the spyware just following “controlled substances” recording every pill you take the rest of your life has failed to reduce the overdose deaths and now being used to deny patients their pain modulating medications for having a phony “overdose risk”. Heroin addicts die from mulit-drug overdose only one per 500,000 die from overdose taking prescription drugs and those maybe statistical error. With virtually no one overdosing on prescription opioid pain medicine why are states paying for something that is no needed.
95% of overdoses are, sadly, in people with receptor addiction disease (heroin addiction) from not having access to medical care, ‘The mass hysteria is costing taxpapers a lot of money for things that already have been shown not to decrease OD deaths and possibly increasing them.

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Tracking every signal pain pain in the US is now being used to deny patients medicines based on an artificial “overdose dose risk score” normed on Heroin addicts using secret algorithms – not appropriate for the regular painful disease patient but interfering with the doctor patient relationships just the same. This is wrong and probably illegal. The word witch hunt is no longer a metaphor . Its getting worse and worse but we will do something about it

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Hi 

I’m from Arkansas. I came to visit my daughter & grandchildren October 28th not realizing I had a broken hip (right) I had fallen the day before I left for Florida & went to the ER X- Rays showed no break so i came to Florida. On November 14th I bent over & felt a pop in my (R) hip & down I went, luckily half on a bed. Went to ER (memorial in hollywood, Fl.) X- Ray showed no break, CT showed an irregularity which prompted an MRI after staying in the short term stay the results from that is a “non displaced superior fracture of the pelvic ramus with extensive marrow adema” can’t have surgery due to location of fracture. 

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VA study uncovers critical link between pain intensity and suicide attempts

https://www.blogs.va.gov/VAntage/67708/va-study-uncovers-link-pain-intensity-suicide-attempts/

Many factors are associated with suicide risk. These factors range from PTSD, depression and anxiety disorder to financial and interpersonal concerns to access to opioids and other lethal means, like firearms. Even when we take these risk factors into consideration, moderate to severe pain intensity is associated with suicide risk.

Veterans are a particularly vulnerable group. The suicide rate among Veterans is 1.5 times that of the general population. Also, Veterans develop chronic pain conditions at higher rates and report greater pain severity than members of the general population.

VA’s Behavioral Health Autopsy Program: Executive Summary reports pain is the most common factor Veterans experience before they die by suicide. The VISN 2 Center of Excellence (CoE) for Suicide Prevention studied the link between reported pain intensity and suicide attempts. The results may uncover how effective pain treatment can be a critical suicide prevention tactic.

Managing pain in daily life

Veterans have several treatment options through VA to cope with pain and reduce pain intensity. Nonmedication interventions are considered first-line treatments. They include physical therapy, cognitive behavioral therapy for chronic pain and chiropractic care. Medication-based treatments include nonsteroidal anti-inflammatory medications and injections. Examples are cortisone for low back pain and botulinum toxin for migraines. Opioids may be used under close monitoring when they are taken appropriately and the benefits outweigh the risks.

Strategies

Strategies that improve psychological well-being can also help Veterans cope with pain in everyday life. Veterans can discuss the following tactics with care providers to see which may work best:

• Be honest about the pain you’re experiencing. An important step in managing chronic pain is accepting that it is part of your life. Accepting the presence of pain can help you move on and engage in enjoyable and everyday activities despite that pain.
• Pace your activities. Although you may not be able to do everything you did before the pain began, try to find ways to reintroduce some activities in a moderated way and create more balance in the activities you’re doing. For example, if you plan to go for a long walk in the morning, consider taking a break mid-day to give your body time to recover and to prevent a pain flare-up. Even if you start to feel better over time, avoid overdoing it to avoid a relapse or further injury.
• Explore mindfulness. Increasing awareness of the present moment can help relieve emotional and mental tension that can intensify physical pain. Meditation and other mindfulness practices help you become more comfortable in feeling the way you feel without judgement, helping to prevent pain from taking over your thoughts and acting on autopilot.

To learn more about pain management treatment provided by VA, explore VA’s pain management webpage for Veterans.

Study findings

A CoE study looked at Veterans’ average pain intensity scores in the year after they began receiving pain specialty services to determine whether pain intensity was associated with suicide attempts. Based on data from 2012–2014, moderate and severe pain over the course of a year increased the risk of a suicide attempt, even after considering other factors like a Veteran’s history of suicide attempts.

As the graph to the right shows, those with higher pain intensity had lower survival rates than those who had mild pain or no pain at all. This close correlation between pain intensity and suicide risk and death rates suggests that reducing pain, or the perception of that pain, can help prevent Veteran suicide.

Advice for Veterans’ family members and friends

Family members and friends are often the first to realize that a Veteran may be at risk for suicide. Warning signs include changes in mood or behaviors, outward comments about suicidal thoughts or increased interest in lethal means, such as firearms and opioids. If you see these signs in a Veteran in your life:

• Start the conversation. Topics of pain and suicide can be challenging to talk about. Still, don’t be afraid to begin the conversation with the Veteran you’re concerned about. Starting the conversation can help the Veteran realize the need to address pain. It also reassures the Veteran that you’re willing to help.
• #BeThere for the Veteran and engage in healthy activities. Invite your friend or loved one to a movie or dinner or for a walk around the neighborhood. Getting a Veteran out of the house can remind them of activities they can enjoy, despite their pain. Research suggests changing a Veteran’s mindset and engaging them in activities can improve overall wellness.

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For numerous years the DEA has “forced/persuaded” the pharmacy wholesalers to RATION controlled substances that a community pharmacy can purchase.  That rationing is based on a PERCENT of all the Rx meds that a particular pharmacy purchases… I have seen rates of 15%-20% being thrown out as the limit of controls that a pharmacy can purchase.

Several of the statements/press releases that has been put out by Amazon over the past 1-2 weeks… have had some vague statements as to what they are intending to do.  One of their statements was to push the issue that they believe that they can sell pts medications for less than their insurance copay.

They also said that they would inventory “common prescribed medications”… since controlled substances are typically 15%-20% of all prescriptions – will they be considered “commonly prescribed medications ” Just think of all the potential headaches of dealing with the DEA that they would avoid if they don’t dispense controlled meds ?

Just like pain clinics wants to only do ESI’s on pts so that they are not dealing with controlled substances.

If people start having their non-controlled meds filled at the Amazon mail order pharmacy, that means that the local community pharmacist will be purchasing fewer non-controlled Rx meds and most likely the DEA will reduce their ability to purchase the amount of controlled substances as they have in the past.

Could this produce a larger “out of stock” issue by local pharmacies for controlled substances and/or if the local pharmacies are even able to retain enough overall Rx business to remain profitable enough to remain in business.

The vast majority of controlled substances are prescribed to pts who are dealing with subjective diseases (Pain, Anxiety, Depression, Mental Health & ADD/ADHD). The total number of pts that could be affected could be a HUGE NUMBER.

As fewer and fewer controlled meds being distributed by pharma wholesalers, will this just encourage the DEA to cut pharma production quotas on controlled meds even that much more ?

Could this end up causing a whole lot of collateral damage to those pts with a valid medical need for controlled substances that NO ONE WILL CARE ABOUT ?

UPDATE

We do not deliver Schedule II controlled medications, which includes most opioids. Learn more at amazon.com/pharmacy.

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Hello Steven

I was very impressed with the article that I just read .  I am having that problem with a Walgreens store located in Indialantic Florida 32903 Highway A1A and Paradise Boulevard. I have been using that Walgreens store where I have been filling my chronic pain medicine hydromorphone (4 mg) for the past 4 months and before that I was with them for years  The pharmacist would not fill my prescription based on the fact that it was increased from 4 mg to 8 mg 3 times a day 90 tablets.  I had to wait 4 days until I found another Pharmacy to fill my prescription and therefore was without my pain medication.  The reason other pharmacies did not want to fill it is because on record I am a patient using Walgreens pharmacy. and I should not be using different pharmacies.   I just went to the doctor and have the same prescription that’s why I  hope you might be able to help me. It is due to be filled on the 27th of this month.

  Here is my response to this pt:

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I have always had a concern about mail order pharmacies.. first of all… all medications have temp storage requirement typically in the mid-50’s to mid-70’s. These storage requirements have to be met by the pharma, wholesaler & the pharmacy.  But, when a pharmacy hands off a packaging of Rx meds to a delivery service… NO ONE has a obligation to maintain those storage requirement.   Normally, if a pharma, wholesaler, pharmacy allows Rx meds to be outside of the required temp range for > 24 hrs the product is consider adulterated and NO LONGER SALEABLE.

From this article and others that I have read, Amazon appears to be “pushing ” paying cash for Rxs.  If this Amazon pharmacy has a contract with your health insurance and you pay cash… it won’t applied to your deductible and highly possible if you submit your cash receipts to your insurance company they will not reimburse you and apply to your deductible because Amazon pharmacy has a contract to bill the insurance for the pt.

Encouraging pts to PAY CASH the Amazon pharmacy will not have to deal with the BS from insurance companies in getting a Rx claim thru the system and with a charge card .. Amazon will get their money in – at most – a couple of days instead of having to wait 2-3 weeks for the insurance company to pay and then reconcile their payment against what was billed and won’t get docked with those unpredictable DIR fees.

If this Amazon pharmacy functions like most mail order pharmacies, filled Rxs may not reach the pt for up to TWO WEEKS and what does their statement mean that they “will offer commonly prescribed medications“… Does that mean NO CONTROLLED MEDS ?  The DEA states that it is RED FLAG for a pt to pay cash for a controlled substance if they have insurance.

Amazon opens online pharmacy, shaking up another industry

https://www.foxbusiness.com/retail/amazon-opens-online-pharmacy-shaking-up-another-industry

The company opened an online pharmacy Tuesday, giving Amazon shoppers the chance to buy their medication and order refills on their phones and have it delivered to their doorsteps in a couple of days, just like a book or toilet paper.

The move propels Amazon into a new business, potentially shaking up the pharmacy industry as it has done to everything from book sellers to toy stores and grocers. Big chains like CVS and Walgreens rely on their pharmacies to bring them a steady flow of shoppers who stop by frequently to pick up their medications.

Amazon said it will offer commonly prescribed medications starting Tuesday, including creams, pills, as well as medications that need to stay cold, like insulin.

Shoppers have to set up a profile on Amazon’s website and have doctors send prescriptions to the Seattle-based e-commerce giant.
ONLINE SHOPPING SURGE COULD LEAD TO HOLIDAY DELIVERY DELAYSMost insurance is accepted, Amazon said. But Prime members who don’t have insurance can also buy generic or brand name drugs from Amazon for a discount.Amazon has eyed the health care industry for some time. Two years ago, it spent $750 million to buy online pharmacy PillPack, which organizes medication in packets by what time and day they need to be taken. Amazon said that PillPack will continue, focusing on shipping medication to people with chronic conditions.

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And something that not many doctors are talking about lately is one of those that apparently is a symptom caused by some vaccines. And it is that although within the study impotence is not taken into account as a determining factor within vaccines, the trend seems to indicate the opposite. That is why at UK Meds they take this problem very seriously and try to deal with it by offering the most effective product against this problem, being one of the best sellers in the United Kingdom.

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