Judge Says DEA, Not Courts, May Be Better Forum to Challenge Cannabis Policy

https://www.law.com/newyorklawjournal/sites/newyorklawjournal/2018/02/14/judge-says-dea-not-courts-may-be-better-forum-to-challenge-cannabis-policy/

A federal judge on Wednesday lobbed tough questions at an attorney for a group of plaintiffs challenging the constitutionality of marijuana prohibition, asking why his court is the best forum to push the government to cease enforcement.

But U.S. District Judge Alvin Hellerstein of the Southern District of New York, while hearing oral arguments on the government’s motion to dismiss the suit,

challenged the Drug Enforcement Administration’s position that marijuana has no acceptable medical use.

“It may not be universal, but some states in their legislative findings have found that there is a legitimate medical use,” Hellerstein said during an exchange with a federal prosecutor before a standing-room-only courtroom.

“So you can’t say what you’re arguing. The argument doesn’t hold.”

The plaintiffs in the suit, filed in July, are challenging the classification of marijuana under the Controlled Substances Act as a Schedule I drug, which is defined as drugs with a high potential for abuse, no accepted medical use, and no way of using or testing them safely, even under medical supervision.

Other Schedule I drugs include heroin, LSD and ecstasy. The plaintiffs ask for a permanent injunction to prevent enforcing cannabis under the CSA.

The lawsuit was filed on behalf of a diverse assortment of plaintiffs, including Marvin Washington, a former professional football player who now works in the cannabis industry; Alexis Bortell, a 12-year-old girl who suffers from epilepsy and says cannabis has kept her seizure-free for more than two years; and Jose Belen, an Iraq war veteran who uses cannabis to treat symptoms of post-traumatic stress disorder.

The plaintiffs argue that the Schedule I classification for marijuana violates their due process rights, First Amendment protections and the right to travel. The oral argument in their case comes as 30 states and the District of Columbia have adopted laws legalizing marijuana, but after U.S. Attorney General Jeff Sessions announced he would roll back the Obama administration’s hands-off approach to states that legalized marijuana.

In arguing for dismissal of the suit in the Southern District, the government contends that changing marijuana’s classification of a Schedule I drug needs to be accomplished through administrative rule-making.

Assistant U.S. Attorney Samuel Dolinger of the Southern District U.S. Attorney’s Office, who presented oral arguments on the government’s behalf, said the plaintiffs have yet to exhaust their administrative remedies to reclassify marijuana under the CSA.

“A ruling on exhaustion would dispose of all of the claims in this case,” Dolinger said. But the plaintiffs argue that, in passing the CSA, Congress created a “completely dysfunctional” construct in which a drug can only be rescheduled through testing but has classified marijuana as so dangerous that it could never have a conceivable benefit.

Additionally, the plaintiffs contend, waiting for the DEA to rule on petitions to reclassify cannabis is often a lengthy process, noting in their court papers that a petition to transfer cannabis to any other classification and another to transfer it to a Schedule II drug, filed in 2009 and 2011, respectively, did not receive rulings until July 2016. Both were denied.

“I represent people who need cannabis to live,” said Michael Hiller, one of the plaintiffs attorneys, during oral arguments.

But Hellerstein, who was appointed to the bench by President Bill Clinton, told Hiller a district court is not the proper place to “weigh all the conflicting elements” of how the DEA determines its narcotics schedule, which he said includes assessments of a drug’s danger to the community.

“An agency is set up to weigh all the things you want me to do,” Hellerstein said. “I think the right thing to do is defer to the agency,” Hellerstein said.

Hellerstein reserved judgment on the government’s motion, telling Hiller his side presented “provocative arguments.”

In addition to Hiller, the plaintiffs are represented by Hiller PC attorneys Lauren Rudik and Fatima Afia; David Holland of the Law Offices of David Clifford Holland; and Joseph Bondy of the Law Offices of Joseph A. Bondy.

Dolinger was joined in the courtroom by Assistant U.S. Attorney David Jones.

The plaintiffs have faced uphill battle so far. In September, Hellerstein denied the plaintiffs’ request for a temporary restraining order to cease cannabis enforcement under the CSA.

Additionally, the U.S. Court of Appeals for the Second Circuit previously held that the Schedule I classification for cannabis is constitutional and, in a 2016 ruling, U.S. District Judge Elizabeth Wolford of the Western District of New York ruled in a criminal case to reject a constitutional challenge to the Schedule I classification.

 

‘She Trusted Me, and I’d Turned Her Away’

Physician wracked with guilt after losing patient to overdose

https://www.medpagetoday.com/blogs/themethodsman/71172

Audrey Provenzano, MD, MPH, a primary care physician in Chelsea, Mass., avoided getting the waiver needed to prescribe buprenorphine (Suboxone), and so was unable to treat an opioid-addicted patient who subsequently died of an overdose. She wrote about this experience in a moving piece appearing Wednesday in the New England Journal of Medicine.

We discussed that story, medicine’s stormy history with opioid abuse, and the politics of the buprenorphine “waiver” in a Doc-to-Doc video conversation.

CVS’s Transparent Opioid PR Stunt

https://www.acsh.org/news/2017/09/28/cvss-transparent-opioid-pr-stunt-11880

CVS has taken it upon itself to enact rules that allow their pharmacists to ignore a physician’s prescription by changing the number of pills, the daily maximum dose, and even the form of the drug itself. And the company’s new policy is based on a decidedly faulty premise, which I will describe below. What the company just did is bad news for both physicians and their patients. Let’s try to set them straight.

Since I am nothing if not helpful, I have taken the liberty of writing up a memo for the company to distribute to its pharmacists. Of course, CVS is free to tinker with the phraseology if they so choose. Corporate-speak is not one of my strengths. Here it is:

MEMO TO ALL CVS MANAGERS (RE: DISPENSING PRESCRIBED PAIN DRUGS, NEW PROTOCOL)

  1. In the morning, open the store.
  2. Have your pharmacists go behind the counter and do their jobs.
  3. Not the jobs of the FDA, DEA, CDC or the KGB.
  4. Tell them to dispense the pills that the doctor ordered. It is the doctor’s call, not theirs.
  5. Close the store.

I see CVS’ recent move to place restrictions on pain medication as little but a calculated attempt to look like heroes in a crisis. This just doesn’t smell right. It is clearly self-serving. And pardon me if I’m not impressed by the company’s $2 million contributed to opioid abuse treatment charities. It may appear to be altruistic, but it’s peanuts to CVS since it represents a whopping 0.02% of their annual profits and 0.001% of its sales ($177 billion in 2016).

I can almost picture all the CVS executives on the golf course patting themselves on the back for scoring big PR points with the public. Perhaps a few of them are even delusional or uninformed enough actually to believe that they just did something useful. But I doubt it. This has “disingenuous” written all over it.

And, if I’m a doctor, I’m gonna be mighty unhappy if a pharmacy doesn’t do what I tell them (not ask them) to do. Plenty of doctors around the country are not terribly happy about it either. I spoke with six. 

One is Dr. Arthur Kennish, a New York cardiologist who has been hassled, just like many other physicians for having the unmitigated gall to treat patients the way they choose. 

“CVS has some nerve. The use of opioids, or any other drug, really, is up to the doctor and his or her patients, not a pharmacist. This is a terrible precedent, which will drive an even bigger wedge between physicians and patients. It’s already too big” – Arthur Kennish, M.D. September 26, 2017

And Dr. Thomas Kline, who is a geriatric specialist in North Carolina, and active in fighting what he calls “a war on pain patients” was even blunter:

“Limiting prescriptions discriminates against 9 million people with painful diseases who will never addict nonetheless suffering inconvenience and humiliation to assuage the comfort zones of a long history of abstinence reformers, coming once again to the polemic footlights.” – Thomas Kline, M.D. September 27, 2017

(See below for quotes from Council M.D.s on this matter)

Here is the breakdown of what CVS is doing that has pain patents terrified and doctors angry. 

  1. Limiting to seven days the supply of opioids dispensed for certain acute prescriptions.

Let’s say that an orthopedic surgeon knows that an operation will cause a patient two weeks of bad pain, at which point they can switch to something like Advil. Executives decided that the store will only give a new patient a one-week supply. Do they know better than the surgeon what is best for his patient? 

     2. Limiting the daily dosage of opioids dispensed based on the strength of the opioid.

At least in the first case, despite wasting the doctor’s time by making him write another script, and having to make two trips to the pharmacy instead of one, at least the patient will get what is needed. But having a retailer dictating a maximum daily dose is really crossing a line. CVS is not qualified to make this determination. Scientifically, it’s even worse. All people react differently to opioids. For example, some are 15-times better at metabolizing the drug than others. So an arbitrary maximum dose may work well for one person but be inadequate for another. Do pharmacists know these patients better than the physician? Do CVS executives even know this?

     3. Requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

  • This is really dumb. Depending on an individual situation, there can be advantages for either immediate-release pills or time-release. A regular opioid pill will bring faster relief than an extended-release version, but wears off much sooner. Time-release medications result in a more consistent concentration of the drug in the blood; fewer ups and downs, as illustrated in Figure 1 below, but they don’t dull the pain as quickly. How exactly has CVS figured out that short-acting opioids are better than long-acting ones for new patients? 

 

Figure 1. A comparison of blood levels of short-and-long acting pain medication.

The CVS policy also raises larger and more far-reaching concerns. Who is in charge of our health? Why are laws being made that tell us how much medicine we can take much less corporate guidelines? Since when do pharmacists at retailers overrule physician decisions?

Unless there is an obvious prescribing error or a serious drug-drug interaction or any other pharmacological issue, they can’t (1). Until now. And you don’t want them to. It takes away a little more of your control of your own health, something that has been trickling away for years.

Why is CVS doing this now? I’ll speculate. During a crisis, it is always a good idea to hop on the “Let’s find someone to blame” bandwagon. Doctors and drug companies have taken the brunt of the blame (and the FDA to a lesser extent) because they are easy and convenient targets. Yes there were some unscrupulous doctors who ran “pill mills” and did much damage. And Purdue Pharma, the makers of OxyContin, got a $685 million spanking for promoting an exaggerated safety profile of the drug. There are other companies that don’t look so hot right now either. But blame is merely a distraction from the problem at hand. Hundreds of people are dying every day and it’s not from the pills. There’s your crisis.

It is always easier to run with the crowd than swim against it, no matter which way it’s going. It did not take long for politicians to buy a one-way ticket in the wrong direction: ‘Sure, everyone knows that these damn pills are killing everyone, so let’s stop them,’ is basically what they tell the public.  In what almost seems to be a tough guy contest, states are blindly following the CDC’s 2016 very flawed “advice” and passing some awful laws. If Kentucky enacts tough laws, then Florida better get tougher, as evidenced by Gov. Rick Scott’s proposed law that would allow a three-day maximum prescription unless strict conditions are met. What’s next? Mandatory bamboo under the fingernails tolerance workshops? If there’s a problem someone has to do something about it, right? If it’s the wrong thing, what are you gonna do? At least it sounded good.

But, perhaps the worst problem with these already-flawed policies and laws is that they are based on the premise that pain patients got hooked on drugs and are now dying from fentanyl. This is demonstrably false. There is ample evidence in the literature that very few pain patients become addicts; estimates range from .05-10%. (See: Heads In The Sand — The Real Cause Of Today’s Opioid Deaths.“) So the ill-conceived laws that are popping up like weeds and policies that CVS initiated are solving the wrong problem. In (supposedly) trying to protect pain patients from themselves, these policies do nothing but punish them with pain, terror, and despair while at the same time tying the hands of physicians who prescribed opioids wisely and responsibly. 

If CVS doesn’t know all of this, they should. If CVS does know this as well and doesn’t much care, you have to give them some credit. Nicely played.

Notes:

(1) In these cases, the pharmacist will consult the physician and offer advice if necessary. They are not overruling anyone. 

(2) Comments from American Council on Science and Health physicians:

“I have an OB/Gyn colleague who prescribed antidepressants to her patient. The pharmacist refused to fill it saying not within the scope of her practice. The pharmacist’s role is not to be questioning a physician’s clinical skill or clinical decision-making. Leave doctoring to doctors.” Dr. Lila Abassi

“Pharmacists, as part of their licensure responsibility, should check prescriptions for accuracy in dosage and can question the use of medications especially in settings of allergies or cross-reactivity with other medications on a patient’s med list. I do not believe that a pharmacist can or should refuse to fill a prescription based on quantities to be dispensed without speaking directly to the prescribing physician.” Dr. Charles Dinerstein

“For pharmacists to be able to override a physician’s order, given the limited scope of their training and that they are not privy to a patient’s entire clinical picture (or medical history), could put a patient at greater risk. As is current practice, discussions with the treating physician to clarify concerns are always welcomed and encouraged before a pharmacist fills a prescription. But, not mandates–and one not in the best interest of the patient is simply unacceptable.”  Dr. Jamie Wells

 

Discussing Benefits of Palliative Care

https://www.practicalpainmanagement.com/resources/hospice/discussing-benefits-palliative-care

A recent meta-analysis found that palliative care interventions were associated with statistically and clinically significant improvements in patient quality of life (QoL) and symptom burden.1

Palliative care improves the quality of life of seriously ill patients.The study analyzed 43 randomized clinical trials, including data on 12,731 patients, with 35 of those trials using “usual care” as the control. While the associations with QoL and symptom burden were challenged by the heterogeneity of current research trials concerning palliative care,2 researchers found palliative care consistently associated with patient and caregiver satisfaction, as well as lower health care utilization.

“We’ve seen people who get involved with palliative care sooner definitely have a better quality of life, and they may live longer,” said Mary Lynn McPherson, PharmD, MA, BCPS, CPE, professor and executive director for advanced postgraduate education in palliative care for the University of Maryland’s School of Pharmacy in Baltimore, Maryland. The meta-analysis only included 1 study that had patient survival as a primary end point. In that study, Bakitas et al did find patient survival 1 year after palliative enrollment was better compared to patients who enrolled 3 months later.3

A similar study in 2010 found patients receiving early palliative care for their lung cancer showed better QoL and mood. And while patients who had “early” palliative care did receive less aggressive care at the end of life, their survival was still longer compared to patients who had standard care.4

Because palliative care is not concerned with patient survival, clinicians and patients may hold the negative perception that patients receiving palliative care will not live as long, something the data appears to disprove. Palliative care “is an added layer along with everything else,” said Dr. McPherson.  “We’re turning the tide from getting practitioners to stop thinking palliative or hospice care means ‘giving up.’ Even hospice care doesn’t mean we’re giving up,” she noted. “There may not be hope for a cure, but there is still hope that we can relieve the symptoms, relieve existential angst, and so on.

“But palliative care is not always about terminally ill patients. It’s all about quality of life—maximizing quality of life and maximizing outcomes, whether they be clinical or terministic,” she concluded.

 

Trial begins for advocates suing Sessions and the DEA over marijuana’s Schedule I status

www.thecannabist.co/2018/02/14/marijuana-schedule-i-lawsuit-trial/98979/

An Iraq War vet, a 12-year-old girl with a seizure disorder and an ex-NFL player are among five plaintiffs challenging the constitutionality of the Controlled Substances Act (CSA) as it pertains to marijuana.

NEW YORK (AP) — Army veteran Jose Belen says the horrors of the Iraq War left him with post-traumatic stress disorder, and the drug that helped him cope best with the symptoms was one his Veterans Affairs doctors could not legally prescribe: marijuana.

“Once I did use cannabis, immediately I felt the relief,” said Belen, who is now working with other medical marijuana users to mount a long-shot court challenge to federal laws criminalizing the drug.

The 35-year-old, married father of two is one of five plaintiffs in a lawsuit claiming that the government’s decision to classify marijuana as dangerous is irrational, unconstitutional and motivated by politics, not hard science.

Iraq war veteran Jose Belen, who takes marijuana to treat post-traumatic stress disorder, poses in front of federal court, Tuesday, Feb. 13, 2018, in New York. Belen is one of five plaintiffs in a lawsuit challenging federal marijuana laws. He is set to appear in a New York courtroom on Wednesday for arguments in a lawsuit that claims classifying marijuana as a dangerous drug is irrational and unconstitutional. (AP Photo/Mark Lennihan)

Government lawyers will argue Wednesday before U.S. District Judge Alvin Hellerstein in New York that the law is well-grounded and the case should be dismissed.

The suit originally was filed in July as a growing number of states have broken with the federal government and declared marijuana to be legal. Thirty have now legalized it in some fashion, including six for recreational use.

The lawsuit challenges the listing of marijuana as a Schedule I drug, a category that includes heroin and LSD. The federal government says drugs under the classification have no accepted medical use and cannot legally be prescribed.

The lawsuit names the Department of Justice, Attorney General Jeff Sessions and the Drug Enforcement Administration as defendants.

The other plaintiffs include:

— Former NFL player Marvin Washington, the co-founder of a company that sells hemp-based sports performance products;

— A nonprofit organization called the Cannabis Cultural Association that helps minorities benefit from the marijuana industry in states where it is legal;

— Twelve-year-old Alexis Bortell, who takes marijuana to control epilepsy, and 7-year-old Jagger Cotte, who uses marijuana to treat a severe neurological disorder called Leigh’s syndrome.

Alexis Bortell, young medical cannabis patient
Alexis Bortell, age 11, gets a kiss from her father, Dean Bortell, as the two wait to testify during a Colorado House committee hearing on marijuana legislation March 6, 2017, in Denver. The Bortell family moved from Texas to Colorado to treat Alexis’ seizures with medical cannabis. (David Zalubowski, The Associated Press)

Poised and outwardly calm, Belen, who lives in Orlando, Florida, said he left a post-military career in insurance to found an organization called Mission Zero that works to end suicide among veterans.

Medical research on marijuana has been sharply constrained by federal law, but Belen said he found it effective for taming PTSD symptoms while other medications pushed him closer to depression and possibly suicide.

He said it is unfair that federal law prohibits him from crossing state lines with the drug, even when traveling to states where it is legal.

“I went to Iraq to free the oppressed and I view this no different,” Belen said. “The oppression is only being done by our own government.”The plai

ntiffs have asked the court for the broadest of remedies: a permanent injunction preventing the government from enforcing the Controlled Substances Act as it pertains to cannabis. It isn’t clear what the practical effect of such a ruling would be.

The government argued in its motion to dismiss the lawsuit that if the plaintiffs want the drug reclassified, there are other options, including an administrative petition to have marijuana rescheduled or asking Congress to change the law.

In a court filing, government attorneys said the administration “uniformly rejects the notion that there is a fundamental right to use marijuana, including for medical purposes.”

Marijuana got its Schedule I designation as part of the ranking or “scheduling” of drugs under the 1970 Controlled Substances Act.

According to the lawsuit, Republican President Richard Nixon ignored an expert panel’s recommendation that possession of cannabis for personal use be decriminalized because he wanted to use drug policy to target anti-war protesters and black people.

The lawsuit quotes Nixon domestic policy chief John Ehrlichman, who was quoted in a 2016 Harper’s Magazine story as having said: “We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin and then criminalizing both heavily, we could disrupt those communities.”

The plaintiffs say marijuana doesn’t meet the Schedule 1 requirements of having a high potential for abuse, no medical use in treatment and no possibility for safe testing.

The lawsuit notes that in 2014 the Justice Department and the Treasury Department’s Financial Crimes Enforcement Network issued guidance for how banks could provide services to marijuana businesses that were legal under state laws.

“On the one hand the federal government wants to put people in jail, while at the same time the federal government currently has a policy to encourage banks to go into business with cannabis companies,” lead attorney Michael Hiller said. “They’re attempting to reserve the right to prosecute people for engaging in the very conduct that the federal government has encouraged.”

Or, used to encourage. Sessions, an opponent of legal marijuana, last month reversed an Obama administration policy of backing off of strict enforcement of federal law in states that have voted to legalize the drug.

Encouraging federal prosecutors to hit hard, he said that Congress had decided that “marijuana is a dangerous drug and that marijuana activity is a serious crime.”

 
 
 
 

 

The Other Side of Opioids

LAS VEGAS – Nightly newscasts across the country are filled with stories about the opioid epidemic — the opioid crisis. Tens of thousands of Americans who die each year are found with opioids in their systems, and so government at every level has stepped in to put limits on otherwise legal medications, including here in Nevada. For millions of chronic pain patients, the crackdown has been a nightmare. They are the forgotten victims in the opioid debate. Approximately 50,000 people a year die with opioids of one kind or another in their systems. The number you don’t hear is this one — there are as many as 25 million Americans who suffer with chronic pain. For many of them, opioid medication means the difference between leading somewhat normal lives, or surviving in constant agony. These are not the people who O.D. on heroin or mix drugs with booze. For the most part, they suffer and die in silence.

NO ONE can diagnose… and NO ONE wishes to help manage the pain ?

At 34-I have had chronic pain & migraines all my life- My mother used to tell me of all the times I Used to bang my head when I was a baby- I have suffered with migraines so bad it felt like my brain was going to squeeze thru my nose- I have pain all thru my body and have seen at least 100 doctors- most of them specialists- if there are others out there like me-I could use someone to talk to- someone to share ideas with or find out if there is a way to correct it- I am NOT A DRUG SEEKER- I am a pain relief seeker but NO ONE believes me- how do I get that across to any doctor or nurse? Does anyone know of a good patient advocate in Dover Delaware? would a Patient Advocate even help or do I have to continue with this miserable condition where I truly cannot lead a life- (I won’t say normal- I just want a life) Please contact me if there is any advice or referrals that I could access.

Almost 1 million Canadians give up food, heat to afford prescriptions: study

http://www.cbc.ca/news/canada/british-columbia/canadians-give-up-food-heat-to-afford-prescriptions-study-says-1.4533476

Nearly one million Canadians spent less on necessities like food and heat to afford their prescriptions in 2016, according to a new study.

The paper, published Tuesday, found that 730,000 people skimped on food and another 238,000 spent less on heating their home — a total of 968,000 people.

“We knew lots of Canadians were having trouble paying for medication,” said Michael Law, lead author on the paper and associate professor in UBC’s school of population and public health.

“Now we know they are trading off other everyday necessities in order to pay for prescription drugs.”

Vitamins and supplements

Canada is the only country in the world that has universal health care but no universal drug coverage. (David Gray/Reuters)

The study surveyed 28,091 people as part of the Statistics Canada Canadian Community Health Survey, asking questions about their finances and prescriptions.

People without insurance, people with lower incomes and younger people in general were more likely to say they struggle to afford medication.

Indigenous people were nearly twice as likely to report challenges, as were women comparatively to men.

The study also said more than 1.6 million Canadians — 8.2 per cent of people who were prescribed medication in 2016 — didn’t fill those prescriptions, skipped doses, or otherwise didn’t take the medicine because they couldn’t pay for it.

 

pharmacy

The study said more than 1.6 million Canadians prescribed medication in 2016 didn’t fill those scrips, skipped doses, or otherwise didn’t take the medicine because they couldn’t afford it. (iStock)

Not taking prescribed medication strains the health-care system, researchers said, as people who stay sick end up taking repeat visits to their doctor or the emergency room. 

The researchers — who are from UBC, Simon Fraser University, McMaster University, and The University of Toronto — said results show that Canada needs to take another look at how prescriptions are covered.

“Despite Canada’s reputation of having a universal healthcare system, the fact that so many people cannot afford their medicines is a sign that people are falling through the cracks,” Law said.

Universal care, no universal coverage

Canada is the only country in the world that has universal health care but no universal drug coverage.

Previous studies have said Canadians pay the second-highest drug prices in the world, after the United States.

On Friday, B.C. announced prescription-drug deductibles will be lowered or eliminated for those making less than $30,000 a year.

Health Minister Adrian Dix said families earning between $15,000 and $30,000 will no longer pay any deductibles for medication.

The cuts will come with changes to B.C.’s Fair PharmaCare plan on Jan. 1, 2019.

US drug companies accused of being ‘cheerleaders’ for opioids

https://www.theguardian.com/us-news/2018/feb/13/us-drug-companies-accused-cheerleaders-opioids

The five biggest companies making prescription opioids have been accused by a US Senate committee of spending $10m on patient advocacy and medical groups to encourage use of the addictive drugs, which are at the root of a public health crisis in America.

The committee reported on Monday that Purdue Pharma, manufacturer of leading narcotic painkiller OxyContin, made the largest donations to outside groups that present themselves as advocates for people suffering from chronic pain.

“In some instances they are merely fronting for these manufacturers, especially if you look at the lobbying they’ve done against restricting opioids,” said McCaskill, adding: “These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history.”

The committee, which has been investigating Big Pharma practices from 2012 to 2017, said Purdue Pharma gave the most money, $4.15m to 12 groups. Purdue said in a statement that it supported organisations interested in helping patients receive appropriate care.

The report notes that organizations such as the American Academy of Pain Medicine play down the risks of addiction and abuse. The report names Purdue Pharma, Janssen Pharmaceuticals, Mylan, Depomed and Insys Therapeutics.

McCaskill launched the investigation last spring by saying: “We want to get to the bottom of why, all of a sudden, opioids have been handed out like candy in this country.”

Another congressional attorney that was in law school during the 70’s… as the DEA/war on drugs was ramping up… Criticizing that Purdue pharma gave about 1/3 million dollars to 12 different pro-patient chronic pain groups..  This is just one of the 535 members of Congress who the lobbyist industry spends 9+million/day to influence these members of Congress…

Congresswoman Mc Caskill won’t have to run for re-election until 2022… voters have short memories so she has plenty of time for voters to forget what Mc Caskill has investigated or voted for.

 

 

What has healthcare in this country SANK TO ?

I Am a 49 year old man with a rare syndrome called Klippel -Trenaunay- Webber -Syndrome..I been fighting this all my life without any doctors knowing what to do for me but rip me open time after time after time. Ever since they started the stop on opioids my pain doctor tells me he can’t do nothing but reduce me cause of the DEA. I’m about to put a bullet in my head to stop the extreme pain I get from him reducing me I am not a drug addict but yet cause of what is going on I get shuffled with them I am a chronic pain suffer NO MORE NO LESS. My doctor tells me I’m going to even get knocked down more when he does this I will not know if I can deal with it cause of what he’s doing I’m stuck in a wheel chair now I haven’t seen my blood doctor or my heart doctor. I get blood clots and bleed very bad get serious infections through out my body that needs to be monitored but can’t get to a hospital to be moved..please help or get my story out there. At my wits end why aren’t they going cause to case why is it that drug addicts get free clinics opened in New Jersey to go and soot up but I can’t get nothing to help with my pain…at this point in my life I don’t know if I should start going that way since that is the way the GOVERNMENT WANTS ME TOO. Or just end my pain. Can’t take it anymore please help…..

 

While I do not encourage anyone to commit suicide… there are some pts in this country are being left with a single choice to put a “end” to their pain – permanently…  Should these chronic pain pts make a final effort to share their pain… making a video… do a facetime live… make a post on FB… send a letter to many friends they can trust to follow thru with their wishes… and that would be to have their prescriber to be charged with assisting suicide or assisting manslaughter… what ever legal violation that they can be charged with…

IF they are so F-ing concerned about their license and their livelihood… shouldn’t a pt put in this position take that final swing at making sure that the prescriber gets what he/she is afraid of… losing their license and their livelihood…  The DEA has “taken out” untold number of prescribers because a small number of their pts have OD’d … maybe they committed suicide and the DEA is their zest to find a prescriber to “take to the cleaners” that they don’t look for the reason for the OD.

Those pts who have been pushed to this point should be “mad as hell and not going to take it anymore” and will spend their final hours/days in sharing their pain with those who have caused them to be in this position.

Personally, I am tried of trying to be politically correct and trying to offer pts some “guidance ” in dealing with their plight… when I know damn good and well that any reference that I give them… it will take 1-2 yrs for the bureaucrats that are suppose to protect these people from being abused to get their bureaucratic ass in gear.. .and we all know by then it will be too little too late.

I just made this post The “NO WIN GAME” … damn if you do… damn if you don’t  

where a prescriber is being sued by a spouse because her husband committed suicide while he was in the middle of a two month weaning down from being on opiates for chronic pain.  It is obvious that healthcare professionals have NO FEAR OF PTS… I feel sorry for this prescriber.. but.. this lawsuit could change the path that chronic pain treatment in this county could take…