eliminating the drug-trafficking organizations and gangs

Posted on November 10, 2015 by Pharmaciststeve

unclesambad

DEA selects Pittsburgh as 1st pilot city for strategy to address drug abuse, violent crime

http://www.wpxi.com/news/news/local/dea-chooses-pittsburgh-first-pilot-city-strategy-a/npKYj/

PITTSBURGH —

The Drug Enforcement Administration held a news conference Tuesday to announce Pittsburgh as the first pilot city for a new strategy aimed at addressing prescription opioid abuse, heroin use and violent crime.

According to a news release, the goals of the new strategy are “stopping the deadly cycle of prescription opioid and heroin abuse by eliminating the drug-trafficking organizations and gangs fueling violence on the streets and addiction in communities.”

DEA officials said they also plan to partner with health care professionals and work with community and social-service organizations that are most equipped to help with the strategy in the long term.

“We’ve gone after the biggest, baddest drug organizations. We haven’t been good about community engagement,” said Gary Tuggle, special agent in charge at the DEA Philadelphia Field Division. Pittsburgh Mayor Bill Peduto also spoke at the news conference and admitted where he thought the city might have gone wrong in the past.

“We’ve looked at this as a law enforcement issue in the past, and we’ve failed,” Peduto said.

National partners participating in the strategy include the U.S. Attorney’s Office of the Western District of Pennsylvania, Boys & Girls Clubs of America, the DEA Educational Foundation, the U.S. Department of Health & Humans Services’ Substance Abuse and Mental Health Services Administration and the White House Office of National Drug Control Policy.

The strategy also plans to crack down on pharmacists who are writing bad prescriptions and build community outreach and education. 

U.S. Attorney David Hickton thanked the DEA for choosing Western Pennsylvania as the first pilot of the new strategy.

“Thank you for putting your trust in Western Pennsylvania. We won’t let you down,” he said to Tuggle.

Numbers gathered from death certificates by Overdose Free PA showed that 50 people overdosed on heroin in 2010. Last year, that number skyrocketed to 157, and current data indicates that the number is on pace to be even higher this year.

Channel 11’s Aaron Martin dug deeper into data from Drug Free PA to see which Pittsburgh neighborhoods have been struck the most by overdoses. 

Beltzhoover, Knoxville and Mount Oliver, along with parts of Brookline and the South Side Slopes, had more than 70 reported fatal overdoes. 

Similar results were found on the North Side, Fineview, Marshal-Shadeland, East Allegheny and Reserve Township. 

Filed under: General Problems | 4 Comments »

Marijuana supporters petition White House to fire DEA chief

Posted on November 10, 2015 by Pharmaciststeve

Marijuana supporters petition White House to fire DEA chief

http://thehill.com/regulation/administration/259706-marijuana-supporters-petition-white-house-to-fire-dea-chief

Drug Enforcement Administration chief Chuck Rosenberg is facing pressure from pot advocates to step down after he called medical marijuana a “joke.”

Nearly 10,000 medical marijuana supporters have signed a petition calling for Rosenberg to be replaced with a more pot-friendly DEA head.

“President Obama should fire Chuck Rosenberg and appoint a new DEA administrator who will respect science, medicine, patients and voters,” reads the petition organized by the Marijuana Majority.

Rosenberg had harsh words about medical marijuana supporters last week during a briefing with reporters.

“What really bothers me is the notion that marijuana is also medicinal — because it’s not,” Rosenberg said. “We can have an intellectually honest debate about whether we should legalize something that is bad and dangerous, but don’t call it medicine — that’s a joke.”

Marijuana advocates responded by organizing a petition calling for Rosenberg to be fired.

“Medical marijuana is not a ‘joke’ to the millions of seriously ill patients in a growing number of states who use it legally in accordance with doctors’ recommendations,” the petition reads.

“It is not a ‘joke’ to the growing number of prominent medical organizations — American Nurses Association, American College of Physicians, American Academy of Family Physicians, for example — who know that cannabis has real and proven medical benefits,” it continued.

Filed under: General Problems | 1 Comment »

Addiction = Mental health… Bureaucrat = CLUELESS ?

Posted on November 9, 2015 by Pharmaciststeve

wave3.com-Louisville News, Weather

TONIGHT AT 11: Heroin users injecting doubt into needle exchange issue

http://www.wave3.com/story/30470887/heroin-users-injecting-doubt-into-needle-exchange-issue

LOUISVILLE, KY (WAVE) – At the same time they’re arresting people in heroin busts in Scott County, they are handing out free syringes to heroin users at a building next door to the police department. Sometimes the users shoot up right across the street.

It’s called a needle exchange because intravenous drug users are supposed to exchange used syringes for clean ones to reduce the spread of disease. But it looks more like a needle supply.

I went undercover for five weeks watching needle exchanges in Scott County, IN and Jefferson County, KY where heroin users often are lined up waiting for it to open.

They bring in their children, their bikes and their dogs, but most of the time they don’t bring any needles to exchange.

“I even noticed over time, repeat customers still not bringing needles with them. Your thoughts?” I asked Metro Health Department Director Dr. Sarah Moyer.

“To me, it’s more important to get them the clean needles to prevent sharing,” Moyer said.

Often I recorded customers walking out and doling out bags of syringes to people waiting nearby. One of the frequent customers who never brings needles to exchange walked out and took off on a 20 minute drive to where a man was waiting on a scooter. He pulled something out of his mouth and made a hand-to-hand transaction.

When I caught up with the van driver heading out with his passengers, he didn’t want to talk about it.

“I take people to work and drop ’em off,” he said.

“Why do you keep going to the needle exchange?” I asked.

“Needle exchange?” he said as he drove away.

How long do they wait before they’re using their taxpayer funded syringes? Twenty-two seconds after one woman left with bags full of needles, a syringe was passed and one of the people in the waiting car used the needle at the front entrance of the UofL School of Public Health.

I recorded two people who brought no needles but walked away with many to a spot across from the main entrance to the Louisville Free Public Library, where one was the lookout while the other shot up and left a syringe behind.

One woman went straight to a nearby business, shot up, left the stuff on the floor by a wastebasket, and then had to sit down outside because she was having a hard time.

Another man walked a block away, sat down along busy Broadway, unpacked his syringe, gloves and gauze, took off his sock and took his time sticking the needle between his toes with kids walking by and people staring.

“I haven’t seen that here,” said Moyer, “but I guess you gave an example for Broadway. They’re going to be using. I’m happy they’re using a clean needle. That’s my thought.”

So what are they using? Health department stats show it’s mostly heroin, but also meth and cocaine.

We’ve been told needle exchanges offer counseling and treatment to try to stop the cycle of addiction. So we sent a producer inside undercover with a hidden camera. A needle exchange worker read him his rights off a form.

“How many do you think you need to last you a week?” asked the worker.

She also asked how often he uses drugs. “How many times a day are you using?” she asked.
 
“I’d rather not talk about it,” our producer told her.
 
“You have to so I know how many needles to give you,” she said.

Seconds later he was on his way, needles in hand.

“All the worker did was just read this form, didn’t offer any counseling, didn’t ask any questions to try to get the person into a treatment center or anything,” I said to Dr. Moyer.

“You’ve got to meet the person where they’re at,” Moyer said. “So if they’re not ready for treatment there’s not really, you don’t need to talk about it.”

What the worker did do was explain if you tell a police officer you have needles from this exchange, you won’t be charged with possessing drug paraphernalia or any substance on the needle.

“Police officers are on board if they pull you over,” the worker said.

“It comes off sounding like you’re helping a person using drugs to not get busted by police,” I said.

“As long as they’re not sharing needles, and (they’re) preventing disease, I think that’s probably a good thing,” Moyer replied.

“That’s tragic,” Kentucky Senate President Robert Stivers said. “Theory and practical application are two different things. The theory is a good theory. Practical application by these people is really abhorrent.” 
 
When we shared our findings with Stivers, he said changes are necessary now.

“They’re not taking needles out of the system. They are just supplying more needles,” Stivers said. “This was not the intent of the legislation. They’re doing nothing but promoting greater use of heroin.”

The Metro Health Department says it’s had more than 1,000 people come in to get free needles in the first four months the needle exchange has existed. They say 64 of those drug users have been referred to Seven County Services case managers for treatment options.

As for Stivers’ comment that the needle exchange workers are promoting greater use of heroin, Moyer said, “Study after study shows syringe exchange programs do not increase drug use.”

Filed under: General Problems | 5 Comments »

Wasn’t the Salem witch trials in Massachusetts ? History repeating ?

Posted on November 9, 2015 by Pharmaciststeve

witchhunt

http://www.unionleader.com/article/20151105/NEWS12/151109548/0/SEARCH#sthash.pt5Hdav0.dpuf

Hassan opioid rules rejected

By MARK HAYWARD
New Hampshire Union Leader

CONCORD — The Board of Medicine rejected on Wednesday a lengthy set of rules developed by the Hassan administration to clamp down on doctors who prescribe opioids, opting instead for a much narrower set of regulations.

The regulations go into effect in 48 hours or less, which itself prompted complaints from the New Hampshire Medical Society.

The board also started the process to adopt a more comprehensive set of rules through the normal process, which requires notice, public hearings and legislative review. That process is expected to be completed by early April.

The board unanimously rejected Gov. Maggie Hassan’s proposed set of rules.

“We’re doing something, but not necessarily everything our governor wants,” said Dr. Louis Rosenthal, a Concord physician who is on the board.

He said physicians have become “more appropriate” in the prescribing of narcotics.

“You can’t hold (physician) licensees responsible for people who overdose from illicit substances,” he said.

The rules adopted Wednesday are in effect for six months.

They require physicians and physician assistants to:

• Adhere to guidelines in a July 2013 model policy developed by state medical boards for the use of opioids.

• Undertake an appropriate risk assessment for patients who suffer from chronic pain and take opioids.

• Explain addiction, overdose, dependency and criminal victimization to patients who suffer chronic pain and take opioids.

A pain agreement, a treatment plan, and follow-up visits are required, as are drug tests when appropriate.

• Provide information, which includes proper disposal of unused drugs, to patients with short-term, acute pain who are prescribed opioids.

Hassan and Attorney General Joseph Foster had pushed for a lengthy set of rules that included specifications for patient evaluations, physician education and testing, patient drug tests, alternative therapies, and use of the New Hampshire Controlled Drug Prescription Health and Safety Program database, which physicians complained was new and time-consuming.

In a statement released Wednesday, Hassan made no mention of the vote to reject her proposal.

She praised the Board of Medicine for swiftly adopting the reforms.

“The Board of Medicine’s action, along with the Executive Council’s approval of my call today for a special legislative session on substance abuse, is important progress in our continued efforts to strengthen the state’s response to the heroin and opioid epidemic,” she said.

But in a statement, two Republican senators noted the ire that Hassan’s proposal drew from physician groups and her own Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery.

There were no public hearings on her proposal, and Sen. Jeb Bradley, R-Wolfeboro, warned that her approach could serve as a warning for the upcoming special session.

“It’s imperative that doctors be involved in developing guidelines so patients who need these medications can receive them, and at the same time work together to reduce opioid abuse,” Bradley said.

Sen. John Reagan, R-Deerfield, said he was disappointed that Hassan did not follow the normal process for emergency rule-making.

The rules that the board did adopt go in effect once they are formally submitted to the Department of Administrative Services.

That’s too quick for the New Hampshire Medical Society.

Past president Dr. Travis Harker said physicians will have no time to write up risk assessments for existing patients who are already taking opioids.

“I’m booked until January,” Harker said. “If I had a month, I could maybe figure it out, but I can’t figure it out in 48 hours.”

Filed under: General Problems | 1 Comment »

Sen Cotton disability & poverty cause of addiction ?

Posted on November 9, 2015 by Pharmaciststeve

http://www.rawstory.com/2015/11/sen-tom-cotton-social-security-benefits-cause-people-to-spiral-downward-into-heroin-addiction/

Sen. Tom Cotton (R-AR) suggested on Monday that population decline and drug abuse in poor areas could be the result of too many people on Social Security disability.

Speaking to the conservative Heritage Foundation on Monday, Cotton warned that communities with high a percentage of residents on Social Security disability had reached a tipping point that was linked to population decline. But he said that communities which used fewer benefits were enjoying a population increase.

“It’s hard to say what came first or caused the other, population decline or increased disability usage,” Cotton opined. “Or maybe economic stagnation caused both. Regardless, there seems to be at least at the county and regional level something like a disability tipping point.”

“When a county hits a certain level of disability usage, disability becomes a norm,” he continued. “It becomes an acceptable way of life and alternative source of income to a good paying full-time job as opposed to a last resort safety net program to deal with catastrophic injury and illness.”

And according to Cotton, that was just the beginning of the bad news for communities with above average disability claims.

“At a certain point when disability keeps climbing and become endemic, employers will struggle to find employees or begin or continue to move out of the area,” he said. “The population continues to fall and a downward spiral kicks in, driving once thriving communities into further decline.”

“Not only that, but once this spiral begins, communities could begin to suffer other social plagues as well, such as heroin or meth addiction and associated crime.”

Cotton revealed that he planned to introduce legislation that would single out non-permanent disability recipients and set a timeline for them to return to work.

Disabled people who are not ready to return to work would be forced to reapply for disability benefits, Cotton said.

“These reforms won’t solve all the problems of Social Security disability but they will address one of the most urgent crises in the program,” he concluded. “And the one, perhaps, most corrosive to effected communities.”

Filed under: General Problems | 12 Comments »

I have been MIA lately

Posted on November 9, 2015 by Pharmaciststeve

analrph2My blog has been rather quite for the last few days… We left Thursday AM for Durham, NC – 550 miles – to help only grandson to celebrate his 9th birthday on Friday and spend the weekend… Today (Monday ) back on the road and back to Indiana.  I took my IPAD along for the trip and mostly was able to eliminate the “trash” from my inbox… but .. not much else..  I hope that I will be able to catch up by week’s end.

Filed under: General Problems | Leave a Comment »

The hook under the bait

Posted on November 7, 2015 by Pharmaciststeve

https://www.washingtonpost.com/news/post-politics/wp/2015/11/07/clinton-supports-removing-marijuana-from-schedule-1-list-joining-democratic-rivals/

There is a hook under this bait.. It will take medical science abt 10 yrs to do clinical trials and get a product to market

Filed under: General Problems | Leave a Comment »

Epidurals Offer Temporary Pain Relief – But At What Cost?

Posted on November 4, 2015 by Pharmaciststeve

Tonight On CBS2 News At 11PM: Epidurals Offer Temporary Pain Relief – But At What Cost?

You don’t want to miss Lisa Sigell’s report on the dangers of epidurals tonight on CBS2 News at 11 p.m. – also streaming live on cbsla.com.

Filed under: General Problems | 1 Comment »

Christie’ point of view on “pro-life”.. more than just the fetus in the womb ?

Posted on November 4, 2015 by Pharmaciststeve

Chris Christie Makes Emotional Plea To Rethink Drug Addiction Treatment

The New Jersey governor shows why he’s so effective in town hall meetings

http://www.huffingtonpost.com/entry/chris-christie-drug-addiction-treatment_56327ee9e4b0c66bae5bc0f3

WATCH VIDEO in above link 

UPDATE: Christie’s talk on addiction, part of the HuffPost original series ’16 and President, has been viewed more than three million times on Facebook and has been shown repeatedly on cable news. 

BELMONT, N.H. — While campaigning recently during happy hour at Shooter’s Tavern here in this small New Hampshire community, New Jersey Gov. Chris Christie (R) related a pair of personal anecdotes to elucidate why he thinks the United States should change the way it handles drug addicts.  

After speaking in highly personal terms about his late mother’s smoking addiction, Christie recounted an emotional story about a law school friend who became addicted to prescription painkillers.

Although Christie has failed to move the needle in national polls, he has been well received in more intimate New Hampshire town halls. Watch the above video, an outtake from a recent episode of ’16 And President, to see why it may be a mistake to count Christie out of the race for the Republican presidential nomination just yet. And watch the full episode below.

Filed under: General Problems | Leave a Comment »

Another “drug related death” ? How easy it is to “bend” the stats ?

Posted on November 4, 2015 by Pharmaciststeve

Suicide and Pain: The Silent Epidemic

http://www.painmedicinenews.com/ViewArticle.aspx?d=Commentary&d_id=485&i=October+2015&i_id=1234&a_id=33865&tab=MostRead

On Oct. 26, 2003, two patients of mine, Randy and Helen—a married couple in middle age and both weary with chronic pain—attempted a dual suicide. Randy succeeded by overdosing on the methadone that was prescribed for his pain. His wife was either lucky or unlucky, depending on your point of view. She survived and was afterward confined to a psychiatric ward for several days.

The social worker who walked into their house that fatal weekend found not only Halloween balloons bobbing eerily but also Christmas presents neatly wrapped. Did this couple always shop early for presents, or had they determined that their plans to exit this life shouldn’t cheat the grandchildren out of holiday presents?

A pile of papers, suicide notes and a will left for family and authorities to find seemed to indicate that the plans had been percolating for several months at least. After the fact, Helen’s daughter conveyed to me her belief that the couple had been talking it over between themselves for at least a year.

After Helen was discharged from the psychiatric hospital, she returned to the clinic where I worked for further treatment of her pain. She opened up about the reasons why she and Randy wanted to die. Randy, she said, had 18 diagnoses and “his pain was outrageous.” Multiple illnesses are correlated with higher suicide risk, and multiple medical problems are common in patients with chronic pain.1 The pain turned to anger for Randy, Helen said. “Lots and lots of anger.”

“At whom?” I asked.

Everyone, Helen said. Everyone whom Randy believed had let him down. For instance, Randy was angry with the doctors who he believed were undertreating his pain. When I asked Helen for her reasons for trying to end her own life, she pointed to an abusive first marriage and a stressful relationship with Randy. Her own pain played a major role, too. She said, “I didn’t have anything to lose. I didn’t have anything to look forward to except pain.” She had fibromyalgia and cervical disk herniation with neck pain, causing constant headaches. She also wanted to be with Randy in the afterlife where they both would be free of pain.

How common is it for people with chronic pain—people such as Helen and Randy—to attempt or complete suicide? It’s difficult to know with any degree of certainty. A potential deficit in our ability to understand the real prevalence of suicides in people with chronic pain is the way the Centers for Disease Control and Prevention (CDC) classifies opioid overdoses. The source of the CDC data comes from medical examiners and coroners. In most states, if an opioid is believed to have contributed to the death but there is no suicide note or other overt evidence that the death was intentional, such as copious amounts of opioids in the stomach at autopsy, it will be classified as unintentional or intent undetermined. In the absence of concrete evidence, it is difficult to know whether the death was truly accidental or intentional. However, an unintentional or undetermined classification allows for civil insurance claims to proceed against the prescriber and for collection on life insurance. Although not a prime reason for classifying deaths as unintentional, such considerations may be factors on occasion. However, the reality of the decedent’s intention may be different in some instances.

A problem results in understating the prevalence of pain-associated suicides, thereby concealing the effect that pain has on the suicide rate. By not understanding the true contribution of pain to the prevalence of suicides, we tragically miss an opportunity to reduce the rate. Intentionality is obvious when someone uses a firearm to end one’s life, but it is less obvious when a person in pain chooses to end his or her life with the medications prescribed for pain.

It is hard to prove the correlation of opioid overdose deaths and pain, so we need to triangulate the data. One interesting observation is that the most common age for suicides from poisoning in the United States (namely, 45-64 years of age) corresponds to a similar age for unintentional overdose deaths (45-54 years of age).2 Furthermore, the CDC reported more than a 400% increase in opioid-related overdose deaths from 1999 to 2010.3 During that same period, the reported suicide rate for adult men increased almost 30% for 35- to 64-year-olds. This is the same age range with the highest prevalence of opioid overdose deaths.4 It is unlikely that we are looking at coincidence.

In addition, the means to end life when pain overwhelms is close at hand, because medications used to treat pain can also be used for the purpose of suicide. The CDC reports that, in 2013, there were approximately 1 million suicide attempts and nearly 40,000 completed suicides in the United States.5 The suicide rate has been increasing in parallel with the number of opioid prescriptions, just as the rate of opioid overdoses has paralleled opioid prescribing. This, too, is probably not coincidental.

People with chronic pain are at high risk for suicide for many reasons. In a recent registry study from Denmark involving 1,871 people with chronic pain, 6% had attempted suicide.6 The authors stated that this reflected a 3.76-fold increased risk for suicide attempts versus people without chronic pain. Risk factors included mental health disorders, social separation or isolation, substance use disorders and “intractable” pain.

Nicole Tang has recently reported that the most significant predictor for suicide attempts in people with pain is “mental defeat.7” Mental defeat is a state of mind marked by a sense of a loss of autonomy, agency and human integrity. It occurs when the fight just doesn’t seem worth it anymore. It is a person’s retreat from his or her battle with pain.

As with Randy and Helen, people may just find that there is no reason to live. If they have been dealing with a chronic pain problem, prescription drugs are likely close at hand. Feelings of hopelessness, seeing “no way out,” social isolation, mental defeat and severe pain intensity are all present in many with intractable pain. It is intuitive that some of the overdoses classified as unintentional are actually intentional, or at least the result of willingness to accept death in an attempt to escape pain.

The effects of suicide on family, friends and communities are devastating and far reaching even long after a loved one has taken his or her life. People in pain who take their lives have usually struggled with shame, the stigma of pain, marital problems and financial problems, and have been treated as if they are drug addicts or lowlifes unworthy of respect, attention or love. Unfortunately, public policy supporting our ability to collect data that could help us understand and prevent many of the tragic deaths has not been a priority. In fact, too often the finger points to the agent (drug) rather than the underlying cause (pain). Defining an overdose as unintentional when it may not be may mislead and conceal an epidemic of suicide.

There are important steps that we should take to address this lack of awareness and data:

  • First, we need to acknowledge that the CDC data may be incomplete and imperfect in defining the intentionality underlying the death.
  • Second, we must recognize that providing opioids to people with severe pain may be providing them the means to commit suicide.
  • Third, and most importantly, we should agree that pain not adequately relieved is a major public health problem that deserves more equitable research funding so that lethal drugs are not a necessary treatment.

It is time that people in pain, and we who have devoted our careers to helping them, demand better treatments. Lives depend on it.

References

  1. Juurlink DN, Herrmann N, Szalai JP, et al. Medical illness and the risk of suicide in the elderly. Arch Intern Med. 2004;164:1179-1184.
  2. Centers for Disease Control and Prevention. Ten leading causes of injury deaths by age group highlighting unintentional deaths, United States-2013. www.cdc.gov/​injury/​images/​lc-charts/​leading_causes_of_injury_deaths_highlighting_unintentional_injury_2013-a.gif.
  3. Centers for Disease Control and Prevention. Unintentional drug poisoning in the United States. July 2010. www.cdc.gov/​HomeandRecreationalSafety/​pdf/​poison-issue-brief.pdf.
  4. King SA. Pain and suicide. Psychiatric Times. June 13, 2013. www.psychiatrictimes.com/​suicide/​pain-and-suicide.
  5. Centers for Disease Control and Prevention. Featured topic: World Health Organization’s (WHO) report on preventing suicide. www.cdc.gov/​violenceprevention/​suicide/​who-report.html.
  6. Stenager E, Christiansen E, Handberg G, et al. Suicide attempts in chronic pain patients: a register-based study. Scand J Pain. 2014;5:4-7.
  7. Tang NK, Beckwith P, Ashworth P. Mental defeat is associated with suicide intent in patients with chronic pain. Clin J Pain. 2015 Jul 21. [Epub ahead of print]

Filed under: General Problems | 1 Comment »

« Previous Page — Next Page »