Springfield patients suffer as pain med shortages hit the Ozarks

42 USC 1395: Prohibition against any Federal interference

https://uscode.house.gov/view.xhtml?req=(title:42%20section:1395%20edition:prelim)

From Title 42-THE PUBLIC HEALTH AND WELFARE CHAPTER 7-SOCIAL SECURITY SUBCHAPTER XVIII-HEALTH INSURANCE FOR AGED AND DISABLED

§1395. Prohibition against any Federal interference

Nothing in this sub chapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

(Aug. 14, 1935, ch. 531, title XVIII, §1801, as added Pub. L. 89–97, title I, §102(a), July 30, 1965, 79 Stat. 291 .)


Statutory Notes and Related Subsidiaries

Short Title

For short title of title I of Pub. L. 89–97, which enacted this subchapter as the “Health Insurance for the Aged Act”, see section 100 of Pub. L. 89–97, set out as a Short Title of 1965 Amendment note under section 1305 of this title.

Protecting and Improving Guaranteed Medicare Benefits

Pub. L. 111–148, title III, §3601, Mar. 23, 2010, 124 Stat. 538 , provided that:

“(a) Protecting Guaranteed Medicare Benefits.-Nothing in the provisions of, or amendments made by, this Act [see Short Title note set out under section 18001 of this title] shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].

“(b) Ensuring That Medicare Savings Benefit the Medicare Program and Medicare Beneficiaries.-Savings generated for the Medicare program under title XVIII of the Social Security Act under the provisions of, and amendments made by, this Act shall extend the solvency of the Medicare trust funds, reduce Medicare premiums and other cost-sharing for beneficiaries, and improve or expand guaranteed Medicare benefits and protect access to Medicare providers.”

 

Ohio Attorney General asks that CVS store be put on probation “for a period of years”

I find it interesting the statements made by attorneys that CVS hires to defend lawsuits or actions against the chain. This case is just another example:  Kristina Dahmann, an attorney for CVS, she pointed out that the state requires no minimum level of staffing at pharmacies, and that weeks-long backups filling prescriptions don’t necessarily mean that patients are waiting that long for their medicine. “Numbers alone don’t tell the story,” she said.

She obviously did not make any claims about pts going without their medications, because of the number of days of unfilled Rxs in the queue where up to an average number of Rxs a store would fill.  I was at an FL BOP meeting in mid-June 2015, where they were discussing a new regulation that would mandate that pharmacists NOT start looking for a reason not to fill a controlled med, when handed a new Rx. Part of the new regulation was to mandate each FL-licensed pharmacist would have to have 2 continued education hrs every 2 hrs. At the end of the meeting, the BOP’s attorney was caught on a “hot mike” moment saying, “We are going to teach Pharmacists COMMON SENSE.”  Personally, I never figured that common sense was something that could be taught. Maybe pts who are patronizing CVS to have Rxs filled might want to consider their options. Here is a hyperlink https://ncpa.org/pharmacy-locator  to find an independent pharmacy, where pts will be dealing with the Pharmacist/Owner, who generally focuses on the pt’s health, rather than how many $$ they can get out of the pt,

Ohio Attorney General asks that CVS store be put on probation “for a period of years”

Understaffing found at Canton pharmacy appears to be widespread

https://ohiocapitaljournal.com/2024/01/16/ohio-attorney-general-asks-that-cvs-store-be-put-on-probation-for-a-period-of-years/

A deputy attorney general working for the Ohio Board of Pharmacy on Thursday recommended that the board fine CVS and place a store it operates in Canton on probation for “a period of years” after inspectors in 2021 found risks to patient safety due to understaffing.

Attorneys for CVS blamed the problems on the coronavirus pandemic. But the board of pharmacy inspectors found similar problems at a dozen other CVS stores in Ohio — some occurring as recently as last year. 

Problems have also been reported at CVS stores in other states. They raise questions about whether they’re due, as CVS contends, to a shrinking labor pool and increasing demands, or whether they’re the product of relentless cost cutting and consolidation by the company.

When Board of Pharmacy inspectors visited Canton store No. 2063 on Sept. 13, 2021, they found a pharmacy so understaffed that the inside counter was closed, the phone wasn’t working and the line of cars to the dive-through snaked around the side of the building. Stock — including controlled substances — hadn’t been shelved. The staff was so harried that it took inspectors 20 minutes to get somebody’s attention, according to the report, which CVS hasn’t disputed.

Inspectors found that it took almost two weeks for the overwhelmed pharmacy to fill many prescriptions. And on a follow-up call a month later, they were told the backlog for some was a full month.

During that period, the pharmacy also filled a prescription with the wrong medication. The patient was supposed to receive a statin to control cholesterol, but instead got the hypnotic sleep drug commonly known as ambien. Fortunately, the mistake was detected before that person took the medication and went for a drive.

Thursday’s hearing was a continuation of one that began in November, and the pharmacy board isn’t expected to make its decision until next month, when it will also take up allegations against another Ohio CVS store. But the penalties it can impose range from a small fine to revocation of the store’s license — and that decision could indicate how hard a line it will take in subsequent proceedings.

The hearings come after the pharmacy board in July released citations against eight CVS pharmacies in response to a records request from the Capital Journal. The board subsequently released citations against five others. They detailed problems similar to some of those alleged at the Canton store — and some revealed losses of controlled substances such as opioids.

On Thursday, lawyers for CVS put on testimony from Dennis McAllister, an expert witness who has worked as a pharmacist in many roles and who served for decades on the Arizona State Board of Pharmacy. 

He said that after viewing some of the earlier hearings and reviewing the inspection reports, he believed the problems suffered at the CVS store in Canton were severe, but they were emblematic of what was happening in the industry nationwide. 

The number of pharmacists and pharmacy technicians had been going down for a decade. Then COVID hit, making workers reluctant to work on the frontlines just as the workload spiked with pharmacies giving covid tests and administering vaccines, McAllister said.

“The industry in general wasn’t able to do stuff in time,” he said.

McAllister praised the hard work of the employees at the Canton store and credited it with quickly fixing problems inspectors found there. But CVS might have something to do with the diminishing pay and more-harried working conditions that have beset the industry, likely leading to the diminishing number of students entering pharmacy school. 

The chain increased the number of pharmacies it owns from 5,474 in 2005 to 9,939 in 2021, according to the German data-gathering firm Statista. Much of that has been from aggressive acquisition of competing pharmacies, closing them and moving their prescriptions to an existing CVS store.

In Thursday’s hearing, board member Tod J. Grimm pointed out that the Canton CVS absorbed the prescriptions of two other pharmacies, but only increased pharmacists’ hours there by two per week.

And at least after the worst of the pandemic, CVS employees said that understaffing CVS stores wasn’t due to a labor shortage, it was a choice.

“Understaffing is pretty deliberate from our upper and middle management,” Iggy Aleksick, a pharmacy technician at a CVS in Bowling Green told the Capital Journal in August, explaining that management wouldn’t OK additional hours even though workers were available.

And while McAllister made much of the burden created at the Canton store by giving covid and flu vaccines, CVS employees said the company relentlessly pushes the services because they’re a source of revenue. Simon Souhrada, a technician at the CVS in Mount Vernon until last June, said it was frustrating to be ordered to make phone calls as the prescription backlog there grew.

“It was all calling people, trying to sell them on vaccines and we would get daily emails demanding that we go faster and faster on these things while the queue (of unfilled prescriptions) was piling up and there was no one to fill it,” he said. “She just focused on all the wrong things and didn’t do anything to help.”

Kristina Dahmann, an attorney for CVS, has relentlessly tried to keep the focus in the hearing on the fact that the problems at the Canton store arose at the height of the pandemic.

In her closing statement, she pointed out that the state requires no minimum level of staffing at pharmacies, and that weeks-long backups filling prescriptions don’t necessarily mean that patients are waiting that long for their medicine.

“Numbers alone don’t tell the story,” she said.

But in their questioning of McAllister, the expert witness, members of the pharmacy board seemed skeptical of claims that the problems inspectors found at the Canton CVS were typical of pharmacies everywhere. All but one are pharmacists themselves, and independent pharmacists have said that while the pandemic was challenging, it didn’t lead to anything like the delays or chaos that the Board of Pharmacy found at numerous CVS stores.

It’s also unclear whether, as they assess the evidence of what happened at the Canton CVS in late 2021, the board will view it in isolation. While Dahmann insisted that problems there were due to the exigencies of the pandemic, board inspectors continue to allege dangerous conditions due to understaffing at Ohio CVS stores. 

In November, inspectors cited three stores for violations in 2023, including six-day backlogs filling prescriptions, dirty conditions and losses of hundreds of doses of the painkiller tramadol.

 

WHEN BADGES AND GUNS DICTATE YOUR HEALTHCARE: DEA A CRIMINAL ENTERPRISE OF DEPARTMENT OF JUSTICE, REFORMED OR BE DISBAND

CHIEF JUSTICE JOHN ROBERTS

AUSA WAYNE PRATT

DRUG ENFORCEMENT AGENCY (DEA) ARMED WITH BADGES, GUNS, AND PROFOUND STUPIDITY NEEDS CONGRESSIONAL REFORM OR BE DISBANDED (updated Repub, Part-1) :ETIOLOGY OF PAIN CARE TULSAFICATION

Overdose Death Notices Plus Guidance Sink Opioid Prescribing

The typical toxicology of a person who OD’d contained 4-7 different substances, one typically being the drug ALCOHOL. When was the last time an opioid was prescribed/filled by a particular person? And did that opioid show up in the OD’s toxicology? According to Wikipedia, there are over 1000 fentanyl analogs and it has been reported that China & Mex cartels are selling Fentanyl acetate on the street, not the Fentanyl citrate that is the FDA-approved analog. Using the descriptive OPIOID is a very broad brush to describe an OD or poisoning while obscuring the details of the OD/poisoning. In reading this article, I get the sense of a lot of “smoke & mirrors” or watching a magician make something appear or disappear. It is like we often see where a “study” is so designed to validate a preconceived conclusion.

Overdose Death Notices Plus Guidance Sink Opioid Prescribing

Doctors who were told about deaths and given planning prompts wrote fewer opioid scripts

https://www.medpagetoday.com/psychiatry/opioids/108282

Physicians who received a letter from a medical examiner about a patient’s fatal overdose — along with suggested guidance for future visits for pain — prescribed fewer opioids, according to a cluster randomized controlled trial.

Doctors who received the death notice plus guidance had a drop in weekly morphine milligram equivalents (MMEs) pre- to post-intervention (157.81 to 77.05), according to Jason Doctor, PhD, of the University of Southern California in Los Angeles, and colleagues.

While physicians who only got a death notice also saw a decline in weekly MMEs (157.70 to 103.16), those with the death notice plus guidance letter had a 12.85% greater decline in opioid prescribing (P<0.001), Doctor and colleagues reported in Nature Communicationsopens in a new tab or window.

“Providing physicians a simple plan that will guide them at a patient visit appears to help temper their use of these drugs,” Doctor said in a press release. “This represents a promising approach to reducing fatal drug overdoses, one that is both affordable and scalable.”

Doctor and colleagues noted that previous workopens in a new tab or window showed that notifying physicians by mail when a patient died of an opioid overdose helped diminish opioid prescribing. But they wanted to know whether adding “planning prompts” — concrete actions that can be triggered by a specific set of circumstances — could reduce this prescribing even further.

“For example, a physician might better use the information in the letter, if the letter guidance urges them to implement steps at the visit, such as discussing alternative pain management strategies or consulting with a pain management or addiction specialist for evaluation and care,” the researchers wrote.

To conduct the trial, Doctor and colleagues randomized 541 clinicians in Los Angeles County to receive either a standard letter about the patient’s death (n=284) or the letter with guidance (n=257).

Participants were included because they prescribed schedule II-IV drugs within the prior year to a patient who died of an overdose where opioids were a primary or contributing cause. Overall, 316 deaths from late October 2018 to late May 2020 were included.

Both physician groups received a letter signed by the examiner-coroner informing them of their patient’s opioid-related overdose death and information about judicious prescription practices. The intervention group additionally received an “if/when-then” plan that explained alternative ways to handle patients who needed pain treatment. The letters were sent monthly between April 4, 2019, and July 8, 2020.

In addition to greater declines in opioid prescribing, doctors who received the additional “if/when-then” plan also had greater declines in benzodiazepine prescribing, with an 8.32% reduction in weekly diazepam milligram equivalents (P<0.001).

The study was limited because it may not be generalizable outside of Los Angeles County, the largest county in the U.S., and by its small sample size. It examined a short-term effect and did not follow up to determine any effects on patient outcomes.

Also, the intervention reached only prescribers with a death in their practice, though the researchers emphasized those clinicians were likely most in need of the intervention.

They called for further research “to confirm the results, examine the long-term effects of the intervention, and explore its potential effects on patient outcomes.”

Doctor added that the study “is part of an evolution toward better understanding how to enact behavior change among physicians whose patients have suffered negative consequences from care by the medical community.”

 

The typical toxicology of a person who OD’d contained 4-7 different substances, one typically being the drug ALCOHOL. When was the last time a opioid prescribed/filled by the particular person? And did that opioid show up in the OD’s toxicology. According to wikipedia there is over 1000 fentanyl analogs and it has been reported that China & Mex cartels are selling Fentanyl acetate on the street, not the Fentanyl citrate that is the FDA approved analog. Using the descriptive OPIOID is a very broad brush to describe a OD or poisoning while obscuring the details of the OD/poisoning. In reading this article, I get the sense of a lot of “smoke & mirrors” or watching a magician make something appear or disappear. It is like we often see where a “study” is so designed to validate a preconceived conclusion.

Pain Upon Pain

https://www.daily-remedy.com/pain-upon-pain/#comment-8491

In an era of continuous medical breakthroughs, it’s disheartening to see a significant segment of the population, specifically those enduring severe, chronic, intractable pain, living in fear of the very institutions designed to alleviate their suffering. These patients, living with relentless pain, amidst a myriad of health complications of serious illnesses which cause Intractable Pain Disease, often find themselves trapped in a healthcare paradox.

Person A: “You need to go to the hospital now!”

Person B: “That’s not happening. I can’t and won’t allow them to treat me… rather mistreat me like that again.”

Person A: “This is absolutely ridiculous! You’re peeing blood and your screams are bone-chilling. Are you passing kidney stones again?”

Person B: “Look, I’m sorry; I’m not going to go through that again! I believe I have better chances of survival at home, and without the mistreatment.”

Person A: “So, you’re just going to stay here, endure this pain, risk sepsis, and not even get examined?”

Person B: “And if it is? Who’s going to help me? I’ve done a home urine test. I don’t have a fever. There are no white blood cells or nitrites present; but there’s a lot of blood, severe burning sensation, nausea, and a significant amount of protein in my urine. We know I’ve had a total hysterectomy, so it’s not menstruation. So, who can say for sure?”

Person A: “A medical professional could.”

Person B: “I’m struggling to not puke on your shoes, as these things rip through me, let alone tolerate your nonsense.”

Person A: “My nonsense? I’m just trying to help you!”

Person B: “If there’s no improvement by tomorrow, I’ll consider scheduling an appointment with my gynecologist. But don’t expect to see me in a hospital, ever again. It’s pain upon pain, and from what I’ve observed, endured, and heard, I’m starting to believe it’s deliberate.”

Person A: “It’s unbearable to see you suffering like this! You really should seek immediate medical attention! What’s wrong with that?”

Person B: “You wouldn’t understand.”

Person A: “Well, I’ll try to understand, if you could at least try to explain!”

Person B: “Even if I explain it to you, I doubt you’ll understand, and I’m hurting badly, but okay: I’m scared.”

Person A: “You’re, you’re scared? You? Scared?”

Person B: “Yes, very much so.”

Person A: “What exactly are you scared of? They are there to help you and to treat you, they’re not going to harm you!”

Person B: “I knew you wouldn’t understand, and I’m honestly glad you don’t. Unfortunately, most people don’t get it until they get it. And ‘treat you’ is right… ‘treat you’ like garbage.”

Person A: “Are you sure it’s not something you’ve done or said? Did you give them a reason to treat you the way that they did?”

Person B: “Yes, I’m positive. Wait! I did commit two offenses, now that you ask. When they asked me what my pain level was, I told them the truth, that it was a nine, and that is now used against me. I committed the offenses of being in pain and telling the truth. My chart is forever marred. My back is killing me! It’s on top of the Adhesive Arachnoiditis and Ehler’s Danlo’s and Chiari and CRPS pain. It feels like someone has punched me in my kidneys. It feels like it’s ripping through me, like the last time. I can’t believe all this blood. My God, this is so painful.”

Person A: “Exactly my point. You need to get to the hospital. I’m calling an ambulance.”

Person B: “Go ahead, it won’t do any good; I’m not going. Besides, they would take me to one of the two worst hospitals in the area. Then, as always, bumpily transport me to yet another low-rated hospital, while strapped down to a painful wooden stretcher for over 9 hours while being cleared for acute trauma to the brain and neck. “Why”, you ask? The two facilities that the ambulance would take you to will gladly inform you, after charging you an exorbitant fee, that they are not equipped to treat you or manage your conditions. Consequently, you must be transported to a “more advanced” hospital.

If you have any doubts, I suggest you check their many reviews while we wait.

And by waiting, I don’t mean waiting for the ambulance or in the waiting room.

I mean waiting for these kidney stones to pass, right here at home.”

 

As they pass, the thoughts run wild:

“While we wait for the new generation of healthcare professionals, who have unfortunately been influenced by the PROPagenda/PROPaganda that has spread across the nation (and the world), all in the name of preventing addiction or overdose, to awaken to this harsh reality. I fully support efforts to prevent addiction and overdose, but I have a question for those implementing these policies. Since the production cuts of FDA-approved medications which treat severe pain for not only chronic pain patients but also palliative care patients, cancer patients, children with sickle cell anemia, and patients with painful, chronic, rare diseases, cuts upwards of 85%, to prevent people from becoming addicted or overdosing: how is that working out for you?”

My real question is: How is that working out for the patients that you have left in the lurch?

Also, is it true that the number of people suffering from addiction and overdoses has indeed seen a drastic increase, contrary to the “hoped-for” decline? This increase has occurred even after cuts in the production of certain medicines commonly blamed as the cause for addiction, yes?

Consider the combat veteran grandparent who had been on a stable dose of 10 milligrams of hydrocodone QID for over 20 years. They were able to take care of their grandchildren, bake Christmas cookies, write out their Christmas cards, cook for Thanksgiving, garden, walk, attend church, and enjoy all their generations of grandchildren. Remember this grandmother who had no cardiac complications! And to prevent her from becoming “addicted,” her treatment was quickly halted. Not only was it halted, but it was halted in a way that went against even the CDC’s own guidelines of not tapering at a rate faster than 10% per month. She wasn’t tapered at all. She was forced to discontinue that medication abruptly. Three days later, she went into cardiac arrest and was not able to be resuscitated.

Consider the child born with sickle cell anemia who was able to fully engage in life and be an active part of their lives and the lives of those around them. Yet, their medicines were taken away from them, drastically and quickly, and without regard for the consequences. They were forced to discontinue the very medicine that took the edge off of the pain just enough that they could focus on playing with their friends and enjoying meals with their family. Now, they are bedridden, constantly crying, and in a fetal position. To add insult to injury, these medicines were replaced with NSAIDs, which are now causing bleeding and erosion of the stomach lining and duodenum, and the pain remains uncontrolled and unstable.

Consider the cancer patient who wanted to continue her career, but the bone pain was so severe that she could barely walk. After being slowly titrated up to a level of adequate pain relief, she was finally able to begin a journey of healing and recovery; and also embrace life, enjoy the company of her family members, and was an active member of her community. That is, until the 2016 CDC guidelines, (which were supposed to be rewritten in 2022 and have some type of positive impact on patients, not profiteers), and despite a 9 to zero Supreme Court ruling in favor of Ruan vs. the United States of America, her medicines were still forcefully discontinued.

She died two months later, at the age of 57.

What was her crime?

What did she do to deserve that death sentence?

Turns out she never had so much as a traffic violation.

There’s that word.

Traffic.

Is this the crux of the matter? Our doctors are now supposed to be police and our police are now supposed to be practicing medicine, right?

Certainly – let’s delve deeper into this:

Our empathetic and dedicated doctors are faced with a challenging task, and one they didn’t sign up for: discerning those who might misuse their prescribed medications. This is a complex issue, considering that the vast majority, likely over 99% of patients, would never contemplate misusing their medicines. These patients understand the invaluable role these medications play in their treatment protocols, often serving as a life-preserving component.

However, there’s a more sinister undertone at play.

Have the masses been deceived to the point where they can’t discern the truth? Or have they been so inundated with falsehoods that they continue to accept the lies as truth?

BLAME GAME

It’s no secret that we have a drug overdose epidemic, particularly lately is an Illicitly Manufactured Fentanyl and Heroin/Methamphetamine – epidemic in this world. Are the true origins and reasons for this epidemic known, or is there a blame game being played? Is there a misinformation epidemic, as well? Are members of opposite “sides” sleeping in the same bed together?

Let’s discuss Fentanyl for a moment. It’s considered Public Enemy #1, correct?

If we’re referring to *illicitly* manufactured Fentanyl, often laced with “who knows what”, and oftentimes carfentanyl, then yes, it alongside other killers like methamphetamines are (partially) Public Enemy #1. Or should it be termed Public Enemy #1.5, considering the other enemies are those distributing it on our streets, inundating our nations with it, and killing our loved ones? If I were to tell you it’s a war on people, not a war on drugs, you’d likely not believe me.  If I told you addiction isn’t caused by drugs, you’d not believe me, again. We’ll save that subject for the experts and for another time.

Situations become particularly frightening and complex when patients can’t articulate their pain, waking up only to vomit and lose consciousness again due to the excruciating pain, especially after a motor-vehicle accident – and they’re assumed to have overdosed, and often medically treated for overdose, without confirmation or evidence of such. Assumptions can be fatal.

In a medical context, Fentanyl and other medicines like it can be lifesavers. It’s used in many situations and circumstances, such as: cancer, severe car accidents, surgeries, and is particularly beneficial for patients requiring intubation, to name a few. Yet, when illicitly manufactured and distributed, it becomes a menace, flooding our streets and causing untold harm, ILLICIT fentanyl is indeed killing more than any of us really know, factually.

This brings us back to the crux of the matter, highlighting the complexity and multi-faceted nature of this issue. It’s not just about medical protocols or patient behavior, but also about larger systemic issues that need to be addressed, and by the appropriate people.

While we acknowledge the invaluable role of medications like Fentanyl in medical treatments and medical facilities, we must also realize and confront the darker aspects of its misuse and illicit distribution. There are agencies for that. And if medicine needs to be practiced, that is supposed to be done by qualified health care professionals…yet there’s a hazy gray line that seems to be between the two.

Mostly peaceful demonstrators

“He told me they were going to m-rder my family while I was at work.”

2021. I was in Portland, Oregon working alongside those desperately trying to hold the #thinblueline – having flown out with a camera crew to show what was REALLY happening.

I was speaking with one of the officers who had worked nearly 100 nights straight on the front line of the riots.

I asked him if it was really as bad as we’d been reporting on.

“No,” he said.

“REALLY!?!?!” I asked.

“It’s so much worse than you can ever imagine,” he told me.

He then shared with me the story about how while he was standing there in the middle of a riot one night, one of these (mostly peaceful?) protestors came up to him, smiling and laughing.

The officer asked what was so funny.

That’s why the guy pulled out a picture of that officer’s wife and kids – on the front lawn of the family’s house.

“One day when you’re at work, we’re going to r-pe and m-rder your wife and kids” he told the officer, before disappearing back into the crowd.”

These are the stories you’ll never hear in the media. These are the reasons why we do at Law Enforcement Today.

And so when trolls on here tell me what we shouldn’t talk about policing or crime or law and order or #lawenforcement on here, my response is simple: we will continue to give them a voice – because if ANYONE deserves it as much as a “sales associate” or a “consultant” – it’s those who protect our country every single day.

REPOST for awareness and so that people can see the TRUTH about what’s happening in this world.

HOW THE DEA FABRICATED THEIR GRAND OPIOID PANDEMIC AND PILL MILL SCAM: WHY BOTH DIRECTOR ANN MILGRAM AND AG MERRICK GARLAND MUST STEP DOWN

DEA DIRECTOR ANNE MILGRAM: The concept of “pre-crime,” once relegated to science fiction, has taken on a chilling reality in contemporary law enforcement practices. In a thought-provoking article titled “Pre-Crime” and the Danger of “Risk Assessments” authored by Paul J. Hetznecker, the issue of “pre-crime” and the utilization of “risk assessments” by law enforcement is brought to the forefront.


HOW THE DEA FABRICATED THEIR OPIOID PANDEMIC AND WAR ON PILL MILL SCAM: WHY DIRECTOR ANN MILGRAM MUST STEP DOWN

 

“OPIOIDGATE:” U.S. DEA TARGETING BASED ON FAULTY SOFTWARE GLITCHES RESEMBLING BRITIAIN’S POSTAL SCANDAL: MILGRAM MUST STEP DOWN

BRITAIN’S POSTAL SCANDAL BASED ON FLAWED PROGRAMING RESULTED IN A MAJOR MISCARRIAGE OF JUSTICE TO POST OFFICE WORKERS

” AMERICA’S OPIOIDGATE SCANDAL:” BEARS STRIKING RESEMBLANCE TO BRITAIN’S POST OFFICE SCANDAL, FAULTY SOFTWARE USED BY U.S. DRUG ENFORCEMENT, HAS SENT OVER 4K WRONGFULLY CHARGED MEDICAL PRACTIONERS TO LONG TERM INCARCERATIONS, ON MANUFACTURED FRAUD VIOLATIONS: “A MAJOR MISCARRIAGE OF JUSTICE” MILGRAM MUST RESIGN NOW!!!

Here’s Why Drug Stores Are Closing In Minority Neighborhoods: Walgreens, CVS, And Rite Aid Shutter More Than 1,000


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

 

 

 

https://www.msn.com/en-us/money/companies/here-s-why-drug-stores-are-closing-in-minority-neighborhoods-walgreens-cvs-and-rite-aid-shutter-more-than-1-000/ar-AA1mXdYB

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.

Walgreens Pharmacy and store closing sign at entrance, Queens, New York

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