CDC: More people are overdosing on this legal drug

Posted on April 12, 2019 by Pharmaciststeve

CDC: More people are overdosing on this legal drug

https://www.daytondailynews.com/news/national/cdc-more-people-are-overdosing-this-legal-drug/SYJXTs2CGveCULnKFa0acO/

An herbal over-the-counter drug was a cause in the overdose deaths of 91 people from July 2016 to December 2017, according to the Centers for Disease Control. 

That’s more than double what was earlier reported.

The CDC also noted that in about 60 of those kratom-related deaths, fentanyl was a co-cause.

A clinic worker at Northside Forsyth Hospital in Cumming, Georgia, said they’ve treated several kratom overdose cases.

“When we have seen them coming in, they have some kind of psychotic episode where they are hallucinating. Some are unconscious,” said Antwan Brownlee, behavioral health clinician at Northside Forsyth Hospital. “From this EMS report, they had given the patient Narcan, and the person was responsive when we started to do the evaluation.” 

The DEA is considering criminalizing kratom, saying it has a high potential for abuse and no currently accepted medical use in treatment.

But a Cobb County, Georgia, woman doesn’t agree.

Christy Garner said kratom has helped her battle chronic pain, while stopping her addiction to opiates.

“It’s given me a new life. When it’s used responsibly, it’s a miracle supplement,” Garner said.

Poison centers have noted a spike in calls related to kratom.

The FDA and DEA have solicited public comment on a proposal to criminalize the possession and sale of kratom.

More than 100,000 have signed petitions opposing plans to make kratom illegal.

Just read the WORDS that they use … “Kratom WAS A CAUSE” and ILLEGAL FENTANYL WAS ALSO IN TOXICOLOGY

Hospital has TREATED SEVERAL KRATOM OVERDOSE CASES — NO ONE DIED ?

Kratom HAS A HIGH POTENTIAL FOR ABUSE  – based on what clinical data ?

Poison Centers have NOTICED A SPIKE in calls related to Kratom – a spike could be a increase from TWO to FOUR ?

In a 550 day period – 90 deaths where KRATOM WAS “A CAUSE”  – NOT THE ONLY CAUSE ?

The DEA is playing “magician” with the numbers… they can turn “small numbers” into seemingly “LARGE NUMBERS”

In the same time frame the two drugs ( Alcohol & Nicotine) would be involved in 825,000 deaths… just 9000 PERCENT MORE PER DAY

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Fed mandate to use opioid data-sharing technology angers states

Posted on April 12, 2019 by Pharmaciststeve

Fed mandate to use opioid data-sharing technology angers states

https://www.politico.com/story/2019/04/12/opioid-data-sharing-angers-states-1320532

The Trump administration is forcing states that want millions in federal grants to use relatively untested technology to share prescription data that is key to combating the opioid crisis.

Using the software, many state officials worry, could mean turning over patient data to law enforcement and invading patients’ privacy. And it would override an already proven system used by doctors in 46 states plus Washington, D.C., and Puerto Rico.

The dispute is over prescription drug monitoring programs, which track all the drugs dispensed in a given state. While handy for doctors seeing whether patients might be receiving too many opioids, or for law enforcement looking for pill mills, it’s inherently limited: An affected patient might easily receive prescriptions from multiple states. Hence the need to share data across state lines. If states use competing systems that don’t communicate, the data-sharing work falls apart.

The dispute is particularly acute given the overdose crisis that’s claiming tens of thousands of lives each year in the U.S. Getting the data-sharing right could help doctors detect patients’ problems sooner and solve them faster.

But opioid prescribing data is already being shared across most of the U.S. That adds to states’ puzzlement that the CDC and Department of Justice’s Bureau of Justice Assistance are requiring grant applicants to provide patient information through a competing data hub called RxCheck, funded by the Bureau.

RxCheck helps pass requests from doctors and pharmacists for prescription history across state lines. The government says RxCheck, which is managed by member states’ prescription drug monitoring boards, will introduce competition in the market.

Officials in 14 states said in a series of letters last fall that the RxCheck hub is being foisted upon them to solve a problem they don’t have. The hub, with its relatively untested technical capacity, could lead to privacy invasions and incapacitate the established data-sharing system most use now, some worry.

“When you have a good thing going, to go and jump into a system that isn’t widely used — it’s kind of like, nonsense,” said Joe Fontenot, assistant executive director of the Louisiana Board of Pharmacy.

The Bureau’s grants, worth hundreds of thousands of dollars to each winning state, were awarded in September. In order to use the money, states had to connect to RxCheck. But the bigger prize is the upcoming CDC grants, worth as much as $9.1 million per state, which also come with the requirement that states use RxCheck. States need to decide on the CDC grants by a May 4 deadline.

A competing technology, backed by a firm called Appriss, has dominated the prescription drug monitoring program market since its entry in 2014. Since 2011, Appriss has also led interstate data-sharing through a system called PMP InterConnect, developed with the nonprofit National Association of Boards of Pharmacy. The federal government thinks that Appriss’ twin dominance puts RxCheck at an unfair disadvantage.

The federal government has been trying to encourage the use of RxCheck since at least May 2012, but only with this latest round of grants has it required the use of the technology.

For affected states, the preference for PMP InterConnect reflects its superiority — and a reason not to dabble with RxCheck.

“We may move from a system that works extremely well to one that has a lot of unknowns and is of uncertain capability,” said David Brown, director of Virginia’s Department of Health Professions.

Brown’s concerns about RxCheck and the grant requirements are shared by many other states. They say the language in the Bureau’s grant requirements opens the door for access by law enforcement contrary to state law. The grant requires software, data, “or other intangible property … designed, developed, acquired, or produced under this award” to be provided upon request.

That leaves open the possibility that state prescription data “owned” by the participating states will be subject to sharing without a review process, New Jersey’s attorney general wrote in an Oct. 31 letter.

Michigan won’t accept the grant money if it requires the state to “violate its own laws,” said Pardeep Toor, spokesperson for the Department of Licensing and Regulatory Affairs. North Dakota may follow suit, although Sen. John Hoeven’s office said he is working to address the state’s concerns.

The CDC grants pose slightly different concerns, mandating that states have archiving plans for their data. That requirement, some states say, would clash with their privacy laws, which require them to scrub old data.

The CDC’s money is perceived as a powerful form of leverage, because it doesn’t specifically flow to drug monitoring programs but rather to state departments of health. A monitoring program director’s concerns might not override a state’s broader interest in the money.

“They’re basically strong-arming the states to say if you want this money for the state, the whole state overall, not just the PDMP, you need to accept this condition,” said Mark Hardy, executive director of the North Dakota Board of Pharmacy.

Only four states use RxCheck, a state of affairs the agencies blame on Appriss, which blocks access through “influence over both the cost and timing of connections that are made at the state level,” said Tara Kunkel, an adviser to the Department of Justice’s Bureau of Justice Assistance.

Kunkel said the federal government had received complaints from 11 states who say the vendor has abused its market position. The states said they’d been unable to access their data without paying extra fees and faced prohibitively high costs to connect providers serving poor or rural areas to PDMPs through their electronic health records, she said.

But not all states agree with the complaint. Cost “has not been a barrier at all,” said North Dakota’s Hardy.

States aren’t sure they can afford to maintain RxCheck and InterConnect at the same time. The National Association of Boards of Pharmacy’s director, Carmen Catizone, says his organization may have to close InterConnect if the government continues to push RxCheck.

Justice and the CDC have attempted to calm such concerns with letters, webinars and FAQs. They say they don’t intend to circumvent relevant laws and that the provisions are methods of combating competitive abuses.

But states also worry that the RxCheck hub may be incapable of handling the demands of data-sharing. Some 20 million transactions per month pass through PMP Gateway, the EHR integration tool, the National Association of Boards of Pharmacy says. RxCheck’s EHR integration only moved out of the pilot phase last fall.

Kunkel also claimed Appriss is using its competitive position to block RxCheck and to choke off provider and government use of prescription data for things like analyses to detect over-prescribing “hot spots.”

Rob Cohen, president of Appriss’ health division, denied the government’s complaints. He said Appriss provides several tools to analyze state data, and only has minimal charges in rare circumstances.

The federal government said RxCheck enables doctors to cheaply access PDMP information directly through their computer systems. In Kentucky, state officials can provide RxCheck to doctors who want a low-cost option, according to Dave Hopkins, a program manager at Kentucky’s PDMP. The Gateway alternative has more features but costs more, he said.

But only a tiny number of doctors have connected their EHRs to PDMPs through RxCheck, Cohen said, while Appriss has connected hundreds of thousands in the state.

RxCheck, he claimed, lacks important features such as robust audit trails that allow administrators to see what user accessed data. While RxCheck may not charge for the integrations, he said, maintenance functions like call centers will get “pushed out to the states, or the vendors to the states, or the EHRs.”

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Florida Attorney General announces fight against opioid abuse in Tampa Bay

Posted on April 12, 2019 by Pharmaciststeve

http://www.fox13news.com/news/local-news/florida-attorney-general-to-announce-fight-against-opioid-abuse-in-tampa-bay

TAMPA, Fla. (FOX 13) – Last year, there were over 1,300 overdose deaths specifically in the Bay Area. The statistics bring to light the local intensity of the opioid epidemic, a reality that far too many families are forced to face.This lies next to the number of people consuming alcohol who often consult DUI attorney for the legal issues caused by it. 

“I lost my brother two years ago to a carfentanil overdose,” said Ellen Snelling with the Hillsborough County Anti-drug Alliance.

Continue reading below

Today, and every day, 17 people throughout Florida will die from overdoses of opioids or heroin, a staggering statistic that Attorney General Ashley Moody says needs to change.

JD Injury Law, AP explains motorcycle accident cases and other accidents “In order to make meaningful strides against this opioid epidemic, we must not let up on our efforts against going after aggressively those who are trafficking in opioids.”

In an effort to tackle the crisis head-on, local, state and federal officials are introducing a strategy calling ‘DEA 360.’

“DEA 360 attacks the drug epidemic from every angle, all sides. We go after the bad guys, and we educate the good guys,” said Mike Furgason with the DEA Tampa District.

They’re calling it a three-pronged approach combining law enforcement, diversion control, and community outreach to address the root issues.　

“A law enforcement solution alone is inefficient, it is instead an integral part of a multi-prong strategy that has to be implemented in unison in order to be as effective as possible,” said Cpt. Mike Jenkins with the Pasco County Sheriff’s Office.

While this won’t be an overnight fix, the future seems promising.

“I believe those numbers will go down with this multi-faceted approach. We cannot arrest our way out of this, it has to be fully engaged from all community members,” said Mark Brutnell, with FDLE.

It’s a new game plan to tackle a problem that kills more than 500 Floridians every month.

DEA 360 has already been successfully implemented in communities across the United States.

Locally, the DEA 360 program will be put in place in 10 counties surrounding the Tampa Bay Area including Hillsborough, Pinellas, Pasco, Manatee, Desoto, Sarasota, Polk, Hernando, Citrus and Hardee. It’s a new game plan to tackle a problem that kills more than 500 Floridians every month.

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Trump Administration Plans To Bail Out Insurers To Hide Higher Drug Costs

Posted on April 12, 2019 by Pharmaciststeve

Trump Administration Plans To Bail Out Insurers To Hide Higher Drug Costs

www.thefederalist.com/2019/04/12/trump-administration-plans-bail-insurers-hide-higher-drug-costs/

This is not a government agency sharing risk, it’s a government agency assuming virtually all of the risk associated with the higher premium costs due to the rebate rule. In other words, a bailout.
Christopher Jacobs

By

April 12, 2019

The more things change, the more they stay the same. On a Friday, the Trump administration issued a little-noticed three paragraph statement that used seemingly innocuous language to outline a forthcoming bailout of health insurers—this one designed to avoid political controversy prior to the president’s re-election campaign.

Republicans like Sen. Marco Rubio (R-FL) quite rightly criticized President Obama for wanting to bail out health insurers via a crony capitalist boondoggle. They should do the same now that Trump wants to waste billions more on a similar tactic that has all the stench of the typical Washington “Swamp.”

Explaining the President’s Drug Pricing Proposal

The announcement from the Centers for Medicare and Medicaid Services (CMS) involves the president’s efforts on drug pricing. As part of that campaign, the administration released a proposed rule—comments on which were due April 8—that would change the system of rebates handled by pharmaceutical benefit managers (PBMs).

At present, drug manufacturers pay rebates to PBMs in exchange for preferred placement on an insurer’s pharmacy formulary. PBMs then share (most of) these rebates with insurers, who pass them on to beneficiaries. But historically, PBMs have passed those rebates on via lower premiums, rather than via lower drug prices to consumers.

For instance, Drug X may have a $100 list price (the “sticker” price that Manufacturer Y publicly advertises), but Manufacturer Y will pay a PBM a $60 rebate to get Drug X on the PBM’s formulary list. It sounds like a great deal, one in which patients get the drug for less than half price—except that’s not how it works at present.

Instead, the PBM uses the $60 rebate to lower premiums for everyone covered by Insurer A. And the patient’s cost-sharing is based on the list price (i.e., $100) rather than the lower price net of rebates (i.e., $40). This current policy hurts people whose insurance requires them to pay co-insurance, or who have yet to meet their annual deductible—because in both cases, their cost-sharing will be based on the (higher) list price.

The proposed rule would require PBMs operating within Medicare and Medicaid to pass any rebates they receive directly through to customers at the point of sale. (Extending this proposed change to other forms of insurance would require Congress to pass legislation.) For the reasons explained above, the change would lower out-of-pocket costs for seniors—particularly for those with very high drug costs. But prohibiting PBMs from applying rebates to premiums means that the latter by definition will rise.

The Policy and Political Problems

The administration’s proposed rule conceded that the proposed change could raise Medicare Part D premiums. The CMS Office of the Actuary estimated the rule would raise premiums anywhere from $3.20 to $5.64 per month. (Some administration officials have argued that premiums may stay flat, if greater pricing transparency prompts more competition among drug manufacturers.)

The rule presents intertwined practical and political problems. From a practical perspective, the administration wants the rule to take effect in 2020. But the comment period on the proposed rule just closed, and the review of those comments could last well beyond the June 3 date for plans to submit bids to offer Part D coverage next year.

The political implications seem obvious. The administration doesn’t want to anger seniors with Part D premium increases heading into the president’s re-election bid. And while the administration could have asked insurers to submit two sets of plan bids for 2020—one assuming the rebate rule goes into effect next year, and one assuming that it doesn’t—doing so would have made very explicit how much the change will raise premiums, handing Democrats a political cudgel on a hot-button issue.

Here Comes the Bailout

That dynamic led to the Friday announcement from CMS:

If there is a change in the safe harbor rules effective in 2020, CMS will conduct a demonstration that would test an efficient transition for beneficiaries and plans to such a change in the Part D program. The demonstration would consist of a modification to the Part D risk corridors for plans for which a bid is submitted. For CY2020, under the demonstration, the government would bear or retain 95% of the deviation between the target amount, as defined in section 1860D-15(e)(3)(B) of the Social Security Act (the Act) and the actual incurred costs, as defined in section 1860D-15(e)(1) of the Act, beyond the first 0.5%. Participation in the two-year demonstration would be voluntary and plans choosing to participate would do so for both years. Under the demonstration, further guidance regarding the application process would be provided at a later date.

To translate the jargon: Risk corridors are a program in which the federal government subsidizes insurers who incur large losses, and in exchange insurers agree to give back any large gains. I explained how they worked in the Obamacare context here. However, unlike Obamacare—which had a risk corridor program that lasted only from 2014-2016—Congress created a permanent risk corridor program for Medicare Part D.

It all sounds well and good—until you look more closely at the announcement. CMS says it will “bear or retain 95% of the deviation…beyond the first 0.5%.” That’s not a government agency sharing risk—that’s a government agency assuming virtually all of the risk associated with the higher premium costs due to the rebate rule. In other words, a bailout.

Déjà Vu All Over Again

The use of a supposed “demonstration project” to implement this bailout echoes back to the Obama administration. In November 2010, the Obama administration announced it would create a “demonstration project” regarding Medicare Advantage, and Republicans—rightfully—screamed bloody murder.

They had justifiable outrage, because the added spending from the project, which lasted from years 2012 through 2014, seemed purposefully designed to delay the effects of Obamacare’s cuts to Medicare Advantage. Put simply, the Obama administration didn’t want stories of angry seniors losing their coverage due to Obamacare during the president’s re-election campaign, so they used a “demonstration project” to buy everyone’s silence.

In response to requests from outraged Republicans, the Government Accountability Office (GAO) conducted multiple reviews of the Medicare Advantage “demonstration project.” Not only did GAO note that the $8 billion cost of the project “dwarfs all other Medicare demonstrations…in its estimated budgetary impact and is larger in size and scope than many of them,” it also questioned “the agency’s legal authority to undertake the demonstration.” In other words, the Obama administration did not just undertake a massive insurer bailout, it undertook an illegal one as well.

The current administration has yet to release official details about what it proposes to study in its “demonstration project,” but, in some respects, those details matter little. The real points of inquiry are as follows: Whether buying off insurance companies and seniors will aid Trump’s re-election; and whether any enterprising journalists, fiscal conservatives, or other good government types will catch on, and raise enough objections to nix the bailout.

Congress Should Stop the Insanity

On the latter count, Congress has multiple options open to it. It can obtain request audits and rulings from GAO regarding the legality of the “demonstration,” once those details become public. It can explore passing a resolution of disapproval under the Congressional Review Act, which would nullify Friday afternoon’s memo.

It can also use its appropriations power to defund the “demonstration project,” preventing the waste of taxpayer funds on slush funds and giveaways to insurers. Best of all, they can do all three.

Republicans objected to crony capitalism under Democrats—Rubio famously helped block a taxpayer bailout of Obamacare’s risk corridor program back in 2014. Here’s hoping they will do the same thing when it comes to the latest illegal insurer bailout proposed by CMS.

Mr. Jacobs is founder and CEO of Juniper Research Group, a policy consulting firm based in Washington. He is on Twitter: @chrisjacobsHC.

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AG Barr believes that CONTINUED OVER PRESCRIBING has to be CUT BACK ?

Posted on April 12, 2019 by Pharmaciststeve

Start listening at about 4:00 as AG Barr is going to “put pressure” on the over prescribing of legal opiates that have been over prescribed and diverted

Filed under: General Problems | 5 Comments »

Veteran who killed himself outside of VA center in Decatur identified

Posted on April 11, 2019 by Pharmaciststeve

Veteran who killed himself outside of VA center in Decatur identified

https://www.ajc.com/news/breaking-news/veteran-who-killed-himself-outside-center-decatur-identified/NMqi3pO2DjCWu7KqOiXtbN/

Victim was 68-year-old Alpharetta man who shot himself

The veteran who killed himself outside the main entrance to the Atlanta VA Medical Center in Decatur Saturday has been identified as Olen Hancock, 68, of Alpharetta, according to the DeKalb County Medical Examiner’s Office.

“After Mr. Hancock shot himself, the staff at the VA immediately assisted him and called 911 for an ambulance,” Mark Anglin, the chief investigator for the DeKalb Medical Examiner’s Office told The Atlanta Journal-Constitution. He said Hancock was transported to Grady Memorial Hospital and pronounced dead at the emergency department.

Another Georgia veteran died by suicide in a parking lot at the Carl Vinson VA Medical Center in Dublin Friday. Veterans Affairs Department officials have declined to identify the victim, citing privacy reasons.

More than 6,000 veterans killed themselves each year between 2008 and 2016, VA figures show. In 2016, 202 veterans died by suicide in Georgia. And between 2015 and 2016, the suicide rate per 100,000 people for veterans ages 18 to 34 increased from 40.4 to 45 nationwide, despite the VA’s efforts to tackle the problem.

 

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FDA New Guidance on Opioids Drawing Response

Posted on April 11, 2019 by Pharmaciststeve

FDA New Guidance on Opioids Drawing Response

www.nationalpainreport.com/fda-new-guidance-on-opioids-drawing-response-8839531.html

The FDA’s safety announcement this week that says it has identified harm reported from sudden discontinuation of opioid pain medicines and is requiring label changes to guide prescribers on gradual, individualized tapering was generally praised.

Stanford Psychologist Beth Darnall—who was in Australia speaking to the 2019 Australian Pain Society speaking on the topic—indicated that the guidance was appropriate.

“It is wonderful to see national agencies issuing dedicated communications to correct the misapplication of CDC guidelines, and to assure patient protections from iatrogenic harms caused by rapid and forced tapering,” she said.

She also said that communicating this message to pharmacies is important.

“The FDA recommends labeling and guidance to clinicians. Who will guide the recommendations and policies to *pharmacies* to assure that clinicians have the *autonomy to implement best practices for their patients* and prevent rapid and forced tapering caused by opioid prescription fills being denied?

For “Richard A Lawhern, PhD, Director of Research for the Alliance for the Treatment of Intractable Pain, this is a long overdue “baby step” the FDA has taken.

“How much longer can FDA, CDC and other Federal and State agencies ignore the even larger reality? he asked. “As several past presidents of the American Academy of Pain Medicine and other prominent medical professionals have pointed out in a December 2018 letter to the Governor of Oregon, there are no published trials data that establish benefit to legacy patients from mandated tapering of opioid therapy. To the contrary, as FDA points out, there is a risk of medical collapse when such measures are imposed.”

A dentist who had to retire due to CRPS nearly two decades ago, was even less enthusiastic.

“I cannot believe that these “findings” were a surprise to anyone that deals with opioids,” wrote Dr. Mark Helfand to the National Pain Report. “I graduated dental school in 1984 and even back then it was known that you should never stop or greatly reduce the dosage of opioids quickly. It must be done slowly and gradually over time. If not, the effects on the patient are at least serious pain and illness. At most, death.”

Gary lives in Virginia and wrote to the National Pain Report that the FDA word getting out needs to happen fast.

“Virginia must not have received the memorandum from the FDA. As of yesterday, April 9 2019, I was told by 5 pain management clinics in Charlottesville, Lynchburg, and Roanoke that they will not prescribe new – or continue to prescribe from other doctors – any narcotic analgesic.”

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PBM’s industry starting to have contracts fall/cancelled like Dominos ?

Posted on April 10, 2019 by Pharmaciststeve

CVS Caremark dumped by big Medicaid insurer

https://www.record-courier.com/news/20190410/cvs-caremark-dumped-by-big-medicaid-insurer

CareSource, by far Ohio’s largest Medicaid managed-care provider, on Tuesday announced that it was firing CVS Caremark as its pharmacy benefit manager. The more than 1 million Medicaid clients served by Dayton-based CareSource now will have their prescriptions handled by Express Scripts, another of the nation’s three dominant pharmacy benefit managers.

The move comes after more than a year of scrutiny by government officials and The Dispatch of CVS’s pricing practices. A study found that in 2017, CVS charged taxpayer-funded companies such as Caresource almost $200 million more for prescription drugs than it reimbursed pharmacists.

“We believe the current PBM model has significant room for improvement,” CareSource President & CEO Erhardt Preitauer said in a statement . “CareSource saw an opportunity to reinvent the model with a focus on transparency, driving real value for stakeholders, building stronger partnerships with local pharmacies and controlling costs.”

gatehousenews.com/sideeffects/cvs-caremark-dumped-big-medicaid-insurer/
Preitauer said that his company will adopt a new model, called “CareSource RxInnovations,” that will provide more transparent pricing that will be verified by an independent third party. He also promised that independent pharmacists, who have suffered declining reimbursements, will be protected from market volatility.

“This is the culmination of a year-long effort to address the major areas of opportunity in the current PBM model,” CareSource Senior Vice President Clayton Edwards said. “We want to create something that better serves members through the integration of all clinical data—medical, behavioral, social and pharmacy. This will allow us to provide holistic care coordination, while also meeting the needs of our other key stakeholders—the states in which we do business and our pharmacy partners.”

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Gutfeld on the fabricated opiate crisis

Posted on April 10, 2019 by Pharmaciststeve

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Do You Know About a Suicide from Chronic Pain?

Posted on April 10, 2019 by Pharmaciststeve

Do You Know About a Suicide from Chronic Pain?

www.nationalpainreport.com/do-you-know-about-a-suicide-from-chronic-pain-8839485.html

It’s an issue we’ve talked about a lot on the National Pain Report—patient abandonment and suicide from chronic pain.

We see it in statistics, we report it in stories, and we see alarming threats of it—many threats—in our commentary section.

(Some so alarming, that we’ve contacted the folks and tried to make sure they were talking with mental health professionals.)

That’s why our radar went up over the weekend, when chronic pain advocate Terri Lewis, Ph.D., sensitively but directly asked people on Twitter to share their stories about loved ones who may have been abandoned by their doctors and/or have chosen to end their lives from chronic pain.

What she is looking for specifically are;

  • Deaths post passage of the CDC guidelines in March 2016 and suicides or deaths from inadequate care among those who completed the survey
  • Confirmation of physician abandonment, under treatment, imposition of step therapy with an unsatisfactory outcome, insurance and/or pharmacy restrictions.

Here is the thread she published:

“I have a grim request. As I begin the analysis on suicide data for persons who chose to end their lives due to unrelieved pain or involuntary taper, I am searching the survey data for persons who submitted & have since deceased.

We know that many remain SKEPTICAL that anyone might make a well-considered decision to end their misery or refuse treatment. I am particularly interested in deaths post adoption of CDC’s guidelines March 2016.

If you have last communications that you are willing to share that document the reasons for their decision or death, please communicate with me so I can follow up with you?

I want to treat these folks as a special data cohort and respectfully address their submissions, their choices, and identify the unique questions that might be raised.”

This survey that she talks about has been promoted heavily by us at the National Pain Report. The survey, which is now closed, had an estimated 5,000 chronic pain patients respond—the largest chronic pain patient survey yet conducted.

If you filled out that survey and have a story to share—email, her tal7291@yahoo.com

If you also are comfortable in sharing those comments—or have your own story to tell that may not fit what Dr. Lewis is looking for and that you are willing to share—please do in our comments section.

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