CDC chief says fentanyl almost killed his son

https://www.nbcnews.com/storyline/americas-heroin-epidemic/cdc-chief-says-fentanyl-almost-killed-his-son-n891976

The new CDC director, Dr. Robert Redfield, says his son almost died of an opioid overdose when he took cocaine contaminated with fentanyl.

The head of the nation’s top public health agency says the opioid epidemic will be one of his priorities, and he revealed a personal reason for it: His son almost died from taking cocaine contaminated with the powerful painkiller fentanyl.

“For me, it’s personal. I almost lost one of my children from it,” Dr. Robert Redfield Jr. told the annual conference of the National Association of County and City Health Officials.

The AP viewed a video of his speech, which he delivered Thursday in New Orleans. Redfield declined to speak about it Monday, except to say in a statement: “It’s important for society to embrace and support families who are fighting to win the battle of addiction — because stigma is the enemy of public health.”

Redfield mentioned his younger son while talking about his priorities for the U.S. Centers for Disease Control and Prevention, where he started as director in March. He listed the opioid crisis first, calling it “the public health crisis of our time.”

Public records show that the son, a 37-year-old musician, was charged with drug possession in 2016 in Maryland. The outcome of the case is not available in public records.

Dr. Umair Shah, the head of Houston’s county health department, applauded the CDC director’s moment of candor.

“It was definitely an intimate moment that grabbed the audience of public health professionals,” said Shah, who just finished a term as president of the association.

About 70,000 Americans died of drug overdoses last year, according to preliminary CDC numbers released last week. That’s a 10 percent increase from the year before.

Most of the deaths involved opioids, which are driving the deadliest drug overdose epidemic in U.S. history. Growing numbers of recent deaths have been attributed to fentanyl and fentanyl-like drugs, which are relatively cheap and are sometimes cut by suppliers into heroin, cocaine or other drugs without buyers’ knowledge.

Can you imagine that.. using the two NOUNS in the same sentence MUSICIAN and COCAINE and anyone being surprised? This “adult kid” was charged with possession in 2016… so it was apparently known to his Father/parents that he had a substance abuse problem..  But his “Doctor”/Father now becomes concerned when his “kid” got a hold some of his “drug of choice” mixed with an illegal Fentanyl analog and almost died.

Was his known addiction/substance abuse of ILLEGAL SUBSTANCES history “no big deal” to his Father prior to his son’s brush with death ?

Now his Father has become a CRUSADER for those suffering from the mental health issues of addictive personalities…  I guess that the Centers for Disease Control and Prevention … the last and newest part of this federal agencies title… PREVENTION… there is apparently NO CONCERN about addressing the treatment/prevention of chronic pain and unrelenting pain of 100 + million of our citizens.

Poor Dr Redfield, he is having to deal with the stigma that his family’s gene pool is “defective” and his son’s mental health disease of addictive personality is a personal embarrassment to him and the family.

Maybe we need to expand the “covert genocide” that our bureaucracy is doing to those suffering from chronic pain and start sterilizing addicts and any off springs before they can spread their “defective gene pool” to the next generation. We can’t legislate morality, we can legislate the legal supply of opiates and other substances that are abused,  so is it time to start legislating what will less the DEMAND part of the equation ?

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WE’VE ALL HEARD THE CHILLING STATISTIC THAT EVERY DAY, AT LEAST ONE NEVADAN DIES FROM AN OPIOID OVERDOSE. THOSE NUMBERS HAVE BEEN USED TO JUSTIFY A CRACKDOWN ON PRESCRIPTION PAIN MEDICATIONS THAT LEFT THOUSANDS OF NEVADANS ABANDONED BY THEIR DOCTORS. BUT IS THE STATISTIC LEGITIMATE? DO OPIOIDS KILL ONE NEVADAN EVERY DAY?

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CVS sues state to block release of report on its drug pricing

http://www.dispatch.com/news/20180716/cvs-sues-state-to-block-release-of-report-on-its-drug-pricing

CVS Caremark is suing the Ohio Department of Medicaid to block it from releasing the full report detailing how the pharmacy middleman charged taxpayers three to six times as much to process prescription drugs for the poor and disabled as the industry standard.

“The disclosure of proprietary information in the Caremark agreements would be devastating to Caremark’s entire nationwide business model,” CVS attorneys argued in an 18-page request for a temporary restraining order filed Monday in Franklin County Common Pleas Court.

Pharmacy benefit managers have long operated in the shadows of the health care system. They buy drugs from manufacturers, distribute them to patients through pharmacies and manage the cost of those drugs through employers and insurers.

The Dispatch has spent the past six months uncovering how PBMs operate in Ohio. The stories have detailed some of the hidden costs PBMs create that critics say drive up the price of medications. We’ve uncovered how PBMs force cancer patients in dire need of medications to wait weeks for drugs that are available on the shelves of their local pharmacies. Stories of how the practices of PBMs have driven neighborhood pharmacies out of business.

Meanwhile, PBMs, drug manufacturers and health-care providers continue to make increasing profits in the billions as health care in America has increased by $1.2 trillion in a decade, according to the U.S. Centers for Medicare and Medicaid Service.

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People are talking about the Addicts who are overdosing do to the “opiods epidemic”?  — Maybe we’re should START talking about the people who actually take them, just to be able to function thru life.  Chronic un-measurable pain is a terrible way to live.   I know from experience that when you live in that much pain, you get to a point where all you can see,  IS the ultimate way out.   Chronic Pain is blinding.  It blinds you from life, from family and joy, and happiness.  It robs you from your hopes and dreams,  and a life you thought you’de always have until all you see is a terrible,  struggling existence.  Until you are left withering and suffering, and unable to get any help,… until you lay there really asking yourself,  “Is this all my life is ever going to consist of?”  Living in sooo much pain?  It is not an option. 

Too many of us are forced to live this way,  until it is just too much to bare and suicide is our only way out. 

I can honestly say, I have thought of this.   I was in so much pain where I was contemplating suicide. Then I found a compassionate, caring group of doctors at a clinic who specialize in pain management and my life was spared.  I was given shots, acupuncture, and massage.  We discussed a diet change, and I started a diet that worked towards anti-inflammatory issues and help too slow down the destruction of Lyme Disease that is still breaking down the joints and bones in my body.  And I was put on a manageable dosing of Demoral.  For 6 years,  I had my life back. I had my dreams back,  and I could see a future of a life filled with family and friends,  and joy and happiness.   My body was still breaking down, and nothing is going to change that.   I’m 53 and have the spine of a 90 year old.  I’ve shrunk over a 1/2″ due to my discs deteriorating and have had 3 discs removed and my spine fused because the pressure was literally cutting off the fluid in my spinal cord.  Both knees are bone in bone.   The joints in my hips,  are deteriorated, and now I have minor un-hinging when I walk.  Shoulders are blown out,  and I have fluid pockets in many of the joints now so that it’s not only painful but difficult to function.   This destruction is not going to stop, or get better, and I don’t care how many Tylenol you throw at it,  it won’t touch the pain.   But the pain management group helped me exist.   The Opiods helped me exist,  and function,  and see a life beyond the blinding pain.   It gave me another day, …another 2,372 days with my family and friends.   – Then came the “War on Opiods”.

 My doctor discussed the issue that this war was causing in his practice,  and what it meant for the patients he spent helping every day.   What it WAS going to ultimately mean for me.  To say I was in a panic is an understatement.  The thought of returning to a life in that much pain,  was unfathomable.  I knew I had about 6 months before he said they (the Do-Gooders and Big Brother) was going to push my doctor to start tapering me down; I was taking 100mg pills every 6 hrs to 8 hrs.

We discussed the other “Acceptable” options, which we had or were already doing, and I cried at the fact;  I knew what was coming.  An unacceptable existence.

It was the same time my parents had talked about getting me and my husband a plane ticket to come to MT for a mini vacation at our family cabin in the Rockies.  I really thought,  “This is going to be my last family vacation.   The last time I am going to be able to make happy memories, For my family.  For my husband.  Because in a year,  I won’t be here.”  Suicide was already in my forethought.

Although the stress of all of it had already began to increase my pain threshold to a daily living of a level 8.5; I agreed to go.   In 11 days I lost 22lbs in inflammation,  due to its elevation and the dryness of the state, and I found out MT was an approved Medical Cannabis State.  I enjoyed the vacation,  and rest and was happy I went.

Though the night I stepped off the plane, my ankles swelled to meet the size of my calves.  I couldn’t walk as my ankles too had begun to break down.

At my next appointment I opened a dialogue with my pain management doctor,  and I asked him about MC and what he thought about it.  In the next couple of weeks I talked with my entire team of doctors,  7 in all, and started finding out the benefits of medical cannabis.  With the exception of my nuerologist who was treating me for my neuro issues and had just begun treating me for seizures,  all of my doctors agreed it might be an option.  So we sold our dream property, got rid of our horses, sold everything in TN and moved to MT. 

I’d like to say everything is 100% better but that wouldn’t be accurate.   Moving to Montana and starting MC has been a challenge.  After an incredibly stressful time of trying to find doctors who would EVEN LOOK at my medical records I was able to find a compassionate doctor in Helena named Dr. Ibsen.  He went over my medical history with me, looked at the extensive list of medications I was taking,  including my pain meds,  reviewed my 6″ stack of medical folders I brought with me, including disk copies of MRI’s and X-Rays, and after an hour of discussion, agreed to take me on.  I cried with relief.  He was my lifeline.

It took 6 months to taper me off my pain meds as well as I dropped down from the other 44 pills I was taking a day to now 7.  Medical Cannabis has not been easy.  Trying to find the right strain for me,  I don’t like the high-drugged up feeling (honestly Demoral never made me feel that way), to the proper dosage that works for me,  has been a challenge.   And it doesn’t relieve the pain completely.   Where Demoral kept it at a manageable level 3-4, MC keeps me at about a level 6, which is uncomfortable most days.   Occasionally,  when I do overdo,  I can spend 24 to 36 hours at a level 8.5 and these are the days I wish I was still taking the opiods or at least they were an option during those times.

All in all, I was lucky.   I was lucky my parents thought to give me a vacation that unexpectedly showed me there might be another option to living. I was lucky my husband agreed that we should sell everything,  and try MT.  I was lucky, and thankful that after meeting and getting turned away from 4 other doctors in MT, that I found a compassionate doctor in Dr. Ibsen, and that he took me on.  I was lucky,  I had options.  It saved my life.

But, I think about all the other pain patients out there who DO NOT, have those options.   This “War On Opiods”, is quickly becoming a “War On Pain Patients”.  I did some research,  and the numbers that are being put out there as label as overdoses due to opiods, also includes all  overdoses on heroin.   These are drugged Addicts who die from heroin overdoses; not pain patients from opioid overdoses.  We are being labeled as Addicts, not as pain patients who are just trying to live a life of a future.  Of hopes and dreams, pain free (or at least manageable).

– Not too long ago, I had a supposed friend call me  an Addict because she had preconceived idea of how I was living my life.  That my taking pain meds to function through the break down of my body, made me the same as her opioid addicted son; someone who did whatever it took to get his fix.  She hurt me and it cost a friendship, but it also made me really see that too many of us are getting labeled “Just Like That”.  Things need to change.  We need to be HEARD, and we need to tell our stories.  We don’t need to have people in Washington DC give us the only option of living a pain free life – is by suicide.  Too many of us are dying as it is.  Please leave our pain management doctors alone as they are our lifeline to the future.  Please watch the video below, these are pain patients who sacrificed it all, because of pain.

This is my story.

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My “little blog” just started its 7th year… I have watched people come ready to change the world and people who are no longer around for various reasons.. some gave up fighting, some have passed away and others – unfortunately – couldn’t stand their unrelenting pain any longer and used the “ultimate option” to resolve their pain.

I have seen the number of Face Book pages that have exploded from a few dozens to hundreds or maybe even THOUSANDS.. and often you see the pictures/names of the many of the same people on many of these pages devoted to chronic pages

I have heard of pts that have sent letters to their representatives in Congress and their State representatives… as well as many in the media industry… some had some gathering of protestors in various locations.

Some states have recently implemented legislation that limits the number of opiate doses acute pts can get… but there has been rumors about many prescribers adopting them for all pts taking opiates… just like they did with the 2016 release of the CDC opiate dosing guidelines.

Often pts are told that their pain doses are being reduced or stopped over fear of losing their license… perhaps it is time for those pts who are having their pain medications reduced or eliminated going after the prescriber’s license.

Here is a list of the physical consequences of untreated pain https://www.pharmaciststeve.com/?p=20995 

Perhaps it is time for pts to start filing complaints with the state medical licensing board…  file complaints with www.cms.gov if you are on Medicare/Medicaid or your insurance company. If your insurance is thru your employer and it is a ERISA policy – your company is providing self-insursed health insurance… there is someone within the company has authority over the policy since the  “insurance company” is only a paper shuffler and paying out the employer’s money.

If your blood pressure started to increase as your pain meds were decreased and nothing was done… file a complaint

If you are no longer able to take care of personal care items – as you were able to do before your meds were reduced – file a complaint

Here is a list of all the states’ medical licensing boards… most/all should have a complaint form on their website  http://physicianjobs.us/Medical%20Boards.htm

Here is website you are able to file your opinions of a practitioner’s care for pts   https://www.healthgrades.com/

If your prescriber explains that they are concerned about their license and their livelihood and that is the reason they are refusing to properly treat your health issues…  If they have reduced your pain medication to a point that you are no longer able to function as you once were before or have totally cut you off..  if you complain… what are they going to do… discharge you from the practice .. then you have a reason to file complaints about retaliation against them.

If you live in one of the 38 states that allow a single party recording… use your smart phone to record your interaction with your prescriber and/or staff.

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Feds Double Down On Pills As Fentanyl Deaths Double

http://www.pressreleasepoint.com/feds-double-down-pills-fentanyl-deaths-double

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https://www.change.org/p/claire-mccaskill-ban-mail-order-drug-mandates-from-all-health-insurance-plans

My son, received a life saving liver transplant at the age of 2. His life depends on the potency and effectiveness of chemotherapy/immune suppression medications. In the past mail order delivered his liquid oral medications in nothing but a plastic envelope on a 102 degree day on a hot enclosed not temperature controlled UPS truck. Shortly after, he went into liver rejection which could have resulted in complete liver failure or death. I speculated that the medication could have been too weak after the delivery of medications in high heat. I vowed to never again risk his life with mail order pharmacy.

Recently, we were mandated/forced to only use mail order pharmacy in order to receive coverage for his life saving medications. Hesitant, I begged for an ice pack. The package arrived on an about 90 degree day again without an ice pack. His labs elevated again afterwards. My son wants to know, “Why would they do that?”

I contacted the manufacturer, who completes all of the testing for my son drugs who stated that both of my son’s medications should be discarded and considered less potent once stored above 86 degrees as higher temperatures and freezing could result in lower potency. I also found out that the liquid medication that the youngest children take are the most harmed by the mishandling of medications outside of the manufactures temperature storage guidelines. Our youngest of children’s lives are being threatened. 

I contacted the mail order pharmacy who refused to take replace or take back the medication. They said the law & USP Pharmacopoeia allows them to ship up to 104 degrees, although the manufacturer states it is not proven safe at these temperatures. 

I contacted the FDA, who states that the mail order pharmacy should be using the manufacturer’s guidelines that have been proven safe. Not the reference range by USP that has not tested my son’s exact medication. However since the mail order pharmacies are regulated loosley by the State Board of Pharmacy, not the FDA there was nothing that the FDA could do. 

I spoke with a UPS driver. He states temperatures on his truck are far above 104 degrees on a 90 degree day. He is mandated to keep his door closed unless getting a package. He states it gets so hot on a 90 degree day that he cannot breathe when he opens the back. 

I made over 30 calls to the insurance company begging for them to please let us pick my son’s medications up at the local pharmacy at which they are filled. My son’s physician wrote a note/appeal as his transplant team has stated that they have tried to voice their concerns about this issue with their pediatric/child patients and no one is listening! The insurance company still denied the doctor’s appeal for us to pick up my son’s medications in the safest way. It was not until the Media became evolved that the insurance company budged. 

I felt helpless and have untied with many other pharmacist, physicians, patients, mothers and fathers, and caregivers who feel the same way. Helpless.

Mail order of prescription drugs should be a choice not the only option of coverage. Mandatory mail order programs from all plan types (INCLUDING the plans that are regulated by ERISA) needs to cease until mail order pharmacies are forced to store and monitor medications during their deliveries at the temperatures tested and proven safe by the manufacturer. I would never put my son’s medications in a hot non-temperature controlled environment, and shoudn’t be forced to only use this option in order to get coverage for his life saving medications.

Mail order pharmacies may appear to save money, but when my son ended up in the hosptial after taking medications that could have been compromised by having lower potency, the cost of the rejection was thousands of dollars. If his liver would have fully failed, the cost of his liver transplant for just 5 days (he was in the hospital for 5 weeks) was over $1,000,000. The lax regulation and oversight may save money on prescription drug plans, but may come at an increased cost to the health plan itself. Also, keep in mind the endless waste of medications that automatically are sent regardless of whether or not patients need them.

Also, people with chronic, complex conditions, should always have the option of face to face interaction with a pharmacist who knows their complex needs and medical history. Could you imagine being required to go to a different doctor every time you needed medical care for you or your family? The pharmacist and patient relationship is crucial to the successful outcome of the patient’s overall health. Taking this away is harmful to patients and be more costly to our already stressed healthcare system.

Another important fact. Mandatory mail order programs are discriminatory. It is estimated that 40% of our homeless are disabled. How is mandatory mail order fair and working for them as they may not have an address and not even know where they will be from day to day?

We need legislation to protect all patients by ending the mandatory mail order pharmacy coverage in every type of plan offered in the nation.  We need your help to make mandatory mail order an option not a mandate.

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: Chronic pain patients in Maine?

Hello – I wrote Gordon Smith, director of the Maine Medical Association, regarding my concerns with the Maine state law restricting dosage of opioid prescriptions. I don’t live in Maine, but he offered to publish a 600-word article in Maine Medicine from the chronic pain patient point of view. I just need to find someone who actually lives in Maine to write it. 

Would you pass this along to any of your members in Maine who might be interested?
His email says “I am sorry that you have suffered under the Maine law. In our presentations to prescribers and occasionally to the public we always acknowledge that a group of patients has suffered, although many have been assisted.  It is important that policy makers do hear your point of view.  If you would like to submit a 600 word article I would make every effort to include it in our upcoming issue of Maine Medicine. Feel free to forward my offer to patients in Maine in similar circumstances.”

Gordon Smith, Esq.

Executive Vice President

Maine Medical Association

gsmith@mainemed.com

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Opioid Treatment 10-year Longevity Survey Final Report

https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/opioid-treatment-10-year-longevity-survey-final-report

Patients in this study were found to be functioning quite well after 10 or more years on generally stable opioid dosages—with the vast majority able to care for themselves and even drive.

About eighteen months ago, I approached the publisher of Practical Pain Management to assist in a survey of long-term, opioid-treated pain patients. Rightly, as any good publisher, he asked why should I go to the time and expense to do a longevity survey? I then presented him my laundry list of reasons for doing the survey. Some explanations of my reasons for doing this survey are given here. Quite frankly this survey was needed, since we simply have little data on opioid long-term treatment.^1,2 Also, opioid treatment is constantly under attack, so it seems logical to see if the popularity of this treatment is justified.

Reasons for the Survey

First, recall that we have just finished the “Decade of Pain.” Ushering in this decade were many laws, regulations, and guidelines—promulgated in many states—that encouraged physicians to prescribe opioids without fear of legal reprisal. Did anyone get help this decade? Did this political and humanitarian effort pay off?

Secondly, my own experience in practice was the predominant factor. I started my pain practice in 1975 while serving as a Public Health Physician in East Los Angeles County. Cancer and post-polio patients needed ‘narcotics’ (the common name prior to the more correct usage ‘opioids’) treatment for their severe chronic pain. I’ve now followed some chronic pain patients still taking opioids after 25 to 30 years.1 Also, I was a government consultant in the 1970s on Howard Hughes who managed to survive 30 years with intractable pain after a 1946 plane crash. His average opioid dosage over that time period was about 200 mg of morphine equivalence. But are my patients unusual or simply responsive to an overzealous clinician? Do opioid-treated patients in the hands of other physicians do just as well over a long period?

A little over a year ago there was another reason to do a longevity survey. At that time there was a vitriolic, anti-opioid propaganda campaign being waged. Some prominent academic institutions, pharmaceutical companies, professional organizations, and journals, almost in unison, essentially claimed that opioids shouldn’t be prescribed due to hyperalgesia or other as-yet unnamed complications. Some parties stated that opioids, if prescribed at all, should have a dosage restricted to some arbitrary number such as 200mg of morphine equivalence a day. Some claims fundamentally suggested that pain should only be treated with non-opioids, because opioids actually “cause pain.” Amazingly, some detoxification centers actually advertised for “clients” on the basis that the person’s pain would be cured if the patient spent $10K or $20K to detoxify from opioids. Needless to say, the anti-opioid campaign was hardly backed by bonafide medical management pain practitioners or scientific studies. So what was needed was a simple survey to see if there are long-term opioid-treated patients who are still doing well.

What the Survey Can’t Determine

This survey was not intended or designed to answer some ancillary questions. Not answered is which opioids are superior or could patients have done as well without opioids? Also, it wasn’t intended to determine optimal dosage or complications. The intent was clear and simple: Do some opioid-treated patients improve pain control, function better, and enhance their quality of life over a 10-year period?

Survey Methods

In early 2009, an advertisement was placed in this publication to identify any physician who had a cohort of chronic pain patients they had treated with opioids for 10 or more years and were willing to share outcome data. Three physicians, one each from Kentucky, Louisiana, and California, reported a total of 76 patients who have been treated with opioids for 10 or more years. These, together with the 24 patients treated by this author,¹ provide a cohort of 100 patients who have been treated with opioids for 10 or more years and serve as subjects for this survey. Physicians completed a survey questionnaire for each patient that inquired about demographic status, cause of pain, opioids currently used, basic physical functions, activities of daily living, and stability of opioid dosage.

Results and Findings

Patients in this study appeared typical of most chronic pain patients in that they are primarily middle age or older and have degenerative diseases of the spine, joints, or peripheral nerves (see Tables 1 and 2). Most have maintained on one opioid, although some patients required two or three. The majority have been on stable dosages for many years (see Table 3). Despite the longevity of treatment, most function quite well. The vast majority of patients report good function in that they can dress, read, attend social functions, drive, and ambulate without assistance (see Table 4). Almost half (45%) reported they had been on a stable opioid dosage for at least 3 years.

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Interesting… both members of the Trump administration in this interview have family/friends that have/had trouble with substance abuse. So it would appear that you get a interview with a myopic view of people abusing some substance that they have chosen to SELF-MEDICATE the monkeys on their backs and/or demons in their heads

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