their bills. Rite Aid just declared their last bankruptcy and closing their last 1000 stores. Walgreen is selling the company to some financial group.

The West Virginia Office of the Insurance Commissioner (OIC) issued a $1.4 million fine to CVS Caremark based on 2,871 violations of several provisions of the 2021 Pharmacy Audit Integrity Act. The OIC said CVS Caremark improperly applied the definition of “rebate” when withholding rebate payments and fees from the health plan, recouped excessive funds from pharmacy claims relative to the financial harm associated with the dispensed products, and exceeded the maximum number of prescriptions covered in a pharmacy audit.

The company also delivered contracts and communications to providers that cited fees associated with the cost of pharmacy audits in excess of those allowed by law and unreasonably designated 65 covered prescription medications as specialty drugs.

The commissioner ordered CVS Caremark to file a plan to address the violations within 30 days and is allowing 90 days to implement it. In the meantime, CVS Caremark requested a stay of the penalty order through the state’s Supreme Court of Appeals. The OIC previously fined CVS Caremark for reimbursing pharmacies below the required commercial market benchmark of NADAC plus the state Medicaid program’s professional dispensing fee.

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Does Sec Kennedy have a clue of the 100+million chronic pain pts will never be able to participate in MAHA

Posted on August 19, 2025 by Pharmaciststeve

Is PAM BONDI/DOJ/DEA AGENDA diametrical opposed to Sec Kennedy’s MAHA (Make American Healthy Again) agenda?  Some 25%-30% of our population has had their QOL continuing deterioration over the last decade. How can that population have any chance of getting healthy again and optimized their QOL, if the intensity of their chronic pain has been increasing because of DOJ/DEA has been constantly intimidating practitioners to prescribe fewer and fewer pain meds along with making the pharmas production quotas >50% less over the last decade. 

Sec  Kennedy is in charge of MAHA (Make America Healthy Again). My money is on that this woman who posted the text below, he doesn’t have a clue about this woman or probably millions of chronic pain pts that are suffering/dying out of sight – out of mind. She is also one of millions that will never be able to attempt to GET HEALTHY AGAIN. All wars have their COLLATERAL DAMAGE, How many tens of millions of chronic pain pts are/have been collateral damage of the war on drugs that has turned into pretty much a COVERT GENOCIDE?

This is suppose to be RFK,Jr’s secretary’s email:  OSA11y@hhs.gov

Robert F. Kennedy Jr. arrives to testify before the Senate Finance Committee during a confirmation hearing on his nomination to be Secretary of Health and Human Services on Jan. 29, 2025, in Washington, DC.

I want to thank you for everything you and Dr Ibsen do for the pain community. You are an amazing human being. A couple of weeks ago I couldn’t take it anymore. I felt like the pain was getting worse and I got sicker. I became homeless and that was the last straw for me. I decided to end my life. I don and cannot do this anymore and if it wasn’t for the stupid cleaning lady at the hotel I would have succeeded I spend time in the ICU and then in a horrible mental ward, then back on the street. My dignity was taken from me. I now have a roommate and thought I would get back on track. But my health won’t hear of it. I have on top of AA cellulitis in both of my lower extremities, kidney stones and a couple of days ago a Merda diagnosis. The spores are in my body. I was send home with four antibiotics that are killing my body as well as Ibuprofen and Tylenol for the stones. I can’t walk far anymore and have given up I wrote a letter for you and Mark should something happen to me. Please, get it to a newspaper. I know I am asking much but I don’t have anyone who would do that for me. Please continue to support those patients and Mark, keep fighting. I love you both, thank you from the bottom of my heart.

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