Legalizing MJ will cause “drug dogs” to be euthanized ?

Illinois police: Keep pot illegal — or we’ll kill the dog

https://www.washingtonpost.com/news/the-watch/wp/2018/05/08/illinois-police-keep-pot-illegal-or-well-kill-the-dog/

As Illinois lawmakers debate whether to become the 10th state to legalize recreational marijuana, a few law enforcement officials in the state have put forth this bizarre argument:

If Illinois legalizes marijuana for recreational use, law enforcement officials fear job losses for hundreds of officers — specifically, the four-legged kind.

Police agencies spend thousands of dollars and months of training to teach  dogs how to sniff out and alert officers to the presence of marijuana, heroin, cocaine and other drugs. If pot use becomes legal, the dogs would likely either have to be retrained — which some handlers say is impossible or impractical — or retired.

“The biggest thing for law enforcement is, you’re going to have to replace all of your dogs,” said Macon County Sheriff Howard Buffett, whose private foundation paid $2.2 million in 2016 to support K-9 units in 33 counties across Illinois. “So to me, it’s a giant step forward for drug dealers, and it’s a giant step backwards for law enforcements and the residents of the community.”

Later in the story, a K-9 trainer suggests some or most of the dogs will need to euthanized.

(By the way, if you think it’s weird that a sheriff would have a “personal foundation” capable of spending more than $2 million on drug dog units for other police departments, so did I. It turns out that Sheriff Buffett is the middle child of the billionaire Warren Buffett.)

There’s a lot to unpack here. First, I’d dispute Buffett’s assertion that legalization is a “giant step forward for drug dealers.” This is true only if you consider retailers who sell marijuana legally to be “drug dealers.” If by “drug dealers” you mean cartels and kingpins who sell the drug on the black market and use violence to settle disputes, legalization is actually pretty bad for them.

But let’s get back to the dogs. Even if it were true that marijuana legalization in Illinois would mean that all drug dogs in the state had to be euthanized, that isn’t an argument to keep marijuana illegal. I’m a dog person. But the drug war is not a make-work program for canines. Second, nine states have already legalized medical marijuana. As far as I know, there hasn’t been mass euthanization of drug dogs in those states. Third, the law enforcement officials in the article argue that even if the dogs aren’t euthanized, they have been very expensive to purchase and train, and replacing them or retraining them to disregard marijuana and alert only to other drugs will be expensive. This, again, is not a persuasive argument for keeping marijuana illegal. The debate is really over whether we should be locking people up over a mostly harmless drug. If it’s wrong to do so, the fact that we’ve already spent a lot of money on a system to enforce a policy we now believe to be wrong is an argument against continuing that policy, not in favor of it. Put another way, if you think marijuana prohibition is justified, then spending money on drug dogs is justified. If you think marijuana prohibition is immoral, how much money we’ve already spent on enforcing that policy has no bearing on whether we should continue spending money on that policy in the future.

But if we are going to talk about cost, do you know what else is expensive? Arresting and jailing people for pot. The Chicago Reader estimated that in 2010, Cook County alone spent more than $78 million arresting and prosecuting people only for possession of marijuana. If we’re really worried about the golden years of drug dogs, that kind of money could purchase them a pretty nice retirement community. I’m thinking bubbling streams, platinum fire hydrants every few feet and a lifetime supply of top-shelf kibble.

But I want to address another part of this story that isn’t getting much attention. I’ve written quite a bit about drug dogs in Illinois, and it turns out they’re pretty terrible at detecting drugs. In 2011, the Chicago Tribune published a review of drug dog searches conducted over three years by police departments in the Chicago suburbs. Just 44 percent of dog alerts led to the discovery of actual contraband. For Hispanic drivers, the success rate dipped to 27 percent. The following year, I obtained the records of an Illinois State Police drug dog for an 11-month period in 2007 and 2008. In nearly 30 percent of cases where the dog “alerted” no drugs at all were found. In about 75 percent of cases, the dog alerted either to no drugs or to what police officers later described as “residue,” which basically means no measurable quantity of a drug and not a significant-enough amount to merit criminal charges. Only 10 percent of the alerts resulted in a seizure of a large-enough quantity of drugs to charge someone with a felony.

This is pretty consistent with statistics from other states, as well as one fascinating academic study, which have shown that drug dogs are far more likely to merely confirm the hunches and suspicions of their handlers than they are to independently detect illicit drugs. The dogs’ high error rates often make them no more accurate than a coin flip. The problem of course is that the entire purpose of the Fourth Amendment is to protect us from searches based solely on a government official’s hunch or suspicion. There’s a reason some legal scholars call drug dogs “probable cause on a leash.”

The K9 trainers I’ve interviewed over the years have told me that drug dogs could actually be trained to only alert when there is a significant quantity of an illicit drug — that is, to ignore “residue.” The reason they aren’t is that police departments don’t want them trained that way. They want dogs that alert as often as possible. They want the dogs to err on the side of false alerts.

Why would police want a dog that falsely alerts? That’s the exact question the late Supreme Court Justice Antonin Scalia asked in a drug dog case a few years ago. The answer is incentives. Searches can lead to evidence of other illegal activity. One incentive is that police officers, particular those in drug enforcement, often evaluated based on the raw numbers of arrests. More searches mean more opportunities to make arrests.

But the more important incentive is civil-asset forfeiture. If the police find even the slightest bit of pot, sometimes even just residue, they can often justify taking a driver’s cash, jewelry or even the car itself. The owner of the property — even if completely innocent — then must endure a number of legal and procedural barriers to getting the property back. Take, for example, the K-9 whose records I reviewed several years ago.

In one case, the discovery of 2 grams of marijuana led to the seizure of $5,190 in cash. In another, 2 grams of pot led to the arrest of the vehicle’s seven occupants and seizure of the $2,000 they had between them. In another, 3 grams of marijuana led to 9 arrests and seizure of $2080. In yet another, one motorist caught with 1.2 grams of pot was arrested and forfeited more than $9,000. Another motorist wasn’t arrested, but had more than $2,000 in cash taken from him because the officer found what he says in the report was marijuana residue. It’s unclear if the residue was either subjected to a field test or taken to a lab for testing.

So over 11 months, this drug dog with an error rate of somewhere between 30 percent and 70 percent may have subjected dozens of people to illegal searches, but the pooch also brought in $11,000 for the state police. The dog is, er, a cash cow.

One particularly lucrative part of the state for police is the I-55/I-70 corridor near the town of Collinsville, which brings in a half-million dollars or more per year for local police. A local police officer pulled over Terrance Huff in 2011 while he was returning from a “Star Trek” fan convention. After the dog “alerted,” the cops searched Huff’s car from top to bottom. They found only what they called “shake,” or marijuana residue. K9 trainers who watched the video of the stop say the dog and officer interactions look like a dog that alerted on command, rather than when the dog detected an illicit substance. Huff later sued. During discovery for his lawsuit, he learned that the officer who pulled him over sometimes “trained” his dog by rubbing marijuana on the bumpers of cars parked in motel parking lots. If those cars were to be later pulled over and sniffed — voila! — instant probable cause for a search.

The police in Illinois aren’t worried about the well-being of drug dogs. They’re worried about the well-being of drug cops. Lots of law enforcement jobs — K9 cops, drug task forces, narcotics detectives — depend on the government’s continued pursuit of marijuana. So, too, do the revenue streams of many police departments and prosecutors’ offices. When there’s a threat to that revenue, they’ll do anything to protect it, including making threats to euthanize dogs, or warning that if we dare to stop cops from taking money from people without due process, we’ll soon see headless bodies hanging from bridges.

Illinois cops have been using their police dogs to violate the rights of people living in or passing through that state for decades. If marijuana legalization puts a damper on that practice, that’s a feature of reform, not a bug.

Our Government Is Murdering Its Own Citizens

https://www.painnewsnetwork.org/stories/2018/5/9/our-government-is-murdering-its-own-citizens

By Lee Horton, Guest Columnist

I am about to start raising holy hell because I now have nothing to lose. The doctor that has been taking care of me the last 5 years is suddenly scared to death and cutting my pain meds, while my insurance is cutting my benefits and raising my deductible and co-pays.

I live on Social Security disability and a meager pension that leaves me with little extra cash at the end of each month. I can no longer afford to fight both disease, injury and now my government. All of these have become the enemy of good health.

I am no longer “entitled” to my life I guess. Since I’m not a taxpayer thru payroll any longer, they do not see me as having any value to this nation. I have accepted that my only future is to have no future at all.  That’s what they have left me with. I’m not good enough, wealthy enough or important enough to save and treat humanely or morally.

I’m being discarded like the trash that my government thinks I am because I have a need for medicines that they are uneducated about and don’t understand. 

The whole “Opioid Crisis” is just a massive coverup for our government’s inability to stop the flow of illegal drugs that are entering this country by the truckload every stinking day. They are the ones that have failed. They are the people that have gotten us all in trouble. They are the ones that created a “drug problem” in this country.

 LEE HORTON

LEE HORTON

Why is it that almost every other nation on the planet with more liberal drug policies has less of a drug dependence problem?  The answer is quite simple. It is because this country views every problem with a punitive solution. The perspective of our leadership is skewed to make everything appear to be criminal when it’s done by the public, but legitimate when done by the federal government.

We might even be seeing a foreign policy tactic by allowing China to export their drugs for sale in this country. Who the hell knows? Remember the “Fast and Furious” gun scandal, Iran-Contra, Noriega, Afghanistan and the Mujahedin? Point being, this government has done it before.

What I do know is that I’m done. I’ll no longer be quiet, and I won’t let them get away with murder. That’s exactly what they are doing, our government is murdering its own citizens by putting us in the position of either suffering every day of our lives or ending our lives.

And we send these callous, heartless and unimaginative politicians to Washington DC so they can lie and hide the truth from their constituents. If any of those people in DC truly believed that the source of the opiate epidemic was the pharmacy, they would be educating themselves on these drugs and how they also benefit more people than they harm.

But we don’t see anyone doing that, do we? We see politicians, department managers, and the heads of the FDA, DEA and other agencies all looking for someone to catch and blame so they can score some points with Congress and get a bigger budget next year.

A good general or military planner always looks for the potential “collateral damage” when putting together a battle plan. The FDA, DEA and Congress have not done that, or they would not have been painting with such a broad brush.

Patients Need to ‘Rise Up’

I’m done with all that BS. I probably only have a few years left, so if I am to have any chance at making any difference and helping anyone that suffers in chronic pain, I must start now.

I have spoken to my doctor about this and he agrees that the patients need to “rise up” and start making noise, and the public needs to be educated and told the truth about the overdose stats the government and media keep listing. The vast majority of opiate-related deaths and overdoses come from heroin, illicit fentanyl, and other illegal street drugs, not the prescription pain meds that they are using as a scapegoat.

This is as good a place as any to start my war on stupidity and ignorance.  I want others to hear why I need these medications that the public is being taught to blame the ills of society on. I have yet to steal a car stereo or rob a liquor store to support my “habit.”  THAT is what the government and the media want the public to imagine when they hear of someone taking opioids.

This is about the health and well being of American citizens that they are placing at risk. It’s easy for them to live with collateral damage when it’s in Syria or Afghanistan, when they don’t have to see the faces and know who and how many they hurt. Let’s see if they are still so eager to cause suffering when it’s their own people.

All the work and risk by colonists to discover America and build a nation, free from persecution and suppression by a corrupt government — out the window.  We’re right back where they started. Literally out of the 16th century frying pan and into the 21st century fire.

Is this proof that liberty, freedom and independence are not yet possible for the human race? Are humans insufficiently evolved? When I see deliberate, intentional cruelty and the persecution of anyone, it makes me stop and wonder.

bigstock-Tell-Us-Your-Story-card-with-c-78557009.jpg

Lee Horton lives in Texas. He has osteoarthritis, neuropathy, stenosis, Ankylosing Spondylitis, fibromyalgia and numerous broken bones due to workplace injuries and accidents. Before he was disabled, Lee worked for 40 years as an operating engineer in heavy construction.

Pain News Network invites other readers to share their stories with us. Send them to editor@painnewsnetwork.org.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Meth use is on the rise: What journalists should know

www.journalistsresource.org/studies/society/drug-policy/methamphetamine-crystal-meth-drugs

Amid the United States’ ongoing opioid crisis, government agencies are documenting the rise of another highly addictive drug: methamphetamine.

Data from the U.S. Centers for Disease Control and Prevention shows that from 2010 to 2014, the number of drug overdose deaths involving methamphetamine more than doubled, jumping from around 1,400 to nearly 4,000 (opioid-related overdose deaths, at 28,647 in 2014, have overshadowed these numbers).

The U.S. Drug Enforcement Administration’s 2017 National Drug Threat Assessment suggests that http://templatelab.com/national-drug-threat-assessment-2017/ is high in the U.S., with many states reporting greater availability since 2013.

The DEA substantiated these reports using purity (the amount of methamphetamine present compared to other substances), potency (how much of the drug is needed to have an effect) and price data. The price of methamphetamine per gram has decreased (it stood at around $58 in September 2016) as its purity has increased.

Nearly 30 percent of agencies responding to the DEA’s 2017 National Drug Threat Survey said that methamphetamine was the greatest drug threat in their areas. Thirty-six percent reported it is the drug that most contributes to violent crime.

In light of these trends, Journalist’s Resource collected recent research and resources to answer questions reporters new to the topic might have.

What is methamphetamine?

Methamphetamine is an addictive drug classified by the DEA as a Schedule II stimulant. It affects the central nervous system, stimulating dopamine receptors in the brain and producing euphoric effects. It can be smoked, snorted, injected or taken by mouth. One form of the drug is crystal methamphetamine, which resembles clear or bluish glass shards. Methamphetamine and crystal methamphetamine are commonly called by slang names including ice, crystal, meth, speed, crank and chalk.

How is it made?

Methamphetamine is a synthetic drug, which means it’s made in a lab, not grown in a field like marijuana or opium poppies. Producing meth thus depends on the availability of the ingredients needed to create it, also called precursors, including ephedrine, pseudoephedrine, and phenyl-2-proponone (P2P). These first two ingredients might ring a bell from trips to the pharmacy. Pseudophedrine is a decongestant used to alleviate cold and allergy symptoms. Ephedrine was commonly used in weight-loss products. Dietary ephedrine products were banned by the FDA in 2004, but the drug is available over the counter for some conditions, like asthma. P2P is a schedule II controlled substance not commonly available in consumer products. The household availability of some meth precursors, though, fostered small, domestic laboratory operations in the early 2000s.

The Combat Methamphetamine Epidemic Act (CMEA), signed into law in 2006, attempted to curtail these efforts by regulating the sale of over-the-counter ingredients, including ephedrine, pseudoephedrine and phenylpropanolamine. Some producers skirt these regulations, martialing teams of people to obtain legal quantities of these ingredients (sometimes repeatedly, through the use of false identification documents), which together net sufficient quantities for production. This practice is often referred to as “smurfing.” (The term, a nod to the cartoon characters, has been used at least since the 1980s in the context of money laundering to describe a process through which droves of people break up larger transactions into smaller ones so as to avoid suspicion.)

These restrictions might also drive manufacturers to synthesize meth with other ingredients. Much of the methamphetamine found in the U.S. today is produced in Mexico using phenyl-2-proponone and trafficked across the border, according to the DEA’s report. This reflects a broader decline of domestic production of methamphetamine since the passage of CMEA and an increase in international production. Domestically, however, conversion laboratories are popping up, particularly in California. These labs transform smuggled methamphetamine into a saleable product.

What are some of the effects of the resurgence of methamphetamine?

Methamphetamine has been linked to a number of health risks, including hepatitis C infection, stroke, psychosis and other forms of psychological distress. A longitudinal study of 278 people who were dependent on methamphetamine but not schizophrenic or manic, published in Addiction in 2014, found that violent behavior increased after subjects used methamphetamine. Methamphetamine users also face a higher risk of death than people who use other drugs, including cannabis, cocaine and alcohol.

A study published in the American Journal on Addictions in 2014 suggests that certain social outcomes, including homelessness, drug dealing, being a victim of violence and prostitution are associated with crystal methamphetamine use.

Research exploring connections between methamphetamine use and criminal behavior indicates that meth users “have more extensive criminal records and are more likely than other drug users to commit property crimes.” Kentucky Department of Corrections data indicates that the percentage of offenders who used methamphetamine in the 12 months before their incarceration has increased sharply over the past five years. In 2012, 23.5 percent of offenders in the state reported using illicit methamphetamine in the 12 months before their incarceration; by 2017, this figure was 43.9 percent.

Are there treatments for methamphetamine addiction?

A number of treatments exist for methamphetamine addiction, including cognitive behavioral therapy and other drug counseling and addiction support services. Unlike treatment for opioid misuse, there aren’t medications that specifically block the effects of or curb cravings for the drug.

 

 

Head of DEA: MJ remains in Schedule I is (because of ) the science

This will surprise absolutely no one, but I don’t have great deal of love or respect for the Drug Enforcement Agency. Never have, and in all likelihood, never will. On Tuesday, the acting head of the DEA (and not sparkly vampire) Robert Patterson was testifying at a House Judiciary Committee hearing on the topic of “Challenges and Solutions in the Opioid Abuse Crisis.” What followed was best described as an “old-fashioned Alabama ass-whuppin'” by some of the elected representatives, who seriously could not believe the words tumbling from Patterson’s stupid mouth.

As summarized by Marijuana Movement, it began with Tennessee Democratic representative Steve Cohen asking why cannabis is still a Schedule I drug, on par with such drugs as heroin. Patterson responded, with a straight face, “The reason why it remains in Schedule I is the science.”

 Cohen managed to refrain from doing a spit take, instead replying, “The science? I’m happy to hear that you believe in science, that’s refreshing.” Cohen then asked Patterson for his personal feelings on re-or de-scheduling cannabis from its Schedule I status, which led to Patterson to complain that the widespread concern surrounding arrests for cannabis, and how they impact communities of color, is essentially baseless, and doesn’t have anything to do with prohibitionist policies. He stated that he thought the country was “going down a bad path concerning marijuana,” and concluded, “At what point did we determine that revenue was more important than our kids?” (You mean the same cannabis tax revenue that’s currently being used to help fund our schools and public safety programs? That revenue?)
 

Rep. Hank Johnson (D-Georgia) drew forth the most outrageous statement from Patterson when he asked out of the 64,000 drug-related overdose deaths in 2016, how many were opioid-related. (44,000.) When he asked about cannabis-related overdose deaths, Patterson responded that while there had not been any “official” deaths of that kind recorded in 2016, he nevertheless was “aware of a few deaths from marijuana.”

“You are aware of a few deaths from marijuana?” Johnson asked. At that point, Patterson said that he didn’t have materials in front of him to reference, but that he believed these deaths were caused by “adulterated” cannabis.

 If you mix cyanide into orange juice, it will kill you. This part is tricky, so try and keep up—is the orange juice fatal, or is it the cyanide?

It pretty much went off the rails when Patterson was later questioned about numerous studies showing the medical benefits of cannabis to treat medical conditions, including those where opioids are frequently prescribed, or studies showing that states with regulated cannabis programs had a decrease in opioid prescriptions. Patterson hadn’t read any of them, wasn’t familiar with them, nor could he site any studies showing that cannabis led to other illicit dangerous drug use.

The DEA’s Robert Patterson is the worst type of mouth breathing moron—one that embraces his willful ignorance, and makes no effort to expand his small-minded and narrow worldview. Which is morally vile when you consider that by just reading a few fucking studies, he could perhaps help enact policies that could literally save tens of thousands of lives.

Upcoming in-district Congressional work periods

Make the most of upcoming opportunities to engage members of Congress while they are back home. Upcoming in-district work periods are currently scheduled for May 25-June 4, June 29- July 9, and July 27-Sept. 3. If you are interested in engaging with a member during one of these periods call their local/district office to make an appt.

 

You claim that they ignore your petitions, your letters, your emails, your faxes…  you call them for an appointment… you may end up with 10-15 minute  ONE TO ONE time with your Federal representative

Want to Talk With the FDA? Here’s Your Chance

www.nationalpainreport.com/want-to-talk-with-the-fda-heres-your-chance-8836221.html

The National Pain Report has done a number of stories recently that have received numerous comments from people complaining about the federal (and in some cases their state) government. The reaction is that recent policies that have been adopted do not have the patient in mind.

This story, published on April 25, set off a firestorm of commentary from chronic patients and providers.

We’ve been talking with Terri Lewis Ph.D. about trying to create a survey from that story that could capture objective and subjective data from you.

She’s done just that, with the goal of having your input inform the FDA as the agency determines where to place the focus on alternatives and new drug development. They are holding a hearing on July 9.

Take the survey here.

The survey will be live until June 17th to give Dr. Lewis time to tabulate and submit to the FDA by the June 25th deadline.

FDA is challenged with determining how to balance the need to ensure continued access to persons who rely on opioids for continuous pain relief while addressing the ongoing concerns about safe use, abuse and misuse.  Many of you will not be able to attend this so we are taking your voices to Washington DC with us.  You can register to attend or view this hearing.

For Lewis, this survey will not only help let the FDA know what chronic pain patients, their loved ones and their providers are experiencing in 2018, but also will help her develop some data about individual states. Her initial focus is on the July 9th hearing.

“This survey is designed to create some patient focused due diligence on chronic pain that our government simply needs to see,” she said.

The National Pain Report is happy to partner in this effort and will share some of the objective results in the coming weeks as people begin to fill out the survey.

The first politician ?

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Reconstruction of what politician looked like before death.

 

 

U.S. Judge Blocks DEA From Suspending Drug Distributor Over Opioid Sales

https://www.usnews.com/news/us/articles/2018-05-09/us-judge-blocks-dea-from-suspending-drug-distributor-over-opioid-sales

A federal judge blocked the U.S. Drug Enforcement Administration from suspending a Louisiana drug distributor from selling controlled substances over allegations it failed to identify suspicious orders of opioids that were diverted for illicit uses.

U.S. District Judge Elizabeth Foote in Shreveport, Louisiana, on Tuesday entered a temporary restraining order blocking the DEA from enforcing an order issued last week that immediately suspended Morris & Dickson Co’s registration.

 The DEA’s order marked the first time during President Donald Trump’s administration that it had moved to immediately block narcotic sales by a distributor as the agency attempts to combat a national opioid abuse epidemic.

A DEA probe focusing on purchases of the highly addictive painkillers oxycodone and hydrocodone showed that, in some cases, pharmacies were allowed to buy as much as six times the quantity of narcotics they would normally order, the agency said.

The DEA on Friday announced it was suspending the registration of privately-held Morris & Dickson, saying the distributer failed to properly identify large, suspicious orders of drugs sold to independent pharmacies.

However in a brief order, Foote wrote that the drug wholesale distributor had demonstrated a substantial likelihood that it would be able to prove the agency’s action was “arbitrary and capricious.”

The judge scheduled a May 22 hearing to determine whether she should issue a preliminary injunction that would further block the DEA’s action.

The U.S. government is trying to crack down on opioid abuse through a number of measures, including a proposal last month to tighten rules governing the amount of prescription opioid painkillers that drugmakers can manufacture in a given year.

Paul Dickson, Morris & Dickson’s president, in a statement said the ruling “means that tens of thousands of patients, many of whom are critical care, are able to get their desperately-needed medications.”

The DEA did not respond to a request for comment on Wednesday.

Family-owned Morris & Dickson was founded in 1841 and is the largest independently owned and privately held drug wholesale distributor in the United States, according to its court filing.

According to the U.S. Centers for Disease Control and Prevention, 42,000 people died nationwide from opioid overdoses in 2016, the last year with publicly available data.

Based on guidance issued by the Centers for Disease Control (CDC)

we all know that the opiate conversion tables are CRUDE ESTIMATES AT BEST… 

We all know that defective CYP-450 opiate enzyme metabolism can greatly effect the therapeutic dose for the pt.

We all know that:

Here is four quotes from the CDC opiates guidelines:

https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

“The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function.”

“Clinicians should consider the circumstances and unique needs of each patient when providing care.”

“Clinical decision making should be based on a relationship between the clinician and patient, and an understanding of the patient’s clinical situation, functioning, and life context.”

“This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.”

We all know that subjective disease are covered under The Americans with Disability Act and Civil Rights Act and discriminating against person in their protect class is consider a civil right violation.

We all know that the majority of the studies that the CDC used to come to the opiate dosing guidelines were rated “3′ or “4”… where “1” = good/excellent, “4” = poor/crap.

We all know that dosing for all disease states – except for subjective diseases – is based on adequate therapies that will return the diagnostic lab values to as close to acceptable values as clinically possible without inducing other adverse side effects.  With subjective disease the only therapeutic outcomes can be based on input from the pt.

We all know that healthcare professionals will not use – or depend upon – testing equipment or any means of testing that will produce inconsistent results.

We all know that <1% of chronic pain pts treated with opiates will become addicted.

It would appear by this letter that the DOL has determined that does above 90 MME/day is a “concerning level of medication” and that will be working on “… curtailing (all) opiate usage …”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

https://www.nbcconnecticut.com/troubleshooters/Hundreds-of-Prescription-Errors-Reported-in-Connecticut-Each-Year-481948561.html

When it comes to prescription drugs, an error at the pharmacy can put a patient’s health at risk.

The Troubleshooters have uncovered hundreds of prescription error complaints filed with the Department of Consumer Protection over the last two years. Some mistakes were so severe that the patients received the wrong drug or an incorrect dose.

Lauren Kagan, of Avon, was prescribed a medication that was supposed to help calm her nerves during a medical procedure, but she says what she received from the pharmacy put her life in danger.

“A trip to the ER would have been definite, for sure,” Kagan said. “But it was not definite that I would have survived.”

Kagan was scheduled to have an MRI, but she can become claustrophobic. She was nervous about getting body scans in such a confined space, so she says her doctor prescribed an anti-anxiety medicine. The recommendation was to take one to two of the pills. Shortly after she had the MRI, Kagan says the medical staffers became concerned about why she was suddenly becoming so groggy and confused.

“They were just curious to know how many of the pills I had ended up taking,” Kagan said.

She said she took the minimum dose — one pill. That decision may have saved her life.

“The doctor had meant for it to be a quarter of a milligram pill, but the pharmacist prescribed a two-milligram dosage,” Kagan said.

Kagan says her husband had to keep her from falling asleep. Taking the recommended two pills would’ve been sixteen times stronger than the dosage she was supposed to be getting.

“I feel like there should be no such thing as a mistake with prescriptions because life or death is on the line,” she said.

Between 200 and 300 prescription error complaints are filed with the Department of Consumer Protection per year, according to state data obtained by the Troubleshooters. In cases where people complained about getting the wrong medications, DCP data shows that nearly 78 percent of complaints were found to be valid. These patients were indeed given an incorrect prescription.

“It could be really simple but it could also be something very severe,” said Lora Rae Anderson, Director of Communications for the Department of Consumer Protection.

Searching through two years of data from the Drug Control Division of DCP, the NBC Connecticut Troubleshooters identified several complaints including:

  • A woman in Enfield who had foot surgery who said she was prescribed 10-milligram opioid pills for pain, but received 80-milligram pills instead.
  • A West Hartford patient who was supposed to get a prescription for an over-active thyroid, but said she received a medication for Alzheimer’s.
  • An elderly man in New Haven who said he was prescribed what was supposed to be an anti-depressant but found out that, for two weeks, he was really taking a blood thinner.
  • A man in Hartford who said he was prescribed an antibiotic but ended up with medication to treat seizures.

“If you’re talking about 50 milligram instead of 15 in say, an infant, that can be really very serious,” Anderson said.

In most cases, when a prescription error complaint is substantiated, the pharmacist will pay a civil penalty to the state to avoid potentially having his or her license revoked. Those fines could be hundreds or even thousands of dollars.

“If there is a routine problem, if the issue is really severe, the long and short is that the fine gets bigger and their license could be at stake,” Anderson said.

Since her medication scare, Kagan said she has learned to follow up by taking a number of steps, including to report a problem not just to the pharmacy, but also to DCP. She said she now double-checks prescriptions – both the labels and the pills.

“We take for granted what’s written on the label because we assume that’s what the doctor has wanted for us,” Kagan said.

The Department of Consumer Protection offers tips to protect yourself against medication errors:

  1. Open the bag at the counter. Check to be sure that you’ve been given is what you’ve actually been prescribed.
  2. Don’t sign too quickly. The agreement you sign acknowledges that you’ve gotten the information you need. Don’t sign it without checking first.
  3. Read the label carefully. Read every word. Check the name of the drug and directions for use. If the directions are unclear, ask the pharmacist to explain them. If the name on the label isn’t the name of your doctor, notify the pharmacist.
  4. Look at the drug itself. If it’s a refill, does it look the same as the previous prescription? Is it the same shape and color? If not, ask the pharmacist.
  5. Ask for printed information sheets. Ask the pharmacist if you need any additional counseling on the medication.

If you have issues with your prescription, complaints can be sent to DCP.DrugControl@ct.gov.

A few days ago, I made this post What is more important… getting your prescription(s) QUICKLY… or… CORRECTLY ?    which was a CVS memo instructing their pharmacists to fill prescriptions when their computer system was “down/off line”

The various state pharmacy practice acts were created in a era when all pharmacies were owner/operator… in fact many of the earliest days of pharmacy, the local physician also served as the local pharmacist.

The “chain pharmacy” concept mostly evolved starting in the early 20th century. When I graduated from Butler University in 1970 there was more independent pharmacies in Indianapolis/Marion county than the ENTIRE STATE of Indiana has today.  Back then there was a chain “Hooks Drugs” that was the TENTH LARGEST chain pharmacy in the country – with 243 stores – all WITHIN the state of Indiana, and there was about 75% of all pharmacies – in the country – were independents.

Today, abt 65% -75% of all community pharmacies are designated at “chain pharmacies” and there is two chains (CVS & Walgreens) have abt 10,000 chain store outlets – EACH.. with a total of community pharmacies being in the 65,000 area.

Several years ago Kevin McCoy published in the USA TODAY  Chains’ ties run deep on pharmacy boards    showing that the vast majority of the Boards of Pharmacies are dominated by chain pharmacy employees.

When the various state practice acts were law, the typical pharmacy was owned/operated by a pharmacist and thus the law focused on a  “Pharmacist in Charge”… the person who was responsible to the board of pharmacy ( BOP) for the legal operation of the pharmacy. 

Today, we have a situation where the ownership of the pharmacy – a minority part of the time – is the pharmacist in charge (PIC)… since the vast majority of pharmacy ownership is by a major publicly held corporation.

Today, the PIC has no say over the operation of the Rx dept… which he/she has the legal responsibility for its operation.  Here is an example in Connecticut where the BOP are going to fine or suspend a Pharmacist for a medication error… which the vast majority of time can be traced back to a “failure of the system” within the Rx dept work environment.

When a entity (BOP) that is in charge of protecting the public’s health and safety and looks to blame individuals within that system..when it is common knowledge that the design of the system itself is the real underlying cause.. suggests that the BOP’s loyalty may be to some entity other than the general public ?