Imagine this: A functioning addict… not committing crimes

Posted on November 13, 2017 by Pharmaciststeve

https://www.wsbtv.com/news/2-investigates/prescription-heroin-the-alternative-approach-to-opioid-addiction/643637593

ATLANTA – As deaths continue to escalate from the opioid and heroin crisis across the country and here in Georgia, Channel 2 Action News visited an addiction clinic doing something you may say is unthinkable: giving heroin to addicts.

Despite the controversy, studies and patients experiences back up the success of the approach.

MONDAY AT 6: Miami, Biloxi, NYC: APD spent thousands to recruit in popular tourist destinations

The idea behind it is simple: If addicts are going to use heroin, why not give it to them in a safe environment?

[READ: Georgia among the top states with opioid overdose deaths]

The drugs are not contaminated, addicts don’t turn to crime and they can start to rebuild their lives.

Such treatment may seem irrational, even dangerous, but it’s gaining attention as the U.S. and Georgia battle an epidemic of overdose deaths.

Of the 1,300 overdose deaths in Georgia, in 2015, 900 of them were due to opioids and heroin.

[READ: Fulton County to sue drug manufacturers in fight against opioid epidemic]

Channel 2’s Tom Regan flew to Vancouver, Canada to see the heroin-assisted-treatment program at Providence Crosstown Clinic. The treatment is directed at hard-core heroin addicts who don’t benefit from other medications like methadone and suboxone.

With nurses standing by with naloxone, the clinic said it’s never had a fatal overdose.

2 Investigates take a look at the program’s success and if the approach could work in the United States, and here in Georgia, to fight the opioid crisis, Monday on Channel 2 Action News at 5 p.m.

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CDC guidelines: fewer opiates being prescribed… pt’s pain levels UP… suicides UP

Posted on November 13, 2017 by Pharmaciststeve

2017 CDC SURVEY RESULTS

Thank you for your interest in our survey on the impact of the CDC’s opioid prescribing guidelines. The online survey of 3,108 pain patients, 43 doctors and 235 other healthcare providers was conducted between February 15 and March 11, 2017 by Pain News Network and the International Pain Foundation (iPain).

Questions Q3 through Q10 were answered by pain patients only, while Q11 through Q19 were answered by doctors and healthcare providers.

Thanks to everyone who participated in this valuable survey.

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NY Post Spreads DEA Disinformation Regarding Kratom

Posted on November 12, 2017 by Pharmaciststeve

NY Post Spreads DEA Disinformation Regarding Kratom

www.inquisitr.com/4617297/ny-post-spreads-dea-disinfo-regarding-kratom/

The New York Post recently published an article regarding kratom that relied heavily on blatant misinformation supplied by the DEA. The article claimed 10 percent of the 23,000 respondents to the call for public comments claimed they supported the DEA ban. They relied on a claim of 15 attributable deaths related to kratom that has bee debunked numerous times. There was also an “anonymous source” who alleged serious withdrawal symptoms related to kratom. Kratom is a Southeast Asian plant related to coffee used for hundreds of years as a folk medicine that many consider to be a life-saver.

The claim that 10 percent of users experienced ill effects from kratom is in conflict with the analysis performed by the American Coalition of Free Citizens. The ACFC findings revealed the actual number to be just under 1 percent. The ACFC’s analysis found 99.1 percent of the 23,000 respondents were in favor of kratom. Only 113 of the 23,000 supported the DEA’s proposed extra-judicial ban. In addition, 48 percent of the respondents were veterans, law enforcement officials, health care professionals and scientists. This population of the respondents came out in favor of kratom and against a ban with a support level of 98.7 percent. Twenty-one percent of the filers who indicated age were 55 or older. Many users of kratom prefer the plant to prescribed pain medication because it is more effective and doesn’t have the same side effects of intoxication and addiction that pain pills do. The 90 percent figure offered by DEA spokesperson Melvin Patterson that the NY Post offers is completely fabricated.

Of the “15 cases of death attributed to kratom,” Dr. Babin cites academic papers regarding a forensic study that revealed 9 deaths attributed to kratom were connected to ingestion of the research chemical o-desmethyl-tramadol. Other deaths involved presence of other drugs in combinations that were more likely to prove fatal. To date, no deaths connected to kratom or its active constituents has occurred even in laboratory animals either due to respiratory depression, lethal overdose or other causes.

The New York Post also makes a point to mention how kratom can bind to the same receptors as opioids. This isn’t misinformation, per se, but it would be more honest to point out that milk, dairy products, and cheese have been shown to bind to opiate receptors as well. The coffee plant has also been shown in studies to result in “potent opiate receptor binding activity.” The coffee plant is actually closely related to kratom. Both are members of the Rubiaceae family. The difference is, caffeine overdose actually does lead to a small number of deaths per year, unlike kratom.

In addition to false claims regarding the percentage of people who experienced withdrawal symptoms from kratom and false claims regarding deaths attributable to kratom, the NY Post reported an “anonymous source” who experienced serious withdrawal from kratom involving vomiting. Multiple studies have confirmed that kratom doesn’t cause physical dependence and withdrawal symptoms are mild and comparable to caffeine withdrawal.

As for kratom being responsible for deaths, recently two coroners were debunked by lawyer and molecular biologist Dr. Jane C. Babin, PhD, molecular biology, Purdue University, and JD, University of San Diego School of Law. Dr. Karl V. Ebner, PhD, is a consultant at KETox Forensic Toxicology Consulting and author of numerous depositions, reports, and opinions related to drug and alcohol-related cases. Dr. Ebner concurred that Dr. Babin’s report “very troubling indications” of incorrect attribution of death to kratom, once again.

When the DEA attempted a ban of kratom at the end of the legislative season the kratom community leaped into full force in record time. 142,000 signatures were received on a White House petition to reverse the ban and three separate actions by congressional representatives were also issued including an official letter of objection to the Office of Management and Budget by Rep. Mark Pocan (D-Wis.) and Rep. Matt Salmon (R-Ariz.) signed by 51 members of the House of Representatives, a Dear Colleague objection led by Sen Orrin Hatch (R-Utah) and a letter of opposition to the DEA from Sen. Cory Booker (D-N.J.), Sen. Kirsten Gillibrand (D-N.Y.) and Sen. Ron Wyden (D-Ore.).

Pharmacologist Dr. Christopher McCurdy and several other experts in the field of pharmacology, ethnobotany and drug addiction addressed their concerns about how a proposed ban could “cripple painkiller research” and shut down a valid alternative used by thousands. CNN‘s Dr. Sanjay Gupta has theorized kratom could help end the opioid crisis. Last year, Dr. Babin wrote to DEA’s Office of Diversion Control to note that their initial conception of the plant was based on “contradictory opinions, incomplete knowledge of the most current scientific evidence and without input from the public on their experience with kratom.”

As for the addictive nature of kratom, Dr. Jack Henningfield is a professor at Johns Hopkins University and one of the foremost researchers on addiction performed a comprehensive 8-factor analysis on the addictive potential of kratom. According to Dr. Henningfield, “It’s important to understand that although kratom has some mild effects similar to opioids, its chemical make-up is different, and it appears overall much safer, with apparently relatively small effects on respiration. In fact, kratom’s analgesic effects and impact on energy, combined with its favorable safety profile supports continued access by consumers to appropriately regulated kratom products while research on its uses continues.”

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Montana leads the nation in suicides per capita

Posted on November 12, 2017 by Pharmaciststeve

Montana needs a pain patient bill of rights

http://helenair.com/opinion/letters/montana-needs-a-pain-patient-bill-of-rights/article_4fd8c999-ae65-5cab-9d78-0c7f65290c95.html

“But pain patients are particularly vulnerable. They die by suicide at twice the rate of the general population. In 2014, 28,000 took their lives.” (http://www.painmedicinenews.com/Policy-and-Management/Article/11-17/Opioid-Crisis-Continues-to-Pressure-Physicians-But-Patients-Bear-the-Pain/45054)

This article points out the crisis — currently invisible — of suicides in pain patients. Given that Montana leads the nation in suicides per capita, would it not be prudent to take whatever measures we can to prevent them?

 

There are several high profile suicides that have been noted in the press (Bryan Spece, Bob Mason). Many, of course, are not found in the press, but the agony for their families is no less. Perhaps you could call for hearings on this very subject. Get to what is so, and respond appropriately.

As you already know from all the hundreds of emails and articles I have sent you, and from this article above, palliative care of the 100,000,000 pain patients in America is disappearing, and that would be 100,000 patients in montana. (See the IOM report on pain in America 2011 for the data).

In Montana, as I have noted before, opiate refugees actually have been seeing doctors outside the state, and killing themselves as access has been withdrawn. This is a public health crisis right under our noses, and I am again sounding the alarm today. Please look into this.

As you know, the Board of Medicine takes no policy actions, just punitive ones. They have cast a pall over pain care by punishing doctors for “over-prescribing,” though no one has ever defined that term. And no one has been sanctioned for “under prescribing,” which must exist if over-prescribing does!

“The Board seeks to assure that no Montanan requiring narcotics for pain relief is denied them because of a physician’s real or perceived fear that the Board of Medical Examiners will take disciplinary action based solely on the use of narcotics to relieve pain. Although improper use of narcotics, like any improper medical care, will continue to be a concern of the Board, the Board is aware that treatment of malignant and especially nonmalignant pain is a very difficult task. The Board does not want to be a hindrance to the proper use of opioid analgesics. Treatment of the chronic pain is multifactorial, and certainly treatment with modalities other than opioid analgesics should be used, usually before long-term opioids are prescribed. Use of new or alternative types of treatment should always be considered for intractable pain periodically, in attempts to either cease opioid medications or reduce their use.”

 

This was the board’s policy on pain management until it disappeared from the BOME’s website somewhere around 2013, with no fanfare and no notice to physicians in the state. The MMA has been notified of this issue, and unfortunately has not acted either, as they are controlled more by specialty intervention doctors. This is a sad truth. I learned from MMA leadership courses that “What Don’t We Know?” Is a useful question to use to manage crises.

This problem can be solved by increasing safety in medicine (like was done with cars), sharing knowledge and using good evidence. Since legislators and federal agencies have made this a political issue, I again bring it to your attention.

We need a pain patient bill of rights in Montana, patterned on those of other states and compassion toward the 100,000 patients in pain in our state, as well as the 10-15,000 pain refugees that suffer daily here.

Sincerely,

And in good health, 

Mark Ibsen, MD

Helena

Filed under: General Problems | 2 Comments »

There are dozens of cases of reported suicides after pain patients had their doses reduced

Posted on November 12, 2017 by Pharmaciststeve

Cracking Down on Opioids Hurts People With Chronic Pain

https://tonic.vice.com/en_us/article/8x5m7g/opioid-crackdown-chronic-pain-patients-suicide

Before he broke his back in a 1980s accident that ultimately triggered years of chronic pain, Jay Lawrence had to make a split-second decision. He was on a bridge with a car in front of him and the brakes on his truck had failed. “He saw a baby seat in the car and he hit the bridge,” says his widow, Meredith Lawrence. She lost her husband to suicide earlier this year after his doctor abruptly decided to cut down his opioid pain medication.

 “He had this great big personality,” she says, describing how Jay loved to be around people and constantly insisted on helping her, even when he was in severe pain.

But in March, Jay Lawrence shot himself with a gun that he insisted she purchase for him. He was 58. They were together in a park in Tennessee, near where, just two years earlier, they had renewed their wedding vows. When he died, Meredith was holding his hand. Afterwards, she called the police and was arrested for assisting a suicide (she’s now on probation).

Jay had warned his wife that there might come a day when the pain became too much for him. He’d had three back surgeries, countless steroid shots and nerve blocks, an electrical stimulator, a morphine pump, and several different types of prescription and non-prescription pain medications. He’d become resigned to the fact that he wasn’t going to regain function, but on good days he could make Meredith coffee before she went to work and help tend to their menagerie of nine cats and two dogs.

Then, in February, his doctor decided he would no longer prescribe the dosage of opioids that allowed Jay this small modicum of function. Since the introduction of the Centers for Disease Control and Prevention’s guidelines for opioid prescribing in 2016, physicians who have chronic pain patients on doses higher than the equivalent of 90 milligrams of morphine a day are under increasing scrutiny, by both civil and criminal authorities.

 Though Jay had not misused the drugs or shown any signs of trouble, he was told that his dose would immediately be cut from 120 milligrams of morphine to 90 and would drop again within two weeks. “I will not do this,” Meredith says he told her. And so, when she couldn’t find another doctor for him and saw that his mind was absolutely made up, she agreed to help. “He was the most stubborn person I ever met,” she says.

“It was either that or I would come home and find him,” she says, adding that she didn’t want that to be her last memory of him and certainly did not want him to die by himself.

“This would not have happened if they’d just left him alone,” she says.

Unfortunately, Jay is far from alone in being subjected to an involuntary opioid dose reduction. Since the guidelines were rolled out, 70 percent of more than 3,000 chronic pain patients who participated in an online survey by Pain News Network reported that doctors had either reduced or simply cut off their medications.

And Jay is also far from the only person to have taken their life in response: several dozen similar cases have been documented by a growing and furious group of pain patient advocates and doctors (who are not funded by pharmaceutical companies), and who are starting to organize in the aftermath of the crackdown.

The stories are nearly unbearable to read: descriptions of various forms of intense agony, mitigated to some extent with medication, which is then stopped regardless of the patients’ pleas. And then, death: often by shooting, sometimes by overdose.

 

“I’ve seen a published list that heavily emphasizes publicly reported events, which includes between 20 and 30 suicides,” says Stefan Kertesz, associate professor of preventive medicine at the University of Alabama, who is trying to raise alarm over the problem with the CDC and other health authorities. Kertesz says he receives numerous emails and social media posts from patients who are suffering and thinks the government needs to fund research to specifically track the outcomes of these patients. “Widespread suicidal ideation should be seen as a signal of a major risk,” he says.

Although the guidelines were intended to be voluntary and to apply only to general practitioners—not pain specialists—they’ve been widely interpreted as a mandate. Doctors who have patients on doses that exceed the guidelines receive letters from insurers and medical boards suggesting that they cut back; state Medicaid policies have been implemented that actually do mandate a maximum legal opioid dose and pharmacies like CVS are imposing their own limits on what they will dispense. The National Committee for Quality Insurance will now rate healthcare organizations on whether they keep doses below the limit—despite a protest letter signed by multiple experts involved in developing the CDC guidelines.

All of this is occurring despite wide individual variation in opioid metabolism (meaning a high dose for one patient will be a low dose for another), tolerance (over time, higher doses can become necessary), pain condition (again, immensely variable) and a complete lack of research showing that forcibly lowering opioid dose is safe or effective.

 

“It remains the case that there is no evidence that mandated prescribing reduction results in better outcomes for patients,” say Kertesz. While some data suggests that some patients improve with voluntary dose reductions—higher doses may sometimes paradoxically increase pain, a phenomenon known as hyperalgesia—none shows that forcible tapers do more good than harm in pain care. A recent study in the The International Journal of Drug Policy found that there was no reduction in addiction rates, either.

“A gradual taper is something every patient on high-dose opioids for chronic pain should be encouraged to do, and doctors owe it to these patients to explain why a taper makes sense,” says David Juurlink, professor of medicine at the University of Toronto, who is a major proponent of decreasing the use of opioids for chronic pain. However, he says, “As much as high-dose opioid therapy is a bad idea, tapering abruptly without the patient’s buy-in makes things worse. I discourage the practice at every opportunity.”

Juurlink says he would never cut opioid dosage as abruptly as was done in Jay’s case. “I would not take someone from 120 to 90 in two weeks, unless he a) really wanted to, and, critically, b) understood that it might be tough, and that I’d take him back up to 120 if things got bad and we’d go more slowly next time.”

In the climate of fear induced by the opioid crisis, however, doctors are focused on self-preservation. Patients report coming into doctor’s offices and seeing signs advising them that medication doses are being dropped, for everyone, no exceptions. “The popular discourse presents opioids as lethal and physicians as no better than heroin dealers,” says Kertesz, “The result of this is that no public authority has been willing to articulate a safe harbor for physicians to protect their patients who need opioids.”

 

These patients need exactly that: some kind of certificate or validation that their doctors are permitted to prescribe for them and they are patients in good standing. The CDC also needs to make a public statement saying that its guidelines cannot be used to prosecute doctors who prescribe higher doses in good faith.

The goal of lowering dosage is supposed to be to protect patients from the overdose death risk associated with high doses. But lowering numbers on a chart isn’t saving lives—and some of these patients could even be overdosing because they’ve had a dose reduction, or fear one.

“Jay said that people need to be held accountable for this,” Meredith says, “My job is to put a face to this problem. Real families are being hurt here. And I’m finding more and more people and hearing more and more stories.”

The CDC, the DEA, and other regulators who oversee our response to the opioid crisis must take heed. Cutting off opioids used by addicted people hasn’t protected them—it’s merely shifted them to more dangerous street supplies like heroin and fentanyl, further increasing the death rate. For pain patients, these suicides and the stories of those whose pain has worsened as their opioids were take away suggest that they, too, are being harmed. Who is being helped here? The operation cannot be a success if the patients die.

If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.

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CVS, Other Pharmacies Update Safety Rules to Prevent Harmful Drug Interactions

Posted on November 11, 2017 by Pharmaciststeve

CVS, Other Pharmacies Update Safety Rules to Prevent Harmful Drug Interactions

www.lawfirmnewswire.com/2017/11/cvs-other-pharmacies-update-safety-rules-to-prevent-harmful-drug-interactions/

Leading national pharmacy chains have updated their safety measures to prevent dangerous drug interactions that could harm patients.

The sweeping changes are the result of a Chicago Tribune investigation that found 52 percent of pharmacies in the Chicago area dispensed risky drug combinations without warning patients about potentially harmful interactions. CVS failed to caution consumers 63 percent of the time, the highest rate among the 255 independent and chain pharmacies tested.

After the report was published in December 2016, CVS upgraded the computer system at its 9,700 stores nationwide to improve patient safety. Pharmacists must now warn patients or consult with the prescribing doctor when an alert shows up for serious drug interactions. The computer system prevents pharmacists from selling medication until they take the required action. Around 30,000 pharmacists and 50,000 technicians received training on the new safety protocol.

“Pharmacies are finally taking steps in the right direction to make significant improvements that address the growing risk of people taking multiple medications that could potentially have harmful, and even fatal, effects,” commented Briskman Briskman & Greenberg medical malpractice attorney Paul Greenberg. “Patients have a right to know about dangerous drug interactions, and it is the pharmacist’s duty to provide that information to them.”

Walgreens announced that it conducted additional training on dangerous drug interactions with the company’s 27,000 pharmacists. Costco, Kmart and Wal-Mart have also updated their computer systems and trained their pharmacists in order to boost patient safety.

While national pharmacy chains have adopted new measures to reduce the number of people hospitalized each year due to dangerous drug interactions, local chain Jewel-Osco did not provide any details about changes implemented after last year’s Tribune report. Investigators found the Chicago pharmacy failed to warn consumers about dangerous medications 43 percent of the time.

According to a statement Jewel-Osco released to the Tribune, “Technological and operational adjustments have been made to assist and monitor our pharmacists as they perform their jobs to ensure patient safety.” The pharmacy did not specify the changes involved. Mariano’s, another local pharmacy chain, now requires all of its pharmacists to undergo training in drug interactions, drug allergy contraindications and other patient safety concerns.

Since all of these pharmacies have “updated their computer software” and “retrained” their Rx dept staff… does this suggest that they knew or should have known all along …that their prescription filling processes was failing to protect pts from known drug interaction(s)  and it took a “damning expose” pointing out the inadequacies of all of these systems/processes and the risk that they were putting the pts that put their trust in these pharmacies to protect them against adverse drug interactions to get them to make changes… that should have been in place … in the first place ?

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DEA: Feds won’t arrest CBD oil users, neither should Indiana

Posted on November 11, 2017 by Pharmaciststeve

DEA: Feds won’t arrest CBD oil users, neither should Indiana

https://www.wthr.com/article/dea-feds-wont-arrest-cbd-oil-users-neither-should-indiana

INDIANAPOLIS (WTHR) — When Scott Wampler picked up his 11-month-old son and felt a lump near his abdomen, he immediately suspected something wasn’t right.

“I knew as soon as I felt it that it wasn’t just a rib,” Wampler recalls.

Doctors confirmed it was a tumor, and they diagnosed the mass inside young Zori Wampler as a rare form of liver cancer.

Zori Wampler’s parents turned to CBD oil to help treat the pain from his cancer treatments.

It meant Zori would spend his first birthday in an Indianapolis hospital, recovering from surgery to remove the cancer. And over the next several months, the toddler endured multiple rounds of chemotherapy.

“He was in a severe amount of pain. We couldn’t even get him to take his medicine,” explained Zori’s mother, Victoria.

That’s when Zori’s parents heard about CBD oil, an herbal supplement derived from cannabis plants. Friends told the Wampler family that CBD oil can calm nerves and effectively treat pain. Scott and Victoria decided to give a few drops to their son, hoping it would reduce his pain with far fewer side effects than the pain medicines prescribed by doctors. They did not expect what happened next.

“He just changed instantly,” explained Victoria. “He was so calm. He was so relieved. He was just happy. It was magical to see him out of pain.”

But what helped the toddler through his cancer treatments is now in legal limbo in Indiana following an Eyewitness News investigation.

State launches CBD Crackdown

CBD oil use is growing in popularity with those looking to treat pain and anxiety. (WTHR Photo)

 
“There’s a lot of confusion about this topic even within state government”

Earlier this year, 13 Investigates exposed a series of CBD raids conducted by state excise police and the Indiana Alcohol and Tobacco Commission. Excise officers confiscated CBD oil products from dozens of stores across Indiana, citing the businesses with violating state law for possessing marijuana.

Marijuana and CBD oil both come from cannabis plants, and that creates a great deal of confusion for law enforcement. While marijuana comes from cannabis plants that have elevated levels of THC (the chemical compound in marijuana that creates a “high” feeling), CBD oil comes a very different variety of cannabis known as industrial hemp. That has little or no THC and causes no high at all.

Immediately following WTHR’s report, state officials met at the governor’s office to discuss the widespread confusion surrounding CBD oil. That meeting prompted the Alcohol and Tobacco Commission to impose a moratorium on the agency’s CBD crackdown, and excise police were ordered to stop confiscating CBD oil products until the attorney general could issue a clarification of state law.

“There’s a lot of confusion about this topic even within state government,” attorney general spokesman Jeremy Brilliant told 13 Investigates this summer. “Our attorneys are trying to figure out in fact what is legal and what is not.”

Months have passed with no clarification from the attorney general and, in the meantime, police departments across the state are interpreting existing law in very different ways.

13 Investigates obtained a copy of an Indiana State Police memo sent in late August. It informed all ISP enforcement staff that possession of CBD oil is not a crime:

“Commercial products manufactured from industrial hemp are lawful to possess and sell in Indiana. A short list of these products may include, but are not limited to, hemp rope, hemp hand lotions, CBD oil, hemp shoes and other clothing articles manufactured from industrial hemp. Keep this information in mind in the event you encounter such products in the course of your duties, and remember these products are lawful to purchase and possess.”

Other police departments in Indiana have a different perspective and, as a result, some Hoosiers now find themselves facing criminal charges for using CBD oil. That is a big concern for families like the Wamplers.

“I think the biggest question for the lawmakers is: What are we supposed to do?” said Scott Wampler. “Nobody really seems to have an answer.”

Illegal under federal law but …

“Anybody who’s in violation always runs that risk of arrest and prosecution”

While state leaders are struggling to figure out CBD law in Indiana, officials at the U.S. Drug Enforcement Administration say federal law on the subject is very clear.

“It’s not legal. It’s just not,” said spokesman Rusty Payne, who met with 13 Investigates at DEA headquarters near Washington, DC.

Payne says cannabis plants are considered a Schedule I controlled substance, and medicinal oils derived from cannabis plants are illegal according to two federal laws: the Controlled Substance Act and the Food, Drug and Cosmetic Act. He said confusion surrounding the Agricultural Act of 2014 (better known as the “Farm Bill”) is frequently cited as legal justification by those who want to manufacture, sell or use CBD oil. The DEA believes the Farm Bill permits only CBD research — not CBD marketing and sales.

“Anybody who’s in violation [of the federal laws] always runs that risk of arrest and prosecution,” he said.

But during the hour-long discussion with WTHR, Payne said families like the Wamplers have little to worry about.

U.S. Drug Enforcement Administration spokesman Rusty Payne (WTHR Photo)

U.S. Drug Enforcement Administration spokesman Rusty Payne (WTHR Photo)

WTHR: We’ve heard from so many people who say this stuff really helps them from a medical perspective.

Rusty Payne: There’s a lot of anecdotal evidence out there – there’s a lot of people out there – telling us the same thing you are: that this stuff has helped their family.

WTHR: What would you tell the mom and dad who are buying this stuff and giving it to their kids because it helps them get through the day?

Payne: Am I speaking as a DEA spokesman or as a father? Because I am a dad. As a father?

WTHR: Yes.

Payne: I’d do the same exact thing — without hesitation. I cannot blame these people for what they’re doing. They are not a priority for us … it would not be an appropriate use of federal resources to go after a mother because her child has epileptic seizures and has found something that can help and has helped. Are they breaking the law? Yes, they are. Are we going to break her door down? Absolutely not. And I don’t think she’ll be charged by any U.S. Attorney.

While that may come as welcome news to the thousands of Hoosiers who use CBD oil, it does not resolve the uncertainty many families are feeling while waiting for clarification from the state.

“I don’t know why anyone would be against this,” Zori’s mother said. “We got to see firsthand what it can do. It’s clearly helpful. This isn’t causing any harm. It only helps.”

A deadly crisis

Officials at the DEA were surprised to learn that state excise officers raided retailers who sell CBD oil and that some Indiana police and prosecutors have been criminally charging Hoosiers who use it. DEA agents could do the same thing if they wanted to, but they are not. Payne says there is a good reason for that.

“We are in the middle of an opioid crisis in this country. That’s our biggest priority right now,” the agency spokesman explained. “People are not dying from CBD. Some would argue lives are being saved by CBD. Are we going to get in the middle of that? Probably not.1“

Asked what advice he might have for Indiana as state leaders wrestle with how to deal with CBD, Payne hesitated, saying the DEA would not weigh in on a state issue. A few moments later, he changed his mind and offered a poignant message for state officials and police.

“I think what they need to do is the same thing we’re doing and that’s prioritize what is truly the biggest issue affecting public safety right now. That would be the opioid epidemic,” Payne said. “According to the CDC, in 2015 we lost 52,000-plus Americans – 52,000 — and a good portion of those are from opioids: heroin, fentanyl, prescription drugs. That has to be our priority right now. Not CBD.”

This spring, Indiana Governor Eric Holcomb told WTHR the opioid crisis is a priority for Indiana and that all options for attacking the crisis would be considered.

“This has got to be front and center on every governors’ mind,” he said. “I’ve just seen case by case by case by case by case by case where these drugs of today are literally hijacking the brains of our fellow citizens.”

But many Hoosiers say when it comes to Indiana’s war on opioids, Indiana is not utilizing a powerful weapon. They say CBD oil could help fight and even prevent opioid addiction — if the state were to embrace it rather than fight it.

“Lets me have my life”

Ruby Houpt believes she is a perfect example.

For years, the Indianapolis resident has taken powerful prescription painkillers and more than a dozen other medications to help manage the painful symptoms of fibromyalgia and degenerative bone disease. Those medical conditions make it hard for Houpt to get out of bed, and she says side effects from some of the addictive pills make her feel like a zombie.

“I didn’t want to live that way. I don’t want to live that way. I shouldn’t have to live that way if that’s the way I don’t want to live,” she told WTHR.

That’s why Houpt decided to try CBD oil, which she takes through a spray or a vape pen, and she likes the results.

“Lets me function. Lets me be normal. Lets me go walk around my house. Lets me load my dishwasher. Lets me make a meal. Let’s me take care of elderly father,” she said. “Just lets me have my life.”

Houpt is not alone. Countless Hoosiers have told 13 Investigates CBD oil gives them incredible pain relief from a wide variety of medical conditions. And the best part, they say, is that their CBD oil drops, pills, balms and sprays helped them to wean off addictive painkillers.

During WTHR’s visit, Houpt dumped out a large bag of pill bottles filled with leftover medications that she no longer needs.

WTHR: After starting CBD oil, you’re not taking any of these?

Ruby Houpt: None. None whatsoever. No opioids. No anxiety medications. No sleeping medications.

WTHR: You mean to tell me, CBD oil could replace all of this?

Houpt: All of it. That’s all the crap I can give back. I don’t want it. The pills, the addiction, it’s not what I want. It’s a high. I don’t want that.

Houpt has been able to discontinue 14 pain killers, anti-depressants, sleeping pills and other addictive drugs because of CBD oil. With countless Hoosiers currently addicted to prescription drugs, she says CBD could make a huge difference, just as it did for her. Houpt plans to keep taking CBD even if the state decides to renew its crackdown.

“I don’t care. They can kiss my ass,” Houpt said when asked what she’d do if the state declared CBD oil illegal. “I’d have to see a judge and say: ‘You know what, your honor, I don’t want to be high; I want to be normal. I don’t want a buzz; I want relief. And this is my relief right here.'”

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Daniel Messel is serving 80 years for murdering Hannah Wilson. He is also charged with attempted rape in a 2012 attack on a young woman in Bloomington, Ind.

 

Changing federal law

“I think the risk is small and the potential rewards are great”

Ignoring federal regulations, many states have passed their own laws to legalize CBD oil. On a very limited scale, Indiana did the same thing earlier this year when lawmakers passed a bill that creates a CBD registry for a small group of epilepsy patients. (Several studies show CBD oil is effective in reducing seizures.) Once registered with the state, those individuals can legally obtain and use CBD oil in Indiana. It was only after the governor signed that bill into law this spring that excise officers launched their crackdown at stores across the state. It is unclear whether individuals who do not suffer from an untreatable form of epilepsy can now legally use CBD oil in Indiana – something that was occurring without incident prior to passage of the new law.

While clarifying state law would help resolve uncertainty for CBD users in Indiana, some supporters of the controversial pain remedy say what’s truly needed is a new federal law to legalize CBD oil in all 50 states.

“Congress could change the law tomorrow, and if they do, that’s what we’ll follow,” said Payne.

Congress is now considering just that, and a current proposal would impact millions of people by dramatically altering the legal landscape for CBD oil.

“I look at how we take such a hard line against using this substance, and I think ‘What are we doing as a nation?'” said Rep. H. Morgan Griffith (R – Virginia). “I want to change the law … and I think the risk is small and the potential rewards are great.”

The congressman has been moved by stories from constituents who’ve been greatly helped by cannabis products such as CBD oil. In January, he introduced HR 715, a bill that would remove CBD oil from the Controlled Substances Act. Griffith believes CBD oil should be legal to help thousands of families just like the Wamplers.

“The stuff creates miracles,” he said. “[If] my kid needed it, I’d do it, and if I feel that way, then I feel I have an obligation to change the laws here in the halls of Congress.”

The legislation has some bi-partisan support, but it’s not yet clear if the House will move the bill through committee for a full vote.

1 Even if the DEA did want to arrest and prosecute individuals who sell or use CBD oil, the Appropriations Act of 2017 seems to put a freeze on such activity. The act states that federal funds may not be used to “prohibit the transportation, processing, sale, or use of industrial hemp that is grown or cultivated in accordance with section 7606 of the Agricultural Act of 2014.”

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CDC makes three recommendations in support of newest shingles vaccine

Posted on November 11, 2017 by Pharmaciststeve

CDC makes three recommendations in support of newest shingles vaccine

http://www.drugstorenews.com/article/cdc-makes-three-recommendations-support-newest-shingles-vaccine?tp=i-H55-Q5U-4s5-7NLEs-1v-164o-1c-1Ig7-7NZff-hAZnY&utm_campaign=Daily&utm_source=Experian&utm_medium=email&cid=18729&mid=108997542

LEXINGTON, Mass. — The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recently voted in favor of three recommendations for the use of GlaxoSmithKline’s recently-approved Shingrix (Zoster Vaccine Recombinant, Adjuvanted) containing QS-21 Stimulon for the prevention of shingles.

“The Advisory Committee’s vote to recommend Shingrix enhanced with QS-21 Stimulon on three different counts further confirms our belief in the vaccine’s efficacy and its potential to extend immunization for up to 62 million adults in the United States,” stated Garo Armen, chairman and CEO, Agenus. Agenus is an immuno-oncology company with a pipeline of immune checkpoint antibodies and cancer vaccines.  “Today’s vote confirms the importance of ensuring that millions of at-risk adults are protected against shingles with Shingrix.”

The three recommendations include:

  • Herpes Zoster subunit vaccine (Shingrix) is recommended for the prevention of herpes zoster and related complications for immunocompetent adults age 50 year and older;
  • Herpes Zoster subunit vaccine (Shingrix) is recommended for the prevention of herpes zoster and related complication for immunocompetent adults who previously received Zoster Vaccine Live (Zostavax); and
  • Herpes Zoster subunit vaccine (Shingrix) is preferred over Zoster Vaccine Live (Zostavax) for the prevention of herpes zoster and related complications.

Shingrix was approved by the US Food and Drug Administration on Oct. 20 for use in adults aged 50 years and older.

Shingles is a major public health issue in the US, impacting as many as 1 in 3 older adults over the age of 50 years. Shingles is caused by a virus called varicella zoster, which is also known as the chicken pox virus. Nearly all older adults have the varicella zoster virus dormant in their nervous system waiting to reactivate with advancing age and weakened immune systems.

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DEA plan for illicit fentanyl aims to make prosecution easier

Posted on November 11, 2017 by Pharmaciststeve

DEA plan for illicit fentanyl aims to make prosecution easier

DEA plan for illicit fentanyl aims to make prosecution easier

http://www.bigcountryhomepage.com/news/main-news/dea-plan-for-illicit-fentanyl-aims-to-make-prosecution-easier/855170494

WASHINGTON (CNN) – The Department of Justice plans to classify illicit versions of fentanyl as Class 1 drugs in an emergency effort to stop the creation of new synthetic opioids and make prosecution easier.

DOJ and Drug Enforcement Administration officials announced Thursday that they intend to classify substances structurally related to fentanyl in “schedule 1,” the highest drug bracket, which is meant for drugs with no medical benefit and a high likelihood of abuse. Heroin and marijuana are also in that category.

The move comes amid the skyrocketing misuse of fentanyl, an opioid typically prescribed for pain.

President Donald Trump “has made it a cornerstone of his presidency to combat the deadly drug crisis in America, and today the Department of Justice is taking an important step toward halting the rising death toll caused by illicit fentanyls in the United States,” Attorney General Jeff Sessions said in a statement released Thursday. “By scheduling all fentanyls, we empower our law enforcement officers and prosecutors to take swift and necessary action against those spreading these deadly poisons.”

In his statement, Sessions also urged Congress to make the new classification permanent.

DEA officials say they have frequently seen chemists and drug dealers alter the molecular structure of the drug by small margins in order to avoid prosecution. Officials hope the new move will thwart those efforts.

“All of these substances are incredibly potent; they all have similar effects on the body, a DOJ official told reporters on a call Thursday. “Our view is these tweaks are efforts to avoid dealing with substances under control either here or abroad.”

Officials say the new scheduling of all fentanyl-related substances will make it easier for them to prosecute dealers and drug chemists because they won’t have to prove the negative effects of each drug individually, the molecules of which might be minutely altered in various ways from the chemical structure of fentanyl.

“The scheduling action that we anticipate will have different ways that the fentanyl molecule can be altered — four points in our scheduling action will be covered,” an official said on the call. “It avoids us dealing with the whack-a-mole problem because any of the ways they will be altered.”

Since 2015, the DEA has instituted six temporary control actions for nine substances that are structurally related to fentanyl.

As usual the MEDIA chooses a graphic of a LEGAL PRODUCT – this time a product made in Germany to be used in Israel – when they are talking about ILLEGAL PRODUCTS. And I thought that only magicians used MIS-DIRECTION to distract you from they are really doing to make you think that they are “creating magic” 

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Are business tactics at some pharmacies risking your health?

Posted on November 11, 2017 by Pharmaciststeve

Are business tactics at some pharmacies risking your health?

http://www.ksdk.com/article/news/local/5-on-your-side/are-business-tactics-at-some-pharmacies-risking-your-health/63-490098147

Some experts claim big pharmacies are taking a big gamble with your health. The 5 On Your Side I-Team uncovers pharmacists are under pressure to fill prescriptions faster, upping the chance you will get the wrong drug.
 
Former Walgreens pharmacist Jackie Howell remembers, “It was, ‘You’re not going fast enough.'”

She’s talking about management’s take on how fast she filled prescriptions.

“They’d like you to fill one a minute if you could,” Howell said.

Even more, Howell claims there was even a timer which would turn red to alert her that she was falling behind.

She also says the consequences were clear.

“They would threaten to decrease your hours, move you to other stores or locations you might not want to be,” she said.

Drugs and medicines are big business these days, something that’s true for big-chain pharmacies. The more prescriptions dispensed, the more money made.

That may be why some pharmacists say they are under a great deal of pressure by the business side of the business to fill more prescriptions faster.

However experts say that while prescription quotas and other forms of “performance metrics” can help drive profits up, they may also be increasing potentially deadly prescription mistakes.

Daniel Hussar is a nationally-known expert and teacher of pharmacology at Philadelphia’s University of the Sciences. He told 5 On Your Side that the pace and pressure of prescription quotas appear to be having an impact on accuracy.

Among other things, he points to figures from the U.S. Food and Drug Administration’s Adverse Event Reporting System. It shows reported medication errors have increased by 450% since 2010.

“The frequency of these errors is increasing greatly,” Hussar said. “I’ve heard some pharmacists say, ‘It’s a blur as to what happened during the day and I can only pray I didn’t make any serious mistakes.’”

For some patients, those prayers aren’t enough.

Michael Gray was fighting lung cancer when he picked up some medicine at his pharmacy, a big-chain store known for using prescription quotas with their pharmacists.

Gray says during pick up, the pharmacists and technicians seemed under stress and in “a hurry.”

Later, he noticed that one medication, which was always a small white pill in the past, was now blue. Three weeks later, Gray says he was near death.

“I couldn’t get my head up off my chest,” said Gray.

Turns out, the pharmacy had mistakenly given him blood pressure medication. Gray says after several weeks in a hospital, he slowly recovered.

“I’m battling cancer already, but then to make it worse by giving you the wrong medicine too is pretty scary” he added.

Eventually Gray sued the pharmacy, and what happened next was typical of similar cases the I-Team found across the county.

Before the case got to court, the corporation settled the suit and had Grey sign a confidentiality agreement. Then the lawsuit itself was made confidential, helping keep the incident out of the public eye.

Hussar said many of these companies see errors and lawsuits as “a cost of doing business.”

According to Christian Tadrus, the chair of the Missouri Board of Pharmacy, pharmacies don’t even need to report these medication mistakes to the state.

“The Board doesn’t require a direct report to us every time that happens,” Tadrus said.

Hussar said that’s the case in states across the country.

5 On Your Side requested on-camera interviews with the companies mentioned in our story. They sent written statements.

CVS wrote:

“The health and safety of our customers is our number one priority. We regularly seek out new technology and innovations to enhance safety, we engage with industry experts for independent evaluations of our systems, and we are committed to continually improving our processes to help ensure that prescriptions are dispensed safely and accurately. In fact, CVS Pharmacy was the first pharmacy in the nation to earn Community Pharmacy accreditation from URAC, the leading health care accreditation organization that establishes quality standards for the health care industry. This accreditation program establishes consistent benchmarks and standards for pharmacy practice quality. Pharmacies that earn this accreditation are recognized as leaders in quality and patient safety.

“Quality health care must be safe, effective and timely in order for patients to achieve their best possible health outcomes, which is why we use metrics to measure the quality and effectiveness of the services our pharmacies provide to patients. The measurements we have in place do not cause an unsafe environment in our pharmacies. That would be a direct contradiction to our company’s purpose of helping people on their path to better health.

“The appropriate use of metrics in our pharmacy practice is commonly used throughout the health care industry to measure clinical activities and health outcomes. One of the most prominent examples is Medicare’s Star Rating System, which is used by the industry to set the standards for timely and effective care. Performance metrics are a valuable tool in helping us meet our patients’ needs and continually improve our systems, processes and services.”

Walgreens declined to comment on this piece specifically, but an email from the business read in part:

“I’d like to direct you to a recent Drug Topics article in which Tasha Polster, RPh, Vice President, Pharmacy Quality, Compliance, and Patient Safety at Walgreens was quoted talking about Walgreens active and leading role in improving pharmacy quality and safety. You could certainly in your piece allude to this industry article and Tasha’s comments.”

Several precautions can help consumers catch medication mistakes.

Any time you pick up a prescription:

  1. Double check that the prescription medication you receive, is the one your doctor sent in. Also make sure to check that the dosage is correct.
  2. Each prescription should contain a description of the correct pill (ex. White pill, round, etc) on the instruction sheets or on the bottle itself. Double check the pill in the bottle is the same as the description. You can also verify this information online by researching the medication you were prescribed.
  3. Sometimes pharmacies switch their generic brands, which can mean the color of the pills will change. If your regular prescription looks different in any way, question your pharmacist.
  4. Reports show sometimes pharmacists can forget to remind you of potential drug interactions. If you are on more than one medication, double check with your pharmacist that there is no risk of an adverse drug interaction.

Finally, if you want to report a pharmacy error to the state Board of Pharmacy, the Board accepts complaints by mail. You can read about the complaint process in a brochure on their website, and the form to send in is also available on the web.

 

 

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