BRITAIN’S POSTAL SCANDAL BASED ON FLAWED PROGRAMING RESULTED IN A MAJOR MISCARRIAGE OF JUSTICE TO POST OFFICE WORKERS
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“OPIOIDGATE:” U.S. DEA TARGETING BASED ON FAULTY SOFTWARE GLITCHES RESEMBLING BRITIAIN’S POSTAL SCANDAL: MILGRAM MUST STEP DOWN
Posted on January 14, 2024 by Norman Clement
Here’s Why Drug Stores Are Closing In Minority Neighborhoods: Walgreens, CVS, And Rite Aid Shutter More Than 1,000
Posted on January 14, 2024 by Pharmaciststeve
This report is a SORT OF MISS LEADING! The two highest-scoring pharmacies ( Good Neighbor Pharmacy & Health Mart) are not chains, in the truest sense. They are both Franchisees and are owned/operated by local pharmacists. Many are independent Pharmacists who converted their independent pharmacy into a franchisee of these pharmacy franchisors corporations. This is just another validation of why I always recommend that pts patronize an independent pharmacy.
The two largest pharmacy chains showed up 4th & 5th on the list with scores that were even LOWER than the average score for all chain pharmacies. In third place is Rite Aid, who is/has filed for BANKRUPTCY. In 2017 they sold off about half of their stores to Walgreens. In 2019 they had a 20:1 REVERSE STOCK SPLIT, to keep from their stock (RAD) from being taken off ( delisted) the NYSE and their stock price grew to $32.48 in late 2020. Their stock closed Friday (01/12/2024) at $0.46/share, and the DEA is “going after” Rite Aid over a handful of their Pharmacists claiming that their stores were https://www.justice.gov/usao-ndoh/pr/united-states-files-complaint-alleging-rite-aid-dispensed-controlled-substances and yet has a higher customer/pt satisfaction score than the two largest chain pharmacies ( Walgreens & CVS).
The satisfaction score of the two largest chain pharmacies fell below the AVERAGE SCORE for the entire category of Brick & Mortar – chain drug stores. Walgreens used to claim: 
I guess it is no longer correct if you are 4th in a satisfaction survey. Here is a link to find an independent pharmacy by zip code and radius https://ncpa.org/pharmacy-locator
Here’s Why Drug Stores Are Closing In Minority Neighborhoods: Walgreens, CVS, And Rite Aid Shutter More Than 1,000
A spate of pharmacy closings in Boston have drawn protests as more than 1,000 drug store chain locations across the country have closed, reigniting long standing concerns that low-income, Black and Latino Americans are bearing the brunt as pharmacies continue to disappear amid increased competition and other factors.
Key Facts
Rite Aid, Walgreens and CVS have, over the last two years, said they’ll close more than 1,500 stores, the Washington Post reported, and experts say minority communities will likely be the first to lose pharmacy access.
The large chains have struggled in recent years—Rite Aid filed for bankruptcy in October, Walgreens stock plunged last week after the company cut its quarterly dividend and CVS has cut more than 1,100 stores since 2018—amid greater competition from Amazon and WalMart, and staffing shortages, according to the Washington Post.
Thousands of independent pharmacies have also been forced out of the market in the last decade.
Research conducted in 2022 by Cornell and Yale University scientists found of the 670 pharmacy deserts in New York City, Los Angeles, Chicago and Houston, all but three were found in predominantly minority neighborhoods.
Crucial Quote
“In Chicago, almost a third to a quarter of the population lives in a pharmacy desert and, if you look at people who live in predominantly Black neighborhoods, that’s more than half of the people living in those neighborhoods,” Xiaohan Ying, lead author of the 2022 paper, told Fobres.
News Peg
Walgreens has postponed the closure of a location in the city’s Roxbury neighborhood, where Black and Latino residents make up 85.4% of the population, until Jan. 31 following protests from residents, the Boston Globe reported Friday. The closure comes months after the company closed stores in Mattapan, Hyde Park and Lower Roxbury—also majority non-white neighborhoods. There are 18 Walgreens stores in Boston, according to the Globe, but only those in minority neighborhoods have closed in the last few years.
Key Background
In the last few years, all of the country’s major pharmacy chains have announced store closures. CVS will complete the closure of 1,124 stores by the end of this year, Walgreens in June said it would close 450 of its locations across the country by August and Rite Aid’s bankruptcy filing came with announcements of almost 200 store closures. Rite Aid said the stores that were closing are those that have underperformed, and Walgreens said in a statement to Forbes that factors like “existing footprint of stores, dynamics of the local market, and changes in the buying habits of our patients and customers” are why some locations close. CVS, which plans to close 300 stores this year, similarly said in a statement locations are chosen based on “local market dynamics, population shifts, a community’s store density, and other geographic access points to meet the needs of the community.” In some cases, “rampant” theft has been blamed for the store’s closures. In October of 2021, Walgreens announced it would close five San Francisco stores, including one in the historically Latino Mission District. But Walgreens’ chief financial officer last Janruary admitted that the company exaggerated the claims of retail theft when it relied on the excuse to close the San Francisco stores. The claims fueled rightwing anger over a rise in crime before Kehoe said on an earnings call that the company maybe “cried too much” about retail shrinkage.
Contra
Jenny Guadamuz, a researcher at the University of California at Berkeley, said the stores that close are almost always in Black or Latino communities. Because minority communities are more likely to have residents on public healthcare programs like Medicaid, which sees a lower medication reimbursement rate than many private insurers, it’s likely true those stores are often a cost burden when compared to others, Guadamuz said. “What they care about is maximizing profits for their shareholders,” she said. “They’ll make any excuse to close lower-profit stores, which are in these Black and Latino communities.”
Tangent
Rite Aid in late 2022 debuted the first of its small-format stores it says exist to combat pharmacy deserts in communities. The chain has opened several stores so far—which take up about 3,000 square feet instead of the usual 11,000 to 15,000—in rural Virginia.”They are strategically placed in areas that don’t have nearby access to pharmacy-related health care services,” Rite Aid said in a statement to Forbes.
Surprising Fact
A study in the Journal of the American Medical Association showed that those without easy access to pharmacies are more likely to fall behind on taking medications and see more medical problems than they likely would have with equitable access, “adding costs to the already overwhelmed health care system.” Those without access to medications join the estimated 9 million Americans who aren’t taking their prescription drugs as prescribed for a number of reasons, including a lack of health insurance and overall cost of medicine. Non-adherence to recommended medication schedules is estimated to cost the United States between $100 billion and $290 billion per year.
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Missing organ mystery: Alabama inmates’ remains returned without a heart | Banfield
Posted on January 13, 2024 by Pharmaciststeve
The bodies of two men who died while incarcerated in Alabama’s prison system were returned to their families missing their hearts and other organs, according to a federal lawsuit. Joseph Scott Morgan, a professor of forensics at Jacksonville State University, joins “Banfield” to discuss.
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When healthcare providers end up really being healthcare deniers
Posted on January 13, 2024 by Pharmaciststeve
I got the email below on Jan 1, 2024. This pt’s story is not a unique issue. Another example of bureaucrats and politicians attempting to “solve” our fabricated opioid crisis by creating a “one size fits all” on pain management.
After having this blog for 12-13 yrs, I have developed a fairly sizeable network of chronic pain pts, chronic pain advocates, and numerous healthcare practitioners. I shared this woman’s email with a couple of select people that I believed might be able to STEP UP. And one did:
When a pt’s long term medical records mean nothing when seeing a new practitioner
When everything seemed to start to fall into place for this young lady. This young lady’s pharmacist and the mid-level practitioner who was forcing her to reduce her pain meds had to step in to make sure that things were not going to change the way that this mid-level practitioner wanted things to happen. Here is a video this young lady sent that she personally explains what has happened.
Hi Steve,
I have sent you my story before. I am a single disabled palliative care sick patient in Maine. In September of 2021, my doctor and I were targeted by the assistant attorney general, Michael Miller. We think it was for 2 reasons-he was very effective at getting patients disability, testings, procedures, equipment, etc and because I require a high dose of opiates to physically and mentally function. Dr. Lommler believes Michael Miller made a deal with the insurance companies and profited somehow for taking him out. Michael Miller used at least 2 agencies to target, harass, and destroy us. They suspended Dr. Lommler’s license for going over the 100 MME limit on my prescription. However, Maine has a palliative care exemption that allows people (like me) to have access to opiates for pain control and disease treatment options. It also allows us to go over the 100 MME limit. They refused to lift the suspension unless he transferred to a “board approved” facility. He chose to retire because he wanted to stay at his independent office with his 200 complicated and unique patients. They gave neither one of us any due-process! They used backdoor methods and I believe they were illegal! There was a covering LNP seeing me for a year. We tried to find a doctor everywhere in Maine to see me but because of the Opiate Task Force and doctors getting red-flagged for going over the 100 MME limit and being dragged in front of the board, no one would see me. I was forced to transition to the hospital where all of my specialists are. You see, Maine and New Hampshire were the 2 states prescribing the most Opiates so they created a New England Opiate Task Force and sent them to work with the Governor Mill’s administration to red-flag doctors prescribing over the 100 MME limit and drag them in front of the board of medicine! They have forced independent providers to either retire or transfer to a “board approved” facility. These “board approved” facilities all have anti-opiate one-size-fits-all policies. The hospital that I am at has an anti-opiate provider masquerading as a “pain specialist.” She believes Opiates are life threatening and dangerous to everyone. She is force tapering me off all my pain medication! I am complicated and unique-I have multiple health conditions. I had an original medical nightmare that left me with life altering physical deformities and severe debilitating pain. I have Crohn’s disease, vitamin and bone deficiencies, and neuropathy-all of these cause malabsorption so I have to take double doses of all of my medication! I cannot have the conventional pain management treatments because I am allergic to everything and sensitive to anything and I have a prosthetic heart valve. I have Scoliosis and severe Osteoporosis with dangerously low Scores. I am 46 in an 86 year old’s body.
They are stereotyping anyone on opiates as addicts and forcing them off pain medication. The only option they give you is Suboxone-I cannot take this because the side effects would be catastrophic to my body. I had nothing but recovery and progress with my 8 1/2 year stable pain regimen. I was able to semi function independently with a decent quality of life. Since this provider has been force tapering me, I can no longer function independently at all and I have zero quality of life! According to Maine’s own definition and standards, what this facility and provider are doing to me is disability abuse! I tried to contact patient services for an advocate but was told there wasn’t one. The woman I spoke with for 2 minutes, asked me what my concerns were. I explained to her what was happening to me. 2 days later I received a letter stating my concerns were forwarded to the Medical Director and Operations Manager and they agree with the provider force tapering me. They also said there was no medical justification for my pain medication. I filed a public accommodation discrimination complaint with the Maine’s Human Rights Commission but haven’t heard a word since intake months ago! The letter gave an 800 number to call if you disagreed with their decision. It was the board of licensure telling you to submit a complaint. I already filed a complaint with the board of medicine and nurses months ago. So, you have to go to the same people that are red-flagging and harassing doctors going over the 100 MME limit. I won’t hold my breath! These are the same people that asked Dr. Lommler how he didn’t know that I was taking half of my pain medication and selling the other half! Dr. Lommler provided them with 7 1/2 years worth of passed urine screens and passed frequent random pill counts! I wasn’t even allowed to attend or participate into the investigation into my opiate use-I could’ve answered that question myself-I have never misused my pain medication! In fact, I did everything that I was supposed to do! How in the world can I trust they will help me!
Since this provider has been forcing me off my pain medication, I have had sky high blood pressures-202/129, severe bloody noses, I have been discharged from aquatic therapy-which I needed to get into my Crow Walker boot, I am completely dependent on my sons, I have had to quit tutoring for supplemental income, I can no longer walk on my crutches so I am trapped in my wheelchair, and I cannot mentally or physically function! My counselor and former providers have tried talking with this provider but she refuses to listen because she knows best. I had to spend my Christmas in the ER and I am now watching my right leg and foot do exactly what my left leg and foot did in my original medical nightmare. When my body is in severe stress, my multiple conditions play off of one another and wreak havoc on my body. Last time, the severe stress was an allergic reaction to hardware (we didn’t know why at the time, it took years to figure it out). This time, it is force tapering my pain medication! This time, it’s the providers choice to force taper me because of her personal feelings about a medication! Medical providers are supposed to do what is in the best interest of the patient, not what is in the best interest of their personal feelings! I have cellulitis in my right leg and foot with ulcers everywhere! I maintain my left leg and foot with Cuban for compression. I tried to wrap my right leg and foot but it’s not used to being wrapped, and I get continuous Charley Horses. They are intolerable with all of my pain medication being taken away! I have severe PTSD and zero trust in doctors from my original medical nightmare! I never ever wanted to go back to that sick person trapped in a wheelchair, I thought I left it behind for ever! This time, I don’t have a heart valve to lose! I am petrified and profoundly devastated because I worked so hard for 8 1/2 years to recover and progress and now that has been destroyed! I see people helping doctors that have been arrested but what about people, like me, who have been targeted, harassed, discriminated against, and literally going through disability abuse-who tells our story and helps us?
My counselor gave me a brochure for adult protective services and she told me to call because what they are doing to me is discrimination and disability abuse. I called and the lady said there is no process for this situation. She told me that it does qualify but the only thing I can do is file a complaint with the board of medicine and nurses because they are the only entities that have authority and jurisdiction over medical providers. I told her that I already filed complaints but it will take months because they only meet one day a month! I told her my body won’t make it that long and I asked her, “what if I die in the meantime?” She said, “let’s hope it doesn’t come to that but good luck!” WHAT? It’s like a nightmare that I cannot wake up from! I have contacted every politician in Maine and asked for their help. Crickets…I requested assistance from Governor Mills but she doesn’t even think she has to answer to her constituents. I have reached out to every volunteer lawyer’s projects and disability rights groups but they all claim no to have the resources to help me. I have documented, taken pictures, recorded videos, screenshot messages from my portal between her and I, audio recorded my video appointments exposing her discrimination and disability abuse! I cannot find an attorney in Maine to help me. This provider only saw me one time in person! She never looked at any areas causing my pain, she’s not monitoring my vitals or everything that is happening to me, she doesn’t even have the correct MRI’s-she’s going by a 2008 one when I was a normal person and could walk on my own, and she’s retaliating against me for filing a complaint! I need help and I don’t know where or who to go to! I even have an appointment with cancer care, January 23rd. I have MGUS and the blood work markers and symptoms all point to it turning into Multiple Myeloma. I asked her to please pause the force taper until I can get into my appointment. She said, “Oxycodone will not cure Multiple Myeloma so the force taper will continue!” How cruel is that!
I was hoping that you may have some direction or advice to help me. If I knew how to file a civil lawsuit against the hospital and provider, I would do it myself. Since September of 2021, I have had to be my own advocate, case manager, and attorney!
I already missed about 6 years of my sons’ lives because of my original medical nightmare! I can do no physical activity without my pain medication! I really don’t think my body will make it through this force taper! Opiates are literally life saving for me! They knew that I wouldn’t be able to find another doctor to see me and Michael Miller and the board of medicine took 2 doctors from me! The provider force tapering me filed a complaint against the LNP that saw me for a year. In it, she said that she felt compelled because Kaye endangered my life by prescribing these life threatening and dangerous medications. She also accused me of bribing Kaye in her complaint. That is ludicrous-I have never bribed anyone! Kaye made it very clear in her response that no one forced or bribed her. She also made it clear that I was the only patient she ever prescribed narcotics for in her entire medical career! I have been accused of selling half of my pain medication and bribing doctors! I am a law abiding Mainer and American just trying to live my life!
Thank you for taking your time to read my email. You can reach me any time at xxx.xxx.xxxx
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When a pt’s long term medical records mean nothing when seeing a new practitioner
Posted on January 13, 2024 by Pharmaciststeve
This is a very sad story about a 46 y/o female whose practitioner of 8 yrs who retired apparently because of his employer deciding how he was to practice medicine and treat pts. Eventually, she was “passed off ” to a mid-level practitioner who started her on a forced reduction of her opioids, and of course, her overall QOL started deteriorating.
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Emmalyn’s Journey funding raising
Posted on January 12, 2024 by Pharmaciststeve
Are you in a soon to become PHARMACY DESERT?
Posted on January 12, 2024 by Pharmaciststeve
Back in the day, in the typical chain pharmacy, 80%+ of the business was in the front end and the balance was in the pharmacy/prescriptions. Thanks to the likes of Amazon, the front end of most chain pharmacies is DYING and the gross profit margins are close to HALF of what they were back in the day in the pharmacy- mostly thanks to the PBM industry. The large chain pharmacies are closing stores because they are not as profitable as they want and some are going the route of CVS in acquiring $10.6B acquisition of Oak Street Health to expand their primary care footprint. Oak Street is a Medicare-focused primary care company. After all, CVS owns Aetna Insurance which provides Medicare-C (Advantage) and Medicare Part D programs. Eventually, all of these medical healthcare companies will end up creating many “healthcare deserts” and some “healthcare oases”. Depending on the population density of where the pt lives, getting access to healthcare could be 10-30 miles from their home.
CVS closing select Target pharmacies, with plans to close 300 total stores this year
CVS is continuing to shutter storefronts in the new year and plans to close select pharmacies inside Target locations in the coming months.
The closures are set to begin in February and should be completed by the end of April. Spokesperson Amy Thibault did not address questions on how many stores are set to close, but The Wall Street Journal reported that “dozens” would be affected.
The closures are part of CVS’s plan to shutter roughly 900 ‒ or 10% ‒ of its stores. The pharmacy chain has closed about 600 stores since 2022 and expects to close the remaining 300 this year.
Why is CVS shuttering pharmacies?
Thibault said the closures are part of CVS’s plan to reduce store and pharmacy density.
The closures “are based on our evaluation of changes in population, consumer buying patterns and future health needs to ensure we have the right pharmacy format in the right locations for patients,” she said in an emailed statement.
Other major pharmacy chains, including Rite Aid and Walgreens, have also been shuttering stores amid rising competition, pressure on prescription profits and waning foot traffic. (Rite Aid also faces pressure to cut costs as it faces a slew of opioid lawsuits. The company filed for bankruptcy last year.)
A sign on the front door of CVS Pharmacy,1535 W. 26th St, announced the storefront will close but the pharmacy will remain open. The storefront will become an Oak Street Health primary care clinic sometime in 2024.
Pharmacists at the three chains have staged walkouts in recent months to protest deteriorating working conditions stemming from a lack of staff and resources.
Which CVS pharmacies are closing?
Thibault declined to share a list of the affected locations.
What happens to CVS employees?
Impacted employees will be offered comparable roles within the company, Thibault said.
What about the customers?
Patient prescriptions will be transferred to a nearby CVS Pharmacy before the closures.
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THE STORY OF PHONEY ALGORITHMS, CIVIL ASSET FORFEITURES, EXPOSING DEA AS A CRIMINAL ENTERPRISE AND HOW GOVERNMENT PROTECTS THE CORRUPTION
Posted on January 12, 2024 by Norman Clement
Is this but just one of the faces that was part of the start of our opioid crisis?
Posted on January 12, 2024 by Pharmaciststeve
Is this but JUST ONE OF THE FACES… that contributed to the beginning of our illegal Fentanyl poisoning crisis? He tells Congress that addiction is a DISEASE… He just won:
Jelly Roll Wins New Artist at 2023 CMA Awards, Urges Fans to Keep Going in Rousing Speech
Personally, I am not a big COUNTRY MUSIC LISTENER, most all the musical artists that listen to are DEAD… my musical tastes are from the 1950s & 1960s and early ROCK & ROLL!
Is Jelly Roll the highly visible personality that could also be a valuable spokesperson for the chronic pain community?
https://www.congress.gov/bill/118th-congress/house-bill/3333/text
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Medical board publishes new guidelines on prescribing opioids for pain
Posted on January 11, 2024 by Pharmaciststeve
If you read the hyperlink below, it concerns a practitioner in Calf that back in Nov 2022, his office practice was raided and shut down by the DEA… NOT THE MEDICAL BOARD OF CALIFORNIA. One of this practice intractable chronic pain pts – 61 y/o – Danny Elliott, who was nearly electrocuted to death in 1991 that precipitated his intractable chronic pain. This physician’s office practice was the third pain clinic that Danny was a pt of since 2018 and shut down by the DEA.
Danny & Gretchen lived in Virginia and flew out to California every 90 days to see Dr Bockoff and they had just arrived in CALF for Danny’s quarterly office appt. Suggesting that he had maybe a few day’s worth of Fentanyl patches on hand. After contacting over 12 different pain clinics and being turned away, they BOTH COMMITTED SUICIDE!
This Couple Died by Suicide After the DEA Shut Down Their Pain Doctor
Medical board publishes new guidelines on prescribing opioids for pain
The Medical Board of California recently published a long-awaited update to its opioid prescribing guidelines, which will make it easier for patients to get the care they need while maintaining appropriate safeguards. Importantly, the medical board has clarified that the guidelines are not intended to replace a physician’s clinical judgment and individualized, patient-centered decision-making.
The guidelines are consistent with recommendations from the California Medical Association (CMA), which had urged the medical board’s Opioid Prescribing Task Force “to use balancing between appropriate risk assessment and ensuring that patients receive individualized care as the guiding principle as you work on this latest update of the guidelines.”
In a letter to the taskforce, CMA noted that previous prescribing guidelines were acutely focused on reducing opioid prescribing to address opioid-related overdose. California already had one of the lowest opioid prescribing rates in the country when the previous guidelines were passed, and has continued to reduce prescribing. The current surge in overdose deaths is related to use of illicit drugs.
The chief of the Stanford University Division of Pain Medicine Sean Mackey, M.D., Ph.D., served as a senior advisor for the medical board’s taskforce and endorsed the revised guidelines.
“I’m a physician scientist, I care for people suffering from chronic pain, many who have intractable pain. Our motivation for revising this document was to learn from the lessons in the past and make it better,” Dr. Mackey said in a letter read at the May board meeting. “We recognize the need to ensure patient access to safe and effective pain management treatment, and at the same time, the need to support physicians providing treatment for people with chronic pain.”
CMA’s requested changes were largely incorporated into the guidelines, including a recognition that the medical board’s Prescription Reviewer Program (formerly known as the “Death Certificate Project”) contributed to physicians being less willing to treat patients with chronic pain.
“We think it is critical to ensure that guidelines recognize the nuance that treating pain requires and acknowledge the complex realities of treating these patients, which include systemic barriers for many patients to access nonopioid therapies or pain specialists and racial and ethnic disparities in care,” CMA wrote in the letter.
The new guidelines address many of CMA’s concerns and adopted CMA recommendations, including:
- Reinforcing the individualized nature of patient care and making clear that it is not intended to be applied as an inflexible standard by health care entities and is not a law, regulation and/or policy that dictates clinical practice.
- Clarifying that patients should not be required to sequentially “fail” nonpharmacologic and nonopioid pharmacologic therapy before proceeding to opioid therapy. The guidelines now state that the basis for initiating opioids should be whether the benefits are anticipated to outweigh the risks of the therapy, rather than by patients having attempted multiple therapies that have inadequately addressed their pain.
CMA also advocated for removing morphine milligram equivalent (MME) thresholds, because those included in the 2016 Centers for Disease Control and Prevention guidelines “established a ‘one-size-fits-all’ approach to opioid therapy that harmed patients” and perpetuated “the false idea that MME thresholds improve patient care.” The adopted guidelines provide a nuanced analysis of using MME, stressing the need for care being individualized and patient centered and for adequate medical recordkeeping that documents prescribing decisions. The final version removed originally proposed language that suggested an upper limit on opioid prescribing of 90 MMEs.
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