PHARMACIST STEVE

It would seem in hindsight, that the war on drugs was mostly built on racism, bigotry and lies.  It has been claimed that the Controlled Substance Act bill was signed into law by a President (“tricky dick nixon) that was known to be a racist/bigot and he wanted to throw blacks and “hippies” into jail. This law was design to deal with the “black drug market” that was created in 1914 by the Harrison Narcotic Act  https://en.wikipedia.org/wiki/Harrison_Narcotics_Tax_Act  This law created the Bureau of Narcotic and Dangerous Drugs  https://en.wikipedia.org/wiki/Bureau_of_Narcotics_and_Dangerous_Drugs  by combining Bureau of Narcotics (Dept of Treasury) & Bureau of Substance Abuse Control (under HHS). Moving dollars committed to deal with narcotic use/abuse/diversion  combined with abt 3 million budget and created the BNDD with a 43 million budget and 1500 agents.  In 1973, the BNDD transitioned into being the DEA.

Today the DEA has abt 10,000 employees – down to 2003 levels and 3.1 billion budget – up abt 50%-60% from 2003. That just tells part of the story, because many cities, counties, states.  Plus prisons (private & gov), our court system ( prosecuting attorneys, defense attorneys, judges & supporting staff ). Over the last 50+ yrs, the war on drugs has become a 100+ billion/yr INDUSTRIAL COMPLEX.

For those of you who believe that trying to talk to your member of Congress and/or getting the local media to cover the denial of care… here is the website for DEA Press Releases https://www.dea.gov/what-we-do/news/press-releases.  JUST TODAY (06/08/2022) the various DEA regional district and/or HQ put out SEVEN PRESS RELEASES to various media sources  – on how the DEA is winning the war on drugs..  A number of years ago – maybe during the Reagan Admin,  some entity within the Federal Gov was charged with making determination of how successful various federal agencies were in meeting their operational charge.  As I remember, the DEA got a GRADE OF ZERO !!!

I started this blog abt 10+yrs ago, just as the prescribing of opiates were peaking. I have seen many advocates come and go… I have seen some non-profits come and go..  I have seen some people who imply that they are part of a non-profit, when they are not..  While most all of these entities profess that they have the same goal, better pain management… but just like a ROAD MAP, there is numerous ways to get from point A to point B.  If everyone has a “different path” and won’t compromise/discuss different paths to come up with a compromise… then the odds of good results, probably decreases dramatically.

The first thing that the pt needs to get a answer to… is what intensity of pain does the practitioner expects the pt to live/exist in.  IMO, a pt’s intensity of pain can basically put into two levels .. =<5 is probably a tolerable level of pain and >5 is an intolerable level of pain and is most likely requiring the pt to live/exist in a torturous level of pain.

If the practitioner can only answer that whatever level of pain the pt has to exist/live in …depends on the MMG/day that the CDC’s guidelines states is the max allowable dose for all disease issues. If this is the limit to the practitioner’s treatment plan and the pt is willing to live/exist in the intensity of pain level that xx MME/day will provide, all advocacy efforts are finished.  If this is the answer to the pt’s treatment, or the pt can share this article with the practitioner  https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154 and ask the practitioner why he/she is limiting pain management therapy based on the MME system which has no science nor double blind clinical study behind it.

Here is a chart that demonstrates the possible complication of pt’s comorbidity from under/untreated pain …

If the practitioner, suggests/insists that you get  non-opiate, non-covered health services (PT, massages, aqua therapy, etc ) not covered by your insurance.  here is free software that has included in its package a spread sheet.  Just create a spread sheets for your monthly income and your monthly expenses… don’t  have to detail, just each month’s total expenses.  Ask the practitioner who he/she would suggest that you work the cost of such health services into your budget.  https://www.openoffice.org/download/index.html   If you don’t drive, how are you suppose to get to the medical appt ?

If  your BP increases dramatically (>180/100), when your pain meds are reduced/stopped, and even after given up to four different BP meds.. suggest that the following graphic be shared with the practitioner, to get confirmation that the practitioner understands the risk – you as their pt – are being put into… high blood pressure – per American Heart Association has always referred to as the “silent killer”

So the practitioner just tells you to take a NSAID (Aspirin, Motrin, etc) to manage your pain.  Just find a number of studies on warning the potential consequences to a pt using NSAIDS long term- kidney damage the most common.

So the practitioner just tells you to take Acetaminophen (Tylenol) to manage your pain.  Just find a number of studies on warnings the potential consequences to a pt using Acetaminophen long term – liver damage the most common

If your practitioner basically “blow your concerns off”, I would created a cover letter and I would take copies of all the information that you provided the practitioner and send them back to the office or dept that manages pt medical records and ask that they all be put into your medical records.  It might not do you, individually, much good, but your family will be able to sue the practitioner if/when you suffer a stroke, heart attack, eye/kidney/liver damage, premature death or commit suicide…  You have put your practitioner on notice that you made them aware that you were aware of the physical health consequences you may suffer, because of their plan of treatment of you.

Filed under: General Problems