It is reported that our nation has a NINETEEN TRILLION DOLLAR national debt.. that figures out to abt $60,000 for every man, woman, child. Since the USA is a country “for/by the people” that means that “we the people” really owes this debt.
It is reported that 47% of the households pays no Federal Income Taxes. Which suggests that there is no way that they could  begin to contribute to paying off their share of the debt.
Some claim to just “take it from the rich”, but when you do the math… if you confiscated ALL THE ASSETS of millionaires, billionaires and it would pay MAYBE 10% of that national debt.

During the last 8 yrs.. our national debt has increased about 10 trillion. Since during that time frame there have been two year periods where each party has been in the majority.. so both parties are equally at fault.

Is the American electorate so uninformed that we just keep sending the same bozos back to Congress and State legislatures?  45% of the eligible voters DID NOT VOTE in the last Presidential election.

Those that are paying attention, has seen just how much there is an “establishment” within Congress and many within that establishment are just not happy that one of theirs is not the “choice of the people” .  Which would strongly suggests that the “establishment” is admitting that they have no intention of representing their constituents.

We are seeing the reporting of more and more OD deaths from Fentanyl… which we/everyone knows is coming from Mexico and China. So why hasn’t increased manpower being devoted to preventing this illegal drug getting to the streets ? So the Congress, state legislatures and others are passing laws that makes Narcan/Naloxone to be OTC… “save the addict” and at the same time passing laws that are harming the chronic pain community and causing all too many to commit suicide because they have no other solution to their unrelenting chronic pain.

We have “crazies” that are killing our cops in our country and innocent people in other countries… and seems to be escalating.  Apparently in the last 24 hrs someone sent out a tweet that police needs to “clean house” of “bad cops”.. and we have all worked in businesses where there are one or more people that are not part of the team and doesn’t follow the rules.  They criticized the tweet, shouldn’t the police … police themselves and getting rid of cops that are not mentally/psychologically suitable to be a cop ? 

There is no chance of having any changes in how those in the chronic pain community are treated unless we have a dramatic change in the member of the House and Senate. Otherwise the ingrained “establishment” will continue on the path they have been on for some time. They will continue to try and “save the addict” while the DEA continues to focus on their war on pts and prescribers… while Meth, Fentanyl, Heroin and other illegal drugs keep flooding the country thru our open borders.

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The state legislature and AG’s seem to have a game plan that they keep bringing out.

A few years ago a small pharmaceutical company brought out a opiate product call Zohydro and basically all it was .. was a long acting (12 hr) Hydrocodone WITHOUT any Acetaminophen/Tylenol.  Came in various strengths from 10 mg to 50 mg.

The anti-opiate groups reacted like a bunch of “rabid dogs”.. they told the media that it was some sort of “death med”… they jumped to comparing the lowest dose of  Vicodin/Norco that was prescribed – 5 mg.. to the most potent strength of the Zohydro 50mg.  Since many chronic pain pts take 4-6 Norco 10/day.. a total of 40 mg – 60 mg.. their reaction was nothing short of irrational hysteria .

State after state starting passing rules about how Zohydro could be prescribed/dispensed.. some even tried to ban its sale in their state.  Because all of this “banning” was done at the state level, the company producing this product had to challenge the rules at the various state level. What state AG’s succeeded in doing was bankrupting the company because the company was force to  fight legal Goliaths in numerous states at the same time.

IMO.. it looks like they are trying the same “game” with limiting opiates to pain pts.. more and more states..plus the Feds are creating rules/limitations.  Early this year, there was a published survey where 90% of the family with a chronic pain pt member. The disease itself and/or the cost of treating the disease was causing a financial hardship on the family.

So it would appear that these “bureaucratic bullies” are creating a “mine field” of state and Federal level obstacles for chronic pain pts to get thru. It is going to take a battalion of attorneys and a Fort Knox pile of money to individually challenge all of these laws.

If your life is not being impacted by all these opiate dosing limitation, but all means… vote to keep the current legislature in place. If you don’t have “deep pockets” to help fund the challenges to all of these unconstitutional laws/rules/regulations… then perhaps you need to consider voting to “clean house”… a legislature can just as easily REPEAL an existing law as they can pass a new law.

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Law to cap opioid prescriptions goes into effect Friday

http://wtnh.com/2016/06/29/law-to-cap-opioid-prescriptions-goes-into-effect-friday/

HARTFORD, Conn. (WTNH) — If you have an opioid prescription, things are about to change. A bill that will shorten prescriptions to just seven days has been approved and will go into effect Friday.

Mothers held photos, telling tragic stories of losing children to heroin, an addiction they say started with pain pills, as Governor Malloy signed a new law hoping to cut down on the number of opioid pain pills on the street. Starting Friday, the new Connecticut law restricts doctors and only allows them them to prescribe seven days worth of opioid pain medicine at a time.

Sen. Dante Bartolomeo representing Middletown and Meriden, says she believes doctors were way over-prescribing the pain pills.

“We have been hearing that often if a child is going to have their wisdom teeth out, that is something that is really common, they will give a 30-day supply and there is just no need for that,” said Bartolomeo.

Dr. Craig Allen is the Medical Director at Rushford. He believes the lawmakers are on the right track and it is a step in the right direction as they’re able to get as many loose pills as they can off the street.

“The research shows that 3 to 5 days worth of these opioid pain medications is generally enough for a surgical procedure,” said Allen.

Dr. Allen says if there is still significant pain after 3 to 5 days, the patient should see the doctor anyway, not take more pain pills, because the pain pills are dangerously addictive, and can hide bigger health problems.

“It’s not masked by a larger prescription of pills, which someone may take or they may not take and they go on the shelf and they go in the medicine cabinet and then they get out on the street,” said Allen.

The law also allows all first responders to carry Narcan, a life-saving drug for someone overdosing on heroin.

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AG locked in prolonged battle with drug companies

http://www.concordmonitor.com/NH-attorney-general-battle-with-drug-companies-3424021

It sounds like to me that the AG of  NH believes that the doctors in NH are not bright enough to know that OPIATES have a POTENTIAL to be addicting.  And these same doctors have been convinced by some marketing program to disregard what they should have learned in medical school about the potential for opiates to be addicting.  Maybe the AG should be asking the NH medical licensing board to suspend/revoke the medical licenses of all of these prescribers ?

One year after the state attorney general’s office filed subpoenas against five large drug companies to discover how addictive painkillers have been marketed in the state, the pharmaceutical giants have handed over nothing more than legal briefs.

“They’ve yet to produce one piece of paper,” said Assistant Attorney General James Boffetti, who is heading up the state’s investigation against the drug companies.

Boffetti’s three-person team is badly outnumbered by lawyers representing the pharmaceutical companies as they fight to get access to internal company documents. The attorney general’s office announced last month it was narrowing its probe to just look at Purdue Pharma LP, which manufactures the opioid OxyContin.

In a lawsuit filed in Merrimack County Superior Court, the attorney general’s office accuses Purdue of engaging in deceptive marketing, misrepresenting the “risks and benefits of long-term opioid use for chronic pain.”

“Purdue sales representatives continue to make sales visits to New Hampshire doctors during which they misleadingly portray or omit the risk of addiction,” wrote Boffetti, adding that the company made 217 marketing visits to the state in 2014, the most recent year with available data.

Boffetti characterizes the legal fight as a “David and Goliath” situation. The state – without any outside assistance – has three lawyers working on the investigation. The pharmaceutical companies have 19.

“They have a virtual army of lawyers, from New Hampshire and outside,” said Boffetti, who is charge of the state investigation. “It’s not just their lawyers, they have the resources of their entire law offices.”

Boffetti’s old boss is one of those lawyers. Former New Hampshire attorney general Michael Delaney is representing Endo Pharmaceuticals Inc., which recently settled with the state of New York over deceptive marketing practices of an opioid it manufactured, Opana ER.

Delaney served as attorney general in New Hampshire from 2009 to 2013.

Boffetti said his office needs help to sort through reams of documents if they come in.

“The volume of stuff to come in will be enormous,” he said.

Boffetti and his team are after internal documents from Purdue Pharma they hope will shed light on how prescription opioids were marketed to doctors and health providers in New Hampshire.

The current legal fight is whether the attorney general’s office can hire outside help.

All of the drug companies have refused to turn over any internal documents, as long as the attorney general’s office works with hired counsel – Cohen Milstein – a firm that has litigated similar cases against the pharmaceutical industry.

Lawyers representing the drug companies have argued Cohen Milstein has an inherent bias against them because it will only get paid if the state takes future legal action against the drug companies. A Merrimack County Superior Court judge recently sided with the state, but the drug companies are refusing to budge.

Lawyers have appealed the decision to the state Supreme Court and argue they should not have to turn over any internal documents until that decision is handed down.

“They don’t want us to know, that’s for sure,” Boffetti said. “We can have no resources; they’ll do everything they can to prevent us from seeing the documents.”

Elsewhere, light is starting to shine on Purdue’s marketing practices. An ongoing Los Angeles Times investigation into Purdue Pharma revealed the company marketed OxyContin as a pill to provide users with 12 hours of pain relief, despite the company’s own studies that showed the drug wore off hours early in many participants, leaving withdrawal symptoms and cravings.

The Times investigation found that Purdue knew OxyContin didn’t last 12 hours before the drug went onto the market.

Nevertheless, the drug maker not only stuck to their claim that the 12-hour window worked, it advised doctors to prescribe stronger doses of the drug if patients complained they weren’t getting the full window of relief, the Times reported.

Furthermore, the paper’s investigation found that Purdue knew of doctors who were overprescribing vast amounts of OxyContin potentially headed for the black market – and frequently did not share that information with law enforcement or cut off the supply.

Purdue Pharma keeps its own database of over 1,800 doctors it suspects are overprescribing, but does not alert law enforcement or medical authorities.

Boffetti said he can’t comment on whether similar overprescribing of OxyContin has gone on in New Hampshire, as the investigation is ongoing. But he said getting internal company documents will be an important piece of that.

“We need to get to the bottom of what they did so we can figure out if they violated the law,” he said.

These types of accusations aren’t new to Purdue. The Connecticut-based company agreed in 2007 to pay $600 million in federal fines after admitting it misled doctors and patients by understating OxyContin’s addictiveness. A federal prosecutor said at the time that the marketing had resulted in rising crime rates, teenage drug addiction and death, among other public health concerns.

Annual revenue at Purdue is about $3 billion, mostly due to OxyContin sales, according to Forbes. The company has made more than $35 billion since releasing OxyContin in 1995.

(Ella Nilsen is at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)

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‘This Is Why People Hate Congress’: What We Heard This Week

http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/59126

“You make it too complicated, you’re going to lose physicians.” — Thomas Eppes, Jr, MD, of Central Virginia Family Physicians, in Lynchburg, Va., on implementation of MACRA.

“This is just one of the most unfair things I’ve ever seen.” — Clarey Dowling, MD, a primary care physician in rural Tennessee, on the state Medicaid program’s insistence that he pay back $200,000 because he isn’t board certified.

“We have clearly heard from arthritis patients in both on-reserve and in urban settings that negative healthcare experiences in specialty care leads to a decision to disengage from further contact with rheumatologists.” — Cheryl Barnabe, MD, of the University of Calgary in Canada, on the prevalence of inflammatory arthritis and healthcare use among First Nations people in Canada.

“If you understand the mechanisms for a particular molecular target, you can develop devices that use electrons to replace drugs.” – Kevin J. Tracey, MD, of the Feinstein Institute for Medical Research in Manhasset, N.Y., on vagus nerve stimulation for rheumatoid arthritis.

“Although cigarettes are still the most commonly used tobacco product, we are seeing the use of other forms of tobacco increasing, which is why it is important to address all forms of tobacco use among adults, not just cigarettes.” – Brian A. King, PhD, of the CDC’s Office on Smoking and Health, on survey results showing that one in four adults still use tobacco products.

“This is why people hate Congress. This is why people hate Washington.” — Sen. Tim Kaine (D-Va.) on the Senate’s inability to pass a Zika funding bill.

“There’s that space opera I always wanted to write.” — Lydia Kang, MD, a novelist and internal medicine physician in Omaha, Neb., joking about her future plans as a writer.

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Professing the Values of MedicineThe Modernized AMA Code of Medical Ethics

http://jama.jamanetwork.com/article.aspx?articleid=2534495

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What? He failed a drug test … so how can he sue under the ADA?

www.hrmorning.com/failed-drug-test-sue-ada/

The moral of this story: Like the feds, the courts want to see you do everything in your power to work with disabled individuals. 

If you can’t show that you did everything in your power to help those with disabilities perform their jobs, you’re going to have a lot of difficulty getting a discrimination claim thrown out of court. That’s the legal landscape employers are now facing.

Driver was on amphetamine

Here’s an example of how tricky it is to comply with the ADA: John Lisotto was denied a position as a truck driver at New Prime Inc., a fuel hauler, because he failed the company’s medical exam during the hiring process.

Lisotto suffered from narcolepsy, and took a prescribed amphetamine — Dexedrine — to manage the sleep disorder.

In anticipation of the drug test, Lisotto submitted a letter from his physician to New Prime.

The letter said:

“the prescribed medication would not adversely affect [Lisotto’s] ability to safely operate a commercial motor vehicle as [Lisotto] had for many years been driving commercial trucks safely … while taking [Dexedrine] and had experienced no problems with narcolepsy.”

Prime’s medical examiner told Lisotto that he needed to be off Dexedrine for at least one month. He also told Lisotto that Provigil was the only medication for narcolepsy that Prime would accept.

After that, Lisotto’s drug test results came back and he was told by one of Prime’s nurses that he couldn’t work for Prime because of his positive test result for Dexedrine. He was then told to return home and take Provigil for six weeks to see how it would affect him.

Lisotto did exactly that.

But when he reached out to New Prime again to inquire about becoming a driver, he was shut down.

Eventually, he received a letter from New Prime’s medical review officer that said:

“Even though you had a prescription for amphetamines, in my opinion you have a disqualifying medical condition since narcolepsy is a safety concern.”

ADA claim

Lisotto then filed a disability discrimination lawsuit under the ADA.

New Prime fought to get his lawsuit dismissed, claiming that Lisotto was required to first seek administrative recourse with the Federal Motor Carrier Safety Administration, which is tasked with resolving “conflicts of medical evaluation” where the physician for a driver and the physician for the motor carrier disagree on a driver’s qualifications.

But the court said there was no such disagreement here. It said both parties’ physicians indicated that as long as Lisotto took proper medication, he appeared qualified.

Instead, it said the breakdown occurred when New Prime’s medical review officer failed to communicate with Lisotto’s physician to determine whether there was a legitimate medical reason to take his failed drug test at face value.

In other words, the biggest problem for New Prime was it cut off talks with Lisotto’s doctor and relied solely on the failed drug test to deny him a job without looking deeper into whether he could still do the job.

As a result, the court ruled Lisotto’s ADA lawsuit could proceed despite his failed drug test, which means New Prime is facing a costly lawsuit or settlement.

Cite: Lisotto v. New Prime Inc.

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New analysis recommends responsible prescription of opioids to pain patients

https://www.sciencedaily.com/releases/2016/07/160713102505.htm

A recent review and analysis suggests that some policies restricting opioid prescriptions to curb overdose deaths could be harming those who need them the most: pain patients.

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Every week I see a few new Face Book pages focused on chronic pain and at least one new petition to the White House, Congress are some bureaucratic entity.  While all these groups are fighting for the same final goal… no one seems to understand that thousands of voice – not in concert – just sounds like a ROAR of NOISE.

All those dozens of petitions… and most get a few thousand signatures at most.. the only one that I know about that got over 100,000 signatures was to recall the head of the DEA.. and that was months ago.. and to the best of my knowledge the DEA has the same leader.

Just look at the many groups that should be advocating/protecting those in the chronic pain community.

AARP… they are suppose to look out for those 50+… estimated guess is that at least HALF of the reported 100-116 million chronic pain pts… would fall into the 50+ age range.. and where is the AARP speaking up for their members and/or age group they are suppose to be supporting ?

ACLU… is suppose to defend civil liberties… other than taking the AG and Medical Licensing board of Indiana to court over emergency rule of mandatory urine testing for all pts taking opiates. Turned out that was a violation of the 4th Amendment

ADA… the Civil Rights Division of the DOJ, plus there are many states that have their own ADA laws. Nearly all of the activity I have seen enforcing this law has been dealing with those people who are HIV+, ethnic groups and those in the LGBT community.

The legal/attorney community, how many times a day do you see an attorney advertising on TV, wanting to sue someone for causing a accident and causing someone else pain and suffering. Yet, I have not seen the first incident of an attorney suing a healthcare professional INTENTIONALLY causing a pt pain and suffering because they reduced the pt’s dose and/or refused to fill their prescriptions.

40+ Governors to sign Massachusetts-inspired opioid prescription compact

Included in that number is Trump’s VP pick Gov Pence.. but don’t that let you decide that Hillary is the one… she has endorsed the one cent per mg opiate tax proposed by WV’s Senator. Everyone at the Federal/State level seems hell-bent on making the CDC opiate guidelines the “law of the land”.

If there are 100-116 million chronic pain pts out there, IMO.. they need to get their act together. The chronic pain community doesn’t need more leaders/advocates than they have those willing to follow.

Maybe it is time for a new “silent majority”… a new T.E.A. party (Tortured Enough Already) and the first order of business is to get organized and vote all the incumbents out of office with this fall’s election.

If the 99% that normally get reelected… get reelected.. the path to reduced opiates for all chronic pain pts has been put in place… another two years allowing that plan to be implemented may make it too long to reverse changes already in place.

They don’t feel your pain… throwing them out of office and letting them find a “real job” will be the first step in sharing your pain.  Their replacements will be so paranoid that they will start listing to their constituents… because if their constituents cleaned house once… it can be done again..

You can register to vote by mail and vote by mail… The only valid reason you can have for not voting is if you can’t make it to your mailbox or you don’t  have the money to buy two postage stamps.

Vote as if your life depended upon it

The only other alternative is to start suing to get your life back, I believe that voting will be the fastest and least expensive path to take.

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