PAINED LIVES REALLY DON’T MATTER ?

This is what happens to chronic pain pts when they can’t get anyone to prescribe/dispense opiates to control their pain. If this pt dies of a stroke or heart attack… will their death certificate say that they died of “natural causes” or due to lack of appropriate care ?

I can’t count the times that I have heard from chronic pain pts that are being forced to lower or eliminate their pain management meds and their blood pressure starts rising and their PCP will start loading them up with different blood pressure meds. – sometimes 4-5 different types of meds and still their blood pressure remains at a level that is above acceptable levels.

It is generally considered “bad medicine” to add medication to a pt’s treatment plan to treat side effects of one or more of their therapies is causing…

Shouldn’t the rising blood pressure as their pain medications are lessened/eliminated be considered a side effect ? Here is a list of all the normal bodily functions that can adversely effected by under/untreated pain.

MAYBE PAINED LIVES REALLY DON’T MATTER to many healthcare professionals and many within various bureaucracies ? This pt made a FB post that going to a ER or Immediate care center would probably not get the pt any sort of treatment.

The Rapp Report: Chronic Pain Awareness The Rapp Report: Chronic Pain Awareness

E08: Live Interview With Tennessee Senate Candidate, Kent Morrell 06/19/2020E08: Live Interview With Tennessee Senate Candidate, Kent Morrell

https://www.podbean.com/media/share/pb-dkhdk-e07d07

We interviewed candidate for United States Senate from the Great State of Tennessee, Kent Morrell, live on the air. 

Kent is running on the Republican ticket. Being a Republican myself, we examined what exactly it means to be a Republican and expressed our disapproval at the current state of our party. Kent hopes to restore true Republican values, values such as limited government and the return of individual liberty as a United States Senator. If you live in the Great State of Tennessee, home of such famous historical figures as David Crockett, and you believe in the ideals and principles of limited government and if you value individual liberty, vote for Kent Morrell. 

The opioid hysteria has allowed the Federal government to balloon at an astonishing rate into our medicare system. Now there is more government than ever before in American history keeping millions of Americans suffering from excruciating pain every day from the treatment they deserve. As Kent and I discussed live on the air, we are endowed by our Creator with unalienable rights, that among these rights are life, liberty, and the pursuit of happiness. And to protect these rights, governments are instituted among men. Kent will fight for liberty. Kent will fight to restore the rights of the people, not just chronic pain patients, but to all Americans, and push back against an out of control, over-inflated government. Washington DC isn’t just in Washington DC anymore. You can find the Federal government in almost every aspect of your life. (Even this podcast. The FCC regulates my airtime.) Help Kent take on the cause of liberty, the same noble cause taken up by the first Republican President, and our greatest President, Abraham Lincoln. 

Be sure and check out Kent’s website and DONATE to his great and noble campaign! https://www.kentmorrell2020.com/

 

CVS Health’s profits in ONE YEAR— 250 BILLION DOLLARS

This year (2020) we changed from Silver Scripts Part D – that is part of CVS Health along with the PBM Caremark…

Part D prgms have deductibles this year for the first time in years… so far year to day – even after paying a $435 deductible on our prescription meds our out of pocket cost with our new Humana Part D program is abt HALF…

Last week I picked up two Rxs for Barb and last year CVS charged us $41.00 copay for the two… this year Humana charged us $3.00 for the two.. in fact one of the two had a $0.00 Copay.

We still are patronizing the same independent pharmacy that we have been using for the last several years.

Naturopathic health іѕ оftеn neglected аѕ merely bеіng a раrt оf thе alternative medicine terminology. Mаnу people stray frоm alternative medicine bесаuѕе thеу fear thаt іt іѕ ѕоmеhоw nоt аѕ reputable аѕ conventional medicine. Wіth mаnу people discovering alternative medicine fоr thе fіrѕt tіmе, аnd tо great results, іt mау bе tіmе fоr a change іn thаt paradigm. Naturopathic medicine іѕ a medical philosophy thаt іѕ аlѕо known аѕ naturopathy. Essentially, thоѕе interested іn naturopathic health practices utilize thе improvement оf health thrоugh thе treatment оf thе bоdу аѕ a whоlе unit. Thіѕ approaches thе body’s оwn capacity tо heal itself аnd, thrоugh alternative medicine, creates a medical philosophy thаt wоuld mоvе thе bоdу tо act іn light оf difficulties. Thе bоdу wоuld mоvе tо act аnd fight a cold, fоr example, bесаuѕе оf naturopathic medicine. For the best naturopathic treatment from Neurvana Health Naturopathic Clinic, You can do visit.

In looking at the pharmacy receipts from last year… Silver Scripts only paid about 20% of the total cost of our prescriptions with the vast majority showing that Silver Scripts paid the pharmacy NOTHING… We where picking up the entire cost of the Rx.

The most recent Rxs the one that was a $3.00 copay Humana paid the pharmacy $67.00 and we paid $3.00….

This might partially explain how CVS Health is able to show that much profit.

Silver Scripts and Caremark/PBM are one of the top three in their respective categories

When open enrollment comes around in Oct…those who are traditional Medicare and have a Part D plan might wish to use this website to check out where your medications could be obtained at a lower out of pocket expense  https://www.medicare.gov/plan-compare/#/?lang=en

 

The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon

Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey

https://pubmed.ncbi.nlm.nih.gov/32326188/

Abstract

Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem.

Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada.

Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation.

Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon.

Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.

CVS is Destroying the Profession of Pharmacy – Part 4

CVS is Destroying the Profession of Pharmacy – Part 4

https://pharmacistactivist.com/2020/June15_2020.shtml

CVS recently reported a 9% increase in same-store sales during the first quarter. During part of the first quarter many retail stores had to close/lockdown because of the COVID-19 pandemic. Many of the purchases in CVS stores were for a wide variety of products and other merchandise that have no relationship to healthcare needs and products. However, unlike many retailers that were required to close during the lockdown, CVS stores have remained open as an essential retailer during the pandemic for the sole reason that they include pharmacies. Not only did CVS experience a large jump in sales, but it announced that it planned to hire 50,000 people in part-time, full-time and temporary roles to keep pace with the demand. This situation is occurring at the same time that many smaller retail stores have had to remain closed and may not be able to reopen because of financial losses. In the interest of the safety of their patients and employees, many independent pharmacies have restricted prescription and other healthcare purchases to curbside pickup or deliveries and/or limit the number of individuals permitted in the pharmacy. CVS reaps great profits from having pharmacies, but harasses its pharmacists and technicians in requiring faster and greater assembly-line productivity in selling prescriptions without consultation. As noted in Part 3 of this series, CVS has betrayed and abandoned its own pharmacists and technicians, as well as the profession of pharmacy.
Ignoring safety
CVS wants others to think they have taken appropriate precautions to protect the safety of their customers and employees. It has failed to do so. It was slow in providing equipment and materials for the protection of its employees, and the implementation of cleaning procedures is woefully inadequate even now. A company can have very comprehensive policies/statements regarding cleaning/sanitizing, but when there is insufficient staffing to perform these tasks, they don’t get done. Where are all those 50,000 workers CVS said it was hiring? If CVS or another retail store is not able to provide a safe location, it should not be permitted to be open until it does. A California congresswoman recently wrote a letter to the CEO of CVS that includes the following statements:

“I am alarmed and disappointed by the conditions that exist in your facilities and for your delivery workers. I am sending along these pictures that show the unsafe conditions.”

In many areas of the country other retail establishments have been permitted to reopen with restrictions as long as appropriate precautions are observed (e.g., customers must wear masks). In my limited travels away from my home, I have been to stores with large signs on the doors saying, “No mask, no entrance.” At CVS, although employees are required to wear masks and customers are requested to, store employees have been instructed to not deny entrance or service to customers who do not wear masks. The message is that CVS management is willing to place CVS employees at added risk for the purpose of not losing a sale. Prior to the pandemic, it was the customers who were at primary risk because of the occurrence of errors resulting from the stressful workplace environment due to management negligence and metrics. Now it adds additional risks for its own store employees that go beyond the stress, burnout/moral injury, and other health issues they were already experiencing. Recently, a former CVS employee came back to the CVS store and committed suicide. The news has been suppressed but the situation is being investigated.

The front-line CVS pharmacists and other employees who place themselves at risk for the sake of more profits for their employer are heroes who should be recognized and rewarded! CVS management that works with no risk from their suites or home offices should be terminated and replaced with management that values its employees and customers.
Pharmacy hero Joe Zorek
Joe Zorek is one of my pharmacy heroes whom I first came to know when he was a student at the Philadelphia College of Pharmacy. Joe worked for CVS for 43 years and was the pharmacist-in-charge for 37 years at the store that was the highest-performing CVS store in his district. Joe’s accomplishments and service to his customers, community, and CVS are all the more remarkable because he experiences the challenges of multiple sclerosis (MS) that is exacerbated by standing for long periods of time. Therefore, it was necessary for him to be seated while he worked during certain periods of the day. The arrangement in which he was seated while he fulfilled and exceeded the responsibilities of his position description was unacceptable to his district leader, and the resulting harassment and the additional stress from management-imposed metrics resulted in a relapse of Joe’s MS. It was necessary for him to take disability leave, but with the expectation that he would return to his position. At the conclusion of the period of disability CVS terminated Joe Zorek.

Joe retained an attorney and sued CVS. In spite of strong CVS pushback, the strong persistence of Joe and his attorney over 5 years resulted in a settlement. The terms of the settlement are confidential (a condition imposed by CVS) and I don’t know the terms or the amount of the settlement. However, I am aware of the going hourly rate for skilled attorneys and the settlement has to be substantial. Joe is “silenced” because of the terms of his settlement, but his wife Paula has been a great source of encouragement and suggestions for many current and terminated CVS pharmacists and technicians. Both of them are heroes in their courage to challenge CVS management and in their advocacy for so many colleagues.
Selected comments from CVS pharmacists and technicians
The following are a small sampling of comments I have received:

“We are told we may use 2 masks a week even though the package says single use only. A sheet is provided to document that the counters and keypads have been sanitized hourly. That lasted about a week and now some days it is not done at all because overworked staff with reduced hours do not have time to do it.”

“I submitted an ethics line complaint about understaffing and risk of patient safety. They responded ‘where is this?’ And I said ‘everywhere.'”

“This CVS response (to Ellen Gabler’s article in the New York Times) is so vague, nonspecific, and full of ignorance that it makes me sick. At the same time, it further fuels the fire within me to expose CVS for the ethics-less sweatshop it is.”

“How many more deaths and articles written will it take for management to do the right things?”

“We are nothing but disposable bodies in this company and the sad thing is that there are unemployed pharmacists who will gladly take our spot with a big pay cut.”

“I ask my district leader for more help. He responds, ‘Nope. Maybe CVS isn’t the right place for you if you need more help.'”

“In spite of almost 20 years working for CVS, I still love being a pharmacist. I just hate my job. I am afraid. Afraid so much that I don’t have the fortitude to reveal my identity. I am afraid I will NOT find another employer if I am terminated by CVS. I know this because I have tried to find other positions.”

“I was written up for not meeting quota on calls and not getting people to refill prescriptions THEY DO NOT NEED.”

“I feel that I am committing fraud with the calls I am required to make and filling items that are not wanted.”

“I was brutally honest on those surveys. I was unemployed 3 months later. They are NOT anonymous.”

“I know 3 pharmacists who responded to the CVS surveys honestly and all of a sudden their scores went down and they were reassigned to other stores or floating duties.”

“The survey is described as anonymous but when you work in a rural pharmacy and there’s only you and your manager, you better bite your tongue.”

“I know of a pharmacist experiencing anxiety who went into very early labor after the pharmacy supervisor threatened her job if all prescriptions are not finished at night.”

“I am a tech and my #1 goal/job is to protect and support my pharmacist. My store has some of the best techs I have ever worked with, and we simply cannot keep up. We are always understaffed and always scrambling, and the pharmacists jump in to help the techs. Then we get patients yelling at us and corporate’s response to us is to reprimand us.”

“In my job as a tech the stress sent me into emotional overdrive. Eventually I landed in a psychiatric unit for 5 days due to the stress of not only my job but also not making enough money in spite of asking for raises.”

“In my estimation, EVERYTHING changed the day when the former CEO retired.”

(Editor’s note: I remember when CVS started and was an advocate for the professional role of its pharmacists and the profession of pharmacy. If the founder of CVS was aware of what CVS has become, he would be turning over in his grave. Oh! My mistake – he is still alive.)

Daniel A. Hussar
danandsue3@verizon.net

 

CVS Places Consumers at Risk of Harm, And is Destroying the Profession of Pharmacy! – PART 1

CVS Places Consumers at Risk of Harm, And is Destroying the Profession of Pharmacy! – PART 2

CVS is Destroying the Profession of Pharmacy – PART 3*

CVS is Destroying the Profession of Pharmacy – Part 4

CVS is Destroying the Profession of Pharmacy: Part 5!

CVS is Destroying the Profession of Pharmacy: Part 6

CVS is Destroying the Profession of Pharmacy – PART 3*

CVS is Destroying the Profession of Pharmacy – PART 3*

https://pharmacistactivist.com/2020/June_2020.shtml

 

Along with Rite Aid, Walgreens, and Walmart!

*Editor’s notes: 1) The first 2 parts are in the February and March 1 issues of The Pharmacist Activist; 2) Reader responses to the editorials have been so supportive and valuable (Thank you) that I will continue the recent schedule of publishing two issues each month.

When you think CVS management can’t get any worse in damaging its own reputation and that of the profession of pharmacy, it finds a way to do it. Where to begin in the voluminous files of messages and news commentaries regarding CVS and other chain pharmacies just since March when I wrote my last editorial about CVS? Let’s start with some headlines regarding lawsuits and selected quotes:

“Blue Cross Blue Shield insurers sue CVS, alleging drug pricing fraud” (Axios Health; May 28, 2020; Bob Herman).

“…the pharmacy chain overcharged them based on ‘artificially inflated prices’ for generic drugs and concealed the true cash prices of those drugs.”
BCBS alleges “CVS offered lower cash prices on generic drugs to compete with Walmart and other low-cost pharmacies, but told insurers those cash prices were significantly higher than they actually were.”
“People enrolled in CVS’ cash discount program in 2015 got a 90-day supply of blood pressure medication nadolol for $11.99. But CVS told BCBS of Florida that the cash price was $180.99 and overcharged $169 as a result, according to court documents.”

“Big Pharmacy Chains Also Fed the Opioid Epidemic, Court Filing Says” (New York Times; May 27, 2020; Jan Hoffman).

“A new court filing…asserts that pharmacies including CVS, Rite Aid, Walgreens and Giant Eagle as well as those operated by Walmart were as complicit in perpetuating the crisis as the manufacturers and distributors of the addictive drugs.”
“The retailers sold millions of pills in tiny communities, offered bonuses for high-volume pharmacists and even worked directly with drug manufacturers to promote opioids as safe and effective, according to the complaint filed in federal court in Cleveland by two Ohio counties.”
“CVS worked with Purdue Pharma, the maker of OxyContin, to offer promotional seminars on pain management to its pharmacists so they could reassure patients and doctors about the safety of the drug.”
“From 2006 through 2014, the Rite Aid in Painesville, Ohio, a town with a population of 19,524, sold over 4.2 million doses of oxycodone and hydrocodone. The national retailer offered bonuses to stores with the highest productivity.”
“Walgreens contract with the drug distributor AmerisourceBergen specified that Walgreens be allowed to police its own orders, without oversight from the distributor. Similar conditions were struck by CVS with its distributor, Cardinal Health.”
“Despite being repeatedly fined by the DEA (for failing to report suspiciously high orders), the companies continued to sell outsize quantities of opioids.”
“Walmart devised a workaround to that reporting requirement. In mid-2012, it fixed a hard limit on opioid quantities it would distribute to its stores, foreclosing the need for its pharmacists to report excessive orders. Yet Walmart simply allowed its stores to make up the difference by buying the remainder of their large opioid orders from other distributors.
“The chains “rewarded pharmacists for churning volume rapidly and, in some instances, pointedly ordered them never to refuse a doctor’s prescription.”
“Supervisors ignored store pharmacists who warned about pill mill doctors, including those who were ultimately convicted.”

CVS Class Action Employment Lawsuit (California)

The lawsuit alleges 10 claims against CVS for California Labor Code violations, and also alleges that CVS engaged in unfair competition by violating the California Labor Code for profit while its competitors were following the laws as required.

Other litigation against CVS
For CVS’ own summary of litigation, I encourage you to access the CVS Health report (Form 10-Q) that it filed with the Securities and Exchange Commission for the quarterly period ended 3/31/20, and read the section on “Litigation and Regulatory Proceedings” on pages 28-33. Yes, 6 pages are needed and CVS must have an army of attorneys that it pays far more than its pharmacists, but not its executives.
CVS “Transform Health 2030” Report
On May 14, CVS issued its 13th annual corporate social responsibility (CSR) report and unveiled Transform Health 2030, the company’s new CSR roadmap for the next decade. The report identifies many excellent programs for which the beneficiaries are very needy and deserving organizations and individuals. These commitments of CVS have a value of millions of dollars.

I read the report in its entirety, and the content reflects several additional important, but unstated, messages. The word “pharmacist” does not appear even once in the lengthy report. The words “pharmacy” and “pharmacies” only appear in two of the many sections of the report that may be accessed by those with the persistence to click on two links. The two sections are “Developing our diverse workforce” and “NBA Point Guard and Former Villanova Wildcat Donte DiVincenzo Helps CVS Health Kick Off Free Health Screenings in Philadelphia.” The word “pharmacy” is included once in the press release, as an example of the CVS “commitment” to a Healthy Planet, in the following statement:

“Removed BPS from CVS Pharmacy customer receipts to increase their recyclability, while enrolling 1.1 million customers in digital receipts in 2019 for a savings of 48 million yards of receipt paper.”

Think of how much more impressive that number would be if CVS had thought to express the length of receipt paper in inches (or centimeters if CVS could properly and fairly use ‘metric[s]’) rather than yards. There is a rumor that all the receipt paper that has been saved is to be used in making CVS brand toilet tissue, but I have not been able to confirm this.

One must question how the CVS wealth was accumulated in an amount so substantial that it is able to give millions away. CVS pharmacists, I, and many (but not enough) others recognize that its wealth has been accumulated at the expense of TMC (too many to count) customers who died or were harmed as a consequence of errors at CVS stores, pharmacists and pharmacy technicians who were terminated and can’t find other employment, and current pharmacists, pharmacy technicians, and managers for whom the abysmal working environment is excessively stressful and even suicidal for some.
Recommendations
It is clear that CVS has forgotten its roots and has abandoned the profession of pharmacy. It is now time for our profession to abandon CVS, and the following recommendations are provided to start this process:

CVS and other pharmacists with entrepreneurial interests should offer to buy or have a long-term lease to own the Pharmacy Department in CVS stores, so that the pharmacies can be operated properly, professionally, and profitably.
Boards of Pharmacy, the DEA, and other law enforcement agencies should conduct very thorough investigations of the CVS organization and stores to identify illegal, fraudulent, dangerous, unprofessional, and unethical practices that place customers and employees at risk.
The Federal Trade Commission and Department of Justice should conduct investigations of the monopolistic, anticompetitive, and illegal practices of CVS Health, and take action to require the divestment of Caremark, Aetna, and Omnicare (and other lesser-known subsidiaries that reduce competition) if CVS wishes to continue to own pharmacies.
Pharmacy organizations and colleges of pharmacy should reject any grants or financial support (including meeting exhibits and “unrestricted” educational grants) from CVS because of its continuing actions that are so destructive to the profession of pharmacy. It may be too late to save the independent and smaller chain pharmacies that have closed or were acquired (often by CVS) because of the anticompetitive and destructive actions of CVS, but every effort must be made to save independent pharmacies and the rest of our profession.
States and Boards of Pharmacy should enact legislation and regulations that require pharmacists to hold the majority ownership in pharmacies. North Dakota has set the standard that other states should follow.
Pharmacists and other employees who have been unfairly terminated by CVS should individually and/or collectively explore legal action. Some former CVS pharmacists have already been successful in taking these actions, but it requires determination and patience. Pharmacists who are aware of attorneys who have been helpful and successful in these efforts are requested to provide their names and contact information to me at the email address below, and I am also actively exploring the best options to pursue this.
More whistleblowers are needed. Current concerned pharmacists should document in detail medication/dispensing errors, as well as illegal, fraudulent, unethical, unfair, and excessively stressful management-imposed programs, activities, and workplace environments.

Daniel A. Hussar
danandsue3@verizon.net

Editor’s notes:
1) The next several issues of The Pharmacist Activist will include comments from anonymous (but with identities that I can confirm) CVS and other chain pharmacists, as well as from physicians and other healthcare professionals who are impacted by decisions and actions of CVS and other chain pharmacies.
2) My editorials regarding CVS and other chain stores are motivated by the purpose of supporting pharmacists in these stores, and the criticisms are directed at executives and other managers in policy-making positions.
3) Although the primary focus of this editorial is on CVS, pharmacists at Rite Aid, Walgreens, and Walmart should also be considering the above concerns that are pertinent to their employment. Future issues of The Pharmacist Activist will address concerns at these companies, including the continued sale of tobacco products.

CVS Places Consumers at Risk of Harm, And is Destroying the Profession of Pharmacy! – PART 1

CVS Places Consumers at Risk of Harm, And is Destroying the Profession of Pharmacy! – PART 2

CVS is Destroying the Profession of Pharmacy – PART 3*

CVS is Destroying the Profession of Pharmacy – Part 4

CVS is Destroying the Profession of Pharmacy: Part 5!

CVS is Destroying the Profession of Pharmacy: Part 6

Waiting for the other shoe to drop ?

I have been a student of our bureaucracy/bureaucrats for nearly 40 yrs and how they act can be highly predictable.

The CDC’s first published opiate dosing guidelines were at first attempted to be done with a great deal of it done in secret.  The meeting of the group was not published and they tried to keep the identity of all those participating in the meeting anonymous.

There was no period for the public to make comment on what was proposed… because there was NO PROPOSAL… the guidelines were created and published.

Immediately after they were published, the then head of the CDC Tom Frieden published a public statement to CLEARLY STATE that the guidelines DID NOT BEAR THE WEIGHT OF LAW… they were just GUIDELINES.

Many of us believe that the CDC did not have the statutory authority to generate these guidelines, thus besides not have the weigh of law they were basically UNCONSTITUTIONAL.

Our system is so designed that bills/laws/interpretation of laws  do not have to meet any constitutional verification before they are put on the books and they can be applied/enforced as long as they remain on the books or until they are challenged in our courts and declared unconstitutional.

Some believe that figuratively  the DEA and the VA were waiting outside of the meeting room door to get a copy of these new opiate dosing guidelines… they may have even been getting copies of the draft guidelines on a daily basis, because it would seem that those two agencies were ready to hit the ground running once the guidelines were officially published.

Again our medical system, once >50% of medical practitioners follow a particular process or policy and procedures it becomes a de-facto the standard of care and best practices. There seemed to be a coordinated push by the VA, DEA, insurance/PBM industry to influence these guidelines with practitioners go get them to adhere to these guidelines.  So once that >50% goal was reached either locally/regionally/nationally … the DEA could come in and accuse prescribers of not meeting the current standard of care and best practices and thus the DEA could draw the conclusion that the prescriber was prescribing controlled meds that were not medically necessary to many/most/all of their pts.

After a couple of years,  there was a growing number of statements that the CDC opiate dosing guidelines were being misapplied… and eventually the CDC agreed to reopen the guidelines for public comment to “revise” the guidelines.

This time the CDC followed the proper federal laws… they made a public announcement that they were revising the guidelines and had a public comment period..  Why shouldn’t they… they created the first set of opiate dosing guidelines without following any of the federal laws and they suffered no consequences and no one bothered to challenge the constitutionality of the original set of guidelines.

Historically, when laws/regulations are open for revision, they usually end up rougher/harder/stricter on those who they are to applied to.

It is no secret that PROP and FEDUP where making comments during the open comment period and those and other similar groups are in lock step with the DEA’s/VA’s agenda on treating pain with opiates and prescribing other controlled substances to people who have a medical need for treating their subjective diseases.

The community had better be prepared for new and tighter guidelines… maybe 50 MME/day limits – for all pts … acute, chronic , terminal.  Maybe limiting PCP’s to maybe 20 -30 MME/day for 7 days for acute pain – no additional pain meds. Expand the guidelines to make it illegal for a pt to be prescribed a opiate, benzo and muscle relaxant together – BY ANY PRESCRIBER(S).

If my suspicions are anywhere near close to where the revised guidelines will end up… the community had better stop all its in-fighting and start raising money to challenge these guidelines in our court system as to their constitutionality. If I am near correct, prescribers will start discharging chronic pain pts – IN MASS – with a 30 days of meds to wean down off their controls.  There is not enough pain clinics to accept or take appropriate care of all the chronic painers.

Suicides will increase dramatically, and street dealers will be more than happy to take care of all the chronic painers seeking relief from their relentless intractable chronic pain… and the street dealers won’t take insurance, won’t want you to pee in a bottle, no pain contracts nor care if you what more meds “early”.

Our healthcare system: Nothing more/less than a FOR PROFIT BUSINESS & GHOST SURGERY

https://www.facebook.com/ghostsurgeries/

This FB page is about The Mayo Clinic, in Rochester, MN and this page was just created in the last week.  There is quite a bit of context on this page so I am not going to try and cut/paste … because there is probably a lot more to come on this page going forward.

This does suggest why medical errors are the THIRD LARGEST CAUSE OF DEATH… behind cancer and cardio.

Georgia has just passed a law that may allow you to continue using whatever pharmacy you would like.

What to know about the Ga. anti-steering law

https://www.wtoc.com/2020/06/16/what-know-about-ga-anti-steering-law/

SAVANNAH, Ga. (WTOC) – It is likely that within the last year you have received a letter or a phone call from your insurance company stating that you can save money by using mail order prescriptions or that you must use a specific pharmacy suggested by your insurance company. What you may not know is that Georgia has just passed a law that may allow you to continue using whatever pharmacy you would like.

In the early months of 2020, the state of Georgia passed House Bill 323, also known as the Pharmacy Anti-Steering and Transparency Act. The laws prohibit PBM (or insurer-owned pharmacies) from profiting off prescriptions “steered” from their PBM and insurance affiliates. They also restrict PBM and insurer patient steering, strengthen anti-mandatory mail order, add additional audit protections, and restrict mining of patient data. The Pharmacy Transparency and Anti Steering Act attempts to meet three goals; increase transparency, allow patients to choose their pharmacy, and make sure patients receive quality care regarding pharmacy services.

So, how do you handle the situation if your insurance carrier tells you must use mail order pharmacy? You may be able to simply opt out by calling them. Telling patients they must use mail order takes away the patients right to healthcare professionals help them manage their medications. Approach the subject with your insurer by calling the phone number on the back of your insurance card. The good news is if you are persistent with your insurance company, they might comply and allow you to continue to use your local pharmacy.

Association of American Physicians and Surgeons Sues FDA for “Irrational” Interference of Access to Life-Saving Hydroxychloroquine

Association of American Physicians and Surgeons Sues FDA for “Irrational” Interference of Access to Life-Saving Hydroxychloroquine

https://www.thegatewaypundit.com/2020/06/association-american-physicians-surgeons-sues-fda-irrational-interference-access-life-saving-hydroxychloroquine/

The Association of American Physicians and Surgeons (https://aapsonline.org) filed a lawsuit against Department of Health and Human Services and the FDA for “irrational interference” by the FDA with timely access to hydroxychloroquine.

Never in history have we seen such a determined effort by the scientific community and pharmaceutical industry to downplay and lie about the use of a successful drug to treat a deadly disease.

Hydroxychloroquine is the first choice in a study of 6,000 doctors treating the coronavirus.
In the field and in independent testing hydroxychloroquine displayed amazing results in treating the COVID-19 virus.

But there was great pushback against hydroxychloroquine for two reasons. The first reason was because it was safe and very inexpensive. The second reason is because Donald Trump promoted its use.

It is not a stretch to say the Democrat establishment would rather see people die than see President Trump be proven right.

So the so-called experts went to great lengths to lie and smear the use of this drug as we have discussed previously.

I smell insurance industry interference in this issue… the medication hydroxychloroquine can still be prescribed by prescribers “off label”  What everyone may run into is that the insurance industry will not recognize it being prescribed off label but will most likely declare that it is an “experimental treatment” and refuse to pay for the therapy. There are some other things going on in the “background”, but this is the first time I have heard the FDA coming out with this sort of order