AG Sessions: Fill up the jails with MJ offenders – regardless of state laws to the contrary

US Revives its Harmful Drug War

Attorney General Sessions to Crack Down on Marijuana

https://www.hrw.org/news/2018/01/04/us-revives-its-harmful-drug-war

US Attorney General Jeff Sessions is reviving the US government’s out-of-date, ineffective, and counterproductive war on drugs. Today it was reported that he will rescind the 2013 Cole Memo, which allowed federal prosecutors to choose not to prosecute marijuana offenses in the states that allow adults to consume it.

U.S. Attorney General Jeff Sessions delivers remarks on the U.S. system for asylum-seekers at the Executive Office for Immigration Review in Falls Church, Virginia, U.S. October 12, 2017. © 2017 Reuters

Last year, Sessions also reinvigorated the war on drugs by rescinding former Attorney General Eric Holder’s Smart on Crime guidance to keep low-level, nonviolent offenders out of prison, and repealed then-President Barack Obama’s 21st Century Policing practices, put in place to curb excessive drug law enforcement.

Earlier this week, California became the sixth US state to allow recreational use of marijuana for adults. Sessions’ latest action shows that the attorney general wants federal prosecutors to have much less leeway in deciding whether to enforce federal marijuana laws in states like California. At a moment when preliminary US Centers for Disease Control data suggests that 146 people are dying every day in the United States from opioid overdoses, it is difficult to understand why the White House is focusing such energy on marijuana policy. President Donald Trump has yet to nominate directors for either the Drug Enforcement Administration or the Office of National Drug Control Policy.

Sessions’ combined actions will fuel arrests and mass incarceration in states and at the federal level. Every 25 seconds, someone in the United States is arrested for merely possessing drugs.

One in nine arrests at the state level is for drug possession – 1.25 million arrests every year – and they all cycle through the criminal justice system. Human Rights Watch has documented that this massive effort has had negligible impact on drug availability, and has even worsened the harms of drug trafficking and drug dependence. Even though African Americans and whites use drugs at the same rates, African Americans are disproportionately targeted, arrested, and incarcerated for drug offenses. Those incarcerated for drug offenses typically do not have access to drug treatment and can carry a scarlet letter for years, which impedes successful reentry into society by limiting housing and employment options.

Make no mistake, the war on drugs is again underway. It’s now up to Congress to check the Justice Department’s misguided policies by passing legislation to decriminalize possession for personal use of marijuana and other drugs.

AG SESSION IS AN IDIOT… and proves it with each succeeding statement he makes

 ATTORNEY GENERAL JEFF SESSIONS Sessions: Opioid Prescriptions at 18-Year Low

www.painnewsnetwork.org/stories/2018/10/25/sessions-opioid-prescriptions-at-18-year-low

Opioid prescriptions in the United States fell by 12 percent in the first eight months of 2018 and will decline even further in coming years, according to Attorney General Jeff Sessions.

“We now have the lowest opioid prescription rates in 18 years.  And we’re going to bring them a lot lower,” Sessions said in prepared remarks at the National Opioid Summit in Washington, DC.

Opioid prescriptions have indeed been falling for many years, but the trend appears to be accelerating as many doctors lower doses, write fewer prescriptions, or simply discharge and refuse to treat chronic pain patients.

Sessions pledged to continue fighting “the deadliest drug crisis in American history” by reducing opioid prescriptions by another third over the next three years. That’s in addition to a 44% reduction in opioid production that the DEA began in 2016.

essions also promised to st

Opioid prescriptions in the United States fell by 12 percent in the first eight months of 2018 and will decline even further in coming years, according to Attorney General Jeff Sessions.

“We now have the lowest opioid prescription rates in 18 years.  And we’re going to bring them a lot lower,”

Sessions said in prepared remarks at the National Opioid Summit in Washington, DC.

Opioid prescriptions have indeed been falling for many years, but the trend appears to be accelerating as many doctors lower doses, write fewer prescriptions, or simply discharge and refuse to treat chronic pain patients.

Sessions pledged to continue fighting “the deadliest drug crisis in American history” by reducing opioid prescriptions by another third over the next three years.

That’s in addition to a 44% reduction in opioid production that the DEA began in 2016.

Sessions also promised to step up efforts against healthcare professionals alleged to have overprescribed opioids. He said the Trump Administration has charged 226 doctors and 221 medical personnel with “opioid-related crimes.”

“These numbers will continue to rise,” Sessions predicted, because of new federal prosecutors and a data analytics team focused on tracking opioid prescriptions.

“This team follows the numbers—like which doctors are writing opioid prescriptions at a rate that far exceeds their peers; how many of a doctor’s patients have died within 60 days of an opioid prescription; and pharmacies that are dispensing disproportionately large amounts of opioids,” Sessions said.

“They will help us find the doctors, pharmacists, and other medical professionals who are flooding our streets with drugs—and put them behind bars.”

At no point in his speech did Sessions discuss the impact the opioid crackdown was having on millions of chronic pain patients, who are increasingly bedridden or disabled due to lack of access to effective pain care.

Earlier this year, Sessions suggested they should “tough it out” by taking aspirin.

While opioid prescriptions have fallen dramatically in recent years, they’ve yet to have much of an impact on the nation’s overdose rate.  Preliminary estimates released by the CDC this week show a modest 2.3% decline in opioid overdose deaths from September 2017 to March 2018. Over 48,000 people died from opioid overdoses during that period, with most of those deaths involving illicit fentanyl, heroin and other opioid street drugs, not prescription opioids.

Sessions said the Justice Department was taking “unprecedented action” against fentanyl traffickers at home and abroad, including the recent indictments of three Chinese nationals and dozens of Mexican drug traffickers.

“China could do more to stop these drugs from coming here.  Frankly, they’re not doing enough.  They must do more,” he said.

AG Session is filing indictment against FOREIGN CITIZENS IN CHINA AND MEXICO and their respective governments are not going to cooperate with those indictments against those people. So Session’s action(s) is nothing but a LARGE SMOKE SCREEN.

Most decline in opioid overdoses but no mention of the increase use/abuse of Methamphetamine, Cocaine, Crack, Marijuana and other substances that substance abusers will find that works for them to help them to GET HIGH.

That 2.3 % decline was based on what number … the 70,000 that the CDC declared is from all drug OD’s are just those that are related to opiates OD… if the later then then reduction could be a couple of hundred – OR LESS.

But is fewer are dying and there is an increase in other substances being abused… then the total “pool” of substance abusers has to be GROWING… many of them are committing crimes to afford to “feed their habit”

Another state gets on the “death with dignity” bandwagon ?

End-Of-Life Care Group Reaches Key Benchmarks In Helping Health Care Providers, Communities Statewide Prepare For Medical Aid-In-Dying Law

https://www.news-line.com/PH_news27492_enews

Compassion & Choices Hawai’i today announced that its public education campaign about the Our Care, Our Choice Act has met several key benchmarks in preparation for the law to take effect on January 1, 2019

Signed into law on April 5 by Governor David Ige, the Our Care, Our Choice Act authorizes medical aid in dying as an end-of-life care option to end unbearable suffering. It is the medical practice which gives terminally ill adults with a prognosis of six months or fewer to live, and who are mentally capable of making their own healthcare decisions, the option of requesting from their doctor a prescription for medication to die peacefully in their sleep.

Compassion & Choices’ Hawai’i Access Campaign is a volunteer-led effort to educate the community, healthcare professionals, health systems and hospices to ensure terminally ill adults in Hawai’i have access to the new law. To date:

•The Campaign has provided hospital and hospice systems statewide with sample policy templates that can be customized to each system.
•For healthcare professionals, the online resource www.compassionandchoices.org/hawaii features Doc2Doc and Pharmacist2Pharmacist consultation services and training videos. In addition, Compassion & Choices is working with the Hawaii •Department of Health advisory group to provide in-person education for physicians and other providers.
•Dr. David Grube, national medical director for Compassion & Choices, is in Hawaii this week presenting “Medical Aid in Dying: A Physician’s Perspective” to physician groups including the Hawaii Society of Clinical Oncologists, Castle Hospital, palliative care doctors and the Department of Health.
•For healthcare consumers, the website features a video for residents explaining medical aid in dying, fact sheets and other important documents in English, Japanese, Tagalog, Ilocano, Mandarin, Hawaiian and Spanish.
•A series of presentations for the community and for medical professionals will be held on the Big Island in Kona, Waimea and Hilo Oct. 23-24 (to register call the Office of Senator Lorraine Inouye at 974-5000, ext. 67335); other islands are being scheduled.
•The Hawaii Psychological Association will provide a special focus on the Our Care, Our Choice Act and training for mental health practitioners during its annual convention, October 26-27.

Compassion & Choices has over 20 years of experience helping states successfully implement medical aid-in-dying laws.

“We know from experience that when this law goes into effect on January 1st—10 weeks from now—there will be dying patients making requests of their doctors for this compassionate end-of-life care option so medical providers need to be ready,” said Kat West, national director of policy and programs. “That’s why Compassion & Choices has begun reaching out to healthcare systems, hospices, physicians and pharmacists to help them prepare.”

Compassion & Choices’ Hawai’i Access Campaign will continue to:

•support local public outreach & education teams on each island;
•provide free education and materials for doctors, pharmacists, nurses and other healthcare providers including webinars, videos and Doc2Doc consultation calls;
provide technical and policy assistance to hospitals, clinics, hospice facilities and •pharmacies statewide; and
•work with government agencies, medical associations, and other ancillary organizations to ensure broad understanding of the law and meaningful access for those who need it.

Educational resources for patients and providers can be found at CompassionAndChoices.org/Hawaii.

As always, open and proactive patient-provider discussion about all end-of-life care options is key to smooth and successful preparation to improve end-of-life care and implement the law in a timely fashion.

“We encourage residents, no matter which island they reside on, to initiate conversations with their doctors now about whether their doctor would support them if they were to become terminally ill and request medical aid in dying. We know from experience it is only way that residents can ensure that they will get the care they want at the end of life,” West said.

Compassion & Choices Hawai’i is the local affiliate of Compassion & Choices, the nation’s oldest, largest and most active nonprofit organization committed to improving care and expanding choice at the end of life. For more information call 808-282-8247 or visit www.compassionandchoices.org/Hawaii..

chronic pain NEVER KILLS ANYONE … nor harms any family ?

Suicide Over Pain- Telling My Brothers Story Because he can’t

https://hudsonvalleydoctorskilledmybrother.wordpress.com/2018/09/14/suicide-over-pain-telling

On August 29th 2018 our house phone rang at 4 am, we ignored it thinking more than likely it was a wrong number because no one we know would call at that time and if they did for some reason they would leave a message. When the machine picked up the caller hung up without doing so and we assumed just that it was a wrong number. So with my husband and I having only about two hours sleep before getting up to start the day attempted to fall back asleep.

A minute or two later my husband got out of bed for some water and I turned over to get comfortable thats when my cell phone rang. This made me realize something was wrong because the calls were minutes apart and the chances of wrong numbers at both our home and my cell were slim to none.

When I picked up my cell phone the caller ID read “NY state Police Department”, partially baffled and now nervous because what could the state police possibly want or have to say especially at this hour I answered the phone. That is when a conversation that crushed my families life ensued.

“Hello” I said nervously

“This is Sergeant (We will just call him Sergeant) from the New York State Police, I am trying to contact Mrs Dagee am I speaking with her?”

“Yes how can I help you?” a sudden pit formed in my stomach, in no way could this be a non urgent matter.

“Mrs Dagee we found your name in the phone of a Raymond Arlugo stating you were his sister is he your brother?”

“Yes did you find his phone somewhere? I tried contacting him yesterday with no success, he doesn’t have a home phone can you keep it at your station then later we will come pick it up?”

“Mrs Dagee, there has been an incident and we would need you to come to your brothers home immediately if possible”

“At 4 am you need me to come to his home if possible? Why is that? Would you please tell me what this is about? What do you mean by incident?

“Mrs Dagee, I rather not go into details over the telephone, if needed we can have a trooper come and escort you”

TELL ME WHAT HAPPENED!! My voice was now raised due to sheer fear. My brother lived alone with my nephew he lived a quiet life anytime the word incident is mentioned it can be a wide range of things but of course you always think the worst.

I must have been louder than I thought because my husband came running to our bedroom, I rarely raise my voice so he must have been startled as his tone louder than usual asked “Whats Wrong Are You OK?”

I just looked at my husband held my hand up in a “Hold on” type motion, there was a brief silence on the phone that seemed to last for hours when the words I never thought I would ever hear were said.

“Mrs Dagee, we received a phone call earlier about a disturbance in your brothers apartment, when we arrived we found him deceased. We have your nephew with us he is OK but we would need you to verify if this is or is not your brother and take custody of your nephew”.

I will be there in no more than a half hours time, please tell my nephew I am on my way.

I hung up my phone looked at my husband who still unaware of what was said on the phone, had this half scared and half confused expression on his face then I told him.

“You need to get the kids ready for school before work, call my job tell them there has been a family crisis, call Julian’s school tell them he won’t be in today I will speak with the Principle to let them know when he will return.”

“Sam what happened to Ray? I am going to go with you let me call Miss Lazar next door she can get the kids ready for school”

I stood getting dressed without saying a word then turned around looked my husband in the face and told him “No I need to Go Handle this, I will Text you once I know more”

“Sam answer me tell me what is going on now!”

“Elliot Raymond passed away, that was the state Police, they are who called on the house phone. I need to get Julian and I want to do this alone.”

“Samantha I am coming with you, I am calling Miss Lazar”

“ELLIOT I HAVE TO DO THIS ALONE!!”

I kissed my husband, grabbed my car keys then headed towards my brothers home. I was completely numb inside, I know what happened I didn’t need anything official, he had been telling me for months.

“Samantha i’m getting tired”

When I arrived at his home it was like a scene from a TV show, police cars outside, police standing around talking while neighbors looked on from the street. When I got out of my car Julian who thankfully was sleeping at a friends house next door when this took place, ran over and hugged me with all his strength while tears flowed. The Sargent I spoke with on the phone walked over an introduced himself.

Once Julian calmed down a little, he went with a female Trooper who held his hand while the Sargent and I walked up to my brothers second floor apartment. The Sargent warned me to prepare myself but at that point I didn’t need to, I had prepared myself the entire ride over.

There he sat in a chair, head leaned over to one side wearing his good clothes in one hand he held a photo of Julian, in his lap was a photo of us as children and in his left hand a 38 revolver. On the side table next to him was a note that read.

Sam,

“I tried, I am sorry for everything but I am tired more than words can express. I begged the doctors for help, they humiliated me and even laughed when I told them this pain was unbearable. I just wanted to be a Dad to Julian.

Samantha make sure he knows I didn’t leave him to hurt him, I just didn’t want to embarrass him anymore.

Ray”

I know people will say “If he loved his son then he would have stuck it out” but you need to understand what Ray had been through in a short amount of time. When he wrote the words embarrassed its not that Julian ever told him “Dad you embarrass me” that was Ray feeling ashamed of not being able to function on a daily basis to be an active part of Julian’s life.

It was in just an eight year span of time Ray had one medical condition after another without a break in-between.

In 2011 Ray was in an accident that caused a brain hemorrhage that needed emergency surgery. It would be the third cranial surgery of his life, he had two neuro surgeries a few years earlier for epilepsy.

This recovery took almost six months. Once he started feeling better, in 2012 Ray started having pain in the front of his neck. The pain would be dismissed by the dozen different doctors from a primary physician, ENT and Endocrinologist.

It was not until Ray ended up with massive swelling that required him to be placed on an intubation tube did they discover a massive benign tumor pressing against his vocal chords. Then to make matters worse Ray also had Thyroid cancer which caused not only weight gain but an enlarged heart due to viral cardiomyopathy.

Those conditions would be treated in New York City, Ray would finally start being his old self by the end of 2012. There were several months Ray was not only was feeling like his former self but even participating in community activities, coaching Julian’s little league team.

While working on his home in the spring of 2014, the ladder Ray was standing on lost footing and Ray would fall 15 feel onto the concrete. The fall broke his collar bone and fractured his shoulder to the extent reconstructive surgery needed to be done. Which took Ray almost a year to recover from.

Once Ray had recovered from the fall he again went back to his normal life, even while recovering he did things on a daily basis that didn’t require him to use his bad arm, he went to physical therapy and when it came to Julian he made sure he never missed an event be it baseball, soccer or at school.

When an oil slick in the road caused him to lose control of his car in the summer of 2016, Ray broke his left hip. Once again he was back to surgery, physical therapy and life on a daily basis even using crutches he never missed an event when it came to Julian. he had recovered fully from his broken hip by the start of 2017 then started to feel tired all the time.

He would address the tiredness with his primary care physician who would do some lab work and tell him it was nothing but a B-12 deficiency. Every day Ray would got to the doctors office and get B-12 injections until feeling better. The one day while we were all at the park during the summer, Ray cooking on the BBQ grill suddenly collapsed and went into convulsions.

We would call the ambulance, Ray was admitted to the local hospital where they informed us damage from his 2011 accident left underlying damage that had caused him to become an uncontrolled epileptic.

Over the next six months Ray would have continuous seizures until they found the right medicine for him. He had been seizure free for almost five months until one day helping our elderly aunt and uncle clean out a garage Ray went into a Grand-Mal seizure and while doing so fell onto some storm windows opening up a massive cut on his stomach. A large portion of the glass was sticking out and ray needed emergency surgery to have it removed.

The surgery while saved him from any impending immediate danger left an infection that Ray soon was diagnosed with Sepsis. He then was admitted into the hospital to treat the blood infection and a have the infected tissue surgically removed. This would happen to him three times in four months.

A week after being home in June of 2018, Ray with his latest stomach surgery healing from the inside out would have another seizure and fall down. In the fall Ray not only broke his jaw but his front teeth as well with the help of dentists from Marylebone Smile Clinic. They wired his jaw shut then a dentist removed his teeth that were broken at the gum line. You should have a peek at these guys who are claimed to be the best in this field.

One night in late June ray sent me a text asking me to pick up Julian because he was in pain and needed to go to the emergency room. I did and Ray went he was diagnosed with chronic pain, told to see his primary physician then prescribed 2 five milligram percocet pills.

When Ray went to his primary physician, (A Doctor I don’t know why Ray continued seeing after he mis-diagnosed him so many times including his cancer) the doctor told him to just take some Tylenol then seek a pain management doctor in the area.

Over the next several months ray had seen five different pain management specialist all of who stated “We Only Treat Orthopedic conditions, the insurance companies only allow us to bill for one condition you don’t meet the guidelines.”

I personally had brought him to several of these doctors, one laughed when reviewing his medical history and told him “Yeah well I guess your out of luck”.

I sought out more doctors and each time it was the same thing “We only treat orthopedic conditions” or “We can do a trigger point injection but only one area we can’t treat your shoulder and hip and jaw”

When I asked why not they would all respond “Because we don’t some relief is better than none take it or leave it”

He was desperate for some relief so Ray would get the injections, yet the pain from all his other conditions grew out of control. He would occasionally go to the ER for some relief, all that did was get him branded a “Drug Seeker” and on occasion he would get one or two pain pills prescribed. Then he would look for another pain management doctor all quick to make an appointment, all quick to give the same answer despite their website stating they treat all conditions.

As summer passed his pain increased, it would become so bad ray laid in bed with tears in his eyes and would ask us to take Julian for a few days so he could play with the kids.

Once August arrived Ray could hardly walk, the pain in his hips, his stomach, jaw and shoulder had become unbearable. He was taking 6000 milligrams of Tylenol to get some relief and he was taking melatonin to get some sleep which by then averaged maybe two hours a night.

When I would go visit Ray and Julian, bring him his mail it would be nothing but bills from doctors who did nothing to help relieve his conditions. His phone rang every hour even more than that from all these doctors who never helped him that wanted their co-pays.

I went to go see ray on August 15th, he could not get out of bed, he had been having seizures because even walking to his kitchen to get his meds was a 45 minute ordeal so he often skipped even attempting to do so. We started having Julian over five out of seven nights a week and when I would bring ray someplace for some help they again treated him like a drug addict.

He had given up even going to see doctors from help by the 22nd of August because the last time he went to the ER by ambulance, they asked him that standard question about “Do you feel like harming yourself” and Ray relied “If I don’t get some sustained relief I am not going to continue living like this”

They stripped him naked placed him in scrubs then called a Psychiatrist because he had to be “In Mental distress”. He spoke with the Psychiatrist in detail and the Psychiatrist told the medical doctor that in his opinion Ray was just suffering from physical pain and needed some help.

They discharged him with a referral to one of the same pain management doctors who had already told us he only did trigger point injections and could not treat several areas “Take some relief because its better than none”

Over the next few days Julian stayed at our house, Ray would call several times a day to speak with him and I would stop over his house several times a day to check on him. he had stopped eating, he would make it to the bathroom then back to bed. He took 3000 milligrams of Tylenol every 2 hours for some pain relief. I would ask him “Ray what Can I do/ Why don’t you come stay with us at the house so you are not alone?”

In response ray would say “No you have your own family, Julian is having a good time there and with me being there it would just remind him of what home is like”.

I called several hospitals, his primary care physician and neurologist for some help on what to do and they all said the same thing “Well there isn’t much we can do call the mental help hotline”

I knew Ray would be angry at me if I did so but I had become worried and called the hotline who only stated “Has he said he is going to harm himself?” When I said no but explained his physical status I was told.

“Maybe he needs some out patient therapy someone to talk with, most of the time this is in their minds and talking gets rid of the pain”

Of course she was probably some volunteer who had no idea about medicine but another call a day later ended in the same result.

On the afternoon of August 27th Ray called and asked for Julian to be dropped off at home, he seemed in good spirits and when I was in the house all he said was “I am in pain but it will be OK I just want Julian home”

When I left I would find out Julian went to go play with some friends outside and one asked if he could spend the night and Ray told him yes. I can only imagine he had already made up his mind and he wanted to spend a night with Julian before he carried it out. Yet because Julian had seen him suffer so long and spent more time in the house due to Ray being unable to function Ray didn’t want to decline Julian an opportunity to have a good time.

I have no idea how long Ray sat looking at the photo of Julian holding that gun before he pulled the trigger. I don’t know why he didn’t call me and why didn’t I insist he came to stay with us.

Throughout all his physical injures and illness, Ray never took prescription pain medicine beyond what was prescribed when it was prescribed so he was not an addict. His body had finally needed something more than Tylenol for comfort.

It was in his medical records Ray had an allergic reaction to NSAIDS, Ray didn’t drink alcohol, he didn’t smoke cigarettes in fact he had no bad habits not even fried or fast food.

I was cleaning out Ray’s house the other day when the phone rang, it was his primary physicians office confirming an upcoming appointment. I said “You are asking about an appointment when the office knows ray passed away?”

“Oh yes I do see a note on the chart my mistake”

She said it as if Ray was no more important than a mistake when ordering the daily lunch special only to realize it was yesterdays special.

An hour later one of the pain management doctors offices called, when I answered I informed them Ray had passed and the woman had the audacity to ask me

“Will you be paying his outstanding balance of $31.74.” She didn’t even offer a half hearted condolence.

Once off the phone with the wretched woman seeking $31.74 for services not rendered I sat looking at a picture or Ray holding Julian and it all hit me at once, I cried like never before uncontrollably.

I wasn’t crying because I miss ray which I do with all my heart, I cried because while I was there to see what he went through on a daily basis it suddenly sunk it what it must have been like to be Ray.

He was a widower, raising a son alone and outside of his medical bills Ray was never in debt. He was never arrested, he attended church every Sunday, he never complained even when the people who were supposedly in a profession to help him didn’t.

He was broken down slowly and not by his physical conditions, ones that alone would have shut down most people let alone combined.

These people laughed at him literally, they called him an addict, yet not one of them have ever suffered his level of pain. They called him mentally unstable, they belittled him as if he was beneath them. Yet Ray while not a doctor of medicine was an educated man with a masters degree in forensic science and would get asked what is individual evidence in forensic science.

Ray was a proud man who had finally decided he was not going to be treated like that anymore and he was not going to allow himself to be bedridden in front of his son crying in agony.

I don’t know what I could have done to help Ray any further than what I did and I will always blame myself. I look at my nephew and I see Ray in him, Julian stands tall he stood tall at rays funeral he didn’t cry he shook peoples hands as they left he thanked them for coming.

When we try to talk with him about Ray he puts on a front as though it was OK. We brought him to grief counseling but he does the same there. At night I head Julian cry alone in the bathroom, when he opens the door he pretends as if though he has no idea what I am talking about if I as him “Are You OK do you want to talk?”

The only thing someone had to do is help Ray with his physical pain, just admit their limitations if that was the issue. Instead they let him die they might as well have pulled the trigger and done it long before Ray did so at least he would have been spared some agony and kept his dignity.

I am going to tell his story and tell what happened at those visits where they degraded him. I will tell it because Ray cannot and he would not because he was not the type of man who complained.

He deserved better and those who were capable of helping him but didn’t have no shame they are not doctors, there is no excuses. It cost a man his life it broke a family it broke a child before he could even become a man.

WHEN WILL SOMEONE TAKE RESPONSIBILITY FOR THAT OR SHOULD NO ONE BE RESPONSIBLE?

 

-my-brothers-story-because-he-cant/amp/

On August 29th 2018 our house phone rang at 4 am, we ignored it thinking more than likely it was a wrong number because no one we know would call at that time and if they did for some reason they would leave a message. When the machine picked up the caller hung up without doing so and we assumed just that it was a wrong number. So with my husband and I having only about two hours sleep before getting up to start the day attempted to fall back asleep.

A minute or two later my husband got out of bed for some water and I turned over to get comfortable thats when my cell phone rang. This made me realize something was wrong because the calls were minutes apart and the chances of wrong numbers at both our home and my cell were slim to none.

When I picked up my cell phone the caller ID read “NY state Police Department”, partially baffled and now nervous because what could the state police possibly want or have to say especially at this hour I answered the phone. That is when a conversation that crushed my families life ensued.

“Hello” I said nervously

“This is Sergeant (We will just call him Sergeant) from the New York State Police, I am trying to contact Mrs Dagee am I speaking with her?”

“Yes how can I help you?” a sudden pit formed in my stomach, in no way could this be a non urgent matter.

“Mrs Dagee we found your name in the phone of a Raymond Arlugo stating you were his sister is he your brother?”

“Yes did you find his phone somewhere? I tried contacting him yesterday with no success, he doesn’t have a home phone can you keep it at your station then later we will come pick it up?”

“Mrs Dagee, there has been an incident and we would need you to come to your brothers home immediately if possible”

“At 4 am you need me to come to his home if possible? Why is that? Would you please tell me what this is about? What do you mean by incident?

“Mrs Dagee, I rather not go into details over the telephone, if needed we can have a trooper come and escort you”

TELL ME WHAT HAPPENED!! My voice was now raised due to sheer fear. My brother lived alone with my nephew he lived a quiet life anytime the word incident is mentioned it can be a wide range of things but of course you always think the worst.

I must have been louder than I thought because my husband came running to our bedroom, I rarely raise my voice so he must have been startled as his tone louder than usual asked “Whats Wrong Are You OK?”

I just looked at my husband held my hand up in a “Hold on” type motion, there was a brief silence on the phone that seemed to last for hours when the words I never thought I would ever hear were said.

“Mrs Dagee, we received a phone call earlier about a disturbance in your brothers apartment, when we arrived we found him deceased. We have your nephew with us he is OK but we would need you to verify if this is or is not your brother and take custody of your nephew”.

I will be there in no more than a half hours time, please tell my nephew I am on my way.

I hung up my phone looked at my husband who still unaware of what was said on the phone, had this half scared and half confused expression on his face then I told him.

“You need to get the kids ready for school before work, call my job tell them there has been a family crisis, call Julian’s school tell them he won’t be in today I will speak with the Principle to let them know when he will return.”

“Sam what happened to Ray? I am going to go with you let me call Miss Lazar next door she can get the kids ready for school”

I stood getting dressed without saying a word then turned around looked my husband in the face and told him “No I need to Go Handle this, I will Text you once I know more”

“Sam answer me tell me what is going on now!”

“Elliot Raymond passed away, that was the state Police, they are who called on the house phone. I need to get Julian and I want to do this alone.”

“Samantha I am coming with you, I am calling Miss Lazar”

“ELLIOT I HAVE TO DO THIS ALONE!!”

I kissed my husband, grabbed my car keys then headed towards my brothers home. I was completely numb inside, I know what happened I didn’t need anything official, he had been telling me for months.

“Samantha i’m getting tired”

When I arrived at his home it was like a scene from a TV show, police cars outside, police standing around talking while neighbors looked on from the street. When I got out of my car Julian who thankfully was sleeping at a friends house next door when this took place, ran over and hugged me with all his strength while tears flowed. The Sargent I spoke with on the phone walked over an introduced himself.

Once Julian calmed down a little, he went with a female Trooper who held his hand while the Sargent and I walked up to my brothers second floor apartment. The Sargent warned me to prepare myself but at that point I didn’t need to, I had prepared myself the entire ride over.

There he sat in a chair, head leaned over to one side wearing his good clothes in one hand he held a photo of Julian, in his lap was a photo of us as children and in his left hand a 38 revolver. On the side table next to him was a note that read.

Sam,

“I tried, I am sorry for everything but I am tired more than words can express. I begged the doctors for help, they humiliated me and even laughed when I told them this pain was unbearable. I just wanted to be a Dad to Julian.

Samantha make sure he knows I didn’t leave him to hurt him, I just didn’t want to embarrass him anymore.

Ray”

I know people will say “If he loved his son then he would have stuck it out” but you need to understand what Ray had been through in a short amount of time. When he wrote the words embarrassed its not that Julian ever told him “Dad you embarrass me” that was Ray feeling ashamed of not being able to function on a daily basis to be an active part of Julian’s life.

It was in just an eight year span of time Ray had one medical condition after another without a break in-between.

In 2011 Ray was in an accident that caused a brain hemorrhage that needed emergency surgery. It would be the third cranial surgery of his life, he had two neuro surgeries a few years earlier for epilepsy.

This recovery took almost six months. Once he started feeling better, in 2012 Ray started having pain in the front of his neck. The pain would be dismissed by the dozen different doctors from a primary physician, ENT and Endocrinologist.

It was not until Ray ended up with massive swelling that required him to be placed on an intubation tube did they discover a massive benign tumor pressing against his vocal chords. Then to make matters worse Ray also had Thyroid cancer which caused not only weight gain but an enlarged heart due to viral cardiomyopathy.

Those conditions would be treated in New York City, Ray would finally start being his old self by the end of 2012. There were several months Ray was not only was feeling like his former self but even participating in community activities, coaching Julian’s little league team.

While working on his home in the spring of 2014, the ladder Ray was standing on lost footing and Ray would fall 15 feel onto the concrete. The fall broke his collar bone and fractured his shoulder to the extent reconstructive surgery needed to be done. Which took Ray almost a year to recover from.

Once Ray had recovered from the fall he again went back to his normal life, even while recovering he did things on a daily basis that didn’t require him to use his bad arm, he went to physical therapy and when it came to Julian he made sure he never missed an event be it baseball, soccer or at school.

When an oil slick in the road caused him to lose control of his car in the summer of 2016, Ray broke his left hip. Once again he was back to surgery, physical therapy and life on a daily basis even using crutches he never missed an event when it came to Julian. he had recovered fully from his broken hip by the start of 2017 then started to feel tired all the time.

He would address the tiredness with his primary care physician who would do some lab work and tell him it was nothing but a B-12 deficiency. Every day Ray would got to the doctors office and get B-12 injections until feeling better. The one day while we were all at the park during the summer, Ray cooking on the BBQ grill suddenly collapsed and went into convulsions.

We would call the ambulance, Ray was admitted to the local hospital where they informed us damage from his 2011 accident left underlying damage that had caused him to become an uncontrolled epileptic.

Over the next six months Ray would have continuous seizures until they found the right medicine for him. He had been seizure free for almost five months until one day helping our elderly aunt and uncle clean out a garage Ray went into a Grand-Mal seizure and while doing so fell onto some storm windows opening up a massive cut on his stomach. A large portion of the glass was sticking out and ray needed emergency surgery to have it removed.

The surgery while saved him from any impending immediate danger left an infection that Ray soon was diagnosed with Sepsis. He then was admitted into the hospital to treat the blood infection and a have the infected tissue surgically removed. This would happen to him three times in four months.

A week after being home in June of 2018, Ray with his latest stomach surgery healing from the inside out would have another seizure and fall down. In the fall Ray not only broke his jaw but his front teeth as well. They wired his jaw shut then a dentist removed his teeth that were broken at the gum line.

One night in late June ray sent me a text asking me to pick up Julian because he was in pain and needed to go to the emergency room. I did and Ray went he was diagnosed with chronic pain, told to see his primary physician then prescribed 2 five milligram percocet pills.

When Ray went to his primary physician, (A Doctor I don’t know why Ray continued seeing after he mis-diagnosed him so many times including his cancer) the doctor told him to just take some Tylenol then seek a pain management doctor in the area.

Over the next several months ray had seen five different pain management specialist all of who stated “We Only Treat Orthopedic conditions, the insurance companies only allow us to bill for one condition you don’t meet the guidelines.”

I personally had brought him to several of these doctors, one laughed when reviewing his medical history and told him “Yeah well I guess your out of luck”.

I sought out more doctors and each time it was the same thing “We only treat orthopedic conditions” or “We can do a trigger point injection but only one area we can’t treat your shoulder and hip and jaw”

When I asked why not they would all respond “Because we don’t some relief is better than none take it or leave it”

He was desperate for some relief so Ray would get the injections, yet the pain from all his other conditions grew out of control. He would occasionally go to the ER for some relief, all that did was get him branded a “Drug Seeker” and on occasion he would get one or two pain pills prescribed. Then he would look for another pain management doctor all quick to make an appointment, all quick to give the same answer despite their website stating they treat all conditions.

As summer passed his pain increased, it would become so bad ray laid in bed with tears in his eyes and would ask us to take Julian for a few days so he could play with the kids.

Once August arrived Ray could hardly walk, the pain in his hips, his stomach, jaw and shoulder had become unbearable. He was taking 6000 milligrams of Tylenol to get some relief and he was taking melatonin to get some sleep which by then averaged maybe two hours a night.

When I would go visit Ray and Julian, bring him his mail it would be nothing but bills from doctors who did nothing to help relieve his conditions. His phone rang every hour even more than that from all these doctors who never helped him that wanted their co-pays.

I went to go see ray on August 15th, he could not get out of bed, he had been having seizures because even walking to his kitchen to get his meds was a 45 minute ordeal so he often skipped even attempting to do so. We started having Julian over five out of seven nights a week and when I would bring ray someplace for some help they again treated him like a drug addict.

He had given up even going to see doctors from help by the 22nd of August because the last time he went to the ER by ambulance, they asked him that standard question about “Do you feel like harming yourself” and Ray relied “If I don’t get some sustained relief I am not going to continue living like this”

They stripped him naked placed him in scrubs then called a Psychiatrist because he had to be “In Mental distress”. He spoke with the Psychiatrist in detail and the Psychiatrist told the medical doctor that in his opinion Ray was just suffering from physical pain and needed some help.

They discharged him with a referral to one of the same pain management doctors who had already told us he only did trigger point injections and could not treat several areas “Take some relief because its better than none”

Over the next few days Julian stayed at our house, Ray would call several times a day to speak with him and I would stop over his house several times a day to check on him. he had stopped eating, he would make it to the bathroom then back to bed. He took 3000 milligrams of Tylenol every 2 hours for some pain relief. I would ask him “Ray what Can I do/ Why don’t you come stay with us at the house so you are not alone?”

In response ray would say “No you have your own family, Julian is having a good time there and with me being there it would just remind him of what home is like”.

I called several hospitals, his primary care physician and neurologist for some help on what to do and they all said the same thing “Well there isn’t much we can do call the mental help hotline”

I knew Ray would be angry at me if I did so but I had become worried and called the hotline who only stated “Has he said he is going to harm himself?” When I said no but explained his physical status I was told.

“Maybe he needs some out patient therapy someone to talk with, most of the time this is in their minds and talking gets rid of the pain”

Of course she was probably some volunteer who had no idea about medicine but another call a day later ended in the same result.

On the afternoon of August 27th Ray called and asked for Julian to be dropped off at home, he seemed in good spirits and when I was in the house all he said was “I am in pain but it will be OK I just want Julian home”

When I left I would find out Julian went to go play with some friends outside and one asked if he could spend the night and Ray told him yes. I can only imagine he had already made up his mind and he wanted to spend a night with Julian before he carried it out. Yet because Julian had seen him suffer so long and spent more time in the house due to Ray being unable to function Ray didn’t want to decline Julian an opportunity to have a good time.

I have no idea how long Ray sat looking at the photo of Julian holding that gun before he pulled the trigger. I don’t know why he didn’t call me and why didn’t I insist he came to stay with us.

Throughout all his physical injures and illness, Ray never took prescription pain medicine beyond what was prescribed when it was prescribed so he was not an addict. His body had finally needed something more than Tylenol for comfort.

It was in his medical records Ray had an allergic reaction to NSAIDS, Ray didn’t drink alcohol, he didn’t smoke cigarettes in fact he had no bad habits not even fried or fast food.

I was cleaning out Ray’s house the other day when the phone rang, it was his primary physicians office confirming an upcoming appointment. I said “You are asking about an appointment when the office knows ray passed away?”

“Oh yes I do see a note on the chart my mistake”

She said it as if Ray was no more important than a mistake when ordering the daily lunch special only to realize it was yesterdays special.

An hour later one of the pain management doctors offices called, when I answered I informed them Ray had passed and the woman had the audacity to ask me

“Will you be paying his outstanding balance of $31.74.” She didn’t even offer a half hearted condolence.

Once off the phone with the wretched woman seeking $31.74 for services not rendered I sat looking at a picture or Ray holding Julian and it all hit me at once, I cried like never before uncontrollably.

I wasn’t crying because I miss ray which I do with all my heart, I cried because while I was there to see what he went through on a daily basis it suddenly sunk it what it must have been like to be Ray.

He was a widower, raising a son alone and outside of his medical bills Ray was never in debt. He was never arrested, he attended church every Sunday, he never complained even when the people who were supposedly in a profession to help him didn’t.

He was broken down slowly and not by his physical conditions, ones that alone would have shut down most people let alone combined.

These people laughed at him literally, they called him an addict, yet not one of them have ever suffered his level of pain. They called him mentally unstable, they belittled him as if he was beneath them. Yet Ray while not a doctor of medicine was an educated man with a masters degree in forensic science.

Ray was a proud man who had finally decided he was not going to be treated like that anymore and he was not going to allow himself to be bedridden in front of his son crying in agony.

I don’t know what I could have done to help Ray any further than what I did and I will always blame myself. I look at my nephew and I see Ray in him, Julian stands tall he stood tall at rays funeral he didn’t cry he shook peoples hands as they left he thanked them for coming.

When we try to talk with him about Ray he puts on a front as though it was OK. We brought him to grief counseling but he does the same there. At night I head Julian cry alone in the bathroom, when he opens the door he pretends as if though he has no idea what I am talking about if I as him “Are You OK do you want to talk?”

The only thing someone had to do is help Ray with his physical pain, just admit their limitations if that was the issue. Instead they let him die they might as well have pulled the trigger and done it long before Ray did so at least he would have been spared some agony and kept his dignity.

I am going to tell his story and tell what happened at those visits where they degraded him. I will tell it because Ray cannot and he would not because he was not the type of man who complained.

He deserved better and those who were capable of helping him but didn’t have no shame they are not doctors, there is no excuses. It cost a man his life it broke a family it broke a child before he could even become a man.

WHEN WILL SOMEONE TAKE RESPONSIBILITY FOR THAT OR SHOULD NO ONE BE RESPONSIBLE?

 

RESPONSE TO ROSANNE CONNER’S OPIOID OVERDOSE | A MESSAGE TO ABC

https://youtu.be/Ud7nKLX-pho

RESPONSE TO ROSANNE CONNER’S OPIOID OVERDOSE | A MESSAGE TO ABC

January 1, 2019, new rules for Medicare Part D reimbursement will go into effect

From Red Lawhern, Ph.D.

On January 1, 2019, new rules for Medicare Part D reimbursement will go into effect. These rules authorize insurance providers to conduct so-called “safety edits” when a patient’s prescriptions exceed one of two thresholds.

Pharmacist and Doctor must conduct a safety review and file a special diagnostic code before the pharmacist will be authorized to bill Medicare for filling or renewing any prescription for opioid pain relievers which exceeds a morphine milligram equivalent daily dose of 90 to 200 MMEDD.

Insurance providers are also authorized to deny Medicare reimbursement for any prescription which brings a patient’s opioid dose to 200 MMEDD or more. This denial is subject to an appeal by the doctor, in which the insurer is the sole authority in determining whether Medicare will reimburse.

The natural outcome of this bureaucratic process will be to deny reimbursement for effective pain relief to many of the 1.6 million Medicare patients who are now maintained on 90 MMEDD or more. Many private insurance plans will also implement these restrictions on pain management. More doctors will be driven out of pain management practice. More patients may be driven into suicide by medical or psychological collapse.

I have prepared a petition to the HHS Centers for Medicare and Medicaid, demanding that “safety edit” rules be suspended for at least one year, pending publication of recommendations from the HHS Inter Agency Task Force on Best Practices in Pain Management, to Congress. I hope to send this petition to CMS by Thursday November 1, and I’m working to post the petition and its supporting documents to an archive of my published work where people can read it on-line.

Especially if you have ever been a medical professional or paraprofessional (physician, PA, nurse, psychologist, medical assistant, patient advocate, diagnostic coder, etc), I invite you to send me email at lawhern@hotmail.com to obtain a copy of the petition. If you agree with its content, you can then send me an email titled “endorsement”, with your name and credentials.

I will post a link when I’ve gotten all of the materials of this petition placed in an online archive.

Please join me to inform CMS that they are about to do something grossly stupid and destructive to hundreds of thousands of people.

So now Medicare are granted itself the right to practice medicine… since one of the basics of the practice of medicine is starting, changing, stopping a pt’s therapy.

Also they are using the flawed MME conversion formulas that have same or similar foot notes:

“Published equianalgesic ratios are considered crude estimates at best and therefore it is imperative that careful consideration is given to individualizing the dose of the selected opioid. Dosage titration of the new opioid should be completed slowly and with frequent monitoring. “

Is Medicare setting up a “mine field” for the pharmacists and the prescriber… for a long time the DEA has stated that it is a RED FLAG for a pharmacy to fill a controlled med for CASH when the pt has INSURANCE… because that is what substance abusers/diverters do and everyone knows that whatever substance abuser/diverters do that it has to apply to chronic pain pts.

So pts should expect to be denied to pay CASH for any opiates prescribed above what Medicare allows.

There also seems to be no accommodation for pts who are fast or ultra fast opiate metabolizers that have a medical necessity for higher/more frequent doses. It would seem that Medicare is trying turn the “art of medicine” into the statistical appropriate medication dosing… at least when it comes to opiates.

This is not going to end well for a lot of chronic pain pts, but maybe this is the bureaucracy’s means of cutting the cost of Medicare/Medicaid/SS.  Since the “insurance company” is a for-profit business… could they be held responsible for assisting suicide for pts they refuse to fill above accepted MME/day doses.

 

we must, indeed, all hang together or, most assuredly, we shall all hang separately

See the source image

 

hospice and palliative care doctor arrested – have we hit bottom yet ?

Afzal Beemath, MD

http://doctorsofcourage.org/afzal-beemath-md/

Forty-two year-old internist Afzal Beemath, MD runs a hospice and palliative care clinic in Lathrup Village, MI. On October 23, 2018, he was indicted, arrested, and placed in jail by false accusations for legitimate patient care. His clinic is closed indefinitely. Where do his patients go? Most of them will probably die. When is this country going to wake up and recognize the police state our government has turned into?

Dr. Beemath is a doctor of South African ethnicity who speaks 7 languages. He got his MD at Santiago University of Technology School of Medicine in Chile and did his Internal Medicine residency at Wayne State University School of Medicine. From 2010 he has been the Director of Palliative Medicine at the Detroit Medical Center, building a Palliative Care program through education and consults. He was Director of Palliative Medicine at Sinai Grace Hospital from 2010 to 2013 [their first black Medical Director], Inpatient Hospice Medical Director from 2010 to 2012, and Medical Director of Palliative Medicine at Harper University Hospital in Detroit from 2013 to 2015.

In 2013, he was honored by Patch in an article titled

Dr. Afzal Beemath Helps Patients With Nowhere Else to Turn

highlighting his work in recognition of Black History Month. As stated in the article, Dr. Afzal Beemath, a modern-day community leader and trailblazer, had a life-long dream of becoming a physician and a passion for helping and healing.

In the article, Dr. Beemath explains that palliative medicine is for patients who have a terminal illness, including hospice patients, and provides symptom relief and comfort management. Patients don’t have to go untreated and can still feel healed. “Physicians don’t leave the patient to suffer.”

The director of Palliative Care Development for Vanguard Health Systems (a multi-state hospital empire), Dr. Robert Zalenski, said “For one individual doctor like Dr. Beemath to have brought so much good to so many in a unique and special way is perhaps unparalleled. He has a healer’s gift.”

Dr. Beemath was key in implementing Vanguard’s ICU-PAL initiative, a 16-week screening of palliative care for critically ill patients. He was the first to start and complete it. Dr. Zalenski credited Dr. Beemath for his outstanding work that made the program successful by stabilizing the patients and making them comfortable.

Dr. Beemath stated: “I always had a life-long dream of being a physician.” “It also satisfies that personal craving for helping fellow man.” His compassion shows when he said “There is a lot of heartbreak,” about when everyone can’t be helped.

Beemath offers autonomy and dignity to patients who are often at the end of their lives. Teronto Robinson, an internal medicine resident at Sinai-Grace in 2013, said “Words can’t describe how I feel about Dr. Beemath, He’s known around the hospital as a very upstanding, friendly guy. He’s always looking out for the patient and the family.”

Palliative medicine helps patients instead of turning them away or stringing them along with false hope.

“So what do you do? You take the patients’ hands, who have entrusted their lives to you, and walk with them to the end,” he said. “We don’t just treat them as a number, and we don’t just treat their numbers,” Beemath said.

Dr. Beemath works to educate metro Detroit on palliative medicine and to specifically involve faith groups and clergy. His goal is to extend palliative medicine back to South Africa. Now that is a caring, compassionate physician, not a drug-dealing criminal like the government wants to make him out to be with their indictment and false accusations spread by the media.

Dr. Beemath is also a writer for PubMed. He has 22 articles listed on his LinkedIn page written about various internal medicine topics, which have been cited collectively 1725 times. That is not the work of a drug dealer.

So here you have a doctor whose job is to keep dying people comfortable with pain relief. And now that you know the man before the indictment, look at what the government is trying to paint him to be.  The 15-count indictment was titled

Physician Charged in a $32 Million Illegal Opioid Distribution Conspiracy

In other words, they took all of the medications he has prescribed to his palliative care patients and painted a propaganda picture that they are all being sold on the street. How can these people sleep at night? 

Then the media take the false statements out of the indictment and publish them like they are facts. Things like:

“illegally distribute more than 1 million doses of drugs, especially opioids”
“recruiting ‘patients’” who did not have a legitimate medical need for the drugs. 
“performing a ‘cursory exam’ on patients”

He is also being attacked for running a “cash only” office. Government propaganda against the combination of an opioid and a benzodiazepine is also being spread by the media, although they have been prescribed together for 40 years without problems.

The real evil people in this indictment are U.S. Attorney Matthew Schneider, FBI Agent Timothy R. Slater, and DHHS Agent Lamont Pugh III, Assistant US Attorneys Regina R. McCullough, Brandy R. McMillion, and Andrew J. Lievense.

The Eastern District of Michigan is one of the twelve districts in the Opioid Fraud Abuse and Detection Unit of the DOJ, created by AG Jeff Sessions, that uses PDMP data to target and prosecute doctors.

So basically Dr. Beemath was targeted because he stood out as a high prescriber when the government searched the PDMP for numbers. Then he is an independent minority physician. The recent law, Pub.L. 115-271, formerly known as H. R. 6, will allow the government to target more doctors through these tactics, even though drugs are not the cause of addiction. The attacks on doctors like this does provide job security for the evil ones above, and bring money in to provide their salaries.

So a caring, compassionate physician was arrested and hauled into the local jail. He had a hearing on Oct. 24, but returned to jail to return to court the next day for a detention hearing. At this time we do not know the results of that hearing. It’s possible he is still sitting in a jail cell.

President Trump and Justice Kavanaugh, you don’t have a clue what a witch hunt is, or how lives and families are ruined. But WE do. Dr. Beemath, I hope you’ve already contacted us at Doctorsofcourage, or will when you see this post. There are things we can help you with.

All Doctors:
You need to join us at doctorsofcourage so that we can fight these illegal attacks. If you don’t, the next target might be YOU!!

 

They claim that history keeps repeating ?

Hitler’s secret Nazi program that killed thousands of disabled people

 

Opiate OD’s DOWN because Methamphetamine use/abuse is UP ?

Methamphetamine Roils Rural Towns Again Across The U.S.

https://www.npr.org/sections/health-shots/2018/10/25/656192849/methamphetamine-roils-rural-towns-again-across-the-u-s

The sharp rise in opioid abuse and fatal overdoses has overshadowed another mounting drug problem: Methamphetamine use is rising across the United States.

“Usage of methamphetamine nationally is at an all-time high,” says Erik Smith, assistant special agent in charge of the Drug Enforcement Administration’s Kansas City office.

“It is back with a vengeance.” he says. “And the reasons for that are twofold.” The drug’s now stronger, and cheaper, than it used to be.

No longer chiefly made by “cooks” in makeshift labs in the U.S., methamphetamine is now the domain of Mexican drug cartels that are mass-producing high-quality quantities of the drug and pushing it into markets where it was previously unknown.

But even in rural communities ravaged by decades of experience with the drug, meth is on the upswing thanks to its relatively low price, availability and a shortage of treatment options.

Before it was shut down last summer, this clandestine lab in Mexico’s Baja California was said to be capable of making 200 kilograms of crystal meth daily.

Guillermo Arias/AFP/Getty Images

Southeast Missouri is often called “the Bootheel” because that part of the state resembles a heel-like protuberance into Arkansas.

Locally produced meth started taking hold in the Bootheel in the 1980s, in little towns such as Qulin, where it snared generations of residents like Dustin Siebert.

“I started using methamphetamine when I was 18, 19 years old,” says Siebert, rubbing his tattooed hands. “And, months later — some four or five months — I was helping other people manufacture it. Took over my life,” Siebert says, “like it did just about everybody else in this area.”

Siebert says he’s been off meth for four years, but he says many people in the town of 450 residents have never been able to fully shake it. Amber Windhorst, the school social worker in Qulin, agrees.

“A high number of our kids are affected by drug use in the home,” she says. “Or Mom and Dad have left because they’re out using.”

Windhorst says grandparents are raising many of those kids, but meth use now spans three generations in some families.

“A lot of times we are teaching our children how to survive,” Windhorst says. “Because you have everything that goes with the drugs — lack of food, lack of safety, shelter.”

Not to mention theft, prostitution and a recent outbreak of hepatitis A.

Meth use dipped early this decade after lawmakers cut access to key ingredients — such as the over-the-counter decongestant pseudoephedrine. Siebert says it was about the same time that opioids took hold in the region.

“Now that they’re hammering down on the opiates,” Siebert says, “guess what’s happening? Now the meth is coming back in”

Law enforcement agencies say drug cartels are pumping cheap, potent methamphetamine from “Mexican superlabs” through established distribution networks for heroin and cocaine. Sgt. Mark McClendon, of the Missouri Highway Patrol, says meth is reaching places and people it never did before.

“The meth problem has basically exploded a across every race and social economic class that you can imagine,” McClendon says.

But at least in Missouri, drug policy isn’t keeping up. The state prioritizes opioid addiction over methamphetamine addiction, making intensive treatment for uninsured meth users hard to come by. And, in contrast with opioids, clinicians have no government-approved medications to help treat methamphetamine addiction.

In fact, just about the only response in southeast Missouri seems to be a crop of new, faith-based meth support groups that have sprung up.

“Campbell’s got one, Malden’s got two, Qulin’s got one,” Siebert says. “Poplar Bluff’s got one every night of the week.”

He founded his own group — the Matthew 25 Project. On a recent Thursday night, a little more than a dozen people — a mix of those addicted to meth, some recently weaned off the drug and others just offering support — met in a stark white room at the Qulin Assembly of God church.

Siebert preaches that God made lots of people with addictive personalities but intended them to be addicted to religion.

“We’re supposed to be addicted to him, and the things of the Kingdom,” Siebert tells the small group. He maintains that limiting access to drugs only creates demand for other drugs.

“Because the problem is addiction,” he says. “Until they figure out why people want to get high and use drugs, it’s always going to be something else.”

Siebert says the decades of experience that southeastern Missouri has with methamphetamine should serve as a warning to parts of the country where use of the drug is only now starting to spread.