State restrictions not associated with reduced opioid misuse among disabled adults

http://www.clinicaladvisor.com/pain-information-center/opioid-prescriptions-among-disabled-adults-unaffected-by-state-laws/article/509047/

Controlled substance laws are not associated with reductions in hazardous opioid use or overdose among disabled Medicare beneficiaries, according to research published in the New England Journal of Medicine.

Ellen Meara, PhD, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, and colleagues, analyzed the associations between prescription-opioid receipt and state-level controlled-substance laws. Data were collected for disabled Medicare beneficiaries between the ages of 21 and 64 who were alive between 2006 and 2012 (8.7 million person-years). The researchers examined the annual prevalence of beneficiaries with 4 or more opioid prescribers, prescriptions yielding a daily morphine-equivalent dose (MED) greater than 120 mg, and treatment for nonfatal prescription opioid overdose, and estimated how opioid outcomes differed based on 8 types of state-level laws.

Between 2006 and 2012, states added 81 controlled substance laws. In 2012, 47% of Medicare beneficiaries filled opioid prescriptions, 8% had 4 or more opioid prescribers, 5% had a daily MED greater than 120 mg, and 0.3% were treated for nonfatal prescription opioid overdose.

“We observed no significant associations between opioid outcomes and specific types of laws or the number of types enacted,” concluded Dr Meara. “For example, the percentage of beneficiaries with a prescription yielding a daily MED of more than 120 mg did not decline after adoption of a prescription drug monitoring program.”

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Democrats Unite, But What Happened To ‘Medicare For All’?

http://khn.org/news/democrats-unite-but-what-happened-to-medicare-for-all/

Just think about it… back in when we were trying to put together Obamacare. There existed two perfectly good national systems – Medicare & Medicaid… but.. Congress had to create a whole different costly infrastructure… creating another set of rules and hiring abt 12,000 IRS agents to make ACA function from the financial side.

They claim that there would be winners and loser in a single payor system.. and some of those BIG LOSERS would be the insurance industry.. because if the government is paying all the bills… why would there be a need for an insurance company ?  Of course, the insurance industry has one of the largest war chests to funding lobbying efforts.

IMO… the more that we have had middlemen trying to help our society save money while providing better healthcare to everyone.. the more expensive it all gets. Are all these middlemen creating a on-going mirage of saving money while in fact diverting more and more of our healthcare dollars to fund their infrastructure and generate a profit to keep their stockholders and the stock market happy.

Just how much of the THREE TRILLION spent on our healthcare.. is being wasted on needless middleman infrastructure and/or how many – if not all – people in our society could be provided with their needed healthcare needs ?

After a raucous debate lasting nearly a year, the Democrats are united on health care. But that unity does not include a call for a single-payer “Medicare for all” health system.

“This campaign is about moving the United States toward universal health care and reducing the number of people who are uninsured or under-insured,” Sen. Bernie Sanders (I-Vt.) said Tuesday in endorsing his rival Hillary Clinton, the presumptive Democratic presidential nominee.

Sanders did win a few health care concessions in the negotiations leading to the endorsement. Clinton vowed to support more funding for community health centers and access to a “public option” government insurance plan, which she has supported in the past.

But on Sanders’ top health priority — his “Medicare for All” plan — there was not a word. At the Democratic Platform Committee meeting over the weekend, an amendment to add a single-payer plan to the document was defeated.

It wasn’t much of a surprise.

Most health policy analysts — including those who are sympathetic to the idea — say moving from the current U.S. public-private hybrid health system to one fully funded by the government in one step is basically impossible. And that’s making a huge assumption that it could get through Congress.

“To try to do it in one fell swoop would be massively disruptive,” said Paul Starr, a professor at Princeton who was a health policy adviser to President Bill Clinton.

The U.S. health care system, said Jeff Goldsmith, a health care consultant and health futurist, is “the size of a country — it’s bigger than France — and it employs 16 million people.”

In moving to a single-payer system, he said, “you’re talking about reallocating $3 trillion, reducing people’s incomes and creating” in effect a single entity that would set prices for all medical services. Single-payer supporters dispute the idea that getting from here to there could not be done.

“We’re so used to such a complicated system in the U.S. that we envisage any change would be incredibly complicated as well,” said Steffie Woolhandler, a physician and one of the founders of the single-payer advocacy organization Physicians for a National Health Program. “But what you’re doing with single-payer is actually simplifying the system.”

For example, said Woolhandler, “the latest data is U.S. hospitals are spending 25 percent of their total budget on billing and administration, and hospitals in single-payer nations like Canada and Scotland are spending 12 percent.”

But while a single-payer system would undoubtedly produce efficiencies, it would also bring huge disruptions. Said Starr, single-payer supporters “haven’t worked through the consequences.”

One of the biggest is exactly how to redistribute literally trillions of dollars. The problem, said Harold Pollack, a professor at the University of Chicago, is that the change will create losers as well as winners.

“Precisely the thing that is a feature for single-payer proponents is a bug for everyone who provides goods and services for the medical economy,” he said, since their profits — and possibly their incomes — could be cut.

And it’s not just the private insurance industry (which would effectively be put out of business) that could feel the impact to the bottom line. Parts of the health care industry that lawmakers want to help, like rural hospitals, could inadvertently get hurt, too. Many rural hospitals get paid so little by Medicare that they only survive on higher private insurance payments. Yet under single-payer, those payments would go away and some could not make it financially. “You would not want to wipe out a third of the hospitals in Minnesota by accident,” Pollack said. “And you could,” if payments to hospitals end up too low.

There are also questions about how feasible it would be to have the federal government run the entire health care system. “It’s hard to be nimble” when a system gets that big, said Ezekiel Emanuel, a former health adviser in the Obama administration now at the University of Pennsylvania. “No organization in the world does anything for 300 million people and does it efficiently.”

To try to do it in one fell swoop would be massively disruptive.

The politics of Medicare — which serves roughly 50 million Americans — already make some things difficult or impossible, he said, pointing to a current fight in which doctors and patient advocacy groups blasted a proposal to move to a more cost-effective way to pay for cancer drugs. “You already can’t do certain things in Medicare because of the politicization,” he said. ”When you cover the whole country, it would be a lot of gridlock.”

Pollack agreed, and pointed out it’s not just the health care industry that could revolt. When the Affordable Care Act was rolled out in 2013, he said, “the people who couldn’t keep their old plans — a very tiny number as a percent of Americans” were furious. “We saw how difficult that was and how angry the public was when that promise wasn’t kept. Now imagine the major shift we’d have to do to move to a single payer system.”

There’s also the question of whether it’s simply too late to go back to the health care drawing board.

Single-payer supporter Woolhandler insists it is not. “Other nations have gone to single-payer systems,” she said. “It usually can be done in about a year.”

The last industrialized country that did the switch was Taiwan, in the mid-1990s. Taiwan, however, with its 23 million residents, has a population larger than New York and smaller than Texas, and had no existing private health insurance system at the time.

“What I’ve often said is we could have done this in the 1940s when Harry Truman proposed it,” said Starr, who has written at length on the history of American health politics. “Health care at that point was probably about 4 percent of [gross domestic product] and there existed at that time a relatively small private insurance industry.” Today health care spending in the U.S. is approaching 18 percent of the nation’s GDP and the private health insurance industry accounts for half a trillion dollars per year.

Both Starr and Pollack, however, said it would be possible to make a switch, although it would have to be carried out over a very long period of time.

“You could imagine some kind of long transition, where you gradually expanded Medicare,” said Starr, “for example moving it down to age 55” and then in later years continue to lower the age threshold.

But even if the U.S. did manage to execute a single-payer system, said Pollack, it would likely prove problematic, particularly in how it would be financed.

“The major value of a single-payer system would be to help the bottom third of the income distribution, and that means the top 20 percent of the population will have to pay more,” he said. “I’m actually in favor of that, but let’s not kid ourselves. That’s a knife fight that’s going to be had.”

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Billings medical marijuana patient faced with leaving Montana to treat “excruciating pain”

http://www.ktvq.com/story/32430890/billings-medical-marijuana-patient-faced-with-leaving-montana-to-treat-excruciating-pain

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Governors to sign Massachusetts-inspired opioid prescription compact

http://www.politico.com/states/massachusetts/story/2016/07/nga-members-signing-ma-modeled-opioid-prescription-compact-103787

BOSTON – More than 40 governors are agreeing to double down on efforts to fight the opioid epidemic through tweaks to the opioid prescription process that are modeled on findings from Massachusetts’ opioid working group.

Those tweaks are enumerated in the Compact to Fight Opioid Addiction, which represents the first time in more than ten years that National Governors Association members have developed a contract to spur coordinated action on a national health issue.

The same day Baker arrives in Iowa, he will brief the press on the NGA’s work on the opioid epidemic, followed by a panel hosted by Baker and New Hampshire Gov. Maggie Hassan, the health and human services committee co-chair, about fighting the opioid epidemic. The panel will also include US Secretary of Health and Human Services Sylvia Burwell.

“Bringing governors together around core strategies to end the opioid epidemic adds momentum behind state efforts and sends a clear signal to opioid prescribers and others whose leadership is critical to saving lives,” Baker said in a statement released today. “Massachusetts is proud to bring our plans to the table for other states as we work collaboratively to find meaningful solutions to this public health crisis.”

The Massachusetts-connected recommendations in the compact include social media efforts like Massachusetts’ “state without stigma” and Good Samaritan advertisements, integrating prescription data for primary medical providers, ironing out opioid prescription guidelines, and creating opioid prescription education around athletic programs.

This compact was the result of a vote during the NGA’s winter meeting to create a set of guidelines for opioid prescriptions.

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The state knows where medical errors are harming patients. But it won’t tell you.

The Pennsylvania Patient Safety Authority tracks troubling “events” to help healthcare providers improve, but keeps its data under lock and key.

http://publicsource.org/investigations/state-knows-where-medical-errors-are-harming-patients-it-won-t-tell-you

Last year, 253 people in Pennsylvania died under circumstances for which a medical professional may have been responsible.

The state knows where these deaths happens — which hospitals, care homes and other medical facilities — but it doesn’t allow you to know.

The agency tasked with keeping data on medical errors and related issues in the the state is the Pennsylvania Patient Safety Authority. It collects hundreds of thousands of reports a year from designated safety officers of medical facilities.

Ninety-seven percent of the roughly 239,000 incidents recorded in 2015 were “near misses,” lapses in safety protocol that were noticed, but did not harm a patient.

More than 7,700 reports recounted “serious events,” in which a patient was harmed. More than half of these cases were complications related to procedures, treatments and tests. Medication error, adverse drug reactions and patient falls, among other issues, made up the rest.

If you want to find out how your local hospital fares on medical errors, the authority can’t help you. The law that created the agency mandates it keeps its reports under lock and key, beyond the reach of the usual ways journalists and lawyers obtain public records in Pennsylvania.

The medical world is growing more aware of the magnitude of medical errors. A study published in The British Medical Journal in May estimated that medical errors are the third-leading cause of death in the United States, behind heart disease and cancer. Yet the agency charged with tracking them in Pennsylvania does its number crunching in the dark.

Medical errors reported in PA, 2005-2015

Classified

The 2002 law creating the state’s Patient Safety Authority dictates that it only releases its data as statistics.

The statute — the Medical Care Availability and Reduction of Error Act, referred to as the “MCare” law — shields incident reports from subpoena in lawsuits and the Right to Know law that enables Pennsylvanians to request many kinds of public records from the state. The names of doctors and others involved are also omitted from reports before they go to the authority.

Did the state ever take corrective action over a “serious event?” That’s also confidential.

Though the two agencies are separate, the Pennsylvania Department of Health reviews reports of infrastructure failures and serious events submitted to the Patient Safety Authority and looks for evidence a state or federal law was broken, according to a department spokesperson.

If there is reason to suspect that’s the case, the department launches an investigation. As for how many they conduct per year, into whom, and what the results were, the public can’t know that either.

“The statute does not permit the department to release information that makes clear when a report to the Patient Safety Authority has resulted in an investigation,” Holli Senior, a special assistant to the department’s secretary, wrote in an email to PublicSource.

Human error

Heart disease is the culprit in one in every four deaths. Cancer took more than 591,000 lives in 2014.

According to researchers at Johns Hopkins University, the next leading cause of death is medical errors. That would put medical error above respiratory diseases, accidents and diabetes.

“Human error isn’t on there but getting run over by a cow is.”

It’s an estimate because “medical error” is not a category on death certificates in the United States. The certificates are based on the International Classification of Diseases.

That index was written before awareness of medical negligence as a major issue, according to Dr. Michael Daniel, co-author of the report. “Human error isn’t on there but getting run over by a cow is,” he notes.

Like the authors of a report on error that shook the medical establishment in 1999, Daniel and Dr. Martin Makary used a synthesis of past reports to calculate the prevalence of medical error in the United States.

The 1999 report, the Institute of Medicine’s “To Err is Human: Building a Safer Health System,” found that, “At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented.”

Daniel and Makary’s 2016 report puts the fatality rate at 251,000 per year.

‘We are not a watchdog’

When Dr. Rachel Levine took the position of state physician general in January 2015, becoming the chair of the Patient Safety Authority’s Board of Directors came with it. She stresses that autonomy is important to maintain the non-punitive, data-gathering role of the authority.

A medical facility’s safety officer, usually a nurse, should feel comfortable reporting all the incidents he or she is mandated to report to the authority without thinking it could come back to harm his or her employer, Levine said.

“I think the idea is to increase facilities’ reporting,” she said, adding, “We want to work with them to help improve patient safety. We are not a watchdog.”

The authority standardized forms for facilities in April 2015 to improve consistency in reporting. The 253 deaths reported in 2015 represent a 22 percent increase in fatalities from 2014, when 208 deaths were reported as stemming from potential medical errors. The authority attributes the increase, in part, to the change in reporting.

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Meanwhile, there are other, more transparent ways that the Department of Health maintains patient safety, said Wes Culp, deputy press secretary. He points to the hospital, nursing care facility and healthcare-associated infection reports available on its website. Also, licensing boards review the conduct of medical professionals.

Regina Hoffman, executive director of the Patient Safety Authority, stresses the need for a “free flow of information.” She said information gathered by the authority has led to efforts to lessen patient falls and pressure ulcers, common problems that were revealed by the data.

Hoffman said it’s crucial that safety officers don’t think they are building a bad reputation by noting lapses in protocol, the ones that don’t involve harm to a patient and make up the majority of reports the authority gets. “It’s very important they are not fearful of reporting,” she said.

Making patient safety data and these reports publicly available isn’t the same as publishing restaurant health and safety violations cited by inspectors, Hoffman said.

Medical providers self-report to the authority. If one hospital has more reports than another, it doesn’t necessarily mean the hospital is lax about patient safety, she said; it could mean the facility takes patient safety more seriously.  

“We would not want to judge a facility by the number of near misses,” Hoffman said. “A good facility is going to report a lot.”

The history of the MCare law

The 2002 MCare bill that created the authority was passed in response to the Institute of Medicine’s 1999 bombshell report on medical errors, which began starkly: “Health care in the United States is not as safe as it should be — and can be.”

Legislators in Pennsylvania began crafting an overhaul of the state’s medical safety and malpractice policies. A major facet of the MCare bill was the establishment of a fund that acted as a kind of state insurance program for people deemed in court to have been injured by medical negligence.

It is financed by surcharges to healthcare providers. What providers are charged each year is based on assessment rates at the Joint Underwriting Association, an insurance industry group. If payments to harmed patients fall lower than expected, facilities get a refund.

The creation of the MCare law “involved a legislative battle between proponents of more protections for patients against proponents of more protections for medical care providers,” attorney Clifford A. Rieders wrote in a 2005 article for the Pennsylvania Bar Association Quarterly.

Gradually, the bill became softer on patient safety, Rieders concluded.

Proposed regulations that would have benefitted patients, he wrote, were removed in legislative committees, including one that would have levied a penalty for altering or destroying medical records.

As part of the overhaul, healthcare providers were required to report an array of incidents to the newly created Patient Safety Authority, which would use them to compile data and make recommendations that would decrease medical errors — and with that the fees to the MCare fund.

Progress and protocols

Deaths from medical error in Pennsylvania have declined from 453 in 2005 to 253 in 2015.

Large healthcare systems also have internal protocols for reducing errors.

Number of reported deaths from medical errors, 2005-2015

*The 253 deaths reported in 2015 represent a 22 percent increase in fatalities from 2014. The Pennsylvania Patient Safety Authority attributes the increase, in part, to the change in reporting.

Source: Pennsylvania Patient Safety Authority 2015 annual report

Dr. Sam D. Reynolds, chief quality officer of Allegheny Health Network, said the conglomeration of hospitals and practices has its own data collection process. In addition to the state-mandated safety officer, each AHN facility has a quality director, and a network of committees and officers review safety data.

UPMC’s chief quality officer, Tami Minnier, said all reports of errors or safety concerns at the network are tracked internally through a software program, and “anyone with a UPMC badge” can make a report. This includes custodians and cafeteria workers. “Sometimes they notice things no one else would,” Minnier said. A committee meets weekly to review the reports.

Daniel, co-author of the recent study, said the issue is not that healthcare systems don’t care or that doctors are trying to hide mistakes.

“The issue,” he said, “is that we haven’t been talking about this like heart disease or cancer or other preventable causes of death because it’s new.”

As the medical field expands and people interact with it more, more errors will happen. It’s one reason Daniel feels human error should be added as a category on death certificates; it would move the issue to the forefront of medical professionals’ minds and may lead to more safeguards to prevent common errors.

“We didn’t always have screenings for heart disease and cancer,” Daniel said, “but we realized the extent of the problems and started. We need to have similar systematic efforts against human error.”

Nick Keppler is a Pittsburgh-based freelance writer who has written for Mental Floss, Vice, Nerve and the Village Voice. Reach him at nickkeppler@yahoo.com.

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HHS announces new actions to combat opioid epidemic

http://www.hhs.gov/about/news/2016/07/06/hhs-announces-new-actions-combat-opioid-epidemic.html

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‘Wino Round Up’ in Wolf Point sparks civil rights lawsuit

http://www.greatfallstribune.com/story/news/local/2016/07/12/mass-detentions-wino-round-spark-civil-rights-lawsuit/87016378/

A civil rights complaint filed in federal District Court on Monday alleges that officers from the Wolf Point Police Department and the Fort Peck Department of Law and Justice engaged in a mass detention of Wolf Point’s “street people,” who were denied basic civil rights and were held in unsanitary conditions including prolonged exposure to the sun and rain and a lack of adequate bathroom facilities.

The mass detentions allegedly began July 12, 2013. The complaint alleges that anyone identified as homeless, a “wino” or a drug addict was forcibly taken into police custody but never charged with a criminal offense, was not read their Miranda rights, was never booked into jail and was not given the opportunity to consult with legal counsel.

The complaint, filed on behalf of 31 plaintiffs who were subjects of the mass detention, names multiple defendants, including the mayor of Wolf Point, the entire 2013 membership of the Fort Peck tribal executive board, former and current law enforcement officials and several other tribal officials. It details a coordinated effort to clear Wolf Point’s streets of any street people prior to the 2013 Wild Horse Stampede, an annual event in Wolf Point that draws large crowds from outside the Fort Peck Indian Reservation.

GREAT FALLS TRIBUNE

The crisis in our backyard: Montana’s reservation housing

 The “Wino Round Up” was allegedly ordered by members of the Fort Peck tribal executive board, and began shortly before noon July 12, 2013.

“The Law and Justice Committee told the police officers … ‘Do something about these homeless street people during the Wild Horse Stampede Rodeo,’” said Mary Cleland, a tribal court lay advocate who is assisting the plaintiffs in the case. “They didn’t even issue any paperwork. They verbally told the captain of the police, ‘Get them out of sight. Put them anywhere, and don’t charge them.’”

The complaint states that approximately 50 men and women were handcuffed and crowded into vehicles during the midday hours of July 12, 2013. Many were hauled 33 miles to the Fort Peck Adult Detention Center in Poplar and held there until the following morning.

“… The combined police forces of the city and tribe’s policing officers on the street did not charge, book or make records of their activities and therefore did not identify many of the persons incarcerated,” the complaint states. “The identity of the city’s arresting officers was likewise hidden.”

The complaint also states that during the “Wino Round Up,” some of the officers detaining Wolf Point’s street people openly referred them as “prairie n——.”

“They just went around grabbing people like they were animals,” Cleland said.

Fort Peck tribal officials did not immediately respond to a Tribune request for comment on the allegations.

Anna Rose Sullivan, city attorney for Wolf Point and deputy county attorney for Roosevelt County, said she could not immediately comment on the complaint because she had not yet reviewed a copy of it, but that both the city of Wolf Point and Roosevelt County officials take the allegations very seriously.

Reba Demarrias, a 55-year-old tribal member from the Wolf Point area, is the lead plaintiff in the case. Demarrias said she is not a street person or an alcoholic but was swept up with the first group of people who were handcuffed and forcibly taken just an hour or so before the start of the Wild Horse Stampede’s parade.

She said that she and 10 other people were crowded into a single vehicle and taken to the adult detention center in Poplar.

“We couldn’t breathe, and we could barely move around,” Demarrias recalled of the half-hour drive to Poplar. “There wasn’t no kind of windows or anything. I didn’t know where we were going or where they were taking us. No one would talk to us. I sat there with my head between my legs trying to get air, because were so stuffed in there.”

The sweep of Wolf Point’s streets was so successful that the tribal jail was quickly filled beyond capacity, overwhelming the facility’s physical and human resources, the complaint states.

The detainees were separated according to gender, then herded into two outdoor recreation areas enclosed by chain-link fences. Each measured approximately 20 feet by 20 feet and were without access to permanent bathroom facilities.

“Everybody was screaming and crying,” Demarrias said. “After a while they came in with two or three trays of goulash. There wasn’t very many. The older ones just gave the food to all the young ones and kind of sheltered them there – trying to calm them down.”

Demarrias said the jail staff told the women that were not being detained, that “they were just being held.”

“The incarcerated plaintiffs were kept without medical treatment, prescription medications prescribed by their physicians, water or toilet facilities,” the civil rights complaint states. “Women were provided a blanket and a pot in which to relieve themselves. Men were instructed to urinate through the fence. Some of the male plaintiffs will testify that they were unable to get near the fence and so were forced to ‘piss or s— their pants.’”

“That day was hot,” Cleland said. “People were passing out from heat exhaustion. They were not fed properly, they were not given mattresses or jail uniforms. They went in their street clothes and they just threw them in there like dogs in a chain-linked exercise court exposed to the elements.

“There was feces all over the basketball court because there were no bathroom facilities,” she added. “One man got heat exhaustion and laid in feces. It’s just an atrocity, and nobody wants to listen.”

Jail staff allegedly made a limited attempt to shelter the detainees from the summer sun, covering at least a portion of each of the exercise yards with large plastic tarps. But a thunderstorm blew in in the evening hours, tearing away the tarps and exposing the detainees to the wind and rain.

After nightfall, the women were taken inside the detention center. The men were housed in a small, windowless garage. The detainees were released the next morning beginning at about 6 a.m.

Reacting to numerous personal accounts of the “Wino Round Up,” Cleland sent a letter to U.S. Attorney General Eric Holder requesting the intervention of the U.S. Civil Rights Commission and a formal investigation into the actions of the Fort Peck tribal executive board, the Wolf Point Police Department and the Fort Peck Department of Law and Justice.

In April 2014, Special Agent Angela King from the Bureau of Indian Affairs’ Internal Affairs Division questioned many of the individuals involved in the “Wino Round Up.” King declined a Tribune request for additional information, saying that she is prohibited from granting any public interviews on the matter. She directed all inquiries regarding the IAD’s investigation to the BIA’s public affairs specialist in Washington, D.C.

However, the Tribune has obtained an abbreviated and heavily redacted copy of King’s report, which reveals that several police officers involved in the “Wino Round Up” expressed concerns about the action’s legality.

“On April 15, 2014, IAD (Internal Affairs Division) interviewed Lieutenant (name deleted),” King’s report states. “Lt. (name deleted) proffered that the corrections officers were told that they would be detaining the ‘street people’ for twenty-four hours. Lt. (name deleted) advised that she protested that this was wrong, that holding these individuals without formally charging them would be violating their civil rights. Lt. (name deleted) asserted ‘I knew this would come back and bite everyone in the ass.’”

King’s report goes on to say that the unidentified female lieutenant expressed her concerns to her immediate superior, but was told, “if I wanted to keep my job I was to follow orders.”

A second IAD interview with the shift supervisor on duty during the “Wino Round Up” reveals similar concerns within the Wolf Point Police Department.

“Sgt. (name deleted) related that he received a phone call from Captain (name deleted) advising that the council was asking the community be cleaned up for the upcoming Wild Horse Stampede. Cpt. (name deleted) informed that the ‘local wino’s/tree people’ were to be picked up, and that there was a resolution in place.”

The captain allegedly told his sergeant that “everything was OK” and that “both corrections and the prosecutor were on board.”

The sergeant subsequently called a police department lieutenant and told the superior officer “that this ‘round up’ did not seem right to him, that ‘it was wrong to just pick people up who are drunk and lying around.’ Lt. (name deleted) concurred that this did not seem right to him either.”

The IAD report goes on to state that the Wolf Point police captain told his concerned sergeant that he would not have to complete paperwork on the mass detentions because the people being picked up “were just being held to sober up.”

King’s report was filed with the Bureau of Indian Affairs office in Bismarck, North Dakota, on Oct. 9, 2014. The civil rights complaint states that King “found in favor of the winos” but did nothing to remedy the abuses.

The case has been referred to U.S. District Court Judge Brian Morris. No further court proceedings had been scheduled as of Tuesday afternoon regarding the complaint.

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As everyone knows, often many people… and all to often bureaucrats don’t consider the unintended consequences and/or collateral damage of implemented changes to the existing status quo.

Up front, I will admit that I am a firm believer in the fact that we need a better monitored/controlled access across our borders.

While Mexico’s border is the focal point  of Trump’s idea of closing our border. While our open southern Mexico border is probably a sizable point of entry of various undesirable people and things entering our country.

Our border with Mexico is about 2000 miles long… but we also have a 5500 mile border with Canada and 9500 miles of shore line. So our total border is 17,000 miles…  building a 2000 mile “WALL” between us and Mexico may only cause those trying to move illegal people or substances to attempt to use some part of the rest of our 17,000 miles of border to accomplish their intended goal.

Let’s presume that the “WALL” is successful in prohibiting the incursion of illegal products and people.. what are the potential consequences.

Right now we have Meth, MJ, Cocaine, acetylfentanyl and other illicit substances coming primarily from Mexico and China. What would happen if the “street supply” of these various substances are dramatically reduced because of  “The wall”. Of course, the first thing is that the price of all these substances will skyrocket.

Skyrocketing prices will probably cause a increase in pharmacy robberies and/or other criminal activity for all those addicts who have been getting “their fix” from street drugs and street vendors.

Perhaps, those who are looking for “closing our border” … need to first consider putting into place the necessary infrastructure to provide treatment to those with chronic pain and substance abuse.

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DEA, others raid drug counseling center

http://fox45now.com/news/local/dea-others-raid-drug-counseling-center

SPRINGFIELD (WRGT) — A drug counseling center was raided today, July 13, 2016, by the Drug Enforcement Administration (DEA).

Agents from several agencies were involved in the search at Reasonable Choices in Springfield.

It went on for more than six hours.

Agents carried out at least a dozen boxes from Reasonable Choices.

“I’ve never been in there . I heard it was supposed to be a good place but that’s all i heard about it,” said neighbor Zac Schwartz.

The Ohio Attorney General’s office, the Medicaid Fraud Control Unit, Ohio Board of Pharmacy, Ohio Medical Board, Springfield Police and the DEA were there for the raid.

“If the DEA is here, it’s been a lot longer investigation than probably anybody knows about so I’m glad to see they’re doing their work,” said Springfield resident Eric Mata.

Mata said his sister was once a client there.

“She would tell me how she would get insurance statements from her insurance company and they would bill for 90, 180 minutes of group counseling that she said she never sat in and when she asked about it, they said don’t worry about it,” said Mata.

The center’s director admits agents are investigating medicaid fraud.

She denies any wrongdoing

One Springfield man sings the praises of Reasonable Choices. He said he knows a lot of people who got help for their drug addiction from the place.

“I know my friends come here and I know they saved their lives because they ain’t doing no more heroin, said Springfield resident John Kuss.

“They do have treatment in there, they have counselors, I don’t care what you say, it’s saving people’s lives, said Kuss.

The director said the center has 350 clients.

Besides counseling, many also get suboxone, used to treat opioid dependency.

“It’s going to be a problem for people not getting their pills to get off the heroin because everybody’s dying off the heroin, said Kuss

The director said Reasonable Choices will open back up tomorrow.

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APhA warns new language and anti-discriminatory rules may impact pharmacy

http://www.drugstorenews.com/article/apha-warns-new-language-and-anti-discriminatory-rules-may-impact-pharmacy

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