“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Could this mean that more CVS Pharmacist “not being comfortable” filling controlled meds ?
BOSTON (AP) — CVS Pharmacy has agreed to pay $3.5 million to settle allegations that dozens of its Massachusetts pharmacies violated federal law by filling forged prescriptions for addictive painkillers and other controlled substances.
U.S. Attorney Carmen Ortiz announced the settlement with the Woonsocket, Rhode Island-based drugstore chain Thursday.
CVS says it entered into the agreement to avoid the expense and uncertainty of further legal proceedings.
Ortiz’s office says the settlement resolves two investigations by the Drug Enforcement Administration after reports of forged oxycodone prescriptions. One involved hundreds of forged prescriptions at 40 CVS stores in Massachusetts and New Hampshire. The other involved 120 forged prescriptions at 10 CVS stores in and around Boston.
CVS says it has tightened its policies and procedures to help its pharmacists determine whether a prescription is legitimate.
It really doesn’t matter when big business is involved.. be it for profit, non profit or governmental… You often have to wonder if what you see is the reality of it all or if there is some hidden agenda. If there is a hidden agenda, no one will every really know… unless legalities are involved and someone ends up getting caught with their hand in the cookie jar.
I have posted before about our judicial system’s apparent “addiction/dependency” on the 51 billion dollars that flow into the judicial system annually to fund the war on drugs.
I have posted about the fact that 43 % of the members of Congress are attorneys (170 House, 60 Senate) and how it would seem that – in general – will not do anything that will deprive the judicial system of any funding.. including failing to acknowledging what everyone considers how big a failure the war on drugs is in reality.
Sometimes, parts of a agenda can be intentionally or unintentionally hidden or can appear to have no association with the agenda at all. This is what could be happening right now. All of a sudden over the last few months there has seemingly been a “bum’s rush” to get a dose or two of Naloxone in as many pockets as possible. There seems to be no limit to the times that a substance abuser should or should not be revived. I have reports of a single person being revived TEN TIMES in one day.
There was a recent DEA report that opiate OD deaths have TRIPLED in FOUR YEARS.. There has been reports that acetylfentanyl from Mexico and China have been added/mixed with Heroin and since acetylfentanyl is 25 -40 times more potent than Heroin.. and as a result many people are dying from a overdose.
There has also been reports for tablets showing up on the west coast .. looking like Narco 10 (Hydrocodone/Acetaminophen 10/325) but in reality it is acetylfentanyl from Mexico or China or some mixture of Heroin and acetylfentanyl.. and more people are dying… Also reported that there has been tablets that appear to be Xanax (Alprazolam ) 2mg showing up on the west coast of Florida but also containing acetylfentanyl and/or mixed with Heroin and again people are dying.
Since the Harrison Narcotic Act of 1914 there has been an estimated 1%-2% of our population abusing some substance other than Alcohol and Nicotine.. the population of the USA back then was around 100 million as opposed to 330 million today.. It is now estimated that there are some 1.9-2.1 million serious substance abusers.. percent of the population has dropped dramatically since 1914 < 0.7 % and with the increased deaths from the acetylfentanyl and Heroin.. is the DEA/judicial system frighten that the serious substance abuser population could be dwindling ?
Does this help explain the “bum’s rush” to get a dose or two of Naloxone in as many pockets as possible ? Could this explain the change in the mindset of the politicians/bureaucrats that substance abuse is a “mental health issue” ? Could this explain the change in the nomenclature .. no more addicts.. no more junkies…just people who take opiates for whatever reason – both legal & illegal – are now being labeled as having a “opiate use disorder” ? And we no longer have accidental/unintentional drug OD’s… now we have deaths that are just a “opiate related death”. Doesn’t matter if their is a lethal amount of opiates in the toxicology report… any amount showing is enough to classify the death as “opiate related”
Then there is the CDC guidelines… wanting no one taking opiates longer than 90 days… with the estimated 106 million chronic pain pts.. there are going to be untold numbers – perhaps millions – that will be forced to go to “the street” to seek whatever pain relief that they can get.
Then there are proposed rule changes that will raise the number of Suboxone pts that a single prescriber can manage at any one time from 100 to 500.
Is it just me… or does it look like all those parties that are addict to the “war on drugs” money… are laying the ground work to make sure that the “substance abusers population” at least stays the same and possibly grows ?
12 Senate seats currently occupied by Senators that are “hard-headed” opposed to the legalization/decriminalization of MJ.. ARE UP FOR RE-ELECTION this fall !
At least 26 U.S. Senators are still dedicated to marijuana prohibition.
A fair amount of attention has been paid to presidential candidates’ positions on marijuana legalization this election cycle. However, United States Congress member stances have received far less coverage.
Considering Congress can amend federal marijuana laws and block executive action in many cases, their positions on marijuana and drug policy will play significantly into the outcomes of reform efforts.
Recognizing this, the National Organization for the Reform of Marijuana Laws (NORML) has gathered Congressional voting records and relevant member statements and compiled “Scorecards” that assign letter grades “A” through “F” to all Congress members.
Twenty-six serving U.S. Senators received failing grades from NORML this year.
“Guest Speaker, Ed Coghlan from the National Pain Report on Wednesday, June 29th, 2016 at 9:00 PM EDT
Live interview with Ed Coghlan from the National Pain Report on June 29th, 2016 at 9:00 PM EDT.
During this special event, we will be discussing a wide range of topics, followed by a question and answer segment where you will be able to ask questions directly to Ed.
This confuses me… yes to decriminalize/legalize all drugs/medications… allow prescribers to treat/maintain all people who need or abuse opiates.. provide pharmaceutical grade medications… Where do you draw the line between “education” and “talk therapy” or is there a “line “?
“For too long we’ve viewed drug addiction through the lens of criminal justice,” President Obama said yesterday at a conference in Atlanta. “The most important thing to do is reduce demand. And the only way to do that is to provide treatment—to see it as a public health problem and not a criminal problem.”
At least one expert totally disagrees. Earlier this month at South by Southwest Interactive (SXSWi), Columbia University neuropsychopharamacologist Carl Hart gave a talk called “Mythbusting the Drug War With Science” in which he explicitly made the case that the notion that “drug addiction is a health problem that requires treatment” is exactly the wrong way to look at the use of drugs in the United States.
“Politicians today, whether Republican or Democrat, are comfortable with saying that we don’t want to send people to jail for drugs; we will offer them treatment.” Hart said in Austin. But “the vast majority of people don’t need treatment. We need better public education, and more realistic education. And we’re not getting that.”
Why does he say most people don’t need treatment? Because—contrary to widespread perceptions—the vast majority of drug users aren’t addicts. “When I say drug abuse and drug addiction, I’m thinking of people whose psycho-social functioning is disrupted,” he said later in the talk. But for more than three-quarters of drug users (and we’re not just talking about marijuana here, either), that description doesn’t apply.
This overturns the conventional wisdom on drug addiction, but Hart thinks that’s a good thing. We’ve all been fed a diet of panic-inducing misinformation about what drugs actually do to our brains, he says.
Most of us were taught that drugs like cocaine are so addictive that a rat in a laboratory experiment will continue to press a lever to receive the substance—to the exclusion of all its other physical needs—until it actually dies. Hart said at first even he believed that finding to be true. But it turns out, those studies weren’t what they were cracked up to be.
“When you have the rat in a cage alone, and there’s nothing else for the rat to do, the rat will repeatedly choose to take cocaine,” he said. “That’s logical. If the only thing you had to do in your life was press a lever to receive cocaine, what are you doing? I hope you’re pressing for the cocaine.”
But if additional stimuli are introduced to the environment, the finding completely falls apart.
“When you enrich the rat’s environment such that you provide something like a sweet drink, or a sexually receptive mate, or some other alternative, the rat doesn’t repeatedly take cocaine,” he explained. “In fact, it’s difficult to get the rat to self-administer or press the lever to take cocaine if you provide the rat with food!”
When he tried to replicate the experiment with drug-addicted humans instead of rats, he found they too behaved logically, choosing, say, $20 in cash as opposed to a $10 hit of coke. “This ‘hijacking’ of the brain’s reward system, that’s a nice sexy metaphor,” he said. “But what we said was that cocaine addicts could not inhibit certain types of responses. They could not delay gratification. They had cognitive impairment such that they couldn’t engage in this long-term planning.” Yet repeatedly in tests, they did.
Once you realize that drugs don’t actually rewire people’s brains, making them unable to function, you can start to focus on things that matter more—like preventing overdoses. The way to do that, according to Hart, is through educational initiatives, not treatment programs.
“Now, if we are concerned about overdose deaths, we need to know how these people are dying,” he said. “The vast majority [75 percent] of people who die from a heroin-related overdose do so because they combine it with another sedative, like alcohol or benzodiazepines….The public health education message is simple: If you’re going to use heroin or another opioid, don’t combine it with another sedative.”
The message should obviously vary according to the substance in question and the population you’re trying to educate. When talking to young people about marijuana, for instance, we should teach them not to start out with large doses. “And if you do and you get anxious, be cool,” he said. “You’re going to be OK!”
The main problem with methamphetamines, meanwhile, is that they disrupt people’s sleep and reduce their food intake. “Sleep is probably the most important biological function. If you don’t get enough sleep, you can get psychiatric illnesses and all types of different illnesses,” he said. “So when I think about education with methamphetamines, you want to make sure people are sleeping. You want to make sure people are eating. You also want to make sure people understand the risks in terms of cardiovascular concerns: If you have a cardiovascular-compromised system, it’s probably not the drug for you.”
These are all examples of harm reduction, something Hart believes we need a whole lot more of. “We can help keep people safe,” he said. “We haven’t made much progress in this regard, but we’re pretending that we are more compassionate people…by saying that we’ll give them treatment.”
Maybe it is just a coincidence but Obama came to power in 2008 and Gov Scott & AG Bondi came to power in 2010… legal opiate Rxs peaked in 2012.. and the DEA has had an increasing war on prescribers/pts over the last 6 -7 yrs. There has been more Heroin deaths in the last FOUR YEARS than in the previous TWELVE YEARS. Maybe if we had a national policy to give proper treatment to those suffering from the mental health issue of addictive personality disorder we would have prevented tens of thousands unnecessary/preventable deaths. Over those four years we would have spend > 200 BILLION dollars fighting the war on drugs. Should Congress consider defunding the DEA’S war on drugs… if you believe this statistic … their failure is accelerating … do they even deserve a grade of F- ?
WASHINGTON – A new report from the U.S. Drug Enforcement Agency analyzing the nation’s ongoing heroin use health crisis says deaths involving heroin tripled between 2010 and 2014.
Other key facts in the report include:
– The number of people reporting current heroin use nearly tripled between 2007 (161,000) and 2014 (435,000).
– Deaths due to synthetic opioids, such as fentanyl and its analogues, increased 79 percent from 2013 to 2014.
The DEA was especially concerned about the recent phenomenon of fentanyl disguised as prescription opiate pills. The pills have been connected to the deaths of 19 people in Florida and California during 2016’s first quarter. Traffickers are exploiting high consumer demand for illicit prescription painkillers by producing inexpensive counterfeits that contain the highly potent fentanyl. In Baton Rouge, one man was convicted of pressing heroin into counterfeit prescription pill form in a similar profit-driven drug trafficking move.
“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,” said DEA Acting Administrator Chuck Rosenberg. “The problem is enormous and growing, and all of our citizens need to wake up to these facts.”
The DEA says the number of users, treatment admissions, overdose deaths and seizures related to the drugs increased over last year’s summary. Heroin was the greatest drug threat reported by 45 percent (up from 38 percent last year and 7 percent in 2007) of state, local and tribal law enforcement agencies that responded to a 2016 survey. Law enforcement agencies across the country reported seizing larger than usual quantities of heroin in 2016. An 80 percent increase of heroin seizures has been reported over the past five years.
I SHOT heroin and cocaine while attending Columbia in the 1980s, sometimes injecting many times a day and leaving scars that are still visible. I kept using, even after I was suspended from school, after I overdosed and even after I was arrested for dealing, despite knowing that this could reduce my chances of staying out of prison.
My parents were devastated: They couldn’t understand what had happened to their “gifted” child who had always excelled academically. They kept hoping I would just somehow stop, even though every time I tried to quit, I relapsed within months.
There are, speaking broadly, two schools of thought on addiction: The first was that my brain had been chemically “hijacked” by drugs, leaving me no control over a chronic, progressive disease. The second was simply that I was a selfish criminal, with little regard for others, as much of the public still seems to believe. (When it’s our own loved ones who become addicted, we tend to favor the first explanation; when it’s someone else’s, we favor the second.)
We are long overdue for a new perspective — both because our understanding of the neuroscience underlying addiction has changed and because so many existing treatments simply don’t work.
Addiction is indeed a brain problem, but it’s not a degenerative pathology like Alzheimer’s disease or cancer, nor is it evidence of a criminal mind. Instead, it’s a learning disorder, a difference in the wiring of the brain that affects the way we process information about motivation, reward and punishment. And, as with many learning disorders, addictive behavior is shaped by genetic and environmental influences over the course of development.
Scientists have documented the connection between learning processes and addiction for decades. Now, through both animal research and imaging studies, neuroscientists are starting to recognize which brain regions are involved in addiction and how.
The studies show that addiction alters the interactions between midbrain regions like the ventral tegmentum and the nucleus accumbens, which are involved with motivation and pleasure, and parts of the prefrontal cortex that mediate decisions and help set priorities. Acting in concert, these networks determine what we value in order to ensure that we attain critical biological goals: namely, survival and reproduction.
In essence, addiction occurs when these brain systems are focused on the wrong objects: a drug or self-destructive behavior like excessive gambling instead of a new sexual partner or a baby. Once that happens, it can cause serious trouble.
If, like me, you grew up with a hyper-reactive nervous system that constantly made you feel overwhelmed, alienated and unlovable, finding a substance that eases social stress becomes a blessed escape. For me, heroin provided a sense of comfort, safety and love that I couldn’t get from other people (the key agent of addiction in these regions is the same for many pleasurable experiences: dopamine). Once I’d experienced the relief heroin gave me, I felt as though I couldn’t survive without it.
Understanding addiction from this neurodevelopmental perspective offers a great deal of hope. First, like other learning disorders, for example, attention-deficit hyperactivity disorder or dyslexia, addiction doesn’t affect overall intelligence. Second, this view suggests that addiction skews choice — but doesn’t completely eliminate free will: after all, no one injects drugs in front of the police. This means that addicts can learn to take actions to improve our health, like using clean syringes, as I did. Research overwhelmingly shows such programs not only reduce H.I.V., but also aid recovery.
The learning perspective also explains why the compulsion for alcohol or drugs can be so strong and why people with addiction continue even when the damage far outweighs the pleasure they receive and why they can appear to be acting irrationally: If you believe that something is essential to your survival, your priorities won’t make sense to others.
Learning that drives urges like love and reproduction is quite different from learning dry facts. Unlike memorizing your sevens and nines, deep, emotional learning completely alters the way you determine what matters most, which is why you remember your high school crush better than high school math.
Recognizing addiction as a learning disorder can also help end the argument over whether addiction should be treated as a progressive illness, as experts contend, or as a moral problem, a belief that is reflected in our continuing criminalization of certain drugs. You’ve just learned a maladaptive way of coping.
Moreover, if addiction resides in the parts of the brain involved in love, then recovery is more like getting over a breakup than it is like facing a lifelong illness. Healing a broken heart is difficult and often involves relapses into obsessive behavior, but it’s not brain damage.
The implications for treatment here are profound. If addiction is like misguided love, then compassion is a far better approach than punishment. Indeed, a 2007 meta-analysis of dozens of studies over four decades found that empowering, empathetic treatments like cognitive behavioral therapy and motivational enhancement therapy, which nurture an internal willingness to change, work far better than the more traditional rehab approach of confronting denial and telling patients that they are powerless over their addiction.
This makes sense because the circuitry that normally connects us to one another socially has been channeled instead into drug seeking. To return our brains to normal then, we need more love, not more pain.
In fact, studies have not found evidence in favor of harsh, punitive approaches, like jail terms, humiliating forms of treatment and traditional “interventions” where families threaten to abandon addicted members. People with addictions are already driven to push through negative experiences by their brain circuitry; more punishment won’t change this.
In line with the idea that development matters, research also shows that half of all addictions — with the exception of tobacco — end by age 30, and the majority of people with alcohol and drug addictions overcome it, mostly without treatment. I stopped taking drugs when I was 23. I always thought that I had quit because I finally realized that my addiction was harming me.
But it’s equally possible that I kicked then because I had become biologically capable of doing so. During adolescence, the engine that drives desire and motivation grows stronger. But unfortunately, only in the mid-to-late 20s are we able to exert more control. This is why adolescence is the highest risk period for developing addiction — and simple maturation may be what helped me get better.
At the time, nearly all treatment was based on 12-step groups like Alcoholics Anonymous, which help only a minority of addicted people. Even today, most treatment available in rehab facilities involves instruction in the prayer, surrender to a higher power, confession and restitution prescribed by the steps.
We treat no other medical condition with such moralizing — people with other learning disorders aren’t pushed to apologize for their past behavior, nor are those affected by schizophrenia or depression.
Once we understand that addiction is neither a sin nor a progressive disease, just different brain wiring, we can stop persisting in policies that don’t work, and start teaching recovery.
Indeed, if the compulsive drive that sustains addiction is directed into healthier channels, this type of wiring can be a benefit, not just a disability. After all, persisting despite rejection didn’t only lead to addiction for me — it has also been indispensable to my survival as a writer. The ability to persevere is an asset: People with addiction just need to learn how to redirect it.
People with arthritis have twofold higher suicide rates than the general population, according to new research from the University of Toronto.
Investigators analyzed data from the 2012 Canadian Community Health Survey – Mental Health, which included 4,885 individuals with arthritis and 16,589 without arthritis, looking for “factors associated with ever having attempted suicide.”
The study results showed that one in 26 men with arthritis had lifetime suicide attempts, compared with one in 50 in the general population. The lifetime prevalence of a suicide attempt was 5.3% in women with arthritis, compared with 3.2% in the general population. Even after adjusting for age, income, chronic pain and history of mental disorders, the odds of a suicide attempt in individuals without arthritis was still 46% lower than in those with arthritis.
“When we focused on adults with arthritis, we found that those who had experienced chronic parental domestic violence or sexual abuse during their childhood, had more than three times the odds of suicide attempts compared to adults with arthritis who had not experienced these childhood adversities,” said lead author Esme Fuller-Thomson, Sandra Rotman Endowed Chair in the Factor-Inwentash Faculty of Social Work and Institute for Life Course & Aging at the University of Toronto, in a press statement. “The magnitude of these associations with suicide attempts was comparable to that associated with depression, the most well-known risk factor for suicide attempts.”
Co-author and doctoral student, Stephanie Baird, cautioned that the cross-sectional nature of the survey did not allow the researchers to establish causality.
“We do not know when the arthritis began nor when the suicide attempts occurred,” she said. “It is possible that other factors that were not available in the survey may confound the relationship.” She cited, for example, that childhood poverty has been strongly linked to both the development of arthritis and suicide risk. Other risk factors include a history of drug or alcohol dependence, anxiety disorders, younger age, and poverty and low education.
The paper was published online in the journal Rheumatology International (2016 Jun 14. [Epub ahead of print]).
