New DEA teams in Cleveland and Cincinnati will combat flow of heroin and fentanyl

http://www.cleveland.com/metro/index.ssf/2017/10/new_dea_teams_in_cleveland_and.html

CLEVELAND, Ohio – The U.S. Drug Enforcement Administration said Friday that it is forming new enforcement teams in new enforcement teams in Cleveland and Cincinnati that will focus on eradicating the flow of heroin and fentanyl.that will focus on eradicating the flow of heroin and fentanyl.

The two enforcement teams are among six that the agency is forming across the U.S. to combat an opioid epidemic that claimed roughly 34,500 lives last year. The other four enforcement teams will be in New Bedford, Massachusetts; Long Island, New York; Charleston, West Virginia; and Raleigh, North Carolina, the agency said in a news release.

The DEA chose the six locations by studying data related to opioid overdose deaths and heroin and fentanyl seizures. The teams’ investigations will not be limited to the geographic areas near those cities, the agency said.

“The DEA’s top priority is addressing the opioid epidemic and pursuing the criminal organizations that distribute their poison to our neighborhoods,” the agency’s acting administrator, Robert W. Patterson, said in a news release. “These teams will enhance DEA’s ability to combat trafficking in heroin, fentanyl, and fentanyl analogues and the violence associated with drug trafficking.”

The agency’s fiscal year 2017 budget includes funding to establish the teams, which will be comprised of DEA special agents and state and local task force officers. The teams are part of a broader DEA strategy that also includes enforcement against international and domestic drug trafficking organizations, the agency said.

The teams are being established at a time when drug overdoses are the leading cause of injury-related death in the U.S. Nearly 54 percent of the country’s 64,000 drug overdose deaths in 2016 were caused by opioids, Centers for Disease Control and Prevention statistics show. 

In Ohio, more than 4,050 people died of unintentional drug overdoses in 2016, with many of those being caused by opioids. In Cuyahoga County, heroin and fentanyl killed more people last year than homicides, suicides and car crashes.

Officials in Cuyahoga County and statewide have taken steps to curb the opioid epidemic by addressing prescription drug abuse, which experts say is inextricably linked to heroin and fentanyl abuse.

On Friday, Cuyahoga County Prosecutor Michael O’Malley announced that his office is filing a lawsuit that accuses several major prescription drug companies of intentionally misleading the public about the dangers of painkillers as they raked in “blockbuster profits.”

Cuyahoga County files lawsuit accusing drug companies of racketeering, leading to opioid epidemic

The lawsuit is similar to one Ohio Attorney General Mike DeWine filed over the summer against some of the same manufacturers.

Cuyahoga County officials are also urging residents to return unused and unnecessary prescription drugs Saturday during the annual Take Back Your Meds Day. The annual event, which is part of the DEA’s National Prescription Drug Take Back Day, will feature more than 40 locations where people can return prescription drugs throughout the county.

The DEA being in charge of the war on drugs for some 43 years… are just now deciding to focus on new enforcement teams in Cleveland and Cincinnati that will focus on eradicating the flow of heroin and fentanyl in just SIX METRO AREAS  Cleveland, Cincinnati, New Bedford, Massachusetts; Long Island, New York; Charleston, West Virginia; and Raleigh, North Carolina

It is reported that we are up to 81 billion/yr in expenditures on the war on drugs and closing in on TWO TRILLION dollars expended since the Control Substance Act was signed into law in 1970… which started with at 43 million/yr budget and 1200-1500 agents.

Collectively, has the DEA had their head stuck up their ass for the last 47 years ? We how have the highest per-cent of our population in jail/prison than any other major country. Mostly for minor non-violent drug offenses.

I am sure that most know by now that we have FOR-PROFIT PRIVATE PRISONS Corrections http://www.cca.com/  is a major player… that lobby Congress for longer sentences for non-violent offenders… so that they make a profit for “baby-sitting” these inmates.

The only “social war” that we have been dealing with longer than the war on drugs is the “war on poverty” that started in 1965 and we have spent some 15 TRILLION on.

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Bright-Light Treatment Shows Promise for Fibromyalgia

https://www.medscape.com/viewarticle/881527

BOSTON — Morning bright-light treatment may be an effective adjunctive treatment for fibromyalgia, improving function and easing pain sensitivity, perhaps by shifting sleep patterns in a way that appears to help fibromyalgia, results of a pilot study suggest.

Helen J. Burgess, PhD, director, Biological Rhythms Research Laboratory and professor, Department of Behavioral Sciences, Rush University Medical Center in Chicago, Illinois, presented the study here at SLEEP 2017: 31st Annual Meeting of the Associated Professional Sleep Societies.

Morning light treatment has been shown to reduce depression. Moreover,  improved mood can lead to diminished pain and improvement in people’s ability to cope and function with pain.

Dr Burgess and colleagues tested the effect of bright-light treatment on function and pain sensitivity in 10 women meeting American College of Rheumatology 2010 criteria for fibromyalgia.

The women slept at home, keeping their usual sleep schedule for 1 week, followed by an overnight session in the sleep lab. During the overnight session, the researchers assessed baseline function (Fibromyalgia Impact Questionnaire [FIQ]), pain sensitivity (heat threshold and tolerance), and circadian timing (dim-light melatonin onset). 

The following morning, the women were randomly assigned to 6 days of a self-administered home morning (n = 6) or evening (n = 4) light treatment, using light boxes 1 hour per day. Afterward, function, pain sensitivity, and circadian timing were reassessed.

On average, the women completed 84% of the scheduled light treatments. No side effects were reported.

Both morning and evening light treatments led to improvements in function and pain sensitivity, but only morning light treatment led to a clinically meaningful improvement in function (>14% reduction in FIQ) and heat pain threshold (P < .05).

Dr Burgess noted that the improvement was about equal to that seen after cognitive-behavioral therapy and about half of that seen after weeks of intense exercise therapy. 

The study also found that phase advances in circadian timing were associated with an increase in pain tolerance (r = 0.67; P < .05).

Dr Burgess cautioned that more study is needed before light treatment can be used to manage chronic pain. “Our study sample was very small, and the results simply suggest that we keep investigating light treatment as a possible treatment to reduce pain and improve function,” she told Medscape Medical News.

“Noteworthy” Study

Approached for comment, Shelby Harris, PsyD, director, Behavioral Sleep Medicine, Sleep-Wake Disorders Center, Montefiore Health System, New York City, said this is a “very noteworthy and novel study since, in terms of helping sleep and fibromyalgia, the researched sleep treatments in this population — that we currently have on hand — are cognitive-behavior therapy for insomnia and medication interventions.”

“This study utilized a simple, quick method (light therapy) to help patients shift sleep patterns in a way that appears to help their fibromyalgia symptoms,” Dr Harris told Medscape Medical News.

“Patients with fibromyalgia typically suffer from difficulties falling asleep and staying asleep,” she said, “and this study noted that early-morning light exposure helped to advance their sleep timing, helping them to fall asleep earlier.”

“It is very possible that earlier sleep times, with less tossing and turning in bed throughout the night, can lead to more alertness in the morning, pain tolerance, helping to decrease pain and increase overall functioning. However, this was a small study and one that needs more research behind it,” added Dr Harris.

She also noted that some patients are “not ideal candidates for light boxes due to eye problems, and it would be interesting to see whether similar results would be found using natural outdoor light. This is worth studying further because a simple technique may make a big impact on the lives of those with chronic pain problems. More research is needed in this area,” said Dr Harris.

Kevin Fleming, MD, medical director of the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in Rochester, Minnesota, also thinks the study is noteworthy.

“Although a small study (just 10 patients) and only 1 week long, it is very suggestive of being useful because it fits with at least one physiology issue known to contribute to FM [fibromyalgia] — bad sleep. Light therapy may address that portion,” he told Medscape Medical News.

“Impaired sleep is known to be common in FM and likely contributes to pain (sleep deprivation makes people have widespread discomfort like FM),” Dr Fleming explained. “Why this is so is unclear; what sleep does for our muscles and brain is uncertain. But lacking good sleep contributes to pain, so it is reasonable to focus on sleep in treating FM.”

“The sleep clock (circadian rhythm) is set at least in part by your exposure to bright light, such as sunlight. Exposure to bright light or light therapy can remedy that part of the sleep disorder,” he noted.

Dr Fleming said light therapy for fibromyalgia is worth continued study. 

“There’d be no way to do a randomized trial I can think of, but size could be increased and compared to usual FM care for 12 months,” he said.

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CALL TO ACTION!! CODE RED!!

I have received confirmation for a face to face sit down with a Congreeman in DC!
WE NEED YOUR LETTERS!
I will hand deliver them to the Congressman myself! I am still waiting confirmation from the Senators office!
Trump just made step 1 to taking our medication away! It’s our job to educate others on how vital this medication is to our ability to function. And a sit down in Washington is as good as it gets!
Write those letters! Email in your photos for our collage and those videos for our YouTube channel. LETTERS ARE THE MOST IMPORTANT!
We are on our way everyone!! Just hang tight ❤️
Remember Together We Are Strong!

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County pays $520,000 to settle excessive force, false imprisonment lawsuit

http://www.mlive.com/news/flint/index.ssf/2017/10/lawsuit_claiming_excessive_for.html

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Trump Administration Declares Opioid Crisis A Public Health Emergency

Title 42 – THE PUBLIC HEALTH AND WELFARE CHAPTER 7 – SOCIAL SECURITY SUBCHAPTER XVIII – HEALTH INSURANCE FOR AGED AND DISABLED §1395. Prohibition against any Federal interference

SEC. 1801. [42 U.S.C. 1395]  Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

The above statute is applicable (only) to care of patients 65 and over (under Medicare and/or Medicaid); and/or persons formally recognized as having “disabled” status under SSI or SSDI:

https://www.ssa.gov/OP_Home/ssact/title16b/1614.htm#act-b1614-a

As I watch President Trump’s speech on addressing the OVER-HYPED “opiate crisis”… the HYPERBOLE in the speech… surpassed all existing SUPERLATIVES in the  English language.

Trump claimed that our Federal government  is going to do some very aggressive arm bending to get the Pharmas to find/create a NON-ADDICTING OPIATE…

We have been down that path and the two drugs that was to suppose to meet that goal… Talwin & Stadol… these two drugs – been on the market for decades – either were abused and/or didn’t do much for pain management… or BOTH..

Trump claimed that we are going ELIMINATE ADDICTION…. he talked about his Brother that had abuse issue with the two drugs – ALCOHOL & NICOTINE – which we currently have an estimated 45 million addicts to the former and 35 million to the latter…  but.. I guess that ADDICTION is not going to go down that path…  and address those addictions… whose use/abuse of those two drugs cause 550,000 deaths each year. He also pointed out that part of the elimination of addiction was the use of DOJ suing anyone that is believed to be part of the problem.

Does all of these promises by Trump … violates sections of Title 42 as posted at the head of this post ?

Trump only mentioned the treatment of chronic pain… but.. stated that the FEDS were going to produce “best practices” in treating chronic pain… we have seen what the CDC considers “best practices” as to opiate dosing to treat chronic pain.

That section of Title 42 seems to suggest that a lot of things that numerous Federal agencies are doing or have done..  the chronic pain community may want to take the suggestion of our President that the legal route may be the only thing left to protect those with chronic pain being able to get adequate treatment will be down the legal path…

While it is claimed that 90% of the chronic pain community are struggling financially,  there are 100 + million in that community and a few dollars from each into a legal defense fund could go a very long way to “level the playing field”.

No law firm is going to take on this type of case on a contingency basis, because within out judicial system the “value of life” of those who are disabled/handicapped, elderly/retired, unemployed is pretty much on par with the value of the family pet… LITTLE OF NOTHING…

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Police: Man hijacks ambulance to ‘score some oxy

https://www.ems1.com/ambulance-crash/articles/347764048-Police-Man-hijacks-ambulance-to-score-some-oxy/

DANVILLE, Pa. — A man stole an ambulance with a crew inside, drove it to a pharmacy to steal pills and crashed into a pole, according to police.

WTVR reported that the Americus Hose Company Ambulance Service crews had just dropped a patient off at an emergency room when Adam Zaharick, a hospital patient, hijacked the ambulance and drove away.

They realized what was going on and jumped out of the ambulance for their own safety,” Americus Hose Company employee Bob Hare said.

Zaharick said that after he was released from the hospital, he wanted to “score some oxy,” according to police. He added that he wanted to put on a show by stealing the ambulance.

Police said Zaharick first crashed into a truck on the hospital campus, and then drove to a CVS pharmacy where he crashed into a pole.

“I don’t know what all kind of damage he’s done, but the ambulance is pretty banged up,” Hare said.

After the crash, Zaharick ran into the pharmacy and jumped over the counter to try and steal pills.

An off-duty federal corrections officer was in the store and tackled Zaharick to the ground until police arrived. He was arrested and faces charges of robbery of a motor vehicle, robbery and burglary.

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Gottlieb: Next Steps in Opioid Crisis May be ‘Uncomfortable’

http://www.raps.org/Regulatory-Focus/News/2017/10/25/28752/Gottlieb-Next-Steps-in-Opioid-Crisis-May-be-Uncomfortable/

In testimony before the House Energy & Commerce Committee on Wednesday, FDA Commissioner Scott Gottlieb said that the next steps in efforts to combat the ongoing opioid crisis will be difficult, but necessary given the spread of the epidemic.

“We’ll need to touch clinical practice in ways that may make some parties uncomfortable,” Gottlieb said, pointing to restrictions on prescribing and mandatory education for physicians as possible steps.

“Long ago we ran out of straightforward options,” he added.

Gottlieb’s remarks come as the US continues to struggle with overdoses that claimed the lives of at least 64,000 people in 2016, according to provisional data from the US Centers for Disease Control and Prevention (CDC).

Gottlieb also said the agency will be taking another look at the benefit-risk framework for opioids in light of the ongoing epidemic to inform its regulatory decisions, “including recommending that products be withdrawn from the market.”

In July, Endo Pharmaceuticals voluntarily withdrew its reformulated Opana ER (oxymorphone hydrochloride) from the market less than a month after FDA requested that the company pull the drug due to public health concerns over abuse.

Medication-Assisted Treatments

Gottlieb announced several steps FDA will take to promote the development and use of medication-assisted treatment (MAT) for opioid addiction.

The agency is also working to draft guidance to promote the development and use of non-abstinence-based endpoints for addiction treatments and support the development of drugs that address symptoms of addiction, such as cravings.

And Gottlieb said that FDA will do more to promote the use of existing addiction treatments such as naltrexone, buprenorphine and methadone.

“One concept that FDA is actively pursuing is the research necessary to support a label indication for medication-assisted treatment for everyone who presents with an overdose, based on data showing a reduction in death at the broader population-level,” he said, adding that the agency is also considering updating the labeling for such drugs to reflect that they may need to be taken for long periods of time.

Lastly, Gottlieb said that FDA will take steps to address the stigma associated with MATs.

“The stigma reflects a view some have that a patient is still suffering from addiction even when they’re in full recovery, just because they require medication to treat their illness,” Gottlieb said.

Access and Affordability

During his testimony, Gottlieb said that inadequate insurance coverage is part of the reason some people with opioid addictions do not receive necessary treatment.

Gottlieb also raised the point that currently the vast majority of opioids dispensed in the US are inexpensive, immediate release formulations. Going forward, Gottlieb said that insurance coverage and reimbursement could be an issue for new abuse-deterrent or non-addictive pain treatments.

“It will be the case that some of those newer drugs will be more expensive than the older formulations, and I think we need to think about how we provide incentives for those to be used—perhaps preferentially—if we think the public health outcome is going to be better,” he said.

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Pharmacist acquitted of murder in 2012 meningitis outbreak

http://www.foxnews.com/health/2017/10/25/pharmacist-acquitted-murder-in-2012-meningitis-outbreak.html

A pharmacist at a facility whose tainted drugs sparked a nationwide meningitis outbreak that killed 76 people was cleared Wednesday of murder but was convicted of mail fraud and racketeering.

Jurors said prosecutors failed to prove Glenn Chin was responsible for the deaths of people who were injected with mold-contaminated drugs produced by the now-closed New England Compounding Center in Framingham, just west of Boston. As the supervisory pharmacist, Chin oversaw the so-called clean rooms where the drugs were made.

Chin’s attorney said he saw the verdict as a victory. He said prosecutors overreached by charging Chin with second-degree murder acts under federal racketeering law.

“This was never, ever, ever — no matter what these prosecutors tell you — this was never a murder case,” Chin’s attorney Stephen Weymouth said after the verdict was read at Boston’s federal courthouse.

“It was his hand, no doubt, that mixed that medicine that killed mom,” the North Carolina man said.

Prosecutors said Chin instructed his staff to use expired ingredients, failed to properly sterilize the drugs and ignored findings of mold and other bacteria in the rooms.

Chin’s attorneys argued he can’t be blamed for the deaths because there’s no evidence he caused the drugs to become contaminated. The attorneys blamed the pharmacy’s co-founder Barry Cadden, who they said treated employees poorly and ordered them to cut corners to increase production and profits.

Jurors acquitted Cadden of second-degree murder under the federal racketeering law but found him guilty of fraud and conspiracy. Cadden tearfully apologized to the victims in June before he was sentenced to nine years in prison.

Chin was charged with the deaths of 25 people in Florida, Indiana, Maryland, Michigan, North Carolina, Tennessee and Virginia. He would have faced up to life in prison had he been convicted of the murders. He is set to be sentenced in January.

Experts and even Chin’s attorney had said before the trial that they believed prosecutors had a stronger case against Chin than they had against Cadden because Chin was the one mixing the drugs in the clean rooms.

The outbreak of fungal meningitis and other infections was blamed on contaminated injections of medical steroids, given mostly to people with back pain.

More than 700 people in 20 states were sickened in what’s considered the worst public health crisis in recent U.S. history. The federal Centers for Disease Control and Prevention put the death toll at 64 in 2013. Federal officials identified additional victims in their investigation, raising the number of deaths to 76.

“Mr. Chin ran NECC’s clean room operations with depraved disregard for human lives,” Acting U.S. Attorney William Weinreb said in a news release Wednesday. “As a licensed pharmacist, Chin took an oath to protect patients, but instead deliberately violated safety regulations.”

FBI special agent in charge Harold Shaw said Chin “gambled with patients’ lives” by cutting corners and ignoring the warning signs that his production methods were unsafe.

“Hundreds of patients were unnecessarily harmed from his reckless disregard for health and safety regulations,” Shaw said.

The outbreak sparked calls for increased regulation of compounding pharmacies, which differ from ordinary drugstores in that they custom-mix medications and supply them directly to hospitals and doctors. Congress in 2013 passed a bill giving federal officials more oversight of the pharmacies.

Pharmacist Chin was the Pharmacist in Charge and/or Responsible Pharmacist… that means that he was legally responsible to the board of pharmacy for the legal operation of the pharmacy.

This shows the difference between how the legal system deals with a healthcare professional is “involved” in the death of a pt and how the DEA deals with a prescriber that has one or more pts that OD.

NECC and Pharmacist Chin was responsible for 76 DEATHS… where as a prescriber can only be accused of having a handful of pts OD.. and the prescriber’s practice is raided, shut down and typically the DEA confiscates all the assets of the prescriber and the prescriber is charged with the pt’s death and normally jailed.

Seems like not just a DOUBLE STANDARD but a very wide gap between the two standards ?

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The opioid crackdown is making life untenable for chronic pain patients like me

http://www.latimes.com/opinion/op-ed/la-oe-sanders-opioid-crisis-national-emergency-20171025-story.html

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