OMG… it is everywhere.. it is everywhere…

Don’t you just hate to hear those with “all the power” to say that they are being pushed to work faster.. If the Pharmacist makes a mistake.. no one at corporate will take any blame for the collateral damage. If Pharmacist collectively said NO… then the corporations have no business plan.. because they only have a permit to operate a pharmacy with a licensed Pharmacists in place.. they don’t have enough “shirts” that have a license to even begin to make more than a very minor number of stores to function…. and it has probably been so long that they have actually practice pharmacy.. that their proficiency in probably in the SINGLE DIGITS…

There was a story the other day about a grader schooler getting Singular 10mg instead of Singular 5 chewable and there was a extra 2 doses in the bottle.. Obviously there was no harm to the kid.. probably more harm to the store’s bottom line.. it has been reported that the Pharmacist was FIRED !

Better to light a candle than curse the darkness

from the Ohio Pharmacists Assoc. Journal, “Ohio Pharmacist.”

from the president’s message February 2015 issue:

“What I would like to see is a course given by OPA…could teach professional survival, to include whether one should carry individual personal liability insurance…training from a human resources attorney, advising what and how a pharmacist  could document happenings when they get that feeling that something isn’t quite right, especially if dangerous practices have been point out to management.  Older pharmacists also need this training as I know personally of instances where individual pharmacists have been let go (especially if they have accrued three to four weeks of vacation per annum, or are simply high on the wage scale), only to be rehired shortly thereafter by the same corporation with entry level wages and benefits.”

—OPA President Robert O. Schmoll, Jr., RPh

There has been a number of us for years that have stated that while pharmacists are highly educated and very bright people.. their knowledge base of the laws that they operate under are limited to those directly affecting the practice of pharmacy… but.. since around 2/3 of these Pharmacists are employees and it would seem that academia could care less about taking any course time to educated these future Pharmacists/employees on the laws of business and their employers would seem to prefer that their employees are “ignorant” of business law.. it makes them that much more pliable in following corporate mandates/edicts that may be questionably legal. After all the employed Pharmacist is expendable and easily replaceable. After all, the chain has now shifted most of the administrative tasks of operating the Rx dept to the tech staff.. so all they really need is a warm body with a license to keep the dept legal and functioning …

 

“Everyone is ignorant, only on different subjects.”
Will Rogers

A “hail mary pass” to try and maintain the war on drugs ?

Marijuana plants are pictured. | AP

Nine former DEA chiefs slam Colorado pot law

All nine former administrators of the Drug Enforcement Administration signed an amicus brief filed Thursday supporting Oklahoma and Nebraska’s Supreme Court petition challenging Colorado’s legalization of marijuana.

The suit claims that Colorado’s legalization efforts conflict with federal narcotics laws and are inhibiting the states’ ability to enforce their own laws.
A marijuana flower nearly ready for harvest is pictured. | AP

Colorado’s law “gravely menace[s]…[t]he health, comfort and prosperity of the people” of neighboring states,” the former administrators write in their brief.

“The federal government made the choice in 1970 that a uniform, comprehensive, and consistent national approach to controlled substances was necessary,” the brief continues. “Principles of federalism, properly understood, therefore support the plaintiff States’ suit against Colorado.”

Under the Obama administration, the Justice Department has declined to enforce federal laws on marijuana in states that have legalized it for recreational use.

The brief, filed on their behalf by the law firm Gibson, Dunn & Crutcher, is the first time all nine former DEA administrators have joined together on a signed statement.

I always thought that we were a country of 50 states and states have the right to govern themselves. Apparently these nine former DEA administrators feel that when it comes to certain things… The FEDERAL MINDSET is SUPREME and should prevail over the rights of the individual states.
Could it be that these former DEA administrators are seeing that the every growing DEA FIEFDOM is starting to crumble ? And this is just one last act of desperation to save that bureaucracy… and the war on drugs… that a every growing majority of citizens views as a waste of  national resources.

I thought that there was a law against this ?


World News Videos | US News Videos

http://abcnews.go.com/Health/sex-couple-blames-discrimination-pediatrician-allegedly-refuses-newborn/story?id=29080781

Same-Sex Couple Blames Discrimination After Pediatrician Allegedly Refuses to See Their Newborn

A married, same-sex couple in Michigan say they felt discriminated against after a pediatrician refused to see their newborn daughter, according to their attorney.

Jami and Krista Contreras of Oak Park, Michigan, welcomed their daughter, Bay, four months ago. Six days after Bay was born, the couple took the infant to a pediatrician, Dr. Vesna Roi, they had chosen after an earlier prenatal visit with the doctor, the couple’s attorney, Dana Nessel, told ABC News.

But after they arrived in the waiting room at Eastlake Pediatrics in Roseville, Michigan, Roi’s colleague came out to meet the family and told them that after “praying on it,” Roi had decided she couldn’t care for Bay, Nessel said.

“[Roi’s colleague] said ‘I’ll be your doctor, I’ll be seeing you today because Dr. Roi decided this morning that she prayed on it and she won’t be able to care for Bay,’” Jami Contreras told WJBK-TV in Detroit. “[Her colleague] told us she [Roi] didn’t even come to the office that morning because she didn’t want to see us.”

Eastlake Pediatrics didn’t immediately respond to ABC News’ request for comment.

Nessel said the couple had met with Roi after a long search for a pediatrician who worked in holistic medicine.

The couple immediately found a pediatrician elsewhere, but were still upset by their interaction. Nessel said they posted about their experience on Facebook and that they felt discriminated against because of their sexual orientation. The couple started to get responses from family and friends.

PHOTO: Jami and Krista Contreras say their pediatrician refused to see their newborn because they are a lesbian couple.

WJBK
PHOTO: Jami and Krista Contreras say their pediatrician refused to see their newborn because they are a lesbian couple.

“It was embarrassing, it was humiliating and here we are, new parents trying to protect her,” Jami Contreras told WJBK-TV. “We know this happens in the world and we’re completely prepared for this to happen other places. But not at our six-day-old’s wellness appointment.”

The couple decided to take their story public recently to show that discrimination among LGBTQ people that they say is still occurring, according to Nessel. She also said the couple wanted to draw attention to other potential instances of discrimination, including a pending state law called the Religious Freedom Restoration Act, which could, in Nessel’s opinion, allow for people to discriminate based on their moral or religious beliefs.

Calls to Roi’s office and home were not immediately returned.

There are no laws in Michigan that protect lesbian, transgender, gay, bisexual or queer people from discrimination.

After Contreras posted about Roi’s alleged dropping them as patients, the pediatrician apparently sent the couple a letter apologizing for not meeting them in person, but not changing her position.

The doctor wrote she “would not be able to develop the personal patient doctor relationship that I normally do with my patients,” according to a copy of the letter Nessel sent to ABC News on behalf of the couple.

Roi also wrote that she didn’t talk to them in person because she felt her presence “would take away much of the excitement” for the new parents. She also wrote in the letter she did not have their number to call them before they arrived for their first appointment with Bay.

Roi didn’t specifically write that she refused to treat Bay because of the couple’s sexual orientation, but both spouses and their lawyer said they believe Roi’s letter leaves no doubt about her motivation.

“After much prayer following your prenatal, I felt that I would not be able to develop the personal patient doctor relationship that I normally do with my patients,” Roi wrote in the letter.

Later she added, ”Please know that I believe that God gives us free choice and I would never judge anyone based on what they do with that free choice.”

The couple has no plans to file a lawsuit or medical complaint, according to Nessel.

Medical ethics experts say Roi’s actions may have been legal, but are ethically complicated.

According to the American Medical Association, doctors should not “refuse care based on race, gender or sexual orientation,” but they can refuse specific treatments if they are incompatible with “personal, religious or moral beliefs.”

Dr. Margaret Moon, associate professor of pediatrics and a faculty member at the Johns Hopkins Berman Institute of Bioethics, said it’s acceptable that Roi felt she could not establish a patient, doctor relationship with the family, but said the doctor could have been upfront earlier.

“The family experienced distress and a sense of discrimination. The family experienced a harm,” Moon said. “The pediatrician could have handled this much differently.”

Another pharmacy that won’t get robbed for a while ?

 

 

Suspect shot in alleged pharmacy robbery in Pinch

http://www.wvgazette.com/article/20150218/GZ01/150219310

W.Va. pharmacist fatally shoots would-be robber

http://www.bdtonline.com/news/w-va-pharmacist-fatally-shoots-would-be-robber/article_1f56986e-b7b3-11e4-9361-6f3d4b7c0889.html

Kanawha County Sheriff Johnny Rutherford said a man attempted to rob the Good Family Pharmacy in Pinch about 9:48 a.m., but was shot by a pharmacist who then rendered medical assistance until the would-be robber was taken to a local hospital.
Kanawha County sheriff’s deputies B.K. Howery (left) and A.C. Pile inspect evidence after a man attempted to rob the Good Family Pharmacy in Pinch at gunpoint. Sheriff Johnny Rutherford said the pharmacist pulled out his own gun and shot the would-be robber, who is being treated at a local hospital.

PINCH, W.Va. — A pharmacist shot a man who was allegedly trying to rob the pharmacy in northern Kanawha County this morning.

Kanawha County Sheriff Johnny Rutherford that a man came into Good’s Pharmacy at 242 North Pinch Road at 9:48 a.m. The man allegedly had a gun and tried to rob the pharmacy.

When the alleged robber pulled out a gun, the pharmacist pulled out his own gun and shot, hitting the other man twice, Rutherford said.

The man was taken to a local hospital.

Rutherford said the pharmacist provided med

– See more at: http://www.wvgazette.com/article/20150218/GZ01/150219310#sthash.rzGRKP4x.dpuf

there was no one left to speak for me

 

First they came for the mentally ill addicts, and I did not speak out—
Because I was not a mentally ill addict.

Then they came for the empathetic prescribers, and I did not speak out—
Because I was not a empathetic prescriber.

Then they came for the Pharmacists, and I did not speak out—
Because I was not a Pharmacist.

Then they came for me—and there was no one left to speak for me.

Dear Sir or Madame,

We would like to introduce ourselves, and then to ask for your understanding.

We are the Chronic Pain Patients of America.

We are here, standing together, although we frequently feel so very alone.

Our numbers are growing, despite the fact that many of us are voluntarily leaving this world, one by one, because we can’t bear the pain.

We are 70-year-old grandparents, whose arthritis has gotten so bad in recent years that we find it difficult to even get out of bed on a good day. Our grandchildren do not understand why we need to take a break just to visit for a while.

We are the middle-aged housewives, who have been stricken with unforeseen spinal conditions that cripple us so severely that our families are being torn to shreds. We used to be soccer-moms, but we now find it nearly impossible to even provide for our children’s basic needs.

We are the college athletes, who nearly died in that auto accident last year. Although our athletic careers have ended abruptly, we still have to get up each day and go through the motions of living.

At some point or another, during our ongoing-suffering, one or more of our once-caring doctors prescribed medication to us that changed our lives.

At the time, most of us were not even aware that what we were taking was stamped with the all-so-evil name of “prescription narcotics,” nor did we care.

All we knew was that, if we took our medicine as directed, we felt relief.

Glorious, merciful relief.

We were able to accomplish tasks we thought were impossible, given our recent diagnosis.

We were, once again, able to walk. We were able to work. We were able to enjoy our friends and family.

We were given a reason to get up in the morning. We were given a reason to live.

We faithfully took our medicine, much like we took our diabetes medicine, or our blood-pressure pills.

We lived for years taking our pain pills, and surviving.

In short, the medicine gave us back some small quality of life.

It is as simple as that.

We have never, ever, taken more medicine than we should.

We have never been “high” on anything, in our entire lives. We don’t even know what it means to be “high.”

For a large number of us, you could even count on one hand the glasses of alcohol we’ve had in our lives.

People who get “high” on any substance, whether it’s a drug of choice, or alcohol, disgust us.

They can all go to an island and enjoy altering their states of consciousness, together, alone, for the rest of eternity, for all we care.

In fact, we prefer they would.

Before we were given prescription medicine, a lot of us consumed something like a bottle of 30 ibuprofen in about a day and a half.

Every day.

Very recently, the DEA, together with physicians and pharmacists everywhere, launched a “war on drugs.”

They tell us there have been so many deaths due to overdose that these medicines are dangerous to all of us.

There has been mandate to greatly reduce the number of patients using pain medication, and also to reduce the number of prescriptions written.

We frankly don’t understand all of these deaths due to prescription pain medicine.

One of three things could be happening here:

Perhaps these deaths were caused by an allergy to the medication. This type of tragedy can occur even with Penicillin.

Or, maybe these people actually took this sometimes-life-saving medicine to get “high,” and they took too much.

They should have been on that island.

Or, they simply could not find enough relief from the medication they were given, and took handfuls instead. We certainly hope not.

The point is, real people, who cannot function otherwise, are losing vital medication.

Elderly Americans, disabled Americans, are having their lives cut short, or, at least, their quality of lives, by being denied a very simple, effective method of pain-relief.

Unless you have experienced chronic pain, there is no way to describe the difference between having pain relief or not.

We stand together as an awesome, forgotten entity in this “war on drugs.”

As we encounter more and more doctors and pharmacists who tell us they are “not comfortable” delivering our medication to us, more and more of us are simply dropping out of the fight.

To them, we say, “We are NEVER ‘comfortable.'”

Our days of comfort, of any kind, have now come to an end.

And, it is madness.

We willingly submit to drug-screening, and the constant scrutiny of our once-understanding medical team.

We never fail, because we take our medications properly.

But, we are forced to be ashamed. We are forced to face life, once again, without proper treatment.

Although some of us are lucky enough to have physicians who are willing to prescribe our medications, we know our days are numbered.

For many, the days have ended.

Every day, pain patients are taking their own lives because they have either been denied medication, or they can no longer take the public humiliation they face when attempting to pick up their medication.

We have been treated like common criminals, not because we abuse our medication, but just because we take the medication AT ALL.

We have been victimized by these over-zealous, war-on-drugs crime-fighters, by succumbing to such horrors as random purse searches.

We have been called names, like “pill-seekers,” and “junkies,” by the very same doctors who developed a care-plan centered around our medications.

We have been warned by their staff that we will end up in a rehab facility if we continue to take our medicine, even though we do so properly.

Time and time again, we are required to undergo painful, and, for the most part, useless procedures, because we know our doctors will not continue our care if we refuse.

Every time we enter our doctors’ offices, we are unsure if we will be allowed to continue with the medicine that has been our primary lifeline.

We never know if our pharmacist will tell us, simply, “No. I won’t fill that for you.”

We are here because it is time to stop the madness.

Our demands are simple:

We want adequate medical treatment for our chronic pain.

We want doctors and pharmacists to stop frightening us by talking to us about addiction and over-use.

We are not addicted, and we do not abuse.

Because this medication is needed by us, as surely as a diabetic needs insulin, or a child with ADHD needs stimulants, we do have a physiological dependence on it.

If an elderly woman takes three helpful narcotic pain pills daily, and her pain will not naturally decrease over the course of her life, do we not WANT, and EXPECT her to DEPEND on a life-giving medication?

To tell her that she will have to abruptly stop her pain-treatment is the same as telling her we don’t care about our elderly in this country.

The same rule applies to younger individuals suffering with chronic pain.

Do the medical and pharmaceutical professions not want them to depend on a much-needed medication?

We want pharmacists to stop bullying us, and telling us that we are, somehow, not worthy of pain-management.

We want the same rights that sufferers of other chronic illnesses have.

We want understanding.

Together, we are fighting the people who are fighting the ambiguous, “war on drugs.”

We want to speak loudly, and to have our voices heard.

Enough is enough, and we have had enough!

A system that is designed to fail

It is a pretty accept fact that humans – in general – or not perfect. Give that fact, it would appear that the DEA seems to believe that those in the healthcare are an exception to the rule. There have been stories of the DEA finding a couple of bogus pts in a prescriber’s practice and the agents will offer the bogus pts a “get out of jail free card” if they testify that the prescriber was writing controlled Rxs for the cost of a office visit.. never does a real physical exam. This is your basic diverter/addict… petty crook/criminal… you see it is not against the law for law enforcement to lie to anyone to “make their case” and they get a criminal to perjury themselves to keep themselves from going to jail.. if they get caught at perjuring themselves they are going to jail.. if they don’t perjury themselves.. they are going to go to jail…

It is so easy to become a bogus pt… you find  a few people (4-5) that have insurance … preferably Medicaid… and a single pt that could demonstrate a physical need for pain meds or other controlled meds…  The “sick pt” gets/makes a fake driver’s license to match their face with the name/dob and other vital data points that matches the person that  has the Medicaid card.. and off he goes to prescriber “A”… gets the Rxs and off he goes to Pharmacy “A”…

Then this same pt gets a different driver’s license to match the second Medicaid’s pts info.. and off he goes to prescriber “B”.. gets the Rxs and off he goes to Pharmacy “B”..

This cycle can be repeated as many times that a new prescriber and pharmacy can be “worked” .. each time more doses are obtained… they are split between the participants… some will sell their meds for a profit… some will take some and sell some.. some will take all of them..  The “real sick pt” always gets a share each time he completes a prescriber/pharmacy cycle.

Once they reach 30 days of doing this.. they start repeating the cycle… always keeping their appt with the prescriber, never asking for early refills at the pharmacy… the “model patient”… calls no attention to themselves. Since the real “sick pt” has to take his meds for his pain.. he will always be able to pass a urine/drug test.

One or more of the participants gets caught selling their share of the medications. DEA confiscates prescriber bottles and starts developing a case against the prescriber and pharmacy involved of filling Rxs for a pt without a legit medical need and who is selling/diverting drugs to the street.

When the DEA approaches the prescriber or Pharmacists about this pt.. they will state that they pulled PMP reports on the pt they saw and all it showed was what the prescriber had prescribed…and the prescriber stated that a in person exam was done on the pt..  Same with the pharmacy… pull PMP report.. nothing suspicious … no RED FLAGS …

The DEA offers the person caught selling the drugs a “deal”… they have records that the doc prescribed, the pharmacist filled.. a crime has been committed. Because this prescriber and pharmacy has a couple of these bogus pts/diverters out of hundreds of legit pts..  The DEA has uncovered a CRIME and if there is a couple of bogus pts in the practice.. there has to be more… best/easiest is to just shut the practice down…

You see the law says that the prescriber/pharmacist must see a VALID state/fed ID.. but the healthcare professional has no way of validating the ID presented by the pt. Unless it obviously looks fake.. how is one suppose to validate it..

First of all the pt presenting a fake ID is breaking the law…  don’t look for any arrest records on that one…  This is just one way for a prescriber/pharmacist to be duped …

Of course, if the prescriber or pharmacist had been able to valid the driver’s license against the state’s online BMV database.. no legal meds would have been diverted. Maybe prescribers and pharmacists just need to stop taking care of pts that need control meds until they can have a process in which to allow them to follow the law about accepting a valid driver’s license ?

Does law enforcement come after a bank employee/officer that gets robbed.. because their security was surpassed and allowed the bank to be robbed ? When Target’s customer database was hacked of financial information… did you see anyone in IT being arrested, fined or sent to jail… ? Was Target as a corporation fined ?

Maybe this war on drugs is run under a different set of rules.. than all the other crimes that criminals pull off ?

It is, as if, the war on drugs is working under a process that is designed to fail… at least not for the DEA.. seems to be working pretty well for them.. after all, they have been at it for 45 yrs. Maybe the war on drugs was designed to be a perpetual motion system and/or a Rube Goldberg system ?

Does being understaffed, dehydrated & hypoglycemic make employees more productive ?

“Are any of you allowed to have drinks in your pharmacy? We aren’t, which is understandable, so we would keep them right outside the pharmacy and step outside to drink them. We recently had a visit from corporate and were told we couldn’t have drinks anywhere, at all. I know I may sound like a brat, but why can’t I just have some water around? My water bottle isn’t hurting anyone sitting OUTSIDE of the pharmacy in a spot hidden from customers.”

This was posted on another Pharmacist FB page.. They forgot to mention that the staff normally is not allowed to have any chairs or stools in the Rx dept either..  They don’t want the customers/pts to think that the staff is just being lazy and sitting down on the job.. or the staff might waste a fraction of a second getting up from a seated position dashing to grab the phone, register, drive thru, consult window or some other task(s) that the corporation expects to be addressed in 15 seconds or less. Try that when you have four customer “contact points” and there is only a Pharmacist and a tech working at one time.

“Cases like this are rare and we take them very seriously. “

Woman says pharmacy pill mixup nearly killed her

http://www.wftv.com/news/news/local/woman-says-pharmacy-pill-mixup-nearly-killed-her/nkDbR/

ORLANDO, Fla. —

An Orlando woman said a trip to a pharmacy for a prescription put her in a hospital and nearly killed her.
 
She said she was supposed to get an antihistamine for allergies but wound up in a hospital.
 
Lettree Battey, 78, said the same doctor has prescribed the same medication and she has had it filled at the same Walgreens pharmacy on South Orange Blossom Trail in the past.
 
She said when she went to pick up her latest prescription for the generic form of Zyrtec, she didn’t expect to get something else.
 
“It seems like the fellow couldn’t understand my doctor’s handwriting,” Battey said.
 
It turns out, the medicine she got at the pharmacy wasn’t the one she said has been on file since at least 2011, but rather was a medicine for diabetics and is used to lower blood sugar.
 
“My blood sugar’s usually up in the 90s, but my blood sugar after the medication, it dropped to 30,” said Battey.
 
The drugs’ spellings did look similar on the paperwork that Channel 9’s Janai Norman saw.
 
Battey said that after taking the generic form of a drug known as Glucotrol, the piano instructor began feeling dizzy. She said she was slurring her words and was so lethargic that her piano students called their parents.
 
“I would’ve gone to bed because I felt tired, and probably would’ve gone into a coma,” Battey said.
 
Battey said she ran up almost $15,000 in medical bills, for what doctors ruled a poisoning.
 
Her attorney, Thomas Nicholl, said what happened to his client happens frequently.
 
“Sometimes with pretty disastrous results, as you can imagine,” Nicholl said.
 
Battey said the Walgreens store did refund money and gave her the correct prescription, but she said she is not satisfied with that because of the serious nature of the mistake,.
 
“Right now I’m thankful that I’m here,” she said.
 
Nicholl said he plans to file a complaint against the Walgreens pharmacy in the next week.

Walgreens sent the following statement to Eyewitness News:

“Cases like this are rare and we take them very seriously.  In the event there is an error with a prescription, our first concern is for the patient’s well-being. We’re sorry this occurred and have apologized to the patient.

We have a multi-step prescription filling process with numerous safety checks in each step to reduce the chance of human error and have reviewed the process with our pharmacy staff.  We encourage patients to check with our pharmacists or their health care provider if they have a question or concern about their medications.”

because at the end of the day, we have to do something ?

Top DEA official wants concerted effort on heroin epidemic

Official: Collective effort among agencies would better tackle problem

http://www.wbaltv.com/news/top-dea-official-wants-concerted-effort-on-heroin-epidemic/31339522#comments

BALTIMORE —The head of the Drug Enforcement Administration in Maryland is pushing for a more coordinated assault on the heroin epidemic.

Recently, local and state officials have all announced new initiatives individually. The comments from the DEA came in an interview with I-Team lead investigative reporter Jayne Miller.

The DEA is the federal government’s drug enforcement arm. Its chief in Maryland said the new focus on the heroin epidemic is a good thing but could be wasted without a coordinated effort.

“Thirty years ago, when I was a cop here, the purity levels were between 3 and 5 percent, with 5 percent being on the high side. Today, we’re seeking purity levels upwards of 85 percent,” Gary Tuggle said.

Tuggle is the top DEA official in Maryland. He knows as well as anyone how heroin addiction has changed and expanded.

It is no longer a problem confined to poor, inner city neighborhoods. Heroin has addicts in households throughout the state. The drug’s newer popularity is fueled by addiction that starts with prescription painkillers.

“Why is it that an individual is prescribed a 30- or 40-day supply of prescription opiates for a tooth extraction when that person might need it for three days or so? Well, guess what? That excess goes into the medicine cabinet, which has probably become to most dangerous part of the house, or it goes into circulation illegally,” Tuggle said.

Last week, the state’s attorney general became the latest elected official in Maryland to declare a new initiative on heroin.

He followed Anne Arundel County Executive Steve Schuh’s announcement of a heroin task force last month and Mayor Stephanie Rawlings-Blake’s task force announcement last fall.

Gov. Larry Hogan also put the heroin problem high on his agenda, including it in his State of the State address.

Tuggle supports Hogan but warns little will be accomplished without a more integrated effort among law enforcement and public health agencies.

“The efforts we see going on locally with these new initiatives we applaud, because at the end of the day, we have to do something. But we are hoping we can do it as a collective effort rather than have individual silos of effort and intelligence that don’t pull together the complete picture,” Tuggle said.

The DEA has recently met with the governor’s office. Hogan has indicated he intends to declare a state of emergency on the heroin epidemic.