http://www.ncpanet.org/home/find-your-local-pharmacy
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Corporate pharmacy practicing medicine without a license ?
Posted on May 8, 2019 by Pharmaciststeve
asked to share
Posted on May 8, 2019 by Pharmaciststeve
FDA is on our side they need to to have a better head count and understand this is millions not thousands as a recent paper reported
also they need to know other drugs are being abruptly tapered
maybe you could spread the word?
i think this would work:
info@fda.gov as a portal
brief messages:
- name, state, phone number (so they can verify) I trust them
- pick one disease
- was tapered off without consent when list all meds tapered
one paragraph mainly want then to count the replies and list the other drugs being tapered
ideas for other groups to contact?
what do you thinks
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Final Thoughts: Democrats Delete God
Posted on May 7, 2019 by Pharmaciststeve
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Great-grandmother with CBD oil arrested at Disney World
Posted on May 7, 2019 by Pharmaciststeve
Great-grandmother with CBD oil arrested at Disney World
https://www.foxnews.com/travel/grandmother-cbd-arrested-disney-world
Disney World may be the most magical place on Earth, but it turned into a legal nightmare for a great-grandmother with arthritis.
A 69-year-old woman was arrested at a Disney World checkpoint when an Orange County Deputy found CBD oil in her purse. She then spent 12 hours behind bars before being released on a $2,000 bond.
Hester Jordan Burkhalter, a great-grandmother from North Carolina, began using CBD oil for her arthritis after her doctor recommended it, Fox 35 in Orlando reported. She even had a note from the medical professional in her purse at the time of arrest, but it didn’t matter.
Burkhalter told Fox 35 that she had been planning on the trip for two years. “I have really bad arthritis in my legs, in my arms and in my shoulder,” she said. “I use (CBD oil) for the pain because it helps.” When she was stopped by security outside of the Magic Kingdom, however, she was arrested. “I’ve never had one speeding ticket in my life.”
Despite the fact that it’s sold on store shelves across the state, CBD oil is still technically illegal in the state of Florida (unless the user has a prescription). This has created a confusing situation in the Sunshine State.
Jennifer Synnamon, a Florida attorney, told Fox 35, “a little drop of oil, with the CBD, is a felony. Meanwhile, you can have up to 19.9 grams of leaf-marijuana, and it’s a first-degree misdemeanor.”
While the Orange County Sheriff’s Office told Fox 35 that their deputy was just following the law, the charges against Burkhalter eventually dropped.
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Amid opioid epidemic, report finds more doctors stealing prescriptions
Posted on May 7, 2019 by Pharmaciststeve
Amid opioid epidemic, report finds more doctors stealing prescriptions
https://www.cbsnews.com/news/amid-opioid-epidemic-report-finds-more-doctors-stealing-prescriptions/
When Lauren Lollini went to the hospital for kidney surgery in 2009, she was shocked when she left with hepatitis C and a liver infection.
“My life dramatically changed because now I am a 40-year-old woman with a 1-year-old daughter who is so fatigued I can’t work,” Lollini said.
Hospital technician Kristen Parker had infected Lollini and at least 18 others by stealing their pain medication and then leaving contaminated syringes for reuse. She’s now serving 30 years in jail.
“She was taking them off surgical trays, using them for herself, her own use, and then filling them with saline and putting them back on trays,” Lollini said. “I really was angry at the broken system. The hospital that hired her — unbeknownst to them that she had been let go from other jobs.”
A new report that will be released Tuesday by data firm Protenus finds that this so-called “opioid diversion” is a growing problem. In 2018, more than 47 million doses of legally prescribed opioids were stolen, an increase of 126 percent from the year before.
Protenus found 34 percent of these incidents happened at hospitals or medical centers, followed by private practices, long-term care facilities and pharmacies. Only 77 percent of the cases identified a particular drug, but the most common was Oxycodone, followed by hydrocodone and fentanyl.
Sixty-seven percent of the time, doctors and nurses are responsible. Dr. Stephen Loyd of Tennessee was one of them.
“What I didn’t realize was how quickly it would escalate. Going from that half of a five milligram Lortab, to within three years about 500 milligrams of Oxycontin a day. That’s about 100 Vicodin,” he said.
For three and a half years, he siphoned drugs away from his patients.
“There was no requirements on what happened to those pills. They could go down the toilet or they could go in my pocket,” Loyd said.
He warns that people who work in the health care industry are at high risk of abuse.
“They’ve got high stress jobs. A lot of them, like myself, have workaholism. And not only that, you have access,” Loyd said.
He’s now been clean for 15 years and was the director of Tennessee’s Mental Health and Substance Abuse Services division before running a rehab facility in Murfreesboro, Tennessee. Loyd implores addicted health care workers to admit they need help, which he knows was the hardest part for him until he was confronted by his own father.
After confessing to his dad fears of losing his house, car and career should he come clean, his father responded, “None of those things are gonna do you any good if you’re dead.”
Kira Caban of Protenus said the firm’s findings are likely a “tip of the iceburg” considering only a fraction of opioid diversions are uncovered because an addict admits to the behavior or a patient gets sick. The Department of Justice established an Opioid Fraud and Abuse Detection Unit to combat this issue, but it’s operational in less than a third of the country.
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What a new rule in Ohio means for people getting pain meds
Posted on May 7, 2019 by Pharmaciststeve
What a new rule in Ohio means for people getting pain meds
Do you or does someone you know have a pain pill prescription? Did naloxone come with the prescription?
More Ohioans can expect to discuss that option as a result of a new rule for doctors.
Doctors who regularly prescribe pain patients high doses of opioids are now required to talk to them about opioid safety, including the use of naloxone.
The State Medical Board of Ohio made the rule that went into effect late in December. It’s for patients receiving new, high-dose prescriptions for pain lasting more than six weeks.
“It is meant to safely manage pain,” said Tess Pollock, spokeswoman for the medical board. “We are not taking opioids away from patients who need them.”
Pollock said that’s something the medical board has been careful about during the opioid epidemic, which has been blamed in part on the overprescription of pain pills. The state continues to try to educate the public about the dangers of opioid medications, and the new rule is one way to prevent accidental overdose deaths, she said.
Naloxone is a non-narcotic that blocks the effects of opioids, restoring breathing in overdosing patients. Higher doses of pain pills, or even an extra pill taken by mistake, can induce overdose.
A recent survey shows that most Ohio pain-pills patients (81%) know if their prescribed medication is an opioid. Most (82%) have heard of naloxone. And most (70%) think it’s a good idea to have it around for safety.
But among those surveyed, few had heard any of that from their physicians.
“We have strong majorities having heard of naloxone, but a small fraction had heard from their own providers,” said Doug Usher, a partner of the research group, Forbes-Tate Partners of Washington, D.C.
The survey wasn’t only for people who get high-dose pain-pill prescriptions, so respondents didn’t necessarily fit the profile of patients who fall under the state’s rule. The minimum strength for the rule is an 80 morphine equivalent dose.
Forbes-Tate surveyed 511 Ohioans in February who’d either been prescribed pain medication or had a family member prescribed it. The market research was commissioned by Adapt Pharma, the maker of Narcan, the brand for naloxone.
Thom Duddy, spokesman for Adapt Pharma, praised Ohio for creating the rule for doctors, noting, “There’s a significant percentage of patients out there that are at risk every day.”
He said Adapt Pharma’s concern isn’t just the prescription of Narcan. “I don’t care if they prescribe syringes and vials of naloxone instead of Narcan,” Duddy said.
The company has committed to the opioid-overdose fight, he said. In 2017, Adapt Pharma provided 25,000 free Narcan kits to Hamilton County alone as part of the region’s initiative to expand access to try to cut overdose deaths.
These days, chronic pain patients often are prescribed opioids at lower doses than that, said Dr. Harsh Sachdeva, who practices at UC Health West Chester and is the director of the pain fellowship program at UC College of Medicine.
“In our chronic pain practice, 70 percent of our patients are under that dose,” Sachdeva said. Patients get additional pain help, including spinal implants and psychological intervention.
Regardless, Sachdeva said his patients are being prescribed naloxone as a safety measure to prevent unintentional overdose.
Not all of them want it, he said.
“I hear it all the time. ‘Why are you giving it to me?’ ” Sachdeva said.
But Ohioans and others nationally might have to get used to the idea of having naloxone awaiting them at a pharmacy along with their pain pills.
The practice of prescribing the two together probably will become routine, medical professionals say.
Young doctors are being taught about the state rule, said Dr. Michael Binder, assistant professor of clinical medicine at UC College of Medicine.
But that’s not all:
“We’re teaching them to have a discussion with all patients about the risks and benefits of their opioid prescriptions,” Binder said. “That’s standard now.”
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Study Finds Prescription Drug Monitoring Programs Ineffective at Curbing Overdoses
Posted on May 6, 2019 by Pharmaciststeve
Study Finds Prescription Drug Monitoring Programs Ineffective at Curbing Overdoses
https://www.ajmc.com/newsroom/study-finds-prescription-drug-monitoring-programs-ineffective
Prescription drug monitoring programs (PDMPs) are now in place in response to rising levels of overdoses involving opioids and synthetic opioids. But a new study that sought to clarify the relationship between PDMPs and their effectiveness in attacking the nation’s drug problem found limited to no evidence that they actually work. In addition, 3 of the studies reviewed found an increase in heroin overdose deaths after the programs began.
Prescription drug monitoring programs (PDMPs) are now in place in all 50 states and the District of Columbia in response to rising levels of overdoses involving opioids and synthetic opioids. But a new study published in the Annals of Internal Medicine that sought to clarify the relationship between PDMPs and their effectiveness in attacking the nation’s drug problem found limited to no evidence that they actually work.
In addition, 3 of the 17 studies reviewed found an unintended consequence, in that heroin overdose deaths rose after the programs began.
“Prescription drug monitoring programs have become a hallmark of any policies that have been put into place, “ said lead author David S. Fink, MPH, a doctoral candidate in epidemiology at Columbia University, in an interview with The American Journal of Managed Care® (AJMC®).
The programs all vary in what they require of both doctors and pharmacists. Some are voluntary and some are not. So far in 2018, 36 states have so-called “mandatory use” policies, which mean that providers must register and use the program.
This review of 17 studies about PDMPs sought to clarify what would make such a program effective, since they are all implemented differently, all with their own nuances, he said.
Although 10 of the studies suggested that PDMP implementation had some low evidence tying it to reductions in fatal overdoses, the evidence was not enough.
“There’s no evidence to say a PDMP works,” Fink said, adding later, “PDMP programs alone are not going to be sufficient to reduce overdoses.”
Of the programs that were most effective, they shared these characteristics, which all indicate signs of a robust and aggressive program, he said:
- Mandatory review of PDMP data by healthcare providers before writing prescriptions
- Frequent, or weekly, updates of data
- Provider authorization to access PDMP data
- Monitoring of noncontrolled substances, even over-the-counter pain relievers.
These factors are meant to combat issues like “doctor shopping,” where a patient seeks multiple opioid prescriptions from different providers, but both Fink and a critic of PDMP programs had concerns about the impact of the programs, albeit different ones.
Fink said his concern is “that when you take away a primary drug that somebody is dependent upon, what’s going to happen in that next stage if a [rehabiliation] program isn’t provided to help those individuals?”
“We saw the same thing when abuse-deterrent OxyContin came out and we saw the switch in heroin overdoses. With PDMPs we seem to be finding the exact same thing,” he said.
Part of the problem is there is a shortage of doctors who are trained in addiction medicine, especially medication-assisted treatment (MAT), including buprenorphine, which is used to prevent relapse in people with opioid dependence.
“Our systematic review found that 3 of the 6 studies that have examined the postimplementation effect of PDMPs on heroin found an increase in heroin overdose deaths following PDMP implementation,” Fink wrote in a follow-up email. “Although the mechanism is unknown, it is possible that restricting the supply of prescription opioids to opioid-dependent persons might drive them to illicit heroin. Thus, policies that can restrict the supply of opioids, such as PDMPs, should be implemented within a suite of policies that can identify and treat those who are opioid-dependent to prevent them from moving to illicit heroin.”
Fink said it would be beneficial for doctors to increase their proficiency with MAT, as well as developing greater empathy for patients who may be seeking care from multiple doctors. The patient may be reported to authorities but without a referral for treatment, he said.
Some experts have started to call for primary care doctors to get involved in MAT to help address the shortage, which in turn may increase the chances that patients will seek treatment from a doctor they know and trust, the Commonwealth Fund reported last year.
But more often than not, PDMP programs are a law enforcement tool to catch doctors and patients, said a frequent critic of the programs in an email to AJMC®.
“Sixty percent of ‘doctor shoppers’ are actually legitimate patients with pain disease, not those with addiction, who are being purposely undertreated and need to look for adequate pain medicine doses by going to more than one doctor,” said Thomas F. Kline, MD, a geriatrician in North Carolina. “This issue was not addressed as an unintended consequence.”
In addition, Kline said PMDPs are being used to send “raw data to law enforcement for further raids and persecution, shaming and blaming medical professionals and their patients whose profiles do not fit the law enforcement view of proper practice of medicine.”
Fink said that there are very few, if any, data on the effects that policies intended to address rising overdose deaths are having on chronic pain or palliative care patients. Most of what he has heard is anecdotal, but it is clear that the “pendulum is swinging in the other direction,” he said, referring to prescribing patterns by doctors.
Major medical associations are in favor of PDMPs, but want them used for patient care first and not as a law enforcement tool, as evidenced by these guidelines from the American Academy of Hospice and Palliative Medicine. Fink’s study did not address provider responses to PDMPs, but he said it is possible that some doctors might report patients as a way of practicing defensive medicine in anticipation of a negative law enforcement response, and that more research is needed in this area.
The 17 articles reviewed for this study were pulled from 2661 records that met the inclusion criteria. In addition, the authors ranked the studies according to a risk of bias, ranging from low to moderate to severe. Most of the studies fell into the moderate to severe category.
Fink and his fellow researchers used state-level and national data to pull information about nonfatal and fatal overdoses.
All of the studies examining the association between PDMP implementation and overdose had methodological shortcomings, including inadequate confounding factors and no adjustment for competing laws and policies that might affect overdoses, such as Good Samaritan, naloxone distribution, or medical marijuana laws.
Fink said more research needs to be done to see if medical marijuana is helping to reduce opioid overdoses.
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Investigation: Chronic pain patients denied life-saving medicine because of opioid crackdown
Posted on May 6, 2019 by Pharmaciststeve
Investigation: Chronic pain patients denied life-saving medicine because of opioid crackdown
PITTSBURGH —
Action News Investigates has learned the war against opioids is causing collateral damage — chronic pain patients who are being denied life-saving medicine.
Watch the investigative report by @VanOsdol_WTAE in the video player above.
Medical experts said the government crackdown on opioids has had a chilling effect — causing doctors, pharmacists and insurance companies to severely restrict access to opioid painkillers.
Cris Orlando uses electrical stimulation to treat a severe spinal condition. But that is not enough to ease the pain.
“A 7- and 8-level pain, to be in that all day long constantly, you want to give up,” he said. “I can’t function. I can’t help my wife around the house. It can be deadly. I mean the depression sets in quick.”
That’s why Orlando said he needs an opioid patch.
But it took six months after he moved to Creighton before he could find a doctor who would prescribe opioids strong enough to treat his pain. He told one doctor he was desperate and worried he might kill himself.
“I went in and said, ‘Will I have to bring my guns to the pawn store again because I’m afraid,'” Orlando said.
Jacqueline Schneider, of Independence, Beaver County, said she knows the feeling. She has multiple spinal conditions that cause severe pain.
“It felt like flesh being torn away from bone or something,” she said.
Last year, she was able to get a prescription for opioids, but she could not find a pharmacy that would fill it.
“I called six (pharmacies) in my area, chains and independents, and every single one of them told me they wouldn’t fill my medication for me. I just felt hopeless. I felt totally hopeless,” she said.
Like Orlando, Schneider was eventually able to get her medicine.
But experts said the difficulties facing them and other chronic pain patients is a national health crisis.
“It’s terrible,” said Dr. Ryan Marino, of UPMC.
He blames the government’s crackdown on doctors and pharmacies who overprescribed opioids, contributing to the epidemic. Now, he said, many physicians are afraid of prescribing any opioids, even to patients who legitimately need them.
“I think the response has been mostly to stop writing them. There really isn’t a middle ground here and most people don’t want to risk that and they’ll stop writing those prescriptions,” he said.
Even if doctors write an opioid prescription, Rosemary Mihalko said pharmacists like her may not fill it, because they fear a government crackdown.
“The biggest concern, honestly, is getting shut down and having your license revoked,” Mihalko said. “It’s easier to turn someone away, even though that’s not the right moral thing to do. It’s safer not to have our license on the line for that.”
One big reason for the concern is a guideline from the federal Centers for Disease Control and Prevention that encourages doctors to reduce prescriptions for opioid painkillers. In the three years since the guideline came out, opioid prescriptions have dropped significantly. That sounds good, but some doctors are pushing back against the CDC, saying the guideline needs to be clarified to avoid harming patients who legitimately need these drugs.
Earlier this year, 300 medical experts signed a letter to the CDC saying doctors and pharmacists are misapplying the guideline, resulting in unnecessary suffering, illicit drug use and even suicide for pain patients.
Among the signers were three former White House drug czars and Marino.
“The pendulum has definitely overswung here where we’re now hurting people with the response we have to people being hurt by overprescribing,” he said.
In a statement, the CDC said the guideline does not endorse mandated or abrupt dose reduction or discontinuation.
But the agency is studying the impact of the guideline on chronic pain patients.
Orlando and Schneider said they hope the government and the medical community will start listening to them.
“We shouldn’t be lumped in with the people who are addicted or abuse medication,” Schneider said.
“It’s just simply unfair to take people that are having chronic pain issues and cut them off of medications that are working,” Orlando said.
They said they have tried alternative therapies to reduce pain — including medical marijuana — and nothing has worked for them.
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Dr Bill Bennett “drug czar” under Bush (43) says that war on drugs – going the wrong way now
Posted on May 6, 2019 by Pharmaciststeve
Dr Bennett is still not really “with it” they were asking him about the bribery charges against the head of insys therapeutics and claim that “if they were pushing pills”… Insys was “pushing” Subsys whicquh is a sublingual Fentanyl spray – currently no solid opiate/controlled substance products. Also is quoting the 72 K deaths… when 40% of those numbers do not involve opiates.
However, he did state that the vast majority of pts who are prescribed them – DO NOT ABUSE THEM – and that the CDC was backtracking on the opiate dosing guideline truthfully stating that they have been misapplied.
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Hallelujah
Posted on May 6, 2019 by Pharmaciststeve