“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
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Fox News medical contributor Dr. Nicole Saphier told “America Reports” Tuesday a full investigation is needed into allegations the CDC withheld large portions of critical COVID-19 data from the public.
NICOLE SAPHIER: If you look across the globe, there is a reason why it is not so black and white in other countries because they’re looking at the big picture, especially when it comes to natural immunity — the true risk of COVID-19 in children, as well as boosters for young, healthy adults and children. Unfortunately, the CDC has done a disservice, in my opinion, to the American people. I think a full investigation should be launched into this, and at this point, we need to make sure that there is full transparency so that the private sector can accurately and adequately analyze the data, because the CDC is not a leader when it comes to public health.
As more and more evidence comes to light that the CDC is the keeper of TRUTHS and the spreader of LIES … Last night I made this postCDC: SOP of misrepresenting the facts that they publish/release Notice that the FDA is pushing the two mRNA versions of the COVID-19 vaccine, J&J has stopped the production of their vaccine, but has millions of doses sitting on their shelves and could start production back up. I find it curious as to why “they” are pushing the two mRNA versions of the vaccines… the mRNA process that is so NEW and so UNTESTED that if that had been the only option, I would have passed on getting a COVID-19 vaccination. At least the J&J vaccine was produced using the same process that we have used for decades for making our flu vaccines. The USA population has been involved in the LARGEST CLINICAL TRIAL with little/no control group and reportedly many/most/all of the serious adverse reactions – some of them lethal – have been not disclosed and/or buried.
Don’t forget all those who have claimed that those CLOTH MASKS do not work – like using a chain link fence to keep mosquitoes out… and yet many state/federal politician/bureaucrats mandate that masks be worn, even those over TWO YEARS OLD. If you notice, many states are now dropping mandatory masks because the mid-term primary will be starting next month. There will be more of our LIBERTIES that they will start GIVING BACK in the near term.
(Reuters) -U.S. health regulators are looking at authorizing a potential fourth dose of a COVID-19 vaccine in the fall, the Wall Street Journal reported on Saturday, citing sources familiar with the matter.
The Food and Drug Administration has been reviewing data to authorize a second booster dose of the messenger RNA vaccines from Pfizer Inc and partner BioNTech SE and vaccines from Moderna Inc, the report added.
The FDA did not immediately respond to a request for comment.
The agency last month cut the interval to get a booster dose of COVID-19 vaccines from Pfizer and BioNTech as well as from Moderna, in a bid to provide better protection sooner against the Omicron variant.
The planning is still in early stages, and authorization would depend on determinations as to whether the second booster should be authorized for all adults or particular age groups, and whether it should target the Omicron variant or be formulated differently, the report said.
It added that no decision was final and that it could be necessary to make booster shots available earlier if a new variant appears.
The United States reported 2,323 COVID-19 deaths on Friday, bringing the total count to 936,523.
The New York Times made an eye-popping admission on Sunday regarding data collected by the Centers for Disease Control (CDC) on Covid-19 vaccines.
In an article titled, “The C.D.C. Isn’t Publishing Large Portions of the Covid Data It Collects,” reporter Apoorva Mandavilli writes: “For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public.”
Mandavilli, who covers science and global health for the Times, reported that the agency has published “only a tiny fraction of the data it has collected” since the pandemic began, including data on booster efficacy for 18 – 49 year-olds, a tremendous chunk of the U.S. population.
Reasons listed include bureaucracy, sample size, and not being “ready for prime time,” but one that’s definitely set to raise lots of eyebrows is the claim that the data could be “misinterpreted” by Covid vaccine skeptics.
Last year, the agency repeatedly came under fire for not tracking so-called breakthrough infections in vaccinated Americans, and focusing only on individuals who became ill enough to be hospitalized or die. The agency presented that information as risk comparisons with unvaccinated adults, rather than provide timely snapshots of hospitalized patients stratified by age, sex, race and vaccination status.
But the C.D.C. has been routinely collecting information since the Covid vaccines were first rolled out last year, according to a federal official familiar with the effort. The agency has been reluctant to make those figures public, the official said, because they might be misinterpreted as the vaccines being ineffective.
Instead, health experts have been forced to rely on data from Israel and elsewhere to make decisions, the Times reported.
Once again, the CDC has been caught not telling/sharing all the facts that they are required to collect and make some seen as all of that raw data. We have seen it with various drug OD and mislead that often suggests that ALL DRUG OD’s have involved opiates and suggest that they are pharma Rx opiates… This article seems that the data regarding the impact on COVID-19 and COVID-19 vaccines … apparently reporting most of the “good” and little of the “bad” Does this suggest that CDC has a propensity to misstate the truth… it is ONCE A LIAR…. ALWAYS A LIAR.
All the alphabetic federal entities that are coming after the chronic pain community… Backin the mid-80s – thru mid90’s our community pharmacy did a fair number of opiate IV on end stage cancer pts at home. What is now known as MME’s were around, but I don’t remember them being referred to a MME, but everyone knew that they were not workable – black & white conversions. Back then, there was no computer to calculate them for you…
‘back in the day” the rule of thumb rotating a pt from one opiate to another… was take the mgs using the opiate conversion answer and CUT IT IN HALF and then titrate the pts meds up or down to optimize their pain management..
The entire CDC guidelines and just about anything dealing with pain management is built on the FOUNDATION OF MME’s.
To the best of my knowledge, the MME’s were determined by naive people with mechanically induced pain (heat or cold) and given a SINGLE DOSE of a particular opiate. This was before our DNA had been mapped and years before the liver CYP-450 was even “discovered” and no one could even believe to create a accurate MME’s without knowing the pt’s CYP-450 liver enzyme metabolism rate and those didn’t come around until the late 90’s or early 2000’s.
Published equianalgesic ratios are considered crude estimates at best and therefore it is imperative that careful consideration is given to individualizing the dose of the selected opioid. Dosage titration of the new opioid should be completed slowly and with frequent monitoring.
Conversion ratios in many equianalgesic dosing tables do not apply to repeated doses of opioids.
The amount of residual drug in the patient’s system must be accounted for. Example: fentanyl will continue to be released from the skin 12 to 36 hours after removal of the patch. Residual effects from discontinued long-acting formulations should also be assessed before converting a patient to a new opioid.
Review the concept of incomplete cross-tolerance: D. McAuley: “Incomplete cross-tolerance relates to tolerance to a currently administered opiate that does not extend completely to other opioids. This will tend to lower the required dose of the second opioid. This incomplete cross-tolerance exists between all of the opioids and the estimated difference between any two opiates could vary widely. This points out the inherent dangers of using an equianalgesic table and the importance of viewing the tabulated data as approximations. Many experts recommend – depending on age and prior side effects – reducing the dose of the new opiate by 33 to 50 percent to account for this incomplete cross-tolerance. (Example: a patient is receiving 200mg of oral morphine daily (chronic dosing), however, because of side effects a switch is made to oral hydromorphone 25 – 35mg daily – (this represents a 33 to 50 percent reduction in dose compared to the calculated 50mg conversion dose produced via the equianalgesic calculator). This new regimen can then be re-titrated to patient response. In all cases, repeated comprehensive assessments of pain are necessary in order to successfully control the pain while minimizing side-effects.”
5. The use of high but ineffective doses of a previous opioid may result in overestimation of the converted opioid.
6. Ideally, methadone conversions (especially patients who were previously receiving high doses of an opioid) should only be attempted in cooperation with a pain specialist or a specialist in palliative medicine.
The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user’s use of or reliance upon this material. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
I have tried to find some information about the person(s) or studies behind the MME’s concept, but have come up empty handed. What would happen if the community could raise some money and challenge the CDC in court to produce the documentation of the studies behind the MME conversion ratios? Might be able to get it with a simple FOIA ( Freedom of Information Act) request.
What would happen if the CDC could not produce a quality study to support the conversion ratios in all of opiates that they have used in the 2016 guidelines and the proposed 2022 guidelines. Could the validity of those very guidelines be put in jeopardy. Could the CDC be forced to rescind those guidelines.. Could that also mean that any other rules/regulations/policies and procedures would have to be made null & void.. until someone did a good quality study to develop workable MME conversions.
Could all those docs who have been put in prison for prescribing above a certain MME that the DEA considers above a certain limit and considers being without valid medical necessity be appealed and most likely overturned and they could be set free?
I am only posting this here on my blog, feel free to share…. just don’t try to share a hyperlink to anywhere on FAKE BOOK… they have labeled my blog as a SPAMMER.
Hi Pharmacist Steve, We have reviewed your appeal for the following content: Video: Prescriber induced SUICIDE We reviewed your content carefully, and have confirmed that it violates our Community Guidelines. We know this is probably disappointing news, but it’s our job to make sure that YouTube is a safe place for all. How this affects your channel We won’t be putting your content back up on YouTube. Our goal is to help you succeed on YouTube. Please take a look at our Community Guidelines, and keep them in mind when posting content in the future. Sincerely, The YouTube Team
It took them 5 weeks to find my video… and only took them TWELVE HOURS to come to their FINAL REVIEW/OPINION.
I am getting tired of all these dip-shits on these website and within many of the groups… I just discovered a group that I am one of the ADMINISTRATORS on where TWO OF THE MEMBERS ON THE PAGE – BLOCKED ME… that is against the page’s rules. They are no longer members of that group.
I feel sorry for those in the chronic pain community… the entire community – IMO – is pretty much circling the drain.
It would seem that I am becoming part of a group of very highly visible people… being banned from FAKE BOOK, now having a YOU TUBE video banned… being banned from Twitter can’t be far behind, President Donald Trump’s new social website is suppose to start up tomorrow (02/21/2022)https://www.truthsocial.com/ I am perplexed and sadden that both the chronic pain community and our entire society as a whole, has divided into so many “tribes”, and even within the tribes there is sniping and back stabbing. Even within the chronic pain community certain tribes appears to be willing to do anything necessary, if they perceive that another tribe is on a “higher hill” or under a “brighter spotlight”.
I am going to keep posting on my blog for the time being, other venues not so much or any at all. OR am I just wasting my time, trying to assist the chronic pain community ?
About 5 weeks ago I posted this video , and I even included links to the two financial settlements in the post… I also shared this post on you tube. In watching the video I created, I stated that I did not support or encourage suicide and I did make reference to the two settlements back to my blog. I filed a response to their removing my video – at least – unlike FAKE BOOK … there was actually a place to type in up to 800 words. I doubt that I will get a response, nor the video restored..
I also went to http://www.google.comand did a search on the word SUICIDE and got 20+ pages with 10 entries on each page… I don’t normally use google for a search engine, I usehttp://www.duckduckgo.com because they are suppose to keep your searches private. This is just a little more from those “little boys” in/around Silicon Valley… that all too many of us have given them this power to decide what we can see and what we can’t see and what/how we are suppose to think.
Two days ago I got this email from YOU TUBE:
Hi Pharmacist Steve, We have reviewed your content and determined that it may not be suitable for viewers under the age of 18, per our Community Guidelines. As a result, we’ve age-restricted the following content: Video: Prescriber induced SUICIDE We haven’t applied a strike to your channel, and your content is still live for some users on YouTube. Keep reading for more details on what this means and steps you can take if you’d like to appeal this decision.
Today I got this email from YOU TUBE
Hi Pharmacist Steve,
We wanted to let you know our team reviewed your content, and we think it violates our Community Guidelines. We know you may not have realized this was a violation of our policies, so we’re not applying a strike to your channel. However, we have removed the following content from YouTube: Video: Prescriber induced SUICIDE We realize this may be disappointing news, but it’s our job to make sure that YouTube is a safe place for all. If you think we’ve made a mistake, you can appeal this decision – you’ll find more details below. What our policy says YouTube does not allow content that contains mature or violent themes where there is a clear intent to target younger minors and families. Family content must not contain adult and age-inappropriate themes such as violence, sex, death, drugs etc
So I did a search on YOU TUBE for just the word SUICIDE, and countless number of videos came up – if you don’t believe me – go check for yourself – here is two in particular that I found Interesting. A “machine” that someone can use to commit suicide and then the enclosure can be used as a COFFIN !
https://youtu.be/vGAYsZPRJhc
I guess that producing a video that involves someone in the medical profession and the pt committing suicide if UNACCEPTABLE to YOU TUBE… but selling equipment for sale that will help a pt commit suicide …. it JUST FINE WITH THEM…. as a side issue… YOU TUBE is OWNED by GOOGLE
FDA Executive Officer Exposes Close Ties Between Agency and Pharmaceutical Companies: ‘Almost a Billion Dollars a Year Going into FDA’s Budget from the People we Regulate’ • FDA Executive Officer Chris Cole: “The drug companies, the food companies, the vaccine companies. So, they pay us hundreds of millions of dollars a year to hire and keep the reviewers to approve their products.” • Cole on FDA fees: “Congress approved user fees for [the] FDA. Basically, we charge the industry millions of dollars in order to hire more drug reviewers and vaccine reviewers which will speed up the approval process. So, they [pharmaceutical companies] make more money.” • Cole: “They [FDA] tone down the impact of the user fees on their operations because they know they’re dependent on the drug companies, and the vaccine companies, and these other companies for their agency to operate.” • Cole on blowing the whistle: “There’s not an incentive to speak out in government, surprisingly. You would think there would be, but there’s not. It’s better just to just not say anything and just ignore it.” • Cole on retaliation in government: “You’ll be marked from getting other jobs because another office is not going to want to hire you if you’ve spoken out about something, right or wrong. They don’t look at what you’ve spoken out about. They’re just not willing to- government’s about rocking the boat and they don’t want to- which is the problem I have with- one of the problems I have with government is, like, they don’t like people rocking the boat, for right or wrong, at all costs. They want to hire a safe person that can do the job but doesn’t necessarily- is a great hire.” [WASHINGTON, D.C. – Feb. 16, 2022] Project Veritas published Part Two of its series on the FDA on Wednesday night which featured FDA Executive Officer, Christopher Cole, speaking about the inner workings of the agency including the FDA’s conflicts of interest, overspending, and why it’s hard for those within the agency to speak out on such abuses. In the footage, Cole talks about the impact that pharmaceutical companies have on the agency including the process for approving drugs. “A long time ago, Congress approved user fees for [the] FDA. Basically, we charge the industry millions of dollars in order to hire more drug reviewers and vaccine reviewers, which will speed up the approval process, so they make more money,” Cole says in the hidden camera footage. He then reveals that the FDA tones down the impact that these user fees have on the agency’s operations because, “they’re dependent on the drug companies, and the vaccine companies and these other companies for their agency to operate.” The incendiary footage, which features Cole talking about how the additional money the FDA brings in “gets banked” to be spent on “whatever you can, whether it’s right or wrong,’’ also features Cole discussing reasons why it’s difficult for anyone in government to speak out about practices he sees as “probably excessive.” “I don’t think there’s enough people saying — they’re, like, ‘Look, that’s fine, but that’s not right. So, we’re not going to charge that.’ You don’t want to be that person. You’re not going to have a long shelf life in the agency if you’re always that person,” Cole said. “There’s not an incentive to speak out in government, surprisingly. You would think there would be, but there’s not. It’s better just to just not say anything and just ignore it. The whistleblower, well, it’s high-profile whistleblower statutes and everything, that’s kind of ridiculous,” Cole said before adding “it’s better to just stay quiet and accept.” Cole’s LinkedIn page lists him as an Executive Officer within the agency’s Countermeasures Initiatives, which plays a critical role in ensuring that drugs, vaccines, and other measures to counter infectious diseases and viruses are safe. He made these revelations on a hidden camera to an undercover Project Veritas reporter. A spokesperson for FDA issued a statement yesterday saying, “The person purportedly in the video does not work on vaccine matters and does not represent the views of the FDA.” This statement appears to contradict a phone call released Wednesday afternoon by Project Veritas wherein Cole reiterated, during the conversation with Project Veritas Founder and CEO, James O’Keefe, that he is “a manager in the office that helps oversee the approval of the COVID vaccines for emergency approval.”
Ever since her son Alec Smith died in 2017, after rationing his insulin because he couldn’t afford the $1,300 monthly cost, Nicole Smith-Holt has talked to thousands of people about how the tragedy happened.
“I never get tired of telling Alec’s story,” she said. “It steals a little piece of my heart every time I do it, but it is important for people to know that his death was absolutely preventable. He should be with us today. I will continue to share his story until we get this fixed and it never happens again.”
Just a few months after Alec’s death at age 26, Smith-Holt launched a campaign to make it easier for people with diabetes to access insulin even if they, like Alec, are uninsured or otherwise can’t afford the cost of their medication. In 2020, thanks in large part to Smith-Holt’s advocacy, the Alec Smith Insulin Affordability Act was signed by Gov. Tim Walz. The law guarantees one-time emergency or ongoing supplies of insulin for Minnesota residents who cannot afford the cost of the drug, and it was the first such legislation passed in the United States.
MinnPost photo by Peter Callaghan
Nicole Smith-Holt and James Holt, Jr. speaking during a 2018 roundtable discussion sponsored by state Sen. Matt Little. A picture of their son, Alec Smith, is on the dais.
While many Minnesotans have taken advantage of the new program, known as the Minnesota Insulin Safety Net Program, there are still many others who are eligible for the benefit but who haven’t heard about it. Now, a new video is trying to address the situation: The “Alec Smith Story,” produced by MNsure, the state’s health insurance marketplace, features Smith-Holt retelling her son’s story and explaining the program and how eligible Minnesotans can sign up.
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Smith-Holt said she decided to get involved in promoting the program after she began hearing from people who said they or their family members were still struggling to afford their insulin, even after the bill was signed into law.
“I had been contacted a lot through social media from people wanting help,” Smith-Holt said. “I was seeing posts on Facebook from people saying they didn’t know this program existed.” She’d also heard from people who’d gone to pharmacies asking for emergency insulin but were turned away.
Frustrated by what she was hearing, Smith-Holt met with the state legislators who’d spearheaded the act as well as representatives from MNsure, the state agency charged with managing public awareness about the Minnesota Insulin Safety Net Program. The group brainstormed ways to get the word out about the program, eventually deciding on the video, because they felt that the finished product could easily be distributed through social media.
“We really wanted to use it as an educational tool for both diabetics and for pharmacists and other health care professionals,” Smith-Holt said. “Hopefully we could also make more nurses and doctors and care providers aware that this program existed.”
Libby Caulum, MNsure senior director of public affairs, said that Smith-Holt’s participation has been key to the program’s success. “There is not a better spokesperson for this than Nicole,” she said. “Her activism and her dedication to making sure this doesn’t happen to other people is the impetus for the law.”
Libby Caulum
The program does not have a big enough budget to afford large-scale ad buys, so organizers are hoping the video will spread organically, through “grassroots” social-media shares. Because Smith-Holt has been willing to step forward and become a symbol of the insulin-affordability issue, people are interested in listening to what she has to say, Caulum said.
“My perspective is the more we can get people to know about the program the better,” she said. “There are so many people who are facing these kind of life-or-death situations who do not realize that there is help out there. The more people who know the better.”
How the program works
There are two parts to Minnesota’s insulin affordability program. First, there is the “urgent need” program where eligible Minnesotans can receive a once-per-year 30-day supply of insulin immediately at their pharmacy for no more than a $35 co-pay. An individual who meets the program’s eligibility standards — someone who isn’t enrolled in Medical Assistance or MinnesotaCare, has proof of state residency and a current prescription for insulin with less than a seven-day supply on hand — can walk into a commercial pharmacy and request a supply.
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Most pharmacists in the state are required to participate in the program, said Cody Wiberg, executive director of the Minnesota Board of Pharmacy. One key element is that the law allows pharmacists to hand out the emergency supply without completing extra paperwork. “The pharmacy is not responsible for checking the income and the employment status and the insurance status,” Wiberg said.
While insulin manufacturers all offer prescription assistance programs designed to help low-income or uninsured individuals afford medications, he said that applying for those programs can be a cumbersome process.
Cody Wiberg
“One of the criticisms of manufacturers is they could take a week or longer to process an application for one of these programs while the person in need went without insulin,” Wiberg said. “Now, manufacturers are required to pay for a one-month supply.”
The free month-long supply of insulin is designed to give individuals time to confirm their eligibility for manufacturers’ programs, to purchase health insurance or to sign up for medical assistance.
“That month is supposed to give them at least some time,” Wiberg said. “If they do apply for one of those programs and they haven’t heard back by the end of the month, they can get a second 30-day supply.”
The second part of the program is the “Continuing Need” program, where MNsure health insurance navigators help eligible participants sign up for insulin manufacturers’ affordability programs. Approved participants can qualify for a year’s supply of insulin for no more than $50 for a 90-day refill.
At first, Smith-Holt and other advocates were concerned about building a program based on insulin manufacturers’ existing affordability programs, because the manufacturers had written disclaimers into their programs that they could end the programs at any time, Wiberg said. “There were stories of people who should’ve been eligible for these programs but who weren’t enrolled properly and didn’t get their insulin.”
In the end, the law was written to allay the concerns of advocates, Wiberg explained. “The law now tells insulin manufacturers that as a condition to receive a license from the Minnesota Board of Pharmacy they have to set up a patient-assistance program that has urgent need and continuing need components, you will follow the state’s criteria, you will set it up and you have responsibilities to patients in order to make sure that patients can access insulin in an emergency.”
‘Not one more’
While Alec Smith’s death of diabetic ketoacidosis — a potentially fatal complication of diabetes that occurs when a person’s body produces high levels of blood acids after being deprived of insulin — was preventable, his decision to ration his insulin wasn’t uncommon.
“It’s a pretty common thing for folks to do,” Caulum said, and “Nicole’s whole purpose in pushing this law is to make sure that no one in Minnesota gets to the point where they feel that their only option is to ration.”
Smith-Holt said Alec had decided to ration until he found a job with health benefits. He’d been diagnosed with Type I diabetes just two years before his death, and though he was doing a good job of living with his disease, he was “still pretty new at trying to learn how to manage it,” and didn’t fully understand rationing’s potentially deadly toll.
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While deaths due to insulin rationing don’t happen every day in Minnesota, they still do happen, Wiberg said, and he and his pharmacy colleagues hope that legislation will make them even more rare. “Even one death is too many,” he said.
Smith-Holt said that she hopes that social media users will forward “Alec Smith Story” far and wide, further spreading the news that Minnesotans with diabetes no longer have to ration their insulin.
“We’ve been doing what we can with our limited budget for this program’s public awareness,” she said. “Reaching people through social media has been pretty successful so far, but we know there is more we can do. One of the things I can do is tell his story and explain why this is so important, so I’m doing that.
I just realized that the CDC guidelines – both 2016 and the new proposed 2022 – do not follow how our healthcare systems works. A pt goes to the practitioner and they if they have obvious symptoms, the practitioner typically will run some lab test (blood/urine)… they get back the values of numerous of substances in those tests and if they are outside of what is considered an acceptable range. If one or more is out of the normal range… the pt ends up getting one or more medications to try and get those labs back into “normal range”. The CDC with their opiate dosing guidelines, there is no reference as to the intensity of the pt’s pain… they focused on the amount of medications that the practitioner can prescribe. No reference to getting the pt’s pain back to a “normal level”… I am not sure if this mind set is UPSIDE DOWN – or – ASS BACKWARDS… In many incidents, it prevents the practitioner from being a HEALER
I find it curious why the CDC has proposed both in the publish 2016 Opiate dosing guidelines and the 2022 proposed opiate dosing guidelines, that they are stating that chronic pain should be treated in an entirely different manner than what medical science does in treating just about any other chronic disease state. It doesn’t make any difference if the pt has been diagnosed with high blood pressure, diabetes, COPD, high lipid/cholesterol and on and on… Typically the diagnosis is done from some urine/blood lab test value that is outside of what has been a predetermined range that is safe. A good example is a pt being diagnosed with having diabetes, a type II diabetic will typically be initially prescribed Metformin with a starting dose of 500 mg BID. If the pt’s blood sugar does not come down to “normal range” the dose can be increased up to 2550mg/day in divided doses. If the pts blood sugar still does not reach “normal range” the practitioner could add a few other meds in combination up to three different meds. If the pt’s blood level doesn’t reach “normal level” the practitioner can add insulin. For decades the standard of care with insulin, insulin potency was standardized at 100 units/ml, but now there are also now 200 units/ml and 500 units/ml. There appears to be NO UPPER LIMITS OF UNITS/DAY for individual pts – dose is determined by their blood glucose or A1C readings returning to what is considered a “normal range” Same thing applies to pts diagnosed with hypertension, the final goal is to get the pt’s BP into normal range no matter the dose or the number of different meds are needed. The CDC previous opiate and proposed opiate dosing guidelines has turned what has been the traditional chronic disease treatment process ON ITS HEAD. First the MME equivalence process has ABSOLUTELY NO BASIS IN SCIENCE. It has been reported that these ratios were developed with opiate naive people with mechanically induced pain (Heat or Cold) and using a SINGLE DOSE. At a time when medical science had no knowledge of CYP-450 opiate metabolism rates and/or PGx opiate metabolism rate. As well as the ratio were determined on the “subjective opinion” of the people involved in this study and the results have no application to the use in treating chronic pain issues. Since studies have demonstrated that treating chronic pain pts with opiates will result in a 0.6% to 2.0% becoming addicted. So this proposed guidelines is prohibiting >98% of chronic pain pts getting treatment with opiates that will optimize their QOL, while there is no proof that those up to 2% will not be abusing some other substance(s). The LD50 of opiates is highly variable and will decrease on those pts who have taken opiates long term. I have had first hand experience with end stage CA pts being given 20mg to 30 mg/hr Morphine via IV without fatal respiratory suppression. In theory, that would be equivalent of 200mg to 300mg of Morphine PER HOUR. Every other chronic disease is treated to get the pt’s vitals into what is considered an acceptable range, The 2016 and 2022 proposed opiate dosing guidelines does not address getting the pt’s vitals to a acceptable range, only limits – in theory – a particular MME max dose and the pt is expected to live/exist in a intensity of pain that many could consider a torturous level of pain, and many other biological/physiological functions are outside of acceptable ranges because of under/untreated pain. The attached chart will demonstrate the possible complication of a pt’s comorbidity issues and/or cause the pt to develop additional comorbidity issues. Practitioners are suppose to be “healers”, but creating opiate dosing guidelines that does just the opposite is basically inhumane. I communicate regularly with pts whose practitioners have taken their pt’s opiate doses down to meet the arbitrary MME limits. Their blood pressure is in “stroke range” , typically north of 200/100 – even when taking four or more blood pressure meds, under/untreated pain has caused their adrenals to fail, in trying to compensate for the stress on their system, and the pt now is diagnosed with Addison’s disease. Pts are dying from premature deaths from all of these unnecessary biological stressors or and many more are committing suicide because they can no long tolerate the intensity of pain that they are being forced to live/exist in. The CDC, needs to rescind/revoke the 2016 guidelines and pull the proposed 2022 guidelines and turn the practice of medicine back to the FDA and the various state medical licensing boards. To do otherwise and proceed with these inappropriate opiate dosing guidelines, would strong suggest that the CDC is confirming that the CDC’s position that putting/leaving chronic pain pts in a torturous level of pain is acceptable and what should be considered “ a normal/acceptable range” for pt dealing with chronic pain.
This is the stock value of META (FB) “FAKEBOOK” as of abt 3:45 today… over the last six months the value of a share of FAKEBOOK is WORTH ALMOST HALF OF WHAT IT WAS AT ITS HIGHEST PRICE OVER THE LAST YEAR ! In fact Meta’s price hit a 52 WEEK LOW (207.16) TODAY.
52 week high is 384.33 and closed today at 207.16
I got a message from FAKE BOOK last night that they had deleted a number of posts linked to my blog on Feb 15th… and apparently … it took forever to get back to Feb 15th of last year… on my FAKE BOOK page and there was no posts on Feb 15th, 2021 and when I tried to click on the theoretical link like this message that I just got – “learn more about our decision and see what you can do” and it went NO WHERE…
I know that one year ago Feb 13, 2021, I did not make 173 different posts or comments… so apparently anyone who did share a link from my blog a year ago… all those links have been deleted..
I guess we are back to Richard Mark and his harem/tribe of minions when they filed a untold number of complaints with FAKE BOOK that my blog was a spammer.
So far, it would appear that FAKE BOOK has deleted around 500 posts, comments or links to my blog that others shared a year ago.
