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Another – OHIO- Lawmaker Overlooks Pain Management in Bill to Fight Opioid Crisis
Posted on March 29, 2019 by Pharmaciststeve
![[Photo: Senator Rob Portman (R-OH) looks on intently during a press meeting.]](https://i0.wp.com/rewire.news/wp-content/uploads/2019/03/rob-portman-740x525.jpg?resize=306%2C217&ssl=1)
Another Lawmaker Overlooks Pain Management in Bill to Fight Opioid Crisis
“Dependence isn’t addiction, and that is continually left out of the discussion and the policies being made,” said disability advocate Maelee Johnson.
Hardly a day goes by when the discussion of opioids and their misuse is not on the front page of local or national newspapers. However, the flipside of the issue, pain management, is barely, if ever, centered in the conversation.
This came up most recently with Republican Sen. Rob Portman of Ohio, who seeks to advance a bill he previously introduced called the Comprehensive Addiction and Recovery Act 2.0, which would, among other things, establish a three-day limit for opioid prescriptions.
This lack of focus on disabled and chronically ill patients has inadvertently pitted doctors against their own patients, who are framed as going down the rabbit hole of dependency following a sprained ankle or routine dental surgery. But this overly simplistic framing erases people with long-term disabilities and chronic health conditions who are struggling to live their lives while being punished for using the best tools we have available to enable their full participation in society.
The Centers for Disease Control and Prevention (CDC) in 2016 offered strategies to taper patients off opioids, but left doctors and patients with their decision-making authority, as it should. However, while the CDC clearly intended the guidelines to be just that—recommendations—that’s not how they’ve been interpreted.
As of last fall, 33 states have put policies in place that limit a person’s access to pain medication, in some cases to three to seven days of medication with no available refills. In some states, this means that patients are forced to go back to the doctor, enduring the burdens of medically unnecessary appointments just to get a new prescription, in order to get the medication they need every seven days.
These are people for whom opioids allow them to go to school, work a job, and manage their home life. In the words of Maelee Johnson, a disability advocate, in an interview for this piece: “Dependence isn’t addiction, and that is continually left out of the discussion and the policies being made.”
This costs lives, Johnson added. “Since the opioid crisis became a political issue, I’ve lost access to all my medication, and I dread having to convince doctors that I need these meds to survive again. The consequences of this are very far reaching.”
It’s not a legislator’s job to diagnose a patient’s ailment or prescribe relief. That responsibility falls to clinicians, who go to school for years for this specialty. And yet, time after time, lawmakers in Congress think they are equipped to address the complex needs of millions of individual patients with their policymaking. In the case of Sen. Portman’s bill, this is especially concerning in light of data pointing to the disastrous impact of arbitrary day-centered limits on pain treatment.
While this bill and similar efforts—including one by Democratic Sen. Kirsten Gillibrand of New York, whose recent policy announcement ended in her pledging to work more closely with the disability and chronic health communities to fix her bill—have an exemption for “people with chronic pain,” this approach fails to take into account what that will mean in practice for actual patients.
Research shows that even when there are exemptions, the patients’ needs are overridden as physicians fear being punished for over-prescribing medication. “Despite exemptions for [chronic pain] patients in the CDC Guideline and Tennessee state law, [a nurse practitioner at Vanderbilt University’s hematology department] had seen a major push from state regulators and insurers to get [sickle cell disease] patients down to lower doses,” noted a 2018 report from Human Rights Watch.
The report showed that legislative interventions such as these do have an impact on the quality of care doctors can provide to their patients who live with chronic pain. Doctors are interpreting the CDC guidelines and congressional action as broad, iron-clad requirements, and patients and people with chronic illnesses are the ones struggling.
Every person experiences pain differently, and legislation addressing this issue needs to take that into account.
Evidence shows that policies inserting the government into the doctor-patient relationship don’t work. For one thing, the majority of people with addiction issues tied to opioids do not receive them from a medical professional. Rather, they receive them from a friend, colleague, or they purchase them on the black market, according to data from the Substance Abuse and Mental Health Services Administration. Furthermore, the U.S. Department of Veterans Affairs, when working on limiting access to opioids among its community, issued a report in 2018 that clearly showed how restrictions did not result in fewer veterans overdosing. It resulted in more veterans dying by suicide, according to the research.
If you enact a policy and it results in constituents dying, it’s a bad policy.
This is what happens time and time again when policymakers craft legislation based on “good intentions” versus tapping into the deep expertise and “lived experience” of the disability community.
Inconsistent enforcement by the Drug Enforcement Administration has also led physicians to be concerned about the prescriptions they’re writing for patients. But it isn’t just the DEA pressuring and arresting physicians; when government intervention is not successful, insurance companies may meddle in complex patient care decisions. The America’s Health Insurance Plans (AHIP) has announced it will begin to track how physicians are complying with these new policies. Though this surveillance data will not be released to the public initially, there is little doubt it will be used to track the preponderance of opioid prescriptions.
This will compound the pressure already on doctors to not diagnose people with chronic pain and will lead to a decrease in access to pain management.
Additionally, there is a concern we will see an expanded list of drugs under restriction; we have already seen anti-seizure and anti-anxiety drugs like gabapentin included in recent state regulations. Broadening what drugs are included will undoubtedly expand who is affected. As we saw when allergy medications became restricted due to their use in manufacturing crystal meth, many times a medication that could be used to combat one symptom could be used for a nefarious purpose.
Instead of trying to force a flawed, one-size-fits-all policy onto hundreds of millions of people in the United States, legislators in Congress should support the dissemination of unbiased, science-based information about appropriate opioid use. Part of the current challenge is that so much of that information is produced by the pharmaceutical industry.
The marketing of OxyContin by Purdue Pharma is a great example of how this can be a conflict of interest. Purdue flew doctors on all-expenses-paid trips to resorts around the country to “educate” them about the merits of the drug. At the same time, the Food and Drug Administration was concluding that OxyContin was not any more effective than any other drug on the market. In 2007, the manufacturer pled guilty to misrepresenting how addictive the drug was and received a significant fine.
Rather than letting pharmaceutical companies run roughshod over clinicians, doctors need education about impacts of over-prescribing, and continuing medical education (CME) requirements should focus on responsible and careful pain management and the consequences of over-prescribing opioids.
Arbitrary limits on the days of medicine a person can receive is not good policy. Nor does it help people. And isn’t that gist of the Hippocratic oath?
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good ole opiophobic INDIANA – TV COMMERCIAL
Posted on March 27, 2019 by Pharmaciststeve
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Indiana Opiate Prescribing Guidelines — MME limit 60/day ?
Posted on March 27, 2019 by Pharmaciststeve
OPIOID PRESCRIBING GUIDELINES
In 2017, more than 6 million opioid prescriptions were dispensed to Indiana residents.[1]Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective pain treatment, while reducing the number of people who misuse, abuse or overdose from these drugs. The following guidelines have been developed and published by experts in the field of pain management to guide clinicians on best practices when it comes to prescribing opioids. Each guideline is tailored to a specified clinical setting.
Chronic Pain – Indiana Pain Management Prescribing Final Rule
In 2014, the Indiana Medical Licensing Board adopted a final rule that regulates physicians engaged in the practice of pain management prescribing, pursuant to Indiana Administrative Code 844 IAC 5-6. These regulations address the main factors of safe and effective prescribing practices that include: patient assessment, non-opioid treatment options, patient information consent, patient follow-ups, INSPECT reports, drug monitoring tests, a daily high dose threshold and a treatment agreement.
Comparison of CDC Guidelines to Indiana Prescribing Rule
The variety of guidelines published by various institutions can often be difficult to compare and contrast. In response to this, the Indiana State Medical Association has compiled a document that compares CDC’s Guidelines for Prescribing Opioids for Chronic Pain with Indiana’s Pain Management Prescribing Final Rule. Although both sets of guidelines are aimed at improving the safety and effectiveness of opioid prescribing practices, the Indiana requirements are tailored more to the state of Indiana, while the CDC’s recommendations apply nationally. Physicians in Indiana may still apply the CDC’s recommendations in their opioid prescribing practices, even if those guidelines are not addressed in Indiana’s requirements.
Acute PainThe Indiana Guidelines for the Management of Acute Pain
The Indiana Guidelines for the Management of Acute Pain guidelines address safe, appropriate and effective opioid prescribing practices for outpatient management of acute pain. They may be applied to patients of all ages presenting acute pain, but they may not apply to acute pain resulting from a chronic condition.
Additional ResourcesCo-prescribing Naloxone to Patients at Risk of Overdose
Co-prescribing naloxone is encouraged by a broad range of stakeholders to help reverse the effects of an opioid overdose for high-risk patients. This resource provided by the American Medical Association (AMA) describes how to determine when it is clinically appropriate to co-prescribe naloxone and provides additional considerations, such as how to approach a patient you wish to co-prescribe naloxone to.
[1] Indiana State Department of Health, Division of Trauma and Injury Prevention, INSPECT.
Data retrieved from https://gis.in.gov/apps/isdh/meta/stats_layers.htm.
Page last updated 11/27/2018
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Opioid Treatment 10-year Longevity Survey Final Report
Posted on March 27, 2019 by Pharmaciststeve
Opioid Treatment 10-year Longevity Survey Final Report
Patients in this study were found to be functioning quite well after 10 or more years on generally stable opioid dosages—with the vast majority able to care for themselves and even drive.
https://www.practicalpainmanagement.com/amp/152
About eighteen months ago, I approached the publisher of Practical Pain Management to assist in a survey of long-term, opioid-treated pain patients. Rightly, as any good publisher, he asked why should I go to the time and expense to do a longevity survey? I then presented him my laundry list of reasons for doing the survey. Some explanations of my reasons for doing this survey are given here. Quite frankly this survey was needed, since we simply have little data on opioid long-term treatment.1,2 Also, opioid treatment is constantly under attack, so it seems logical to see if the popularity of this treatment is justified.
Reasons for the Survey
First, recall that we have just finished the “Decade of Pain.” Ushering in this decade were many laws, regulations, and guidelines—promulgated in many states—that encouraged physicians to prescribe opioids without fear of legal reprisal. Did anyone get help this decade? Did this political and humanitarian effort pay off?
Secondly, my own experience in practice was the predominant factor. I started my pain practice in 1975 while serving as a Public Health Physician in East Los Angeles County. Cancer and post-polio patients needed ‘narcotics’ (the common name prior to the more correct usage ‘opioids’) treatment for their severe chronic pain. I’ve now followed some chronic pain patients still taking opioids after 25 to 30 years.1 Also, I was a government consultant in the 1970s on Howard Hughes who managed to survive 30 years with intractable pain after a 1946 plane crash. His average opioid dosage over that time period was about 200 mg of morphine equivalence. But are my patients unusual or simply responsive to an overzealous clinician? Do opioid-treated patients in the hands of other physicians do just as well over a long period?
A little over a year ago there was another reason to do a longevity survey. At that time there was a vitriolic, anti-opioid propaganda campaign being waged. Some prominent academic institutions, pharmaceutical companies, professional organizations, and journals, almost in unison, essentially claimed that opioids shouldn’t be prescribed due to hyperalgesia or other as-yet unnamed complications. Some parties stated that opioids, if prescribed at all, should have a dosage restricted to some arbitrary number such as 200mg of morphine equivalence a day. Some claims fundamentally suggested that pain should only be treated with non-opioids, because opioids actually “cause pain.” Amazingly, some detoxification centers actually advertised for “clients” on the basis that the person’s pain would be cured if the patient spent $10K or $20K to detoxify from opioids. Needless to say, the anti-opioid campaign was hardly backed by bonafide medical management pain practitioners or scientific studies. So what was needed was a simple survey to see if there are long-term opioid-treated patients who are still doing well.
What the Survey Can’t Determine
This survey was not intended or designed to answer some ancillary questions. Not answered is which opioids are superior or could patients have done as well without opioids? Also, it wasn’t intended to determine optimal dosage or complications. The intent was clear and simple: Do some opioid-treated patients improve pain control, function better, and enhance their quality of life over a 10-year period?
Survey Methods
In early 2009, an advertisement was placed in this publication to identify any physician who had a cohort of chronic pain patients they had treated with opioids for 10 or more years and were willing to share outcome data. Three physicians, one each from Kentucky, Louisiana, and California, reported a total of 76 patients who have been treated with opioids for 10 or more years. These, together with the 24 patients treated by this author,1 provide a cohort of 100 patients who have been treated with opioids for 10 or more years and serve as subjects for this survey. Physicians completed a survey questionnaire for each patient that inquired about demographic status, cause of pain, opioids currently used, basic physical functions, activities of daily living, and stability of opioid dosage.
Results and Findings
Patients in this study appeared typical of most chronic pain patients in that they are primarily middle age or older and have degenerative diseases of the spine, joints, or peripheral nerves (see Tables 1 and 2). Most have maintained on one opioid, although some patients required two or three. The majority have been on stable dosages for many years (see Table 3). Despite the longevity of treatment, most function quite well. The vast majority of patients report good function in that they can dress, read, attend social functions, drive, and ambulate without assistance (see Table 4). Almost half (45%) reported they had been on a stable opioid dosage for at least 3 years.
| Age (Yrs) | Range 30-83 |
|---|---|
| Males | 61 (61%) |
| Females | 39 (39%) |
| Length of time in opioid treatment | 10 – 35 yrs |
| Stable opioid dosage without significant escalation | 3mos – 31 yrs |
| Spine disease | 51 |
| Arthritis | 16 |
| Peripheral neuropathy | 14 |
| Headache | 10 |
| Knee diseases | 5 |
| Abdominal adhesions | 5 |
| Hip diseases | 4 |
| Shoulder/arm diseases | 4 |
| Fibromyalgia | 4 |
| 113* | |
| *Adds up to more than 100 as some patients had more than 1 diagnosis. | |
| No. of Opioids Currently Used | N(%) |
|---|---|
| 1 | 62 |
| 2 | 26 |
| 3 | 12 |
| Opioids Currently Used | |
| Hydrocodone | 56 |
| Oxycodone | 25 |
| Fentanyl | 15 |
| Morphine | 13 |
| Methadone | 8 |
| Propoxyphene | 8 |
| Hydromorphone | 5 |
| Other | 6 |
| N(%) | |
|---|---|
| Dress without assistance | 82 |
| Attend church/social events | 89 |
| Read newspapers, books, magazines | 97 |
| Gainful employment | 25 |
| Care for family | 61 |
| Ambulate unassisted | 85 |
| Ambulate with cane | 5 |
| Drive a car | 74 |
Discussion
Recent epidemiologic studies indicate that about 10 million Americans now take opioid drugs for chronic pain control. This relatively recent and dramatic occurrence has had little outcome study.1,2 The author recently reported 24 Southern California chronic pain patients who were treated with opioids over 10 years and who had positive social, physical, and functional results.1 Outcomes from other patients treated by other physicians in other geographic areas were needed to confirm or deny the positive outcomes found with one physician in one geographic area. As stated above, this survey was not intended and doesn’t imply that there are patients who may have done as well or better if treated differently. Also this survey does not include patients who did not respond to opioids or stopped them due to complications.
This survey doesn’t lay claim to any sophisticated epidemiogic methodology or randomization. All this survey intended to do was meet one fundamental goal: “Are there chronic pain patients in the United States who have taken opioids over 10 years and report less pain, better function and have a better quality of life?” This survey satisfies this simple goal.
Conclusion
Patients reported here are functioning quite well after 10 or more years in opioid treatment. The vast majority can care for themselves and even drive. Opioid dosages have generally remained stable for long periods without significant escalation. Given the findings here, there is no obvious reason to discourage opioid use or encourage pain patients to cease opioids.
References
- 1. Tennant F. A 10-year evaluation of chronic pain patients treated with opioids. Heroin Addict Relat Clin Probl. 2009. 11: 31-34.
- 2. Portenoy RK, Farrar JT, Bakonjam M, et al. Long term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study. Clin J Pharm. 2007. 23: 287-299.
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Senator Kamala Harris requested to investigate Medical Board Police Corruption in California
Posted on March 27, 2019 by Pharmaciststeve
Senator Kamala Harris requested to investigate Medical Board Police Corruption in California
To:
Honorable Kamala D. Harris
United States House of Senate
Washington, DC 20510
URGENT MATTER: Widespread Corruption against Doctors
BRIEF INTRODUCTION
The Drug Distributors and Big Pharma are unlawfully guiding the Department of Justice (DOJ), Drug Enforcement Agency (DEA), Medical Boards (MB), and other Government Taxpaying Agencies (GTA) regulating the Medical Practice Act. The Washington Post and 60 Minutes conducted a joint investigative research and published it in October of 2017, detailing how the Drug Distributors guided top-level officials employed by the DEA and the DOJ.1 The Drug Distributors paid-off 53 of the U.S. top DEA / DOJ Lawyers, Prosecutors, and Chief Executives, from 2000 to 2017, and members of Congress. Evidence shows these top Government employees switched sides and presently employed with the Drug Distributors. When many people think about professional investigative services, the image of a man wearing a long overcoat and sunglasses and conducting a stakeout with a high-powered camera and binoculars comes to mind. The fact is, however, that there are a wide range of investigative services that you may use over the course of your life, to know more refer investigationhotline. The Drug Distributors called for a Nationwide War against American Peoples in Pain and Doctors who treated them.2 Although the Drug Distributors called for this so-called war against doctors and patients; they utilized GTA’s like the DOJ and the DEA to conduct their war by controlling the top employees of these agencies and by controlling and directing the Mainstream Media to provide false narratives and create a false Nationwide crisis of opioid overdose deaths caused by doctors, a fact that has been proven to be false and malicious.3 The Drug Distributors have created and implemented a Coercive Monopoly using the GTA’s to Run Doctors out of Business and clear the way for “RETAIL” clinics to take over the community base clinic market shares, a scheme that violates Antitrust Laws in the United States.4
STATE ENFORCEMENT CORRUPTION
The Medical Board is a state regulatory agency and they utilize dully sworn peace officers to investigate doctors and other healthcare providers. The DOJ provide lawyers and prosecutors to team-up with MB law enforcement employees. The state Governor oversees the MB and the state Attorney General directs the DOJ employees. The Governor and the state Attorney General contracts with the Office of Administrative Hearings to hire administrative judges to hear complaints made against doctors and healthcare professionals. The MB / DOJ enforcement team can also access other GTA’s to assist, such as the IRS, DEA, FBI, or Local Police units. The Washington Post joint investigation detailed that the Drug Distributors have control over these agencies that are responsible for regulating doctors by virtue of controlling the top GTA employees and personnel. The doctors and healthcare provider’s rights to due process and fair hearings have been placed in jeopardy by enforcement misconduct, special interest agendas, and serious DOJ misconduct, including murdering of doctors and healthcare providers California:
- Doctor Anthony Jackson of California gathered several black medical associations and Al Sharpton’s group to sue the MB for discrimination and racism in October of 2016.5 A few days later he suddenly died according to Al Sharpton’s group leaders. This is extremely suspicious and foul play is suspected.
- Cassandra Hockenson, a CBS investigative reporter working for the MB suddenly died months after Dr. Anthony Jackson. She witnessed the MB publish a false report, the mysterious death of Dr. Jackson, and she was at the venue when Dr. Jackson said the MB was engaged is discrimination against Blacks and people of ethnic color. Her death is extremely suspicious.6
- An open letter was sent to the MB in December of 2017, requesting for an investigation into Dr. Jackson’s and CBS reporter Cassandra Hockenson deaths and demanding them to stop mocking Dr. Jackson’s Death within their agency.
SERIOUS REGULATORY MISCONDUCT
- A complaint was sent to Governor Jerry Brown, informing him that CVS Health was colluding with the GTA’s to run doctors out of business, with credible evidence to back-up allegations, as the Washington Post provided about the DEA and DOJ. Brown’s office ignored the complaint and CVS Health is a big donor of Brown and a part of his inner circle.
- The Attorney General of California, Xavier Becerra, is not competent for AG title or position, he was involved with concealing evidence and providing false evidence to Washington State Capitol Police, in the matter of the Awan’s family scandal.7 Becerra’s leadership enables more unlawful misconduct by DOJ employees by allowing misconduct against doctors and patients in the state of California.
- The Governor of California and the State Attorney General supports the Sanctuary State initiative executive orders, which violates Federal Laws and hurts American Blacks and people of Ethnic Color like myself. The lack of respect for the laws and the United States Constitution has led to serious misconduct on all levels, (i) Enforcement, (ii) Judicial, and (iii) Constitutional protections for doctors and citizens of this state.
COMMON ENFORCEMENT MISCONDUCT
- Concealing evidence and exculpatory evidence is extremely common
- Threatening doctors and witnesses is extremely common
- Manufacturing evidence against doctors is extremely common
- Making false statements and committing perjury is extremely common
- Planting / tampering with chart evidence is extremely common
- Retaliation, monitoring personal calls, and sending confidential informants to clinics to incriminate doctors unlawfully is extremely common, getting their informants to sue doctors is common, and
- Colluding with administrative judges to unlawfully remove licenses from doctors in California occurs frequently. Brown appointed Zackery Morazzini, a top AG supervisor to head the Administrative Judges; this is causing a further decline of due process rights for doctors.
THIS MATTER IS URGENT
In my personal experience with the MB, DOJ, and the Judiciary, I realized there is extreme misconduct and corruption, evidence tampering, retaliation, harassment, manufacturing evidence, perjury, and judicial misconduct was identified.8 I have also looked at numerous cases against doctors like Dr. Ray Salerian, who was sentenced to 4 months in jail in solitary confinement, he was raped, tortured, his attorney Kevin Byers and consultant Siobhan Reynolds were killed in a mysterious plane crash, and then his Centre contributor Dr. Solange McArthur died suddenly. Dr. Salerian life was also threatened and he moved back to his country in Greece.9 The DEA and FBI oversight for government reform also identified innocent peoples murdered by corrupt government employees and confidential informants, who are mostly being deployed towards clinics. Another successful Beverly Hills Turkish doctor, Guven Uzun, sued CVS Health and the MB for telling his patients he was not licensed, for fraud, perjury, and violation of due process rights. CVS attorneys paid-off the judges according to Dr. Uzun and his 10 Million dollar lawsuit against a MB crooked defense attorney whose wife (Dorothy Kim) worked for the prosecution, without his knowledge, and later she was appointed, as a Superior Court Judge, which is outrageous, and Uzun’s lawsuit was thrown out of court on a technicality. Dr. Uzun has written the DOJ and FBI numerous times concerning all the fraud and misconduct going on in California and they intentionally targeted him because of his ethnic background and success as a prestigious Beverly Hills Neurologist.10
CLOSING WORDS
CVS Health, is one of the major sponsors of the Tom Marino Bill, they have access to GTA’s confidential investigative files and they are using this unlawfully information to run doctors out of business, like we have seen in the case of Dr. Uzun, and thousands of similar cases by telling patients their doctors are under GTA criminal investigations, this is occurring Nationwide and requires urgent attention.11 This matter is urgent because Drug Distributors are corrupting the Medical Practice Act and destroying the Doctor-Patient relationship by virtue of Fraud and illegal competition.12 The Washington Post Joint Investigation provides substantial proof that the Drug Distributors are controlling GTA’s to create a false opioid crisis concerning doctors and chronic pain patients, and they are using this hysteria to provide accountability for calling patients drug addicts and arresting thousands of U.S. trained doctors, calling them drug dealers, a term coined by the “CVS-DEA” partnership that was identified in 2012 and affirmed in court documents that I received from CVS Attorneys.
Thank you Mr. Barbosa for taking the time to review this important update and sharing this information with Senator Kamala Harris.
Kind regards,
Mr. Billy Z. Earley,
Physician Assistant Healthcare Advocate (PAHA),
National Adviser American Pain Institute (API),
National Adviser Black Doctors Matter (BDM),
Advocate World Sickle Cell Federation (WSCF),
Writer/Contributor Doctors of Courage (DOC).
REFERENCE LINKS:
1The Drug Industry Triumph Over The DEA
2Rx for Danger: CVS’ ‘blacklist’ of some doctors sparks outcry, legal action
http://www.orlandosentinel.com/health/os-cvs-blacklisted-doctors-20120114-story.html
3Drug Distributors Behind Massive Fraudulent DEA Arrests Of Doctors In U.S.A., featured presenter: Dr. Michael Schatman.
https://www.youtube.com/watch?v=oJ1lw9BcOPU
4FEDERAL TRADE COMMISSION SOUGHT TO INVESTIGATE FORTUNE 500 HEALTHCARE CORPORATION FOR ANTITRUST VIOLATIONS
5Prominent Black Doctor Ends Up Dead After Accusing The Medical Board Of Discrimination
6Black doctors accuse state medical board of racial profiling
http://wavenewspapers.com/black-doctors-accuse-state-medical-board-of-racial-profiling/
7EXCLUSIVE: DWS IT Guy Was Banned From House After Trying To Hide Secret Server
8California Medical Board Accused of Illegally Targeting Black Doctors
http://greaterdiversity.com/california-medical-board-accused-of-illegally-targeting-black-doctors/
9DEA vs Alen J. Salerian, MD
http://doctorsofcourage.org/alen-j-salerian-md/
10Beverly Hills Doctor Accuse Medical Board Of Ethnic Cleansing
11Indianapolis doctor wins defamation judgment against CVS
12Governor Jerry Brown Ties To CVS Pharmacy Under Grand Jury Investigation
https://www.youtube.com/watch?v=Hjmxb8Yng4Q
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U.S. Government and Top Mexican Drug Cartel Exposed as Partners
Posted on March 27, 2019 by Pharmaciststeve
U.S. Government and Top Mexican Drug Cartel Exposed as Partners
For over a decade, under multiple administrations, the U.S. government had a secret agreement with the ruthless Mexican Sinaloa drug cartel that allowed it to operate with impunity, an in-depth investigation by a leading Mexican newspaper confirmed this week. In exchange for information and assistance in quashing competing criminal syndicates, the Bush and Obama administrations let the Sinaloa cartel import tons of drugs into the United States while wiping out Sinaloa competitors and ensuring that its leaders would not be prosecuted for their long list of major crimes. Other revelations also point strongly to massive but clandestine U.S. government involvement in drug trafficking.
Relying on over 100 interviews with current and former government functionaries on both sides of the border, as well as official documents from the U.S. and Mexican governments, Mexico’s El Universal concluded that the U.S. Drug Enforcement Administration (DEA), Immigration and Customs Enforcement (ICE), and the U.S. Justice Department had secretly worked with Mexican drug lords. The controversial conspiring led to increased violence across Mexico, where many tens of thousands have been murdered in recent years, the newspaper found after its year-long probe. The U.S. agents and their shady deals with Mexican drug lords even sparked what the paper called a “secret war” inside Mexico.
The newspaper’s investigation also confirmed long-held suspicions that U.S. authorities were signing secret agreements with Mexican drug cartels — especially Sinaloa, which CIA operatives have said was a favorite for use in achieving geo-political objectives. Supposedly without the knowledge or approval of officials in Mexico, ICE and DEA, with a green light from Washington, D.C., made deals with criminal bosses allowing them to avoid prosecution for a vast crime spree that has included mass murder, corruption, bribery, drug trafficking, extortion, and more. In exchange, cartel leaders simply had to help U.S. officials eliminate their competitors — certainly a win-win scenario for crime bosses who prefer to operate without competition or fear of prosecution.
As The New American first reported in early 2011, a high-ranking operative with the Sinaloa cartel had outlined elements of the criminal agreements with U.S. authorities in official court documents. “The government of the United States and its various agencies have a long history of providing benefits, permission, and immunity to criminals and their organizations to commit crimes, including murder, in exchange for receiving information against other criminals and other organizations,” trafficker Jesus Vicente “El Vicentillo” Zambada-Niebla argued in U.S. court filings cited by El Universal. The New American has also reported extensively on the Zambada-Niebla case and what it reveals.
Experts quoted in the Mexican paper echoed other analysts who have spoken out in recent years, saying that the U.S. government scheming handed the Sinaloa cartel de facto status as the primary powerhouse. In fact, during the period when El Universal says the relationship between American officials and Sinaloa chieftains was most active — 2006 through 2012 — drug war-fueled violence in Mexico surged to unprecedented levels. There are numerous indications that despite official denials, top Mexican officials may have been aware of the schemes, or even involved in them.
Also part of the U.S. government deal with Sinaloa, analysts and Zambada-Niebla have said, was the Obama administration’s “Fast and Furious” gun-running program to arm Mexican cartels at U.S. taxpayer expense. Most recently, a whistleblower from the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) said that U.S. Border Patrol agent Brian Terry, killed with a Fast and Furious gun, was murdered by criminals working for the FBI. “It is clear that some of the weapons were deliberately allowed by the FBI and other government representatives to end up in the hands of the Sinaloa Cartel,” stated a motion filed in U.S. court by Zambada-Niebla’s defense team, adding that the U.S. government has documents showing that the weapons were provided by authorities pursuant to the agreement with Sinaloa.
According to former officials and drug kingpins, the agreements between Sinaloa and Washington also allowed the criminal empire to ship multi-ton quantities of hard drugs across the border into the United States. In all, El Universal said there had been at least 50 meetings in Mexico between U.S. government agents and senior Sinaloa bosses, along with many more phone calls and e-mails. The criminal syndicate’s leaders “were given carte blanche to continue to smuggle tons of illicit drugs into Chicago and the rest of the United States and were also protected by the United States government from arrest and prosecution,” Zambada-Niebla’s court filings state, adding that the U.S. government has the documents proving it. “Indeed, United States government agents aided the leaders of the Sinaloa Cartel.”
Unsurprisingly, none of the American federal agencies implicated in the machinations would comment on the revelations. However, citing court documents and official records it published online — as well as numerous interviews with federal agents, convicts, and analysts — the paper was able to conclusively confirm what experts and even officials have been arguing for years: The U.S. government is deeply intertwined with the drug trade. It was not clear what statutory or constitutional authority Washington, D.C., believes would authorize its functionaries to participate in, protect, and facilitate wanton criminal activity.
Mexican authorities, meanwhile, were reportedly kept largely out of the loop surrounding DEA meetings and agreements with top leaders in Mexico’s most notorious criminal syndicates. Officials in Mexico also claimed to be in the dark about the Obama administration’s program to arm the cartels with U.S. weapons. According to analysts quoted in the El Universal report, if it is true that Mexico City was unaware, that only adds to the troubling implications of the unlawful scheming between U.S. officials and criminal bosses from Mexico and Colombia to Afghanistan and Southeast Asia.
Among other concerns, experts highlighted violations of human rights, infringements on the sovereignty of other nations, and more. It also helped fuel the devastating violence that has plagued the nation and claimed the lives of between 50,000 and 100,000 people in less than a decade. If Mexican authorities in fact approved the U.S. government’s drug-running schemes in Mexico, they broke the law, too, legal experts told the paper, saying the Mexican Constitution could not be trumped by bilateral agreements or anything else.
The latest revelations in the El Universal report came just days after the emergence of more explosive information implicating the CIA in drug-trafficking yet again. In an investigative article for Narco News entitled “DEA Case Threatens to Expose US Government-Sanctioned Drug-Running,” veteran drug-war journalist Bill Conroy highlights another U.S. government investigation that, perhaps inadvertently, ended up implicating the infamous American intelligence agency in major cocaine trafficking operations once more. Citing official documents and numerous U.S. officials, the piece also notes that CIA-sponsored drug running has been a persistent and ongoing problem.
In fact, it would not be the first time that the DEA has stumbled on major CIA drug-running operations. Even former DEA chief Robert Bonner, during an explosive interview with CBS, revealed that his agency had learned that the U.S. intelligence outfit unlawfully imported a ton of cocaine into the United States in cooperation with the Venezuelan government. According to the agency’s inspector general, the CIA was indeed working with traffickers but received a “waiver” from the Justice Department purporting to allow the government crime spree to remain secret. More recently, a Mexican official accused the CIA of “managing” the global drug trade.
The Mexican investigation follows decades of explosive revelations and accusations, many documented by The New American, suggesting that Washington, D.C., plays a crucial role in facilitating the international drug trade. In fact, more than a few officials, drug lords, and analysts have even said that the CIA and other secretive U.S. and foreign agencies actually run the global trade in narcotics, laundering the profits, and more. The DEA was even investigated by Congress last year for helping to launder drug money, while the ATF was exposed supplying U.S. weapons to Mexican cartels. ICE has reportedly been allowing cartel hit men into the United States to murder. So far, none of the high-ranking officials responsible for the lawlessness have truly been held accountable.
Photo shows alleged hit men working for Sinaloa drug cartel along with grenades, automatic weapons, and body armor: AP Images
Alex Newman, a foreign correspondent for The New American, is normally based in Europe after growing up in Latin America, including seven years in Mexico. He can be reached at anewman@thenewamerican.com.
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Committing suicide use to be ILLEGAL… now states are ENCOURAGING IT
Posted on March 26, 2019 by Pharmaciststeve
New Jersey approves bill allowing terminally ill patients the right to die
New Jersey Gov. Phil Murphy (D) on Monday announced he will approve a bill that allows physicians to provide lethal prescriptions to terminally ill patients who want to die.
“Allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do,” Murphy said Monday. “I look forward to signing this legislation into law.”
Shortly before his statement, the New Jersey state Assembly passed the “Medical Aid in Dying for the Terminally Ill Act” in a 41-33 vote on Monday, according to NJ.com.
The state Senate reportedly passed the bill in a 21-16 vote minutes later.
Susan Boyce, a 55-year-old woman from Rumson who has been diagnosed with a terminal autoimmune disease, told the local publication that she has been “working on this quite a while.”
Boyce, who needs an oxygen tank in order to breathe, said that having the law is “something I want the option of.”
“I don’t know what’s in store for me,” she said.
During a debate prior to the vote, state Assemblyman Jay Webber (R) called on his colleagues to delay the vote on the measure.
“Once you cross this line, Mr. Speaker, there is no going back,” Webber said, according to the NJ.com.
Webber argued that some elderly people support assisted suicide because they don’t want to be a burden to their family and friends.
“Don’t make the right to die an obligation to die,” he said.
However, state Assemblyman John Burzichelli (D), who co-sponsored the legislation, argued that the state has enough safeguards in place to protect those most vulnerable.
“The right of self-determination stands firms no matter what … we control our destiny,” Burzichelli said.
The legislation will go into effect four months after being signed by Murphy.
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Blaming Prescription Pain Pills For The Opioid Epidemic Is Fake News
Posted on March 26, 2019 by Pharmaciststeve
Blaming Prescription Pain Pills For The Opioid Epidemic Is Fake News
How negligent media have helped inflate a deadly moral panic over prescription opioids and ignored the real sources of addiction, while hurting people who live with devastating chronic pain.
https://thefederalist.com/2019/03/26/blaming-prescription-pain-pills-opioid-epidemic-fake-news/
Angela Kennecke is a popular reporter for a television news station in my hometown of Sioux Falls, South Dakota. Each weeknight, Kennecke is at the anchor desk for KELO, a CBS affiliate, and has been there as long as I can remember. For many people in the “Sioux Empire,” Kennecke’s work on television is a normal part of the day, and they can count on her to tell them how it is.
But Kennecke’s objectivity was shaken in May 2018, when her 21-year-old daughter, Emily, was found dead after overdosing on heroin that had been laced with the opioid fentanyl. This tragedy, which made national news, deeply affected Kennecke and the Sioux Falls community. Now, almost a year since Emily’s death, Kennecke has become South Dakota’s leading reporter on the opioid crisis.
In 2017, the Centers for Disease Control and Prevention (CDC) counted 47,600 opioid-related deaths, three-quarters of which involved heroin or “synthetic opioids other than methadone,” a category that consists mainly of fentanyl or its analogs. In 2011, 2,666 deaths involved drugs in that category; by 2017 the number had increased to 28,466, or 60 percent of opioid-related deaths.
Fentanyl in the medical setting is the narcotic drug most commonly administered during surgery. Outside the surgical room, it is primarily prescribed by doctors in the hospital to palliative care patients due to its high potency, which is 50 to 100 times greater than that of morphine. Unfortunately, fentanyl is also dirt cheap for black-market drug dealers to import from China and Mexico. In recent years, traffickers have increasingly turned to fentanyl as a heroin booster and substitute.
The Rise of Black Market Fentanyl
Although opioid-related deaths are driven mainly by heroin and black-market fentanyl, you would not know that from most of the press coverage, which emphasizes pain medication prescribed to patients who become addicted, overdose, and die. This narrative is “fake news.”
Just 30 percent of opioid-related deaths in 2017 involved commonly prescribed pain pills, and most of those cases also involved other drugs. People who die after taking these drugs typically did not become addicted in the course of medical treatment. They tend to be polydrug users with histories of substance abuse and psychological problems.
Contrary to what you may have read or see on TV, addiction is rare among people who take opioids for pain. In a 2018 study of about 569,000 patients who received opioids after surgery, for example, just 1 percent of their medical records included diagnostic codes related to “opioid misuse.” According to federal survey data, “pain reliever use disorder” occurs in 2 percent of Americans who take prescription opioids each year, including non-medical users as well as bona fide patients.
“The current battle against fentanyl as a street drug has little or nothing to do with American medical practice,” writes Harvard-trained anesthesiologist Richard Novak. “Most of the fentanyl found on the streets is not diverted from hospitals, but rather is sourced from China and Mexico.”
Yet, politicians, law enforcement agencies, anti-drug ad campaigns, movies, and TV shows still put pain treatment at the center of the “opioid crisis.” Kennecke’s reporting has helped perpetuate this false narrative. In a 50-minute news special that aired last December, for instance, representatives of the two largest South Dakotan hospitals brag about cutting opioid prescriptions by a whopping 38 percent. Kennecke asks no questions and shows no skepticism.
While fentanyl is mentioned as a cause of the crisis, prescription analgesics gets much of the blame. A viewer only needs to see the opening image of a black background covered in a waterfall of pills to understand the correlation being made. In her news reports and work for her opioid-addiction charity, Emily’s Hope, Kennecke frequently refers to prescription opioids while talking about deaths caused mostly by fentanyl and heroin.
To be fair, her reporting and charity work are done with good intent, and Kennecke is far from alone in reporting this narrative. You can almost count on two hands the number of journalists in the country reporting on this issue responsibly. But this kind of thing—where someone pushes a specific narrative for a cause without regard to the full context and facts of a story—isn’t journalism, it’s activism.
No one can blame Kennecke, Eric Bolling (a national conservative personality whose son died from a fentanyl overdose in 2017), or any other journalist whose life is affected by a fentanyl death for getting emotional. It is understandable that they feel as strongly as they do. But reporting one-sided and biased information is unethical because their reporting is influential.
For example, Bolling reportedly has President Trump’s ear and helped influence an anti-opioid bill package that Congress passed last year. Activism like this comes with a heavy price.
Cracking Down in the Wrong Areas
Thirty-three states have now created laws that severely restrict opioid prescriptions in response to the hysteria. Most of these laws put hard day limits on prescribers. In Florida, for example, they impose a three-day limit on any prescription opioid for acute pain. The combination of these laws, plus overactive Drug Enforcement Administration (DEA) agents, has made pain specialists scarce in states such as Montana and Tennessee.
Due to the media hysteria which in turn inspires political hysteria, it is now harder than ever to get an opioid prescription for those in chronic pain, even though there is currently no equivalent medical treatment to replace the prescription opioids used by 18 million Americans for long-term pain. In 2017, a New England Journal of Medicine study found, the number of doctors who prescribed opioids at all fell by 29 percent. That same journal in a more recent study found a decline of 54 percent in prescription opioids by doctors for first-time-opioid patients between 2012 and 2017.
A nationwide survey of almost 4,000 pain patients by Dr. Terri Lewis found that 56 percent reported either disruption in pain treatment or outright abandonment by their once trusted doctors.
So awful is the reaction against chronic pain patients that 300 drug policy, addiction, and pain treatment experts, including three former White House drug czars, recently urged the CDC to clarify its 2016 opioid prescription guidelines, which have been widely interpreted as imposing arbitrary limits on average daily doses. Last November, the American Medical Association approved a resolution noting that guidelines had been read “by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia.”
While the news media aren’t to blame for the backlash against doctors and their chronic pain patients, they are guilty of sustaining the moral panic underlying it—a panic that is causing many needless deaths. Just go to any chronic pain patient forum, social media group, or even the federal government’s regulatory website to read the thousands of stories of quality-of-life reductions and suicide plans.
Kelly Goricki, a mother of four, offered this account on Chronic Pain Reddit:
It pisses me off when I get treated like a drug-seeking junkie by doctors who can CLEARLY see my well-documented injuries in my medical files. It pisses me off when my doctor, who doesn’t have chronic pain and has watched my injuries worsen dramatically over the last decade+ tells me I/my injuries ‘shouldn’t hurt that bad/aren’t that bad,’ as she watches my physical decline and takes away pain meds that allowed me to care for myself, my home, and my family, just so she ‘doesn’t have to deal with the paperwork.’ It pisses me off I’m treated like a junkie bad mother because someone finds out I take pain medication. It pisses me off that people assume the same meds I have been prescribed for (years) ….. make me high, or that I abuse them to get high.
An anonymous commentator had this to say on the government website regulations.gov:
I have fibromyalgia, arthritis, depression and diabetes. About 2 years ago my physician decided to take all of (his) patients off of pain meds. … The pain level is very extreme and it is 24/7 chronic pain. I can not function with this pain at a level that I could full time. I live by myself and can no longer support myself. I feel that eventually suicide may be my only option. I never abused my meds and I was able to function.
All this misery for this patient, Goricki, and an untold number of other patients is happening because the media and the CDC have made their physicians’ jobs impossible.
Desperation for Chronic Pain Patients?
Many of these patients used their prescriptions responsibly for decades, but they are now being pushed into trying dangerous surgical interventions or desperately buying drugs off the street. Reporters like Kennecke are helping to push chronic pain patients past their breaking point. It’s a pointless sacrifice, since opioid-related deaths have continued to rise even as prescriptions of pain medication have fallen dramatically.
As someone who is disabled and suffering from intractable pain, I know this problem keenly. For more than a year, I have lived without a prescription of low-dose oxycodone I responsibly used for almost nine years.
While not a perfect treatment for my pain, oxycodone did allow me enough function to survive. While on it, I attended college, served a mission, obtained my bachelor’s and master’s degrees, and ran for school board twice. All that was taken away from me a year ago by a doctor who didn’t want to deal with the hassle that now comes with opioid prescriptions.
Reporters like Kennecke are doing what they think is right. The deaths caused by fentanyl are real and atrocious. But what she and too many of our leaders are doing by associating prescription opioids with fentanyl deaths is unethical and inaccurate. And the deaths of innocent pain patients will be the price of it. Journalists must ask themselves: Does our misreporting have a cost?
Peter Vaughn Pischke is a journalist and podcast host for TheSiouxEmpire.com. He can usually be found manning the Happy Warrior Podcast: providing commentary on conservative and nerd-culture news and ideas. You can find him on Twitter: @happywarriorp.
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CVS asked us to fill out a “safety” survey
Posted on March 26, 2019 by Pharmaciststeve
CVS asked us to fill out a “safety” survey and how well our teams adhered to policies and procedures for safe practices… Then they left a comment space at the end, which I dutifully filled in.
This is a CVS pharmacist’s response to the corporation’s how Rx dept staff are:
how well our teams adhered to policies and procedures for safe practices
This is just one of their pharmacist’s opinion but from what I have heard others share to a major degree the same feelings and you as a pt… are you putting your health/safety at risk by having your prescriptions filled there ?
Here is a link to help you find a independent pharmacy – by zip code – where you will be dealing with the pharmacist/owner
http://www.ncpanet.org/home/find-your-local-pharmacy
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