“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
After the recent crackdown on prescription and synthetic drugs across the state, authorities are now focusing on controlling an herb currently legal in Florida and believed to elicit the same effects of some narcotics. Made from the leaves of trees that grow in southeast Asia, kratom is on the radar of many agencies: the U.S. Food and Drug Administration began detaining imported kratom last year and the Florida Department of Agriculture and Consumer Services ordered grocery and convenience stores to stop selling the products. The U.S. Drug Enforcement Administration also added it to its list of drugs of concern.
In Florida, Sarasota is the only county that has outlawed the herb.
The rest of the state might be next: State Rep. Kristin Jacobs of Coconut Creek filed a bill in January that would make the supplement a controlled substance.
“This is Florida’s next crisis,” Jacobs said. “We must at some point figure out how to become proactive rather than reactive to these kinds of efforts.”
But many kratom users credit the herb for curbing their addictions to pain medication.
“I am concerned,” said Tammy Hartman of North Fort Myers. “I don’t want to go back to the situation and the mental place I was at.”
In Tampa Bay, kratom is being sold in smoke shops, including in Dunedin, Safety Harbor, and St. Pete Beach, said Pinellas Sheriff’s Capt. Mark Baughman, who oversees the narcotics division.
“I’m hoping something will be done,” Baughman said. “I think that because it’s still relatively new on the market that we haven’t seen all the side effects.”
Kratom, also available online, comes in pills, crushed leaves, and powder that can be added to drinks. One bottle of capsules containing two doses costs about $20.
Kratom has been used in southeast Asia for decades, according to the DEA. At low doses, it functions as a stimulant that triggers alertness and energy. At high doses, kratom can cause sedative effects similar to opiates.
Side effects may include nausea, itching, and loss of appetite, the DEA reports, although some cases of psychosis have been documented, including hallucinations and confusion.
Some research suggests kratom can have dangerous interactions if taken with prescription drugs. Jacobs said investigators recently told her about a Santa Rosa county man found dead after taking kratom.
According to the DEA, the supplement has no “legitimate medical use.”
Chris Giblin, owner of smoke shops in Holiday and Clearwater, said most of his kratom customers use it to alleviate pain. Since Giblin began selling it more than two years ago, kratom has become one of the most popular products at his stores.
James Morrissette, a Cape Coral distributor, said many kratom users use it to treat fibromyalgia, anxiety, and insomnia.
“It’s growing,” Morrissette said of kratom’s popularity. “There’s a tremendous amount of interest and it’s solving problems with many people’s lives.”
Morrissette created the Facebook group, “The American Kratom Society,” which has more than 1,400 members. Among them is Hartman. She took prescription drugs for 10 years to cope with back pain related to a motorcycle crash.
“I had become addicted to it,” she said. “I had taken them for so long they weren’t working so well.”
A few years ago, she started taking kratom daily. Her pain is gone and she doesn’t feel the grogginess triggered by pills, she said. If kratom is banned in Florida, Hartman, 42, said she will consider moving to another state.
“If this does pass,” she said, “it can change my life all over again.”
Contact Laura C. Morel at lmorel@tampabay.com or (727)445-4157. Follow @lauracmorel.
Info box
Kratom: a tree growing in southeast Asia that produces leaves used in supplements to boost energy or treat ailments such as pain and insomnia.
How it’s taken: In many forms, including capsules or powder that can be added to drinks.
States that have banned kratom: Indiana, Tennessee, Vermont, and Wisconsin. Arizona created an age 21 restriction.
Countries that have banned kratom: Australia, Burma, Thailand, and Malaysia.
Toward the end of the operation, however, the DEA may have allowed the twins to keep trafficking their drugs, according to thousands of federal court records, police reports, and court testimony analyzed by Chicago Reader’s Jason McGahan in 2013.
While it might seem shocking that a government agency would let crimes continue, had the twins been arrested immediately, officials never would have nailed two even larger criminals.
On the other hand, it probably would have prevented tons of cocaine from entering US streets.
The twins’ organization grew in Chicago in the early 2000s and at some point began operating within the largest drug trafficking group in the world, the Sinaloa cartel.
Apparently fearing prison time, the Flores twins eventually surrendered themselves on Nov. 30, 2008. Even before that, however, they had teamed up with the DEA to give information on high-ranking Sinaloa leaders in hopes of obtaining more lenient sentences.
While the twins’ cooperation officially began in October 2008, the their lawyer initially made contact with the DEA in April 2008, according to court documents analyzed by McGahan. Between April and the time of their arrest, the brothers’ reportedly trafficked six to eight tons of cocaine into the US.
During his trial, for example, Jorge Llamas, a Chicago drug pusher for the Flores brothers, gave the following testimony under cross-examination:
Q: Let me ask you this: How many times did you pick up drugs or deliver drugs for the Flores brothers from April ’08 through December ’08?
A: Ooh. I don’t know.
Q: Lots of times?
A: Not as much, because … I wasn’t on the day-to-day. So it wasn’t as much as prior ’04.
Q: But it was still going strong, wasn’t it, from April ’08 to December of ’08?
A: Yeah.
The DEA withheld the exact details of an arrangement, if any, it had with the Flores twins prior to their official cooperation. The DEA didn’t immediately respond to Business Insider’s request for comment.
During the trial of one of the brothers’ alleged customers, special agent Matthew McCarthy was asked directly about this issue, according to McGahan. The customer’s lawyer asked him whether the twins provided such worthwhile information that the government would allow them to keep importing drugs during the first part of their cooperation.
“They weren’t in our control,” McCarthy told the court. “We couldn’t stop them.”
U.S. Department of JusticeMargarito Flores
The government, however, would have benefitted from letting the twins continue their drug operation. That way, the DEA could gather information on other traffickers and file charges.
In October 2008, Margarito wore a wire during a meeting at a secret mountain compound with the heads of the Sinaloa cartel: Vicente Zambada-Niebla; his father, Ismael “El Mayo” Zambada, and the kingpin, “El Chapo” Guzman, one of the world’s most wanted drug lords.
On the recordings, Zambada-Niebla asked Margarito to obtain “big, powerful weapons” so the cartel could “blow up some buildings.” Based on these conversations, among other evidence, prosecutors built a case against him.
With the aid of the twins, the DEA also set up a sting operation in December 2008 that put 10 of the twins’ customers, mostly low-level dealers, behind bars, according to the McGahan. But they were small fish compared to the cartel bosses that were almost in the feds’ grasp.
Zambada-Niebla, known as “El Vicentillo,” was eventually captured in 2013. Taking a deal, he pleaded guilty and cooperated with authorities in exchange for a minimum of 10 years in prison. Zambada-Niebla likely flipped on other Sinaloa cartel members, including El Chapo, the notorious drug lord who was subsequently captured in February 2014.
It’s unclear whether the DEA knew the extent of the Flores’ brothers actions during their cooperation. But this isn’t the first time the US government may have allowed illicit activities to happen on its watch.
Documents published by El Universal in early 2014 revealed that between 2000 and 2012, the DEA struck a deal with the Sinaloa cartel itself. While leaders provided information on rival cartels to the US, the organization smuggled billions of dollars of drugs.
El Universal also found that cooperation between the Sinaloa cartel and others peaked between 2006 and 2012 — a period when the Flores twins operated as well as when drug traffickers essentially conquered Mexico.
Toradol, also known as Ketorolac, is a non-steroidal anti-inflammatory drug (NSAID). It is used on a short term basis to treat severe pain. It can be taken as a pill, used as an injection or given through an IV. It is often used to reduce fever, pain and swelling. For Migraineurs, Toradol is used in the emergency room along with a cocktail of other medications to try to break a bad cycle of Migraines. Occasionally it is prescribed to a patient to use at home.
I personally use Toradol at home when I’ve had days of relentless Migraines. It’s usually a last resort before I go to the ER. I take it as an injection. Recently I went to fill a prescription of Toradol and was told that the manufacturer was not currently distributing this drug and there wasn’t a date set as to when it would be available. Good thing I didn’t need it right away, I was just trying to stockpile as much as I could.
According to a press release, particulate matter was found in vials of Toradol. Particulate matter could mean that a hard substance was found floating in the liquid vials, in this case it was calcium-ketorolac crystals. Likely this is caused by improper packaging or storage. Affected vials were distributed between Feb 2013 and Dec 2014.
While not life-threatening if the medication was used, it could cause inflammation at the injection site, delayed effects of the drug or allergic reaction. I called the manufacturer,Hospira, to find out when the drug is expected to become available again. I was told that because of this issue,Hospira basically swept the drug off the shelves and is currently working to replace the inventory. Within the past two weeks,Hospira began to distribute new vials ofToradol to hospital and wholesalers, however it can take time for the market to become saturated again with a new supply.Upon further investigation, Hospira has recalled their drugs 20 times in the past 6 months. Drugs such as lidocaine, heparin, propofol, sodium chloride, dextrose and fentanyl. Reasons for the recalls range from particulate matter, leaking packages, mislabeling, cracked glass or vials, mold and improper temperature storage. In February 2015, Pfizer Pharmaceutical announced that it is purchasing Hospira. Hopefully this merger will improve the manufacturing standards of these drugs.
I also found that Sagent Pharmaceuticals, which also produces Toradol, recalled three lots of the medication in October 2014. This recall was due to incorrect labeling of the expiration date. For more information about this recall, visit: http://investor.sagentpharma.com/releasedetail.cfm?releaseid=874502
If you want to know if a medication you are on has been recalled, the Food and Drug Administration compiles an updated list. If you ever question that a drug you have received is tainted, report your concerns to the manufacturer as well as the FDA. http://www.fda.gov/Safety/Recalls/
For decades, the World Health Organization has designated pain treatment as a fundamental human right. Nonetheless, about 75 percent of the global population still doesn’t have access to basic pain relief medications, according to a new report from United Nations researchers — which means that about 5.5 billion people may suffer in pain if they become chronically or terminally ill.
The new report, which was prepared by the International Narcotics Control Board (INCB), documents where pain medication is currently concentrated. More than 90 percent of the world’s morphine is consumed by just 17 percent of the global population, mostly Westerners living in wealthy places like the U.S., Canada, Australia, and Western Europe. Meanwhile, even as the developing world has recently seen a rise in the incidence of cancer, there aren’t many opioids left for them.
This disparity may even be in violation of international human rights laws. More than five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs — a treaty that requires countries to work on combating illegal narcotic abuse, as well as expand access to the narcotic drugs that are necessary for pain relief.
But, thanks to years of policy influenced by propaganda about drugs, most countries have focused only on the first part of that mandate. Groups like Human Rights Watch have carefully tracked the unintended consequences of severely restricting opioids: In many countries, that’s kept essential pain medications out of reach of cancer patients. As Al Jazeera recently reported, struggling patients have essentially become collateral damage in the War on Drugs.
“Governments must strive to achieve a well-functioning national and international system for managing the availability of narcotic drugs and psychotropic substances that provides relief from pain and suffering by ensuring the safe delivery of affordable drugs to those patients who need them while preventing overprescription and the diversion of drugs for the purpose of abuse,” the INCB report concludes.
Figuring out how to balance public health concerns with drug policy isn’t always so straightforward. Here in the United States, for instance, federal officials cracked down on Americans’ access to painkillers in order to prevent illegal opioid abuse — which simply led to an uptick in the abuse of a different type of narcotic. Now that prescription pills are harder to get, more Americans are turning to heroin. Overdose deaths from heroin have quadrupled since 2000, an epidemic that is ravaging rural areas of New England.
Walgreens boasts convenient locations, a wide array of products, and a killer tax strategy.
When it works, local tax officials warn, kids and homeowners suffer.
In the fall of 2012, county tax officials in Kentucky began preparing for a clash with the pharmacy chain, which operates thousands of stores in the U.S. and has a market value of more than $90 billion. Walgreens was challenging its tax assessments at stores across the state. If the company won, the assessors feared, other national retailers would follow suit, threatening the budgets of already struggling school districts.
“If you start losing the tax assessments on all of these leases, the cost is going to be hundreds of millions of dollars,” says David O’Neill, the property valuation administrator in Kentucky’s Fayette County.
The tax people rallied. Workers in the state’s largest counties compiled a report on Walgreens’ strategy and circulated it to smaller tax offices. When the Deerfield (Ill.)-based chain asked a state court to halve the taxes on a drugstore in Lexington, the assessors passed the hat. Kentucky school districts, which receive about two-thirds of property tax revenue, chipped in $26,000 so the county could afford to hire expert witnesses.
Last month, a Kentucky circuit court judge ruled in favor of Fayette County, which includes Lexington, concluding the latest skirmish in a long-running battle between national drugstore chains and tax assessors. Walgreens declined to say whether the company would appeal the ruling.
Walgreens, CVS, and other big drugstore chains have been challenging property tax assessments in courts around the country for the past decade, with little national notice. They argue, sometimes successfully, that the rent they pay their commercial landlords doesn’t accurately reflect property values. When they win, they get their tax bills slashed.
Here’s how it works:
Most national retailers would rather rent their stores than tie up billions of dollars in real estate. Walgreens leased 80 percent of its 8,300 stores as of August 2014, according to company filings. CVS owned just 5 percent of its 7,800 stores as of the end of last year.
The basic idea is to rent stores under contracts, called net leases, that make the tenants—the drugstores—responsible for property taxes and other expenses. To compensate the investors who sink cash into the real estate, Walgreens and other retailers pay rents that include a premium above the cost of building the store. Once the stores are occupied, net leases often trade among investors.
It’s a hefty market. About $45 billion in net leases for U.S. properties changed hands in 2014, according to Will Pike, a senior vice president at commercial real estate firm CBRE.
In tax board and judicial appeals that have sought to cut levies by more than 50 percent, Walgreens and CVS have argued that the price investors will pay to own a drugstore lease is the wrong tool for determining the tax. Instead, they say, the assessments should hinge on the amount the landlord could get if the drugstore moved out and another retailer moved in. That would lower the assessment, because the pharmacy chains have proved willing to pay higher rents than other tenants.
So the same premium that entices investors to buy the net leases gives the drugstores leverage in their tax arguments.
The chains say it’s only fair. They complain that counties are taxing corporate debt instead of sticks, bricks, and mud—assessors’ slang for land and buildings.
“We’ve become more concerned in recent years with the use of valuation methodologies based on the value of our long-term leases in addition to the value of the real estate itself,” says Phil Caruso, a spokesman for Walgreens.
“CVS Health is committed to being a good corporate citizen in the communities we serve and to paying our fair share of property tax,” says Mike DeAngelis, director of public relations for the company.
The strategy has met with mixed results. In Florida and New York, where Rite Aid has challenged its assessments, courts have rejected the net lease argument. Wisconsin has ruled in favor of pharmacies. Tax assessors scored in the Ohio courts but saw their points erased when the state’s legislature revised the tax law in the pharmacies’ favor.
Commercial property taxes fund public schools, roads, and other infrastructure in many states. Big-box stores and other national retailers have tried out the drugstores’ argument, says Tim Wilmath, a tax assessor in Hillsborough County, Fla., whose office won a state court case against CVS in 2013. But the pharmacy chains have the most at stake. That’s because of the premium they’re willing to pay for stores in busy locations, and because they lease a lot of stores, relative to other retailers.
“If they can sell the argument, they reap tremendous reward,” Wilmath says.
The Walgreens store located at 2290 Nicholasville Rd. in Lexington, Ky.
Source: Charles Bertram/Lexington Herald-Leader
In 2005, Walgreens made a deal with a local developer to lease a drugstore on the site of a former Howard Johnson hotel on Nicholasville Road, a seven-lane thoroughfare that carries commuters past the University of Kentucky Medical Center and into the city’s downtown. Two years later, the developer sold the lease—which required the pharmacy to pay $33,500 a month for at least 25 years—to an investor for $6.3 million.
O’Neill, the tax assessor, used that price to value the store at $5.1 million in 2012. That figure was based on an agreement between Walgreens and a previous assessor to value stores below the sale price of the lease to avoid a formal appeal, O’Neill says.
But Walgreens argued that number was too high, because it included a return on investment for the developer. “Walgreens pays rent that is in excess of market because this business arrangement is, in essence, a financing mechanism,” the company argued in a legal brief.
Amid the disagreement, lawyers on both sides have sought the higher moral ground.
“In Kentucky, the school districts are hungry for money, big time,” says Robert Hill, a Maplewood (Minn.)-based lawyer who has represented both Walgreens and CVS in property tax cases. “The assessors want to make it so if you’re a national chain, you subsidize everyone else.”
Amy Seibel, a lawyer in Mequon, Wisc., who has represented tax assessors against the pharmacy chains, says homeowners can expect their tax assessments to rise as counties try to make up for lost revenue.
“The average homeowner is outraged when you tell them what’s happening,” she says.
The chains will keep fighting. Walgreens spent five years battling the tax assessment on a Madison (Wisc.) drugstore before winning a state Supreme Court judgment in 2008. In Fayette County, even if the recent ruling stands, the county probably won’t be done grappling with the pharmacy chains.
As Wilmath, the Florida assessor, puts it: “Walgreens and CVS are very, very aggressive in their property tax appeals.”
“Off the medication, she becomes excessively out of control, incapable of controlling her behavior. She becomes a danger to herself. It’s just not safe,” Townsend said.
Keara sees a specialist at All Children’s Hospital in St. Petersburg, who gave her the prescription. It’s a drive Townsend now takes often because her local pharmacies, which had filled the Focalin for more than a decade, suddenly refused.
“CVS pushes it back to me and tells me flat out, ‘I will not fill this,'” Townsend said. “They have no response other than, ‘I’m sorry. You have to take it somewhere else.'”
The someplace else is the pharmacy at Children’s Hospital, which is a 230-mile, four-hour round-trip from their home in Ocala.
“It costs a lot of money to have a child like this, and then have a prescription that’s not worth the paper it’s written on? It’s unheard of. Doctors have no power today,” Townsend said.
WSVN — Prescriptions for powerful painkillers have tripled in the past 12 years, with more people becoming addicted as a result. But local researchers are using new technology to create “tamper-proof pills” that can save lives. Investigative reporter Carmel Cafiero is on the case.Cory Lewis spent years addicted to prescription painkillers. The “Hard Times” tattoo on his neck is a constant reminder of those dark days. It started when he was prescribed highly addictive oxycodone.Cory Lewis: “I had two surgeries done on my ankle and then I got sent to the pain clinic to pick up medication.”But as 7News first revealed years ago, many of the pain clinics that popped up all over South Florida were nothing more than fronts for selling drugs. Like so many others who started with a legitimate need. Cory says once the pain was gone, the need for the pills remained.
Cory Lewis: “If I didn’t have them I would get sick.”
Jim Hall: “Oxycodone led the prescription drug problem in Florida.”
Substance abuse expert Jim Hall says the drug epidemic exploded when people discovered tampering with the pills gave them the greatest high.
Jim Hall: “Opiate addicts learned they could crush the extended released form of oxycontin and get the full dose all at once.”
7News documented that behavior outside pill mills and even in pharmacy parking lots. Addicts crushed and snorted and crushed and shot up within moments of getting their hands on pain pills. Scientists say abusers do that to bypass the time-release formula.
David Mastropietro: “You can crush it and really get all that medication that was for eight to 12 hours right up front within about ten to 15 minutes.”
But that could be changing thanks to new technology being developed at Nova Southeastern University. Researchers are developing tamper-proof medications.
David Mastropietro: “You can see that my continuously hitting the product. We’re not seeing any major breakage of the tablet.”
Pills even survive a rough ride in a blender.
David Mastropietro: “It would be difficult to snort a tablet when it doesn’t really break up.”
And the pills are equally impossible to turn into a liquid to inject.
David Mastropietro: “As soon as they start to mix it or dissolve it and get the drug out, you’ll start to see that it starts forming a really thick gel.”
And that makes it impossible to draw the medication into a syringe. NSU researchers hope to bring the new technology to the market soon.
Hossein Omidian: “Right now we are in the process of talking to the pharmaceutical companies.”
Cory thinks that if the tamper-proof pills were available when he was prescribed, maybe he would not have become an addict and maybe his brother would be alive today.
Cory Lewis: “My little brother didn’t make it. He stumbled in front of a car while under the influence.”
Nationwide, overdose deaths from pain killers have reached 15,000 a year. The research and development going on here at NSU holds the promise of reducing those heartbreaking losses in the future.
Carmel Cafiero, 7News.
IF YOU HAVE A STORY FOR CARMEL TO INVESTIGATE: Miami-Dade: 305-627-CLUE Broward: 954-921-CLUE E-mail: clue@wsvn.com
Tampa, Florida — A dangerous armed robber is on the run and Tampa police hope evidence left behind inside the Hyde Park CVS will help hunt him down.
Officers shot his alleged partner-in-crime and took Tony Harrison into custody.
The only customer inside the store at the time talks with 10 News about his terrifying escape. He doesn’t want to be identified, because one of the two armed robbers who terrorized him and 4 employees hasn’t been caught.
One armed robbery suspect on the loose
Second suspect sought in CVS robbery
He says endured the longest 7 seconds of terror inside the CVS on Wednesday morning faced with an armed robber’s gun, yet when he saw the chance to escape and get help he didn’t hesitate.
“Thank God, I get to live,” says the customer. He’d been shopping at the CVS store on South Howard Avenue just after 1 a.m., when police say the gunmen stormed the store.
“The suspects were demanding money at gunpoint, very violently dragging the victims from the store around getting them to open registers,” says Andrea Davis, spokeswoman for Tampa police.
Then, the customer says the robbers tried to corral everyone to the back of the store at gunpoint. “I think I was with him for exactly 7 seconds. He tried to move me, and he heard a noise and he went to check the noise. The manager was yelling, and he ran to see what was going on,” says the customer. The robbers got distracted, and the customer saw that window of opportunity to run out the front door.
“I took off and first thing I did from outside, like when I was getting in my car was to call 911 and make sure they were there. Thank God everybody’s safe,” the customer says.
When a retired TPD officer hired to patrol Hyde Park along with Officer Ryan Jacques arrived, they say accused robber Harrison came out the front door and refused to get down on the ground. Both officers opened fire hitting and wounding Harrison. TPD tells 10 News that Harrison had to have surgery, but is expected to survive.
Investigators believe forensic evidence from the store will lead them to the second robber.
The terrified customer hopes the suspect is caught soon. When 10 News asked if this was the scariest 7 seconds of his life, the customer says, “Very much so, you know? It’s actually an experience that I don’t really like to happen again.”
Police say they’ll step up patrols in Hyde Park on Wednesday night to help ease neighbors’ fears until the second robber is caught.
10 News is digging deeper into the number of robberies in the area. Tampa police pulled the numbers and say there have been only 5 robberies in that area of South Tampa over the last year. Most of the robberies appeared to happen at businesses. The same CVS was robbed just 5 months ago.
CVS released this statement: “We are grateful no one was hurt and for the quick response by the police. We are cooperating with police in their investigation and as it is on-going will defer to them regarding any additional comments.”
