Have you ever notice that anytime somebody wants to get something changed.. it normally involves two things MONEY .. donated to a political campaign or MONEY to pay a law firm to file a lawsuit.

President Trump tried to put a temporary ban on immigrants from a handful of middle east countries and Attorney Generals from two different states – challenged his executive orders in the courts.

Cities, counties and states have filed lawsuits against the three major drug wholesalers for the “opiate epidemic” in their particular geographic areas. They are suing business entities that do not sell any products directly to the general public. Their customer base is pharmacies, hospitals and the like.

Cherokee Nation sues pharmaceutical companies over opioid abuse

The DEA uses laws and their interpretation of the laws (Control Substance Act 1970) to intimidate healthcare providers and my money is on the fact that many of those interpretations are actually UNCONSTITUTIONAL… but until someone challenges their constitutionality in our court system the DEA will continue to apply and enforce those laws. Keeping the 81 billion that funds the war on drugs is a pretty good incentive to maintain the status quo. A lot of paychecks are being covered with that money.

We know that there are numerous drug/alcohol treatment centers that are supporting various anti-opiate groups. Members of Congress have proposed laws that would encourage treating “addicts” with a C-III medication (suboxone) and letting them be dependent on that medication rather than being dependent on a C-II legal medication.

Those 45 million Alcoholics, 35 million Nicotine addicts, 2.1 million opiate addicts and the 100+ million chronic pain pts are just “conduits” for a whole array of business to make money.

Two things that the chronic pain community has in common is under/untreated pain and a LACK OF UNITY.  Just look at the hundreds – or thousands – of Face Book pages devoted to pain and/or disease where pain is a major component.

You can also divide the chronic pain community into to groups.. those that have had their pain management meds cut and those that have yet to have their pain management meds cut.

How many chronic pain pts have contacted a law firm about suing some entity that is adversely impacting their quality of life ?… and a equal number have received a “NOT INTERESTED”… and because someone who is handicapped/disabled, elderly, unemployable… in our legal system… the value of their life is “very little” so there is no financial upside for the law firm to take the case on a contingency basis.  It has been estimated that 90% of the families with a chronic pain pt… is struggling financially because one spouse can’t work and/or the cost of therapy.

Congress is currently considering a CAP on medical malpractice lawsuits damages at 250,000.. just about ensuring that no law firm will take on a case on a contingency basis.  After all about 40% of Congress is attorneys.. they know what they are doing and who they are doing it to.

IMO, nothing is going to change until those in the chronic pain community gets their act together – UNIFY – create a non profit to create a legal defense fund..  With a 100 million chronic pain pts… it wouldn’t take much effort to create a legal defense fund with 5-10-15 million and I can assure you that if the chronic pain community approaches a major law firm with that much money behind them… you won’t hear “NOT INTERESTED”…

 

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Kept in the Dark: Oregon hides thousands of cases of shoddy senior care

http://www.oregonlive.com/health/index.ssf/2017/04/senior_care_abuse_neglect_poor_care_hidden.html

Oregon officials have concealed from the public thousands of confirmed cases of shoddy care and elder abuse, whitewashing safety records at hundreds of homes for seniors across the state.

The Department of Human Services operates a website that is supposed to help consumers identify safe havens for their aging loved ones, including those suffering from Alzheimer’s and other debilitating illnesses.

But an investigation by The Oregonian/OregonLive found that officials have excluded nearly 8,000 substantiated complaints of substandard care from the state’s website.

The newsroom spent months analyzing state records that aren’t available online, compiling for the first time a full accounting of substantiated complaints at Oregon care centers. Reporters wrote computer code to download every online complaint from the website and used the data to identify thousands of missing records.

More than 60 percent of the substantiated complaints against care centers in Oregon since 2005 can’t be found on the state’s website.

The excluded complaints, all validated by the department’s own employees, show cases of elderly residents being punched, pushed, slapped or sexually abused by staff. Other missing complaints describe residents who had valuables stolen or who landed in the emergency room after getting the wrong medication.

The omissions skew the track records of more than nine out of every 10 senior care centers in the state.

“It’s a mess,” said Ashley Carson Cottingham, who inherited the program when she became director of Aging and People with Disabilities program in December 2015.  

Most of the omissions are intentional, part of a departmental policy adopted years ago to withhold certain types of information from the public, officials said. Others are due to mistakes in the way state workers classify complaints.

“There is inconsistency all over the place,” Carson Cottingham said.

The agency intends to replace the website and post all new validated complaints online in the future, a spokesman said. But a replacement could be years away because the department has decided to tackle other software projects first.

Sue Crawford learned the hard way that the state’s consumer website can’t be trusted.

With her 93-year-old mother, Marian Ewins, battling dementia, Crawford spent two weeks dutifully touring care centers, interviewing staff and zeroing in on a new place near her home.

She went to her computer and checked the state’s consumer website for Washington Gardens Memory Care in Tigard.

It looked squeaky clean.

No complaints of abuse, neglect or shoddy care had arisen in the entire three-and-a-half years the home had been open.

But the state website did not reveal the 10 times that Washington Gardens had been hit with substantiated findings of abuse, neglect or poor care.

Washington Gardens failed to seek timely medical treatment in 2013 for a resident who died after vomiting repeatedly, turning pale and pleading for help, state investigators found. The state also determined that in 2014 the facility failed to protect one resident from another who had a history of aggression, sending the victim to the hospital after a fight.

And the state found Washington Gardens didn’t do enough to keep a resident with a history of falls from breaking a hip and suffering facial injuries in 2015.

None of this information made it onto Oregon’s consumer website.

Based on what the state website showed and her visit to the center, Crawford expected great care for the woman who decades earlier taught her to sew and sprang for an $80 pink prom dress during lean times, urging her to keep the price a secret from her father.

Crawford was shocked by what she says she witnessed after her mother moved in.

Two days in a row, Crawford said, she arrived for visits to find her mother sitting in her own feces. Ewins was admitted to a hospital with diarrhea and dehydration, hospital records show.

In addition, Crawford said she was present when a staff member discovered that half the drugs in her mother’s locked medication drawer were labeled for another room. According to medical charts that Crawford obtained from Washington Gardens, her mother missed two consecutive days in a week of prescribed blood pressure readings.

Crawford filed a complaint with the state in September 2015. A spokesman for Oregon’s Aging and People with Disabilities program said the complaint was not investigated at the time and that the state has opened a new investigation, two years later.

Frontier Management, the Oregon company that runs Washington Gardens, would not comment on specific cases but said in a statement: “At the time of the alleged incidents in question, we followed applicable policies and procedures, conducted thorough investigations and reported the incidents to the proper authorities.”

Had Crawford known that state investigators linked substandard care to a death at Washington Gardens, she would have looked elsewhere.

“I would not put her in some place that might put her in harm’s way or jeopardy,” Crawford said. She relocated her mother in August 2015, after just three months at the Tigard care center.

The misleading online profile that Crawford found for Washington Gardens is far from unusual. About 600 nursing homes and other senior care centers around Oregon have incomplete records online, The Oregonian/OregonLive’s analysis found.

Officials who run the state’s website say it was never designed to display every complaint. The human services department decided about nine years ago to show only cases that led to a finding of “facility abuse.” The website tells visitors about this omission.

But in interviews and emails, agency managers did not have a clear-cut definition of how they distinguish “facility abuse” from other findings of fault. The Oregonian/OregonLive found hundreds of complaints with the words “abuse,” “neglect” or “exploitation” that the state excluded.

Tom Peine, an agency spokesman, acknowledged that leaders who built the website a decade ago might not have made the best decisions about what to include.

Agency managers also said they didn’t realize the website omitted some complaints that match their own criteria for posting until contacted by The Oregonian/OregonLive.

The state launched the website in 2008 after years of prodding by U.S. Sen. Jeff Merkley, who was a state representative and then speaker of the Oregon House. He was shocked when The Oregonian/OregonLive told him in March that so many substantiated complaints were excluded from the website.

“That’s terrible,” he said.

Putting complaint data online can give consumers valuable information in their quest to find a high-quality center or home, specialists say.

But if the information is not complete, consumers see an inaccurate picture, said Fred Steele, the state’s long-term care ombudsman.

“Touring a facility is only going to show you oftentimes what the physical aesthetics of a building are,” Steele said. “It doesn’t show you what’s actually happening behind the scenes.”

Easy access to information about deficient care helps consumers at a difficult time.

“In today’s day and age, it feels very unacceptable that this information isn’t publicly available yet” online, Steele said.

An industry official, Linda Kirschbaum, said she had no idea that any substantiated abuse complaints were excluded from the website until being contacted by a reporter.

“We support full transparency of completed abuse investigation reports being online,” Kirschbaum, the Oregon Health Care Association‘s senior vice president of quality services, said in a statement.

The state’s Aging and People with Disabilities program has decided to replace one software system and expand another before addressing the website’s shortcomings. Carson Cottingham’s staff said they considered taking the site down but decided to leave it up until whenever it can be replaced. No date has been set. And they have not committed to putting the 8,000 missing complaints online.

The Oregonian/OregonLive is publishing its entire database of substantiated complaints today and intends to update it regularly.

Carson Cottingham’s agency, which previously gave the newsroom the data for free, now says it will charge up to $375 for the time it would take staff to produce updates.

Clean records mask problems

Complaint investigations start when victims, family members, advocates, care center staff or others alert the state to potential cases of substandard care and abuse.

Under state rules, abuse can include an “active or passive” failure to provide basic care needed to keep residents healthy and safe. The written definition encompasses both harm and “risk of serious harm.”

The state’s Aging and People with Disabilities program keeps records of substantiated complaints in an internal database, including narratives of what went wrong. Since 2008, the program has also presented a much less detailed list of complaints on its website.

The Oregonian/OregonLive requested all the state’s substantiated complaints and compared the data with what’s on the web.

The analysis revealed glaring gaps.

Just 9 percent of residential care centers, assisted living facilities and nursing homes had accurate records online.

Of the 642 facilities open as of late last year, 585 had incomplete records at the time of the analysis. Of those, about 350 had more than double the number of complaints shown on the state’s website. Fifty-nine care centers falsely appeared to have perfect records. Just like Washington Gardens, they had zero complaints online. In reality, none of these places were complaint-free.

In all, facilities with incomplete records have the combined capacity to serve more than 35,000 people.

Mistakes that matter

Oregon keeps two sets of books on senior care, The Oregonian/OregonLive investigation found.

The state does indeed track all substantiated complaints of abuse, neglect and poor care in an internal database. Every single record details a facility’s violation of Oregon rules. But the state withholds about 60 percent of the substantiated complaints from its consumer website, the analysis shows.

Oregon still has not clearly told website visitors that thousands of substantiated complaints have been deliberately or accidentally omitted, or that many of those complaints involve neglect and abuse.

Human services officials posted a disclaimer in February that the data “may not always be complete,” months after being contacted by The Oregonian/OregonLive.

The sorts of records hidden from view frequently involve issues that matter to consumers. They range from inadequate care to outright violence and degradation.

In a case at Churchill Residential Care in Eugene, the state’s complaint summary says staff members saw signs that a resident had a stroke one morning in July 2014. They waited four and a half hours to call an ambulance, according to the state record. 

The case was not online at the time of The Oregonian/OregonLive’s analysis. The agency said a data entry error caused the omission, which has since been corrected.

A spokesman for the company declined to comment on the specific case, citing resident privacy. In general, however, Churchill Estates believes all substantiated abuse cases should be published online, the spokesman said.

State rules also require centers to anticipate problems such as frequent falls or fights between aggressive dementia patients. Staff members at these centers are supposed to design care plans to minimize risks. When instructions are not followed, residents can get hurt.

An investigator concluded that’s what happened in July 2012 to a resident who broke an arm falling on concrete at Arbor Oaks Terrace Memory Care in Newberg.

Employees didn’t follow the resident’s care plan, which explicitly said the person should always be accompanied to avoid falls, the state found.

Staff members learned about the injury only after another resident found the person on the ground, the state concluded. Investigators also concluded that the resident’s personal physician had asked to see the patient the same day, but the Arbor Oaks staff waited until the following day to take the person to the doctor.

That incident is not online.

Other complaints hidden from public view show residents stripped of their dignity.

A staff member at Quail Park at Crystal Terrace, a Klamath Falls care home, shared a photo on social media in February 2015 showing a resident’s naked buttocks, a state investigator found. The resident was in the bathroom in the picture, the investigator wrote. A caption under the photo said “My job…” followed by three pistol emojis, according to the state’s investigation.

A state investigator later described showing the victim the picture and explaining what happened. The person looked distraught, according to the report.

The home’s parent company in Seattle, Living Care Senior Lifestyle Communities, said in a statement that it fires staff members who don’t follow its policies or Oregon rules.

“In this particular case, after an immediate and thorough investigation, the employee associated with this event was terminated,” the statement said, a fact supported by state records.

The substantiated complaint appears nowhere on the state’s senior care website.

Another investigation, involving Vineyard Heights Assisted Living and Retirement Cottages in McMinnville, found that in December 2015 a caregiver deliberately hit a resident’s head against a bathroom wall. The blow left the victim’s head bloodied, an investigator wrote.

The victim told another staffer, who saw the bloody cut. But that person chose not to report it, the investigation concluded.

That evening, the caregiver who injured the resident took the victim to the shower with help from another staff member, the official report says. The resident started screaming, begging not to be left with the caregiver, according to the report.

The state’s findings indicate the caregiver who hurt the resident was going to be moved to another part of the facility and retrained, but that the caregiver gave notice and left the facility a week after the incident.

The substantiated complaint is not online.

Frontier Management runs both Vineyard Heights and Arbor Oaks. The company responded to questions about the substantiated complaints at those facilities and at Washington Gardens by saying managers followed procedures, conducted thorough investigations and reported incidents to authorities.

Decisions and missteps

One reason the state’s senior care website leaves out so much data is a judgment call: Managers who designed the website almost a decade ago decided to include only certain categories of complaints.

Current and former officials at the human services department could not recall who decided the types of substantiated complaints to keep off the website.

The head of senior services at the time was James Toews, now an acting deputy chief in the federal equivalent for Oregon’s program. He declined to comment about the database.

Peine, the human services spokesman, said the website was designed to include only cases in which the facility is found to be responsible for abuse, not cases in which staff were solely blamed.

Complaints eliminated for this reason include the resident photographed in the bathroom and the resident whose head was hit against a wall. Even though the facilities were found responsible for rule violations that allowed the abuse to occur, the complaints were kept offline because staff members were faulted for the abuse itself.

The state also excludes many complaints that involve no harm, even if agency managers found the problems serious enough to warrant further action.

At Pacific Gardens Alzheimer’s Special Care Center in 2015, caregivers made more than 70 medication mistakes in four months, investigators found, resulting in 17 official findings against the facility. The pattern prompted the state to demand a “plan of action” from Pacific Gardens.

But only one of the state findings is online: a resident who received another person’s medication and became sedated. The other 16 cases ended with no visible harm and are hidden from website visitors.

A Pacific Gardens spokeswoman said the home promptly corrected the medication errors once they were discovered.

Complaints labeled “potential for harm” or “no negative outcome” account for about 2,500 of the substantiated complaints that are missing from the website, or around 30 percent of the records that have been kept offline.

The state fined the facilities in hundreds of those cases.

Carson Cottingham, who oversees the consumer website, said some complaints  don’t appear online because state employees have been inconsistent in how they code complaints.

Other staff errors have kept some complaints off the web, even when they met the state’s criteria, agency staff acknowledge. Among them was the death that Sue Crawford should have been able to see when researching Washington Gardens.

Leslie Ross, who manages a website on long-term care in California through the University of California, San Francisco, said consumers would prefer to simply see every substantiated complaint — no matter what happened or who’s at fault.

What can’t be found

It’s hard to predict which cases of substandard care will end up online and which will not.

For example, state records show there were at least 11 thefts from residents at Emeritus at Springfield-The Woodside, an assisted living facility, in a three-month period in 2013. One resident reported missing $300. In each case, the state faulted the facility for failing to provide a safe environment for residents, a violation of Oregon’s long-term care regulations.

None of these substantiated complaints are on the state’s website.

Yet very similar complaints — made in the same year, against a care center with the same owners, and located in the same city — are all online.

Search the state website for “Emeritus at Springfield-The Briarwood,” and you’ll find records corresponding to thefts of two fishing poles, tackle boxes and $370 in cash.

Both facilities have a new owner, Brookdale Senior Living, and have been renamed. A spokeswoman said that the safety and well-being of residents is the company’s top priority. The spokeswoman also said Brookdale complies with the state’s reporting requirements.

Even when all complaints against a care facility make it online, they can’t be found easily if the center changes hands. Previous complaints are listed under the home’s former name, which a consumer may not know to check.

Of the roughly 650 care centers licensed in Oregon, more than a quarter have complaints that can be found only under their previous names.

River Grove Memory Care in Eugene, for example, shows four complaints racked up since the current owners bought it in 2015. However, searching for the home under three of its previous names and owners shows an additional 31 complaints. Seventeen of those happened in the two years before the current owners took over.

It would take a thorough knowledge of the home’s history to find them. River Grove used to be Santa Clara Special Care Community. Before that, Sierra Oaks of Santa Clara. Before that, Santa Clara Residential Inn.

A River Grove representative, Terri Waldroff, said her company has nothing to do with the problems at the center under previous owners. She said the current owners have renovated the campus, added a kitchen and hired new staff.

The facility shouldn’t be associated with the old complaints, she said.

The state’s existing policies support Waldroff’s perspective. But Carson Cottingham said it may be time for the state to revisit its approach.

“I don’t think it gives the consumer a full picture of what’s going on in a facility,”

she said.

Giving Oregonians access to each care home’s full compliance history regardless of ownership, said Carson Cottingham, is the “right thing to do.”

Problems known, fixes elusive

The department added caveats to its consumer website after The Oregonian/OregonLive alerted officials to problems.

The site now advises consumers to visit care centers and to call the state ombudsman.

In February, the department added a disclaimer at the bottom of the page.

“Oregon DHS is aware of the technical and other issues regarding some instances where data may not be complete and is working to correct these underlying issues,” the disclaimer says.

The division did not put online the abuse complaints against Washington Gardens for months after being alerted by The Oregonian/OregonLive. In the third week of March, they appeared on the website.

For nearly two years after Crawford did her research, consumers considering Washington Gardens wouldn’t have known about its tainted record. They wouldn’t have known that the center was fined three times after residents fell and hurt themselves, including two who suffered fractured hips. State website visitors wouldn’t have known that a resident had to be hospitalized after a fight. And they wouldn’t have known that a resident died there after vomiting and crying for help that came too late.

Aging and disabilities officials say they don’t intend to mislead the public.

“In no way are any of our decisions ever to limit information from being out there for them,” said Nathan Singer, deputy operations director.

Carson Cottingham wants her staff to eventually replace the website, posting all new substantiated complaints. Agency officials also would like to post all new inspection reports and sanctions.

“My approach is that we need to be fully transparent and to be as helpful as possible,” said Carson Cottingham.

Still, the state has no concrete timeline for making its consumer website complete. Carson Cottingham said any update could be years away.

Her agency plans to replace an internal software system for tracking abuse by the end of the year and to then expand the system that tracks inspections. Only after both projects are complete will the department be in a position to replace the online tool, officials said.

But those projects won’t necessarily put online the nearly 8,000 complaints that are excluded from the state’s website. What’s more, state officials say they plan to scrap the current website, which could move all current complaints offline.

Members of the public can request paper or electronic copies of a facility’s complaint records by contacting the aging services program, agency officials said.

Merkley, the Oregon politician who wanted a website to simplify the process of picking a care facility, was stunned to hear how incomplete the consumer website is.

“You’ve got to have the information to hold an organization accountable,” Merkley said.

 

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“The DEA has lost its moral authority”: Rep. Jared Polis pulls no punches in exclusive interview

Colorado congressman talks with The Cannabist about marijuana policy, states’ rights, and why Attorney General Jeff Sessions needs to ‘get with the times’

www.thecannabist.co/2017/04/20/colorado-congressman-rep-jared-polis-marijuana-policy-interview/77729/

In his eight years on Capitol Hill, Congressman Jared Polis has doggedly championed cannabis legalization.

For the Democrat from Colorado, it’s a matter of personal freedom, a means toward more a effective criminal justice system, and a potential boost for local and regional economies. It’s also policy that a majority of voters in his home state want: Colorado legalized medical marijuana in 2000 and then became the first U.S. state to have legal, regulated sales of recreational marijuana in 2014.

Polis pulled no punches in an exclusive marijuana-focused interview with The Cannabist in Denver just days before 4/20. Scroll down for video in which the congressman discusses his personal views; policy positions and proposed legislation; the newly formed Cannabis Caucus; the DEA’s failure on medical marijuana; and what he’d say to Attorney General Jeff Sessions.

On why he champions legal cannabis

“Look, these are decisions that people get to make in life. To somehow say that just because you happen to choose to use marijuana you’re some kind of criminal is not only offensive, but it’s really counter-productive as a society in terms of shifting money away from businesses to cartels, having police waste their time on something of no public safety consequence, and putting good people potentially in jail and in court.”

 

On the prospect for passing marijuana reform legislation in the current Congress

“The bills, like Regulate Marijuana Like Alcohol, it’s a tough-going, because procedurally it has to flow through committees whose chairmen are not friendly toward medicinal or recreational cannabis. So the best route … would be to go around leadership with these floor amendments (Rohrabacher-Blumenauer and McClintock-Polis). It doesn’t matter if Paul Ryan or Mitch McConnell or Kevin McCarthy vote against them, if you have sufficient votes on the floor to pass them, they become part of those appropriations bills … and no federal funds can be used to enforce federal laws in areas where it’s legal in a state, as long as you’re following state law,” he said.

“That’s what I think we have an operational majority to do. So that’s step 1. It might take a few more years to get to the whole enchilada.”

 

On the Cannabis Caucus and Attorney General Sessions

“I would point out the imperative — for Colorado but also states where over 60 percent of the American people live — that they get with the times, look at the data and allow the states the room to come out with the right way to regulate marijuana,” he said.

“And that’s not where he is today, but the more he hears it, the more people he hears it from, the better, and he needs to catch up from the age of Reefer Madness to the 21st Century. We’ve got to bring him there over the course of the next few months.”

 

On the DEA’s stance on medical marijuana

(Watch the full video at the top of this post)

“The DEA has lost their moral authority in this matter, which is sad and dangerous for us as a nation, because we are suffering under the scourge of meth abuse and opioid abuse. … This is ripping families apart. People are dying. It’s awful. And yet the DEA is removing their eye from the ball and they’re saying we’re going to classify CBDs as Schedule I and we’re going to bust somebody who’s trying to help their migraines. I mean, this is a huge disservice for the public health, huge disservice to our country, and it’s why, of course, the DEA should reschedule marijuana. That doesn’t solve all of our issues, but at least it allows for medicinal use and testing. But two, Congress needs to take this up, because we can’t allow this DEA to continue to act as a rogue agency. Too many lives are at risk.”

On “Big Marijuana” concerns and the business of legal cannabis

“I think so and, you know, some of that comes back to the public and municipal and county and state regulatory apparatus, right? We certainly, for instance, have independent liquor stores in our state because we only allow grocery stores to sell liquor in one (store). You could certainly have municipal rules that nobody can own more than one dispensary in your boundaries. You could have state rules about size, so it’s entirely up to policy-makers and your elected officials whether this winds up as one super-chain of 50 dispensaries or whether they’re all independently owned or operated or somewhere in-between.”

 

 

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Fox News Will Replace Bill O’Reilly With Tucker Carlson

http://www.msn.com/en-us/news/us/fox-news-will-replace-bill-o%E2%80%99reilly-with-tucker-carlson/ar-BBA3b33?

In the wake of Bill O’Reilly’s ouster, Fox News Channel issued a talking points memo of its own: Its primetime lineup will maintain a similar tone and attitude even without the person who was arguably the network’s most recognizable anchor.

Bill O’Reilly has never suggested anything other than he is STRONGLY OPPOSED to any opiate abuse nor supports the legalization of Marijuana.. It has also been apparent that he doesn’t begin to understand that addiction/substance abuse that is a mental health issue..

After last week’s five day diatribe of Tucker Carlson on the over hyped opiate epidemic in this country… Carlson will step into O’Reilly’s shoes in regards to our “war on drugs”

IMO… both of these gentlemen are from the same arrogant, narcissistic, bloviating mold.  

Filed under: General Problems | Leave a Comment »

Governments using data to track, predict opioid overdose

Data is helping the city of Cincinnati and the state of Ohio to find geographic hotspots for overdose and predict opioid risk patterns

CINCINNATI — Data is being used by cities and governments to track overdoses and predict opioid trends.

Cincinnati Chief Data Officer Brandon Crowley presented how data is being used to track the city’s opioid epidemic last month with Socrata to deploy first responder resources and advise community outreach.

After a spike in overdoses in 2016, Cincinnati began analyzing EMS response data to identify trends and geographic points to help strategically deploy public safety officers and medical resources.

The Heroin Dashboard is a subset of EMS data which captures responses to reported heroin overdose incidents. The dataset helps the city dispatch roving medics and increase public safety and public health response in hotspots while it also advises on trends.

For example, Crowley said the city was able to better understand why it was exhausting its naloxone supply. It turns out EMS was having to administer double doses for a particular cut of heroin used at a particular point in time.

Thirteen months of anonymized data is shared through a visualization — including adjusted incident latitude and longitude coordinates — which is updated daily, helping to keep communities appraised. Residents and community leaders can use the Heroin Dashboard to understand overdoses in each neighborhood, and they can access the full data through the city’s Open Data Portal.

While the city has not yet implemented predictive modeling with its heroin incident dataset, Crowley said data analysts do intend to build on it. But at the state level, analysts have begun using Prescription Drug Monitoring Program (PDMP) data, which Ohio launched in 2010, to predict opioid risk patterns throughout the state.

Leveraging State PDMP Data

The state of Ohio has been combining data on known overdose deaths with prescription data from the Ohio Automated Rx Reporting System (OARRS), which tracks the dispensing of controlled prescription drugs to patients Ohio, to build predictive models as early detection for overdose.

A National RX Drug Abuse & Heroin Summit webinar on May 4, featuring Chad Garner, director of OARRS along with speakers from Appris Health, will explain how PDMP data and advanced analytics can impact detection of prescription narcotic and opioid overdose deaths and review the early identification process of prevention and management of substance use disorders.

According to the 2016 OARRS annual report, the total doses of opioids dispensed to Ohio patients decreased 20.4 percent from 793 million in 2012 to 631 million in 2016.

Nearly all U.S. states have adopted PDMP systems that support data analytics efforts to better understand and address the opioid epidemic, except Missouri. Although Missouri Senator Rob Schaaf, a physician, said that he will now support the system if the proposed state law requires doctors to use it, according to the Associated Press.

Ohio requires doctors to access OARRS, and the state’s Board of Pharmacy requires pharmacists to use it before dispensing medication.

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FDA: No Codeine or Tramadol for Children Under 12 — Period
Warnings for children with medical conditions, breastfeeding moms

https://www.medpagetoday.com/pediatrics/generalpediatrics/64673

Use of both codeine to treat pain and coughs and tramadol to treat pain are now both contraindicated in young children under the age of 12, said the FDA in a statement.

Products containing codeine or tramadol will now carry a “Contraindication” for children under the age of 12, which is the FDA’s strongest warning. The agency cited concerns about slowed or difficult breathing or death, especially among younger children and infants in its decision to restrict the use of products containing these two drugs.

“We are requiring these changes because we know that some children who received codeine or tramadol have experienced life-threatening respiratory depression and death because they metabolize (or break down) these medicines much faster than usual (called ultra-rapid metabolism), causing dangerously high levels of active drug in their bodies,” said Douglas Throckmorton, MD, deputy center director for regulatory programs, Center for Drug Evaluation and Research, in a statement.

Throckmorton added in a media briefing that there is no way to know which children are “rapid metabolizers,” because it is genetically determined and varies by racial and ethnic group.

The FDA also added a new “Warning” advising against the use of products with codeine and tramadol in children ages 12 to 18 who are obese or have obstructive sleep apnea or serious lung disease. There is also a strengthened “Warning” advising against the use of these products among breastfeeding mothers, as it may cause serious harm to their infants.

The agency noted that since 2013, prescription products containing codeine have contained a boxed warning and contraindication for children and teens up to age 18 for pain management after removal of tonsils and adenoids. The same will now be true for tramadol-containing products.

“We understand that there are limited options when it comes to treating pain or cough in children, and that these changes may raise some questions for healthcare providers and parents,” said Throckmorton. “However, please know that our decision today was made based on the latest evidence and with this goal in mind: keeping our kids safe.”

The FDA has been evaluating the use of codeine in cold-and-cough medicines in children since 2015 and the risks of using the pain medicine, tramadol, in children ages 17 and younger since September 2015. In 2016, the American Academy of Pediatrics issued a policy statement that advised against the use of codeine in all children.

The agency advised healthcare professionals that single-ingredient codeine and tramadol is only FDA approved for use in adults. Clinicians should advise parents to seek over-the-counter products or other FDA-approved prescription medicines to treat cold and cough in children under the age of 12 years.

At the briefing, Throckmorton described these new “labeling updates” as building on “our understanding of a very serious safety issue based on the very latest evidence.” He added that the FDA plans to hold a public advisory committee later this year to discuss the broader role of prescription cold and cough medicines in children, including those containing codeine.

If an adult inflicts pain on a child.. if found out.. you can expect child protective services/social services to be at their door… it is called CHILD ABUSE…

So now the FDA seemingly mandates that we allow children under 12 to “live in pain” and/or “cough their heads off” because they have seemingly determined that it is best for a child to JUST SUFFER THRU IT…

Again, the bureaucracy in trying to protect a few… tend to make rules/laws/guidelines that cause the overall majority to JUST SUFFER THRU IT.   This is not CHILD ABUSE ?

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Got a call yesterday from a friend – 63 y/o male.. who has been reluctant to see doctors and more reluctant to take medication(s).

SURPRISE… his blood pressure is high, as is his cholesterol… So the doc wants him to take two different medications..

My friend starts rebelling against taking medication… the doc told him that if “they” reviewed his files and it showed that the doc did not offer treatment for those two conditions… the doc could be charged with MALPRACTICE.

I know that CMS has increased focus on pts getting and taking medications for diabetes, cholesterol, and blood pressure… but this fellow is still employed and has insurance thru his company… outside of CMS’ over sight.

 

Is it time for chronic pain pts to start “rocking the boat”.. when a prescriber tells you that they are cutting your pain meds .. tell them that you are going to cut your meds for hypertension, diabetes and cholesterol in a similar amount as your pain meds… if your pain deserves less treatment.. why not your other medications/conditions ?

CMS has this FIVE STAR RATING in which insurance companies, prescribers, pharmacies are having their feet held to the fire about their pts not being compliant with the medications to treat those specific disease.  If their pts are non-complaint… their reimbursements will GET REDUCED !

They tell you that they are concerned about losing their license… in reality they don’t care about their license.. they care about the income that their license allows them to generate.  Share your “pain” with them !

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Man shoots himself in the spine to end agonizing back pain – and is JAILED for possessing a gun

• Paul Davis spent Christmas in Belmarsh prison after trying to paralyse himself
• The 44-year-old was trying to end agonising pain of a degenerative disc disorder
• He tried to shoot himself twice but gun, which he bought 20 years ago, jammed
• Davis, of Sidcup, Kent, originally acquired weapon following his mother’s death
• Judge quashed his three-year jail sentence, calling his case ‘wholly exceptional’

http://www.dailymail.co.uk/news/article-4135208/Man-shoots-spine-end-agonising-pain.html

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It’s time to end civil asset forfeiture

http://thehill.com/blogs/pundits-blog/civil-rights/329346-its-time-to-end-civil-asset-forfeiture

By any stretch of the imagination, it hasn’t been a banner couple of weeks for federal agencies that engage in the little-known practice of civil asset forfeiture.

Two separate reports—one by the Department of Justice’s Office of the Inspector General (OIG), and the other by the Treasury Inspector General for Tax Administration (TIGTA)—painted a bleak picture of both departments’ use of the practice, which allows federal law enforcement to seize, keep, and repurpose assets on the suspicion that they’re involved in criminal activity. This process was intended to target bona fide lawbreakers. However, it has become a veritable Godzilla of late, targeting not just proven criminals but individuals who have never been convicted of a crime, let alone even charged with one.

The process has come under withering scrutiny from across the ideological spectrum for years—from the Heritage Foundation to the ACLU—for its increasingly broad scope of practice and limited due process protections for innocent property owners.

 

Such proponents of reining in civil forfeiture have long argued that the practice hasn’t appeared to be in the interest of combating crime, but rather to generate profits. At face value, it’s difficult to argue otherwise. According to an Institute for Justice study, net assets in the DOJ and Treasury forfeiture funds increased by 485 percent between 2001 and 2014, but only 13 percent of DOJ forfeitures between 1997 and 2013 came after a criminal conviction. In other words, forfeiture activity has exploded, but not necessarily against those proven to have committed an actual crime.

These new reports do little to dissuade these concerns, either. According to an analysis of 100 DEA cash seizures that featured no court-issued warrant or presence of narcotics, the OIG found that the DEA could not verify in 56 cases that such seizures advanced or were related to ongoing criminal investigations. Meanwhile, the TIGTA found that the IRS has been freezing accounts under the guise of anti-structuring laws. These statutes were originally intended to combat criminal enterprises involved in money laundering. However, in a whopping 91 percent of sampled cases, the laws were being used to forfeit assets from individuals and businesses found to have obtained their income legally.

While supporters of the status quo are fond of claiming that individuals receive adequate due process in civil forfeiture proceedings before property is taken, a deeper scan of the OIG report reveals a disturbing lack of process at all. Of those DEA cash seizures performed between 2007 and 2016 that resulted in forfeiture, 81 percent were done administratively, which allows agencies to keep assets without judicial involvement whatsoever. These cases amount to little more than a rubber stamp, and are singularly lucrative: the DEA alone confiscated $3.2 billion from such forfeitures over that 10-year period. Orwell himself would shudder. 

As troubling as these revelations are, they aren’t surprising. Such are the fruits of allowing federal bureaucracies to expand their authority on autopilot. By the very nature of its charter, the IRS is already imbued with awesome power to peer into nearly every aspect of a person’s life, and we’ve already seen what that capability has borne. In the recent past, various nonprofit groups have been targeted for inordinate scrutiny by the Lois Lerners of the world—unscrupulous types who will inevitably wield levers of power to dubious ends if given rein to do so. 

The ability to unilaterally seize and keep property—with little recourse to the individual—is no different. The administrative swamp is deep and its reach broad, making it liable to ensnare many people whose sole transgression is being an easy target.

Fortunately, elected officials in Congress are taking renewed interest in the situation, refiling several bills that would greatly circumscribe the ability to forfeit property without appropriately tying it to criminal activity. They should move on the matter quickly. The government’s own watchdogs are confirming with hard facts what many people have suspected about civil forfeiture all along: that it’s being used against people who have done nothing wrong.

All that remains is to end it.

 

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Secret Hospital Safety Reports May Become Public Under CMS Proposal

https://www.managedcaremag.com/news/secret-hospital-safety-reports-may-become-public-under-cms-proposal

Under a new proposal from the Centers for Medicare and Medicaid Services (CMS), the public could soon get to read confidential reports about medical errors and mishaps in the nation’s hospitals that put patients’ health and safety at risk, according to an article posted on the ProPublica website. The CMS wants private health care accreditors to publicly detail problems they find during inspections of hospitals and other medical facilities, as well as the steps being taken to fix them.

Nearly 90% of U.S. hospitals are directly overseen by health care accreditors, not by the government. Each year, the CMS takes a sample of hospitals and other health care facilities accredited by private organizations and does its own inspections to validate the work of those groups. In 2016, the agency reported that accrediting organizations often missed serious deficiencies found soon afterwards by state inspectors.

In 2014, for example, state officials examined 103 acute-care hospitals that had been reviewed by accreditors during the past 60 days. The officials found 41 serious deficiencies. Of those, 39 were missed by the accrediting organizations. This disparity “raises serious concerns regarding the [accrediting organizations’] ability to appropriately identify and cite health and safety deficiencies” during inspections, CMS officials wrote in their draft regulations, scheduled to be published on April 28.

The new proposal follows steps that the CMS took several years ago to post government inspection reports online for nursing homes and some hospitals, the article notes. ProPublica has created a tool, “Nursing Home Inspect,” to allow people to more easily search through nursing-home deficiency reports. The Association of Health Care Journalists has done the same for hospital violations.

Those government inspection reports do not identify patients or medical staff, but they do offer a description—often detailed—of what went wrong, ProPublica says. This includes medication errors, operations on the wrong patient or the wrong body part, and patient abuse.

But private accrediting organizations, the largest of which is The Joint Commission, have not followed suit, creating a patchwork of disclosures in which some inspections are public and others are not. The proposed rules from the CMS are designed to fix this.

Medical errors are a leading cause of death and injuries in U.S. hospitals. A 1999 report by the Institute of Medicine estimated that up to 98,000 people a year die because of mistakes in hospitals; subsequent reports have said that the number is much higher.

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