https://daily-remedy.com/podcast/a-conversation-with-pharmacist-steve-ariens/
Filed under: General Problems | 1 Comment »
Here is yours truly: 15 minutes of “fame”
Posted on October 3, 2021 by Pharmaciststeve
I have heard something about a “new math”… but the DEA apparently has created their own math system
Posted on October 3, 2021 by Pharmaciststeve
I love “DEA MATH”… lets look at the 2012-2016 is FIVE YEARS – 1825 days… it is estimated that there is abt 100,000,000 chronic pain pts… abt 30% of the population.. so of those 265 doses for every person would be abt 900 doses for each chronic pain pt – leaving nothing for acute pain.. so doing the simple math…. 900 doses for every chronic pain pt would mean that they MAY HAVE been prescribed a SINGLE DOSE EVERY OTHER DAY for five years.
For the county of 400 dose for every person … may have received FIVE DOSES EVERY WEEK for five years. – again leaving no opiates to treat acute pain for anyone post surgery or accident.
the typical chronic pain pts that is classified as intractable chronic pain – abt 25-35 million pts (8%-10% of our population) – requiring up to 3 long acting opiates and up to 4 short acting for break thru pain..
Ohio has population of abt 12 million …. meaning that they have a estimated 1- 1.2 million intractable chronic pain pts living in Ohio.
This link is to a article that states that 75% of opiate OD’s is from ILLEGAL FENTANYL.. and the last time I checked neither drug wholesalers nor pharmacies sell/dispense illegal Fentanyl
Could better chronic pain management – prevent thousands of OD’s (suicides) EACH YEAR ?
Are these opiate lawsuits just a bureaucratic “money grab”… the money from the 1998 Tobacco settlement where bureaucrats sued companies producing a LEGAL PRODUCT for the “believed” health issues they adversely affected. Of course, tobacco already had a “sin tax” put on it years ago. That settlement was to be paid out over 25 yrs and that “free money annuity” is about to run out… the vast majority of the states in that settlement agreed to put that money toward getting people stop smoking, but it would appear that abt 95% of all that money just got “dumped” into the state’s general fund. The states and feds apparently were able to “double dip” on that money… since all the law firms took the case on a contingency basis – they took a percentage of the settlement – and the bureaucrats would have gotten taxes paid by the law firms on their profits from handling those lawsuits.
Have these bureaucracies really got financially addicted to all that “free money” ? Maybe they didn’t want to raise taxes or cut services to deal with the reduced cash flow as the tobacco settlement comes to a end.
This whole opiate lawsuit is over getting money to help the “poor addicts” and some are already speculating that 95% of the money will get dumped into the state’s coffers and I have read where this money will be paid out over 18 yrs… and the bureaucrats will “double dip” once again via the taxes that the law firms’ profit from the settlement.
So what industry, that is selling a legal product, be the next to get sued – starting in about 12 yrs… so that another “free money annuity” can be in place when this opiate money dries up. Since the use/abuse of alcohol currently contributes to more annual deaths than all drug overdoses… give you an suggestions ?
Pharmacies face 1st trial over role in opioid crisis
https://abcnews.go.com/Health/wireStory/pharmacies-face-1st-trial-role-opioid-crisis-80364447
A bellwether trial is set to start Monday in federal court in Cleveland to determine whether retail pharmacy chains are liable for costs related to the opioid crisis in two Ohio counties
“People need to realize that drug addiction is a family disease, and everyone in the family is affected by it,” said Sharon Grover, whose daughter died after becoming addicted to prescription pain pills and then heroin. “I’m never going to be the same.”
Grover, who lives in the small Trumbull County community of Mesopotamia Township, said she believes her daughter, Rachael Realini, started using prescription painkillers around 2013, but missed any signs of her addiction. By 2016, she told her mother she needed help. When pain pills became scarce, she turned to heroin to feed her habit.
“She looked terrible,” Grover said of her daughter, a registered nurse and mother of two small children. “We hugged, and I told her we would get through this.”
Attempts at rehabilitation in Ohio and Florida failed. Realini was found dead at her home in April 2017 from a fentanyl overdose, an autopsy showed. No other drugs were found in her system.
An attorney for the counties, Frank Gallucci, said that is similar to the pattern seen throughout their communities: Heroin and synthetic fentanyl have largely replaced prescription painkillers, which have been harder to obtain as the industry has been forced to dial back on dispensing.
Another major pharmacy chain, Rite-Aid, settled with Lake and Trumbull counties, which are located outside Cleveland. The Trumbull settlement was $1.5 million; the Lake County amount has not been disclosed.
The trial starting Monday before U.S. District Judge Dan Polster is part of a broader constellation of federal opioid lawsuits — about 3,000 in all — that have been consolidated under the judge’s supervision.
Jim Misocky, an attorney and special projects coordinator in Trumbull County, along with Lake County Administrator Jason Boyd, said the ongoing opioid crisis has been a burden financially. They cited increased costs for their courts, jails, foster care, law enforcement and addiction treatment
The financial burden is especially acute in Trumbull County, where there have been thousands of job losses in recent years in steelmaking, auto manufacturing and automotive supply companies.
“It’s been a big hit on the budget,” Misocky said. “We don’t have a lot of wealth in this community.”
Trumbull County has had to hire a part-time pathologist in the county coroner’s office, Misocky said. When the county morgue fills up, bodies are sent to Cleveland or Lake County for autopsies.
Lake County’s Boyd said addiction treatment facilities there are “well beyond capacity.”
“That’s an issue we hear about continuously,” he said. “‘Where are we going to treat these people?’”
Attorneys for the two counties say 80 million prescription painkillers were dispensed in Trumbull between 2012 and 2016, according to data made public earlier through the court. In Lake County, it was 61 million pills. In trial briefs, the pharmacy companies argue that they followed guidelines established by the U.S. Drug Enforcement Administration and the state of Ohio in how their stores dispensed painkillers.
Attorneys for CVS, based in Rhode Island, said the allegations against the company “are completely unfounded.”
“The evidence presented at trial will show not only that CVS met the legal requirements for distributing prescription opioid medications in Lake and Trumbull Counties, but that it exceeded them,” attorneys for the company wrote.
Attorneys for Illinois-based Walgreens said the two counties were using “confused and contradictory legal theories against other defendants before they landed on the idea to sue retail pharmacy chains.”
The trial will be the fourth in the U.S. this year to test claims brought by governments against different players in the drug industry over the toll of prescription painkillers. Verdicts or judgments have not yet been reached in the others.
With trials ongoing and others queued up, many of the most prominent defendants have already reached settlements. Sometimes, they involve a small number of governments or just one defendant such as Rite Aid.
The nation’s three largest drug distribution companies, AmerisourceBergen, Cardinal Health and McKesson, along with drugmaker Johnson & Johnson, reached a $26 billion nationwide settlement earlier this year. A federal bankruptcy judge recently approved a settlement for Purdue Pharma, the maker of OxyContin, that is potentially worth $10 billion. The global consulting firm McKinsey & Company earlier this year agreed to pay nearly $600 million for its role in advising drug makers on how to boost sales of prescription opioid painkillers.
And in Ohio, lawsuits filed by two larger counties, Cuyahoga and Summit, against drug distribution companies were settled for $260 million before the start of trial in November 2019.
Grover believes the pharmacy giants bear a large responsibility for her daughter’s addiction and is glad they’re on trial.
“The pharmacy companies are the biggest drug dealers there are,” Grover said. “They’re white collar drug dealers, and they need to be held accountable.”
I love “DEA MATH”… lets look at the 2012-2016 is FIVE YEARS – 1825 days… it is estimated that there is abt 100,000,000 chronic pain pts… abt 30% of the population.. so of those 265 doses for every person would be abt 900 doses for every chronic pain pt – leaving nothing for acute pain.. so doing the simple math…. 900 doses for every chronic pain pt would mean that they MAY HAVE been prescribed a SINGLE DOSE EVERY OTHER DAY.
For the county of 400 dose for every person … may have received FIVE DOSES EVERY WEEK. – again leaving no opiates to treat acute pain for anyone post surgery or accident.
the typical chronic pain pts that is classified as intractable chronic pain – abt 25-35 million pts (8%-10% of our population) – requiring up to 3 long acting opiates and up to 4 short acting for break thru pain..
Ohio has population of abt 12 million …. meaning that they have a estimated 1- 1.2 million intractable chronic pain pts living in Ohio.
BTW… who is producing opiates in a “pill” form ?… the last – maybe only – pill dose available was a Ex-lax dose in “pill form”
Filed under: General Problems | 1 Comment »
Interesting read FROM SIX YEARS AGO
Posted on October 2, 2021 by Pharmaciststeve
Filed under: General Problems | Leave a Comment »
Is chain pharmacies in the middle of a staffing crisis ?
Posted on October 2, 2021 by Pharmaciststeve
I know a couple of weeks ago the Walgreen store that is closet to the house, apparently all three pharmacist WALKED.. and the Rx dept in this particular store has been open very sporadic hours and I had head about another Walgreen is a small Indiana town about 15 miles are so from me and a city with only a 600 population and Walgreens is the only pharmacy in town… was having similar staffing problems and sporadic Rx dept being open. I am hearing that the two CVS pharmacies in our county seat of abt population of 85,000 … both of their Rx depts are opening sporadically. One is in a Target store and the other is one of their 24 hr stores… and they have had a sign out front “WE NEVER CLOSE”.
The independent pharmacy that we use… I am normally in/out in < 5 minutes … unless I stop to talk.. Generally, by the time that I get to the checkout register at the pharmacy either the tech or the pharmacist has pulled our waiting meds from the Rx waiting wreck… they have our charge card on file and generally, I just have to sign for the meds and I am on my way… Here is a link to find a PATIENT FRIENDLY INDEPENDENT BY ZIP CODE https://ncpa.org/pharmacy-locator
It would seem that Pharmacists have finally gotten fed up with how they are being more and more mistreated. Maybe the final straw may have something to do with the upcoming – and now approved – COVID-19 booster shot, just as flu shot season approaches. I have seen Walgreens offering first $25,000 sign on bonus for a 3 yr contract and then I saw the sign bonus was raised to $50,000… but these pharmacists are being offered $15/hr less than I was being paid the last year that I worked – 2013… and I had not had a raise in about 5-6 yrs. A $25,000 sign on bonus for 3 yrs is about $4/hr over 3 yrs… From what I have heard from chain pharmacists… they are protecting their own mental and physical health and in turn – to a certain degree – protecting those of the pts that patronize these stores. Under the work environment that these pharmacists and their technicians are expected to preform very exacting tasks… and I am sure that there are many more near misses – medication errors – that we never heard about… but… how many med errors have been “settled” with a non disclosure agreement and a CHECK… Apparently the cost for the pharmacy chains to settled and “bury” all of these med errors with a check and the pt signing a non disclosure agreement… is less than the profit that the chain can generate by under staffing and overworking their staff in the Rx dept. Do yourself a favor, find a pharmacy that your good health is more important to them than their bottom line profits.
Goshen pharmacy customers have long waits for drive-thru only service
GOSHEN — A shortage of pharmacy workers caused frustration this week when CVS reopened its pharmacy services as drive-thru only and long lines of vehicles quickly formed.
After being closed for four days earlier this week, the pharmacy at the CVS store at Main and Madison streets, reopened with drive-thru only service Thursday, according to customers who were waiting in a long line Friday morning.
Mark Thompson of Goshen had a story of frustration to tell.
Keeping his sense of humor and a smile on his face, Thompson recounted how he waited in line for an hour Thursday and when he reached the service window he was told his prescription, which he said was supposed to be filled Monday, was not ready yet. Thompson said he was told the medication would be ready in about an hour.
He then returned to the store about 4:30 p.m. and waited in line again.
“I got all the way up there and was about two cars away and they closed, they close at 6,” he said. “So, I am back again.”
Friday morning Thompson said he had been in line for an hour and was about half way to the window. During that time the line of vehicles varied from 20 to close to 30. The long line stretched back from the drive-up window, north around the parking lot and then out onto Madison Street and back to the traffic signal at Main Street.
Thompson has been a loyal customer at the CVS pharmacy for about 20 years and said he has never had a problem of having to wait so long to fill a prescription.
He laughed when he said he was enjoying his day off from work “learning patience.”
Thompson had already called his doctor Thursday and asked that his monthly refill of his prescription be sent to another local pharmacy.
“Looking forward, I probably won’t come here again, to be honest,” he said.
Customer Sue Wilfong, who used to work at another local chain-owned pharmacy, said she was not angry and that her former company is also experiencing a shortage of pharmacy workers.
She said there is a worker shortage, but the pharmacy staffs are also tasked with more duties during the pandemic.
“I feel for them, I really do,” Wilfong said of pharmacy workers. “They are also bombarded with having to do the testing, the vaccines and both the COVID as well as the flu shots now. It is just stretching their people too much.”
Wilfong normally has her prescriptions mailed to her, but she needed some expensive medicine and had a coupon for it, so she needed to visit the store in person.
Having waited for 40 minutes already and being still toward the end of the line, Wilfong said she had an incentive to stick with the slow creep toward the service window.
“So, I am going to wait for that coupon,” she said with a big laugh.
COMPANY RESPONDS
Asked about the situation in Goshen, a CVS spokesperson sent an email from the company that stated: “Throughout the pandemic, our employees have continued to serve as a critical resource for health care services, prescriptions, vaccinations, COVID-19 testing and other products and supplies in communities like Goshen, at a time when they’re needed most. As our employees continue to be there for our customers, we’re adding to our talent pool to provide them with even greater support and welcome interested candidates to apply.”
The company also said Goshen customers have another option to fill prescriptions at a local CVS store.
“We encourage area customers to also utilize the nearby CVS Pharmacy within the Target store located at 3938 Midway Road for an additional access to service, and where prescriptions are also seamlessly available,” the company stated.
In a Sept. 20 nationwide news release, CVS Health announced it would be recruiting qualified candidates to fill 25,000 clinical and retail jobs. The company planned to hold a national jobs event Sept. 24.
“These new and existing positions will help the company continue to respond to the needs of communities across the country during the fall and winter months when the incidence of flu is expected to increase and as COVID-19 vaccination and testing remain in high demand,” the company said in the Sept. 20 statement.
The openings mostly are for full-time, part-time and temporary licensed pharmacists, trained pharmacy technicians and nurses, the company explained.
Retail workers are also needed.
The company is administering COVID-19 booster shots, COVID-19 vaccinations, COVID-19 tests, as well as seasonal flu shots, according to the release.
“Every flu season we need additional team members,” said Neela Montgomery, executive vice president, CVS Health and president, CVS Pharmacy, “but this year we’re looking for even more. With the continued presence of COVID-19 in our communities, we’re estimating a much greater need for pharmacists, trained pharmacy technicians, nurses and retail store associates.”
Filed under: General Problems | Leave a Comment »
Do various businesses mandating COVID-19 JAB to keep your job .. responsible for adverse reactions ?
Posted on October 2, 2021 by Pharmaciststeve
This is a interesting “happening” in Denver. This police officer has experienced some serious side effects after getting the Pfizer COVID-19 JAB to keep his job, even though this officer had already had and survived COVID-19 and had “natural antibodies”. Apparently “SCIENCE” does not apply in DENVER, CO’s policies. This attorney stated that he is also representing ELEVEN other people in the area over mandatory JABS.
Congress indemnified just about anyone involved with the creation and administration of these COVID-19 vaccines, apparently they did not indemnified various business entities from mandating people they had control over to have the JAB and if they experienced any serious adverse events.
Depending on how this lawsuit “shakes out” …could result in some positive things for the chronic pain community.
This lawsuit could come to the conclusion that if a bureaucracy is going to practice medicine and refuse to follow “THE SCIENCE” that they have some liability for the consequences or collateral damage.
Imagine a hospital/healthcare system, Insurance/PBM, Chain pharmacy …. implements some sort of adherence to the CDC GUIDELINES… and the chronic pain pt at the end of these edicts has some comorbidity complication… end up with a hypertensive crisis, stroke, death… or premature death or a number of other very serious complications and/or QOL degrading… All listed in the chart below.
Filed under: General Problems | Leave a Comment »
Could better chronic pain management – prevent thousands of OD’s (suicides) EACH YEAR ?
Posted on October 2, 2021 by Pharmaciststeve
I love “DEA math problems”… this article states that 75% of the 93,000 drug overdoses was caused ILLEGAL FENTANYL – amazing they actually stated that the deaths were caused by ILLICIT FENTANYL without showing a graphic of a legal Fentanyl Rx med. This calculates out to abt 70,000 of the 93,000 ALL DRUG OVERDOSE DEATHS.
Here is a chart that shows OD deaths up to 2019 … we have abt 320,000,000 population… so doing the math… Heroin is abt 4/100,000 of 12,800 deaths, Methadone is abt 1 so 3200 deaths, Cocaine and Meth is abt 5 so that is 16,000 each… Using that chart the apparently the number of illegal Fentanyl OD’s have abt DOUBLE between 2019 and 2020.
Using the chart it would appear in 2019 83,000 OD’s from the illegal drugs on this chart and if one adds the estimated 15,000 that die from the use/abuse of NSAIDS – most GI bleeds… one comes up with 98,000 OD from just this hand full of drugs/meds. That would be abt 5%-7% error on these sources on numbers from matching up… I guess that is close enough for the bureaucrats.
But the chart shows that abt 12,000 people OD’d on Rx opiates… that would throw the total OD’s in 2019 to 110,000… But those legal opiate OD’s don’t delineate how many were legally prescribed to the person that OD’d… but that is only about 10% of all OD’s using legal opiates… but … it would be interesting to know how many people OD’d with their legally prescribed opiates and if they had any other substances in their toxicology. Since most OD’s, toxicology shows 4 to 7 different substances, with one typically being the DRUG ALCOHOL. My money would be on … if the toxicology only showed a legally prescribed opiate and alcohol … it would most likely be a SUICIDE ! Even if this data was ever divulged, it would appear that OD’s with legally prescribed opiates by chronic pain pts… is in the single digit percentages of all OD’s. One could speculate that if chronic pain was better managed … that thousands of OD’s could be prevented.
Fentanyl frenzy: More than 800 people arrested in DEA crackdown on fake fentanyl-laced pills
The Drug Enforcement Administration said Thursday it made 810 arrests and seized more than 1.8 million fake pills during a two-month sweep to stem the flow of counterfeit medications containing the synthetic opioid fentanyl.
The lethal tablets are fueling a surge in U.S. drug-overdose deaths in recent years, and largely are trafficked from Mexico, where drug cartels produce the tablets from precursor chemicals imported from China, top U.S. officials said at a news conference Thursday.
“Illicit fentanyl was responsible for nearly three-quarters of the more than 93,000 fatal drug overdoses in the United States in 2020,” Deputy Attorney General Lisa Monaco said at Justice Department headquarters.
“The pervasiveness of these illicit drugs, and the fatal overdoses that too often result, is a problem that cuts across America from small towns to big cities and everything in between.”
DEA Administrator Anne Milgram said the agency is working to shut wide distribution networks selling tablets that look like name-brand prescription medications such as Xanax and Percocet.
“DEA laboratory testing reveals that today, four out of 10 fentanyl-laced fake pills contain a potentially lethal dose (2 milligrams),” the agency said in a news release.
Milgram said the DEA has never seen a higher lethality rate.
The fake pills seized were capable of killing more than 700,000 people, she said.
During the sweep, the DEA also seized enough powder to make tens of millions of pills, more than 4,000 kilograms of methamphetamine and more than 650 kilograms of cocaine.
The agency seized more than 9.5 million fake tablets last year, a 430% increase over 2019.
Milgram said the pills are widely available on social media platforms as well as on the streets, an issue that she said social media companies need to address.
Milgram said she raised the issue with Mexican Attorney General Alejandro Gertz Manero during a meeting this week, asking to work with Mexican law enforcement agencies to tackle the problem.
Earlier this week, the DEA issued a public safety alert about a sharp increase of fake prescription pills laced with fentanyl and methamphetamine. It was the first such alert issued by the DEA in six years.
Filed under: General Problems | 2 Comments »
Looks like: No one from FBI or DEA will get fired for not taking the JAB
Posted on September 29, 2021 by Pharmaciststeve
Filed under: General Problems | 4 Comments »
4-year-old mistakenly gets COVID vaccine instead of flu shot at Maryland Walgreens
Posted on September 28, 2021 by Pharmaciststeve
Could this be another incident of over-worked/under staffed pharmacy depts? Recently a Walgreen near us had a three pharmacists abruptly quit/walked out and the Rx dept was open sporadic hours and I have heard of other Walgreen in the area having similar pharmacist shortage and was only opened when they could find a pharmacist willing to work a shift. While the adult dose of Pfizer vaccine is 0.3 ml and Pfizer has submitted data to the FDA to get permission to get it to kids 5-11 y/o, but what I have read … the dose for that age group is suppose to be 0.1 ml. The volume of flu shot for a 5 y/o child is suppose to be 0.5 ml … so nothing in this article states the dose volume this 4/yo received. Any adverse side effects/consequences to this child is most likely TOTALLY UNKNOWN.
4-year-old mistakenly gets COVID vaccine instead of flu shot at Maryland Walgreens
https://www.tri-cityherald.com/news/coronavirus/article254598832.html
A Maryland pharmacist mistakenly injected 4-year-old Colette Olivier with the Pfizer/BioNTech COVID-19 vaccine instead of the flu shot.
Colette’s mom, Victoria Olivier, said the pharmacist’s clinical error was a “record-scratch” moment that she feared could have serious consequences for her daughter, according to the Baltimore Sun.
“All of us were just stunned,” Olivier told the newspaper. “No one really knew what to do, of course.”
Colette received the vaccine on Sept. 18 and has not experienced any major side effects, the Baltimore Sun reported.
Walgreens said safety checks are in place and that “we’ve recently reviewed this process with our pharmacy staff in order to prevent a future occurrence,” Walgreens spokesperson Phil Caruso told McClatchy News.
“Patient safety is our top priority,” Caruso said. “Events like this are extremely rare and we take this matter very seriously. We are in touch with the patient’s family and we have apologized.”
Currently, COVID-19 vaccines are only approved for children 12 to 15 years old, according to the U.S. Food and Drug Administration.
The Pfizer vaccine is not yet approved for children under 12, though the company said Tuesday that it has submitted research to the FDA and is hopeful that the shots could be ready in November, according to The Associated Press.
Moderna, meanwhile, is testing its vaccine “in elementary school-aged children. Results are expected later in the year,” AP reported.
The Olivier family isn’t planning on filing a formal complaint with Maryland regulators to investigate the incident, WBFF reported.
Medical experts told the Baltimore Sun that although the pharmacist’s error was frightening, “it should not dictate how other families feel about seeking medical care or vaccinations for their children.”
Parents with kids under 12 are split when it comes to vaccinating their children.
A Gallup poll released Tuesday found that 55% of parents with children under 12 plan to get them vaccinated, and 45% of parents said they won’t.
Still, the American Association of Pediatrics currently discourages medical professionals from injecting vaccines in children under 12.
“The dose may be different for younger ages,” the group said in a news release. “The AAP recommends against giving the vaccine to children under 12 [years] until authorized by the FDA.”
Filed under: General Problems | Leave a Comment »
Corrupt Scheme to Monetize Veteran Health Records Uncovered
Posted on September 28, 2021 by Pharmaciststeve
Corrupt Scheme to Monetize Veteran Health Records Uncovered
A press release posted by the House Committee on Oversight and Reform today provides the results of an investigation by the committee uncovering a corrupt scheme by several Trump Administration associates to capitalize on suffering veterans.
The three accused Trump associates from the former president’s private golf club known as the “Mar-a-Lago Trio” as reported by CNBC News “are billionaire Marvel Entertainment Chairman Ike Perlmutter, attorney Marc Sherman and doctor Bruce Moskowitz.” It is reported that both Jared Kushner and Ivanka Trump were aware of the efforts by the trio to profit from their shaping of Veterans Administration (VA) policies. The “Mar-a-Lago Trio” reportedly meant to monetize VA health records in a “hugely profitable” deal with Johnson & Johnson, Apple, and CVS and flouted Federal Advisory Committee Act (FACA) requirements.
The House Committee on Oversight and Reform states:
“‘Our joint investigation found that Ike Perlmutter, Marc Sherman, and Dr. Bruce Moskowitz, bolstered by their connection to President Trump’s private Mar-a-Lago club, violated the law and sought to exert improper influence over government officials to further their own personal interests,’ said the Chairs.”
Background: FACA Flouted by Associates
FACA lays out the rules of engagement for advisory committees. However, when Reed Cordish, a former senior aide to President Donald Trump advised the trio of the need to “form a FACA group,” billionaire Marvel Entertainment Chairman Ike Perlmutter responded:
“Thanks for your email and especially the thoughts on FACA. The good news is that we have been advised that FACA does not apply because we are not a formal group in any way.”
The Oversight Committee released the trove of emails today.
Former President Trump announced the administration’s intention to set up a group to “straighten out the VA” on January 11, 2017. The oversight committee report goes on to say that the trio would “help then-VA Secretary nominee David Shulkin implement new policies, including a proposal to monetize veterans’ patient data.”
According to the oversight committee:
“The Federal Advisory Committee Act (FACA) requires that groups advising the executive branch operate with transparency and a balanced approach. The Mar-a-Lago Trio refused to comply with this law and, with the knowledge of Jared Kushner, Ivanka Trump (using a personal email account), and other top White House advisors, hid their efforts to influence VA policies from public view.”
The Oversight Committee goes on to say that:
“The Trio was informed by multiple federal officials that their work constituted an advisory committee, which is subject to the transparency and balance requirements in FACA.”
Veterans and the Overdose Crisis: White House Appears to Have Been Aware of Issue of Veteran Suicides
It is well known within communities that the VA health system was the first to begin targeting patients with anti-medication management policies concerning the treatment of pain. Many advocates have tweeted to the Trump White House and written letters, and even held protest rallies against the policies which began proliferating within the rest of the healthcare system via state and federal initiatives to mitigate the so-called “opioid crisis.” Especially in the wake of the Centers for Disease Control and Prevention’s (CDC) 2016 Guidelines on Prescribing Opioids for Chronic Pain.
The email trove released by the Oversight Committee appears to show the Trump White House knew veteran suicides were an issue and it’s possible they also knew that many of the suicides may be linked to heavy-handed policies at the VA due to incorrect assumptions about what was driving the overdose crisis.
One of the emails from Ike Perlmutter to Reed Cordish states:
“Our team of medical experts are working on a telehealth initiative and delivered a draft Executive Order to the President…while you are working with the DEA and DOJ, without the courtesy of advising us, which could have tremendous implications on the wording or, worse yet, the prudence of an Executive Order in the first place. This parallel path as well creates the potential for embarrassment for the President and wasted invaluable time that our veterans can ill afford. … We will arrange and conduct discussions with Apple…”
The emails clearly depict the trio and White House officials held discussions with Johnson & Johnson, Apple, and CVS Health on behalf of the federal government after Ivanka Trump and Jared Kushner introduced them to the CEOs of each company — Alex Gorsky, Tim Cook, and Larry Merlo. It’s also clear they were coordinating with the DEA and DOJ.
The Oversight Committee report says:
“The trio engaged these companies on proposals including the development of a platform for veterans’ medical records, efforts to reduce veteran suicides including a joint public awareness campaign, and efforts to expand access to care for veterans by providing veterans service at CVS’ MinuteClinics.”
The report goes on to say:
“The Trio worked with Secretary Shulkin to award a consulting contract to Terry Fadem, the former president of Dr. Moskowitz’s nonprofit foundation, to explore monetizing VA patient data. Mr. Fadem proposed in an email exchange with Dr. Moskowitz that patient data ‘be leveraged into hundreds of millions in revenue.’ Dr. Moskowitz responded that ‘J&J, CVS, and Apple all wanted the data base’ and that Johnson & Johnson ‘want[s] the VA databank and biobank which will be hugely profitable to them.’ [p. 24–27] According to a presentation prepared by Johnson & Johnson, a next step was to ‘Work through legal barriers on getting access to VHA EMR [Veterans Health Administration Electronic Medical Records] databases.’ [p.33]”
There was no acknowledgment of the heavy-handed federal response to the overdose crisis which began targeting patients and their doctors several years ago. Federal and state policies have made them targets of the United State’s war on drugs despite most overdoses being the result of illicitly manufactured fentanyl (IMF) in the black market supply.
Data from both the VA and the American Medical Association (AMA) demonstrate that veterans and many more in the private sector were rapidly force tapered off of their medications. According to Dr. Michael Schatman, the Editor-in-Chief of the Journal of Pain Research, the VA force tapered veteran patients twice as quickly as the private sector.
From a 2018 VA report:
“Highlights from the data include:
- A 41-percent drop in opioid-prescribing rates across VA between 2012 and 2017
- Ninety-nine percent of facilities decreased their prescribing rates.
- San Juan, Puerto Rico, and Cleveland, Ohio, top the list of medical centers with the lowest prescribing rates, at 3%.
- El Paso, Texas, and Fayetteville, North Carolina, are most improved, and decreased prescribing rates by more than 60 percent since 2012. El Paso’s prescribing rate decreased by 66%, and Fayetteville’s decreased by 65%”[1]
The AMA’s 2018 data is similar but includes decreases in prescribing across sectors:
“Opioid prescriptions are decreasing nationwide.
Between 2013 and 2017, the number of opioid prescriptions decreased by more than 55 million — a 22.2 percent decrease nationally. All 50 states have seen a decrease in opioid prescriptions over the last five years.
The nation saw a 9 percent decrease — more than 19 million fewer prescriptions — between 2016 and 2017 alone.”[2]
And in 2021, the AMA demonstrates that our current policies concerning prescription medications for pain are inadequate because the problem never stemmed from prescribing but rather the black market drug supply being poisoned by IMF.
It’s a shame the trio and the administration didn’t “work through legal barriers” of veterans and other patients getting access to life-saving medications considering it’s obvious they are capable of working through such barriers when it suited their wallets.
The Poisoning Crisis Continues Unabated
Despite this drastic decrease in prescribing, the United States experienced its worst year of overdoses yet in 2020, and statistics for 2021 are likely to be just as dismal.
The reason? Federal and state public health agencies and legislatures are focusing on the wrong premise. The assumption made by the CDC and other federal agencies is that it is patients on medications for pain and their prescribing doctors that are driving the overdose crisis. However, as this author has previously uncovered, CDC’s data on unintentional overdoses is fatally flawed and combines heroin and illicit fentanyl poisonings within their “prescription opioid overdose” categories.
Overdoses are not the result of prescriptions being given to patients but rather, are a result of IMF proliferating on the streets. Poisoning the illicit drug supply, along with the problem of polypharmacy (users taking several drugs at once).
In fact, a recent study utilizing the Prescription Drug Monitoring Program (PDMP) may be widely representative. The study was undertaken by Alexander Walley, a researcher at Boston Medical Center and Associate Professor of Medicine at Boston University School of Medicine. It was discovered that only about 1% of overdose decedents had an active prescription at the time of death and that a majority had died of heroin or fentanyl overdose.
Even in cases of decedents overdosing on so-called “prescription opioids,” they are almost never prescribed to them. And yet, patients continue to bear the weight of the drug war and are expected to face continued barriers in accessing medication management for their pain, while poisoning of the black market supply continues unabated.
It is reported that almost 20 veterans commit suicide every day. Many of these suicides are likely a direct result of their inability to access medications that allow them to remain active and the cruel theft of their quality of life is likely similarly correlated with this frightening trend. Instead of attempting to restore access to these life-saving medications, or at the very least, work on decreasing barriers to appropriate treatment, the trio and the Trump White House appear to have been planning a way to profit from these veterans’ suffering. Going so far as to plan a joint public awareness campaign leveraging celebrities from Marvel Entertainment.
No doubt these veterans, suffering from the obligatory yet failing drug war, are beyond grateful to hear that their medical records were to be leveraged into “hundreds of millions in revenue” and that the trio and the administration were planning to profit while throwing them some “awareness” via a celebrity circus. It’s too bad they didn’t take it a step further and redirect federal resources to target the real problem, IMF in a completely separate black market supply, and relax the prohibition of pain medications on the medical side via VA policies.
Conclusion: Calls for Greater Transparency
At the very least, we can expect discussions on efforts to increase transparency when it comes to advisory committees. The Oversight Committee writes:
“…The Committees’ investigation demonstrates the need for Congress to pass the Federal Advisory Committee Transparency Act, which would ensure the American people know who is providing advice to federal policymakers and would require agencies to disclose whether individuals on advisory committees have conflicts of interest.”
As most of my readers already know, the problem of material conflicts of interest and a culture of federal public health agencies ignoring ethics frameworks and their own rules is nothing new. However, more transparency for advisory committees in the wake of these revelations is sure to be a positive development.
Filed under: General Problems | 2 Comments »
Intractable Chronic Pain is just ONE ACCIDENT AWAY
Posted on September 28, 2021 by Pharmaciststeve
Filed under: General Problems | 5 Comments »