A town in Massachusetts decided to stop arresting drug users. 2 months later, here’s how it’s going.

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Multi-State Alliance Forms Against Heroin, Prescription Pill Epidemic

http://www.greenevillesun.com/news/local_news/multi-state-alliance-forms-against-heroin-prescription-pill-epidemic/article_67c31eee-a2d2-5c0a-96cf-7de7995ceca1.html

100,000 people die annually from hospital acquired infections, 58,000 homicides annually, 40,000 commit suicide annually, 35,000 die annually in car accidents. We can’t make healthcare providers wash their hands and other things that prevents hospital acquired infections, how do you prevent all those suicides, we continue to sell cars, and we kept killing each other off. But all of those deaths are less important than those who suffer from mental health addiction…  and their answer to this problem ???  The summit seeks to target the national and regional problem “by dismantling drug trafficking organizations that distribute heroin and prescription pills and by increasing prevention and educational efforts,” the release said.

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J.D. Power survey: Customers satisfied with pharmacies

http://www.drugstorenews.com/article/jd-power-survey-customers-satisfied-pharmacies?utm_term=DSN204731&utm_source=MagnetMail&utm_medium=subject&utm_term=Weekend%20Update%3A%20DSN%E2%80%99s%2010%20HOTTEST%20TRENDING%20stories%20this%20week&utm_content=DSN-NLE-WeekendUpdate-08-29-15

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As Insurers End Coverage for Compounded Drugs, Patients Struggle

https://senior.com/as-insurers-end-coverage-for-compounded-drugs-patients-struggle/

It’s a David-vs.-Goliath dispute, and millions of patients are caught in the middle — perhaps even unaware they’re about to lose coverage for the compounded medications they need for their conditions.

At issue are the customized medications pharmacists prepare for patients who can’t metabolize or tolerate commercial drugs. Compounded medicines often are the only option for doctors treating certain children and seniors, patients coping with the pain of cancer and diabetes, and those with liver or kidney diseases.
In one corner: powerful insurance companies and pharmacy benefit managers (PBMs) hell-bent on saving money by eliminating or cutting coverage of those medications.

In the other corner, fighting to reverse their moves: a coalition of patients, physicians, pharmacists and pro-patient groups like the Veterans Advocacy Group of America, the Kidney Cancer Association and the Arthritis Foundation.

“This is about shifting costs to patients,” says Jay McEniry, executive director of Patients and Physicians for Rx Access (saverxaccess.org). “Physicians are being placed in the impossible position of either prescribing a compounded medication the patient needs but can’t afford, or prescribing a less effective treatment because it may be covered by the patient’s insurance.”

The list of “Goliaths” who’ve announced or already implemented such cutbacks now includes United Healthcare/Optum Rx, Catamaran, CVS/Caremark, Harvard Pilgrim and Blue Cross Blue Shield plans in several states.

But the coalition’s immediate wrath is directed at the nation’s largest PBM: Express Scripts, which in September is slated to stop covering 1,000 drug ingredients commonly found in compounded medications — effectively “eliminating an entire class of medications,” says McEniry.

Express Scripts and others argue that commercial drugs can do the job just as well for less money. But try telling that to patients like Linda Sauer.
The Dwight, Illinois, woman relies on her doctor-prescribed compounded medications for relief from several painful and debilitating conditions, and is outraged that Express Scripts’ decision leaves her no choice but to pay for them out of pocket.
“They’re denying me access to medicines that work better than the mass-produced drugs I’ve tried,” she says. “It will cost me and others hundreds of dollars per month.”

Sauer at least has read the advisory notice from Express Scripts, which the coalition claims gives “misleading reasons” for targeting what it calls “essential medicines” whose ingredients are purchased from FDA-regulated suppliers. But what of patients who didn’t?

Sadly, they’re in for a shock the next time they try to fill a prescription.

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Heroin users are cutting their heroin with a deadly chemical in hopes of bringing themselves ‘as close to the line as possible’

http://finance.yahoo.com/news/junkies-cutting-heroin-deadly-chemical-022046937.html

There is an alarming new trend among heroin users.

They’re mixing the drug with the synthetic opiate fentanyl — an anesthetic that is 30-to-50 times more potent than heroin, and infinitely more deadly.

“The big thing with heroin users now is finding heroin laced with fentanyl,” explains Drug Enforcement Agency (DEA) Spokesperson Matthew Braden to Business Insider. “Fentanyl to the touch in its pure form will kill you by touching it.”

Braden recalls an addict who used heroin laced with fentanyl explaining his decision:

The junkie said, “Hey, ya know what? We all know that it could very well kill us, but that is exactly what we are looking for. To get as close to the line as we can possibly get,” Braden said.

According to the National Institute on Drug Abuse, fentanyl is a powerful synthetic opiate analgesic that is 80-to-100 times more potent than morphine.

It is used to treat patients with severe pain or to manage pain after surgery. Street names for the drug include Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, as well as Tango and Cash.

It works by binding to the brain’s opiate receptors to drive up dopamine levels and produce a state of euphoria and relaxation. The National Institute on Drug Abuse notes that cutting fentanyl with street-sold heroin amplifies its potency and potential danger. Effects can include drowsiness, respiratory depression and arrest, nausea, confusion, constipation, unconsciousness, coma and, as Braden notes, death.

“It takes very little for someone to overdose on it, to cause the level of respiratory depression that would cause you to die,” DEA spokesperson Barbara Carreno told Reuters.

Mexican cartels produce a variant called acetyl fentanyl and smuggle it into the United States for distribution, according to an NPR report. The DEA warns that all around America, drug dealers are cutting heroin with acetyl fentanyl to drive up the potency of their product.

“If you make that right mix, everyone loves your stuff,” Angelo Alonzo, a recovering addict who tried heroin laced with fentanyl, told NPR. “But, you know, that right mix might kill some people, too.”

NPR adds that heroin laced with acetyl fentanyl can fetch a higher price on the street, and the DEA says it is not included in many screens for toxic drugs. 

In a period from late 2013 through 2014, federal officials estimate that there were at least 700 fentanyl-related deaths nationwide. More recently, reports of fentanyl overdoses have spread like wildfire.

This week, Maine Gov. Paul LePage convened a summit to address the heroin crisis in his state, calling on the National Guard to aid in efforts to thwart drug traffickers.

“In July alone, we suspect that approximately one death a day in Maine was due to a drug overdose of some sort,” Maine Attorney General Janet Mills told NPR. “We are confirming this with laboratory testing, but a substantial number of those involved fentanyl.”

While Braden calls the issue “maddening,” the bitter irony is that addicts want heroin laced with the deadly chemical.

“The sad thing is that when people hear that people are dropping or dying out there, that is usually when an addict wants that specific stuff,” Alonzo told NPR.

“They think that the high is unbelievable. And they want it, and you can understand why. But that is a tough call, you are playing with your life.”

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‘End-of-life counseling’: Death panels are back

http://nypost.com/2015/07/12/end-of-life-counselling-death-panels-are-back/

Is the Government DOUBLING DOWN … those with chronic diseases that are costly to treat/manage getting more and more DENIAL OF CARE… now they want to pay for those on Medicare ( Old & Disabled) to get END OF LIFE COUNSELING.

Look out, Grandma: Medicare said on Wednesday it wants to start paying for end-of-life counseling.

It’s being sold as “death with dignity,” but it’s more like dying for dollars. Seniors are nudged to forego life-sustaining procedures and hospital care to go into hospice. That enriches the booming hospice industry and also frees up dollars for the left’s favored social causes.

Why is the government meddling with how we cope with death? The Institute of Medicine doesn’t mince words. Scrimping on seniors will free up money “to fund highly targeted and carefully tailored social services for both children and adults.” Just like ObamaCare. Robbing Grandma to spread the wealth.

In 2009, President Obama said seniors are getting too many procedures and maybe they’re “better off not having the surgery, but taking the painkiller.” Obama’s health guru Ezekiel Emanuel argues the elderly should be a lower priority because “they have already had more life-years.”

It’s the perfect storm of ideology and industry greed, with hospice providers lobbying lawmakers to make end-of-life counseling the standard.

And not just once. Hospice advocates want to drill their morbid message into patients’ heads. “It has to be a series of recurring conversations over years,” an industry representative insists.

Imported from Europe, the hospice industry has boomed — and taken a sharp turn from nonprofit to aggressively for-profit. Revenues are up 500 percent since 2000, and the industry is flexing its muscle in state capitols and Washington, DC.

In 2010, industry lobbyists convinced New York lawmakers to compel all doctors to offer end-of-life counseling to patients with terminal illnesses. New York’s law imposes heavy fines, even jail time, on doctors who don’t.

The state’s physicians protested that some patients will break down at the mention of hospice and give up on life. Other doctors have patients who are religiously or culturally opposed. But the law prohibits exemptions.

Advocates say end-of-life counseling is always voluntary for the patient. Technically that may be true, but if your doctor faces penalties for not doing it, you’re going to feel pressured to go along.

That was the problem with the end-of-life counseling provision in an early draft of ObamaCare in 2009. It said Medicare would pay doctors for end-of-life counseling. Fine.

But the bill went on to prescribe what doctors would have to discuss. That’s not fine.

Uncle Sam can’t possibly know better than your family, the doctor at your bedside and maybe your minister or rabbi.

And the provision would’ve punished doctors who didn’t go along, which the Institute of Medicine is calling for again.

A doctor’s quality rating (and pay from Medicare) would have depended partly on the proportion of patients who had advanced directives and how many adhered to them. Hardly voluntary if your doctor’s pay depends on your sticking to your “Do Not Resuscitate” order.

Trouble is, some seniors who could survive their illness and go home are pressured into forgoing medical care. Advocates parrot the statistic that 25 percent of Medicare hospital expenditures are for the last year of life.

That’s like harping on how often Babe Ruth struck out.

Three-quarters of the time, this care is helping seniors. A major study of 208 California hospitals proves that spending more on Medicare patients leads to substantially higher survival rates. More seniors in these higher-spending hospitals make it home and resume their lives.

Despite the consequences of coaxing seniors into less care, Jeb Bush is on the bandwagon, saying seniors should be forced to fill out an advanced directive in order to get Medicare.

His Republican rivals should make it clear they won’t give the government control over this highly personal decision.

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I have recently heard of three chronic pain pts that have committed suicide. It wasn’t on the news.. it wasn’t on the web… it was friends that stated they had lost friends to suicide. How many others have taken a similar path on a daily basis..  It is reported anywhere from 15 K to 46 K people dying from drug overdoses.. how many of these deaths were suicides and just “covered-up” as a death by drug overdose ? We have abt 40 K that commit suicide every year in this country by non-drug methodologies.

Have you ever noticed that when some addict/junkie dies of a drug overdose.. which could just as well be a suicide.. their family becomes incensed because their loved one died because of their addictive personality and their abuse of some substance ?  They form groups and contact the media to try and make sure that “it never happens again to anyone else’ loved one ”

But it seems that when a chronic pain pts commits suicide because of under treated/untreated pain and/or plain old denial of care… their relatives seem to go as silent as the now dead chronic pain pt is.

To some.. it would seem that pained lives DON’T matter to many.

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Cocaine Production Plummets After DEA Kicked Out Of Bolivia

http://www.mintpressnews.com/cocaine-production-plummets-after-dea-kicked-out-of-bolivia/209065/

According to data released by the United Nations, cocaine production in the country declined by 11% in the past year, marking the fourth year in a row of steady decrease.

Bolivia — After the U.S. Drug Enforcement Agency (DEA) was kicked out of Bolivia, the country was able to drastically reduce the amount of coca (cocaine) produced within its borders. According to data released by the United Nations, cocaine production in the country declined by 11% in the past year, marking the fourth year in a row of steady decrease.

It was just seven years ago that the DEA left Bolivia — and only three years after that, progress was finally made. The strategy employed by the Bolivian government may be a surprise to many prohibitionists because it did not involve any strong-arm police state tactics. Instead, they worked to find alternative crops for farmers to grow that would actually make them more money.

“Bolivia has adopted a policy based on dialogue, where coca cultivation is allowed in traditional areas alongside alternative development [in others],” Antonino de Leo, United Nations Office on Drugs and Crime’s representative in Bolivia, told VICE News.

“It’s not only about making money off a crop. In the old fashioned alternative development approach, we substitute one illicit crop for a licit crop. It’s about a more comprehensive approach that includes access to essential services like schools, hospitals, and roads in areas that traditionally have been hard to reach,” Leo added.

There are unfortunately still harsh laws against drug trafficking in Bolivia, but these have been active since the height of the drug war and have had no effect on the recent decline in production. Bolivian president, Evo Morales — a former coca farmer himself — has been less heavy handed since the DEA left the country, a move that allowed the government to develop alternatives for the struggling farmers instead.

The drug war is one of the most misunderstood subjects in mainstream political discourse, even among people who are sympathetic to the plight of responsible drug users. It is rare for someone to come out and say that all drugs should be legal, but in all honesty, this is the only logically consistent stance on the issue. To say that some drugs should be legal while others should not is still giving credence to the punishment paradigm and overlooking the external consequences of drug prohibition — or prohibition of any object, for that matter.

As I explained in an earlier article, there are many external factors that are affected by the drug war that many people don’t take into account. That is because when you carry out acts of violence, even in the form of punishment, you then create a ripple effect that extends far beyond the bounds of the original circumstance to affect many innocent people down the line. The list in my previous article delves into those external factors to illustrate how drug users and non-users alike would be a lot better off if prohibition ended immediately.

The list includes the following advantages of full legalization:

(1) Reduce violent crime

(2) Improve seller accountability and drug safety

(3) Reduce drug availability to children

(4) Reduce nonviolent prisoner population

(5) Real crime can be dealt with

(6) Encourage genuine treatment for addicts

(7) Prevent drug overdoses

(8) Protect individual rights

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Pain by the Numbers

http://www.medpagetoday.com/PainManagement/PainManagement/53225

In one of the largest population studies on pain to date, researchers with the National Institutes of Health estimate that nearly 40 million Americans experience severe pain and more than 25 million have pain every day.

Those with severe pain were more likely to have worse health status, use more health care, and suffer from more disability than those with less severe pain.

“There are so many people in the severe pain category that something has to be done,” said Richard Nahin, the lead author of the analysis and lead epidemiologist for the National Center for Complementary and Integrative Health, the arm of the NIH that funded the study. “If people are in the most severe category of pain, whatever treatment they are getting may be inadequate.”

Published in The Journal of Pain earlier this month, the study is an analysis of 2012 data from the National Health Interview Survey. It follows a comprehensive 2011 Institute of Medicine report on pain.

The analysis examined pain differences among ethnic groups. For example, Hispanics and Asians are less likely to report pain.

“If you are dealing with a minority group that doesn’t speak English, you need to pay greater attention to eliciting what they mean when they say they have mild pain or severe pain,” Nahin said.

The authors of the analysis hope their work will help inform greater research and better treatment options for people in pain.

“We’re doing a lot of research on the mechanism of pain and potential medications. The problem is there is no silver bullet,” said David Shurtleff, deputy director of NCCIH. “These data are giving us a better understanding of the pain conditions in the United States. We now can understand how sub-populations across age and across ethnic groups are experiencing pain.”

Shurtleff said that pain is a challenge to treat because it is not just about what happens to a person physically. Emotional and cognitive factors come into play as well. “Our major focus is on symptom management for pain,” he said. “It’s not necessarily [one] medication or behavioral intervention. It’s likely to be an integrative approach using multiple strategies to help patients alleviate their pain.”

Paul Gileno, who has had chronic pain since he broke his back 12 years ago, is doing just that. Gileno, who founded the U.S. Pain Foundation advocacy group, uses acupuncture, meditation, and changes to his diet to manage his pain. He is now able to take fewer painkillers, he said.

“You need to keep trying these different modalities because you never want to give up hoping that your pain can be reduced or go away,” he says.

Gileno endured multiple surgeries and has tried many different pain medicines, but he still lives with pain every day.

Untreated pain is something Dr. Sean Morrison sees in many of his patients. He is a geriatrician and director of Palliative Care at Mount Sinai Hospital in New York.

“Pain causes a tremendous amount of suffering,” said Morrison. “It has huge economic costs, because of people who cannot work … And it has a significant impact on caregivers who are caring for people who have pain.”

As more effective treatments are developed for a greater number of diseases, a growing number of people will suffer from pain as a side-effect, he said.

“Many of the cancer drugs we use now result in permanent nerve injury and resulting neuropathic pain which is very difficult to treat,” he said.

Another of Morrison’s frustrations is the growing level of scrutiny physicians and pharmacists are under as they treat pain. The law enforcement crackdown on prescription drug abuse appears to be making it harder for legitimate pain patients to get the medicines they need.

“What’s happening is that the same drug is being used appropriately by group of patients and inappropriately in a large segment of the population,” Morrison said. “What we’ve seen is people in pain are the unintended victims of the war on drugs.”

NIH is in the process of finalizing a National Pain Strategy to coordinate efforts among different agencies to prevent, treat, manage, and study pain.

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