“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
UnitedHealth Group Inc (UNH.N) has been sued by three customers who accused the largest U.S. health insurer of charging co-payments for prescription drugs that were higher than their actual cost and pocketing the difference.
The lawsuit, filed Tuesday in federal court in Minnesota by three UnitedHealth customers, seeks to represent a nationwide class that it says could include “tens of thousands” of people insured by UnitedHealth.
The lawsuit said Minnesota-based UnitedHealth and affiliated companies charged customers co-payments for drugs that were significantly higher than prices it negotiated with pharmacies for those drugs.
For example, the lawsuit claims, one class member paid a $50 co-payment for Sprintec, a contraceptive, while UnitedHealth paid the pharmacy only $11.65. The pharmacy was then required to hand the extra $38.85 over to UnitedHealth under its agreement with the insurer, the lawsuit said.
The lawsuit claims that such a co-payment “is not a ‘co-‘ payment for a prescription drug because the insurer is paying nothing,” but is instead “a hidden additional premium.”
The lawsuit says UnitedHealth has hidden this practice from its customers, forcing them to overpay for a wide variety of common, low-cost drugs.
The lawsuit claims UnitedHealth’s co-payments violate the Racketeer Influenced and Corrupt Organizations Act (RICO), a federal law used to target illegal conspiracies, and in some cases also violate a federal law governing employee benefit plans.
UnitedHealth spokesman Matt Wiggin said in an email that the company had not yet been served with the complaint, and that “pharmacy benefits are administered in line with the coverage described in the plan documents.”
Ingredients for the deadly synthetic narcotic fentanyl are so easy to obtain that mom-and-pop drug labs are cropping up around the country, Breaking Bad-style
A California couple operated an illegal pill-making lab from their third-floor apartment in this San Francisco building, according to the Drug Enforcement Administration. Photo: Laura Morton for The Wall Street Journal
By
Jon Kamp and
Arian Campo-Flores
SAN FRANCISCO—The married couple living in the third-floor, ocean-view apartment were friendly and ambitious. She explored the city, posting selfies on Facebook. He started a small music label at home.
“They were nice people,” said Ann McGlenon, their former landlady. “She’s very sweet. He’s a go-getter.”
Authorities say Candelaria Vazquez and Kia Zolfaghari had darker aspirations. Working from unit 6, the pair built a small enterprise making counterfeit prescription pills, the Drug Enforcement Administration says. They designed pills to resemble legitimate oxycodone tablets, with an important, and potentially dangerous, twist, according to the DEA: Instead of oxycodone, they used the deadly synthetic opioid fentanyl as a main ingredient.
Mr. Zolfaghari worked a pill-press machine in their two-bedroom, 1,100 square-foot apartment, the DEA said, where they also kept an action figure of Walter White, the protagonist of the series “Breaking Bad,” in which a high-school chemistry teacher cooks up batches of methamphetamine.
According to a DEA affidavit, the couple sold the pills to buyers around the U.S., including in Washington state and North Carolina. A federal grand jury in San Francisco indicted them on June 21 on charges including conspiracy to manufacture and distribute fentanyl. Both pleaded not guilty.
A screenshot of Facebook photos showing Candelaria Vazquez and her husband, Kia Zolfaghari.
Small-scale drug labs are cropping up around the country, as budding home-brew traffickers discover how easy it is to manufacture pills using synthetic opioids to meet a skyrocketing demand. Law enforcement says the phenomenon threatens to atomize the illicit narcotics trade, adding a troubling new dimension for authorities already strained trying to halt larger-scale drug gangs.
Abuse of opioids, including prescription drugs, heroin and synthetic narcotics like fentanyl, has reached crisis proportions. The Centers for Disease Control and Prevention said more than 28,000 people died from opioid-related overdoses in 2014, the last year of nationwide data, more than double the total from a decade earlier.
More-recent figures from individual states compiled by The Wall Street Journal suggest the crisis is getting worse, supercharged by fentanyl, a synthetic drug up to 50 times as powerful as heroin. Ten states—Maine, New Hampshire, Vermont, Rhode Island, Connecticut, Pennsylvania, Maryland, North Carolina, Kentucky and Ohio—saw 12,244 fatal drug overdoses of all kinds in 2015, up 21% from 2014, while fentanyl-related deaths across those states soared 128% to 3,883.
Authorities are investigating roughly a dozen suspected fentanyl pill-making operations in states including California, Tennessee and Utah, according to the DEA and local investigators.
These manufacturers aren’t the usual drug kingpins, and some, such as Mr. Zolfaghari and Ms. Vazquez, have no known cartel ties. Instead, they have all the necessary supplies. Though illegal, anyone can order online ingredients needed to set up shop at home, including mixing agents and pill-pressing equipment.
One kilogram of fentanyl, which runs about $3,500 from a Chinese manufacturer, can yield as many as one million pills, according to the DEA. At a street price of $10 a tablet, that can generate $10 million in sales. And barriers to entry are low. A pill press used to mold powder into a tablet runs roughly $1,000, and a die set to stamp it with markings that mimic prescription medication costs about $130, the DEA says.
“What is scary is that it’s the tip of the iceberg,” says Casey Rettig, a special agent in the DEA’s San Francisco division, referring to the freewheeling nature of some small-scale pill-making operations. “It begs the question for us: Are sellers just going to press anything” into pills?
The arrival of small-scale fentanyl pill makers represents a new phase in the illicit drug trade. A decade ago, fentanyl surfaced as a street drug in the U.S., mixed into the heroin supply. At the time, federal authorities traced it to a lab in Toluca, Mexico, that obtained fentanyl ingredients from suppliers in China, according to the DEA. After Mexican authorities shut the Toluca lab down in 2006, the problem largely petered out.
Around 2013, roughly when authorities were cracking down on pain clinics that sold vast quantities of prescription opioids, bootleg fentanyl started making a comeback on the streets. Some U.S. buyers today are ordering fentanyl online directly from Chinese labs. Catering to the same demand pain clinics once served, new drugmakers are turning fentanyl powder into tablets that often are externally identical to legitimate prescription drugs.
In June, law enforcement in Utah arrested a man who allegedly bought a fentanyl variant online and pressed it into fake oxycodone pills in a motel room in the Salt Lake City suburb of Sandy. In January, authorities arrested a union tradesman accused of making thousands of imitation oxycodone tablets with the fentanyl variant acetyl fentanyl in his Queens, N.Y., home.
Because of a lack of quality control—the pill makers sometimes use kitchen blenders to mix ingredients—the amount of fentanyl in tablets can vary by a factor of 10 or more, according to a lab analysis cited by the DEA. Unsuspecting buyers could end up ingesting something much more powerful than what they were expecting.
Replicas of generic hydrocodone painkiller tablets that actually contained fentanyl caused more than 50 overdoses, including at least 13 deaths, in the Sacramento, Calif., area in March and April. “These people are going down hard, they’re going down extremely fast,” said Timothy Albertson, a toxicologist and internist at UC Davis Medical Center in Sacramento, which received 18 pill victims in eight days, including one who died.
The pills were stamped with “M367,” which made them look like real generic pain tablets sold by Mallinckrodt PLC that are supposed to contain hydrocodone bitartrate and acetaminophen. A company spokeswoman said the company has been working with the DEA concerning the Sacramento probe.
In Tennessee, authorities linked three deaths earlier this year to fentanyl-laced tablets that were made to resemble a brand-name painkiller. Investigators believe multiple pill-making operations function in the state, said Tennessee Bureau of Investigation spokesman Josh DeVine.
At least nine people in Pinellas County, Fla., died between January and March from tablets mimicking an antianxiety medication that instead contained synthetic opioids, said Sheriff Bob Gualtieri. “For all I know, it was some guy in a garage here” making them, he said.
The entrance to the building where a San Francisco couple allegedly operated an illegal pill lab using the synthetic opioid fentanyl as a main ingredient. Photo: Laura Morton for The Wall Street Journal
Ms. Vazquez and Mr. Zolfaghari, the San Francisco couple, who are both 40, are unlikely candidates to run a drug lab.
Ms. Vazquez, who goes by “Candy,” studied health information technology at Western Career College in the nearby city of Emeryville nearly a decade ago, according to her Facebook page. Of Filipino heritage, she worked several years ago in a job taking care of elderly people, according to her friend Mae Romano-Dunning.
Mr. Zolfaghari is from Fremont, Calif., and played football in high school and community college, according to his father, Behrooz Zolfaghari, who came to the U.S. from Iran nearly 50 years ago. The younger Mr. Zolfaghari started his own independent hip-hop music label focused on up-and-coming rappers. The label no longer has an operating website.
By about 2010, Mr. Zolfaghari had rented a small house in Richmond, Calif., telling his landlord, Robert Riggs, he worked at a local Honda dealership. “As far as I know he was a nice guy,” Mr. Riggs said.
Mr. Zolfaghari and Ms. Vazquez traveled to Reno, Las Vegas and Beverly Hills together, posting photos of their trips on Ms. Vazquez’s Facebook page. They married in 2013, according to her attorney.
Mr. Zolfaghari was struggling with an addiction to opioids sparked by old football injuries, his father said, which led his son to fentanyl.
In March 2014, likely while living in Richmond, Mr. Zolfaghari started buying pill-making supplies, including cutting and binding agents, to process fentanyl, according to email records reviewed by the DEA.
The agency’s Ms. Rettig declined to address where he allegedly acquired the equipment. She said it is common for manufacturers to order supplies online from China or sometimes through the “darknet”—a restricted part of the internet accessible only with special software. Though it is illegal to import pill presses without notifying the DEA, the agency said Chinese suppliers sometimes ship them in pieces to evade detection.
A screenshot of Ms. Vazquez’s Facebook page shows the interior of the apartment allegedly used to manufacture illegal pills.
In early 2015, Ms. Vazquez and Mr. Zolfaghari relocated to a modern apartment in San Francisco’s tranquil Sunset District. They told their new landlady they wanted to improve their credit so they could buy a place of their own.
Mr. Zolfaghari talked about his passion for music. He had high hopes for an album by their friend King Harris, a rapper from Oxnard, Calif., and in September 2015, he filed paperwork with the California Secretary of State for a new venture called Planet Zero Records LLC.
The husband and wife set up their fentanyl pill-making operation after moving in, the DEA says. The tablets Mr. Zolfaghari made were circular, white and stamped “ETH” and “446,” markings seen on some oxycodone pills, according to a DEA affidavit.
Pill-making typically involves mixing fentanyl with a cutting agent such as mannitol, a sugary substance, to dilute its strength, according to Karl Nichols, a special agent in the DEA’s San Francisco division. The manufacturer adds a binding agent to hold the ingredients together and pours the mixture into a funnel on the pill press. A small amount drops into a die set, and with the swing of a handle, the pill press stamps the mixture into a tablet.
During a six-month span, Mr. Zolfaghari sold more than 1,500 fentanyl-laced pills to a confidential source working with the DEA, in deals brokered by their friend, the rapper Mr. Harris, according to the DEA affidavit. The grand jury also indicted Mr. Harris, who has pleaded not guilty.
Ms. Vazquez didn’t return calls seeking comment, and her lawyer, Mark Goldrosen, said he was still reviewing the case. Mr. Harris declined to discuss the case, citing his attorney’s advice. Mr. Zolfaghari’s attorney, Harris Taback, declined to address the charges against his client, who, he recently said, was in court-ordered drug treatment.
On one recorded call, the DEA says, Mr. Harris told the source that Mr. Zolfaghari promised “that he can press 100 out fast as f—.”
Authorities say Mr. Zolfaghari also sold pills on the darknet, including one package sent to Charlotte, N.C. He conducted numerous transactions using bitcoin and appeared to have cashed out over $230,000 in the digital currency, according to a DEA seizure-warrant application. Ms. Vazquez’s role centered on receiving drug proceeds, buying supplies and mailing pill shipments, authorities say.
California’s largest tax-collection agency doesn’t show any reported employer wages for Mr. Zolfaghari for the years 2012 through 2015, according to the seizure-warrant application. But the couple were good tenants who paid their $3,000 monthly rent on time with cashier’s checks, according to their landlady. They once triggered a noise complaint, which they quickly addressed by moving a TV and disconnecting a subwoofer speaker, their landlady said.
In May, Mr. Zolfaghari and Ms. Vazquez celebrated their third wedding anniversary at a Morton’s steakhouse, where a custom-printed menu congratulated them. Mr. Zolfaghari bought his wife flowers and a Louis Vuitton purse. Ms. Vazquez posted pictures on her Facebook page as she went to the hair salon and prepared for their date. “Have fun beautiful couple,” one friend wrote.
That same month, Mr. Zolfaghari’s Planet Zero Records label released “Nightmare on Wolff Street,” an album by Mr. Harris. “We believe we’ll be up for a Grammy,” Mr. Zolfaghari told Ms. McGlenon, his landlady. He sent her a link to listen to the album, whose second track is called “Dope House.”
In a June buy, Mr. Harris ordered 500 pills at a price of $6,000 for a DEA informant, the agency said. After the informant deposited the money in a bank account in Ms. Vazquez’s name, the DEA said, Mr. Zolfaghari texted Mr. Harris, “Got it, had orders for 800 yesterday so I gotta get back to work right now.”
The next day, Mr. Zolfaghari and Mr. Harris met outside the San Francisco apartment. Agents observed Mr. Zolfaghari exit the building wearing a dark beanie cap, sunglasses and a satchel. Mr. Harris opened his car trunk and Mr. Zolfaghari handed him a tan envelope that agents said they later found contained 500 fentanyl-laced tablets.
A view of the apartment building where Candelaria Vazquez and Kia Zolfaghari allegedly operated a pill-making lab. Photo: Laura Morton for The Wall Street Journal
On June 10, authorities descended on their building, sealed off the street below and arrested the couple, as well as Mr. Harris. A clandestine-lab team from the DEA, outfitted with white hazardous-materials suits and oxygen tanks, entered their apartment.
Inside, investigators found the array of pill-making equipment, according to the seizure-warrant application.
A glass display case contained three luxury watches valued at $70,000. Ms. Vazquez’s “shoe collection was stacked virtually from floor to ceiling,” many with price tags of more than $1,000, the seizure-warrant application says. There was $44,000 in cash in a bedroom and a trove of expensive goods, including Hermès bracelets and Tom Ford handbags. And one Walter White doll.
Bill Clinton closed this presentation by saying that Hillary is going to bring more change… I remember when Obama was running for his first term… my primary tech was a 50 something single black female… and she got all excited that Obama was going to bring CHANGE.. I told her at the time.. CHANGE can be a double edged sword.
Ask those in the chronic pain community how CHANGE has impacted their life since Obama came to office in 2009.
Ask those people who can no longer afford their health insurance premiums and if they can… they have such a HIGH DEDUCTIBLE that they can’t afford to seek medical care.
Ask people on Medicare Disability or Senior citizens on Social Security.. and how the government’s manipulation of the cost of living has meant that those have gotten little/nothing in increases in their social security checks each year.
Many of us believe – in reality – that cost of living has not been near zero for the last 6-8 yrs.
While the Federal Reserve is suppose to be non-political – they have kept the interest rate at near zero.. so those retired folks .. who have saved up for their retirement… are not generating any interest on their money and having to “liquidate” their savings to meet their day to day living expenses… instead of the normal 4%-6% interest money markets normally pay.
They act like Medicare/Medicaid is a panacea… just ask someone that has those two for insurance… and just how difficult it is to find a doctor to take you on as a new patient. Right now, around HALF of all doctors are 55+… if they have save/invested their money… if they have to chose between retiring and/or accepting the low reimbursements provided… many may chose to just “throw in the towel” … and pts will end up being seen mostly by what is referred to as mid-level healthcare professionals – ARNP,NP, PA, and maybe even Pharmacists.
Just look at all the CHANGES in the last 12-18 months… DEA rescheduled Hydrocodone products to C-II
They refused to change the C-I scheduling of MJ/MMJ,
The CDC generated “guidelines” for opiate dosing.. which many are now treating as “the law”
The Surgeon General sent a letter to all prescribers… encouraging them to prescribe LESS OPIATES
The DEA reduced the opiates that manufacturers can produce for 2017 by 25% +
The DEA is going to reschedule Kratom to C-I… it is just a matter of time… IMO.. before the end of the year..
WV’s Senator Manchin has been promoting a “opiate prescription tax” — which Hillary has endorsed/supported
Hillary has also endorsed/supported a “soda tax” that the city of Philadelphia has implemented… neither of these taxes are targeting “millionaires and billionaires “
Neither of the Presidential candidates are talking about or to the chronic pain community. If AG Loretta Lynch and the DEA of the DEA Chuck Rosenberg remain in office.. the direction and momentum of the war on drugs/pt/prescribers will probably not change… may even gain momentum … going down hill…
JUST WATCH… the DEA screwed up using the wrong law and declaring an EMERGENCY to reschedule Kratom… They will now go back to the drawing board and find or create an interpretation of some law that they believe that they can use.. they will have some public comment period.. and just like the CDC’s actions with their pubic comment period.. the public comment period CHANGED NOTHING.. in their proposed opiate prescribing guidelines… and the DEA will go down the same path… the 50+ House members and the 10+ Senators and their letters to the DEA.. will get them all past the November election… I expect that the DEA will try to implement the rescheduling between the Nov 8th election and the Jan 20th inauguration. While the rest of the legislative/executive branches of our Federal government are in transition.
BERKELEY, Calif. (KTVU) – The US Drug Enforcement Agency backed off banning a popular herb after major pushback from users and federal legislators. The Southeast Asian tree leaf Kratom was supposed to be named an illegal schedule 1 substance, the same classification as heroin, on September 30.
The DEA delayed the ban after Congressional lawmakers urged a public comment period. Kratom sellers and users, however, fear the ban is still coming from DEA.
Berkeley’s Twisted Thistle Apothicaire said it started selling Kratom a year after opening 6 years ago.
“We didn’t get into this business for Kratom. Kratom found us,” said owner Ethan Franc.
Franc said customers swear the powdered leaves, used for hundreds of years in Asia, are the answer to their physical and emotional ailments.
“Pain relief or getting off opioid addiction,” said Franc.
“We’ve had customers use it to get off anti depressants.”
The Haight’s Head Rush smoke shop said people frequently ask for Kratom.
“A lot of people use it to stay off of the methadone and opiates,” said Head Rush’s Allan Sprage. “My description is like a cloud suit. It’s comforting for sure.”
The DEA called for an emergency ban on Kratom on August 30, claiming Kratom has hallucinogenic properties and is addictive. Descriptions Kratom advocates dispute.
“As far as addictive, it’s on par with coffee and caffeine,” said Franc.
The DEA also says Kratom is associated with 15 US deaths, but advocates say those cases may have been in combination with opioid use.
Multiple herbal shops and smoke shops pulled Kratom and prepared to destroy supplies in anticipation of the September 30 ban, but the DEA delayed the ban for an undetermined amount of time.
“My greatest hope is that people have access to it,” said Franc, who believes Kratom will end up on the Black Market if outlawed.
The legal consequences have not been laid out for possession or sale of Kratom if a ban goes through.
Advocates worry a level one classification will also mean research on Kratom and why people experience pain relief and addiction management will stop.
When dealing with an employee’s medications, silence on an employer’s part equal liability.
There is no doubt that prescription pain medication abuse is a rampant problem in America. Indeed, this week the State of Ohio even went so far as to limit the ability of an injured worker to receive reimbursements for pain meds from the state workers’ compensation fund.
So, what then does one make of this story from Employment Law 360, describing a recent lawsuit the EEOC filed against a Georgia medical practice?
Alunda Hunt was fired from his job at Spaulding Regional Medical Center shortly after revealing to his employers that he was being treated with prescribed narcotics and spinal injections for a chronic medical condition, despite his ability to perform his job duties, according to the EEOC’s complaint. …
According to the complaint, Hunt, who suffers from an impairment that limits his neurological and musculoskeletal systems, was hired to treat acutely ill patients for Georgia Hospitalists Group in July 2013. The following month, as part of the credential verification process, Hunt supplied a doctor’s note explaining he was being treated for chronic pain with a combination of prescribed narcotics and back injections, the complaint states. When Hunt refused to resign, the company fired him, the EEOC said. …
What does it appear this employer may have done wrong to catch the EEOC’s ire? Think back to my past from last month discussing the ADA and prescription meds. What steps must an employer take to avoid an ADA claim after learning that an employee is taking a prescription drug that may affect job performance?
After an employer learns that an employee is taking a prescription drug that may affect job performance, it should request a medical certification regarding the effect of the medication on the ability safely to perform essential job functions. That certification will enable the employer to engage the employee in the interactive process and making the individualized determination of whether a reasonable accommodation is even possible.
In its lawsuit, the EEOC alleges that Hunt supplied a doctor’s note explaining that he was being treated for chronic pain with a prescribed narcotic, and further explaining that he was subject to urine tests and monitoring via the Georgia Board of Pharmacy to ensure compliance with his treatment plan. The employer, however, allegedly assumed that the medication rendered him unable to meet his job requirements. It failed to engage in the interactive process with this employee to determine whether he could perform the essential functions of his job with, or without, reasonable accommodation based on the medical certification.
Beware the same error in your workplace. The ADA is all about engaging in conversations and avoiding assumptions. When dealing with an employee’s medications, silence on an employer’s part equal liability. When an employee presents for duty with a prescription medication, ask, certify, verify, and, if possible, accommodate. If you cannot make a reasonable accommodation after engaging the employee, then, and only then, are you free to terminate.
Jon Hyman is a partner at Meyers, Roman, Friedberg & Lewis in Cleveland. To comment, email editors@workforce.com. Follow Hyman’s blog at Workforce.com/PracticalEmployer.
Hillary Clinton was in the Senate between Jan 2000 until Jan 2009… when she resigned in the middle of her second term to become Sec of State.
During that time frame… our country’s national debt increased abt 5 TRILLION DOLLARS… about 1.7 billion/day
During the 8 yrs of the Obama administration… our national debt increased ANOTHER 10 TRILLION DOLLARS .. about 3.5 billon/day.
While in the world of “government” there is no such things as a “profit/loss”… just “surplus/deficit”
She can’t understand how someone could lose close to ONE BILLION in a SINGLE YEAR.. when she has been part of the system that has spent billions more PER DAY than they take in.
We find that for those filing their personal income taxes on 15 April 2014, they must comply with the terms of a tax code that takes 73,954 pages to explain. To tax professionals.
Congress has established nearly 74,000 pages in our tax code and some would claim that following the tax code and a person paying what is legally required by that tax code – even if it happens to be ZERO – is not paying their FAIR SHARE.
It has been reported that 47% of US families PAY NO FEDERAL TAXES… some families get a FEDERAL TAX REFUND when they don’t pay federal taxes in the first place. Because they follow the tax law… are they not paying their FAIR SHARE ?
The math that comes to the conclusion as to what each and everyone one of us is our “fair share” of federal taxes we owe… seems to be very FUZZY MATH.. and to some… that formula is not contained within the 74,000 pages of our tax code. Maybe we need to treat the Federal government like a CHARITY… and they need to start “passing the hat” to help pay our bills… unfortunately… Congress would probably spend 10%-20% more than was collected.
Is it only me.. but.. doesn’t it seem strange that a chronic pain pt can be turned away – refused to have a medically necessary medication filled – and this is different than giving a pt the wrong medication… and the first situation has no consequences… no attorney will even discuss the issue.. but in this particular case… a pt given the wrong dose… and the pt is seeking to “be made whole” …The plaintiff is seeking an unspecified amount in damages.
Although both patients can suffer harm/damages… only the latter is significant enough for an attorney to seek legal redress ?
NEW ORLEANS – A woman alleges she was given the wrong prescription at a New Orleans pharmacy.
Shenelle Blanks, also known as Shanelle Blanks, wife of and Aaron Blanks, filed a suit against Walgreen Louisiana Co. Inc., also known as Walgreens Family of Companies, XYZ insurance company and John Doe in the Orleans Parish Civil District Court.
According to the claim, the plaintiff was a customer at the Walgreens Pharmacy located at 6201 Elysian Fields Ave. on Aug. 23, 2015, when the incident occurred. The suit states that the plaintiff was caused personal injury when she was given an incorrectly filled prescription for her blood pressure medication.
The defendants are accused of acts of omission and negligence through failing to provide accurate dose of medication and failing to realize the incorrect strength of the medication was dispensed.
The plaintiff is seeking an unspecified amount in damages. She is represented by Sidney D. Torres, Roberta L. Burns and Beau F. Camel of the Law Offices of Sidney D. Torres II in Chalmette.
The case has been assigned to Division F Judge Christopher J. Bruno.
The above organizations are the ones sponsoring this… what is commonly referred to as anti-detailing… the reverse of what drug company reps do with doctors… “detailing” the medications that their employer produces…
PhRMA represents the country’s leading biopharmaceutical research companies and supports the search for new treatments and cures.
I guess that these groups could me grouped under the new group of M.A.D.D. – Malcontents Against Doing Drugs. Doesn’t matter if the person has a medical necessity for taking opiates are not… “doing drugs” is “doing drugs”..
So this war on drugs has transformed into a war on patients and law enforcement/judicial system is drawing in various other non-governmental entities to help in the fight. It would appear that the more LOPSIDED this war becomes.. the more it appears into becoming a GENOCIDE. Since one side of this war doesn’t possess the physical, mental, financial strength to “put up a fight”.
IMO.. things are not going to change – or more likely to continue to get worse… until the chronic pain community gets their “dollars together” and bring some “hired guns” (attorneys) into this fight.
Too many chronic pain pts being lied to… being denied care… being abandoned… being thrown into cold turkey withdrawal and other issues that pts with other critical health issues would could be considered PATIENT ABUSE
If you notice, the video talks about the ILLEGAL form of Fentanyl and the ILLEGAL Heroin.. as if these can be found at the local pharmacy
Volunteers working to lower the death toll from the heroin epidemic will pay doctors a visit Oct. 6, delivering a message about what federal authorities believe is the best way to attack the crisis.
They will talk to doctors about guidelines from the Centers for Disease Control and Prevention on limiting opioid prescriptions for adults in an outpatient setting and exploring alternatives.
“Three days or less will often be sufficient; more than seven days will rarely be needed,” the guidelines state. There are exceptions, such as the treatment of hospice patients or those with active cancer.
The door-to-door protest to lower opioid prescriptions, called “Knock Out Opiate Abuse Day,” is the first nationally, said Angelo Valente, executive director of Partnership for a Drug-Free New Jersey, which is behind the event.
“We believe many doctors are not as aware of the issue as they need to be about safe prescriptions,” Valente said.
Dentists’ offices will also be part of the campaign.
Interrupting a doctor’s work day is something pharmaceutical salespeople do routinely, Valente said. And the effort has the support of pediatricians and dentists groups.
The Medical Society of New Jersey also issued a statement Monday saying they were in favor of the effort.
“We support all efforts that encourage patients to use prescription drugs responsibly, as our members continue to be on the front lines treating those patients who suffer from addiction,” Mishael Azam, chief operating officer and senior manager of legislative affairs for the society, said in the statement.
That same day, volunteers will also fan out to neighborhoods to hang messages on door knobs to make the public more aware of the CDC guidelines, Valente said.
Valente expects more than 2,000 volunteers to take part in the event, which runs from 10 a.m. to 3 p.m.
Training sessions are set for Tuesday at Fairleigh Dickinson University’s School of Pharmacy, Room 209, 230 Park Ave., Florham Park, NJ 07932.
Another session is scheduled to be held Thursday at Rutgers EcoComplex Auditorium at 1200 Florence Columbus Road, Bordentown, NJ 08505. Registration at both events runs from 6 p.m. to 7 p.m. and training, from 7 p.m. to 8:30 p.m.
Valente said organizers will contact those who cannot make the training sessions.To register, click here.
Organizers for each county will coordinate the visits, he said.
BOSTON >> Nurses packed a hearing room Tuesday to voice strong opposition to regulatory changes they said could allow unlicensed workers to administer medication, pull trained nurses away from bedsides and potentially put patients at risk of medication errors.
Wearing scrubs, Massachusetts Nurses Association jackets and stickers saying, “Every patient deserves a nurse,” they told the Board of Registration in Nursing that administering medications should be the responsibility solely of licensed nurses who know the effects of different drugs and can assess a patient’s condition before offering a dose.
The board is weighing a series of amendments to its regulations, including revisions to the section governing delegation of certain nursing activities to “unlicensed persons” — workers who are not licensed as nurses but perform complementary or assistive roles, like orderlies, aides, assistants and technicians.
Nurses association president Donna Kelly-Williams said in written testimony that the proposed regulations “could be interpreted by unscrupulous health care administrators as a gateway to allowing unlicensed people to administer medications to any patient in any setting,” including in hospitals and long-term care facilities.
The Department of Public Health, however, said the changes would not expand the limited settings in which nurses are authorized to delegate medicine administration.
Hospital nurses who spoke at the hearing expressed fears they would be pressured to delegate medication administration, though the regulations specify that the decision to delegate “is made by the delegating nurse only” and employer policy or contracts cannot mandate delegation.
“Today we are under a great deal of pressure to delegate things, and that delegation pressure comes from above, from the managers, and they are under pressure for us to delegate more and more things,” said Nora Watts, a nurse at Newton-Wellesley Hospital. “Don’t make any mistake, there will be so many more errors if we do this because of how complicated the medications are, and you’re putting me and my family and your family and the people of the commonwealth of Massachusetts at great danger if you go forward with these changes to medication administration.”
William Lahey, a nurse at Worcester’s Saint Vincent Hospital, said he believed the proposal was an attempt at “cutting the costs of having registered nurses.”
Nurses are currently only authorized to delegate medication administration in public and private school settings, and that would not change under the new regulations, according to the Department of Public Health.
“The proposed amendments make no changes in current state law governing to whom a nurse may delegate medication administration, but rather serve the interests of patient safety by clarifying existing regulations on the delegation of nursing activities, including the administration of medication,” DPH spokesman Tom Lyons said.
Rep. Denise Garlick of Needham, a nurse and chairwoman of the Joint Committee on Elder Affairs, urged the board to take care in the wording it chooses, saying the proposed regulatory language could have unintended consequences.
“The specter of unqualified and unlicensed personnel administering meds in any setting, if that is not your intent, must be unequivocally repudiated,” Garlick said.
Addressing the board alongside Worcester Rep. Mary Keefe, Garlick said 71 lawmakers had signed onto her written testimony and that there was a “large cadre of legislators who want to be vigilant about this process.”
Meg Doherty, a former chair of the Board of Registration in Nursing, spoke in support of the amendments, saying there are not enough nurses to meet the medication need of patients who wish to remain at home while receiving care.
“Change will continue at an exponential rate and currently untrained care aides, neighbors, anybody, are hired, directed by patients in their homes, and to me, this is an unsafe practice as opposed to creating safety parameters,” she said.
The Home Care Alliance of Massachusetts also offered support for delegation in home settings, submitting written testimony that said the new regulations would build “a framework which would permit home health nurses to operate at the top of their license, retaining those responsibilities pertaining to assessment and critical decision-making.”
The alliance’s testimony said the changes would increase “the efficiency and availability of care at a time when the number of elderly in our population, including those who will be cared for at home, is drastically increasing.”
