I find it very interesting when one bureaucracy is going to sue another bureaucracy.  Especially when one bureaucracy’s action interferes with the ability to generate some revenue by another bureaucracy. Could this be a “backhanded”  process of the DEA’s wish to yank pharmacy’s DEA licenses so that there are few pharmacies in the state that could buy/dispense controls?

Georgia Medical Cannabis Officials Weigh Response To DEA Threat Against Pharmacies, Including Possible Lawsuit

https://www.marijuanamoment.net/georgia-medical-cannabis-officials-weigh-response-to-dea-threat-against-pharmacies-including-possible-lawsuit/

The commission that oversees Georgia’s medical marijuana program held a special meeting on Wednesday to discuss recent letters from the Drug Enforcement Administration (DEA) warning pharmacies that dispensing THC under a state-authorized program could put their businesses at risk.

Officials at the meeting generally said the letters stand in the way of expanding medical marijuana access to patients, with one calling on supporters to contact Congress about the issue and another alluding to potential litigation the state may file against DEA over the dispute.

Georgia is the first state in the nation to pursue a plan to distribute medical marijuana through existing pharmacies that already dispense other drugs. Already about 120 independent pharmacies have applied to offer low-THC cannabis products.

But in its November 27 letter to pharmacies across the state, DEA said that federally registered pharmacies “may only dispense controlled substances in Schedules II-V of the Controlled Substances Act. Neither marijuana nor THC can lawfully be possessed, handled, or dispensed by any DEA-registered pharmacy.”

At Wednesday’s special meeting of the Georgia Access to Medical Cannabis Commission (GMCC), members said they’re still committed to prioritizing safe access for patients despite the federal threats.

Currently the state has only nine licensed dispensaries in operation, said GMCC Chair Sid Johnson. There are also 23 pharmacists approved to provide medical marijuana, whom Johnson described as “a critical part of ensuring access to patients, particularly in rural areas.”

“I want patients to know that we are well on our way to fully implementing the Hope Act,” Johnson said, referring to a 2019 law that expanded the state’s limited medical marijuana program, “and we will continue to pursue our mission of ensuring access to medical cannabis for all patients across Georgia.”

He added that “we support the work of the Board of Pharmacy, which licenses pharmacists to dispense medical cannabis.”

The commission’s general counsel, Jansen Head, said she believed the Board of Pharmacy has since paused its licensing of pharmacies to dispense medical cannabis. But behind the scenes, Head added, officials are discussing how to respond.

“I don’t think the state is quiet. I think right now we’re gathering information and seeing what’s the best way to move forward while also keeping in mind the interests of our patients and the industry,” she said. “I know that’s not super specific, but there are things kind of developing in response to the letter.”

Any legal action, she suggested, would need to come from the state attorney general’s office.

“We’re not the only key players in the program, and so it does require collaboration with our sister agencies,” she said. “And then obviously, any kind of action that we would take are things that we would do through the arms of the AG’s office, through the executive branch.”

One issue Head highlighted is a congressionally approved budget rider that bars the federal government from interfering with state-legal medical marijuana programs.

Specifically, it prohibits the Department of Justice (DOJ) from using its resources to prevent states “from—and I’ll quote—’implementing their own laws that authorize the distribution, possession or cultivation of medical marijuana,’” Head said at the meeting. “And that’s the program we have in Georgia.”

The budget rider, she added, limits federal law enforcement “from taking legal action against the states directly in order to prevent us from promulgating or enforcing our medical marijuana laws.”

Whatever the intent was with the DEA letters,” the lawyer continued, “more than half of our access points for medical relief—which is the pharmacies—they’re impacted and at risk of no longer making this medicine available to patients, as recommended by their physicians.”

While Head didn’t explicitly say the state was weighing a lawsuit to fend off the DEA warnings, she described a path the state could take to push back against the threats.

Commission member Bill Prather, a pharmacist himself, said he interpreted DEA’s correspondence as a shot across the bow.

“I no longer own a pharmacy or any part of a pharmacy,” Prather said. “If I did, I would take the letter from the DEA as, in my opinion, exactly what it is, which is a direct threat to pharmacies, saying, ‘If you dispense this product, we’ll pull your DEA permit.’”

Andrew Turnage, executive director of GMCC, said the conflict demonstrates “the need for federal government to update the laws and policies regarding the use of cannabis.”

“It’s a federal issue, so we don’t have the authority to intervene,” he said, “but we certainly want to encourage everyone to reach out to their members of Congress and make their wishes and concerns known about this issue.”

Marijuana Moment reached out to multiple members of Georgia’s U.S. House delegation for comment last week and this week, with little response.

“Cannabis could have some medicinal benefits, and we owe it to patients to research and test the drug for that purpose,” Rep. Buddy Carter (R-GA) told Marijuana Moment. “The DEA has made it clear that pharmacies dispensing certain THC products are in violation of federal law and that guidance should be taken seriously.”

On the Senate side, meanwhile, staff for Sen. Raphael Warnock (D), who recently confronted bankers in a committee hearing about the need for social equity in marijuana reform, did not respond to emails. Sen. Jon Ossoff’s (D) office declined to comment.

Georgia’s Board of Pharmacy has also not responded to Marijuana Moment’s requests for comment.

State officials recently presented the pharmacy plan at a meeting of the Cannabis Regulators Association, or CANNRA, and Turnage said it was “definitely an item of discussion.”

“The feedback that we received in that environment was simply this: ‘This is exactly the way that it should have been from the beginning. This model makes perfect sense,’” he recalled. “But they also expressed concern as it relates to finding out about the DEA’s letter.”

“A lot of states who are also medical states, they’re kind of eager to learn more about what Georgia will do,” added Head, the body’s general counsel. “They’re really looking at how Georgia is going to handle this tension.”

Head also said she was happy to hear support at the CANNRA meeting from regulators in other states who have “dealt with the DEA in different situations.”

“They really encouraged us to really try to see that through, to not be afraid of the challenges,” she said. “I think we had about seven or eight other states really putting themselves out there to support Georgia if if there’s some developments in response to the DEA letter. They’ve got attorneys, also attorneys general who just kind of offer themselves up as a resource.”

Brather, the physician, said that “It would really help us as far as distribution of the product if pharmacies could dispense it, because there is a pharmacy I believe in all but three or four counties in this state.”

“It will be a huge help to our patients, which are the main focus, if they could get their medication in a pharmacy,” he said.

Turnage, the commission’s executive director, agreed.

“There’s something really important about a licensed professional being between a regulated drug in a patient with a medical need,” he said. “And to the extent that we have been able to under the framework of our state’s law, the commission and the Board of Pharmacy have carried that vision into reality.”

“While our licensed dispensaries are certainly more than capable of providing access for patients in Georgia,” Turnage added, “they are limited in number by the statute, and therefore they’re not always within the immediate vicinity of where patients live.”

One member of the commission said he appreciated DEA as an agency, which he claimed “provides some value.”

“I believe that we really don’t know enough about THC to be using it safely,” said Bill Bornstein, a doctor and chief medical officer at Emory Healthcare. “That’s not to say I’m not supportive of what we’ve done in the state of Georgia, but there are a lot more questions that need to be answered.”

At the same time, Bornstein said similar DEA threats wouldn’t apply to physicians, who don’t technically prescribe marijuana to patients but instead merely certify that someone has a qualifying condition for the program.

Georgia’s Board of Pharmacy began accepting applications from independent pharmacies to dispense low-THC cannabis oil, which under state law can contain no more than 5 percent THC, in October. The goal was to improve access to medical marijuana among patients, who are otherwise restricted to just seven dispensaries that have opened in the state since April.

The Atlanta Journal-Constitution reported early that month that nearly 120 pharmacies had applied to the Board of Pharmacy to dispense marijuana products made by Botanical Sciences, one of the state’s two licensed producers. Pharmacies could also distribute medical cannabis from Trulieve, the state’s other licensed producer.

As of late October, at least three pharmacies had begun dispensing Botanical Sciences products, the company said in a press release. According to a map on the company’s website, more than 100 more are slated to open soon.

If sales of medical cannabis products went online in all locations, about 90 percent of Georgians would be within a 30-minute drive of a pharmacy selling marijuana, according to an Associated Press report. The state allowance applies only to independent pharmacies, not larger chains such as CVS and others.

DEA sent the warning letters to Georgia pharmacies amid the federal agency’s ongoing review of a recommendation by the Department of Health and Human Services (HHS) that marijuana be rescheduled under the Controlled Substances Act (CSA), reportedly to Schedule III. The recommendation was leaked in late August, and DEA has yet to publicly act on it.

While the Congressional Research Service (CRS) recently concluded that it was “likely” that DEA would follow the HHS recommendation based on past precedent, DEA reserves the right to disregard the health agency’s advice because it has final jurisdiction over the Controlled Substances Act (CSA).

In October, HHS first publicly revealed a one-page version of the rescheduling memo, though it was heavily redacted to remove key information. This past week, the government handed over another 252-page tranche of documents related to the review, again with the majority of information blocked out.

Broadly, the new documents outline new scientific information that’s come to light in recent years subsequent to an earlier denial of a rescheduling petition, which HHS suggests might now necessitate rescheduling marijuana.

“The current review is largely focused on modern scientific considerations on whether marijuana has a CAMU [currently accepted medical use] and on new epidemiological data related to the abuse of marijuana in the years since the 2015 HHS” evaluation of marijuana under the CSA’s eight-factor analysis.

HHS also notes that it “analyzed considerable data related to the abuse potential of marijuana,” but added that it’s a complicated consideration, “and no single test or assessment provides a complete characterization.”

Earlier this month, six Democratic governors wrote a letter to the Biden administration urging that rescheduling be completed by the end of the year. As DEA implied in its letter to the Georgia pharmacy, pharmacies would be permitted to dispense marijuana if it’s moved to Schedule III, although pharmaceutical products would first need to be approved by the Food and Drug Administration.

“Rescheduling cannabis aligns with a safe, regulated product that Americans can trust,” says the governors’ letter, which points to a poll that found 88 percent of Americans support legalization for medical or recreational use. “As governors, we might disagree about whether recreational cannabis legalization or even cannabis use is a net positive, but we agree that the cannabis industry is here to stay, the states have created strong regulations, and supporting the state-regulated marketplace is essential for the safety of the American people.”

Even if THC is moved to Schedule III, however, the Food and Drug Administration (FDA) would still need to approve marijuana-based drugs before they could be legally distributed at registered pharmacies like those in Georgia.

 

 

 

Filed under: General Problems | 2 Comments »

Where is the logic/common sense is these statements?

Since 2017, there has been a 26% reduction in daily opioid prescriptions

541 drug overdose deaths in Utah in 2022, opioid-involved fatal drug overdoses have remained relatively stable in recent years. 74% involved an opioid.

I wonder what drugs were involved in the 26% of fatal drug overdoses. This appears that this healthcare organization has little concern of the roughly 190 people died from those other drugs. I could help but notice that they LUMPED ALL OPIOID DRUGS as if a single category.  How many pts prescribed opioids OD’d on their prescribed medication(s)?  How many OD’s on pharma opioids that were diverted? How many people OD’d on illegal drugs from China/Mexican cartels?  Maybe putting forth the DETAILS, would point out how warped their logic is?

It states in the article that  Rula Hunter had a back injury and was prescribed Oxycontin in 1996  and IMMEDIATELY BECAME ADDICTED and there is a mention of her going to rehab – no date or duration.  Here is her Obit  https://www.lindquistmortuary.com/obituaries/rula-hunter. She died in 2023 at the age of 72 y/o.

Did Intermountain Health start this program after the CDC published their 2016 opioid guidelines in 2016? We all know that those guidelines where misapplied and misguided.

Intermountain Health Partners with Utah Agencies to Achieve 26% Daily Opioid Prescription Reduction

https://www.prunderground.com/intermountain-health-partners-with-utah-agencies-to-achieve-26-daily-opioid-prescription-reduction/00323472/

Intermountain Health, Bonneville Communities That Care, and Utah prevention campaign Know Your Script unveiled 20-foot-high standing chandelier display.

Ogden, UT (PRUnderground) December 12th, 2023

Filed under: General Problems | 5 Comments »

 

I have heard from a number of attorneys that when a federal prosecutor takes someone to federal court, 90%-95% of the time they will be found guilty. After you watch this 17 minute video of a Federal Prosecutor, you will easily understand how that high conviction rate can be attained. What I suspect, that each possible violation this attorney claims. He is only talking about a single pt and a single interaction with a practitioner.  Just imagine, the number of possible federal law violations can could be fabricated on just 1-2 handfuls of pts from a particular practitioner’s practice?

As I remember, several years ago, a particular rural doctor, was initially charged with 400 counts. Each count worth 20 yrs in prison. Makes sense why he agreed to plead guilty to a SINGLE COUNT.  As I remember this practitioner was in his 60’s, so a single count was worth 20 yrs in prison and as I understand it, there is no early parole in our federal system. They must serve at least 85% of their sentence.

It was indicated that this was in 2019,  I wonder if these Federal prosecutors are still going after prescribers, since the number of  poisoning/ODing from illegal Fentanyl from China & Mexican cartels have probably doubled since then. Maybe it is too difficult to confiscate assets of these criminals that are “off-shore”?

I think if you consider the video – as a whole – these Federal prosecutors’ end goal was criminal/civil asset of a prescriber’s assets. that is “free money” that these Feds can put in their dept’s coffers to use/spend as they wish.

 

Filed under: General Problems | 4 Comments »

Bombshell Revelation from Government

https://doctorsofcourage.org/bombshell-revelation-from-government/

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Filed under: General Problems | 3 Comments »

I saw someone make this statement on the web. Don’t they know who they work for? The “they” ,that they are talking  about is POLITICIANS. Particularly those in Congress.  https://www.bbc.com/news/av/election-us-2020-54696386  According to this article in 2020 Federal Presidential and Congressional candidates spend 14 BILLION – TWICE AS MUCH as was spent on the 2016 election.

That doesn’t include the 4.1 billion that was spent on lobbyist in 2022. That is 11+ million/day, to help influence the 535 members of Congress. That averages out to abt $11,000/day – 7 days a week on each member of Congress.  https://www.opensecrets.org/news/2023/01/federal-lobbying-spending-reaches-4-1-billion-in-2022-the-highest-since-2010/

With all those $$ flowing into election campaigns, and $$ to influence members of Congress by Lobbyists, who believes that any letters, emails, phone calls to member of Congress will influence their decisions in any way?

Congress basically functions on a seniority system.  Both the House & Senate have numerous committees. Each committee has a chairman, who will belong to the political party of the majority of the particular party and a co-chair that belongs to the political party that is the majority. The balance of each committee will reflect the percentage of the political party in the majority.

For anything to potentially become a law, it starts with a bill being introduced by one of the members of a the appropriate  committee. The chairman may nor may not bring up a bill for a vote. If the chairman does not bring a bill up for a vote. It becomes DOA.  I saw it reported that Alexandria Ocasio-Cortez  (AOC) introduced 20 bills during her first 2-yr term in the House, and none was brought up by chairman of the committee for a vote.

If a bill get voted out of committee, the bill goes to the Speaker of the House or Head of  the Senate. Each can chose to bring the bill to the floor for a vote or not. If one or both of those refuses to bring the bill to the floor for a vote, the bill DIES!

If the bill is passed by the House and the Senate, it is then sent to the President to sign it into law.

The President can sign the bill into law or veto it. If the President VETOES the bill, then the Senate and House has the option to override the President’s veto with a 2/3 vote by each. If the Senate or the House fails to vote to override the bill, the bill becomes law.

 

 

Filed under: General Problems | 3 Comments »

 

 

 

 

 

 

 

This post originally appeared on my blog Nov 16,2014 and last updated Feb 4,2016. https://www.pharmaciststeve.com/genocide-in-america/ This is before the CDC 2016 opioid dosing guidelines were published and about 2-3 yrs after the opioid Rxs dispensed had peaked.  Some states have passed law in recent years, that is suppose to protect practitioners and pts when prescribing opioids to pts. But few seem to admit that they have done little/nothing to help all involved. Is all the deaths from under/untreated pain or is all the suicides just “swept under the rug” and all the relatives leave the funeral home, saying ” .. at least he/she is “at peace…”

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This page is going to contain posts made on other places on the web by those in chronic pain and how the war on drugs has turned into a war on pts. The number of people who are abusing some substance is not going down, but the number of chronic pain pts not being able to get their chronic pain adequately treated is rapidly increasing… as is the use/abuse of Heroin.

History shows us other countries that have had a OVERT genocide… It would appear that our society has chosen to have a COVERT genocide. The rules/guidelines in place is like playing cards with a stacked deck  Just label it as a accident ?

And the whole process’ genesis was based on racism and bigotry War on Drugs GENESIS… BIGOTRY ?

As more and more chronic painers lose or have their therapy cut or they are more and more home bound and more and more INVISIBLE to our society.. They are emotionally, physically, mentally exhausted… many are losing or have lost the will and ability to “FIGHT” and having to deal with increased depression.

I am not encouraging or endorsing suicide.. I am trying to make those with chronic pain MORE VISIBLE to those in our society that are CLUELESS !

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For 16 yrs I used pain meds with very little problems. I took higher doses then most. Some people think if u weight 100 lbs u shouldn’t need the same dose as a 200 lb man. I sometimes vacation from one med to another for a month or two then go back . This helped to keep doses from getting higher and higher. Worked for me. I took my meds every 4 hours. i lived a pretty good life. Could work clean house and care for the kids. Do my community service. Felt pretty good about myself. Then last yr around this time it all went down hill. Only allowed to use meds every 6 hrs and at half the dose. Then no one would fill my scripts because my drs office was 40 miles from my home. For one yr I got my meds by mail or fed ex. That really sucked waiting and waiting for my meds to come. Then Aug 21 2014 I got that letter from my dr. Dropping me as a patient after 16 yrs. now I have nothing. I suffer everyday every hour every min. I can’t sleep I can’t function. I wake up everyday wishing I hadnt. Why didn’t I just die? I never thought this would happen to me never never but it did. I almost did kill myself two weeks ago but I don’t want to do that to my son. The pain it would cause him. What is my future don’t know? I did get lucky a couple days ago and found an old pain patch from 2008. Worked great. Don’t want to hear anything about it being expired nor do I suggest this to anyone else. What did I have to lose? I got to be a person again for a few days.got some stuff done. Made me feel better about myself. I smiled and got some sleep. I know that my life has to have some kind of pain management or I will kill myself. I would like to have my old meds back but those days r gone now. Medical marijuana is now my only hope because the pill problem keeps getting worse. I need that hope. I don’t want to die but I can’t live with this nerve pain. At the city hall meeting for mmj those people against talked about pain meds and pot as one and the people that used them r just the scum of the earth.the looks I got. I am sick not an addict or a bad person. I am a good caring person and didnt deserve the looks I got. I hope this doesn’t happen to anyone else in this group. But I don’t see things getting better only worse in this state of FL. This group keeps growing more groups r popping up. Sorry to say but we r at war. I know how the Jews felt when Hitler came to town. People,here in FL Pam Bondi is way ahead in polls. Why she is a monster. I have new found hope from younger people voting and or getting involved in their government. But this too might take some time. Got to vote. Talked to over 50 kids yesterday at the mall about voting this coming election.they can make things better for us so u better treat these kids with respect. They r our future

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WELL SHIT!!!! I JUST GOT OUT OF ICU FOR TRYING TO KILL MYSELF BECAUSE IM SO TIRED OF HAVING UNMANAGED PAIN TO BEGIN WITH HERE IN LOVELY FLORIDA……GOOD THING I HAVE A BACK UP PLAN CAUSE IM NOT DRINKING CHARCOAL AGAIN!

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http://www.news-press.com/story/news/crime/2014/09/08/death-investigation-at-groves-rv-park-in-fort-myers/15280035/

A husband and wife were found dead at their trailer Monday at the Groves RV Resort on John Morris Road, apparently the victims of a murder-suicide.

The Lee County Sheriff’s Office responded to unit #100 in the resort at 16175 John Morris Road at 8:30 a.m. Monday.

The sheriff’s office report said the response was in reference to a male caller advising the LCSO that he and his wife “could no longer stand the pain and that they were leaving.”

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 We SHOULD BE spending our time trying to take care of our pain !!!  I don’t think heroin addict’s spend that much time running around looking for it on the streets !!!
I ALMOST HAD TO go that route … Because of WAY Too much pain …  With absolutely no pain relieving medication  Better off …going to the streets eh ???
No judgements or rationing on the streets !!!  No wonder we turn to the streets for our necessary/life saving medication !!! Is that their agenda ???
Or just wait till we kill our selves because the pain is too bad ???  Kinda like genocide by suicide ?!?! It’s just unacceptable !!!

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Just can’t do this anymore

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I am done. Fed up of pain. Fed up of drs and people screwing my life up. Making me live in agony for no reason when they have the power to help. I only ever go to hospital when there is no other choice, when I am in a full blown life threatening crisis. I only ever cry out for support when I am at the end of my rope. But now that rope has snapped. Can’t keep asking for help and support and being rejected by everyone again and again. It is in humane to be in this much pain, it is cruel. I don’t know how much everyone expects me to deal with all the time but I am DONE. I am not living like this anymore.

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I’m about done with living. This isn’t living and I hate the quality of so called life I have. This whole thing has thrown me into a fibro flare on top of my back pain. I hurt so bad now I want to die.

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 This is a debate question. Not a plan of action !!!!   When is it okay to give up?  When is it okay to want to stop this constant pain?  My wife says it’s selfish for anyone to contemplate taking their life but I think it’s selfish to make someone live like this Every day …..day after day after day.  Today is not a horrible day. Today is an okay day. This is a debate question. Not a plan of action !!!!

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 Maybe I shouldn’t ask this, but I’m absolutely at my end. Feel free to message me if you don’t feel comfortable here. I need pain meds, BADLY. I can’t go on much longer this way. I contemplate suicide daily. I’m not a good mother. Or wife. Or friend (which I’ve lost most because the pain makes it unbearable to go out and be social). I can’t work much anymore, which is putting a huge financial and mental/emotional strain on my poor husband. I can barely keep up with my housework either. I feel like a 30 year old failure. My doctor took me off of the one thing that helped me, tramadol. Since then I’ve rapidly gone down hill.

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 I bet no one would care if I died, so why not get it over and done with, I mean no one wants to help me. So why bother with life. I’m in agonizing pain daily. Im a looser now and always will be and I drive people away so dont bother being my friend because ill probably make u hate me like I do with everyone else.

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 My wife has really been struggling in the last few months. This month has especially been difficult. She has stated many times that her fibro is getting worse. She has ran out of her pain meds and became very depressed. Yesterday she tried to kill herself. I found her face down on her bedroom floor. She had overdosed on other medications and was barely conscience. Ambulance took her to er, after 5 hours a private room. She finally became alert at 11pm enough to answer questions. She was transferred to an ICU last night and today at 5pm transferred to another hospital to deal with the depression.

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 I know it is heartbreaking to miss these things and see the disappointment on their faces and people and family want to judge me because I have decided to end my pain on my dad’s bday and are making preparations to do so then I do not have to face begging doctors for enough ends that don’t even touch my pain and be treated like a criminal because I have multiple health issues. I give up

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 http://www.infowars.com/i-am-sorry-that-it-has-come-to-this-a-soldiers-last-words/

This is what brought me to my actual final mission. Not suicide, but a mercy killing. I know how to kill, and I know how to do it so that there is no pain whatsoever. It was quick, and I did not suffer. And above all, now I am free. I feel no more pain. I have no more nightmares or flashbacks or hallucinations. I am no longer constantly depressed or afraid or worried

I am free. I ask that you be happy for me for that. It is perhaps the best break I could have hoped for. Please accept this and be glad for me.

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 I have a family member who has been in excruciating pain for years, surgeries and injections made it worse. The only thing that gave him the slightest relief was methadone. Well, insurance changed their rules and would not pay anymore, so they have been paying out of pocket. Sunday night he snapped, couldn’t take it anymore and took his life. Why am I telling you? His family is falling apart.

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 Hey everyone, I am xxxxxx, 33 years old RSD both legs from thigh to toes, spreading to my hands and calves. I am the most depressed I have ever been, I lost my job, Im a nurse, nothing bad, they were just ridding themselves of Per Diem nurses so I took that hit. I am a single mother of two beautiful girls, 4 years old and 19 months old. My car is about to die, my pain is incredible and nothing seems to work,my hair is falling out root to tip in clumps, I cant stop crying, all I need is a hug. It is so hard to wake up every day and be in this horrific pain. Im out of options, I don’t have any fight left in me,im done with this.

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 i am seriously considering participating in Doctor assisted end of life ..reason i can’t take this pain anymore.. It’s not fair for my wife to see suffer on a daily basis.. we don’t have children.. I understand such bill is directed to terminally ill..I will find a mental health provider who will support my decision.. No body cares!.. I reach out to the medical community they use me for $$$ i am referring to surgeons and the legal community could care less.. I guess my ethnicity as a latino in spite of my american heritage is not worth the effort.. It’s not just the arch problem i have a torn theal sac and my orthopaedic surgeon has abandoned me completey.. Sure my wife’s insurance has made him rich along with my medicare due to Permanent disablity.. let’s face it.. the medical and legal community would see me as a total loser..If i hit the lottery or had resources life would be totally different in spite of my pain..I am sick and tired of the bullshit and pain that i endure each and every day…

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 Last night a 19 year old friend from Key West died. Pain medication overdose how sad.

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 http://www.rawstory.com/rs/2014/11/mich-medical-marijuana-card-holder-commits-suicide-after-police-witch-hunt-over-pot-butter/

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 This weekend has been awful. I lost 2 good friends. One died of a heart attack and the other committed suicide pain level is out of the roof

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 I just want to die, then I will be in peace no more pain!

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Have anyone of you got to the end of the rope and want to let go. No more pain, i wouldn’t in my wildest dreams wish the amount of pain im in on my worse enemy. There is days i pray for god to end it. in sick and tired of being sick and tired. all the meds im on even meds for depression are not helping.i cant sleep, sit, stand, walk w/o being in major pain. i need help i cry myself to sleep the nights i do sleep. im at my max by the DEA law idk what else to do

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 Sxxxxx  hung herself Christmas morning. She could no longer take the pain. She tried for a year and a half. She lost her job and had to move in with her son. She spent her last months home bound. She was very scared and alone. The pain was bad enough where she needed help getting into the bath…
Everyone please think of her today. This could be any one of us….
How much can you take? It’s not like she could put the pain away in a drawer for a while. She couldn’t just take a vacation from it. It caused her daily severe panic and fear of leaving the house…Or thinking of the future. She left no note …  12/28/2014

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My late wife Karen lost her battle to Chronic Pain via suicide. I’d like to find out more about the (Cake) movie?

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At around 330 am my cell phone rang and when your phone rings at that time it’s not going to be good, a very good and close personal friend of mine had been found unresponsive in her bathroom by her hubby, one of my best friends and how I met her actually, he thought maybe she had a heart attack and called 911. They get there and get her to the hospital had to shock her 5 times before they called it. Not knowing the reason they had to run to screens and do an autopsy. She was a chronic pain patient who her new PCP told her she was to young to be experiencing that kind of pain and sent her to a Psychiatrist early this week who was very nice and respectful to her and gave her phych meds and a sleeping pill. Her new Dr being a yutz that she is cut her off of her pain meds accept topomax and a muscle relaxer, this down from oxycodone and other meds. She committed suicide early this morning. Her daughter found the note along with all her personal papers including a living will that was DNR, hospital ER staff is not to blame nor the EMT’S because it has not been notorized as of yet. But this Doctor, boy this Doctor she is going to be meeting my lawyer friend I went to High School and some College with and if he can win a case before the supreme court he can kick this Doctors ass. I will also be calling the Bishop Cupich and a very old friend Cardinal Timothy Dolan who started out as a Priest and the Bishop in Milwaukee to get her a dispensation to be buried in consecrated ground and to be able to have her mass and funeral at her Church. So after typing all of this it was to say we have lost another one unable to bear the pain anymore. No she wasn’t in this group she is from Chicago area.

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CRUCIFIED ON THE BLUE CROSS: JEWISH, BLACK, BROWN, AND WOMEN PRACTITIONERS CONFIRMED DISCRIMINATION UNITED STATES DEPARTMENT OF JUSTICE vs. NEIL ANAND ( THE 3rd. DOSE)

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ALLEGATIONS OF 3RD REICH NAZI IDEOLOGIES IN U.S. HEALTHCARE PROSECUTIONS SPARK PUBLIC CONCERN AS TO THE FINAL SOLUTION IN MEDICAL PAIN CARE TREATMENT ( THE ADELGLASS PAPERS, “1st DOSE” )

 

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WHO releases guidelines on chronic low back pain

https://www.who.int/news/item/07-12-2023-who-releases-guidelines-on-chronic-low-back-pain

The World Health Organization (WHO) is releasing its first-ever guidelines on managing chronic low back pain (LBP) in primary and community care settings, listing interventions for health workers to use and also to not use during routine care.

Low back pain is the leading cause of disability globally. In 2020, approximately 1 in 13 people, equating to 619 million people, experienced LBP, a 60% increase from 1990. Cases of LBP are expected to rise to an estimated 843 million by 2050, with the greatest growth anticipated in Africa and Asia, where populations are getting larger and people are living longer.

The personal and community impacts and costs associated with LBP are particularly high for people who experience persisting symptoms. Chronic primary LBP referring to pain that lasts for more than 3 months that is not due to an underlying disease or other condition – accounts for the vast majority of chronic LBP presentation in primary care, commonly estimated to represent at least 90% of cases. For these reasons, WHO is issuing guidelines on chronic primary LBP.

“To achieve universal health coverage, the issue of low back pain cannot be ignored, as it is the leading cause of disability globally,” said Dr Bruce Aylward, WHO Assistant Director-General, Universal Health Coverage, Life Course. “Countries can address this ubiquitous but often-overlooked challenge by incorporating key, achievable interventions, as they strengthen their approaches to primary health care.”

With the guidelines, WHO recommends non-surgical interventions to help people experiencing chronic primary LBP. These interventions include:

• education programs that support knowledge and self-care strategies;
• exercise programs;
• some physical therapies, such as spinal manipulative therapy and massage;
• psychological therapies, such as cognitive behavioural therapy; and
• medicines, such as non-steroidal anti-inflammatory medicines.

The guidelines outline key principles of care for adults with chronic primary LBP, recommending that it should be holistic, person-centred, equitable, non-stigmatizing, non-discriminatory, integrated and coordinated. Care should be tailored to address the mix of factors (physical, psychological, and social) that may influence their chronic primary LBP experience. A suite of interventions may be needed to holistically address a person’s chronic primary LBP, instead of single interventions used in isolation.

The guidelines also outline 14 interventions that are not recommended for most people in most contexts. These interventions should not be routinely offered, as WHO evaluation of the available evidence indicate that potential harms likely outweigh the benefits. WHO advises against interventions such as:

• lumbar braces, belts and/or supports;
• some physical therapies, such as traction (i.e. pulling on part of the body);
• and some medicines, such as opioid pain killers, which can be associated with overdose and dependence.

LBP is a common condition experienced by most people at some point in their life. In 2020, LBP accounted for 8.1% of all-cause years lived with disability globally. Yet clinical management guidelines have been developed predominately in high-income countries. For people who experience persisting pain, their ability to participate in family, social, and work activities is often reduced, which can negatively affect their mental health and bring substantial costs to families, communities, and health systems.

Countries may need to strengthen and transform their health systems and services to make the recommended interventions available, accessible and acceptable through universal health coverage, while discontinuing the routine delivery of certain interventions. Successful implementation of the guidance will rely on public health messaging around the appropriate care for LBP, building workforce capacity to address chronic low back pain care, adapting care standards and strengthening primary health care, including referral systems.

“Addressing chronic low back pain requires an integrated, person-centred approach. This means considering each person’s unique situation and the factors that might influence their pain experience,” said Dr Anshu Banerjee, WHO Director for Maternal, Newborn, Child, Adolescent Health and Ageing. “We are using this guideline as a tool to support a holistic approach to chronic low back pain care and to improve the quality, safety and availability of care.”

LBP affects life quality and is associated with comorbidities and higher mortality risks. Individuals experiencing chronic LBP, especially older persons, are more likely to experience poverty, prematurely exit the workforce, and accumulate less wealth for retirement. At the same time, older people are more likely to experience adverse events from interventions, reinforcing the importance of tailoring care to the needs of each person. Addressing chronic LBP among older populations can facilitate healthy ageing, so older persons have the functional ability to maintain their own well-being.

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The following article is from Dr. Daniel A. Hussar, Ph.D. who is a retired professor from the Philadelphia College of Pharmacy and produces a monthly newsletter about pharmacy issues starting back in 2006. https://pharmacistactivist.com

Dan’s and my path crossed about a decade ago when one of his former students, Joe Zorek, who was suing CVS over EEOC, ADA and Whistleblower violation. and Joe reached out to me to help him spread the word about his lawsuit via my blog.

Joe was able to get CVS to settle without going to court, but while the terms of Joe’s agreement with CVS was confidential. In talking with Joe back then, Joe was very happy with his settlement.

Pharmacy Concerns are Receiving Unprecedented Media Coverage: Synergies and Momentum can be Achieved!

https://pharmacistactivist.com/2023/November_2023.shtml

Media coverage of pharmacy-related issues during the last year has been extensive. The high cost of drugs has been a long-standing concern that continues, but much of the recent coverage has focused on medication errors, staffing and workplace conditions that cause moral injury to pharmacists and increased risk of errors for patients, anticompetitive practices of the health insurance companies with their PBMs and pharmacies, the domination of chain stores in community pharmacy and the decline in numbers of independent pharmacies, the increased number of pharmacy deserts, the fragmentation in the medication distribution system (i.e., local community pharmacy, mail-order pharmacy, specialty pharmacy), and the reduction of personal communication with and counseling of patients.

Media attention to these multiple issues is often initiated because of a harmful medication error. Although this coverage may focus on an experience in a single pharmacy that may also identify the pharmacist responsible for the error, the publicity is a blemish on the reputation of our entire profession. However, an increasing number of reporters are looking for explanations and underlying reasons for an error, and discovering there are many contributing factors such as corporate policies/metrics and understaffing. As much as we may dislike seeing a pharmacy error publicized, the more extensive coverage that reveals the error-prone circumstances under which many pharmacists work is of value to our efforts to increase awareness of and reform the pharmacy practice system. Some examples of the recent media coverage are provided in the following discussion.

USA TODAY

“Prescription for disaster: America’s broken pharmacy system in revolt over burnout and errors” is the title of the first-page story in USA TODAY on October 26. Written by senior investigative reporter Emily Le Coz, this commentary provides excellent comprehensive coverage that identifies numerous factors that contribute to the stressful pharmacy workplace challenges and the occurrence of errors. She initiated her investigation upon learning of a dispensing error that harmed a young child. At each stage of her investigation, she discovered one problem after another that result in the “broken pharmacy system” and the increased risk of errors. Excerpts of her article are provided below:

(Editor’s note: The strategy of CVS and others against whom lawsuits are filed when there is no question that harm was caused by an error, is to quickly reach a confidential settlement in an amount that is likely just a small fraction of what might have been obtained if the lawsuit had gone to trial).

Numerous pharmacists told USA TODAY that errors are not consistently reported – even internally. Small mistakes and those caught early are routinely hidden.

Even when they do report potentially fatal errors, some pharmacists said, no one from their companies investigates how they occurred or makes changes to prevent them from repeating.

Pharmacists are personally liable for medication errors and risk fines, discipline and loss of license if investigated and found responsible by their state board. Many told USA TODAY they get little or no support from their company when mistakes happen, even if the conditions imposed by those companies contribute to those errors.”

(Editor’s note: This shocking statement by CVS attorney Stilling demonstrates how the company’s priority is to protect its own interests while making their pharmacists vulnerable to disciplinary action. It should be widely communicated throughout our profession as a warning about the lack of support and potential consequences for pharmacists who work for certain corporate employers).

Ordinarily I would not include such extensive excerpts from another publication about situations that are so well known to pharmacists and that many are personally experiencing. However, what I have included is just a fraction of the USA TODAY coverage that also includes commentary on “Pharmacists bleeding, crying, working alone,” as well as issues such as pharmacists leaving the profession and plummeting enrollments at many colleges of pharmacy.

Emily Le Coz has provided exceptional coverage of the risks for patients and the concerns of pharmacists in her report, and also very effectively identifies and connects the multiple factors that create and exacerbate the current challenges. Although her report focuses on problems, it is not until the problems are well understood by the public and our legislators that our profession will be effective in developing and implementing solutions. I encourage you to access and read the entire report, and use the coverage of her objective “outside” observations to support your personal relevant experiences in messages with your community and local media.

The Ohio Capital Journal

Over a number of years, Marty Schladen has provided extensive coverage of pharmacy-related issues for the Ohio Capital Journal and previously for the Columbus Dispatch. His investigations were important in determining that in 2017, PBM middlemen and “secondary middlemen” charged Ohio $224 million more for drugs dispensed to participants in the Ohio Medicaid program than they paid pharmacies. The Ohio attorney general filed lawsuits that resulted in large settlements with certain of the middlemen (please see the August 2023 issue of The Pharmacist Activist).

Schladen has recently investigated and published in a series of reports about numerous errors and violations at CVS stores that were documented in Ohio Board of Pharmacy inspector reports. The Ohio Board held meetings on November 7-8 and Schladen’s excellent coverage and selected excerpts include:

November 8, 2023: “CVS disciplinary hearing before Board of Pharmacy begins.”

November 9, 2023: “Ohio pharmacy board members seem skeptical of CVS claims.”

November 30, 2023: “Still more Ohio CVS pharmacies accused of staffing-related problems.”

Marty Schladen understands and clearly articulates how pharmacy workplace conditions, errors, and violations are related to the policies and compensation/economic practices of PBMs that increase the risk of errors for patients, moral injury for pharmacists, and the financial survival of pharmacies. His recent commentary, “Pharmacy middleman grants huge bonuses for winning business meant to help the poor,” (November 17, 2023) begins:

Numerous other publications have also recently reported on the concerns of pharmacists and the risk to patients that result from the corporate dominance of pharmacy and other areas of health care. As examples, recent articles in The Wall Street Journal address issues about PBMs, health insurance companies, and pharmaceutical companies:

The possible merger between Cigna and Humana, which are already among the largest health insurers, has the potential to further reduce competition and increase corporate influence/control of the healthcare system. If the companies’ discussions progress in this direction, a merger would probably be challenged by the Federal Trade Commission (FTC) which is already investigating anticompetitive actions and programs of merged/acquired healthcare companies that were previously approved. There is bipartisan interest and concerns regarding the issues being addressed by the FTC, as well as legislative proposals designed to correct current problems. However, we must never underestimate the ability of the corporations such as PBMs to identify and exploit loopholes in any legislation and manipulate them to their advantage. This makes it all the more important that the public, legislators, and government officials have a clear understanding of the present concerns and consequences for the purpose of constructing legislation and taking actions that will be most effective in providing impactful reforms of our current healthcare system. If substantial reforms are to be achieved regarding pharmacy-related issues, our profession must give a very high priority to assuring that the public, legislators, and other decision-makers have a full understanding of our concerns and their risks/consequences, as well as the urgency for reform. It is in this direction that investigative reports of Emily Le Coz, Marty Schladen, and others are of great value in increasing the awareness and understanding of the public of the issues that place them at risk of harm.

Building momentum

Emily Le Coz’s investigations involved interviews with numerous pharmacists which increased the scope and depth of her coverage. Among those whom she interviewed are Michael Hogue, CEO of the American Pharmacists Association (APhA), and Doug Hoey, CEO of the National Community Pharmacists Association (NCPA). They are the leaders whom the media contact at an early point in their investigations of pharmacy-related issues, and they have been widely quoted in recent media coverage. These interviews, as well as those with other pharmacists have great benefit not only for increasing the awareness of the public of our concerns, but also their awareness of our associations and their programs and activities which are of importance for the public. The formidable challenges continue and may seem impossible to resolve, but I am impressed and encouraged by recent actions of our associations, as well as many individual pharmacists.

In addition to their support for pertinent legislative proposals, the associations’ concerns about the anticompetitive actions of health insurers and PBMs have been widely communicated. At its annual meeting in October it was announced that NCPA is working with three law firms in creating a limited liability company called TRUST LLC (www.fightPBMs.com), which will investigate and, when appropriate, litigate or arbitrate on behalf of community pharmacists to recover coerced price concessions (DIR fees) which have been assessed by PBMs and insurance plans and appear to be in violation of federal antitrust law and state contract laws. It has also been recently announced that Matt Osterhaus of Iowa is the lead pharmacist in a class-action lawsuit against CVS Health, CVS Caremark, and Aetna.

The APhA has established several programs to document unacceptable workplace conditions and to support the well-being of pharmacists. CEO Michael Hogue has recently stated that: “The APhA has been focused on longer-term fixes, and what we’ve heard loud and clear is we need to focus on the acute problems. That’s what we are going to do.” Hogue has met with CVS pharmacists who participated in the walkout of numerous CVS stores in the Kansas City area in protest of understaffing and stressful working conditions. The actions of these courageous pharmacists have resulted in wide media coverage and has provided the impetus for subsequent walkouts and initiatives to start a pharmacy guild. On October 30, Michael Hogue released a statement regarding the challenges for pharmacists, and excerpts are provided below:

This is, by far, the strongest and most direct position I have seen from APhA regarding the challenges that threaten future opportunities and accomplishments in our entire profession. Pharmacists in every area of responsibility must support these positions, and synergies can be achieved by close working relationships with media personnel in increasing public awareness of the concerns that place them at risk.

We must build on the momentum that currently exists!

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