Up to 40% of post-operative pts .. 7 days opiate Rx – NOT ENOUGH !!!

Posted on October 1, 2017 by Pharmaciststeve

Defining Optimal Opioid Pain Medication Prescription Length Following Surgery

https://www.news-line.com/PH_news28370_enews

A new study led by researchers at the Center for Surgery and Public Health at Brigham and Women’s Hospital analyzed opioid prescription data from the Department of Defense Military Health System Data Repository, identifying more than 200,000 opioid-naïve individuals who had undergone one of eight common surgical procedures between 2006 and 2014 and were subsequently prescribed opioid pain medication. Their findings appear in JAMA Surgery.

Every day, more than 90 Americans die after overdosing on opioids, according to the National Institute on Drug Abuse. Misuse of and addiction to opioids has become a public health crisis with more than 2 million Americans suffering from substance abuse issues related to prescription opioid pain medication. While over-prescription of pain medications has been implicated as a driver of this growing opioid epidemic, few guidelines exist on how to appropriately prescribe opioid pain medication following surgery with the goal of balancing pain with risk of addiction. There have been several recent governmental efforts to address the rise in opioid pain medication prescriptions, which quadrupled between 1999 and 2012. In Mass. and New York, legislation has limited initial prescription lengths to less than seven days and driven the development of drug monitoring programs.

To determine optimal opioid pain medical prescribing practices, particularly in the setting of postoperative, outpatient pain management, researchers from the CSPH at BWH investigated opioid pain medical prescription patterns following common surgical procedures. The team sought to identify the appropriateness of the prescription as indicated by the rate of prescription refills and to develop recommendations.

Using a nationally representative sample of people who were opiate naïve undergoing common procedures, researchers found that median prescription length for the first-time prescriptions was four to seven days, and that the number of people who required a refill of their opiate prescription varied from 11.3% to 39.3% depending on the type of procedure performed. The duration of the prescription also varied depending on the category of procedure, from nine days for general surgery procedures to 15 days for musculoskeletal procedures.

“While seven days may be more than adequate for many patients undergoing common general surgery and gynecological procedures, prescription length limits may need to be extended to 10 days, recognizing that as many as 40% of patients may still require a refill at a seven-day limit for pain management, particularly following many orthopedic and neurosurgical procedures,” said first author Rebecca Scully, MD, MPH, a resident in the Department of Surgery at BWH who works in the CSPH.

Researchers used data from the Military Health System Data Repository, which tracks care delivered to active, disabled and retired members of the US armed forces and their dependents. Researchers identified 215,140 individuals aged 18-64 who had undergone one of eight common surgical procedures (cholecystectomy, appendectomy, inguinal hernia repair, ACL reconstruction, rotator cuff tear repair, discectomy, mastectomy and hysterectomy) between 2006 and 2014 and had filled at least one opioid pain medication prescription in the 14 days following the procedure. The study excluded individuals with a prior diagnosis of chronic pain, substance dependence or an opioid prescription within six months preceding the index procedure. General surgery procedures were performed on 122,435 individuals, while 47,998 underwent musculoskeletal procedures, and 44,707 received a mastectomy or hysterectomy.

Using a mathematical model, researchers determined that the optimal length of opiate prescription was four to nine days for general surgery procedures, four to 13 days for women’s health procedures, and six to 15 days for musculoskeletal procedures.

“We recognize that the opiate crisis is being addressed on many social, legislative, and policy levels,” said senior author Louis Nguyen, MD, MBA, MPH. “We hope our paper provides a quantitative analysis of current prescribing patterns and sheds light on the optimal prescription in patients undergoing surgical procedures.”

Filed under: General Problems | 1 Comment »

CVS’s Transparent Opioid PR Stunt

Posted on September 28, 2017 by Pharmaciststeve

CVS’s Transparent Opioid PR Stunt

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

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

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

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

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

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

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

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

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

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

Arthur Kennish, M.D. September 26, 2017

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

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

Thomas Kline, M.D. September 27, 2017

(See below for quotes from the American Council physicians’ take on this matter)

So, what is CVS doing that has pain patents angry and terrified? Let’s examine the three worst ideas.

  1. Limiting to seven days the supply of opioids dispensed for certain acute prescriptions.
  • Let’s say that an orthopedic surgeon knows that an operation will cause a patient two weeks of bad pain. At which point they can switch to something like Advil. Yet, a bunch of executives decided that the store will only give a new patient a one-week supply. Do they know better than the surgeon what is best for his patient? 

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

  • This one is even worse. At least in the first case, despite wasting the doctor’s time by making him write another script, and having to make two trips instead of one, at least the patient will get what is needed. But having a pharmacist dictating a maximum daily dose is really crossing the line. It is none of their damn business. Scientifically, it’s even worse. All people react differently to opioids. For example, some are 15-times better at metabolizing the drug than others. So an arbitrary maximum dose may work well for one person but be inadequate for another. Do you guys even know this?

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

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

 

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

But the CVS policy raises larger and more far-reaching concerns. Who is in charge of our own health? Why are laws being made that tell us how much medicine we can take? And, since when do pharmacists overrule physician decisions?

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

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

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

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

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

Notes:

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

(2) Comments from the American Council’s physicians:

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

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

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

It would seem that CVS is trying to “ride the wave” of public sentiment…  Abt one + year ago CVS eliminated all the sales of tobacco products… given that this is a LOW GROSS PROFIT MARGIN product and at risk of high pilferage … and was not a customer self-service item… so it is questionable if this category of product even produced a NET PROFIT, so… was this move toward a “more healthy image” for CVS or them “dumping” a unprofitable category and put a spin on it as being giving CVS a more of a “healthcare provider” image and not the convenient/variety store with a prescription dept in the back…that is reality.

CVS’ front end sales have been sliding for several years…  http://marketrealist.com/2015/08/can-cvs-front-store-business-overcome-key-headwinds/

They are adding more “healthy snack product” to their inventory… placing them in the high visibility space that was previously occupied by what is now deemed “unhealthy snack foods” and moved those “unhealthy products” to less visible shelf space.

Even though use/abuse of tobacco products directly/indirectly contributes to abt 450,000/yr death, Many CVS stores continue to sell Alcohol products who use/abuse contributes to some 100,000/yr deaths…

Over the last decade, CVS has been fined tens to hundreds of millions of dollars by the DEA for what the DEA determined as “contributing to opiate diversion and addiction”.  Two of their stores in Sanford, FL were “ground zero” when the pill mill problem in FL erupted earlier in this decade.

Now CVS and its PBM subsidiary (Caremark/Silver Scripts) are jumping on the current  and revised “war on drugs” bandwagon ?  Will this denial of care to those with chronic pain and other subjective diseases just an attempt by CVS to get them in DEA’s “good graces” … since they are now a full fledged “partner” in fighting the war on drugs.

Which could means fewer fines for CVS and larger bottom line profits for CVS… if many pts end up suffering from untreated pain and/or ends up committing suicide because of the denial of care that they experience at the hands of CVS Health… just COLLATERAL DAMAGE so that CVS can make more profits ?

 

Filed under: General Problems | 4 Comments »

The War on Drugs is based on FAKE SCIENCE, warns lab science director who says labs routinely engage in “science crimes” against innocents

Posted on September 27, 2017 by Pharmaciststeve

https://youtu.be/RqJ7kLGjU9s

The War on Drugs is based on FAKE SCIENCE, warns lab science director who says labs routinely engage in “science crimes” against innocents

http://www.naturalnews.com/2017-04-20-the-war-on-drugs-is-based-on-fake-science-warns-lab-science-director.html

(Natural News) The “War on Drugs” is a grand science hoax based on faked laboratory analyses conducted by lab science con artists working for government.

That’s not hyperbole, by the way: It’s a matter-of-fact description of exactly how the drug war is being waged in America, thanks to lab science criminals like Annie Dookhan, who pleaded guilty to systematically faking lab science that convicted over 24,000 people on charges of drug possession. (See the video below.)

Now, over 20,000 of those convictions are about to be thrown out because Dookhan deliberately faked the science.

“About 21,000 drug convictions are set to be thrown out in Massachusetts after a chemist admitted tampering with evidence and falsifying results,” reports Sky News. “It could be the single largest dismissal of criminal convictions in US history.”

Knowingly falsified drug test results to convict innocent people in the interests of government prosecutors

Natural News covered all this five years ago when it was first learned that Dookhan falsified lab science evidence in as many as 34,000 cases. As this Natural News story documented:

Dookhan has admitted she improperly removed evidence from storage, forged the signatures of colleagues and did not conduct proper tests on drugs for “two or three years,” according to a copy of a State Police report obtained by the Boston Globe newspaper recently.

It took five years for the courts to finally order prosecutors to drop the 24,000+ drug convictions, all while innocent people were left to rot behind bars while the “justice system” kept them all imprisoned under false pretenses. As Natural News reported earlier this year:

Recently, the state’s highest court ordered prosecutors to drop a significant portion of the more than 24,000 drug convictions to resolve a scandal – where thousands of people were wrongfully convicted on drug charges in Massachusetts – that has plagued the legal system since 2012.

Annie Dookhan is just one of thousands of lab scientists across America who are faking drug tests every day to falsely convict innocent people

As the lab science director of an internationally accredited laboratory — CWC Labs — I can authoritatively tell you two astonishing things that have become clear to me over the last three years of interacting with the lab science community:

#1) Nearly all the field drug test kits produce false positives for a wide range of substances, from over-the-counter medicines to chocolate bars. A narcotics detective can easily produce a “hit” for almost any suspected substance by coaxing a “positive” from the drug test kits. These kits are scientifically worthless and meaningless, yet the courts continue to treat them as some sort of gold standard proof of evidence of possession. Many of these kits are read by a totally subjective opinion of the color of the resulting liquid, for example. “Color” is completely subjective, and it varies wildly based on ambient light conditions, the mood of the law enforcement officer, and the color pigmentation of the original sample. The human eye gauging a color is not science… it’s total hokum.

#2) Most science labs have no real interest in analytical accuracy. I know this because people in the industry keeps telling me I’m totally obsessed with extreme accuracy, and I’m finding that this dedication is apparently unique to my own lab. To my astonishment, I’ve come to learn that typical drug labs have huge “error budgets” for analytical accuracy, and many of those labs have no idea what their real error rates might be through the entire process of sample prep, analyte extraction, instrument analysis and reporting.

Some labs don’t even know the real LoD or LoQ (Limit of Detection / Quantitation) of the substances they’re looking for (analytes) in the instruments they’re using for testing, and even worse, many labs operate with unclean analytical practices that can result in significant “carryover” which can contaminate one sample with the residues of the previous sample. In other words, there are without question people sitting in prison right now whose only crime was being the next sample in the sequence after a high-concentration sample was run before theirs.

Right now, I could walk into almost any crime lab in America and find huge faults, errors and even fraud in their analytical methods, lack of proper sample handling, lack of technician training, bad statistics, bad reference curves, bad instrument calibration and so on. I’m convinced that nearly every government-promoted crime lab in America is engaged in its own “science crimes” that are designed to deliberately produce false positives in order to continue the tyrannical, idiotic “war on drugs” and keep themselves in business, collecting government money for producing totally junk science.

Annie Dookhan is just the tip of the iceberg on all this. Watch my mini-documentary below to learn the shocking truth about fake lab science pushed by governments all across America. Share this video everywhere… there are innocent people behind bars right now who were convicted by all this fake science.

Filed under: General Problems | 1 Comment »

Governor Jerry Brown Ties To CVS Pharmacy Under Grand Jury Investigation

Posted on September 26, 2017 by Pharmaciststeve

Governor Jerry Brown is accused of giving CVS Pharmacies access to top secret confidential Government files used to open thousands of Minute Clinics and run unsuspecting doctors out of business by telling patients their doctors are criminals. BAD NEWS MEDIA DISCLAIMER: The content of this video does not reflect the opinion of Bad News Channel. The video provided is the property of a 3rd party and all rights are reserved. Please Support: www.americanpaininstitute.com and Please Donate to Our March on Washington DC: https://www.gofundme.com/sickle-cell-… Please Sing Petition For Police Review Committee of Medical Boards at Change.org: https://www.change.org/p/medical-boar… 2018 PAIN PATIENTS ADVOCACY WEEK April 23 to 30 Click Here: http://www.painpatientscoalition.com/… Video Testimony is the property of 3rd party source. Please contact Mr. Billy Z. Earley directly at bze123.fccf@gmail.com if you have any questions. Billy Z. Earley Physician Assistant, Healthcare Medical Advocate, World Sickle Cell Federation Advocate, National Advisory Board Black Doctors Matter, National Advisory Board American Pain Institute, Coalition for the Humane Treatment of Sickle Cell.

Filed under: General Problems | Leave a Comment »

Fla. Gov. Announces Proposed 3-Day Limit on Opioid Prescriptions

Posted on September 26, 2017 by Pharmaciststeve

Fla. Gov. Announces Proposed 3-Day Limit on Opioid Prescriptions

https://www.usnews.com/news/national-news/articles/2017-09-26/fl-gov-announces-3-day-limit-on-opioid-prescriptions

Florida Gov. Rick Scott announced a new proposal for a three-day limit on prescribed opioids in his state. Scott said Tuesday he will propose the legislation and more than $50 million to next year’s budget to combat opioid abuse, WPTV reported.

The legislation would require all health care providers who prescribe or distribute medication to participate in the Florida Prescription Drug Monitoring Program, a statewide database that monitors prescriptions for controlled substances. The legislation includes reforms to combat unlicensed pain management clinics and require continuing education courses on responsibly prescribing opioids, and would also create new opportunities for federal grant funding, according to a statement from the governor’s office.

A highlight of the legislation is a three-day limit on prescribed opioids, unless strict conditions are met that would require a seven-day supply.

The proposed $50 million budget would include funding for substance abuse treatment, counseling and recovery services, and The Florida Violent Crime and Drug Control Council.

“These proposals will make a major impact on limiting the chance of drug addiction, reducing the ability for dangerous drugs to spread in our communities, giving vulnerable Floridians the support they need, and ensuring our hard working law enforcement officers have the resources to protect Floridians,” Scott said in a statement.

 

Scott declared the opioid epidemic in the state of Florida a public health emergency in May and the Centers for Disease Control and Prevention reports deaths from prescription opioids and heroin have more than quadrupled since 1999.

Senate President Joe Negron and House Speaker Richard Corcoran are both supportive of the legislative. In a statement from the governor’s office, both said they are committed to working to combat opioid abuse and are “dedicated to protecting our families and communities from the national opioid epidemic.”

Scott is “tapped out” as governor… 2018 is his EIGHTH YEAR and can’t run again… so is he not running for any other federal offices or is he setting the stage for his AG Pam Bondi to be able to run on the continuing platform of continuing Gov Scott’s being a hard ass on substance abuse… except the two drugs alcohol and Nicotine 🙁

 

Filed under: General Problems | 6 Comments »

CVS Health moves to limit access to opioid painkillers

Posted on September 26, 2017 by Pharmaciststeve

CVS Health moves to limit access to opioid painkillers

http://www.foxbusiness.com/markets/2017/09/21/cvs-health-moves-to-limit-access-to-opioid-painkillers.html

I am not going to copy/paste this entire post… from Fox Business article… if you do web search of “CVS limits opiates” you will get DOZENS OF PAGES from various sources

“One of the largest managers of pharmaceutical benefits in the U.S. says it will start limiting the duration and dose of some prescriptions for opioid painkillers, in an effort to combat widespread addiction.”

There is little hard evidence that the legal prescribing of opiates to pts with a valid medical necessity causes addictions, but is the FOR PROFIT CVS Health taking advantage of the fabricated opiate crisis to help pad their bottom line at the expense of the quality of life of a lot of opiate dependent chronic pain pts ?

IMO, there is a lot of “practicing medicine without a license” going on.

CVS would limit opioid prescriptions to seven days or less for certain patients with acute pain who haven’t previously taken an opioid painkiller.

CVS will also limit patients with chronic pain to a maximum daily dose of 90 morphine milligram equivalents, or MMEs, a standard unit of measure in pain medicine, Dr. Brennan said.

Starting in February 2018, if CVS-covered patients arrive at the pharmacy with a prescription above the new limits, the pharmacy will kick it back to the doctor for review, Dr. Brennan said.

So CVS is providing a “second opinion” to all prescribers .. whether they ask for it or not ?… except …. There will be ways around the rules — doctors will be able to appeal the limits, 

But the “way around the rules” .. is normally referred to as a PRIOR AUTHORIZATION… which involves TIME… and as we all know TIME IS MONEY…  and CVS and others involved in paying for prescriptions … knows that prescribers are already pushed for time and often it is easier for the prescriber to AGREE than fight the denial.  In other words… is it easier for CVS to increase profits than for the prescriber to make sure that their pts get their necessary medication(s).

Since many prescribers have a time management incentive to JUST AGREE.. it will fall back on to the pt to “take the bull by the horns”  If you are on Medicare/Medicare Advantage” here is the 2018 Medicare and You 2018 booklet

https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf   page 103 – Section 9 Know your Rights and Protect Yourself from Fraud.  This provides the pt’s rights under Medicare and how to appeal.

I would suggest that all pts make a photo copy of their prescription before handing it over to a Pharmacist. I also suggest that all pts audio/video record all interactions with Rx dept staff.  Pharmacists like all other healthcare professionals are pressed for time and contacting a prescriber to get the authorization to dispensed a reduced amount… may be used to get the pt to agree to the reduced amount of opiates are wait a unknown period of time for the prescriber to return the Pharmacist’s call.

Legally a Pharmacy can provide a partial amount and furnish the balance of a C-II within 72 hrs.  Don’t agree to a reduced amount of doses… agree to a partial fill with the understanding that the Pharmacists will contact the prescriber and if the prescriber refuses the reduced amount… the Pharmacist can’t state that the pt agreed to a reduced amount – because the pt has been doing a audio/video recording to prove what was said and what was done or what was not said and not done.

The FEDS have increased that 72 hr period to 30 days, but not all states have changed their state laws to align with the Federal law, so the state law’s 72 hr period still prevails

What the pt should be trying to document is that their prescriptions was dispensed with fewer doses than was prescribed and the prescriber did not authorize the reduction… Meaning that someone authorized the reduction without legal authority.

It is illegal for a licensed prescriber to prescribe (start, change, stop medication) without first doing a in person physical exam and it is also illegal for a prescriber to “practice medicine” in a state in which they are not licensed.

If the pt can document that they were provider fewer doses than their prescriber authorized, it will be up to the pt to start filing complaints and grievance with various federal/state agencies.

If the pt believes that the pharmacist or some person working for CVS, another PBM or insurance company has caused the number of doses to be reduced and it was not authorized by the pt’s prescriber…  here are web sites to go to …to file complaints about practicing medicine without a license

Defintion: 

prescriptive authority

(prē-skrĭp-tĭv)

The limited authority to prescribe certain medications according to established protocol. In the U.S., prescriptive authority has been granted to advanced practice nurses, optometrists, osteopaths, physicians, podiatrists, and veterinarians among other health care professionals.

http://physicianjobs.us/Medical%20Boards.htm

https://nabp.pharmacy/boards-of-pharmacy/

If the pt believes that they have been discriminated against and/or denied proper therapy:

https://www.ada.gov/filing_complaint.htm

https://www.justice.gov/crt/how-file-complaint

https://www.medicare.gov/claims-and-appeals/file-a-complaint/complaint.html   800-Medicare

without proper documentation – copy of the prescriptions, audio/video recording of what was said and prescriber verifying that they did not authorize a change in the quantity and the pt did not agree to a change (partial fill) of the prescription(s) – it will be the pt’s word against everyone else… and the pt will most likely be labeled as a lair and drug seeker or addict.

If only a few pts follow thru and file complaints/grievances… those agencies will just label those filing complaints as unhappy substance abusers/addicts and their complaints will be dismissed or discarded.

 

 

 

 

 

 

 

 

 

 

Filed under: General Problems | 4 Comments »

Take a STAND … or let them CUT YOU OFF AT THE KNEES ?

Posted on September 26, 2017 by Pharmaciststeve

ATTENTION ALL OREGON PAIN PATIENTS this Attorney needs to hear from YOU!!!! This ATTORNEY is interested in getting a court case started for chronic pain patients suffering & deprived of their care but she must hear from you. I HOPE & PRAY so many pain patients from Oregon call so they will have  case open to every pain patient   PLEASE PLEASE CALL !!!!!!! KAY TEAGUE ATTORNEY AT LAW SOKOL & FOSTER P.C. STROWBRIDGE BUILDING 735 S.W. FIRST AVENUE PORTLAND, OREGON 97204 (503) 228-6469 FAX # (503) 228-6551 E-MAIL KAY@SOKOLFOSTER.COM

Filed under: General Problems | 9 Comments »

CDC Launches New Campaign Against Rx Opioids

Posted on September 25, 2017 by Pharmaciststeve

CDC Launches New Campaign Against Rx Opioids

www.painnewsnetwork.org/stories/2017/9/25/cdc-launches-new-campaign-against-rx-opioids

The Centers for Disease Control and Prevention has launched a new marketing campaign to combat the abuse of prescription opioids – a campaign that completely ignores the increasing role of heroin and illicit fentanyl in the nation’s overdose crisis.

The Rx Awareness campaign will use videos, online advertising, billboards, newspapers and radio ads to increase awareness “about the risks of prescription opioids and stop inappropriate use.” The campaign will initially run for 14 weeks in Ohio, Kentucky, Massachusetts, and New Mexico, with a broader release expected as additional states receive funding through CDC programs. No estimate of the cost of the campaign was released.

“The U.S. Department of Health and Human Services (HHS) is committed to using evidence-based methods to communicate targeted messages about the opioid crisis and prevent addiction and misuse in every way we can,” HHS Secretary Tom Price, MD, said in a statement. 

The Rx Awareness campaign features “real-life accounts” of people recovering from opioid addiction or who have lost loved ones to a prescription opioid overdose.

“Prescription opioids can be addictive and dangerous,” a woman says in an online banner ad.

“One prescription can be all it takes to lose everything,” a man says in another ad.

Although addictive behavior typically starts during adolescence, the Rx Awareness campaign is targeting adults aged 25-54 who have used prescription opioids at least once either medically or recreationally.

Teresa-dangerous-CDC_Facebook_13.jpg

“We learned that adults between the ages of 45 and 54 had not yet been targeted by a broad-reaching campaign. This information was reinforced by surveillance data indicating that the population with the highest fatality rate from opioid overdoses was non-Hispanic white adults ages 45–54,” the CDC said in an unusually detailed explanation of the rationale behind the campaign.

“We also found a need for communication efforts to deliver primary prevention messages to younger audiences ages 25–35, who are less likely to experience chronic pain but may be exposed to opioids for other reasons, such as having a sports injury or undergoing a dental procedure.”

The four states initially being targeted all have soaring rates of opioid overdoses, but in recent years most of the deaths have been linked to heroin and illicit fentanyl, not prescription opioids. 

The latest report from the Massachusetts Department of Public Health, for example, shows prescription opioids were involved in only 15 percent of opioid-related overdose deaths in the first quarter of 2017. Fentanyl was involved in 81 percent of the Massachusetts deaths and heroin in 39 percent of them. 

The CDC said heroin is not mentioned in the Rx Awareness campaign because it doesn’t want to “dilute” its primary message.

“The campaign does not include messages about heroin. Specificity is a best practice in communication, and the Rx Awareness campaign messaging focuses on the critical issue of prescription opioids. Given the broad target audience, focusing on prescription opioids avoids diluting the campaign messaging. Heroin is a related topic that also needs formative research and message testing,” the CDC said.

One of the video testimonials featured in the campaign is the story of Steve Rummler, a Minnesota man with chronic back pain who became addicted to painkillers. Rummler died of a heroin overdose at the age of 43.

His mother Judy, who appears in the video, founded the non-profit Steve Rummler Hope Foundation, an anti-opioid activist group. The Rummler foundation is the “fiscal sponsor” of Physicians for Responsible Opioid Prescribing (PROP), a designation that allows PROP to collect tax deductible donations using the foundation’s non-profit status. PROP founder Andrew Kolodny, MD, is listed as a member of the Rummler foundation’s medical advisory committee, as is PROP President Jane Ballantyne, MD.

The CDC said it developed the videos and other campaign material using a “mixed-method design integrating data from in-depth interviews and a quasi-experimental, one-group retrospective post-then-pretest (RPTP) survey was used to assess target audiences’ responses to campaign messages.”

In the other words, they did a pilot study. The CDC said most participants thought the campaign material was “attention grabbing, believable and meaningful.” Many also said they would share the video testimonials with others.   

“This campaign is part of CDC’s continued support for states on the frontlines of the opioid overdose epidemic,” said CDC Director Brenda Fitzgerald, MD. “These heartbreaking stories of the devastation brought on by opioid abuse have the potential to open eyes – and save lives.”

Filed under: General Problems | 4 Comments »

Healthcare professional DENIED CARE… PT DIED … charged with MANSLAUGHTER …

Posted on September 25, 2017 by Pharmaciststeve

The nurse accused of withholding a diabetic inmate’s insulin is being sued over his death

http://www.sunherald.com/news/local/crime/article175282196.html

A George County inmate’s estate is suing the county, the city of Lucedale and registered nurse Carmon Sue Brannan because he died in the county jail after seven days without the insulin that had been delivered for him.

The lawsuit filed in U.S. District Court accuses the county and city of “deliberate indifference” to the medical needs of William Joel Dixon, who lay overnight on a jail cell floor before Brannan realized mid-morning on Sept. 24, 2014, that he was dead, according to a sworn statement filed in the case.

Brannan is scheduled for trial Oct. 16 in George County on a manslaughter charge.

The jail had insulin on hand for Dixon, including one batch delivered by his mother and another fetched by a jailer from the glove compartment of Dixon’s car, records in the case show.

The car was towed after a Lucedale police officer arrested Dixon on drug possession, driving under the influence and child endangerment charges.

 Brannan called Dixon’s mother after he was arrested and talked to her about his diabetes and need for insulin, the lawsuit says. Brannan checked his blood sugar only once during his seven days in jail, the lawsuit says.

Witnesses from the jail have told investigators that Brannan claimed Dixon was “faking” his medical condition.

An autopsy determined Dixon died from diabetes.

The lawsuit seeks unspecified damages to compensate Dixon’s heirs for his death and punitive damages from Brannan.

Dixon was deprived of his constitutional rights to due process because he was denied medical treatment, the lawsuit says, despite exhibiting symptoms of illness for days. Before he lost consciousness, the lawsuit says, Dixon was unable to eat and was vomiting.

The lawsuit, which represents only the Dixon estate’s side of the case, claims George County has a policy or custom of prohibiting jail staff from summoning emergency medical assistance from outside the jail.

Anita Lee: 228-896-2331, @calee99

 
 

Filed under: General Problems | 2 Comments »

Pain never KILLED ANYONE… can just cause the pt to COMMIT SUICIDE ?

Posted on September 24, 2017 by Pharmaciststeve

Filed under: General Problems | 7 Comments »

« Previous Page — Next Page »