Bedford Police Department. The Bedford Police Department works day in and day out to keep our Bedford community safe. To address the drug epidemic that neighborhoods across Indiana continue to face, officers are working with our local schools to teach all students to have drug-free futures. I’m honored to fight for our law enforcement officers and first responders in Congress to keep them safe.

Trey Hollingsworth  Indiana 9th District House Member

Various entities have been trying to “teach all students to have a drug-free future” for over FOUR DECADES.  That is TWO GENERATIONS that we have tried to “educate on not smart to abuse drugs”.  So since we have as many or more people abusing controlled substance now as back them… Is this a FAILURE of all those various entities who have tried to reach kids ?

OR Is this a issue that our country has a substantial and/or growing number of people who are dealing with mental health issues for various reasons ?

Filed under: General Problems | 2 Comments »

Editorial: Why is the Florida Senate helping drug companies in opioid lawsuit?

Attorney General Ashley Moody wants access to the state’s prescription database to build her case. The Senate’s concerns about patient privacy are unfounded.

www.tampabay.com/opinion/editorials/editorial-why-is-the-florida-senate-helping-drug-companies-in-opioid-lawsuit-20190501/

Don’t be fooled: The “privacy” concern that state senators are using to hinder Florida’s lawsuit over the opioid epidemic benefits only big corporations that need to be held accountable for the public health crisis. In the final days of the legislative session, the Senate should follow the House’s lead and give Attorney General Ashley Moody a legitimate tool to pursue the state’s claim in a timely manner. Any legitimate privacy issues can be addressed without undermining or delaying the state’s pursuit of justice.

Moody wants access to the state’s prescription drug database to bolster Florida’s lawsuit against the nation’s largest drug makers, distributors and pharmacies, which the state reasonably accuses of recklessly supplying Floridians with drugs. On Monday, the House unanimously passed legislation, HB 1253, granting Moody access to the Florida Department of Health’s data. But the Senate has refused to take up the issue, which would hand a big win to the pharmacy giants and a big loss for public health and safety.

The database tracks all monitored drugs, from oxycodone to sleeping pills. But Moody can’t use it for the state’s civil lawsuit, which is filed in Pasco County. By law, the use of the database is restricted to criminal cases and administrative actions against physicians. Moody needs the database to show specific examples that Walgreens, along with its rival CVS, “raced to sell as many opioids as possible” while failing to stop suspicious shipments of drugs, as the lawsuit alleges.

But the Senate bill stalled in the committee of Sen. Lizbeth Benacquisto, a Fort Myers Republican, who said she won’t hear the measure because of concerns it could invade the privacy of patients. Other opponents contend that allowing access would be a misuse of personal information and an invitation to hacking. These are the same hollow arguments that lawmakers voiced for years before the drug database was finally created in 2009. “They use the word ‘privacy,’ which gets people’s attention,” said former Sen. Mike Fasano, who was instrumental in getting the database created and is now the Pasco County tax collector. “What this comes down to is protecting the corporations that need to be held accountable for helping to create this epidemic.”

If Moody’s lawyers got access to the data, they would not see patients’ names. There would be a unique identifying number for each patient, along with the patient’s year of birth and their city, county, and zip code. Dates of birth and sex would also be removed, and the attorney general could use the information only as evidence in a civil, criminal or administrative suit against a pharmacy or dispenser. Experts have assured the attorney general that the risk of re-identification is nearly impossible, calling the concerns “conspiracy theories” with “no basis in reality.”

Moody still could get the information from the companies through the lawsuit’s discovery process. But that would be expensive and the companies could drag out the process for years. There is no justifiable reason for denying the state a narrow, practical path for presenting its case.

The human and public health costs of the opioid epidemic are staggering; between 1999 and 2016, more than 200,000 people nationwide have died from overdoses related to prescription opioids, including thousands of Floridians. Opioids killed nearly 6,000 people in the state in 2016 alone. It’s beyond time to hold those responsible accountable, and the Senate should allow the state to gather all of the facts for its lawsuit in the most effective manner.

Filed under: General Problems | 1 Comment »

Amid Opioid Crisis, Walgreens Adds Mental Health Training For Pharmacists

https://www.forbes.com/sites/brucejapsen/2019/05/01/amid-opioid-crisis-walgreens-adds-mental-health-training-for-pharmacists/#2f041e427b68

Walgreens plans to increase mental health and substance abuse training for hundreds of pharmacists and staff at its drugstores amid the U.S. opioid epidemic.

Walgreens has partnered with the National Council for Behavioral Health and the American Pharmacists Association to make training available to Walgreens pharmacy staffers in “mental health first aid,” which those involved say will help assist patients suffering from mental health conditions or substance abuse.

“With the growing need for services and resources to help those living with mental health conditions, as well as substance use and addiction, we can play an important role by giving our pharmacists and certain team members the training to help those in crisis,” Walgreens Boots Alliance co-chief operating officer Alex Gourlay said in a statement.

The strategy is the latest from big healthcare companies to ratchet up screening for patients with substance abuse and mental health conditions in the wake of the deadly opioid epidemic. Major health insurers like Anthem, Cigna and UnitedHealth Group are closely monitoring prescriptions and making sure physicians in their networks adhere to certain protocols and recommended dosages.

By improving mental health education, screening and literacy, companies could also be engaging in risk management.

Drug makers and other healthcare companies like Walgreens that have been involved in the production, sale and distribution of opioids may have reason to fear “a tobacco-style master settlement agreement,” a report last year from Fitch Ratings said. Other companies that distributed or sold opioids also face some risk, including drugstore chains like CVS Health, which is also at some financial risk because it owns the pharmacy benefit manager (PBM) Caremark, Fitch said. Other PBMs, including Express Scripts now owned by Cigna and UnitedHealth Group’s OptumRx, could also face some risk.

Walgreens has increased mental health services in recent years as the company has added more medical treatments and wellness services to become a retail health destination for consumers. Three years ago, Walgreens expanded mental health services to include access to behavioral health treatment via Breakthrough, a unit of telemedicine firm MDLive. Walgreens also expanded customer options for treatment, screenings and awareness through its mental health platform, Walgreens.com/mentalhealth, which was launched in May of 2016.

The additional “mental health first aid” training administered by the National Council, trains “participants in mental health literacy, understanding risk factors and warning signs for mental health and addiction concerns, and strategies for how to help someone in both crisis and non-crisis situations,” Walgreens and the council said. “One in five people experiences a mental health or substance use issue in a given year and it’s likely that most of those individuals use a pharmacy’s services during that year,” the National Council for Behavioral Health’s CEO Linda Rosenberg said.

If you are a chronic pain pts or a pt that has a medical necessity for controlled substances and you patronize Walgreens.. you may soon start receiving the recommendation to seek out mental health services – for your opiate use disorder…  you see that they have changed or in the processing of changing the nomenclature…  There seems to no more addiction or dependency but anyone using a opiate (legally/Illegally) > 90 days.. is now being diagnosed with a “opiate use disorder” diagnosis.

You see, the Tobacco Settlement money ..it has been paid out on a annual basis from the tobacco companies and that will be drying up in another 4-5 yrs and a lot of bureaucracies have become “financially dependent/addicted” on this money and they face the possibility when the money dries up to raise taxes, cut budgets or find another source of revenue… and now everyone and their brother is filing suits against the major pharmas, wholesalers, and major chain pharmacies… but there is more deep pockets within the Insurance industry- which includes the PBM’s.  So all of those within these industries are trying to CYA there “deep pockets” from all the law firms that are working on a contingency basis with suing everyone that is involved with the controlled substance distribution system.  These bureaucracies are “hiring” all of these law firms on a contingency basis… so they have nothing to lose.. since the law firms only get paid if they win a settlement.

Filed under: General Problems | 4 Comments »

International GUIDELINESon HUMAN RIGHTSand DRUG POLICY

29 pages click link to upload *.PDF

Filed under: General Problems | Leave a Comment »

Movement to reform pharmacy middlemen reaches a boiling point nationwide

https://www.dispatch.com/news/20190429/movement-to-reform-pharmacy-middlemen-reaches-boiling-point-nationwide

They once were the obscure middlemen reaping billions off prescription-drug transactions as they worked behind a veil of secrecy. But a wave of reforms to the $400 billion-a-year industry of pharmacy benefit management is cresting across the United States.

According to the National Academy for State Health Policy, 101 PBM reform bills are being considered in 41 states this year.

PBMs, such as CVS Caremark, OptumRx and Express Scripts, act as the middlemen between health insurers, drug manufacturers and pharmacies. Their contracts typically keep pricing and rebate data secret, leading many people to conclude that they’re partly to blame for the rising price of drugs, which itself is the fastest-rising part of the health-care sector.

Following a Dispatch analysis last year of confidential pharmacy-reimbursement data, the Ohio Department of Medicaid released its own analysis showing that in 2017, CVS Caremark and OptumRx charged taxpayers $224 million more for drugs than they reimbursed pharmacists. That was three to six times the going rate, according to the analyst who did the report, which didn’t look at whether the PBMs were pocketing portions of rebates and other fees they were collecting.

“Unfortunately, things were really, really bad in Ohio,” said Anne Cassity, vice president of federal and state affairs for the National Community Pharmacists Association, an industry group representing independent pharmacies.

But things also were bad elsewhere, such as in Kentucky, where a state report determined that the “spread” between what PBMs billed taxpayers for Medicaid drugs and what they paid pharmacies was $123.5 million in 2018, prompting Kentucky Attorney General Andy Beshear to launch an investigation.

Louisiana, New York, and Arkansas each has either passed or is considering measures that would ban such spread pricing. Other states are considering various types of bills, such as ones in California and Oregon intended to increase transparency, while still other states are considering bills that would require PBMs to provide pharmacists with minimum reimbursements.

In West Virginia, rising drug costs in the Medicaid program prompted officials there to carve Medicaid drugs out of its managed-care system. State Medicaid officials have broken up PBM functions, leading to an increased transparency that they say saved $54.4 million a year.

Cassity, of the national association of pharmacists, praised that approach and said that states are leading the way in approaches to reform.

Pharmacy benefit managers defend their role, saying that they save money for consumers and arguing that many of the recent legislative initiatives would increase costs.

“Pharmacy benefit managers (PBMs) serve as the only check in the prescription-drug supply chain against drug-makers’ sole power to set and raise prices,” said Greg Lopes, spokesman for the Pharmaceutical Care Management Association, a national organization representing PBMs. “Any new state legislative mandates that undermine PBMs’ cost-savings tools would not reduce prescription-drug prices for consumers; rather they would reduce access and increase prescription-drug costs.”

Lopes cited a 2017 study by the University of Southern California that found that for every $100 spent on branded drugs, PBMs retain about $2, compared with $58 for manufacturers. For generic drugs, PBMs retain $7, compared with $18 for manufacturers.

However, Neeraj Sood, who conducted the study, told The Dispatch in January that it’s incorrect to use his work to evaluate whether that’s a fair split between manufacturers, which develop and produce medicines, and PBMs, which facilitate sales.

“You and I ask, ‘Is (the amount PBMs are getting) a reasonable number, or should PBMs be making less than that?’ My research didn’t address that question,” Sood said. He added that he is working on a study to try to find an answer.

The Montana legislature recently passed a bill meant to attack the PBM problem. Senate Bill 71 would require the Montana Securities & Insurance Commissioner to regulate PBMs that serve private health plans on the individual market. Similar reforms already have been made for state employees through the companies that administer the state’s self-funded insurance plan. The change is intended to require insurers to look out for taxpayer interests and to give state regulators the power to effectively check insurers’ math.

The Benefits of Weight Loss Pills Supplements
Incorporating weight loss pills supplements into your weight management plan can offer numerous benefits:

1. Increased Weight Loss
Benefits of Weight Loss Pills Supplements can accelerate your weight loss journey, helping you reach your goals more efficiently when combined with a balanced diet and regular exercise.

2. Appetite Control
Appetite suppressants can help you overcome the challenges of emotional eating and curb cravings, leading to better control over your food choices.

3. Boosted Energy
Some weight loss supplements contain ingredients that provide an energy boost, which can enhance your motivation for physical activity and daily tasks.

4. Enhanced Metabolism
Metabolism boosters can optimize your body’s calorie-burning potential, making it easier to manage your weight.

5. Improved Confidence
Achieving weight loss milestones with the help of supplements can boost your self-confidence and sense of accomplishment.

Choosing the Right Weight Loss Pills Supplements
When considering weight loss pills supplements, it’s crucial to prioritize safety and efficacy. Here are some essential factors to consider before making a purchase:

1. Ingredients
Examine the list of ingredients and their dosages to ensure they are safe and match your weight loss goals. Avoid products with proprietary blends that don’t disclose individual ingredient amounts.

2. Customer Reviews
Check customer reviews and testimonials to gauge the experiences of others who have used the product. Look for reviews from reputable sources to get a better understanding of its effectiveness.

3. Scientific Evidence
Look for supplements backed by scientific research and clinical studies, indicating their safety and effectiveness in aiding weight loss.

4. Side Effects
Be aware of potential side effects and interactions with other medications you may be taking. Consult with a healthcare professional if you have any underlying health conditions.

5. Brand Reputation
Choose products from well-established and reputable brands known for their quality and commitment to consumer safety.

The bill would allow the insurance commissioner access to PBM contracts and require insurers to use a list of drug prices that would be disclosed to regulators, secret, PBM-generated cost lists that prevail in the industry. It would outlaw spread pricing by requiring PBMs to pay pharmacists their costs plus a dispensing fee. It would eliminate after-the-fact fees that PBMs charge to take back part of the reimbursements they’ve already paid pharmacists.

SB71 also would take away health plans’ incentive to steer patients to expensive drugs with big rebates by mandating that all money collected by PBMs from manufacturers be returned to the state, and by forcing open contracts and other records to ensure that happens.

That provision would prevent insurers from boosting profits by classifying some portion of rebates as a medical expense, said Derek Oestreicher, an attorney for the Montana insurance commissioner who was involved in developing the measure.

“It’s ultimately important that insurers take back the reins from pharmacy benefit managers,” he said, explaining that he’d seen crazy things as he worked on the bill. One PBM contract he saw defined “rebate” as a number of things — “rebates” not among them.

Marilyn Bartlett was recently named 13th on Fortune magazine’s list of the World’s Greatest Leaders for her work reforming how Montana does business with hospitals, managed-care companies and PBMs. She said it took a hard political fight to pass SB71 over the objections of insurers and PBMs. It remains to be seen whether Democratic Gov. Steve Bullock will sign the bill. His office didn’t respond to a call last week for comment.

Maine lawmakers began hearings this month on a sweeping package of five bills broadly modeled on the Montana legislation.

The role of PBMs “is supposed to be about working on behalf of patients to drive down the cost of prescription drugs and serve as a check against the power of pharmaceutical companies,” said state Sen. Heather Sanborn, D-Portland. “However, more and more evidence has emerged that PBMs have taken advantage of their secrecy and used their position to pad their own investors’ pockets rather than drive down costs for consumers.”

In Ohio, Medicaid managed-care company CareSource earlier this month touted a new contract with Express Scripts that it says will bring new transparency to the system. The contract will be available to state officials, but not the public, however.

Company officials say making the contract public would give an unfair advantage to its competitors.

Montana’s Oestreicher isn’t buying that.

“Let’s be clear, we’re not dealing with the Coca-Cola recipe here,” he said. PBMs “are always coming up with more algorithms to become more profitable and more secretive.”

Filed under: General Problems | Leave a Comment »

DOJ Declines to Prosecute DEA Agent Who ‘Provided False Statements Under Oath’ About Subordinate Who ‘Apparently’ Had Sex in Park

https://www.cnsnews.com/news/article/cnsnewscom-staff/doj-declines-prosecute-dea-agent-who-provided-false-statements-under

(CNSNews.com) – The Department of Justice has declined to prosecute a Drug Enforcement Agency special agent who “provided false statements under oath” to the Office of the Inspector General of the Department of Justice about a subordinate who “apparently engaged in sexual activity in a public park,” according to a summary of the case released by the IG.

“The Department of Justice Office (DOJ) of Inspector General (OIG) initiated this investigation upon the receipt of information alleging that a Drug Enforcement Administration (DEA) Assistant Special Agent in Charge (ASAC), since retired, had contact with a local police officer after the officer observed the ASAC apparently engaged in sexual activity in a public park,” said the IG’s summary.

“The ASAC was on annual leave on that date,” said the summary.

“During the course of the investigation, the OIG found indications that the ASA’s immediate supervisor, the Special Agent in Charge (SAC), failed to properly report the ASAC’s contact with the local police to the DEA Office of Professional Responsibility (OPR), and provided false statements during his OIG interview concerning the ASAC’s conduct.

“The OIG investigation found that by apparently engaging in sexual activity in a public park, the ASAC failed to act in a professional manner as a DEA employee, in violation of federal regulation and DEA policy,” said the summary.

“The OIG investigation further found that the SAC failed to properly report to DEA OPR the ASAC’s contact with local police; showed favoritism to the ASAC by not reporting the incident to DEA OPR, which would have allowed for an impartial review of the incident; and provided false statement under oath to the OIG concerning his knowledge of the allegations involving the ASAC, all in violation of federal regulations and policies,” said the IG’s summary.

“Prosecution of the SAC was declined,” said the IG’s summary.

“The OIG has completed its investigation and provided its report to the DEA for appropriate action,” said the summary.

So when you work for law enforcement and you commit a crime and then another person in law enforcement LIES ABOUT WHAT WENT ON…  and everyone goes on with their life without any consequences.  Laws apparently are only meant to apply to those outside of law enforcement ?

Filed under: General Problems | 2 Comments »

Kolodny: Opioid Makers’ Deception Merits Dramatic Responses

https://www.addictionpro.com/article/kolodny-opioid-makers-deception-merits-dramatic-responses

In a workshop talk on preventing future public health catastrophes at the Rx Drug Abuse & Heroin Summit, Andrew Kolodny, MD, opened with the comment, “I’m not playing the blame game.” Still, the co-director of the Opioid Policy Research Collaborative at Brandeis University delivered blistering criticisms for many contributors to the opioid epidemic.

Makers of powerful opioids clearly headed the list, but government regulators, state medical boards and accrediting agencies all were targeted during Kolodny’s talk. At the heart of his concern is the role that pharmaceutical industry money has historically played in compromising the mission of these other entities.

“A big problem, I believe, is the revolving door,” said Kolodny, referring to the common practice of drug regulators leaving government to take jobs in the industry they had been overseeing. Kolodny, who disclosed he is assisting states in lawsuits against opioid manufacturers, placed atop his list of solutions the imposition of limits on the revolving-door practices.

He also advocates campaign finance law reform. “Congress failed in its oversight,” he said, as the Food and Drug Administration recklessly allowed opioid manufacturers, absent research evidence, to promote the idea that opioid painkillers were safe for long-term use.

Questioning accepted wisdom

Kolodny questions the general explanation for how the opioid crisis has evolved in the U.S. The account goes that a first wave of overprescribing of prescription painkillers led to a crackdown that forced addicted individuals to heroin, which then became a more deadly trend when fentanyl infiltrated the supply. Kolodny believes this explanation oversimplifies the issue somewhat. First, “We really haven’t had a crackdown—we’re still massively overprescribing opioids,” he said.

Also, the three-wave construct ignores that heroin use was steadily increasing in many places at early stages of the prescription opioid crisis, Kolodny said. Young, mainly white, adults started with prescription opioid use and moved to heroin because doctors grew more uncomfortable writing multiple prescriptions for younger patients, a concern they didn’t apply to older patients who were able to stay on prescription opioids, he said. Another cohort that is ignored in the conventional wisdom, he said, are older inner-city adults, mostly non-white, who had a longtime heroin addiction but now faced deadly consequences of their use. In Washington, DC in particular, “Fentanyl was killing men who had survived 40 to 50 years with a heroin addiction,” Kolodny said.

He outlined the well-financed marketing efforts of Purdue Pharma and other drugmakers in assisting prescribers to grow more comfortable with opioids as a class, as they characterized any resistance to prescribe as “opiphobia” that would result in patients suffering needlessly. Helping the effort, however, were also entities such as the Federation of State Medical Boards, which sent the message that physicians would be sanctioned for undertreating pain, and the Accreditation Council for Continuing Medical Education, which failed to enforce its standard that continuing medical education be free from commercial bias, Kolodny said.

Outcome-focused sessions

Another workshop on the second day of the conference discussed a University of Kentucky team-based initiative to link emergency medical patients with opioid use disorders to ongoing care. The First Bridge Clinic was launched in early 2018 and involves the cooperation of a multidisciplinary team that includes waivered doctors and nurse practitioners, a nurse navigator, a licensed therapist and a certified peer support panelist.

Among the panelists, and Bridge Clinic leaders, was cardiac anesthesiologist J. Thomas Murphy, MD, who said he became board certified in addiction medicine and waivered to prescribe buprenorphine after seeing an increase in patients needing surgery for complications of endocarditis.

Another outcome-focused session at the conference featured two physicians who discussed improving services for pregnant women with opioid use disorder and their families. Mishka Terplan, MD, MPH, professor of obstetrics and gynecology and medical director of the MOTIVATE Clinic at Virginia Commonwealth University, lamented the lack of evidence-based care for pregnant women, even though it has been known since the 1970s that methadone is compatible with an uneventful pregnancy and the birth of a child with manageable symptoms. From 2002 to 2009, the percentage of addiction treatment centers offering services for pregnant and postpartum women actually declined from 19% to 13%, Terplan said.

Stephen Patrick, MD, MPH, director of the Vanderbilt Center for Child Health Policy, discussed the successes of an interdisciplinary Team Hope project at Vanderbilt that has been able to reduce lengths of stay for newborns who have been exposed in utero to opioids. The effort has emphasized standardizing protocols and taking a more compassionate approach that seeks not to routinely separate the baby from the mother.

I remember AK stating that he has never said that opiates SHOULD NOT BE USED FOR TREATING LONG TERM CHRONIC PAIN LONG TERM

but in this article AK is quoted:   He also advocates campaign finance law reform. “Congress failed in its oversight,” he said, as the Food and Drug Administration recklessly allowed opioid manufacturers, absent research evidence, to promote the idea that opioid painkillers were safe for long-term use.

AK seems to vision himself as a “knight on a white horse” that save our country from continued opiate crisis… but is he more like Don Quixote

Filed under: General Problems | 3 Comments »

Munster doctor sentenced for over-prescribing pain pills

https://www.nwitimes.com/news/local/crime-and-courts/munster-doctor-sentenced-for-over-prescribing-pain-pills/article_31c9fcad-d45b-5ef5-b493-777b0439c2f6.html

Filed under: General Problems | 4 Comments »

Tragic Veteran Suicide At Cleveland VA Medical Center

www.disabledveterans.org/2019/04/30/tragic-veteran-suicide-at-cleveland-va-medical-center/

A veteran tragically took his own life yesterday at the Cleveland VA Medical Center just outside the facility’s emergency department.

“Our deepest condolences go out to the loved ones affected by this death,” the VA Northeast Ohio Healthcare System said in a statement. “Suicide prevention is VA’s highest clinical priority. One life lost to suicide is one too many.”

The facility cited privacy concerns when asked to provide additional details about the suicide. The immediate response is not unlike that of other facilities where veterans committed suicide on agency property including two suicides in Atlanta and the third in Texas.

Gary Pressley, 29, shot himself in a parking lot with a self-inflicted gunshot wound. Olen Hancock, 68, shot himself and died the following day. A third veteran shot himself in a VA waiting room located in Austin, TX.

“Every one of these is a gut-wrenching experience for our 24,000 mental health providers and all of us that work for VA,” Richard Stone, MD, of the Veterans Health Administration (VHA) said at the time. Dr. Stone is the Executive in Charge for VHA.

Congresswoman Speaks On Ohio Suicide

“I am heartbroken following the suicide of a veteran outside the Cleveland VA this morning,” said Rep. Marcy Kaptur (OH). “The level of pain that brings someone to suicide is fortunately unimaginable to many of us. My sincere condolences and prayers are with the veteran’s family and friends during this immensely difficult time.”

“The fact that 20 veterans a day take their own life – over 7,000 a year – is a tragedy. With seven incidents of veteran suicide on VA property in 2019 alone, 25 in the last 18 months, it’s critical we do more to stop this sustained national crisis. That is why I am working closely with my colleagues in the House and Senate to take decisive action to investigate and bring to an end the epidemic of veteran suicide.”

Veteran Suicide Data

Over 6,000 veterans have committed suicide since 2016. After the recent suicides, VA reiterated that suicide prevention is VA’s top clinical priority.

“The sad thing that we confront every day is that of the 20 veteran suicides that occur across the country 14 of those veterans are outside of our department,” Wilkie said.

“What I’ve envisioned is the opening of the aperture to the states and localities to get them resources to find those veterans. One of the tragedies is that many of those veterans who take their lives come from my father’s era – Vietnam. So we have Americans whose problems in many cases began building when Lyndon Johnson was president. We have to tackle this issue in a way that we haven’t tackled it before.”

Is It A ‘Sad Thing’ To Be Outside VA?

One theme that keeps coming up is the VA’s argument that 2/3 of veteran suicides are by veterans not receiving health care from VA. Somehow, the argument goes, VA will reduce veteran suicides by pushing all veterans into the VA system.

Here’s the thing.

Most veterans do not receive health care from VA, around 2/3. So, it makes sense that around 2/3 of the veterans committing suicide are outside the VA system.

Is that fact alone a bad thing?

On its face, the numbers seem to suggest a veteran is at least as likely to commit suicide who uses VA health care services as a veteran who does not use those same services.

So, is pushing all veterans into the VA for health care the answer to veteran suicide?

It seems unlikely.

About VA Northeast Ohio Healthcare System

The Cleveland VA Medical Center serves over 110,000 veterans. It is part of the VA Northeast Ohio Healthcare System, which is part of VISN 10 that serves 685,000 veterans throughout Michigan, Ohio, Northern Kentucky, and Indiana.

If you are reading this and experiencing mental health struggles, you are invited to call the Veterans Crisis Line at 1-800-273-8255 and press 1.

However, please note that some veterans who call the hotline report that they receive visits from police shortly after calls.

Filed under: General Problems | Leave a Comment »

Nearly all doctors can freely prescribe opioids. Now a new movement aims to vastly deregulate an addiction treatment

www.statnews.com/2019/04/30/loosen-restrictions-on-prescribing-buprenorphine-addiction-treatment/

WASHINGTON — Eighteen state public health directors, a growing group of physicians, and a prominent member of Congress are pushing a dramatic expansion of substance use treatment by posing a simple question: Why can’t doctors who prescribe opioids also prescribe drugs to treat opioid addiction?

Their push to deregulate use of buprenorphine, which is used to lessen opioid cravings and withdrawal symptoms, would represent a fundamental shift in U.S. substance abuse treatment. The medication — and addiction medicine in general — are highly regulated, largely due to fears that opioid-based treatment drugs like buprenorphine and methadone could be misused.

This week, the effort will gain support from Washington: Rep. Paul Tonko (D-N.Y.) will soon introduce legislation to allow any medical practitioner licensed to prescribe controlled substances to prescribe buprenorphine, he told STAT. Currently, physicians must undergo an eight-hour training to prescribe the drug — 24 hours for nurse practitioners and physician assistants.

“These professionals can use their training and skill and ability to provide medication for treatment of pain,” Tonko said in an interview. “But when it comes to addressing the illness of addiction, they have to jump through additional hoops.”

The bill, Tonko said, “removes unnecessary obstacles and really expands the access we’ve created to provide for treatment on demand.”

Tonko’s push — though in its early stages — gives formal backing to an effort by treatment advocates who have long argued the federal government’s response to a crisis claiming 50,000 lives each year has been irresponsibly slow and at times counterproductive.

This month, top health officials in 18 states, three U.S. territories, and the District of Columbia wrote health secretary Alex Azar urging him to relax restrictions on the addiction medication.

Deregulating buprenorphine would make it far easier for Americans to get addiction care from their own doctors instead of being pushed through bureaucratic hoops and into treatment programs of varying quality, said Dr. Andrew Kolodny, the co-director of the Brandeis University Opioid Policy Research Collaborative. Currently, just 1 in 20 doctors have obtained the license necessary to prescribe it.

“For your average person who is opioid-addicted, who may have a relationship with their primary care doctor who they know and trust,” Kolodny said, “there’s a 95% chance that doctor is going to have to say: Well, let’s find a place to send you.”

The movement, however, appears to lack institutional support from major addiction medicine groups, including the American Society of Addiction Medicine. The National Council for Behavioral Health, which represents mental health and addiction providers, has no position on the proposal.

Opponents of deregulating addiction medicine say it could encourage more people to use buprenorphine illegally. In recent years, the Drug Enforcement Administration has raided the offices of numerous physicians who prescribe buprenorphine, including a leading addiction doctor in Tennessee and the past president of the American Society of Addiction Medicine, to investigate whether the high-volume treatment facilities had effectively become “pill mills.”

Filed under: General Problems | 6 Comments »