Chronic pain drives millions of Americans to suicide: CDC report reveals rise in patients with cancer, arthritis, and back pain taking their own lives

Posted on September 24, 2018 by Pharmaciststeve

https://www.dailymail.co.uk/health/article-6152779/Chronic-pain-drives-millions-Americans-suicide.html

  • CDC researchers analyzed suicide data on 18 states between 2003 and 2014
  • They found the rate of people with chronic pain taking their own lives went up
  • Firearm-related injuries were the most common cause of death in all suicide cases, but more common among pain patients than those without pain
  • Researchers say this shows a clear need for suicide prevention for pain patients, even if they don’t seem at risk 

Chronic pain from cancer, arthritis, and other conditions drives millions of people to suicide every year, a new report warns. 

The mortal implications of pain have been widely discussed in recent years since the opioid epidemic showed painkillers can drive anyone to overdose, whether intentionally or not. 

But a new report by the CDC warns overdoses account for a minority of deaths among people who suffer from chronic pain. 

In recent years, the number of chronic pain patients intentionally taking their own lives has soared, with most cases committed using a firearm. 

The researchers warn their findings highlight that suicide prevention should be a fundamental element of care for chronic pain patients, especially when their treatment involves highly-addictive, potentially lethal drugs. 

CDC researchers analyzed suicide data on 18 states between 2003 and 2014. They found the rate of people with chronic pain taking their own lives went up (file image)

CDC researchers analyzed suicide data on 18 states between 2003 and 2014. They found the rate of people with chronic pain taking their own lives went up (file image)

Pain is a daily reality for at least 25 million Americans, according to national data. At least 10.5 million suffer severe pain on a daily basis. 

New data compiled by researchers at the Centers for Disease Control and Prevention, published today in the journal Annals of Internal Medicine, hammer home why there is more to it than habitual discomfort.

Looking at just 18 states between 2003 and 2014, lead author Emiko Petrosky and colleagues found 123,181 people had committed suicide. A staggering nine percent of them (10,789) had been battling chronic pain, particularly from things like arthritis, cancer and back pain.

It was a connection that became stronger and stronger over the years. In 2003, 7.4 percent of suicide cases were tied to chronic pain. By 2014, that figure had risen to 10.2 percent.     

Firearms are the most common cause of death for all suicides in America, but this study shows it is more common for people with pain (53.6 percent) than those without (51 percent). Meanwhile 16.2 percent of pain patients who committed suicide died by overdose.

The study also found chronic pain patients were more likely than others to have been diagnosed with anxiety and depression, and were much more likely than to have opioids in their system at the time of their death than those who were not suffering from pain (whether the drugs were a cause of death or not).

Writing in an editorial released in tandem with the study, Dr Mark Ilgen, of the department of psychiatry at the University of Michigan, says the findings show a clear need to ‘raise hope in persons with chronic pain’.

‘Suicide prevention involves making effective pain interventions more available,’ he says, but warns that that is, clearly, not enough. 

These interventions, Dr Ilgen explains, ‘extend beyond providing access to opioids and should also include, if appropriate, other medications, interventional programs, physical therapy, and psychosocial approaches.’ 

‘These pain-related interventions need to be supplemented with mental health treatment in persons with pain and depressive and anxiety-related symptoms to foster hope and help address suicidal thoughts and plans.’ 

  • For confidential support in the US, call the National Suicide Prevention Line on 1-800-273-8255 
  • For confidential support in the UK, call the Samaritans on 116123 or visit a local Samaritans branch, see www.samaritans.org for details. 
  • For confidential support in Australia, call the Lifeline 24-hour crisis support on 13 11 14

Does this report suggest that the war on drugs and substance abusers has/is causing chronic pain pts to commit suicide because of their unrelenting, unbearable pain ?  Where is the media with their outrage of all of these otherwise preventable deaths.. as you do with substance abuser who die from a OD ?

Has the deaths/suicides of those in the chronic pain community became ACCEPTABLE to our society while we try to prevent those who abuse some illegal substance OD are so unacceptable that our society is pulling out all the stops in an attempt to prevent those OD’s… and yet the number of deaths are increasing both by chronic pain pts committing suicides and substance abusers that are ODing

where is the OUTRAGE by the media and the families of those who are committing suicide and/or ODing from using/abusing an illegal substance ?

Perhaps this suggests where the media and others “fighting the war on drugs”  has their “head”

Filed under: General Problems | 18 Comments »

The Link Between Drug Policy and Access to Medicines

Posted on September 23, 2018 by Pharmaciststeve

The Link Between Drug Policy and Access to Medicines

https://www.opensocietyfoundations.org/explainers/link-between-drug-policy-and-access-medicines

How does drug control policy undermine access to medicines?

Virtually all governments have laws and regulations that control the public’s access to substances judged to be potentially harmful. Some of these controlled substances may have medical or scientific uses, yet they are inaccessible to people who could benefit from them. The result is that tens of millions of people suffer because they lack access to essential medicines.

What is the impact on people’s health?

Some 75 percent of the world’s population—about 5.5 billion people—live in mostly low- and middle-income countries in which effective pain-relieving medicines are largely inaccessible.

For instance, more than five million terminal cancer patients and one million end-stage AIDS patients suffer from severe pain every year. Still others are forced to upend their lives to access the medicines they need—two-year-old Tristan Forde suffered 20 seizures a day until his family moved from rural Ireland to Colorado to legally access the medical marijuana that finally eased his suffering.

Many of these patients could benefit from morphine, the gold standard for the treatment of severe pain. Morphine is not expensive, but many governments severely limit its use. Over 90 percent of all morphine is used in a small number of high-income countries that are home to only 17 percent of the world’s population.

Does drug control policy affect access to medications used for mental health as well?

Yes. Numerous psychotropic medicines, antidepressants, and a wide range of antipsychotic medicines are unavailable to millions with psychosocial disabilities. Medicines prescribed to treat addiction are outlawed in some countries, or so tightly regulated that they are available to very few. Medicines that block psychotropic effects of illegal drugs are prioritized as treatment over those that may be more effective and affordable, but are deemed to have a potentially mood-altering effect. 

How does drug control policy affect research into new medicines?

Drug policy can undermine research that could uncover the medical value of many substances. For example, cannabis and related compounds known as cannabinoids have been shown to treat childhood epilepsy, and relieve pain and nausea associated with cancer and chemotherapy. But the use, sale, and production of medical cannabis remain overly regulated or even unlawful in many countries, and research on their benefits restricted.

Some indigenous peoples have centuries-old traditions that involve ritual or therapeutic use of plant-based psychotropics, including psychedelic substances such as ayahuasca and peyote. Research into the medical benefits of these substances is similarly nonexistent or heavily restricted in most countries.

Aren’t these controls necessary for governments to protect the public from substances that could harm them?

Harmful drug use is certainly a public health problem, but in many countries, drug control policies lean too heavily towards limiting access to medicines for which patients have a legitimate and urgent need.

Of particular concern is access to opioid medicines, such as morphine, oxycodone, hydrocodone, and codeine, all essential medicines for the treatment of pain which are often heavily restricted. Methadone and buprenorphine (also opioid medicines) are essential for treatment of both pain and opioid dependence, but are grossly underused and overregulated.

Ketamine is considered by the World Health Organization (WHO) to be an indispensable anesthetic in low- and middle-income countries. Despite this, China has led global efforts to heavily restrict or even eliminate it, due to its hallucinogenic properties and potential for recreational use.

Who sets the guidelines for how these medicines are controlled?

The vast majority of countries are party to three United Nations drug conventions, which are meant to guide national decisions about which substances should be controlled. The UN is also meant to guide countries in determining whether or not a substance has medical or therapeutic use, and how to ensure availability of controlled substances for licit medical use.

The drug conventions designate WHO as the expert agency for determining the medical value of psychotropic substances, but too often WHO’s opinion is challenged because of security concerns, sometimes misguided.

Why don’t more political leaders and medical professionals challenge these policies?

Many factors conspire to keep controlled medicines inaccessible:

  • Drug control authorities may not be adequately informed about the practical safeguards that can keep controlled medicines in the health system from being diverted to illicit use. 
  • Policymakers, health professionals, and the general public may harbor misinformed fears of addiction, or prioritize control of medicine supply over treatment for those in need.
  • Physicians may fear prosecution under wide-ranging drug laws if they prescribe a controlled medicine that is somehow diverted. 
  • Health professionals may have to jump through so many onerous drug-control hoops—heavy paperwork requirements, limits on the prescription amount or duration, the need for special licenses—that they decide to avoid using controlled medicines altogether. 

In many places, nonuse or underuse of controlled medicines simply becomes an entrenched reality: medical school curricula stop teaching on the subject of controlled medicines, and policymakers are inexperienced in crafting measures to meet the challenge of balancing drug control and access to medicines. In addition, drug manufacturers may compound these barriers by pressuring countries to purchase the most expensive formulations of controlled medicines, and health authorities may be unaware of affordable options.

What can be done to improve access to controlled medicines?

The UN General Assembly Special Session on drug control in 2016 urged governments to adopt balanced drug control policies that could be achieved in part by establishing a strong national authority to estimate the level of need for and ensure availability of controlled medicines, ensure adequate training for health professionals on their use, and establish effective but not unduly repressive antidiversion measures.

These measures are unlikely to succeed, however, unless the governance of drug control policy is also “balanced,” with health and social sectors on par with—and not dominated by—the security and policing sectors.

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Using the UN Human Rights System to Advocate for Access to Palliative Care and Pain Relief

Posted on September 23, 2018 by Pharmaciststeve

Using the UN Human Rights System to Advocate for Access to Palliative Care and Pain Relief

https://www.opensocietyfoundations.org/voices/ukraine-investigates-health-care-abuses-torture

Toolkit cover

In late 2014, Kseniya Shapoval received a phone call from a young woman named Oksana in Western Ukraine. Oksana’s grandfather, suffering from terminal cancer, was discharged from the hospital three days before his death without pain medication. He died crying in agony. 

Oksana wanted to make sure no one else suffered the way her grandfather did, so she contacted Shapoval after hearing about her work on palliative care with the International Renaissance Foundation, Open Society’s foundation in Ukraine.

Shapoval investigated the situation, and realized further scrutiny was required to understand why Oksana’s grandfather had inadequate access to pain medication.

Thanks to Ukraine’s formal monitoring mechanism, Shapoval was able to take action.

In 2013, the UN Special Rapporteur on Torture found that severe abuses in health care settings amount to cruel, inhumane, and degrading treatment, and even torture. The Special Rapporteur further pointed out that denial of care is also an issue—for example, denial of essential pain relief medications (including morphine or opioids) due to an inadequate supply of medications, or policies that prioritize drug control over patients’ rights.

Ukraine has applied this novel approach to patient rights. It draws upon the state’s obligations under the Convention against Torture and Optional Protocol to prevent acts of torture and other cruel, inhuman, or degrading treatment.

Specifically, the Optional Protocol introduces a system of independent national monitoring bodies collectively known as the National Preventive Mechanism (NPM). The NPM is mandated to conduct regular visits to places where persons are deprived of their liberty. Crucially, the phrase “places where persons are deprived of their liberty” is interpreted more broadly than places of detention, and includes a range of closed facilities. 

Dr. Andrey Rohansky, trained as both a doctor and a lawyer, brings a unique perspective to the challenges surrounding patient rights in his role as executive directive of the Institute of Legal Research and Strategies. Rohansky joined forces with Shapoval and human rights advocates to argue that closed health facilities—where a person is not free to leave—amount to places where people “are deprived of their liberty.”

In 2014, the Ukrainian NPM agreed, and further stipulated that palliative care patients need special rights protection. The NPM determined that palliative care hospices can conditionally be interpreted as places of detention due to the high degree of control exercised over patients’ living conditions.

Around the time of Oksana’s call, the NPM embarked upon its first monitoring visit to a closed health facility. Shapoval and Rohansky joined the group as civil society experts.

At Shapoval’s proposal, the NPM conducted a monitoring visit to Oksana’s grandfather’s hospital in Western Ukraine. The visit revealed a number of significant issues including weak prescription and discharge protocols, which resulted in patients frequently being discharged without pain medication. The NPM official report and recommendations for the hospital were submitted to the Ministry of Health and local government.

A follow-up NPM visit was conducted in March 2015, revealing the district health department had responded to the report and recommendations. This response included terminating the employment of the doctor overseeing the hospital, and conducting training for doctors on prescriptions, record keeping, and pain management for discharged patients.

Proving itself to be a valuable tool for patient rights, the NPM has now monitored eight closed facilities and has followed up with reports and recommendations. This innovative use of the NPM has the potential to improve conditions at a systemic level, and uphold the dignity of the sick and most vulnerable in society. 

Ukraine Applies Anti-Torture Standards to Health Care

Elderly woman with her face in her hands

A woman sits on a bed in the main hospital in Debaltseve, Ukraine, in March 2015.Photo credit: © Vadim Ghirda/AP

In late 2014, Kseniya Shapoval received a phone call from a young woman named Oksana in Western Ukraine. Oksana’s grandfather, suffering from terminal cancer, was discharged from the hospital three days before his death without pain medication. He died crying in agony. 

Oksana wanted to make sure no one else suffered the way her grandfather did, so she contacted Shapoval after hearing about her work on palliative care with the International Renaissance Foundation, Open Society’s foundation in Ukraine.

Shapoval investigated the situation, and realized further scrutiny was required to understand why Oksana’s grandfather had inadequate access to pain medication.

Thanks to Ukraine’s formal monitoring mechanism, Shapoval was able to take action.

In 2013, the UN Special Rapporteur on Torture found that severe abuses in health care settings amount to cruel, inhumane, and degrading treatment, and even torture. The Special Rapporteur further pointed out that denial of care is also an issue—for example, denial of essential pain relief medications (including morphine or opioids) due to an inadequate supply of medications, or policies that prioritize drug control over patients’ rights.

Ukraine has applied this novel approach to patient rights. It draws upon the state’s obligations under the Convention against Torture and Optional Protocol to prevent acts of torture and other cruel, inhuman, or degrading treatment.

Specifically, the Optional Protocol introduces a system of independent national monitoring bodies collectively known as the National Preventive Mechanism (NPM). The NPM is mandated to conduct regular visits to places where persons are deprived of their liberty. Crucially, the phrase “places where persons are deprived of their liberty” is interpreted more broadly than places of detention, and includes a range of closed facilities. 

Dr. Andrey Rohansky, trained as both a doctor and a lawyer, brings a unique perspective to the challenges surrounding patient rights in his role as executive directive of the Institute of Legal Research and Strategies. Rohansky joined forces with Shapoval and human rights advocates to argue that closed health facilities—where a person is not free to leave—amount to places where people “are deprived of their liberty.”

In 2014, the Ukrainian NPM agreed, and further stipulated that palliative care patients need special rights protection. The NPM determined that palliative care hospices can conditionally be interpreted as places of detention due to the high degree of control exercised over patients’ living conditions.

Around the time of Oksana’s call, the NPM embarked upon its first monitoring visit to a closed health facility. Shapoval and Rohansky joined the group as civil society experts.

At Shapoval’s proposal, the NPM conducted a monitoring visit to Oksana’s grandfather’s hospital in Western Ukraine. The visit revealed a number of significant issues including weak prescription and discharge protocols, which resulted in patients frequently being discharged without pain medication. The NPM official report and recommendations for the hospital were submitted to the Ministry of Health and local government.

A follow-up NPM visit was conducted in March 2015, revealing the district health department had responded to the report and recommendations. This response included terminating the employment of the doctor overseeing the hospital, and conducting training for doctors on prescriptions, record keeping, and pain management for discharged patients.

Proving itself to be a valuable tool for patient rights, the NPM has now monitored eight closed facilities and has followed up with reports and recommendations. This innovative use of the NPM has the potential to improve conditions at a systemic level, and uphold the dignity of the sick and most vulnerable in society.

Filed under: General Problems | 1 Comment »

OHIO: Pharma opiate OD’s lowest in 8 yrs… Total opiate OD deaths – EIGHT YEAR HIGH !

Posted on September 23, 2018 by Pharmaciststeve

Fatal drug overdoses in Ohio increase to record number

A review of the data shows fentanyl continued to fuel the drug epidemic

https://www.wkbn.com/news/ohio/fatal-drug-overdoses-in-ohio-increase-to-record-number/1468760131

COLUMBUS, Ohio (AP) – Information reported to the state shows fatal drug overdoses increased to a record 4,854 last year in Ohio, a 20 percent rise compared with the previous year.

The Columbus Dispatch reports data on unintentional drug deaths reported to Ohio’s Department of Health show 2017 was the eighth year in a row that drug deaths increased. Ohio’s county coroners logged 4,050 fatal overdoses in 2016.

A review of the data shows fentanyl continued to fuel the drug epidemic. The synthetic opioid accounted for nearly three-fourths of last year’s overdose deaths.

A state Health Department spokesman says there was progress in reducing the number of prescription opioids available for abuse. Reported fatal overdoses from prescription opioids last year totaled 523, the lowest number in eight years.

 

 

 

 

 

 

 

 

 

This report is like a Magician … what you see … challenges what you don’t see..  While legal opiate prescriptions are down as are OD deaths from those particular drugs … but what they are not talking about is the increase in use/abuse of Meth, Cocaine, Crack, Marijuana and other substances.  We are now seeing reduced use/abuse of illegal Fentanyl analogs and Heroin because substance abusers are not necessarily STUPID… they are seeing how LETHAL the mixture of Heroin and a illegal Fentanyl analog that is being sold on the street is… so the typical substance abuser will chose to abuse what is in vogue, is the most available or the least expensive.  But what is not being talked about much is that illegal Fentanyl analogs is now starting to show up in Cocaine that is being sold on the street.

Will the politicians/bureaucrats be able to do what seems to be the “simple math” that legal prescribing of pharma opiates has little/nothing to do with the use/abuse/OD’s of various legal and illegal opiates ? Color me skeptical !!!

Filed under: General Problems | 6 Comments »

This is from FLORIDA… part of the world’s best healthcare system ?

Posted on September 22, 2018 by Pharmaciststeve

Image may contain: one or more people and closeup

I didn’t go to ER I went to walk in clinic so but I still think walk in clinics can write a prescription for pain medication if they wanted to. I didn’t ask for any either but they didn’t offer any.

Image may contain: one or more people and closeup

 

Filed under: General Problems | 8 Comments »

The CDC and their fabricated data ?

Posted on September 21, 2018 by Pharmaciststeve

A little CDC.gov forced honesty from their new report released 8/31/18:

Opioid deaths:
14,487 out of a total of 325.7 million people in the US died in 2016 from LEGAL PRESCRIPTION opioids.
That’s .000004% of the population! Now why is there a hysteria over PRESCRIPTION opioids?

Good question!

Especially when alcohol related deaths are
88,000 of 325.7 million. That’s a much BIGGER number!!
Yet… No hysteria over alcohol

1.3 million people are injured with 35,000 that die in car wrecks per year. Just to give you a reference. A WAY BIGGER number. No hysteria over that. (edited.)

Hmmm. 🤔

Maybe it’s because this is how they reported opioid deaths to the media:

‘Drug overdose deaths in 2016 reached a NEW RECORD HIGH.’
‘Drug Overdose Mortality:
A RECORD NUMBER of drug overdose deaths occurred in 2016: 63,632,
A RECORD 19.8 PER 100,000 PERSON’S.’
(19.8/100,000 is still only .0001% but it looks BIGGER reported this way.)

Sounds like everybody is dying from opioids doesn’t it? Now why did they say 66,632 died when I said 14,487 up top? That’s a BIG difference!

Well…CDC combined LEGAL, law abiding citizen prescription opioid deaths, with ILLEGAL heroin, cocaine, and fentanyl deaths!
Why would anybody want to DO that?
It’s kind of misleading isn’t it?
Well…it makes a BIGGER NUMBER.

Where’s all the hysteria and ‘crisis’ for the 1,300,000/325,700,000 each year DYING of car wrecks!!? I can make that sound awful! And it is! But it’s still only .003% of the population and people have decided it’s worth the RISK:BENEFIT RATIO to drive. And the government lets them.

Because of the way the CDC reported opioid deaths, and others’ agendas, a wildfire of hysteria resulted, causing disabled by pain patients to lose their opioid medicine, their ability to function, their dignity as they are treated like drug addicts, and any quality of life. Imagine an Ice cream headache 24/7/365 covering different parts of your body. You can’t think with this type of ceaseless pain. You want to die.

This is something that is personal and each person has to decide the risks they take in life. Risks are everywhere, and people have to decide if something is worth the benefit. It’s called ‘informed consent’ when you know of the risk before you take it.

Shouldn’t people in agonizing pain be able to decide if the RISK:BENEFIT RATIO of .000004% is worth the benefit of being able to get out of bed and function? Work? And not want to die from tortuous pain?

Doesn’t make sense, single moms are facing homelessness as they can no longer work due to unbearable pain, MS, lupus, etc etc; also Vets who risked their lives for our country with painful injuries, now lie there wanting to die. Elderly people lie there sobbing with NO RELIEF, day after day, wishing they would die. Where’s the hysteria over that?

We have no voice. People/media listen to those in power. Not the multitudes suffering at their hands. Please share the TRUTH.

ALL the above information can be found here: Where things are in context. A LOT harder to get information here than in the hysteria promoting news. And they’re counting on that apparently.

Reference CDC.gov 2018 ANNUAL
SURVEILLANCE REPORT OF DRUG-RELATED RISKS AND OUTCOMES

Filed under: General Problems | 5 Comments »

emergency room she was denied any pain medication ..even during debridement

Posted on September 21, 2018 by Pharmaciststeve

Image may contain: one or more people, food and indoor

Image may contain: one or more people and food

Image may contain: one or more people

For people who think that the refusal to treat pain is just for chronic pain patients and they don’t feel that they shouldn’t help fix this issue. she got severely burned on her arm and went to the emergency room she was denied any pain medication while she was there and was sent home with nothing and was also was not given anything for When they did the debridement. So if you think this problem won’t affect you think again

Filed under: General Problems | 37 Comments »

$100K per year of life gained: CVS’ move to let insurers cap drug prices sparks intense controversy

Posted on September 21, 2018 by Pharmaciststeve

$100K per year of life gained: CVS’ move to let insurers cap drug prices sparks intense controversy

https://www.advisory.com/daily-briefing/2018/09/21/drug-prices

Amid an industry-wide debate on how to stem drug price increases, CVS launched a new program to allow self-funded insurers to deny coverage for certain treatments deemed too expensive—a move that is sparking intense industry debate, Vox reports.

Infographic: 5 ways to control the flow of drug expenditures

About the CVS program

Under the program, CVS allows self-funded insurers—such as large employers—to exclude coverage for prescription drugs if the list price is above $100,000 for every quality-adjusted year of life gained, according to the Institute for Clinical and Economic Review’s (ICER) quality-adjusted life-year (QALY) metric.

However, the new coverage denial policy would not apply to any drug FDA designates as a “breakthrough” therapy, Vox reports.


Get 4 pharmacy-led tactics to reduce employee benefit costs

The program is intended to give insurers a tool to reduce drug spending, according to Vox. CVS in an August report said the program aims to “put pressure on manufacturers to reduce launch prices to a reasonable level.”

In a Health Affairs blog post published Monday, Troyen Brennan and Surya Singh of CVS wrote, “Until now, PBMs such as CVS Health have had no ability to impact the initial launch price of a drug, which is set solely by the manufacturer, seemingly without regard to the inherent value of the medication or what the payer or patient can afford.”

Industry criticizes proposal

However, CVS’ program is drawing criticism from industry stakeholders. Robert DuBois of the National Pharmaceutical Council in a dueling Health Affairs blog post published Monday criticized the program’s use of a single cost-effectiveness metric to assess the value of a medication. “To fully assess the value of a treatment, stakeholders must account for other considerations important to patients,” such as whether the drug is designed to treat a previously untreatable illness, DuBois wrote.

He also took aim at CVS’ $100,000 threshold, arguing that ICER’s value framework does not consist of a single metric for determining which treatments are cost-effective, but has a variable threshold (sometimes $100,000, other times $150,000). He argued that the single $100,000 threshold does not take into account the full economic value of a treatment, such as increased productivity or reductions in caregiver burdens.  

Dubois added that the program’s exclusion of specific drugs based on QALY fails to account for the varying ways patients react to medications. As a result, Dubois said a drug’s exclusion from coverage would not reflect the drug’s full value to all patients.

Which side is right?

Walid Gellad, an expert on prescription drug policy at the University of Pittsburgh, called the debate between CVS and industry a “good” one, because “there really isn’t a right answer.”

Gellad explained that rising drug list prices has left health system stakeholders with few options to restrain costs and that similar programs are likely to appear in the future. Already, Vox reports Veterans Affairs has begun using ICER’s quality assessments to decide whether to cover specific drugs. Gellad said, “Something like this is the inevitable future. Nothing else is talking about launch prices. Some version of this is where everybody is heading.”

However, Gellad said there are definitely flaws with CVS’ program, namely the use of a single metric to determine the value of a drug. “The idea that we base something solely on a cut point determined by one cost effectiveness analysis from ICER is a big step to take. It’s like a giant step forward when you don’t really know how to walk yet,” Gellad said (Scott, Vox, 9/17; CVS report, August 2018).

Five ways to control the flow of drug expenditures

Prescription drug expenditures are the fastest growing component of health care spending. And while reducing unwarranted prescribing variation is the single biggest improvement opportunity, there are several other near-term chances to reduce spending and grow revenues.

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Local chronic pain sufferers protest opioid restrictions at the capitol

Posted on September 21, 2018 by Pharmaciststeve

https://www.channel3000.com/news/local-chronic-pain-sufferers-protest-opioid-restrictions-at-the-capitol-1/796876048

On Tuesday morning, a group of people gathered in the Wisconsin capitol rotunda to tell their stories of chronic pain and protest guidelines the Centers for Disease Control and Prevention has put on opioids in an attempt to stop the addiction epidemic.

Dr. Mandira N Mehra – Reviews

Pain Medicine Madison, WI   https://www.vitals.com/doctors/Dr_Mandira_Mehra/reviews 

3.3 Stars – out of a possible 5.

Dr Mehra is correct pain management is a give and take… they give LITTLE and TAKE A LOT !

 

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AG Session: sizable number of physicians who were over prescribing opioid pain pills, which were not helping people get well

Posted on September 21, 2018 by Pharmaciststeve

Utilizing the palliative care “loophole” in chronic pain management

www.medium.com/@aaronsells/utilizing-the-palliative-care-loophole-in-chronic-pain-management-6a25611a6f21

The DOJ is successfully escalating angst among general practitioners, who are already reluctant to prescribe narcotics above guidelines, (that were established by the CDC), out of fear of being targeted as outliers by the DEA. In turn, many patients with intractable pain are forced to, “make due”, with what pain medication they are prescribed, and tension runs high between appointments as their doctors push for even further tapering.

Attorney General Jeff Sessions announced in January that over the next 45 days, a “surge” of Drug Enforcement Administration agents and investigators will focus on pharmacies and prescribers who are dispensing unusual or disproportionate amounts of opioid drugs.

The U.S. Drug Enforcement Administration has arrested 28 people and revoked the registrations of over a hundred others in a nationwide crackdown that targeted prescribers and pharmacies that dispense “disproportionally large amounts” of opioid medication.

For 45 days in February and March, a special team of DEA investigators searched a database of 80 million prescriptions, looking for suspicious orders and possible drug thefts.

The so-called “surge” resulted in 28 arrests, 54 search warrants, and 283 administrative actions against doctors and pharmacists. The DEA registrations of 147 people were also revoked — meaning they can no longer prescribe, dispense or distribute controlled substances such as opioids.

The DEA said 4 medical doctors and 4 medical assistants were arrested, along with 20 people described as “non-registrant co-conspirators.” The arrests were reported by the agency’s offices in San Diego, Denver, Atlanta, Miami and Philadelphia.

In an interview with AARP, Sessions defended the use of data mining to uncover health care fraud.“Some of the more blatant problems were highlighted in our Medicare fraud take down recently where we had a

sizable number of physicians that were over prescribing opioid pain pills which were not helping people get well,

but instead were furthering an addiction being paid for by the federal taxpayers. This is a really bad thing,” Sessions said.“It’s a little bit like these shysters who use direct mail and other ways to defraud people. They will keep doing it until they’re stopped. In other words, if we don’t stop them, they will keep finding more victims and seducing them.”

As a growing trend of doctors across America voluntarily leave pain management, their patients are left without medical care. From there, the sick and disabled get bounced back to primary care. General practitioners, no longer in the business of treating pain, can only offer referrals but rarely communicate or follow up with their colleagues to facilitate a comparable continuity of care. These limitations have been further aggravated, through an effective surreptitious recruitment campaign organized by Dr. Andrew Kolodny, Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management, christened PROP (Physicians for Responsible Opioid Prescribing). Armed with government propaganda, Prop docs function as the CDC mouthpiece and have infiltrated teaching universities, medical schools, CME courses,and large HMOs. There they double down and intentionally disseminate biased misinformation, present flimsy evidence as a matter of fact that, more often than not, aggregates chronic pain and addiction. Is there any way around this patient-doctor dilemma?

In an interview with AARP, Sessions defended the use of data mining to uncover health care fraud. “Some of the more blatant problems were highlighted in our Medicare fraud takedown recently, where we had a sizable number of physicians who were overprescribing opioid pain pills, which were not helping people get well, but, instead, were furthering an addiction, [all] being paid for by the federal taxpayers. This is a really bad thing,” Sessions said. “It’s a little bit like these shysters who use direct mail and other ways to defraud people. They will keep doing it until they’re stopped. In other words, if we don’t stop them, they will keep finding more victims and [keep] seducing them.”
As a growing trend of doctors across America voluntarily leave pain management, their patients are left without medical care. 
From there, the sick and disabled get bounced back to primary care. General practitioners, no longer in the business of treating pain, can only offer referrals, but, they rarely communicate with, or follow up with, their colleagues to facilitate a comparable continuity of care. These limitations have been further aggravated through an effective, surreptitious

recruitment campaign organized by Dr. Andrew Kolodny, Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management, christened PROP (Physicians for Responsible Opioid Prescribing). Armed with government propaganda, Prop docs function as the CDC mouthpiece, and have infiltrated teaching universities, medical schools, CME courses, and large HMOs. There, they double down and intentionally disseminate biased misinformation, present flimsy evidence as a matter of fact that, more often than not, aggregates chronic pain and addiction. 

Is there any way around this patient-doctor dilemma?

The answer might be as simple as a physician order for palliative care — a treatment option already covered by CMS and most private insurance. You can have it at any age and any stage of an illness, but, early on in your illness is recommended.
Palliative care, (pronounced pal-lee-uh-tiv), is specialized medical care for people with serious illnesses. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age, and at any stage in a serious illness, and it can be provided along with curative treatment¹

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