Congress quietly ends federal government’s ban on medical marijuana

http://www.latimes.com/nation/la-na-medical-pot-20141216-story.html

Approval of the pot measure comes after the Obama administration directed federal prosecutors last year to stop enforcing drug laws that contradict state marijuana policies. Since then, federal raids of marijuana merchants and growers who are operating legally in their states have been limited to those accused of other violations, such as money laundering.

Isn’t it amazing, the Feds intimidated the banking system to refuse these MJ merchants having a banking account and allow the merchants to have the ability to accept charge cards. So all transactions had to be in CASH. The State of Colorado imposed a penalty on any business that paid their sales tax with CASH. So the judicial system went after these MJ merchants for money laundering … Who would have seen that coming ?

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Pharmacists prepared to handle community health crisis

http://wane.com/2014/12/16/pharmacists-prepared-to-handle-community-health-crisis/

FORT WAYNE, Ind. (WANE) – Pharmacists across the area are aware of the increased possibility of a robbery now that 5,000 pain patients are without a doctor.  We first shared with you police worry that some of those people may turn to crime to get medication they need.

Now, the goal here isn’t to scare people.  Allen County Health Commissioner Deb McMahan asked we share this information because an informed community is a healthy community.  Because opiods are highly addictive, pharmacists are on alert for anything suspicious.

“This is a really important health issue for the patients, the medical community, and the community at-large,” Allen County Health Commissioner Deb McMahan explained.

Dr. McMahan says the medical community is maxed out and cannot absorb 5,000 patients quickly.  That’s why a room full of experts ranging from law enforcement to pain management and mental health professionals are working together.

“We actually just yesterday met with all of the high up managers at the area retail pharmacies because it’s very important that they are aware of what’s going on,” Palliative Care Pharmacist at Parkview Tracy Brooks said.

Palliative Care Pharmacist at Parkview Tracy Brooks is one of the dozen hoping to make a difference.  She says that starts with pharmacists being aware of the community health crisis.

“When people walk into a pharmacy we need to treat them like a patient. We need to respect this entire situation.”

At the same time, some pharmacies are implementing their own steps to keep employees and customers safe in case there is a robbery.

“I am making sure that the pharmacist and the technicians remember to treat all patients with unbiased respect and patients need to do the same thing. Pharmacists are trying to do a job and keep everyone safe. There needs to be some allowances that this isn’t going to be an instantly filled prescription. You know drop it off, have the time to come back and get it later in the day.”

Of course, not everyone who takes pain medication is addicted to it or will go to desperate measures to get it.  Police and pharmacists say they’re simply prepared in case robberies do spike.

Info for former patients of Dr. Hedrick

• Call your family doctor and schedule an appointment to get a referral to a new pain management doctor.
• Those who don’t have a family physician should go to an urgent care clinic or worst-case scenario the E-R.
• They’ll be able to help get medication needed until patients can see their new pain doctor.
• PLEASE BE PATIENT  
  

If they were that concerned about these pts… maybe they would have done some pre-planning before 5000 pts are thrown into the street… with a medical community that is “maxed out”.  IMO… their expression of concern is INSINCERE and UNDER WHELMING… Unfortunately, the consequences and collateral damage of law enforcement’s actions… they will not be held personally responsible.

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Analysis: Overprescribers have troubling records

http://www.bucyrustelegraphforum.com/story/news/local/2014/12/15/analysis-overprescribers-troubling-records/20454371/

Prescribing high volumes of Schedule 2 drugs can indicate a doctor is running a pill mill, said Andrew Kolodny, chief medical officer of Phoenix House, a New York-based drug treatment provider.

“We wait till these doctors kill people. … It doesn’t make any sense,” said Kolodny, founder of Physicians for Responsible Opioid Prescribing, which advocates for tighter regulation of painkillers.

“It’s a real area of concern for us,” said Shantanu Agrawal, a physician who is director of the Center for Program Integrity within the federal Centers for Medicare and Medicaid Services.

Medicare’s Part D data draws a roadmap to the doctors who prescribe controlled substances most frequently.

In 2012, 269 providers wrote at least 3,000 prescriptions for Schedule 2 drugs, ProPublica’s analysis shows. They were concentrated in a handful of states. Florida led the country with 52 providers, followed by Tennessee with 25.Ohio had 15 doctors dole out more than 3,000 prescriptions for those drugs — tied for third with North Carolina.

Imagine those Seniors and disabled who are covered by Medicare Part D taking more C-II for pain management…. and the “cut-off” if a prescriber is running a pill mill is having 250 chronic pain pts (12 Rxs/yr X 250) = 3000 prescriptions.  Now that the DEA is strongly suggest that all Rxs are for 30 days supply… any prescriber that has been providing 90 days supply.. with this change a large number of prescriber could be pushed over the “trigger” of operating a “pill mill”

And we all know that treating chronic disease states is all about NUMBERS !

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Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD), “causalgia”, or reflex neurovascular dystrophy (RND) is an amplified musculoskeletal pain syndrome (AMPS). It is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS is expected to worsen over time.[1][citation needed] It often initially affects an arm or a leg and often spreads throughout the body; 92% of patients have reported experiencing its spread, and 35% of patients report symptoms throughout their whole body.[2]

Complex Regional Pain Syndrome is a multifactorial disorder with clinical features of neurogenic inflammation (swelling in the central nervous system), nociceptive sensitisation (which causes extreme sensitivity or allodynia), vasomotor dysfunction (blood flow problems which cause swelling and discolouration) and maladaptive neuroplasticity (where the brain changes and adapts with constant pain signals); CRPS is the result of an “aberrant [inappropriate] response to tissue injury”.[3] Treatment is complicated, involving drugs, physical therapy, psychologic treatments, and neuromodulation and is usually unsatisfactory, especially if begun late.[4]

CRPS is associated with dysregulation of the central nervous system[5] and autonomic nervous system resulting in multiple functional loss, impairment, and disability. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.

http://en.wikipedia.org/wiki/Complex_regional_pain_syndrome

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Police: Community health crisis may lead to more pharmacy robberies

Notice the verbiage … it goes from PATIENTS that NEED – NOT WANT – and they go from dependent to ADDICTION. wonder how many more suicides

I bet that in Indiana’s AG Zoeller office.. they are CELEBRATING… because his BITTER PILL PROGRAM http://www.in.gov/bitterpill/  Is working ?

Of course, Indiana has one of the highest meth lab busts, pharmacy robberies and Heroin use/abuse/death is on a dramatic upswing.

I guess that “success” is in the eye of the beholder !

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just read your article on “When valid prescriptions are refused” and it was worth readying because I just experienced my first issue with a Pharmacist at the CVS in New Jersey.  I forwarded this letter to the President and I received a call from xxxx from the executive office advising e that they stand behind this Pharmacist decision and then she threatened that she was going to warn all the other Pharmacist in my area that I had this problem with their Pharmacist.

    Below is the bases of my letter and I wanted to know if this falls in the category of which you spoke, and I wanted to know if the laws that you spoke of apply also in New Jersey?

“Dear Mr. Larry Merlo:

I am truly deeply saddened that I have been forced to take my time to type this letter of complaint and forward it directly to your attention concerning the Pharmacy Manager, xxxxxx at the xxxxxxxxx, New Jersey store number xxxx, and a negative notation placed on my account without cause or reason.   Although, I have been a customer of CVS for many years and I have never had to ever come close to any type of complaint with this company until now. In August 2014, I somehow fell and fractured a bone in my big left toe and received a script for Tylenol IV with Codeine from the Emergency Room Doctor as a form of break through pain relief from this fracture and so that I would not exceed my current medication dose of morphine 30 milligrams, every six hours written by another Doctor for another medical reason.  

I brought my script to be filled to CVS Pharmacist and she advised me that she could not fill my script for the Tylenol IV with Codeine, until she verified that the E.R. Doctor was aware that I was already taking morphine: something that I have never heard of or ever experienced in the seventeen years that I have been taking this controlled substance. However, considering the fact that I provided a completed list of all the medications that I am currently taking to the E.R. Doctor, a list that I keep in my wallet and have also provided a copy for your viewing, I knew that verifying this information would not be a problem and that I could get my script filled and make my way back home to get off my foot which was already turning blue and inflamed in pain.

I heard when xxxx called The xxxxxx Memorial Hospital in xxxxx, NJ  and after getting transferred several times was able to contact Dr. xxxxxx and confirm that he was aware that I am on thirty milligrams of Morphine every six hours. Then CVS Pharmacist lowered her voice and continued the conversation, which I thought was unusual but didn’t think anything of it until moments later when CVS Pharmacist handed me back my script and advised me that it could not filled “because the Doctor agreed with her that since I am on morphine that this script for the Tylenol IV with codeine would have little to no effect on me.” I was outraged because I had to hobble another 70 yards back to my car, drive another three miles out of my way and hobble another 150 yards to have my script filled, with no questions asked, by a competitor who is aware of my current and past medication history.

 In lure of the fact that this is the second time that CVS Pharmacist has gone out of her way to interfere with the completion of my scripted medication and my Doctors requests, that I felt the need to send this written formal complaint directly to your attention and respectfully request that you investigate her actions and motives. The first incident, which happened approximately two months earlier, was over looked because I did not wish to be responsible for any actions taken towards this employee at my request; however, because I honestly wish to continue to do business with this company.”

Apparently the doc did not say to cancel the Tylenol No.4… since the Pharmacist gave it back to the pt.. Wonder what the Pharmacist said to the doc when she LOWERED HER VOICE in talking with the prescriber on the phone ?

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http://www.pharmacytimes.com/news/Pharmacists-Provide-New-Pathway-to-Naloxone

From the article:

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Rx for reform: NC pharmacists try to boost health and cut costs

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Doctors treating prescription drug abuse

Doctors say they are less likely to prescribe pain killers like Oxycodone and hydrocodone

http://www.news8000.com/health/doctors-treating-prescription-drug-abuse/30211166

from the article:

Now many physicians are turning to safer, less harmful alternatives.

“There are medications that don’t have addiction potential that can be very useful for pain management. As well as procedures, injections, physical therapy is very helpful for people. So there are a lot of things that can be done aside from using drugs,” said Gundersen Health System Doctor William Bucknam.

I guess this doctor presumes that everyone pain is the same level intensity… never changes.. and no one gets GI bleeds or cardiovascular from NSAIDs  and everyone has the insurance coverage, time, and money for deductibles and copays  for all those alternative “safer therapies”  And spinal injections have never caused http://en.wikipedia.org/wiki/Arachnoiditis nor killed anyone  http://en.wikipedia.org/wiki/New_England_Compounding_Center_meningitis_outbreak

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