I guess they are right… you can’t please everyone

A email from someone who is obviously not a fan

Thank you for being the worst possible version of yourself. Thanks to your imbecilic, ancient perspective on how to be a pharmacist, I’ve got drug addicts quoting your statements to me, telling me I am violating their civil rights. In truth, I’m denying people filling subutex, instead of suboxone, for no medical reason. Who also showed up in a group….who also had filled suboxone a few days ago at a different pharmacy, from a different md. But you say pharmacists are in the wrong. You immediately recommend legal action in your responses. You are terrible person. Thanks for justifying and empowering the threats of junkies everywhere.

Retirement was hard on you. By every account I can find, you once fought for pharmacists. Hilarious, considering your outright dismissal of us now. There are still a few here and there who remember you as a reasonable person. But that’s not you anymore. Instead, you pass judgement from retirement. Your perspective was likely spot on while you were active, but that’s not current pharmacy. Here’s a exercise that could determine your intentions…..comment on the situation I referenced in my first email. You noticeably failed to do so in your first response.

Apparently, according to this Pharmacist… my blog has an extensive readership of drug addicts… sounds to me that this Pharmacist would seem to believe that most everyone taking a opiates is a drug addict.

How the CDC Misclassifies Opioid Overdoses

How the CDC Misclassifies Opioid Overdoses

www.painnewsnetwork.org/stories/2016/1/12/how-the-cdc-misclassifies-opioid-overdose-deaths-1

By Denise Molohon, Guest Columnist

I think the minute anyone without bias or personal agenda began reading through the CDC’s proposed guidelines for opioid prescribing, they must seriously question many things.

Chief among them, the highly suspect “low to very low quality” evidence being presented to support their “strong recommendations,” but also their dangerously skewed data; which ultimately could leave millions of chronic pain sufferers critically ill, without sound medical treatments, and with little to no quality of life.

In a recent CDC Morbidity and Mortality Weekly Report (MMWR) on drug and opioid overdose deaths, I found myself doing the exact same thing — seriously questioning the data. In 2014, the report found that 28,647 people died of drug overdoses involving opioids, including heroin, a 14 percent increase over the previous year. 

However, the CDC admits in the MMWR, that “some overdose deaths may have been misclassified and the data has limitations.” I wondered how much was misclassified? Exactly what data has limitations and why?

I believe the American people have a right to transparency and full disclosure, not flawed data that is often presented in a confusing manner, such as the following qualifiers in the MMWR:

“At autopsy, toxicological laboratory tests might be performed to determine the type of drugs present; however, the substances tested for and circumstances under which the tests are performed vary by jurisdiction.”

“The percent of overdose deaths with specific drugs identified on the death certificate varies widely by state.”

“Approximately one fifth of drug overdose deaths lack information on the specific drugs involved. Some of these deaths might involve opioids.”

 “Heroin deaths might be misclassified as morphine because morphine and heroin are metabolized similarly, which might result in an underreporting of heroin overdose deaths.”

 If heroin deaths are being misclassified as morphine, which results in the “underreporting” of heroin overdose deaths, then wouldn’t the opposite also hold true? That there is “over-reporting” of morphine deaths, which are then misclassified as prescription opioid deaths? 

According to the Washington Post, CDC Director Tom Frieden admitted some heroin overdose deaths were counted twice!

Another egregious misclassification, which I find grossly unjustified, is the following:

“Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as ‘prescription’ opioid overdoses.”

On the surface this statement doesn’t appear too concerning. Until you begin to take a closer look at what has been happening over the last 3-5 years with heroin and illicit fentanyl overdose deaths, and how both illegal and legal opioids have been lumped together into one category.

All opioid pain reliever deaths are counted as “prescription” opioid overdoses. Why?

“Natural opioids” includes those heroin deaths that were misclassified as morphine related overdose deaths, which no doubt contributed in some degree to that 14% increase in opioid overdose deaths in 2014.

But how many of these heroin deaths were misclassified? We may never know. The DEA reported last year in its National Heroin Threat Assessment Summary that, “Many medical examiners are reluctant to characterize a death as heroin-related without the presence of 6-monoaceytlmorphine (6-MAM), a metabolite unique to heroin, but which quickly metabolizes into morphine.  Thus many heroin deaths are reported as morphine-related deaths.”

illicit fentanyl seized in ohio

illicit fentanyl seized in ohio

“Synthetic opioids” includes not only prescribed fentanyl, which is a potent pain reliever, but illicit fentanyl overdoses,  which have skyrocketed over the last two years. Because most medical examiners and coroners did not routinely test for fentanyl in 2014, many illicit fentanyl/heroin overdose deaths were also probably counted as prescription opioid overdoses. 

Medical examiners and coroners are just now beginning to test for fentanyl because of the sharp rise in overdose deaths in the U.S. and Canada. Both the CDC and the DEA issued advisories about illicit fentanyl overdoses last year, but we don’t know exactly how many deaths there were.

Why is the data about opioid overdoses so flawed and what is the government doing about it?

A federal agency called the Substance Abuse and Medical Health Services Administration (SAMHSA) brought together groups of experts four times in 2003, 2007, 2010, and again in 2013. All agreed uniform standards and definitions were needed for classifying opioid-related deaths. Guidelines were developed in July 2013 by SAMHSA to provide uniform standard procedures for medical examiners, coroners and other practitioners.

The CDC is not only aware of these guidelines, but it recently recommended medical examiners and coroners in all states implement them “to ensure death reports are complete and accurate.”

“It is especially important to include the word ‘fentanyl’ on the death certificate when the drug is a contributing cause of death,” the CDC said in a Health Advisory distributed on October 26, 2015.

Why fentanyl? Based on reports from states and drug seizure data, a substantial portion of the increase in synthetic opioid deaths appears to be related to increased availability of illicit fentanyl, which is often combined with heroin or even sold as heroin.

David J. Hickton, U.S. attorney for western Pennsylvania and co-chair of the Justice Department’s National Heroin Task Force, told the Washington Post that “fentanyl and more potent heroin appear to have contributed to the 2014 spike in fatal overdoses.”

According to the DEA’s National Heroin Threat Assessment Summary, the overwhelming number of fentanyl overdose deaths are not attributable to pharmaceutical fentanyl but rather illicit fentanyl.

“There have been over 700 overdose deaths reported, and the true number is most likely higher because many coroners’ offices and state crime laboratories do not test for fentanyl or its analogs unless given a specific reason to do so,” the report warns. “While pharmaceutical fentanyl (from transdermal patches or lozenges) is diverted for abuse in the United States at small levels, this latest rash of overdose deaths is largely due to clandestinely-produced fentanyl, not diverted pharmaceutical fentanyl.”

Note that the DEA is making a critical distinction between an illegal drug and a legal prescription drug. Why isn’t the CDC doing this?

In my opinion, for the CDC to lump all opioids together as “prescription” opioids or as “pain relievers” shows a highly dangerous bias, an unwillingness to address the soaring number of heroin and fentanyl overdoses, and a lack of competence in taking a responsible leadership role.

If the CDC can’t be counted on to clearly report on the data, sources and causes of overdose deaths, how can we trust their opioid prescribing guidelines?

Stroke has a new indicator!

http://www.wisdomtoinspirethesoul.com/2014/09/strokes-warning-signs.html?m=1

I URGE YOU ALL TO READ & SHARE THIS; YOU COULD SAVE A LIFE BY KNOWING AND PASSING ON THIS SIMPLE INFORMATION.

Stroke has a new indicator! They say if you forward this to ten people, you stand a chance of saving one life. Will you send this along? Blood Clots/Stroke – They Now Have a Fourth Indicator, the Tongue.
 During a BBQ, a woman stumbled and took a little fall – she assured everyone that she was fine and she said she had just tripped over a brick because of her new shoes.

They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Jane went about enjoying herself the rest of the evening.

Jane’s husband called later telling everyone that his wife had been taken to the hospital – (at 6:00 PM Jane passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Jane would be with us today. Some don’t die. They end up in a helpless, hopeless condition instead.

It only takes a minute to read this.

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke…totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

IDENTIFYING A STROKE

Thank God for the sense to remember the ‘3’ steps, STR.
Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.

T *Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently) (i.e. Chicken Soup)

R *Ask him or her to RAISE BOTH ARMS.

If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.

New Sign of a Stroke ——– Stick out Your Tongue

NOTE: Another ‘sign’ of a stroke is this: Ask the person to ‘stick’ out their tongue. If the tongue is ‘crooked’, if it goes to one side or the other that is also an indication of a stroke.

A cardiologist said that if everyone who gets this message shared it with 10 people; you can bet that at least one life will be saved.

I have done my part. Will you?
Please share this link on your Facebook wall. It could save a life.

FDA evaluates popular antibiotic that patients say makes them sicker

FDA evaluates popular antibiotic that patients say makes them sicker

http://www.kctv5.com/story/28170151/fda-evaluates-popular-antibiotic-that-patients-say-makes-them-sicker

KANSAS CITY, MO (KCTV) –

It is an antibiotic powerful enough to kill anthrax or the plague, but it is being prescribed for simple infections like sinusitis and urinary tract infections.

One group wants the Food and Drug Administration to reach beyond a black box warning issued in 2008 for Levaquin after an internal FDA report showed possible links between the drug and debilitating diseases like ALS, Alzheimer’s and Parkinson’s.

“We’re talking about a possible drain on future healthcare costs,” Linda Martin, of Arizona, told KCTV5 News in a phone interview.

Martin took Levaquin three times for sinus infections. She is now an outspoken critic of the drug, helping file a citizen petition last year calling for better labeling by the FDA. Click here to read the petition.

Levaquin is an antibiotic known as a “quinolone” or “fluoroquinolone.” Other brand names include Cipro, Avelox and Levofloaxcin.

“It’s a good antibiotic for infections in many different organ systems in many parts of the body, so it’s very widely used over the last 20 years,” said chief medical officer Dr. Lee Norman at the University of Kansas Hospital.

The FDA issued a black box warning in 2008, a serious red flag meant for doctors to note before prescribing quinolones to their patients. The warning came after the FDA discovered Levaquin to cause tendonitis and tendon tears.

But people like Chris Butler of Raymore say their doctor doled out the medicine three to four times a year for sinus infections well after the black box warning surfaced.

“It makes me angry. It is hard for me to even express just how angry I am. Because I feel doctors, pharmacists, medical practitioners should know about black box warning on drugs,” Butler said.

Butler underwent four tendon tear surgeries and started experiencing neurological disorders before he launched his own investigation into Levaquin. It wasn’t until 10 years after his first Levaquin prescription, he figured out, he had been taking a drug known to cause such injuries.

In 2013, the FDA started warning users of peripheral neuropathy, neurological diseases that can lead to tingling and pain in the limbs. Butler also knows those symptoms well.

“Even to this day I will have shooting pains in my hands and my feet. My hands will go numb, my feet will go numb,” Butler said.

But what hasn’t been disclosed is a condition called “mitochondrial toxicity” detailed in the 2013 internal FDA report. It is a condition that can lead to lasting neurodegenerative diseases.

“Mitochondria are the little organs inside each cell that are basically power plants that generates the cell,” Norman said.

Research in non-human mammals showed quinolones can cause the weakening of those cells.

Martin and the citizen petition wants these possible serious side effects to be on all warning labels for antibiotics like Levaquin.

The FDA told KCTV5 it is not ready to respond to the request.

The group has also shared the information with lawmakers on the U.S. Senate Health Committee which includes Kansas Sen. Pat Roberts. He did not return our messages for comment.

“I trusted my doctors to do what’s best for me. And when I realize when I couldn’t trust them to warn me about the drugs, it was my responsibility,” Butler said.

Butler is not taking legal action against his doctors or the drug company. He says his sole purpose in speaking out is to raise awareness about taking prescription pills like Levaquin.

“It’s being used for things like sinus infections. For women, UTI’s is this drug appropriate for those situations?” Butler asked.

Norman doesn’t believe quinolones should be taken off the market. He says these kinds of antibiotics save lives but consumers need to ask more questions and do research before popping a pill.

“Does every doctor know about every single product and every line of the package insert? No. I can assure you, no,” Norman said, “I really think it’s important people ask questions.”

Opioid & Heroin Town Hall

www.kxl.com/event/opioid-heroin-townhall/

Opioid & Heroin Town Hall

  • March  22 Wednesday 7:00 pm (PDT)
  • Skype Live Studio 1210 SW 6th Ave Portland, OR

Come to the Skype Live Studio for an FM News 101 town hall discussion on the Opioid & Heroin Epidemic. Hear from experts from the medical field, police, and government.


The Opioid & Heroin Town Hall is made possible by Western Psychology Services

One Good Thing with Ken McKim: S1E10 – Sickle Cell Hope

One Good Thing with Ken McKim: S1E10 – Sickle Cell Hope

As Doctors See Benefits of Medical Marijuana Treatments for Seniors, Calls for Changes in Policy

As Doctors See Benefits of Medical Marijuana Treatments for Seniors, Calls for Changes in Policy

Sat, Mar 11

Doctors across the country are calling for a re-think of current government policies, in terms of allowing medical research on medical cannabis, as elderly patients see dramatic results to treat pain.

DEA Shamefully Admits Legal Marijuana is Doing What the Drug War Couldn’t in Decades

DEA Shamefully Admits Legal Marijuana is Doing What the Drug War Couldn’t in Decades

www.anonhq.com/dea-shamefully-admits-legal-marijuana-drug-war-couldnt-decades-video/

By United States federal law, marijuana is illegal irrespective of the reason for its use. The government agency responsible for the regulation of drugs in the country, the Drug Enforcement Administration (DEA), has refused to delist marijuana from Schedule 1 of the Controlled Substances Act.

But despite the federal ban, states have made changes to their marijuana laws. During November 2016, marijuana won major ballot victories in states across the country.

DEAMedical marijuana legalization, on the ballot in Florida, received a whopping 71% support from voters. Medical marijuana legalization also received massive endorsements in Arkansas and North Dakota. Voters in California, Nevada, Massachusetts and Maine also approved measures to legalize marijuana for recreational use in their territories.

The good news is that the legalization spree of the plant by states is yielding massive results. Apart from the fact that legal marijuana has resulted in creating new opportunities through jobs creation and generation of revenues for various state governments, it is also tackling a serious long-time problem facing the United States — the drug problem.

DEA

In 1971, President Richard Nixon started the so-called war on drugs. Nixon argued that there should be a set of drug policies that discourage the production, distribution, and consumption of psychoactive drugs deemed illegal by the United Nations. Of course, Nixon’s argument was accepted by the political elite, and for many decades now, the United States government has waged a ruthless war against drugs.

The economic and human cost of this war has been massive. In 2010, it was estimated that the United States federal government spent over 15 billion dollars on the drug war, amounting to a rate of $500 per second. State and local governments also spent at least $25 billion fighting the drug war during the same period. In 2012, it was again estimated that the country had spent $1 trillion since the Nixon era fighting the drug war. Apart from the wasting of taxpayer money, the United States government also provides military aid to Mexico, which serves as a gateway for drugs entering the United States. The use of force against drug cartels claims nearly 50,000 lives each year. In the United States, over 1 million people, the majority of them African-Americans, are incarcerated every year for drug law violations.

DEA

But despite this financial and human cost, the war on drugs has been a complete failure. The Global Commission on Drug Policy released a report in 2011 stating unequivocally that “The War on Drugs has failed.”

More psychoactive drugs, excluding marijuana, are still finding their way into the United States. Cocaine remains the leading substance entering the United States through the southern part of the country. Although the entry of cocaine and other substances into the United States are on the rise, that of marijuana is reducing significantly.

In 2016, data released by the United States Border Patrol showed marijuana seizures along the southwest border with Mexico have tumbled to their lowest levels in at least a decade. Border agents seized roughly 1.5 million pounds of marijuana at the border — down from a peak of nearly 4 million pounds seized in 2009.

DEA

The big question here is why this sudden drastic reduction? The answer is simple: legal marijuana. Ever since states defied the DEA to legalize marijuana, either for recreation or medical purpose, domestic production of the plant has surged – especially in states such as California, Colorado and Washington.

Basic economics suggests if there is more supply, price will fall. If price falls, business becomes unprofitable. Marijuana prices have therefore fallen in the United States. When states were yet to legalize the plant, users were relying on supplies from Mexico. Because of the Mexican monopoly, the price was high. Mexican growers and smugglers were making huge profits, while the United States was spending scarce resources fighting the trade.

Marijuana growers in Mexico now face tough competition in the United States, making their business unprofitable. It’s now no longer worth smuggling marijuana into the U.S., hence the reduction in seizure by border officials.

DEA

“Two or three years ago, a kilogram [2.2 pounds] of marijuana was worth $60 to $90. But now they’re paying us $30 to $40 a kilo. It’s a big difference. If the U.S. continues to legalize pot, they’ll run us into the ground,” a Mexican marijuana grower told NPR news in 2014.

The DEA confirmed marijuana entering the United States has reduced. The agency went further to say it found evidence of the flow of illegal marijuana starting to reverse, with some cases demonstrating marijuana produced in the United States being smuggled to Mexico.

From the available evidence, legal marijuana has proven the solution to the U.S. drug problem is legalization. If psychoactive drugs in general are legalized, supply would increase, leading to a fall in price. It would then become unprofitable to smuggle, driving away criminal networks associated with the trade.

Why Nobody Has A Right To Health Care

Why Nobody Has A Right To Health Care

www.thefederalist.com/2017/03/10/nobody-right-health-care/

Just because our rights are secured by government, it does not follow that they must be provided by government.

Buried beneath the Obamacare replacement debates is the philosophical question of whether health care is a “right.” Article 25 of the United Nations’ Declaration of Rights, for instance, declares it so. While this is correct as a means, it’s wrong as an end. Understanding the distinction is vital.

For the first time in human history, the Declaration of Independence announced that “all men are created equal.” As Abraham Lincoln argued, everyone is equal because everyone is free, and everyone is free because everyone is equal. Hence no man has the authority to rule over another without the other’s consent. Furthermore, because this equality emanates from the “Laws of Nature and of Nature’s God,” it imbues every individual with the rights to life, liberty, and the pursuit of happiness.

 

Government’s first purpose is to secure these natural rights, which means it’s proper for government to pursue policies that help carry them out. Our right to life, for instance, subsumes the means necessary to achieve it. As Harry Jaffa put it, “Providing food and medical care are among the means by which the purpose of securing the right to life is implemented” (emphasis added).

But just because our rights are secured by government, it does not follow that they must be provided by government. This means that while it is correct to suggest that people have a right to food, it is incorrect to say that the state must provide it. Indeed, flowing from our rights to liberty and life, we have the right to keep the fruits of our labor, through which the marketplace has proved superior in providing access to food, as failed communist states have made clear. This brings us to the heart of what is wrong with declaring health care—ex nihilo—a human right.

If Health Care Is a Right, Doctors Are Slaves

While in a sense we have a right to medical care (which is rightly why nobody is refused in an emergency), we possess it only as a means to an end (the right to life), not as an end itself. Making it an end—a “human right”— signifies that it is no longer legitimate to debate the wisdom and prudence of various means of providing it. In a word, means and ends become inverted. Health care turns into a categorical imperative of government. The result is a betrayal of both natural law and sound public policy.

Natural law emerges from our equality rooted in our common human nature as spelled out in the Declaration of Independence. In the words of Thomas Jefferson: “The evidence of this natural right, like that of our right to life, liberty, the use of our faculties, the pursuit of happiness, is not left to the feeble and sophistical investigations of reason, but is impressed on the sense of every man. We do not claim these under the charters of kings or legislators, but under the King of kings.”

 

Ergo, rights must emerge from and accord with human nature. Here’s Jefferson’s compatriot, George Mason: “Now all acts of legislature apparently contrary to natural right and justice, are, in our laws, and must be in the nature of things, considered as void. The laws of nature are the laws of God: A legislature must not obstruct our obedience to him from whose punishments they cannot protect us. All human constitutions which contradict His laws, we are in conscience bound to disobey. Such have been the adjudications of our courts of justice.”

Medical care stems not from human nature but from outside of it. This “positive rights” view allows for government to grant as a “human right” anything that may be desirable. But this leads to the problem of our “rights” competing with and contradicting one another. If I have a right to health care, then resources must be channeled for that purpose. But what if doing so sucks resources away from providing access to, say, food? Which right trumps which?

It’s Turtles All the Way Down

Some might reply that the solution to this dilemma is to simply legislate food as a human right, too. But that is no solution. For what, then, about housing? A decent wage? Education? Transportation? On what grounds can we reject these as “rights”? The regrettable fact of life is that our desires are infinite, but resources are not. Natural law remains the sole remedy for this predicament.

Moreover, increasing bureaucracy in health care is bad public policy. There is almost no arena in which government offers a good or service cheaper or more abundantly than private markets. Despite what we often hear, health care is hardly a “free market.” The U.S. government spends more on health care per capita than all but three countries in the world. Indeed, nearly half of all our health-care dollars are spent by the state. It’s no wonder costs have spiraled out of control.

 

Importantly, areas of the health industry where Uncle Sam has interfered least, such as cosmetic surgery and eye surgery, have witnessed either stable or declining prices. We would therefore do well to move health policy toward a more, not less, free-market solution.

But the first step in doing so is to understand the true basis of our rights, which begins by reacquainting ourselves with the natural law principles of the founding. “Let us readopt the Declaration of Independence, and with it the practices and policy which harmonize with it,” Lincoln implored. We should take his advice. We might begin with the truth that all men are created equal.

restrictions on opioid prescribing might even increase opioid poisonings

Do Opioid Restrictions Reduce Opioid Poisonings?

https://www.cato.org/blog/do-opioid-restrictions-reduce-opioid-poisonings

In a recent working paper, economists Thomas Buchmueller and Colleen Cary find that one particular kind of restriction does reduce opioid misuse among Medicare beneficiaries:

The misuse of prescription opioids has become a serious epidemic in the US. In response, states have implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient’s opioid prescribing history. While few providers participated in early systems, states have recently begun to require providers to access the PDMP under certain circumstances. We find that “must access” PDMPs significantly reduce measures of misuse in Medicare Part D.

Yet, they also find

no statistically significant effect [of must access PDMP’s] on a key medical outcome: opioid poisoning incidents.

How is this possible?

The simplest explanation is that, despite all the hype, prescription opioids are not that dangerous, even in heavy doses, when used under medical supervision. Instead, most poisonings reflect use of diverted prescription opioids, or black market opioids like heroin, that users obtain when doctors cut them off from prescription opioids. These alternate sources may be adulterated, of higher dosage than the user realized, or consumed with other drugs that generate adverse reactions.

Under this interpretation, restrictions on opioid prescribing might even increase opioid poisonings.