Press Conference to Announce Filing of Federal Civil Rights Lawsuit

http://www.thsintl.org/press_conference_to_announce_filing_of_federal_civil_rights_lawsuit

Press Conference to Announce Filing of Federal Civil Rights Lawsuit

LOS ANGELES, California (July, 2, 2015)- The Law Office of Matthew Pappas, The Human Solution International, the Law Office of Anthony Curiale and The Swain Law Office will hold a press conference on Friday, July 3, 2015 at 1 :30 p.m. at the Marriott Live located at 900 W. Olympic Blvd. in Los Angeles.

Attorney Matthew Pappas and retired L.A.P.D. Deputy Chief Steve Downing will discuss additional video of Santa Ana officers engaged in inappropriate behavior during raids of medical marijuana collectives and will provide an update on evidence of political corruption related to Santa Ana’s medical marijuana ordinance and lottery. Patient Marla James will show a new electric wheelchair paid for and provided to her by a cannabis oil company in Colorado after people working for the company watched video of the May 26 Sky High collective raid in Santa Ana. Thereafter, attorneys Anthony Curiale, James Kajtoch and Stefan Borst-Censullo will discuss a multi-million dollar state claim for damages filed on behalf of patients attacked during April and May raids in Santa Ana.

The Swain Law Office will announce the filing of a federal civil rights lawsuit against the Kansas Department for Children and Families and State of Kansas. Earlier this year, cannabis oil activist and Crohn’s disease sufferer Shona Banda, who has successfully used cannabis oil to manage her disease and developed her own inexpensive method to extract it, had her home raided by police and son taken simply because she uses cannabis to treat her serious condition. Thereafter, the State of Kansas arrested Ms. Banda and charged her with felony marijuana violations exposing her to a potential 30-year jail sentence.

Joe Grumbine, President of the Human Solution International, a human rights organization based in Southern California, along with Rolland Gregg, one of five people charged by the federal government with violating federal law for growing marijuana for a family member with cancer and other seriously ill patients in Washington state, will discuss the federal government’s refusal to comply with provisions of section 358 of the 2015 federal appropriations act barring federal funds from being used to interfere with implementation of medical marijuana laws in 35 states. Attorney Matthew Pappas will discuss the filing of a federal lawsuit seeking to enjoin the Justice Department from spending further money in the criminal case against Gregg.

Highlighting widespread corruption by city officials related to medical marijuana, fOlmer Planning Commissioner Dean Gray will discuss a state lawsuit filed against the City of Desert Hot Springs for corruption, Brown Act violations and civil rights violations along with evidence presented that the Mayor of Desert Hot Springs along with other city officials were directly involved with medical marijuana collective applicants in that city’s score-based ordinance that resulted in approval of the collective applicant the Mayor now works for. Pappas will also discuss an additional federal lawsuit against the City of Anaheim filed by Tony Jalali seeking damages caused by Anaheim’s continuing attack on him after he won against the federal govemment and city in a forfeiture action in 2013.

While significant civil rights gains have been achieved in the last few weeks, seriously ill and disabled individuals continue to face discrimination and widespread corruption simply because medical cannabis is effective for them. From taking children to jailing hundreds of thousands of Americans, the federal government as well as state and local governments continue to target patients. For More Information, contact Sergio Sandoval, Director of Press Relations, the Law Office of Matthew Pappas, 562-533-1628, sergio.sandoval@mattpappaslaw.com

Visit The Human Solution International athttp://www.thsintl.org to find information on how you can help end prohibition because, “No One Should Go To Jail For A Plant!”

About The Human Solution International:THSI is a grassroots federally recognized 501(c)3 nonprofit organization, which includes over 50 chapters. THSI supports members of the community through the trials they face as cannabis consumers through court support, prison outreach, and education. Members believe that standing together in solidarity against this unfair treatment of civil rights will keep people out of prison for a plant which has been proven to hold many medicinal and health benefits.

The Human Solution International

A 501(c)3 Civil Rights Organization

Ph: (951) 934-0055

Fx: (520) 509-6845

Email: media@thsintl.org  

www.thsintl.org

No One Should Go To Jail For A Plant!

END

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Authorized generics may have better quality

http://www.abqjournal.com/650667/health/authorized-generics-may-have-better-quality.html

People have become suspicious of the quality of generic drugs. Is there a way to benefit from the lower cost of these copycat medicines without sacrificing effectiveness?

Authorized generics may be a solution to this dilemma. Many physicians and patients are unaware that this option exists. The brand-name manufacturer makes a deal with a specific generic company to supply its drug directly or provides the generic maker with precise instructions on how to duplicate the brand-name product. No one else has access to this information, as it is considered a trade secret.

We recently heard from a reader about just such a situation: “You wrote about someone whose insurance refused to pay for Celebrex and was switched to the generic celecoxib. The person had begun to experience swollen joints and the other symptoms Celebrex treats.

“I had the same reaction when I got switched but had read in your column about others with the same problem. I talked to my pharmacist, who said it was the most common complaint he heard, but that there was a solution.

“He said to ask specifically for celecoxib made by Greenstone. It is identical to Celebrex and is manufactured by the same company. Because it is a generic, insurance will pay for it, and most pharmacies will order it for you every month. (Allow a couple of extra days to get it filled.)

“Within a week I was able to use my hands again. They had gotten so bad I could not even grip my steering wheel. Now I call in my script a few days early so they can order the Greenstone celecoxib, and I’m back to doing the things I enjoy. I hope this information helps other readers as much as your column has helped me.”

The generic manufacturer Greenstone is a subsidiary of the drug giant Pfizer. It is hardly any wonder that Pfizer, maker of Celebrex, would provide its own company the right to market an authorized generic.

The Food and Drug Administration may have mixed feelings about authorized generics. That is because the agency asserts that all FDA-approved generic drugs are identical to their brand-name counterparts.

Despite such reassurances, the American public has reason to be concerned. According to Reuters, the FDA has barred 44 Indian pharmaceutical manufacturing facilities from exporting medications to the U.S. since 2011. Most of these products were generic drugs.

These companies are responsible for a significant proportion of the generic drugs taken by Americans. Companies such as Aurobindo, Dr. Reddy’s Laboratories, Polydrug, Ranbaxy, Sun Pharmaceutical and Wockhardt all have received FDA warnings about quality control.

We have received thousands of complaints about generic drugs in the past decade. Readers of this column have reported troubles with anti-seizure drugs, antidepressants such as bupropion, heart medicines like metoprolol and medications for attention deficit disorder.

Anyone with a complaint about a generic drug should report the problem directly to the FDA with the name of the manufacturer. The FDA website is: www.FDA.gov/MedWatch.

Until the FDA solves its generic-drug monitoring problem, patients may wish to ask their pharmacist for an authorized generic. When such an alternative exists, it may be worth paying a bit more for the extra reassurance such a designation provides.

Joe and Teresa Gredon answer letters from readers. You may email them via their website: PeoplesPharmacy.com

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No Easy Answers To Drug Abuse, Forum Attendees Say

http://www.courant.com/news/connecticut/hc-windham-overdose-forum-0930-20150930-story.html

WILLIMANTIC — While reports of overdoses from heroin, synthetic marijuana and other drugs crop up in Willimantic, medical and addiction professionals agreed the complicated issues around substance abuse aren’t confined to the city lines.

At a forum hosted by Hartford HealthCare Tuesday night at Eastern Connecticut State University, professionals gathered to talk about the growing issue of overdoses and substance abuse throughout the region.

“We do see a significant volume of heroin and K2 abuse in Willimantic but we do see it on the college campuses, like here at Eastern or at UConn … and we do see it in the small towns like Scotland or Chaplin,” said Bill Muskett, manager of the Windham Hospital EMS program.

K2 is one of the street names for a synthetic form of marijuana. Willimantic police investigated at least seven overdoses of K2 over the summer.

Heroin deaths have also increased dramatically in Connecticut’s large cities and small towns in recent years, with more than 300 fatalities linked to overdoses in 2014, up from 100 in 2012, state records showed.

Muskett said emergency response personnel go into houses at 3 a.m., wake up overdose victims and bring them to the hospital — it doesn’t matter where.

Jim O’Dea, vice president of operations for Hartford HealthCare’s Behavioral Health Network, agreed.

“There are 169 towns and villages in the state of Connecticut,” O’Dea said. “There are people in every community who are dealing with these issues.”

Heroin has been an issue in the area for many years, but new synthetic drugs are also popping up in the region as they become available.

“There is no easy way to track what is in people’s body,” said Vicki Barbero, director of outpatient services at Perception Programs Inc. “K2 is new, they are changing it all the time.”

Muskett said it might not always be K2, but there are other similar drugs across the country, such as the stimulant called flakka in Florida, that may make their way here.

There is no specific type of person who’s affected, those in attendance agreed.

“This disease does not discriminate,” said Leah Russack-Baker, director of the Natchaug Hospital Quinebaug Adult program. She said drug abuse is seen in men and women from all professions.

“In order for change to happen we really do need to have uncomfortable conversations,” Russack-Baker said.

A solution, however, is not as easy.

“If there was one solution we would have figured it out already,” O’Dea said. “I’ve practiced in this area for 25 years, if there was one solution we would have found it, believe me.”

O’Dea said there are many resources, whether locally or on the state level, to help those facing issues with substance abuse.

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DEA drug scheduling process illogical, should be reformed

https://www.dailytexanonline.com/2015/09/30/dea-drug-scheduling-process-is-illogical-should-be-reformed

With the legalization of marijuana in states such as Colorado and Washington, drug law is starting to ease up on the state level. However, national associations, such as the Drug Enforcement Administration (DEA), still spread misinformation about drugs, and its current drug scheduling is misleading and potentially harmful.

The DEA organizes drugs into five categories, Schedule 1 through 5. Schedule 1 drugs are supposed to be very dangerous, “with no currently accepted medical use and a high potential for abuse.” The three most instantly recognizable Schedule 1 drugs are heroin, LSD and marijuana.

By any metric, heroin is vastly more dangerous than marijuana or LSD. Heroin is extremely addictive and has been responsible for the collapse of many people’s lives. This is in sharp contrast to LSD and cannabis, which are virtually impossible to overdose on and have low addiction potential. 

These aren’t cherry-picked examples, either. There are multiple irrational classifications on the DEA’s list. Cocaine, a drug with a high addiction risk, is Schedule 2, which is lower than cannabis. Even meth, which rivals heroin in its capacity to destroy lives, is Schedule 2.

Part of the problem is that it is difficult to study drugs in general. The National Institute on Drug Abuse (NIDA) only receives around $1 billion in funding every year, not nearly enough to keep up with the nation’s ever-changing drug trends. On top of this, researchers looking for a grant to study a drug must have an established background, and, once he or she gets a grant, it usually takes four to five years to complete research — by which time the current drug climate has changed completely. All these layers of bureaucracy create an environment that is not friendly to drug reform.

Stephanie Hamborsky, Plan II and biology senior and the president of Students for Sensible Drug Policy, said drug scheduling is “completely misinformed, with no objective analysis.” 

Hamborsky added that drug policy is based on the interests of big pharmaceutical companies. While there is no way to prove this, it is interesting that prescription drugs with established addiction potential, such as Xanax, are listed very low on the DEA’s list at Schedule 4.

The problem with grouping drugs such as marijuana with drugs such as heroin is that it destroys the government’s credibility. If a high school kid, who has been told all their life by the drug education program DARE and the government that marijuana is an immensely dangerous and addictive drug, tries it and finds out that it is marginally dangerous at best, what does that tell them about the other drugs that they’ve been told about? If authority figures lie about marijuana, why wouldn’t they be lying about heroin?

The government sabotages its own credibility with its outdated and misinformed drug laws. To salvage credibility, the government should put more money toward drug research in order to properly classify drugs, increase awareness of the truly dangerous drugs and cure the dangerous misconceptions that have entered the American consciousness.

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Medical Marijuana Helps. Now, How to Pay for It?

http://www.medpagetoday.com/Blogs/KevinMD/53780?xid=nl_mpt_DHE_2015-09-30&eun=g578717d0r

What is not to like about medical marijuana? It treats pain, vomiting, fatigue, anxiety, depression, insomnia, seizures, muscle spasms, Crohn’s disease, and allows many cancer patients to resume remarkably normal lives. It is not addictive. It does not interact with other medicines. It acts quickly and is easy to adjust. It can be consumed in numerous ways. It is safer than essentially any other drug: 1,500 Tylenol deaths in the U.S. in the last ten years; overdoses from marijuana in the entire world literature? None.

To that list, I add another: Compared to other medicines, it is downright cheap.

Tom was in my office today. He suffers from severe chemotherapy and cancer induced painful electric shock-like neuropathy of his hands and feet. You know what it feels like when your hand “falls asleep?” Think of that, times ten and all the time.

This incapacitated Tom, leaving him house and essentially chair bound. In response we put him on a cocktail of medicine, including steroids, Lyrica, Cymbalta, Neurontin, Oxycontin, and Percocet, each with its own side effects, including sleepiness, confusion, loss of taste, nausea, tremors, nightmares, narcotic dependence, and severe constipation. Trapped between the eternal burning and handfuls of drugs, he began to wonder whether if it was worth living.

We begged Tom to try medical marijuana, but he resisted this recommendation, because it seemed to conflict with his religious beliefs. Finally, when his minister gave the OK, he was prescribed one ounce of marijuana, per month, through the New Jersey Medical Marijuana Program (NJ MMP).

His neuropathy came under immediate and complete control. He stopped all the medicines, except a rare Percocet. He was able to leave his house, walk long distances, and return to life.

Here is the amazing part. Tom’s insurance company paid over $1,500 a month, for the pills. One month of marijuana, through a registered New Jersey dispensary, cost under $600. Not only was there a life-changing improvement in his symptoms, with essentially no side effects, there is a 65% marijuana discount.

Great story, right? Happy ending? The NJ MMP saves the day?

Unfortunately, no. You see, Tom may soon have to stop using marijuana and resume his prior costly caustic cocktail of drugs. Why? His health insurance company will pay for a pile of pills, but not marijuana. Tom must pay. Federal law prohibits the medical use of marijuana; therefore, no insurance company can legally afford to pay for cannabis.

So, let’s do a net calculus. If Tom stops using medical marijuana, he will not have to pay the $500 a month that a disabled cancer patient cannot afford. Instead, he will experience pain, decreased function and increased drug side effects. Judging by the way things were headed, when he was on pills, his life may even be shortened. The insurance company will have to pay $1,600 or more a month, as well as the cost of any medical complications or side effects. In other words, Tom will get worse care at far greater cost: the American way.

It is time to legalize medical marijuana throughout the United States. It has fewer side effects than any alternative. It is a better drug for many problems. It is good healthcare finance. The insurance industry should demand it. Legislators support it. Moreover, patients, in desperate need, would be transformed by it.

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The True Cost of the Medication Mistake: Creating an Environment that Limits Errors

http://www.healthcaredesignmagazine.com/article/true-cost-medication-mistake-creating-environment-limits-errors

How do errors in medication distribution impact a hospital’s bottom line? Just a single medication error can cost a facility hundreds of thousands of dollars. On a grander scale, medical errors cost up to $1 trillion annually according to a report in the Journal of Health Care Finance.

More importantly, preventable medical errors impact lives. In fact, they are the third largest cause of death in the United States. The Journal of Patient Safety estimates between 210,000 and 400,000 people die each year in the U.S. from adverse effects of medical treatment in hospitals. This is surpassed only by heart disease and cancer.

This staggering figure was first brought to light by the Institute of Medicine’s (IOM) study To Err Is Human. A follow-up report indicated that medication errors are among the most common medical mistakes, causing up to 400,000 drug-related injuries in hospitals each year. That means a patient may be exposed to at least one preventable adverse drug event (ADE) each day. Errors occur during every step of the process but are most prevalent during prescription and administration.

How can designers aid hospitals in addressing the issue of medication errors? Creating spaces with improved point-of-care storage and distribution is one way to do just that. Medication storage and distribution at the point-of-care has been proven to reduce medication errors, theft and loss and, in turn, improve delivery accuracy.

Installing in-room or near-room, wall-mounted systems such as the WALLAroo® with ISONAS™ technology is one way hospitals are combatting never events and medication diversion. These secure systems allow medications, personal protection equipment, critical supplies, and patient data to be housed securely at the point of care.

One of the challenges of point-of-care storage has always been security. Now, with the advanced security of “Pure IP” access control technology, authorized users can open locked cabinets and other access points with a single swipe card. Access permissions are controlled through the facility’s existing credentialing system. The system offers real-time tracking of activity per cabinet and user for complete visibility, with ongoing history and audit reports to adhere to the chain of custody requirements of HIPAA. These systems can also include data encryption, with lockdown and emergency functions, and an anti-tamper alarm system.

The simplification of the clinical workflow can be the first step in creating an environment that actively thwarts medication errors.  With simple, secure, and fast access to medications at the point of care, ever-busy clinical teams can maintain their focus with individual patients without leaving the point of care.  Ultimately making the elimination of medication errors not only possible—but attainable.

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Guns kill people in the US because we pervert the Second Amendment

http://www.theguardian.com/commentisfree/2015/oct/02/oregon-college-shooting-guns-kill-people-in-us-pervert-second-amendment?CMP=ema_565c

There seems to be a parallel between those who have lost loved ones to the consequences of undiagnosed/untreated mental health issues. This article is about the shooting in Oregon… and those who have lost loved ones and other groups start calling out for more “gun free zones”.. and restrict the sale of guns… which they believe that this will keep the guns out of the hands of criminals and the mentally ill.

Like this young man, who was the center of this shooting.. he was not looking to rob someone or some other sort of personal gain..  This was a person with known mental issue and one of the things reported that he was “upset about” was that he didn’t have a GIRL FRIEND.

It is the same sorts of arguments used by those who have lost a loved one to the mental health issue of additive personality  and have OD’ed.  Ban the drugs, stop producing the drugs…

So that it never happens again.

Just how many different things could we “ban” so that no unnecessary deaths ever happen again.. ???

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74 overdoses in 72 hours: Laced heroin may be to blame

http://www.chicagotribune.com/news/local/breaking/ct-heroin-overdoses-met-20151002-story.html

Just imagine what would happen if those with the mental health disease of addiction, if they could legally purchase commercially available opiates. Other countries have tried this and drug overdose deaths have dramatically DECREASED… because many/most of these people are not interested in dying, just desperate to quiet the demons in their head and/or monkeys on their back. So they purchase unknown substances from whatever source they can find.  How much more is it costing our system to treat 74 overdoses in a hospital than providing these people with a “known product” ? Are our societal phobias adding to our overall healthcare system costs ?

By Friday afternoon, 14 people had been rushed to Mount Sinai Hospital in Chicago in the previous 24 hours to be treated for heroin overdoses, some with the needles still stuck in their arm, according to hospital officials.

In all, nearly 75 people have overdosed in Chicago since Tuesday afternoon from dangerous batches of narcotics, possibly heroin laced with the painkiller fentanyl, according to city health and fire officials. Police were investigating if at least one recent death was caused by a heroin overdose.

“We suspect what is happening is the same thing that happened in 2006 when people were getting heroin that was cut with fentanyl, which is a very strong narcotic,” said Diane Hincks, a registered nurse and emergency room director at Mount Sinai on the West Side. “That’s what we think is happening.”

By early Friday afternoon, emergency crews had responded to 74 cases over 72 hours, more than double the same three-day period last year, said Larry Langford, spokesman for the Chicago Fire Department.

Hincks said some of the 14 overdose victims treated at Mount Sinai had collapsed as soon as they injected themselves. The hospital typically sees two or three overdoses a day, she said.

Two of Mount Sinai’s patients were in intensive care, another was still undergoing treatment, seven had been discharged and a few more were still in the emergency room as of about 3 p.m, Hincks said.

Chicago police said the drugs were purchased primarily at two locations on the West Side, one of them in the North Lawndale community. A sample of heroin recovered by police may have contained fentanyl, authorities said.

The Drug Enforcement Administration is working with Chicago police to try to find the source of the dangerous batches of drugs.

At City Council budget hearings Friday afternoon, Chief Mary Sheridan, head of the Fire Department’s emergency medical services division, said all the recent overdose victims were stabilized with a single dose of Narcan, a heroin antidote carried by Chicago paramedics, and then transported safely to hospitals. But fire officials said the victims required additional doses of Narcan after arriving at hospitals.

“They’re taking double and triple the doses of Narcan in order to bring them out of their stupor,” Hincks told the Tribune.

Paramedics and other Fire Department personnel were given extra Narcan for their medical runs, officials said.

Chicago police, meanwhile, are looking into whether a 49-year-old man who died of an apparent drug overdose in the West Side’s East Garfield Park neighborhood had ingested narcotics from one of the dangerous batches, according to law enforcement sources.

The victim was found dead in a third-floor apartment Thursday night in the 3300 block of West Ohio Street, police said. An autopsy on the victim Friday was inconclusive, pending toxicology studies that could take up to eight weeks to complete, according to a spokesman for the Cook County medical examiner’s office.

The Chicago Recovery Alliance, which helps drug users, trains the public in overdose prevention, provides HIV testing and conducts needle exchanges, urged caution.

“The best thing would be to have (Narcan),” said Dan Bigg, the group’s director. “And watch each other’s backs.”

Fentanyl-laced heroin has been causing overdoses across the nation. The DEA issued a nationwide health alert in March.

Dr. Steven Aks, chief toxicologist at Stroger Hospital and an emergency physician, said fentanyl is used for especially painful surgical procedures.

The powerful synthetic painkiller adds a potent kick to heroin, making it attractive to suppliers seeking an edge with customers.

The last major outbreak of fentanyl-related deaths took place between 2005 and 2007, killing more than 1,000 people across the country. Dozens in the Chicago area died of overdoses, including from fentanyl mixed with other drugs.

Hincks recalled how busy Mount Sinai’s emergency room was for a few weeks in 2006, when she was a charge nurse, because of the fentanyl-laced heroin.

“I remember how crazy it was,” she said. “It got to the point it was just full. We had everyone lined up in the halls on carts. … It was very busy.”

Cristina Villarreal, a spokeswoman for the Chicago Department of Public Health, said that by 8:30 a.m. Friday more than 20 people had been treated for heroin overdoses. Villarreal said the department was awaiting lab results to confirm if the heroin was laced with fentanyl.

“We are working closely to ensure that area hospitals are tracking individuals affected and are maintaining a necessary stock of medication supplies — including Narcan,” Villarreal said in an email.

John Callahan, coroner of Grundy County, said his office has seen three heroin-related deaths in the Morris and Coal City areas this year — but all of them came in August.

He said he had been contacted by the DEA about two weeks ago.

“They’re trying to trace back where this potent heroin came from,” Callahan said. “The way I understand it, there’s a bad batch.”

Heroin overdose deaths have been on the rise statewide since 2011, according to data from the Illinois Department of Public Health. Last year, 633 heroin overdose deaths occurred in Illinois, up from 583 in 2013. In Cook County, heroin overdose deaths remained largely unchanged last year at 283, down eight from 2013.

A recent Roosevelt University report concluded that the Chicago area is racking up more heroin-related emergency room visits than any other metro area in the country. Compounding the problem was that state-funded drug treatment had dried up, the report found.

Illinois’ heroin crisis has drawn increasing attention from government officials in recent years, and lawmakers have proposed numerous measures aimed at attacking the problem.

Chicago Tribune’s John Byrne and The Washington Post contributed.

jgorner@tribpub.com

pnickeas@tribpub.com

rsobol@tribpub.com

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Feds, Pharmacies Grapple With Pain Pill Dilemma

http://health.wusf.usf.edu/post/feds-pharmacies-grapple-pain-pill-dilemma#stream/0

Susan Langston wiped away tears as she spoke of a 40-year-old woman who had struggled with cancer for a decade before a Fort Myers pharmacy refused to fill a prescription for pain medication.

The prescription was rejected because it was written by a doctor at the Cleveland Clinic, a facility 100 miles away from the woman’s home and where she sought cancer treatment after her own doctors told her she was going to die.

But, according to the chain pharmacy’s policies, the prescription was flagged because it wasn’t ordered by the woman’s regular doctor, the woman traveled a long distance to obtain the prescription, and it came from South Florida, a part of the state once considered the pill-mill capital of the nation.

According to Langston, the pharmacist quit.

The cancer patient’s plight is one of many stories Langston has fielded in her job as the U.S. Drug Enforcement Administration diversion program manager in the Miami office.

“This girl is being labeled a drug seeker, a doctor shopper. She went to a different doctor. She got a different pain medicine. She drove a long distance, and she paid cash. But she also walked in there with a bald head to a pharmacist that she’s been going to for 10 years, who knows she’s none of those. And that’s awful. That’s not what we’re about. No one has ever gotten in trouble with the DEA in Florida from filling a cancer person’s prescription,” an emotional Langston said in an extended interview this week via Skype with The News Service of Florida.

Florida patients like the Fort Myers woman are caught in the crosshairs of a state and national crackdown on prescription pill abuse that’s morphed into a dreaded “pharmacy crawl” by people suffering from cancer, chronic pain and other illnesses but who can’t get their doctors’ orders for pain medications filled.

Pharmacists blame an overzealous Drug Enforcement Administration for the problem. Doctors — and the DEA — point the finger back at the pharmacists charged with filling prescriptions or at the corporations that have developed checklists to screen out dubious patients.

Meanwhile, some patients are checking into hospice care early — or even committing suicide — in search of relief.

The dilemma has reached such proportions that the Florida Board of Pharmacy is considering changes to its rules regulating the dispensing of pain medications, switching from a focus on detecting fraudulent prescriptions to ensuring that legitimate patients get the drugs they need.

But most of the players involved in Florida say the proposed rule change, scheduled for a vote Monday by a pharmacy board committee, alone will likely do little to alleviate the situation.

The rule change won’t have any effect on the policies of corporations like Walgreens and CVS, or on the policies of distributors who control the supply of drugs that flow into pharmacies.

“So it doesn’t really matter what the state of Florida says, or the DEA, or anyone else, as long as the corporation says, this is what we think,” Langston said.

Pharmacy chains won’t reveal their checklists for which patients pass muster.

When asked whether CVS has such a policy, company spokesman Mike DeAngelis referred to guidelines laid out in an industry paper released this summer, endorsed by more than a dozen associations representing doctors’ groups, chain pharmacies, pharmacists and distributors.

The “Stakeholders Challenges and Red Flag Warning Signs Related to Prescribing and Dispensing Controlled Substances” includes myriad items related to how people behave when they present prescriptions to be filled, as well as to the prescriptions themselves. One trigger is whether the patient “presents prescriptions for highly abused controlled substances,” something common for patients with chronic pain or cancer.

“Our corporate office will look into any complaint we receive from a patient who believes they are being denied a legitimate prescription, but our pharmacists do a great job in using their professional judgment to determine whether a controlled substance prescription was issued for a legitimate purpose,” DeAngelis said in an email.

One major concern for pharmacists involves an unwritten “30 percent rule” — the amount of pharmacies’ prescription drug orders made up of controlled substances — that many believe triggers scrutiny by the DEA.

But Langston denied that such a rule exists.

“There’s no number, officially, that triggers anything,” she said.

DEA probes are sparked by a “totality of circumstances,” Langston said.

“Volume, amount ordered, amount received by a pharmacy is only one of those circumstances. But we know that volume alone does not always tell the whole story. We’re very aware of that,” she said.

Langston is frustrated at the blame being placed on her agency.

“We want all pharmacists, patients, doctors and the public to know that the DEA does not want to interfere in any way with legitimate medical care. That would be morally wrong. We want legitimate patients to get the help and the medications that they need,” she said.

But a report from the U.S. Government Accountability Office this summer, based on surveys with industry professionals and DEA officials, found that over half of DEA registrants — pharmacies and distributors — have changed certain business practices based on the result of the agency’s enforcement actions.

More than half of distributors have placed stricter limits on quantities of controlled substances that their customers can order, the report found.

And more than half of individual pharmacies and chain pharmacies reported that the stricter limits “have limited to a ‘great’ or ‘moderate extent,’ their ability to supply drugs to those with legitimate needs,” according to the report.

In contrast, DEA officials “said they generally did not believe that enforcement actions have negatively affected access.”

Cardinal Health, one of the country’s largest distributors, referred questions about its policies to June testimony from one of the company’s top executives at the Florida Board of Pharmacy’s Controlled Substances Standards Committee.

The DEA has instructed distributors not to ship suspicious orders to pharmacies and to report them to the federal authorities. Failure to do so could result in the loss of the distributors’ DEA registration, Gary Cacciatore, the company’s vice president of regulatory affairs, told the committee.

Cardinal Health has placed “individualized limits on each controlled substance drug family,” imposed limits on particular drug strengths within a drug family and scrutinizes the drugs that the DEA has identified as being widely diverted, such as oxycodone and alprazolam, he said.

“These factors and many others play a role in our decisions to service customers and in setting limits on the distributions of controlled substances,” Cacciatore said.

The DEA’s actions may have had an even greater impact on the behavior of distributors and pharmacies in Florida.

In a 2012 settlement agreement, Cardinal Health was banned from shipping and selling narcotics from its Lakeland facility for two years.

Walgreens agreed to a historic $80 million penalty in 2013 related to dispensing of highly addictive narcotics.

And, earlier this year, CVS agreed to pay $22 million in fines after DEA investigators revealed that employees at two of the chain’s Sanford stores were doling out controlled substances without legitimate prescriptions. Three years ago, federal authorities stopped the stores from dispensing a number of highly addictive controlled substances, including oxycodone.

According to the Government Accountability Office report, the number of DEA complaint investigations jumped nationally from 907 in 2009 to 1,428 in 2013, as state and federal authorities grappled with a prescription drug-abuse epidemic that earned Florida the dubious distinction as the epicenter of the problem.

At the urging of Florida Attorney General Pam Bondi in 2011, state lawmakers imposed strict regulations on doctors and pharmacies about dispensing highly addictive pain medications. The effort was aimed at shutting down rogue clinics that had popped up in areas like South Florida and had drawn addicts and traffickers from states hundreds of miles away.

The law barred doctors from dispensing powerful narcotics from their offices, and shuttered almost all of the pill mills where doctors wrote hundreds of prescriptions for pain medications each day.

But the pill-mill problem hasn’t gone away, Langston said.

“Those same lines of people — those people shooting up in their cars, urinating, buying and selling urine, buying and selling pills — they ended up at pharmacies,” she said.

While most pharmacists turned those patients away, “we had a lot of bad pharmacists that turned a blind eye,” Langston said.

“When you have people shooting up in your parking lot, there’s a problem. These aren’t cancer patients or surgery patients doing this. And it’s awful that people like that are having to suffer,” she said.

Langston said she was in a pharmacy earlier this month when a homeless man paid $800 in cash for powerful narcotics. That pharmacy is now under investigation, she said. She watched as the man placed the $20 bills into stacks on the counter.

“It was really sad. I couldn’t believe that pharmacist took that money,” she said.

The DEA has no control over pharmacies’ pricing of drugs, Langston said.

“They can charge what they want. That’s not against the law. But when a pharmacist will do that, it’s very telling. Very telling,” she said.

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