060915-agenda <– click on link to see published agenda
http://www.wesh.com/health/pharmacists-discuss-issues-causing-prescription-drug-problems/33510484
http://www.wesh.com/health/special-committee-meets-to-discuss-prescription-drug-problems/33478036
What I am putting in this post.. will either be MY OPINION of what I observed at the FL BOP meeting and/or paraphrasing what I understood was said.
The 800 lb Gorillas in the room was the absence of the DEA representative that had a “scheduling conflict” and was not able to attend this meeting. IMO.. clearly demonstrates the DEA’s interest in not changing the status quo. If there was a state legislator or a representative from Scott’s or Bondi’s office at the meeting, I was not aware of them. With a estimated 1/3 of the population affected by chronic pain in FL.. the elected officials for these people sure seem to lack interest in issue… Bondi, in particular, was sure interested in using pill mills and drug abuse her in the last re-election campaign.
After the 3+ hr meeting.. the words of the Committee chairman Gavin Meshad… pretty much laid out the future.. the BOP only meets every TWO MONTHS and apparently the FL SUNSHINE LAWS prohibits members from discussing any part of issues on a one to one basis outside of a open public meeting. He also stated that a solution was to involved many different “players”.. of course, the DEA, the BOP, the prescribers, pharmacists for starters… somethings may involve going to legislators and then all the various lobbyists from who knows what industry can get into “playing games” with any new or change to existing laws.
Being a “student” of the political process for decades… this meeting is typical of the political process.. there was a lot of rhetoric… not the first promise… and not the first action.. or proposed action.
In the discussion among the committee members themselves.. there seemed to be three words/phrases that dominated the discussion, DEA, FEAR, DRUG ABUSE. Even though I brought up in my statement that we don’t have an abuse problem .. but a untreated mental health issue… EVERYONE continues to focus on DRUG ABUSE… FLBOP062015 <– Here is my proposed presentations, not knowing that there was going to be a THREE MINUTE limit.. which they strictly enforces on everyone EXCEPT for the representative of NACDS ( National Assoc of Chain Drug Stores) who was allowed to read his entire prepared statements… I guess that the old saying that “sharks don’t attack each other” is correct 🙂
There was three pain prescribers in the audience that provided testimony about how pts are being denied their needed medications and are suffering.
There was two pain prescribers on the committee and it was obvious that they are not happy with Pharmacists selectively filling pain meds. One of the pain prescribers asked the legal counsel for the BOP if the BOP had ever sanctioned a pharmacist for LYING TO A PATIENT…. and the first response was NO !! there is nothing in the practice act about being truthful.. and then the legal counsel proceeded to start talking about “fraud” in the practice act… I guess that UNPROFESSIONAL CONDUCT has a very narrow meaning within the FL practice act.
The other pain prescriber.. elaborated on a story about prescribing 30 10 mg HCD/APAP to a pt/neighbor and it was filled at WAGS… 90 days later he wrote another Rx for 30 doses and the RPH called the prescriber up.. asking ICD9’s, what had been tried before … the typical inquisition by some Pharmacists.. which the prescriber accommodated the RPH.. to which the RPH still refused to fill the Rx… the prescriber asked the Pharmacist for her name/license number and the response was “..I don’t have to provide that …”
This prescriber, also stated that he had checked the FL PMP (E-FORSE) for this particular pt.. and discovered that the first HDC/APAP Rx was not even recorded.. and stated that was a violation of the law… the silence among those on the committee was DEAFENING.
The Exec Direction of the FL Pharmacy Assoc Michael Jackson relayed a story about him receiving a call from a vacationer to FL that was having trouble getting their pain medication filled.. and asked for his help… either because of .. or in spite of the fact that this vacationer was a DEA AGENT… he made a few phone calls to help get this pt their necessary pain medications… Personally, under such a situation.. I would have told this pt that they just needed to “suck it up… at can’t be all that bad …pain never killed anyone ” :-)…but I digress… 🙁
One Board member Jeenu Philip who is a PDM for WAGS… made the comment that not all of the Pharmacists under his supervision “.. always made good decisions when determining who should or should not get their medications “.
The representative from Cardinal Health Gary Cacciatore is both an attorney/Pharmacist as is Vice President and Associate Chief Regulatory Counsel
His presentation and statements were very analytical and non-clinical… it was all about the GROSS NUMBER of doses… statistics… that a particular pharmacy purchases and Cardinal has some VERY COMPLEX formulas and other methodologies to determine if a particular pharmacy has a need for a certain number of doses for their pts legit medical needs. However, since a number of currently practicing Pharmacist testified that they are having to allocate or ration controls to their pts… perhaps Cardinal’s and the other wholesalers’ COMPLEX FORMULAS need to be revised to reflect REALITY ! and if you read between the lines.. the DEA has provided the drug wholesalers with very ambiguous guidelines that can be – as with most things with the DEA – subject to different interpretations on any given day.. Cardinal was the wholesaler whose central FL distribution center was caught up in the 2011-2012 pill mill bust that included two CVS stores in Sanford FL and reportedly the cost to Cardinal before all the dust settled was 34 million dollars and their central FL distribution center DEA license was suspended for two years..
This is a quote from a recently published article in DRUG TOPICS from Robt Mabee Attorney/Pharmacist
A well-documented dilemma unfolds when doctors decide to practice law and lawyers decide to practice medicine. Lawyers and judges are trained to take an adversarial approach to decision-making. Physicians are trained in a collegial environment that encourages decision-making by consensus. http://drugtopics.modernmedicine.com/drug-topics/news/rx-drug-use-treat-dont-indict
There is an estimated 6-7 million chronic pain pts in FL.. and 11 provided testimony yesterday that represents 0.000157 % of the chronic pain population that came to present their side of how the war on drugs/pts was adversely affecting their lives.
YOU DO NOTHING…. YOU GET NOTHING !
Filed under: General Problems
Hell I’m even afraid to go to my Doctor tomorrow, the look at you like you’re doing something wrong instead of trying to help. This is due to the pressure they are under not to write scripts for people that need it.
I am on fire after reading about the uselessness of this meeting. Three minutes for each person to speak except for the head of a large national drugstore chain? I am on fire after reading about the uselessness of this meeting. Three minutes for each person to speak except for the head of a large national drugstore chain? Are you fucking kidding me? Not too long ago I tried to organize a protest of citizens that are affected by these shortages and quotas to protest in front of the DEA Are you fucking kidding me? Not too long ago I tried to organize a protest of citizens that are affected by these shortages and quotas to protest in front of the DEA Office in Orlando or perhaps the Fort Lauderdale area or somewhere or maybe all the offices on one day. Office in Orlando or perhaps the Fort Lauderdale area or somewhere or maybe all the offices on one day. Not a whole lot of interest in that idea? They know the median times when will die down and it will go back to business as usual. But it might scare the hell out of them if they had 100 people not a whole lot of interest in that idea? They know the median times when will die down and it will go back to business as usual. But it might scare the hell out of them if they had 100 people protesting on the same day at the same time. There is power in numbers. If we have any chance of rprotesting on the same day at the same time. There is power in numbers. If we have any chance of reining in these Neanderthals people have to be willing to stick their neck out a little bit. In these Neanderthals people have to be willing to stick their neck out a little bit. Most chronic pain patients really have nothing to lose. We live a life of suffering 24 seven 365 days a year. Most chronic pain patients really have nothing to lose. We live a life of suffering 24 seven 365 days a year. We need to get serious if this is ever going to change. This meeting was just to meeting the blow smoke up peoples asses and placate people after they got riled up after we need to get serious if this is ever going to change. This meeting was just to meeting the blow smoke up peoples asses and placate people after they got riled up after Matt Grant’s investigative reporting.
I implore that chronic pain patients and their family and friends and other interested parties get on the same page and plan a statewide protest at every DEA office in Florida. I’ll be that chronic pain patients and their family and friends and other interested parties get on the same page and plan a statewide protest at every DEA office in Florida. I’ll be The planner if you like. This is got to get done. Protester should show up was fake blood on their hands The planner if you like. This is got to get done. Protester should show up was fake blood on their hands and many signs that speak the truth. You do nothing you get nothing.
Since the meeting was scheduled so far in advance, using an excuse like a scheduling conflict just goes to show you that the DEA is allowed to lie (and get away with it), no matter what the issue. Isn’t there more than one DEA agent in Florida who could have attended?
Not that they needed to attend, as all the lawmakers in Florida have their back. The DEA isn’t scared of the players who attended this meeting — this agency has friends in high places. The DEA rules by fear; they’re never hampered by it.
And here I thought that the media attention in Florida would make a difference. Is there any kind of media attention that the DEA would be concerned with? Apparently not. I think it’s been proven over and over again that the DEA is allowed to do whatever it wants without facing any consequences (as are most terrorists).
If I could drive to Orlando I would’ve been there. But due to the chronic pain and the meds I am not able to drive long distance. Thanks for keeping us updated.
Steve:
Thank you and many others, including Matt Grant of WESH2 news. Poignant stories.
Yes I should have been there ..I dropped the ball….