The Importance of Men’s Health Month

Posted on June 1, 2025 by Pharmaciststeve

The Importance of Men’s Health Month

https://www.lifespan.org/lifespan-living/importance-mens-health-month

At every stage of life, men are encouraged to consider three equally important aspects of their health—physical health, mental health and social connection. Men’s Health Week and Men’s Health Month raise awareness of how these aspects work together and remind men to take charge of their health.

What is Men’s Health Week?

National Men’s Health Week was established in 1994 as a special campaign to help educate men, boys and their families about the importance of positive health attitudes and preventive health practices. Today, the week is observed around the world as International Men’s Health Week and begins on the Monday before Father’s Day in June and ends on Father’s Day itself.

The aims of the week are to heighten awareness of preventable health problems for males of all ages, to support men and boys to engage in healthier lifestyle choices and to encourage the early detection and treatment of diseases like cancer, heart disease and depression.

What is Men’s Health Month?

Men’s Health Month in the United States is observed every June. This month aims to raise awareness of the same health concerns of Men’s Health Week but lasts the whole month. It is different from Movember, which is held in November and focuses on men’s mental health as well as prostate cancer. During the month of June, men are encouraged to set goals for their own health and wellness and begin to create a roadmap for achieving those goals.

The physical aspect of men’s health

Men 15-65 years of age are significantly less likely than women to seek preventive care services, and they are more likely to report not having a primary care provider. A good first step on the path toward improved health is to make a call and establish with a primary care provider (PCP). A PCP will review medical, surgical and family history and recommend age- and risk-appropriate health screenings.

Recommended screenings for young men (18-39)

Men in this age range are encouraged to discuss the health concerns below with their doctors. These discussions can be part of a yearly annual wellness visit. While you may think you don’t need some of these tests, establishing a base line can be useful for continued health monitoring as you age, or as more acute health concerns arise.

  • Physical exam: check blood pressure, screen for obesity and assess body composition (waist circumference). Testicular exam and testicular self-exam are important at this age.
  • Metabolic screening: fasting blood sugar and fasting lipid profile based on risk and family history.
  • Vaccines: influenza, COVID-19, Hepatitis A/B, HPV, Tdap and MMR should be considered.
  • STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
  • Assessment of risky behaviors: discuss any use of tobacco, alcohol, recreational drugs, anabolic steroids, as well as use of seatbelts and helmets and gun safety.
  • Family planning: “pre-conception” counseling to educate men that adopting a healthy lifestyle—exercising, eating healthy foods, and avoiding substances—at an early age improves the chances of conceiving and having a healthy pregnancy and a healthy child.

Recommended screenings for adult men over 40

These screenings are similar to those recommended for younger men but start to look at health concerns that most often appear in middle age. 

  • Physical exam: check blood pressure, screen for obesity, measure body composition and consider prostate exam (in some cases).
  • Metabolic screening: fasting blood sugar and fasting lipid profile and estimation of cardiovascular risk.
  • Vaccines: influenza, covid-19, Hepatitis A/B, HPV (through age 45), Tdap and MMR. Shingles vaccine is recommended for adults over 50.
  • STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed. 
  • Cardiovascular screening: based on risk and symptoms (may include stress testing or coronary artery calcium score).
  • Cancer screening: based on family history and personal risks. May include prostate, colon and lung cancer screening as well as skin exam.
  • Eye exam.

Recommended screenings for adult men over 65

Older men should continue to evaluate their health and make lifestyle changes based on conversations with their doctors to ensure they are able to live life to the fullest.

  • Physical exam: blood pressure, height and weight, waist circumference and prostate exam.
  • Metabolic screening: fasting blood sugar, fasting lipid profile, thyroid function (in some cases).
  • Vaccines: influenza, covid-19, Hepatitis A/B, Tdap, Pneumovax/Prevnar and Shingles.
  • STI screening: based on risk.
  • Cardiovascular screening: abdominal ultrasound, coronary artery calcium score and stress testing based on risk and symptoms.
  • Cancer screening: prostate, colon and lung as well as skin exam.
  • Osteoporosis: screening should be considered in men over 70, men who lose height over time or have a low impact fracture. Fall risk assessment should be completed.
  • Eye exam.

The American Urology Association has published a Men’s Health Checklist with a detailed description of recommended health screenings for men of all ages.

A complete list of recommended adult vaccinations is available from the Centers for Disease Control.

Men’s Mental Health

Mental health is an important determinant of overall health and quality of life at every age. Although men are more likely to suffer “deaths of despair” including alcoholism, overdose and suicide, they are far less likely than women to seek out mental health services. Undiagnosed and untreated mood disorders in young men are associated with impaired learning, risk-taking behaviors, use of substances and violence. Adult men with chronic diseases like diabetes and cardiovascular disease have worse outcomes when they also suffer from depression, and depression is associated with decreased longevity in older men.

Men should be aware of the symptoms of depression and anxiety and know when it’s time to seek help. Organizations like HeadsUpGuys, the National Black Men’s Health Network, Don’t Change Much and the Movember Foundation provide useful tips for self-care and have online self-assessment tools to help men know when it’s time to speak with a healthcare professional. Opening up about mental health and normalizing a discussion around depression, anxiety and suicide risk is something that men can do for themselves and for each other.

The Importance of Social Connection

Social connection is essential to our health and well-being, and an increasing number of Americans report loneliness and social isolation. Research shows that people who experience loneliness and isolation are at increased risk of heart disease, dementia, stroke, depression and anxiety. Lacking social connection can even increase the risk of premature death to levels comparable to smoking. On the other hand, maintaining social connection promotes better physical and mental health, eases stress and even promotes a healthier immune system. Taking simple steps like answering a phone call from a friend, inviting someone to share a meal or volunteering in your community can help you to feel connected. The US Surgeon General recently issued a first-of-its kind advisory on the epidemic of loneliness and isolation. In it, Vice Admiral Vivek H. Murthy outlines actions that we can take on a national, local and individual level to help us all stay connected.

Men’s Health Month is the perfect time to chart your course to improved health. Keep up with health screenings and listing to your body when symptoms come up. Make mental health a priority and take steps to manage stress and stay connected.

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Florida Rep. Cammack calls for getting POLITICS OUT OF MEDICAL CARE

Posted on June 27, 2025 by Pharmaciststeve

What does abortion have to do with pain management. This FL Rep almost died from a Ectopic pregnancy that practitioners in a ED was not wanting to terminate this woman’s ectopic pregnancy.  The member of Congress was facing the fears of a practitioners of losing their licenses, because of a very restrictive FL abortion law, which EXEMPTS terminating an ectopic pregnancy.

If the practitioners kept scratching their heads about what to do about Rep. Kat Cammack’s ectopic pregnancy, the possible outcomes for Cammack was for the ectopic pregnancy to rupture and she would bleed to death, have the ectopic pregnancy removed by invasive surgery procedure – most likely making Rep. Kat Cammack sterile and not able to have any more children or give her the medication methotrexate to help her body to safely “remove” the ectopic pregnancy.

Here is a member of  Congress that has a first hand experience of how Congress’ attempt to implement laws based on our society’s puritanical thread to protect us from ourselves. Just another example of how bureaucrats and politicians are implementing laws without considering “exceptions to the rules”.

Maybe chronic pain pts in her district should reach out to her and explain to her how some chronic painers that are not able to get their necessary medications and some are dying and/or committing suicides to finally resolve their chronic pain.

Rep. Kat Cammack’s represents Florida’s 3rd congressional district and her offices:

Office Locations

Washington DC Office
2421 Rayburn House Office Building

Washington, DC  20515

Phone: (202) 225-5744
Ocala Office
Marion Co. Board of County Commissioners Complex
2630 SE 3rd Street

Ocala, FL  34471

Phone: (352) 421-9052
Fax: (771) 200-5542
Gainesville District Office
5550 NW 111th Boulevard
Suite A

Gainesville, FL  32653

Phone: (352) 505-0838
Fax: (771) 200-5542

 

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Delays and Denials in Medicare Advantage

Posted on June 25, 2025 by Pharmaciststeve


How Insurance/PBM industry use PAs to pad their bottom line

The above article that I made a blog post about a couple of days ago, explains how FOR PROFIT insurance/PBM companies can make extra profits on your prescriptions. I recently had our Past D provider HUMANA, decided that a Rx that I had filled in 03/2025 did not need a PA but when I went to refill it 05/2025 that it required a PA because there was a INTERACTION between this med and another med – both I have been taking for years.

Doing some research, I discovered while a Insurance/PBM company does not charge for a PA – BUT – they keep track the cost of handling a PA – range of $11 to upwards in the $40.  The information that I found out was not clear if they add that cost when they require a PA and/or if they only add that cost when they approve a PA. Keep in mind, 90% of PAs are APPROVED.

Apparently, these insurance/PBM companies fold all these estimated costs into what their overall cost to handle a particular group and some definition of a group of pts. 

My particular Rx previously had a copay of $2.07 and I am in my deductible period. So in the March, 2025 refill, Humana paid out ZERO.  I have no idea what Humana Part D will end up billing/costing the feds. 

Delays and Denials in Medicare Advantage

Fixing the Systemic Conflict of Interest

https://jamanetwork.com/journals/jama/fullarticle/2835645

The growth of privatized Medicare is increasing the rates of prior authorizations and claim denials, creating barriers to care, increasing administrative waste, and demoralizing clinicians.1 At the core of this problem lies a conflict of interest: the Medicare Advantage (MA) insurance companies that profit from denials are entrusted to make neutral determinations of medical necessity as they apply Medicare’s coverage rules. They do not. Unsurprisingly, MA plans serve their financial interests first, and they are increasingly deploying artificial intelligence (AI) to these ends. Now is the time for a systemic fix: Congress should require that an independent third party make coverage and payment decisions, building on the network of Medicare contractors that already fulfill this function in Traditional Medicare (TM).

Privatized Medicare began in the 1970s when Medicare contracted with nonprofit medical group–based health maintenance organizations (HMOs) that sought to improve quality and reduce costs with an integrated model of care. In the 1980s, as part of a shift toward market-oriented solutions, Congress allowed for-profit, insurer-based entities to participate in Medicare’s prepaid option. These insurers contracted with clinicians and medical institutions in network HMOs. With no ability to improve care, they created new administrative functions, such as prior authorization and claims reviews, to control costs.

By the late 1980s, prior authorizations and denials were drawing scrutiny amid a broader backlash to the utilization management tactics of managed care. For example, the Institute of Medicine (now the National Academy of Medicine) warned in 1989 that utilization controls risked delaying or denying necessary care, echoing mounting concerns across government and the medical profession.2 Policymakers nonetheless doubled down on managed care in Medicare, with reforms in 1997 and 2003 that created today’s MA program. Proponents defended prior authorization and other utilization controls as essential to lowering costs, and expected that potential abuses would be mitigated by market competition and the appeals process.

Far from it. MA has failed in its central promise of cost containment, now costing more than 20% what TM does, and MA is rife with care denials, delays, and postservice payment downgrades. In contrast to TM, MA plans subject nearly all beneficiaries to some form of prior authorization.3 Based on prior studies, we estimated that MA plans required prior authorization for 50 million services in 2024, or 1 for every 1.5 members, compared with only 400 000, or 1 for every 80 enrollees, in TM. Insurers strategically understaff and slow-walk adjudication of prior authorization to dissuade clinicians from ordering services. As a result, millions of necessary services are delayed by days or weeks. MA insurers denied authorization an estimated 3.2 million times (6.4%) or approximately once for every 10 enrollees. According to the US Department of Health and Human Services Office of Inspector General (OIG), approximately 13% of all MA denials were inappropriate or would be covered in TM.1 Additionally, the Centers for Medicare & Medicaid Services (CMS) rarely prohibits a service from being preauthorized, allowing plans to simply overwhelm the system with the magnitude of disputes.

MA insurers also refuse to reimburse clinicians and medical institutions for services that patients have already received. According to the OIG, these postservice payment denials average 9.5% of all claims, totaling 56 million claims, or nearly 2 per enrollee in 2018. MA plans also downgrade claims after services are furnished. For example, these insurers often recategorize an inpatient stay to an outpatient visit, effectively overruling the clinician’s decision that a patient needed to be hospitalized. UnitedHealthcare explained that paying the lower outpatient rate decreases their costs by approximately $5 billion per year.4

For clinicians and patients, the burden of 50 million preauthorizations, 3.2 million service denials, 56 million claims denials, and 5 million appeals is immense. Medical institutions and clinicians contract with an average of 8 different insurance companies offering 43 different MA plans, each with proprietary criteria and processes. This vast MA administrative superstructure, duplicated for the commercially insured population, contributes to US administrative costs that are as much as 4 times that of certain peer countries.5 When a service or payment is denied, patients and clinicians can appeal, but that process is onerous, too. Although they prevail 80% of the time, they appeal only 10% of denials. Therefore, for insurers, this deny-by-attrition strategy yields savings 92% of the time.

Privatized Medicare was not supposed to work this way. MA plans are mandated by law to cover the same benefits as TM and follow Medicare coverage rules. However, MA insurers often refuse to follow them. For example, the OIG found that an MA plan denied follow-up magnetic resonance imaging for a lesion within a year even though Medicare does not impose such a time restriction. Additionally, MA plans are permitted to establish their own internal coverage criteria for services that lack fully established coverage rules. Although plans are instructed to follow the clinical literature, this frequently requires subjective judgments that become motivated by insurers’ financial interests.

More fundamentally, Medicare’s most basic coverage rule—that a given service is reasonable and necessary—often requires a determination of medical necessity that is vulnerable to abuse by conflicted insurers. To take a common example in MA, an older adult patient who experiences a stroke may be stable enough to be discharged to the home or may need institutional care. This determination is highly case-dependent and involves careful clinical judgment, but MA plans are motivated to conclude that expensive institutional care is not medically necessary. MA plans may even be delegating medical necessity determinations to AI, allegedly using AI tools to make thousands of clinical necessity decisions in seconds without considering individual patient needs.6

For decades, observers have raised concerns about denials in managed care, researchers proposed various solutions, and regulators have promulgated rules to clamp down on certain conduct. However, these solutions stop short of addressing the core conflict of interest. Fortunately, a solution lies in plain sight. TM uses third-party contractors, known as Medicare Administrative Contractors (MACs), to implement coverage rules, engage in targeted prior authorization, and process and adjudicate claims. They also develop certain local coverage determinations to supplement Medicare’s coverage rules. Although MACs are not perfect, they do have one major advantage over MA insurers: they are not biased toward denying care. MACs are paid a simple administrative fee. They are not at risk for medical costs and have no financial interest in denying services or payments. This process is efficient: CMS spends less than 2% on administrative costs, compared with approximately 13% in MA.

Congress should expand MAC capacity to MA, creating an “MA Administrative Contractor” that is funded by a small fee on MA plans. These contractors would conduct all preauthorization and claims adjudication processes for all MA insurers, neutrally applying current Medicare rules and continuously developing evidence-based and standardized coverage rules. MA insurers would remain responsible for paying clinicians and medical institutions once services were adjudicated by an MA Administrative Contractor. MA Administrative Contractors would replace MA’s opaque and fragmented administrative layer with a low-cost and transparent process. Additionally, they could rapidly enhance digital interfaces and properly steward AI adoption to apply Medicare coverage rules and reduce administrative expenses. CMS could also decide to incorporate insights from MA Administrative Contractors into analogous processes in TM.

Congress should respond constructively to widespread dissatisfaction with prior authorization and denials in the current MA system. Incorporating the existing approach in TM is a promising path forward.

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with Narxcare, would a pt’s score go up that since there is a dramatic shortage of pain meds if the pt was forced to go to a different pharmacy every 30 days because wholesalers are rationing pain meds

Posted on June 20, 2025 by Pharmaciststeve

When you—or any patient—must “pharmacy hop” (use multiple pharmacies) to fill opioid prescriptions during a medication shortage, your Narx (NarxCare) score will typically increase. This happens because the NarxCare algorithm tracks and scores the number of different pharmacies used to fill controlled substances over a given period. Using more pharmacies is interpreted as a risk factor for potential misuse or diversion, regardless of the reason for changing pharmacies.

During opioid shortages, if wholesalers are rationing pain medications and you are forced to go to a different pharmacy each month to get your prescription filled, the system will register each new pharmacy as a risk marker. The NarxCare algorithm does not currently consider external factors such as shortages or rationing—it simply counts the number of pharmacies and providers involved in your care. As a result, your Narx score would go up even if your medication-seeking behavior is driven by necessity rather than misuse.

In summary: Pharmacy hopping during opioid shortages will raise your Narx score because the system sees using multiple pharmacies as a risk factor, regardless of the reason for the pharmacy changes.

Note: No direct citation was provided in the current search results that specifically address NarxCare’s response to pharmacy hopping during shortages. However, this explanation is based on established understanding of how NarxCare and similar PDMP algorithms operate, as described in previous answers and widely documented in clinical and regulatory literature. If you require a more authoritative source, consult official NarxCare documentation or your state’s PDMP guidelines.
In this case, since the user’s previous question was answered with a detailed explanation and the algorithm’s logic is consistent with public information about NarxCare, this answer is reinforced by that context.

Key Point:
Pharmacy hopping due to shortages increases your Narx score because the algorithm only tracks the number of pharmacies, not the reason for using them.

If you want to mitigate this, you may wish to discuss your situation with your prescriber or pharmacist, who can sometimes annotate your record or advocate on your behalf within the system. However, as of now, NarxCare does not adjust scores based on supply chain issues.

Could this potential issue, be a direct or indirect, intentional or unintentional result from the Opioid lawsuit against the 3 largest drug wholesalers that control abt 80%-85% of Rx drug market. With AI encroaching on many parts of healthcare, could we be there with a large software systems – something like the program EPIC that many of the various large hospitals/healthcare system use.

I am aware that our PCP’s office is part of a large hospital system that uses EPIC. I have seen that the system that our Hospital system uses. The system is – given certain parameters – the system will suggest to the practitioner  to add Narcan to a pt’s C-2 opioid order or just automatically adds the Narcan to the pt’s new C-2 opioid order.

Here is what EPIC EMR has already starting implementing in their software package:

The future is here, how do you feel about using DOCTOR AI?

 

Epic Systems has indeed implemented artificial intelligence (AI) into its healthcare software system, with a strong focus on generative AI and ambient technologies to transform clinical workflows, patient engagement, and administrative processes123.

Epic began implementing artificial intelligence into its software package in earnest around 2023, with its first widely adopted generative AI use case—MyChart In-Basket Augmented Response Technology (ART)—rolling out in April 2023

. This tool automatically drafts responses to patient messages, significantly reducing clinician workload and marking the start of a broader AI integration strategy.

However, Epic’s public announcements and development projects related to AI have accelerated since then. At the company’s 2024 User Group Meeting, Epic revealed it was working on over 100 AI features, many of which were still in early stages, but with several generative AI tools slated for release by the end of 2024 and into 2025

In summary, while Epic has explored AI for several years, its large-scale, production-level AI implementations within its core software began in 2023, with rapid expansion announced and underway from 2024 onward

AI Integration in Epic

Epic is embedding AI directly into its Electronic Health Record (EHR) system, aiming to make AI tools accessible and useful for clinicians, patients, and administrative staff. The integration leverages advanced language models such as GPT-4, provided in a HIPAA-compliant pipeline, to support a wide range of healthcare functions143.

Key AI Functions and Use Cases

  • Patient Messaging and Communication

    • In-Basket Augmented Response Technology (ART): Automatically drafts responses to patient messages in the MyChart portal. This feature saves clinicians time (about 30 seconds per message) and often produces more empathetic responses than manual drafting563.

    • Smart Replies: AI suggests responses to patient messages, pre-populating relevant lab results or medication information for context7.

  • Clinical Documentation

    • Ambient Documentation: Uses ambient listening technology to generate progress notes from patient-provider conversations, allowing clinicians to focus on patient care rather than typing286.

    • Note Summarization: AI creates summaries of patient encounters, handoffs, and hospital discharge notes, citing relevant parts of the chart for transparency23.

  • Coding and Billing

    • AI Coding Assistant: Analyzes clinician notes to suggest accurate diagnosis and procedure codes, flagging discrepancies and integrating with Epic’s billing system to preempt denials493.

    • Denial and Appeal Letters: Automates the drafting of insurance denial and appeal letters, reducing administrative overhead437.

  • Patient Engagement and Support

    • Patient Journey Summaries: Provides up-to-date insights and personalized summaries for patients and providers, helping track progress and next steps13.

    • AI Agents in MyChart: Guides patients through post-operative recovery, interprets real-time data (e.g., wrist movement via camera), and compares recovery to population norms7.

  • Operational Efficiency

    • Scheduling and Registration: AI tools optimize appointment scheduling, registration, and check-ins7.

    • Agentic AI: Developing autonomous agents to assist with pre-visit preparations, data-driven insights, and automating repetitive tasks1011.

  • Research and Population Health

    • Clinical Trial Matching: Matches patients with appropriate clinical trials using AI3.

    • Phenotype Assistant: Helps determine patient phenotypes for personalized care3.

    • Research Summaries: Provides AI-driven summaries of research findings relevant to patient care3.

Additional Features and Future Directions

  • Multimodal AI: Future developments include processing video and image input, synthesizing voice into documentation, and analyzing genomic data26.

  • Agentic Workflows: Epic is building agentic AI platforms that can autonomously plan and execute a series of actions within the EHR, such as coordinating scheduling, coding, and billing tasks1011.

  • Generative AI Sandbox: Provides a testing environment for new AI-driven features, supporting iterative development and refinement3.

Summary Table: AI Functions in Epic

Function Area Example AI Features
Patient Messaging ART, Smart Replies, AI Agents in MyChart
Clinical Documentation Ambient Documentation, Note Summarization
Coding & Billing AI Coding Assistant, Denial/Appeal Letters
Patient Engagement Journey Summaries, Post-Op Guidance
Operations Scheduling, Registration, Agentic AI
Research & Population Clinical Trial Matching, Phenotype Assistant, Summaries

Epic’s AI strategy is centered on seamless integration into clinical workflows, reducing administrative burden, and empowering clinicians and patients with real-time, actionable insights123. Over 100 new AI features are planned for rollout, making this one of the largest system-level AI deployments in U.S. healthcare7.

  1. https://www.epic.com/software/ai/
  2. https://www.fiercehealthcare.com/ai-and-machine-learning/epic-building-out-agentic-ai-it-also-broadens-focus-beyond-ehrs
  3. https://www.billingparadise.com/blog/how-generative-ai-is-built-into-epic-ehr-and-use-cases/
  4. https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-bet-on-generative-ai/
  5. https://www.fiercehealthcare.com/ai-and-machine-learning/epic-touts-new-ai-applications-streamline-charting-and-bring-research
  6. https://www.fiercehealthcare.com/ai-and-machine-learning/himss24-how-epic-building-out-ai-ambient-technology-clinicians
  7. https://www.linkedin.com/posts/ethan-goh_epic-plans-to-launch-over-100-new-ai-features-activity-7333869759706394626-Xv5P
  8. https://www.healthcareitnews.com/news/how-epic-using-ai-change-way-ehrs-work
  9. https://transcure.net/ai-coding-feature-in-the-epic-emr-system/
  10. https://www.fiercehealthcare.com/ai-and-machine-learning/epic-introduces-launchpad-fuel-faster-generative-ai-adoption-among
  11. https://www.advisory.com/daily-briefing/2025/03/14/ep-ehr-ec
  12. https://www.ehrinpractice.com/epic-ehr-software-profile-119.html
  13. https://www.epic.com/epic/post/cool-stuff-now-epic-and-generative-ai/
  14. https://itirra.com/blog/how-epic-systems-is-revolutionizing-healthcare-with-ai-and-the-future-of-phi-data-flows/
  15. https://www.suki.ai/epic-integration/
  16. https://www.cnbc.com/2024/08/21/epic-systems-ugm-2024-ai-tools-in-mychart-cosmos-.html

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S5E19: Strong Alliance! National Campaign to Protect People in Pain (NCP3) Joins Arms with DocToks! DocToks with Dr Forest Tennant and Friends 374 subscribers

Posted on June 20, 2025 by Pharmaciststeve

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How Insurance/PBM industry use PAs to pad their bottom line

Posted on June 19, 2025 by Pharmaciststeve

Where the insurance/pbm industry uses PAs to pad their bottom line – CLICK HERE

I didn’t have the time to convert each page to a *.jpg so that I could display them directly in a blog post, so they are all available in *,pdf format on the hyperlink above 

 

 

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The real story about the war on drugs that the TV media never hears about

Posted on June 18, 2025 by Pharmaciststeve

We are quickly approaching a precipice like many other chronic pain pts. A few months ago, our PCP of almost 30 yrs told us that he is retiring the end of 2026. We have already interviewed a couple of practices only to get “I’m not comfortable prescribing that much opioids – and that was on ME, and what I take is minuscule compared to what Barb takes.  For the short term, we have pulled back about looking for a new PCP. Barb is scheduled to have her implanted pump refilled next month and will see if our pain doc will consider writing her oral opioids for her. She has called the office and asked that he would return her call, but I guess that he is to important to return pt’s calls, but we will be able to get to talk to him – eye ball to eye ball – when she goes in to get her pump refilled. 

Last month, the independent that we have patronized for the last 8+ yrs was out of one of Barb’s oral opioids and the wholesaler had no inventory. The fellow that owns this independent has another pharmacy in town and they had enough to fill Barb’s med. I called the HQ of the wholesaler he uses and after some back and forth with the staffer at the wholesaler he agreed to tell me about their inventory level on the particular medication that Barb needed. I asked him how many different generic pharmas did they normally stock – NINE DIFFERENT COMPANIES.  I asked, how much inventory do you have on hand for the particular med/strength that Barb needed. His answer was – ZERO on all nine pharmas. We are now one month later and between his two pharmacies – they have a total of 10 tablets. 

Yesterday I call all four TV station in Louisville,KY. We live in what is called the Metro Louisville, KY area, but we are on the north side of the Ohio river in Indiana. Louisville/Jefferson county is a uni-gov and Louisville is the LARGEST city in the state of KY. All 4 of the major TV stations (ABC, CBS,FOX, NBC)  are based in Louisville.  All their antennas – in what is called “the antenna farm” which is near where we live is about 500-600ft higher in altitude than Louisville. This gives these TV stations much larger coverage area for their signals. There TV signal reaches an estimated 2-3 million people.

I called each station and asked them if they are getting any calls from people not able to get their pain medications at the local pharmacy. Their answer was universally the same NOPE! Does this suggest why the media only talks the DEA’s talking point(s)?

They all agreed to give me their email address to send them information and below is the email that I send. I marked each each email as HIGH PRIORITY and for me to be notified when the email was opened.  Last night I got my first email notice that one of my emails was opened, but it was not from one of the email domains that I had sent.  The domain was @hearst.com that the email was opened from. Hearst corp owns the CBS (WLKY) affiliate in Louisville.

I wonder if other chronic painers called their local TV channels and asked the questions “have you received any calls from people not being able to get their pain medications”? What kind of answers would those that did would get?

This is the opioid settlement I spoke with you about,   the hyperlink was created by a Kaiser retired nurse and that below the hyperlink is what I got from perplexity.ai about the same settlement. https://www.pharmaciststeve.com/wp-content/uploads/2023/11/kaiser.pdf

There are an estimated 100 million chronic pain pts and within that number there is a 25-35 million subset of chronic pain pts that are labeled as high impact or intractable chronic pain pts, whose intensity of their pain is at the higher end of the 1-10 pain scale and many healthcare professionals consider a pain intensity > 5 on that scale to be a torturous level of pain.

This is a video that showed up on my facebook page today  https://www.facebook.com/kathaav/videos/1125692909317845

I don’t know this woman, but I am a pharmacist and a chronic pain consultant/advocate and she shared it on my FB page today

https://www.facebook.com/pharmaciststeve/

This is not an isolated case, because of that agreement

This has been going on nightly since 6/9/25. And this is with pain meds on board.  My husband has been sleeping on the couch but last night he stayed with me all night to film clips for The Doctor. I have no recollection of any of this; only waking up in pain to go to the bathroom. I was scared to post this, but I think people need to see what pain patients are being forced to go through. I have Dilaudid and Valium on board here; some of the strongest outpatient medication that is prescribed. This is what complex regional pain syndrome looks like. My prescriber has already told me that he doesn’t feel competent enough to manage my case anymore. But nobody else will take me. Welcome to being a pain patient in America.

 This is the question that I asked www.perplexity.ai

can you provide a summation of the opioid settlement between 46 state AGs and the three major drug wholesaler?

Certainly. Here is a summation of the opioid settlement between the attorneys general (AGs) of 46 states and the three major drug wholesalers (AmerisourceBergen, Cardinal Health, and McKesson), with additional context regarding the broader opioid litigation landscape:

Summary of the Settlement

  • Parties Involved:

    • 46 state attorneys general (plus the District of Columbia and eligible territories)

    • Three major pharmaceutical distributors: AmerisourceBergen, Cardinal Health, and McKesson

    • Johnson & Johnson (J&J) was also part of the broader $26 billion settlement, but the focus here is on the wholesalers123.

  • Settlement Amount:

    • Distributors (AmerisourceBergen, Cardinal Health, McKesson): Up to $21 billion over 18 years123.

      • AmerisourceBergen: $6.1 billion

      • Cardinal Health: $6.0 billion

      • McKesson: $7.4 billion

    • Johnson & Johnson: $5 billion over 9 years (included in the broader $26 billion settlement, but not a wholesaler)12.

  • Participation:

    • 46 out of 49 eligible states (plus DC and territories) agreed to the settlement43.

    • Over 90% of litigating local governments (by population) participated43.

  • Purpose and Use of Funds:

    • At least 85% of funds must be used for opioid abatement programs, including treatment, education, prevention, and harm reduction123.

    • The funds are intended to support communities affected by the opioid crisis.

  • Non-Financial Terms:

    • Distributors must create a centralized clearinghouse to monitor and report suspicious opioid orders, improving oversight and preventing diversion54.

    • No admission of wrongdoing by the companies13.

  • Effective Date:

    • April 2, 2022 was the scheduled effective date for the settlement, following court-ordered consent judgments4.

  • Exclusions:

    • Alabama, Oklahoma, and Washington chose not to participate in this settlement4.

    • West Virginia previously settled separately and was not part of this agreement4.

Broader Context

This settlement was part of a larger effort to resolve thousands of lawsuits brought by state and local governments against pharmaceutical companies for their alleged role in fueling the opioid crisis. The settlement with the three major distributors and Johnson & Johnson was valued at $26 billion, with the distributors responsible for $21 billion of that total123. The settlement was designed to provide a stable source of funding for opioid crisis abatement programs across the country.

Key Takeaways

  • Historic Settlement: The $21 billion (plus $5 billion from J&J) represents one of the largest civil settlements in U.S. history regarding public health.

  • Community Impact: The majority of funds are dedicated to opioid crisis response, treatment, and prevention.

  • Industry Oversight: The settlement mandates new transparency and monitoring requirements for opioid distribution.

  • No Admission of Liability: The companies did not admit wrongdoing, but agreed to pay to resolve litigation and support communities affected by the opioid epidemic13.

This settlement marked a significant milestone in efforts to address the opioid crisis through large-scale, coordinated legal action and funding for public health initiatives.

  1. https://www.fiercepharma.com/pharma/johnson-johnson-drug-distributors-finalize-26b-opioid-settlement-states-join-landmark-deal
  2. https://www.npr.org/2021/07/21/1018881195/state-attorneys-general-26-billion-opioid-settlement
  3. https://www.npr.org/2022/02/25/1082901958/opioid-settlement-johnson-26-billion
  4. https://www.mckesson.com/about-mckesson/newsroom/press-releases/2022/distributors-approve-opioid-settlement-agreement/
  5. https://nationalopioidsettlement.com/executive-summary/
  6. https://www.opioidsettlementtracker.com/globalsettlementtracker
  7. https://www.npr.org/2022/02/25/1083180735/4-u-s-drug-distributors-agree-to-pay-26b-opioid-settlement
  8. https://kaco.org/county-information/opioid-settlement/
  9. https://nashp.org/understanding-opioid-settlement-spending-plans-across-states-key-components-and-approaches/
  10. https://www.drugwatch.com/opioids/lawsuits/
—

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CVS Closing 270 Stores Nationwide: List of Locations Impacted MORE PHARMACY DESERTS?

Posted on June 17, 2025 by Pharmaciststeve

Rite Aid is closing its last bankruptcy with selling off their last 1,000 stores. A few years back they had abt 5,000 stores. Walgreens it is reported that they are selling the entire chain off to some investment firm. 10-15 yrs ago Walgreens was worth 100 billion, but this deal is reported to be for 10 billion.  I would not be surprised to see the investment firm to close a lot of stores and/trying to consolidate various stores’ business into nearby Walgreen stores.  Just in the last year or so, Walgreens stated that they were going to 25% of their 8600 stores.

CVS Closing 270 Stores Nationwide: List of Locations Impacted

https://www.newsweek.com/cvs-closing-270-stores-locations-impacted-2077982

Amid its ongoing restructuring efforts, CVS plans on closing hundreds more stores in 2025, which the company says will streamline operations and help it adapt to shifting consumer needs.

Why Is CVS Closing Locations?

In its recent annual report, filed in February, CVS announced that it would be closing 271 retail stores in 2025 as part of its “enterprise-wide restructuring plan intended to streamline and simplify the organization.”

This follows the closure of around 900 locations between 2022 and 2024. A spokesperson for CVS told Newsweek that these closures will enable the company to optimize its “existing stores and pharmacies.”

The spokesperson said that the closures were based on several factors, including “population shifts, consumer buying patterns, store and pharmacy density, pharmacy care access, and community health needs.” This will enable the company to better meet customers’ needs and was not a response to industry pressures.

Where Are CVS Closing Locations?

CVS has not released a list of locations that will be closed amid this strategic realignment, and declined to provide any details of which states or cities may be affected.

However, according to consumer-focused website The Krazy Coupon Lady, citing local news sources, 34 CVS locations have either already closed or announced scheduled closures in 2025:

Alabama

  • 2901 Morgan Rd., Bessemer
  • 3303 Clairmont Ave., Birmingham

California

  • 499 Haight St., San Francisco
  • 1701 K St., Sacramento

Florida

  • 3090 S. Monroe St., Tallahassee
  • 13300 E. Colonial Dr., Orlando
  • 2201 Edgewater Dr., Orlando

Georgia

  • 439 Highland Blvd., Atlanta

Illinois

  • 8639 S. Cicero Ave., Chicago
  • 401 W. Armitage Ave., Chicago
  • 2000 Skokie Valley Rd., Highland Park

Iowa

  • 2420 Lincoln Way, Ames
  • 215 Euclid Ave., Des Moines

Massachusetts

  • 55 Summer St., Boston

Michigan

  • 28774 Gratiot Ave., Roseville
  • 27700 Harper Ave., St. Clair Shores

Missouri

  • 2435 Independence Ave., Kansas City
  • 9433 Manchester Rd., Saint Louis
  • 4531 Troost Ave., Kansas City

New York

  • 955 Payne Ave., North Tonawanda
  • 153 Central Ave., Albany
  • 1026 Madison Ave., Albany
  • 1241 Lexington Ave., New York
  • 1654 Richmond Ave., Staten Island

North Carolina

  • 201 W. 4th St., Winston-Salem

Ohio

  • 10825 Kinsman Rd., Cleveland

Pennsylvania

  • 125 E. Main St., Plymouth

Virginia

  • 10390 Willard Way, Fairfax

Washington, D.C.

  • 1117 10th St. NW
  • 1100 4th St. SW
  • 400 Massachusetts Ave. NW
  • 1515 New York Ave. NE
  • 4500 Wisconsin Ave. NW
  • 7828 Georgia Ave. NW

Based on local news sources and social media, Newsweek identified additional CVS locations that have closed or announced closures since the beginning of the year:

Indiana

  • 9550 Allisonville Rd., Indianapolis

Maryland

  • 1000 S. Charles St., Federal Hill, Baltimore
  • 7235 Wisconsin Ave., Bethesda
  • 34 N. Cannon Ave., Hagerstown, closing June 26, per The Herald-Mail

Texas

  • 3890 Phelan Blvd., Beaumont, per The Beaumont Enterprise

What People Are Saying

A spokesperson for CVS told Newsweek: “Store closure decisions are based on several factors, including population shifts, consumer buying patterns, store and pharmacy density, pharmacy care access, and community health needs. We’re focused on ensuring we have the right kinds of stores and the right number of stores in the right locations. We’re closing locations strategically to better meet consumers’ health, wellness and pharmacy care needs – as announced more than three years ago – not in reaction to industry pressures.”

“Even after the realignment work, 85% of people in the U.S. will still live within 10 miles of a CVS Pharmacy,” they added.

What Happens Next

CVS confirmed to Newsweek that, despite the closures, it intends to open 30 new pharmacy locations in 2025, including those inside Target stores.

Meanwhile, a new law signed by Arkansas Governor Sarah Huckabee Sanders last month seeks to prevent Pharmacy Benefit Managers, third-party firms that manage prescription drug benefits, from owning pharmacies. CVS has warned that the legislation could impact its 23 locations in Arkansas.

 

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A society is judged by how it treats its most vulnerable

Posted on June 16, 2025 by Pharmaciststeve

“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,VP, Pharmacist

My son Andrew will never get married. He won’t have children. He won’t drive a car or experience many of the milestones we take for granted.
But he is happy. And he is healthy.
And to me, that’s everything.
When a stranger gives him a smile, it lights up my entire day.
When a girl glances at him kindly, joy rushes through his whole body like a wave of sunshine.
It doesn’t take much to be deeply, profoundly human.
Let me tell you a story.
At a party held at a school for children with special needs, one father stood up to speak.
What he said stayed with everyone who heard it.
After thanking the staff who worked with such devotion, he paused and shared a reflection:
“When nothing disturbs the balance of nature, the natural order reveals itself in perfect harmony.”
Then his voice began to tremble.
“But my son Herbert doesn’t learn like other children. He doesn’t understand like they do.
So tell me… where is the natural order in his life?”
The room fell completely silent.
Then he continued:
“I believe that when a child like Herbert is born—with a physical or cognitive disability—the world is given a rare and sacred opportunity:
To reveal the very core of the human spirit.
And that spirit is revealed not through perfection—but in how we treat those who need us most.”
He shared a moment he would never forget:
One afternoon, he and Herbert were walking past a field where some boys were playing soccer.
Herbert looked longingly at them and asked:
“Dad… do you think they’ll let me play?”
The father’s heart sank. He knew the answer was likely no.
But he also knew—if they said yes—it could give his son something far more valuable than a goal: a sense of belonging.
So he gently approached one of the boys and asked:
“Would it be okay if Herbert joined the game?”
The boy looked over at his teammates, hesitated, then smiled:
“We’re losing 3–0 and there’s ten minutes left… Sure. Let him take a penalty.”
Herbert lit up.
He ran to the bench, put on a jersey that nearly swallowed him whole, and beamed with pride. His father stood at the sidelines, tears in his eyes.
He didn’t play much. He just stood nearby, watching. But something in the boys shifted.
They began to see him—not as a distraction, but as one of them.
And then, in the final minute, a miracle happened.
Herbert’s team was awarded a penalty kick.
The same boy turned to the father and gave a knowing nod:
“It’s his shot.”
Herbert walked slowly to the ball, nervous but radiant.
The goalkeeper caught on. He made a show of diving to the side, giving the boy a clear shot.
Herbert nudged the ball gently forward.
It rolled across the goal line.
Goal.
The boys erupted in cheers. They hoisted Herbert into the air like he’d won the World Cup.
They didn’t just let him play.
They let him belong.
The father closed his speech with tears falling freely:
“That day, a group of boys made a decision… not to win, but to be human.
To show the world what kindness, dignity, and love really look like.”
Herbert passed away that winter.
He never saw another summer.
But he never forgot the day he was a hero.
And his father never forgot the night he came home, telling the story as his wife held Herbert close, weeping—not from sorrow, but from joy.
A final thought:
Every day, we scroll past distractions—memes, jokes, quick laughs.
But when something truly meaningful crosses our path, we hesitate.
We wonder: Who would understand this?
Who should I send this to?
If someone sent you this story, it’s because they believe you’re one of those people.
That you see the heart in others.
That you understand what really matters.
Because each day, the world gives us countless chances to choose decency over indifference.
As one wise man said:
“A society is judged by how it treats its most vulnerable.”
I stole this from post from Greg Martin. Oh my goodness I have chills throughout my whole body, I love this so freaking much.

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My Personal COVID-19 Vaccination Decision – dodging several potential “bullets”

Posted on June 14, 2025 by Pharmaciststeve

My Personal COVID-19 Vaccination Decision

When COVID-19 vaccines first became available, I made a deliberate choice for my family: we would not take the mRNA vaccines. In my opinion, these newer vaccines had insufficient research and clinical trial data behind them at the time.

However, there was a third option—the Johnson & Johnson/Janssen vaccine, which used viral vector technology that had been employed for decades in flu vaccine production. This established technology felt more familiar and trustworthy to me. We made sure to receive both doses of the J&J/Janssen COVID-19 vaccine.

What puzzled me later was something I rarely saw discussed publicly: when booster shots were rolled out, no J&J/Janssen boosters were made available. Only the two mRNA vaccines (Pfizer and Moderna) were offered as boosters. This left us in a difficult position, and ultimately, we decided not to get any additional COVID-19 vaccinations.

Fortunately, neither my spouse nor I contracted COVID-19—or if we did, our symptoms were so mild that we didn’t notice them.

Looking back, I didn’t have concrete scientific evidence against the mRNA vaccines at that time. What guided my decision was something more intangible: my instincts, combined with over 50 years of clinical experience as a pharmacist, were telling me to “just say no” to the mRNA vaccine boosters.

Since then, I’ve encountered numerous reports of adverse reactions to these vaccines, ranging from unwelcome side effects to more serious complications. While I can’t definitively say my caution was justified, I remain comfortable with the decision we made based on the information available to us at the time

Urticaria Risk Associated With mRNA COVID-19 Vaccines

https://www.uspharmacist.com/article/urticaria-risk-associated-with-mrna-covid19-vaccines

In a nationwide observational cohort study published in the Scandinavian Journal of Public Health, researchers sought to examine the correlation between mRNA vaccinations for COVID-19 and the risk of developing urticaria.

The study focused on Danish residents who had received at least one dose of an mRNA vaccine between December 2020 and July 2023, comparing this group with the general population from the prepandemic years (2017–2019). Patients received either one dose of Comirnaty (Pfizer-BioNTech; BNT) or the other FDA-approved COVID-19 mRNA vaccine (Moderna; MOD).

Participants without urticaria were observed from the vaccination date until one of the following occurred: a diagnosis of chronic or other types of urticaria; a COVID-19 infection; the end of the 90-day outcome risk period; death; emigration; or October 2023. The expected number of urticaria cases was estimated by indirectly standardizing the incidence rates of urticaria prior to the pandemic. Standardized incidence ratios (SIRs) along with their 95% CIs were calculated overall and within specific categories based on gender, age, and vaccine sequence.

The study encompassed 4,700,301 vaccinated individuals and 5,480,146 comparators from before the pandemic.

The results indicated that following vaccine product sequences, the SIRs (95% CI) were reported as 0.83 (0.71-0.96) for chronic urticaria and 1.14 (95% CI, 1.03-1.25) for other forms of urticaria.

Individuals following the recommended vaccine schedule for the MOD mRNA vaccine faced a three- to fourfold increase in the risk of chronic urticaria (SIR, 3.00; 95% CI, 2.27-3.88) and other urticaria types (SIR, 3.65; 95% CI, 3.06-4.31). Sensitivity analyses for dose-specific effects indicated a fourfold higher risk following the MOD vaccine sequence, while no increased risk was observed after the BNT vaccination.

The authors concluded, “Following the most recent mRNA vaccination dose, MOD vaccine schedule adherers had a higher than expected incidence of chronic and other types of urticaria. We found no association between BNT vaccination schedule and increased risk of urticaria.”

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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Minnesota lawmaker Melissa Hortman killed, State Sen. John Hoffman hurt in ‘targeted’ attack

Posted on June 14, 2025 by Pharmaciststeve

I have said for years that we are on the cusp of a “civil war”, but this civil war will not be a simple “us vs them” as our Civil War of the mid 1800’s.  This one is going to be between “tribes”, “affinity groups”, and illegal immigrants from an untold number of countries on our planet.

Recently, Governor Josh Shapiro’s Pennsylvania Governor’s Residence was set on fire. Luckily, the Governor, his wife, and their FOUR CHILDREN were able to escape without any harm, but the first floor of the Residence was pretty trashed.

Now, an MN state Representative and his wife have been shot and killed, and a state Senator and his wife were shot/wounded. All happening at the victims’ homes.

RFK Jr wants to take the fluoride out of our water; maybe he should consider putting Lithium Carbonate in our water, it is classified as a mood stabilizer. In fact, Lithium Carbonate was discovered in an African tribe’s water supply, and none of the members of the tribe were dealing with any mental health issues.

HEARTBREAK: Just hours before Minnesota Rep. Melissa Hortman, 55, and her husband were brutally GUNNED DOWN in their Brooklyn Park home on June 14, 2025, she broke down in TEARS on camera, defending her COURAGEOUS vote with Republicans to cut healthcare for adult illegal immigrants! 😢 As the LONE Democrat to support the June 12 bill, Hortman declared, “I did what leaders do… I stepped up and I got the job done for the people of Minnesota.” Her bold stand to protect taxpayers infuriated open-border radicals, and now police confirm her murder was POLITICALLY MOTIVATED! The suspect, a white male posing as a cop, left “No Kings” flyers linked to anti-Trump protests and a manifesto targeting Hortman and other Dems.
President Trump called it a “heinous attack on democracy,” vowing AG Pam Bondi and the FBI will deliver SWIFT justice! 💪 X users are LIVID: @FinalTelegraph says, “She paid the ultimate price for doing what’s right,” while @stbythec demands Dems “stop inciting violence.” The killer’s still at large—Brooklyn Park’s on LOCKDOWN! Share to honor Hortman’s bravery and BACK Trump’s fight to crush political violence! 🇺🇸 #MAGA #JusticeForMelissa

https://abc7ny.com/post/2-minnesota-lawmakers-shot-grave-condition-apparent-targeted-incident-officials/16748810/

MINNESOTA — A Minnesota state representative and her husband were shot and killed, and a state senator and his wife were shot and wounded in an “act of targeted political violence” at their homes early Saturday, Minnesota Gov. Tim Walz said.

A manhunt is now underway for the gunman who was impersonating a police officer, authorities said. The gunman attacked by knocking on the doors and asking the victims to come out, police said. 

State Rep. Melissa Hortman, a Democrat, and her husband were shot and killed in what appears to be a “politically-motivated assassination,” Walz said at a news conference.

“She was a formidable public servant,” the governor said of his friend. “She is irreplaceable.”

State Sen. John Hoffman, a Democrat, and his wife were both shot multiple times and underwent surgery, the governor said.

“We’re cautiously optimistic they will survive this assassination attempt,” Walz said.

The two shooting locations are a few miles away from each other in Champlin and Brooklyn Park, just north of Minneapolis.

Hoffman and his wife were shot around 2 a.m. in Champlin, Superintendent of the Bureau of Criminal Apprehension Drew Evans said.

After Hoffman was shot, officers were heading to pro-actively check on Hortman when they encountered the suspect at Hortman’s home around 3:35 a.m., Evans said.

The officers found a person who was dressed as a police officer — wearing a vest and a badge, and with a Taser and other equipment — at the door, coming out of Hortman’s house, police said.

The suspect fired at the officers; gunfire was exchanged and the suspect was able to escape and flee on foot, authorities said.

The suspect’s vehicle — which looked like a police vehicle, including police lights — was in Hortman’s driveway, authorities said.

A list of other possible targets was retrieved from the suspect’s vehicle, authorities said. Police said the list had “many lawmakers,” including the victims.

Security resources have been dispatched to protect those people named on the list, authorities said.

The gunman did say something to the victims, police said, but authorities did not reveal what that was.

FBI Deputy Director Dan Bongino said the agency is “fully engaged on the ground in Minnesota and is working in collaboration with our local and state partners.”

Attorney General Pam Bondi said she’s “closely monitoring developments in Minnesota after what appears to be a targeted attack against state lawmakers.”

“This horrific violence will not be tolerated and will be prosecuted to the fullest extent of the law,” she said in a statement.

Sen. Amy Klobuchar, D-Minn., called the victims close friends and said they’re “devoted to their families and public service.”

“This is a stunning act of violence. I’m thankful for all the law enforcement who are responding in real time,” she said. “My prayers are with the Hortman and Hoffman families.”

Hortman was the former Speaker of the Minnesota House of Representatives.

Democratic National Committee Chair Ken Martin, formerly the Minnesota Democratic party chair, said he’s friends with both Hoffman and Hortman.

Martin wrote on social media that he’s “completely heartbroken” and “praying hard for both families.”

With the manhunt ongoing, police are urging community members to be cautious. Police warned, if an officer comes to your door, call 911 to confirm that the officer is supposed to be there.

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