One veteran tells the story of his struggles trying to manage chronic pain

One veteran tells the story of his struggles trying to manage chronic pain

https://newschannel9.com/features/price-of-freedom/one-veteran-tells-the-story-of-his-struggles-trying-to-manage-chronic-pain

We have spent several weeks reporting on the crisis of drug and opioid related deaths and overdoses and what’s being done about it.

Tonight in the Price of Freedom we take a look at part of this crisis that many believe is overlooked. That is the people who suffer with chronic pain and now don’t have access to the pain medications they desperately need.

And many of those people who need help have worn our country’s uniform.

Scott McConathy enlisted in the Air Force in 1993.

He was 19 years old.

“I basically enlisted right after high school,” McConathy told us via Skype.

April 19, 1995 is a day many people in this country will never forget.

At 9:02 AM The Alfred P Murrah Building in Oklahoma City was bombed killing close to 170 people and injuring more than 680 others.

That morning Scott McConathy was 8 and a half miles away at Tinker Air Force Base. He was one of the many people who responded to the bombing.

“When I showed up it was such a big explosion that it actually had lit vehicles on fire that were down the road,” McConathy said. “There’s all these fires going on, and they didn’t know that it was a bomb at first.”

He spent the first two days at the site of the explosion then he volunteered to work with the U.S. Marshals.

“They would get bulldozers and load up dump trucks.” McConathy said. “They would take them out to this field and dump them, and me and other guys and Marshals would sift through. What it was it was evidence collection, and in that process. And I don’t want to get too much into it because it’s upsetting, but there was a nursery that was there. So there were things that you see that I thought actually was a doll part, but it turned out to be remains.”

Today Scott and his wife Emily live in Oregon.

Scott says for months he has struggled to leave his home.

He suffers from PTSD from the Oklahoma City Bombing. He has Crohn’s Disease and chronic pain from injuries to his back and knees from training incidents during his time serving in the military and several other health issues.

“It’s pretty bad. Just trying to survive every day hour by hour,” McConathy said. “Sometimes it feels like a minute will go by and it feels like three or four hours, and the days are just really, really long.”

He says a little more than a year ago he was feeling much better.

He was able to work and sleep and go on hikes with his wife so he says he asked to have his medication reduced by 50 percent.

Scott told me for 12 years he was prescribed 60 mg of Morphine 3 times per day.

He says after working with several doctors to find a level of pain management that would work for him medical records he provided us show he was eventually prescribed 40 milligrams of hydrocodone per day.

That is a fraction of what he was taking a little more than a year ago.

Not long after that he claims he was told the VA would no longer prescribe him any pain medication.

He says now he can’t manage his pain enough to work, sleep through the night, and he struggles to leave his home

“I can really see how other people that don’t have the support system that I do that this could actually cost lives in a couple of different ways,” McConathy said. “There is a lot of hopelessness in this. I do have a little bit of hopelessness when it comes to the medical system just not my life. I love my life.”

Scott McConathy says during all of this he asked to have his pain medication increased, but claims that request was denied several times by doctors at the VA.

He told us he took his complaints to the White House Veterans Crisis Line, and his local VA Medical Center’s Chief of Staff.

He claims not long after that conversation he was told the VA would no longer fill his pain medications.

He told me that he believes that was “retribution” for his complaints.

We reached out to that VA Medical Center in Oregon for comment. They have not specifically spoken about this veteran’s case, but they did defend the Administration’s practices on pain management.

VA has been recognized by many as a leader in the pain management field for the responsible use of opioids, and the department is sharing its knowledge and experience with federal and local governments and across the nation’s health-care networks.

In 2017, VA released its top eight best practices for reducing opioid use.

These best practices are invaluable tools for others working to balance pain management and opioid prescription rates.

In 2018, VA became the first hospital system in the country to publicly post its opioid dispensing rates.

Because some Veterans enrolled in the VA health care system suffer from high rates of chronic pain, VA initiated a multi-faceted approach called the Opioid Safety Initiative (OSI) to make the totality of opioid use among America’s Veterans using VA health care visible at all levels in the organization.

Results of key clinical metrics measured by the OSI from Quarter 4, Fiscal Year 2012 (beginning in July 2012) to Quarter 2, Fiscal Year 2019 (ending in March 2019) demonstrate:

351,971 fewer patients receiving opioids (679,376 patients to 327,405 patients, a 52 percent reduction).

97,925 fewer patients receiving opioids and benzodiazepines together (122,633 patients to 24,708 patients, an 80 percent reduction).

252,295 fewer patients on long-term opioid therapy (438,329 to 186,034, a 58 percent reduction).

The overall dosage of opioids is decreasing in the VA system as 43,254 fewer patients (59,499 patients to 16,245 patients, a 73 percent reduction) are receiving greater than or equal to 100 Morphine Equivalent Daily Dose.

These results have been achieved during a time that VA has seen an overall growth of 255,431 patients (3,959,852 patients to 4,215,283 patients, a 6.5 percent increase) that have utilized VA outpatient pharmacy services.

We expect even better management of pain medications for Veterans when VA and the Department of Defense roll out new, integrated electronic health records.

The new records will give health care providers a full picture of patient medical history, enabling better treatment and better clinical outcomes.

It will also help us better identify Veterans at higher risk for opioid addiction and suicide, so health care providers can intervene earlier and save lives.

New York state plans major lawsuit against drug makers – Governor Andrew Cuomo accuses drug makers of causing ‘immeasurable’ damage; reaction on ‘The Five.’

New York state plans major lawsuit against drug makers

Sep. 11, 2019 – 6:37 – Governor Andrew Cuomo accuses drug makers of causing ‘immeasurable’ damage; reaction on ‘The Five.’

Neighborhood pharmacies, under siege

Neighborhood pharmacies, under siege

https://www.nydailynews.com/opinion/ny-oped-neighborhood-pharmacies-under-siege-20190909-gca6eanb2fb63psmxf2f6u22qa-story.html

I proudly represent hundreds of neighborhood-based pharmacists who stand at the front line of health care for families in their communities. Patients depend on their pharmacists for advice on medications, to ask general questions about their health and of course to get the medicine they need, when they need it.

Across New York State, neighborhood pharmacies play a big role in our economy. The National Community Pharmacists Association reported that the Empire State was home to some 2,400 community-based pharmacies in 2017. They generated approximately $8.4 billion in outlet-wide sales and employed more than 22,000 people that year.

But today, independent neighborhood pharmacies face a serious competitive threat. You may assume I’m referring to chain pharmacies, but I’m not. You might think chain drug stores pose challenges to us, but we’re happy to go head-to-head with them when it comes to the quality and intimacy of our services.

In fact, the primary threat to our survival comes from a cadre of greedy middlemen who occupy an obscure and exploitative stratum of the prescription drug supply chain. Called Pharmacy Benefit Managers, they’re a powerful force wreaking havoc on local drug stores.

The stealthy, all-but-extortionate impact of PBMs has surged in the past few years.

  

OK, so what do these PBMs actually do?

Originally designed to help insurers manage insurance claims paperwork and provide administrative support, PBMs have grown into an unwieldly, hydra-like beast. PBMs play the role of middlemen among insurers, drug makers and pharmacies, exercising control over which drugs your insurance will cover, drug prices and the reimbursement levels pharmacies receive when distributing medications. They can even dictate which drugs doctors can prescribe for you.

And they’ve consolidated. Today, the vast majority of prescriptions are processed by PBMs that own or are owned by major national health insurance companies – Cigna, United HealthCare and Aetna – and these three PBMs, all Fortune 25 corporations, collectively control nearly 80% of the market.

  

Not only can PBMs determine what drugs a patient uses; they can also determine where a patient gets their drugs. PBMs will frequently self-refer patients to mail order or chain pharmacies that are in their network, resulting in a greater return for the PBM even though this may not be the most affordable option for the patient.

Last January, a survey of more than 500 New York City neighborhood pharmacy owners conducted by the New York City Pharmacists Society showed how deeply PBM abuses are jeopardizing the viability of “mom-and-pop” pharmacies. Seventy percent of the owners were forced to reduce store hours or lay off employees last year because of PBM abuses. Ninety-two percent have contemplated similar curtailments this year for the same reason.

One nefarious PBM practice is called “spread pricing,” which usually pertains to the pricing of generic drugs. Under spread pricing, PBMs charge their sponsor-client one price for a drug, then most often pay the dispensing pharmacy a much lesser amount (frequently below the pharmacy’s cost), pocketing the difference for themselves.

 

This is contributing to the closure of family pharmacies. And it cost the state’s Medicaid managed care organizations at least $300 million in overcharges in 2018, according to the Pharmacists Society of the State of New York.

PBMs often force neighborhood pharmacies to sign onerous, take-it-or-leave-it contracts that dictate reimbursement rates. As small mom-and-pop businesses, we’re in no position to go up against some of the country’s largest corporations.

A recent state Senate report found that PBMs often demand patients to fill prescriptions using PBM-owned mail order pharmacies, further impairing the viability of local pharmacies.

  

Fortunately, lawmakers are now recognizing the damage caused by PBM misconduct and are starting to reel in their power. For example, while “spread pricing” continues in the private sector, Albany recently banned its use in the state’s Medicaid program. And, taking a cue from several other states, both houses of the state Legislature recently passed a PBM reform package that will help protect patients, taxpayers and neighborhood pharmacists from our broken prescription drug system.

The bill would mandate the licensing and regulation of PBMs, require disclosure of the details of “spread pricing” in both private and public insurance plans, and require disclosure of information on discounts, rebates and other kick-backs they receive from drug manufacturers — and make sure those savings are passed on to consumers.

Now, it’s up to Gov. Cuomo to sign this bill. The time has come to neuter the deleterious impact of this industry.

Chronic Pain Suicide: as seen on the web 09/11/2019

My close friends brother-in-law committed suicide last Sunday, he wasn’t found until tuesday. He suffered chronic pain, would run out of his meds early and use alcohol in between time. He isolated himself.

This last refill, he took them all and left a 3 page letter. His name is Mark Apple. He leaves behind 2 brothers (one is a twin) and his mother. He was unmarried and had no children.

This is so sad. I hate this so much. There is just no reason this should happen, that people lose hope simply because they can’t get relief.

“Narcan is as useful for me as a screen door on a submarine”

DEA proposes lowering opioid production quotas by 30% , expanding marijuana research

DEA proposes lowering opioid production quotas, expanding marijuana research

https://www.washingtontimes.com/news/2019/sep/11/dea-proposes-lowering-opioid-production-quotas-exp/

The Drug Enforcement Administration on Thursday proposed reducing the manufacturing quotas for the five most frequently abused opioids by an average of 30 percent in 2020.

Simultaneously, the DEA announced it would triple the amount of marijuana grown for research.


The moves signal the Trump administration is cracking down on opioid abuse while softening its hard-line stance on marijuana as a number of states continue to legalize its use.

DEA takes seriously its obligations to both protect the public from illicit drug trafficking and ensure adequate supplies to meet the legitimate needs of patients and researchers for these substances,” DEA acting Administrator Uttam Dhillon said in a statement.

The anti-drug agency said will reduce fentanyl production by 31 percent, hydrocodone by 19 percent, hydromorphone by 25 percent, oxycodone by nine percent and oxymorphone by 55 percent.

Combined with a reduction in morphine, the proposed quota would decrease opioid production by an average of 53 percent since 2016.

The DEA is requesting more than 3.2 million grams of marijuana to be grown legally in 2020, up nearly a third from the 2.4 million grown this year. The increased haul will be used for scientific research.

Both proposals are part of the DEA’s annual quota for manufacturing controlled substances to meet the nation’s medical, scientific, research and industrial needs.

800,000 GMS increase in MJ for RESEARCH… that is abt 1750 lbs.. or about 5 lbs/day.

Cut the availability of opiates for legal therapy, and increase MJ for RESEARCH… meaning that it could take 10-15 yrs before that research could get a meaningful MJ product for treating various health issues… NO GUARANTEES that anything will prove to be useful for treating any health issue.

So the DEA is determining the level of therapy that both acute and chronic pain pts require… without examining the FIRST PATIENT ?

Human Rights Watch Accuses Tennessee Of Over-Regulating Pain Management

Human Rights Watch Accuses Tennessee Of Over-Regulating Pain Management

https://www.nashvillepublicradio.org/post/human-rights-watch-accuses-tennessee-over-regulating-pain-management#stream/0

A report from Human Rights Watch accuses Tennessee of regulating opioids to the point of depriving patients in pain. Along with Washington State, the analysis focuses on Tennessee because of its new prescribing regulations, which are considered some of the strictest in the nation.

In its 109-page report, Human Rights Watch interviewed patients who were involuntarily weaned off of high-doses of powerful painkillers. Tennessee’s new law doesn’t directly impact so-called chronic pain patients, but it seems to have had a chilling effect. Several tell the advocacy organization that their doctors feel pressure to lower everyone’s dosages.

Gail Gray of Celina, Tennessee, tells HRW that her primary care physician cut her pain medication nearly in half but still felt like he could get in trouble. So Gray was forced to a clinic an hour away, which she worries might be a “pill mill” since they only take cash.

“I’m not comfortable with this. I feel like he [my primary care doctor] has pushed me into doing something that’s not right, and I don’t want to break the law,” she said.

More: Tennessee Doctors In Training Mode As Nation’s Tightest Opioid Restrictions Take Effect

HRW also interviewed clinicians, like a nurse practitioner from Vanderbilt’s hematology department who tells of her difficulty with insurance companies denying heavy prescriptions for a sickle cell patient.

A doctor in Knoxville describes how a new state law requiring physicians to try alternatives before turning to opioids has resulted in risky decisions. At times, he’s recommended surgery as a first course of action, just to avoid flack from regulators.

“It’s really against everything I was trained to do, but it’s the will of the legislators and regulators,” Dr. Joe Browder said.

The state did not respond to the study, which was funded by the U.S. Cancer Pain Relief Committee, a nonprofit with ties to pain management and the pharmaceutical industry. But Human Rights Watch says its top recommendation is for states to just limit the unintended consequences of cracking down on opioid prescribing.

Calling all CPP group leaders and CPP advocates

Calling all CPP group leaders and CPP advocates:
We are developing a questionnaire to send out to House, Senate, and Presidential Candidates to find out their positions on areas of our concern. By doing so, we also tell them those areas of concern, and hopefully get them to be vocal about them on the campaign trail. It’s time that the topic of the war on doctors and patients no longer be ignored by the political parties and their candidates.

This is a major undertaking, with hopefully 1000+ replies. We will need to have a data-evaluation service or some manner of organizing and reviewing the replies.

Are you willing to help? If so, reply on the Contact form on https://doctorsofcourage.org/communication-campaign/.
Right now, please give us questions you think are pertinent to be answered by the candidates. Tell us if you are willing to work on a panel to construct the questionnaire. If you know of anything like this that has been done before, please share. And last, but definitely not least, tell us if you have access to a data-evaluation program, or could get your hands on one. This is way over my level of IT capability. But computer data-crunching would be so much more time-effective than the old-fashioned way.
This is something that we can all do together with the greatest impact to make a difference in the War Against Doctors and Patients. I hope that all leaders get involved in one way or another. Please re-post to your own group as well, to spread the word. Share by email to all advocacy groups.

The Washington Post is interested in speaking with pharmacists and pharmacy technicians

The Washington Post is interested in speaking with pharmacists and pharmacy technicians who worked at chain drug stores during the opioid crisis between 2006 and 2014. If you want to talk to one of the reporters, reach out to Meryl Kornfield. Her cell is 305-798-6033 and her email is meryl.kornfield@washpost.com.
 

Medical Board Corruption is violating Your Constitutional Rights!

Medical Board Corruption is violating Your Constitutional Rights!

https://www.change.org/p/dr-arnold-feldman-medical-board-corruption-is-violating-your-constitutional-rights?recruiter=461102418&utm_source=share_petition&utm_medium=facebook_messenger_mobile&utm_campaign=psf_combo_share_initial&recruited_by_id=16638790-b554-11e5-b0b3-9db5ca0edfe4&share_bandit_exp=initial-17753323-en-US&share_bandit_var=v1&use_react=false

                                           Feldman v Federation
Patient Petition

For Patients and their families, friends and loved ones

We, the undersigned, submit this petition in support of the above lawsuit, filed by Drs. Feldman and Kaul. We are the patients, the people without whom the American healthcare system would not exist, and the people for whom the system was intended to serve. We all suffer from chronic debilitating pain, that has had devastating and tragic consequences on our lives, and those of our fathers, mothers, brothers, sisters and children. We, the voting public, the people of this country, have been forgotten by the politicians, the insurances companies and healthcare corporations, who have raped our healthcare system for profit, mercilessly and behind their faceless corporations, have, through their predatory pricing deprived us of life saving care. We are dying and no one cares, except our doctors, healers like Drs. Feldman and Kaul.
 
Within at least the last five years, our access to life saving treatment has been either severely reduced or completely eliminated. This is a direct consequence of rampant corruption within state medical boards and reckless, evidentially unsupported policies propagated by politically motivated state and federal bureaucrats. These agencies and the people who work within them do not care for our welfare, our lives and the unrelenting pain in which we now live, because of their own selfish economic and political agendas. We wake in pain, we live in pain, and when we can actually go to sleep, we know that our relief will be short lived. Many of us think about suicide every day. At least in death we will have relief from the excruciating agony that now plagues our existence, because corrupt medical boards have taken away the licenses of our doctors, and deprived us of care. For some of us, our doctors have been sent to jail for life, for simply doing their job, that of healing our pain. We are shocked, saddened and find it hard to believe we live in America, the supposed land  of the free and the brave. Well those brave enough to treat our complicated and debilitating pain have been mercilessly thrown into concrete cages, had their careers destroyed and left to rot, while we, and there are now many of us, have been abandoned by the profiteers and opportunists who now run our healthcare system. At the center of this cesspool of corruption are the state medical boards, who claim to “protect the public”. This is a massive lie.
 
These agencies abuse their power, unregulated, unsupervised and existing not to help the public, but to exploit and profit from the public, us. They use us as their excuse, their cover, to perpetrate their crimes against humanity. Their crimes contribute to the epidemic of physician suicides in the United States, reported as four hundred a year, although the number is likely much higher, and they kill patients, by taking away our doctors, jailing our doctors and causing them to commit suicide. Corrupt medical boards have permitted corrupt insurance companies, pharmaceutical companies and healthcare corporations to financially rape the American public, dictate local healthcare policy, and revoke the licenses of our doctors in the most cruel and arbitrary manner, with no regard for due process or the law. All of these events have caused us and our families immense suffering, and for too long we have suffered in silence, hoping that eventually sense would prevail, that our doctors would start to take care of us once again, without fear of jail or license revocation. We now see that hope in the lawsuit that Drs. Feldman and Kaul are about to file. We see two dedicated, courageous and committed men, whose fight is a righteous one, one for the people, for us, the American people, the people who pay taxes, who vote and who power, we are convinced, will cause Drs. Feldman and Kaul to prevail in their landmark case to end medical board corruption.
 
We will be victorious in our fight for justice.