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“THE DAISY CUTTER”
Posted on November 7, 2023 by Norman Clement
Pharma prescribed opioids to pts with valid medical necessity -0.022% pts OD’d
Posted on November 3, 2023 by Pharmaciststeve
https://www.hrw.org/sites/default/files/report_pdf/hhr1218_web.pdf
I won’t go into a lot of horrific issues in the USA’s history. All the wars that we have gotten involved it or got drug into. All drug overdoses have gone from about 14K to >110K AND GROWING. “They” talk about OD/poisoning from fentanyl, seldom/never mentioning that the fentanyl analog involved is not approved by the FDA, making it ILLEGAL FENTANYL and never mention that there is some 1400 different known fentanyl analogs.
It is pretty much common knowledge where all those illegal fentanyl are coming from, China & Mexican cartels. The “bodies” attached to all those kilotons of illegal Fentanyl is pretty well known. What we don’t know is all the “bodies” attached to the 2016 CDC Opioid dosing guidelines.
Newest attack on chronic pain community by 41 State AGs that is going to be the next large attack on the chronic pain community AGREEMENT
This agreement was apparently made in the spring of 2022, and was not suppose to see the light day, but fortunately someone leaked it, around April , 2023. The body count that this agreement is going to create, could make the CDC’s 2016 guidelines look like something developed by amateurs.
Coroners have in the past, disregarded deaths caused by under/untreated pain, that caused a untold number of deaths that were most likely labeled as “natural causes”. The deaths caused by the forceful tapering of a chronic pain pts pain medications may never be accurately measured.
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Imagine: 14 y/o chronic painer that has already survived 54 surgeries
Posted on November 1, 2023 by Pharmaciststeve
Credit to patient advocate Bob Sheerin
Little Emmalyn has been diagnosed with AA cyst and several auto immunes since 18 months old! She is now 14! She’s had 54 surgeries since birth & 4 brain surgeries just last year and a lumbar surgery in 2023! Sper0 Clinic in Arkansas is offering her placement in the program if $2500.00 can be met for down payment for a February 2024 start date! This program runs 40,000 and so many medical professionals are satisfied this program maybe so helpful to Emmalyns needs! This little lady is the most deserving young warrior and her and her mother fight so hard on both pain patients rights and the legislation side of things! Her personality is so contagious it’s amazing for a little lady that’s in so much pain! As much as she suffers and still finds the time to fight for others is an absolute inspiration to the medical field and to advocates everywhere! Let’s share this and show little Emmalyn her work and her suffering is all part of the plan to help others as well as herself! Plus trust me we want to get her better because she’s one heck of an advocate! #helpEmmalyn #Cppnation #apdf #showingcompassion #fightingtheimpossiblefight #apdfkids #chronicpain #illinoisdoctors
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Profits should not be put ahead of pt & staff mental/physical safety
Posted on October 31, 2023 by Pharmaciststeve
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Narxcare: changing the rules of the game as to who is at risk of overdosing?
Posted on October 31, 2023 by Pharmaciststeve
Now they are ADDING consideration of MOUD (medications for opioid use disorder) and this was a new one on me, but a short web search and I found … Buprenorphine, methadone, and naltrexone brought to us by substance abuse and mental health service administration of our FEDERAL GOVERNMENT https://www.samhsa.gov/medications-substance-use-disorders I guess that Narxcare did not want to leave out those who are in addiction recovery and creating a numerical value assigned to their unintentional overdose risk score.
Another example that DATA is the new GOLD RUSH
Dear Prescription Drug Monitoring Program User,
Bamboo Health is excited to announce new NarxCare functionality within the Prescription Drug Monitoring Program beginning on November 15th! This will be available to users accessing Patient Reports via both PMP AWARxE (web portal) and PMP Gateway (integration).
What’s New?
We’ve created a new version of the Overdose Risk Score, which is comprised of two parts:
- A new unintentional overdose death risk scoring model
- Presentation of key contributing factors to the model’s calculation of the likelihood of unintentional overdose death alongside the model
Why Make These Changes?
Research indicates that contributing factors to unintentional overdose death risk have evolved since launching the initial Overdose Risk Score. In light of these learnings, among other components, the new model:
- Separates MME (morphine milligram equivalent) from MOUD (medications for opioid use disorder)
- Focuses on dispensations within the last 365 days, as opposed to a longer period
The new model also benefits from user feedback obtained during pilot implementations.
In addition, a new tile places all scores and the Additional Risk Indicators in one location. This ensures that the controlled substance-specific exposure scores and overdose risk score model are always displayed together. The tile communicates if the score is below average, average or above average with a graphical display. Key Contributing Factors to the unintentional overdose death risk score model are listed on the right hand side of the tile.
We will make additional detail on the new model available to users in the coming weeks. To learn more about NarxCare, please refer to our knowledge center.
We greatly appreciate your support of the PMP! Please contact Bamboo Health with any questions at https://bamboohealth.com/customer-support/.
Thank you!
The Bamboo Health Team
CAUTION / IMPORTANT REMINDER: Pharmacists and physicians use Overdose Risk Scores as indicators to further review details in the patient’s prescription history as they attend to the patients. Overdose Risk Scores are intended to aid, not replace, medical decision-making. Other patient-centric factors, such as mental health conditions (e.g., depression, anxiety, bipolar disorder, dementia), substance use conditions, respiratory conditions, hepatic and renal conditions, and history of overdose, may influence unintentional overdose death but are not incorporated in the PDMP data used to calculate the Overdose Risk Score. None of the information presented should be used as sole justification for providing or refusing to provide medications.
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PAUL HETZNECKER, ESQ: PRE CRIME AS GOVERNMENT ILLEGALLY INTRUDES INTO PERSONAL MEDICAL RECORDS OF DR. NEIL ANAND, MD WITHOUT WARRANTS
Posted on October 30, 2023 by Norman Clement
FORBES MAGAZINE EXPOSES MASSIVE GOVERNMENT INTRUSION INTO THE PERSONAL MEDICAL RECORDS OF PHILADELPHIA PHYSICIAN DR. NEIL ANAND, MD IN 2020
Posted on October 30, 2023 by Norman Clement
‘Pharmageddon’ is coming: Thousands of pharmacists plot next walkout over work conditions
Posted on October 29, 2023 by Pharmaciststeve
‘Pharmageddon’ is coming: Thousands of pharmacists plot next walkout over work conditions
Workers from some of the nation’s biggest pharmacy chains, from CVS to Walgreens, have planned another “walkout” starting Monday as they continue to plead for better working conditions.
They’re calling it “pharmageddon,” Shane Jerominski, a licensed pharmacist for over a decade who is helping coordinate the latest protest, told FOX Business.
From Monday through Wednesday workers at Walgreens, CVS and Rite Aid have pledged to call in sick, according to Jerominski. It comes on the heels of a protest earlier this month when Walgreens employees at 200 of its nearly 9,000 locations called out sick. Shortly before that, CVS employees in at least a dozen Kansas stores didn’t show up to work in a separate walkout.
Jerominski says workers are demanding a slate of things to ease the onslaught of duties they have taken on in recent years. Some of the biggest demands include guaranteed hours and better pay for technicians. They also want pharmacists and pharmacy managers to have a direct say in the scheduling.
The hope is that these changes will lead to better staffed stores, improve their work-life balance and reduce the margin of error that they say could impact patient safety.
“We are a force to be reckoned with and we demand more from those who would see us and those we care for suffer,” a letter sent to Walgreens staff from organizers of “pharmaggedon” said.
It’s hard to pinpoint how many people will be involved in this latest effort, according to Jerominski. However, according to a poll posted on his social media page, The Accidental Pharmacist, over 2,000 people said, “I’m all for this no matter what.”
An additional 1,442 people said they would as long as “hundreds to thousands of pharmacists and technicians” participate, according to screenshots of the poll seen by FOX Business.
Aside from asking people to call out sick, Jerominski is also trying to organize protests in front of CVS and Walgreens headquarters this week to make their movement more visible.
Jerominski doesn’t consider himself a main organizer of this effort. However, he believes he is in a good position to help given the reach his social media account has and his background working as a pharmacist for Walgreens and CVS before transitioning to an independent retail pharmacy later in his career.
The Accidental Pharmacist Facebook page has 122,000 followers, most of whom are pharmacists, technicians and other health care workers. Jerominksi says he gets direct messages “constantly about working conditions.”
The pharmacist who organized the first Walgreens walkout earlier this month and spoke to FOX Business on the condition of anonymity, previously warned that workers would escalate the matter with a pharmacy-wide protest if their issues weren’t addressed.
The issue is that major pharmacy chains have been unable to effectively staff their stores and pharmacies. At the same time, they have ramped up vaccine appointments, which made pharmacies fall behind on filling prescriptions, according to the pharmacist.
“Our stores are still thousands of prescriptions behind. Our patients are still going days, weeks or even months without their needed medicine. And they’re pretending that there’s not a problem,” the pharmacist, told FOX Business Friday. “Until they acknowledge that there’s an actual problem and work to address the actual problem… we have to keep pushing.”
Jerominksi said he heard about this problem from other workers too. He also reviewed internal documents from some CVS stores, seen by FOX Business, indicating that they have a week’s worth of backlog.
“It could be forever before a patient ends up getting their medication,” he said.
But that’s only part of the problem, according to Jerominski.
“Every time the pharmacist steps away from their filling the checking prescriptions, you introduce the chance for error,” he said.
The pharmacist who organized the Walgreens walkout agrees previously telling FOX Business that, “in an industry where a missed decimal point, a missed number or a letter could mean life or death for a patient, it really becomes a dangerous situation when you’re understaffed and overworked.”
Both the pharmacist and Jerominski said that since the margins are higher on vaccines, they have been the priority.
“It used to be just during flu season, but now it’s all year long, whether it’s COVID boosters or RSV,” Jerominski said.
Amid the growing issues in the industry, a spokesperson for Rite Aid told FOX Business that the company is comitted to “providing safe, productive and supportive work environments for all our associates, including our dedicated pharmacists, who serve our communities by providing vaccines, prescriptions and day-to-day guidance on whole health.”
The company says its efforts over the past few years and in recent months to improve the work-life balance, as well as working conditions for pharmacists, “is evidence of our commitment to the team.”
A spokesperson for CVS said it’s not seeing any “unusual activity regarding unplanned pharmacy closures or pharmacist walkouts” and that it’s working with its pharmacists to directly address any of their concerns.
The spokesperson added that the company is working to develop a “scalable action plan to support both our pharmacists and our customers, that can be put in place in markets where support may be needed.”
Walgreens says it took “a number of steps in our pharmacies to ensure that our teams can concentrate on providing optimal patient care.” This includes enhancing technology and centralizing many of its operations to help maintain “appropriate workloads.”
Still, the company noted that it’s continuing to focus on how it recruits, retains and rewards pharmacy staff.
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Some Walgreens pharmacy workers say they are planning another walkout. Here are their reasons why
Posted on October 23, 2023 by Pharmaciststeve
After the last “Walgreen’s Walkout”, I read some pts making statement(s)… that “their Walgreens was open and no problem getting my Rxs filled”. I doubt if most Walgreens – & CVS – pharmacies are better staffed than others. What pts don’t realize, if the pharmacy corporations expects the staff to routinely work > 100%, the staff will end up creating “short cuts” to try to keep or catch up and those “short cuts” will almost always cause some med errors. While some med errors are caught and never gets to the pts and/or the pt notices the error and never takes the med, but some don’t and the consequences can be quite devastating. Here, but one of those times, where things went drastically WRONG!
Some Walgreens pharmacy workers say they are planning another walkout. Here are their reasons why
Some pharmacy workers at Walgreens, one of the nation’s largest drugstore chains, say they are planning another walkout at the end of October, and organizers are hoping this time the protest spreads nationwide.
Workers have already been staging walkouts in scattered cities to protest working conditions that they say put customer safety at risk. The actions so far this month closed a handful of pharmacies briefly, and slowed business at several others; Walgreens told CNN the impact has been “minimal.”
Now some pharmacy staff and organizers in multiple states have confirmed to CNN that they’re planning another walkout, and picket lines, with a window from October 30 to November 1 to protest staffing levels and other issues.
Shane Jerominski, an independent pharmacist who used to work for Walgreens and is one of the walkout’s organizers, told CNN that he has been working with representatives from unions to plan demonstrations beginning the day before Halloween – a particularly busy time for pharmacy chains as cold and flu season begins and demand for vaccinations soars.
A spokesperson from the United Food and Commercial Workers International Union told CNN that they support the organizers planning a walkout and protests. So does SEIU-United Healthcare Workers West.
“Health care workers and consumers are experiencing unprecedented strain caused by understaffing by health care corporations,” Renée Saldaña, press secretary of UHW-West Health, said in a statement to CNN. “We support all health care workers who are organizing and taking a stance to improve staffing.”
Organizers told CNN that they’re still holding out hope that Walgreens will work with them to reach a solution to problems they say range from understaffing to a rapidly expanding workload to low pay.
In a statement to CNN, Walgreens said about 20 stores out of about 9,000 had “disruptions over three days,” Oct. 9-11. Walgreens walkout organizers told CNN that their tally is much higher, with about 600 employees participating.
Walgreens just named a new CEO, Tim Wentworth, who praised pharmacists during the company’s Oct. 12 earnings call – but made no mention of the walkouts the previous days. Walgreens also announced that it expected to cut at least another $1 billion in costs next year. Shares of the company have fallen over the last year, to about $21 at Friday’s close from $41 in November 2022.
Walgreens did not respond to CNN’s requests for an interview with Wentworth.
Meanwhile, the company told CNN that it won’t “speculate on potential workforce disruptions,” and added that “our ongoing efforts since the onset of the pandemic have included an emphasis on how we recruit, retain, and reward our pharmacy staff.”
Fraser Engerman, senior director of external relations at Walgreens, said the company is aggressively taking steps to address concerns about workloads, wages, hiring bonuses, flexible schedules and creating dedicated positions to manage inventory and administrative tasks for pharmacy teams. “And we’re empowering store and district leaders to pause routine activities during this busy immunization season to focus on the clinical care and services our patients require,” the company said in a statement.
The following three Walgreens employees told CNN their reasons for walking out. All asked not to be identified by name due to fears of reprisal.
While Walgreens declined to respond to their specific points, Engerman added that the company was “regularly listening to feedback and responding, learning, and implementing what we can, when we can, to address concerns.”
‘We’ve had pharmacists leaving in tears’
A pharmacy manager in Oregon knew the pharmacy couldn’t run without him there – so when he called out Oct. 9, the pharmacy closed.
He reopened the pharmacy the next day, he said, because “there’s a lot of people on my staff that want to work, and they need to work.”
But it’s an everyday struggle to manage the pharmacy, he said.”They expect you to do walk-ins on top of appointments for people, so you can imagine how many immunizations. And we’re supposed to look up people’s vaccine histories. And then there’s just one pharmacist, and they have to counsel the patients, they have to take the phone calls from doctors, they still have to fill prescriptions,” he said. (While pharmacy technicians complete many tasks around the pharmacy, they can’t advise on medication.)
“People either walk out of the job or they just don’t show up or quit,” he said. “We’ve had pharmacists leaving in tears and never come back.”
‘It’s exhausting to get yelled at multiple times a day’
A pharmacy technician and immunizer in Wisconsin described her typical day to CNN: “The pharmacy counter has patients lined up to the freezer section of the store, the drive-thru has stacks of cars nearing the neighboring street, 50 prescriptions are waiting to be typed, 650 prescriptions are printed on the filling station, 200 prescriptions are waiting to be verified for sale by the pharmacist, dozens of warehouse totes filled with medication are waiting to be put on our shelves, hundreds of rejected insurance claims are needing to be resolved, hundreds of prescriptions are overdue, dozens of patient care calls are overdue, hundreds of out-of-stock medications are needing attention, dozens of prescriptions are needing to be mailed, dozens of prescriptions are needing to be prepared for DoorDash and dozens of prescription requests are sitting in the message queue.” And the pharmacy is expected to act much like “a fully-functioning vaccination clinic.”
“We are failing every day to meet our patients’ needs and they do not hesitate to let us know,” she said. “It’s really exhausting to get yelled at multiple times a day and then have to help the next customer with just a smiling face,” she said. But she doesn’t blame customers for being angry.
“It’s the work environment, it’s the way that the industry is built, that disappoints all of us. The bottom line is that we’re not servicing these customers to our fullest capabilities and the reason is that we’re overwhelmed.”
‘We don’t want raises; we want help’
A pharmacy technician in Oklahoma walked out during the last protest because she felt like there was no other option.
Her team cares deeply about their customers, she told CNN. She even had a coworker who came in the day after her father died because “she didn’t want us to suffer or the patients to suffer,” the technician said.
The walkout, she explained, came from that same place of extreme care.
“If we could get one thing out of this, it would be for Walgreens HR to realize that we are severely understaffed for the workload they expect us to do,” she said. “It puts our physical and mental health at risk, and most importantly it puts our patients in danger. One individual is going the work of four. We don’t want raises; we want help.”
For all of this, she makes about $16.50 an hour; “I’m only making $1.50 more than our 16-year-old cashier,” she said.
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IMAGINE: chronic pain pts in the VA system increasing use of MJ to treat their pain?
Posted on October 23, 2023 by Pharmaciststeve
When you consider who funded this study – Funding for the study was provided by the National Institute on Drug Abuse, the New York State Psychiatric Institute, and the VA Centers of Excellence in Substance Addiction Treatment and Education
Could one expect any sort of different conclusion that the one that those conducting this study came to? Does this suggest that chronic pain should not be treated and/or any treatment of chronic pain is considered a “use disorder”?
Cannabis Laws Linked to cannabis use disorder in Adults With Chronic Pain
https://www.medscape.com/viewarticle/997414
TOPLINE:
Enactment of medical and recreational cannabis laws in the US has been associated with an increase in the prevalence of cannabis use disorder (CUD), with particularly steep increases noted among older adults with chronic pain, a study of US veterans shows.
METHODOLOGY:
- To study a reported increase in the prevalence of CUD among adults with chronic pain, researchers assessed the effect of medical cannabis laws (MCL) and recreational cannabis laws (RCL) on the increase in the US Veterans Health Administration (VHA).
- They analyzed 15 repeated cross-sectional VHA electronic health record datasets from 2005 to 2019; 3.2 to 4.6 million patients were included per year.
- Patients were stratified by chronic pain status using validated criteria.
TAKEAWAY:
- Overall, the associations of MCL and RCL with CUD prevalence were greater among patients with chronic pain compared to those without the condition.
- Enacting MCL led to a 0.135% absolute increase in CUD prevalence among patients with chronic pain, 8.4% of which was directly attributable to MCL, vs a 0.037% absolute increase in CUD among those without chronic pain, 5.7% of which was attributable to MCL.
- Enacting RCL led to a 0.188% absolute increase in CUD prevalence among patients with chronic pain, with 11.5% of the total increase due to RCL, vs a 0.042% absolute increase in patients without chronic pain, 6.0% of which was attributable to RCL.
- Introducing RCL was associated with the greatest increases in CUD prevalence among patients aged 65–75 years with chronic pain.
IN PRACTICE:
“When developing cannabis legislation, unintended consequences should be considered, including increased risk of cannabis use disorder in large vulnerable subgroups of the population such as patients with chronic pain,” the authors write. “The national increases in cannabis use disorder prevalence, including the disproportionate increase among those with chronic pain, underscore a growing need in the VHA and elsewhere to screen for cannabis use and offer evidence-based treatments for cannabis use disorder,” they add.
SOURCE:
The study, with first author Deborah Hasin PhD, Columbia University Irving Medical Center, New York, was published online October 11 in The Lancet Psychiatry.
LIMITATIONS:
Patients in the VHA differ from the general population in that most are White men, and many are in the older age group (65–75 years). No subject pain measure or cannabis use measure were available.
DISCLOSURES:
Funding for the study was provided by the National Institute on Drug Abuse, the New York State Psychiatric Institute, and the VA Centers of Excellence in Substance Addiction Treatment and Education. Hasin has disclosed no relevant financial relationships. A complete list of author disclosures is available with the original article.
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