Pharmacy closes today at 3 PM – because of staffing issues

Posted on December 12, 2021 by Pharmaciststeve

Under staffing issues have been at a ever increasing problem for several years… with the COVID-19 pandemic… many chain pharmacies – particularly the two BIG BOYS in the country… have resisted adding Rx dept staff… while adding services of COVID-19 testing, shots and then came the flu vaccinations starting in Aug. and probably peaking in Oct-Nov…  staffing issues and work environment has apparently came to a HARD BOIL…  and Rx dept staff are apparently quitting in large numbers..

For years, many of us “old timers/legacy pharmacists” have been telling the younger Pharmacists that they need to stand up for every increasing bad/dangerous work environments.  The chains budget $$$ to settle mis-filled Rxs and as long as the profit of under staffing is greater than the cost of settling the mis-fills things will continue to deteriorate…  Most would reply that the “pts count on me, I can just abandon them” and legacy pharmacist would tell them.. they come because of the company’s name on the front of the building.

What we are now seeing on airplanes as passengers act up and get out of hand… mostly because they are pretty liquored up… From what I have been hearing from the “pharmacy front lines”…  some sick pts – who are not feeling very well – are becoming very belligerent, and demanding and have been do so for some time.  As more and more chains are using pharmacists from a “floater pool” … these staff pharmacists of these chains are starting to realize that the pts are not coming to a particular store because of them.

there has been some reports from some of the major chains, by their staff pharmacists that they have 10 days worth of prescriptions “stacked up in the computer ques” and District Managers/Supervisor telling them to just FOCUS ON THE Rx WAITERS !

I wonder what those Pharmacists think today about all those pts coming to their store…. because of them.

 

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Nonmedical Opioid Use After Short-term Therapeutic Exposure in Children: A Systematic Review

Posted on December 12, 2021 by Pharmaciststeve

Apparently some have to do studies … just to get money grants –  In this example, they use data of low methodologic quality  and Risk factors were contradictory and remain unclear, they come to the conclusion Given the lack of clear evidence regarding short-term therapeutic exposure.. that prescribers should basically come to using “sound clinical judgement in prescribing opiates.” One must wonder how many of our tax dollars was spent for 2 reviewers to “dissect” 21 observational studies’ data to created a narrative summary that the data in the chosen studies was of poor quality, contradictory and only a UNCLEAR CONCLUSION was the determination in the end.

Nonmedical Opioid Use After Short-term Therapeutic Exposure in Children: A Systematic Review

https://pubmed.ncbi.nlm.nih.gov/34816280/

Abstract

Context: Opioid-related harms continue to rise for children and youth. Analgesic prescribing decisions are challenging because the risk for future nonmedical opioid use or disorder is unclear.

Objective: To synthesize research examining the association between short-term therapeutic opioid exposure and future nonmedical opioid use or opioid use disorder and associated risk factors.

Data sources: We searched 11 electronic databases.

Study selection: Two reviewers screened studies. Studies were included if: they were published in English or French, participants had short-term (≤14 days) or an unknown duration of therapeutic exposure to opioids before 18 years, and reported opioid use disorder or misuse.

Data extraction: Data were extracted, and methodologic quality was assessed by 2 reviewers. Data were summarized narratively.

Results: We included 21 observational studies (49 944 602 participants). One study demonstrated that short-term therapeutic exposure may be associated with opioid abuse; 4 showed an association between medical and nonmedical opioid use without specifying duration of exposure. Other studies reported on prevalence or incidence of nonmedical use after medical exposure to opioids. Risk factors were contradictory and remain unclear.

Limitations: Most studies did not specify duration of exposure and were of low methodologic quality, and participants might not have been opioid naïve.

Conclusions: Some studies suggest an association between lifetime therapeutic opioid use and nonmedical opioid use. Given the lack of clear evidence regarding short-term therapeutic exposure, health care providers should carefully evaluate pain management options and educate patients and caregivers about safe, judicious, and appropriate use of opioids and potential signs of misuse.

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GONE WRONG: Civil Asset Forfeiture — seized car of Grandmother living in homeless shelter

Posted on December 11, 2021 by Pharmaciststeve

Massachusetts returns car to grandmother six years after mistakenly seizing it

https://www.foxnews.com/politics/massachusetts-returns-car-grandmother-six-years-after-mistakenly-seizing

Police suspected the car had been a part of a crime in Berkshire County

A Massachusetts grandmother is calling for reform of the asset forfeiture system after the state wrongfully suspected her car had been involved in a crime and seized it for six years.

Malinda Harris, now a 61-year-old single mother who resides in Springfield, looked on in March 2015 as police confiscated her 2011 Infiniti G37 after it was believed to have been involved in the commission of a crime in Berkshire County. On the same day the vehicle was seized, Harris, who was living in a shelter at the time, had loaned the car to her son, Trevice, who police suspected was dealing drugs.

It was not until October 2020, five years after the seizure, that Harris received legal notice that the state would be keeping her car permanently unless she talked to them. After receiving the notice, and not being able to afford a lawyer at the time, Harris received assistance from the Goldwater Institute – which helped her get her car back earlier this year.

“I’m one of countless Americans who have had their property taken away under civil asset forfeiture laws,” Harris wrote in a March 2021 USA Today op-ed. “There are so many of us that billions of dollars of property are seized every year. Unlike so many other victims, I decided to fight the government to get my property back.”

Harris testified before members of the Civil Rights and Civil Liberties Subcommittee on Wednesday, detailing the civil asset forfeiture and describing it as a “very difficult time” amid the COVID-19 pandemic.

“They had no warrant, they didn’t show me any paperwork, I never got a receipt for my car, they basically told me they were taking the car and that’s what they did,” Harris told members of the committee.

“The forfeiture was very stressful,” Harris said, commending the Goldwater Institute for stepping in to help resolve the matter. “My thoughts were all over the place and this was a very difficult time.”

Harris told the committee that she does not believe “people should be allowed to police for profit,” insisting that the state “should have a better burden of proof” before being allowed to seize someone’s personal property.

The Goldwater Institute noted that Harris’ car, which sat unused in an impound lot for more than half a decade, was “undriveable due to non-maintenance and neglect” once she regained possession. However, after “minor repairs and replacing the tires,” Harris was able to give the car to her granddaughter, one of Trevice’s daughters who began college this fall. Trevice was murdered in an unrelated incident in December 2018.

According to the House Oversight committee, the government “does not need to convict or even charge individuals before seizing their assets” and in some states, law enforcement agencies are “allowed to keep 100 percent of the seized assets proceeds, creating a perverse incentive for agencies to abuse the civil rights of Americans in exchange for profit.”

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WAGS: the pharmacy America trusts – when it is open

Posted on December 11, 2021 by Pharmaciststeve

State Pharmacy Board meets to discuss Walgreens closures

https://wgme.com/news/local/state-pharmacy-board-meets-to-discuss-walgreens-closings

PORTLAND (WGME) — The state is taking action in the face of sudden disruptions at Walgreens pharmacies.

The group that regulates pharmacies in Maine met Thursday to talk about the issue.

The issue is going before the State Pharmacy Board because the closures are repeatedly happening at the same locations.

It’s impacting people’s access to vaccines, COVID testing and medications.

“This is the most unusual grouping of reports,” Office of Professional and Occupational Regulation Administrator Geraldine Betts said.

When pharmacies change their hours to their posted schedule, the State Pharmacy Board has to be notified.

If that happens four or more times in a calendar month, the board can eventually require the site to change its hours.

“The board has, not that I recall, ever gone into that,” Betts said.

The repeated problems discussed Thursday reportedly happened at 13 Walgreens pharmacies from Buxton to Bar Harbor, Lewiston to Brunswick.

One site in Auburn was closed nine times in October.

“Always closed, but it’s happening all around town though,” pharmacy customer Melissa Fisher said. “There’s not enough people to keep it open.”

The location on Congress Street in Portland closed four times in October and another four times in August.

“When you call, they say they’re open, but when you get here, they’re not open,” Fisher said.

Others were shocked it was such an issue.

“Anna the pharmacist, I’ve seen her work from open to close day after day after day,” pharmacy customer Peter Winchester said.

All of the reports presented to the board blamed staffing problems.

“Did I hear this was happening with other chains and or individual pharmacies as well?” Pharmacy Board Member Tim McCormack said.

“We have not seen reports from others just yet,” Betts said.

That is something the state is looking out for, but so far, the problem seems limited to Walgreens.

“We’re kind of tired of using the term ‘unprecedented times,’ but I’ve been doing this for 20 years and have never ever seen it as tough as it is,” Pharmacy Board President Brad Hamilton said.

The state is going to remind Walgreens that it has to clearly post changes to the hours and customers have to be notified of another nearby location that can help.

The state has already reached out to the chain to get more info about why this is happening.

The board even discussed having a meeting with a representative.

In a statement to CBS13, Walgreens said, “We apologize for any inconvenience to our customers and patients, as we have adjusted pharmacy hours in our stores to accommodate current staffing needs, while also working to ensure minimal disruption to our customers. “

The pharmacy chain added that it was proud of the extraordinary efforts of its pharmacy and store teams.

“Throughout this greater demand for COVID-related services, they are working to ensure that our patients and customers are cared for, even as we address staffing challenges due to the ongoing labor shortage. What we are seeing currently is consistent with what many other healthcare entities have been experiencing,” Walgreens said. “We’ve expanded our recruitment efforts amidst a pronounced labor shortage, and we’re taking every step possible to help meet current heightened demand for COVID-19 vaccinations, as well as testing and other pharmacy services.”

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Mom Is Suing Hospital for Performing an Emergency C-Section Without Anesthesia

Posted on December 10, 2021 by Pharmaciststeve

Mom Is Suing Hospital for Performing an Emergency C-Section Without Anesthesia

https://www.parents.com/pregnancy/giving-birth/mom-is-suing-hospital-for-performing-an-emergency-c-section-without/

A woman and her fiance are suing Tri-City Medical Center in Oceanside, California after she says doctors performed an emergency cesarean section on her without anesthesia.

Having to undergo an emergency C-section is stressful and can even be traumatic. But at least in the U.S., moms can expect that their hospitals will have an anesthesiologist on staff to manage her pain during the surgery. But in a horrific lawsuit out of Oceanside, California, a woman asserts that her doctor performed an emergency C-section without any anesthesia.

Delfina Mota and her fiancé are suing Tri-City Medical Center, claiming medical malpractice and emotional distress from the procedure. According to court documents, Mota was 41 weeks along when she arrived at the hospital on November 15 to be induced. She labored all night, and then around 5 a.m., the situation took a scary turn. The doctors couldn’t pick up the fetal heartbeat, so her doctor, Sandra Lopez, called for an emergency C-section.

Mota—who had been given an epidural the previous night—was transported to the operating room and an anesthesiologist was paged multiple times, but didn’t answer. At that point, the epidural had “no effect on the surgical site for the C-section, which was located on her abdomen,” according to the lawsuit. Yet, before the anesthesiologist could reach the OR, Lopez ordered that Mota be strapped down and she made an incision in the mom-to-be.

Cesarean section tools
Credit: Samrith Na Lumpoon/shutterstock

In the doctor’s “Operative Report,” quoted in the complaint, Lopez stated that she made the incision without anesthesia and separated Mota’s abdomen muscles to reach her uterus before the anesthesiologist walked into the room.

“[Mota] was crying and screaming at the top of her lungs, that she could feel everything that was happening and was also pleading for help, and for Defendants to stop cutting her,” until she passed out, according to the complaint.

The suit alleges that Mota’s fiance Paul Iheanachor could hear Mota from the hallway. He recalled to the Los Angeles Times, “I heard the screams, the horrific screams. That’s when I realized they were cutting her without anesthesia.”

In retrospect, Mota told the paper, “I understand why they did it. But this is a hospital…. There should have been measures in place.”

Mota and Iheanachor shared with the L.A. Times that they’re now proud parents of a 7-month-old baby girl named Calli. Nonetheless, if the series of events did play out as the lawsuit alleges, the new mom has likely had to do a great deal of emotional healing, as well as physical.

A spokesperson for medical center said in a statement: “Patient safety and quality are the utmost priorities for Tri-City Medical Center and all of our partners. Tri-City Healthcare District cannot comment further on pending litigation.”

No doubt this story could send chills up expectant parents’ spines. But it does bear noting that, while there are very rarely cases for a C-section to be performed without anesthesia (and they often need to be in third world countries), it’s very rare for this to happen in the U.S., according to John Thoppil, MD, OB/GYN, of River Place OBGYN in Austin, Texas.

Most C-sections are done under regional anesthesia—a spinal block or an epidural block—which numbs only the lower part of your body. That way you can remain awake. In some, uncommon cases, general anesthesia may be needed, but there are dangerous risks, like aspiration, Dr. Thoppil notes.

Of course the dose of an epidural a woman is given will vary, if she’s laboring vs. having a C-section, as doctors want you to be able to push and have motor function in the former scenario.

But avoiding a horrific situation like the one described in this lawsuit may very well boil down to proper communication between doctor and patient. Doctors should tell their patients that during a C-section, despite anesthesia, they’ll feel a bit of pressure or even discomfort with the procedure. Patients should always share what they’re feeling, Dr. Thoppil notes. And of course, there is never an excuse for OBs failing to hear their patients.

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COPS confiscate $100,000 – owner not arrested nor charged with crime

Posted on December 10, 2021 by Pharmaciststeve

When Dallas PD gave its K9 unit dog, Ballentine, kudos for sniffing out a suitcase containing more than $100,000, many criticized the department for its practice of civil asset forfeiture. The process allows law enforcement officers to seize assets they believe to have been involved with a crime.

 

However, officials also reported the 25-year-old owner of the suitcase was neither arrested nor charged with any crime.

According to CBS DFW, Dallas police “did not give any details about the nature of the follow-up investigation, what led to the seizure, which techniques and tactics were utilized, nor which Federal partners were involved.”

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DEA agent sentenced to 12 years in federal prison for conspiring with cartel

Posted on December 10, 2021 by Pharmaciststeve

A former Drug Enforcement Administration (DEA) agent was sentenced to more than 12 years in prison on Thursday for conspiring with the Colombian cartel.

Jose Irizarry and his wife Nathalia Gomez-Irizarry were arrested in February 2020 in San Juan, Puerto Rico after they were accused of laundering money for the Colombian cartel.

Authorities accused the couple of being involved in a seven-year scheme of diverting more than $9 million from undercover DEA money laundering investigations into banks.

According to the Department of Justice, Irizarry and his family received at least $1 million in kickbacks for their involvement.

Both Irizarry and his wife pleaded guilty to 19 charges in September 2020. The charges against them included money laundering, honest services wire fraud, bank fraud and aggravated identity theft.

As part of the plea agreement Irizarry has been ordered to pay $11,233 in restitution and forfeit a diamond ring and luxury sports car he bought with the money he received.

Special Agent in Charge Brian Payne of the IRS Criminal Investigation said in a statement, “Irizarry betrayed his oath to serve and instead used his position to further the criminal activities of a violent drug cartel while enriching himself.”

“While his actions represent an egregious breach of the public trust, they are in no way a reflection of the overwhelming majority of special agents who serve with honor and integrity. IRS-CI will take every step necessary to ferret out those who cave into temptation and grossly misuse their power,” said Payne.

U.S. District Judge Charlene Honeywell ordered that Irizarry begin his prison term immediately on Thursday, and he was remanded into the custody of the U.S. Marshals Service.

Officials previously announced in late 2020 that Gomez-Irizarry had been sentenced to 60 months probation.

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Karma can be a BITCH

Posted on December 10, 2021 by Pharmaciststeve

See the source image
Many of you may remember a “gentleman” in Dec of 2019 that posted on FB that he was having his family come to visit him at Xmas when he was going to start a suicide by starvation. At the time, I did blog about him and the trouble that he was having getting adequate pain management.  As Xmas came and went and it became apparent that he appeared to be nothing more than scammer and con artist and appeared to be a “virtual panhandler”.  The first of Jan 2020, I pulled down the blog post and replaced it with a post about what a “person” was doing to the chronic pain community… no names mentioned. I concluded that I was giving him too much exposure and visibility to the chronic pain community via my blog. I did not want those in the community that I was endorsing what he was doing,

A month or so ago, I got a DEMAND that I take that two yr old  post down from this “gentleman”… Knowing what he had done to those in the chronic pain community over the last two years.. I was not sure what he was up to… but.. did not want to destroy what I did – or did not – post about anyone… So I put a password on the post and made it private.  Apparently, from what I have been told  – that caused him to get his panties in a knot.

I have been told that he contacted some legal aid services, wanting to sue me, and I am told that he was told that HE HAD NOTHING !!!

Apparently this “gentleman” was not done with his vindictiveness … Apparently he “stirred up” is harem of minions … getting them to file a untold number of complaints with FB about my blog being a SPAMMER.  Since FB apparently does not verify any such complaints … just reacts and declared my blog as a SPAMMER and has removed AT LEAST any reference to my blog anywhere on FB in 287 posts and 17 comments…

I have been told recently that some of the people that fell for his “virtual panhandling shtick” over the last two years and have called the authorities on his “virtual panhandling ” over the last two years…  and at least a couple of them have been interviewed by the FBI.  How many have reached out to the authorities, I don’t have a exact number or even a educated guess.  I was even told that his girlfriend/wife has even turned him in…  I guess to try to CYA herself.

I have not heard from the FBI, maybe because all I know is what has been shared with me second or third hand… If even HALF of what has been shared with me is true…this “gentlemen” may be on the way to getting “three hots and a cot”, but on the positive side…  the Supreme Court ruled years ago that the 8th Amendment (no cruel and unusual punishment) ONLY APPLIES TO PRISONERS…. so maybe his pain will get addressed properly in the future ?

My blog is up and running, mainly because I own the domain that my blog is on…  no one has any ability to censor or ban me there.

 

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If Bob was playing BASEBALL – he would batting ONE THOUSAND !

Posted on December 10, 2021 by Pharmaciststeve

https://www.labordish.com/wp-content/uploads/sites/22/2015/02/baseball.jpg

We met with Dr’s and Medtronics this morning with minor child..7 years old with Spinal Bipita and a few other issues. Child walks on all 4″s as her little spine is very crooked! (Poor Baby) Medtronics is willing to try a pain pump but needs to have a corporate meeting and have several discussions on plan of attack as Child has many bad spots in her spine. Child will start an opioid theropy program recommended by our own Steve Ariens RPH! I was really impressed with the hoops everyone seems to be jumping through all of a sudden. Child was taken to Observation Center and was monitored and Re-Checked before she is sent home!

Child’s mom text me about 20 minutes ago and said she was doing awesome and they will set up next appointment for February with Medtronics and myself!

I’m more surprised at this outcome more so than the first 2! We struggled on medication but Steve Ariens RPH is the man!  He finally broke the tie and the argument the 3 doctors were having  We obviously found a good combo with meds I never heard of and they seem to be working great! Yay  APDF is 3 for 3 with these children  So proud of my APDF team! 1 more to go next Wednesday (fingers crossed) 4 for 4 would be awesome 

American Pain and Disability Foundation is run entirely by VOLUNTEERS and funding is done by Donations.  Now in its THIRD YEAR,  volunteers are coming together in “small teams” to work for the improvement in the QOL of pain pts.  Each team with individuals with complimentary and synergistic talents and each team working on different areas to collectively address improving pain management for the pain community as a whole. There is no one “SILVER BULLET” or “MAGIC WAND” to get the community from here and now to that point in the future where sanity returns to the appropriate treatment of pain.

https://americanpaindisabilityfoundation.org/

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AMA Story No. 537

Posted on December 8, 2021 by Pharmaciststeve

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