The feds should end their losing war on weed

Posted on December 26, 2017 by Pharmaciststeve

http://thehill.com/opinion/international/366516-the-feds-should-end-their-losing-war-on-weed

The renewed battle over marijuana prohibition in the United States is a fight the federal government appears set to lose, much as it could not sustain the 13-year prohibition against alcohol. 

Cannabis has been legitimized for medical or recreational use in almost 30 states and the District of Columbia. The primary opponents to legalization were, until recently, federal, state and local law enforcement agencies who feared the loss of personnel and funding, as well as the alcohol lobby. The new antagonist-in-chief is Attorney General Jeff Sessions, who believes marijuana is a gateway drug with no valid uses.

At the federal level, marijuana is classified as a Schedule I Substance alongside heroin, even though it is non-lethal and various studies abroad have shown clear medical benefits. Those include alleviating the nausea and loss of appetite suffered by cancer patients undergoing chemotherapy, easing the pain of certain forms of arthritis without the risks of opioid addiction, helping to control the seizures in epilepsy and reducing the pain of multiple sclerosis. 

But because of its Schedule I status, it’s very hard to do scientific research on marijuana in the U.S. as the Drug Enforcement Administration (DEA) issues very few permits for such work. 

That’s an unfortunate reality. Presently, most of the illicit marijuana in North America is grown by Mexican drug gangs (largely the Sinaloa Cartel), both in their country and in many remote areas of the U.S., including on state and federal forestlands. These domestic grows pollute the environment and place visitors to such recreational areas at great risk, as cultivation sites are protected by heavily armed workers.

Marijuana production and sale is estimated by the DEA to be about 50 percent of cartel income, or billions of dollars annually. If cannabis were fully legalized in the U.S. and taxed and controlled like alcohol, it would not only severely crimp cartel revenues, it would yield needed funds for government entities and programs. Perhaps some of that money could be dedicated to help treat and prevent opioid addiction.

The fact of the matter is that people will continue to use regardless of its legal status. Those who can’t get it in the illicit market have turned to synthetic substitutes that are widely sold in bodegas and head shops. These are unfortunately dangerous, and often lethal, to users. Legalizing cannabis would end the market for counterfeit cannabis and save lives, and it would enable wide domestic research into the potential medical uses for this common weed.

If the attorney general would look to the Prohibition years, he might see the futility of crusading against marijuana. Unfortunately, with no clear policy from the White House, it seems only Congress holds the power to thwart Justice Department policy. Because the federal legislature is so polarized and gridlocked, that could take some time. 

A modern, well-run Justice Department should focus its anti-drug efforts on things that are truly detrimental to public health. Those include hardcore addictive substances like heroin, cocaine and methamphetamines, as well as prescription opioids. The attorney general should allow the states to decide on how to regulate cannabis within their respective borders and end draconian DEA requirements for scientific research into marijuana.

If, on the other hand, the Justice Department is determined to protect our health and safety from hazardous substances, perhaps it should dispatch teams of federal narcotics agents to slap cigarettes, junk food and liquor out of people’s hands. Those undermine public health much more than marijuana.

Martin W. Schwartz is an attorney based in New York. He worked previously as an assistant district attorney in Bronx County, a special counsel for the U.S. Department of Justice-FBI, and for more than a decade as a special agent for the U.S. Customs Service, retiring as a security and intelligence officer.

Filed under: General Problems | Leave a Comment »

“The system” … just managed to “take out” another “taker” ?

Posted on December 25, 2017 by Pharmaciststeve

Please don’t take my comment the wrong way I just meant that even though I have known it has pointless I have begged and pleaded non stop begging all day every day for help for this pain to go away even for the slightest relief and it only ever just continued to get worse. Worse that the most horrific torture any person could even begin to imagine with their darkest thoughts and no matter what I prayed for no matter that I have been willing to literally removed every limb of mine in the most slow and painful possible way if it would just calm this pain this horrific torture it did nothing but get worse no matter what I have been willing to give up or go through for it to even just be reduced slightly. It has destroyed everything in my life and everyone’s lives close to me which is pretty much no bodily. I have lost everything and everyone because of this so clearly there is no god of any kind or he hates me for some reason and wants me to go through the worst kind of hell anything or anyone could ever be put through…literally. And I have fought through it over and over every moment for the last 16 years and I’m just so tired I can’t do it another might I won’t do it and I just can’t a ever again. I’m sorry to the one or two people my death may affect I really am but I just can’t anymore I really am so so so sorry I’m so sorry I really am. If you need to hate me because of this that is ok whatever you need to do. I have done everything I can but its just become too much for any person to bear. I am so very sorry I truly am

Filed under: General Problems | 4 Comments »

Opioid distributors point the finger back at DEA for not stopping the epidemic

Posted on December 24, 2017 by Pharmaciststeve

Opioid distributors point the finger back at DEA for not stopping the epidemic

With municipalities across the country, including Palmetto and Manatee County, filing or considering lawsuits against major pharmaceutical companies and distributors for damages relating to the opioid epidemic, the blame game is in full swing.

Distributors are trying to separate themselves from the crisis because they neither manufacture nor prescribe the drugs. They argue that if anyone is to blame, it’s the Drug Enforcement Administration, which oversees their regulatory requirement and has the authority to control the flow of opioids, as well as see the bigger picture better than any single distributor.

“When we talk about who is controlling supply and demand, the DEA plays a huge, huge role in determining how many entities can write, dispense and transport medicine,” said Clare Krusing, with the Healthcare Distribution Alliance, a national trade association representing major distributors. “That’s the key job the DEA has, but also to oversee the annual quota production. They have the authority to set the yearly limit that determines how much can be in the market. So the idea that distributors are responsible for flooding the market is factually not correct.”

DEA public affairs spokesman Wade Sparks said many factors are taken into consideration when establishing a quota. They range from estimates of the legitimate medical need, estimates of retail consumption, history and forecasts, and data from the DEA’s internal system.

In correlation with the rising overdose death numbers, the DEA reduced the amount of opioids in the market beginning in 2016 and did so again in 2017. Before that, Krusing notes, the DEA increased the supply quota year after year.

An example of how effective a cut can be is when the DEA, in the 1970s, reduced the amphetamine quota to successfully combat the abuse of speed.

In the next decade, the DEA was successful again in reducing the illicit use of Quaaludes. The DEA also is responsible for licensing how many entities can write and dispense prescriptions, as well as how many distributors can transport the product and those numbers continue to rise.

According to the Department of Justice, the state of Florida has 90,192 retail controlled substance registrants and 862 wholesalers as of November. In November 2016, there were 81,108 retail dispensers and 841 wholesalers. Similar increases have occurred during the past few years.

 
 

“From our standpoint, why didn’t the DEA exercise the quota authority they have?” Krusing said. “The number of registrants and the quota are key issues. A lot of these lawsuits mischaracterize distributors alerting regulators for suspicious orders. One distributor only knows what it ships to a particular hospital or pharmacy. Say for an example, they ship 100 pills to the CVS down the street. That distributor doesn’t know if a competitor also is shipping to that same CVS as well. The only agency that captures the full picture is the DEA.”

Sparks said the DEA was not going to comment on Krusing’s claims, but said distributors can help simply by following the law.

“All registrants, including distributors, should be following all the rules and regulations which apply to them under federal law,” Sparks said. “And if they do not, DEA uses all available means – administrative and criminal – to ensure that it’s 1.7 million registrants (across the U.S.) handling prescription drugs comply with the law.”

We are deeply engaged in the issue and are taking our own steps to be part of the solution. But we aren’t willing to be scapegoats.

John Parker, senior vice president for Healthcare Distribution Alliance

Krusing couldn’t speak on where manufacturers come into play, but noted, “Again, they produce the amount based on quotas set by the DEA.”

The federal Centers for Disease Control and Prevention recently released disturbing numbers in relation to the epidemic. More than 42,000 Americans died from overdoses in 2016, a 28 percent increase from 2015. The number of deaths related specifically to fentanyl and other synthetic opiates more than doubled from 9,580 in 2015 to 19,413 in 2016.

The Healthcare Distribution Alliance represents some of the largest distributors in the country, including Cardinal Health, AmerisourceBergen and McKesson, which was recently fined $150 million after the DEA spent two years investigating the company. The DEA agents in the case wanted criminal charges filed, but the Justice Department reached a settlement in the case with McKesson, which creates $200 billion in annual revenue. McKesson also was able to keep all of its licenses for more than 70 distribution centers.

The DEA accused McKesson of ignoring its requirement to report suspicious orders. Krusing said the reality is that there is little a distributor can do to influence medical decisions and prescription practices.

“We don’t have clinical guidance,” she said. “But we can work hard within our supply chain to make them aware of the provisions. We do have a list of solutions we feel are common sense and practical changes. One of the biggest is the existing technology that uses a database that would alert to those who cross state lines to get a drug they can’t get in their state. Unfortunately, a lot states have it, but don’t mandate its use that would improve tracking on a provider level.”

All registrants, including distributors, should be following all the rules and regulations which apply to them under federal law.

Wade Sparks, DEA public affairs

Who is ultimately to blame may play itself out in the courts. Jessica Husley Nickel, president of the Addiction Policy Forum, said the solution is everyone’s responsibility. In an email to the Bradenton Herald, Nickel said we are losing a generation of Americans to preventable and treatable addiction.

“To put the numbers in perspective, we lose the equivalent of nearly three sold out 747s every week to drug overdose deaths … Enough is enough,” Nickel said. “We simply don’t have a moment to waste when it comes to helping families who are struggling. We must get people access to quality care, resources and information they need. We need everyone at the table to address this crisis and help save lives.”

Enough is enough. We simply don’t have a moment to waste when it comes to helping families who are struggling.

Jessica Husley Nickel, president of the Addiction Policy Forum

John Parker, senior vice president for Healthcare Distribution Alliance, said distributors want to be at the table, but won’t accept being a law enforcement scapegoat.

“As distributors, we understand the tragic impact the opioid epidemic has on communities across the country,” Parker said. “We are deeply engaged in the issue and are taking our own steps to be part of the solution. But we aren’t willing to be scapegoats … Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated.”

The Healthcare Distribution Alliance reviews key priority issues and advocates on behalf of its pharmaceutical distributor members for standards, public policies and business processes that ensure a safe and efficient supply chain, according to its website.

Distributor AmeriasourceBergen is another Fortune 500 company, ranked 11th with a $150 billion annual revenue. In 2014, the corporation established the AmerisourceBergen Foundation, a not-for-profit philanthropic arm of the corporation. The foundation is offering municipalities drug deactivation resources that use technology combined with water to deactivate opioids in a safe manner, rendering them useless and safe for disposal.

“The epidemic of opioid abuse demands action, attention and a collaborative approach,” said Gina Clark, president of the foundation, who also is executive vice president and chief communications and administration officer at AmerisourceBergen Corp. Clark says the company is united, “in our responsibility to create healthier futures. Through this program, we will provide communities with the resources needed to deactivate prescription medications in a safe and effective manner, and help advance their efforts to prevent opioid abuse.”

Filed under: General Problems | 3 Comments »

Deception On Both Sides: The FDA vs. Pro-Kratom Advocates

Posted on December 24, 2017 by Pharmaciststeve

www.wokeamerican.net/deception-on-both-sides-the-fda-vs-pro-kratom-advocates/

The FDA launched a press release warning individuals about Mitragyna speciosa (Kratom) on November 14, 2017. Although that assertion did not affirm the federal government goes to pursue a ban on the plant, it isn’t a really hopeful message. Much just like the DEA, the FDA highlighted poisonings and fatalities related to kratom and kratom-containing merchandise. But it is possible most of these concerned polydrug publicity. There’s little proof kratom by itself has a excessive overdose demise potential.

We’re nonetheless ready to see what the FDA recommends to the DEA. That suggestion might push the federal government in the direction of prohibiting the substance, simply as federal authorities tried to do via emergency scheduling in 2016.

Along with discussing the deceptive nature of the FDA’s assertion, I talk about deceptive statements from advocates who oppose a ban. Sadly, it seems lots of people are advocating towards prohibition utilizing arguments that unfold false concepts concerning the substance.

TDC web page (with references): https://thedrugclassroom.com/video/deception-on-both-sides-the-fda-vs-pro-kratom-advocates/

Reddit dialogue: https://www.reddit.com/r/TheDrugClassroom/comments/7fnvuj/deception_on_both_sides_the_fda_vs_prokratom/
————

Donate to The Drug Classroom:

https://www.patreon.com/TheDrugClassroom

https://www.paypal.me/TheDrugClassroom

Bitcoin: 1HsjCYpBHKcVCaW4uKBraCGkc1LK8xoj1B

————

Thank you to my Patreon supporters: RollSafe.org, Gui Kirsch, Jonathon Dunn, Thomas Anaya, michael hoogwater, Beau Jaco, Alexander Pavlenko, Lars Nilsson, Billy, Abdulaziz Al-Kuwari, Sam A., Reece hosford, Felix Wisniewski, Jarrod o’connell, Daniel X Moore, Dahmon Bicheno, Christoffer Finstad, Zachary Thomas Binkley, Sami Parsegov, Dane Overman, Squadra Dumay, Dragonhax, Case van der Burg, John Riccardi, Matúš Zdút, Sebastian, Jacob Fournier-Paradis, Ben Shipp, and David Kernell.

————

Facebook – http://facebook.com/thedrugclassroom
Twitter – http://twitter.com/drugclassroom
Email – seth@thedrugclassroom.com

————

The Drug Classroom (TDC) is devoted to offering the kind of drug schooling everybody ought to have. Drugs are by no means going to go away our society and there has by no means been a society free from medicine.

Therefore, it solely is sensible to offer actual schooling free from propaganda.

TDC does not advocate drug use. Rather, we function with the intention of decreasing the hurt some substances can convey.

Feel free to ask questions!

 

 

Filed under: General Problems | Leave a Comment »

AZ: lawmaker wants to allow prescribers to practice medicine without bureaucratic interference

Posted on December 23, 2017 by Pharmaciststeve

Lawmaker Wants To Stop Government Regulation of Painkiller Prescriptions

https://www.thefix.com/lawmaker-wants-stop-government-regulation-painkiller-prescriptions

Scottsdale representative Jay Lawrence

An Arizona rep believes prescription regulation should be decided between doctors and their patients.

Scottsdale representative Jay Lawrence Photo via YouTube

 

A Republican representative from Arizona has proposed legislation that will prevent state or local government from limiting the amount of prescription painkillers.

Scottsdale representative Jay Lawrence has said that regulating prescriptions should be a matter left to physicians and their patients, which stands in opposition to positions supported by Governor Doug Ducey and state health director Dr. Cara Christ, both of whom have either ordered or called to have initial opioid prescriptions restricted to no more than a week’s supply, with the exception of certain provisions, in the face of Arizona’s rising overdose death statistics.

 

While Lawrence agrees that prescription opioid dependency poses a serious threat to his constituents, he argued that “enough disciplines” already exist to adequately monitor prescriptions throughout the state.

“I want to see those disciplines in place so we know who is prescribing, how much they’re prescribing, and if someone is shopping doctors,” said Lawrence, who was quoted in the Arizona Daily Star. “I do not believe that government can step in to tell the medical profession and tell medical doctors what is correct to prescribe.”

For Daniel Scarpinato, a press aide for Governor Ducey, the representative’s stance runs contrary to logic about the current situation in Arizona.

“In the last year, we’ve had hundreds of people die from opioid-related overdoses,” he said. “That’s a huge number of people. So, absolutely, something more needs to be done here.” Scarpinato noted that medical professionals are not voicing opposition to Governor Ducey and Christ’s plans, which as the Daily Star noted, are also supported by the Arizona Medical Association.

He also pointed to recent data from the Controlled Substances Prescription Monitoring Program, which found that four doctors in a single small county prescribed nearly 6 million pills over the course of a single year.

“We’re not talking about blow-drying hair,” said Scarpinato. “We’re talking about drugs that can be miracle drugs for some but are very addictive and we’ve seen can lead to death. [So] we need to give law enforcement the tools in law to be able to hold [medical professionals] accountable.”

 

Under guidelines recommended by Ducey in September 2017, initial opioid prescriptions would be limited to five days for new patients, while maximum doses would also be limited. The guidelines would also require a tapering plan for pain medications and require prescriptions for such drugs to be filed electronically to limit diversion.

Cara Christ concurred with the decision, adding that the state recommended the five-day plan based on research from the Centers for Disease Control and Prevention (CDC) and restriction plans in other states.

Filed under: General Problems | 10 Comments »

Op-ED: The Opioid Epidemic Hasn’t Happened by Chance

Posted on December 23, 2017 by Pharmaciststeve

www.nationalpainreport.com/op-ed-the-opioid-epidemic-hasnt-happened-by-chance-8835108.html

As HHS Secretary-nominee Alex Azar awaits Senate floor action, Dr. Jernigan warns on his drug industry ties and calls for consideration of alternative medicine approaches to health care, especially for the opioid epidemic.

America’s addiction to pain pills was entirely predictable. The nation has long been over-medicated, blithely popping 3.2 billion medications annually, according to the CDC.*

Watch any nightly network newscast and we’re bombarded with drug ads, playing on our myriad health concerns and promising blissful remedies. Harvard tells us that the drug industry spends more than $5 billion a year on consumer advertising**, supporting, according to the U.S. government, more than $300 billion in pharmaceutical sales.*** Add to that the astronomical popularity of non-prescription or OTC drug products, and you can see that we’re a nation consumed by our aches and pills.

Given this environment, it is somewhat concerning that the nominee for Secretary of Health and Human Services, whose job is to protect Americans’ health, is the former president of the U.S. division of global pharmaceutical marketer Eli Lilly and Company. His disposition towards expanding our synthetic drug culture versus furthering the development and application of natural medicine should be carefully explored during Congress’s consideration of his nomination.

While many pharmaceuticals clearly can save, extend and improve the quality of life, the reality is that their long-term use conveys merely the illusion of health. Remission is promoted as success, even though it is but a temporary abatement of symptoms. While Americans consume the most prescription medications, the World Health Organization ranks the U.S. as having the worst health among developed countries. With drugs to control the symptoms of every named illness, Americans are oblivious to the reality that despite their pills, they’re getting sicker.****  

A vital key to a healthier and more productive population is the development and promotion of a new medical corps, trained in the pure treatment philosophy of biological medicine, focused on identifying and treating the root causes of illness, rather than just the symptoms.

True healing cannot occur by simply masking symptoms. In those instances where pharmaceuticals are required as first-line treatment, the aim should be to get off medication as quickly as possible, and identify and correct the cause at its source.

The biological medicine treatment option is particularly effective for those with chronic pain and illness – cases that have been considered untreatable in conventional drug therapy – without the risk of addiction or worse. It applies advanced science in diagnostics and treatment technologies to treat the patient, not the disease, by restoring the body’s own healing potential.  

Lifetime reliance on pharmaceutical drugs only benefits the drug industry. While prescription drugs are convenient, requiring little time and effort to prescribe, symptom-suppression is not a real solution to health problems, and it often entails side effects that reduce productivity and ultimately lower quality of life.

Americans should demand that our healthcare providers, elected officials and industry regulators acknowledge the drug industry’s grip on our healthcare system, and work to recognize and promote natural treatments and disciplines that seek to restore health, versus continuing promotion of the drug-induced illusion of health. The confirmation process for HHS Secretary-designate Azar is a prime opportunity to start this process.

Dr. Jernigan is Founder of the Hansa Center for Optimum Health, Wichita, Kansas.

I could not agree with this doctor more.. except for different reasons… The opiate crisis started with the Harrison Narcotic Act 1914 https://en.wikipedia.org/wiki/Harrison_Narcotics_Tax_Act when our Congress was driven by racial biases and bigotry passed this bill which was signed into law by Woodrow Wilson… this law… created the “black drug market” and a pseudo prohibition of opiates.

The Feds have created an assortment of various agencies to enforce the Harrison Narcotic act https://en.wikipedia.org/wiki/Federal_Bureau_of_Narcotics

In 1970 Congress passed a bill that created the Controlled Substance Act (CSA) which created the BNDD ( Bureau of Narcotics and Dangerous Drugs)… which a couple of years later would evolve into the infamous DEA. The CSA replaced the National Narcotic Bureau and its TWO MILLION/yr budget with 1500 employees and a 42 million/yr budget, and the WAR ON DRUGS was officially declared.

Currently the DEA has an official TWO BILLION/yr budget and 12,000 employees and an additional 79 billion/yr is spent by other city/county/state agencies, courts, prisons and others engaged in fighting the war on drugs.

In 1917 our judicial system declared that opiate addiction was a CRIME and not a DISEASE and any doctor caught maintaining or treating a opiate addict would be sent to prison.

Today, even though the last two Surgeon Generals have stated that addiction – all addictions – is a mental health issue and not a moral failing the DEA continues to function under a 100 y/o belief. So President Trump has a member (DOJ) of his cabinet that is working under the century old idea that opiate addiction is a crime and another member of the cabinet ( Surgeon General) working under the current concept that addiction is a MENTAL HEALTH DISEASE.

Some believe that the part of definition of socialism is for a bureaucracy to create a problem and then create a “solution” to the earlier problem that the bureaucracy created.

Coroners are now seeing between 60%-99% of all OD’s with a illegal Fentanyl analog and/or Heroin and typically 4-5 other substances in the person’s toxicology report. Yet, DOJ/DEA/law enforcement is still pursuing entities withing the legal medication drug channels of distribution. Maybe because law enforcement is still living in a early 20th century mindset or the entities that they are pursuing are not armed, don’t shoot at law enforcement, easy to locate, and have a excellent “paper trail” ?

And DOJ/DEA is still functioning like a Ford Model T.. which is what was the normal mode of transportation in 1917. Maybe they are still operating in the “horse and buggy” mode of the early 20th century.

Filed under: General Problems | 3 Comments »

Trump DOJ cancels rule protecting disabled employees

Posted on December 23, 2017 by Pharmaciststeve

Trump DOJ cancels rule protecting disabled employees

Attorney General Jeff Sessions is rescinding policies concerning civil rights, people with disabilities and immigrants.

Filed under: General Problems | Leave a Comment »

53 flags: Group constructs memorial to raise awareness of veteran suicides

Posted on December 22, 2017 by Pharmaciststeve

120517-mis-nws-vet-suicide-01

http://missoulian.com/news/local/flags-group-constructs-memorial-to-raise-awareness-of-veteran-suicides/article_c2951f78-c970-5a5a-95ba-548575ef2ab4.html

In Missoula County in 2016 alone, 18 military veterans took their own lives. That’s a staggering number, an average of more than one every three weeks. It’s also by far the largest number for any county in the state, where a total of 53 veterans took their own lives that year.

“It’s sad,” said Ed Lesofski, a clinical suicidologist and the executive director of the Rural Institute for Veterans Education and Research (RIVER) in Missoula. “It’s a hidden epidemic. We’ve got to do more to help our veterans.”

Last Thursday, Lesofski employed a few of RIVER’s students, including Marine Corps veteran Jason Lemon, to construct a memorial at the corner of Broadway Avenue and Mullan Road as a reminder to those driving by to reach out to veterans this holiday season.

 

“Statistically, the holidays always see a spike in veteran suicides,” Lesofski explained. “This is the time of year when they really need our help.”

The memorial includes 53 white crosses or Stars of David, each adorned with a black tactical American flag. Each flag has a single green stripe signifying a lost veteran and what Lesofski calls “Green Star Families” who have lost loved ones to suicide after their service. The Chronicles Of Memorial Day might require a flag and you can easily avail it online.

In 2014, Montana had the highest per capita suicide rate in the nation, according to the Department of Veterans Affairs. That year, 58 veterans took their own lives, a rate of 68.6 percent compared to the national veteran suicide rate of 38.4.

Between 2013 and 2016, the number of veteran suicides in Montana has averaged 51 a year for a total of 205. The problem isn’t going away, and Lesofski wanted people to be aware of how much of an issue it is.

Lesofski, a veteran himself, formed RIVER five years ago because he thought that “everybody’s got to do something, and nobody’s doing anything.”

“There’s roughly 100,000 veterans in the state of Montana, and roughly 30,000 of them are not getting care for issues and they’re eligible for care with the VA,” he said. “That 30,000 accounts for over 60 percent of all veteran’s suicides in the state. There are solutions out there but they’re just not getting it.”

Many veterans are reluctant to seek treatment because they don’t want to be diagnosed with Post-Traumatic Stress Disorder.

“Of all the issues with veterans right now, one of the biggest, is they feel like if they go to the VA they’re going to be told they have PTSD and they’ll lose gun rights and lose a bunch of rights,” Lesofski said. “PTSD is what I refer to as the ‘current leprosy diagnosis.’

“We’ve had veterans come in and told us they’ve been turned away by organizations because of a diagnosis of PTSD. So the veterans aren’t stupid. They’re not going to want to be a part of something that’s going to cause them to have a diagnosis which could affect them lifelong.”

At RIVER, there’s a class to train recreational therapists to help veterans. Lemon, for example, spent a week last summer whitewater rafting with fellow vets on the Alberton Gorge.

“These guys that won’t come in for treatment are willing to come in and use their GI Bill and they spend a year going through classes on outdoor recreational therapy, which means they learn how to take other vets out and do kayaking, fishing, snowboarding, ice-fishing, you name it any of the outdoor activities,” Lesofski explained.

 

“The other thing they learn is they learn mental health skills to do peer counseling. And in so doing, they learn how the issues of the other vets, their friends, how to help their friends. Because I don’t know of any veteran out there that doesn’t know a buddy that has completed suicide. It’s an epidemic in this state,” he said.

Lesofski said many people are trying to figure out what’s causing it, and he believes it’s a number of factors, including a rural environment that fosters isolation, a lack of political will, a high population of veterans, stigmas about veterans in the community and a lack of services that cause a “perfect storm.” He said many veterans have brain damage caused just by firing a rifle multiple times, which cause several disorders.

“They all have very similar symptoms,” Lesofski said.

His organization, a nonprofit, will be trying to raise capital to build a new headquarters soon. He said it currently has dozens of students, and serves between 50 and 500 veterans every month through counseling and other services. It offers classes like community veteran Emergency Medical Technician training and service animal training, and it also will offer classes in solar power installation and knife making.

This past fall, Sen. Jon Tester, D-Mont., announced that the Missoula Veterans Affairs Community Based Outpatient Clinic will get more than $6.94 million in federal funding from bipartisan legislation to triple in size and hire more staff.

Tester, a ranking member of the Senate Veterans’ Affairs Committee, also grilled VA Secretary David Shulkin on the topic of suicides during a September meeting.

“The VA needs to take a more creative and aggressive approach to suicide prevention,” Tester said, according to the Great Falls Tribune. “We need an action plan on how the VA is addressing this crisis in Montana that engages local communities, providers, veterans and their family members. It’s on all of us to make sure that not one life is lost.”

Filed under: General Problems | Leave a Comment »

Rehab Expert: Pain Patients Denied Needed Opioids in Palliative Care

Posted on December 22, 2017 by Pharmaciststeve

http://www.painmedicinenews.com/Policy-and-Management/Article/12-17/Rehab-Expert-Pain-Patients-Denied-Needed-Opioids-in-Palliative-Care/45403#_=_

David, a 38-year-old father of four and five-year survivor of fungal meningitis, experiences the long-term effects of contaminated epidural injections that have left him with headaches, visual disturbances, tinnitus, adhesive arachnoiditis and fibromyalgia.

His story exemplifies the gap between state and federal health care laws and treatment protocols for those with chronic pain requiring high-dose opioid therapy, wrote Terri Lewis, PhD, in “States of Pain: Part II. The Influence of Regulations” in National Pain Report.

“High-dose opiates—depending on the document, set of guidelines and law you’re looking at—are now being unilaterally redefined as addiction,” said the rehabilitation and mental health educator and clinician from Nashville, Tenn. “Our interactions with the care system are built on a scaffold of law, regulation, policy, professional practices, insurance regulations, guidelines and personal resources. This scaffold is destabilizing across the system as new guidelines and reactive public responses to increasing opioid-associated overdoses seize the public imagination.”

Dr. Lewis cited a conflict between the Controlled Substances Act, which classifies opioids as a Schedule II narcotic, and the Drug Enforcement Administration (DEA).

“The driver is rooted in DEA policy in managing Schedule II narcotics and comingling this activity with interdiction of illegal distribution to the streets,” she explained. “The DEA will claim they do not tell individuals how to practice. But they do influence choices about what is being done to treat at the local level by the thrust of current prosecutions.”

“It’s not so much classification of opioids as Schedule II substances as [it is] state laws and guidelines governing who can prescribe them, when and how that may pose a barrier to managing chronic pain,” said Joe Rotella, MD, chief medical officer, American Academy of Hospice and Palliative Medicine. “Because of a shortage of palliative medicine and pain specialists, many people with chronic pain receive care solely from a primary care provider.”

Larry Driver, MD, who sits on the professional education committee and chairs the CME oversight committee for the American Academy of Pain Medicine, agreed, stating, “We certainly need more physicians and other health care professionals who can provide appropriate and safe pain management and palliative care. This includes being aware of patients at risk for medication misuse or abuse and potential addiction, and taking steps to mitigate those risks while caring for the patient.”

Indeed, said Dr. Lewis, “we need more physicians trained in family medicine, physiatry, neurology, pain management and allied health practitioners. We need designated, mandatory medical home programs located within physician practices in every state, and every insurer to reimburse for palliative, medical home and integrated treatment. Guidance, issued by the Federation of State Medical Boards, needs to be rewritten; and every state pain regulation ought to contain consistent, unifying language to distinguish acute from palliative and hospice pain care.”

She added that conflating addiction prevention within palliative and hospice care must be modified, so physicians can “treat the whole person.”

“It’s critical to elevate knowledge of appropriate prescribing of controlled substances across various providers and specialties,” Dr. Rotella said. “Today, there is little to no curricula on managing pain in medical and nursing schools.”

He pointed out that the Palliative Care and Hospice Education and Training Act, a bipartisan bill, “would expose medical students, nursing students, pharmacy students and social work students to palliative care education and training early on to develop skills in assessing and managing pain and evidence-based prescribing. Palliative care focuses on care coordination. So, expanding these skills can play a role in stemming opioid misuse.”

Filed under: General Problems | 2 Comments »

How fentanyl gets to the U.S. from China

Posted on December 22, 2017 by Pharmaciststeve

How fentanyl gets to the U.S. from China

https://news.vice.com/en_us/article/j5vpdx/how-fentanyl-gets-to-the-us-from-china

The powerful synthetic opioid fentanyl is now the deadliest drug in America, causing an estimated 19,000 fatal overdoses in 2016.

The DEA says most of the illicit fentanyl comes from China, either shipped directly to U.S. consumers through the mail or mixed with heroin that is smuggled across the southern border by Mexican drug cartels.

At New York City’s JFK airport, the point of entry for about 60 percent of the country’s international mail packages, seizures of fentanyl by Customs and Border Protection agents increased from 7 in 2016 to 84 in 2017. All of the packages came from China. Nationwide, fentanyl seizures by CBP increased from 459 pounds in 2016 to 1,296 pounds last year.

In New York City, the DEA seized a record 193 kilos of fentanyl in 2017 — enough to kill the city’s population 11 times over. James Hunt, special agent in charge of the DEA’s New York field division, said it’s virtually impossible to stop the flow of fentanyl.

“The southwest border of the United States is porous,” Hunt said. “There’s thousands of miles of border. Thousands of trucks stop every day at the border. There’s millions and millions of parcels coming into the country every day, you can’t search them all. And traffickers know that.”

Filed under: General Problems | Leave a Comment »

« Previous Page — Next Page »