MSNewsNow.com – Jackson, MS

http://www.msnewsnow.com/story/38346875/what-about-us-innocent-victims-of-the-opioid-crisis

JACKSON, MS (Mississippi News Now) –

Mississippi leads the nation in the number of opioid prescriptions written. In 2016, there were 560 opioid deaths here and the National Institute on Drug Abuse reports more than 115 people in the United States die every day after overdosing on opioids. 

It’s these statistics that have led to lots of regulation — rules and regulations that some are saying have gone too far.

In some cases these rules and regulations prevent patients from getting the much needed relief these prescriptions offer.

Meet Hugh. 

He’s just one of many folks here in Mississippi needing these meds and now, with all the new regulations, Hugh and so many other people are asking…

“What about us?”

Hugh Swarts said he was proud to serve his country in the military and would still be serving if he could. He suffered serious injuries in Vietnam, including multiple gunshot wounds and a type of cancer related to the chemical, Agent Orange. In addition to chronic pain, Swarts also suffers from PTSD.

Click here to watch Hugh Swarts’s full interview

In January, he and his wife, Linda, were stunned to learn the opioid that has kept him stable for more than 15 years, was no longer available.

”And since this happened, everything’s falling apart,” said Swarts. “We stay upset. I don’t sleep anymore because of worrying about this.”

“My pain medicine has been cut, I say, by a third down,” said Thomas McCoy. “So I’m taking a third of what I was taking before.”

McCoy said he’s been prescribed an opioid for the pain he suffers from a back injury since 1999.

”People that are in chronic pain that go through this, we’re not drug addicts,” explained McCoy. “We’re legitimate patients that have legitimate disorders and there’s nothing else we can do.”

These are two of the victims caught in the scramble to address a very serious opioid abuse crisis in Mississippi and all across the country.

“While we want to turn off the spigot, we created these folks who’re dependent on opioids out there for their function and it’s not either or,” said U.S. Surgeon General Jerome Adams.

The epidemic brought the U.S. Surgeon General to the University of Mississippi Medical Center for a panel discussion that included a host of medical professionals and Governor Phil Bryant.

READ MORE: U.S. Surgeon General in Mississippi to discuss opioid epidemic

“Now, I don’t go about issuing executive orders on a daily basis, but it had risen to the level of a crisis of a tornado,” said Governor Bryant.

That executive order, issued last year, requesting the Mississippi Board of Health issue rules to limiting opioid prescriptions, among other things; leaving many in the medical community scratching their heads.

“There’s been some confusion,” said Dr. William Aron. “I’m confused about it.”

Dr. Aron heads Pathway Healthcare, an addiction treatment center in Jackson.

“Mississippi has one of the highest rates of opioid prescription writing in the nation,” explained Aron. “It’s not extremely high in the number of deaths but there have been something like 560 deaths in 2016.”

Dr. Aron said studies show opioids are not the best way to manage pain, but alternatives are often too expensive and not covered by insurance.

Thomas McCoy said,  “Doctors are afraid to prescribe medicine because of, you know, the DEA or whatever coming in,” said McCoy. “So they’re using the CDC guidelines as though they’re the law and they were set up to be a recommendation of how to treat people when they started on chronic pain medicine.”

For Hugh and Linda Swarts, it’s a situation, they say, where politics and medicine don’t mix.

“But for politics to be involved, I don’t see where the Governor got his medical training,” said Linda Swarts.

“I would like to take the least amount possible too, but I don’t want to end up back the way I was when I was in the hospital nine months out of the year, because til this happened, I was totally stable,” said Hugh Swarts.

“I feel sorry for people that are addicted to the drugs,” said McCoy. “I have known people that have died that were addicted to the drugs, but just because they’re abusing the medication. We should’t punish the people that aren’t.”

“I’ve got a few years left,” said Swarts. “I’m in my 70s. I don’t understand why, as long as I’m doing what the doctor orders, why politics can get involved in my medical treatment.” 

So, what are the alternatives?

Doctors say treatments like acupuncture or nerve blocks may work and there are high-tech chronic pain relief alternatives like radio waves and electrical signals.

Some medical professionals point to harvesting stem cells from a patient’s bone marrow and injecting them back into an affected area is one of the most promising future solution.

Filed under: General Problems | 2 Comments »

Can pharmacists deny medications in Arizona? It depends

https://www.azcentral.com/story/news/local/arizona/2018/07/24/can-pharmacy-refuse-fill-prescriptions-arizona/823305002/

In recent weeks, two people were denied medications at Arizona pharmacies, bringing attention to laws that govern when and why pharmacists can refuse to fill prescriptions.

Hilde Hall, a transgender woman, said last week that a pharmacist at CVS in Fountain Hills refused to fill a prescription for hormones. CVS said the pharmacist violated company policy and was fired.

A few weeks earlier, Nicole Arteaga said she was denied a prescription to medicine for a miscarriage at a Peoria Walgreens. The company said their policy allows employees to not fill prescriptions if they have moral objections, but the prescription is supposed to be referred to another pharmacist to meet the patient’s needs in a timely manner. 

In Arteaga’s case, a state law allows pharmacists and doctors to deny care for abortion-related procedures and medications. The medicine for Arteaga’s miscarriage, misopristol, can also be used for medication abortions.

But in Hall’s case, there is no state law that explicitly allows pharmacists to deny medication to transgender people, and federal law says people can’t be denied care because of gender identity.

Pharmacists have a clear right under Arizona law to not fill prescriptions of abortion medication, but it’s not clear how state law affects those who refuse prescriptions in other cases, like Hall’s. 

What the law says about abortion medications

Arizona law contains a so-called “conscience clause,” which allows pharmacists and other health professionals to object to participating in or facilitating certain abortion-related health care practices. 

The law says they can object in writing to “abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum on moral or religious grounds.”

If a pharmacist objects, they are supposed to return the prescription to the patient. 

Several states have similar refusal laws, while other states specifically prohibit pharmacists from denying medications on moral grounds alone, according to the National Conference of State Legislatures. 

Religious grounds can’t affect licenses

Another Arizona law says the government can’t “deny, revoke or suspend” a professional license, like that of a pharmacist, based on the practice of their religious beliefs, as long as the behavior doesn’t constitute “unprofessional conduct” for the profession.

The statute says professionals can decline to provide or participate in services that violate their “sincerely held religious beliefs.”

It also says the person can’t lose their license if they express these beliefs in a professional setting “as long as the services provided otherwise meet the current standard of care or practice for the profession.” 

In Hall’s case, it is not clear why the pharmacist refused to fill the prescription. 

The Arizona State Board of Pharmacy doesn’t include denying medications in its rules under unprofessional conduct. 

While pharmacists may be protected from losing their license for refusing to fill a prescription for religious beliefs, they could be fired if they don’t follow company policies when they do so.

Federal law may apply

A provision in the federal Affordable Care Act prohibits discrimination by health providers who receive federal funding, which may apply to the situations of refused medications.

Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, disability and gender identity by any health-care organizations that receive federal funding. 

Pharmacies like CVS and Walgreens typically receive federal funding because they accept payments from Medicare and Medicaid.

A post about the ACA provision on the American Pharmacists Association’s website from 2016 says the rule may allow civil lawsuits against pharmacies that refuse to “treat patients in a manner consistent with their gender identity.”

Can’t deny for any reason

Kam Gandhi, executive director of the state pharmacy board, said pharmacists can’t refuse any medications — only those legally allowed under the abortion medication statute.

“Pharmacists do have the right to refuse to fill prescriptions, but it has to be for a legitimate medical reason,” he said.

Pharmacists have a responsibility to make sure medications don’t negatively interact with each other, and they have more leeway to refuse fills on controlled substances, Gandhi said.

“I don’t want to say their forced to fill it, but they have to have a pretty darn good reason not to fill it,” he said.

Customers can file complaints with the pharmacy board if they believe a pharmacist has violated the law. The pharmacy board said it is investigating both recent cases of refusals.

Confusion reigns

Steve Kilar, a spokesman for the Arizona chapter of the American Civil Liberties Union, said the organization believes it’s only legally justified to deny medication in the specific instances outlined in the state statute on abortion services.

But that provision on abortions is “creating too much confusion” for pharmacies over what they can and can’t do, Kilar said.

“People shouldn’t have to guess as to whether they’re going to be served when they walk into a place of business,” he said.

Emma Chalverus, an employment attorney at law firm Davis Miles McGuire Gardner, said the laws that govern pharmacy refusals are complicated.

The case of the misopristol denial falls under the specific statute that allows pharmacists to deny abortion services, Chalverus said.

“It is clear that in the first case with Walgreen’s the pharmacist was allowed to refuse to give her her medication,” she said.

But there is not a parallel law that allows denials for medications for transgender people, she said. However, there isn’t a law that says pharmacists must dispense those medications either, she said.

“When there’s no law there, it’s hard to give a definitive answer,” Chalverus said.

She said companies may want to accommodate employees who have sincerely held religious beliefs, but they likely have policies that dictate what should then happen if a pharmacist refuses to fill the prescription.

If an employee doesn’t follow those company policies, the company is probably within its rights to fire them, she said.

Reporter Bree Burkitt contributed to this story.

Filed under: General Problems | Leave a Comment »

Patients in ‘dire need’ of opioids after a crackdown on pain clinics

https://www.courier-journal.com/search/clark/

Retiree Michael Anderson says he’s dependent on the opioids that ease the searing pain in his neck and head, but his supply was abruptly cut off when investigators raided his pain clinic.

“I’m in dire need,” the 67-year-old said during a recent interview at his Louisville apartment. 

Anderson suffers from occipital neuralgia, electric-shock-like chronic pain in the neck and back of the head. He knows when his medication runs out, painful withdrawals will begin.

He is one of thousands of Kentuckiana chronic pain patients displaced by local, state and federal crackdowns on clinics accused of being pill mills, defrauding Medicaid or both, according to area doctors. And Russell Coleman, U.S. Attorney for the Western District of Kentucky, has said other investigations are underway — with more closures and criminal charges anticipated.

Louisville’s plight of pain patients clambering for a doctor mirrors a national trend after Attorney General Jeff Sessions created a task force in February to target opioid abuse, including overprescribing of pain and addiction medicines.

Doctors say the federal raids on medical clinics lead to unintended consequences — patients thrust into painful withdrawals and left vulnerable to suicide or dangerous street drugs.

“We were just left out there to swim in the sea,” Anderson said.

There aren’t enough addiction or pain specialists to accommodate an influx of patients from ongoing closures, said Dr. Kelly Clark, a Louisville addiction specialist who heads the American Society of Addiction Medicine. 

“This is a hole in the public health system. They are currently trapped,” she said of displaced patients. “There will be more.”

Area physicians are hustling to coordinate a response to help patients whose treatment regimes were interrupted without warning, said Dr. Wayne Tuckson, president of the Greater Louisville Medical Society.

When investigators “go in with a sledgehammer and shut down a practice without consulting community physicians, suddenly we have patients thrown loose,” he said.

“We do have a significant overdose problem and we have to do something about that. But we have to be careful that our actions do not jeopardize the care of patients.”

Federal officials have described one of their critical roles as targeting rogue doctors who capitalize on vulnerable pain and addiction patients with a free flow of addictive pills.

Many general practitioners haven’t received pain management training, making them uncomfortable especially authorizing high doses of narcotics. Fears can be exacerbated when doctors can’t review the patients’ treatment history because investigators have seized medical files.

“Docs are very much afraid when it comes to writing pain medications,” Tuckson said. “We don’t want patients to become addicted. And we don’t want to have our licenses — and therefore our livelihoods — at stake.”

Clark and Tuckson are teaming with health department officials, pain management and addiction specialists and emergency room physicians to develop a list of resources for patients. Dr. James Patrick Murphy, a pain and addiction specialist who treats Kentuckiana patients, helped rally peers by sending an email last week that warned: “We are going to be flooded by patients in crisis.”

Murphy said doctors plan to create a website and model the guide after one in Washington.

Dr. Brett Stacey, medical director of the Center for Pain Relief at the University of Washington Medical Center-Roosevelt, described the “panic through the Puget Sound region” in 2016 when 2,500 patients were displaced after a pain practice with multiple locations closed. Officials scrambled to set up a hotline, manned by pain-trained pharmacists, with backup from physicians, Stacey said in a YouTube video posted by Pharmacy Times TV.

Louisville doctors are working to set up a similar hotline for patients with a list of area doctors willing to accept new patients either on an interim basis or long term.

“I would love to tell you we will have something in place before the next doors are shuttered, but we don’t know when that will be,” Tuckson said.

Anderson said he first learned about the criminal probe of his doctor’s practice, Bluegrass Pain Consultants, after seeing a June 12 television newscast of law enforcement raids that included the Champion Farms Drive location next to the Montessori School of Louisville. The retiree said he frantically tried to call the office for instructions on what to do, but said he couldn’t get through to any employees and was placed on a long hold before the call was disconnected.

One Bluegrass location, on Dutchman’s Parkway, does remain open Monday through Friday with “limited hours,” according to a voice message at the business. Calls seeking specific hours and comment on the probe have not been returned.

Regardless, Anderson said two pharmacists from different companies told him they won’t honor any prescription issued by Bluegrass. Law enforcement officials, including the U.S. Drug Enforcement Administration, won’t publicly name doctors or businesses that are being investigated unless official charges are brought.

But if pharmacists learn of a police raid of a clinic or have other reasons to suspect a prescription might not be legitimate, they can turn the customer away. 

“As long as the doctor is still licensed the prescription is still valid, but they have a right to refuse if they don’t like the look of a prescription,” said Benjamin Vinson, DEA’s supervisory diversion investigator.  

Pharmacists can check a private DEA registry of doctors allowed to prescribe controlled substances — and verify state medical licensure, Vinson said. 

Mark Glasper, executive director of the Kentucky Pharmacists Association, recommends that patients whose prescriptions aren’t being honored, seek treatment from their primary care physicians.

Anderson rushed to find another pain clinic, but said his medicine will run out before the late-July appointment.

He plans to ask his general practitioner to refill his oxycodone, but he doesn’t know if the doctor will agree to prescribe an opioid.

Days ago, he began drastically reducing his regular dose of oxycodone — known by one of the namebrands, OxyContin — to conserve the remaining pea-sized pale-green pills. But that left him dizzy, off-balance and coping with numbness on his face, sensitivity to light and sounds and a throbbing headache. He canceled his water aerobics class, skipped his performance in the church choir and has mostly remained inside his apartment.

“If a practice is closed, the patients who are legitimately taking their medications as prescribed can be in a dire situation,” Clark said. “They look and feel extremely sick.”

Some patients likely will end up in emergency rooms from opioid withdrawals, which can cause cramps, chills, sweats, vomiting, diarrhea, sleeplessness and dehydration.

For patients who are dependent — not addicted — they will feel better after a few days of withdrawals, Clark said. Those who are addicted wouldn’t be able to voluntarily taper off and going through withdrawals wouldn’t stop cravings. 

Due to an unrelated mishap, Anderson once went without his medicine for more than a week, sending him into withdrawals. He couldn’t sleep, his body trembled from “twitches,” he was anxious and began to hallucinate. 

“I sat up here and cried,” he said. “I don’t think I could go through that again.”

The Courier Journal will publish the hotline and website listing resources as soon as it is available.

If you’re experiencing depression, contact the Seven Counties crisis line at 502-589-4313.

Reporter Beth Warren: bwarren@courier-journal.com; 502-582-7164; Twitter @BethWarrenCJ. Support strong local journalism by subscribing today: www.courier-journal.com/bethw.

It would appear that Dr Clark has been dealing with addicts too long and/or she believes that chronic pain is not a real disease worth treating.  Just imagine how some pts would feel that has diabetes, COPD, hypothyroidism, asthma, hypertension or other disease issues that require routine medication to help them control the adverse effects of their disease state… if they have to stop taking their medications.. how many days before you think that they will start feeling better ?

Of course, everyone’s body is DEPENDENT on food, liquid/water, sleep… I wonder how many days it would take Dr Clark to “feel better” if she stopped “feeding” those dependencies ?

You know there are 3+ cops killed every week in 2018 and yet when is the last time that you have even heard of a DEA agent even getting shot… let along killed ? If you have noticed for the last couple of years – in particular – all you read about in the media is about illegal substance being seized in transit and/or raiding some prescriber’s office.  HALF of DEA agents WORKS AT A DESK… that is where they do all their “desk audits” of the prescriber’s offices that they raid…  but doing these two things… gives them enough material to create the media enough content to give the image that they are doing something productive in the war on drugs. Just nothing dangerous or would put their “asses at risk”.

Filed under: General Problems | 3 Comments »

The pharmacist at the Royston GA rite/walgreens refused to fill my script, his name is Chris and he said he couldn’t fill because it was written from my pain Dr in brasselton. He said it would have to be from a local dr. I live in Royston GA an I think this is definitely denied  my rights. The is script is valid and I only fill at walgreens ,I don’t use any other pharmacy

The 2010 census population of Royston, GA was 2582 and it was LOWER in 2016 of 2563… and this Walgreen pharmacist expects a pt to find a pain specialist in such a small town ?  According to www.healthgrades.com the closest “pain doc” is abt 25 miles away.

I realize that the DEA claims that a pt traveling a “long distance”  to get a controlled med prescribed or dispensed… but have they defined what a “long distance is” ?

Is this just another example of a pharmacist … when handed a Rx for a controlled med.. starts looking for a reason to “just say no”… at one time the common excuse was “I’m not comfortable”.. and just what does that mean… they are constipated ?… they haven’t had time to take a restroom break ? The temperature in the Rx dept is too hot or too cold ?

Recently a CVS pharmacist got FIRED because he  not only refused to fill a transgender pt a Rx for female hormones but also confiscated the prescription  https://www.nytimes.com/2018/07/20/us/cvs-pharmacy-transgender-woman-nyt.html

When is the last time that you saw where a pharmacist got FIRED for refusing to fill a chronic pain pt’s prescription for pain medication… strangely enough both the transgender pt and the chronic pain pt are consider a “protected class” under the Americans with Disability Act.  Likewise, the ACLU was “johnny on the spot” when the transgender person got denied.. and how many chronic pain pts have contacted the ACLU about being discriminated against at the local Rx dept and been given some excuse for not interested in getting involved.

Did anyone notice that the DOJ’s Civil Rights Div was AWOL on this discrimination issue with CVS and the transgender pt ?  Didn’t AG Session claim that he was going to be a “by the book” Attorney General ?  Maybe Jefferson Beauregard Sessions III has some pages missing from his “book” or just hasn’t been able to read “every page” ?

Filed under: General Problems | 2 Comments »

Feds order Georgia sheriff to return $69G spent on Hellcat muscle car

http://www.foxnews.com/auto/2018/07/20/feds-order-georgia-sheriff-to-return-69g-spent-on-hellcat-muscle-car.html

A Georgia police department is in hot water over the purchase of a Hellcat muscle car.

Fox 5 reports that the U.S. Department of Justice has asked the Gwinnett County Sheriff’s Office to pay back $69,258 that it received from a federal program that distributes seized drug money to law enforcement agencies, which was used to buy the 707 hp Dodge Charger Hellcat in May.

“We have not yet responded to that letter and we’re examining all our options,” department spokesperson Shannon Volkodav told Fox 5.

The Charger is a popular vehicle among law enforcement agencies, but Dodge does not make a Special Service model with the Hellcat’s 6.2-liter supercharged V8 engine for this purpose. The Hellcat boasts a top speed of 204 mph.

The black sedan is being used as Gwinnett County Sheriff Butch Conway’s official car, which the DOJ said differed from the use stated in the application for the funds as an “undercover/covert operations” vehicle.

The federal agency described it as an “extravagant expenditure,” which is not allowed under the program.

The department has also used the car to promote a “Beat the Heat” community outreach program, where citizens get to race against police officers on drag strips and are taught about the dangers of street racing and distracted driving.

DODGE CHARGER HELLCAT TEST DRIVE

Volkodav said that there was no intention of misleading the DOJ and that the language used in the letter was essentially boilerplate for any vehicle assigned to the department’s special investigative services division.

“Staff is working with the Sheriff’s Office to respond to the Department of Justice regarding the vehicle purchase. We are committed to resolving the matter quickly and will be adding review points in our process for equipment purchased with asset forfeiture funds to make sure we comply with guidelines set forth by the Department of Justice,” Gwinnett County Administrator Glenn Stephens told Fox 5.

Georgia Ethics Watchdog’s Director William Perry told the Atlanta Journal-Constitution that the program money should be “treated the same way as a dollar coming out of a taxpayer’s pocket.”

Until the matter is resolved, the Sheriff’s Office has been cut off from the DOJ’s seized asset reallocation program.

Filed under: General Problems | Leave a Comment »

Tough reelection? Sponsor an opioid bill

Most of the bills sponsored by vulnerable lawmakers are not controversial, in part because they don’t designate new spending

https://www.politico.com/story/2018/06/16/lawmakers-opioid-bills-midterms-624926

Everybody wants their name on a bill addressing the opioid crisis — especially Republicans facing tough reelection battles.

That’s why House leadership will bring more than 70 such bills to the floor by the end of the month, many sponsored by the most vulnerable members of the GOP conference. The schedule allows lawmakers to show they’re trying to combat a public health emergency that claims 115 lives per day and is a top concern of midterm voters. But it’s a cumbersome, piecemeal approach involving hours of votes on narrow bills that Democrats complain don’t go far enough and are being rushed through the legislative mill.

“We know we’ll have to pull them together at some point, but they put a lot of work into them,” said House Energy and Commerce Chairman Greg Walden (R-Ore.), whose panel originated most of the measures. “Everybody has their own idea and their own cause and thing they’re working on.”

This week alone, the House passed more than 30 bills sponsored by members from both parties, mostly by voice vote with no dissent. Democrats aren’t shy about touting their involvement, despite their misgivings about the overall process: Energy and Commerce ranking member Frank Pallone (D-N.J.) took credit for one bill that would expand the FDA’s power to stop illegally made opioids from arriving through international mails.

But it’s House Republicans who most feel the need to promote their legislative accomplishments. Eleven of the 17 GOP incumbents the nonpartisan Cook Political Report classifies as in toss-up races are primary sponsors of legislation that is expected to be considered by the House this week or next.

For good reason. The drug abuse epidemic is sure to again be a top issue with voters heading into the midterms. A CBS News poll from May found 71 percent of voters described it as a “very serious” issue facing the country, including 78 percent of Republicans, 72 percent of Democrats and 67 percent of independents. Nearly 80 percent of all voters said the federal government should do more to address the crisis.

Bringing dozens of bills to the floor, instead of one comprehensive measure, makes it easier for members to show they’re engaged, said former Republican Rep. Mary Bono, who now advocates for people recovering from addiction and is co-founder of the Collaborative for Effective Prescription Opioid Policies. “It’s hard to go out on the campaign and say I negotiated this provision into the bill,” she said. “Leadership recognizes they should give credit where credit is due.”

Responding to the crisis was a pillar of President Donald Trump’s campaign that helped capture hard-hit states like West Virginia, where he received nearly 70 percent of the vote. But critics say all the talk hasn’t translated into meaningful results, and they blame Republicans for simultaneously undercutting critical safety net programs like Medicaid.

“Republicans aren’t addressing the problem in a meaningful way,” said Rep. Jared Polis (D-Colo.), who is running for governor in his state. “If Republicans were serious about dealing with opioids, they would drop their assault on Medicaid,” he said, adding that the GOP’s efforts to repeal Obamacare would be disastrous for people with substance abuse issues.

The American Action Network, a GOP outside group, has launched a six-figure ad buy in 28 districts with competitive races, touting Republican candidates’ efforts to work across party lines to address the crisis.

“Members of Congress need to go in front of their constituents and explain to them what they’ve done to make their community a better place,” said Corry Bliss, executive director of the American Action Network and Congressional Leadership Fund.

Rep. Buddy Carter (R-Ga.) said voting on narrow bills one-by-one can prevent the legislation from getting bogged down by political roadblocks.

“There are a lot of good ideas out there,” he said. “And sometimes when you put them all together, then it kind of causes problems.”

Republican supporters of the bills say the extended time on the floor reflects how seriously the House takes the opioid issue.

Most of the bills sponsored by vulnerable lawmakers are not controversial, in part because they don’t designate new spending. Rep. Barbara Comstock of Virginia, who polls show trailing a Democratic challenger in her suburban swing district outside Washington, D.C., sponsored one measure that passed and would require HHS to issue guidance on obtaining better clinical data on non-opioid alternatives.

Likewise, Rep. Carlos Curbelo of Florida, who polls also show is trailing in one of the most competitive races in the country, has a bill that would require HHS to develop a toolkit for hospitals to help reduce opioid misuse.

Other bills focus on propping up the behavioral health workforce, expanding access to treatment and curbing the flow of illicit substances.

The House-approved bills are expected to be combined into a single package that will be sent to the Senate. There, lawmakers plan to bring their own anti-opioid legislation to the floor next month. The HELP and Finance committees have combined their opioid-related bills into one legislative package each. It’s unclear whether amendments will be allowed on the Senate floor — a process lawmakers would like, but that could up take time.

Advocates are divided on how much the work will reduce overdose deaths and prevent more people from becoming addicted.

“It’s a very comprehensive response,” said Jessica Nickel, founder and CEO of the Addiction Policy Forum. “It addresses non-opioid alternatives, important prevention programs and child welfare components. It’s a really important step.”

But some say that without guaranteed, long-term funding, the legislation won’t make much of a difference.

“This is not going to fix the problem,” said Mark Covall, president and CEO of the National Association for Behavioral Healthcare. “We need to find a sustainable solution. We shouldn’t be looking at it from a grant-based system.

This has been a long-term problem that is not going to go away.“

Pick whatever you want 2 -3 -12 million .. as the number of serious addicts/substance abusers..  No matter which number you chose … it is dwarfed by the number  of chronic pain pts..  but who does the 435 member of House of Representatives  claims to care about ?

According to this article, they are still using the “fake facts”  from the CDC of 115 lives OD’s every day. Who recently admitted that they overstated that number by 53%.

If you are a chronic pain pt .. you probably need to research your Federal Representative position on this issue – opiate abuse – which they admit  –

This has been a long-term problem that is not going to go away.

Filed under: General Problems | Leave a Comment »

https://www.forbes.com/sites/nicksibilla/2018/07/20/congress-demands-justice-department-return-millions-seized-unfairly-from-taxpayers/#2fa782421043

In the latest salvo against civil forfeiture, 21 Republican Members of Congress sent a letter to Attorney General Jeff Sessions on Thursday that demanded the Justice Department “immediately return” up to $22 million that was “seized unfairly by the government.” Using civil forfeiture, the Internal Revenue Service raided bank accounts from hundreds of owners for alleged “structuring” offenses, which involves making a series of cash transactions under $10,000 to skirt federal reporting requirements.

“What was done was not fair, just or right in most cases,” the letter declared, which was co-signed by House Ways and Means Chair Kevin Brady (R-TX), Oversight Subcommittee Chair Lynn Jenkins (R-KS), and former Oversight Subcommittee Chair Peter Roskam (R-IL). “The IRS’s actions led to the destruction of many lives and small businesses, some of which will never fully recover.”

In response to a public backlash, the IRS announced two years ago that it would notify owners who had their property forfeited under structuring laws that they could file petitions to recover what was taken. Appearing before a House Ways and Means Oversight Subcommittee hearing last month, representatives from both the IRS and Justice Department provided an update on the structuring petitions they had received. The contrast between the two agencies was stark.

After mailing over 1,800 letters to property owners, the IRS received 464 petitions. Upon further review, only 208 petitions were within its jurisdiction. Among those petitions, the IRS decided to grant 174 (or roughly 84 percent), and returned over $9.9 million to property owners.

For the remaining 256 petitions, the IRS sent those to the U.S. Department of Justice, and recommended that DOJ grant 194 of those petitions. Yet the Department only accepted 41 petitions—less than 1 in 6 petitions—and refused to return more than $22.2 million.

Slamming DOJ’s position as “wholly indefensible,” the Members of Congress wrote that they were “profoundly troubled by the significant discrepancy between the IRS’s recommended outcome and DOJ’s final decisions.” “By DOJ’s own testimony, the mitigation process acts as a pardon request, permitting a plea for leniency,” noted the letter. “It provides DOJ with a safety valve that allows for the correction of actions taken by the Government, which in hindsight, we may realize were in error. This is one of those instances.”

Although structuring was promoted as a way to combat money laundering, drug trafficking, and other criminal enterprises, the IRS regularly seized money that had been legally earned by small business owners. In fact, a report by the Treasury Inspector General for Tax Administration found that out of a sampled 278 structuring cases, 91 percent were “legal source cases,” i.e. they were not derived from illegal activity.

But in October 2014, the IRS announced that it would no longer confiscate cash from legal source structuring cases, after The New York Times ran a front-page story on new lawsuits filed by the Institute for Justice that challenged structuring. As for illegal source cases, the IRS has only conducted 32 seizures since the new policy was implemented.

The shift in policy was an important win for private property rights and due process. But it did not apply to owners who had their cash confiscated before the policy change. In order to help prior victims of structuring get back their money, the Institute for Justice filed “petitions for remission or mitigation” in 2015, paving the way for others to follow. In less than a year, IJ successfully secured the return of $29,500 taken from Randy Sowers, a Maryland dairy farmer, and more than $150,000 that was forfeited from Ken Quran, who runs a convenience store in rural North Carolina. Neither man was ever charged with a crime.

Now the fate of the 194 owners denied their property’s return by DOJ may ultimately lie with Jeff Sessions, one of the nation’s top cheerleaders for civil forfeiture. Last summer, the Attorney General reversed restrictions placed on “adoptive” forfeitures, making it easier for local and state agencies to circumvent state laws that protect innocent owners. He later defended that decision by declaring, “I love that program. We had so much fun doing that, taking drug dealers’ money and passing it out to people trying to put drug dealers in jail. What’s wrong with that?”

Yet even Sessions has voiced qualms about structuring. During a 2015 Senate Judiciary Committee hearing on civil forfeiture, then Sen. Sessions said he believed that that “structuring can be abused,” and “people have made some valid points about it.”

Filed under: General Problems | Leave a Comment »

How do i get faster? I’m told I’m too slow. 80 seconds to grab medication. Count it. And label the bottle and place in the rack is too slow. 150 seconds to greet the customer. Get their medication. Take care of any issues and bag their stuff is too slow. I need to cut that time in half according to my boss.

60 seconds max per customer and 30-40 seconds to dispense. And maybe 30 seconds or less on data entry.

I’ve only improved by a couple seconds in 90 days.

What happened to ensuring patient safety these chains market to their customers?

How to find a local independent pharmacy/Pharmacist

Filed under: General Problems | 1 Comment »

Drug Firms Blame Opioid Crisis on Illicit Websites, Dealers

https://www.bloomberg.com/news/articles/2018-07-19/drug-companies-seek-to-blame-opioid-crisis-on-illegal-dealers

Two pharmaceutical companies say the real culprits in the opioids epidemic are illegal dealers of the painkillers and want them to be on the hook financially for any damages potentially assessed against drugmakers.

Endo International Plc and Mallinckrodt Plc sued a host of convicted drug dealers and Internet sites this week for illegally offering opioids. Among them: RxCash.Biz, which offers misbranded opioids online, an Italian man indicted for of operating so-called pill mills, and a Tennessee resident who’s serving 10 years for possessing fentanyl with an intent to distribute.

The companies also named Tennessee counties and towns, seeking a ruling that effectively limits the firms’ financial responsibility over claims they fueled a public-health crisis through their marketing of the prescription painkillers.

The suit, filed July 16 in state court in Kingsport, Tennessee, comes almost two months after a Tennessee judge rejected Endo’s and Mallinckrodt’s push to have the Tennessee municipalities’ opioid suit thrown out. Tennessee Attorney General Herbert Slatery III also sued opioid makers in May, saying their marketing of the drugs as nonaddictive violated federal and state laws.

If lawyers for Tennessee cities and counties persuade a jury to tag Endo and Mallinckrodt with millions in damages over their opioid sales, the drugmakers argue, they “are entitled to contribution from the illegal supply chain defendants,’’ according to court filings.

Gerard Stranch IV, a lawyer for Sullivan County, Tennessee, which is among the municipalities that sued the companies, said the case is frivolous.

“They’re basically suing us for not having enough body bags on hand to clean up after their mess,” he said. “It’s a PR stunt. What they’re trying to do is intimidate other cities and counties from filing these lawsuits against them.”

Opioid Judge Wants ‘Meaningful’ National Accord on Cities Suits

Endo and drugmakers Johnson & Johnson and Purdue Pharma LP are among the companies in talks with state attorneys general and lawyers representing cities and counties seeking a resolution of cases accusing the companies in the crisis. A judge in Cleveland overseeing the consolidation of local governments’ opioid suits has said he wants a deal that goes beyond money, addressing the companies’ business practices and the roots of the crisis that claims the lives of more than 100 Americans daily.

Endo, which makes the drug Opana, and Mallinckrodt, which produces a generic version of Oxycodone, say that 90 percent of opioid overdoses “involve illegal, non-prescription opioids and the majority of those who misuse prescription medications obtain their pills illegally.’’

Pharma companies have no duty to deter “illegal pill mills and unscrupulous doctors who divert legal drugs for illegal purposes,’’ their lawyers noted.

“This is the first in the nation type of filing that properly describes the cause of the so-called opioid epidemic as the true source, which is the illegal supply chain, which has been documented by regulators, the scientific community and even some of the authorities connected with the plaintiffs themselves,” said John Hueston, an outside attorney for Endo.

Stranch said the companies’ complaint cites a database the cities and counties don’t have access to, and pointed out that the drugmakers didn’t use that information to help stem the epidemic. He said that the companies are challenging findings that the court already made and trying to re-litigate the case.

He said he asked for information about any diversion of opioids to potential pill mills, as well as the identities of doctors suspected in overprescription or diversion activities and the drugmakers have refused to provide them.

Opioids and Heroin and the U.S. Epidemic of Addiction: QuickTake

Barry Staubus, Sullivan County’s district attorney, said the suit is without merit. Under Tennessee law, prosecutors can bring such civil cases on behalf of the residents of their counties.

“We’ve been inundated by opioids and we’ve done the best we can,” he said. “They’re trying to shift responsibility from themselves to someone else.”

Other plaintiffs include two other district attorneys and a baby, who allegedly was born with neonatal syndrome because of exposure to opioids. The two lawyers couldn’t be reached for comment.

“The whole idea is ridiculous,’’ said Paul Hanly, a New York-based plaintiffs’ lawyer and one of the leaders of the Cleveland process. “I don’t see why the drug companies think they should be absolved from liability for the conduct of third parties. I don’t think it will fly.’’

In its filing, Endo and Mallinckrodt seek a ruling barring the municipalities from challenging in the future a jury’s division of damages between the companies and the drug dealers.

The case is Endo Health Solutions Inc v. Alfa Bay, No. C-41916, Div-C, Sullivan County Circuit Court (Kingsport, Tennessee)

Filed under: General Problems | 9 Comments »

I did this post a few days ago

My Pharmacist Humiliated Me When He Refused to Fill My Hormone Prescription and ACLU cares about this denial

Below are a few posts from a Face Book page…. apparently from some techs that worked with this particular pharmacist and the issue was from back in April  but chain pharmacies do not like BAD PRESS… it would appear that CVS had put up with this pharmacist’s attitude for some time without taking any action.

“So I worked with the pharmacist in question in this article and I can say that he denied a lot of scripts for no logical reasoning…. he truly is a horrible human being.”

  “this pharmacist is the most egotistical jackass I have ever worked with. He absolutely refused to do anything besides verification because everything else is considered “tech work” he also spoke to the staff in a condensening manner and said things such as “I am a pharmacist, you are a tech, you do not speak unless spoken to”

“1) this was from april…. 2) the pharmacist in question has been terminated (rightfully so)… 3) customer relations is as helpful as our cvs help desk (helpless desk) … 4) good for her speaking her mind and bringing this to light“

Filed under: General Problems | 4 Comments »