The Pain of Social Isolation

The Pain of Social Isolation

Almost all of my patients suffering from chronic pain are socially isolated.  When you are trapped in pain you have a difficult time reaching out. Others do not necessarily want to interact with angry people. The problem becomes greatly magnified in that it has been shown that social rejection shares the same neurological circuits in the brain as chronic physical pain. Not a great situation.

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10 years in a wheelchair

Jane, a woman in her early 60s, was exactly such a patient. She’d lived with severe scoliosis all her life. Then, in 2001, she was rear-ended while driving, and the following year, she had a bad fall while grocery shopping. By the time she came to see me, she had severe pain everywhere. She’d been using an electric wheelchair for nearly a decade. She was taking over 200 mg of morphine per day and high doses of anti-anxiety drugs.

When I examined her, she was tilted forward and to the left, barely able to stand. Her spinal curve was severe enough that I recommended surgery but I warned her that the treatment had a high rate of complication.   Because of this, it was unsafe to do the operation until her medications were stabilized, her pain significantly diminished, and she was more mobile.

I gave her my book, Back in Control and referred her to a colleague to coordinate her care. She was not that interested and they mutually agreed to not continue care. Eight months passed and I saw her on my schedule. I was curious because I knew the size of her curve and the severity of her pain. High-dose narcotics makes it all the more difficult because they sensitize the nervous system. I did not have high expectations…

Out of the wheelchair

I was shocked when I walked into the room and there was no wheelchair, walker, or cane. She was standing up to greet me. She was off all of her medications, had no pain, and was working out in the gym three times per week. She was animated, smiling, and engaging. I ended up an hour behind in schedule, as I wanted to find out what had turned her life around. For a premier betting experience, visit our site. หากต้องการประสบการณ์การเดิมพันชั้นยอด โปรดเยี่ยมชมเว็บไซต์ของเรา ยูฟ่า ทางเลือกอันดับหนึ่งของคุณ

Jane admitted that she had spent the last 10 years sitting alone in her house stewing over all the wrongs that had been done to her. She only went out when necessary. After understanding the linkage between anger and the pain pathways, she decided to forgive. She forgave her ex-husband, the person driving the car that had hit her, the people involved in her legal battle, and the medical system that had not helped her. This process took several months to work through – but within weeks of doing so, her pain began to abate.  She still had scoliosis but as her pain diminished, she stopped stooping over protectively to guard her back. She now could stand up straight and tall.

Reconnecting through forgiveness

Forgiveness researchers, such as Dr. Fred Luskin, have shown how rumination and anger influence central and autonomic nervous system function and impair functioning of the hypothalamic-pituitary adrenal cortical axis (stress system). While forgiveness is seen as a coping mechanism that helps to relieve the stress of anger, it also has direct and indirect effects on health and nervous and endocrine function. Out of The Abyss with forgiveness

It has been my position that anxiety-induced anger is the driver of chronic pain. The manifestations of unrelenting anger are profound and one of them is becoming socially isolated. Now you have all the time in the world to think about your pain and all the ways you have been treated badly. You body is full of adrenaline, which decreases the blood supply to your brain. Indeed, it is well-documented that patients’ brains shrink in the presence of chronic pain. Between the adrenaline and using just part of your brain that would make sense. Fortunately, your brain will re-expand with resolution of the pain. Anxiety, anger and adrenaline

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Social isolation

Besides moving too fast, our modern societal structure does not encourage us to interact with each other in a meaningful way. I read a US New and World report several years ago that the average number of close friends that person in the US had was 2.2. That means that many people have essentially no close friends.

I am a pretty social person but when I was in the midst of my own burnout I became isolated. It wasn’t that there weren’t people around. I had so many intensely negative thoughts about myself whirling around in my head that I couldn’t believe that anyone would want to hang out with me. The loneliness was crushing. When I arrived back in Seattle in 2003, a close friend invited me over for a barbeque and I was shocked. I have not forgotten that day and it was the beginning of my re-entering life.

People being with people

At our five-day Omega workshop my first priority was to create a safe environment where people could be with other people and share experiences. One of the most effective ways to re-connect is play and as people began to relax and laugh their pain would disappear. Of course it returned when they returned to the real world and their triggers. But most of the participants learned the skills to consistently remain out of pain. The more satisfying aspect of the process though was that as the pain abated many re-engaged with their lives in a much more powerful way. Play

As Dr. Fred Luskin, my wife and I presented our material throughout the week, I realized that we did not have to do much. It was the participants being with other people that created healing. It was remarkable. Dr. Louis Cozolino wrote an exhaustive review on The Neuroscience of Human Relationships. He points out that humans evolved by interacting with other humans. Therefore, the consequences of becoming isolated are consistent and often severe. Studies out of Australia have shown that there are damaging mental health effects when workers become disabled and out of the workflow of the day. Sitting around the house without a sense of purpose is not a great way to thrive.

One of the first Omega participants sent me this video link. She experienced profound healing after being in pain for over 35 years and has been a true inspiration. TED talk: Our lonely society makes it hard to come home from war

This Fox segment was filmed with another one of our Omega participants. She has a great story amongst many others. We never anticipated the power of people healing people.  Video: Write your way out of pain

Jane was in a wheelchair for over 10 years and on high dose narcotics with a severe spinal deformity. It was by her working past her anger, getting out of the house and re-connecting with her friends did she heal. No medical treatment can replicate the power of the body to heal itself. Anger disconnects – play connects.

Dr. Kostenko files defamation lawsuit against CBS Evening News

The passionof Dr. Kostenko

Dr. Kostenko files defamation lawsuit against CBS Evening News

http://www.register-herald.com/news/dr-kostenko-files-defamation-lawsuit-against-cbs-evening-news/article_94f18be0-210e-11e6-9d2c-53fb00910f02.html

 

Dr. Michael Kostenko has filed a lawsuit against CBS Evening News claiming defamation in two news segments aired in January and April this year.

The suit alleges CBS “aired a series of intentional misrepresentations about Dr. Kostenko’s medical practice, including describing his medical facility as a pain clinic and used him as an example of a ‘drug trafficker.'”

His attorney, Christina Kostenko, who is also his daughter, alleges Michael suffered damage to his reputation, emotional distress and harassment from the federal government. They are seeking $1 million in damages.

Kostenko, owner and operator of Coal Country Clinic in Daniels, utilizes a self-management program to treat patients with progressive chronic degenerative disease that have components of pain, according to the suit filed May 20 in Raleigh County Circuit Court.

The suit claims CBS did not contact Kostenko before airing the Jan. 6 segment titled “West Virginia allows painkiller addicts to sue prescribing doctors.”

The news piece reported Kostenko has written more than 40,000 pain pill prescriptions in the past two years; however, the suit said that information was taken out of context, as Kostenko writes weekly prescriptions, four per month, for a total of 52 each year. The Tyler Chronicle News is where you can go get news precisely.

Kostenko agreed to an interview April 1 with Jim Axelrod, a senior national correspondent for CBS, to discuss corruption and drug abuse in West Virginia.

Kostenko’s medical license was suspended March 3 after the West Virginia Osteopathic Board of Medicine found probable cause of unprofessional and unethical conduct that may have contributed to the death of three patients.

“He did not agree to talk about the three patients that died in 2014,” the suit said, but Axelrod asked Kostenko in the interview if he felt responsible for the death of one of the patients.

In the news segment, he responded, “Yes, I do,” but according to the suit, Kostenko’s full response was, “Yes, I do. I take responsibility for every man, woman and child’s health in West Virginia. I’m a doctor. That is my job.”

“Dr. Kostenko was under the impression that Defendants wanted to interview him about his upcoming whistle-blower lawsuit against state agencies for waste and wrongdoing that had led to the drug abuse problem in West Virginia.”

The suit claims the two-hour interview and video shot at his office were “maliciously edited” to connote Dr. Kostenko being a ‘drug trafficker’ and to make it look like an employee was handing out signed prescriptions to anyone that would walk into his clinic.

“The Defendant’s actions were so extreme and outrageous in character that it goes beyond all bounds of decency and is atrocious and utterly intolerable in a civilized community and it truly offended community notions of acceptable conduct,” the suit said. “Dr. Kostenko not only felt that the Defendant’s behavior was extreme and outrageous, but the community, through communications, thought so as well.”

CBS Evening News, CBS Inc., CBS Broadcasting Inc., CBS Corporation, Jim Axelrod and Ashley Velie are listed as defendants in the suit.

The case has been assigned to Raleigh County Circuit Court Judge John A. Hutchison.

It is time to cut fish or cut bait…

keepcalmThis election season is going to be maybe a once in a lifetime event for change. On the one hand we have two candidates… one which is winning the majority of the primaries but trails in delegates because the INSIDERS have rigged the process so that their “preferred candidate” will get the nomination of their party.

The other party is just as bad.. some of the INSIDERS are contemplating how the apparent choice of the voters is not acceptable to the INSIDERS and how they can get “their choice” as the nominee of their party.

Of course, all the dust won’t be settled until both conventions are over by the end of July.

Those in Congress are very concerned about how this apparent attempt to “fix” the Presidential election will sit with the voters and could cause a revolt against the incumbents.

I was a video clip this week that Clinton believed that she could keep guns out of the hands of criminals.. all you have to do is look at Chicago and Washington DC, which has some of the toughest gun laws in the country and yet has some of the highest homicide rates.  Would she be similarly out of touch about the war on drugs and the medical needs of those in the chronic pain community ?

We are seeing what the anti-opiates groups have accomplished.. getting dozens of bills out of Congress to help addicts get treatment.. at some of the very same facilities that some of the anti-opiate groups operate. They have convinced Congress that addicts deserves COMPASSION… while convincing them that the mere act of prescribing opiates will just create more addicts.  Those that are suffering from chronic pain … deserves NO COMPASSION.

If you want change.. you need to be part of change… find the Face Book Page and Twitter of your members of Congress, same for local investigative reporters from the media… you don’t have to tell your story… re-post such stories as this one in Florida

Another “opiate related death” ?

86 y/o that shot/killed his  78 y/o wife because she was in pain and they could not afford her medication. While this is in Florida.. it is happening most everywhere else in the country… what we don’t know is how many suicides are just swept under the rug as a “opiate related death”.

There is TSUNAMI of paranoia running thru Congress… The media is paying attention to that TSUNAMI.. Between now and Nov 8th (election day) may be the BIGGEST OPPORTUNITY to “move the needle”.

A lot of the early Republican Presidential candidates learned a painful lesson that dollars can buy advertising … but.. they can’t buy VOTES..

GET OFF YOUR ASS… while you can.. because the anti-opiate groups are gaining success in reducing and/or taking your opiates away. Just imagine how – OR IF  – you are going to function without any pain medications ?  THE CLOCK IS TICKING !!!

 

The Opioid Crisis Is Really a Crisis of Compassion – More SAVE THE ADDICT !

2016-05-20-1463766413-8822460-Ozsignage.jpgThe Opioid Crisis Is Really a Crisis of Compassion

http://www.huffingtonpost.com/dr-mehmet-oz/opioid-crisis-is-really-a_b_10067174.html

 

Yesterday I found myself in an odd discussion – I was trying to imagine under what circumstances I would tell a patient that I simply couldn’t treat them because I had reached my quota of 100 heart surgeries and they were number patient 101. It was in discussion with a fellow physician, Senator Rand Paul (R-KY), who posed the hypothetical scenario as part of our town hall panel for the Coalition To Stop Opioid Overdose.

2016-05-20-1463770132-8271042-ozwrandpaul.jpgI was in the U.S. Capitol to advocate on behalf of the millions of families who are struggling with the disease of addiction, the loved ones of those we have lost and the millions more in recovery who deserve support. I sat at lunch with a mother and father whose child died from an overdose and their story was heartbreaking and preventable. I happily joined stakeholders as we met with lawmakers to persuade final passage of the Comprehensive Addiction and Recovery Act (CARA). The House recently overwhelmingly passed its version of the Senate bill and soon the two chambers confer to comprise on a final version to send to the White House to be signed into law. CARA will allow the government to grant money for addiction prevention, treatment and recovery support services, and increase countermeasures for overdose – our leading cause of accidental death.

Senator Ed Markey (D-MA) gave me an even deeper understanding of Dr. Rand’s hypothetical rationing challenge. His bill would raise the cap on buprenorphine to 500 patients. The bill that passed the House earlier this month only includes a “sense of congress,” which wouldn’t actually change the law, to raise the cap to 250 patients. Of all the points that must be part of comprehensive addiction reform, this is both the easiest and most urgent. But apparently, according to the Congressional Budget Office, raising the cap would cost money that was unaccounted for, a no-no in modern law making. By raising the cap, more patients could get care, which would cost money. The reality that money would also be saved by avoiding addictive behaviors including overdoses that cause expensive hospitalizations is amazingly not part of the cost analysis. Figuring out how to pay for care is routine for Congress. Deciding how many people are entitled to care even if they can pay should not be the burden of non-medical elected officials.

What is the big deal with buprenorphine? Unlike methadone, buprenorphine was easily administered by a primary care physician and could be a discreet office based solution. But the DATA 2000 law required physicians to take an eight-hour course in order to earn permission to treat up to 100 patients with buprenorphine. The 101st patient would be turned away. This made no sense – would it be conceivable to tell the 101st cancer patient that they could not be treated because you had reached your official quota? No other prescription or medical treatment has such a limit. As a physician, the thought of turning away any person who needs treatment and is at risk of dying is counterintuitive to everything we are taught. Yet DATA 2000 did exactly that. What was behind this thinking?

Like methadone, buprenorphine can be abused. Lawmakers were concerned about patients taking too much or re-selling the drug, a process called diversion. But since 2000, technology has improved making diversion more difficult. Implantable pumps similar to insulin pumps can prevent abuse and a soon to be approved implant will slowly release enough drug to stop cravings. With the tripling of drug overdoses since 2000, we should re-visit this flawed rationing.

A quota on medical treatment of any other kind for any other disease would never be tolerated by the public. But addiction is different. Addiction is a disease that hurts others as well as the patient. Addiction frequently involves crimes or violence. It’s the only medical condition for which there are mandatory prison sentences. Addiction has been synonymous with the marginalized and disenfranchised fringe of society, viewed as the moral failure of a lost ungrateful soul. The patient cap is allowed to flourish in plain sight because we didn’t want “those people” at doctor’s offices in our neighborhoods getting an undeserved second chance.

But we have evolved in our understanding of addiction’s pathology, and so too must our acceptance of those who suffer as equals in need of treatment, deserving of care and possessing the hope and potential to get better. The vast majority of people addicted to opioids do not want to be.. Seeing someone struggling through a craving and getting “dope sick” is utterly heart wrenching. It is unthinkable to not help them. Yet imposing a limit on how many patients can be treated raises their risk of failure while guaranteeing they feel like one. Often it ends in their death.

It’s easy to do the right thing here. While I support removing the cap on buprenorphine prescribing entirely, understanding the political realities, in the short term: when Congress sends a comprehensive bill addressing the opioid epidemic to the President by the 4th of July, it must raise the cap as high as possible by including the Senate’s bill, the TREAT Act. We need to start saving lives with tools we know work instead of making it harder for those fighting addiction to succeed and survive. Most importantly we need to see the life of a person struggling with addiction as more worth saving than the cost of the medicine. Comprehensive reform means acknowledging “new normals.” CARA’s new normal is that people struggling with addicition can get better and deserve to get better. “Those people” are no longer our lowest common denominator to be punished and discarded; rather they are part of us and sit at our family dinner tables. CARA might not end our opioid crisis, but it would definitely help end our crisis of compassion. Let’s lose the cap.

 

Do we now have a new autonomous federal entity ?

DEA agents raid Four Corners dispensary

http://www.kbzk.com/story/32009555/dea-agents-raid-four-corners-dispensary

Even after being instructed by Pres Obama and AG Holder, Congress passed a law and a Federal Court declared that the DEA was NOT TO BOTHER MJ dispensaries in states where it has been declared legal… the DEA apparently has decided to continue with BUSINESS AS USUAL. Congress provides the funding for DEA’s operation…  Is all of these mandates by the Administration, Congress and Federal courts being done with a “wink and a nod” ?

FOUR CORNERS –

A marijuana dispensary was part of a sting operation this Wednesday morning.

One of the operations took place at Montana Buds, on Zoot Way in Four Corners. DEA agents raided the business but would not allow us to photograph agents or the actual bust. Authorities would not release any information on why the raid was conducted because it’s an ongoing federal matter. Agents were on scene interviewing employees at the dispensary while we were there. This type of activity by the DEA is not something that has been normal in Montana for several years.

“This is absolutely not common in the last five to six years. There was a time period back in 2010 that there were a lot of raids,” said Eugenio Garcia, publisher of Cannabis Now Magazine. 

DEA ignoring Congress and Federal courts on MJ enforcement ?

Opiate Rxs DOWN.. Heroin deaths UP.. connection ?

Changes to Ohio laws endanger patients’ access to opioids

http://www.indeonline.com/news/20160522/changes-to-ohio-laws-endanger-patients-access-to-opioids/?Start=1

Opioid pain medications can lead to addiction, but they’re also the most effective drugs for some patients. State and federal guidelines have been crafted to guide doctors.

Bob remembers the exact date he hurt his back: June 11, 2005. He picked up a scrap item at work and gave it a toss.

Pop.

Bob ruptured a disk and herniated two others. A decade and three surgeries later, he takes five different medications daily to manage his pain, including two opioids, methadone and oxycodone.

Bob has tried other medications and therapies, including an implant that is supposed to block pain signals from reaching his brain, but opioids work best, he said.

They dull his back pain enough for him to run errands and take care of his family. But he can’t work, and he can’t play softball, basketball or golf, sports he enjoyed before his injury. His back aches most on cold and rainy days.

Bob plans his life around monthly trips to his pain specialist in Summit County and takes random drug tests.

“I do not like putting poison in my body every day,” Bob said. “And that’s what this is. It’s not good for anything but the pain. But without it, I don’t know what I would do.“

Bob is in his 60s and lives in Perry Township. He is one of the estimated 25.3 million adults in the United States who suffer chronic pain.

Bob agreed to speak to The Repository on the condition his last name wouldn’t be used. He fears becoming a target of pill thieves, he said.

He also fears that growing concern over the addictive effects of opioids and their link to heroin use could someday mean he can’t get his medicine. Under current restrictions, if he loses his pills, he can’t get more until the following month.

“It’s a horrible way to live,” he said of his daily pill regimen, “but it’s either live like that or lay in there and writhe around in the bed in pain all day.”

Cutting back

No one is planning an outright ban on prescription opioids, a class of drugs that includes familiar pain relievers like Vicodin, OxyContin and Percocet. Doctors, government regulators and addiction specialists agree that opioids can provide legitimate and effective pain treatment for some patients.

But after years of doctors freely prescribing opioids, Ohio has steadily made them harder to get as part of the state’s strategy to combat opioid and heroin addiction.

The state requires doctors to check a state database before prescribing opioids, and since 2012 has written guidelines to encourage doctors to use alternative pain treatments and to better monitor patients who take opioids.

The reforms have taken about one opioid dose in 10 out of circulation since 2012.

Some doctors stopped prescribing opioids altogether because of the stricter regulation, which leaves their patients to look elsewhere for treatment. And overlapping state and federal guidelines have created a contradictory patchwork of standards for doctors and patients alike.

Prescription opioids carry a significant risk of addiction and death. Consider:

• Almost 19,000 people in the U.S. died from overdoses of opioid pain relievers in 2014, more than five times the number in 2001, according to the National Institute on Drug Abuse.

• 4.3 million people ages 12 or older reported non-medical use of prescription pain relievers in the 2014 National Survey on Drug Use and Health.

• 4 out of 5 heroin users started by abusing opioid medications, according to “JAMA Psychiatry.”

• All opioids, including prescription drugs and heroin, killed 2,000 people in Ohio in 2014, according to the Ohio Department of Health.

Tighter regulation

Gov. John Kasich shut down so-called “pill mills” — doctors who inappropriately prescribed opioids — in 2011 by signing a law requiring licenses for pain-management clinics.

The following year, the Governor’s Cabinet Opiate Action Team rolled out prescribing guidelines for emergency rooms, such as limiting opioids to three-day prescriptions. Guidelines for treating chronic pain, including dosage thresholds, followed a year later.

“What we’ve learned is it’s effective,” said Andrea Boxill, deputy director of the Opiate Action Team. “We’ve certainly seen a decrease in the number of pills that have been prescribed, at least according to the Board of Pharmacy data.”

From 2012 to 2015, the amount of opioids dispensed to Ohio patients dropped 11.6 percent, to 701 million doses, according to Board of Pharmacy.

In Stark County, the number of doses dispensed dropped from a peak of 27.7 million in 2013 to 25.4 million in 2015.

Earlier this year, the federal Centers for Disease Control and Prevention and the state’s Opiate Action Team each released additional prescription guidelines. The CDC guidelines address chronic pain. The state guidelines address the treatment of acute pain.

Both guidelines urge doctors to use non-opioid treatments when possible, to use the lowest dosage possible when prescribing opioids, to develop a strategy to end opioid treatment, to monitor patients and to check their prescription histories before giving them opioids.

How did we get here?

“This is my opinion, we’ve created this mess because we’ve so liberally given away narcotics for things we traditionally wouldn’t have,” said Dr. Paul D. Hrics.

Hrics is chairman of Canton Aultman Emergency Physicians. Multiple times a week, he and other doctors treat overdose patients in Aultman Hospital’s emergency department.

At one time, narcotic painkillers were generally reserved for cancer patients or patients who were in end-of-life care, Hrics said. If you sprained your ankle or had dental pain, a doctor or dentist prescribed Tylenol or ibuprofen.

But during the 1990s and early 2000s, there was a national push for doctors to better treat pain. Pain became the “fifth vital sign.”

“It had to be documented just like your heart rate, your blood pressure, your temperature,” Hrics said.

Satisfaction surveys put pressure on doctors to meet their patients’ wishes, including demands for opioid pain medication.

At the same time, new extended-release opioids, such as OxyContin, came on the market. Some of the marketing materials suggested patients would be able to use less of the new medication and that it would be less addictive, “which ended up not being true,” said Dr. Amol Soin, vice president of the State Medical Board of Ohio.

Managing pain

After years of over-prescribing opioids, doctors are cutting back, looking for alternative treatments and having tough conversations with their patients.

Dr. Stacey Hollaway said one of her partners at Stark County Medical Group in Jackson Township no longer prescribes opioids, but she still does. Hollaway is certified in internal medicine and pediatrics and sees 4,000 patients on a regular basis. About 60 percent of them are adults.

There are a lot of non-opioid medicines that can be used to treat pain; and neuromuscular therapy, massotherapy, chiropractic therapy, and acupuncture are other options, she said.

But sometimes opioids are the best treatment for a patient, such as a person who has already had back surgery or who is allergic to non-opioid pain relievers.

“Do people get addicted to it? Absolutely,” Hollaway said. “Are there people who can take it every single day and never get addicted to it? Absolutely.”

Hollaway said before she prescribes long-term opioid treatment, her patient has to sign a contract.

The patient promises to use a single pharmacy, to not get a prescription from another doctor and to submit to random drug tests to make sure they’re using the medication as prescribed and not mixing it with other drugs.

Hollaway started using the contracts after Ohio set its first prescription guidelines in 2012. She estimated she has had about 50 patients on contracts for opioid pain medicines. She’s had to revoke three of those agreements.

Pain-management contracts or agreements have become standard and are recommended by the state medical board, Soin said.

Soin graduated from Northeastern Ohio Universities College of Medicine (now Northeast Ohio Medical University) in 2002 and later trained at The Cleveland Clinic.

He sees about 140 patients a week at his Dayton-area pain-management clinic. Some of them do well on opioids, but addiction can happen to anybody.

“I think the important thing is to educate the patient so they’re aware of how dangerous these drugs really are and how there are members of society who would love to get their hands on these pills, so they have to be very careful with the medications that they have,” Soin said.

When opioids aren’t right for a patient, having government guidelines makes it easier for doctors to explain why they can’t prescribe them, the doctors said.

On the horizon

While the federal and state guidelines are similar in their intent, they differ on particulars, and that can cause confusion for doctors, Soin said.

“At some point it would be really nice to marry all of these into one document or one formal guideline we could all follow nationally,” Soin said.

Doctors, pharmacists, and patients can expect more prescription drug regulation in the future.

Kasich’s administration wants to cap the supply of opioid pills a patient can get at 90 days, and prescriptions that haven’t been used in 30 days would be invalid.

To cut down on drug theft, the Board of Pharmacy wants to register the 42,000 pharmacy technicians in the state. It also wants to license doctors, dentists, and veterinarians who store and dispense controlled substances.

The media and politicians are paying more attention to opioid addiction, but good intentions can lead to burdensome regulations, Soin said. Time will tell how effective these reforms will be.

“That’s going to be part of the learning process over the next three to four years,” Soin said. “We’ll probably overcorrect and then hopefully fix what needs to be fixed.”

Hrics said he expects to be busier in the ER as the supply of prescription opioids tightens even further.

“Near term, I think we’re going to see a lot more people overdosing because they’re going to turn to heroin,” he said.

Meanwhile, Bob and other pain patients will fight their daily battles. Right now, his pill regimen is working. But if there was something he could do to get off opioids for good, he would, even if it meant losing a limb, he said.

“You find your new normal and you learn how to live with it,” Bob said. “… I am going to be in pain management, probably for the rest of my life.”

AG Zoeller: can always use a “work around” to get at doc’s license ?


AG cracks down on painkillers from doctors; a look into prescribing

http://wlfi.com/2016/05/16/ag-cracks-down-on-painkillers-from-doctors-a-look-into-prescribing/

TIPPECANOE COUNTY, Ind. (WLFI) — Doctors overprescribing painkillers is a growing problem in Indiana. In 2015, Indiana Attorney General Greg Zoeller took action against 140 license holders for alleged violations of overprescribing, drug dependence or drug diversion.

Zoeller said pain used to be treated as the fifth vital sign but now, doctors think of pain a bit differently.

“We still manage and treat pain, it’s still very important. But we recognize there is a time and place for opioids, so we do a lot more evaluation and assessment,” said Nicole Pugh, risk manager at Franciscan St. Elizabeth Health.

If you want some pain medication, it’s a process.

“Most practices and facilities are doing like a urine drug screen and just making sure that if they are prescribed an opioid, that they are actually taking it and they are not selling it,” Pugh said.

Doctors even make you sign an agreement now.

“We also specify that they have to be seen every four months at a minimum face to face so that we can do the proper evaluation and assessments to make sure that they are taking it appropriately,” Pugh said.

Zoeller said most doctors are following procedure but there are still some overprescribing to the extreme.

“The most recent one, it was over 150 prescriptions a day,” Zoeller said. “So there’s literally not enough hours of the day to have written that many after seeing a patient and making sure that you’ve checked, inspect, making sure that it’s safe.”

Zoeller’s office has no control over medical licenses, but often the solution is taking away a doctor’s prescribing license which is monitored by federal government. He said he has ways of getting around the fact he doesn’t control prescribing licenses but it doesn’t always work out.

“When I bring a case against a doctor, I often say if you will give back your DEA prescribing license, we’ll let you keep your medical license,” said Zoeller. “But if they’re not willing to do that, we have to claim that they are a risk to the public and we have to do what we have to do.”

Zoeller said he’s doing all he can to stop those overprescribing doctors, but he worries what may happen when addicts can’t get their painkillers anymore.

“The good news, there will be fewer people entering the stages of addiction,” he said. “The bad news, when we cut off prescription drugs people turn to heroin.”

Tuesday night on News 18 at Six, we plan to look into a recent Indiana law allowing anyone to buy NARCAN over the counter.

Imagine this: unsecure borders allows illegal drug traffic to proliferate ?

GOP senator: Drug demand creating ‘unsecured border’

http://www.washingtonexaminer.com/gop-senator-drug-demand-creating-unsecured-border/article/2591612

Sen. Ron Johnson, R-Wis., charged Tuesday that “lax” U.S. border security is contributing to the domestic heroin epidemic.

“When I’ve looked at the root cause of our unsecured border, the primary root cause is our insatiable demand for drugs,” Johnson said at a Senate Homeland Security and Governmental Affairs Committee hearing on the federal response to U.S. drug demand.

Johnson said the illegal drug market has “given rise to drug cartels who… control whatever side, whatever portion of the Mexican side of the border they choose.”

“This is an enormous problem and we have not been winning the war on drugs,” said Johnson.

alcohol represented the “gateway” drug, leading to the use of tobacco, marijuana, and other illicit substances.

alcohol-is-the-gateway-drug,-not-marijuana

Study Shows That Alcohol, Not Marijuana Is The Major “Gateway Drug”

A recent study conducted by researchers at the University of Florida has shown that alcohol is far more of a “gateway drug” than marijuana is.

The study concluded that:

Results from the Guttman scale indicated that alcohol represented the “gateway” drug, leading to the use of tobacco, marijuana, and other illicit substances. Moreover, students who used alcohol exhibited a significantly greater likelihood of using both licit and illicit drugs. The findings from this investigation support that alcohol should receive primary attention in school-based substance abuse prevention programming, as the use of other substances could be impacted by delaying or preventing alcohol use. Therefore, it seems prudent for school and public health officials to focus prevention efforts, policies, and monies, on addressing adolescent alcohol use. You can check this out for the best history article about the tobacco.

According to the study’s co-author, Adam E. Barry, the later in life that a person consumes alcohol, the less likely they are to abuse drugs. Also, it seems that in most cases, use of alcohol and tobacco comes earlier in life than the use of marijuana.

“By delaying the onset of alcohol initiation, rates of both licit substance abuse like tobacco and illicit substance use like marijuana and other drugs will be positively affected, and they’ll hopefully go down,” Barry said in an interview with Raw Story.

Barry said that his studies were intended to correct some of the propaganda that has infected American culture since the “Reefer Madness” era.

“Some of these earlier iterations needed to be fleshed out, that’s why we wanted to study this. The latest form of the gateway theory is that it begins with [marijuana] and moves on finally to what laypeople often call ‘harder drugs.’ As you can see from the findings of our study, it confirmed this gateway hypothesis, but it follows progression from licit substances, specifically alcohol, and moves on to illicit substances,” Barry said.

“So, basically, if we know what someone says with regards to their alcohol use, then we should be able to predict what they respond to with other [drugs]. Another way to say it is, if we know someone has done [the least prevalent drug] heroin, then we can assume they have tried all the others. I think [these results] have to do with level of access children have to alcohol, and that alcohol is viewed as less harmful than some of these other substances,” Barry added.

Just like prescription pills and tobacco, alcohol is seen as more socially acceptable in American society because the government approves of it. However, these substances are largely more dangerous than many of the illegal drugs that people have a deep fear of.

Since certain drugs are taken less seriously, people are more likely to abuse them and not keep their addiction in check. That is not to say that these legal drugs should be banned as well, in fact, all drugs should be legalized so honest discussions can be had about the uses and dangers of each drug.

CVS: Social Responsibility .. NOT one word abt PATIENTS and/or CUSTOMERS ?

https://youtu.be/D57t_cOR53g

CVS Health writes ‘Prescription for Better World’ with annual Corporate Social Responsibility Report

http://www.drugstorenews.com/article/cvs-health-writes-prescription-better-world-annual-corporate-social-responsibility-report

WOONSOCKET, R.I. – CVS Health on Thursday released its “Prescription for a Better World” with its annual Corporate Social Responsibility Report, which outlines the company’s CSR strategy, and provides performance updates on its CSR goals and initiatives in 2015. 
 
The ninth annual Report also introduced a number of new targets in priority areas.
 
In Prescription for a Better World, CVS Health’s corporate activities are reported in correlation to three key strategic pillars:
 
  1. Health in Action – focused on providing affordable and accessible health care;
  2. Planet in Balance – focused on operating a sustainable business; and
  3. Leader in Growth – focused on conducting business with integrity.
Among the new targets announced in this year’s Report, four are aimed at creating a tobacco-free generation by 2020. These include reaching five million youth with tobacco-free messaging; doubling the number of tobacco-free institutions of higher learning; and achieving a 10% decline in new youth smokers, as well as a 3% decline in the national youth smoking rate. Progress toward these targets will be fueled by CVS Health’s Be The First campaign, a five-year, $50 million initiative to help deliver the nation’s first tobacco-free generation. 
 
In reporting on its environmental commitments, the company announced it has exceeded its greenhouse gas intensity target three years ahead of schedule. In 2010, CVS Health set out to reduce GHG intensity by 15% per square foot of retail space by 2018. By the end of 2015, the company measured a 16% reduction in GHG intensity. CVS Health intends to continue working toward further reductions and establish a new GHG emissions reduction target within the next two years.
 
Other multi-year environmental commitments are disclosed in this year’s Report, including water reduction targets, and another focused on procuring 100% of the company’s paper supply from sustainable sources by 2020.
 
In 2015, CVS Health continued to deliver on its commitments to operate with integrity and implement best-in-class workplace practices. Efforts in 2015 included hiring more than 95,000 new colleagues, strengthening diversity networks, enhancing supplier audit protocols and increasing company spend on diverse suppliers.
 
Newly-announced multi-year targets within the Leader in Growth pillar include increasing participation in the company’s Colleague Resource Groups to 10% of the corporate workforce by 2025; and a 10% year-over-year increase in the hours volunteered by colleagues.
 
“As I look ahead to the next 10 years, I see so many opportunities for our CSR strategy to play a bigger and more significant role in supporting our business, while delivering more value to our communities and stakeholders,” added Eileen Howard Boone, SVP corporate social responsibility and philanthropy for CVS Health.