Colorado and Montana’s Murderous 50MG MME Ceiling. Pain Crisis 2018 Continues.

Posted on April 18, 2018 by Pharmaciststeve

https://mtrx2010.livejournal.com/2593.html

​Yesterday I saw an article posted by a doctor/pain advocate which shocked,  and gave me nightmares.  I actually had nightmares after reading the article,  and seeing the evil the state of Colorado unleashed on it’s own residents.  In short,  the article states non-cancer patients can not receive more than 50MG of MME pain medicine a day.

It’s a horrifying atrocity,  and terrifying to think anyone could do that to another human being.  It’s one of those things that makes everyone feel unsafe across the country.  As I mentioned I had actual nightmares of the matter,  and I’ve been in a deep emotional slump since I read the report on the rampant,  inhumane evil sweeping my country.  Unbelievable.

I cried,  cursed,  and prayed for all the people effected by Colorado’s atrocious 50MME ceiling placed on all those innocent patients.  The fact it applies to everyone without cancer puts a barrel in the mouth of every patient who’s been,  is, and will be in severe pain.  The first thing which ran through my mind was my entire experience with falling off a 60FT cliff,  and having my feet reconstructed.

Heel and foot surgeries are among the absolute most painful surgeries.  The pain in my feet during and following months after reconstruction was so horribly severe,  they had to run a tube from my arm down into my heart to pump pain medicine directly into my heart.  Even dilauded,  despite it’s well known potency,  wasn’t adequate to subdue the pain and screaming of my surgeries.  It came down to nerve blockers.  They had to turn my legs off to control the pain,  and I actually set a medical record for how long a person can wear nerve blockers in their legs.

The pain of my nerve blockers being removed was abysmal.  I lost all the color in my skin and turned white from the pain.  I fought off shock symptoms,  and had to be monitored 24/7 for weeks after my nerve blockers came out,  because the pain was,  what i believe to be the limit of what a person can tolerate.  If I hadn’t had adequate pain medicine I would have died.  When I got home I was taking 2 10MG Hydrocodone ever 4HOURS and the pain was still intolerable.  I spent my days and nights sobbing and often screaming from the torture.

When I read the article I tried to imagine what it would have been like trying to survive the hell surgery and outpatient wound-care on only 50MME and my heart palpitated with anxiety and panic as the thoughts raced through mind.  I could see all the tragedy headed for Colorado,  and the hopeless ignorance of the murderers writing these laws.  There’s no way I could have survived on 50MME,  and Ive even been approached by other individuals who have had foot reconstruction,  and they told me the same exact thing.  Even before they were aware of my personal story with foot surgeries.

Not all surgeries hurt the same,  and some are outright torture.  Many patients get stuck with metal,  muscle and skin grafts,  and synthetic body parts in their feet and hands,  like myself,  which makes that pain endure indefinitely.  The hands and feed are some of the most sensitive parts of the body,  and getting them reconstructed is an agony which can not even be approached by a 50MG MME Ceiling.  The horror of the possibility anyone could think 50MG mme could even approach the pain of limb reconstruction is tearing at my soul.

​​There are huge nerve branches in the feet.  Many are thick,  and almost all of them converge in the foot itself.  When my feet were reconstructed all these nerves were destroyed by extreme swelling,  necrosis,  and chunks of flesh lost in the failed surgeries.  When they cut out several grams of flesh from the outside of my heel I lost feeling of pinky toes.  -And when the flesh on the back of my heel and along the side became necrotic due to medical negligence,  neuropathy set in throughout my entire foot.  My nerves were so severely damaged simply feeling the breeze on my toes from someone walking by was enough to make me scream.  My toes hadn’t been injured.  It was purely an effect from the severely damaged nerves and tissue throughout my feet.

To think Colorado believes 50MME could possibly do anything for pain this severe shows an extreme case of ignorance,  stupidity,  and incompetence.  It also reveals the lack of compassion and empathy of the people running their state in both legislation and medical law.  Colorado needs to rework their votes as citizens.  Even if Colorado calls it off do to torture and patient suicide it can still happen again,  because the people committing these crimes against patients have no idea what they’re doing,  or any clue as to how much they’re actually torturing the population.

A common discussion is draining the swamp.  We need to get rid of the people who are leading and fueling the opioid hysteria,  and the attack against innocent pain patients and doctors as soon as possible.  We need to start casting our votes against opioid hysteria supporters regardless of our political parties and alignments.  We can fix the rest of the problems later,  but as for now the pain crisis is the primary concern.  We need to eliminate these employments immediately.  In the meantime the casualties continue to mound up.

There are all kinds of painful surgeries and medical conditions,  and they are not the same.  Pain which endures is pain which kills.  It’s appalling to think these white shirts can’t comprehend that.  Then again when you think about the cliche soulless bureaucrats and corporate minded entities committing these crimes-it’s no surprise.

We haven’t seen a witch hunt like this on native soil in centuries,  and like all witch hunts there are numerous deaths and casualties.  The real tragedy is when these witch hunts take place in our own government who always justifies the murder and torture of their victims.  These people are supposed to know better-and yet they don’t know anything.  They literally have no idea what pain is or how it affects our lives.  Every person and medical condition is different.  One size does not fit all,  and 50-90MME is murder.  Plain and simple.

This is one of the greatest crimes committed against Americans by the American people in decades.  We’ve done some pretty horrible things to each other trying to push opinions and hysteria on each other-but this leads to torture and death.  -And the fools are pushing the opioid hysteria and torture deserve immediate imprisonment for their crimes against humanity,  but if we don’t do something about it they will get away with it,  and our children will pay for the evil burning across America in 2018.  This is the year of  pain and suffering for Americans.

Ive been in agony ever since the 90MG mme by medicaid took hold in my life as of march 2018,  and have spent everyday in bed.  I went from being active and working my way back into society,  being productive,  caring for my elderly mother,  and for once in many years,  having an appreciation for life,  to being completely bed ridden and destitute.  Ive lost so much hope in humanity and America this year-I’m not sure if I can ever get it back.  I’ve never observed such an intense wide spread evil in this country,  and the fact it’s getting worse breaks my heart and makes me fearful of the future.  2018 has been a traumatic year for me and pain patients everywhere.  It will not be soon forgotten.

I keep trying to think of ways to battle the hysteria,  but what can I do in so much pain?  What can I do with these permanently broken ankles?  How can I fight this evil which seeks destroy me,  my country,  and my children?  I feel so helpless and powerless it seems that death eminent for us with little to no way out.

I don’t get it.  I can’t get it.  How can we as Americans do something so wide spread and murderous to each other??  it doesn’t makes sense.  The entire ordeal is mind blowing.  America has never been a country to let it’s own people suffer to death on our own soil,  or to allow torture in the public eye.  -And yet here we are.  WTF happened??

We have got idiots running our government agencies and posting false statistics to push their agenda.  We have politicians in power willing to kill innocent people if it means improving their own careers.  This evil is a product of the evils in office,  and we have to do something about it as a people.  The general public doesn’t see it as immediate genocide,  but that’s what it is.  We’re dying slowly and painfully,  and that pace somehow justifies the murder.  This is the American Holocaust.

​​

​My heart aches,  and my prayers go out to the victims of the wide spread 90MG MME ceiling on pain medicine,  and the victims of Colorado and Montana’s 50MG MME ceiling placed on pain medicine.  I pray the evil legislation is overruled as soon as possible,  and life,  love,  mercy,  and medicine be returned the lives of the innocent victims of the opioid hysteria.  The opioid hysteria is destroying all traces of humanity and compassion throughout these norther states,  and the powers who govern them.  Now would be a good time to form a Pain Patient Party,  and push out the inhumane villains who seek to destroy the lives of innocent pain patients everywhere.  Heroin and Chinese fentanyl is not medicine and doesn’t belong on the same page with prescription medicine,  and their overdoses do not belong with ours,  the pain patients.  We are not addicts,  we are patients.  We are not criminals-we’re victims.  There is no Opioid Crisis only Opioid Hysteria.

I hope one day these words mean something where it matters.  I hope one day all this suffering pays off,  and I hope one day I can rest easy knowing I won’t be medically abused by my own leaders,  and my children’s future is safe free of torture and murder by the moral crusaders fueling one of the most evil hysterias to ever plague our great nation.

-Marty(Intractable Pain Patient for Life)

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AG’s: giving law enforcement TOTAL ACCESS TO STATES’ PMP .. NO WARRANT NEEDED ?

Posted on April 17, 2018 by Pharmaciststeve

DEA to share painkiller prescription information with 48 states

http://krcrtv.com/north-coast-news/eureka-local-news/dea-to-share-painkiller-prescription-information-with-48-states

WASHINGTON, D.C. — Attorney General Jeff Sessions announced Tuesday that the Drug Enforcement Administration (DEA) has reached a prescription drug information-sharing agreement with 48 Attorneys General.

 “Better information means better decisions,” Attorney General Jeff Sessions said. “Today’s agreement with 48 Attorneys General will give DEA and the states alike more information they can use to prosecute the criminals who are contributing to our national drug emergency. That means more prosecutions and ultimately fewer drugs on our streets. Would-be criminals should be warned: we are now better equipped than ever to find the fraudsters who are fueling our nation’s addiction crisis.”

“This partnership provides an unprecedented opportunity to use DEA and state resources and information to jointly combat pill diversion and trafficking,” said DEA Acting Administrator Robert W. Patterson. “We are losing far too many Americans to opioid abuse and addiction. I salute these states for their proactive efforts and know they will make a significant difference as we attack this epidemic across the country.”

 DEA has reached an agreement with Attorneys General from 46 states, Puerto Rico, and the District of Columbia to share prescription drug information with one another in order to aid investigations. DEA’s Automation of Reports and Consolidated Orders System (ARCOS) system collects some 80 million transaction reports every year from manufacturers and distributors of prescription drugs. DEA will provide the Attorneys General with that data, and the states will provide their own information, often from prescription drug monitoring programs (PDMPs) to DEA. Under the agreement, both state and federal law enforcement will have more information at their disposal to find the tell-tale signs of crime.

I smell a RAT 

 

 

I guess when our judicial system is concerned there is no law that applies to them.  This agreement  seems to throw – out the door – any concerns of the Private Health Information (PHI) that is protected by HIPAA.

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Senate panel unveils bipartisan new bill to combat opioid epidemic

Posted on April 17, 2018 by Pharmaciststeve

https://www.nbcnews.com/politics/congress/senate-panel-unveils-new-bipartisan-bill-combat-opioid-epidemic-n866641

WASHINGTON — A Senate panel on Tuesday introduced a comprehensive congressional plan in response to the growing opioid addiction epidemic.

 

The bipartisan bill comes as the death toll from prescription opioid addiction continues to skyrocket. In 2016, over 42,200 Americans died from an opioids overdose, according to the latest CDC data — five times higher than in 1999.

The epidemic has affected every state in the country, making the issue a top priority on both sides of the aisle.

Congress has previously addressed the crisis by giving agencies more funding to research solutions and distribute grants, such as the $3.3 billion that was included in the massive omnibus spending bill last month. But critics said that interagency reform, not just funding, was necessary for long-term results.

The ambitious new measure, now under consideration in the Senate’s Health, Education, Labor and Pensions committee, includes 40 bipartisan proposals intended to drastically expand the ability of multiple government agencies to address the ongoing crisis.

Provisions in the bill would encourage further research at the National Institutes of Health to develop nonaddictive painkillers, urge the Food and Drug Administration to recommend certain limits on the number of opioids prescribed to a patient, and call on the Centers for Disease Control and Prevention to collect more data about overdoses, which officials can then use to more effectively combat the epidemic.

The legislation also includes Jessie’s Law, a proposal that would give doctors greater access to medical records documenting a patient’s addiction history.

The White House last month released the outlines of its own three-pronged approach to combating the epidemic, which would prioritize decreasing opioid overprescription, expanding access to treatment and curbing the supply of illegal drugs entering the country from elsewhere. The proposal drew controversy over President Donald Trump’s suggestion that some drug dealers be subject to the death penalty.

Legislation to aid law enforcement efforts to combat the epidemic fall under the jurisdiction of the Senate Judiciary Committee, although the measure introduced Tuesday does outline requirements for the FDA and Custom Border Patrol to more effectively detect and seize illegal drugs, like fentanyl, that cross U.S. borders.

The panel is aiming to move the bill through the committee by next week and send it to the full Senate for consideration. Their House counterparts are planning to move forward on similar proposals by Memorial Day.

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Two FOR PROFITS MERGE — goal to generate BIGGER PROFITS -or – improve pt care and QOL ?

Posted on April 17, 2018 by Pharmaciststeve

Shareholders approve merger of CVS, Aetna

www.chaindrugreview.com/shareholders-approve-merger-cvs-aetna/

WOONSOCKET, R.I. — CVS Health has moved a step closer to completing its acquisition of insurer Aetna Inc. after stockholders of both companies overwhelmingly approved the deal. The combination must still pass the scrutiny of regulators, ­however.

More than 98% of CVS shares were voted in favor, while about 97% of Aetna shares voted to approve the deal. The merger is expected to close in the second half of this year.

“The combination of CVS Health and Aetna brings together two complementary businesses with an expanded set of unique capabilities to create a new, community-based open health care model that is easier to use and less expensive for consumers,” said Larry Merlo, president and chief executive officer of CVS, in a statement.

Whether megamergers such as the CVS-Aetna combination or the planned tie-up of Express Scripts Holding Co. with Cigna Corp. will actually deliver lower costs or any other benefit to patients and health care providers remains to be seen, according to some industry observers and analysts. What they will unquestionably accomplish, though, is yet more massive concentration in the health care industry.

If both deals are completed, all three of the nation’s largest pharmacy benefits managers will be linked to three of the largest insurance companies. CVS, Express Scripts and United­Health already process more than 70% of all U.S. ­prescriptions.

The final hurdle for the CVS-Aetna deal will be to convince antitrust enforcers that their combination will in fact result in efficiencies that lower health care costs and produce better outcomes. According to a Bloomberg News report, mergers and acquisitions involving PBMs such as CVS are usually investigated by the Federal Trade Commission, but in this case the Justice Department’s antitrust division, which handles health insurance mergers, is investigating the merger, since it combines a PBM and an insurer.

The wave of consolidation has drawn harsh criticism from the National Community Pharmacists Association. “We’re seeing the growing balkanization of the health care industry, a world in which patients may be forced into a health care kingdom — the CVS-Aetna kingdom, the Cigna-Express Scripts kingdom, the UnitedHealth-OptumRx kingdom — where the borders aren’t porous, and patients are stuck with what they get,” said NCPA chief executive officer B. Douglas Hoey.

Other industry observers question how much cost savings will be left to pass on to consumers after paying for merger-related costs and servicing a ballooning debt load. CVS, for example, reportedly issued about $40 billion of investment-grade debt to finance the acquisition, which would make it the third-largest corporate bond sale on record, if accurate.

In any case, the main impetus for both the CVS-Aetna combination and the Express Scripts-Cigna deal may have been the interests of Amazon.com in moving into the highly dysfunctional U.S. health care field.

 

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Nursing homes routinely refuse people on addiction treatment — violating ADA ?

Posted on April 17, 2018 by Pharmaciststeve

www.statnews.com/2018/04/17/nursing-homes-addiction-treatment/

Nursing facilities routinely turn away patients seeking post-hospital care if they are taking medicine to treat opioid addiction, a practice that legal experts say violates the Americans with Disabilities Act.

After discharge from the hospital, many patients require further nursing care, whether for a short course of intravenous antibiotics, or for a longer stay, such as to rehabilitate after a stroke. But STAT has found that many nursing facilities around the country refuse to accept such patients, often because of stigma, gaps in staff training, and the widespread misconception that abstinence is superior to medications for treating addiction.

In Ohio — where 100 people a week died of opioid overdoses between August 2016 and August 2017 — a trade group representing more than 900 care facilities said in a written statement that none of its member facilities accepts patients who receive methadone or buprenorphine for addiction.

In Massachusetts, another state that is reeling from a flood of opioids, a nurse case manager at Boston Medical Center said it can be “next to impossible” to find a place that will accept a patient who takes these medications.

“It’s so bad — you’re just begging and pleading with these places,” said Maureen Ferrari, a nurse case manager who for nearly a decade has worked at Boston Medical Center finding post-hospital placement for patients. She said only two nursing facilities in the Boston area accept people on addiction medicines, adding that this roadblock can harm patients and turn a two-day hospital stay into one that is a week long, driving up health care costs.

“It’s well-settled in the case law that people with opioid use disorder have a disability as recognized under the ADA,” said Sally Friedman, legal director of Legal Action Center, a nonprofit policy and law group based in New York City.

“Opioid addiction is a chronic disease like any other, and nursing homes should be ashamed of themselves for excluding people who are receiving the most effective form of treatment for this chronic disease,” Friedman said.

Yet the law has not been enforced when it comes to people addicted to opioids, experts say, and many nursing facilities and industry leaders seem unaware of their obligations.

“The imperative to provide people with addiction with medication has not percolated,” said Leo Beletsky, an associate professor of law and health sciences at Northeastern University.

Officials with a handful of state long-term care organizations polled by STAT, including trade groups in Wyoming and Montana, said they did not know whether facilities in their area had policies on how to continue addiction treatment among patients admitted to their facility, something experts said is unsurprising.

“There is a lot of confusion about what is legal and not legal,” said Dr. Sarah Wakeman, an addiction specialist at Massachusetts General Hospital, who added that her team faces difficulty finding post-hospitalization placement “every single day” for people who take medicine for addiction.

“There are facilities that do not understand that they are not allowed to do this,” she said.

In an effort to combat this confusion, the Massachusetts Department of Public Health in 2016 issued guidance for nursing facilities caring for patients who take medicines for addiction. The state’s circular letter asserted that care facilities must provide medication-assisted treatment for people who are already on it, and who otherwise are eligible for admission. A spokesperson said that the department addresses any concerns related to the topic that are brought to its attention, and that it reviews a facility’s policies and procedures when conducting a nursing home on-site visit. But the agency has not tracked complaints about addiction-related admission denials.

“There is a lot of confusion about what is legal and not legal. There are facilities that do not understand that they are not allowed to do this.”

Dr. Sarah Wakeman, addiction specialist at Massachusetts General Hospital

 The U.S. Department of Justice has begun an investigation of detention centers that don’t make medication-assisted treatment available to inmates with addictions. And Beletsky, citing federal government sources, said a campaign to boost ADA enforcement among care facilities may be on the horizon.

It’s a move that can’t come too soon, he said. Failing to enforce the ADA for people with opioid use disorder “is a missed public health opportunity that is probably measured in lives,” Beletsky said. The Department of Justice declined to comment.

Refusing care to people on medication for addiction can have dire consequences because pressure to stop these proven treatments could open the door to relapse and overdose.

Part of the reticence to accept patients with addiction stems from unfamiliarity with the medicines used to treat them. Nursing facilities may not have a clinician licensed to prescribe buprenorphine on staff, for example, and facilities may be unaware that the patient’s primary care doctor often can continue to provide the medicine.

“We have faced hurdles even when clinicians who are discharging patients stable on medications to treat opioid use disorder are willing to continue prescribing these medications while patients are recovering at facilities,” Dr. Sabrina Assoumou, an infectious disease physician at Boston Medical Center, wrote in an email.

Treatment of addiction is also an unfamiliar process for many facilities, where resources often already are stretched thin.

“You are taking on a chronic disease that you may not have the infrastructure to deal with,” said Dr. Wes Klein, an internist and the medical director of Duffy Health, a community health center in Hyannis, Mass. “That may scare people a little bit.”

Some addiction experts have begun partnering with nursing facilities to make sure the addiction treatment a person receives in the hospital isn’t a barrier to the next step in their medical care.

Center for Behavioral Health, a group of four addiction treatment centers in Las Vegas and Reno, Nev., began offering educational sessions on medication-assisted addiction treatment for nursing facility staff when some expressed discomfort with the medicines. The sentiment stemmed largely from a lack of experience with the addiction medicines — and a common misconception that medication-assisted treatment for opioid addiction represents replacing one addiction for another.

There is a “total lack of understanding and knowledge of medication-assisted treatment,” said Dr. Lesley Dickson, an addiction psychiatrist at Center for Behavioral Health. “Most doctors don’t even seem to know what it is.”

The reaction, Hales said, has been “surprisingly positive.”

“Most people go off of the stigmatized version of medication-assisted addiction treatment,” Hales said. “Then when you throw out what it really is — the raw data, the patient success stories — they are like, ‘Maybe this isn’t what I thought it was.’”

Wakeman’s team, too, recently began a partnership with two area nursing homes. The team provides prescriptions for patients admitted to the facilities so they can continue to take methadone and buprenorphine, and offers guidance if questions arise about proper dosages or other logistics.

“We need to think about how to help these facilities and how to support them in caring for a population they are not used to caring for,” Wakeman said. The needs of patients with addiction, many of whom may be younger than those who traditionally have stayed in nursing homes, “may be different from what facilities have historically thought about.”

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Bernie Sanders introduces bill to impose jail time for execs behind opioid crisis

Posted on April 17, 2018 by Pharmaciststeve

www.statnews.com/2018/04/17/bernie-sanders-bill-jail-opioid-crisis/

WASHINGTON — Sen. Bernie Sanders (I-Vt.) will introduce a bill Tuesday that would impose jail time for pharmaceutical executives whose companies engage in manipulative practices when marketing opioids.

The legislation would impose a 10-year minimum prison sentence and fines equal to an executive’s compensation package if the individual’s company is found to have illegally contributed to the opioid crisis. It would also impose an additional fine on those companies of $7.8 billion — one-tenth the annual cost of the crisis, per a 2016 estimate.

The bill outlined a number of mechanisms by which the Department of Health and Human Services could demonstrate such liability, including by mandating written justifications for pill orders that seem medically unreasonable. And the legislation would establish an opioid reimbursement fund, to be administered by HHS, that would collect the fines levied under the new law and distribute them to other federal departments.

The bill would also prohibit companies from direct marketing of opioid products without adequate warning of their addictive properties and establish a reimbursement fund that would collect revenues from the penalties imposed.

In many cases, the bill’s proposals take aim at the most-cited perceived misdeeds of opioid makers and distributors.

Purdue Pharma, which manufactures the opioid painkiller OxyContin, announced in February it would no longer directly market the drug to doctors, a major shift for the company that has shouldered an increasing share of the blame for the national crisis.

McKesson, a drug distributor, is said to have shipped 5 million opioid pills to a West Virginia town with 400 residents over a two-year span.

Those two companies are among a larger group of manufacturers and distributors being sued in a consolidated case in an Ohio federal court. The Department of Justice said earlier this month it planned to file an amicus brief in the case.

Sanders’ new effort is the latest in a spate of opioids-related bills, but takes aim at pharmaceutical companies more explicitly than others. Some version of an opioids-related bill is seen as the last major legislation likely to be pursued on Capitol Hill prior to midterm elections in November.

Rep. Greg Walden (R-Ore.), who chairs the House Energy and Commerce Committee, has said he hopes to bring a legislative package to a vote by Memorial Day.

 

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DEA moves to curb oversupply of opioids

Posted on April 17, 2018 by Pharmaciststeve

http://thehill.com/policy/healthcare/383600-dea-moves-to-curb-oversupply-of-opioids

The Drug Enforcement Administration (DEA) is attempting to reduce the oversupply of opioids in an effort to curb the number of painkillers sold illegally.

Specifically, the agency is proposing a rule that would change how it sets limits on the amount of opioids drug companies can make every year.

“Under this proposed new rule, if DEA believes that a company’s opioids are being diverted for misuse, then they will reduce the amount of opioids that company can make,” Attorney General Jeff Sessions said Tuesday during remarks he gave on the opioid crisis in North Carolina.

The opioid crisis has hit communities across the country hard, and death rates continue to climb. Some areas have seen a large influx of pills into often small communities, and policymakers are grappling with how to curb the number of painkillers that are sold illegally.

West Virginia Attorney General Patrick Morrisey (R) says the proposed rule is the result of a lawsuit he filed against the DEA seeking more transparency and input in the process the agency uses to determine how many opioids can be produced each year. The lawsuit was placed on hold in March after Sessions asked the DEA to evaluate its policies on crafting production quotas for opioids.

“The reform sought by DEA proves the impact of our lawsuit is still reverberating in Washington and producing real results capable of ending the oversupply of deadly and addictive painkillers that has killed far too many,” Morrisey, who is running for the Senate, said in a statement.

The proposed rule hasn’t been filed in the Federal Register as of Tuesday afternoon, but Morrisey’s office sent out a copy.

According to the document, the proposed rule would let the DEA take into account the extent to which pills are sold illegally when setting production quotas for opioids.

It would also consider “relevant information” from various agencies from the Department of Health and Human Services and its agencies, such as the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and the Centers for Disease Control and Prevention. States could also have input and request a hearing if it believes a quota is excessive.

“The current regulations, issued initially in 1971, need to be updated to reflect changes in the manufacture of controlled substances, changing patterns of substance abuse and markets in illicit drugs, and the challenges presented by the current national crisis of controlled substance abuse,” the rule states.

The public comment period for the rule is 15 days.

Sessions also announced an agreement with 48 attorneys general to share prescription drug information to combat the diversion and trafficking of painkillers.

 

 

 

 

 

 

 

 

 

 

 

 

As the number opiate prescriptions hit a TEN YEAR LOW and OVERDOSE DEATHS hit a TEN YEAR HIGH..  hospitals are reporting serious shortage of injectable opiates.. The DEA is looking for ways to justify cutting the opiate production quotas for the pharmas.  When statistics strongly suggests that there is current not enough opiate prescriptions filled would not be enough to meet the valid medical/therapy needs of the intractable chronic pain pts let along the other 70-80 million chronic pain pts and those acute pain pts dealing with pain from a accident or medical procedure.

I wonder if the DEA will use the CDC’s 64,000/yr drug overdose deaths… and overlook or ignore the fact that abt 1/3 of those numbers have nothing to do with opiates and abt 35K are due to ILLEGAL OPIATES and there are no published stats as to how many of all those 64K overdose drug deaths are in fact SUICIDES.

But the TRUTH AND FACTS have never gotten in the way of the DEA doing what they want to do…

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Jacksonville employee named Melinda Power demanded that military flags be removed ?

Posted on April 17, 2018 by Pharmaciststeve

In the clip, a man identifying himself as a business owner claimed that a Jacksonville employee named Melinda Power had demanded that military flags be removed. In addition, the unnamed business owner claimed Power told a combat veteran customer he had done “nothing” for the country. Video shared by a local news outlet included an image of a citation:

The same news article reported that the citation had to do with the amount of signage displayed by Jaguar Power Sports, not the military flag, and included video (without audio) of interaction between Power and the anonymous customer. In early accounts of the 16 April 2018 dispute, employee Katie Klasse quoted Power as saying the unnamed man’s service “didn’t matter.”

But when the veteran was interviewed by the same station, he himself stated that in fact Power said his opinion on the citation “doesn’t really matter at this point” as she was present only to discuss city ordinances:

Changes made to Jacksonville’s signage ordinances, if any, are not clear based on social media commentary. However, according to city code enacted in March 1987, the flags on display at Jaguar Power Sports do appear to be violating City of Jacksonville Building Inspection Division Sign Laws:

Sign Exemptions

… United States of America, State of Florida, and Local Government flags (Duval/Jacksonville) may be displayed.

[…]

Unlawful Sign Structures

… Consists of streamers, ribbons, pennants or wind activated devices, multiple flags, including multiple flags of states, governmental units, balloons, including individual and giant balloons which are inflated and tethered for support which encompass an area or areas, singularly or in aggregate, greater than twenty-five (25) square feet.

Jaguar Power Sports was cited but not fined for the flag violation, and Jacksonville’s mayor later said that code would be amended to allow military flags to be flown in the manner permitted for American flags as of 17 April 2018.

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After a motorcycle accident, this woman ‘just wanted to keep my leg’

Posted on April 17, 2018 by Pharmaciststeve
Amberly Lago survived a devastating motorcycle accident and endured 34 surgeries and extreme chronic pain. She joins Megyn Kelly TODAY to share her story, as recounted in her book “True Grit and Grace: Turning Tragedy Into Triumph.” She says her leg was “completely shattered” and explains why she chose not to have it amputated.

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How France Cut Heroin Overdoses by 79 Percent in 4 Years

Posted on April 16, 2018 by Pharmaciststeve

https://www.theatlantic.com/health/archive/2018/04/how-france-reduced-heroin-overdoses-by-79-in-four-years/558023/

In the 1980s, France went through a heroin epidemic in which hundreds of thousands became addicted. Mohamed Mechmache, a community activist, described the scene in the poor banlieues back then: “To begin with, they would disappear to shoot up. But after a bit we’d see them all over the place, in the stairwells and halls, the bike shed, up on the roof with the washing lines. We used to collect the syringes on the football pitch before starting to play,” he told The Guardian in 2014.

The rate of overdose deaths was rising 10 percent a year, yet treatment was mostly limited to counseling at special substance-abuse clinics.

In 1995, France made it so any doctor could prescribe buprenorphine without any special licensing or training. Buprenorphine, a first-line treatment for opioid addiction, is a medication that reduces cravings for opioids without becoming addictive itself.

With the change in policy, the majority of buprenorphine prescribers in France became primary-care doctors, rather than addiction specialists or psychiatrists. Suddenly, about 10 times as many addicted patients began receiving medication-assisted treatment, and half the country’s heroin users were being treated. Within four years, overdose deaths had declined by 79 percent.

 

Of course, France has a socialized medical system in which many users don’t have to worry about cost, and the country also developed a syringe-exchange program around the same time. Some of the users did sell or inject the buprenorphine (as opposed to taking it orally, as indicated), though these practices didn’t result in nearly as many deaths as heroin does.

“It seems that the French model raises questions about the value of tight regulations imposed by many countries throughout the world,” wrote the author of a study on the phenomenon, the French psychiatrist Marc Auriacombe, in 2004.

Just what are these regulations? In the United States, doctors must take a special, eight-hour class to get a waiver that allows them to prescribe buprenorphine. The classes can cost money and force even more tasks into doctors’ already packed schedules. In one study, 10 percent of doctors said they didn’t even know how to get the waiver. According to Andrew Kolodny, a psychiatrist who studies addiction at Brandeis University, some primary-care doctors might frankly be daunted by the prospect of working with addicted patients—a sentiment that’s also reflected in physician surveys. Meanwhile, there is no special training class required to prescribe prescription painkillers, Kolodny points out. (There’s also a cap on how many buprenorphine patients a single doctor can have, though Congress is considering waiving this limit through new legislation.)

 
There are multiple other issues in the American health-care system that make accessing buprenorphine difficult for addicted people. Medicaid pays for a substantial chunk of all drug-abuse treatment, but state Medicaid programs impose limits on when and how they’ll cover buprenorphine.

Finally, doctors know that if they sign up to prescribe buprenorphine, all the local heroin users will flock to them, potentially crowding out their other patients, says Stanford University professor of psychiatry Keith Humphreys. “Doctors also want to take care of kids with colds, and adults with bad backs and cancer patients and the panoply of humanity that they know how to take care of,” he said via email. One way to resolve this would be to require doctors who are licensed to prescribe prescription painkillers to also prescribe buprenorphine.

The result of all this is that many addicted people just can’t find a doctor willing to prescribe them buprenorphine on demand, especially if they want insurance to pay for it. For example, The Atlantic looked up Parkersburg, a city of 30,000 people in West Virginia, the state with the most overdose deaths, on Suboxone.com, a site that lists buprenorphine providers. We found 10 doctors within a 50-mile radius who prescribe buprenorphine, and we attempted to reach all 10.

Some of the contacts appeared to be in the same office. We were told one doctor had a waiting list for patients, three doctors did not accept insurance and charged hundreds of dollars a month in cash, one had a number that was disconnected, and, finally, one was both accepting new buprenorphine patients and took insurance.

“If you really want someone who’s addicted to seek treatment, you have to have it be less expensive than using heroin,” Kolodny said. For many addicted Americans, that’s not currently the case.

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