Robert D. Rose Jr.‎ to Vets Fight Back

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I recently saw your website and read your views on how to file a complaint. However, Im in Louisiana and have a friend that was denied a narcotic medication refill because it was after 2 days since it was prescribed from the emergency room. She  was still in pain and wasn’t able to get it filled because she had not received her paycheck. She also did not have insurance to pay for it. What are we supposed to do or can we do about this?

This was an interaction at the local large chain pharmacy – one that has their “good faith filling policy”

Part of that policy is that the pharmacist is not suppose to fill controlled prescriptions for pts wishing to pay CASH..

It is reported that some 30 million Americans DO HAVE HEALTH INSURANCE… so it would appear that those 30 million pts  ( close to 10% of the USA population ) need not come to this chain pharmacy if they need a controlled prescription filled…

Once again my recommendation to pts in need of getting controlled prescriptions filled is DUMP THE CHAINS !!!

Here is a link to help you find a independent pharmacy by zip code http://www.ncpanet.org/home/find-your-local-pharmacy 

The chain store pharmacist gets paid every week … regardless if they fill your prescription(s) or not… at a independent pharmacy you will – most likely – be dealing with the Pharmacist/owner who only gets paid if they fill legit/on time/medically necessary prescriptions.. They typically understand that the world is not perfect and some people can’t afford insurance and or that don’t have the money to get prescriptions filled when they need them.

The money you spend in a locally owned independent pharmacy STAYS IN YOUR COMMUNITY.. profits aren’t sent off to some corporate HQ in another state or another country.. It is one way to BUY USA !

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Well I’ve been going to the same PM Dr for the past 8 years.

Always had a good relationship.

I’ve used only the same pharmacy for well over 15 years.

Always took my meds as prescribed.

2 oxycodone 5/325 per day.

Never had them lost or stolen.

No matter how unbearable at times, I’ve never called in between appts.

Just one of the most honest/compliant patients she’s had IMO.

Anyway the bottom line is she alleged me to be negative on my urine 3 times so she cut me off last month.

She said I’m still a patient for now and can go back for injections if I wish.

I have access to my records via the Patient Portal and for every accused negative it shows positive and I know I was positive because I certainly took them.

I’m assuming this positive is from the cup.

They then send the urine to a lab.

Because the lab shows negative, I guess that’s all that matters to her.

I could see if I was negative on the cup AND the lab I wouldn’t have much of an argument, even though I took them as prescribed. But I’m positive and negative which makes no sense to me.

At my last appt, I called her out on this and told her to “stop trying to convince me that I was negative, it’s like me trying to tell you that you didn’t wear shoes to work this morning, sounds silly doesn’t it?”

She said she believes me but can no longer prescribe because of the lab results.

She printed out the lab results and gave me copies.

As you’ll see, it was collected the day of my appt. 

The lab receives it 3 days later and possibly didn’t test it for yet another week.

I do believe I have a fast metabolism because I’m 56 and weigh the same as I did in high school. I’ve never been able to gain weight.

So my questions are:

1) did the time it took for the lab to process the urine have any effect on the outcome?

2) do you feel she should have based her decision on the fact that the cup was positive for every one?

I will leave it as this for now although as you can imagine I have a ton of questions.

I feel completely blindsided and this couldn’t have happened at a worse time as on top of my chronic pain I’m also in a bad flare of diverticulitis and scheduled for a colectomy on July 10.

Thank you very much for your input and time!

It seems strange to me that a physician would send out a urine sample to a outside lab when the office’s testing shows the medication that the pt is prescribed shows up in the test…

I am not very knowledgeable on urine testing procedures, but common sense would suggest that tests on a sample that is not stored properly or mishandled.. could allow the medication being tested for to deteriorate until it was at such a level that it could not be detected.

I found this website that discusses mishandling and other issues effecting false urine test outcomes http://www.brighthub.com/science/medical/articles/71492.aspx

I also find it strange that the physician is willing to continue treating the pt with ESI’s… it is common knowledge that ESI’s are MUCH MORE PROFITABLE for a practice than getting a office visit charge for writing a prescription.

For a pt to have their pain managed on such a low dose of Oxycodone  – a total of 10 mg/day – seems so benign. Could this physician have figured out how to improperly store or mishandle urine samples being sent to outside labs so that the sample will deteriorate to a point that it will test negative for the medication that the pt is on .. so that there is “proof” of a negative test ?

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White House says diabetics don’t deserve health insurance

http://shareblue.com/white-house-says-diabetics-dont-deserve-health-insurance/

Donald Trump’s budget chief again revealed the Republicans’ callous approach to health care, arguing that some diabetics simply do not deserve health insurance, because of how they may have developed the illness.

Donald Trump’s budget director specifically called out people suffering from diabetes as a group of Americans who do not deserve the protection of health insurance.

Mick Mulvaney, director of the Office of Management and Budget (OMB), weighed in on the issue at the Light Forum at Stanford University. He was asked if families should be denied medical care because they can’t afford it, a standard Sen. Bill Cassidy (R-LA) had termed “the Jimmy Kimmel test,” after the late night comedian’s recent emotional call for improved health care.

Mulvaney said he believed in helping to provide “a safety net so that if you get cancer you don’t end up broke,” but separated those situations from others he termed “ordinary healthcare,” what he described as the heart of the debate.

He continued, “That doesn’t mean we should take care of the person who sits at home, eats poorly and gets diabetes. Is that the same thing as Jimmy Kimmel’s kid? I don’t think that it is.”

As of 2014, 29.1 million Americans suffer from diabetes, which is about 9.3 percent of the population.

Under Mulvaney’s standard, an examination of their eating habits and how their disease was triggered would have to be undertaken before it could be determined whether they are deserving of health insurance or not. In the meantime, people will suffer and possibly die from their illness.

The Affordable Care Act mandates coverage for people with pre-existing conditions like diabetes, without casting about for blame or applying some kind of litmus test to discern if they are deserving of treatment.

The system championed by Trump, House Speaker Paul Ryan, and the Republican Party would upend that safety net and contribute to ill health and death, in order to justify their sanctimonious attitude.

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Chronic pain sufferers applaud changes to opioid limits law

http://www.wcsh6.com/news/local/chronic-pain-sufferers-applaud-changes-to-opioid-limits-law/450683168

AUGUSTA, Maine (NEWS CENTER) — People taking opioid painkillers for chronic pain are breathing a little easier. A new state law that went into effect Friday is clearing up confusion about how much a patient can legally take.

The law used to require people taking opioids to taper down their daily doses to no more than 100 morphine milligram equivalents, with exceptions only for those under hospice or palliative care in connection with a serious illness.

Doctors knew they could prescribe more for patients treated for cancer or hospice care, but many didn’t think they could go over that limit for patients with chronic pain. This new law makes it clear that people with chronic pain can be exempt.

► Two Midcoast business owners notify state of intent to sue over opioid taper rule

Brian Rocket, a midcoast lobster wholesaler was one of those patients who was told by his doctor several months ago that he had to taper down his opioid dose to meet a new state law. He suffers from chronic pain from prior injuries and was worried he wouldn’t be able to run his business.

With the new law in effect, he says his doctor’s now confident that Brian is exempt from that 100-milligram limit and can accept a higher dose.

“I’ve certainly been reclassified under the palliative care back to where I was on medicine and I can function,” he said. “I can live to fight another day.”

► People prescribed opioids for pain seek changes to Opioid Rx Limits Law

Eric Wass, a roofing contractor, who for 20 years has been taking opioids to manage chronic pain, was also forced to taper down and is also now allowed a higher dose. He said it’s made all the difference.

“I can work all day and I have a vegetable garden over there now,” he said, “so it’s giving me my life back because it was being taken away from me.”

Both men went so far as to hire a lawyer to sue the state and then testified at public hearings about the need to change the law.

► VERIFY: Can people with chronic pain be exempt from Maine’s opioid RX limits?

Lawmakers heard those pleas and passed a bill the governor signed — offering relief for those who found themselves dependent on painkillers after having them legally prescribed by their doctors.

“It’s not much fun,” Wass said. “I’m not proud of it. I don’t like it, but I don’t have much choice.”

Maine DHHS expressed concerns about adding too many exemptions to the law, saying that excessive overprescribing of opioid painkillers is what led to this epidemic that Maine and the nation are now facing.

World Health Organization definition of palliative care:

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:

• provides relief from pain and other distressing symptoms;
• affirms life and regards dying as a normal process;
• intends neither to hasten or postpone death;
• integrates the psychological and spiritual aspects of patient care;
• offers a support system to help patients live as actively as possible until death;
• offers a support system to help the family cope during the patients illness and in their own bereavement;
• uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
• will enhance quality of life, and may also positively influence the course of illness;
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

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While this may seem VERY STRANGE.. In June of 1960.. I turned THIRTEEN … the above picture  was from the 8th grade “safety patrol”.. I am second row… third from right…  Thanks to my old time friend… standing to my immediate left… he saved all of these – some believe – embarrassing pictures and posts them on my Face Book page … but his birthday was 8 days ago !!! So he is actually OLDER than me 🙂  Only time that was significant is when we could get our driver’s licenses.

I capped off the 60’s by marrying my wife in June 1969 and  graduating from college in May 1970.

So today I turn 70’s and thus my travel thru the 60’s again… this time as a SENIOR CITIZEN.. rather than a TEENAGER

Both decades had their challenges… some I wish to remember and celebrate and others … I would rather forget 🙁

As I enter my EIGHTH decade on this earth quoting…  the movie character from Galaxy Quest…  Jason Nesmith  (Tim Allen) :Never give-up, never surrender.

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This isn’t easy for me but I would like to share a very upsetting and frustrating experience I have had with a doctor and ua lab results.
A little about me, I suffer from RSD/CRPS, Fibromyalgia, Occipital Neuralgia, I’ve had Thoracic surgery yrs ago which seems to be given me pain also, Cervical disc fusion 2-7, asthma and more. I feel I am a good patient, always following instructions and seeking out new treatments on my own, on the net and through all my Facebook groups. These groups have been extremely helpful in many ways.
I have a PCP, Neurosurgeon, Anesthesiologist for pain blocks, ENT, and Neurologist who treats my pain with some meds and once with Occipital blocks.

For the past year I’ve had sinus face and ear pain so my PCP set me up with a wonderful ENT. Due to the asthma/copd he wanted to do a balloon sinuplasty in office but insurance wouldn’t approve, but they did approve the OP Full in hospital sinuplasty. While waiting for surgery date I was put on 1 Rx of amoxicillin then 2 Rx of Amoxicillin-Clav. Almost 4 weeks of antibiotics.

I visit the neurologist, get my Rx and do a ua. I mention to the lady that I was taking new meds (antibiotics) she says nothing and walks away.
Then the following Saturday I receive a certified letter in the mail. I open it, read it, and just started losing it. The stress brought on a bad asthma attack. Family wanted me to go to the hospital but I refuse. This letter was from the neurologist and said I tested positive for “cocaine”, and that after 6/16 he would no longer treat me as I breeched the pain contract. After I get my breath, I get ANGRY! WTF? I have NEVER EVER use cocaine or any other street drugs. I’m losing it. My family who doesn’t get how we chronic pain patients are being treated by drs, and pharmacist just thought the dr would fix it. We all know that doesn’t happen. You just get kick to the curb and that’s that. Those who know me would have never thought this would happen to “me”.
That night I contacted Pharmacist Steve and Dr Mark Ibsen for their help and knowledge. These two men are the most caring and helpful people who I have the pleasure of meeting through FB. Both explained that labs are NOT 100% accurate AND that there are other drugs/foods that CAN show a FALSE/POSITIVE for cocaine or other illegal drugs. WHAT? I had no idea about this. Their help and info pushed me into fighting to clear me of being red flagged. I spoked to my local pharmacist who was outraged, I called my PCP to request another ua but they didn’t think the dr would accept that. I also saw my ENT who confirmed what Dr Ibsen mention that ENT’s may use a cocaine substance in surgery as it’s a good dilator. (Surgery was after the us) He says he doesn’t use it in surgery but did say the spray used in office is Pontocaine & Tetracaine which was used prior to the ua. He wasn’t sure if these would cause the positive results.
So the following day after I see the ENT I go to this drs office and ask to speak to the dr about these results. First a lady comes out and has the test results & shows me the report. I practically start crying and she says she believes me when I say I never use but…. it’s the metabolites. I still don’t understand and the nurse comes out and says I can do another ua and I give her my ENT meds (only new meds) and all my OTC meds and she says she will call me with the results this week.
During this several day wait in hell I gather up all my meds, write everyone down and list all the OTC meds I have in the house that I may have used. This included vitamins, sinus spray/pills etc…. I go to the pharmacy as Pharmacist Steve suggested and get a printout of several months of everything I’ve been prescribed and then FAX all this to the dr so he would have this first thing Monday morning.

Everyone I spoke to and internet searches ALL said that the amoxicillin COULD produce a FALSE/POSITIVE for cocaine. In my mind that HAD to be the problem as that was the only new med I had taken. Oh the stress & frustration of this! Something like this the Dr SHOULD know this. The dr at the time did not know yet that I had been on amoxicillin or had had surgery. But dam, I’ve seen him for years and never had a positive ua. I would have appreciated a call into the office to discuss this instead of getting a shitty letter that nearly sent me to the hospital stressing out.
As we know, depression is a huge part of chronic pain and I could see this stress sending me down that deep dark hole…. But Pharmacist Steve, Dr Ibsen, and others gave me hope and the strength to fight this stigma.

Today I received a call from the drs office saying that after going over all the information I had faxed and the 2nd ua results the Dr WILL “continue” to see me. No apology of course. I will see him early next month and hope to have a SERIOUS discussion about this. I so understand the drs are under scrutiny by the DEA etc…. but this is no way to treat a long term “good” patient.

At the moment this has left me with the question, do I want to even continue to see this dr? (I liked him because he’s one of the “very few” drs that understand RSD/CRPS as his wife has this terrible disease). Could it happen again to me or someone else who doesn’t have the resources of professionals like I had to see me through this nightmare? I guess I will see him next month and see how the discussion goes.

I share my horrible experience and what I’ve learned hoping it never happens to you too.

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Steve my name is XXXXX I was told about you on a IC site another young women has taken here life this past weekend . I am 62 and on disability my husband decided 6 months ago he no longer wants to be married. On top of that my family Dr had her nurse call me and say she would be taking me off my pain meds. She wants to send me to a pain clinic. I feel like the other shoe just fell. I also have 2 knees that need replaced but due to my high white count due to my IC the dr will not due the surgery on top of diabetes. also had mri done am i’m in therapy for spine problems. I had 2 disc in my neck replaced 6 years ago and still deal with pain and weakness. how can I get help I was told you are trying to help people with chronic pain. Im scared and alone any help would be so helpful. thank  you

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Jeff Sessions is wrong about the War on Drugs

https://action.aclu.org/secure/sessions-war-on-drugs

Attorney General Jeff Sessions is spouting rhetoric and promoting policies that we’ve been working hard to put in the past. With near-consensus that the War on Drugs was a failure on all levels, the country is ready to move to smart and commonsense reforms to our broken criminal justice system.

Except for one man: our top law enforcement official, Jeff Sessions.

Sessions has reversed an important charging policy that instructed prosecutors to avoid getting caught in the stranglehold of mandatory minimum sentencing. Mandatory minimums are widely understood as racist, destructive to families and communities, and fundamentally unfair. So why is our attorney general actively undoing policy in order to encourage the harshest possible punishments?

Jeff Sessions has a history of endorsing ineffective policies and positions based on political rhetoric. He wants to put as many people as possible behind bars. And not just anyone – the War on Drugs policies Sessions is rolling out target and harm Black and Brown people and communities.

This has to end. We need smart criminal justice reforms – not regressive, recycled policies. Add your name now to tell Jeff Sessions that no matter what he says, the War on Drugs must end.

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Supreme Court tightens rules on class-action lawsuits

https://www.washingtonpost.com/business/capitalbusiness/supreme-court-tightens-rules-on-class-action-lawsuits/2017/06/19/435260c6-550a-11e7-a204-ad706461fa4f_story.html#comments

The Supreme Court on Monday issued a ruling that makes it more difficult for plaintiffs attorneys to look for friendly locations for their lawsuits, a practice known as “court shopping.”

The court reversed a lower-court decision on class action lawsuits, ruling that hundreds of defendants who sued Bristol-Myers Squibb in California over injuries associated with the blood-thinning drug Plavix could not sue in that state because they were not residents.

The 8-1 decision led by Justice Samuel Alito rejects a liberal standard for where plaintiffs can sue, creating a hurdle for litigants. The majority decision said non-state plaintiffs had failed to establish a strong connection between their alleged injury and Bristol-Myers actions in California.

The plaintiffs had claimed the drug manufacturer misrepresented the risks of strokes and heart attacks due to Plavix.

The court, speaking specifically of the non-California residents who joined the class-action suit against the drugmaker, said those individuals “are not California residents and do not claim to have suffered harm in that State. . .It follows that the California courts cannot claim specific jurisdiction.”

“The non-residents were not prescribed Plavix in California, did not purchase Plavix in California, did not ingest Plavix in California, and were not injured by Plavix in California,” Alito said in his majority opinion. “The mere fact that other plaintiffs were prescribed, obtained, and ingested Plavix in California—and allegedly sustained the same injuries as did the non-residents—does not allow the state to assert specific jurisdiction over the nonresidents’ claims.”

In her dissent, Justice Sonia Sotomayor said she feared the consequences of Monday’s decision.

“The majority’s rule will make it difficult to aggregate the claims of plaintiffs across the country whose claims may be worth little alone,” she said in the dissent. “It will make it impossible to bring a nationwide mass action in state court against defendants who are ‘at home’ in different States. And it will result in piecemeal litigation and the bifurcation of claims. None of this is necessary.”

Andrew Pincus, a Supreme Court lawyer with the Washington office of Mayer Brown, said the ruling leaves open “two big questions:”

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