UNCLE SAM… the latest “drug dealer” …DEA official says drug difficult to detect in mail

Image result for cartoon USPS truck

Fentanyl-related deaths skyrocket in Baltimore

http://www.wbaltv.com/article/fentanyl-related-deaths-skyrocket-in-baltimore/8681319

Over the past two years, fentanyl-related deaths have skyrocketed and officials said the product itself coming by a method we all use almost every day.

 “I died. I woke up in an ambulance. They were bringing me back to life,” said Douglas Frier Jr. “I hear the birds singing now. I really hear them.”

Frier struggled with addiction for 30 years and has now been in recovery for a little more than 18 months.

“Drugs through the mail. Was that ever something you came across?” WBAL-TV 11 News reporter Omar Jimenez asked.

“I was like, ‘Wow, that’s a nice way to get something.’ “The same drug that’s been killing everybody here in Baltimore, that fentanyl, they have ordered it through the mail,” Frier said.

It’s a common practice in the region.

“They’ll usually ship it in a container, a package that’s labeled as something else,” said Todd Edwards, special agent with the DEA.

The DEA said the latest spike in synthetic supply is coming in part from China, and it’s getting into Baltimore through every day packages.

“Whether it’s printer cartridges, printer toner, toys, something like that and they’ll ship it to whatever address you want,” Edwards said.

Authorities said one of the biggest challenges is the sheer volume of packages in circulation at any given time. For example, UPS said on average, on a non-peak day they deal with over 18 million packages and documents.

“Unless you have an ongoing investigation, it’s very hard to find these packages. Fentanyl is tasteless. It’s odorless. Dogs can’t detect it,” Edwards said.

So how do authorities even begin to tackle this?

“It’s just a very difficult job,” Edwards said.

The DEA said a dose of heroin is about a 10th of a gram, but fentanyl comes in micro-doses of one one thousandth of a gram, which is a grain of salt, but about 50 times more potent than the heroin itself.

“Now, it’s not only stuff you can get addicted to. It’s stuff that’s going to kill you,” Edwards said.

Through September of 2016 it killed 503 people in the Baltimore metro, more than three and a half times the amount from all of 2015, which was 137 deaths.

It’s a first-hand experience Frier hopes will change.

“I’ve seen people buy, walk around the corner, take a sniff and die right there. It’s frightening that our city has come to this, and I’m so scared that it’s going to deteriorate even further,” Frier said.

It is a feeling shared by the many fighting the epidemic on the ground, on the web and through a combination of those two in the mail.

The DEA said they’re trying to work with Chinese officials to open a third office there as they try and get a handle on the supply of synthetic drugs, specifically fentanyl, flowing into the region.

 

FALSE POSITIVE DRUG TEST …He is seeking damages for his loss of liberty and for emotional and psychological harm.

Former Middletown man’s false-positive drug test leads to lawsuit

http://www.recordonline.com/news/20170205/former-middletown-mans-false-positive-drug-test-leads-to-lawsuit

A drug test can change your life.

Test positive one day for an illicit drug, and you can lose your job, or your kids, your marriage or your freedom.

 Dec. 17, 2007, was that day for Eric Landon, formerly of Middletown.

He was two weeks from finishing probation for a felony forgery conviction. And then, a saliva drug screen showed a false-positive for marijuana.

“I was a guy that was, for the first and only time in his life, engaged to be married and become a stepfather to two young girls, was at the beginning of living and working in a perfect kind of town for me – Albany, and had career and business plans and opportunities stacked up and waiting to be activated by, and all timed, with one thing: the end of that probation sentence,” Landon said.

“And none of that ever got to happen.”

If not for Landon’s natural wariness – a trait that led him to get his own blood tests and to document everything – he would likely have gone to prison on that false-positive screen.

Instead, he’s David taking on a Goliath, and he helped make a new law.

Landon is suing the testing company, Kroll Laboratories LLC, in Orange County Supreme Court for negligence over its failure to follow established scientific and state standards for testing and reporting of results.

 Landon said the probation violation triggered by the test left him with diagnosed post-traumatic stress disorder.

He is seeking damages for his loss of liberty and for emotional and psychological harm.

This negligence claim – that a testing lab has a “duty of care” or responsibility to the person being tested – did not exist in New York law until Landon’s case.

Jackie Lustig, the senior director of corporate communications for Alere Toxicology, which now owns Kroll, said the company does not comment on ongoing litigation.

Lawyer Mitchel Ochs of Manhattan-based Anderson & Ochs LLP, who represents Kroll in Landon’s lawsuit, did not respond to multiple phone calls and an email seeking comment on the case.

In legal papers and during in-court arguments, Ochs has argued that Kroll’s labs did everything they were supposed to do in processing Landon’s sample.

Kroll denies that Landon has suffered damage that can be recovered through a negligence claim.

 

“Our argument is that nothing we did was the legal cause of the harm he claims,” Ochs argued in court on Aug. 18, 2015, according to a transcript.

“It was the county that took our – our results. It was the county that decided to do additional testing. It was the county that decided to commence violation of parole (sic) proceedings.”

According to court papers, Kroll offered, at one point, to settle Landon’s claim for $100,000.

Landon said he turned down the offer on principle. He wants his day in court.

Orange County spokesman Justin Rodriguez said the county no longer uses Kroll or Alere.

Since 2012, probation has used instant tests – three different companies since then, as pricing changes and technology improves – to administer the roughly 4,000 drug tests the department conducts annually.

As of late January, about 2,400 people were on probation in Orange County – about 40 percent of them for felonies.

 

‘Fatally flawed’

Landon said his case is about the principle.

“I want every probationer to find out that they should get their own blood test,” he said.

Documents show that Landon’s Dec. 17, 2007 specimen, once screened, didn’t contain enough material for confirmation.

New York’s testing standards – which labs must follow to maintain a license to operate in the state, and which Kroll was obliged to follow by its contract with Orange County – require that an insufficient sample be discarded as “fatally flawed.”

If Kroll had followed those requirements, there would have been no extension of probation and no anguish, Landon argues.

In 2001, Landon was arrested on forged-prescription charges.

 

He says he had been prescribed opioids for intractable migraines and became dependent, but he makes no excuses for the crime.

He pleaded guilty to second-degree forgery, a felony, and was sentenced in January 2002 to five years of probation.

An early drug test showed positive for marijuana; Landon said that, too, was a false-positive.

 

He started getting his own blood tests immediately after every probation test.

False-positives can be caused by environmental exposure to a drug, or by medications. Confirmation testing weeds out those false alarms.

Dec. 17, 2007 was supposed to be Landon’s last probation appointment.

He had a full-time retail job and part-time funeral services work waiting for him upstate.

 

“I was laying the first row of bricks in the foundation in Albany, when everything was made different – and far worse – for me,” Landon said.

The probation officer asked him to take one last drug test, using the then-standard OraSure Intercept saliva swab kit.

Court documents show that Kroll notified the probation officer of the positive screen on Dec. 20, 2007.

She requested a confirmation test and filed paperwork to revoke probation, charging Landon with testing positive for marijuana and denying that he had used marijuana.

Kroll’s documentation shows that they could not perform the confirmation because the sample was insufficient.

Court of Appeals victory

On Jan. 2, 2008, Judge Jeffrey Berry extended Landon’s probation until the test issue could be resolved, despite Landon’s proof of clean blood test results and despite him passing a urine test that morning at the courthouse.

 

As the probation fight unfolded, Landon says, his relationship with his long-term girlfriend deteriorated.

Landon and his lawyer demanded a hearing.

In mid-March 2008, according to court papers, probation withdrew the revocation petition, and Judge Berry released Landon from probation.

Landon said he called a lawyer from the parking lot to start his lawsuit.

As the civil case began, Landon’s relationship with his girlfriend ended. He moved to Erie, Pa., hoping for a fresh start.

Lawyers Robert Isseks and Kevin Bloom filed a federal class-action lawsuit against Orange County, probation, the probation officer and her boss, and Kroll on behalf of Landon and others similarly situated.

That case was dismissed after they failed to amend a flawed complaint.

 

The lawyers then filed a new class action against Kroll in Orange County Supreme Court, but the court dismissed the claim, accepting Kroll’s argument that they were responsible only to the county.

By the time the state’s highest court was ready to hear his appeal, Landon had parted ways with Isseks and Bloom over strategy disagreements.

Landon argued his own case before the Court of Appeals on Sept. 3, 2013. His victory there resurrected his lawsuit.

Landon’s life revolves around the litigation.

He does his legal research at the Erie County, Pa., courthouse.

He writes his own briefs, investigates witnesses, and makes the six-hour drive to argue his case in court.

He has devoted his limited spare time and money to rescuing and caring for stray cats.

 

“I haven’t sat in a restaurant in eight years,” he said. “I haven’t been on a date. I haven’t been to a concert.”

His case survived bids by Kroll for dismissal in 2015 and again in November.

Landon lost his economic harm claim because he couldn’t document the expenses and losses, but Orange County Supreme Court Judge Catherine Bartlett ruled that his claims on loss of liberty and emotional harm will go forward.

Kroll appealed the latest ruling.

Landon’s case returns to court for a pretrial conference on March 30, when Judge Bartlett will likely set the trial date.

 

Caregivers…. GIVING THE WRONG CARE ?

Nine in 10 carers are giving patients the wrong drugs

http://themissouriinjuryblog.com/23684/nine-in-10-carers-are-giving-patients-the-wrong-drugs/

More than 90 per cent of carers looking after people at home make potentially deadly errors with their medicines, according to a new study.

Sick and elderly patients are being given the wrong drugs, overdoses or, in some cases, no medication at all. The mistakes are being made by paid care workers and people looking after their own relatives.

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Experts fear that thousands are unwittingly being put in danger because drug administration at home is rarely monitored.

More than 90 per cent of carers are making deadly errors with their medicines. Sick and elderly patients are being given the wrong drugs, overdoses or no medication at all (file photo)

Researchers who carried out the study warned: ‘Home medication administration errors by carers are a potentially serious patient safety issue.’

NHS medication blunders have been in the spotlight in recent years. A report in December claimed one person a week dies because doctors or nurses give them the wrong drug, or too high or low a dose of the right drug. And a 2015 study in the British Medical Journal found one in 100 NHS patients is exposed to potential harm through medics’ drug blunders.

But researchers claim far less attention has been paid to mistakes made by carers tending patients in their own homes. They fear, with an ageing population, the risk of serious life-threatening errors will increase. It is estimated that 60 per cent of adults in the UK will act as a carer to an elderly relative at some point.

Experts blame the number of pills many people have to take. It is thought that 60 per cent of adults in the UK will act as a carer to an elderly relative at some point in their lives (file photo)

Thousands of elderly people in Britain take a daily cocktail of medicines to manage chronic health conditions such as dementia, high blood pressure and raised cholesterol.

A team from the London School of Economics, Imperial College London and Oxford University studied research databases for home drug blunders. 

The results revealed that 92 per cent of home carers had made at least one potentially serious medication mistake. 

Faults ranged from giving dangerously high doses to forgetting them completely.

One in 12 admitted giving too little medicine and one in 15 an accidental overdose.

Researchers blamed the number of pills many people have to take, problems understanding prescription instructions and poor communication between carers sharing responsibility.

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Previous studies have found that one in eight patients at home has suffered serious side effects from drug blunders.

Joshua Gaffney, 22, from Yeovil, Somerset died after being given six bottles of prescription medication when he was supposed to have little more than a teaspoon

A young man died after being given six bottles of prescription medication when he was supposed to have a little more than a teaspoon.

Joshua Gaffney, 22, was given 84ml of the psychosis drug Clozapine instead of 6ml shortly before being found dead at his home in February 2012.

A post-mortem examination and toxicology report found that the cause of death was acute Clozapine poisoning.

Nurse Amanda Young, 41, was cleared of manslaughter but was struck off in January last year after a Nursing and Midwifery Council disciplinary panel ruled she could no longer treat patients as her ‘misconduct is fundamentally incompatible with continuing to be a registered nurse’.

Young administered 14 times the right dose of Clozapine to Mr Gaffney, above, while he was being treated for schizophrenia at home in Yeovil, Somerset.

Mr Gaffney’s mother Tina Marren said her family had been ‘devastated’ by his death.

In a report on the findings, the researchers said: ‘Medications are mostly taken in patients’ own homes, increasingly administered by carers. But studies on safety have been largely conducted in the hospital setting. The home care setting should be a priority for the development of patient safety interventions.

‘The number of carers will rise by around 60 per cent over the next three decades. They will be in a position to hinder or help the safety outcomes of those cared for.’

Royal College of GPs chair Professor Helen Stokes-Lampard said: ‘Carers such as family members and parents do a really difficult but vital job.

One in 12 admitted giving too little medicine and one in 15 an accidental overdose, according to researchers at the London School of Economics (file photo)

‘It can be challenging to ensure relatives with long-term conditions are taking the right dose at the right time. Patient safety is really important and carers can seek advice from their pharmacist or GP.’

Hugh Williams, of the charity Action Against Medical Accidents, said: ‘It is easy to see that this might result in serious injury or even fatalities.

‘Carers provide a vital role and it is essential that they get the support they need.’

Another example of the DEA re-interpreting the CSA to serve their agenda ?

Man sentenced for selling synthetic marijuana at Delavan store

http://www.gazettextra.com/20170206/man_sentenced_for_selling_synthetic_marijuana_at_delavan_store

MILWAUKEE—The man who owned the Delavan Smoke Shop and sold pounds of synthetic marijuana as incense will serve five years of supervised release with nine months of home confinement, a judge decided.

David Yarmo, 49, pleaded guilty in November to selling a misbranded drug in 2014 and money laundering charges.

U.S. District Judge Lynn Adelman handed down his sentence Friday in federal court in Milwaukee.

Both offenses stemmed from his selling packages of aromatic potpourri that did not list the controlled substance AB-Fubinaca as an ingredient. He also wrote a check to his supplier using money earned from prior sales of the packages.

According to a memo filed with the court by Yarmo’s attorney, John Markham of Boston:

In 2006, Yarmo bought the business at 127 Park Place, which was frequented by police officers, attorneys and judges.

Yarmo was a valued member of the community, operating a store that had 10 full- and part-time employees at one time. The store sponsored concerts in a local park and had donated sound equipment to the city’s park and recreation department.

In September 2012, the Drug Enforcement Administration seized Yarmo’s incense inventory, valued at $100,000, alleging it contained a drug similar in chemical structure to a controlled substance.

Yarmo sued to get his inventory returned, arguing that it did not contain a banned substance. However, in May 2013, before the court could rule on Yarmo’s request, the DEA listed a substance in his inventory as a controlled substance, and the court concluded it could not return it to him.

In February 2014, the DEA listed AB-Fubinaca as a controlled substance. On April 4, 2014, the DEA and local law enforcement returned to Yarmo’s shop and seized packages that contained AB-Fubinaca.

Yarmo had bought 778 pounds of “aromatic potpourri,” which contained AB-Fubinaca, between Feb. 26 and March 28, 2014, according to the plea agreement.

The DEA also seized the balances of two of Yarmo’s bank accounts, totaling $776,097, contending they were obtained from the sale of controlled substances.

Yarmo agreed to forfeit $404,802, the store’s checking account balance, which was obtained from AB-Fubinaca sales received after it was listed as a controlled substance. The government returned the store’s $371,295 savings account balance to Yarmo.

Yarmo maintained that he did not know AB-Fubinaca had become illegal to possess, but he conceded that the government did not have to prove he knew that AB-Fubinaca was a controlled substance, only that he was selling a substance the government could prove he knew contained AB-Fubinaca.

The Smoke Shop was closed by court order in a nuisance lawsuit the city of Delavan filed in Walworth County Court.

Yarmo has since opened a store in Harvard, Illinois, but sells no loose incense products. Residency law requires him to live there, but he commutes to the Delavan area to be with his family, Markham said.

Markham had asked Adelman for a probation-only sentence, arguing that Yarmo was unaware that AB-Fubinaca had been listed as a controlled substance only seven weeks before his store was searched.

Hemp Industries Association Sues DEA

Hemp Industries Association Sues DEA Over Illegal Attempt to Regulate Hemp Foods as Schedule I Drugs

http://www.military-technologies.net/2017/02/06/hemp-industries-association-sues-dea-over-illegal-attempt-to-regulate-hemp-foods-as-schedule-i-drugs/

WASHINGTON, Feb. 6, 2017 /PRNewswire-USNewswire/ — The Hemp Industries Association (HIA), the leading non-profit trade association consisting of hundreds of hemp businesses, has filed a motion to hold the Drug Enforcement Administration (DEA) in contempt of court for violating an unchallenged, long-standing order issued by the U.S. Court of Appeals in San Francisco, prohibiting the agency from regulating hemp food products as Schedule I controlled substances. Specifically, the HIA asserts that the DEA continues to operate with blatant disregard for the 2004 ruling made by the Ninth Circuit Court of Appeals, which permanently enjoined the DEA from regulating hemp fiber, stalk, sterilized seed and oil, which are specifically exempted from the definition of ‘marijuana’ in the federal Controlled Substances Act.

To read the motion, please visit: https://thehia.org/resources/Documents/Legal/HIA-v-DEA-9th-Circuit-Motion.pdf.

“We will not stand idly by while the DEA flouts the will of Congress, violates the Ninth Circuit order, and harasses honest hemp producers trying to make a living with this in-demand crop,” said Colleen Keahey, Executive Director of the Hemp Industries Association. “Hemp is a healthy superfood with vital nutrients such as Omegas 3 and 6, protein, fiber and all 10 essential amino acids that are ideal for today’s family.  The DEA must stop treating hemp, hempseed and hempseed oil, which is a nutritious ingredient, as something illicit. We have to address the challenges that thwart the domestic industry’s progress and especially those that mislead state Departments of Agriculture and limit entry of legal hemp products into the marketplace.”

Historically, the DEA has made persistent efforts to regulate hemp products. In 2001, DEA issued an Interpretive Rule attempting to ban all hemp seed and hempseed oil food products that contained even minuscule, insignificant amounts of residual THC. The HIA immediately filed suit to stop the enforcement of this rule, which resulted in what became known as the “Hemp Food Rules Challenge.”  Ultimately, the subsequent ruling made by the Ninth Circuit issued serendipitously on February 6, 2004, found that the DEA had not followed necessary scheduling procedures to add non-psychoactive hemp to the list of Schedule I controlled substances; and additionally, that Congress clearly did not intend that hemp be prohibited by the Controlled Substance Act when it adopted language from the 1937 Marijuana Tax Act to define the drug ‘marijuana.’ To read the full 2004 court opinion, please visit: http://www.votehemp.com/PDF/HIAvDEA_9th_final_decision.pdf.

In December of 2016, the DEA in conjunction with the North Dakota Department of Agriculture (NDDA) indicated to Healthy Oilseeds, LLC that shipment of the company’s hemp products made from hemp grown under the state’s hemp pilot program and Congress’ Agricultural Act of 2014 (Farm Bill), would require a permit from the DEA, as the hemp protein powder and hempseed oil food items were subject to DEA regulation. Specifically, Healthy Oilseeds received communication from the NDDA stating that export of its hemp products to other states was prohibited, “because industrial hemp is a Schedule I controlled substance under the Federal Controlled Substances Act.” To view this correspondence between NDDA and Healthy Oilseeds LLC, please visit: https://thehia.org/resources/Documents/Legal/HIA-v-DEA-9th-Circuit-Motion-Exhibits.pdf.

DEA’s actions violate the clear Congressional intent of not only of the Farm Bill, which defines industrial hemp as distinct from ‘marijuana’ and legalizes its cultivation and processing under licensing programs in place in 31 states; but also further violate the Consolidated Appropriations Act of 2016, which specifically prohibited federal authorities from using funds to obstruct the “transportation, processing, sale, or use of industrial hemp…within or outside the State in which the industrial hemp is grown or cultivated.” Hence, the DEA may not require lawfully licensed hemp farmers or manufacturers in the U.S. to register for a permit to engage in interstate commerce of industrial hemp products.  Indeed, by taking this action, the DEA is violating federal law, misusing taxpayer dollars, and thumbing its nose at Congress.

“Here in Kentucky, our Commissioner of Agriculture, Ryan Quarles, has built a successful pilot program that works closely with local law enforcement and is creating desperately needed economic opportunity for hundreds of farmers,” stated Bill Hilliard, CEO of Atalo Holdings, Inc.  “As states have wisely taken the initiative in this growing industry, the DEA doesn’t need to be interfering on our farms.”

Joe Sandler, HIA’s lead counsel, further stated:  “Thirteen years ago DEA was told in no uncertain terms by the U.S. Court of Appeals that Congress had made its intent clear:  DEA has no power to regulate hemp seed and oil, and the hemp food and beverage products made from them.  It is disappointing that the industry has to revisit the issue, and take this step to compel DEA to obey the law.”

On January 13, 2017, the Hemp Industries Association, among other petitioners, filed a Petition for Review with the Ninth Circuit Court of Appeals, to challenge the DEA’s recent effort to append Schedule I of the Controlled Substances Act to include lawful hemp-derived non-psychoactive cannabinoids such as cannabinol, which the DEA has arbitrarily termed “Marijuana Extract.” In addition to this suit, and today’s actions taken to affirm the legality of hemp food products, the HIA does intend, in due course, to challenge the DEA’s repeated refusal to abide by other Congressional directives on industrial hemp.

The Hemp Industries Association (HIA) represents the interests of the hemp industry and encourages the research and development of new hemp products.  More information about hemp’s many uses and hemp advocacy may be found at www.TheHIA.org.

To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/hemp-industries-association-sues-dea-over-illegal-attempt-to-regulate-hemp-foods-as-schedule-i-drugs-300402745.html

SOURCE Hemp Industries Association

Pneumonia vaccine may not be effective in rheumatoid arthritis patients

Pneumonia vaccine may not be effective in rheumatoid arthritis patients

http://www.clinicaladvisor.com/infectious-diseases-information-center/pneumonia-vaccine-not-effective-in-rheumatoid-arthritis-patients/article/635670/

The 23-valent pneumococcal polysaccharide vaccine (PPSV23) may not be effective for preventing pneumonia in patients with rheumatoid arthritis (RA) who are at risk for infections, according to a study published in Arthritis Research & Therapy.

Kiyoski Migita, from the Japanese Hospital Organization and Department of Rheumatology at Fukushima Medical University, and colleagues conducted a double-blinded, randomized, placebo-controlled trial across rheumatology departments in Japanese National Hospital Organization hospitals. The study included 900 RA patients who had been treated with biological or immunosuppressive agents.

The study participants were randomly assigned to receive PPSV23 (n=464) or placebo (n=436). The researchers examined incidences of all-cause pneumonia and pneumococcal pneumonia as the primary end point and death from pneumococcal pneumonia, all-cause pneumonia, or other causes as the secondary end point.The researchers found that 17 of the patients (3.7%) who received the vaccine and 15 of the patients (3.4%) in the placebo group developed pneumonia. The overall rate of pneumonia was 21.8 per 1,000 person-years among patients with RA. In addition, the presence of interstitial pneumonia (hazard ratio, 3.601) was associated with an increased risk of pneumonia among RA patients.

The investigators note that the patient population in the current study had a high risk of infection, and the results may not be applicable to other RA populations.

“While PPSV23 vaccination is recommended for adults ≥65 years of age, our results suggested uncertainty regarding its effectiveness for pneumonia in RA patients at high risk for infections,” the study authors wrote. “Clinicians should keep in mind the patient’s age and the presence of interstitial pneumonia because such patients are at an increased risk of developing pneumonia.”

MJ.. LEGAL IN COLORADO… DEA PULLS DOCS’ DEA LICENSE for recommending MJ to pts ???

DEA pulls certificates for two Colorado doctors in medical marijuana controversy

http://www.denverpost.com/2017/02/06/dea-pulls-doctors-certificates-medical-marijuana/

The federal Drug Enforcement Administration has pulled the medicine-prescribing certificates of two Colorado doctors, after those physicians had their state licenses suspended in Colorado over medical marijuana recommendations.

The doctors — Gentry Dunlop and Janet Dean — were two of five Colorado physicians whose licenses the state Medical Board suspended last summer, alleging that the doctors wrote improperly large numbers of medical marijuana recommendations authorizing high plant counts..

Last week, the DEA published a notice in the Federal Register that it had revoked Dean’s certificate of registration, which allows her to prescribe controlled substances. The move was not unexpected, and the DEA’s notice said the revocation was a consequence of the state license suspension, which blocked the doctor from practicing medicine or prescribing medication in Colorado, and not the result of new information.

Late last month, the DEA published a similar notice for Dunlop. Searches of the Federal Register for notices relating to the other suspended doctors turned up nothing.

Four of the suspended doctors — everyone but Dean — filed suit over the suspensions last year. After winning a brief reprieve, a judge in Denver allowed the suspensions to continue while the doctors’ administrative appeals progressed. The doctors appealed the judge’s order; meanwhile, their cases at the Medical Board are also still pending. Lee Rasizer, a spokesman for the state agency that houses the Medical Board, said he could not comment on the cases.

The doctors were each accused of recommending that hundreds of patients be allowed to grow or possess more than the standard six marijuana plants per patient. The doctors say their suspensions were arbitrary, and that all of their recommendations conformed to the law and policy.

Man’s best friend – can legally use Marijuana

Medical marijuana for dogs

http://news4sanantonio.com/news/local/medical-marijuana-for-dogs-02-03-2017

SAN ANTONIO – Medical marijuana… for your dog? It’s real – and according to the Drug Enforcement Administration, perfectly legal.

“Kona is my 13-year-old Dutch Shepherd mix,” says Bea Adams as she pets her dog.

Adams recently noticed a change in Kona’s behavior.

“I hadn’t slept in weeks,” Adams says. “She kept me up at night, licking.”

Kona’s red, itchy skin was caused by seasonal allergies, a common ailment. Veterinarian Dr. Michelle Bammel at Westridge Pet Hospital suggested a treatment called Therabis.

“It’s just a natural antihistamine,” Dr. Bammel says.

The natural ingredient is CBD hemp oil. It’s not legal for humans, but DEA spokesperson Melvin Patterson says it’s okay for pets because pet products aren’t considered for human consumption.

“I tell people: it’s not pot. That’s the first thing out of their mouths,” Dr. Bammel says.

She says the treatment won’t get your dog high because it doesn’t contain THC.

“The joke is industrial hemp is kind of the sober cousin of marijuana,” Dr. Bammel says.

She recommends pouring the packet in your dog’s food, and the chemical ingredients will relieve itching and anxiety.

“There’s a lot of great attributes to it that you can get without having your dog get high or all the psychotropic effects of it – they don’t have those,” Dr. Bammel says.

Adams says Therabis cleared up Kona’s skin.

“I’d say about the third day on it, the itching was completely gone,” the dog owner says.

She urges dog loves concerned about the stigma of medical marijuana to consult with their veterinarians.

“I think they should keep an open mind on any natural product, especially for the dogs,” Adams says.

 

By law, pharmacies are not required to report complaints/mis-fills

Channel 2 Investigates reveals pharmacies with most complaints about prescription errors

http://www.click2houston.com/news/investigates/channel-2-investigates-reveals-pharmacies-with-most-complaints-about-prescription-errors

The number of complaints filed has nothing to do with the number of mis-fills that actually occur. Unless prescribers or pts file complaints with the state Board of Pharmacy… it is just “swept under the rug”..

HOUSTON – Channel 2 Investigates is revealing the local pharmacies with the most complaints about prescription errors.

Many mistakes never get reported, and there are steps you can take to prevent a dangerous mixup.

  •   Evan Merritt is just 7 months old. In his short life, he’s been through a lot.

“He’s had a rough several months of life,” said Evan’s mother, Krisztina. “He’s kind of hit every bump in the road.”

Merritt was born with a serious kidney condition. He’s already had one surgery and a second surgery is just weeks away.

“He was placed on a maintenance antibiotic from birth,” Krisztina said.

In October, Merritt’s doctor prescribed a new antibiotic.

“We gave him that antibiotic every day for 30 days,” Krisztina said.

When it was time to refill the prescription, Krisztina claims something was off.

“The two medicines looked so different,” Krisztina said.

Merritt’s dad went back to the pharmacy to check it out.

“The pharmacy tech was shocked,” Krisztina said.

Merritt’s parents think the new prescription was right, but what he had taken every day for the previous month was wrong.

“It was terrifying,” Krisztina said. “I didn’t know if it was a medication with long-term implications on his health. I still don’t know that.”

The family contacted CVS and, “We then filed a complaint with the Texas State Board of Pharmacy Licensing,” Krisztina said.

CVS said, “We fully investigated Ms. Merritt’s complaint last fall and determined that her child’s prescription was filled correctly. A thorough review of the safety procedures during the filling of the prescription in question found that all steps were performed correctly and no error was made. We informed Ms. Merritt of our findings in November.”

The case is not closed yet. The State Pharmacy Board is still investigating.

For months, Channel 2 Investigates poured through complaints about prescription errors.

By law, pharmacies are not required to report complaints. Most of the time, complaints come voluntarily from doctors or patients.

The CVS pharmacy on the 9500 block of Broadway in Pearland had the most complaints in our area — five since 2010.

The Walgreens on the 6800 block of South Fry road in Katy received four complaints.

“We see, it’s a wide range,” said Allison Vordenbaumen Benz, R.Ph., M.S., director of professional services with the Texas State Board of Pharmacy. “All the way from something that involves a miscount. If the patient was supposed to receive 30 tablets and they only received 28. They might have the wrong directions for use on the prescription label, they might have a situation where one patient gets another patient’s prescription or it’s the wrong drug, or it’s the right drug but the wrong strength.”

While a miscount might sound insignificant, mistakes like this can be deadly.

“Fortunately, that does not happen very often,” Benz said.

Channel 2 Investigates also found three complaints filed against the CVS on the 3800 block of Old Spanish Trail. In one case, the patient was “bedridden and experiencing end-stage liver failure.”

After receiving the wrong medicine, the patient became “non-responsive” and was hospitalized for 15 days.

The pharmacy is now on a two-year probation.

Board action can range from a warning letter to losing a license.

View Document: Dispensing Error Guidelines

So how can you help prevent pharmacy mistakes?

1. Talk to your pharmacist. Ask the pharmacist to look at the drug and dosage before you leave.
2. Look at the insert that comes with the medication. Compare the shape, size, markings and color of the medicine before you take it.

“Never, ever take it for granted that the prescription you fill and pick up is exactly what you think it is,” Krisztina said.

CVS also told Channel 2 Investigates “Errors are very rare, but when they happen we investigate to determine how it occurred as part of our process of continual improvement.”

When you discover a problem, it’s important to file a complaint, which you can do here.

CVS’s complete statement:

“The health and well-being of our patients is our number one priority. Our pharmacists follow comprehensive quality assurance processes to ensure prescription safety and accuracy. Every prescription dispensed at CVS Pharmacy undergoes a multi-step review by a pharmacist prior to being dispensed to a patient.

We fully investigated Ms. Merritt’s complaint last fall and determined that her child’s prescription was filled correctly. A thorough review of the safety procedures during the filling of the prescription in question found that all steps were performed correctly and no error was made. We informed Ms. Merritt of our findings in November. In addition, we resolved the complaint concerning the 4-year old incident that occurred at our Old Spanish Trail pharmacy with the Board of Pharmacy back in 2014 and took corrective action with the pharmacy.

As a health care company that strives to help people on their path to better health, we seek out new technology and innovations to enhance safety, we engage with industry experts for independent evaluations of our systems, and we are committed to continually improving our processes to help ensure that prescriptions are dispensed safely and accurately.

Prescription errors are a very rare occurrence, but when they happen we do everything we can to take care of the patient’s needs, including contacting their prescriber to address any health concerns. In addition, we require our pharmacies to report such events to the company’s patient safety organization as part of our program to learn from these incidents and continuously improve quality and patient safety.”

Walgreen’s complete statement:

“The four complaints at the store inquired about occurred between 2008 and 2011. In two of those cases the Texas State Board of Pharmacy concluded its investigation by dismissing the complaints with no disciplinary action taken.  With all prescriptions filled in our pharmacy, our first concern is always the patient’s well-being. We take this issue very seriously and have a multi-step prescription filling process with numerous safety checks in each step to reduce the chance of human error. In the event an error occurs, we investigate what happened and work to prevent it from happening again.”

Improving Opiate Drug Utilization Review Controls ?

Improving Drug Utilization Review Controls

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-02-01.html

It looks like CMS (Center for Medicare & Medicaid Services) is trying to implement CDC opiate dosing guidelines on all Part D/Medicare Advantage pts. More “bureaucratic creep” on the guidelines… that – per the CDC – did not bear the weight of law.

While not stated in this information, there has been other “rumors” that CMS via their Part D providers to restrict pts to a single provider and pharmacy.  This statement really concerns me ….sponsors are expected to reduce beneficiary overutilization of opioids and maintain access to needed medications“...  and if a particular pharmacy that a pt is locked into… has a pharmacist on staff that “is not comfortable” filling opiates… the pharmacy is out of stock for a number of reasons… how much influence or FORCE to get the Part D program and the pharmacy to “maintain access to needed medications”… how long will a pt have to suffer thru cold turkey withdrawal… while the “wheels of the bureaucracy” gets corrective action in place ?  After all the “pharmacy crawl” will not be a option.. since the pt is locked-in to a particular pharmacy… which may or may not be a singular store and not all the stores in an entire chain.

Medicare/Medicaid has a “freedom of choice of providers” by pts from day one… now they are going to take that freedom away at their opinion of a pt’s MAY be getting excessive opiates. Once again, there is seemingly no consideration for the pt’s severity/intensity of pain, CYP-450 enzyme metabolism defect of opiates. Like everything else with a “cookie cutter” type of medical care… those 5%-10%  at each end of the “bell curve”..  those “out-liers” are just SCREWED in regards to getting adequate therapy.

Maybe we should be on the lookout for increased passage of “assisted suicide” laws…to help those out-liers with access to a “final solution” to resolve their chronic pain issues ?


To address the opioid epidemic, CMS has implemented a medication safety approach by which sponsors are expected to reduce beneficiary overutilization of opioids and maintain access to needed medications. CMS also implemented the Overutilization Monitoring System (OMS) to help oversee sponsors’ compliance with this CMS overutilization guidance. Building upon these successes, CMS is proposing a number of updates to these policies intended to address drug utilization concerns within the Part D program for 2018, including:

  • Proposing revisions to the retrospective drug utilization review criteria used to identify potential opioid over utilizers through the OMS to better align with the CDC guideline on opioid prescribing, reduce false positives, and maintain a policy that is still manageable for sponsors; and
  • Proposing establishing the expectation for sponsors to, at a minimum, implement hard formulary-level safety edits based on a cumulative morphine equivalent dose (MED) approach to prospectively prevent opioid overuse at point of sale at the pharmacy.   

Process
Comments on the proposed Advance Notice and Draft Call Letter are invited from the industry, seniors, consumer advocates, and the public, and must be submitted by March 3, 2017. The final 2018 Rate Announcement and Call Letter, including the final Medicare Advantage and FFS growth percentage and final benchmarks will be published by Monday, April 3, 2017. 

Comments can be emailed to: AdvanceNotice2018@cms.hhs.gov

The Advance Notice and Draft Call Letter may be viewed through: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/ and selecting “Announcements and Documents.”