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Six felony murder indictments in Pryor accidental overdose case part of a larger prescription drug problem

http://www.tulsaworld.com/news/courts/six-felony-murder-indictments-in-pryor-accidental-overdose-case-part/article_3d48d845-b746-5120-8945-9a2e39cc594d.html

Mike Miers is taken into custody at his apartment by a multi-agency task force serving warrants on Miers and five other people on drug distrubtion conspiracy and first degree murder charges in the drug death of Jennifer McNulty in Pryor on Sept. 2. Michael Wyke/Tulsa World

PRYOR — The felony murder indictments of a teenage son and five others in the accidental pain pill overdose of a Pryor woman is indicative of a larger prescription drug problem that Mayes County prosecutors are hoping to bottle up.

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And we spend 51 billion a year fighting the war on drugs… look were deaths from drug overdoses is on the list

Rank	War	Years	Deaths	Deaths per Day	US Population in First Year of War	Deaths per Population
1	American Civil War	1861–1865	750,000[93]	420	31,443,000	2.385% (1860)
2	World War II	1941–1945	405,399	297	133,402,000	0.307% (1940)
3	World War I	1917–1918	116,516	279	103,268,000	0.110% (1920)
4	Vietnam War	1961–1975	58,209	11	179,323,175 (1960)	0.030% (1970)
5	Korean War	1950–1953	54,246	45	151,325,000	0.020% (1950)
6	American Revolutionary War	1775–1783	25,000	11	2,500,000	0.899% (1780)
7	War of 1812	1812–1815	15,000	15	8,000,000	0.207% (1810)
8	Mexican–American War	1846–1848	13,283	29	21,406,000	0.057% (1850)
9	War on Terror	2001–present	6,717	1.57	294,043,000	0.002% (2010)
10	Philippine–American War	1899–1902	4,196	3.8	72,129,001	0.006% (1900)

——————————————————————————————————————————————————-

2014  thru 12/22
Abortion:	1065068
Heart Disease:	581859
Cancer:	562463
Tobacco:	341365
Obesity:	299426
Medical Errors:	204819
Stroke:	125751
Lower Respiratory Disease:	139416
Accident (unintentional):	123319
Hospital Associated Infection:	96558
Alcohol:	97533
Diabetes:	72009
Alzheimer’s Disease:	82878
Influenza/Pneumonia:	52498
Kidney Failure:	41707
Blood Infection:	32638
Suicide:	38543
Drunk Driving:	32974
Unintentional Poisoning:	30974
All Drug Abuse:	24388
Homicide:	16385
Prescription Drug Overdose:	14630
Murder by gun:	11209
Texting while Driving:	5841
Pedestrian:	4877
Drowning:	3818
Fire Related:	3414
Malnutrition:	2704
Domestic Violence:	1424
Smoking in Bed:	761
Falling out of Bed:	584
Killed by Falling Tree:	146
Struck by Lightning:	80
Mass Shooting:	12
Spontaneous Combustion:	0

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Dennis Banks Issues a State of War Declaration between AIM and Drugs; Will Lead Longest Walk 5 – War on Drugs

http://nativenewsonline.net/currents/dennis-banks-issues-a-state-of-war-declaration-between-aim-and-drugs-will-lead-longest-walk-5-war-on-drugs/

GRAND RAPIDS, MICHIGAN —Dennis Banks, co-founder of the American Indian Movement, has announced he will lead the “Longest Walk 5 – War on Drugs,” along a three-thousand mile route from California to Washington, D.C.

“Because of the extremely high rate of suicides, and other drug-related deaths, I am issuing a state of war declaration between the American Indian Movement and drugs across America. The deaths are at a pandemic stage,” stated Banks in a news release issued on Thursday from Grand Rapids.

The Longest Walk 5 – War on Drugs will begin on February 13, 2016 in La Jolla, California and end in Washington, DC on July 15, 2016.

“Today, I announce a walk across America to draw attention to and seek guidance on drug-related issues that are causing devastation on Indian reservations and communities in the United States,” stated Banks, who has been involved in several Longest Walks since 1978.

The Longest Walk 5 – War on Drugs will visit several American Indian reservations and communities as it makes its way to Washington, DC. At various stops, Banks will meet with tribal officials and other American Indians involved in substance abuse issues in Indian Country.

Orlando Vigil will serve as the national coordinator of the Longest Walk 5 – War on Drugs.

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White House Takes Aim at Billions in Medicare and Medicaid Fraud

http://www.thefiscaltimes.com/2015/09/04/White-House-Takes-Aim-Billions-Medicare-and-Medicaid-Fraud

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Federation of State Medical Boards
Of the United States, Inc.
MODEL POLICY FOR THE USE OF CONTROLLED
SUBSTANCES FOR THE TREATMENT OF PAIN
Introduction
The Federation of State Medical Boards (the Federation) is committed to assisting state medical
boards in protecting the public and improving the quality and integrity of health care in the United
States. In 1997, the Federation undertook an initiative to develop model guidelines and to
encourage state medical boards and other health care regulatory agencies to adopt policy
encouraging adequate treatment, including use of opioids when appropriate for patients with pain.
The Federation thanks the Robert Wood Johnson Foundation for awarding a grant in support of
the original project, and the American Academy of Pain Medicine, the American Pain Society, the
American Society of Law, Medicine, & Ethics, and the University of Wisconsin Pain & Policy
Studies Group for their contributions.
Since adoption in April 1998, the Model Guidelines for the Use of Controlled Substances for the
Treatment of Pain have been widely distributed to state medical boards, medical professional
organizations, other health care regulatory boards, patient advocacy groups, pharmaceutical
companies, state and federal regulatory agencies, and practicing physicians and other health
care providers. The Model Guidelines have been endorsed by the American Academy of Pain
Medicine, the Drug Enforcement Administration, the American Pain Society, and the National
Association of State Controlled Substances Authorities. Many states have adopted pain policy
using all or part of the Model Guidelines.1 Despite increasing concern in recent years regarding
the abuse and diversion of controlled substances, pain policies have improved due to the efforts
of medical, pharmacy, and nursing regulatory boards committed to improving the quality of and
access to appropriate pain care.
Notwithstanding progress to date in establishing state pain policies recognizing the legitimate
uses of opioid analgesics, there is a significant body of evidence suggesting that both acute and
1 As of January 2004, 22 of 70 state medical boards have policy, rules, regulations or statutes reflecting the
Federation’s Model Guidelines for the Use of Controlled Substances for the Treatment of Pain and two (2)
states have formally endorsed the Model Guidelines.
F e d e r a t i o n o f S t a t e M e d i c a l B o a r d s
o f t h e U n i t e d S t a t e s , I n c .
Federation of State Medical Boards
of the United States, Inc
chronic pain continue to be undertreated. Many terminally ill patients unnecessarily experience
moderate to severe pain in the last weeks of life.2 The undertreatment of pain is recognized as a
serious public health problem that results in a decrease in patients’ functional status and quality
of life and may be attributed to a myriad of social, economic, political, legal and educational
factors, including inconsistencies and restrictions in state pain policies.3 Circumstances that
contribute to the prevalence of undertreated pain include: (1) lack of knowledge of medical
standards, current research, and clinical guidelines for appropriate pain treatment; (2) the
perception that prescribing adequate amounts of controlled substances will result in unnecessary
scrutiny by regulatory authorities; (3) misunderstanding of addiction and dependence; and (4)
lack of understanding of regulatory policies and processes. Adding to this problem is the reality
that the successful implementation of state medical board pain policy varies among jurisdictions.
In April 2003, the Federation membership called for an update to its Model Guidelines to assure
currency and adequate attention to the undertreatment of pain. The goal of the revised model
policy is to provide state medical boards with an updated template regarding the appropriate
management of pain in compliance with applicable state and federal laws and regulations. The
revised policy notes that the state medical board will consider inappropriate treatment, including
the undertreatment of pain, a departure from an acceptable standard of practice. The title of the
policy has been changed from Model Guidelines to Model Policy to better reflect the practical use
of the document.
The Model Policy is designed to communicate certain messages to licensees: that the state
medical board views pain management to be an important and integral to the practice of
medicine; that opioid analgesics may be necessary for the relief of pain; that the use of opioids for
other than legitimate medical purposes pose a threat to the individual and society; that physicians
have a responsibility to minimize the potential for the abuse and diversion of controlled
substances; and that physicians will not be sanctioned solely for prescribing opioid analgesics for
legitimate medical purposes. In addition, this policy is not meant to constrain or dictate medical
decision-making.
Through this initiative, the Federation aims to achieve more consistent policy in promotion of
adequate pain management and education of the medical community about treating pain within
the bounds of professional practice and without fear of regulatory scrutiny. In promulgating this
2 SUPPORT Study Principal Investigators. A controlled trial to improve care for seriously ill hospitalized
patients: JAMA, 274(20) (1995): p. 1591-1598.
3 A.M. Gilson, D.E. Joranson, and M.A. Mauer, Improving Medical Board Policies: Influence of a Model,
J. of Law, Medicine, and Ethics, 31 (2003): p. 128.
Federation of State Medical Boards
of the United States, Inc
Model Policy, the Federation strives to encourage the legitimate medical uses of controlled
substances for the treatment of pain while stressing the need to safeguard against abuse and
diversion.
State medical boards are encouraged, in cooperation with their state’s attorney general, to
evaluate their state pain policies, rules, and regulations to identify any regulatory restrictions or
barriers that may impede the effective use of opioids to relieve pain. Accordingly, this Model
Policy has been revised to emphasize the professional and ethical responsibility of the physician
to assess patients’ pain and update references and definitions of key terms used in pain
management.
The Model Policy is not intended to establish clinical practice guidelines nor is it intended to be
inconsistent with controlled substance laws and regulations.
Model Policy for the Use of Controlled Substances for the Treatment of Pain
Section I: Preamble
The (name of board) recognizes that principles of quality medical practice dictate that the people
of the State of (name of state) have access to appropriate and effective pain relief. The
appropriate application of up-to-date knowledge and treatment modalities can serve to improve
the quality of life for those patients who suffer from pain as well as reduce the morbidity and costs
associated with untreated or inappropriately treated pain. For the purposes of this policy, the
inappropriate treatment of pain includes nontreatment, undertreatment, overtreatment, and the
continued use of ineffective treatments.
The diagnosis and treatment of pain is integral to the practice of medicine. The Board encourages
physicians to view pain management as a part of quality medical practice for all patients with
pain, acute or chronic, and it is especially urgent for patients who experience pain as a result of
terminal illness. All physicians should become knowledgeable about assessing patients’ pain and
effective methods of pain treatment, as well as statutory requirements for prescribing controlled
substances. Accordingly, this policy have been developed to clarify the Board’s position on pain
Federation of State Medical Boards
of the United States, Inc
control, particularly as related to the use of controlled substances, to alleviate physician
uncertainty and to encourage better pain management.
Inappropriate pain treatment may result from physicians’ lack of knowledge about pain
management. Fears of investigation or sanction by federal, state and local agencies may also
result in inappropriate treatment of pain. Appropriate pain management is the treating physician’s
responsibility. As such, the Board will consider the inappropriate treatment of pain to be a
departure from standards of practice and will investigate such allegations, recognizing that some
types of pain cannot be completely relieved, and taking into account whether the treatment is
appropriate for the diagnosis.
The Board recognizes that controlled substances including opioid analgesics may be essential in
the treatment of acute pain due to trauma or surgery and chronic pain, whether due to cancer or
non-cancer origins. The Board will refer to current clinical practice guidelines and expert review in
approaching cases involving management of pain. The medical management of pain should
consider current clinical knowledge and scientific research and the use of pharmacologic and
non-pharmacologic modalities according to the judgment of the physician. Pain should be
assessed and treated promptly, and the quantity and frequency of doses should be adjusted
according to the intensity, duration of the pain, and treatment outcomes. Physicians should
recognize that tolerance and physical dependence are normal consequences of sustained use of
opioid analgesics and are not the same as addiction.
The (name of board) is obligated under the laws of the State of (name of state) to protect the
public health and safety. The Board recognizes that the use of opioid analgesics for other than
legitimate medical purposes pose a threat to the individual and society and that the inappropriate
prescribing of controlled substances, including opioid analgesics, may lead to drug diversion and
abuse by individuals who seek them for other than legitimate medical use. Accordingly, the Board
expects that physicians incorporate safeguards into their practices to minimize the potential for
the abuse and diversion of controlled substances.
Physicians should not fear disciplinary action from the Board for ordering, prescribing, dispensing
or administering controlled substances, including opioid analgesics, for a legitimate medical
purpose and in the course of professional practice. The Board will consider prescribing, ordering,
dispensing or administering controlled substances for pain to be for a legitimate medical purpose
if based on sound clinical judgment. All such prescribing must be based on clear documentation
of unrelieved pain. To be within the usual course of professional practice, a physician-patient
Federation of State Medical Boards
of the United States, Inc
relationship must exist and the prescribing should be based on a diagnosis and documentation of
unrelieved pain. Compliance with applicable state or federal law is required.
The Board will judge the validity of the physician’s treatment of the patient based on available
documentation, rather than solely on the quantity and duration of medication administration. The
goal is to control the patient’s pain while effectively addressing other aspects of the patient’s
functioning, including physical, psychological, social and work-related factors.
Allegations of inappropriate pain management will be evaluated on an individual basis. The board
will not take disciplinary action against a physician for deviating from this policy when
contemporaneous medical records document reasonable cause for deviation. The physician’s
conduct will be evaluated to a great extent by the outcome of pain treatment, recognizing that
some types of pain cannot be completely relieved, and by taking into account whether the drug
used is appropriate for the diagnosis, as well as improvement in patient functioning and/or quality
of life.
Section II: Guidelines
The Board has adopted the following criteria when evaluating the physician’s treatment of pain,
including the use of controlled substances:
1. Evaluation of the Patient—A medical history and physical examination must be
obtained, evaluated, and documented in the medical record. The medical record should
document the nature and intensity of the pain, current and past treatments for pain,
underlying or coexisting diseases or conditions, the effect of the pain on physical and
psychological function, and history of substance abuse. The medical record also should
document the presence of one or more recognized medical indications for the use of a
controlled substance.
2. Treatment Plan—The written treatment plan should state objectives that will be used to
determine treatment success, such as pain relief and improved physical and
psychosocial function, and should indicate if any further diagnostic evaluations or other
treatments are planned. After treatment begins, the physician should adjust drug therapy
to the individual medical needs of each patient. Other treatment modalities or a
rehabilitation program may be necessary depending on the etiology of the pain and the
extent to which the pain is associated with physical and psychosocial impairment.
3. Informed Consent and Agreement for Treatment—The physician should discuss the
risks and benefits of the use of controlled substances with the patient, persons
designated by the patient or with the patient’s surrogate or guardian if the patient is
Federation of State Medical Boards
of the United States, Inc
without medical decision-making capacity. The patient should receive prescriptions from
one physician and one pharmacy whenever possible. If the patient is at high risk for
medication abuse or has a history of substance abuse, the physician should consider the
use of a written agreement between physician and patient outlining patient
responsibilities, including
a. urine/serum medication levels screening when requested;
b. number and frequency of all prescription refills; and
c. reasons for which drug therapy may be discontinued (e.g., violation of
agreement).
4. Periodic Review—The physician should periodically review the course of pain treatment
and any new information about the etiology of the pain or the patient’s state of health.
Continuation or modification of controlled substances for pain management therapy
depends on the physician’s evaluation of progress toward treatment objectives.
Satisfactory response to treatment may be indicated by the patient’s decreased pain,
increased level of function, or improved quality of life. Objective evidence of improved or
diminished function should be monitored and information from family members or other
caregivers should be considered in determining the patient’s response to treatment. If the
patient’s progress is unsatisfactory, the physician should assess the appropriateness of
continued use of the current treatment plan and consider the use of other therapeutic
modalities.
5. Consultation—The physician should be willing to refer the patient as necessary for
additional evaluation and treatment in order to achieve treatment objectives. Special
attention should be given to those patients with pain who are at risk for medication
misuse, abuse or diversion. The management of pain in patients with a history of
substance abuse or with a comorbid psychiatric disorder may require extra care,
monitoring, documentation and consultation with or referral to an expert in the
management of such patients.
6. Medical Records—The physician should keep accurate and complete records to include
a. the medical history and physical examination,
b. diagnostic, therapeutic and laboratory results,
c. evaluations and consultations,
d. treatment objectives,
e. discussion of risks and benefits,
f. informed consent,
g. treatments,
h. medications (including date, type, dosage and quantity prescribed),
i. instructions and agreements and
Federation of State Medical Boards
of the United States, Inc
j. periodic reviews.
Records should remain current and be maintained in an accessible manner and
readily available for review.
7. Compliance With Controlled Substances Laws and Regulations—To prescribe,
dispense or administer controlled substances, the physician must be licensed in the state
and comply with applicable federal and state regulations. Physicians are referred to the
Physicians Manual of the U.S. Drug Enforcement Administration and (any relevant
documents issued by the state medical board) for specific rules governing controlled
substances as well as applicable state regulations.
Section III: Definitions
For the purposes of these guidelines, the following terms are defined as follows:
Acute Pain—Acute pain is the normal, predicted physiological response to a noxious chemical,
thermal or mechanical stimulus and typically is associated with invasive procedures, trauma and
disease. It is generally time-limited.
Addiction—Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial,
and environmental factors influencing its development and manifestations. It is characterized by
behaviors that include the following: impaired control over drug use, craving, compulsive use, and
continued use despite harm. Physical dependence and tolerance are normal physiological
consequences of extended opioid therapy for pain and are not the same as addiction.
Chronic Pain—Chronic pain is a state in which pain persists beyond the usual course of an
acute disease or healing of an injury, or that may or may not be associated with an acute or
chronic pathologic process that causes continuous or intermittent pain over months or years.
Pain—An unpleasant sensory and emotional experience associated with actual or potential tissue
damage or described in terms of such damage.
Physical Dependence—Physical dependence is a state of adaptation that is manifested by drug
class-specific signs and symptoms that can be produced by abrupt cessation, rapid dose
reduction, decreasing blood level of the drug, and/or administration of an antagonist. Physical
dependence, by itself, does not equate with addiction.
Pseudoaddiction—The iatrogenic syndrome resulting from the misinterpretation of relief seeking
behaviors as though they are drug-seeking behaviors that are commonly seen with addiction. The
relief seeking behaviors resolve upon institution of effective analgesic therapy.
Substance Abuse—Substance abuse is the use of any substance(s) for non-therapeutic
purposes or use of medication for purposes other than those for which it is prescribed.
Federation of State Medical Boards
of the United States, Inc
Tolerance—Tolerance is a physiologic state resulting from regular use of a drug in which an
increased dosage is needed to produce a specific effect, or a reduced effect is observed with a
constant dose over time. Tolerance may or may not be evident during opioid treatment and does
not equate with addiction.
©Copyright May 2004 by the Federation of State Medical Boards of the United States, Inc.

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Outspoken Helena doctor to stop treating pain patients

http://ravallirepublic.com/news/local/article_669903bc-540a-11e5-9480-8b21610dba53.html

Dr. Mark Ibsen of Helena has been an outspoken advocate for providing chronic pain patients with the medications, including opiates, they need to carry on with their lives.

This week, in a short note, Ibsen told his patients he would no longer be able to do that.

Ibsen’s decision follows the Ravalli County indictment of Dr. Chris Christensen of Florence on 400 felonies, including two counts of negligent homicide.

Prosecutors allege that Christensen distributed prescription drugs to patients outside the course of his professional practice, including providing methadone to two Missoula patients who overdosed and died.

Ibsen’s note read: “To our patients: in solidarity with Dr. Christianson (sic), and in acknowledging the extreme hostility of the regulatory environment in which we are operating, Dr. Ibsen will no longer be prescribing any pain medications to chronic pain patients. Dr. Ibsen will be taking some time off to plan the next safe course of action. We wish you all the best.”

Ibsen’s announcement set off a panic for the hundreds of people who depend on him to treat their chronic pain, said Kate Lamport of Helena.

She knows. She’s one of them.

A mother of four, the 32-year-old Lamport suffers from fibromyalgia, a chronic disorder characterized by deep, general pain, fatigue and tenderness.

“My entire body hurts,” she said. “My joints feel swollen. Bending over and standing hurts. My muscles ache and spasm to the point I can’t use my arms. I lose feeling in parts of my body. I drop things. I fall. I run into things.”

When Lamport’s previous physician was unable to treat her pain, she turned to Ibsen.

“He listened to me,” she said. “I spent two or three hours with him that first day … He’s a person who listens to you and explores alternatives. He wants you to get better. He doesn’t just say ‘take these medications’ and then sends you on your way.”

Ibsen prescribed a course of medications, including opiates, that Lamport said helped her function again.

Lamport was so impressed with Ibsen that she began volunteering at his Helena clinic to help other chronic pain patients fill out forms and find alternative resources.

Many of those patients are now contacting her and looking for answers that she can’t give.

“I get messages all day,” she said. “People are saying to me: ‘What am I going to do? No doctor will treat me. I’ve called all over.’”

Lamport said she doesn’t know what to tell them.

“They really don’t have any choices,” Lamport said. “They don’t have a doctor they can turn to. Every doctor that I called, especially after this Christensen thing, does not want to take anybody with a pain condition.

“They call up asking me for help, and I don’t have an answer,” she said. “That’s because I really don’t know. Some of them can’t even afford to get a medical marijuana card.”

Lamport is quickly weaning herself off her medications while looking for some alternative ways to treat her chronic pain.

“Withdrawal is not fun,” she said.

Before she received treatment from Ibsen, her days were often spent curled up on her bed or her couch crying out in pain, she said.

“Right now, I’m afraid of going back to my couch,” Lamport said. “There are so many of us who are just trying to live our lives. I just want to be able to make dinner for my kids and go to their football games. My kids are what keep me going. Without them, I would have given up a long time ago.”

Ibsen said last week that his decision to stop prescribing pain medications to his patients with chronic pain was heartbreaking.

“I tried to figure out a way to cut down on the volume of chronic patients that I treat,” he said. “How do you make the decision on who gets thrown off the island?”

His decision has been a long time coming.

In June, a state examiner found that the Montana Board of Medical Examiners had failed to meet its burden of proof that the longtime Helena doctor had over-prescribed pain medication to nine patients. The examiner did rule that Ibsen needed to improve his record keeping.

The board brought the action two years earlier against Ibsen, owner of Urgent Care Plus and a former emergency department doctor at St. Peter’s Hospital.

Ibsen said the matter was incredibly stressful.

The action by the board was initially filed in July 2013 after a former employee made allegations that Ibsen over-prescribed medications to nine patients. The investigation later expanded to include 21 former patients of Christensen who sought Ibsen’s care after a drug task force raided and shut down the Florence clinic.

Ibsen is certain that he’s still being investigated by the federal Drug Enforcement Administration (DEA).

In 2014, Ibsen said a DEA agent told him: “You are not only risking your license by prescribing to these folks, you are risking your freedom.”

Ibsen said he asked the agent what he could do to ensure that he was doing things right.

He said the agent replied: “I can’t tell you. We’re not doctors.”

Since then, Ibsen said he’s taken to wearing a GoPro video recorder around his neck to document all of his interactions with patients.

After hearing about the charges against Christensen and reading a similar story from Florida where authorities are seeking the death penalty against a physician in a similar case, Ibsen said it was “too dangerous” for him to continue in this regulatory climate.

“That was pretty much it for me,” he said. “These guys are not going to stop.”

Ibsen said he has already heard from patients who are preparing themselves for a life without the medications that have kept their chronic pain at bay.

One patient suffers from a relatively unknown malady called adhesive arachnoiditis that causes unbearable chronic pain.

“Under my care, she has gone on pain medications that allowed her to go back to work,” Ibsen said. “She couldn’t work before that happened. She can’t function without high doses of opiates … She told me she’s going to quit her job because she knows she won’t be able to do it.

“I have case after case after case like that,” he said. “It’s heartbreaking.”

He said the stress has finally taken its toll.

“I can’t even think straight any more,” he said.

Ibsen said his staff was on board with his decision to take some time off to consider his options.

“I think we need to return to the urgent-care model,” Ibsen said. “We’ll have to limit how many prescriptions for pain medication that we write … I treated the most difficult patients. Other doctors wouldn’t do it. I now see why.

“I’ve done my best for my patients and I wish them well,” he said. “I’m on some kind of path and I’m not sure where it’s going to take me.”

Pain-patient advocate Terri Anderson of Hamilton said it’s time for chronic-pain patients and their families to step forward and let regulators know about this growing health care crisis.

“Pain patients are committing suicide, and families don’t want to talk about this as they view it as bringing shame on them,” Anderson said.

Anderson said 40 percent of all suicides in Montana are directly related to chronic pain and illness.

Anderson suffers from adhesive arachnoiditis caused by a failed medical procedure that misplaced steroids in her spine. She lost her civil engineering career with the U.S. Forest Service because of it.

Anderson will rely on high powered opiates for the rest of her life to address the “suicide-level pain” that’s been created, she said.

“Spinal injections expose patients to many risks for temporary benefits,” Anderson said. “Patients are bullied, shamed, dismissed and abandoned if they do not submit to profitable procedures in Montana pain clinics.”

Anderson said it’s time for patients and their families to file complaints with the Board of Medical Examiners if they are coerced to undergo risky procedures or if they are denied appropriate medications.

“Only then will we get the attention of the regulators,” she said.

The Montana Medical Association did not return a phone call for comment on this story.

The inability of chronic-pain patients to obtain medications will drive some to look to the black market, Lamport said.

“There will be a rise in the number of people using heroin and other street drugs,” she said. “This is a health care crisis. Everyone is afraid.

“There’s only so much pain a person can endure before they give in,” Lamport said. “That’s just the reality of our lives. When you can’t eat, can’t get out of bed and you just lay there in a ball crying all day and all night, there’s just only so much you can take.

“If a doctor can give you a medication that allows you to work and be a productive member of your community and take care of your family, why would you take that away?” she said. “This is really inhumane. We’re backed into a corner without any treatment options. It’s just not right.”

Filed under: General Problems | 2 Comments »

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/InVitroDiagnostics/HomeUseTests/ucm125722.htm

If the test results are negative, can you be sure that the person you tested did not abuse drugs? No. No drug test of this type is 100% accurate. There are several factors that can make the test results negative even though the person is abusing drugs. First, you may have tested for the wrong drugs. Or, you may not have tested the urine when it contained drugs. It takes time for drugs to appear in the urine after a person takes them, and they do not stay in the urine indefinitely; you may have collected the urine too late or too soon. It is also possible that the chemicals in the test went bad because they were stored incorrectly or they passed their expiration date.

If you get a negative test result, but still suspect that someone is abusing drugs, you can test again at a later time. Talk to your doctor if you need more help deciding what steps to take next.

I have received TWO EMAILS TODAY regarding pts being “fired” for failing a pee in the cup drug test. Typically, the stories that I have heard, there is a denial of a repeat test, even though it is reported that these tests can have up to  a 40% false positive/negative.

We know that most chronic pain clinics have a waiting lists of pts wanting to be seen… Are these pts that are being “fired” are those that have run up a unpaid bill and reached a cut off point… Has their insurance become slow to pay and/or reduced their allowables for the services provided and/or paying less frequently for particular procedures.

Has the prescriber accepted too many pts into the practice that can safely handled and a negative/positive urine test is used to thin the heard of pts that they have little possibility of collecting monies due, have insurance issues of timely payments, reduced allowables or other issues that the prescriber and/or staff no longer wish to deal with… and use the “failed urine test” as the methodology to fire pts.

Most likely, the pt never see the actual test container and the results not does the practice make a digital of the results as proof.. all there is .. is the staff’s reading of the results that are recorded into the pt’s records.

What is a patient to do ? Normally the pt is given the “bad news” several days after the test was taken and likely all proof of the test results have been discarded or destroyed.  Going to a independent lab to get retested, the prescriber could claim that the pt started taking their medication again just to pass the test.

Of course, having a independent test would allow the pt to send a letter to the prescriber asking that a letter from the pt and the second test be included in their medical records.  Pt should also request a copy of all their medical records from their former physician.

Of course, the pt could fight the prescriber for being lied to and falsely fired.. but.. do you want a prescriber treating you.. who lied to you about urine test ?

 

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Closed Formulary Could Decrease Use of ‘N’ Drugs

http://www.riskandinsurance.com/closed-formulary-decrease-use-n-drugs/

I may have missed it, but in this whole article on workman comp and medication therapy.. I did not see ONE WORD on pt outcomes. There is a lot about CUTTING COSTS…  In fact I can’t find the word PATIENT in this entire article either.  Doesn’t that give you the WARM FUZZIES ?

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