Orrick, Representing Marijuana Advocate, Challenges DEA Statements About Pot

http://www.therecorder.com/home/id=1202773915178/Orrick-Representing-Marijuana-Advocate-Challenges-DEA-Statements-About-Pot?

A national nonprofit advocacy group supporting legal access to medical marijuana has petitioned the U.S. Justice Department to require drug enforcers to correct allegedly false and misleading information about cannabis use on its website.

Americans for Safe Access, represented pro bono by Orrick, Herrington & Sutcliffe, cites 25 alleged violations by the U.S. Drug Enforcement Administration of the Information Quality Act. The law, also known as the Data Quality Act, requires federal agencies to draft guidelines that ensure the “quality, objectivity, utility and integrity of information” that they distribute and to provide a mechanism to correct any misinformation.

“We have taken this action to stop the DEA’s relentless campaign of misinformation about the health risks of medical cannabis in its tracks,” said Vickie Feeman of Orrick, a Silicon Valley partner who’s pro bono counsel to the nonprofit petitioners. “We’re hoping this is a very straightforward petition. We’re going after specific statements they themselves have said in recent reports are wrong.”

A representative of the DEA did not immediately comment Monday on the petition. Under the Justice Department’s guidelines, the department has 60 days to respond to the petition.

The petition states that the DEA continues “to disseminate certain statements about the health risks of medical cannabis use that have been incontrovertibly refuted by the DEA itself.” The petition pointed to statements the agency recently made in its refusal to reschedule marijuana to a lower classification of controlled substances. The petition contends “the DEA’s recent statements confirm scientific facts about medical cannabis that have long been accepted by a majority of the scientific community.”

Among the alleged DEA misstatements that are challenged in the petition: “Evidence of the damage to mental health caused by cannabis use—from loss of concentration to paranoia, aggressiveness and outright psychosis—is mounting and cannot be ignored.”

In its recent refusal reclassify marijuana, the agency said: At present, the available data do not suggest a causative link between marijuana use and the development of psychosis. And also: Numerous large, longitudinal studies show that subjects who used marijuana do not have a greater incidence of psychotic diagnoses compared to those who do not use marijuana.

Americans for Safe Access states in its petition that members of Congress are using DEA’s inaccurate information to inform their votes on recent legislation, including the Compassionate Access, Research Expansion, and Respect States. The bill would protect patient access to medical cannabis in states with existing medical cannabis programs from federal intervention. And it would also would also reschedule marijuana, easing restrictions on medical and scientific research of the substance.

The Information Quality Act’s requirements govern nearly all federal agencies and are enforced by the office of information and regulatory affairs within the Office of Management and Budget.

“We are simply taking the DEA’s own statements, which confirm scientific facts about medical cannabis, and analysis that has long been accepted by a majority of the scientific community,” said Steph Sherer, executive director of Americans for Safe Access, in a statement. “Our request is simple: the DEA must change its public information to better comport with its own expressed views, so that Congress has access to the appropriate tools to make informed decisions about public health.”

The petition from Americans for Safe Access is posted below.

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G.O.P. Plans Immediate Repeal of Health Law, Then a Delay

www.nytimes.com/2016/12/02/us/politics/obamacare-repeal.html

Obamacare was signed into law March 2010… with the “worse part – higher premiums ” of it not kicking in until 2017… when Obama would be out of office.  Part of their “bad timing” was that the 2017 HIGHER premiums were announced right before the Nov election.  There is a disproportion number of Republicans in the Senate up for re-election in 2018.  So … any more “bad news” from Congress about the replacement for Obamacare will be pushed off until after the 2018 election. It would appear that “the swamp” is going to be alive and well for another couple of years… AT LEAST !

It is not sheer coincidence that at least one idea envisions putting the effective date well beyond the midterm congressional elections in 2018.

“We are not going to rip health care away from Americans,” said Representative Kevin Brady, Republican of Texas and chairman of the Ways and Means Committee, which shares jurisdiction over health care. “We will have a transition period so Congress can develop the right policies and the American people can have time to look for better health care options.”

Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee, said: “I imagine this will take several years to completely make that sort of transition — to make sure we do no harm, create a good health care system that everyone has access to, and that we repeal the parts of Obamacare that need to be repealed.”

But health policy experts suggest “repeal and delay” would be extremely damaging to a health care system already on edge.

OPEN Graphic

“The idea that you can repeal the Affordable Care Act with a two- or three-year transition period and not create market chaos is a total fantasy,” said Sabrina Corlette, a professor at the Health Policy Institute of Georgetown University. “Insurers need to know the rules of the road in order to develop plans and set premiums.”

Details of the strategy are in flux, and there are disagreements among Republicans about how to proceed. In the House, the emerging plan, tightly coordinated between Mr. Ryan and Mr. Pence, is meant to give Mr. Trump’s supporters the repeal of the health law that he repeatedly promised at rallies. It would also give Republicans time to try to assure consumers and the health industry that they will not instantly upend the health insurance market, and to pressure some Democrats to support a Republican alternative.

“I don’t think you have to wait,” Representative Kevin McCarthy of California, the majority leader, told reporters this week. “I would move through and repeal and then go to work on replacing. I think once it’s repealed, you will have hopefully fewer people playing politics, and everybody coming to the table to find the best policy.”

Under the plan discussed this week, Republicans said, repeal will be on a fast track. They hope to move forward in January or February with a budget blueprint using so-called reconciliation instructions, which would allow parts of the health care law to be dismembered with a simple majority vote, denying Senate Democrats the chance to filibuster. They would follow up with legislation similar to a bill vetoed in January, which would have repealed the tax penalties for people who go without insurance and the penalties for larger employers who fail to offer coverage.

That bill would also have eliminated federal insurance subsidies, ended federal spending for the expansion of Medicaid, and barred federal payments to Planned Parenthood clinics.

But in the Senate, Republicans would need support from some Democrats if they are to replace the Affordable Care Act.

The budget reconciliation rules that would allow Republicans to dismantle the Affordable Care Act have strict limits. The rules are primarily intended to protect legislation that affects spending or revenues. The health law includes insurance market standards and other policies that do not directly affect the budget, and Senate Republicans would, in many cases, need 60 votes to change such provisions.

Repealing the funding mechanisms but leaving in place the regulations risks a meltdown of the individual insurance market. Insurers could not deny coverage, but they would not get as many healthy new customers as they were expecting. Hospitals would again face many uninsured patients in their emergency rooms, without the extra Medicaid money they have been expecting.

Even a delay of two to three years could be damaging. Health policy experts said the uncertainty could destabilize markets, unnerving insurers that have already lost hundreds of millions of dollars on policies sold in insurance exchanges under the Affordable Care Act.

 Republicans hope to pressure vulnerable Democrats like Senator Joe Manchin III of West Virginia to support a replacement of the health care law. Credit Al Drago/The New York Times

“Insurers would like clarity on the shape of the replacement plan to continue participating on exchanges if Obamacare is repealed,” Ana Gupte, an analyst at Leerink Partners who follows the insurance industry, said Friday.

Republicans are hoping that Mr. Trump will be able to use his bully pulpit to lean on vulnerable Democrats up for re-election in states Mr. Trump won, such as Senators Joe Manchin III of West Virginia and Jon Tester of Montana.

“When that date came and you did nothing, if you want to play politics, I think the blame would go to people who didn’t want to do anything,” Mr. McCarthy said.

But Democrats may not be so quick to break.

“If they are looking at fixing what’s there, I’ve been wanting to work with Republicans for years now,” said Mr. Tester, whose state cast just 36 percent of its vote for Hillary Clinton. “But if they are going to take away provisions like pre-existing conditions, lifetime caps, 26-year-olds, I think they are barking up the wrong tree.”

And some moderate Republicans see peril in repealing first and replacing later, favoring instead a simultaneous replacement to ensure a smooth transition.

“We are firing live rounds this time,” Representative Charlie Dent, Republican of Pennsylvania, said. “If we repeal under reconciliation, we have to replace it under normal processes, and does anyone believe that the Senate Democrats, with their gentle tender mercies will help us?”

Republicans said they would work with the Trump administration on replacement legislation that would draw on comprehensive plans drafted by Mr. Ryan and Representative Tom Price, the Georgia Republican picked by Mr. Trump to be his secretary of health and human services.

Any legislation is likely to include elements on which Republicans generally agree: tax credits for health insurance; new incentives for health savings accounts; subsidies for state high-risk pools, to help people who could not otherwise obtain insurance; authority for sales of insurance across state lines; and some protection for people with pre-existing conditions who have maintained continuous coverage.

Republicans said they hoped that the certainty of repeal would increase pressure on Democrats to sign on to some of these ideas.

Democratic leaders, for now, feel no such pressure. Republicans “are going to have an awfully hard time” if they try to repeal the health law without proposing a replacement, said Senator Chuck Schumer of New York, the next Democratic leader. “There would be consequences for so many millions of people.”

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Trump’s pick for key health post (CMS) known for punitive Medicaid plan

https://www.theguardian.com/us-news/2016/dec/04/seema-verma-trump-centers-medicare-medicaid-cms

 

Jessica Glenza in New York

@JessicaGlenza

Sunday 4 December 2016 07.00 EST

 Seema Verma, Donald Trump’s choice to head the two largest public health insurance programs in the US, is a conservative darling who has introduced work requirements and lockout periods for impoverished recipients into the medical safety net in three states.

A close adviser to vice-president-elect Mike Pence, Verma – Trump’s nominee for administrator of the Centers for Medicare and Medicaid Services (CMS) – made her name devising Indiana’s Medicaid plan, one of the most punitive in the country.

Medicaid is a public health program that ensures America’s poor and disabled have health insurance. Obamacare dramatically expanded the program, which now serves more than 73 million people.

The unique requirements Verma and her consultancy firm SVC Inc   http://www.svcinc.org/  designed for Indiana require that the destitute in that state have “skin in the game” by paying “premiums”, even if they were just $1.

In Ohio, a plan designed by Verma’s company and rejected by the current leaders of CMS required people with low incomes to be barred from public health insurance until all “premium” arrears were up to date.

Her plans were “about saving the dollars by any means possible”, said Indiana Representative Charlie Brown, the ranking Democrat on the public health committee.

As a consultant in each state, Verma was the driving force in designing Indiana’s “HIP 2.0” public insurance plan for the poor, and is highly regarded in conservative circles because of its emphasis on personal and fiscal “responsibility”.

Though her plan expanded Medicaid to nearly 400,000 Hoosiers, she has argued that new recipients are “able-bodied” enough to not need “the same set of policy protections” as the “aged, blind, or disabled”. Instead, Verma’s plan forces recipients to pay up to 2% of their income to “premiums”, held in a system similar to tax-free accounts available to commercial plans.

It is a plan meant to mimic the commercial market, as a financial lesson for its recipients. It remains one of the most complex and punitive Medicaid expansions in the country, an outlier in a system of state-run safety nets largely free for the poor.

Further, it is built on the back of the Affordable Care Act, a law that her potential future boss, Congressman Tom Price, explicitly opposes. Trump has nominated Price to be health secretary.

She is often described as a behind-the-scenes Republican operative. Regarded as smart and talented, she is also considered single-minded and conservative. She is a registered Republican, and recently agreed to participate in the “leadership network” of the American Enterprise Institute, a rightwing thinktank.

Her father, Jugal Verma, 77, described her as someone with “passion” for her work, and sympathy for the poor. Each morning on her way to work, he said, she pulled her car to the side of the road to hand the same homeless man cash. “It used to amaze me,” he said.

“She grew up in a Democratic household. I am a staunch Democrat,” said Jugal Verma, discussing his daughter’s work in the deeply conservative Pence administration. “She doesn’t do anything if she doesn’t believe in it.”

  Tom Price is poised to be the next US health secretary. Photograph: Jim Lo Scalzo/EPA

She and Price, if he is confirmed by the Senate, will be charged with helming a more than $1.1tn budget dominated by public health programs for the very poor, disabled and elderly. Medicaid alone covers more than 73 million Americans, nearly one-quarter of the American population. Neither Verma nor a Pence spokesman replied to a request for comment.

Verma’s best known work used a little-known provision of federal health law to push conservative ideas through despite the Obama administration. The strategy made her an influential consultant to Republican state administrations.

In Indiana, for example, some of the most controversial provisions of the state’s law were pushed through using this obscure 1115, or “eleven-fifteen”, waiver. While Obama’s administrator of the Centers for Medicare and Medicaid Services did not approve all of Verma’s plans – a punitive provision developed with Ohio was denied – some were successful. Others are still pending the approval of an agency she may soon run.

“One example of a provision in Indiana, which I think is very severe, burdensome, and in fact does not promote the objectives of the Medicaid program, [is] if someone [can’t pay premiums], they get kicked off the program,” said Andrea Callow, a policy analyst at Families USA, a not-for-profit organization focused on consumer health.

Premiums are typical of commercial insurance plans – they require beneficiaries to make a monthly payment. But Medicaid recipients typically do not pay premiums because their incomes are so low. The Medicaid expansion carried out under Obamacare allows people to earn a salary of about 138% of the poverty level, about $16,000 for an individual, and remain eligible.

In Indiana, if people on Medicaid earning between $11,000 and $16,000 don’t pay their “premiums”, they can be locked out of the program for up to six months, a provision even commercial insurance does not impose.

“If someone can’t scrape up the money for premiums for two months, they get dis-enrolled, and they get locked out for six months,” said Kallow. “Then say they get cancer, they get hit by a truck, they have an accident. They have absolutely no place to turn for health coverage.”

Kentucky’s 1115 waiver, on which Verma’s company SVC also consulted, proved equally complex and even more controversial. The state asked CMS to allow Kentucky to impose work requirements beginning three months after benefits began, something no state in the country requires as a condition of Medicaid.

“Kentucky’s new expansion proposal has work requirements,” said Kallow, “There’s even sort of unpaid community service, which is very troubling.”

After three months, “able-bodied” adults of working age would need to participate in a “work activity” for at least five hours per week. After one year, that requirement would increase to up to 20 hours per week. If that requirement were not met, the state could end the person’s benefits.

“There seemed to be a paralysis of analysis as it relates to the downtrodden, those who are in the greatest needs,” said Brown.

During a public comment period on Kentucky’s 1115 waiver, 90% of the 1,700 comments received were negative. Analysts also contend that such requirements mean building a new, large bureaucracy just to track whether Medicaid beneficiaries are complying.

“I have no problem with the personal responsibility features to the extent that they improve outcomes,” said Ed Clere, former Republican chair of the Indiana House public health committee. “One of the big questions going forward, both for Indiana and now for the country, will be: is there a link between these personal responsibility features in the way of financial participation and improved healthy outcomes?

“I haven’t seen any evidence.”

However, even critics said portions of the plan designed by Verma improved services. The fact that a voluntary, Obamacare-sponsored Medicaid expansion took place at all in Indiana, a deep red state, had a huge impact in the eyes of many serving poor patients there. Another 19 states still have not expanded Medicaid, even though Obamacare pays for 90% of expansions.

“I have insurance, my child is sick, I take her to the doctor,” said Lauren Lamb, outreach coordinator at a chain of north-west Indiana health clinics, HealthLinc. “I don’t think about it, but when you see people that don’t have that coverage … they worry if their kid is sick, if they can even take them to the doctor.”

The change, Lamb said, comes when patients realize they are eligible for health insurance they can afford.

“You see them, and they leave, and they’ve got tears in their eyes, because they can’t believe how lucky they feel that day. It just sits in your heart.”

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Free Event to Answer Insurance Related  Questions

LiveSupportgroup.com is hosting a free event on Monday, the 5th of December at 8:00 PM est, to answer questions and educate the members on insurance for 2017…

The group will have a licensed insurance agent on hand to answer insurance questions ranging on “Everything from policies on Medicare/Medicaid/Obamacare, understanding prescription plans etc.  This also includes private insurance also, and ‘what if you have both’ – cost factors / how to save, etc.”

The agent can also provide a number for people to call in their various states, and it should be known that the cost of getting private help is completely free.

According to the group, if anyone has a questions that the specialist does not know, she will personally get back to the group with the answers.

You do have to sign up in order to be able to access the group – and that is free, as well.

Here’s what they shared with us about how to sign up in advance of the Monday event:

1. To attend, please join livesupportgroup.com on our main website at www.livesupportgroup.com.  We ask for first name, last initial and a current email address, that’s all!  Once you join, please go to your email and confirm your free membership.  Just an FYI – LSG does not allow any 2nd/3rd party advertising to your emails and the site is SSL secured!
2. Please make sure you sign up as soon as possible so that you can receive your personal link in time for the event. If you join last minute, you may not be able to get the link in time.

Live Support Group is a non-profit corporation which has created an online support group for chronic pain patients that has begun to attract a wide audience. 

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Few are buying non-prescription naloxone at pharmacies

http://www.mansfieldnewsjournal.com/story/news/local/2016/12/03/few-buying-non-prescription-naloxone-pharmacies/94686092/

Eighteen Richland County pharmacies started selling naloxone without a prescription this year, but few residents apparently are purchasing the opioid overdose-reversal medication.

In fact, at the five local pharmacies willing to discuss the specifics of their naloxone sales, no doses of the drug have been sold over the counter without a prescription.

Pharmacists and public health officials say a combination of a lack of awareness, the stigma surrounding drug addiction, the high cost for consumers without insurance and the preventative nature of the drug account for the lack of sales.

Naloxone, sold under the brand names Narcan and Evzio, blocks the effects of prescription opioids, heroin and fentanyl on the brain and reverses an overdose. It has become the primary tool in fighting the epidemic of opiate overdoses.

Jay Fordyce, a pharmacist with Discount Drug Mart in Shelby, said he believes the lack of sales could be due to a lack of awareness, with the public not realizing they now can walk into a pharmacy and purchase the drug without a prescription.

“I don’t know if people are afraid to come up to the pharmacy and ask for naloxone or what,” he said. “I think people just don’t know about it.”

The Shelby store keeps one box of the drug in stock, containing two nasal pumps.

Chris Peshek, a regional pharmacy supervisor with Discount Drug Mart, said the Discount Drug Mart stores on Briggs Drive in Mansfield and Mansfield Avenue in Shelby have not sold any doses of naloxone since the chain started doing so in April.

He said it could be related to the sense of shame that can surround drug addiction.

“It keeps coming back to that stigma of not wanting to admit you have a problem or not wanting to get help for the problem because you’re afraid that somebody’s going to find out,” he said. “Because of that really strong stigma associated with drug addiction, people don’t want to be seen walking into a drugstore to buy naloxone.”

Three-quarters of the 24  pharmacies in Richland County sell naloxone — four CVS pharmacies, two Discount Drug Mart pharmacies, three Kroger pharmacies, one Meijer pharmacy, five Rite Aid pharmacies and three Walgreens pharmacies.

Map of drug stores selling naloxone

Twelve of the pharmacies are in Mansfield, three are in Ontario, two are in Shelby and one is in Lexington.

CVS, Meijer, Rite Aid and Walgreens declined to share their sales numbers, citing corporate privacy policies.

Similar to Discount Drug Mart’s lack of sales, the three local Kroger pharmacies have not sold any naloxone doses, according to Jennifer Jarrell, a Kroger media relations representative. The Kroger pharmacies on Park Avenue West, Ashland Road and Lexington Avenue, all in Mansfield, have been selling naloxone over the counter since February.

Costs range from $40-$145 a dose

Cost could be another prohibitive factor for buying naloxone at pharmacies.

A two-pack dose sells for about $40 at Meijer and $136 at Walgreens. A single dose of the drug is $45 at Kroger and up to $140 at Rite Aid and $145 at CVS. When it’s bought as a preventative measure, it can be difficult to rationalize spending that much money on it, pharmacists say.

Fordyce has customers come in interested in purchasing naloxone, but no one’s bought any from him yet.

“I guess he decided he didn’t need it that bad,” Fordyce said of a man who came in to buy naloxone but who walked away when he found it it was $75 to $80 per single dose at Discount Drug Mart.

But patients with insurance usually pay a maximum of about $10 out-of-pocket, Peshek said.

Fordyce said the pharmacy bills the insurance of the person buying the drug, not the person who uses it.

“I would encourage people first thing to the call their prescription insurance and ask if they cover (naloxone) and what their co-pay would be,” Fordyce said.

The nature of naloxone’s preventative nature also could be a prohibitive factor. People who can stop an overdose have to prepare in advance to help a loved one who overdoses in the future.

“You have to be thinking way ahead,” Peshek said. “You need it right away, so you’re just going to go to the hospital or ER.”

Fordyce emphasized people who are overdosing still need medical attention, even if they get a dose of naloxone.

The effects of opioids can last between six and 12 hours, but naloxone wears off in 20 to 30 minutes.

“This is just the first step if there’s an overdose,” he said. “You should still call 911 or go to the hospital. Odds are, they’re going to need more (naloxone).”

Legislature passed bill unanimously

Ohio Gov. John Kasich signed House Bill 4 into law in July 2015 to allow pharmacists to dispense naloxone without a prescription to at-risk opioid users and those who can intervene during overdoses, such as family members, friends or roommates. The bill had passed both the Ohio House and Senate unanimously.

“For friends and family members, pharmacies play a unique role,” said Cameron McNamee, director of policy and communications for the State of Ohio Board of Pharmacy. “If you have an active opioid user in your family and they feel like they’re not ready to get help yet, getting naloxone from a pharmacy is one of the best things you can do to get a little bit of peace of mind.”

Previously, pharmacies could not sell the drug without a prescription from a doctor.

Nearly 1,400 pharmacies, or 65 percent of all Ohio retail pharmacies, in 84 of Ohio’s 88 counties sell naloxone without a prescription as of the end of November.

Holmes, Morgan, Noble and Vinton counties do not have any pharmacies selling naloxone.

Not many other alternatives

Currently, the only other way to receive naloxone is from first responders or high-risk agencies, such as hospitals or mental health agencies.

Richland Public Health started providing naloxone kits to first responders and their high-risk contacts in February with funding from the Ohio Department of Health.

The kits, known as Project DAWN kits, come with two pocket masks, two atomizers, two two-milliliter syringes and two milligrams of naloxone.

Project DAWN, which stands for “deaths avoided with naloxone,” is an Ohio community-based overdose education and naloxone distribution program.

The first site was created in Portsmouth in 2012.

First responders administer naloxone if they believe someone has overdosed or if they observe symptoms such as blue or gray skin, sweating, unresponsiveness, absent or shallow breathing, absent or shallow pulse or pinpoint pupils, said Keith Evans, public health nursing supervisor with Richland Public Health.

It can be administered via intravenous (through the veins), intraosseous (into the bone marrow) or intranasal (in the nose) methods, Evans said.

Richland Public Health has provided 30 to 40 kits to first responders since January.

But the organization started discussions with the Ohio Department of Health in October to receive shipments of naloxone kits available to the public.

“Like any disease, if you get rid of that disease, then you can start the healing process,” Evans said. “Easier said than done to eliminate the product from the community.”

There are more than 50 Project DAWN naloxone distribution and training sites across Ohio, where members of the public can receive naloxone kits and training on how to administer the drug, but there are none in Richland County.

“When I see things like that where the county has a drug problem and then I also see that same county doesn’t have a Project DAWN, it always kind of makes me scratch my head,” Peshek said.

55 overdose deaths in 2016

So far in 2016, there have been 55 drug overdose deaths in Richland County, according to the Richland County Opiate Board’s Keith Porch, who is assistant police chief with the Mansfield Police Department.

Richland County has seen an increase in the number of overdose deaths since 2012, when there were seven overdose deaths.

In 2013, there were 22 deaths, in 2014, there were 25 deaths and in 2015, there were 42 deaths.

ejmills@mansfieldnewsjournal.com

419-521-7205

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Oregonian Turns To Heroin For Pain Relief After Opioid Prescription Cut

http://www.opb.org/news/article/oregon-heroin-opioid-prescription-addiction-treatment/

John lives in his truck and takes heroin to deal with his chronic pain. “It’s a really upsetting story and one thing that’s so upsetting about it, is that it’s actually quite common,” said neurologis Dr. Eve Klein.

Every year more than 500 Oregonians overdose and die on painkillers. As a result, Oregon doctors are reducing prescriptions dramatically. In this three-part series, OPB’s Kristian Foden-Vencil looks at new approaches to the state’s opioid epidemic. Read more: Part 1 | Part 2 | Part 3

John is a carpenter, OPB is only using his first name for reasons that’ll become clear in this story.

John grew up in southern Oregon and for 20 years had a successful business installing kitchens. Then, in 2005, he was in a car crash. “I mean, fractured my neck, fractured my back. I had to have my right shoulder replaced,” he said.

John was prescribed opioids to deal with the pain.

“After about four years I was on 160 milligrams of oxycontin … and then it was 56 milligrams of oxycodone and that went on for maybe four years.”

Today, he’s a mess. He lives in his pick-up truck and is in constant pain.

Without pain killers he said, he misses work. Which is why he was alarmed recently when his doctor — following new state guidelines — started reducing his dosage.

“The first thing he did was cut me back by a full one-third,” he said. “It became an argument with him. Two months later, he cuts me back by another full third,” he said.

John concedes he was using too many opioids — but points out it was all legal and under a doctor’s supervision. He said tapering off the drugs left him with terrible pain in his neck and back.

“Your body becomes so jittery and moving around. And just, I mean there’s no place of comfort,” he said. “I mean it’s torture.”

John said he stuck with the low doses for seven weeks, then decided to visit Old Town Portland to buy heroin.

He was incarcerated for cocaine use in the 1980s, which is how he knew where to go for illegal drugs. He said he turned to heroin because he had to have something to deal with his chronic pain.

He didn’t want to inject it, so his solution was to cook the heroin in tin-foil with a lighter — like he’d seen others do — then inhale the fumes.

“But most of the drug just goes up in smoke. So the next time I went to this dealer, I said, ‘Well, how do you do it?’ And he said, ‘Well, I snort it.’ And I said, ‘Well this is black tar, how do you snort it?’ And he said, ‘Oh! You cook it and you put it in a needle except you take the needle off and you shoot it up your nose and snort it,’” explained John.
 
John said he understands the need to crack down on opioids. He knows more than 28,000 Americans overdose and die abusing the drugs every year. But, he said, acupuncture and physical therapy just don’t give him much relief.

“It’s a really upsetting story and one thing that’s so upsetting about it is that it’s actually quite common,” said Dr. Eve Klein, a neurologist working on pain management. She said when somebody’s been on opioids so long, tapering often doesn’t work. She hasn’t met John but thinks he should probably go to a methadone clinic.

“And then once he’s on something like methadone and he’s stable and he’s out of that rat race of needing heroin every six hours. Then he can start looking into things like, ‘OK, what am I going to do about pain management now?,’” she said.

Congress just passed a bill to reduce opioid addiction. Democratic Oregon Sen. Ron Wyden voted for it, but said it’s only a “half measure.” He’s said more legal options for dealing with pain are needed, “If all you do is restrict choices to medication, the addiction does not vanish magically. You’ve got to have prevention and treatment.”

Meanwhile, John lives in his truck and seeks relief where he can. He’s terrified of the traffic stop that could land him in jail.

A Portland pain management program that doesn’t use opioids is showing success, according to a new report.

The Quest Center started working with FamilyCare 18 months ago — one of the state’s largest Coordinated Care Organizations.

Instead of opioids, the center helps patients deal with pain using acupuncture, massage, meditation and other alternative treatments.

Dr. David Eisen said a six month study showed 80 percent of patients reported less pain on average. “Seventy five percent reported an increase[d] ability to do normal work. And that’s huge,” she said. “Washing yourself, cleaning your house, being able to lift, bend and stoop. If people can resume activities of daily living, their life becomes much better.”

An average of 78 Americans die every day from opioid abuse — at least half get the drugs from a prescription.

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In SEVEN WEEKS we will have a NEW PRESIDENT along with a whole new Cabinet members and other new people in very important positions, many who have the ability to have positive or negative influence/impact on the chronic pain community.

Hopefully, this new administration will take a different approach of enforcing the Americans with Disability Act and denial of care and those on Medicare/Medicaid/Medicare Advantage program that they will recognize similar denial and sub-par treatment of chronic pain pts.

Here is where you can file a complaint of ADA violations https://www.ada.gov/filing_complaint.htm

Here is the website of Center Medicare/Medicaid Services (www.cms.gov) 800-MEDICARE

Health and Human Services has a on line complaint form http://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/index.html

Everyone needs to get motivated to file complaints/violations of existing laws/rules/regulations, once these new bureaucrats are in place. The bureaucrats are routinely told that there are some 100 + million chronic pain pts… when they only get a few dozen complaints… they will – most likely – ask “where is the problem” ??

There can’t be much of a problem… if only a few dozen people are being compromised enough to take action… THERE REALLY IS NO PROBLEM !!!

Our new President will be sworn in Jan 20,2017… which is a FRIDAY… you want change… you want to make a impact… flood their emails, faxes, Facebook, Twitter accounts and start filing complaints with the above agencies on Monday  Jan 23, 2017… as the new administration comes to power.

If the vast majority of chronic painers chose to do little/nothing at this point in time… the likelihood of things improving for the chronic pain community will be between SLIM and NONE !

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Martin Shkreli’s $750 life-saving drug recreated by high school students for $2

http://www.ctvnews.ca/health/martin-shkreli-s-750-life-saving-drug-recreated-by-high-school-students-for-2-1.3185163#_gus&_gucid=&_gup=GSEmail&_gsc=u38DMmS

Remember Martin Shkreli? He’s the so-called “pharma bro” who was dubbed “the world’s most hated man,” and a symbol of corporate greed, when he hiked the price of a life-saving drug from US$13.50 to $750 per tablet after his company Turing Pharmaceuticals acquired rights to the drug in 2015.

Now, the former CEO and hedge fund manager is responding to claims that he’s been “shown up” by a group of high school students in Australia. The Sydney Grammar School students managed to recreate the active ingredient in the anti-parasitic drug Daraprim for a fraction of the price Shkreli’s company charges.

The teenagers produced 3.7 grams of the key ingredient, pyrimethamine, in their high school chemistry lab for only AU$20, which works out to AU$2 per pill. Daraprim is used to treat infections such as malaria and toxoplasmosis, particularly in patients with weakened immune systems, such as those living with HIV, undergoing chemotherapy or pregnant women. The drug is listed on the World Health Organization’s list of essential medicines.

According to the Sydney Morning Herald, the students began working on the project as part of an after-school program under the guidance of Alice Williamson, a chemist at the University of Sydney, and the school’s Open Source Malaria Consortium, which is an online research-sharing platform. They were tasked with using publicly available ingredients to treat malaria.

A couple of the students involved in the experiment told the Australian newspaper that the controversy surrounding Shkreli and the drug made the project more engaging.

“Working on a real-world problem definitely made us more enthusiastic,” Austin Zhang, 17, said.

Another member of the team, 17-year-old James Wood agreed.

“The background to this made it seem more important,” Wood said.

Williamson said the Sydney Grammar School students were also outraged by the Shkreli scandal, which motivated them to focus on synthesizing the important drug. The teenagers said they participated in the year-long venture to highlight Turing Pharmaceutical’s inflated price of US$750 per Daraprim tablet. In most countries, the drug is sold for approximately $1 to $2 per tablet.

The teenagers said their goal isn’t to sell the drug, but to inspire other manufacturers to use their inexpensive method. The details of the student’s experiment have been published online.

The students’ story has attracted international attention, which prompted countless social media users to heckle Shkreli about it online.

So how has the man who once spent US$2 million on the lone copy of a Wu-Tang Clan album responded to the students’ project? Shkreli took to Twitter on Wednesday to dismiss the significance of the achievement and laugh off the mocking comments directed at him.

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