How a SINGLE PAYOR national healthcare system could work ?

VA retaliation against whistleblower: doctor kept in empty room

http://www.foxnews.com/us/2017/03/30/va-retaliation-against-whistleblower-doctor-kept-in-empty-room.html

Dr. Dale Klein may be the highest-paid U.S. government employee who literally does nothing while he’s on the clock. A highly rated pain management specialist at the Southeast Missouri John J. Pershing V.A., Klein is paid $250,000 a year to work with veterans, but instead of helping those who served their country, he sits in a small office and does nothing. All day. Every day.

“I sit in a chair and I look at the walls,” the doctor said of his typical workday. “It feels like solitary confinement.”

A double board certified physician and Yale University fellow, Klein said the Department of Veterans Affairs (V.A.) took away his patients and privileges almost a year ago after, he alleges, he blew the whistle on secret wait-lists and wait-time manipulation at the V.A. in Poplar Bluff, Mo., as well as his suspicion that some veterans were reselling their prescriptions on the black market.

When his superiors did nothing, Klein went to the inspector general.

“Immediately after the V.A. found out I made these disclosures, I started to get retaliated against,” Klein said.

Klein was initially placed on administrative leave. The Missouri-V.A. closed his pain management clinic and tried to terminate him. According to court documents, the V.A. tried to fire Klein “not based on substandard care or lack of clinical competence” but instead for “consistent acceleration of trivial matters through his chain of command.”

“I do not consider secret wait-lists and manipulations of wait times to be trivial matters,” Klein said.

The Office of Special Counsel, an independent federal investigative agency in Washington, D.C., made it clear that since the doctor was a whistleblower, he could not be fired. But Klein said the retaliation continued and believes his superiors stripped him of his duties to silence him.

“It could set a bad precedent for other whistleblowers because they’re going to say, ‘I don’t want to risk my livelihood, my career, my security because I see what happened to Dr. Klein and I don’t want that to happen to me or my family’,” said Natalie Khawam, president and founder of the Whistleblower Law Firm, which represents Klein.

The situation grew so dire that Senate Homeland Security and Government Affairs Committee Chair Ron Johnson, R-Wisc., chose to step in, writing a letter in January to the acting V.A. secretary requesting the V.A. “cease all retaliatory actions” against Klein.

“I’m concerned about a doctor who could be utilizing his skills to help veterans, but who is not able to utilize those skills,” Johnson said.

Remarkably, Klein isn’t the only V.A. employee who allegedly has been retaliated against. In fact, his story sounds eerily similar to that of Brian Smothers, who worked at the Denver V.A. from 2015 until last November when he says conditions grew so hostile he quit.

Smothers served in the Colorado Army National Guard and Reserves from 1999 to 2007, and later joined the Denver V.A. to help veterans engage with their own healthcare and assisted the Post-Traumatic Stress Disorder clinical team.

“I come from a family of veterans who really highly values service to others and helping veterans and that’s what I wanted to dedicate my life to doing… helping veterans who may be struggling,” he said.

Smothers was working as a peer support specialist when he alleges he found more than 3,500 veterans on what he believes were “secret” wait-lists at V.A. facilities in Denver, Golden and Colorado Springs.

“It looked like some kind of game they were playing with veteran’s mental healthcare, and I was very upset,” Smothers said. “It became clear to me very quickly that many of the veterans that were on the PTSD clinical team’s wait-list had been waiting for care for three, four, five, six months,” Smothers said.

The reason, Smothers alleges, is profit: “People who run the V.A. and the mental health division hid these wait-lists so they could meet performance goals, and as a consequence of meeting these goals, got bonuses. They defrauded the federal government because it benefited them.”

Smothers is haunted by one veteran’s death in particular, an Army Ranger in Colorado Springs who told the V.A. that he had been waiting for care and was suicidal. Instead of helping him, the V.A. allegedly placed him on a wait-list and he committed suicide a short time later, Smothers said.

“I wish I could have done more to change the system from within because as far as I understand nothing is being done to change any of this,” Smothers said.

After Smothers reported the allegations to the inspector general, he said his superiors retaliated by forcing him to sit in his office, without any work assignments or authority to see patients. Human Resources also tried to get him to destroy the wait-lists, he alleges, and sign a piece of paper saying he had “compromised the integrity of the healthcare system,” Smothers said.

The V.A. declined to address the allegations on camera and instead referred us to the inspector general, who confirmed it “identified wait-time and other issues in recent published reports and testimony before Congress regarding Colorado V.A. facilities.” 

Sen. Johnson intervened on Smothers’ behalf and got the inspector general to launch an investigation.

“It has quite honestly been shocking to somebody like me who comes from the private sector, the pervasiveness of retaliation even though we have 100 years of laws against retaliating against whistleblowers in government,” Johnson said.

Johnson is now trying to pass a whistleblower protection bill to help V.A. employees like Smothers and Klein.

A spokesperson from the V.A. said due to on-going investigations, the V.A. cannot comment on specific cases but added the department recognizes the importance of all employees, to include whistleblowers, who identify problems that impede the optimal delivery of care and services to Veterans.

Klein said he hopes the V.A., under the Trump administration, will make substantial changes so veterans can get quality care they need and so those who uncover problems or wrongdoing – and report it – are protected.

“This is a heart-stopping moment for the V.A. and the transformation can start in Poplar Bluff, Mo.”

 

A new chronic pain group

www.opioidpainpatients.com/

https://www.facebook.com/opioidpainpatients/

 

 

marijuana industry: unintended consequences ?

Denver marijuana industry is eating into area’s restaurant jobs

http://www.foxnews.com/food-drink/2017/03/31/denver-marijuana-industry-is-eating-into-area-s-restaurant-jobs.html

The population of Denver has been steadily growing over the past few years, but not enough of its new inhabitants want to work in the restaurant industry.

The reason? The higher-paying jobs are in weed, man.

New eateries are popping up all over Denver to meet the increased demand of residents and tourists, but restaurant owners claim they’re having a hard time filling their kitchens with able-bodied workers, Bloomberg reports.

“Our work force is being drained by the pot industry,” Denver restaurateur Bryan Dayton told the site.

“Enter the weed business, which pays $22 an hour with full benefits,” added Dayton. “You can come work in a kitchen for (me) for eight hours a day, in a hot kitchen. It’s a stressful life. Or you can go sort weed in a climate-controlled greenhouse. It’s a pretty obvious choice.”

So why don’t restaurant owners just pay a little more? Quite simply, the marijuana industry can generally afford to pay workers at various levels much higher wages, they argue.

In 2016 alone, Fortune reports that Colorado businesses brought in over $1 billion in revenue — as well as $150 million in tax revenue for the state — but dispensaries and growhouses don’t have the same kinds of margins or overhead as the dining industry, say restaurateurs.

“If you make 10 percent profit in the restaurant business, you are in the hall of fame as a great operator,” explained award-winning sommelier and Denver restaurateur Bobby Stuckey. “Compare that to most other businesses — and presumably the legal pot industry — where if you did 20 percent profit, you would be fired.”

Stuckey, too, claimed that marijuana dispensaries — which supply strong strains of pot and THC-infused edibles — are largely responsible for a 2 percent decline in alcohol sales at his restaurants, as patrons are choosing to show get high instead of drink.

But lucrative paychecks may not be the sole reason Denver’s waitstaffs are leaving for greener pastures. Bakers and pastry chefs are seeing new opportunities in the edible pot industry, says Jennifer Jasinski, who owns multiple eateries in the city.

“Laced candies and gummy bears are sought-after treats when they are made well, so pastry chefs and cooks can make them for three to four times the money a restaurant can pay,” Jasinski told Bloomberg.

On the other hand, Eater cites a study from The Oregonian which found that dispensary employees in Oregon, where recreational marijuana was legalized in 2015, earned an average of $21,000 per year in 2016, or “well below the average annual wage in Oregon,” according to economist Josh Lehner of the Oregon Office of Economic Analysis.

Whatever the reason for Denver’s dilemma, Dayton told Bloomberg that there is a small silver lining to the cloud of marijuana smoke that’s hanging over his restaurants: More tourists are suffering from an acute case of the munchies.

 

Methadone Accounted for 23% of Opioid OD Deaths in 2014

Methadone Accounted for 23% of Opioid OD Deaths in 2014

http://www.medpagetoday.com/painmanagement/painmanagement/64247

CDC report: Higher use of the prescription drug found among Medicaid population

  • by Molly Walker
    Staff Writer, MedPage Today
 Methadone-related overdoses accounted for nearly one in four deaths related to prescription opioids in 2014, despite a recent decline in drug overdose deaths involving methadone, said researchers from the Centers for Disease Control and Prevention.

Overall, the rate of methadone-overdose deaths increased 600% from 1999 to 2006 (from 0.3 persons per 100,000 to 1.8 per 100,000) before declining to 1.1 per 100,000 in 2014, reported Mark Faul, PhD, and colleagues.

While the drug accounted for only 1% of all opioid prescriptions, methadone-related deaths were responsible for 22.9% of opioid-related deaths in 2014, the authors wrote in the Morbidity and Mortality Weekly Report,

In an attempt to explain this decline in methadone-related mortality, the researchers noted that the FDA issued a Public Health Advisory in December 2006 that linked methadone to reports of respiratory depression and cardiac arrhythmias, among other serious side effects. Moreover, in January 2008, there was a voluntary manufacturer restriction that limited the distribution of the 40 mg formulation of methadone.

Faul and colleagues also examined methadone prescription by insurance type and found that prescriptions for methadone accounted for a higher portion of all opioid prescriptions in the Medicaid population compared with the commercially insured population — 0.85% weighted versus 1.1%, respectively.

Further, the team investigated the role that Medicaid preferred-drug-list (PDL) policies played in these potential deaths, examining the rates of fatal and nonfatal methadone overdose among Medicaid enrollees in two states where methadone was listed as a preferred drug on its PDL (Florida and North Carolina) versus one state where methadone was not listed on the PDL (South Carolina). Not surprisingly, overdose rates were significantly lower in South Carolina than in both North Carolina and Florida:

  • Florida: 1.75 per 100,000 persons, 95% CI 1.57-1.94
  • North Carolina: 1.67 per 100,000 persons, 95% CI 1.35-1.98
  • South Carolina: 0.81, 95% CI 0.65-0.96

“Given that methadone prescribing rates are higher among persons enrolled in Medicaid, strategies to reduce methadone prescribing among persons in this population might further reduce injuries and deaths from methadone,” the authors wrote. “If confirmed by additional studies, other states could consider Medicaid drug utilization management strategies such as PDL placement among other evidence-based strategies.”

The researchers examined three sources for these data: Drug overdose deaths and mortality rates were calculated through National Vital Statistics System Multiple Cause of Death mortality files and bridged U.S. Census data for 1999-2014. Truven Health’s MarketScan database for commercial claims and encounters was examined and compared with information from Medicaid multistate databases for 2014. Finally, Health Care Utilization Project data were examined from three states to determine whether a state’s policy was associated with higher methadone morbidity and mortality rates.

Methadone can be a excellent pain management medication but it should not be prescribed by prescribers that are not “up to speed” on the idiosyncrasies of this medication and does not do the necessary follow up testing on pts taking Methadone.

IMO.. this is another good example of bureaucrats interfering with the practice of medicine by mandating Methadone as the drug of choice for Medicaid pts because Methadone is a VERY INEXPENSIVE medication.

Of course, no bureaucrat/politician will be held responsible for helping to contribute to all these preventable deaths.

Bureaucrats restrict legal opiates while China PUMPS ILLEGAL OPIATES into our country

DEA: Made-in-China Lethal Opioid Fueling U.S. Drug Epidemic

http://www.foxbusiness.com/features/2017/03/31/dea-made-in-china-lethal-opioid-fueling-u-s-drug-epidemic.html#

A homemade designer version of fentanyl, the highly addictive opioid which is similar to morphine but is 50 to 100 times more potent, has been the center of drug busts across the country this month—with law enforcement pinpointing its origin from underground labs in China. The DEA says the China-U.S. supply is further fueling the country’s drug epidemic.

“This stuff is unbelievably potent. It is so powerful that even a tiny amount can kill you,” DEA spokesman Rusty Payne tells FOX Business. “China is by far the most significant manufacturer of illicit designer synthetic drugs. There is so much manufacturing of new drugs, [it’s] amazing what is coming out of China. Hundreds of [versions], including synthetic fentanyl and fentanyl-based compounds.”

Fentanyl, the opioid that killed singer Prince and is often prescribed to late-stage cancer patients, has been classified as a schedule II drug in the U.S. for decades, which makes it a felony to sell or use without a prescription. China only made the drug illegal in 2015, and at that point black market Chinese labs began increasing production of their own versions, including the one turning up recently across the country called furanyl fentanyl.

“While heroin gets harder to buy on the street or from a dealer, fentanyl comes via FedEx,” Brad Lamm, CEO of Intervention.com, tells FOX Business.

Authorities say dealers across the country have been lacing heroin with the potent analog. Payne adds that Mexican drug cartels are now switching from heroin to fentanyl because of the high-profit margin.

“A kilogram of fentanyl is so much [more] lucrative for a trafficker than a kilogram of heroin, because you can mix a very small amount of fentanyl with a lot of other things and sell it on the streets and take that kilogram a lot farther. And the profits are so much greater,” he says.

But the powder alone is deadly.

“Fentanyl is scary because if it touches your skin you can have major side effects to it, including death,” adds Payne.

The cost of counterfeit pills containing fentanyl or fentanyl-related compounds retail for $10 to $20 per pill in the U.S. (Depending on the purity of the fentanyl and the dosage).

Brooklyn District Attorney Eric Gonzalez announced this week details on a mail-order furanyl fentanyl smuggling ring bust. The operation had been bringing the drug — which has been dubbed “White China” — into the U.S from Asia. NYPD Chief of Detective Bob Boyce said that this was the first time investigators have seen this type of fentanyl in New York City.

Also this week, Cincinnati Customs and Border Protection agents said they seized 83 shipments of illegal synthetic drugs, including 36 pounds of furanyl fentanyl, from China. However, law enforcement said the six shipments of furanyl fentanyl were originally destined for Camden, New Jersey.

Meanwhile, local and state police in Boston this week recovered approximately 520 grams of a white powder that tested positive for fentanyl from behind a freezer in a restaurant basement. Suffolk County District Attorney Dan Conley called it a “major” drug seizure, but did not disclose if the drug was furanyl fentanyl, or if it was made in China.

According to the DEA, fentanyl overdose outbreaks have recently hit Ohio, New York, Pennsylvania, Michigan, Illinois, Alaska, Louisiana and Oregon. In 2015, opiates factored in 33,091 U.S. deaths, which was up more than 4,000 from the previous year, according to the U.S. Center for Disease Control and Prevention.

Payne says China has “really stepped up lately,” working hand-in-hand with the U.S. to help curb this growing problem. In January, DEA acting administrator Chuck Rosenberg was invited to China to meet with Beijing drug control officials at the invitation of the China Ministry of Public Security.

Lamm, who runs a drug and alcohol rehab center in California, warns that while the drug “makes you feel great, like the best high ever,” the potency makes it extremely easy to overdose on.

“It mellows you out to such an extent that you could potentially stop breathing,” he says.

Complaint: #CVS dispensed wrong medication to customer

Complaint: CVS dispensed wrong medication to customer

http://setexasrecord.com/stories/511099973-complaint-cvs-dispensed-wrong-medication-to-customer

MARSHALL – A Cass County man is suing CVS for giving him the wrong medication, per recent Marshall federal court records.

In a lawsuit filed Mar. 30, Atlanta resident Gerald Hobson says that he was supposed to get his prescription of Digoxin from the defendant, but a pharmacy employee neglected to follow the ordering physician’s instructions.

 

Hobson was allegedly dispensed 23 Ambien instead of the Digoxin.

“Shortly after taking what he thought was his Digoxin medication and while operating his vehicle, the Ambien began to effect his cognitive abilities which resulted in Plaintiff having two motor vehicle accidents within a short time period of each other,” court documents assert.

They add that the plaintiff sustained permanent injuries in the accidents.

Consequently, he seeks unspecified monetary damages and a jury trial.

Attorney Reid Wm. Martin of the law firm Martin Walker in Tyler is representing Hobson.

Marshall Division of the Eastern District of Texas Case No. 2:17-CV-0248

what to do.. when they say no and pt is denied care

Multiple times a week I get a email/text/phone call from pts asking the same or similar question(s) about being denied care by some part of the healthcare system.  I am going to put this post on the RESOURCE TAB on my blog so that I can just forward that link to pts in the future.

There are a lot of moving parts between the pt and getting appropriate care. Insurance companies, Prescription Benefit Managers (PBM), Hospitals and their employed prescribers,  prescribers in private practice, bureaucrats/politicians.

If at all possible, it is advisable to do a audio/video recording of what the healthcare provider said as to what he/she was going to do or not do and, if possible, the reasons for his/her decisions. Prevents in the future the healthcare professional developing amnesia of what was said and/or denying what they said.

Likewise there are numerous potential legal issues that may apply to a individual pt:

Americans with disability act discrimination – which is considered a civil rights violation. https://www.justice.gov/crt/how-file-complaint  there could be a ADA law also at the state level.

patient abandonment is involved  What is Patient Abandonment?

Medical Battery

PT/Senior Abuse – denial of care and/or throwing pt into cold turkey withdrawal

Failure to meet standard of care and best practices (Malpractice)

The CDC opiate dosing guidelines that were published in March 2016 have become de-facto standard of care and best practices. Some prescribers are claiming that they are following these guidelines, when in fact they are following the MOST STRICT portions of the guidelines that are suppose to only apply to pt with ACUTE PAIN.

Here is four quotes from the CDC opiates guidelines:

https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

“The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function.”

“Clinicians should consider the circumstances and unique needs of each patient when providing care.”

“Clinical decision making should be based on a relationship between the clinician and patient, and an understanding of the patient’s clinical situation, functioning, and life context.”

“This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.”

Core function of the practice of medicine:  Exam pt, diagnose, treat/cure/maintain/prescribe medication 

Prescribing encompasses the starting, changing, stopping a pt medication.  It is ILLEGAL for a prescriber to prescribe medication for a pt that they have not done a in person physical exam. If a insurance company/PBM tells you that they won’t pay for your medication or especially if they stop paying for your medication.. that is the practice of medicine and they don’t have a license to practice medicine.

If your insurance is Medicare/Medicaid/Medicare Advantage:

You need to file a GRIEVANCE with www.cms.gov (800-MEDICARE) against anyone involved with you being denied care.

Don’t let a insurance company/PBM tell you that their policies/limits are in CONCRETE… everything with health insurance can be APPEALED… They don’t have to tell you about this… unless you ASK… then they have to provide you in WRITING what their appeal process is..  Never take NO for a answer from your Insurance company.  With Medicare/Medicaid/Medicare Advantage… there is an appeal process outside of the insurance company’s… once you exhaust the insurance company’s appeal process you have to appeal to a Administrative Law Judge… > 50% of pts that goes this far will get approved.

If your insurance is thru an employer…. you need to find out if the employer is self-insured (ERISA). The employer pays all the bills, the “insurance company” just adjudicates the claims. Contact whoever is in charge at the employer and see if they will intervene… the employer can tell the insurance company to pay/cover whatever you need.

If you h ave single/family insurance policy… then your options may be limited to state’s Insurance Commissioner, Medical Licensing Board, Pharmacy Board, Accreditation Agency – like Joint Commission

Legal action, in our legal system the “value of life” of a individual who is handicapped/disabled, elderly, unemployable has LITTLE VALUE and it is unlikely that a law firm with take a case on a contingency basis because there is little financial upside for the law firm.

As more and more large entities – bureaucrats/politicians, corporations, insurance companies/PBM’s are getting into the business of dictating the practice of medicine. The interest of the class action law firms may change, since the decisions of a corporation with deep pockets that has caused harm to tens of thousands of pts by their actions… means that the class action law firms could see a financial upside in suing a law corporation.

 

 

 

 

“I saw them placing business and profits before patient care,”

Local heart surgeon wins legal battle with Memorial Hermann Hospital

http://www.khou.com/news/local-heart-surgeon-wins-legal-battle-with-memorial-hermann-hospital/427090868

HOUSTON – A heart surgeon won legal battle with one of the best hospital systems in the country. 

Dr. Miguel Gomez, III dragged Memorial Hermann through Texas small and supreme courtrooms. After four years, he won $6.4 million.

Yet, he is in pieces barely holding it together like the diploma on his wall.

“Once they damage your reputation, people lose confidence in you,” said Dr. Gomez.

His grandfather, also named Miguel, left Cuba during its revolution as a med school valedictorian.

Since the government banned him from taking his degree or mailing it to Miami, loved ones shipped it piece by piece through Spain.

Six years later, Miguel, Sr. earned his permit to heal. That commitment inspired his grandson.

“My grandpa was tough and he would have fought the battle I fought,” said Dr. Gomez. “I have no doubt.”

Memorial Hermann Hospital hired Dr. Gomez as a surgeon in their renowned Memorial City Heart and Vascular Institute.

For 15 years, he made headlines then quit his dream job over something hard for him to say in public.

“I saw them placing business and profits before patient care,” said Dr. Gomez.

He claims administrators pushed some people to do jobs they never trained for and did not always supply operating rooms with enough or the right equipment.

He complained about it. He lost patients, he said. Instead of performing one to two surgeries a day, he performed one or two a week. 

In their judgement, jurors blamed Memorial Hermann administrators for targeting him in peer reviews and crushing his reputation with misleading stats on his patients dying, court documents said.

In a statement, a hospital spokesperson called the ruling “disappointing.”

“While we have the utmost respect for the judicial process, Memorial Hermann is disappointed with Wednesday’s verdict. At trial, Dr. Gomez questioned the System’s quality review process, expressing concerns that he was unfairly targeted because his mortality data was misleading and made him look bad.

However, our focus on quality data has never been about singling out one specific physician or physicians; rather we rely on that data to form the basis for our process, the same process widely accepted and utilized nationwide, to evaluate and improve the quality of care provided by our physicians and hospitals.

While we had hoped the jury would recognize this important distinction, the process we began in 2009 has helped get the System to where it is today. 

In 2012, Memorial Hermann became the first health System in Texas to be awarded the prestigious Eisenberg Patient Safety Award, an award presented by the National Quality Forum and The Joint Commission which recognized us as leaders in delivering safe, effective health care with a patient-centered focus.

We are proud of our employees and affiliated and private physician partners, who helped make this achievement possible and have consistently followed best practices to continuously improve patient safety and quality.

Nowhere is this perhaps more evident than at Memorial Hermann Memorial City Medical Center, which today ranks among the best cardiovascular surgery programs in the country. Over the last several years, the Medical Center has earned the top three-star rating from the Society of Thoracic Surgeons on more occasions than any other hospital in Houston, based on public reporting.

A three-star recognition means a facility is in the top 7 to 8 percent of hospitals nationally and is the highest possible rating a facility can receive for cardiovascular surgery.

The purpose of reviewing quality data was not to hurt Dr. Gomez but to improve patient safety, which it did and continues to do today and, going forward, the System will continue to take the steps necessary to ensure our patients are receiving the safest care possible. This verdict will not change that.”

The hospital system still boasts the highest possible rating for cardiovascular surgery and patient safety awards. It matters little to Dr. Gomez.

Though he works with another hospital, his reputation remains scarred, he said.  Dr. Gomez does not know when his business will recover. However, his family history suggests it is just a matter of time.

KY Senate OKs bill limiting some painkiller prescriptions

KY Senate OKs bill limiting some painkiller prescriptions

www.wtvq.com/2017/03/30/senate-oks-bill-limiting-painkiller-prescriptions/

FRANKFORT, Ky. (AP) – Kentuckians would be limited to a three-day supply of powerful prescription painkillers in most cases under a bill that has cleared the state Senate on the final day of the legislative session.

The Senate voted 29-9 to approve House Bill 333 on Thursday. The bill forbids doctors from prescribing more than a three-day supply of prescription painkillers but lists many exceptions including cancer treatment, chronic pain and end-of-life care.

The bill also defines “fentanyl” and “carfentanil,” two synthetic drugs similar to opioids but much more dangerous. Fentanyl accounted for 420 drug overdose deaths in 2015, up from 121 deaths in 2014, according to the most recent drug overdose report.

The Senate made a few changes to the bill. If the House agrees by midnight, it will go to the governor’s desk.

State Law Enforcement Concerned About Growing Presence of Synthetic Opioid Carfentanil

State Law Enforcement Concerned About Growing Presence of Synthetic Opioid Carfentanil

http://www.kaaltv.com/article/stories/S4440562.shtml

Authorities concerned about recent overdose deaths attributed to a powerful synthetic opioid aim to get out in front of what they say is a growing public safety concern.

A Thursday press conference at Minneapolis City Hall comes on the heels of a medical examiner report showing a Faribault woman’s overdose death in February was attributed to carfentanil, a synthetic opioid 10,000 times more potent than morphine. 

Several officials who spoke called this a “crisis.” 

Carfentanil is used as a tranquilizing agent for elephants and other large mammals, and its lethal dose in humans is unknown, according to the Drug Enforcement Administration. Fentanyl is lethal around 2 milligrams. Faribault police on Thrusday said an amount of Carfentanil the size of a grain of salt could be deadly.

The drug can come in several forms and can be absorbed through the skin or through accidental inhalation, according to the DEA. The agency said that means the drug poses a serious risk to first responders and health care workers as well.

Authorities say the drug has been linked to five confirmed carfentanil overdoses deaths across the state. These cases happened between Jan. 30 to Feb. 17. Three cases were in Minneapolis, one was in Dakota County and the other in Rice County. 

An additional four to five cases are waiting for toxicology reports to confirm carfentanil is the cause of death.

Dr. Andrew Baker, chief medical examiner for Hennepin, Dakota and Scott counties, said at the press conference that toxicology reports do not show the presence of carfentanil at an autopsy.

Therefore, it requires specialized testing. 

Baker said the routine drug and alcohol screenings are usually “quite comprehensive.” But when recent cases did not turn up a cause of death, special testing was sought for carfentanil.

The victims ranged in age from 23- to 43-years-old, Baker said. And they were “otherwise free of disease.” 

Law enforcement officials say the drug’s presence in the illicit U.S. market is concerning, as the relative strength of carfentanil could lead to overdoses even among opioid-tolerant users. 

In fact, heroin or fentanyl users might not even be aware the drug is laced with carfentanil, a DEA agent said at the press conference. Distributors might not know either. 

The DEA agent also said the drug is so strong “there is no way you could dilute it for human consumption.” 

Carfentanil comes mostly from China, and it is brought in via traditional trade routes through Mexico, authorities report. 

The DEA issued a nationwide warning about the drug in September, saying its improper handling could be deadly. The drug is 100 times more potent than fentanyl, which is 50 times more potent than heroin, according to the DEA warning.

“Deadly carfentanil in Minnesota is extremely concerning for public safety,” Fairbault Police Chief Andy Bohlen said. “And we urge citizens to contact law enforcement if someone has come in contact with this substance.”