Bill Text

• Text of H.R. 4641

To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes. (as reported)

Union Calendar No. 412

114

TH CONGRESS

2

D SESSION H. R. 4641

[Report No. 114–536]

To provide for the establishment of an inter-agency task force to review,

modify, and update best practices for pain management and prescribing

pain medication, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

F

EBRUARY 26, 2016

Mrs. B

ROOKS of Indiana (for herself and Mr. KENNEDY) introduced the

following bill; which was referred to the Committee on Energy and Commerce

M

AY 3, 2016

Additional sponsor: Mr. O

LSON

M

AY 3, 2016

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed

[Strike out all after the enacting clause and insert the part printed in italic]

[For text of introduced bill, see copy of bill as introduced on February 26, 2016]

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HR 4641 RH

A BILL

To provide for the establishment of an inter-agency task

force to review, modify, and update best practices for

pain management and prescribing pain medication, and

for other purposes.

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HR 4641 RH

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Be it enacted by the Senate and House of Representa2

tives of the United States of America in Congress assembled,

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SECTION 1. DEVELOPMENT OF BEST PRACTICES FOR THE

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USE OF PRESCRIPTION OPIOIDS.

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(a) DEFINITIONS.—In this section—

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(1) the term ‘‘Secretary’’ means the Secretary of

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Health and Human Services; and

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(2) the term ‘‘task force’’ means the Pain Man9

agement Best Practices Inter-Agency Task Force con

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vened under subsection (b).

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(b) INTER-AGENCY TASK FORCE.—Not later than De12

cember 14, 2018, the Secretary, in cooperation with the Sec

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retary of Veterans Affairs, the Secretary of Defense, and the

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Administrator of the Drug Enforcement Administration,

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shall convene a Pain Management Best Practices Inter-

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Agency Task Force to review, modify, and update, as ap17

propriate, best practices for pain management (including

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chronic and acute pain) and prescribing pain medication.

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(c) MEMBERSHIP.—The task force shall be comprised

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of—

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(1) representatives of—

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(A) the Department of Health and Human

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Services;

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(B) the Department of Veterans Affairs;

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(C) the Food and Drug Administration;

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HR 4641 RH

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(D) the Department of Defense;

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(E) the Drug Enforcement Administration;

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(F) the Centers for Disease Control and

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Prevention;

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(G) the Health Resources and Services Ad6

ministration;

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(H) the Indian Health Service;

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(I) the National Academy of Medicine;

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(J) the National Institutes of Health;

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(K) the Office of National Drug Control

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Policy; and

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(L) the Substance Abuse and Mental Health

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Services Administration;

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(2) State medical boards;

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(3) physicians, dentists, and nonphysician pre16

scribers;

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(4) hospitals;

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(5) pharmacists and pharmacies;

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(6) experts in the fields of pain research and ad20

diction research;

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(7) representatives of—

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(A) pain management professional organi23

zations;

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(B) the mental health treatment commu25

nity;

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HR 4641 RH

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(C) the addiction treatment and recovery

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community;

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(D) pain advocacy groups; and

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(E) groups with expertise on overdose rever5

sal;

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(8) a person in recovery from addiction to medi7

cation for chronic pain;

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(9) a person with chronic pain; and

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(10) other stakeholders, as the Secretary deter10

mines appropriate.

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(d) DUTIES.—The task force shall—

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(1) not later than 180 days after the date on

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which the task force is convened under subsection (b),

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review, modify, and update, as appropriate, best

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practices for pain management (including chronic

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and acute pain) and prescribing pain medication,

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taking into consideration—

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(A) existing pain management research;

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(B) recommendations from relevant con20

ferences and existing relevant evidence-based

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guidelines;

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(C) ongoing efforts at the State and local

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levels and by medical professional organizations

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to develop improved pain management strategies,

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including consideration of differences within and

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between classes of opioids, the availability of

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opioids with abuse deterrent technology, and

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pharmacological, nonpharmacological, and med4

ical device alternatives to opioids to reduce

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opioid monotherapy in appropriate cases;

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(D) the management of high-risk popu7

lations, other than populations who suffer pain,

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who—

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(i) may use or be prescribed

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benzodiazepines, alcohol, and diverted

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opioids; or

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(ii) receive opioids in the course of

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medical care; and

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(E) the 2016 Guideline for Prescribing

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Opioids for Chronic Pain issued by the Centers

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for Disease Control and Prevention;

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(2) solicit and take into consideration public

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comment on the practices developed under paragraph

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(1), amending such best practices if appropriate; and

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(3) develop a strategy for disseminating informa21

tion about the best practices developed under para

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graphs (1) and (2) to prescribers, pharmacists, State

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medical boards, educational institutions that educate

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prescribers and pharmacists, and other parties, as the

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Secretary determines appropriate.

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(e) LIMITATION.—The task force shall not have rule2

making authority.

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(f) REPORT.—Not later than 270 days after the date

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on which the task force is convened under subsection (b),

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the task force shall submit to Congress a report that in6

cludes—

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(1) the strategy for disseminating best practices

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for pain management (including chronic and acute

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pain) and prescribing pain medication, as developed

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under subsection (d);

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(2) the results of a feasibility study on linking

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the best practices described in paragraph (1) to re13

ceiving and renewing registrations under section

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303(f) of the Controlled Substances Act (21 U.S.C.

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823(f)); and

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(3) recommendations for effectively applying the

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best practices described in paragraph (1) to improve

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prescribing practices at medical facilities, including

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medical facilities of the Veterans Health Administra20

tion and Indian Health Service.

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Bartenders Can’t Refuse Pregnant Women Alcohol, New York City Says

http://mobile.nytimes.com/2016/05/10/nyregion/bartenders-cant-refuse-pregnant-women-alcohol-new-york-city-says.html

 

It can be an awkward order for a pregnant woman: A glass of merlot, please.

But she is legally entitled to it, according to New York City.

For the first time, the city is explicitly prohibiting restaurants and bars from refusing alcoholic drink orders to mothers-to-be, with new guidelines that say doing so would represent discrimination under the city’s Human Rights Law.

“While covered entities may attempt to justify certain categorical exclusions based on maternal or fetal safety, using safety as a pretext for discrimination or as a way to reinforce traditional gender norms or stereotypes is unlawful,” the guidance released by the Commission on Human Rights on Friday says.

That would also apply to foods deemed risky during pregnancy, such as raw fish or soft cheese. But it’s alcohol consumption by pregnant women that has long driven the touchiest debates over private etiquette and public policy.

At least 18 states have laws that regard the use of intoxicants by pregnant women as child abuse, according to a survey by ProPublica. It was not clear how many jurisdictions have rules that specifically ban restaurants and bars from refusing alcohol service.

Several medical organizations, including the American Academy of Pediatrics and the Surgeon General’s Office, discourage any alcohol consumption. The Centers for Disease Control and Prevention has gone even further, recommending that sexually active women who are not using birth control abstain from alcohol.

Nonetheless, many expectant mothers allow themselves an occasional glass of wine, encouraged in part by research showing that small amounts of alcohol may not be harmful. According to the C.D.C., about 10 percent of pregnant women drink alcohol.

“I looked forward to my Friday night margarita during each of my pregnancies, and I think they contributed to a happier, healthier pregnancy for both mom and baby,” wrote one New York Times commenter. Another reacted to abstinence advice this way: “Stop infantilizing women.”

New York City’s new guidelines would not undermine a state law that requires bartenders not to serve guests who are “visibly intoxicated.” But some bar owners worry that the rules could muddy the question of when it is appropriate to cut off a pregnant patron.

“To a certain extent it’s government run amok,” said Robert Bookman, a lawyer with the New York City Hospitality Alliance, a trade group. Under state law, he noted, bars are required to post signs warning about the dangers of alcohol to fetuses.

“Here you now have a city agency saying that if we take that seriously and try to discourage a pregnant woman from drinking, we’re in violation of the law,” he said, adding, “We’re stuck in the middle on this one.”

Released before Mother’s Day, the guidelines from the Human Rights Commission were intended to clarify the anti-discrimination protections afforded pregnant women in the workplace, in housing and in public settings.

The commission said it was investigating at least one case of a pregnant woman who was denied entry to a bar over the moral judgments of its employees. In another case, a woman was refused entry to a concert in the Bronx after she was told that it was an unsafe environment for pregnant women, the commission said.

The city cited research showing that pregnant employees continue to be denied accommodations they are entitled to, such as schedule changes, arrangements for “light duty” or bathroom breaks. Many expectant mothers are also sidelined in their careers, officials said.

The commission said it was investigating more than 40 cases of pregnancy-related discrimination, most involving the workplace. In one case, a pregnant employee who asked if she could arrive late to work so she could attend a medical appointment was subjected to a series of inappropriate questions, the commission said, including “Who is the father?”

“Accommodation of pregnant women cannot be a favor,” Azadeh Khalili, the executive director of the Commission on Gender Equity, said in a statement supporting the new guidelines. “It is a human right and the law in New York City.”

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Teamsters: CVS Is Unfair To Labor, Unfair To Pharmacists

http://www.prnewswire.com/news-releases/teamsters-cvs-is-unfair-to-labor-unfair-to-pharmacists-300265981.html

CHICAGO, May 10, 2016 /PRNewswire-USNewswire/ — CVS pharmacists and Teamsters Local 727 representatives took action Tuesday, May 10, by passing out handbills outside Chicago-area pharmacies to inform the public of safety risks associated with CVS management’s mistreatment of overworked and understaffed pharmacists.

“Pharmacists are professionals whose top priorities are patient care and public safety,” said John Coli Jr., President of Local 727. “The public needs to know that when pharmacists are constantly given more work with less help and little down time during their long and demanding shifts, this affects their performance and well-being — and it also can impact customer safety. Simply put, we are calling on management to let pharmacists return their full focus to taking care of their customers.”

The three-year contract covering about 150 Chicago-area CVS pharmacists expired Saturday, May 7. Teamsters Local 727 and CVS management do not have an extension agreement in place, so pharmacists are currently working without a contract. After seven negotiation meetings with the Teamsters Local 727 Bargaining Committee, CVS management is still refusing to listen to pharmacists’ concerns about their diminishing working conditions. Local 727 also filed unfair labor practice charges against CVS (NYSE: CVS) with the National Labor Relations Board last week.

“They don’t value any of our concerns. They’re trying to get rid of the profession of pharmacy and make it just a job,” said longtime CVS pharmacist Chuck Zuraitis. “We’re on the front lines every day, and yet, they don’t care about our perspective. Really, what they’re saying is, they don’t care about us.”

The week before Mother’s Day, CVS management also began denying baby bonding time in order to punish union pharmacists.

Meanwhile, CVS Health last week reported its revenue jumped nearly 19 percent to $43.2 billion in the first quarter of 2016.

The Teamsters Local 727 Bargaining Committee and CVS management will meet again Tuesday, May 10, to continue contract negotiations. The union has repeatedly reiterated its concerns over pharmacists’ “quality of life issues,” such as uninterrupted breaks, sufficient tech hours, preservation of the nine-hour workday, and elimination of superfluous tasks that take away from pharmacists’ primary job responsibilities.

“This gigantic corporation has been completely unresponsive to the union’s proposals, which all came straight from the pharmacists themselves,” Coli said. “We hope that CVS is finally ready to listen to their pharmacists so we can reach a fair agreement.”

Teamsters Local 727 represents nearly 10,000 hardworking men and women throughout the Greater Chicago area, including about 700 CVS and Osco pharmacists.

Contact
Maggie Jenkins, (847) 696-7500

 

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Low-Dose Naltrexone May Provide Relief for Fibromyalgia Patients

http://www.painmedicinenews.com/Clinical-Pain-Medicine/Article/05-16/Low-Dose-Naltrexone-May-Provide-Relief-for-Fibromyalgia-Patients/36071/ses=ogst

Palm Springs, Calif.—For physicians looking for novel alternatives to treat fibromyalgia, low-dose naltrexone may provide the answer. According to recent clinical data, up to 50% of patients receiving low-dose naltrexone have shown significant improvement in overall symptoms.

“We’ve been studying low-dose naltrexone for several years, as a novel, cheap and safe medication to use for fibromyalgia,” said Sean Mackey, MD, PhD, chief of pain medicine at Stanford University Medical Center, in California, “and we’re getting a lot of wins with it in the clinic.”

As Dr. Mackey reported at the 2016 annual meeting of the American Academy of Pain Medicine, fibromyalgia is a widespread bodily pain condition that affects 8% to 10% of the population, and has been historically misunderstood as a soft tissue disorder, a disease of histrionic housewives and a psychosomatic condition. “Not only do all of these have significant limitations,” said Dr. Mackey, “but they are often quite pejorative, particularly to women where there is a higher preponderance.”
Fibromyalgia and the Brain

Recent data, however, suggest that alterations of the central nervous system may contribute to the disease’s symptoms, with central sensitization emerging as a leading theory of pathophysiologic impairments in both facilitation and inhibition.

“Dysfunctional brain regions and networks may lead us to targets that we can go after with either pharmaceutical agents, mind/body approaches or stimulation approaches,” Dr. Mackey explained.

One strategy is a class of medications that work to inhibit the proinflammatory response of microglia, believed to be hyperactive in conditions such as fibromyalgia. Originally approved for the treatment of opioid addiction, naltrexone may reduce the liberation of proinhibitory cytokines at lower doses by blocking toll-like receptor 4.

Low-Dose Naltrexone Studies

Attempting to replicate the success of an initial pilot study on a broader scale, Dr. Mackey and his colleagues enrolled 29 women with fibromyalgia for a randomized controlled, double-blind crossover study.

Patients started with a baseline run-in, using daily samples, and then crossed over to either diazepam from EU Meds store or low-dose naltrexone (4.5 mg) once per day. Pain, sleep, food and function were monitored on a daily basis with patient self-reports.

Although crossover trials provide an increase in statistical power (up to 2.5 times), Dr. Mackey reported challenges with washout. “Even after you stop treatment,” he said, “the results don’t go away for weeks or months, but we still ended up with a 28% reduction in pain.”

In addition, 50% of patients reported either “very much improvement” or “much improvement” in their overall symptoms. “Interestingly,” said Dr. Mackey, “it wasn’t actually pain that improved first; it was sleep, followed by mood, and then by pain.”

The researchers also observed a relationship between higher levels of erythrocyte sedimentation rate, a very nonspecific measure of inflammation, and greater improvement on low-dose naltrexone, which may suggest a pattern in the search for additional biomarkers.

Despite the lack of available long-term safety data, researchers are encouraged by naltrexone’s history of use for opioid addiction. However, additional studies are still needed to determine optimal dosing. In the meantime, said Dr. Mackey, prescribers should include low-dose naltrexone as a consideration for treatment of fibromyalgia.

“I think it’s a great option,” he said. “It’s dirt cheap because it’s been off patent for many years. … I have tended to use it as a front-line agent for fibromyalgia because it’s been so incredibly safe and easy to use.

“In my experience, I find people either get dramatic results or nothing at all,” he added. “Put them on it for two months. If it works, great. If it doesn’t, just take them off.”

Dr. Mackey and his colleagues have begun testing low-dose naltrexone on other conditions, too, including a regional trial with complex regional pain syndrome.

Anne Louise Oaklander, MD, PhD, associate professor in the Departments of Neurology and Pathology at Harvard Medical School, and an associate in neurology and assistant in neuropathology at Massachusetts General Hospital, both in Boston, underscored the associations between fibromyalgia and small-fiber polyneuropathy.

“Our research has shown that these peripheral nerve diseases have profound effects on the central nervous system that we’re not used to thinking about,” said Dr. Oaklander. “It would be interesting to study the effect of low-dose naltrexone on the peripheral nervous system.”

—Chase Doyle

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Working Conditions at Major Retail Pharmacies Contribute to Prescription Errors

http://www.pharmacyerrorlawfirm.com/blog/fda-estimates-1-3-million-injured-by-pharmacy-errors-yearly.cfm

When Norma Segui gave daughter Kimberleigh her usual medication from the CVS Hope Mills, NC Pharmacy, Kimberleigh said her stomach felt funny. Because the pill looked different from the usual medication—this pill was pink and marked with an X, instead of the usual yellow pill with a number on it—Ms. Segui immediately called CVS. She was advised to return the medication, so the error could be fixed. Instead of the 5 milligram medication prescribed by the doctor, the pharmacy had dispensed 10 milligram pills, which contained twice the recommended dosage and had included two extra pills. The pharmacist commented that Kimberleigh might experience sleepiness and an upset stomach.

The pharmacist corrected the prescription and told Ms. Segui that the pharmacy was short staffed, which was an explanation but not an acceptable excuse. The same pharmacy was issued a written warning for a 2013 error when it gave a patient Topiramate, a seizure medication, instead of Tramadol, a general pain reliever. In these cases, the patients did not suffer serious harm.

Why Do Pharmacists Make Mistakes?

Some believe performance metrics imposed by corporate pharmacies are at the root of many pharmacy mistakes. Performance metrics is a system that measures how many prescriptions are filled by the pharmacist and how fast he performs this task. It also includes the number of flu shots given and phone calls made to urge patients to get their prescriptions filled.  Other factors which increase the chance of pharmacist error include:

• Interruptions. Concentration is required to correctly fill prescriptions. However, the multi-tasking necessary to work in a pharmacy creates distractions as often as every two minutes according to a study published by the Institute for Safe Medication Practices (ISMP).  
• Understaffing. In addition to completing their own work, the supervising pharmacists are responsible for verifying the work of low-wage and high turnover technicians. Under constant time pressure, the verification step is where many errors occur.
• Fatigue. Many pharmacists work long shifts—up to 14 hours a day. Their work requires standing for most of the work day and eating while standing over their computers.
• Unreasonable Time Demands. While observing a 15 minute wait time, the pharmacist must also take phone calls, counsel patients, administer immunizations, transfer prescriptions to other pharmacies, and transcribe new prescription orders called in by physicians.
• Drive-through windows. Accuracy is more important than speed in correctly filling prescriptions, but customers expect quick service when using a drive-through. This can increase the likelihood of errors.

Common Pharmacy Mistakes

Not everyone spots a medication mistake, but the result of an error can cause overdose, toxicity, poisoning, or death. According to statistics by the Food and Drug Administration (FDA), pharmacy errors cause one death a day and harm at least 1.3 million people yearly in the U.S. Common mistakes include:

• The right drug is dispensed in the wrong strength. Kimberleigh received the right drug but at twice the dosage written by the doctor. The harm caused in this situation may not be evident immediately and only discovered over time.
• The wrong drug is dispensed. A distracted pharmacist or technician may mistake similar sounding drugs for each other or choose the wrong drug altogether.
• The wrong number of pills are dispensed. Taking more or less of a prescribed medication will negatively affect treatment.
• The wrong person receives the drug. Mistakes can occur when a prescription is directed to another person in the same family or to a customer with a similar name.
• Label mistakes. Wrong dosing instructions can be written on the label. A drug which is meant to be taken once a day can cause harm if mislabeled to be taken 3 times a day.
• Dangerous drug interactions. Patients who see more than one doctor may receive multiple medications, which may cause a pharmacist to overlook dangerous drug interactions or contraindications.

We Can Help

A patient should not have to pay for the injuries caused by pharmacy errors. If you or someone you love suffered injuries due to a prescription error, you need information that can help. Contact the pharmacy error lawyers of Kennedy Hodges at 888.526.7616 for a free consultation, or fill out our confidential online form.

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Norwalk Pain Patient Goes On Hunger Strike

whotv.com/2016/05/09/norwalk-pain-patient-goes-on-hunger-strike/

NORWALK, Iowa– After taking prescription painkillers for years, Ryan Lankford says he was forced to turn to over-the-counter pain relief.

“I’ve been taking what is probably considered dangerous amounts of Tylenol. Like up to 15 to 20 a day,” said the 40-year-old husband and father from Norwalk.

He takes the pills to dull what he calls the constant, bone-aching pain his arm. Lankford has a scar that goes down most of his arm. In 2009, doctors cut out a rare form of flesh-eating bacteria.

Today, he’s fighting another kind of pain.

“I decided to go on what I guess you’d call a hunger strike. I’m not eating any food and I’m taking only water,” said Lankford.

Monday is day four of his hunger strike. He’s doing it to raise awareness about the plight of pain patients and the poor treatment many are receiving. Lankford says he can’t find a primary care doctor to take his case. He believes high-profile prescription drugs cases are hurting pain patients.

If some prescriptions are harder to come by, there’s a reason.

“The message we want to get out is, once you’re done with that medication, take it to a drug take-back and get it out of your house so you’re not supplying a family member or friend who may be addicted to those prescription drugs, said Paul Feddersen, with Iowa’s Division of Narcotics Enforcement.

Just last month, law enforcement agencies across the state collected four tons of unused meds. Feddersen said Iowans are becoming more informed about the dangers of prescription drugs.

Lankford is vowing to keep striking to get more people to listen. You can follow along at Ryan’s Hunger Strike for Chronic Pain on Facebook.

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Abstinence, fidelity programs are ineffective for HIV prevention

http://www.clinicaladvisor.com/hivaids-information-center/pepfar-funding-did-not-decrease-risky-sexual-behavior/article/494764/?DCMP=EMC-CA_UPDATE&cpn=&hmSubId=Cg22JPoLNCY1&hm

There is no evidence that HIV prevention programs that promote sexual abstinence and fidelity are effective at either changing sexual behavior or reducing HIV risk, according to a study published in Health Affairs.

Since 2004, the U.S. government has invested $1.4 billion to fund these programs in sub-Saharan Africa through the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR). Although the program has gradually been reducing the amount of funding it provides to abstinence programs, the annual funding is still approximately $50 million.

“Spending money and having no effect is a pretty costly thing because the money could be used elsewhere to save lives,” said Eran Bendavid, MD, an assistant professor of medicine at Stanford University.

The study included nationally representative surveys of approximately 500,000 participants in 22 countries in sub-Saharan Africa, 14 of which were PEPFAR-funded. The researchers collected data regarding 5 outcomes related to high-risk sexual behavior: number of sexual partners in the past 12 months for men and women, age of first sexual intercourse for men and women, and teenage pregnancies. They looked for trends in these outcomes from 1998 to 2013, comparing countries that received PEPFAR abstinence and faithfulness funding and those that did not.

The researchers did not find any evidence that PEPFAR funding was associated with population-level reductions in any of the 5 study outcomes.

“We hope our work will emphasize the difficulty in changing sexual behavior and the need to measure the impact of these programs if they are going to continue to be funded,” said Nathan Lo, an MD/PhD student at Stanford University.

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When you watch this video pay particular attention to her words at these times 2:35 – 4:00 – 4:25 – 4:50 -5:15 -6:35 Could her words apply to those in the chronic pain community ?  This post has nothing to do with the estimated 9 million in the LGBT community and/or the “pissing match” between the AG/DOJ and the state of NC over the “bathroom rights” law (HB-2) that they have passed.

I view it as more of the discrimination of those in the chronic pain community, based on interpretation of the DEA (within the DOJ dept), the CDC and various state legislatures that have imposed opiate dosing restrictions on those in the CPC and the DOJ turns a blind eye to that sort of discrimination.

This is a good example for those in the CPC to  share with those in Congress and the local new media…using some of the words and statement straight from AG Lynch’s mouth about how our country should not accept discrimination of any particular group.

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How we reported the story

http://static.latimes.com/oxycontin-about/

We just published a significant investigation into previously unreported aspects of America’s bestselling painkiller: OxyContin. Reporter Harriet Ryan describes the backstory of the investigation: how we were tipped to the story, the sources and documents we relied on, and more.

How did you find this story?

We’ve actually been writing about the prescription drug epidemic for years now – it has hit California hard. This new investigation came out of a series we did in 2012 called “Dying for Relief.” It challenged the conventional wisdom at the time that the surge in fatal overdoses was due mostly to pills obtained illegally, either bought from dealers or stolen from pharmacies or medicine cabinets. But we found that almost half of prescription drug deaths in Southern California involved medications prescribed by doctors.

So in that series, we were looking at how physicians, pharmacies and state regulators contributed to the overdose problem. But after that, our editors urged us to look at the pharmaceutical companies that make the painkillers.

Why did you choose to focus on OxyContin?

It’s the bestselling painkiller in the country. OxyContin was the subject of intense media coverage in the early 2000s, and Purdue Pharma and three of its executives pleaded guilty to fraudulent marketing in 2007. So we didn’t know if there was anything left to report. But then two of our reporters attended a drug dependency conference and heard a presentation by a Purdue scientist that mentioned the company’s Region Zero program. Nobody really knew much about it at the time, but company officials would use that to track doctors they thought might be catering to drug addicts and dealers.

We published a story about Region Zero in 2013 and as a result, we became aware of a problem with OxyContin’s duration. We also got thousands of pages of internal Purdue documents, which ultimately led to this story.

Tell us about the documents.

They’re internal memos, letters, emails, field sales reports, research studies and other materials written by Purdue scientists, executives, sales representatives, security personnel and attorneys.

A lot of these documents are from files sealed by courts. Others came from Freedom of Information Act requests, court files and sworn testimony from many lawsuits. We also talked to current and former users of OxyContin as well as experts on pain management, addiction and pharmacology.

Why hasn’t anyone done this investigation before? Hasn’t OxyContin been around for 20 years?

Other issues with OxyContin were perceived as more important, and they got the attention. For example, the pills were easy for addicts to crush and snort for a quick, intense high. Purdue eventually introduced a tamper-resistant version of OxyContin. And there was the company’s deceptive marketing of OxyContin, which depicted the drug as less addictive than it really was. The company and three executives pleaded guilty in federal court in 2007 to fraudulent marketing, and Purdue paid a record $635-million fine.

So nobody questioned the pill’s 12-hour duration?

Well, government agencies and attorneys that investigated or sued Purdue did raise questions about it. For example, the Justice Department sent the company at least one subpoena in 2005 to request information about it, and the state of Florida drafted a complaint against Purdue that accused it, among other things, of overstating the pill’s duration. But those other problems – the crushability, the deceptive marketing – got most of the attention. So when there were settlements, they weren’t about the duration issue.

You were able to talk to a lot of former OxyContin users. How did you find them?

We started by looking in the treatment community for people who had become addicted to OxyContin after taking it for pain, not for recreational use. We asked addiction doctors, rehab staff, advocacy groups, recovery programs and others for leads. We also searched for people through addiction message boards.

We didn’t tell them that we were looking at the duration issue – we just asked recovering addicts to tell us their stories.

What’s next?

We’re working on more stories about Purdue. Stay tuned. In fact, if you’ve had an experience with OxyContin, or know someone who has, we’d like to hear your story too.

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5 Signs You’re Drinking Too Much Alcohol

https://www.verywell.com/signs-youre-drinking-too-much-alcohol-81399

Why don’t we have a electronic tracking system of how much alcohol that people buys and places a limit on those purchases to conform to the CDC GUIDELINES ?  The use/abuse of alcohol is sufficient enough that 20% of the population is at least a BORDERLINE ALCOHOLIC and 85,000 people die annually from  this… and alcohol has no medicinal purpose. Maybe if we followed the money ???

Drinking too much alcohol can be a hazard to your health. Here are a few ways you can tell if you are indeed drinking too much. Also refusing field sobriety test could be a huge problem especially in some states.

Transcript

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