www.medium.com/@robertdrosejr/preliminary-injunction-vs-veterans-affairs-75fa0eac9e3f

Request for Court Injunction Against ‘Opioid Safety Initiative’

[This is the actual paperwork filed by plaintiff, Robert D. Rose Jr., in Greeneville Federal Courthouse, 220 W Depot St # 200, Greeneville, TN 37743 (423) 639–3105 on May 7, 2018.]

 

 

Comes now plaintiff, Robert D. Rose Jr., and hereby requests the Court and the Clerk of the Court to enter the following request for a Preliminary Injunction suspending the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017. This request is made pursuant Federal Civil Rules of Civil Procedure, Title VIII. Provisional & Final Remedies. Rule 65.

Additionally the plaintiff makes the following requests of the Court and the Clerk of the Court:

a. This injunction request not be sealed. This case is the only hope thousands of veterans and civilians have that one day soon their healthcare needs will once again be met by medical professionals across the country.

b. The same as in the denied Ex Parte Injunction, the plaintiff respectfully requests an open hearing at the earliest possible convenience of the Court at which witness, veterans, loved ones and caregivers, can be provided detailing the harm the Department of Veteran Affairs’ opioid safety initiative is causing within the veteran community as well as in the civilian community. This request for testimony also includes civilians being affected by the Centers for Disease Control (CDC) copied and adopted a majority of the VA/DOD policy into the controversial CDC Opioid Guidelines targeting the elderly, cancer patients and the disabled.

c. Pursuant to advice from the clerk’s office, it is hereby requested in view that many witnesses are homebound and/or located in other states the court allow teleconferencing testimony from these witnesses either by Skype or other technology allowing their voices to be heard regarding this policy which is adversely effecting so many of our nations heroes.

Reasons for request for Preliminary Injunction:
In Doc 56, the court states “Plaintiff has managed to last a year and a half without “[p]roper pain management treatment,” he has failed to show that an immediate injury will occur…” The plaintiff’s response to this statement is as follows:

First, plaintiff has not died or committed suicide as have so many others since beginning the forced taper in November 2016 after being denied all pain medications on December 29. 2016. As a Christian, the plaintiff will never commit suicide and dishonor Jesus Christ our Lord and Savior or jeopardize being in His presence again.

The first incidence in which the plaintiff was in the presence of Jesus Christ was in 1991 when plaintiff incurred most of the injuries to his spine as he fell from a cliff into the Mediterranean Sea. As the plaintiff was drowning, plaintiff was surrounded by the most wonderful white light filled with unconditional love erasing all of plaintiff’s pain and worries. The plaintiff’s Savior embraced him in that moment and the plaintiff heard in his head “Not yet.” Although the plaintiff looks forward to being in His presence again, the plaintiff would prefer to remain around many more years to see his grandchildren.

As to the plaintiff’s being able to “manage[…]” the past one year, six months, two days, or 548 days with unrelenting pain speaks to plaintiff’s WILL to live; not to the plaintiff’s QUALITY of life. Since the beginning of the forced taper and ultimately the denial of all lifesaving medications AND ensuring a quality of life medications, the plaintiff’s quality of life has dropped to being less than the plaintiff’s worse day in Marine Corps boot camp during the summer of 1983 at Parris Island, sand fleas and all. Here are a few additional examples to supplement what was already included in the initial complaint and amended complaint.

a. Unable to attend son’s fiancé’s college graduation, December 2017 or after party because of pain and high blood pressure.

b. Summer 2017, mowing my yard required about two hours. Each time resulted in plaintiff being homebound for three or four days more if rainy. This did not include weed eating, blowing the driveway or trimming my trees or bushes. The plaintiff being unable to care for any of the many flowers in plaintiff’s gardens resulted in most dying. Spring 2018, Washington County city workers ruined trees and bushes shading plaintiff’s patio. Summer 2018, plaintiff is paying for minimal yard care.

c. A trip to the grocery store requires plaintiff to lie in bed for several hours before plaintiff is able to prepare minimal subsistence meals. Many days dinner consists of grilled cheese and bologna sandwiches.

d. Monday, April 23, 2018, it required approximately four (4) hours to travel to Greeneville Federal Courthouse, to file the Ex Parte Injunction (Doc. 53) and return to plaintiff’s in Gray, Tennessee. This one trip left plaintiff mostly homebound in bed for the following two and half days unable to complete basic hygiene or care for his 100% disabled wife, Pilar A. Rose.

e. Unable to decorate home with even a small Christmas tree or manger scene, December 2016 and December 2017.

f. Plaintiff is extremely frustrated at being unable to remember small things which were formerly committed to memory such as the Lord’s Prayer when pain levels explode.

g. Spring 2018, unable to go with wife to a special dinner prepared by son at his new apartment with his fiancé.

h. With much shame, the plaintiff has prayed multiple times to God to take him home as the pain has gotten too unbearable. Thankfully, God has ignored these pleas so that plaintiff might live to fight another day. Each morning and evening, regardless of suffering, plaintiff gives thanks to God for allowing plaintiff to remain for one more glorious day. “I can do all things through Jesus Christ which strengthens me.” Philippians 4:13

For each of the items listed, plaintiff can add additional items as to why plaintiff’s quality of life has diminished so dramatically. However, the plaintiff is a United States Marine. The plaintiff believes with all his heart he was spared in 1991 with these injuries so as to defend the right for quality healthcare for all his Brother and Sister WARRIORS in all branches of the Armed Forces. As long as their lives are in jeopardy by this policy and the Department of Veteran Affairs continue to deny veterans quality healthcare; the plaintiff refuses to die!

As to failing to show an “immediate injury will occur;” plaintiff has no answer. The complications associated to untreated pain were very clear and specific in the Ex Parte Injunction, (Doc 53) and other documents provided to the court. Plaintiff will testify that on multiple occasions he has taken Benadryl to lower pain induced high blood pressure and severe chest pains. Plaintiff can attest to being afraid to return to Mountain Home VAMC Emergency Room for fear of being arrested or discharged again without the benefit of proper medical care. Diagnosed years ago with Major Depressive Disorder, plaintiff assures the Court these conditions have worsened to the point of desperation most days: depressed mood, loss of interest or pleasure, significant change in appetite/weight, insomnia/hypersomnia, psychomotor agitation/slowing/loss of energy, feelings of worthlessness, inability to concentrate, recurrent thoughts of suicide.

Plaintiff can attest to not having sufficient funds to go to a civilian hospital for treatment of these conditions at the present time. Plaintiff has secured private insurance at significant cost which will go into effect July 1, 2018. It is the plaintiff’s desire with proper medical care,; this case will be better researched and presented in future correspondence and/or motions and especially at any hearings. The defendants will not stand a chance of anything less than GUILTY of all allegations by a jury of our peers.

In response to statement in Doc 56, in that plaintiff “fails to comply with the requirements of Rule 65(b)(1) in that “neither his original nor his amended complaint is verified,” the plaintiff is including the following summary of the original and amended complaints in hopes it is sufficient for the Court. Additionally, plaintiff makes the following declaration:

“As God is my witness and by the notary by and for the State of Tennessee located at the end of this Preliminary Injunction request, every statement and every document plaintiff, Robert D. Rose Jr., has made, is making or will make to the Eastern District Federal Court regarding Case #2:17-cv-204 Rose v Roe is truthful and factual to the best of the plaintiff’s ability, so help me God. May it be known now and forever.” “For there is nothing covered, that shall not be revealed; neither hid, that shall not be known.” Luke 12:2.

Summary of complaint and reasons needed for Preliminary Injunction barring further harm by the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017.

a. October 2016, defendant nurse practitioner Christina Craft, whom plaintiff had never met, called to inform per new VA policy to deny 90% of all veterans (elderly, cancer patients & disabled) all pain medications, she was going to put plaintiff on forced taper to zero. When objected, defendant stated the plaintiff had the normal spine of any other fifty year old male and that plaintiff had no choice. She refused for an in-person consult. She refused to provide this directive in writing.

b. October 15, 2016 after contacting the office of defendant David Hecht, an appointment with defendant Craft was granted. At this visit defendant repeated claims from the phone conversation. Defendant refused to look at years of medical records documenting injuries by Veterans Affairs medical personnel, civilian doctors and US Navy doctors (plaintiff has a copy of medical files from the United States Marines with inclusive records from 1983 to 1994) brought to the appointment by the plaintiff. Defendant again refused to provide a hard copy of guideline or directive she was using to force taper.

c. October 28, 2016, defendant James Crider, defendant’s Crafts supervising medical doctor, secretly entered into plaintiff’s VA medical records that plaintiff had broken “pain contract” for not complying with forced taper. Defendant Crider had never met or spoken to plaintiff. Beginning November 1, 2016 through December 29, 2016 plaintiff was forced to taper from 180mg Morphine Sulfate (three 60mg tabs daily) to zero. Plaintiff was advised of this entry in the plaintiff’s medical records by defendant Dale Whitson on October 24, 2017 in a secure message email notification of why he was refusing to treat veteran’s chronic pain disease: “Official violation of pain agreement was entered in chart on October 28, 2016 by Dr. James Crider. Apparently was taking morphine inappropriately, not according to his taper schedule.” This was the first time plaintiff was informed of this violation by any member of Mountain Home VAMC staff.

d. November 29, 2016 plaintiff went to Mountain Home VAMC Emergency Room for chest pains, difficulty breathing and excruciating pain (for full details, please see Amended Complaint Doc. 22 for full details). Defendant Suzanne Allen eventually discharged plaintiff apologizing for being unable to do more per opioid safety initiative. Defendant Allen refused to provide copy of policy or directive; a one page document stating to 1) continue with taper: 2) Moist heat to neck and back; 3) Use muscle relaxers as prescribed; 4) Call PCP for pain management referral; was all the discharge paperwork plaintiff was provided by discharge person. This occurred even though plaintiff was still experiencing same complaint as when first arrived and having an excessively high blood pressure reading (approximately 220/175 or 225/170) which was in the heart attack stroke range.

e. December 2019 defendant Craft called plaintiff to offer a return to a reduced 120mg Morphine Sulfate daily per excessively high blood pressure in Emergency Room and difficulty dealing with pain levels. Defendant Craft indicated it would only be temporary until plaintiff would be forced taper to zero. No exception. Plaintiff declined offer.

f. December 15, 2016 defendant John Hendricks met with plaintiff for the first time. In forty minutes or less defendant had determined the plaintiff suffered from “opioid use disorder,” “substance abuse disorder” and something else dealing with drug abuse. Plaintiff pointed out in clear terms, the plaintiff’s behaviors, actions and accomplishments in nearly twenty years or pain management did not meet the DSMV or DSMIV criteria for these diagnoses. Defendant Hendricks then strongly urged plaintiff to go through the detox program at Bay Pines Rehabilitation facility in Florida. Plaintiff declined per primary caregiver for 100% disabled wife, Pilar A. Rose. Defendant then urged plaintiff to accept Suboxone as an alternative to Morphine Sulfate as a pain management tool. Plaintiff declined for several reasons including the following:

a. Plaintiff is not an addict.
b. Suboxone is illegal to be prescribed off-label in Tennessee; it is only for addicts addicted to ILLEGAL fentanyl, heroin and illegally acquired opioid analgesics.
c. Research articles suggest Suboxone is specifically designed to be a more addictive synthetic opioid replacement drug with harsh withdrawal symptoms if attempting to end treatment. Additional research suggests Suboxone has a 66% (sixty-six percent) fail rate at helping addicts and/or chronic pain patients.
d. Manufactures, Indivior, have a twenty plus page of dangers associated with this addiction treatment drug.

g. December 15, 2016 Dr. Lisa Paderna, plaintiff’s psychologist for many years, after observing her supervisor’s “interview” secretly entered in plaintiff’s medical records “opioid use disorder.” The accompanying note by Dr. Paderna suggests this diagnosis was ordered by her supervisor, defendant Hendricks. Plaintiff was unaware of this entry for many months until plaintiff accidently stumbled upon an “administrative note” entered in plaintiff’s medical record not meant for veteran’s eyes.

h. December 2016, defendant Craft doubled three separate blood pressure medications to control excessive high blood pressure readings (heart attack & stroke levels) due to the untreated chronic pain from injuries sustained in the United States Marines. As the court can ascertain by the dosages, these doses are now at highest recommended levels:

a. Hydrochlorothiazide 25 mg
b. Benazepril HCL 40 mg tablet
c. Amlodipine Besylate 10 mg tab

i. January 2017 at behest of defendant Dean Borsos, plaintiff met with defendant, defendants Mark Crider, Thomas Edwards (dismissed from case by court), David Hecht via telephone conferencing and a roomful of other staff members. The purpose of the meeting was to convince plaintiff to stop misbehaving and objecting to the force taper. Edwards promised he would do everything in his power to provide aid and quality medical care for injuries to spine. All present refused to look at military records or civilian records demonstrating the extent of damage to spine, hips, legs and ankles stating they understood the damage was extensive. All present refused to provide hard copy of policy/directive.

j. May 20, 2017 met with defendant Mark Vernon. Defendant stated plaintiff should never have been removed from established pain management protocols. Stated all medical staff was under new guidelines/directives preventing any prescribing of opioid medications. Stated plaintiff should continue to smoke to help with the stress of being in pain all the time. Although diabetic, plaintiff should continue drinking Mt Dew as the sugar molecules would attach to the pain receptors in the brain and block some of the pain signals. Although plaintiff had last dose of pain medications on December 29, 2016, defendant ordered a drug screen. This test was negative for ALL pain medications for spine, hip, leg and ankle issues; more importantly it was negative for all ILLEGAL substances.

k. May 23, 2017 met with Thomas Edwards and defendant Teresa Odom. During this encounter, defendant Odom offered wheelchair yoga class as a solution to the unrelenting pain but no medications to get plaintiff from home to the classes. Declined offer. Keep in mind, last dose of pain medications was on December 29, 2016 and drug screen on May 20, 2017 was negative for illicit drugs, Edwards offered the detox program at Bay Pines Rehabilitation facility in Florida. Plaintiff declined. Edwards then offered Suboxone for treatment of pain. Plaintiff declined for same reason explained above. Edwards then commented that plaintiff was out to destroy him and all doctors at Mountain Home VAMC. Plaintiff agreed to this statement by including statement “by all legal means available.” Plaintiff followed up this encounter with a Secure Message email re-stating “by all legal means available” and forwarded it to the leadership at the Department of Veterans Affairs and the Congressional VA Committees. Edwards and defendant Odom had plaintiff’s medical record “red-flagged” as being a threat to himself, others and the staff at the VA facility. The result of such a flag meant if plaintiff reported for any appointment at the VA facility the plaintiff would have been arrested and detained if not being properly escorted by VA facility law enforcement officers. Plaintiff was unaware of this flag until June when he received a letter ordering plaintiff to report to the Disruptive Behavior Clinic located in the VAMC police department.

l. June 6, 2017, plaintiff reported to Mountain Home VAMC police station as ordered met with defendant Jerry Shelton and four other individuals plaintiff had never seen before or since. The defendant Shelton had his badge, a sidearm and handcuffs prominently displayed for the plaintiff to see. The tone and atmosphere established defendant Shelton as an interrogator in an apparent effort of intimidation. Defendant Shelton did not provide or state his medical training which would have qualified defendant to determine mental health status of plaintiff. The entire meeting seemed to be targeted at getting plaintiff to accept the opioid safety initiative and to stop creating waves with medical personnel, the Department of Veterans Affairs leadership in Washington and numerous congressional leaders which had been contacted regarding the policy to deny 90% of all veterans, the elderly, cancer patients and the disabled, all pain medications. Plaintiff advised defendant he would continue to fight the policy using all legal means available. The flag was “cleared” meaning the plaintiff will not be arrested but remains as a warning to other providers’ plaintiff is seeking legal relief from these policies as they continually refuse to provide said policies in writing.

m. July 3, 2017 complete details of encounter with Mountain Home VAMC law enforcement acting on behalf of Defendant Roe and/or his staff was provided with Doc 31, at 01, 02 and 03 to the courts on March 22, 2018. Considering that information deals with criminal acts, plaintiff will not add to this request for a Preliminary Injunction against the Department of Veterans Affairs’ opioid safety initiative.

n. September & October 2017 plaintiff was informed defendant Vernon had been replaced by new primary care physician (PCP) defendant Whitson. Plaintiff made numerous attempts to contact defendant by phone, leaving messages each time to please return to call(s). Defendant never responded to these calls. October 11, 2017, Dr. Provence, Chief of Primary Care, whom the plaintiff had never met, called advising “my doctor” without naming the individual was out of town. Plaintiff sent secure message email on this date to Provence (Attachment 01) describing the difficulties contacting the new PCP, defendant Whitson. Then on October 24, 2017 defendant’s nurse advised via secure message defendant Whitson would not treat any pain conditions due to defendant Crider’s entry on October 28, 2016 stating the defendant had violated the patient pain contract.

o. October 9, 2017 plaintiff called and spoke with defendant Dean Borsos regarding the death of his sister Melissa Anne Rose on October 8, 2017. Plaintiff explained how at Sycamore Shoals Hospital, Elizabethton, Tennessee, plaintiff collapsed from the stress of pain, increased blood pressure and emotional loss simply from the forty minute drive to see his sister in the hospital (she was deceased by the time plaintiff arrived). Plaintiff begged the defendant for enough pain medication for one week to be with family and friends during this tragic period. He refused any medical treatment however throughout this week of grief; plaintiff received multiple calls from woman identifying herself as being in charge of hospice for Mountain Home VAMC, Dr. May. This person repeatedly insisted plaintiff should go to the Johnson City Medical Center or the Sycamore Shoals Hospital anytime there were chest pains, extremely high blood pressure or excruciating pain as the Department of Veterans Affairs would pay for the emergency room visit. Plaintiff advised Dr. May that defendant Borsos had stated the VA would not pay for such a hospital visit and defendant Lonnie Hatton had made similar statements on multiple occasions. Dr. May insisted the plaintiff could trust her and to just go to the emergency room. Plaintiff requested multiple times by phone and through secure messaging email (Attachment 02) for Dr. May to put these statements “the VA would pay for such medical treatment” in writing. After the secure message was sent, plaintiff never heard from Dr. May again.

p. January 5, 2018 the plaintiff was referred to East Tennessee Brain and Spine Center by Mountain Home VAMC for pain management treatment. On this date was plaintiff forced to provide drug screen; negative for thirteen (13) ILLICIT drug classes.

q. January 2018 plaintiff finally met with defendant Whitson. During this appointment the defendant made some extremely troubling statements.

a. Plaintiff should never have been removed from the pain management protocols established considering the dose had remained stable and effective with no violations of the pain contract as previously indicated by defendant Crider.

b. Medical staff, doctors and nurses were provided lists of five to ten [veterans’] names and told to discontinue all opioid related pain medications. Medical staff could request waivers from the administration but these were all denied. No exceptions.

c. Medical staff, doctors and nurses, was forced by intimidation of implied threats regarding continued employment with the Department of Veterans affairs if they did not comply with these directives. Defendant Whitson stated he only had a few years till retirement and was terrified of what he would do if terminated this close to the finish line.

d. Defendant Whitson stated he did not fear the lawsuit as he and everyone else working for the Department of Veterans Affairs were only following orders and not complicit in any wrongdoing.

e. Defendant Whitson refused to provide copies of any policies/directives or lists reminding plaintiff his retirement was too important to mess up by providing evidence.

r. April 2018, plaintiff was advised of being assigned a new PCP; no name provided in letter. Sent blind secure message email to Mountain Home VAMC to request medical assistance (Doc 53, at 01) from the new PCP. Nurse Sherry Pierce’s denial response (Doc 53, at 02) by the new primary care physician (PCP), Dr. Avonda, is the first time any member of Mountain Home VA Medical Center has put in writing the specific reason for denying 90% (ninety percent) of all veterans, the elderly, cancer patients, the disabled, all pain medications.

It is for this reason, Sherry Pierce’s secure message (Doc 53, at 02) [copy below]that plaintiff again requests a Preliminary Injunction be enjoined against the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017.

Plaintiff respectfully requests this Injunction endure until such time studies can be conducted to determine the number of deaths once a veteran has been forced tapered or denied all pain medications. The deaths should include those listed as natural causes (cancer, old age, heart attack, et cetera), illicit drug use and suicides AFTER the medical establishment abandoned all quality medical care/treatments, the Hippocratic Oath and scientifically proven lifesaving medications known as “opioids.”

Aren’t the lives of veterans worth the approximate $4 million dollars (advertising budget) it uses for media blackouts on the suicides, even on those VA properties and using it to proudly announce the statistical numbers of veterans denied these lifesaving medications without reporting the harm. Using the Department of Veteran Affairs’ own database, an external team should be able to quickly track these numbers from ALL fifty states, commonwealths and other VA/DOD medical system controlled facilities handling/submitting this information. It is imperative for an outside agency to conduct this research considering the level of misinformation put forth by the Department of Veterans Affairs and the Office of the Inspector General regarding the suicides since 2012 when the opioid safety initiative was first implemented in St Cloud, Fargo and Minneapolis Minnesota.

In reference to Courts Order (Doc 53), plaintiff “fails to certify any efforts made to give notice to defendants,” the plaintiff is providing certified mail certificates from the United States Postal Service as Attachment 03. Since these certificates are not possible prior to mailing, the defendants will not be receiving a copy of this specific attachment.

Again plaintiff makes the following declaration. As God is my witness, and by the notary by and for the State of Tennessee located at below of this Preliminary Injunction request, every statement and every document plaintiff, Robert D. Rose Jr., has made, is making or will make to the Eastern District Federal Court regarding Case #2:17-cv-204 Rose v Roe is truthful and factual to the best of the plaintiff’s ability, so help me God. May it be known now and forever: “And ye shall know the truth, and the truth shall make you free.” John 8:32

Respectfully

Robert D. Rose Jr.
BSW, MEd. USMC
Plaintiff

Filed under: General Problems | 2 Comments »

http://michiganradio.org/post/deaths-michigan-suicide-drugs-and-alcohol-set-soar

Filed under: General Problems | 2 Comments »

“There is no fuzzy math here. It is very straightforward and Attorney General Jeff Sessions and his anti-pot crusade, are on the losing side of the argument.”

Kennedy criticized Attorney General Jeff Sessions for his stance on legalized pot as studies show that marijuana could help improve the opioid crisis

Filed under: General Problems | 1 Comment »

https://www.reuters.com/article/us-walmart-opioids/walmart-to-restrict-opioid-dispensing-at-its-pharmacies-idUSKBN1I81YH

Walmart Inc said on Monday it would restrict initial acute opioid prescriptions to no more than a seven-day supply as the retailer aims to curb an opioid epidemic that has plagued the United States.

The supply limit will begin within the next 60 days, the company said.

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 115 Americans die on average every day from an opioid overdose.

The initiatives apply to all the pharmacies of Walmart and its Sam’s Club unit in the United States and Puerto Rico.

(This story has been corrected to add dropped words “initial acute” in first paragraph)

Filed under: General Problems | 2 Comments »

www.dailycaller.com/2018/05/06/patrick-morrisey-dea-proposal-raging-inferno-of-tragic-destruction/

West Virginia Attorney General Patrick Morrisey filed a formal document in support of a Drug Enforcement Administration (DEA) proposal that would limit opioid manufacturers to producing only enough to fill legitimate medical need.

The DEA proposal is a direct response to a lawsuit Morrisey filed against the agency in December 2017, pushing the agency to review how it determines drug quotas — the amount of opioids manufactures are allowed to produce to meet market demand.

Morrisey, a Republican, blasted the Obama administration for constructing the current process of setting drug quotas and using metrics and methods that inflate opioid production far above the medical need. Extra opioids are sold on the black market and end up in the hands of addicts largely living in depressed communities, according to Morrisey’s formal demand of support.

“The Obama DEA’s broken quota system resulted in unconstrained and unvalidated increases each year for the past decade that fueled the drug epidemic,” Morrisey wrote. “It is as if the Obama DEA soaked our nation with gasoline that puddled and pooled in vulnerable communities where rampant criminal and negligent conduct ignited this dangerous excess opioid supply into a raging inferno of tragic destruction and death.”

Rather than relying solely on industry input, the DEA would set drug quotas using input from states and other federal agencies as well. The new quota will also account for the number of opioids flowing into the black market. Finally, states will have the ability to call administrative hearing in Washington to show evidence of excess opioids and drug abuse.

The DEA proposal is a huge victory for Morrisey, whose state is one the opioid crisis has hit hardest.

“The excess narcotics supply naturally flowed to the devastated coal fields of West Virginia and other communities that were hardest hit by the recession,” Attorney General Morrisey wrote. “As every West Virginian now knows, next came overdoses, recoveries, and overdoses where no recovery was possible. All of this was made possible because of a broken quota system that failed to protect the public from euphoria producing drugs that also had the power to kill.”

WHAT COULD GO WRONG ?

Having part of our judicial system – DOJ – and Pharmas to determine what some 100 million people with chronic pain and untold number dealing with acute pain need in regards of opiate doses… without the ability to do IN PERSON PHYSICAL EXAMS to determine the needs of pts suffering from subjective diseases ?

IF you notice, the DRIVING FORCE behind this is ANOTHER ATTORNEY

Filed under: General Problems | 2 Comments »

Here is the link

https://gababouthealth.com/

 

Thank you,

Denise

 

Denise R. Molohon

ASAP – Arachnoiditis Society for Awareness & Prevention

ATIP – Alliance for the Treatment of Intractable Pain

FIPR – Families for Intractable Pain Relief

 

Sent from my iPhone

Begin forwarded message:

From: Ingrid Hollis <dharmagarden@yahoo.com>
Date: May 6, 2018 at 11:43:55 AM EDT
To: “Denise R. Molohon” <dmolohon@gmail.com>
Subject: New Blog -Dr.T pt.

Dr.T wanted to make sure everyone knows about this new blog by one of his PTS…can you share ?
Thanks Ingrid

 

—– Forwarded Message —–

From: Forest <veractinc@msn.com>

To: dharmagarden@yahoo.com <dharmagarden@yahoo.com>

Sent: Saturday, May 5, 2018, 2:31:00 PM MDT

Subject: Fw: New Blog (typos fixed()

 

Ingrid,

 

This is a lovely person.  I would like for you to cross-link with anyone.

 

Best wishes always,
Forest Tennant

“Written but not reviewed.”

 

Contact Information:

Forest Tennant M.D., Dr. P.H.
338 S. Glendora Ave.
West Covina, CA 91790-3043
Clinic Ph: 626-919-0064
Clinic Fax: 626-919-0065
Office Ph: 626-919-7476
Office Fax: 626-919-7497

 

Please review our websites as we recurrently update information.

Websites:
www.arachnoiditishope.com
www.familiesforiprelief.com
www.foresttennant.com
www.hormonesandpaincare.com
www.practicalpainmanagement.com

—– Original Message —–

From: Gabriella Guetzkow

To: Ingrid Hollis ; KRISTEN OGDEN

Cc: Forest Tennant

Sent: Monday, April 16, 2018 12:12 PM

Subject: New Blog (typos fixed()

 

Hello,

 

I launched my blog, finally and have dedicated it to Dr. Tennant.  I am trying to add a section for pain patients their families and caregivers can share their own experiences and information that has been helpful to them. I will be adding videos on YouTube and on the blog under the same name. The blog is for people with chronic health issues/diseases and/or chronic and Intractable pain disease.

 

As you know all too well, things are at an all time low for us. The myths of the opioid epidemic are adversely affecting so many legitimate patients who are not abusing or misusing their prescriptions. Our lives hang in the balance… our lives literally depend on education and getting the media to change the way they address this crisis to affect constructive policy changes for compassionate care and access to pain medications. People are suffering and are loosing access at alarming rates. I hope to help affect positive changes by starting a conversation about it, sharing information while also creating a place for a supportive community to form.

 

Thank you Kristen and Hollis for working tirelessly for advocating for our rights. What you’re doing matters!

 

I was hoping that you could share the link to my blog with your list of Dr. Tennant’s patients and whoever else you think would be interested in it.

 

Here is the link

https://gababouthealth.com/

 

Thank you!

—

Sent from Gmail Mobile

Filed under: General Problems | Leave a Comment »

FDA Public Meeting for Patient-Focused Drug Development on Chronic Pain

https://www.eventbrite.com/e/public-meeting-for-patient-focused-drug-development-on-chronic-pain-registration-44555070415

On July 9, 2018, FDA is hosting a public meeting on Patient-Focused Drug Development for Chronic Pain. FDA is interested in hearing patients’ perspectives on chronic pain, views on treatment approaches, and challenges or barriers to accessing treatments for chronic pain. FDA is particularly interested in hearing from patients who experience chronic pain that is managed with analgesic medications such as opioids, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants; other medications; and non-pharmacologic interventions or therapies.

The questions that will be asked of patients and patient representatives at the meeting are listed below, organized by topic. For each topic, a brief initial patient panel discussion will begin the dialogue. This will be followed by a facilitated discussion inviting comments from other patients and patient representatives in the audience. Webcast participants will also have an opportunity to provide input through webcast comments. 

If you are attending the meeting in person and are interested in providing comments as part of the initial panel discussion on July 9^th, indicate so during the registration process. Potential panelists must send a brief summary of responses to the discussion questions below by June 25^th to PatientFocused@fda.hhs.gov. Panelists will be confirmed prior to the meeting.

There will also be an opportunity for patients, patient stakeholders and others to provide comments on issues other than topics 1 and 2 during an Open Public Comment session. Sign-up for Open Public Comment will occur on-site during the day of the meeting.

For more information, please visit the FDA meeting website: 

https://www.fda.gov/Drugs/NewsEvents/ucm603093.htm.

 DISCUSSION QUESTIONS

Topic 1: Symptoms and daily impacts of chronic pain that matter most to patients

1. How would you describe your chronic pain? (Characteristics could include location, radiation, intensity, duration, constancy or intermittency, triggers etc.)
2. What are the most significant symptoms that you experience resulting from your condition? (Examples may include restricted range of motion, muscle spasms, changes in sensation, etc.)
3. Are there specific activities that are important to you but that you cannot do at all or as fully as you would like because of your chronic pain? (Examples of activities may include work or school activities, sleeping through the night, daily hygiene, participation in sports or social activities, intimacy with a spouse or partner, etc.)
4. How has your chronic pain changed over time? (Considerations include severity and frequency of your chronic pain and the effects of chronic pain on your daily activities)

Topic 2: Patients’ perspectives on current approaches to treatment of chronic pain

1. What are you currently doing to help treat your chronic pain? (Examples may include prescription medicines, over-the-counter products, and non-drug therapies)
2. How has your treatment regimen changed over time, and why? (Examples may include change in your condition, change in dose, or treatment side effects)
3. What factors do you take into account when making decisions about selecting a course of treatment?
4. How well does your current treatment regimen manage your chronic pain? (Considerations include severity and frequency of your chronic pain and the effects of chronic pain on your daily activities)
5. What are the most significant downsides to your current treatments, and how do they affect your daily life?
6. What challenges or barriers to accessing or using medical treatments for chronic pain have you or do you encounter?
7. What specific things would you look for in an ideal treatment for your chronic pain?

 

 

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“CVS Pharmacy is currently forcing its pharmacy employees, both pharmacists and technicians, to sign off on a learning module that forces them to comply with the company’s limited and dangerous computer downtime procedures. These downtime procedures (RxConnect Offline) include the filling of prescriptions with limited patient history data and no failsafes in place to prevent errors. When CVS’s computer system goes out, a process called Downtime starts up. This Downtime process allows pharmacy employees to fill prescriptions in a very limited capacity. However, all is not well in Whoville… While in Downtime, Brand name drugs will not substitute to their generic counterparts allowing the chance for improper drug pick errors. SIG codes will not populate in the computer allowing the chance for direction input errors. And, perhaps most interesting of all, all patient cost copays will have to be determined at the pharmacy employees’ discretions which, if figured incorrectly, is a breach of the contract pricing agreed upon by federal Medicare plans, state Medicaids, and other 3rd party payors. All hard copy scanning for visual verification of the Rx written info and all drug utilization review functions are disabled, meaning that the pharmacy staff and pharmacists have to fill and check the prescriptions without the whole medical picture. The downtime program has no listings for patient allergies, medical conditions, or past medication usage and history. (The med history only goes back a few months while in downtime… Nevermind that erythromyin Rx the patient could have restarted from last year! That doesn’t cause any interactions, does it?) Also, throw in the fact that CVS purposely understaffs their stores and pharmacies in an attempt to save payroll. A stressful and overworked environment now becomes a hazardous hellhole when the computers are not doing what they are supposed to. What a complete recipe for disaster and another dangerous situation for patients to be in! CVS Learnet module 200017 asks all pharmacy employees to sign off on several pieces of information including an agreement to verify all waiting prescriptions, all prescriptions due within 1 hour, and to data enter all new and incoming prescriptions. This learning module also asks pharmacy employees to sign off on a legal acknowledgement that states: “I acknowledge that I have received and read, and I understand and agree to abide by the policies, procecdures and training set forth in the RxConnect Offline Fills Best Practices (#200017) training.” Let’s not forget CVS’s tag-line of “up to and including termination” if you don’t do what their corporate stooges say! So basically, CVS reserves the right to terminate the employment of any pharmacist or pharmacy technician who refuses to comply with the filling of medications while their computer system is down, no matter how dangerous the consequences could be. They are also using this sign off as an opportunity to shift all blame for medication misfills onto the pharmacist who is being legally forced (at risk of firing) to fill Rxs in this stressful and alarming environment. Here’s an idea, CVS… Stop bringing your crappy computer system down on already busy and stressful Mondays. Stop forcing your pharmacists and technicians to knowingly endanger patient lives. Stop threatening your employees’ jobs to cover your own shortcomings. Stop shifting all blame away from yourselves so your shareholders stay rich. Just because you’ve figured out that medication misfill lawsuits can be bought off cheaper than what it costs to come up with better computer systems and to better staff your pharmacies, doesn’t mean you should do it. We know you corporate slimeballs call it “the cost of doing business”. Will you continue to call it that if it’s your loved one who gets hurt? Come up with a better computer system, one that doesn’t go down regularly, allow proper and safe pharmacy staffing, and keep the people who depend on these medications safe!”

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About 2.5 weeks ago… my sciatic nerve decided to “march to a different drummer”. By now, I have went thru two weeks of  high dose & decreasing Prednisone without much change in my dramatically elevated pain level.  On the “second day”, I could not get in to see any of the seven prescribers in PCP practice that we have been going to for 20 yr+, so I went to the “Urgent Care” in the same bldg – owned by the same hospital – as the PCP group.

I already have a “iffy back” that is subjective to being “painful” because of activity – like yard work and because of that, I typically have a fair amount of opiates and muscle relaxers in the house.  I had already started “treating” the pain at its onset.

After a few days, the intensity of the pain hadn’t lessened, I was concerned that the Prednisone that I had received from the Urgent care was “too low a dose “.. so I was able to get an appt with the PCP group and the prescriber that I saw agreed on the low Prednisone dose and TRIPLED the dose.

Another week had passed and no change in the intensity of my pain and our PCP decided that it was time to get a MRI..  Had the MRI on Wednesday and had the last appt of the day with our PCP on this past Friday.  It would seem that the “spongy fibrocartilaginous material” between L4-L5 had bulged and had impinged on the sciatic nerve.

I am now waiting for a referral to a neural surgeon and hopefully will be seeing him this coming week.

Our PCP has always let me titrate my own opiate dose when I have had painful flares over the years.  By this point, I was running low on opiates.  I was using a rather low dose of a IR opiate and in it would now appear that I am a fast/ultra fast opiate metabolizer.  Taking a dose, it would “kick-in” in about 30 -45 minutes and start to dramatically “peter-out” about 2.5 hrs after taking the dose.  So a IR dose that should have been providing 4-6 hrs of some pain management… was providing only about TWO HRS.

Our PCP gave me a paper Rx to take to the pharmacy to get filled for enough to last me about 3 weeks.  At the pharmacy, the pharmacist told me that SILVER SCRIPTS has a QUANTITY LIMIT of SIX DOSES IN 24 HRS… and I am taking TEN DOSES every 24 HOURS !

So I go home and call Silver Scripts and talk to the PA dept… I am first told that it would take at least 72 hrs…   they would have to talk to the doctor…  I did not have 72 hrs of medication left and I was the last appt for the weekend.

I pointed out to the PA dept customer service that running out of medication would cause my pain level to go to the upper end of the pain scale, and I could be dependent enough that I could be thrown into withdrawal if I ran out of medication.

I identified myself as a Pharmacist whose specialty was pain management and intentionally throwing me into withdrawal resulting in a torturous level of pain and withdrawal that could be considered pt/senior abuse and that torture in this country is still considered ILLEGAL..   I sensed that I was not getting very far with this person.. 

So… I stated that one of the basics of the practice of medicine is the starting, changing or stopping a pt’s medication and that Silver Scripts did not have a license to practice medicine and that their chief Medical Director Dr Brennan… only had a license to practice medicine in MASS as well as having a law degree.. so he should be well aware what is legal or illegal and being done under his name.

I also told the CS person that it is ILLEGAL – under the controlled substance act – for a prescriber to prescribe controlled substance for a person that he/she had not done a in person physical exam and that Dr Brennan does not have a license to practice medicine in the state of Indiana – where I live.

The CS person asked me if I wanted them to process the PA even if they couldn’t get a hold of the prescriber….. and that would be 24 hrs… and I repeated that I would be out of medication before the 72 hr time frame.  This was about 6 PM on Friday and was assured that I would receive a determination by 6 PM on Saturday.

About 11 AM on Saturday, I got a voice mail…that the PA has been approved 🙂

In the interim, I went to the Silver Scripts formulary (2018) on the web.. and found the following:

Notice that their QL’s have nothing to do with mgs/day but tablets/caps/day.  And if your necessary dose of Oxycodone is 10 mg/dose… they will only pay for Oxy/APAP 10/325 and allow enough APAP/day that could harm your LIVER.  Of course, if this destroys your liver and you need a transplant… then it is Medicare that has to pick up the cost… since they only have to worry about the cost medications.

 

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http://www.barrowjournal.com/archives/12787-Buffington-Drug-laws-just-clogging-up-courts.html

America’s war on drugs has been a catastrophic failure. Look at the arrest and incident reports in this week’s newspaper to see just how little impact the current legal system has had on illegal drug use and abuse.
And that’s just the tip of the iceberg. There’s a massive amount of abuse of legal drugs across the country, as evidenced by the ongoing opioid epidemic.
It’s time the nation, from the federal government down to local governments, re-think these misguided efforts.
We are clogging up our courts and jails with people who often need addiction treatment, not a cell. In the process, we are sometimes ruining the lives of young people whose only “crime” was to get caught with a marijuana joint.
There has to be a better way to deal with serious drug addictions and minor recreational drug use in this country than to push citizens through the legal system’s meat grinder.
At the federal level, there are two things that need to happen:
•Remove marijuana as a Schedule 1 drug. As currently classified by the DEA, Schedule 1 drugs are supposed to have no accepted medical use and have a potential for abuse. Marijuana clearly doesn’t meet that standard. There’s a growing body of evidence that the chemicals found in the cannabis plant do have medical value. But medical research on cannabis has been stymied by its being classified by the federal government as a Schedule 1 compound. The reason marijuana is a Schedule 1 drug today has nothing to do with medical or scientific evidence and everything to do with politics. Before 1942, marijuana was listed as a legal medicine in the U.S. It was removed as a legal substance following the 1930s “reefer madness” propaganda. (That movement was rooted in an anti-Mexican sentiment sweeping California at the time. That grew into a national movement fueled by “yellow journalism” publisher William Randolph Hearst.) In the early 1970s, President Richard Nixon went on a rampage against drugs, especially against marijuana which was connected to the anti-Vietnam War “hippie” movement. Nixon punished that movement, which didn’t support him politically, by having cannabis listed as a Schedule 1 drug under the DEA, an agency which his administration had helped create. It’s very clear that cannabis should not be listed as a dangerous, addictive drug that has no medical value. Congress should force the DEA to change that.
•In addition to ending the farce about marijuana, the federal government should crack down harder on the pharmaceutical companies that manufacture addictive opioid drugs and market them as being harmless. Some of that is happening and big pharma is increasingly coming under scrutiny for its role in creating the opioid crisis. (There isn’t space here to outline all those details, but if you’re interested look up Purdue Pharma and see how that company marketed OxyContin in the 1990s and early 2000s.) But more can be done by the feds to hold big pharma accountable for its misleading marketing of dangerous, addictive drugs.
At the state and local level, there are things that can also be done differently:
•Marijuana use should be decriminalized by state and local law enforcement. That’s already being done in some jurisdictions. Locally, the Town of Braselton has stopped arresting for minor marijuana possession and just issues a citation (like a speeding ticket) instead. The City of Jefferson does that sometimes, depending on who the arresting officer is. But too many other local law enforcement agencies continue to arrest people for having a small amount of marijuana. That’s nuts. It’s clogging up our courts and ruining the lives of people whose only offense is having a bag of weed in their car. Issue a ticket and unless someone is clearly under the influence of drugs, let them go on their way.
•The state government should put much more funding into mental health and addiction programs. Many of those who have addiction problems have other mental health or life problems. Putting these people in jail isn’t getting them the help they need.
•The state should continue to open the door to cannabis for medical use despite its conflicted status at the federal level. State legislators often say they can’t expand medical cannabis because of the feds, but that’s just a copout. State legislators are often willing to give their middle-finger to the feds on other issues, so why not this?
•More drug courts that focus on changing behavior rather than criminal punishment need to be created and funded by the state.
•Every local government should join in the class-action lawsuit that is aimed at suing the pharmaceutical companies that helped the opioid crisis. Several area governments have already signed on and those that haven’t should do so.
There are no magic formulas to ending drug addiction, just as there has never been a way to stop alcoholism. The nation tried Prohibition for 13 years and that only led to more crime and public corruption. The current prohibition on drugs has not been successful, either. Since 1973, we’ve had a sustained “war on drugs” where we’ve tried to use law enforcement as a weapon to change social behavior. It hasn’t worked. Screaming “law and order” failed.
It’s time to try something new.

Perhaps the “war on drugs” is just a methodology for our judicial system to become self-perpetuating industrial complex ?

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