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This CVS pharmacy is ten days behind on filling prescription
Posted on November 11, 2019 by Pharmaciststeve
This pharmacy is ten days behind on filling prescription. Hire some people. Never mind. I’m transferring all my prescriptions out ASAP.
— at CVS Pharmacy. 2100 East Dublin Granville Road, Columbus, Ohio 43229
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Epidural Steroids Home Page
Posted on November 10, 2019 by Pharmaciststeve
Epidural Steroids Home Page
https://www.burtonreport.com/infspine/epiduralsteroidhomepage.htm
all patients who’s Interventional Pain Management Clinics and the doctors (doctors of a mixed bag called “proceduralists”) who are performing Epidural Steroid Injections to read this report in full, clicking on ALL HIGHLIGHTS IN RED, for a thorough understanding. It is imparaitive that every patient know just how dangerous these spinal epidurals are and it’s never okay for any doctor NOT to give patients full disclosure of the nuerotoxins that are being used in corticosteroids, including all serious neurological adverse events before signing any consent forms. It’s NEVER OK to not give FULL INFORMED consent and legally IGNORANCE is No Excuse.
I also advise any patient being forced by using extortion tactics to give this report directly to the Clinic Manager and seek out a lawyer as soon as possible. No lawyer or doctor can argue the facts in this report done on behalf of the many millions who have died suffering in severe intractable pain and the urgent need to eliminate this practice using nuerotoxic chemicals anywhere near the Human Spinal Cord.
NO JUDGE could argue on the side of any defendant who uses nuerotoxic chemicals in Spinal Epidural Procedures and walks away from the catastrophic harms in silence.
These procedures must be eliminated from all human medical care.
History of Epidural Steroid Injections
Epidural Injections and Aseptic Hip Necrosis
Preservatives In Epidural Injections
The Real Health Issue With Epidural Steroid Injections
It is estimated that there is TEN MILLION ESI’s are given every year and abt 5% of pts will end up with adhesive arachnoiditis and practitioner pushes the needle ONE MILLIMETER TOO FAR and injects the medication into the spinal column fluid… This class of medication is discourage its use as ESI by both the FDA and the company that makes the primary medication that is used.
Medications can be injected into the spinal fluid, but they must not only be STERILE & PYROGEN FREE which all injectable medications must be… but those safe to be injected into that spinal fluid but also be PRESERVATIVE FREE & A SOLUTION.
The class of meds that is typically used with ESI’s is a SUSPENSION and NOT PRESERVATIVE FREE. If it is unintentionally injected into the spinal fluid… ALL HELL BREAKS LOOSE… causing a disease/condition that is both EXTREMELY PAINFUL AND IRREVERSIBLE.
Even if the pt receives multiple ESI’s over extended period of time, that are done correctly there is the potential of other adverse systemic side effects that can happen.
Why do practitioners – with all of this well known potentially adverse health problems – continue to force pts to get these procedures ? Could be that the medications used are not under the under the control of the DEA and the practitioner can charge for these procedures… typically they are able to charge THOUSANDS OF DOLLARS FOR EACH PROCEDURES PROVIDED ON A SINGLE DAY.
Some practitioners goes so far as refusing to provide the pt with any oral opiates unless the pt submits to on going ESI’s.
There is a law firm in Northern KY that is suing a large pain clinic over such practices https://www.pharmaciststeve.com/?p=28739 Doctor would not give individuals their pain medication … unless they capitulated in having an epidural
Not to mention the number of various professional services/procedures that are being discouraged by the FDA and/or other Fed/state agencies ?
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is this a indication of the level of care that Kaiser Permanente provides to its pts ?
Posted on November 10, 2019 by Pharmaciststeve
Kaiser Permanente CEO Bernard Tyson dead at 60
https://www.foxbusiness.com/money/kaiser-permanente-ceo-bernard-tyson-dead
Health care provider Kaiser Permanente CEO Bernard Tyson died Sunday at the age of 60, FOX Business confirmed.
Tyson had been active on social media as of Saturday, after speaking at a gathering called AfroTech.
“It is with profound sadness that we announce that Bernard J. Tyson, Chairman and CEO of Kaiser Permanente, unexpectedly passed away early today in his sleep. On behalf of our Board of Directors, employees and physicians, we extend our deepest sympathies to Bernard’s family during this very difficult time,” Kaiser Permanente told FOX Business in a statement.
The California-based health care organization described Tyson as “an outstanding leader, visionary and champion for high-quality, affordable health care for all Americans.”
Kaiser Permanente’s board of directors named Gregory A. Adams, Executive Vice President and Group President, as interim Chairman and CEO effective immediately.
Bernard Tyson (Courtesy: Kaiser Permanente)
In 2013, Tyson became CEO of Kaiser Permanente, one of the nation’s largest not-for-profit health plans serving 12.3 million members. Kaiser Permanente had roughly 9 million members when Tyson assumed the post.
During that same time, Tyson also grew revenue from $53 billion to more than $80 billion. He earned about $10 million in compensation in 2016, according to Modern Healthcare.
Tyson garnered praise during his time at the top of the health care provider, including his inclusion in TIME’s Health Care 50 for his work boosting community health in areas in need, like West Baltimore’s 21223 zip code.
His career at Kaiser Permanente began more than 30 years ago. He was born in the San Francisco Bay Area, where the company is headquartered, and attended Golden Gate University in San Francisco.
Most all of us have all heard of the horror stories of pt care that Kaiser provides.. especially chronic pain pts and those having to deal with subjective diseases.. In fact a letter was recently sent to pts that Kaiser will not longer prescribe certain classes of controlled substances and put a low limit on the mgs/day of opiates that a pt can have… regardless of the pt’s needs or conditions causing the pain. Is it inconceivable that Mr Tyson would not be using Kaiser to provide for his healthcare ?
Here is the letter that Kaiser sent out just last month:
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Michigan: potentially addicting drug IN SHORT SUPPLY … BUREAUCRATS DEMAND A SOLUTION
Posted on November 10, 2019 by Pharmaciststeve
Michigan liquor shortage driven by software problems at one of three state distributors
https://finance.yahoo.com/news/michigan-liquor-shortage-driven-software-175734509.html
Michigan residents are experiencing a liquor shortage due to a software glitch with one of the major distributors in the state, hitting restaurants, bars and retailers throughout the state.
The Detroit Free Press reports that the Republic National Distributing Company, one of only three distribution agencies authorized to deliver alcohol in the state, has faced continual software problems since moving into a new warehouse in the city of Livonia.
The glitch has produced such a backlog of deliveries that the Michigan Liquor Control Commission is intervening, according to the Free Press.
“We are holding RNDC (Republic National Distributing Company) accountable on how they plan to fix this situation for our licenses,” Michigan Liquor Control Commission Chairman Pat Gagliardi said in a statement Friday. “It’s our priority to ensure our licenses have their shelves stocked for the public, especially in advance of the holiday season.”
One beverage manager in Royal Oak expressed her frustration over the situation, saying alcohol orders are coming in four to five days late despite the fact that she has been placing orders weeks in advance in an effort to reduce the delays.
“With the upcoming holiday season, it’s especially challenging to plan for new menus when availability of product is so unpredictable,” said Ale Mary’s Beer Hall beverage manager Pam Stigall. “It is my hope that they are able to resolve this problem sooner than later.”
The Michigan Liquor Control Commission and attorney general’s office held a meeting last week with establishments suffering from the delivery backlog to address concerns and find ways to remedy the situation.
Meanwhile, Stigall told the news outlet that the RNDC sent her a private message on social media after she posted about the ongoing alcohol delivery logjam.
“RNDC (Republic National Distributing Company) understands your frustration and is doing everything in our power to correct the situation,” they said in the message. “Sometimes growth comes from unforeseen challenges, and we’ve experienced more than our share with the opening of our new Livonia facility.”
The state of Michigan’s website has since created an online complaint report for licensed liquor retailers who are experiencing issues ordering spirits.
Just imagine a “drug” that is potentially addicting and whose use/abuse contributes to abt 100,000 deaths/yr and the Michigan bureaucrats are demanding that this shortage of supply get rectified NOW… Could it really be that these bureaucrats are seeing all that lost of liquor and sales taxes because with the “holiday season” quickly coming up… how many MILLIONS of tax dollars does the state stand to lose ? Maybe it is just that the state of Michigan is “financially addicted” to all that “sin tax money” ?
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Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death
Posted on November 10, 2019 by Pharmaciststeve
The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015
https://journals.sagepub.com/doi/abs/10.1177/0033354919878429
Abstract
Objectives:
Opioid-related overdoses are commonly attributed to prescription opioids. We examined data on opioid-related overdose decedents in Massachusetts. For each decedent, we determined which opioid medications had been prescribed and dispensed and which opioids were detected in postmortem medical examiner toxicology specimens.
Methods:
Among opioid-related overdose decedents in Massachusetts during 2013-2015,
we analyzed individually linked postmortem opioid toxicology reports and prescription drug monitoring program records to determine instances of overdose in which a decedent had a prescription active on the date of death for the opioid(s) detected in the toxicology report. We also calculated the proportion of overdoses for which prescribed opioid medications were not detected in decedents’ toxicology reports.
Results:
Of 2916 decedents with complete toxicology reports, 1789 (61.4%) had heroin and 1322 (45.3%) had fentanyl detected in postmortem toxicology reports. Of the 491 (16.8%) decedents with ≥1 opioid prescription active on the date of death, prescribed opioids were commonly not detected in toxicology reports, specifically: buprenorphine (56 of 97; 57.7%), oxycodone (93 of 176; 52.8%), and methadone prescribed for opioid use disorder (36 of 112; 32.1%). Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death.
this study was for a time frame BEFORE the CDC published their opiate dosing guidelines. Legal opiate Rxs PEAKED in 2012 and started declining… so this study period was during a time Rx opiate presribing were declining.
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how safe is YOUR HOSPITAL ?
Posted on November 9, 2019 by Pharmaciststeve
https://www.hospitalsafetygrade.org/
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chuckle of the day 11/09/2019
Posted on November 9, 2019 by Pharmaciststeve
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Suicides from under/untreated pain – KNOWS NO AGE LIMITS
Posted on November 8, 2019 by Pharmaciststeve
Akaiah Nicole Altstock
Akaiah Nicole Altstock, 14, of Sneads Ferry, North Carolina, died Wednesday, September 25, 2019. A celebration of life was held on the beach where she loved to walk. Yellow carnations were released into the Atlantic Ocean by all in attendance.
Akaiah could no longer fight the pain after years of battling chronic migraine headaches.
She is survived by her grandparents, Randy and Marsha Altstock; sister, Skyy Altstock, all of Sneads Ferry, NC; her father, Matt Altstock of Salem; and her uncle and aunt, Kyle and Danielle Bruhn and cousins Garrick and Lydia Bruhn of Jacksonville, North Carolina.
Electronic condolences may be left for the family at www.jonesfh.org Pender Pines Garden Center, of Hampstead, North Carolina, is designing a Japanese style memorial to be planted at the family’s home. Our family requests that anyone who knows about a potential suicide to please speak up, let someone know.
Arrangements are by Jones Funeral Home, Holly Ridge Chapel.
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The study of opiates working well for long term chronic pain – that they said DIDN’T EXIST ?
Posted on November 8, 2019 by Pharmaciststeve
Opioid Treatment 10-year Longevity Survey Final Report
Patients in this study were found to be functioning quite well after 10 or more years on generally stable opioid dosages—with the vast majority able to care for themselves and even drive.
About eighteen months ago, I approached the publisher of Practical Pain Management to assist in a survey of long-term, opioid-treated pain patients. Rightly, as any good publisher, he asked why should I go to the time and expense to do a longevity survey? I then presented him my laundry list of reasons for doing the survey. Some explanations of my reasons for doing this survey are given here. Quite frankly this survey was needed, since we simply have little data on opioid long-term treatment.1,2 Also, opioid treatment is constantly under attack, so it seems logical to see if the popularity of this treatment is justified.
Reasons for the Survey
First, recall that we have just finished the “Decade of Pain.” Ushering in this decade were many laws, regulations, and guidelines—promulgated in many states—that encouraged physicians to prescribe opioids without fear of legal reprisal. Did anyone get help this decade? Did this political and humanitarian effort pay off?
Secondly, my own experience in practice was the predominant factor. I started my pain practice in 1975 while serving as a Public Health Physician in East Los Angeles County. Cancer and post-polio patients needed ‘narcotics’ (the common name prior to the more correct usage ‘opioids’) treatment for their severe chronic pain. I’ve now followed some chronic pain patients still taking opioids after 25 to 30 years.1 Also, I was a government consultant in the 1970s on Howard Hughes who managed to survive 30 years with intractable pain after a 1946 plane crash. His average opioid dosage over that time period was about 200 mg of morphine equivalence. But are my patients unusual or simply responsive to an overzealous clinician? Do opioid-treated patients in the hands of other physicians do just as well over a long period?
A little over a year ago there was another reason to do a longevity survey. At that time there was a vitriolic, anti-opioid propaganda campaign being waged. Some prominent academic institutions, pharmaceutical companies, professional organizations, and journals, almost in unison, essentially claimed that opioids shouldn’t be prescribed due to hyperalgesia or other as-yet unnamed complications. Some parties stated that opioids, if prescribed at all, should have a dosage restricted to some arbitrary number such as 200mg of morphine equivalence a day. Some claims fundamentally suggested that pain should only be treated with non-opioids, because opioids actually “cause pain.” Amazingly, some detoxification centers actually advertised for “clients” on the basis that the person’s pain would be cured if the patient spent $10K or $20K to detoxify from opioids. Needless to say, the anti-opioid campaign was hardly backed by bonafide medical management pain practitioners or scientific studies. So what was needed was a simple survey to see if there are long-term opioid-treated patients who are still doing well.
What the Survey Can’t Determine
This survey was not intended or designed to answer some ancillary questions. Not answered is which opioids are superior or could patients have done as well without opioids? Also, it wasn’t intended to determine optimal dosage or complications. The intent was clear and simple: Do some opioid-treated patients improve pain control, function better, and enhance their quality of life over a 10-year period?
Survey Methods
In early 2009, an advertisement was placed in this publication to identify any physician who had a cohort of chronic pain patients they had treated with opioids for 10 or more years and were willing to share outcome data. Three physicians, one each from Kentucky, Louisiana, and California, reported a total of 76 patients who have been treated with opioids for 10 or more years. These, together with the 24 patients treated by this author,1 provide a cohort of 100 patients who have been treated with opioids for 10 or more years and serve as subjects for this survey. Physicians completed a survey questionnaire for each patient that inquired about demographic status, cause of pain, opioids currently used, basic physical functions, activities of daily living, and stability of opioid dosage.
Results and Findings
Patients in this study appeared typical of most chronic pain patients in that they are primarily middle age or older and have degenerative diseases of the spine, joints, or peripheral nerves (see Tables 1 and 2). Most have maintained on one opioid, although some patients required two or three. The majority have been on stable dosages for many years (see Table 3). Despite the longevity of treatment, most function quite well. The vast majority of patients report good function in that they can dress, read, attend social functions, drive, and ambulate without assistance (see Table 4). Almost half (45%) reported they had been on a stable opioid dosage for at least 3 years.
| Age (Yrs) | Range 30-83 |
|---|---|
| Males | 61 (61%) |
| Females | 39 (39%) |
| Length of time in opioid treatment | 10 – 35 yrs |
| Stable opioid dosage without significant escalation | 3mos – 31 yrs |
| Spine disease | 51 |
| Arthritis | 16 |
| Peripheral neuropathy | 14 |
| Headache | 10 |
| Knee diseases | 5 |
| Abdominal adhesions | 5 |
| Hip diseases | 4 |
| Shoulder/arm diseases | 4 |
| Fibromyalgia | 4 |
| 113* | |
| *Adds up to more than 100 as some patients had more than 1 diagnosis. | |
| No. of Opioids Currently Used | N(%) |
|---|---|
| 1 | 62 |
| 2 | 26 |
| 3 | 12 |
| Opioids Currently Used | |
| Hydrocodone | 56 |
| Oxycodone | 25 |
| Fentanyl | 15 |
| Morphine | 13 |
| Methadone | 8 |
| Propoxyphene | 8 |
| Hydromorphone | 5 |
| Other | 6 |
| N(%) | |
|---|---|
| Dress without assistance | 82 |
| Attend church/social events | 89 |
| Read newspapers, books, magazines | 97 |
| Gainful employment | 25 |
| Care for family | 61 |
| Ambulate unassisted | 85 |
| Ambulate with cane | 5 |
| Drive a car | 74 |
Discussion
Recent epidemiologic studies indicate that about 10 million Americans now take opioid drugs for chronic pain control. This relatively recent and dramatic occurrence has had little outcome study.1,2 The author recently reported 24 Southern California chronic pain patients who were treated with opioids over 10 years and who had positive social, physical, and functional results.1 Outcomes from other patients treated by other physicians in other geographic areas were needed to confirm or deny the positive outcomes found with one physician in one geographic area. As stated above, this survey was not intended and doesn’t imply that there are patients who may have done as well or better if treated differently. Also this survey does not include patients who did not respond to opioids or stopped them due to complications.
This survey doesn’t lay claim to any sophisticated epidemiogic methodology or randomization. All this survey intended to do was meet one fundamental goal: “Are there chronic pain patients in the United States who have taken opioids over 10 years and report less pain, better function and have a better quality of life?” This survey satisfies this simple goal.
Conclusion
Patients reported here are functioning quite well after 10 or more years in opioid treatment. The vast majority can care for themselves and even drive. Opioid dosages have generally remained stable for long periods without significant escalation. Given the findings here, there is no obvious reason to discourage opioid use or encourage pain patients to cease opioids.
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