There are many kinds of ADDICTION… Congress is ADDICTED TO CONTRIBUTIONS ?

Posted on November 1, 2016 by Pharmaciststeve

Op-Ed: Congress and Big Pharma lobby created opioid epidemic in U.S.

http://www.digitaljournal.com/news/politics/op-ed-congress-and-big-pharma-lobby-created-opioid-epidemic-in-usa/article/478603

The opioid epidemic in the U.S. is getting worse by the day and to many of us, Big Pharma has Congress by the short hairs in order to protect their $9 billion a year in profits. Well, apparently, this is exactly what’s happening.

 
 

In an exclusive investigation published on Monday, the Guardian, with the help of Joseph Rannazzisi, head of the DEA office responsible for preventing prescription medicine abuse until last year, explained how Congress has been kowtowing to the drug industry.

 

Rannazzisi is accusing Congress of putting Big Pharma profits ahead of the public’s health in the opioid addiction crisis in this country. Rannazzisi told the Guardian that drug companies and their lobbyists have a “stranglehold” on Congress.

 

And with profits of $9 billion a year on the trade in opioid painkillers, the fact that nearly 19,000 people a year are being killed because of those profits is not really their concern.

 

Rannazzisi says the drug industry engineered recently passed legislation in April 2016 called the Ensuring Patient Access and Effective Drug Enforcement Act. Under this law, the Drug Enforcement Administration (DEA) is supposed to warn pharmacies and distributors if they are in violation of the law.

 

In other words, the law says crooked doctors and pharmacies are to be given a warning first if they are in breach of the law governing the dispensing of opioids, giving them a chance to comply with the law before their licenses are withdrawn.

 

Rannazzisi says the law was a “gift to the industry” because it limits what the DEA is allowed to do. “This doesn’t ensure patient access and it doesn’t help drug enforcement at all,” he said. “What this bill does is take away the DEA’s ability to go after a pharmacist, a wholesaler, manufacturer or distributor.”

 

“The bill passed because ‘Big Pharma’ wanted it to pass,” he added. “When I was in charge what I tried to do was explain to my investigators and my agents that our job was to regulate the industry and they’re not going to like being regulated.”

 

And that seems to be the crux of the matter. The Big Pharma lobby has spent millions of dollars in the past fifteen years or so, just to influence opioid legislation. They have also created widespread opposition to the new guidelines from the Centers for Disease Control and Prevention (CDC) on opioid prescriptions.

 

Lee Fang of The Intercept laid bare Big Pharma’s hand in getting Congress to pass some meaningless legislation that called for the guidelines “to be reviewed and potentially changed by a new panel made up of representatives from a range of stakeholders, and for the revisions to incorporate ‘pain management’ expertise from the ‘private sector.'”

 

But the accusations only get worse. In July, the Comprehensive Addiction & Recovery Act (Cara) passed the Senate. CARA calls for a pain management taskforce, funding into addiction research, better access to treatment options and drug rehabilitation.

 

But guess what? The Republican-held Senate refused to fund the law. “The bill was ‘comprehensive’ in name only; without funding, its policies are little more than empty promises,” reads a report, Dying Waiting for Treatment, issued by Senate Democrats.

 

And don’t think our lawmakers aren’t taking their share of Big Pharma’s handouts. Senator Orrin Hatch, chairman of the finance committee pocketed $360,000 from the drug industry, according to the Center for Public Integrity and Representative Mike Rogers became over $300,000 richer.

 

The list goes on and on, with Rannazzisi citing entities such as the American Chronic Pain Association and the US Pain Foundation which receive millions in funding from the opioid drug industry. In all fairness, the directors of the two foundations say the drug companies do not influence anything they do.

 

But the bottom line in Rannazzisi’s accusations is that the drug industry is responsible in many ways for the opioid addiction problem we have today. And yes, these companies exert a great deal of influence in getting legislation passed that is to their benefit.

 

If you think about it for a minute, we don’t have a Congress that is putting our best interests, regardless of it being our health, or anything else, at heart. As long as some big company has the lobbyists and money to spend, they can buy anyone’s vote, and that is exactly what is happening.

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First day of new OBAMACARE programs AVERAGE 25% INCREASE in RATES

Posted on November 1, 2016 by Pharmaciststeve

toobigobamacare

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Takes FDA EIGHT MONTHS to block adulterated drugs being imported

Posted on November 1, 2016 by Pharmaciststeve

ideaupassOutrage of the Month: Foreign Drug Manufacturer Blocks FDA Inspection

http://www.huffingtonpost.com/michael-carome-md/outrage-of-the-month-fore_b_12753644.html

On Dec. 14, 2015, an investigator from the Food and Drug Administration (FDA) arrived at Nippon Fine Chemical’s drug manufacturing facility in Hyogo, Japan, to conduct an inspection. But during the inspection, the facility’s quality control manager — in an audacious challenge to the FDA’s legal authority — directed employees to stand “shoulder-to-shoulder” in order to bar the FDA investigator from entering the facility’s quality control laboratory, where drugs destined for the U.S. market were analyzed. A recent FDA warning letter detailed this and other unacceptable behavior by company officials during the agency’s inspection.

Americans depend on medicines produced by foreign drug manufacturers. In fact, the FDA estimates that 40 percent of all finished drug products dispensed in the U.S. and 80 percent of all active pharmaceutical ingredients used in medications consumed by U.S. patients are imported from other countries.

To ensure that drug products flowing into the U.S. from foreign manufacturers are safe and meet the FDA’s rigorous quality standards, inspectors from the agency must have unfettered access to any foreign facility making drug products that are to be imported into the U.S. A key component of an FDA inspection is the assessment of the manufacturer’s quality control laboratories and procedures for testing and analyzing raw materials, intermediate products and final drug products.

As it turns out, the FDA investigator had reason to be concerned about the performance of Nippon’s quality control laboratory at its Hyogo facility. During the inspection, the investigator found records of complaints the company had received from its customers about finding “glass, hair, cardboard, metal, product discoloration, and a black spider” in Nippon’s drugs.

In further attempts to impede the FDA’s inspection, the company refused to provide the agency with copies of these customer complaints, and a quality assurance manager prevented the FDA investigator from taking photographs of equipment used to manufacture drugs distributed in the U.S.

On Aug. 8, 2016 — after several months of reckless hesitation — the FDA finally placed Nippon on an import alert, an action that allows the U.S. to detain all of the company’s drug products at the border. The FDA declared Nippon’s drug products to be “adulterated” because company employees limited the FDA’s inspection of the Hyogo facility, including by refusing to permit the FDA investigator to enter the quality control laboratory.

This is not the first time that the FDA has encountered companies that blocked an agency investigator from inspecting a drug manufacturing facility, and it undoubtedly will not be the last. To protect American patients, the FDA must aggressively inspect drug manufacturers in foreign countries. Moreover, the agency must impose import bans more promptly whenever a company interferes with an FDA inspection, particularly when it finds compelling evidence of poor manufacturing quality, as was the case with Nippon.

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Ibsen continues fight against Montana Board of Medical Examiners

Posted on November 1, 2016 by Pharmaciststeve

Ibsen continues fight against Montana Board of Medical Examiners

http://www.kxlh.com/story/33534138/ibsen-continues-fight-against-montana-board-of-medical-examiners#

HELENA –

Mark Ibsen, a Helena physician, continues his fight against the Montana Board of Medical Examiners in District Court.

Ibsen is fighting the suspension of his license over allegations that he over-prescribed pain medication and failed to keep proper patient records.

Ibsen’s suspension has been itself suspended by order of Judge James Reynolds.

His lawyer, John Doubek, told the court this case began when a former employee of Ibsen, terminated for cause, filed a complaint with the Board claiming nine patients were over-prescribed pain medications.

After years of hearings, Ibsen’s license was suspended on March 22nd by the Board.

During Monday, hearing, Doubek criticized the Board for rejecting 80 findings of fact established by their own hearings officer. In critiquing their conduct, Doubek suggested the board created their own facts to fit the suspension.

Judge James Reynolds said, “That almost sounds like a conspiracy theory here.”

“Well, nobody likes to take on City Hall,” replied Doubek.

Doubek went on to tell the judge there is no evidence of improper record-keeping by Ibsen.

At issue is whether or not Ibsen kept written pain medication contracts with his patients.

During the hearing the questions arose as to whether those contracts were part of common medical practice at the time.

The Board maintains they were, while Ibsen says they were not.

The larger issue, whether or not Ibsen over-prescribed opioid pain-killers to his patients, was also addressed.

Ibsen has long maintained that he has great success with weaning drug-dependent patients off powerful pain medications.

Ibsen has been a vocal critic of how the medical establishment, including the federal Drug Enforcement Agency and pharmacies, have treated opioid addiction.

Doubek told the court that the Board’s own expert witness could not find any patient of Ibsen’s who received too many painkillers.

Graden Hans, counsel for the Board, countered by saying the Board has clear statutory authority to reject or modify decisions by hearings officers.

Hahn said the Board’s review of Ibsen’s records show a clear pattern of breach of patient care and an on-going risk to patient safety.

Judge Reynolds questioned how the Board of Medical Examiners handled its decision in this case, saying rewriting a hearing officer’s decision puts Montana’s Administrative Procedures Act on its’ head.

“Why have a hearings officer at all, if findings are going to be rejected?” asked Reynolds.

Hahn said the Board is given that discretion by state statue.

Doubek countered, citing Brackman vs. Board of Nursing, a 1993 Montana case where charges of unprofessional conduct against six nurses were dismissed by a district court because the Board of Nursing modified or rejected the findings of a hearing examiner.

That ruling was upheld by the Montana Supreme Court.

At the end of the hour and a half hearing, Judge Reynolds said he’ll take the matter under advisement and rule at a later date.

The Board’s suspension of Ibsen has been put on hold pending the outcome of this case.

witchhuntCAN YOU SAY WITCH HUNT ???

I have been “consulting ” with Dr Ibsen for at least THREE YEARS and he was already at least a YEAR into this ABUSE OF POWER.  Dr Ibsen is not the only prescriber in MT that has been subjected to this Montana Board of Medical Examiners’ ABUSE OF POWER… I know of at least two other prescribers in the state.. there may be more… but.. the “environment of fear” created by this board in MT is so great that many chronic pain pts have been forced to seek treatment OUTSIDE OF THE STATE, because many in-state prescribers will not treat chronic pain pts.  I have been told of many “chronic pain refugees” that are flying to a chronic pain specialists in CALF every 90 days to be able to get adequate therapy to help them maintain some quality of life for themselves.

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Grandma and Grandpa, shoplifters? #CVS thinks so

Posted on November 1, 2016 by Pharmaciststeve

Grandma and Grandpa, shoplifters? CVS thinks soGrandma and Grandpa, shoplifters? CVS thinks so

http://nypost.com/2016/11/01/cvs-warns-employees-that-old-people-like-to-shoplift-suits/

 

 

Public enemy No. 1 at your local CVS: Grandma and Grandpa.

Seven discrimination lawsuits filed Monday against the pharmacy chain in courts across the city include the revelation that a CVS “Loss Prevention” handbook warns employees that senior citizens on a “fixed income” present a “special shoplifting concern.”

Attorneys from the Manhattan law firm Wigdor LLP brought the suits on behalf of former employees arguing that the policy is “tantamount to an admission of discrimination against older customers.”

The lawyers, Michael Willemin and David Gottlieb, have testimony from 16 whistleblower ex-staffers who claim that CVS stores across the city discriminate by profiling elderly shoppers, as well as blacks and Hispanics.

CVS’s 2014 “Loss Prevention” training guide says that “each store may have special shoplifting concerns based on it’s location, type of customer, etc.,” according to court papers. Sticky-fingered seniors are listed as one “special concern,” the suit says.

One of the cases was brought by a former “market investigator” for CVS named Anson Alfonso. The Bronx man was part of a team of undercover employees who helped track and bust shoplifters.

Alfonso, 27, worked as a store detective from January 2013 to October 2014. He told The Post that store managers, supervisors and even stock personnel would frequently swipe security tags past checkpoints to set off an alarm when an elderly person was ambling out of the CVS.

Modal Trigger
Anson Alfonso (left) and Eduardo Leach say they were forced to profile shoppers for potential shoplifting.Photo: Matthew McDermott

He said co-workers would set off the alarms “and make me humiliate people or embarrass people for no reason.”

“They would say, ‘I didn’t see it but I know that old person was stealing,’ ” Alfonso said.

The shoplifting-among-the-AARP-set theory mirrors a 1998 “Seinfeld” episode titled “The Bookstore,” in which Jerry catches his Uncle Leo stealing a book from Brentano’s. When Jerry confronts him, Leo protests that the petty theft is his right as a senior citizen.

“It’s not stealing if it’s something you need,” Jerry’s dad, Morty, says, with his mom, Helen, noting, “Nobody pays for everything.”

A shocked Jerry shouts, “You’re stealing, too?!” and Morty explains, “Nothing. Batteries. Well, they wear out so quick.”

But attorney Gottlieb says there’s nothing funny about the pharmacy chain harassing innocent seniors and other groups protected under the law.

“It is reprehensible that CVS targets customers based on race, ethnicity and even age, and we intend to hold the company accountable for these practices,” he said.

The new filings come a year after Gottlieb’s firm sued CVS in a federal class action, alleging store managers ordered security guards to focus on minorities.

A CVS spokeswoman said, “We are not aware of these new cases, so we are unable to comment specifically. However, in previous cases brought by the same law firm on similar complaints, plaintiffs’ attorneys have not been able to produce any documentary evidence to support their allegations.”

 

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How Safe is Your Hospital?

Posted on November 1, 2016 by Pharmaciststeve

How Safe is Your Hospital?

http://www.hospitalsafetygrade.org/for-hospitals

For Hospitals

More than 2,600 general hospitals are issued a Leapfrog Hospital Safety Grade twice per year. The Safety Grade uses national publicly available data from a variety of sources. However, because of inadequate data, we are unable to assign a grade to certain hospitals, such as critical access hospitals, specialty hospitals, children’s hospitals, outpatient surgery centers, etc.

Hospitals with questions about the Leapfrog Hospital Safety Grade should contact the Safety Grade Help Desk.

If your hospital would like to issue a press release announcing your Leapfrog Hospital Safety Grade, please contact us for a template release that you can customize to your hospital. For information on licensing your Safety Grade for marketing purposes, please visit www.hospitalsafetyscorelicensure.org

Methodology

Download the Leapfrog Hospital Safety Grade Scoring Methodology for October 2016.

For detailed information on the measures used to calculate the Leapfrog Hospital Safety Grade, please reference the following documents:

LEAPFROG HOSPITAL SAFETY GRADE MEASURES

Infections
  1. MRSA Infection
  2. C. diff Infection
  3. Infection in the blood during ICU stay
  4. Infection in the urinary tract during ICU stay
  5. Surgical site infection after colon surgery
  1. Methicillin-resistant Staphylococcus aureus (MRSA)
  2. Hospital-onset Clostridium difficile Infection (CDI)
  3. CLABSI
  4. CAUTI
  5. SSI: Colon

Problems with Surgery
  1. Dangerous object left in patient’s body
  2. Surgical wound splits open
  3. Death from treatable serious complications
  4. Collapsed lung
  5. Serious breathing problem
  6. Dangerous blood clot
  7. Accidental cuts and tears
  1. Foreign Object Retained
  2. PSI 14: Postoperative Wound Dehiscence
  3. PSI 4: Death Among Surgical Inpatients
  4. PSI 6: Iatrogenic Pneumothorax
  5. PSI 11: Postoperative Respiratory Failure
  6. PSI 12: Postoperative PE/DVT
  7. PSI 15: Accidental Puncture or Laceration

Practices to Prevent Errors
  1. Doctors order medications through a computer
  2. Staff accurately record patient medications
  3. Handwashing
  4. Communication about Medicines
  5. Communication about Discharge
  6. Staff work together to prevent errors
  1. Computerized Physician Order Entry (CPOE)
  2. Safe Practice 17: Medication Reconciliation
  3. Safe Practice 19: Hand Hygiene
  4. HCAHPS Composite 6: Discharge Information
  5. HCAHPS Composite 5: Communication About Medicines
  6. Safe Practice 2: Culture Measurement, Feedback & Intervention

Safety Problems
  1. Dangerous bed sores
  2. Patient falls
  3. Air or gas bubble in the blood
  4. Track and reduce risks to patients
  5. Take steps to prevent ventilator problems
  1. PSI 3: Pressure Ulcer
  2. Falls and Trauma
  3. Air Embolism
  4. Safe Practice 4: Identification and Mitigation of Risks and Hazards
  5. Safe Practice 23: Care of the Ventilated Patient

 Doctors, Nurses & Hospital Staff
  1. Training to improve safety
  2. Effective leadership to prevent errors
  3. Enough qualified nurses
  4. Specially trained doctors care for ICU patients
  5. Communication with Doctors
  6. Communication with Nurses
  7. Responsiveness of Hospital Staff
  1. Safe Practice 3: Teamwork Training and Skill Building
  2. Safe Practice 1: Leadership Structures and Systems
  3. Safe Practice 9: Nursing Workforce
  4. ICU Physician Staffing (IPS)
  5. HCAHPS Composite 2: Doctor Communication Star Rating
  6. HCAHPS Composite 1: Nurse Communication Star Rating
  7. HCAHPS Composite 3: Staff Responsiveness

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Lawsuit alleges Lee County pharmacist overdosed girl

Posted on October 31, 2016 by Pharmaciststeve

Lawsuit alleges Lee County pharmacist overdosed girl

www.winknews.com/2016/10/31/lawsuit-alleges-lee-county-pharmacist-overdosed-girl/

SOUTH FORT MYERS, Fla. — A Fort Myers family says their toddler was poisoned and hospitalized with an antibiotic overdose because a pharmacist at a CVS mislabeled a prescription bottle.

Alba Botero, the girl’s mother, filed suit Oct. 14 alleging that pharmacist Sameer Maniktala, who works at the CVS on 12255 S. Cleveland Ave., put double the prescribed dose on the label of a medicine for then 2-year-old Emily Rull, causing severe illness. Both Maniktala and CVS are named as defendants.

Rull began showing symptoms — including vomiting, diarrhea and severe pain — shortly after her mother gave her the medication, according to the suit. A few days later, her mother called poison control and was instructed to immediately take the child to the emergency room. Doctors there confirmed the overdose, the suit said.

The girl contracted conjunctivitis in both eyes and a sinus infection and will have health problems for the rest of her life, according to the suit, which cites severe physical, mental and emotional pain, disability and disfigurement. The family is seeking reimbursement of medical expenses in excess of $15,000 as well as damages.

CVS did not immediately respond to a request for comment.

FILED LAWSUIT PDF

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Another day… another DEA RAID of a physician’s office

Posted on October 31, 2016 by Pharmaciststeve

swatUzma Ehtesham, MD

by | Oct 31, 2016 | Doctor Raided

doctorsofcourage.org/index.php/2016/10/31/uzma-ehtesham-md/

Uzma Ehtesham, MD, a psychiatrist in Norton, VA is the next independent minority SW Virginia doctor to be attacked illegally by the government for monetary gain. This time it appears to be state, not federal. Naturally with all the money the feds are making with these heinous acts, the states want some of the pie. On October 12, 2016, the Sheriff’s office, state police, and the Virginia Alcohol Beverage Control division raided her office but declined to comment on what was happening.

I happened to be carrying my message of illegal government overreach to the doctors in the SW Virginia region, and a patient in another office told me of Dr. Ehtesham’s raid. According to the patient (purely unsubstantiated), the doctor was raided because another area doctor’s son overdosed on some of her medication.

Now first, the government doesn’t work that fast. The twenty year old man died October 9 and the raid happened three days later. Before raids on doctors’ offices occur, they have been under investigation for possibly years. So I think the two occurrences were partly coincidental. However, I’ll bet the government pushed the raid up a bit so that the publicity of the young man’s death could be used against Dr. Ehtesham later.

But something that Dr. Ehtesham needs to know is that the young man’s father was investigated by the Virginia Board of Medicine in 1994, at which time he admitted that he owned some marijuana. So is medication really a contributor to this young man’s possible addiction? It sounds like the familial tendency was already in place.

Dr. Ehtesham was one of the doctors on my list to visit when I was informed of her circumstances. I went to her office, introduced myself to her receptionist who went back to the doctor to see if she would talk with me. The answer I got was to wait until she had spoken with her lawyer. Big mistake. Big, big mistake (borrowed from Julia Roberts in Pretty Woman). After waiting for 30 minutes, I got the implied message and left. Later I returned and the receptionist continued to work behind the glass window as I stood there for 5 minutes. A patient finally remarked, “She’s ignoring you. You’ll have to talk through the glass.” I left.

Part of the problem with getting these attacks on doctors stopped is that defense attorneys are in on them as well. They know that their financial interests are in keeping the attacks going. So they don’t want their clients speaking to others who could show them the corruption in the legal system. They get by with this because of the “anything you say can and will be used against you in a court of law” statement.  But, for any doctors reading this (and I hope Dr. Ehtesham comes to my website as I left my card), I warn them about saying anything to me. In general, I am the one doing the talking, so that they know what the future holds, and how to best approach the situation. As I am available for consults, I can evaluate their records and office procedures, help them understand what the government might do, and point out the good defensive strategies they have. But defense lawyers want to keep their clients in the dark. Remember—lawyers aren’t working for you, they are working for the Bar Association and themselves.

The following comments by Dr. Ehtesham’s patients on Facebook show that she is following the proper procedures to ensure legitimate prescribing to the best of her ability:

  1. Say what you will, she was a good psychiatrist and I didn’t see her just handing out pills. Actually she was rather strict on some, dating them for exact due date. Too many people are upset with her over the wait, and not getting their preferred pills.

  1. I’ve known her for the better part of a decade and she was always by the book on drug screens and prescription monitoring reports. Something is not adding up.

  1. I don’t get why the VA ABC agents went in? I never got a beer there…

  1. Dr. Uzma Ehtesham is a wonderful psychiatrist that just does not hand out more meds than what she should.

  1. I don’t know how that works. I guess her clinic is shut down. You can’t find and keep a good doctor for the overrun of dope heads.

  1. Anyone who knows her knows this woman cares deeply for her patients. Psychiatry isn’t an easy field and the mainstay treatment does involve medication management. I have always had great respect for her as a clinician.

  1. I’ve been with her around 15 years. I don’t know what I will do without her! She’s helped me more than anyone else could ever have, and the one thing I love the most about her is she always tells me the truth there’s onlhy so much she can do to help me. Give it to the Lord. He is my rock and is always there for me! God bless you Dr. Ehtesham. You are in my prayers.

There is a large hospital-owned clinic presence in Norton. I’ll bet she is competition and the hospital and government are working together to get rid of her.

So, Dr. Ehtesham, I wish you the best in your fight against government overreach. Please know that I am available if you ever want to talk with me.

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Chronic-pain patients at high risk of suicide

Posted on October 30, 2016 by Pharmaciststeve

A frustrated Gary Rager looks on as his girlfriend Karen Brooks talks about her chronic pain condition.Chronic-pain patients at high risk of suicide

http://articles.orlandosentinel.com/2013-01-24/news/os-chronic-pain-suicide-20130124_1_chronic-pain-patients-chronic-illness-rheumatoid-arthritis

Two months ago, Gary Rager’s girlfriend asked him to do the unthinkable.

The 44-year-old woman, who has suffered disabling pain for the past three years, asked Rager if he would help her end her life.

“I don’t want to kill her, and I don’t want to go to prison. But I don’t want to see her suffer anymore either,” said Rager, a 59-year-old Sanford sculptor whose work appears at area theme parks and public spaces throughout Orlando.

Such are the desperate measures that many afflicted with chronic disabling conditions — and those who love them — contemplate.

Some do more than think about it.

Like many patients in chronic pain, Karen Brooks has seen dozens of doctors over the past few years.

All take tests and discuss her physical health, but few have inquired about her mental health, said her sister, Michelle Brooks, of Maitland, who takes her sister to her doctors’ appointments.

Given the high correlation between chronic illness or pain and depression — even suicide — more providers need to bring up the dark subject, health experts say.

Large-scale studies show that at least 10 percent of suicides — and possibly as many as 70 percent — are linked to chronic illness or unrelenting pain.

Authors of a 2011 British study that looked at the link concluded that patients with such conditions “should be considered a high-risk group for suicide … and much greater attention should be given to providing better … psychological support.”

But doctors are often too busy focusing on physical problems to deal with the mental ones that go with them, say those specializing in chronic illness.

Fading away

Brooks has been diagnosed with several medical conditions in an attempt to explain and treat the severe pain that consumes the left half of her face. Her most recent diagnosis, which she got last week, is rheumatoid arthritis.

A progressive, chronic disease that causes painful inflammation in joints throughout the body, rheumatoid arthritis is often misdiagnosed, said Dr. Shazia Bég, assistant professor of rheumatology at University of Central Florida College of Medicine.

Though she is not Brooks’ doctor, Bég said the recent diagnosis could very well explain Brooks’ chronic facial pain as well as her overall stiffness, wasting and suicidal thoughts.

Today, at 5-foot-five, Brooks weighs just 90 pounds — 40 pounds less than in better days. She can’t chew, or eat solid food, or get up or walk by herself. She needs someone with her 24 hours a day.

“I can’t imagine living 20 more years like this,” said Brooks, sitting in her mother’s compact Winter Park home.

“It’s hard to watch someone you love be in pain and fade away,” said Rager, who met Brooks in 2007. “But the way the medical system is set up, there’s nothing we can do. She has to suffer every day from now until she dies.”

Brooks traces the pain in her jaw back to 1999. She went to several dentists and cranio-facial experts. She tried acupuncture, pain medications, laser pain treatment and even brain surgery, during which a neurosurgeon moved some blood vessels pressing on a facial nerve.

Nothing has brought relief.

“They euthanize a poor animal that’s suffering, and call that humane,” said Rager. “But they will let a person rot away over years. That’s just wrong.”

“It’s so sick that these prisoners on death row who have killed 20 people get to lay there with a needle and just fall asleep,” said Brooks. “That’s the best way to die, and they’re the ones who get to die that way.”

More need to listen

“It’s well-known that people with rheumatoid arthritis have a high risk of depression and anxiety,” said Bég. About one-third suffer from these mental-health problems.

Many believe the number is probably higher, but many patients and doctors don’t talk about it.

Depressed patients do worse with pain relief, which puts them at an increased risk of death from suicide, studies show. That’s the case not only for patients who suffer from autoimmune diseases such as rheumatoid arthritis and lupus, but also for those with heart disease and cancer, experts say.

“We know that chronically ill patients who are also depressed have lower rates of compliance with their health plans, and poorer outcomes,” said Dr. Julie Demetree, a psychiatrist at South Seminole Hospital, in Longwood.

Although doctors are paying more attention to the relationship between chronic pain and illness and suicide, “there’s still room for improvement,” she said.

Part of the solution is for doctors to listen more. “You can get a lot from a patient in a 20-minute visit without having to order tests,” said Bég.

“Not every specialist is trained to treat depression, but all are trained to ask about it, and that’s not done,” she said.

Because Brooks is on Medicaid, the list of doctors she can see is short, and the wait for an appointment often long.

Last April a primary-care doctor referred Brooks to a rheumatologist, a doctor who specializes in arthritis. She finally got in to see him last week. He diagnosed her as having rheumatoid arthritis, but never asked about her mental health, said Michelle Brooks, who sat in on the visit.

Though Brooks still feels her situation is hopeless, Rager and her sister are hopeful that the new diagnosis and new treatment regimen, which includes steroids, will turn her around.

“If the diagnosis is correct — and today’s blood tests are very accurate — and she gets proper treatment, I would expect her to get better,” said Bég.

“I can’t believe it’s taken us so long to get here,” said Rager. “If this really is the solution, think of all the suffering that could have been prevented.”

mjameson@tribune.com or 407-420-5158

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Just another STATISTIC of the WAR ON DRUGS ? how many suicides goes unreported ?

Posted on October 30, 2016 by Pharmaciststeve

Desperation and death after Seattle Pain Centers close: ‘The whitecoats don’t care’

http://www.seattletimes.com/seattle-news/health/the-whitecoats-dont-care-one-mans-desperation-and-death-when-pain-clinics-close/

At a memorial service for her son on Oct. 15, Lorraine Peck holds a locket he’d given her with their pictures in it. (Ken Lambert/The Seattle Times)

A 58-year-old former patient of Seattle Pain Centers committed suicide last month, leaving notes claiming he could find no help for his chronic pain after the chain of clinics closed in July following state sanctions.

JoNel AlecciaBy JoNel Aleccia
Seattle Times health reporter

Two days before he shot himself in the head, Denny Peck called 911 and said he couldn’t stand the pain.

Peck, 58, told the fire-department dispatcher that he had been a patient of Seattle Pain Centers, a chain of Washington clinics, until it closed abruptly in July amid allegations of improper oversight and patient deaths.

“They’ve been shut down by the government,” Peck said in the Sept. 15 call, which was punctuated by sharp cries and grunts.
Find help

Seattle Pain Centers’ former patients should seek advice from their primary-care providers and insurance plans about finding a new source of pain management, officials said.

Call the Washington Recovery Helpline at 1-866-789-1511, or visit www. warecoveryhelpline.org

Or call the Washington Suicide Prevention Life Line at 1-800-273-8255.

Washington State Department of Health

“And, anyways, I got severe back pain and everything. I took the last of my pills and I’m going through some serious withdrawal symptoms. I got the crawling skin and everything else. Can you guys help or not?”

But the woman on the phone said she couldn’t give Peck any drugs, only a trip to the hospital, which he declined. In the weeks before he called 911, Peck’s family said he contacted primary-care doctors and went to emergency rooms. The family doesn’t know all the details, but Peck said he couldn’t get the pain pills he needed.

On Sept. 17, just after 10 a.m., Thurston County sheriff’s deputies were summoned by the worried manager of Peck’s mobile-home park outside Yelm. They found Peck in bed, two guns in his lap and bullet wounds on both sides of his head, according to the deputy’s report.

“Can’t sleep, can’t eat, can’t do anything,” said a handwritten note left nearby, “And all the whitecoats don’t care at all.”
Denny Peck, 58, of Yelm, killed himself on Sept. 17, two months after the abrupt closure of Seattle Pain Centers cut off his supply of pain medications. (Courtesy of Lorraine Peck)
Part of this note was read by Lorraine Peck at the memorial service for her son, Denny Peck, who killed himself Sept. (Ken Lambert/The Seattle Times)

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Denny Peck, 58, of Yelm, killed himself on Sept. 17, two months after the abrupt closure of Seattle Pain Centers cut off his supply of pain medications. (Courtesy of Lorraine Peck)

The death of Peck — an easygoing Seattle native who was injured 26 years ago in a commercial-fishing accident — is the only fatality reported among former Seattle Pain Centers patients since the clinics closed, state health and Medicaid officials said. Many factors can contribute to suicide, but the case provides a window into the desperation some pain patients feel.

“Every time someone takes their life, it’s a tragic loss for their family and the community,” Dr. Kathy Lofy, the Washington state health officer, said in an email.

“We know that many people struggle with pain, both physical and emotional. We want people to know that it can get better and that there are people and resources that can help. If anyone feels helpless or desperate, we hope they will reach out for help and that people surrounding them will take action.”

About 8,000 patients were prescribed opiates by Seattle Pain Centers this year, part of an estimated 25,000 seen at eight clinic sites since 2008. The sites closed days after state regulators suspended the medical license of former director Dr. Frank Li, saying he failed to properly monitor Medicaid patients, possibly contributing to at least 18 deaths since 2010.

Li, who has denied the allegations, has not been charged with a crime.

A hearing before members of the state Medical Commission is set for April.
“Left in a lurch”

Government documents showed that state officials were warned in 2015 about overdose deaths among Seattle Pain Centers patients. And they were told three years ago that Li had been blocked from prescribing for the state workers’ compensation program.

Some critics complained that state health officials took too long to act. Others said that when they did, there was no plan in place to absorb a huge number of pain patients, including many, like Peck, who were taking very high doses of dangerous opiates or who had complicated medical conditions.

“This was such a huge surprise to the entire system,” said Dr. Ray Hsiao, president of the Washington State Medical Association. “This is unprecedented.”

State health-department officials said legal constraints prevented them from warning people about the charges that were coming against Li. Once they were public, Lofy and others reached out immediately to providers and patients.

People are falling through the cracks. It’s just terrible. It’s just tragic.” – Jennifer Hanscom, executive director of the medical association

“When Dr. Li closed his clinics, we developed information and strategies to help patients know how to find help,” health-department spokeswoman Julie Graham said in an email. “We’ve also been working to make sure that health care providers understand how to take on the care of patients with chronic pain issues within the guidelines of the state’s pain rules.”

Still, thousands of former Seattle Pain Centers patients flooded emergency rooms and others reported desperate efforts to find new care. Officials at the state’s largest pain programs scrambled to absorb hundreds of clients.

Officials at the medical association urged their primary-care members to help. In a recent blog post, Hsiao was blunt.

“No matter your opinion on the state’s handling of this situation, one thing is clear: thousands of patients in our communities have been left in a lurch, suddenly and unexpectedly cut off from appropriate treatment for their pain, or opioid medication management.”

But Hsiao said that while some doctors have agreed to help, others have balked.

“They’re saying, I just don’t have the capacity for it,” Hsiao said in an interview. “I’m seeing patients every 15 minutes. How can I give these patients the time?”

Some doctors said they’re skeptical of stepping up after being told to send chronic pain patients to specialists, as recommended in guidelines pioneered by Washington state in 2007 and finalized in 2012.

“For years, primary care physicians have been pushed away from treating chronic pain, threatened with lawsuits and licensure action,” Dr. Russell W. Faria of Auburn said in an email. “I can fairly guarantee that primary care physicians will not be very receptive to this call, to put it mildly.”

The result? “People are falling through the cracks,” said Jennifer Hanscom, executive director of the medical association. “It’s just terrible. It’s just tragic.”
Decades of pain

For Peck, the trouble began in 1990, when he was injured while working on a fishing boat in Juneau, Alaska, crushing several vertebrae.

“He has been in pain ever since,” said Peck’s mother, Lorraine Peck, 86, of Seattle.

The pain haunted Peck, who was raised in Ballard and is remembered by his family as a kind, smart, friendly guy who played the drums, worked as a cook and a welder and ran a limestone plant before signing on to the trawler. He lived on a boat at Seattle’s Fishermen’s Terminal for a time, and always wanted to be near the water.

Peck had two children, a son, Jasen Peck, 35, and a daughter, Amanda Peck, 32.

Amanda Peck said she didn’t remember a time when her dad didn’t hurt.

Denny Peck moved to Yelm five years ago and kept his pain under control with visits every three months to a local Seattle Pain Centers site, according to a clinic bill. At the time of his death, he still owed $131.82 for care, it showed.

Peck was taking high daily doses of opiates, including morphine and oxycodone/acetaminophen, plus powerful muscle relaxants, prescription records showed.

When the clinics closed in July, Peck tried to find a new primary-care provider, as state health officials advised patients to do.

“No doctor would chance losing his license due to new laws, and Denny saw no help from the medical people although he tried and tried,” said Peck’s obituary on the funeral-home website.

Peck’s family said he sought help at the Washington Center for Pain Management, another provider, but his family contends he wasn’t given enough medication. Officials at that center said privacy laws prevented them from confirming whether he had been treated there.

Peck rationed his final pills, his mother said. But then he ran out.

“He was in so much misery,” she said.

When Lorraine Peck talked to her son in the days before he died, she urged him to talk to a pastor with a local church.

“I think he found peace,” she said. “I could not fault him at all. He could see no other way out.”

About three dozen people gathered for a memorial service for Denny Peck on Oct. 15 — the day Seattle was threatened with a big windstorm — to say goodbye.

Stories were shared, as was the letter he left behind.

“I feel sorry 4 all of the people that got kicked out and R still in pain,” Peck wrote. “Find them and help them!! Help them, please, they hurt still.”

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