“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Before the heroin epidemic became a nationwide problem, claiming thousands of lives; Plano, Texas, was already entrenched. And like many of the places caught in the cross hairs of the continuing heroin crisis, Plano is the last place that one would expect to be swept into the opioid tidal wave.
For six years she termed herself the “chief propagandist” — or spokeswoman — for the Drug Enforcement Agency (DEA). Before that, as a Plano mother and teacher, Belita noticed what was happening in her community. She described Plano as an area rivaling Newtown, Connecticut, or Cape Cod — tight-knit regions where tragedy strikes hard and deep.
She explained that “[Plano] has the best school districts in the state of Texas…it’s a gated community. And in 1998, for heroin to be that prevalent in the community was stunning. Stunning. We got all the media attention because we were this upscale Texas neighborhood that nobody thought would be inundated with heroin.”
Nelson decided to take action, saying, “I decided I’d had it. I was going to organize my community and fight this thing at the grassroots level. But we were never grassroots because the first thing I did was go on the Oprah show for the DEA.”
Belita stresses that she was never officially employed by the DEA but traveled for six years as a sort of unofficial spokeswoman for the agency. The group recruited her because their goals aligned, and in many ways, she was perfect for the role. She was a mother who had witnessed the toll of heroin first-hand. She was passionate and knew what she was talking about. Belita spoke to schools and parent groups and appeared on television networks.
With the help of a former Dallas Cowboy, she founded the Starfish Foundation to tackle heroin addiction. That organization ran until 2004 when one of the employees pocketed the donation money and left the foundation scrambling in the dark.
In our interview, Belita was hesitant to speak too openly but mentioned that when she first went to work with the DEA (she was contacted and became familiar with agency’s goals), she was told “‘Marijuana is safe, we know it’s safe, but it’s our cash cow and we will never, ever, give it up.’” When the DEA seizes a car or makes a drug bust, it’s likely they’ll find wads of money. They turn in the pot (or other drugs) — and keep the cash.Civil asset forfeiture law essentially gives the police and feds free reign, and they have confiscated billions of dollars from Americans, a majority of whom have not been charged with a crime.
Belita, like many people, posits that the DEA is not willing to give up the long disproven idea that marijuana is a “gateway drug.” Unlike heroin, most people are open to trying marijuana. At high school or college parties, it’s much more likely that a joint is being passed around than a needle. While a joint conjures up images of Bob Weir or SOJA on stage, a needle brings to mind a lifeless Philip Seymour Hoffman or Basquiat.
Belita cut ties with the DEA in 2004 after becoming frustrated with the system and the government’s need to keep marijuana criminalized, despite knowledge that the drug was safe.
While at the Starfish Foundation, Belita heard time and time again the tale of pot-smoking teenagers who were pushed into heroin simply because marijuana carries harsh penalties. And it’s a story that’s been told repeatedly. Today Belita works for the Gridiron Cannabis Foundation, a nonprofit dedicated to fighting CTE, concussions, Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, neuropathy, dementia, chronic infammation, Leukemia, and brain and other cancers. But the group’s pockets that only stretch so far.
In contrast, her opposition — and the opposition of anyone fighting the heroin epidemic and hoping to legalize marijuana — are big pharma companies.
Recently, we’ve seen pharma companies hit the grassroots to secure influence. Anti-Media and a number of other news outlets recently reported on an opioid company pumping half a million dollars into Arizona anti-marijuana groups in an effort to keep the plant illegal. These sorts of campaigns do not serve the dead in Plano and the hundreds of thousands around the nation suffering from opioid addiction. Rather, they benefit CEOs and pharmaceutical groups who have invested millions in developing drugs that minimize pain. Unfortunately, they come with a dangerously high likelihood of addiction.
Big pharma corporations see dollar signs in every painkiller that moves across a counter, but some of which could easily be replaced by marijuana, which is increasingly proven to help decrease pain. So the American consumer, from Plano, Texas, to Portland, Maine, is faced with the dilemma — is it better to be a living Bob Weir or a dead Basquiat?
Bellmawr, New Jersey, C.O. Truxton, Inc. is voluntarily recalling lot 70952A of Phenobarbital Tablets, USP, 15 mg, to the consumer/user level. The manufacturer received a confirmed customer complaint that a bottle labeled as phenobarbital 15 mg was found to contain phenobarbital 30 mg tablets.
This mislabeled product could expose the consumer or their pet(s) to potential overdosing that can cause severe intoxication which may lead to cardiogenic shock, renal failure, coma or death. C.O. Truxton, Inc. has not received any reports of adverse events related to this recall.
The product is indicated for use as a sedative or anticonvulsant and is packaged in 1000 count bottles, NDC 0463-6160-10, UPC 7 0463616010 6, lot number 70952A, expiration date 11/17. The 15 mg Tablet is debossed with “West-ward 445” on one side and blank on the reverse side; the 30 mg Tablet is debossed with “West-ward 450” on one side and scored on the reverse side. The product was distributed Nationwide in the USA to Physician & Veterinarian Treatment Centers.
C.O. Truxton, Inc. is notifying all customers on record who purchased the affected product via US Mail which includes a recall letter, recall response form and is arranging for full credit returns, replacements, etc. of all recalled product. Consumers/distributors/retailers that have recalled product should stop using the product and return their product to their place of purchase.
Consumers with questions regarding this recall can contact C.O Truxton, Inc. by phone at (856) 933-2333, Monday to Friday between the hours of 9am and 5pm (EST). Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this drug product.
Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA’s MedWatch Adverse Event Reporting program online, by regular mail or by fax.
Regular Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit a fax to 1-800-FDA-0178
A Glencoe woman hugged her attorneys after a jury in Chicago awarded her $3 million Thursday in a lawsuit against a pharmaceutical company that she blamed for her husband’s suicide.
“We won!” she mouthed to one of her lawyers.
Wendy Dolin’s husband, Stewart, stepped in front of a CTA Blue Line train in the Loop on July 15, 2010. He had been taking paroxetine, a drug for depression and anxiety, and his widow claimed in her lawsuit that GlaxoSmithKline failed to warn her husband’s doctor of the drug’s increased risk of suicidal behavior, leading to his death.
GlaxoSmithKline makes Paxil, a brand-name version of paroxetine. Though Stewart Dolin was taking the generic form, his widow’s suit argued — and the jury agreed — that the pharmaceutical company was still responsible because the drugs are identical and have the same labeling.
Stewart Dolin was a corporate attorney and a partner at the Reed Smith law firm at the time of his death. He was 57.
Wendy Dolin called the verdict “a great day for consumers,” though she said the result was bittersweet.
“This for me has not just been about the money. This has always been about awareness to a health issue, and the public has to be aware of this,” she said after the verdict was announced in federal court following three days of jury deliberations.
“None of us here are anti-drug. That’s not the issue,” Dolin added, “but we are patient advocates and we hope that people will start asking better questions.”
Officials from the pharmaceutical company said the verdict was disappointing and that they plan to appeal.
“GSK maintains that because it did not manufacture or market the medicine ingested by Mr. Dolin, it should not be liable,” the company said in a statement. “Additionally, the Paxil label provided complete and adequate warnings during the time period relevant to this lawsuit.”
Wendy Dolin’s suit, which alleged negligence and wrongful death, originally named the generic drug manufacturer and its distributor as defendants, but U.S. District Judge James Zagel ruled earlier to release them from the suit, saying they had no control of the drug’s label.
“We’re hoping this sends a clear signal to (GSK) that they need to change the label” to indicate a suicide risk for those over the age of 25, said R. Brent Wisner, one of Wendy Dolin’s attorneys, who called the lack of such labeling “outrageous.”
“We’re just really happy that we finally had a chance to bring all this to court for the first time (and) show all these documents to the public which had, until this day, been under seal,” he said.
Wendy Dolin now advocates for patient safety and aims to raise awareness about akathisia, a state of restlessness or anxiety that sometimes occurs as a side effect of certain antidepressant and antipsychotic drugs. She has started a nonprofit organization, the Medication-Induced Suicide Prevention and Education Foundation in memory of Stewart Dolin.
“I think Stewart would be very proud of his family and how we’ve all stood together and made a difference,” Wendy Dolin said, “that we didn’t allow this injustice.”
If a corporate entity can be held responsible for medication that they originally produced… can be held responsible for a pt committing suicide when taking that medication..
It is a know fact that chronic pain pts have a twice possibility of committing suicide.. so if some entity fails to treat chronic pain or reduces a otherwise stable chronic pain pts medication and they commit suicide.. could they he held responsible for their suicide ?
The unprecedented scourge of opioid overdose deaths, which is devastating the Midwest, has not spared Minnesota. Like most other states in the region, increases in deaths have skyrocketed — by as much as fivefold within a few years.
Unfortunately, it appears Minnesota is heading down the same misguided path that kickstarted the nationwide plague seven years ago — simply stopping the pills.
Minnesota’s state Attorney General Lori Swanson recently joined her Wisconsin counterpart Brad Schimel in a media campaign called “Dose of Reality.” It seeks “to raise awareness about how to safely use, store, and dispose of opioid prescription painkillers.” Both Swanson and Schimel have bought into a false narrative that sounds plausible but has, in fact, had the opposite effect, hurting both addicts and pain patients alike.
Much of the narrative is a result of bungling at the Centers For Disease Control and Prevention. The agency, which failed to understand addict behavior, developed a naïve and simplistic strategy that may have sounded reasonable but backfired horribly. Turning off the spigot of opioid medications at the pharmacy has been an unmitigated disaster by any measure.
Addicts are dying in record numbers, but not from pills such as Vicodin or Percocet. This is the false narrative. The real killers are injectable narcotics like heroin and its evil cousin fentanyl. Perhaps worse, patients with severe pain who have been living barely tolerable lives now must fight increasingly Draconian regulations to obtain the medication they need to survive.
We should have learned our lesson in 2010, the year abuse-resistant OxyContin was approved. The evidence was there for all to see. As OxyContin use plummeted, addicts switched in droves to heroin. This should have, but did not, prevent another false narrative: that today’s deluge of addiction resulted from over-prescribing opioids to patients with legitimate needs who later became addicts.
Is the narrative convincing? Yes. Accurate? Anything but. Multiple reviews — including a systematic, evidence-based analysis known as a “Cochrane Review” of 26 studies — and a 38-study review in the journal Pain concluded that a very small number, about 10 percent, of people who took opioids to manage pain become addicted. Rather, the vast majority of today’s addicts became so because of the recreational use of opioid pills; they later progressed to injectable narcotics once the pills became prohibitively expensive and difficult to obtain.
Beginning around 2013, an already-bad situation began to worsen. The demand for heroin became so great it was supplemented with, or replaced by, fentanyl, which is not only far more dangerous but also very easy to synthesize. Even chemists with marginal skills, mostly in China, can prepare large quantities of the drug in a short period of time. From there, it makes its way to Mexico, the source of virtually all fentanyl in the United States.
The result of this confluence of events could not be clearer. In Massachusetts, during the first quarter of 2016, more than 90 percent of overdose deaths involved fentanyl, heroin, or both, compared to 10 percent for prescription opioid pills. Data from the departments of health in Ohio, Philadelphia, and Florida show that heroin and/or fentanyl is responsible for about 80 percent of opioid overdose deaths. Kentucky, despite a crackdown on pill mills and doctor shopping, ranks third in the nation in heroin/fentanyl deaths, which have tripled since 2010.
The notion that the unwinnable war on drugs can be won by counting Vicodin prescriptions is perversely wrong. The crack and methamphetamine epidemics did not begin from prescriptions. Neither did this one.
Worse still, the federal Drug Enforcement Administration is now seizing deadlier analogs of fentanyl, some of which are over 100 times more potent. Overdose deaths will only increase as these “super fentanyls” make their way into bags of “heroin.”
The lesson we should have learned in 2010 is that the only policy worse than not restricting opioid pills is over-restricting them. Pain patients suffer, and more addicts die. Everyone loses.
Jonathan “Josh” Bloom is the director of chemical and pharmaceutical sciences for the American Council on Science and Health in New York City (acsh.org).
Ryan Johnson was 22 when he succumbed to a heroin addiction that had intensified as the Erie, Pennsylvania, high school graduate grew disillusioned with his future. His mother found him in his room with his head slumped and lips blue.
It was June 28, 2014, the day of his sister’s master’s-degree graduation party.
“He just saw his life as not what he wanted it to be, and he didn’t know how to get it there,” said Sue Johnson, who lay next to her son’s corpse for an hour. He had dropped out of a two-year culinary program and was working part-time, low-wage jobs. He often compared himself with his peers in college and his athletic, academic older sister.
The fates of the less-educated and those who graduate from universities diverge in dire ways. Middle-aged white Americans without four-year degrees are at increasing risk of dying, a well-documented trend driven not only by drug use but also by alcoholism, suicide, and slowing progress against heart disease and cancer. Outcomes may worsen further as millennials-Johnson’s generation-grow older.
“America is not a great place for people with only a high school degree, and I don’t think that’s going to get better anytime soon,” said Angus Deaton, a Nobel Prize-winning Princeton University economist.
It’s too soon to tell whether millennials will die at higher rates in middle age than today’s 45- to 54-year-olds, said Anne Case, a Princeton economist who identified the “deaths of despair” trend with Deaton, her spouse and co-author. But in stories like Johnson’s, there are reasons to worry.
Case and Deaton have a theory for why mortality has risen for less-educated whites. For all the debate over whether college is worthwhile, high school graduates who go straight into the workforce have higher unemployment, weaker wage growth, and less chance of marrying than their predecessors and educated peers. Community supports have broken down, and as disadvantage snowballs, premature deaths rise.
Those problems could intensify for the next generation that reaches middle age. Many millennials, born after 1980, joined the workforce during the Great Recession, so they faced low starting salaries and tough job prospects. And they’re saddled with student debt. Still, almost two-thirds lack a bachelor’s degree, which in today’s economy is a near-prerequisite for jobs that provide higher wages and benefits.
Meanwhile, marriage is happening later and less often. Religious affiliation and union membership have declined, so when life doesn’t work out well for millennials, they’re on their own.
While blacks and Hispanics without college degrees are also falling behind economically and socially, middle-age mortality has worsened for whites in particular over the past 20 years-a fact some attribute partly to social context.
“For whites, their reference group is previous generations of whites,” said Shannon Monnat, a Penn State University professor who studies the opioid epidemic in rural America. “When they look back on their parents and grandparents, it feels like their generation is doing worse.”
Such decline runs deep in Erie, where Johnson attended school and worked a string of part-time restaurant jobs. Nestled against the gray-green waters of one of America’s Great Lakes, the town has been declining since the 1970s. Its population dropped below 100,000 in 2014 for the first time since 1920.
Formerly grand red-brick factories have broken windows and vine-covered exteriors. The local General Electric Co. plant, which makes locomotives for export, has shed almost half its workforce in recent years-1,500 jobs were cut last year, and 950 were moved to Texas in 2013. While service industries including health care show signs of life, high-paying jobs that require only a high school education are increasingly limited.
“A lot of that leads to despair, to hopelessness,” said Scott Slawson, a longtime GE welder and union local president. “It’s a scary path we’re on.”
Erie’s suicide rates have risen, with 48 last year, up from 29 a year on average for the past half-century, according to county coroner Lyell Cook. There were 95 drug deaths in surrounding Erie County last year, up from a historically normal 40, and 35 drug deaths in 2017 as of mid-March, with another 12 likely overdoses awaiting toxicology reports.
The opioid crisis, born of heavy prescribing of addictive pills and compounded by readily available street heroin, has added fuel to the fire for people already facing a tough labor market.
“It stems from depression,” said Jack Martin, a 63-year-old funeral director who’s dealt with many overdose deaths. That’s especially true for younger victims. “When they look down the road: Am I going to get married? Am I going to be successful? Am I going to have enough money?”
Just 71.3 percent of 25- to 34-year-olds who graduated high school but didn’t go on to college were employed in 2016, versus 85.2 percent of college graduates.
Signs of distress are already showing up. Today’s 20- to 34-year-olds are killing themselves at higher rates than people of similar age in 2000. Alcohol-induced deaths have been rising across age groups, and the rate doubled for 25- to 34-year-olds from 1999 to 2015, based on Monnat’s analysis of Centers for Disease Control and Prevention data.
Nationally, 25- to 34-year-olds make up the biggest share of opioid overdoses, and their proportion has been climbing, based on Kaiser Family Foundation data.
Johnson started using opioids in high school after breaking his collarbone, first in football and again while wrestling, and he got hooked on his prescription, his mother thinks. He was a functional addict at first, caring and warm, but things slipped out of control after he graduated and found that his skills-art and cooking, but not academics-meant little in the workforce. After dropping out of culinary school, he went to rehab for the first of three times.
At one point, things were looking up: He was clean and got a full-time job making wood pallets. But his co-workers did drugs, and before long, he was using again.
“That was the thinking there: It’s a stupid job. It doesn’t matter if you’re high to work it,” his mother said.
The cycle ended in June 2014. While she was getting ready for the party for her daughter, who had earned a degree in occupational therapy, Sue Johnson went to wake her son. She couldn’t: He had overdosed.
The next year, Martin, the funeral director, started teaching students at a local high school about opioid abuse. He brings health classes to his funeral home and shows them the white-tiled preparation room and the cold, steel table where he lays out bodies.
“I actually scare the crap out of them,” he said. “But it works.”
He shows them pictures of heroin-dead, explaining that just years before their bodies passed through this sterile room, the deceased had walked high school halls. Among the pictures is a snapshot of Johnson, shaggy-haired and smiling.
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.
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”…
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.
Selling Senior Care: Kept in the Dark
Many people want to be reassured they’ve found a safe home for aging parents. Sometimes, they are badly misled.READ THE SERIES
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.
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.
Sue Crawford talks about the challenges she’s faced in caring for her mother. Here, Sue was on her way to visit her mother at Avamere at Sherwood, an assisted living center in Sherwood, Oregon. Crawford tried to ensure that her mother was properly cared for at the end of her life. She placed her in Washington Gardens Memory Care in Tigard in 2015 but kept her there only stayed there three months. Crawford, who considered the care at Washington Gardens to be shoddy, placed her mother in two more facilities, ending up at Avamere at Sherwood. Ewins died in 2016 after suffering from dementia. Beth Nakamura/Staff
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.
Kate Brown
Brown is the governor of Oregon.
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.
U.S. Sen. Jeff MerkleyThe Oregonian/OregonLive
“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.
Selling Senior Care: Kept in the Dark
The Oregonian/OregonLive has posted all substantiated complaints available from 2005 through early 2016 on its website, including those that the state has held back. Visit OregonLive.com/senior-care.READ ALL STORIES
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.
Alissa Keny-Guyer
Keny-Guyer chairs the Oregon House Human Services committee.
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.
Clyde Saiki
Clyde Saiki is the director of the Department of Human Services.
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.
Selling Senior Care: Kept in the Dark
Abuse, as defined in Oregon statute, spans everything from physical, verbal and sexual harm to neglect and abandonment. Financial exploitation is also abuse, as is the unnecessary use of restraints.READ ALL STORIES
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.
Sara Gelser
Gelser chairs the Oregon Senate Human Services committee.
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.
“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’
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.”
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.
Additionally, Martha MacCallum will stay at 7 p.m. in a program that will be re-titled “The Story” starting April 28. She has been hosting a program centered on the first 100 days of President Donald Trump’s administration. Eric Bolling, a longtime “Five” contributor and “O’Reilly Factor” substitute anchor, will get a new 5 p.m. show starting May 1.
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.
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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