Where is the AARP ?

Our Mission

AARP is a nonprofit, nonpartisan, social welfare organization with a membership of nearly 38 million that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families — such as health care, employment and income security, and protection from financial abuse.

Since AARP represents those 50+… they claim that they have a membership of 38 million and that they fight for HEALTHCARE. How many of those 38 million members do you think suffer from CHRONIC PAIN, DEPRESSION, ANXIETY, MENTAL HEALTH ISSUE and are having a difficult time getting their medications or getting adequate/appropriate treatment for those health issues.

Someone would have to have their head stuck somewhere to not notice all the attention that is being paid to those who suffer from substance abuse , chronic pain and other subjective diseases.  You can search their website and there is a large array of articles on chronic pain and substance abuse.. including one by DR. OZ about treating chronic pain – WITHOUT MEDICATIONS..

It would seem that the only people that think that continuing the war on drugs is a good thing is those who work for the judicial system, those in Congress, those who operate addiction rehab centers and those that have lost a loved one from a opiate OD.. because their mental health issues could not be properly addressed.  That comes up to a percent in the low teens of the population.  So, as a country, we are spending 51 billion/yr because a small minority of our population thinks it is a good thing.

At $16 dues/member/yr those 38 million submit 600+ million dollars/yr… not counting all the royalties they collected from all those endorsement deals.  According to their 2013 Financial Statement published in their website their total revenue was 1.4 BILLION DOLLARS.  If they are doing any lobbying for those members who suffers from subjective diseases… it is either TOTALLY INEFFECTIVE or SO LITTLE that it is a waste of resources.

I have been a member of AARP for nearly 20 yrs and am starting to really question why/if.. I will renew our membership when it comes due.

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Pain-clinic patients worry as DEA moves toward revoking doctor’s registration

http://www.seattletimes.com/seattle-news/freaking-out-pain-clinic-patients-worry-as-dea-steps-up/

Since it is estimated that there is between 1.9 and 2.1 million serious opiate addicts in the USA… which .. if 25,000 pts of these eight clinics have been “thrown to the curb”… either means that these clinics were providing opiates to 12.5 % of all the addicts in the USA or there is a lot of legit chronic pain pts that are being thrown into cold turkey withdrawal… subject to having a hypertensive crisis, stroke and death.  I may have missed it… but I see no allegation or proof of deaths from opiates that had been provided to pts.  Another case of guilty without proof ?

Federal Drug Enforcement Administration officials are taking steps to revoke the DEA registration of Dr. Frank Li, medical director of Seattle Pain Clinics, whose license was suspended by state officials last week.

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The real reason that so many more Americans are using heroin

https://www.washingtonpost.com/news/wonk/wp/2016/07/20/the-real-reason-that-so-many-more-americans-are-using-heroin/#comments

President Obama has committed to sign the Comprehensive Addiction and Recovery Act, which includes among its provisions new policies to reduce inappropriate prescribing of prescription opioids such as Oxycontin and Vicodin. Given the ongoing epidemic of addiction and death caused by opioid painkillers, this seems like sensible public-health policy, but some critics charge that tighter prescribing rules simply cause prescription opioid users to switch to heroin, thereby feeding a second opioid epidemic. The prestigious New England Journal of Medicine recently published the first systematic analysis of this terrifying possibility.

Wilson Compton of the National Institute on Drug Abuse, who led the analysis, discovered that the timing of the prescription opioid and heroin epidemics is not consistent with the simple narrative that increased controls on the former instigated use of the latter. Heroin use and heroin-related emergency-room visits and hospitalizations were rising for years before the 2009-2011 period in which controls of prescription opioids expanded — for example, by strengthening of state prescription-monitoring programs, crackdowns on pill mills and the introduction of an abuse-deterrent formulation of Oxycontin.

Compton and colleagues also noted that fatal heroin overdoses began rising in 2007 — prior to the initiation of tighter opioid prescribing practices — and have not showed any consistent relationship with prescription opioid overdoses since. Heroin deaths rose from 2011 to 2012, when prescription opioid deaths had their only year-on-year drop, but they kept rising the next year, when prescription deaths were flat and have kept increasing since the time that prescription opioid deaths began rising again.

If controls on prescription opioids are not driving the heroin epidemic, what caused this drug to reemerge? Compton and colleagues point to the establishment of heroin markets that expanded access to a cheaper, more potent opioid that appealed to people addicted to prescription painkillers. This is highly plausible, given evidence that Mexican heroin traffickers made special efforts to expand into communities with established prescription opioid problems.

Compton also points out that “addiction to pharmaceutical opioids drives many people to seek new sources whether there are any controls in place or not.” As users become tolerant to the effects of opioids, they often consume an increasing amount of the drug until they simply cannot afford to purchase the dozens of pills they want each day from legal or illegal sources. Heroin, which once may have seemed unthinkable, thus becomes attractive because of its affordability.

Compton does not deny that some people, particularly those who are already using some heroin in addition to pharmaceutical opioids, might increase their heroin use if their doctors cut them off their prescription, and indeed studies of people being treated for heroin addiction document that such patients exist. But consider this analogy: If you live in Hawaii, most of the tourists you meet will have arrived by airplane, but it does not follow that most of the world’s tourists who board airplanes are going to Hawaii.

By the same token, studies of the select sample of people being treated for established heroin addiction by definition will never capture data on the far larger number of people who responded to reduced access to pharmaceutical opioids by ceasing use of those drugs. Nor will such studies make apparent an even more important group of beneficiaries of more careful opioid prescribing rules: the individuals in the future who will not be inappropriately prescribed opioids in the first place.

Keith Humphreys is a professor of psychiatry and mental-health-policy director at Stanford University.

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Don’t let a lawyer be your doctor

http://setexasrecord.com/stories/510964210-don-t-let-a-lawyer-be-your-doctor

The following is a public service announcement from the Southeast Texas Record:

There are many personal injury attorneys advertising in Texas media and making misleading and inflammatory claims about prescription drugs, the companies that manufacture them, and the doctors who prescribe them, according to a recent medical survey.

Heart attacks, strokes, hemorrhaging, aneurysms, and internal bleeding are some of the things that can happen when patients discontinue taking prescribed medication or alter their dosages in response to misinformation from personal injury attorneys looking for clients for lawsuits against drug companies and doctors, the doctor survey says.

Eight out of 10 Texas doctors agree that “personal injury lawsuit ads can lead patients to stop taking their medicines as prescribed,” according to a recent survey by Texans Against Lawsuit Abuse.

“Consumers need to understand that the intent of these ads is to generate lawsuits, not to provide sound health information,” says Steven L. Gates, president of the Texas Osteopathic Medical Association. “They should remember two very important things: Don’t believe everything you see in any ad – especially medical lawsuit ads. And, patients should always ask their doctor, not a lawyer, about health concerns.”

If you have misconstrued the scare tactics of personal injury attorneys as legitimate medical advice and suffered adverse consequences, you should be entitled to hold those attorneys accountable for their unprofessional behavior.

Don’t be a victim. Don’t change your medical regimen because of something you heard a personal injury attorney say. If you have questions about your treatment, ask your doctor.

Don’t let a lawyer be your doctor. Don’t let biased advertisements mislead your loved ones with fast talk and hysterical claims.

Don’t let personal injury attorneys drum up business at your expense with one-sided ads about prescription drugs. To find out what you can do about those ads, visit the Texans Against Lawsuit Abuse website at tala.com or call 1-800-476-1442.

Ref.: Personal injury attorney Louisville Kentucky Hughes & Coleman.

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The results of DENIAL OF CARE and COLD TURKEY WITHDRAWAL

This appeared in a closed FB page dedicated to chronic pain pts and their advocates. To those who know what they are doing.. it is well known that cold turkey withdrawal from opiates or benzos can cause a hypertensive crisis… causing a stroke and sometimes DEATH..  We routinely see prescribers being charged with various crimes for pts dying from ODing on controlled meds… Does anyone believe that we will see charges against health care DENIERS when pts DIE from cold turkey withdrawal ?

If this pt had died of a medical error, I would bet that attorneys would be circling like vultures circling over “road kill”… but.. will they bother to take a second look at this unnecessary PREVENTABLE DEATH ?

Loss of Life due to CDC Guidelines – It is with a very heavy heart that I report that one of our  members lost a cousin due to the government’s gross negligence of the chronic pain patients. I won’t divulge names at this time, as I want to respect the family’s time to grieve. It was reported by one of our members that she lost her cousin, age 56, due to a massive stroke caused by the sudden discontinuance of his meds. His meds were not discontinued because it was in the best interests of his health. It was because of the government’s War on Heroin. He was taken off life support rather than being left in a vegetative state. Please keep this family in your prayers as his two daughters try to cope with this tragic loss. A doctor is responsible for this death. Our government is responsible for this death. The CDC, DEA, and the State of Florida is responsible for this man’s untimely and needless death. Please keep this family in our prayers.

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Walgreens gives away pharmacy guide on treating LGBTI customers with respect –

The guide carries information on HIV, PrEP, hormone therapy for trans people and how to create an inclusive and welcoming pharmacy

  http://scl.io/W-dnuSxx#gs.fkacar8

Wouldn’t it be nice if Walgreens wanted all pts to consider Walgreens an inclusive and welcoming pharmacy?  Unfortunately, they have created their “Good Faith Policy”  (http://paindr.com/is-walgreens-opiate-policy-deceptive/) instructing their Pharmacists which customers are allowed to fill their controlled medications and which are not.  HARDLY INCLUSIVE AND WELCOMING ?  Of course, last quarter Walgreen reported a 4.6% increase in prescription volume… so turning away from their prescription dept a certain subset of the population has not seemed to harm their overall prescription business.  Could it be considered a DISCRIMINATORY POLICY by “welcoming ” one group of people covered under the Americans with Disability Act and “discourage” providing prescriptions to another group of people covered under the ADA ?

Walgreens, the largest drugstore chain in the US, is distributing 70,000 copies of a new resources guide on treating LGBTI customers with respect to health care professionals across the country.

The guide has been produced in partnership with Human Rights Campaign (HRC). It carries information on appropriate LGBTQ terminology and identities, and on the health disparities experienced by LGBTQ people.

There are also section related to transition services and hormone therapy for trans people, HIV medication and PrEP. There is also advice on creating an inclusive and welcoming pharmacy environment.

‘LGBTQ people often experience barriers to care, and, for many, their most frequent interaction with a health care professional occurs right in their own neighborhood pharmacy,’ said Tari Hanneman, Director of the Human Rights Campaign Foundation’s Health Equality Project, in a statement.

‘This guide will help ensure that they are treated with dignity, respected in their identities, and able to gain the necessary and inclusive health care we all need to live and thrive.’
LGBT people are 68% more likely to smoke cigarettes; and are 2.5 times more likely to suffer from depression and anxiety

‘With almost 8,200 drugstores nationwide, touching the lives of eight million customers daily in stores and online, we have a tremendous opportunity to serve as a model of quality and individualized care for people of all sexual orientations and gender identities,’ said Richard Ashworth, President of Pharmacy and Retail Operations for Walgreens.

‘By making training materials available to all our pharmacists and health care service providers, we can do even more to create a welcoming environment and build LGBTQ patients’ confidence and trust that the health care advice we provide is sensitive to their unique needs and concerns.’

Among the disparities noted by the guide are that LGBT people are slightly less likely than non-LGBT counterparts to have health insurance; LGBT people are 68% more likely to smoke cigarettes; and are 2.5 times more likely to suffer from depression and anxiety.

The guide comes two months after the US Department of Health and Human Services (HHS) Office for Civil Rights introduced a regulation that provides explicit protections from discrimination on the basis of gender identity and sex stereotyping, in healthcare and insurance.

This extends to health care programs – including pharmacies – that receive any federal funding.

In 2014, the Williams Institute in Los Angeles published a report on the discrepancies experienced by many LGBT people in accessing healthcare, including the fact that 29% of LGBT people reported not having a personal doctor, compared to 21% of the non-LGBT population.

Walgreens – headquartered in Deerfield, Illinois – has consistently scored the top mark of 100 in HRC’s annual Corporate Equality Index, which scores companies according to their LGBT-friendly policies and procedures.

The Walgreens/HRC guide can be read here. – Read more at: http://scl.io/W-dnuSxx#gs.fkacar8

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Justice Department preparing to challenge Anthem, Aetna deals: report

http://www.modernhealthcare.com/article/20160719/NEWS/160719879

Isn’t it amazing that the FTC and DOJ has challenged/denied with some 6-12 different mergers in different industries … including these in the health insurance industry. But apparently there is little concern about the merger of CVS/Target and Walgreens/Rite Aid.. resulting in these two name plates controlling some 40%-50% of the community pharmacy outlets and in some major markets 70%+.  Does the FTC & DOJ have alternative motives or a “end game” ?

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Senator Durbin Sends Letter to DEA Calling for Stricter Limits of Opioid Pills

As Acetylfentanyl is flooding the USA market from China and Mexico… and killing addicts because it is being mixed with Heroin on the street… these six Senators call for a reduction in the production of legit opiate medications.  Legal opiate prescriptions PEAKED in 2012 but OD deaths from various opiates continue to increase. Just as everyone else is coming to the realization that addiction is a medical health issue.. these bone-headed Senators are looking for the cause in the WRONG PLACE. I guess these Senators believe that doing something.. even if it is the WRONG THING.. is better than doing nothing at all ?

enewspf.com/2016/07/19/senator-durbin-sends-letter-dea-calling-stricter-limits-opioid-pills/

CHICAGO –(ENEWSPF)–July 19, 2016.   U.S. Senator Dick Durbin (D-IL) today released a letter to the Drug Enforcement Administration (DEA), calling on the agency to use its power to ‎more aggressively combat the opioid epidemic that is affecting communities across Illinois and the country. With its existing quota-setting authority, DEA effectively serves as a gatekeeper for how many opioids can be produced and sold in the United States every year. Durbin has urged DEA to help keep the dangerous pills from flooding the U.S. market by setting lower quotas in the coming years. Durbin’s letter is cosigned by Senators Sherrod Brown (D-OH), Edward Markey (D-MA), Amy Klobuchar (D-MN), Angus King (I-ME), and Joe Manchin (D-WV).

“We agree and believe efforts to halt this widespread epidemic will not be successful unless we use every tool at our disposal. We urge DEA to utilize its existing quota setting authority, to the fullest extent possible, to combat this epidemic,” the Senators said in the letter. “Fourteen billion opioid pills are now dispensed annually in the United States – enough for every adult American to have a bottle of pills. Certainly, the pharmaceutical industry is at fault for decades of misleading information about their products and the medical community bears responsibility for its role in over-prescribing these dangerous and addictive drugs, but we remain deeply troubled by the sheer volume of opioids available – volumes that are approved by DEA.”

For the past two decades, the DEA has approved ever-greater increases in opioid quotas, allowing production of oxycodone to increase 39-fold, hydrocodone to increase 12-fold, hydromorphone to increase 23-fold, and fentanyl to increase 25-fold.

Durbin’s letter outlines changes DEA should immediately adopt to improve the quota setting process, including: making the quotas that each drug company receives public; justifying the public health benefits of any opioid quota increase; and taking the opioid epidemic into consideration when setting quotas. Last month, Senator Durbin introduced the Addiction Prevention and Responsible Opioid Practices Act (A-PROP Act), which would mandate these changes.

While urging DEA and pharmaceutical companies to do more to help prevent addiction before it starts, Durbin has also worked to expand access to treatment for those who have already become addicted to opioids. Despite studies showing medication-assisted therapies to be highly effective in reducing opioid dependency, there has been significant under-treatment due to a federal cap limiting the number of patients that physicians can treat using those therapies.  In 2012, of the 2.5 million Americans who abused or were dependent on opioids, fewer than one million received medication-assisted therapy.

Durbin applauded a policy change made earlier this month by the U.S. Department of Health and Human Services to raise the cap on the number of patients licensed providers (including physicians, nurse practitioners and physicians assistants) can treat using medication-assisted therapies, including buprenorphine, from 100 to 275.  Durbin, a cosponsor of the Recovery Enhancement for Addiction Treatment Act (TREAT Act), has been advocating for this policy change for more than a year.

The full text of the Senators’ letter can be found below:

July 19, 2016

The Honorable Chuck Rosenberg, Acting Administrator

United States Drug Enforcement Administration

8701 Morrissette Drive

Springfield, VA 22152

Dear Acting Administrator Rosenberg:

Our nation is in the midst of a prescription opioid and heroin crisis that is destroying the lives of our friends, our neighbors, and our family members. In 2014, 28,647 people nationwide died from an opioid overdose. As you stated in announcing the 2016 National Heroin Threat Assessment Summary, “We tend to overuse words such as ‘unprecedented’ and ‘horrific,’ but the death and destruction connected to heroin and opioids is indeed unprecedented and horrific.” We agree and believe efforts to halt this widespread epidemic will not be successful unless we use every tool at our disposal. We urge the Drug Enforcement Administration (DEA) to utilize its existing quota setting authority, to the fullest extent possible, to combat this epidemic.

We have appreciated hearing about DEA’s efforts to combat the ongoing opioid crisis, including DEA’s “360 Strategy.” While this strategy lists demand reduction as a core focus, it appears primarily focused on the downstream dynamics of the problem, such as targeting the violent cartels and drug trafficking gangs responsible for perpetuating the opioid epidemic. These efforts, much like DEA take-back days, are critically important and should be commended. However, they do not go far enough. We believe DEA can and should be doing more.

Each year, DEA is responsible for setting annual quotas for manufacturers’ production of schedule I and II controlled substances, including opioids. In effect, DEA serves as a gatekeeper for how many opioids are allowed to be legally sold every year in the United States. Yet, for the past two decades, DEA has approved significant increases in the aggregate volume of opioids allowed to be produced for sale in the United States. Between 1993 and 2015, DEA allowed aggregate production quotas for oxycodone to increase 39-fold, hydrocodone to increase 12-fold, hydromorphone to increase 23-fold, and fentanyl to increase 25-fold. According to IMS Health, 14 billion opioid pills are now dispensed annually in the United States – enough for every adult American to have a bottle of pills. Certainly, the pharmaceutical industry is at fault for decades of misleading information about their products and the medical community bears responsibility for its role in over-prescribing these dangerous and addictive drugs, but we remain deeply troubled by the sheer volume of opioids available – volumes that are approved by DEA.

The Controlled Substances Act provides DEA with a number of authorities, which, if utilized fully, could help appropriately reduce the number of opioids available nationwide. First, when DEA, in a given year, approves a higher opioid quota than is ultimately used, DEA can and should lower the ensuing year’s quota accordingly if there is no other compelling need for the higher quota. Second, DEA has the authority to approve mid-year quota adjustments and thus could take a more judicious approach for initial opioid quota setting and allow for mid-year adjustments, if needed. Finally, when setting quotas, DEA’s authority states that “the Administrator shall consider changes in the currently accepted medical use in treatment with the class or the substances which are manufactured from it.” We believe the recent Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain constitutes a “change in the currently accepted medical use” of opioids and should be taken into consideration when setting future years’ opioid quotas.

The 2016 CDC Guidelines recommend dramatic changes in how opioids are prescribed for chronic care patients. For instance, the medical experts at the CDC recommend that patients receive immediate-release opioids instead of extended-release or long-lasting opioids; that patients receive the lowest effective dosage of opioids possible; and that patients receive opioids for the shortest possible effective duration. Taken together, these CDC recommendations clearly demonstrate that fewer opioids will be medically necessary in the coming years.

These new guidelines – coupled with recent opioid drug manufacturer settlements acknowledging both the addiction risks of these products and the insufficient research body about the effectiveness of opioids when used long term – provide grounds within the scope of DEA’s existing authority to take proactive steps to lower quotas.

In addition to the steps outlined above, we also strongly urge DEA to do the following:

• Remove, for schedule II opioids, the 25 percent across-the-board aggregate production quota increase that was implemented in 2013;

• Take into consideration the impact of the opioid manufacturing quotas on the downstream public health burden of opioid misuse and diversion;

• Make public the approved individual manufacturing quota for each manufacturer of schedule II opioids, including oxycodone, hydrocodone, oxymorphone, hydromorphone, and fentanyl;

• In years during which the approved opioid manufacturing quotas increase, provide public justification to explain why the public health benefits of increasing the quotas outweigh the consequences of having an increased volume of such substances available for sale and potential diversion in the United States; and

• Identify formal strategies to improve data collection from approved drug collection receptacles, mail-back programs, and take-back events on the volume and class of controlled substances that are collected and develop a plan to use this information to inform the quota-setting process in subsequent years.

Thank you for your commitment to finding a solution to the prescription opioid and heroin crisis. We look forward to working with you to address this epidemic and request that you outline any authorities DEA needs, but does not currently have, to address the quota-setting concerns and proposed changes outlined above. We appreciate your consideration and look forward to your response.

Sincerely,

Source: http://www.durbin.senate.gov

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Pa. boards of pharmacy and medicine approve new opioid prescribing guidelines

http://www.post-gazette.com/news/overdosed/2016/07/19/Pa-pharmacy-board-approves-new-opioid-guidelines-but-medical-board-doesn-t-commit/stories/201607190150

Does it seem strange to anyone but me.. that the PA Board of Pharmacy is getting involved with prescribing guidelines when the profession that they oversee.. DOES NOT HAVE PRESCRIPTIVE AUTHORITY

I find it interesting that while most Medical Licensing Board would sanction a prescriber for prescribing medication for a pt that they had not done a in-person physical exam of the pt, but these same bureaucrats sees it within their scope of authority to place limits on the amount of opiates that a prescriber can give a pt.  Another example of those that who are placed in authority would do things – write regulations concerning – that they could not do as a practicing physician without the risk of being sanctioned by the Medical Licensing Board. Unless one or more prescribers hire a law firm to challenge the legality of this regulation.. it will remain “on the books” and be enforced.

The state boards that oversee licensing and discipline for doctors and pharmacists agreed Tuesday to adopt new guidelines for distributing and prescribing opioids.

While the Board of Pharmacy’s vote came quickly in open session, the Board of Medicine’s vote to approve two sets of opioid prescribing guidelines came after a closed-door executive session of an hour and 10 minutes. The medical board approved guidelines dealing with emergency room care and the use of the painkillers to address non-cancer pain and agreed to address additional guidelines at a meeting next month.

Physician General Rachel Levine told both boards that an overemphasis on pain reduction, the development of powerful opioids and the influx of cheap heroin have “exploded into the overdose crisis that we’re seeing today.”

A record 3,383 Pennsylvanians died of overdoses in 2015, and Dr. Levine said the numbers in the first quarter of this year suggest an even grimmer toll for 2016. Nationally, the annual number of overdose deaths is approaching the American death toll from the entire 12-year Vietnam War, she said.

The Board of Pharmacy, which licenses and regulates pharmacists, quickly and unanimously approved new guidelines for dispensing opioids. The Board of Medicine listened to and questioned Dr. Levine for an hour before meeting in executive session.

“Properly prescribed opioids have a wonderful place in medicine,” said Keith E. Loiselle, the public’s representative on the Board of Medicine. He feared that “physicians become so fearful of making a mistake in this that they begin to underprescribe or perhaps not appropriately prescribe. … Not every patient becomes a heroin addict.”

“No one is saying that all opioids are bad,” Dr. Levine answered. “But the pendulum has swung way too far” towards overprescribing.

At an afternoon press conference, Gov. Tom Wolf said he was proud of his administration’s work in creating the guidelines.

“The goal for all of us is to reduce the pattern of over-prescription,” he said.

Dr. Levine said the guidelines were developed by the Safe and Effective Prescribing Practice Task Force, a group of physicians, nurses, state agency leaders and community advocates. She said the guidelines encourage the “judicious” prescribing of opioid pain medications as well as other clinical efforts before opioids are used.

“Really, opioids should be one of the last treatments for acute pain or chronic pain, as opposed to the first treatment that’s prescribed,” Dr. Levine said.

In addition to the state board of medicine’s affirmation earlier Tuesday of the guidelines for chronic non-cancer pain and emergency departments, the board will hold a special session in August to review the guidelines for geriatrics, obstetrics and gynecology and treatment of opioid use disorder in pregnant women, Dr. Levine said.

The guidelines are voluntary, Mr. Wolf said.

“The emphasis on the guidelines is not so much for policing, it is much more to emphasize the treatment of this disease as we treat other diseases,” said Secretary of Health Dr. Karen Murphy.

Some examples of the advice in the guidelines:

• Patients with chronic pain not associated with cancer, if prescribed opioids, can be ordered to undergo periodic urine or saliva screenings and pill counts, in an effort to ensure that they aren’t taking extra drugs, or selling their medicine.

• Opioids shouldn’t be mixed with benzodiazepines, which are a class of sedatives.

• Prescriptions for opioids written in emergency departments should generally not be for more than seven days worth of pills.

• Pharmacists should be on the lookout for patients who may be getting opioid prescriptions from multiple doctors, or even forging prescriptions.

• Opioids should not be a first choice for pregnant or nursing women,because the mother’s chronic use of the painkillers can lead to neonatal abstinence syndrome, feeding difficulties, seizures and other symptoms in the child.

• Doctors should do a careful risk analysis before prescribing opioids to patients with psychiatric disorders.

• Elderly patients seem to be at increased risk of falling in the early weeks of opioid use, and should be especially warned against taking the painkillers with alcohol.

Pennsylvania lags behind some other states in approving guidelines. And even if its boards adopt the recommendations offered by Dr. Levine, Pennsylvania’s crackdown won’t match that of Kentucky, where the crossing of the 1,000-fatal-overdoses-per-year mark spurred a vigorous response.

Kentucky’s legislature passed into law in 2012 requirements that physicians conduct complete examinations and drug history checks of patients, and write up treatment plans, before opioids are prescribed. The law also required that doctors there recheck the prescription database every time opioids are recommended.

The Wolf administration in the last two months swung behind proposals to require that all prescribers take regular refresher courses in the proper prescribing of opioids, and that they check an emerging patient drug history database every time they recommend controlled substances.

The Pittsburgh Post-Gazette in May reported the results of a six-month investigation showing that, from 2011 through 2015, in Pennsylvania, Ohio, West Virginia, Maryland, Virginia, Kentucky and Tennessee, 608 doctors were disciplined by state medical boards for overprescribing narcotics.

Of the seven states, Pennsylvania was the least likely to discipline a given doctor for prescribing too many narcotics. States that vigorously policed physicians — often using narcotics guidelines and prescription databases — tended to see steeper declines in opioid consumption, the investigation found. Only Kentucky saw overdoses decline.         

Dr. Levine said the state has responded to the overdoses with a six-pronged effort, including the guideline push. The other prongs:

• The administration is working with medical schools to teach students about addiction.

• Free refresher courses in opioid prescribing are now available to doctors and pharmacists.

• The database of patient prescription history will be available to doctors at the end of August, allowing them to ferret out drug-seeking patients and refer them to treatment.

• Treatment for addiction will be enhanced through $20 million in new grants to 20 centers of excellence statewide.

• Wide distribution of the drug naloxone has reversed at least 1,088 overdoses that could have been fatal.

Karen Langley contributed to this report.

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Bipartisan Opioid Abuse Bill Heads to the President’s Desk

http://www.painmedicinenews.com/Web-Only/Article/07-16/Bipartisan-Opioid-Abuse-Bill-Heads-to-the-President-s-Desk/37111/ses=ogst

Will this bill OVERTURN the 1917 court ruling that opiate addiction is a CRIME and not a DISEASE… so that prescribers can now legally prescribe opiates for both those suffering from the mental health disease of addictive personality disorder and those with chronic pain without concerns of the DEA’s interference with the practice of medicine ?  Could present a real dilemma for the DEA.

Last year, overdoses from heroin, prescription drugs and opioids surpassed car accidents as the leading cause of injury-related deaths in the United States, according to the Centers for Disease Control and Prevention. In a rare bipartisan effort, legislation to help reverse this statistic is headed toward the president’s desk, and he is expected to sign the bill.

In a 92-2 vote, the Senate passed a compromise bill, which was already approved by the House, to tackle what is being called the nation’s epidemic of opioid abuse. Sen. Sheldon Whitehouse (D-R.I.) and Rep. Jim Sensenbrenner (R-Wis.) introduced the Comprehensive Addiction and Recovery Act (CARA; S. 524, H.R. 953), and there has been broad support for the measure.

“Today’s strong bipartisan vote is a victory for American families who are struggling with the disease of addiction,” said Sen. Rob Portman (R-Ohio), one of the co-authors of the Senate bill. “This is a historic moment, the first time in decades that Congress has passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery. This is also the first time that we’ve treated addiction like the disease that it is, which will help put an end to the stigma that has surrounded addiction for too long.” In Rhode Island in 2015, 258 people lost their lives to overdoses—more than the number of those killed in homicides, suicides and car accidents combined. That same year, 439 people in New Hampshire were lost to a drug overdose, while the most recent figures for Ohio and Minnesota stand at 2,744 and 571, respectively.

CARA will strengthen prescription drug monitoring programs to help trace drug diversion and help people gain access to services for addition.

CARA also will expand:
• prevention and education efforts to prevent the abuse of methamphetamines, opioids and heroin to promote treatment and recovery;
• the availability of the overdose reversal agent, naloxone, to law enforcement agencies and first responders;
• resources to identify and treat incarcerated individuals with addiction disorders; and
• disposal sites for unwanted prescriptions.

In addition, CARA proposes to launch:
• an evidence-based opioid and heroin treatment and intervention program that uses best practices; and
• a medication-assisted treatment and intervention demonstration project.

Although there is wide support for the measure, there is not wide agreement about how to pay the estimated $900 million that will be used to fight the epidemic by enhancing prevention, treatment and policing.

“The bill now going to the President’s desk is no more than a half measure,” said Senate Committee on Finance Ranking Member Sen. Ron Wyden (D-Ore.) in a statement. “If Congress takes a political victory lap without adequate funding, this attempt to address the opioid epidemic will have been an empty promise. Until the job is finished and important addiction treatment and prevention programs are in effect, the opioid crisis will continue to rage.”

Deaths from opioid abuse have reached their highest levels since 2014, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years.

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