Another new law from a bureaucrat with a “addict in the family” that OD’d

North Carolina Drug Control Bill Seeks to Add More Restrictions on Doctors, Pharmacists

www.claimsjournal.com/news/southeast/2017/03/08/277262.htm

North Carolina lawmakers can save patients’ lives, spare their families and combat an ongoing opioid-abuse crisis by putting tighter controls on physicians and pharmacists who hand out powerful pain-killing medicines, supporters of a drug control bill said Thursday.

The plan announced by Republican lawmakers and new Democratic Attorney General Josh Stein would put new restrictions on medical providers who prescribe and dispense opioid drugs like OxyContin and morphine and limit their public supply. Such drugs carry a high risk of addiction and are often considered a gateway to the use of heroin and other illegal drugs. The bill also includes $20 million over two years for local substance abuse treatment and recovery services.

One of the chief sponsors, Sen. Tom McInnis, R-Richmond, said his stepson died in 2007 at age 22 after a fight with drug addiction he said intensified when he was prescribed an opioid following an automobile accident.

“We lost a beautiful vibrant wonderful son to this epidemic,” McInnis said at a Legislative Building news conference. “He was given a vial of these horrid, horrid addictive drugs and he started a downhill spiral that ended up with the loss of his life.”

Nearly 250 heroin deaths were reported in North Carolina in 2014, a more than five-fold increase from 2010, according to state health statistics. Four North Carolina residents die every day from drug and medication overdoses, backers of the bill said. Many more are hospitalized or go to emergency rooms.

“Opioids are tearing families apart all across our state. Too many of our neighbors, co-workers and family members are dying,” Stein said.

The measure would require physicians to log on to the state’s controlled substance database system and examine a patient’s prescription history to prevent overprescribing. Such information could show when abusers go to multiple physicians seeking prescriptions for their favored drug. Doctors would pay a $20 annual fee to keep up the system.

Pharmacists also would be required to register with the system and report controlled substance transactions within 24 hours. Pharmacy registration is essentially encouraged now and transactions now can wait 72 hours. Those who don’t file proper reports could be fined.

Doctors also would have to prescribe controlled substances electronically to reduce fraud. In most instances they would be limited to initially prescribing no more than a 5-day supply of a controlled substance for treatment of “acute pain.” This would stop 30-day supplies that bill supporters say can lead to addiction or unused pills left in medicine cabinets for young people to take. State health officials would audit prescriber records.

Bill sponsor Rep. Greg Murphy, R-Pitt and a physician, said some of the restrictions place more “bureaucratic hassle and paperwork” upon doctors, but it’s worth it.

“Our goal here is to save lives, to save families, to save businesses and it is an honorable and laudable and I believe attainable goal that we all must be willing to make sacrifices to achieve,” Murphy said.

The measure also would expand a 2016 law that created a statewide standing order at all pharmacies for access to a prescription drug that can reverse overdoses of opium-based drugs.

The bill would need House and Senate approval before going to Gov. Roy Cooper’s desk. Cooper’s proposed state budget includes $14 million to treat and combat opioid-related drug abuse and overdoses.

Stein said he would soon convene a task force of law enforcement officials to recommend new criminal charges for opioid drug dealers.

Ethan Buck of Greenville, who began using prescription opioids at age 12, advanced to heroin before becoming homeless and finally getting help. Now 20, Buck attended Thursday’s event and warned drug addiction can happen to anyone no matter their education or status.

“It’s not a disease that discriminates,” Buck said.

Cadden Seeks Acquittal on All Charges : after causing 76 deaths, 700+ harmed

Cadden Seeks Acquittal on All Charges

http://meningitis-etc.blogspot.com/2017/03/cadden-seeks-acquittal-on-all-charges.html

BOSTON, Mass.- The head of a drug compounding firm blamed for a deadly fungal meningitis outbreak is asking a federal judge to acquit him on all charges, including racketeering and 25 counts of second degree murder.
In a 38-page motion filed today in U.S. District Court, Cadden’s attorneys are charging that federal prosecutors failed to present adequate evidence of second degree murder though they conceded the evidence might support “at most” a manslaughter charge.
The motion, which was not unexpected, comes as federal prosecutors are about to call their last witness in a trial that began in January.
In testimony today a former employee described how she and a colleague created dozens of phony prescriptions to present to state officials in response to a complaint that had been filed against Cadden’s company, the New England Compounding Center.
Cadden has been charged in only 25 of the 76 deaths recorded in the 2012 fungal meningitis outbreak. He was one of 14 to be charged in late 2014 following a lengthy grand jury probe. Charges against two defendants have been dismissed, Two others pleaded guilty to reduced charges with the remaining facing trial later this year.
Cadden’s motion states that federal investigators, despite spending years on the case, still could not explain how vials of methylprednisolone acetate became contaminated with fungus.
“The fact that 25 (people) died is not in dispute,” the motion states, adding that federal investigators never found evidence at NECC of the specific fungus, exserohilum rostratum, that was found in the bodies of victims and unopened vials of NECC steroids.
“Despite calling over 50 witnesses over 41 days, the government has failed to prove what caused the contamination,” the motion states, adding that Cadden did not compound the steroids that caused the outbreak.
The government, the motion continues, “has provided no evidence that Cadden acted with the requisite intent to commit second degree murder.”
Calling the murder charges unprecedented for “a participant in a non-violent business,” the motion concludes, “The court should exercise its extreme discretion to grant the motion for acquittal.”
At the court session Beth Reynolds, who worked for NECC’s sales arm, Medical Sales Management, said that one of her duties was to ensure that pharmacists and technicians were properly licensed and registered.
A hesitant witness who spoke at times in whisper soft tones, Reynolds said she and another worker were assigned in 2012 to take patient names from a list at the Mass. Eye and Ear Infirmary and insert them on prescription forms.
According to previous testimony, the drugs in question already had been delivered to Mass Eye and Ear without patient specific prescriptions as required under state law. In fact the drug, a numbing agent, already had been administered to patients.
Reynold’s assignment followed a complaint the health facility had filed with the state Pharmacy Board against NECC. The complaint charged the drugs that didn’t have the required potency, prompting complaints from patients and doctors.
The witness identified a series of emails relating to the project.
“The labels have all been created, printed and proofed,” Reynolds wrote in one email.
She said that both she and her colleague, Michelle Rivers, thought the project was “out of the ordinary.”
She said she didn’t like another 2012 assignment from Cadden, which was to compile a list of states that allow prescriptions to be filled under certain circumstances without the name of a patient. Under so-called office use provisions set quantities of drugs can be dispensed for use in a hospital or doctor’s office in situations where the patient’s identity can’t be determined in advance.
She said the assignment made her feel uncomfortable and she did not know what was going to be done with the information.
An official of the Massachusetts Pharmacy Board later testified that there is no such exemption from the patient specific requirement for pharmacies, like NECC, licensed in Massachusetts.
Other witnesses provided additional testimony and evidence about the Mass Eye and Ear Infirmary incident including an email from Cadden with instructions on the need to insert patient names in each prescription.
Contact: wfrochejr999@gmail.com

 

Medical persecution: goal of $$$ from civil forfeiture ?

Clarence Scranage, Jr., MD

www.doctorsofcourage.org/index.php/2017/03/08/clarence-scranage-jr-md/

Clarence Scranage Jr., MD, 61, of Richmond, VA is the next doctor illegally persecuted by the government for money. He was indicted Feb, 2017 on a charge of conspiracy to possess controlled substances with the intent to distribute them and 18 counts of distribution of controlled substances.

All of the news media reported the exact same information, so it is obviously government propaganda that they copied from the indictment. The news media also brought out past government attacks to paint Dr. Scranage in as bad a light as possible. They should have nothing to do with the current situation and poor reporting like that makes a fair trial impossible. Also, the attacks mentioned are usually planned government attacks created for the purpose of leaving a paper trail.

Dr. Scranage meets all the criteria for doctors that are specifically targeted for attack by the government:

  1. Older (so they can forfeit all assets—savings, property, etc) Yep—proven by the fact that the indictment seeks the forfeiture of $650,000 they base on these prescriptions
  2. Minority,
  3. Primary care who moved into pain management. Dr. Scranage was board certified in Emergency Medicine, but developed his pain management practice involving 3 clinics in the Richmond area.

According to the indictment, Dr. Scranage was in a conspiracy with Anthony Harper, who has pleaded not guilty to all 19 charges. Prosecutors claim Harper simply gave names of people to Dr. Scranage who then wrote prescriptions which Harper then paid for. Is anyone really gullible enough to believe that, in today’s pain management-attacking world?

And the charges are the standard illegal government maneuvering in order to charge a legitimate physician with criminal activity. From the media information, it can be gleaned that the people recruited by Harper did come to see Dr. Scranage as patients. They were evaluated and received legitimate prescriptions for their diagnosis. But because they acted fraudulently, the government uses that as an avenue to attack the doctor. If people present to a doctor fraudulently, THEY have committed a crime. But the government doesn’t get as much through attacking them as they do the doctor, so they ignore the illegal activity of the fraudulent patient, and instead, make deals with them for false testimony to use against the doctor.

The indictment accuses Scranage of repeatedly failing to individually assess the medical needs of the people for whom he wrote prescriptions. But if he saw the patient and prescribed medication, then he assessed the medical needs. It’s the government breaking the law by illegally misinterpreting the CSA.

I just hope Dr. Scranage also pleads NOT GUILTY!  I’m going to be at his trial and will give him support any way I can, hopefully through testimony. Please contact me, Dr. Scranage.

 

 

ESI and FATAL OUTCOME !

UPDATED: KPD officer allegedly stole Fentanyl from woman

UPDATED: KPD officer allegedly stole Fentanyl from woman

http://www.kokomotribune.com/news/local_news/updated-kpd-officer-allegedly-stole-fentanyl-prescription-from-woman/article_58a49e6a-0426-11e7-8890-0741438c76d7.html

KOKOMO – Kokomo Police Department officer Heath Evans was charged Wednesday with two felony drug counts and misdemeanor theft for allegedly stealing Fentanyl from a local woman in December.

Evans, who was the focus of an internal KPD investigation, was charged with a felony count of obtaining a controlled substance by fraud or deceit; a felony count of possession of a narcotic drug; and misdemeanor theft. A warrant was issued for Evans’ arrest today and bond has been set at $10,000.

Evans’ initial appearance is set for 9 a.m. March 16 in Howard Superior Court I.

 

According to a probable cause affidavit, Evans responded to a welfare check for a woman named “Nancy” on Dec. 22, after Nancy’s friend called police to say she was worried about Nancy’s wellbeing.

After speaking with Nancy and leaving the residence, Evans reportedly returned to the home to ask Nancy if there was anything further he could do for her.

Nancy told Evans that she needed her prescription picked up from a doctor’s office and then filled at the CVS Pharmacy located at Sycamore Street and Dixon Road, according to court documents. Originally, Evans told Nancy that he could drop off the prescription and Nancy could have a friend pick it up.

Approximately 30 minutes later, however, Evans returned to Nancy’s home, providing her with an unstapled pharmacy bag. Nancy found the situation to be “odd and peculiar” as her prescription bag of Fentanyl patches are always stapled and include two boxes, according to the affidavit.  

Only one box was in the bag given to Nancy.

After Nancy questioned Evans, he told her, “That’s what they gave me.”

Evans then sat down and began to question Nancy on how to apply Fentanyl patches, asking her where she puts them on her body, according to the affidavit. At Evans’ request, Nancy even changed her Fentanyl patch and applied a new patch. Fentanyl, a powerful synthetic opioid analgesic, is used to treat severe pain.

In an interview with KPD investigators, Nancy said that because of the theft “she is suffering both mentally and physically.” Nancy’s interview with police was conducted on Jan. 12.

On Jan. 13, KPD Detective Derek Root went to the CVS at Sycamore Street and Dixon Road and spoke with the store manager, who provided Root with video of the Dec. 22 incident.

 

Root also acquired the pharmacy label printout of Nancy’s prescription for Dec. 22 for two boxes of Fentanyl, 50 microgram patches, with five patches in each box.

Root also was given a CVS signature log and a copy of the prescription. A CVS Pharmacy tech later confirmed that Evans picked up two boxes of Fentanyl patches.

In the affidavit, Root says he made several attempts to meet and speak with Evans about the situation, but that Evans initially advised him to speak with his attorney. Despite speaking with Evans’ attorney, no interview or statement was given by early February.

On Feb. 21, Root received a sealed envelope from KPD Capt. Shane Melton, which contained lab results from Evans’ urine screens. The sealed envelope was given to Melton from Howard County Prosecutor Mark McCann. Root had previously completed a subpoena request for lab results of Evans’ urine screens.

The urine screen showed a positive test for the presence of Fentanyl, after which Root requested an arrest warrant.

Evans was put on administrative leave without pay following the reading of a memorandum from KPD Chief Rob Baker at Wednesday’s Board of Public Works meeting.

In a press release, McCann said “the case is still under investigation and anyone having information concerning this case should contact the Kokomo Police Department or the Howard County Prosecutor’s office.”

Class action: #Walgreens, #CVS, #Osco overcharging diabetics on Medicare for insulin pumps, supplies

Class action: Walgreens, CVS, Osco overcharging diabetics on Medicare for insulin pumps, supplies

http://cookcountyrecord.com/stories/511087986-class-action-walgreens-cvs-osco-overcharging-diabetics-on-medicare-for-insulin-pumps-supplies

A Geneva resident who says pharmacies are overcharging people with diabetes for medication is pursuing a class action complaint against some of the country’s largest retail drug stores in Chicago federal court, seeking at least $5 million. 

Robert Mayberry filed his complaint March 3, naming as defendants Walgreens, CVS Pharmacy and Osco Drug parents Albertsons and Supervalu. He accused each pharmacy of improperly processing claim payment and reimbursement of insulin pump supplies, which are supposed to fall under Medicare Part B, resulting in customers paying more than their intended share. 

Not only do these customers pay more out of pocket, the complaint continues, they also reach Medicare Part D limits faster, thereby incurring out-of-pocket expenses for other prescriptions that are supposed to fall under Part D, until they reach Medicare’s catastrophic coverage threshold. In 2016, Medicare participants were completely responsible for Part D drugs after reaching $3,310 in plan purchases until they’d spent $4,850 out of pocket. 

According to the complaint, Part B covers medical services required for people with diabetes as well as some preventive services for Medicare beneficiaries considered at risk for diabetes. Specifically, this includes external insulin pumps and insulin for those pumps. Part D covers anti-diabetic drugs, including insulin, and supplies needed for inhalation or ingestion. 

The distinction, per Mayberry’s complaint, is that “most health insurance plans, including Medicare and Medicaid” classify an insulin pump and supplies — which includes the drug itself — as durable medical equipment. He further alleges the pharmacies are motivated to misclassify these purchases in pursuit of profits because the Center for Medicaid Services has cut its rate of reimbursement for the products. The pharmacies make more money when patients pay out of pocket. 

Mayberry said he’s been on Medicare since 1996 and has had type 2 diabetes and used insulin to control blood glucose for about 35 years. He said for the last 15 years, he’s had a prescription for an insulin pump. On Feb. 23, 2016, his Part D coverage supplier, WellCare, sent him a denial of benefits notice regarding insulin, which is when he said he realized he’d been improperly paying out-of-pocket expenses for years. 

The complaint accuses the pharmacies of fraudulently concealing their claims reimbursement processes, depriving customers of the ability to learn they were paying too much and overextending their Plan D contributions. That concealment, Mayberry contends, tolls any statute of limitations defense. 

Formal allegations include a violation of the Illinois Consumer Fraud and Deceptive Business Practices Act, as well as similar laws of other states, common fraud by omission and unjust enrichment. 

The pharmacies, Mayberry alleges, “continuously and consistently failed to disclose to consumers … the defective claims process concerning insulin prescribed for use via pump (and) failed to make these disclosures despite opportunities through” employees, advertising, websites and sales literature. 

The class would include all Medicare or Medicaid plan participants who obtained an insulin pump from the named pharmacies from 2006 through the present. 

In addition to class certification and a jury trial, Mayberry’s complaint seeks restitution, compensatory damages, punitive, statutory and treble damages, as well as attorney fees and interest. He also wants the court to compel the pharmacies to establish a program to reimburse customers for Medicare claims related to insulin pumps that were previously denied or insufficiently paid. 

Representing Mayberry in the matter, and serving as putative class counsel, are attorneys with the Clifford Law Offices, of Chicago.

My inbox today: A “FUN RIDE” thru the local ER ?

My ER visit (May 23, 2015) was horrible.

On that day, I had fallen in a restaurant. I slipped in an unseen, unmarked puddle of water and fell, HARD, on my back down the entire length of my spine. I instantly froze, partly in shock, partly because I was terrified I had done some damage to either of the fused regions of my spine (C4-C6 and L4-S1). I was checked out by paramedics and eventually allowed to get to my feet. Not being able to tell how I felt (from the shock of the fall), and I wasn’t hurting any more than usual at the moment, so we declined the ambulance ride and stayed to eat the lunch we had ordered.

Throughout the meal, my pain started developing and increasing, so we decided to go to the ER to have me checked out, particularly to have imaging done to see if any damage was done to or around the hardware in my fusions.

I was triaged and taken back for assessment. I was passed off to a physician’s assistant who eventually agreed that I needed a full-spine CT. Once this was decided, I requested something for the pain, which had continued to escalate and spread up and down my spine. The PA grudgingly agreed to ordering a Percocet. At this point, she started treating me like a drug seeker. As time went by and no medication arrived, I asked a passing nurse if I could just take an oxycodone from my purse. The nurse obtained permission and I followed through.

The PA asked me some strange questions. She asked me if I was afraid and whether or not I felt safe. I thought this was odd, even understanding that perhaps it was a question regarding abuse? Knowing that I came to the ER after a fall in a public restaurant full of people, who called 911, I thought it was strange. Then at one point she had me sit up so that she could check my leg reflexes with her little hammer. While tapping, she asked when my knee replacements had been done. Again, very odd, considering that I have no surgical scars on my legs whatsoever. (The answer was that no, I had never had knee replacements.)

The CT was a bit of a nightmare that added to my pain. Halfway through the full-spine scan, I was abandoned without explanation. I eventually had to call out for help. It turned out that a child had coded and all hands were needed there, and thankfully the tech shut off the machine before he left. However, the scan had to be completely done over, extending my time on a hard, narrow table, increasing my pain.

Thankfully, the CT images showed no damage done from the fall. By this point, my pain level was very high (8 out of 10), and I knew the limited amount of pain medication I had (1 pill per day, for a severe chronic condition called Adhesive Arachnoiditis) would not be enough to bring my body out of the pain flare caused by the trauma of the fall and exacerbated by the long, long time spent on the CT table. I talked to the PA about this and requested IM morphine (liquid morphine injected into the muscle) to bring the pain down to at least what it was when I entered the hospital. She exploded and said “We do NOT give out prescriptions for pain medication!!!” I quietly told her I did not ask her for one, only for the IM morphine to reduce the pain.

This is where she looked me in the eye and LIED to me, telling me that morphine could NOT be given IM. I looked at her in silence for about a minute, and then told her, “That’s interesting, because that’s exactly what I was given last November when I came in with a scorpion sting. In fact, it was here in this hospital, you can you check my records.” I had to insist she look at my chart. She left the area and I never saw her again, and I was eventually given the morphine IM by a nurse, but never received the single percocet tablet that was ordered (I’m guessing they cancelled it correctly).

This was my first experience being treated like a drug-seeker. My words were twisted, and I was lied to. Years ago I probably would have meekly shut up and suffered, but I am so tired of the mistreatment that chronic pain patients receive at the hands of their doctors, their pharmacists, hospital workers, and people in general. How do I go about preventing this mistreatment from happening again?

I also had a bad experience (just not directly) with a rookie pharmacist in 2013. My husband had gone to pick up a new prescription at XXX, because I wasn’t allowed to drive yet. My lumbar fusion was in June of 2013, and my surgeon was carefully titrating me off my oxycontin after the surgical pain had passed. It was a Friday, and I was having my follow-up with my surgeon’s PA rather than with my surgeon. We decided to reduce the oxycontin from 80mg 2x daily to 60mg 2x daily. For some reason (it was the only time this ever happened to me), she took my bottle of pills (I don’t even know why I had them with me; it could be she called and requested that I do so, but cannot truly recall this detail), leaving me 1 or 2 tablets in case it took extra time for the pharmacy to fill the new script.

The pharmacist refused to fill the script because it was “too early” for a refill, not acknowledging it was a NEW prescription of a lower-strength medication. My husband pointed this out to her, but she said it didn’t matter, it was too early. When requested to call the doctor’ office (it was after hours, but they have an answering service), she complied, but when the doctor on call was not the PA who wrote the script, but actually MY DOCTOR, under whose license the PA wrote the script. She REFUSED to talk to him and told my husband she would not fill the script.

When my husband asked if he could send her the bill if he had to take me to the ER for withdrawal complications, she said it didn’t matter, she wasn’t going to risk her license to do her job. That was that.

Fortunately, I had just enough oxycontin of lower strengths to cobble together (along with the 1 or 2 tablets left to me by the PA) to get me through Sunday night. I called my doctor first thing Monday and he got the pharmacist straightened out, so I was blessed to have continuity in my medication until I could get help from my doctor, without having to suffer withdrawal, humiliation, and further torture in the ER.

The pharmacist was completely out of order and negligent in her duty as a pharmacist. She refused to fill a completely legitimate prescription and refused to talk to the doctor who could verify it for me. She put my health at risk with her profiling behavior. One of my biggest regrets is not reporting her infraction right away. Unfortunately, this happens a lot with chronic pain patients; we are so exhausted from our daily battles, that the non-essential ones slip by without prompt action (especially when recovering from major spine surgery).

opioids have been shown to be highly effective in the treatment of chronic nonmalignant pain

Nadeau_Neurology 2015   <— click here to read

ABSTRACT

The recent American Academy of Neurology position paper by Franklin, “Opioids for chronic
noncancer pain,” suggests that the benefits of opioid treatment are very likely to be substantially
outweighed by the risks and recommends avoidance of doses above 80–120 mg/day morphine
equivalent. However, close reading of the primary literature supports a different conclusion:
opioids have been shown in randomized controlled trials (RCTs) to be highly effective in the
treatment of chronic nonmalignant pain; long-term follow-up studies have shown that this effectiveness can be maintained; and effectiveness has been limited in many clinical trials by failure to
take into account high variability in dose requirements, failure to adequately treat depression, and
use of suboptimal outcome measures. Frequency of side effects in many RCTs has been inflated
by overly rapid dose titration and failure to appreciate the high interindividual variability in side
effect profiles. The recent marked increase in incidence of opioid overdose is of grave concern,
but there is good reason to believe that it has been somewhat exaggerated. Potential causes of
overdose include inadequately treated depression; inadequately treated pain, particularly when
compounded by hopelessness; inadvertent overdose; concurrent use of alcohol; and insufficient
practitioner expertise. Effective treatment of pain can enable large numbers of patients to lead
productive lives and improve quality of life. Effective alleviation of suffering associated with pain
falls squarely within the physician’s professional obligation. Existing scientific studies provide the
basis for many improvements in pain management that can increase effectiveness and reduce
risk. Many potentially useful areas of further research can be identified. Neurology® 2015;85:1–6

Family says cancer-stricken toddler died after hospital medical mix-up

Family says cancer-stricken toddler died after hospital medical mix-up

http://www.ctvnews.ca/canada/family-says-cancer-stricken-toddler-died-after-hospital-medical-mix-up-1.3313954

A Quebec hospital has launched an investigation after a toddler who was being treated for cancer died in their care late last year. The parents of Ghali El Amrani, who died at 23 months, believe they lost their son after he was mistakenly given an extra injection of potassium.

Last June, Ghali El Amrani was diagnosed with neuroblastoma, a form of cancer that had spread to the child’s bone marrow. He was taken to CHU Saint-Justine Hospital, where he underwent six rounds of chemotherapy, followed by a bone marrow transplant.

“He was supposed to do five more days and go home,” his mother Hadil told CTV Montreal.

A shot of potassium was prescribed following the procedure and the nurse was supposed to give him two injections: one potassium, one saline solution, said Hadil.

But the nurse injected her son with two shots of potassium, she added.

The alleged overdose sent her son into cardiac arrest. Ultimately, Ghali suffered four heart attacks as medical workers tried to save his life.

“His heart came back after 25 minutes. He was transferred to another department and unfortunately he did (have) three heart attacks after the first one,” Hadil said.

In a preliminary report, the coroner stated as a probable cause of death that the child received care for a neuroblastoma “in which a solution of potassium and phosphate was administered by mistake.”

CHU Sainte-Justine has admitted that medication did play a role in the child’s death but say at this stage in the illness, they cannot place blame on any member of the care team.

The family’s lawyer, Jean-Pierre Menard, told CTV Montreal hospital nurses are supposed to follow a clear-cut protocol while treating patients. “Normally, there is a double-checking process to make sure that everything is properly identified. So the only way by which such a situation can occur is because somebody, somewhere, hasn’t complied with the protocol,” Menard said.

He added medical mix-ups are far too common. “Every year, we’re handling between at least five to 10 cases of medication error that have caused death or serious physical impairment … damage to a patient.”

Hadil said that her family doesn’t “have the real story” because the nurse doesn’t “remember anything.”

The family is planning to file a claim against the hospital but Hadil said more than financial compensation and an apology from the hospital, she wants answers.

CARROLL: Opioid guidelines to inflict more pain

Frank CarrollCARROLL: Opioid guidelines to inflict more pain

http://rapidcityjournal.com/carroll-opioid-guidelines-to-inflict-more-pain/article_e7e608f0-3a5e-5c08-bb88-d4dd19fb7b0b.html

Author and advocate for chronic-pain patients, Dr. Richard A. Lawhern, communicates daily with thousands of pain sufferers on Facebook and other social media. What he hears is a chilling and deepening fear for the future as people in pain are increasingly being denied effective treatment by their doctors and lawmakers.

In March 2016, the U.S. Centers for Disease Control and Prevention (CDC) issued guidelines for prescribing opioids to adult, non-cancer pain patients. These guidelines have greatly worsened conditions for pain sufferers by driving doctors out of pain-management practice and forcing major cutbacks in pain treatment.

In ongoing legislative discussions in South Dakota, Dr. Chris Dietrich warned the Department of Health and Human Services that the new rules would put many pain doctors out of business and ruin the lives of thousands of pain sufferers.

 In spite of his warnings, the South Dakota Legislature has passed laws that will severely curtail legitimate pain control while doing nothing for illegal drug use and addiction.

Patients who have successfully managed on opioids for decades are being deserted, often without withdrawal assistance and with no access to effective alternative pain therapies. Many are becoming disabled altogether, bedridden and losing their capacity to sustain employment or family relationships. Many are committing suicide, overcome by agonies imposed on them by their physicians and irresponsible government agencies. More are turning to suicide as this crisis continues and deepens. A frightening example is the more than 30 military members who commit suicide daily.

The CDC acknowledges their recommendations for guidelines are grounded on weak medical evidence. Previous research in Food and Drug Administration and National Institutes of Health studies was ignored. The guidelines also ignore the reality of a substantial cohort of patients among whom opioid treatment is both appropriate and the only resort after the failure of all other therapies. Addiction is not a problem for these patients: Pain is a life-threatening problem.

 
 The CDC content was unduly influenced by selecting anti-opioid advocates as primary participants in the core writers group. Writers’ utilized a biased selection of medical research to unfairly dismiss the effectiveness of opioids in treating chronic pain. They also inflated perceived risks of opioids. For example, in South Dakota last year only 25 deaths were attributed to opioids, with over half of those from heroin.

Although opioid-related deaths are a serious public health issue in some places, relatively few deaths are caused by drugs prescribed to legitimate pain patients. Deaths come from illegally imported fentanyl, heroin, and opioids diverted by theft or fraud.

There is no recognition of variances in opioid metabolisms among pain patients. The hard limit on prescribing opioids in the guidelines is not supportable scientifically.

Worse, the guidelines parrot unproven assertions that drug tolerance is universally experienced among chronic-pain patients — the more you take the more you need. This assertion is neither true nor proven in the literature or in practice.

The guidelines were originally meant as advisory information for general practitioners, subject to tailoring for each individual patient, never as a mandatory, one-size-fits-all restrictive edict. If made mandatory, the 90 morphine equivalent, an upper limit on opioid dose levels, will effectively destroy the lives of many tens of thousands of chronic-pain patients who have maintained at higher and stable doses for years.

Now, the HHS Centers for Medicare and Medicaid propose to integrate the March 2016 CDC guidelines as mandatory standards of practice in insurance reimbursement. This must not be allowed to happen. The only ethical way forward is to withdraw the guidelines for a total rewrite, this time led by board-certified pain-management specialists and chronic-pain patients themselves.

 Frank Carroll is a freelance writer and columnist. He can be reached by emailing frankcarrollpfm@gmail.com or visiting blackhillsforestpros.com.