Ohio: MMJ legal… if you can get it prescribed, afford a permit to buy and find a place that sells it

Posted on February 20, 2017 by Pharmaciststeve

Ohio’s medical marijuana program is still developing, but advocates remain worried about accessibility

http://www.thepostathens.com/article/2017/02/marijuana-rules-patient-access

Talk about your “BUREAUCRATIC NONSENSE”… the Ohio legislature authorizes 40 distributors in a state that has 88 counties and you charge pts a $50/yr fee to have the PRIVILEGE to purchase Medical Marijuana and you prohibit pts from growing for their own personal use, and a unknown number of prescribers will actually recommend/prescribe MMJ in the first place.   Could it be that these politicians are more interested in the revenue that could be generated by the legalization of Medical Marijuana than the quality of life benefits that many pts can have from this therapy ?

Ohio’s medical marijuana program has yet to develop fully, but some patient advocates are concerned the rules and regulations coming out of Columbus will make it difficult for college students and people in less-populated areas to receive treatment.

Patients will have to pay an annual $50 registration fee, according to patient and caregiver rules submitted by the State of Ohio Board of Pharmacy. Veterans and low-income Ohioans can receive a 50 percent reduction in their registration fee.

Leigh Goldie, founder and executive director of the nonprofit Empowering Epilepsy, said between tuition and fees, paying the annual registration fee on top of medication costs can be difficult for college students. That is especially true for students with conditions such as epilepsy, who may not be able to work.

“Where’s the extra cash for a college student to do this?” Goldie said. “The college cost is just a hurdle in itself. Unless they have a family that has really saved for their college education, that only adds to the hurdle.”

Patients in general have trouble finding stable employment because of the nature of the condition, Goldie said, and even if they apply for Social Security disability benefits, the perception is they are still able to work because the seizures only happen every so often.

Goldie added that students who qualify for medical marijuana might need it to maintain their performance in school. With a condition like epilepsy, for example, certain types of seizures and other epilepsy medications can affect the patient’s memory, making it harder to process information and commit it to long-term memory.

Don Keeney, the resident of the Southeast Ohio chapter of the National Organization for the Reform of Marijuana Laws — commonly referred to as NORML — said other aspects of the law, such as the number of dispensaries, could pose challenges to Ohio residents.

Ohio’s pharmacy board proposed rules that would allow 40 dispensaries, and the board would be able to issue additional licenses based on population and geographic distribution.

“We’ve got 88 counties, so somebody’s going to have to do without, and probably least populated areas would be the ones,” Keeney said.

A survey of Ohio physicians conducted by the State of Ohio Medical Board suggested 222 of the physicians surveyed indicated they were both likely to recommend medical marijuana and they worked for a health system that would allow them to do so, less than 7.5 percent of total respondents. Four of those responses appear to have come from Athens County. Three responses came from counties surrounding Athens, and 37 came from Franklin County, the county where Columbus is located.

Officials at OhioHealth O’Bleness Hospital have not stated whether its doctors will participate in the medical marijuana program. Curtis Passafume, who serves as the vice president for Pharmacy Services at OhioHealth, chairs the program’s advisory committee.

Dr. James Gaskell, the health commissioner at the Athens City‑County Health Department, said his department would likely not be involved in Ohio’s medical marijuana program in any way, but he would have to see what the state law looks like and how it will be implemented.

Keeney said people should be allowed to grow their own plants and smoke them, which Ohio’s medical marijuana law doesn’t allow. Past ballot initiatives, however, have pushed for allowing people to home-grow.

“They always say this is a young people’s item,” Keeney said. “No, it’s everybody’s item. I’ve signed people on petitions from 80 to 18 and all in between.”

Several groups have put forth ballot initiatives seeking to legalize marijuana in the state in past years, a process which requires gathering signatures and submitting the petition to the Ohio Attorney General for approval.

The Washington, D.C.-based Marijuana Policy Project dropped its ballot initiative effort last year after Ohio lawmakers passed the bill legalizing medical marijuana. Keeney, who has been involved in various initiatives, said he was working with them at that time.

“I have very little faith in elected officials,” Keeney said. “That’s why I push citizens’ ballot initiatives.”

Goldie said she is concerned about the “duty to report” provision of the law, which would require patients to notify the state’s board of pharmacy of any arrests or charges. People with epilepsy can often be arrested because of how people perceive their behavior during seizures, which could prevent them from receiving medical marijuana, she added.

“People with epilepsy are very often arrested and charged with crimes, such as drunk and disorderly conduct, resisting arrest, unlawful entry and even assault on a police officer while they’re having a seizure,” Goldie said.

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FAKE NEWS: Opiates are HIGHLY ADDICTIVE

Posted on February 20, 2017 by Pharmaciststeve

https://youtu.be/ao8L-0nSYzg

http://theunboundedspirit.com/drugs-dont-cause-addiction-this-short-animated-video-will-change-your-view-on-drugs-forever/

 

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DEA agent: ‘We had no leadership’… so we did NOTHING ?

Posted on February 20, 2017 by Pharmaciststeve

DEA agent: ‘We had no leadership’ in WV amid flood of pain pills

It looks like the only way that anyone can get the DEA to “stay on the reservation” is to hire lobbyists to get Congress to pass laws and hire attorneys. I guess when you are trying to deal with LAW ENFORCEMENT… especially the DEA…they don’t listen to – or have – common sense…  It is like some Pharmacists that when you hyper-focus on stopping substance abuse.. everything starts looking like substance abuse and when you have the ability to take actions on personal opinions, believes, phobias, biases… facts just tend to get in the way of doing what is believed to be just/prudent.  In all wars there is unintended consequences, collateral damage and innocent victims.

During the years drug firms poured millions of highly addictive pain pills into West Virginia amid a rise of overdose deaths, the U.S. Drug Enforcement Administration had a shortage of leadership in the state, according to a DEA official.

“We had no leadership in West Virginia. We had none,” said Karl Colder, special agent in charge of the Washington, D.C., field office, which covers Virginia, Maryland, the District of Columbia and West Virginia.

Between 2007 and 2012, drug wholesalers shipped 780 million hydrocodone and oxycodone pills to West Virginia, while 1,728 people fatally overdosed on those two powerful painkillers, the Gazette-Mail reported in December.

Before 2013, the highest-ranking DEA agent in West Virginia was a group supervisor, Colder said. Now, the DEA has a Charleston-based assistant special agent in charge who reports directly to Colder. The agency also has hired more agents and set up tactical diversion squads in Clarksburg and Charleston.

“In the past, they were just supervisors, and they had to run enforcement operations,” Colder said. “You had no leadership in West Virginia. This is the first time the community has seen the special agent in charge.”

Colder, who became special agent in charge in 2013, and four other DEA officials were in Charleston last week to announce the agency will spend $500,000 on a program that aims to reduce heroin and prescription drug abuse in Kanawha, Putnam and Cabell counties. West Virginia has the highest drug overdose death rate in the nation.

The night before their press conference in Charleston, the DEA agents talked about recent national reports that revealed agency lawyers had put the brakes on enforcement actions against drug distributors, starting in 2013.

Following the reports, the DEA announced drug giant McKesson agreed to pay $150 million to settle a case, and wholesaler Cardinal Health agreed to pay $44 million in fines.

“We also were targeting their DEA numbers, their registration numbers, but, unfortunately, if you read The Washington Post, you’ll know, unfortunately, there was some pressure,” said Ruth Carter, the DEA’s diversion program manager. “We were told … you know.”

Five former DEA supervisors told The Post they were frustrated by the sharp drop in enforcement actions. The former head of the diversion office, Joseph T. Rannazzisi, said he was summoned to a meeting in 2012 during an investigation of Cardinal Health. Rannazzisi told the The Post he was chastised for “going after industry.”

Carter said a Department of Justice lawyer, whom she didn’t name, directed agents to halt an ongoing investigation against Cardinal Health, the nation’s second-largest drug wholesaler.

“One DOJ official told us we could not pursue Cardinal any further,” Carter said. “That’s the only thing I know that’s true. Yes, they did. But those people aren’t at DOJ anymore. Everyone at DEA, we want to do the right thing.”

 Carter later clarified none of her superiors tried to kill the investigation outright.

“We were told not to go any further,” she said. “‘You’ve done enough investigating. Let’s just process the case.’”

Last month, Cardinal Health and wholesaler AmerisourceBergen abruptly agreed to settle a four-year legal battle with the state of West Virginia, which had accused the companies of fueling the state’s prescription drug problem. Cardinal Health and AmerisourceBergen paid a combined $36 million — the largest pharmaceutical settlement in state history. The money will go to drug treatment programs that help West Virginians addicted to opioids.

The DEA agents also answered questions last week about a new law — passed by Congress last spring — that allows drug distributors to submit corrective action plans to persuade the DEA to stop investigations against the companies. The law also raises the bar for the DEA to temporarily suspend their licenses, according to a Los Angeles Times report.

“They can submit those to us,” Carter said. “That’s part of the reason some of these settlements have been slower. That is happening, yes, but if it’s a continual, ongoing, egregious thing, that’s a whole different story.”

Colder said drug distributors hire an army of lawyers to fight the DEA when the agency investigates the companies and tries to sanction them.

“Taking action against them is more complicated, and it’s going to be harder because you’re dealing with very high-priced attorneys,” he said. “They’ll hire four or five law firms to represent them.”

In a follow-up story, The Washington Post reported the nation’s largest drug distributors have hired more than 40 former DEA agents over the past decade. The Post article described the hires as a “revolving door.”

“It’s the carousel,” Colder said. “You have some of our retirees who go on and work for these companies. They’re going to pay the big dollars, and whoever has the experience, that’s who they go after. Hopefully, they’re going in there to train people how to do things the right way.”

Colder said there’s nothing nefarious about DEA agents going to work for drug wholesalers.

“It just so happens we have truly qualified people,” he said.

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Doctors in ‘pill mill’ arrests suing Carmel, DEA agent

Posted on February 20, 2017 by Pharmaciststeve

LOGO COURTS

Doctors in ‘pill mill’ arrests suing Carmel, DEA agent

http://www.heraldbulletin.com/news/local_news/doctors-in-pill-mill-arrests-suing-carmel-dea-agent/article_82811a60-f788-11e6-a867-83fddbf61da2.html

INDIANAPOLIS — A team of doctors initially accused of operating a “pill mill” is suing the city of Carmel and a Drug Enforcement Agency agent for false arrests they say destroyed their careers.

The physicians include Dr. George Agapios, who had a Pendleton family practice and was working part-time for a Carmel opiate addiction treatment clinic when he was charged in 2014 with five felonies involving dealing in a controlled substance. The charges, filed by the Indiana Attorney General’s office, were dismissed in Hamilton County Superior Court in December 2015.

Charges against three other doctors were either dropped or ended in acquittal.

 The doctors’ complaint, filed recently in U.S. District Court for the Southern District of Indiana, is a continuation of a federal lawsuit they filed in 2016 against a number of entities including the city of Kokomo and Hendricks County. However, many of those defendants were dismissed from the initial lawsuit.

The new complaint is against DEA agent Gary Whisenand, the city of Carmel and Carmel police officer Aaron Dietz.

In Carmel, the group’s clinic was operated as the Drug & Opiate Recovery Network (DORN) where Suboxone, used to manage pain and relieve opioid dependency, was often prescribed but not dispensed, court documents said.

 DORN’S medical director was Dr. Larry Ley. Dr. Ronald Vierk was an anesthesiologist at Reid Hospital in Richmond and practiced part-time at a DORN office in Richmond. Dr. Luella Bangura was a Lafayette family physician who practiced part-time at DORN’s Kokomo office. Agapios is the fourth plaintiff in the complaint.

DORN’s main clinic was in downtown Carmel.

The lawsuit claims “The presence of a clinic specializing in the treatment of opioid dependency in Carmel, Indiana, was in visible contrast to the political position of the Carmel city administration that there was no significant opioid drug addiction problem in Carmel, Indiana, that would require such a facility.”

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FAILED: proposed legislation that would have cut the MJ eradication program’s funding in half

Posted on February 20, 2017 by Pharmaciststeve

DEA’s Marijuana Eradication Program in Washington State

http://northwestcannacast.com/deas-marijuana-eradication-program-in-washington-state/

SEATTLETIMES.COM – It’s a scene that continues to unfold in Washington state: A helicopter hovers low over the trees, deep inside a park in the Cascade Mountains a SWAT team dressed in Kevlar rappels from the chopper to the ground other officers, federal agents and state environmental officials move toward the site on foot, alert for armed guards, booby traps and razor fencing.

The targets of these taxpayer funded efforts aren’t terrorism suspects or dangerous fugitives they are marijuana plants.

The Drug Enforcement Administration (DEA) has for decades poured millions of dollars into a nationwide marijuana eradication program, and the effort continues even in Washington, where the drug was legalized for recreational use in 2012. Financial documents obtained from the DEA show that in fiscal year 2016, Washington was the nation’s fourth largest recipient of eradication funding, at $760,000. According to the most recent data, each plant the state destroys costs taxpayers $26.49, over six times the national average.

Washington’s funding has fallen 28 percent over the last three fiscal years, from about $1.1 million. But funds for the DEA’s marijuana eradication program have seen larger cuts in other states where the drug has been legalized, according to the financial documents. Colorado’s funding dropped to zero over the past two fiscal years. Oregon’s budget has been slashed by 80 percent from $1 million to $200,000 during the same time.

Upon release of the DEA’s financial documents, a bipartisan group of eight members of Congress sent a letter in October to the U.S. Government Accountability Office that called the program’s roughly $18 million annual cost wasteful.

“While the DEA’s Cannabis Eradication Suppression Program has been in effect nationwide for three decades, the recent trend in state laws to legalize and decriminalize the production, distribution or consumption of marijuana calls into question the necessity of such a program,” the letter states.

One of the letter’s signees, U.S. Rep. Ted Lieu, D-Calif., proposed legislation last year that would have cut the eradication program’s funding in half. The effort failed.

Lieu, in an interview with The Seattle Times before the November election, said that legalization of recreational marijuana in California the nation’s top cultivator would force the DEA to reassess the feasibility of trying to suppress the country’s supply. The election saw voters in California, Maine, Massachusetts and Nevada approve measures to legalize marijuana for recreational use. Voters in Arkansas, Florida, Montana and North Dakota approved the drug for medical use.

Legalization will accelerate discussions of whether the drug’s national prohibition can be maintained, Lieu said.

“I don’t believe the arguments that this program is needed. From a taxpayer’s standpoint, it doesn’t make any sense that Washington state is still spending so much money on marijuana eradication,” Lieu said. “There are so many more worthwhile uses for it.”

Lt. Chris Sweet of the Washington State Patrol has managed the state’s eradication program since 2013, mainly by requesting and administering federal funds. Sweet said that when he attends law-enforcement conferences, he’s frequently asked how he can operate a marijuana-eradication program in a state where the drug is legal.

“I hear it all the time: ‘You guys still have an outdoor-eradication program when you’re a legalized state? How does that make sense?’ ” Sweet said.

Eradication remains a law-enforcement priority because Mexican drug cartels may have moved their marijuana-growing operations north of the border, where the climate produces higher-quality plants, Sweet said. These organizations tend to operate on swaths of public land, often in mountainous regions, where detection of large crops is difficult.

The abundance of good growing terrain along the eastern slopes of the Cascades has led the Sinaloa Cartel of Mexico — considered the world’s most powerful drug-running operation — to operate in that region for some time, according to a recent joint report from the DEA and Department of Justice.

The presence of Mexican drug cartels might explain why Furadan, a pesticide banned in the United States and “only made south of the border,” has been found on Washington’s illicitly grown marijuana crops, Sweet said. California authorities have also cited the pesticide as evidence of Mexican involvement in grow operations there. Starting this year, Sweet said, officers removing illegal marijuana plants must wear protective suits and be accompanied by Department of Ecology agents.

The DEA’s eradication program gained national attention in September after a helicopter, a bevy of police vehicles, state police officials and National Guard troops descended upon the home of an 81-year-old Massachusetts woman to haul off a single marijuana plant growing in her garden.

However, small growing operations are not typically targeted by the program. The average size of a Washington crop bust in 2015 was 609 plants; the average size nationally was 519, according to DEA records.

There have been roughly 57,000 plants eradicated in Washington so far this year, a 63 percent increase over 2015’s total haul. Sweet believes the involvement of Mexican drug cartels helps explain the rise in plant discoveries this year.

“No one had a crystal ball about how legalization would affect our outdoor growing, but with the spike this year, we’ll have to see what the coming years bring,” he said. “Is it a freak thing? It’s too early to tell.”

But the DEA’s records show that the number of plants found in Washington this year is almost identical to the number found two years ago, and down significantly from the 346,484 plants eradicated five years ago. Nationwide, the records show a nearly 70 percent decrease in the number of grow sites eradicated between 2010 and 2014.

Morgan Fox, communications manager of the Marijuana Policy Project, the largest U.S. nonprofit dedicated to marijuana reform, said the best way to limit the impact of drug cartels is to “eliminate the illicit market, and make it not worth it economically. That’s what we see legalization doing.”

“Law-enforcement organizations are loath to give up on funding sources, so there are times there is a concerted effort to tell a dramatic story,” Fox said. “Marijuana eradication is just playing whack-a-mole.”

In justifying the program’s continued existence in Washington, Sweet cited the need to fight Mexican gangs, and to mitigate the environmental damage caused by grow operations. The fact the program has been slashed in Colorado and Oregon is ominous to him, he said.

“We’ve seen the proposals in Congress, and the public perception, and the adage that this is money that can be used for other programs, like education and treatment,” Sweet said. “That’s definitely a big concern.”

For Fox, the fact eight more states legalized pot this November illustrates the program’s increasing irrelevance. After alcohol’s prohibition, he said, a criminal element remained in the industry for a while but diminished as the legal market established itself.

“We don’t see illicit criminal organizations planting secret vineyards on national parks when the market has been made legal for wine,” said Fox. “There’s still some illegal moonshine stills around the country, but it’s not a big issue. This is where we’re headed as a country.”

 

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Pharmacist wins Walmart lawsuit

Posted on February 20, 2017 by Pharmaciststeve
 
Pharmacist complained about staffing conditions/levels became DEPLORABLE – untrained – insufficient- inexperienced – creating a “public safety concern”
This is in NH… and the PRIMARY CHARGE of the Board of Pharmacy is to PROTECT the public’s health and safety.
I am surprised that the TV reporter did not interview someone from the NH Board of Pharmacy.
According to this article http://usatoday30.usatoday.com/money/industries/health/2008-12-30-pharmacies-boards-mistakes-prescriptions_N.htm
The Boards of Pharmacy are “stacked” with non-practicing corporate Pharmacists… working for the same chains that they are suppose to oversee and regulate. Some believe that this could present a conflict of interest. Since most Boards of Pharmacy member are appointed by the state’s Governor…  You can come to your conclusion as to why it is mostly Pharmacists/employees of large corporations that get appointed to the boards.

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Primer on Whistleblowing in Healthcare

Posted on February 19, 2017 by Pharmaciststeve

Primer on Whistleblowing in Healthcare

http://bnlawatlanta.com/wp-content/uploads/2014/05/Healthcare-Whistleblowing-April-14.pdf

http://bnlawatlanta.com

This was sent to me by a middle aged Pharmacist who has just gotten toss to the curb because of nebulous issues of corporate policies and procedures being theoretically broken. 

Any employee that works for a business that deals with receiving Federal money, could learn a lesson from this primer from a law firm in Georgia.

Document what “wrong doings” that your employer is doing like tomorrow is going to be your last day on the job.

 

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This was posted on another FB page… FYI !!!

Posted on February 19, 2017 by Pharmaciststeve

Hey folks, here’s an opportunity to maybe change the dialog on opioid hysteria. NPR has a sunday morning program called the “Call In Show” and next week the question is “How has the opioid epidemic effected you?” We should all call in- dial 202-216-9217 with full name, where you are calling from and your story! Maybe if they hear from enough of us they will start showing how this is hurting chronic pain patients and our abilities to receive adequate pain relief…

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Why Congress doesn’t need to repeal ACA/Obamacare

Posted on February 18, 2017 by Pharmaciststeve

Humana has already announced that they will no longer participate in Obamacare in 2018 and the CEO of Aetna recently stated that “they had not made the decision yet about 2018 ” If both of these very large ACA providers are not participating in 2018, that means that there will be a lot of areas that will not have the first insurance company to sell policies and competition in a lot of areas will be limited to just one provider… basically NO COMPETITION.
All Congress has to do is repeal/rescind the premium subsidies and the ACA will collapse under its own weight… when people are expected to pay the “full rack rate” for their health insurance premiums.

Insurance can’t even approach an “affordable level” unless all that expect/need coverage participate.  Below is a table of per-cent of drivers that are uninsured per state.. from a low of  3.9% (Mass) to a high of 25.9% (OK). Every state has MANDATORY VEHICLE INSURANCE.

http://www.carinsurance.com/Articles/uninsured-motorist-coverage-state-averages-of-uninsured-drivers.aspx
Estimated percentage of uninsured motorists by state

State          Uninsured Rank (2)       State                   Uninsured        Rank (2)
Alabama        19.6%        7                  Montana              14.1%                  15
Alaska            13.2           21                Nebraska              6.7                       44
Arizona          10.6           29               Nevada                  12.2                     23
Arkansas       15.9            11                New Hampshire  9.3                       34
California      14.7            13               New Jersey           10.3                     30
Colorado       16.2             9                New Mexico          21.6                     4
Connecticut   8.0            41               New York               5.3                       49
Delaware        11.5           27               North Carolina     9.1                        35
D.C.                 11.9           24               North Dakota       5.9                        47
Florida (3)     23.8          2                 Ohio                       13.5                        17
Georgia          11.7            26              Oklahoma             25.9                        1
Hawaii           8.9             37              Oregon                     9.0                        36
Idaho             6.7             45               Pennsylvania          6.5                        46
Illinois           13.3          20                Rhode Island         17.0                        8
Indiana         14.2           14                South Carolina      7.7                          43
Iowa              9.7             32                South Dakota        7.8                          42
Kansas          9.4            33                Tennessee               20.1                        6
Kentucky      15.8           12               Texas                        13.3                         19
Louisiana      13.9          16               Utah                          5.8                          48
Maine            4.7            50               Vermont                  8.5                           39
Maryland      12.2          22               Virginia                   10.1                          31
Massachusetts3.9         51                Washington           16.1                          10
Michigan       21.0          5                 West Virginia         8.4                           40
Minnesota    10.8          28               Wisconsin               11.7                          25
Mississippi   22.9          3                 Wyoming                8.7                            38
Missouri        13.5          18

I would suspect that you will find similar numbers of people driving cars that don’t have a driver’s license.

It is estimated that the USA has a 1-2 TRILLION/yr  underground economy and the income taxes evaded on that money… would close the annual deficit in the Federal budget… about 600 billion/yr

http://www.alternet.org/story/152446/inside_the_trillion-dollar_underground_economy_keeping_many_americans_%28barely%29_afloat_in_desperate_times/

Congress has mandated that hospital have to treat/stabilize anyone walking thru their doors… seeking treatment. Also medical bills are the largest single reason for personal bankruptcies.  Meaning that a lot of “small businesses” – doctors, pharmacies, hospitals end up “eating” those $$$ wiped clean with a person declaring bankruptcy.

Let’s approach this issue of providing healthcare in a business like manner.. even though Obamacare has abt 20 million people with coverage.. we still have abt 30 million that still doesn’t have any health insurance.

Lets start with a 5% sales tax very soon and beginning with 2018 let everyone enroll into Medicare in their birth month. Like most sales taxes… food, medication, rent, utilities will be exempt. Phase out Obamacare in the same manner. Everyone will have a deductible of maybe 5% of their gross income, and will pay 20% after the deductible. There will be no more prior authorizations, quantity limits, step therapy and the rest of the BS that insurance companies have put in place in order to “save the system money”,but has done more to establish their dictatorship over our healthcare and help “pad their bottom line”.  Those currently on Medicaid or getting some sort of subsidy will continue to get some sort of subsidy.

The sales tax rate will be adjusted annually based on one year back actual cost per capita to provide healthcare to our citizens.  No system will ever be perfect, but we need to strive to improve upon what we have failed to do to date. The transition will be neither painless nor transparent, but there are no quick fixes.

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bill in West Virginia to add kratom to their controlled substances list

Posted on February 17, 2017 by Pharmaciststeve

From Susan Ash Director of The American Kratom Association

Folks, we have a new bill in West Virginia to add kratom to their controlled substances list (its been included under the misconception that its contributing to the existing opiate problem there). But we are on top of the situation and there is no need to panic. Let’s let our lobbyists continue to work behind the scenes and give us direction on what we can be doing after the weekend. Thanks

 

Another case of politicians/bureaucrats trying to protect us from ourselves ?

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