Another person with a platform and visibility that some business trying to make a profit from the fabricated opiate crisis  has hitched their wagon to Miss America 2020.

I looked up Virginia Commonwealth University and their PharmD program is a 4 yr program with tuition 32K – 45K/yr (in state, out of state)

Camille Schrier…an incoming second year pharmacy graduate student… meaning that she has finished ONE YEAR toward her 4 yr PharmD degree and she is professing to be a EXPERT on the opiate crisis and medication safety.

According to Wikipedia  https://en.wikipedia.org/wiki/Camille_Schrier and As a child, Schrier was diagnosed with a mild form of Ehlers-Danlos Syndrome.^[7][8] During the Miss America 2020 competition, Schrier also revealed that she was diagnosed with obsessive-compulsive disorder and recovered from an eating disorder as a teenage

Schrier in public service announcement for National Prescription Drug Take-Back Day, for the Drug Enforcement Administration, 2020

due to the COVID-19 pandemic, the Miss America organization announced that Schrier would serve an additional year after her term as Miss America was due to expire in December 2020

She also apparently has a partnership with Safe Rx

Maybe with those combination of medical issues… she may have had some first hand experience with substance abuse ?

Looks like the DEA and this company Safe Rx… all they need is a pretty woman with high visibility and ONE YEAR towards a PharmD degree to promote her to the public as a EXPERT that they should listen to on our dealing with the fabricate opiate crisis  and medication safety

Miss America Is A Pharmacist: How Camille Schrier Advocates For Change In The Opioid Crisis

https://www.forbes.com/sites/jessicagold/2021/07/30/miss-america-is-a-pharmacist-how-camille-schrier-advocates-for-change-in-the-opioid-crisis/

When you think of Miss America, you probably don’t think of a scientist pursuing her doctorate degree in pharmacy at Virginia Commonwealth University, who speaks about the opioid epidemic and medication safety. Conversely, when you think of a pharmacist, you probably don’t think of a woman in heels and makeup, who enjoys fashion, just as much as science.

But, that is just who you get when you meet Camille Schrier, Miss America 2020 and an incoming second year pharmacy graduate student. In representing the balance of the two, and educating people about both roles, she has been able to break down many different stereotypes. She calls herself a “science princess” and perhaps this is best showcased by her unique talent from competition. She did a science experiment. Though the idea was to display her skills and talents, and the experiment itself came from YouTube, to Camille it really represents, “just being yourself in every situation.” 

Perhaps that attitude has allowed her to use her time as Miss America to compliment her education and future career in pharmacy in unexpected ways. Chief among them is using her advocacy platform for her social impact initiative, “Mind Your Meds,” which has a strong focus on combating the opioid epidemic. In other words, she used her newfound megaphone to try to make larger changes in her future field.

She explains, “One of the things that I started to really recognize in my role is how much pharmaceutical products can be misused in a way that leads to overdoses and substance use disorder, and that it’s more than just, you know, someone deciding to pick up an illicit drugs out of the blue, and become addicted to that substance…Once I became a pharmacy student, I started to understand how…substances that people have found to be so beneficial, can also be dangerous for some people.”

Miss America also led her to new partnerships, like hers with Safe Rx, a company fighting America’s opioid epidemic with its locking pill bottles, to help with medication safety in the home and safe storage. The locking pill bottles are kind of like safety locks on guns, or seatbelts in cars, and actually help put safety controls on medications via a combination lock.

Doing so prevents kids, for example, who are home right now from accessing them, especially unsupervised. Camille feels having a possible solution allows her to take a step beyond educating people about risks, and provides people with actionable steps. She can focus on prevention, which she believes increases her power as an advocate. 

Prevention is one key for change, as is actually talking about the epidemic out loud. This is sorely needed particularly right now as deaths in the United States due to drug overdoses are at an all time high. In fact, recent Centers for Disease Control and Prevention (CDC) data, show that more than 93,000 people died from overdose in the last year, an increase of nearly 30% from 2019. Yet, if you turn on the television, the media rarely discusses it. 

Camille says, “The thing that really kind of breaks my heart is when I watch T.V. during Covid-19 and I hear about the Covid-19 death numbers, and I hear about the vaccines that are being quickly developed to be able to overcome this pandemic. There’s a silent epidemic of addiction and substance use disorder that happens in our country, and has been continuing to happen for 10, 15, 20 years and has never gotten the type of publicity or action that Covid-19 has because of the stigma associated with it.”

She points out that this remains true even as the numbers have increased and the conversation has become even more critical. However, the media silence has only increased her desire to be an advocate for change and to become a pharmacist.

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Many employees that work for large companies may or may not be aware that their health insurance is provided by their employer on a self-insured basis, this is referred to as a ERISA prgm. It is claimed that about 50% of large employers are self-insured.  The employee is presented with a “health insurance card” and or a “Prescription drug card”  What the employee may or may not understand is that the well recognized name on their health insurance card is NOT AN INSURANCE but acting as an administrator for the employee to pay the medical expenses that is incurred by the employees and their families.  The “insurance company” has no real financial liability… they could be working on an administrative fee of so many $$$/employee/family and/or some percent of what is paid out as a administrative fee.

The insurance company will generally win the business from the employer with some “dog and pony show” … promising to help the employer lower overall health expenditures for the company. What the employer may not realize that saving money will mean coercing employees to use their mail order pharmacy, step therapy where the pt has to fail on the least costly med before they can “try” the next high cost med and sometimes any improvement is where the next step in the therapy is allowed to be tried… any improvement in QOL … is sufficient.

Also,what many employees don’t understand that there is someone within the company that has the authority to call the insurance/PBM company and tell them to pay for any med or procedure, because it is the employer’s money that is being spent.

Hypothetical,  an employee’s spouse is a chronic pain pt.  The insurance/PBM approached the employer to implement a opiate dosage reduction program… help prevent addiction among employees and/or family members.  So the insurance/PBM implements the CDC opiate dosing guidelines and puts a max MME/day at 90 MME’s. One or more of the employees or their spouses are fast/ultra fast metabolizers and dealing with CRPS… meaning that they are going to need high single doses and very frequent dosing per 24 hrs to help maintain their QOL.  These pts have been stable on very high doses for several years or a couple of decades… and their dose is slowly – or very quickly – reduced  and the pt starts becoming chair/bed/house confined..

Using the chart belong the employee goes to the person that oversees ERISA program.  Need to point out to this insurance/pbm point person… the number of very possible compromising the existing comorbidity issues and/or creates new comorbidity issues… One example is that under/untreated pain… will cause the pt’s system to keep pumping out adrenaline … which will mean that the pt’s adrenal glands will eventually fail and the pt will end up with Addison’s disease.

Here is a post on how liver damage can be for a pt who is taking Tylenol/Acetaminophen  https://www.pharmaciststeve.com/liver-injury-from-acetaminophen-at-low-doses-linked-to-fasting-heavy-drinking/   I can hear the first comment … my spouse doesn’t drink… great… but what happens when the pt goes into a flair and ends up in bed or on the living room couch for a few days..  DOESN’T EAT MUCH – like FASTING ?… they continue to take their Tylenol/Acetaminophen and ends up with liver damage.

Point out to the insurance/pbm contact person… things like their spouse could end up hypertension, resulting in eye and/or kidney damage. Could suffer a hypertensive crisis and end up with a paralyzing stroke and/or death…

The pt being forced to take NSAID and/or Tylenol/Acetaminophen… 15,000 people die every year from gastro bleeds from use/abuse of NSAID

The pt could end up with increased anxiety and/or depression

All of these issues – except death – is going to cost the employer money… paying for increase medical/hospital expenses because the insurance/PBM got the employer to let them introduce a opiate reduction program to help to keep employees and their family members from becoming addicted to opiates.

The number of possible complicated health issues for the chronic pain pt that has their opiate therapy reduced/eliminated.

Give the insurance/pbm contact person this chart and let them assign a $$$ figure to each of the possible health complications for their spouse and/or how many other spouses of employees could be impact in a equal or similar manner…  I suspect that the potential costs to the employer is MUCH … MUCH greater that the cost of paying for rehab for anyone who might become addicted and seeks treatment.

There is very seldom a situation when a MIDDLEMAN comes into a process that can cut overall costs of a program. Middlemen have a cost overhead and a desire to show a profit. It is more likely that middlemen will increase overall costs of a process.

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https://www.drugs.com/interactions-check.php?drug_list=2758-0,531-0

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Per the Civil rights law, racism is a civil rights violation… as is discrimination under the Americans with Disability Act. It becomes more and more obvious that the FEDS/DOJ are the driving force behind discrimination – or even favoritism – of certain segments of the populations.  Right now Gov Abbott has stated that he is going to arrest/jail illegal aliens coming into Texas – for trespassing on private property of numerous family farms that are on the Texas/Mexican border.

It has been reported that some 10%-20% of these illegal aliens test COVID-19 positive and abt 30% refuse a COVID-19 vaccination when offered. The Federal DOJ Attorney General Garland it has been reported that he is going to sue Gov Abbott if he starts arresting/jailing illegal aliens.

Reportedly, abt ONE MILLION + illegal aliens have been allowed into our country in the last SIX MONTHS.  While legal citizen have been encouraged to get COVID-19 vaccination and seemingly many businesses, academia and federal employees are in the process being mandated to get vaccination … if they wish to keep their job. Discrimination/Racism now seems to be a TWO WAY STREET.  What happened to all the EQUITY that has been a major battle cry since the beginning of the year?

Racism as a Chronic Disease: We Are All Affected

https://www.clinicaladvisor.com/home/the-waiting-room/racism-chronic-disease-we-are-all-affected/

Recent literature has increased the focus on health disparities related to racism, not race, as a major cause of illness.

Since the inception of Western medicine, however, there has been an effort to identify genes specific to certain races that would explain why minority populations, including Black, Indigenous, and people of color (BIPOC), have a higher disease burden than White populations.

I attended PA school from 1998 to 2000, and even then our lectures frequently discussed how certain populations are more likely to have certain diseases, including heart disease, diabetes, and hypertension. We know that it is true, but we also know that race is a non-scientific construct, widely based on racist beliefs. I recall a Black classmate who would mumble to those of us around him during lectures, “oh great, here’s something else that is wrong with me.” His comments were certainly reflective of the false and unscientific beliefs that race is a cause of illness.

The issue of how to view the impact of institutional and individual racism on the health of BIPOC has gained increased attention, including exploring new and novel ways to think about racism and health. A Baylor College of Medicine blog post from 2020 illustrates some new and creative thinking on this topic. Blogger Haley Jackson Manley, research assistant in the Center for Medical Ethics and Health Policy at Baylor College of Medicine, shared her insightful take in that post:

“It’s more than just semantics that irks me when people talk about racism as a pandemic. A pandemic implies an outbreak. A disease that is fleeting and may be new or has seasons, such as the flu. Racism is not that. Racism is not new. It’s unceasing with no treatment or vaccine in sight. A more appropriate diagnosis would be racism as a chronic disease, like cancer or diabetes. But this particular chronic disease does not destruct the body of the individual who is infected. Instead, in America, its effects are felt throughout the entire African American community and are not only physical but also emotional and social.”

This really got me thinking about the concept of racism as a chronic disease that affects the physical and mental health of BIPOC. But it also posed questions about how to view this perspective. For example, if we accept that racism is a chronic illness, it leads me to wonder who then has the illness. We know that BIPOC are most affected by racism. But are such populations the ones with the disease or is it those who have racially biased beliefs and actions?

Just because BIPOC bear the brunt of demonstrated negative health impacts from racism, does that really equal having the illness? For example, if an authoritarian parent berates and abuses their child, and causes the child harm, who has the disease in that case? It hardly seems reasonable to describe the harmed child as the diseased party. Instead, it’s the parent with the illness.

But racism can be more subtle. Certainly, explicit racist behavior would lead us to conclude that the source of the behavior is the root cause of the illness. But what about when implicit and unconscious bias and racism is the root of the problem? Research repeatedly demonstrates that implicit and unconscious biases are pervasive among all humans. It also tells us that it predictably affects the health of minority populations. So, does that mean that all humans who hold implicit biases should be viewed as having a disease? Or is implicit bias itself a disease?

I’m inclined to think that it is, depending on how we define disease. Part of being a human being is dealing with our own inevitable disease states, ranging from rhinitis to cancer, from COVID-19 to depression. A reasonable assertion would be that our implicit and explicit biases may need to be viewed as a disease state because of the known negative health impacts they have on others. 

Finally, what about society itself? Can a society with various cultures have a disease? It makes sense to me that societies can indeed be ill, with the illness caused by collective biases, hatred, ignorance, and racism. In the end, we know that the primary sufferers of racism are BIPOC. But asserting that they are the ones with the disease feels like a blaming-the-victim exercise, something that medicine knows much about. What really matters, however, is the chronic occurrence of ignorance, hatred, explicit and implicit bias, and historic prejudice within the medical community that dates back to its origins. This has resulted in premature death and unequal burden of illness and misery on BIPOC. Our job as PAs, nurse practitioners, and other health care providers is to understand how racism impacts us and our patients and establish ways to mitigate this impact. The job of medicine is to address how explicit, or even implicit biases, have made those of us with racial biases sick as well.

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https://youtu.be/pj1IpD7_aT8?t=586

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Congresswoman Kat Cammack website

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I just got a text from Paula and Joe suddenly passed away last night… Those Pharmacist that know Joe will remember him for “taking on” CVS Health over ADA, EEOC and Whistle blower lawsuit… and walked away a WINNER, that was abt 5 yrs ago.

I think that Joe was 69 y/o and regardless of him dealing with MS… was able to work as a Pharmacist for some 40 yrs.

Joe was one of those “good old time Pharmacists” that always tried to meet the pt’s needs.

RIP Gravestone

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Pfizer Vaccine Protection Wanes After 6 Months

https://www.medscape.com/viewarticle/955601

Pfizer’s COVID-19 vaccine continues to show strong protection against serious illness and hospitalization after 6 months, but overall protection against the virus appears to wane after a half a year, according to a new study.

The July 28 preprint report of the study, which has not been peer reviewed, suggests a gradual “declining trend in vaccine efficacy” over 6 months after a two-dose regimen of the Pfizer vaccine. The study included more than 45,000 people worldwide.

The study found that overall effectiveness fell from 96% to 84%.

A third booster dose of the Pfizer vaccine increases neutralizing antibody levels against the Delta variant by more than five times compared to levels after a second dose in people aged 18 to 55 years, new data from Pfizer show.

The immune response to the third dose appears even more robust ― more than 11 times higher than the response to second shot ― among people aged 65 to 85 years.

The company noted this could mean an estimated 100-fold increase in Delta variant protection after a third dose. These new findings are outlined in a Pfizer second quarter 2021 earnings report, which notes that the data are submitted for publication in a medical journal.

The data come from a relatively small number of people studied. There were 11 individuals in the 18- to 55-year-old group and 12 people in the 65- to 85-year-old cohort.

“These preliminary data are very encouraging as Delta continues to spread,” Mikael Dolsten, MD, chief scientific officer and president of the worldwide research, development and medical organization at Pfizer, said during prepared remarks on a company earnings call today, CNN reported.

Availability of a third dose of any of the current COVID-19 vaccines would require either amending the US Food and Drug Administration (FDA) emergency use authorization or granting full FDA approval status to the vaccine.

The possibility of a third-dose authorization or approval has not been without controversy. When Pfizer announced intentions to file for FDA authorization of a booster dose on July 8, the Centers for Disease Control and Prevention, the FDA, and the National Institutes of Health were quick to issue a joint statement saying that they would decide when the timing is right for Americans to have a third immunization. The agencies stated, in part, “We are prepared for booster doses if and when the science demonstrates that they are needed.”

In addition, the World Health Organization said at a media briefing on July 12 that rich countries should prioritize the sharing of COVID-19 vaccine supplies to other countries in need worldwide before allocating doses for a booster shot of its own residents.

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