www.painnewsnetwork.org/stories/2019/2/1/civil-rights-case-gives-hope-to-pain-patients

 

 

 

 

 

 

 

In reading between the lines of this article, it does not say that this pt was a chronic pain pt or a substance abuse pt in treatment.  I have stated many time that I had concerns that chronic pain pts being treated with Suboxone for pain that at some time down the path that someone would jump to the conclusion that the pt was a substance abuser or a substance abuser in recovery… when in reality they were being treated with Suboxone for chronic pain.  It has been reported that not every chronic pain pt will have adequate pain management using Suboxone.

Just like we seen healthcare professional will take the 90 odd pages of the CDC opiates dosing guidelines and find a favorite sentence, paragraph or page …typically evolving around the 90 MME daily limit and don’t ready any further, but adopt that daily MME limit and profess that they are following the CDC guidelines.

This article also doesn’t clarify if the pt is in substance abuse treatment/recovery or a chronic pain pt.. just automatically LABELED as a pt dealing with OUD – OPIATE USE DISORDER..  which many likes to define as a pt taking opiates (legally/illegally) for > 90 days.  It would seem no more labels as a substance abuser/addict or a pt being legally treated with one or more controlled substances that will create a physical dependency. Everyone seems to be lumped into just one classification…

Just like we seldom see the use of a accidental opiate OD… but rather a broader term – opiate related death… whereas anyone whose toxicology shows a opiate or controlled substance in their toxicology … one of the causes of their death will be “opiate use disorder” and most likely will be the first listed cause of death.

One can only come to the conclusion that these new terms serves the agenda of certain parts of our bureaucracy… basically falsely creating LARGER NUMBERS … just like they like to report the 72k DRUG OVERDOSE DEATHS and then imply that they are all caused by opiates.. and fail to acknowledge that within that number 15K are caused by NSAIDS.  They also just state that FENTANYL is involved in more and more OD’s but they fail to acknowledge that there are some 1400 different Fentanyl analogs and the only one that is legal for human use in the USA is Fentanyl Citrate.

there seems to be a lot of SMOKE AND MIRRORS being used to fabricate a conclusion or what reality REALLY ISN’T

Filed under: General Problems | 4 Comments »

Dear Mr. Ariens:

I recently went to a pharmacy for my daughter’s controlled medication that she had a refill left. The normal pharmacist was on holiday.

The visiting pharmacist advised she looked into the cost of the  medication and noted that the insurance was only 2 percent and that was too little. She replied she could transfer the prescription to another pharmacy.

 

While at the pharmacy I called the insurance company (Medicare) to get an explanation. 

 

She over heard my conversation and exclaimed that the medication was covered, but she felt the loss was to much and again said she could transfer to another pharmacy.

 

Can she deny my daughter her medication (treatment) because she felt that Medicare was paying too little for the  $3,300 cost of the medication?  This pharmacy has filled this medication at least since 2012.

 

What can I do and can I file an ADA discrimination or pharmacy board compliant? Please note:This pharmacy is located in an exclusive zip code and her comments were very upsetting to My disabled daughter.

Thanks in advance for your assistance.

These “drug cards” – PBM (Prescription Benefit Manager) have in their contract that pharmacies normally states that the pharmacy must fill valid Rxs if the pharmacy has the medication in stock.. it does not matter if the pharmacy makes or loses money on the prescription.

Some independent pharmacists have stated – that the reason they sold/closed their pharmacies was because they were losing money on >25% of all prescriptions they fill.

Filed under: General Problems | 3 Comments »

Pain medicine was a by-thought to me. My main medicine was Lorazepam 3 x a day that saved my life 24 years ago when a respected psychiatrist ruled out other medicines and put me on it.
I had severe panic disorder that had destroyed my life. For 24 years, I lived a normal life with this simple medicine, not even a narcotic.
My Psychiatrist retired and called my PCP in 2012 to continue the lorazepam established treatment.
My PCP agreed to continue the care. My family doctor, who’s elderly now, also was the last physician to treat cancer patients, the elderly, and provide end of life care pain relief to local residents.
HE WAS JUST RAIDED BY THE DEA last month. He had a feud with WalMart Pharmacy and their is no question that the local Walmart retaliated against my family physician by using the DEA.
Quitting my simple lorazepam suddenly can actually cause death. 2 of my 3 refills were invalidated, even though I have the soonest appointment to see another Psych in May.
I’m down dosing myself and I’m physically now at significant risk of seizures and death. My blood pressure writing this is at 170/110, pulse 90 because I’m down dosing myself for lack of any help in the medical field. My pharmacists feels helpless because he knows I don’t abuse medicine and is well aware of my disorder.
Because my family doctor was busted by the DEA for treating patients humanly, I can’t go to an ER because I would be labeled a drug addict, even though Lorazepam withdrawals can kill and isn’t even a narcotic!
I just want my life back, but since I will run out of simple anxiety medicine. I may not survive more than a month from now. It’s not like I’m 20 and healthy and can adjust. My heart literally can’t take it.
Please sign me up to sue the DEA in honor of my physician and for the HELL I’m going through even though I was a law-abiding citizen who took my medicine responsibly!

Filed under: General Problems | 1 Comment »

Filed under: General Problems | 3 Comments »

Dr. Ginevra Liptan

Filed under: General Problems | 4 Comments »

Linder v. United States

https://en.wikipedia.org/wiki/Linder_v._United_States

Linder v. United States, 268 U.S. 5 (1925),^[1] is a Supreme Court case involving the applicability of the Harrison Act. The Harrison Act was originally a taxing measure on drugs such as morphine and cocaine, but it later effectively became a prohibition on such drugs. However, the Act had a provision exempting doctors prescribing the drugs. Dr. Charles O. Linder prescribed the drugs to addicts in Moore, Oklahoma, which the federal government said was not a legitimate medical practice. He was prosecuted and convicted. Linder appealed, and the Supreme Court unanimously overturned his conviction, holding that the federal government overstepped its power to regulate medicine. The opinion of the court was written by Justice James Clark McReynolds and states, “Obviously, direct control of medical practice in the states is beyond the power of the federal government.”

Filed under: General Problems | 6 Comments »

www.cergm.carter-brothers.com/2019/03/14/ohio-drug-overdose-data-good-news-for-chronic-pain-patients/

I’ve monitored Ohio’s efforts to collect drug overdose data since 2015 and until now, it’s been discouraging, showing overall rising rates between 2000 and 2017. But new data shows an encouraging trend in the fight against illegal drug use, more importantly the data blows holes in claims that chronic pain treated with opiates is a leading cause of drug overdose deaths.

Prescription Opiate Data

First, the overall death rate from prescription opiates shows a solid trend of decreases since 2011. Clearly Ohio’s efforts at collecting specific data points on prescribed opiates is now having a payoff.

 

 

 

 

 

 

 

 

 

 

Second, the number of written scripts from physicians is down dramatically. It’s likely this data point hides a more ominous statistic, that of the number of patients who have legitimate medical conditions which qualify them for treatment with opiates, but have been denied treatment due to the backlash of sentiment around treating chronic pain with opiates combined with fear physicians have from state medical board regulations.

 

Third, Ohio’s prescription drug monitoring program identifies people  attempting to fill scripts from multiple doctors. While overall this is also good news, it too may hide an ominous data point which remains unknown, that of patients with legitimate medical problems who are under prescribed due to the backlash of sentiment spurred on by the CDC’s out of context guidelines for treating chronic pain.

 

 

 

 

 

 

 

 

Illegal Opiate Data

Forth, the percentage of overdose deaths from Fentanyl as compared to other opiates has seen a dramatic increase since 2003 while deaths from other sources continues to decline. This is now signalling that more effort and funding are needed for law enforcement in thwarting this scourge of drug abuse.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fifth, when comparing trends on selected opiates, clearly prescription opiate overdose deaths are declining. Heroin deaths have had mixed but improved outcomes, benzodiazepeines deaths are down while deaths from cocaine and methamphetamines have risen since 2010.

 

 

 

 

 

 

 

 

 

Overdose deaths by age group remain relatively unchanged. While many argue that those aged 60 and older have a higher risk, the data doesn’t support such conclusions.

 

 

 

 

 

 

 

 

Sixth, when comparing Fentanyl overdose deaths to drug seizures by law enforcement, the news is encouraging but a clear trend is still lacking. We know that Fentanyl and Carfentanyl overdose deaths have increased since 2011, but this data would suggest more funding and effort is needed with law enforcement to fight this crisis.

 

Seventh, the data points on this graph have been updated from previous graphs to now separate prescription opiates from illegal opiates. We know that most death certificate data does not make a differentiation between prescription opiates vs illegal opiates. So agencies in Ohio have started collecting data from other sources as documented in this post.

The rise in illicit Fentanyl deaths since 2013 is alarming, demonstrating how some people who had access to prescription opiates turned to illegal sources. This too may hide a ominous trend which is not investigated and reported. Patients who have been denied treatment due to the general sentiment towards opiates and fewer prescribers writing scripts for otherwise legitimate medical conditions.

 

 

 

 

 

 

 

 

 

 

 

 

In large part due to the rising rate of illicit Fentanyl overdose deaths, the number of overdose deaths per 100,000 population remains at an all time high. Still for those who claim that treatment of chronic pain with opiates is a leading cause of overdose deaths, the data from Ohio no longer supports this claim.

 

 

 

 

 

 

 

 

 

 

This graph also underscores how illegal drug use has been and remains the number one cause of overdose deaths in Ohio. As of 2017 70% of all overdose deaths are from Fentanyl, 20% from Heroin, 31% from Cocaine and 10% from prescription opiates.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

It’s been know since the start of the opiate crisis that most overdose deaths result from a combination of drugs. This is a new graph showing those combinations of drugs in Ohio. Fentanyl and Cocaine make up the largest group at 22%, followed by Fentanyl and Heroin at 14%, followed by Fentanyl and prescription opiates at 9%.

These stats are very revealing, showing that even with prescription opiates, those dying from these combinations are most likely illicit drug users and not chronic pain patients.

 

This data from Ohio is unprecedented in its scope and detail, supporting what the chronic pain community has been saying since the onset. Improved methods at monitoring, in data reporting and collection, physician use of this data combined with better screening for drug abuse is finally producing a picture which is rational and believable.

Ohio has committed to being a leader in the war on illicit and illegal drug use. This data is encouraging and good news for chronic pain suffers. Still, we know from individual reports this data hides another view which is troubling and an underlying cause of the increased number of suicides. That of fear driving prescribers to kick some patients to the curb and denying them access to healthcare. 

I only hope Ohio will exercise as much due diligence in uncovering this aspect of healthcare for Ohioans as they have in fighting the drug abuse war.

 

Filed under: General Problems | 1 Comment »

ww.nationalpainreport.com/surprise-turn-at-oregon-health-meeting-on-forced-opioid-taper-proposal-8839121.html

The highly anticipated meeting in Oregon to consider a policy to force taper some Oregon Medicaid pain patient who use opioids took a surprising turn.

The head of the Oregon Health Authority called off today’s review in light of potential conflicts of interest by staff.

Dr. Catherine Livingston is a family medicine physician who serves as a contracted medical consultant to the Health Evidence Review Commission (HERC). In addition, she is a co-investigator on two studies evaluating the impact of HERC’s previous decision to expand pain management coverage for people suffering from back pain.

“It is vital for the Oregon Health Plan to cover safe and effective therapies to help people reduce and manage chronic pain. Yet it is also vital that Oregonians have full confidence in the decisions the HERC makes to assess the effectiveness of health care procedures,” OHA Director Patrick Allen said in a statement published in this press release released on Thursday.

Apparently, Dr. Livingston’s potential conflict was uncovered by a chronic pain activist who has been fighting HERC’s attempt to force taper any pain patients.

“We are pleased that the OHA is taking time to investigate possible conflicts of staff, consultant and commission members,” said Amara M., who prefers we don’t use her last name. “We believe there are other possible conflicts.”

The HERC proposal has received withering criticism from providers who treat chronic pain from across the country and as recently as last week the commission received a letter from Stanford’s Sean Mackey and other pain leaders who wrote:

“We continue to have grave concerns with the primary goal of the current proposal, namely, its call for non-consensual forced tapering off prescription opioid analgesics of a broad class of patients.”

Sean Mackey, M.D., Ph.D., is Chief of the Division of Pain Medicine and Redlich Professor of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and Neurology at Stanford University. He is a Past President of the American Academy of Pain Medicine.

For chronic pain advocates in Oregon, today’s delay allows them to continue to work to educate HERC members and the general public about what the advocates believe will cause real damage to chronic pain patients.

“Maybe they can take the time to read Dr. Mackey’s letter and other communications by people who treat chronic pain about what a horribly bad idea forced opioid tapering is,” said Amara M.

Filed under: General Problems | 3 Comments »

Attention: Dr Tennant who supports us chronic  pain patients is asking that we patients —wright Paul Ramsey letters and get Jane Ballantyne fired and removed !!!
she’s the one who’s culpable in getting the CDC to write the restrictions and she’s claiming we don’t need opiodes and she stated that we pain patients need to embrace our pain and accept it !!!

now Dr Tennant is asking that we write letters to Paul Ramsey Who is the CEO of the UW medicine and Dean of school of medicine and ask for Jane Ballantyne removal immediately along with Sullivan they are both prop members who have caused this mess..
Please help n share.

Filed under: General Problems | 3 Comments »

Drug importation is not the solution to prescription drug costs

https://www.bendbulletin.com/home/6981704-151/guest-column-drug-importation-is-not-the-solution

State lawmakers are tired of waiting on their federal counterparts to act on prescription drug prices.

The state Senate recently held a hearing on a bill that would call on the Board of Pharmacy to import prescription drugs from Canada. A companion bill, which would require the Oregon Health Authority to enact an importation program, is pending in the state House of Representatives.

As a pharmacist, I see and feel my patients’ pain from the high cost of medications that only seems to grow more expensive each year. Their frustration is my profession’s collective frustration too.

I can understand why they — or anyone — would think purchasing drugs from outside the U.S. would make prescriptions more affordable.

Yet importing prescription medication from Canada or other countries would be a cure worse than the disease. It would threaten what patients need even more than lower prices: safety and choice.

Our patients’ safety is our top concern, and the reality of so-called “Canadian” drug sites is that most are not Canadian, nor do they sell Health Canada-reviewed or approved medications. A 2017 review by the National Board of Pharmacies showed many of these sites do not require a valid prescription — a troublesome prospect in light of the nation’s opioid crisis.

Worse, several were found to sell counterfeit medications. The World Health Organization estimates that 1 in 10 medicines in developing countries is counterfeit — a significant public health threat, which Americans are immune to given the Food and Drug Administration’s “track and trace” system that is the safest in the world.

Consider the ramifications of counterfeit medicine. A fake Rolex may give you the wrong time, but it won’t kill or maim you.

As a pharmacist, my job is to know what’s in my patients’ medications and how to mitigate potential side effects and drug interactions. The problem with fake medications is there’s no way to know what’s in them until it’s too late.

Even if state health authorities could somehow verify the safety of Canadian drugs, it’s Pollyannaish to believe that Canada, which is experiencing widespread drug shortages, would allow its limited supply to be exported.

Christopher Ward, a Canadian health consultant explains that “in Canada, we have faced significant drug shortages. There’s no way there’d be support for this type of operation.”

And even if Canada had excess supply, it likely wouldn’t sell to the U.S. at the same price Canada charges its citizens. Doing so would cause public outcry given the chronic funding shortfalls experienced by the country’s universal health care system.

“Canada’s pricing controls don’t apply to exports,” notes Canadian health care expert Tim Squire.

Foreign countries like Canada are able to offer their citizens cheaper drug prices because their governments use price controls. This is unfair to American patients who are forced to subsidize the artificially low cost of these drugs in foreign countries. Yet foreign patients pay the price in lack of access. If manufacturers can’t meet the low prices demanded by governments, their citizens simply go without.

Canadians only have access to about 50 percent of the new medicines that Americans enjoy. That number falls to just 33 percent for Australians.

So what’s the solution to rising drug prices if not importation? Reforming the opaque supply chain. Transparent prices, absent middlemen who increase drug prices by more than $150 billion annually, can reduce costs in the same way they do in virtually every other sector of the economy.

In the meantime, Oregon shouldn’t fall for the siren song of prescription drug importation.

Filed under: General Problems | 1 Comment »