Relax: Nothing is under control

Posted on November 2, 2024 by Pharmaciststeve

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Lauren Conrad Quote: “Sometimes, you just have to take a step back and ...

I have been writing/sharing on my blog for 13-14 yrs. I have seen many people who would come into the community the with attitude that they can “get ‘er done”.  They stay/hang around for a few months, maybe even a few years, and then they realize that the task is something that they can’t tackle, and they are GONE!

I have seen a lot of in-fighting within the multitude of “support groups’, even seen some support groups disband and then some of the fragments of those groups create another group or two and the cycle keep repeating.

I complained to Barb once many months ago, about all the infighting,  I married a very wise woman… she told me that I would never understand… because I never a girl/female in Jr/Sr High School.

Reading what those two attorney posted on the web over the last few weeks, it is posted below. I don’t think that the community will ever fine enough money to hire an attorney/law firm that has enough balls to address the problems with practitioners being able to  treat chronic pain and other subjective diseases, with the appropriate controlled medications.

Barb just had an appt with our PCP, who we have been seeing since last 1969 – early 1970. He is like a “Dr Marcus Welby” – if you don’t know the reference – do a web search. He is pulling back on his office hrs. He lost a adult kid to COVID-19 during the epidemic and he recently had some health issues where he was out of the office for a few weeks.

Years ago, he told the that  -God willing- he was going to be practice till he was 75 y/o.  But now he is about 70 y/o. I have an appt with him the first week of Feb, 2025. I will find out what his plans are.

We may be looking for a new PCP soon, but I know a number of the local prescribers and being a decent advocate, I think that we can hopefully transition over  to a new practitioner without missing a beat. Only time will tell.

IMO, the community has fragmented itself into many pieces or “tribes”, each with at least one Face Book page. Last week, I was not feeling very well one day and I just turned my phone off and shut my computer down.  The next morning, I found over 100 emails and I can’t count the number of FB posts – many of them repeats of people re-posting them in hopes that someone would read them. Then there was all the texts.

I have made nearly 11,000 posts on my blog over the years and it is approaching THREE MILLION PAGE VIEWS. I am approaching the end of my EIGHTH DECADE ON THIS PLANT.

Barb and I tend on aging in place, but I have not been able to find a “handyman” to do much of the maintenance around the house. I have the experience and the tools to do most all of the work, but my energy and endurance isn’t what it use to be.

Within the next few weeks, I will be pulling back from reading any of the Face Book pages and responding on those pages. I am still going to be around, and I can be reached via the links listed below. Chronic pain pts are still going to continue to get their pain meds taken away and they are still going to have to take a stand to get some of them back.

The path that the community may be on, may take longer than the number of years that I have left to try to change directions.  It looks like I may have other personal battles that I may have to deal with, and family comes first.

 

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“Red Flag” Prosecutions against physicians continue. In United States v. Campbell, the Government used its unenumerated list of “red flags” to support a smoke-fire prosecution absent actual evidence. Tune into my 6th Circuit Oral Argument this Wednesday.

Could this be why no one can get a law firm to sue medical care deniers

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November is Diabetes Awareness Month

Posted on November 1, 2024 by Pharmaciststeve

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Finally, Someone is Listening to People in Pain!

Posted on October 31, 2024 by Pharmaciststeve

I have read about rumors that Pres Nixon in passing and signing the CSA bill into law, had Congress put in some “special language” in the bill that would make the law more difficult to repeal or change. Back in 1969-1970, it was believed that addiction was a choice and not a medical/healthcare issue. So the logic was that since addiction was a choice, Congress labeled it as a legal matter, so Congress gave the enforcement of breaking this law to DOJ… so the only “tool” that DOJ had in their “toolbox” was jail or prison. The DOJ stopped reporting how much they were spending in fighting the war on drugs as the total cost approached 100 billion/yr. The last estimate that I have seen in the cost of fighting the war on drugs is in the 120-140 billion/yr. Since the primary function of a bureaucrat is to perpetuate and grow the bureaucracy that work for. I have seen reports that when Congress created the DEA in 1973 with 43 million/yr & 1200 employees. That means in 50 yrs, the DEA budget has only been increased 3,333 times from where they started.  Since over the last decade, the number of people being poisoned/OD’d for illegal opioids is up 6-7 times.  Which would suggest that the DEA has been a complete failure at the charge they have been given.

Finally, Someone is Listening to People in Pain!

https://www.acsh.org/news/2024/07/30/finally-someone-listening-people-pain-48900

With “The Real Opioid Crisis in Three Charts,” a patient advocacy group has briefed senior FDA officials on major changes needed in public health policy for the regulation of prescription opioid pain relievers, and doctors who prescribe them. Perhaps now someone is truly listening to people in pain.

@Is someone finally listening?

As an unpaid healthcare writer and patient advocate, I’ve written for 27 years on opioid prescribing, pain management, and patient advocacy.  Several of my shorter articles appear on Pain News Network or here on the American Council on Science and Health.   Until recently, my work and that of many others had been met with official governmental silence (aka “stonewalling” by government authorities).  

The silence might be about to change.  

On July 23, 2024, I joined six other members of the Speakers Bureau of the National Campaign to Protect People in Pain, to offer a one-hour “listening session” to senior officials of the US FDA Center for Drug Evaluation and Research (CDER). A 25-page summary of the proceedings has been posted to social media platforms and shared with the US FDA Office of Communications, Professional Affairs and Stakeholder Engagement (PASE).  Under the session rules, what follows below does not represent a commitment on the part of FDA, either to validate our stated findings or to take action thereon.

The one-hour FDA presentation was titled “The Real Opioid Crisis in Three Charts”. Our key points included these:

  • If the FDA audience carries away nothing else from this session, they should remember this:  There is no such thing as opioid use disorder. The term originated in 2013 with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – a document rejected by the National Institute for Mental Health as a framework for organizing research.   Data published by the CDC itself completely discredits the notion that doctors prescribing to their patients are or ever were responsible for the US opioid crisis.  And both CDC and DEA have known this reality for years.
  • US CDC and US DEA are usurping missions delegated to the FDA by law, in the establishment of safety standards for prescription drugs. The consequence of this usurpation is the ongoing destruction of American pain medicine.
  • CDC prescribing guidelines can be shown to incorporate outright fraud including failure to address genetically mediated opioid metabolism, misrepresentation of the effectiveness of non-opioid alternative therapies, one-size-fits all MMED dose criteria unsupported by science, and misrepresentation of opioid therapy, especially high-dose opioid therapy, as ineffective for long-term use.
  • DEA prosecutions are grounded on non-representative “expert witnesses” who testify to anything DEA wants, no matter how false.  Likewise, Administrative Law  Judges deny defendants adequate representation by pre-trial asset confiscations and by rulings biased in favor of the DEA.
  • It is now known beyond contradiction that incidence of addiction and overdose in pain patients treated by a doctor is too small to measure accurately within confounds of diagnosis and poor clinician training. Law enforcement is particularly ill-equipped to comment on this issue.  It is also known to CDC and DEA that doctors overprescribing to patients was never a significant cause of the US opioid crisis — and is not now.
  • Our speakers appealed to FDA to take public action to repudiate and demand the withdrawal of horrendously damaging injunctive relief provisions imposed by the National Opioid Settlement.  We also encouraged the Agency to take immediate action to correct its own databases concerning shortages of prescription opioids created by the US National Opioid Settlement injunction.
  • We asked FDA to publicly repudiate and demand withdrawal of CDC/VA/DoD opioid prescribing guidelines, without replacement.  In a spirit of transparency, we also disclosed that stakeholder participants in the session are co-complainants in formal complaint actions filed May 21, 2024 with the US Department of Justice Office of Civil Rights and the Office of the Inspector General of DHHS. We allege criminal fraud and denial of US citizens’ civil rights on the part of CDC authors and approving officials for the 2016 and 2022 published opioid prescribing guidelines. 

Findings briefed in the FDA Listening Session are being disseminated widely to US government Agencies including the National Institutes of Health, National Institute on Drug Abuse, National Centers for Injury Prevention and Control, and the Offices of the Surgeon General and the Inspector General in the Department of Health and Human Services.  Online meetings are being requested with the Federation of State Medical Boards and all State Medical Boards, Boards of Pharmacy and Departments of Health. 

It is time for the war on chronic pain patients, doctors and pharmacists to end.  This Listening Session may be a first step in finally getting government authorities to hear our urgent pleas.

Richard A. Lawhern PhD is a volunteer subject matter expert on public health policy for regulation of prescription opioid analgesics and clinicians who employ them. Over 27 years, he has authored or co-authored over 250 papers, articles, and interviews in a mixture of peer-reviewed medical journals and mass media. He is also a member of the Scientific Advisory Board of ACSH,

The National Campaign to Protect People in Pain is an informal alliance of hundreds of experienced pain management clinicians, patients, family caregivers and advocates.  The National Campaign is lobbying for major changes in public health policy governing the practice of pain medicine in America.     

 

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Chronic painers’ votes matter

Posted on October 30, 2024 by Pharmaciststeve

 

In the 2020 Presidential election there was a total of 159 million votes for the two candidates for USA President. There is claimed that there is somewhere north of 100,000 people are dealing with chronic pain.

That number strongly suggests that regardless of what candidate one is talking about. If the chronic pain community got behind to dethrone an incumbent or elect a first time candidate for a city/county/state/federal office.  If the community got united behind a particular candidate, that person would be elected or dethroned.

Joe Biden 4 yrs ago

 

Joe Biden yesterday

Over the last FOUR YEARS the CDC has stated that the number of our citizens that have been poisoned/OD on illegal Fentanyl from China and Mexican cartels is in the 400,000 neighborhood. The USA has only 47 cities with a population of > 400,000 people.

Apparently it is recognized that the CDC opioid dosing guidelines have had a significant impact on the chronic pain community, but little/no real interest in any attempt in tracking the number of citizens that have died as a result of those CDC guidelines.

https://www.perplexity.ai

how many chronic pain pts have died from having their pain medication reduced or stopped entirely over the last 4 yrs because of actions of the DEA

While there is no precise data on the number of chronic pain patients who have died specifically due to medication reductions or discontinuations over the last 4 years, this issue has been recognized as a serious concern:

## Impact of Opioid Prescription Changes

The CDC and FDA have acknowledged that abrupt or rapid discontinuation of opioid pain medications can lead to serious consequences for chronic pain patients, including:

– Severe withdrawal symptoms
– Uncontrolled pain
– Psychological distress
– Increased risk of suicide

In 2019, the FDA reported receiving reports of serious harm, including suicide, in patients who had their opioid medications suddenly discontinued or rapidly decreased[1].

## Unintended Consequences

The 2016 CDC guidelines on opioid prescribing, while intended to address the opioid crisis, had some unintended negative effects:

– Many doctors became hesitant to prescribe opioids, even to long-term pain patients
– Some patients had difficulty getting prescriptions filled at pharmacies
– Rapid tapering or abrupt discontinuation of opioids became more common

These changes left many chronic pain patients struggling to manage their conditions[2].

## Lack of Comprehensive Data

Unfortunately, there is no centralized tracking system that captures deaths specifically related to opioid discontinuation in pain patients. The full scope of this issue remains unclear due to:

– Difficulty determining cause of death in complex cases
– Lack of standardized reporting on medication changes prior to death
– Potential misclassification of deaths (e.g. as drug overdoses)

While exact numbers are unavailable, individual cases have been reported. For example, a man named Danny Elliott died by suicide in 2022 after being unable to find a doctor to continue his long-term pain medication[2].

## Recent Guideline Updates

In 2022, the CDC released updated opioid prescribing guidelines that aim to provide more nuanced guidance and reduce harm to pain patients. The new recommendations:

– Emphasize individualized patient care
– Warn about risks of rapid dose changes
– Acknowledge that some patients may benefit from long-term opioid therapy

However, experts note it may take time for these updates to significantly impact clinical practice and policies[2].

While the full human cost remains unknown, it’s clear that opioid prescribing changes have had profound effects on many chronic pain patients. Balancing pain management with opioid risk reduction continues to be a complex challenge for the medical community.

Citations:
[1] https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
[2] https://www.cnn.com/2023/03/17/health/opioid-chronic-pain-cdc-guidelines-khn-partner/index.html
[3] https://www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf
[4] https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
[5] https://www.ama-assn.org/press-center/press-releases/report-shows-decreases-opioid-prescribing-increase-overdoses
[6] https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
[7] https://www.ncbi.nlm.nih.gov/books/NBK537318/
[8] https://www.psychiatry.org/patients-families/opioid-use-disorder

 

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Pain Refugees: Collateral Damage of the War on Drugs

Posted on October 29, 2024 by Pharmaciststeve

Pain Refugees: Collateral Damage of the War on Drugs

https://www.cato.org/events/pain-refugees-collateral-damage-war-drugs

For much of the 21st century, public health officials and policymakers have blamed doctors for overprescribing opioids and causing the overdose crisis. In response, the Centers for Disease Control and Prevention issued pain management guidelines aimed at reducing opioid prescriptions. Most states have codified them into law.

Federal and local drug task forces have arrested doctors whom they accuse of overprescribing opioids. This has led to a situation where many physicians either undertreat pain or choose to abandon their long-term pain patients. As a result, opioid prescribing has dropped below 1992 levels, while overdose deaths among nonmedical users have skyrocketed.

This crackdown has also created a population of “pain refugees”—chronic pain patients who have lost or were abandoned by their doctor and are left searching for a doctor willing to treat them. Many, out of desperation, turn to the black market for relief, while others resort to suicide.

Join us to discuss the pain refugee crisis, its causes, and potential solutions. Our panel includes a physician who treats and advocates for pain patients, an attorney who defends these doctors, a civil rights attorney who is also a patient advocate, and a pain refugee.

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what they give with one promise – they take away without mentioning it

Posted on October 28, 2024 by Pharmaciststeve

Medicare enrollment for 2025 now open

Next year, Medicare folks are going to get a break when they pay $2,000 out of pocket for medications and get ZERO COPAY after than point.

Have you ever squeezed a balloon? What happens, one part gets smaller and the other part gets LARGER?

I went out to www.medicare,gov website to see what was being offered.  I just looked at premiums and deductible.  That is the only thing that I can be comfortable that won’t change during 2025.

Come to find out, in 2024 our 12 monthly premiums and annual deductible was LESS than our DEDUCTIBLE WILL BE IN 2025

In 2025, our 12 monthly premiums and annual deductible will be 134% HIGHER. In 2025, together we will be paying > $1,000 more for  12 monthly premiums and annual deductible. Than we had to pay in 2024. Before we get the first $ in benefits.

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file a Constitutional Challenge to the 2016 Comprehensive Addiction and Recovery Act (CARA)

Posted on October 27, 2024 by Pharmaciststeve
 
 
An attorney IS NEEDED who would file a Constitutional Challenge to the 2016 Comprehensive Addiction and Recovery Act (CARA) which did the same thing the DEA is doing to data mine to prosecute doctors.   
 
They are using “Summary Statistics” and the Bell Curve, and gave Medicare and the private corporations administering Medicare benefits the right to restrict access to opioids for all the “beneficiaries.” 
 
All people taking opioids are now deemed “at-risk” for overdose and/or diversion, without any evidence, and, Medicare and the corporations administering Medicare benefits are using Summary Statistics and the Bell Curve to monitor patients whose doses fall outside the “normal use,” without any definition of what “normal use” is, other than asserting the Bell Curve and DEA Dose Caps.  
 
You cannot put human beings taking opioids into a Bell Curve like that.  
 
Some metabolize differently than others, some have conditions that require doses in excess of what “another person” would need.   
 
It seems to me that a Constitutional Challenge needs to be filed, because this violates the 14th Amendment.   
 
This provision of the CARA Act takes away “life, liberty, and the pursuit of happiness,” particularly LIFE, and this provision has 
ACTUALLY KILLED AND IS STILL KILLING PEOPLE, due to medical complications and suicide after forced-tapers or sudden discontinuation of meds.
 
Everyone, please start contacting attorneys.   
 
Send them this, and direct them to page 48 of the CARA Act. 
 
THANK YOU!
David Smith … daveys35@gmail.com

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Tennant Foundation: PARTICIPANTS NEEDED FOR STUDY

Posted on October 27, 2024 by Pharmaciststeve

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Could this be why no one can get a law firm to sue medical care deniers

Posted on October 26, 2024 by Pharmaciststeve
I share this post from my blog on another website

Should Clinicians Be Liable for Patient Suicide After Failing to Prescribe Pain Medications?

Another person made the following comment on that blog post

Pain Psychologist and Attorney
They absolutely should, and the facts presented demonstrate a clear violation of the standard of care. Unfortunately, opiate hysteria and the ill advised MDL have spawned a number of so-called experts who will gladly line their pockets as they have in criminal cases against prescribers. Medical negligence cases, when tried, are battle of the experts. The “experts” who supported the opiate litigation and have an income stream from DEA enforcement actions will no doubt work to hopeless and confuse a jury.

Steve Ariens,P.D. 

Chronic Pain Management Consultant
I asked this person the following question:
putting your “attorney hat” on, why is no attorney interested in pursuing large healthcare corporations that instruct their employee prescribers to limit opioid therapy to the MME system – which has no double-blind clinical studies to support their conclusions and/or when pts’ opioid meds are cut and the pt’s blood pressure goes to hypertensive crisis level – because their elevated pain level – and they do nothing and/or put the pt on 4 different categories of BP meds and their BP doesn’t lower because their under/untreated pain apparently uses a different pathway to cause the elevated blood pressure, but the pt is still at risk for heart attacks, strokes, kidney and eye damage. The attached graphic shows all the health complications of under/untreated pain for a patient. Doesn’t this describe intentional malpractice and known harm to pts?

Pain Psychologist and Attorney  RESPONSE:

 the cynical answer, which I’m afraid is the truth, is that the world of class action/mass tort lawyers are heavily invested in the false narrative that they played a major role in advancing. All of this is part and parcel of the same problem. The entire narrative is built on demonizing prescription opiates. Doing the right thing and admitting that they were wrong and to try to rectify the situation like likely creates too much cognitive dissonance.
Now the community knows why they can’t get any attorney to go after a healthcare corporation or prescriber for denial of care and/or intentionally put some pts in a torturous level of pain!

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There is a old saying….

Posted on October 26, 2024 by Pharmaciststeve

Quote Origin: If You Are Not a Liberal at 25, You Have No Heart. If You Are Not a Conservative at 35 You Have No Brain

There is also a old saying, with age, comes wisdom. – or is it common sense and many figure out that friendship is more important than some political beliefs?

Typically, good friends will have your back, politicians will lie to your face!

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