How Have the CDC Opioid Guidelines Affected You?

How Have the CDC Opioid Guidelines Affected You?

www.painnewsnetwork.org/stories/2017/2/15/how-have-the-cdc-opioid-guidelines-affected-you

By Pat Anson, Editor

Next month will mark the one year anniversary of opioid guidelines released by the Centers for Disease Control and Prevention – guidelines that discourage primary care physicians from prescribing opioids for chronic non-cancer pain.

At the time of their release, the CDC estimated that as many as 11.5 million Americans were using opioid medication daily for pain relief. Many of those patients now say their doses have been abruptly lowered or they are unable to obtain opioids at all.

That could be a good thing, depending on your point of view about the nation’s so-called “opioid epidemic.” Former CDC director Thomas Frieden, MD, has called the guidelines an “excellent starting point” to stop an epidemic fueled by “decades of prescribing too many opioids for too many conditions where they provide minimal benefit.”

Many pain patients disagree, saying they’ve used opioids safely and effectively for years. They say the guidelines have had a chilling effect on many of their doctors and are being implemented in ways that go far beyond what the CDC intended.  

“Last year, when the CDC ‘recommendations’ came out, the entire building of the only doctor’s office I can go to decided they were rules, and cut me from 210 mg/day morphine to 90 mg. Now they say they can only give me 60 mg/day,” wrote Eli, one of hundreds of patients we’ve heard from in the past year.

“I’m in so much pain I can’t properly care for myself, nor get to town for supplies when I need them. I’ve become increasingly more disabled and dependent on others.”

“My pain management doctor told me that the CDC required that all morphine be taken away from all Americans,” wrote a California woman who suffers from severe back pain. “He even stated that surgeons were sending home their post-surgery patients with Motrin, nothing else.

“What are you people in the CDC doing? Don’t you realize how paranoid doctors can get? You may think using the term ‘guideline’ will help them understand what you are trying to do, but you have created a bunch of neurotic paranoids. Stop it. Do something before you kill all of us.”

“I am a 76 year old intelligent woman who is not an addict or an abuser, yet I am denied relief from unremitting pain even after 20 years of trying every drug and treatment modality available,” wrote Roberta Glick. “I am at a total loss as to what to do, how to fight, etc.  My physician is a strong supporter.  He is not the problem. He also is a victim of misguided CDC attempts to curb drug addiction.”

Are the CDC guidelines voluntary or mandatory? Have they improved the quality of pain care? Are patients being treated with safer and better alternatives? Most importantly, are soaring rates of opioid abuse and addiction finally being brought under control?

Those are some of the questions Pain News Network and the International Pain Foundation (iPain) are asking in an online survey of patients, doctors and other healthcare providers.

“I strongly believe that as these guidelines are implemented by doctors and hospitals around the country there are important lessons to learn from those who are affected by them,” says Barby Ingle, president of iPain and a PNN columnist.

“I hope that pain patients and providers participate in this survey so that we can begin to show how deep the impact actually is to the chronic pain community one year later.” 

The online survey consists of less than a dozen multiple choice questions, which should take only a few minutes to complete. Please take time out of your busy day and complete the survey by clicking here.

The survey findings will be released on March 15th, the first anniversary of the CDC guidelines. By taking the survey, you can also sign up to have the results emailed to you.

Insurer Humana bails on ACA exchange business for 2018

Insurer Humana bails on ACA exchange business for 2018

http://www.wave3.com/story/34504129/insurer-humana-bails-on-aca-exchange-business-for-2018

Health insurer Humana is leaving the Affordable Care Act’s public insurance exchanges for next year as it regroups after ending its proposed combination with rival insurer Aetna.

Humana Inc. covers about 150,000 people on exchanges in 11 states.

The insurer said Tuesday it had taken several actions to improve that business, but it was still seeing signs of unbalanced risk in that customer population. Health insurers have struggled to attract enough healthy people to their risk pools to balance the claims they incur from people with expensive medical conditions.

Humana and Aetna said earlier Tuesday that they were calling off Aetna’s roughly $34 billion acquisition of Humana. That deal already had been rejected by a federal judge who was worried about its impact on competition.

When people cannot control their “feelings”… textbook Mental Health.. ADDICTION

Spotlight on KY as overdose numbers soar

http://www.wave3.com/clip/13100521/spotlight-on-ky-as-overdose-numbers-soar

Pay attention to what Josh said… Tylox (Oxycodone & Acetaminophen) made “him feel good”… the reason that he kept taking opiates after his acute pain was resolved.

When “life happens .. you want to go back to being high… so don’t  have to worry so much ..”

Addiction is so HARD TO BEAT.. because you are dealing with a mental health disease and attempting to treat a mental health disease via abstinence is pretty much a guaranteed path to FAILURE… this may be why the typical addiction rehab center has a 95% FAILURE RATE..

IMO… the 5% of successes are not really suffering from addiction, but after taking opiates for acute pain… they are not titrated down to avoid withdrawal symptoms .. so they continue taking opiates to avoid withdrawal sysptoms.. once someone helps them titrate down… they are a “SUCCESS” of getting off opiates

 

We’re from the government and here to help ourselves abusing our powers/authority ?

TSA Busted in Massive $100 Million, 40,000 lb Cocaine Smuggling Conspiracy

http://thefreethoughtproject.com/tsa-indicted-cocaine-conspiracy/?

San Juan, Puerto Rico – In a case highlighting the infiltration of the Transportation Security Administration (TSA) by transnational criminal organizations, twelve current and former TSA officers and airport staff were indicted for allegedly trafficking over 20 tons of cocaine — worth over $100 million — into the U.S. over a 28-year time frame.

Last Wednesday, a federal grand jury returned an indictment against the twelve defendants, who are charged with conspiracy to possess with intent to distribute cocaine.

From 1988 to 2016 the conspirators allegedly smuggled about 40,000 pounds, or twenty tons, of cocaine through Luis Muñoz Marín International Airport in San Juan, Puerto Rico, and into the United States, according to the DOJ.

The DOJ press release detailed how the massive trafficking operation allegedly worked:

During the course of the conspiracy, the defendants smuggled suitcases, each containing at least 8 to 15 kilograms of cocaine, through the TSA security system at the Luis Muñoz Marín International Airport (LMMIA). Sometimes as many as five mules were used on each flight, with each mule checking-in up to two suitcases. From 1998 through 2016, the defendants helped smuggle approximately 20 tons of cocaine through LMMIA.

 

Six current and former TSA employees, José Cruz-López, Luis Vázquez-Acevedo, Keila Carrasquillo, Carlos Rafael Adorno-Hiraldo, Antonio Vargas-Saavedra, and Daniel Cruz-Echevarría allegedly smuggled multi-kilogram quantities of cocaine while employed as TSA Officers at the San Juan airport. Their full time responsibilities were to provide security and baggage screening for checked and carry-on luggage that was to be placed on outbound flights from the LMMIA. During the duration of the conspiracy, these TSA employees smuggled multi-kilogram quantities of cocaine through the TSA X-Ray machines within LMMIA and onto airplanes without detection.

 

“These individuals were involved in a conspiracy to traffic massive quantities of illegal narcotics to the continental United States,” said Rosa Emilia Rodríguez-Vélez, U.S. Attorney for the District of Puerto Rico. “These arrests demonstrate the success of the AirTAT initiative, which has successfully allocated a dedicated group of state and federal law enforcement officers, whose mission is to ensure that our airports are not used in the drug traffickers’ illicit businesses.”

Defendants Edwin Francisco Castro, Luis Vázquez-Acevedo and Ferdinand López are alleged to have operated as facilitators between drug trafficking organizations and the TSA employees who smuggled the cocaine into the airplanes. Defendant Miguel Ángel Pérez-Rodríguez, an airport security company employee, was a source of supply of cocaine to the drug trafficking organization, according to the superseding indictment.

The DOJ press release notes the strategic nature of the operation:

Defendant Javier Ortiz began assisting drug trafficking organizations as an employee of Airport Aviation Services (AAS) as a baggage handler/ramp employee. During the time of the conspiracy Ortiz used to pick up suitcases he knew contained cocaine from the mules at the airline check-in counter. Ortiz would then place the suitcases into the X-Ray machines being monitored by the TSA drug trafficking organization members, who cleared the suitcases. After the suitcases had been cleared by TSA members, Ortiz took the suitcases to their designated flight, making sure no narcotic K-9 unit or law enforcement personnel were present when the suitcase went from the checkpoint to the airplane. Once the suitcases were loaded into the airplane, defendant Ortiz would make a phone call to a drug trafficking organization member indicating the all clear and the mules would then board the airplane. Ortiz also paid the TSA employees for clearing the suitcases through TSA security.

Defendant Tomas Dominguez-Rohena assisted the drug trafficking organization by taking the suitcases he knew contained cocaine after they had been cleared by TSA members or smuggled passed security to their designated flight. Defendant José Gabriel López-Mercado was a mule for the criminal organization.

“This investigation was initiated by TSA as part of its efforts to address employee misconduct and specific insider threat vulnerabilities. TSA has zero tolerance for employees engaged in criminal activity to facilitate contraband smuggling,” said José Baquero, federal security director for Puerto Rico and the US Virgin Islands, in the Monday press release.

The indictment was a result of an internal TSA investigation by the Airport Investigations and Tactical Team (AirTAT), a 2-year-old multi-agency initiative.

If convicted, the defendants face prison terms of between 10-years to life in prison.

Not surprisingly, this is the second such bust of TSA officials in only 2 years for transporting massive amounts of cocaine.

 In November 2015, three former TSA agents were indicted on charges of defrauding the government and smuggling cocaine.

According to the indictment, 35-year old Joseph Scott, 32-year-old Michael Castaneda, and 27-year-old Jessica Scott, all former TSA agents at San Francisco International Airport, were involved in an ongoing operation to help transport drugs through airport security.

Still feel safe with the TSA protecting the nation’s airports?

Mexican official: Cartels send $64B in drugs into US annually

Mexican official: Cartels send $64B in drugs into US annually

http://www.foxnews.com/us/2017/02/13/mexican-official-cartels-send-64b-in-drugs-into-us-annually.html

President Trump’s proposed wall along the southwest border could cost Mexico more than just the price of building it: An official estimated that cartels send a stunning $64 billion worth of drugs into the U.S. every year.

Mexico’s former Public Safety Secretary Genaro Garcia Luna dropped the number at a recent conference in Ciudad Juarez. Luna said drug trafficking organizations have successfully exploited globalization, technology and financial markets to supply America’s appetite for narcotics, according to the Latin American Herald Tribune.

 In 2013, Forbes named Luna one of the country’s top 10 most corrupt officials, and he has long been alleged to have ties to Joaquin “El Chapo” Guzman’s Sinaloa Cartel. His estimate may be astronomical, but it sounds about right, according to Scott Stewart, vice president for tactical analysis for the Austin-based geopolitical intelligence agency, Stratfor.

“It definitely runs into the tens of billions of dollars,” Stewart said.

Stewart said nobody, not even the cartels, know how much money is being made. He did say that the Mexican heroin and methamphetamine economy is booming, which is evident in the extraordinary rise of heroin overdoses in the U.S.

Building the wall, which Trump famously said Mexico will pay for, will stop the twin tides of illegal immigrants and deadly drugs, said Rep. Duncan Hunter, R-Calif.

“Drug smugglers will always get creative and look for new ways to evade law enforcement, but without any kind of infrastructure we’re essentially inviting them to cross the land border either on vehicle or by foot,” Hunter told Fox News. “In San Diego, the double-fence halted vehicle drug drive throughs—in other words, there haven’t been any. 

Hunter said improvements in the fencing and Border Patrol strategies have dropped the smuggling of people and narcotics significantly. 

“Fencing can cut off major corridors for smugglers and it’s a force multiplier for the Border Patrol that either stops crossing attempts or slows them down enough for agents to respond,” Hunter said.a

2016 Drug Trend Report

Express Scripts’ 2016 Drug Trend Report: 7 things to know

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/express-scripts-2016-drug-trend-report-7-things-know?page=0,1

6. Pain medication spending is driven by two brand-name medications. Pain medications are the fifth costliest class of drugs.

One in five people filled a prescription for a pain medication in 2016.  Despite a 95% generic fill rate for this class of drugs, spending was driven by just two brand-name medications: Lyrica (pregabalin) and OxyContin (oxycodone).

When you consider that there is an estimated 100 + million chronic pain pts – about 1/3 of the USA population … and… 20% of the population had filled a prescription for pain medications… including those needing pain meds for acute pain…does this suggest that there is a gross UNDER TREATMENT OF PAIN IN THIS COUNTRY.

DEA Removes Marijuana Misinformation from Website

After Months of Public and Legal Pressure, DEA Removes Marijuana Misinformation from Website

https://thejointblog.com/dea-removes-marijuana-misinformation-website/

The Drug Enforcement Administration (DEA) has removed marijuana misinformation from their website following months of public and legal pressure.

After months of public pressure, and a legal request by the nonprofit medical cannabis advocacy group Americans for Safe Access, the DEA has removed factually inaccurate information about marijuana from their website.

As part of the legal request, Americans for Safe Access argued that there was over 25 incorrect statements on the DEA’s website about cannabis, which violates the Information Quality Act, which prohibits government agencies from providing false information to the public, and requires them to respond to requests for correction of information within 60 days.

“The DEA’s removal of these popular myths about cannabis from their website could mean the end of the Washington gridlock” said Steph Sherer, Executive Director of Americans for Safe Access. “This is a victory for medical cannabis patients across the nation, who rely on cannabis to treat serious illnesses. The federal government now admits that cannabis is not a gateway drug, and doesn’t cause long-term brain damage, or psychosis. While the fight to end stigma around cannabis is far from over, this is a big first step.”

Americans for Safe Access’ full legal request which brought forth this change can be found by clicking here.

The next to the last option ?

This appeared as a comment on another closed FB page for Chronic Painers !

I called my doctor out on this and all he could respond with was that his hands were tied and that management has changed the policies, as they are following the max daily dosage but refusing to follow the guidelines on exemptions

How many in the chronic pain community have signed various petitions… how many have made phone calls… sent letters/emails… to various entities…

Does this statement now demonstrates that prescribers are reluctant to follow the guidelines that the CDC and some states have published ?  This particular pt was told that THE MANAGEMENT had made the mgs/daily limits decision..

So if this MANAGEMENT does not have a license to practice medicine then they are apparently believing that they are capable of doing so

IF this management does have a license to practice medicine then we are talking about COLLUSION among the prescribers in this group.. to discriminate against a specific group of pts.. because of their medical necessity for certain medications (controlled substances).  COLLUSION is ILLEGAL as is discriminating against those covered by the Americans with Disability Act… it is considered a CIVIL RIGHTS VIOLATION.. the same if they refused to treat a pt because of the color of their skin, their religious beliefs, sexual preferences … etc…etc…

Law firms are not going to take on a single pt’s legal issues on a contingency basis because in our legal system the “value of life” of someone who is disabled/handicapped, elderly, unemployable is “NOT MUCH”… but when a SINGLE ENTITY – like a corporation… makes a decision/policy that will harm hundreds or thousands of people the formula changes.

Here is a previous post that I made and suggest that your read it

Regain your quality of life … SUE THEIR ASS !

Or you can continue to sign petitions, sending letters/emails/faxes to our elected officials… and see where that gets you…  The problem belongs to those in the chronic pain community… only those in the chronic pain community can hope to change the direction things have taken.

 

This is where the class actions can begin

lawsuit form with filler and book

The following was posted on a closed FB page for chronic painers…  The CDC guidelines are for PRESCRIBERS… United Healthcare or any other insurance company CANNOT LEGALLY ADOPT THESE GUIDELINES or force prescribers to follow them.

Here one of my previous posts that goes into details

Regain your quality of life … SUE THEIR ASS !

Maryland Medicaid/(potentially Medicare) Users: I was just accidentally pre-informed by a representative named Llyod at United healthcare that on January 1st an internal memo was sent out that as of June 30th they will be adopting CDC guidelines, but it will not effect short acting pain medications or cancer patients. At that point I asked him if he was telling me they will be limiting the dose to 90MME or doing away with long acting all together. He got nervous and connected me to a manager. The manger said Llyod should not have shared that with me and he can give no further details. I argued for an hour that the cat is out of the bag and that I wanted further clarity, but he basically said they will be mailing out the information on the changes by April 30th. So there you have it, low income and disabled people are going to suffer. It’s official. You should have heard how mad he was when I kept insisting I can’t UNHEAR what was said, and I will not “wait” for further instructions as this effects me now and you already gave me concrete information that you are limiting chronic pain patients doses of opioids at least by some capacity. I asked him if I had recorded it and played it back would he keep denying what I heard, and he freaked out. He FINALLY admitted that he knows that I heard something, but it was not to be shared so he will not elaborate on the exact specifics. He then had the nerve to tell me LLyod is in trouble for telling me. I told him the only person to be in trouble should be you for lying and denying what you know I know, and this company for preparing to severely hurt chronic pain patients with little notice. It’s disgusting and sad. I’m so upset.

Survivor of 5 heroin overdoses describes struggle with addiction

Just listen to this young man’s words….

“I didn’t want to get sober…”

“I didn’t care anymore…”

“I couldn’t get high anymore… nothing to live for…. shoot as much as you can …”

“… way of life .. jail… homelessness…begging… not having anything …”

Are those the words of someone who is suffering from a mental health issue… severe depression… suicidal ..???

I don’t think that it would take someone with a Masters or PhD in Psychology or a Psychiatrist to notice that,, except for the reporter interviewing this young man.

 

http://www.whas11.com/news/local/survivor-of-5-heroin-overdoses-describes-struggle-with-addiction/311985283

LOUISVILLE, Ky. (WHAS11) — The morning after doctors in Louisville, Kentucky reported a record 24 heroin overdoses, lawmakers called for more funding of opioid addiction recovery programs. But as Congressman John Yarmouth and Lexington Mayor Jim Gray called out Senators like Rand Paul, a young man described his experience.

“Daniel” is now a recovery mentor at The Healing Place, an addiction recovery center. He survived 5 heroin overdoses in 2015 before seeking treatment at the Louisville center.

Daniel’s conversation with WHAS 11 Political Editor Chris Williams describes a courageous effort to change and save his own life.

Daniel: “I don’t really know. I didn’t really care anymore so I just was trying to get high, and I couldn’t get enough, man.  And it really didn’t, and my mind told me that I didn’t have nothing else to live for, everything was already gone, might as well just shoot as much as you can.”

Chris: “You overdosed how many times last year?”

Daniel: “5 times.”

Chris: “Do you realize how ridiculous that sounds to somebody who doesn’t use? Do you realize that it sounds pretty ridiculous?”

Daniel: “Absolutely. It sounds ridiculous saying it unless you’ve been there.”

Chris:  “When you tell people, oh yea I overdosed five times last year, it sounded like you were just going to the store, buying your groceries.”

Daniel: “It was just a way of life, that’s kind of how it was really. It was normal for me, jails, homelessness, begging, not having nothing, overdoses.”

Chris: “What’s it like to get revived by NARCAN?”

Daniel: “Honestly man, it sucks. It hurts. It throws you into immediate withdrawals.”

Chris: “Why do you think you were brought back so many times?”

Daniel: “I think, really to be able to help somebody who’s inside and can’t see a way out.”

Daniel is not alone at the Healing Place. Many of those helping with recovery know the struggle first hand.

You can see more of what Congressman Yarmuth and Mayor Gray had to say at their news conference. We’ve posted the entire video online.Here is the statement released by Senator Rand Paul’s office:

 “It’s disappointing that rather than focusing on the bipartisan work of Congress in addressing the opioid epidemic, Mayor Gray is once again politicizing a crisis. The heroin epidemic facing our Commonwealth is too important to be left to partisan bickering, which is why Dr. Paul reached across the aisle to work with Democrat Sen. Ed Markey to ensure crucial language from their bill, the TREAT Act, was included in the final opioid bill to expand access to addiction treatment. In addition to voting for $1.5 billion in funding for addiction prevention and treatment efforts, Dr. Paul has led on this issue and will continue standing for Kentucky families as we fight back against this epidemic and help people find a path to recovery.”