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This video is 5 yrs old …but… unfortunately still pertinent
Posted on November 28, 2019 by Pharmaciststeve
Open letter to all those Federal Bureaucrats interfering with pain pts getting their therapy
Posted on November 28, 2019 by Pharmaciststeve
Open letter to all those Federal Bureaucrats interfering with pain pts getting their therapy:
I‘m one of millions of Americans that live in constant chronic pain. I’m on social media and I connect with many like me, and worse. There are two major groups of people who are very different, yet being grouped together and compared as one. There’s the addicted– and then there’s pain patients. We do not seek pain meds for anything other than pain relief and quality of life. I’m 56 yrs old with grown sons and grandsons. This is the make up of pain patients. We’re not in the streets seeking drugs, but forced to pain MGMT where we’re treated like addicts. We’re subjected to pill counts, urine screens, and a contract. We carry a stigma bc of this. We’ve lost friends, family, and have been humiliated. We’re subjected to injections in our spine that isn’t FDA approved and is not done properly. And because of this, I had to have major spine surgery. These injections were against my spine surgeon’s advice in his referral. I was told by pain MGMT if I didn’t have these injections, I couldn’t get my pain meds. I’m now left with nothing and my life consists of me and my sofa, with no quality of life. I can’t play with my grandchildren, I can’t do laundry, and I live on an income that I can’t live on because I was forced on disability. I live with my son, which I’ve been bounced back and forth between my two sons and their families. I want to work, even part time. I cannot. There are millions like me, some even worse. The torture we live in everyday is absolutely ludicrous as American citizens. Since we have to fight for the right to get our meds to live and have QOL, from this government entity, that shouldn’t even be involved in this, I’m not going to beg for my meds, I’m going to demand them. I’m a part of the We in We The PEOPLE.
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Production at Teva API plant halted until next year – how many vital meds will be in short supply ?
Posted on November 27, 2019 by Pharmaciststeve
Production at Teva API plant halted until next year
https://www.fiercepharma.com/manufacturing/production-at-teva-api-plant-halted-till-next-year
Teva Pharmaceuticals is having issues with its active pharmaceutical ingredient (API) plant in Italy serious enough that it has had to stop production.
The Israeli drugmaker sent a “Dear Customer” letter to clients saying that it does not expect to restart production until after the first of the year.
“We have been asked by the regulatory authorities to submit new registration requests for products produced at the site. The submission of this documentation will be limited in scope and will not require resubmission of the DMFs (Drug Master Files),” the drugmaker said in an update on the Italian site in Bulciago.
The company said it is working to return to production as quickly as possible but does not expect that will happen “before the end of this year.”
A Teva spokesperson did not respond to two requests for comment on what led to the halt in production.
The problems have come up even as the drugmaker has been going through a major downsizing of its manufacturing operations over the last couple of years. That stemmed from CEO Kåre Schultz cutting $3 billion in annual operating expenses to return the drugmaker to firm financial footing after its troubled $40 million deal to buy generic drugmaker Actavis from Allergan. While the drugmaker has very nearly reached its financial goals, Schultz has said that Teva will continue to look at ways to trim the extended manufacturing network.
Cost has not been the only issue with the Actavis buy. Teva received a warning letter earlier this year for a former Actavis site in Florida over issues in the laser drilling of a schizophrenia drug. The FDA noted that the issues predated Teva’s 2016 deal but said the drugmaker hadn’t done enough to get on top of them. Teva, which has brought in an outside consultant, says it is working closely with the FDA.
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Apparently this CVS/Target pharmacy customer was UNHAPPY
Posted on November 27, 2019 by Pharmaciststeve
CVS/Target pharmacy destroyed by woman with metal pole
https://www.koin.com/news/crime/target-pharmacy-destroyed-by-woman-with-metal-pole/
Target said nearly all the medication, medical supplies and selves were ruined and the total cost of damage was over $100,000.
Daniel was booked into the Multnomah County Detention Center on charges of criminal mischief, burglary and disorderly conduct.
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Dr Mark helping one chronic pain pt at a time 11/18/2019
Posted on November 27, 2019 by Pharmaciststeve
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Dr. Mark sharing his thoughts
Posted on November 27, 2019 by Pharmaciststeve
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Frustrated opioid patients speak out: ‘I now buy heroin on the street’
Posted on November 27, 2019 by Pharmaciststeve
Frustrated opioid patients speak out: ‘I now buy heroin on the street’
One woman spoke of how her mother, at 72 years old, and in pain because of degenerative bone disease, saw only one way out after her opioids were tapered down. She committed suicide.
A husband whose wife of 50 years suffers from neurological and spinal diseases and who no longer can get a prescription for painkiller patches said, “A welcome death has become a discussion.”
Paul Wayman, a 69-year-old veteran, wrote: “The VA cut my pain meds cold turkey after over 25 years. I now buy heroin on the street.”
“You need to talk with veterans. My friend has more metal and screws in him than a robot, but no more pain meds. Suicide is the only light at the end of the battlefield,” Wayman said. “I used to do a lot of volunteer work, loved doing it with my wife. Now I get high so I can walk.”
AS DOCTORS TAPER OR END OPIOID PRESCRIPTIONS, MANY PATIENTS DRIVEN TO DESPAIR, SUICIDE
“All we’re asking is some relief. And some quality of life,” he said. “Ending life now is not on bucket list. I do think about it all the time.”
Wayman is among the hundreds who reached out to Fox News through emails and messages on social media, following the publication of a three-part series on the nation’s struggle to address its crippling opioid crisis, caused mainly by illegal drugs, and the unintended victims – chronic pain sufferers who have relied on prescribed opioids for relief – left in its wake.
U.S. Air Force veteran Herb Erne II, 76, of North Carolina, died by suicide in February 2018. On the right is the note to his wife, saying he could no longer stand the chronic pain.
The series showed the federal government’s approach to addressing the overdose epidemic by targeting the supply and prescribers of opioids has unwittingly led many doctors to cut down or cut off their patients’ pain medications altogether. The approach – bolstered by 2016 Centers for Disease Control and Prevention (CDC) guidelines for opioid prescribing that, despite the agency’s warning that they merely were suggestions, not to be enforced as law – has left many chronic pain sufferers undertreated, with some contemplating taking their own life.
Pain patients who shared their frustrations and desperation and, in several cases, questions about whether they could go on much longer included a wide range of mothers, fathers, executives, farmers, maintenance workers, doctors, nurses, law enforcement officials and veterans. All described their experience of being limited by their diseases and pain to being debilitated and bedridden, after being tapered down or denied continued prescription opioids.
“My wife lives in extreme pain,” wrote Tom Walker of Lousiana. “She has had countless epidural procedures, to no avail. And add one very invasive back surgery, to no avail. She suffers from three different neurological diseases as well.”
The only source of relief, transdermal fentanyl patches, was discontinued, he said.
“When I reminded the doctor about his Hippocratic Oath, he informed us that he was not going to lose his job over a patient,” said Walker, who has been married for 50 years. “She went thru [sic] a very painful ‘Cold Turkey’ process.”
Casting the restrictive policies on painkillers as a “mutant outgrowth of the CDC’s position on opioids,” Walker said, “I am afraid that this has become the cause du jour for too many law enforcement agencies and politicians.”
DOCTORS CAUGHT BETWEEN STRUGGLING OPIOID PATIENTS AND CRACKDOWN ON PRESCRIPTIONS
Julie McLeland wrote: “My mother hung herself in August after her ‘pain management’ doctor made some radical changes to her drug protocol.”
“She was only 72 and had degenerative bone disease in her back,” McLeland said. “She lived in misery and died in despair because it was politically popular to ignore patients who desperately need medication and paint them as addicts without moral compasses. She is loved and missed. Thank you for giving her a voice.”
Herb Erne III, a registered nurse, wrote: “My father was a victim of the opioid scare, he took his life because nobody would help him with his pain. He was 76 with several health problems, one being chronic leg pain that started about 18 month prior to his suicide. Nothing would help with the pain.”
“He was scheduled to have surgery this past January. The surgeon decided to postpone the surgery until my father had regained his strength, he was receiving Home Health at the time” Erne wrote. “He asked his primary MD for help with the pain but he would not write for narcs and nothing he tried was working for pain control.”
Erne continued: “The MD referred him to a pain clinic, with similar results. On February 10th of this year, my father put a gun in his mouth and pulled the trigger. My mother was out at the time and found him when she returned home. I arrived shortly after. He left a note saying he just could not take the pain.”
Erne says his father, a U.S. Air Force veteran and former employee of General Electric’s aircraft division, was one of the many pain patients who are the silent victims of the opioid crisis.
“As a nurse, I have seen addicts and the other end of opioid abuse,” he said, “but there is another side to this crisis that people are not talking about, those that actually need pain medications but cannot get them because of the ‘fear factor’” of running afoul of the anti-opioid – including legal ones taken safely under medical supervision – backlash.
Pain patient advocate Bill Murphy of New Hampshire said: “The voices of addiction recovery advocates have been very effective over recent years, and rightly so. The problem against which they fight is very serious and the funding they have received for addiction education and more effective rehabilitation facilities is outstanding.”
“But the chronically ill who do not abuse, who do not divert, have become the unintended victims of misguided and overzealous efforts by policy and regulation making bodies in the government,” he said. “Addiction does not seek managed care. Pain management returns and improves function. Our leaders need to understand this.”
HEALTH EXPERTS OFFER SOLUTIONS FOR UNINTENDED CONSEQUENCES OF OPIOID CRACKDOWN
Another veteran wracked by pain from battlefield injuries wonders where the appreciation of the country he risked his life for is as health care providers deny him the medical relief that long kept him functional and grateful to wake up each day.
“This has to stop” wrote Rick Campbell, a disabled veteran who lives in Alabama and describes being in pain three-fourths of his waking hours. “I have been on opiates for over 15 years and have not overdosed or had a medical emergency due to them, but am being forced off and left to suffer in pain.”
“It is insane and we are suffering,” he said. “It is sad our country cares more about illegal drug users than they do the veterans that served this country and need the medication and have documented proof of it.”
Asked by Fox News for a response to a complaint by many veterans that VA facilities are undertreating their pain, the VA said in a statement: “VA is recognized by many as a leader in the pain management field for the responsible use of opioids across the VA health care system. For instance, in January the department became the first hospital system in the country to release its opioid prescribing rates.
“Because some Veterans enrolled in the VA health care system suffer from high rates of chronic pain, VA initiated a multi-faceted approach called the Opioid Safety Initiative (OSI) to reduce the need for the use of opioids among America’s Veterans using VA health care. Since its launch, the program has resulted in 308,911 fewer Veteran patients – a 45 percent reduction – receiving opioids from July of 2012 to June of 2018.”
Dr. Stephen Gelfand, a member of the Physicians for Responsible Opioid Prescribing (PROP), which says that opioids for chronic pain harm people more than they help, said in an email: “The efforts of PROP should not be derailed by the one-sided, opioid industry efforts to disparage the CDC Guideline.”
Referring to a news item in South Carolina about a large drug-trafficking operation that was selling heroin, fentanyl, crack cocaine, among other drugs, Gelfand said: “I am sick and tired of hearing how there should be few limits to opioid prescribing, when the track record of widespread over-prescribing has led, not only to the staggering rising toll of opioid-related addiction and death, but also to the great expansion of this lucrative criminal illicit opioid drug trade which affects society and all of us.”
Gelfand said there are doctors and drug companies that overstate the negative impact of restricting prescription opioids because of “a financial stake in maintaining the volume of opioid prescriptions.”
“They have taken advantage of chronic pain patients on opioids, many of whom suffer from opioid use disorder or the disease of addiction, which is characterized by denial and withdrawal symptoms, including pain, and used as an excuse for opioids being ‘needed’ lest they are at risk for ‘suicide,'” he wrote. “In other words, the occurrence of withdrawal, which is an inevitable consequence or direct effect of chronic opioid use, is being used as a reason to disparage the CDC Guideline and reject important gradual opioid tapering regimens, especially at high doses, or the more difficult discontinuation of opioids in some patients, or the essential referral of others for needed addiction treatment services, including the use of buprenorphine.”
“We believe in careful, gradual tapering of opioids to avoid or significantly attenuate withdrawal, as well as in the imperative of the prevention of addiction initially, by avoiding opioids in the vast majority of patients with chronic non-cancer pain, while prescribing them only for a carefully screened and monitored select minority.”
Dr. John Swicegood, an Arkansas physicain who has been a pain specialist for 33 years, vehemently disagreed, and lamented “the harm brought about by this ‘opioid crisis’ narrative… throwing every legitimate patient suffering chronic pain, even cancer and palliative pain, under the bus.”
TOUGH NEW OPIOID POLICIES LEAVE SOME CANCER AND POST-SURGERY PATIENTS WITHOUT PAINKILLERS
“I went personally to all Arkansas congressional offices more than once explaining this, that a social narrative was replacing science. lt was curious to just see someone’s eyes glaze just over when I went on to explain this, I kept saying, the ‘opioid crisis’ is not your grandmother taking 3 lortabs per day,” Swicegood wrote in an email.
“We see about 4,500 encounters per year – and they are infirmed, sick, crippled, in wheelchairs, walkers, having either failed spine or orthopedic surgery or not candidates – this is the group in the shadows. It is not your young tanned rested male or female walking in with minor findings wanting disability and opiates (we screen them out – this BTW is the population of misuse, diversion and addiction, enabled by our failed culture).”
“This was an opportunity for [insurance companies] to bail on opiate prescription coverage as well as to place public focus implying pain care was addicting everyone,” Swicegood said, “and this was the crisis, to the extent physicians were to blame, the government was not stopping bad doctors. For example, pill mills are mostly uncredentialed physicians that the DEA continues to re issue schedule 2 controlled substance permits -despite knowing they were selling RX for cash. This continues in our area.”
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A Year of Historic Action to Combat the Opioid Crisis… Has HIPAA protected data just become a OPEN BOOK ?
Posted on November 26, 2019 by Pharmaciststeve
A Year of Historic Action to Combat the Opioid Crisis
https://www.whitehouse.gov/articles/year-historic-action-combat-opioid-crisis/
One year ago this week, President Donald J. Trump declared the opioid crisis a public health emergency. Ever since, the Trump Administration has applied an all-of-Government approach to the epidemic, allowing each agency and department to do their part to help the cause.
This is a crisis that cannot be solved through Government action alone. Private-sector and nonprofit partners are stepping up and stepping in to make a difference. Today, President Trump hosted 21 of these organizations at the White House. Their work is innovative, groundbreaking, and promising for the millions of Americans who struggle with addiction or support loved ones who do.
Amazon
Mr. Brian Huseman, Vice President, Public Policy
Amazon will help first responders more efficiently access critical medical records and has programmed Alexa voice service to answer important questions about opioids and addiction.
Belden Industries
Mr. John Stroup, President, Chief Executive Officer and Chairman of the Board
Belden will expand their rehab and employment program to two additional U.S. facilities in 2019 and provide a Blueprint for companies to adopt to recruit and retain employees supporting recovery.
Blue Cross Blue Shield Association
Mr. Scott P. Serota, President and CEO
Blue Cross Blue Shield Association will launch Blue Distinction® Centers for Substance Use Treatment and Recovery and will establish a toll-free national hotline to provide all Americans a way to locate designated treatment centers.
Cigna
Mr. Alan Muney, Chief Medical Officer
Cigna will partner with the Veterans Health Administration to help veterans manage pain, improve access to opioid addiction treatment and improve mental well-being, and will work to reduce opioid-related overdoses in various communities by 25 percent within three years.
CVS Health
Mr. Thomas Moriarty, Executive Vice President, Chief Policy & External Affairs Officer, and General Counsel
CVS Health is committed to installing 1,100 additional permanent medication disposal units in communities and reaching 250,000 students and parents with its opioid abuse prevention program by the end of 2019.
Dispose RX
Mr. John Holaday, CEO
DisposeRx is committed to stopping opioid abuse, by contributing DisposeRx packets that can remove over 10 million opioids from our nation’s medicine cabinets.
Emergent BioSolutions
Mr. Mike Kelly, President US Operations
Emergent BioSolutions will offer Free NARCAN® Nasal Spray to all 16,568 public libraries and to each of the 2,700 YMCA locations in the United States.
Facebook
Mr. Kevin Martin, Vice President, US Public Policy
Facebook is committed to addressing the opioid epidemic through impactful public-private partnerships including: a link to SAMHSA’s Helpline in Search, and supporting the Ad Council PSA and DEA Takeback Day.
Global Teen Challenge
Mr. Ed DeShields, Board Member
Global Teen Challenge, the largest treatment center worldwide, is building a national Treatment Information System so its 250 U.S. treatment centers can understand which recovery programs are showing the most promise of success from addiction.
Google
Ms. Susan Molinari, Vice President of Public Policy and Government Affairs
Google has created a Locator Tool for National Take Back Day that they’ll promote on the Google.com homepage, and will launch a partnership with Walgreens to display permanent drug disposal locations on Google Maps.
Johnson & Johnson
Ms. Linda Murray, Senior Vice President, Consumer Experience and Global Editor in Chief, BabyCenter
Johnson & Johnson will continue educating America’s nurses and physicians to fight substance abuse and launched an opioid addiction awareness campaign that reached more than 2.5 million expectant parents via BabyCenter.
Leidos
Mr. Roger Krone, Chairman and CEO
Leidos is committing to an additional $3 million to opioid related causes, and furthering efforts to educate our workforce of 32,000 employees and launching a coalition of dozens of companies to address the crisis.
MyPillow
Mr. Mike Lindell, CEO
MyPillow employs workers directly after graduating from faith-based drug treatment and will soon launch the Lindell Recovery Network to bring hope, recovery and mentorship to thousands struggling with opioid addiction.
National Head Start Association
Mr. Damon Carson, Board Chairman
The Head Start community will expand training to all 245,792 staff in over 21,000 centers nationwide to address the far-reaching impacts of parent substance-use disorder on young children and families
National Safety Council
Ms. Debbie Hersman, CEO
National Safety Council will spread awareness of the crisis through the Prescribed to Death traveling Memorial, and will educate 1,000 more physicians on safer prescribing practices.
Red Cross
Mr. Jack McMaster, President, American Red Cross Training Services
Red Cross will offer our online course, First Aid for Opioid Overdoses, to give all Americans the knowledge to respond to a suspected opioid overdose emergency and will integrate opioid education in over 3 million annual first aid trainings.
Rite Aid
Ms. Jocelyn Konrad, Executive Vice President for Pharmacy
Rite Aid is offering free DisposeRx packets with new opioid prescriptions. Its Foundation installed 312 medication disposal units and launched the Prescription Drug Safety Initiative for students across the country.
Ultimate Fighting Championship
Mr. Lawrence Epstein, Senior Executive Vice President and COO
UFC commits to launching a public service campaign to bring attention to the opioid crisis, using UFC athletes, its powerful social media platforms, and popular live events to educate millions of people on the dangers of opioid abuse.
Unshattered
Ms. Kelly Lyndgaard, Founder and CEO
Unshattered will expand their partnerships with recovery centers across the county and provide employment and job skills training to double the number of women that we serve by the end of 2020.
Walgreens
Mr. Rick Gates, Walgreens Senior Vice President for Pharmacy and Health Care
Walgreens is expanding its medication disposal program to all of its stores, and collaborating with Google to provide information about the location of disposal sites on Google’s platform.
Walmart
Mr. Paul Beahm, Senior VP of Health and Wellness Pharmacy Operations
Walmart will continue to limit initial, acute opioid prescriptions to a 7-day supply, use analytics to block illegitimate prescriptions, and require E-Prescriptions for all scheduled drugs by January 1, 2020.
Looking at this list of the 21 organizations at this White House meeting …. I see at least FOUR of the the major pharmacy chains, several of the major insurance companies and most of the major internet data collectors. All/most of these companies have access or in charge of protecting HIPAA data on all of us. Missing is all the DRUG WHOLESALERS and ALL THE PHARMAS with the exception of J&J.
This was ONE YEAR AGO… how much data has been collected, in the interim, on anyone legally being prescribed controlled substances ?
How many people dealing with chronic pain and other subjective diseases have to suffer, die or commit suicide because of this “gang of 21” KISSING UP to the administration ?
How much longer is those in the chronic pain community going to continue to act like a bunch of feral cats.. running in all directions and fighting among themselves. ?
These companies represents multiple TRILLIONS of dollars of net worth…
JUST TODAY AMAZON announced Amazon launches medication management features for Alexa As Amazon moves further into the healthcare market, the company today is rolling out a medication management feature for Alexa owners. The feature will allow customers to set up their own medication reminders and request voice refills using their prescription information
Over the eight years that I have been posting on my blog… I have seen advocates coming forward… eager to “right the ship”… and typically after 6-24 months… they become discouraged and “disappear”… Eight years of watching people contacting their members of Congress, dozens of media outlets, untold number of petitions and perhaps THOUSANDS of Face Book pages devoted to pain in some manner, making comments to various alphabet of federal/state agencies… which is not much more than a diversion… because the conclusion/outcome is preordained…
The number of legal opiate Rxs peaked in 2011-2012 and have been declining every year… how many have died from complication of their co-morbidity issues from under/untreated pain and the cause of death “NATURAL CAUSES”… how many have committed suicide from the unrelenting pain… I suspect that the number we know is much smaller than the REAL NUMBER.
With the technology that this “gang of 21” has… could be a modern day TROJAN HORSE… but with this TROJAN HORSE… the killing will be a very large COVERT GENOCIDE.
It may now be TOO LATE to create a legal defense fund… This David & Goliath battle may not turn out the same way as it did in the bible
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non-physician clinicians: are not trained to be substitutes of physicians
Posted on November 26, 2019 by Pharmaciststeve
15 Doctors Fired From Chicago-Area Health System
https://www.medpagetoday.com/publichealthpolicy/workforce/83576
At least 15 physicians have been fired from Edward-Elmhurst Health as the suburban Chicago-based health system moves to cut costs, sources told MedPage Today.
The doctors, who worked across its seven “Immediate Care” or urgent care sites, will be replaced by advanced practice nurses,
according to an email sent by hospital leadership that was shared with MedPage Today. The physicians were informed late last week that they would be terminated as of April 1, 2020.
A physician who spoke on the condition of anonymity said the doctors were “broadsided” by the news. While they harbored some concerns that a few of the slower urgent care sites might be turned over to non-physician clinicians, they weren’t expecting so many of the sites to be impacted and for such a large number of doctors to be let go.
In their email, hospital system CEO Mary Lou Mastro, MS, RN, and Chief Medical Officers Robert Payton, MD, and Daniel Sullivan, MD, pointed to patient cost concerns as the reason for eliminating the jobs: “Patients have made it very clear that they want less costly care and convenient access for lower-acuity issues (sore throats, rashes, earaches), which are the vast majority of cases we treat in our Immediate Cares.”
“Beginning in the spring of 2020, we will move to a delivery model in which care is provided by Advanced Practice Nurses (APNs) at select Immediate Care locations,” they wrote.
Leadership also stated in the email that they are “working closely with these physicians to assist them with finding alternative positions within Edward-Elmhurst Health or outside our system,” but doctors noted that they face a saturated Chicago healthcare market and they’re likely to have to relocate.
Keith Hartenberger, a spokesperson for Edward-Elmhurst Health, confirmed the layoffs: “We continue to assess our care delivery models in the interest of providing cost-effective care to our patients. We shared with physicians that we have plans to change the model next year at some outpatient sites and are working with anyone affected to find alternative placement.”
The move is becoming a more familiar one as some health systems try to save money by relying more heavily on non-physician clinicians.
Last year, 27 pediatricians at a chain of clinics in the Dallas area lost their jobs and were replaced by nurse practitioners — even though the chain subsequently changed its name to MD Kids Pediatrics.
Rebekah Bernard, MD, wrote in Medical Economics that she spoke with three of the pediatricians who were fired: “They told me that they and their physician colleagues were completely shocked by the sudden firing. ‘We thought we were going to retire from this place,’ one told me.”
Also in 2018, Charlotte, North Carolina-based Atrium Health ended a nearly 40-year contract with a 100-member physician group, signing up instead with Scope Anesthesia, which says it’s dedicated to forming partnerships with certified registered nurse anesthetists. Atrium said it too was looking to reduce patient costs.
“This trend of shuttering hospital departments and firing physicians to save money is dangerous and short-sighted,” Bernard wrote.
Purvi Parikh, MD, of NYU Langone Health in New York City, and a board member of Physicians for Patient Protection, which advocates against other healthcare providers replacing doctors, said that
although non-physician clinicians “are vital members of the healthcare team, they are not trained to be substitutes of physicians and as a result diagnoses are missed and improper treatments and tests [are] prescribed.”
Parikh said patients “have the right to choose a facility that is physician-only or one with physician-led care. In Chicago, luckily there are other options among competitors.”
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what part of Palliative Care do you not understand
Posted on November 25, 2019 by Pharmaciststeve
