how many thousands of legit chronic pain pts thrown to the curb with this raid ?

Posted on July 3, 2018 by Pharmaciststeve

I am an avid reader of your post and articles. I am a 59 year old man with progressive stage III Adhesive Arachnoiditis living in Indian Mound, TN where I recently moved from Mt Pleasant, SC to live with my 32 year old son is stationed at Ft Campbell, Kentucky. I also recently completed robotic surgery to remove cancer cells from my kidney and surrounding organ tissue. I moved here in this past January where I was fortunate to meet Dr. Kroll with CPS (Comprehensive Pain Specialist) located in Clarksville, TN. 

I was Blessed to have located a very compassionate Doctor and staff for my pain management needs from 34 years of dealing with pain. 

I was notified today that ALL CPS Pain management offices in Tennessee are closing as of July 31, 2018. My understanding is that these offices are owned by one of the Tennesse Senators or lawmakers here in TN. I am new to the are this past 6 months so I am not up to speed with verification of this fact. However it is noteworthy and something I feel needs attention. 

No referral information for other Pain Management Doctors or Clinics were provided. 

My experience with both my doctors, (Dr Peter Kroll and Dr. Rebekah Pierce) as well as the Staff here at the Clarksville, TN office has been first class. So I was a bit shocked to receive this news with no recommendations or referrals to help in relocating to another PM operation. They are working with me to transfer my records to my PCP and they are still performing a Nerve Ablation procedure on July 25. 

 

I am 59 years old with very serious conditions:

Post operative Cancer 5-21-18

Stage III Adhesive Arachnoiditis

Chronic Pancreatitis 

And a number of other very pain related conditions. 

Now I am faced with locating a new PMP by July 31, ALONG WITH All the patients from what I believe is over 6 offices in TN.

From what I have read to date, no lawmaker was involved in the Medicare fraud scheme revealed this past April,  that possibly led to the closing of ALL CPS pain management operations.

 

My Concern:

There are literally thousands of Chronic Pain patients now displaced from their doctors, with no help or direction being provided to ensure there is no disruption of life saving medications that provide a modest quality of life. I am Blessed to have a son in the Army to help me get around to locate a new PMP. However, I am among thousands of patients now looking for a new PMP here in Tennessee where PMP are already overloaded with patients. It seems clear that with the closing of all of these offices across the state, the Tennessee Pain Management network of physicians here in TN quite possibly will not be able to take in these thousands of displaced patients. 

The lack of knowledge resources and referral resources is astonishing. Thousands of Chronic Pain Patients are now faced with very real fear and anxiety of trying to locate a new PMP in an already overburdened and limited PMP resource here in TN. Recent laws and new guidelines now directed at Chronic Pain patient care in Tennessee have already pushed an already unstable Chronic Pain care network even further into an abyss that is going to very quickly manifest into intolerable stress levels in the newly displaced population of Chronic Pain patients that may very well lead to countless deaths among the TN Chronic Pain community. Some from suicide from patients that finally give up on the TN healthcare system, and then patients that do not have a family support system to help navigate themselves to what Chronic Pain Physicians still exist in TN. It is a given that the vast majority of now displaced patients will be forced to go through an indefinite time period with NO pain medication. ALL Chronic Pain patients are already living with the minimum dosage of pain medication possible because of the abuses of state governments that have avoided, either unintentionally or intentionally, the serious needs of Tennessee Chronic Pain Patients. 

People keep getting displaced and thrown out of what may have been years or decades of pain management care by physicians that now have little empathy for displaced Chronic Pain Patients that are from all walks of life. This is heartbreaking. Where is the outrage from Mothers, Fathers, Sisters and Brothers being separated from critical medication and doctors that help provide dignity and a reasonable quality of life for the elderly, disabled and helpless. 

You see outrage about Children being temporarily separated from their parents all over TV. 

But virtually no real coverage OR outrage at Parents, Sons, Daughters and disabled being placed in jeopardy of real life and death situations because of the lack of adequate pain management. How many here in Tennessee will now die, either from suicide or reactions from being cut off from powerful medications that can clearly result in death among the weak and disabled. 

Thank you Steve for reading this and hopefully passing on any advice for the thousands of displaced Chronic Pain patients now in Tennessee.

It is a real shame, because the doctors that treated and managed my Chronic Pain management needs, Dr. Peter Kroll and Dr. Rebekah Pierce were among the best physicians I have ever been Blessed to have in my Life. I feel their lives have probably been turned upside down almost as much as the patients they treated with Compassion and Care. I believe it is CPS itself that has made the decisions now affecting both the doctors and patients soon to be FORMER Doctors and Patients.

IF IN FACT, a senior Lawmaker here in TN is the owner of all CPS locations in the state of TN. Then that Lawmaker should face serious scrutiny into how the closing of these facilities are being handled. VERY serious scrutiny. 

I located this information from the BBB:

GOVERNMENT ACTION

The following describes a pending government action that has been formally brought by a government agency but has not yet been resolved. We are providing a summary of the government’s allegations, which have not yet been proven.

According to information on file with BBB, on April 4, 2018, the United States Department of Justice and the Assistant United States Attorney for the Middle District of Tennessee issued an indictment on John Davis, former CEO of Comprehensive Pain Specialist. Mr. Davis is charged with one count of conspiracy to defraud the United States and pay and receive health care kickbacks in conjunction with a Federal Health Care Program, and seven counts of paying and receiving health care kickbacks. This matter is still pending. For more details click here: https://www.justice.gov/usao-mdtn/pr/two-tennessee-health-care-executives-charged-role-46-million-medicare-kickback-scheme

 

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@CVS Health/Caremark/Silver Scripts screwing pts on Medicare Part D ?

Posted on July 3, 2018 by Pharmaciststeve

https://www.wsj.com/articles/cvs-exploits-pbm-role-and-taxpayers-pay-1529956036

http://www.arkansasmatters.com/news/local-news/lawmakers-pharmacists-meet-with-cvs-over-regulation-of-pharmacy-benefit-managers/985681024

https://insurancenewsnet.com/oarticle/pharmacy-middlemen-reap-millions-from-medicaid

My wife and I  have Silver Scripts Part D health insurance… which the PBM is Caremark… which is part of CVS Health.. My wife has a lot of chronic health issues and one of the medications that she has been taking for over 10 yrs I was trying to get refilled and Silver Scripts wanted – once again – a prior authorization for something that they have been paying for … for over 10 yrs..  They told me that the copay – if they approved it – would be $600 and change… for a 90 days supply which is constantly increasing…

I asked the pharmacy that I patronized what they cash price was and was quoted the figure $300 and change…  I went out to www.goodrx.com and found a local pharmacy that would charge $87 and change for the same prescription.

If I had the pharmacy that I normally go to fill the prescription and billed Silver Script… I would have been charged $600 and change and they would have reimbursed the pharmacy for far less and claw back the difference  http://www.pharmout.com/pharmacy-insights/pharmacy-clawback-issue

This prescription is a controlled substance C-IV medication… so now she is throwing a “RED FLAG” according to the DEA for paying cash for a controlled substance when she has insurance.   Is Caremark putting Medicare Part D pts in a compromising position… pay their INFLATED COPAYS or run the risk of becoming a target of the DEA for throwing RED FLAGS ?

Silver Scripts is the 2nd or 3rd largest part D provider … for seniors and disabled on Medicare.

This year, apparently Silver Scripts decided to have “preferred pharmacies” which only they were able to charge the copays that Silver Script charged everyone last year…  just so happens there is only 10 preferred pharmacies in Clark-Floyd-Harrison counties – 8 of them being CVS stores and one independent in Jeffersonville & Corydon.  This year, our out of pocket expenses have jumped some 30%+ because the closest preferred pharmacy is over 9 miles away and the independent pharmacy that we use will deliver to us…. If we are not able to get out.

I don’t know if some/many at HHS, CMS or members of Congress are asleep at the switch or just turning a blind eye to what is going on.

I have taken my own advice that I regularly handout and  have filed a grievance/complaint with CMS (800-MEDICARE) and I have just begun.. When these entities have screwed with others… I can only make a recommendation as to what they can/should do… but now  I HAVE SKIN IN THE GAME…

 

 

 

steve

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How Florida’s new opioid-prescription law affects you

Posted on July 3, 2018 by Pharmaciststeve

How Florida’s new opioid-prescription law affects you

http://www.theledger.com/news/20180702/how-floridas-new-opioid-prescription-law-affects-you

As Florida’s new law on opioid prescriptions went into effect Sunday, patients seeking relief from pain may find there have been changes in what they are prescribed, dosages and physicians who will treat them.

LAKELAND — As Florida’s new law on opioid prescriptions goes into effect Sunday, patients seeking relief from pain may find there have been changes in what they are prescribed, the dosages they are given and perhaps even in the physician who will treat them.

The most publicized part of the law is the limiting of opioid prescriptions to three days, seven days if a physician documents that it is medically necessary, for people with intense pain from surgery, a traumatic injury or an acute illness. Patients with such acute pain will have to be reassessed by a physician to get a refill at the end of a three-day or seven-day prescription.

Patients with chronic, long-term, debilitating pain, including those with cancer pain and those needing palliative and end-of-life care, are not limited to the three-day or seven-day prescriptions.

Recognizing that drug overdose is the leading cause of accidental death in the United States, the Florida Legislature enacted the complicated law in an effort to reduce addiction from opioid medications. The intent is to encourage physicians to prescribe the lowest dosages that will take the edge off intense pain or to use alternative medications and therapies.

Emergency department physicians and surgeons have already been working to reduce the use of opioids, said Dr. Timothy Regan, an emergency medicine physician who is chief medical officer for Lakeland Regional Health.

There is general recognition that a past trend encouraging physicians to try to eliminate pain has led to over-prescribing, which fueled the opioid epidemic, Regan said.

The federal government has changed verbiage hospitals must use when patients are asked about their hospital stay, Regan said. The question used to be how well have they controlled your pain; now the question is have they talked with you about your pain.

“This allows prescribers to address pain control in a more conservative way” rather than encouraging over-prescribing, Regan said.

Chronic-pain patients who have been using opioids, such as for back pain or knee pain, should still be able to get their medications, but they might see some differences under the new law.

“We have been educating our patients in advance,” said Dr. John Ellington, who is in charge of risk management at the 200-physician Watson Clinic in Lakeland. Posters explaining the law have been up at the clinic’s various facilities and the clinic’s website posted an article explaining the law, he said.

The law requires physicians to go through several steps when prescribing opioids for chronic pain, and some physicians may not want to go through all those steps and take the risk of making a mistake that could end up with a censure or, for flagrant violations, a criminal charge, Ellington said.

“Will some doctors not prescribe opioids at all? Certainly,” Ellington said. Although, he added, most physicians likely will make adjustments to their practices and continue to prescribe.

In order to prescribe opioids, physicians, osteopaths, dentists, optometrists, podiatrists, nurse practitioners, physicians and others who are allowed to prescribe controlled substances must:

‒ Register with the federal Drug Enforcement Agency.

‒ Complete a two- or three-hour course on prescribing.

‒ Register under their medical license that they treat chronic pain.

‒ Document the patient’s pain and make a written plan for treating the pain.

‒ Check the state database to see whether there are other narcotic/opioid prescriptions for the patient.

‒ Check the patient’s photo ID against the medical records.

‒ And enter the prescription into the state database by the end of the next business day.

“A lot of people may feel uncomfortable doing that,” Ellington said. Some might decide to no longer prescribe opioids, even to long-term patients with chronic pain. They might refer them to a pain management clinic for treatment.

Regan said that pain management specialists likely will see a spike in business because of the referrals. However, pain management specialists are trained in not just narcotic medications but also in alternative medications and alternative therapies, which might end up being in the best interest of the patient, Regan said.

Dr. Francisco Chebly, medical director of the large Lakeland Regional Health Physician Group, said that if a doctor has been comfortable writing prescriptions, the new law should not be a major obstacle.

“It is a little bit of an extra step” to check the database, “but should not cause a deterrent.” Chebly said. “It is only a matter of a few seconds to log in” to the database.

“A doctor should be aware if a patient has been doctor shopping” in an attempt to obtain extra narcotics, Chebly said.

Regan said that Lakeland Regional is working to incorporate access to the database with its electronic records system, making it easier for doctors to check whether a patient has other opioid prescriptions.

Patients should be aware their doctor will ask them more questions, but it’s not because their doctor doesn’t trust them, Regan said. “Physicians are being held accountable to prescribe in a responsible way, and patients should be aware of that.”

The law also addresses what pharmacies must do to check the legitimacy of prescriptions and ensure a patient is not being sold multiple narcotics from a variety of prescribers.

“There is nothing about this law that means legitimate patients cannot get legitimate medicine for legitimate reasons,” Ellington said.

Correction: Dr. Francisco Chelby’s name was originally misspelled in this story. This online version has been corrected.

Marilyn Meyer can be reached at marilyn.meyer@theledger.com or 863-802-7558. Follow her on Twitter @marilyn_ledger.

 

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How to meet the new TN opiate dosing guidelines for IDIOTS

Posted on July 3, 2018 by Pharmaciststeve

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Another Pharm-deity hell bent on saving addicts – how many will end up committing suicide ?

Posted on July 2, 2018 by Pharmaciststeve

‘Black Hawk Down’ veteran now deployed in fight against opioids

http://www.foxnews.com/us/2018/07/02/black-hawk-down-veteran-now-deployed-in-fight-against-opioids.html

An Army veteran who fought in the Battle of Mogadishu and later was portrayed in the film “Black Hawk Down” is now deploying on a new mission: the war against opioids.

Former Delta Force operator and Master Sgt. Norman Hooten has obtained his doctorate’s degree in pharmacy and says he is making the jump to the medical field to help fellow veterans who are suffering.

“I lost a couple of close friends that died of drug related overdoses and they were really good guys – special operations guys,” Hooten said in an interview with the Department of Veterans Affairs last week. “Losing my fellow soldiers to substance abuse was almost as bad as losing them in combat. All their talent and potential was lost and I wanted to do something about it.”

Hooten on Friday completed his residency at a VA hospital in West Palm Beach, Florida, and is now part of the staff at one of the VA’s facilities in Orlando.

Hooten first wanted to pursue a career in medicine in August 2001 when he retired — but he was soon recalled to active duty after the 9/11 terror attacks. He was deployed to Afghanistan, before spending eight years with the Federal Air Marshal Service and then working as a contractor in Jordan. In 2012 he headed back to medical school to complete his studies, the VA says.

“It’s never too late to make a difference and go back to learn and grow,” Hooten said. “You should give back until your last dying breath. I started [pharmacy] school at 52 and at 57 I’m finishing up my residency.”

Hooten said during an Army event in 2013 that one lesson he took from the Battle of Mogadishu was to be creative and adapt to any situation.

“Train like you fight,” he said. “Don’t train like you think you’re going to fight. Don’t train like you want to fight. Do a real good analysis of the enemy, because he’s 50 percent of that equation, and then train like you will fight. Get used to being creative and adapting to the enemy’s actions.”

Now he is telling the VA that he “can’t stand idle while veterans suffer with addiction.”

“If I can help just one veteran, or have just one call me later to tell me that I was able to help them get off opioids, then that would be tremendous,” Hooten said.

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Is there something in the water in TENNESSEE ?

Posted on July 2, 2018 by Pharmaciststeve

“You do what you can to survive.” Linda and Larry Drain got married in 1981, but when Linda’s eligibility under Medicaid was threatened, they were forced to either separate or lose her benefits. Now they live 40 minutes away from each other in low-income housing.

 

Filed under: General Problems | Leave a Comment »

more RHETORIC ??? when is the chronic pain community going to see some POSITIVE ACTION ?

Posted on July 2, 2018 by Pharmaciststeve

Chronic pain patients, overlooked in opioid crisis, getting new attention from top at FDA

https://amp.usatoday.com/amp/727015002

The Food and Drug Administration is working to address how the opioid epidemic response has affected chronic pain patients, who often can’t get relief.

Tough state laws on prescribing that took effect Sunday, Centers for Disease Control and Prevention (CDC) dosage guidelines and state and federal charges against doctors who prescribe opioids are an overreaction to addiction, according to several dozen people with unremitting pain who contacted USA TODAY. 

CDC researchers said in an article in April in the American Journal of Public Health that they overestimated the number of Americans who have died of prescription opioid overdoses. Because of inaccurate tracking methods, the CDC said it incorrectly counted many overdoses from illicitly manufactured synthetic opioids such as fentanyl as prescription drug deaths. 

The CDC had estimated 32,445 Americans died from overdoses involving prescription opioid pain medication in 2016. The CDC’s new estimate of fatal overdoses from prescription opioids is 17,087, or 53 percent of the original estimate.

Even though state laws say chronic pain patients who need medication will receive it, “that’s not what’s happening,” says Lauren Deluca of Worcester, Massachusetts, who founded the Chronic Illness Advocacy & Awareness Group last year after her own challenges getting the opioid painkillers she needed. 

The Food and Drug Administration (FDA) is trying to undo some of the damage through a host of actions that include a public meeting July 9 on chronic pain drug development and the challenges pain patients face in getting the treatment they need. 

Moriah White of Braxton County, West Virginia, calls herself an “opioid war casualty” and said she welcomes any help the government is willing to offer. She had to leave a job teaching special education because of the condition fibromyalgia, which makes her skin feel like “a sunburn scrubbed with a wire brush.”

Danny Elliott’s pain doctor was charged last week in a “takedown” in Florida and Georgia of 600 doctors accused of health care fraud and illegal opioid prescribing by Justice Department and Drug Enforcement Administration officials. The former pharmaceutical industry salesmen was electrocuted in1997, which left him with a traumatic brain injury that was so painful he contemplated suicide. He is trying to find a new doctor. His previous one was the first “who actually gave me some relief from my pain.”

DEA Miami Field Division Deputy Special Agent in Charge Jaime Camacho said last week that the agency is “committed to ending the opioid crisis that continues to plague Florida and endanger the welfare of our communities.”

Clinical psychologist Michael Schatman, editor in chief of the Journal of Pain Research, who describes himself as an “opioid moderatist,” said about 90 percent of people are better off without opioids.

White House anti-opioid ads target teens, adults

But it’s the 10 percent who need them that are terribly harmed by policy and enforcement actions pushed by groups he said are “radically anti-opioids.” 

“For years, federal and state legislators did nothing, leaving it up to state medical boards and the regulatory agencies, which was the problem,” said Schatman, research director at Boston Pain Care, which has treated hundreds of patients without an overdose or suicide. “Now all of a sudden, state legislators are passing incredibly draconian laws that are and have the future potential to literally kill people.” 

He cited laws, such as one that took effect July 1 in states including Florida, that tighten regulation of doctors who prescribe opioids and other controlled substances. End-stage cancer patients and the elderly don’t have long enough to live to become addicted and  suffer needlessly because of the law, Schatman said.

Florida House Speaker Richard Corcoran, who attended the bill signing, defended the approach, according to the Orlando Sentinel.

“Is that an inconvenience? Yes,” said Corcoran. “Is an inconvenience worth saving 50,000 lives nationwide? Absolutely.”

That attitude has led some doctors whose patients have had no problems with opioid prescriptions to back away from prescribing them. Schatman said there’s a big difference between depending on opioids to survive and becoming addicted to them. 

Cathy Mitchell, a disabled registered nurse, suffers from a long list of injuries and diseases, including osteoarthritis, post-major lumbar surgery for ruptured discs, cervical scoliosis and bilateral carpal tunnel syndrome.

Disabled since 2013, she said only opioids provide the pain relief that allows her to “function daily.” 

She has to go to a pain clinic every 28 days and her primary care doctor every three months. After 10 years of being treated for  pain and anxiety “without causing any problems,” Mitchell can no longer be treated for both.

Making matters worse for what’s estimated to be millions of patients, the Centers for Medicare and Medicaid Services plans to drop coverage of opioid medications above a certain dosage starting next year. 

Elsewhere at the Department of Health and Human Services, the FDA’s plans include encouraging medical device development for pain and hosting a drug development meeting July 9 that focuses on how hard it is for patients with chronic pain to get treatment and what solutions exist. 

“The reality is that the opioid drugs work for certain patients, and there are certain situations where the opioids are the only drugs that work for those patients,” FDA Commissioner Scott Gottlieb said. 

The FDA’s success will be tested by the fact that physicians are largely policed by states and that even as opioid prescriptions go down, overdose deaths increase as many suffering from addiction have moved on to heroin, often in combination with other drugs. The FDA recommended that doctors reduce opioid prescriptions, but doctors and their medical societies remain opposed. 

State medical boards have been especially aggressive in some states going after the licenses of doctors for overprescribing opiate painkillers. 

Chronic pain patients across the country said that when physicians lose their license or stop treating pain patients, it can be difficult, if not impossible, to find a new doctor willing to take them on as a patient. 

In Virginia, then-Governor Terry McAuliffe boasted on a panel in October that the state led the nation in reductions in opioid prescribing, including a drop of a third in the prior six months. Doctors aren’t allowed to prescribe or refill a prescription for opioids for longer than 10 days without a written explanation. 

Two years ago, the state medical board suspended the license of Jenny Austin’s primary care doctor.

Austin, a former investment banker, had to take so much time off from work for crippling pain from migraines and a neurological disorder, she sought a higher dose of painkillers. She continued to see her Virginia doctor even after she moved to Louisiana, because she was “desperate to find a solution that would reduce my hospitalizations.”  

Instead, she’s out of work and bedridden much of the time. 

To help remedy this, the FDA is considering encouraging medical professional societies to develop evidence-based guidelines on appropriate prescribing and the possibility of incorporating new prescribing information on opioid painkiller labels. 

Schatman is skeptical the efforts will make much difference, in part because he said “there’s no empirical evidence that apps and other ‘medical devices’ can improve the quality of pain medicine in the United States.”

“The opioid pendulum has swung awry,” Schatman said. “This current climate of opiophobia is … leaving patients more dysfunctional, with diminished quality of lives, severe hopelessness and increasing suicidality in the chronic pain patient population.” 

 

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As seen on the WEB !

Posted on July 2, 2018 by Pharmaciststeve

Federal judge is taking testimonials from Pain patients he can order an injunction stopping the government from further restriction of opioids must have all comments by July 17th

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Filed under: General Problems | 12 Comments »

What Every Patient Should Know About NarxCare

Posted on July 1, 2018 by Pharmaciststeve

What Every Patient Should Know About NarxCare

www.painnewsnetwork.org/stories/2018/5/19/what-every-patient-should-know-about-narxcare

Walmart and Sam’s Club recently announced that by the end of August their pharmacists will start using NarxCare, a prescription tracking tool that analyzes real-time data about opioids and other controlled substances from Prescription Drug Monitoring Programs (PDMP’s).

Recent studies question the value of PDMP’s, but 49 states have implemented them so that physicians, pharmacists and insurers can see a patient’s medication history. Granted, there is a need for monitoring the select few who doctor shop and/or abuse their medications, albeit that number is only in the 2 percent range.

What is NarxCare? Appriss Health developed NarxCare as a “robust analytics tool” to help “care teams” (doctors, pharmacists, etc.) identify patients with substance use disorders. Each patient is evaluated and given a “risk score” based on their prescription drug history. According to Appriss, a patient is much more willing to discuss their substance abuse issues once they are red flagged as a possible abuser.

“NarxCare automatically analyzes PDMP data and a patient’s health history and provides patient risk scores and an interactive visualization of usage patterns to help identify potential risk factors,” the company says on its website.

“NarxCare aids care teams in clinical decision making, provides support to help prevent or manage substance use disorder, and empowers states with the comprehensive platform they need to take to the next step in the battle against prescription drug addiction.”

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www.apprisshealth.com/solutions/narxcare/

Sounds great doesn’t it? Except prescription drugs are not the problem and never really have been. Illicit drug use has, is, and will continue to be the main cause of the addiction and overdose crisis. 

Even the name NarxCare has a negative connotation. “Narx” stands for narcotics. And in today’s environment, narcotics is a very negative word. NarxCare makes me feel like a narcotics police officer is just around the corner.

Each patient evaluated by NarxCare gets a “Narx Report” that includes their NarxScores, Overdose Risk Score, Rx Graph, PDMP Data and my favorite, the Red Flags. The scores are based on the past two years of a patient’s prescription history, as well as their medical claims, electronic health records and even their criminal history.

Ohio, Michigan, Indiana, Iowa, and several other states are using NarxCare to supplement their own PDMPs. And Walmart isn’t the only big retail company to adopt it. Kroger, Ralphs, Kmart, CVS, Rite Aid and Walgreens are already using NarxCare. There’s a good chance your prescriptions are already being tracked by NarxCare and you don’t even know it.

But NarxCare doesn’t just analyze opioid prescriptions. It also tracks other controlled substances, such as antidepressants, sedatives and stimulants. If a patient is on any combination of those drugs, their risk scores and their chances of being red flagged will be higher – even if they’ve been safely taking the medications for years.

There are several other ways a patient can be red flagged, such as having multiple doctors or pharmacies. But what if you moved and changed physicians? What if you had the same physician for many years and he/she retired or moved away? What if your pharmacy refused to fill your prescription and you had to go pharmacy hunting every month? What if you had dental surgery and your dentist placed you on a short-term pain medication?

Unfortunately, the NarxCare scores do not reflect any of that. How can raw data on prescription medications be an indicator of abuse? I believe there is some merit in tracking and weeding out the rare abuser, but NarxCare doesn’t factor in all the “what if’s” that can happen to law-abiding and responsible patients. 

As pain patients, we need to be acutely aware of the negative impact this analytics tool can have. Many of us have already been required to sign pain contracts, take drugs tests, and undergo pill counts. In 2019, Medicare will adopt policies making it even harder for patients to get high doses of opioid medication. Some insurers are already doing it. We’re already being policed enough as it is.

I intend to ask my physician, pharmacist and case manager if they utilize NarxCare. So should you. If they say yes, ask them why. Ask your doctor if they believe you are at risk for substance use disorder. Why is their judgement and treatment of you being second guessed by anyone?

This is the same company that sold a “bill of goods” to a number of states on using their database on the sale of Sudfed ( pseudoephedrine) used in making Meth.  The first time I used it … I said out loud … this is a stupid system… it won’t work… there is no validation of the driver’s license and once a person got a fake driver’s license past one pharmacist/tech… all you had to do was put in the driver’s license number and all the rest of the data lines auto filled .. and the Rx dept staff dropped into confirmation bias mode… and if the correct time had lapsed since the last purchase… it was approved to sell..  So the person with multiple fake driver’s license move on to the next pharmacy … gave them a different license and bought more… it took the state of Indiana several years for the legislature to figure this out and get out of the program and implement a new law.. that is slowing down the sale of Sudafed, but all along.  about 80% of meth was being imported from Mexico… so if nothing else it reduced the number of local meth labs.

I have heard all to often from pts about pharmacist being all about “the numbers” … this is just one more step for the corporate pharmacy chains to rescind the pharmacist’s professional discretion and dictate if this system shows certain data/parameters… the pharmacists is to refuse to fill.. won’t make any difference if the data is wrong or the artificial intelligence (AI) behind the determination is faulty…  all of these factors means “just say no”…..

Just imagine, all the sensational national news reports you have heard about these new self driving cars…  a few have crashed, one hit a pedestrian dressed in dark clothing walking across a unlighted multiple lane road at night…  How many cars crash in California.. how many make national news – all that is made by TELSA… that have semi-autonomous drive capability. At last count I think that the total TESLA fatal car crashes is 3 or4 and everyone made national news.

When this AI algorithm fails… it won’t make national news… because it will just be a denial of care… it will just be potentially throwing a pt into cold turkey withdrawal. The AI failures may never even be recognized because there will be no immediate/direct body count to make sensational national news ?

Since this appears to be a drive mostly by the chain pharmacies… this is just another good reason to move all your prescriptions to a independent pharmacy… where the pharmacist/owner may or may not be using it.. .but.. it will be his/her professional discretion as to believe what this AI program determines is red flags or not red flags and won’t have some corporate edict and threat of being fired if they don’t follow the corporate edict to the letter … no matter what their own professional opinion tells them is the right thing to do…

Here is a website to help anyone find a independent pharmacy by zip code https://ncpa.org/pharmacy-locator

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We are going to start seeing falling numbers of opiate OD’s

Posted on July 1, 2018 by Pharmaciststeve

Over the next year, we are going to see the number of opiate OD’s starting to slowly decline.. .and the bureaucrats are going to “shout from the rooftops” that Narcan has saved all of these lives and the forced reduction in legal opiate prescriptions was the other reason.

To a certain degree, that may be true for those addicts who got a hold of some mixture of illegal Fentanyl analog and Heroin and wasn’t aware of its potency and Narcan may have saved their ass and taught them a valuable lesson.. but.. did it solve their addiction problem and convinced them to get sober… maybe a few percent.

They are just going to find some other “safer” substance to abuse..  marijuana, alcohol, methamphetamine, cocaine, crack for starters and will probably be poly-substance abusers.  After all typically the current OD will have 4 to 7 substances show up in their toxicology..

I don’t see the bureaucrats understanding the real reason behind this drop in OD’s and will continue to push for less and less legal opiate prescribing for pain.. don’t want to go down that path again ?

What are they going to blame as the “gateway drug” for the substances that will end up being abused… alcohol is a legal product and Methamphetamine & Cocaine are legal prescription products… but.. little to none is prescribed to pts.

But if there is not a decrease – or only a slight decrease in OD’s – could be from the suicides of chronic pain pts who can’t stand their pain any longer and decide to put a final end to their pain.  But if they use their existing pain opiates … most likely their deaths will be labeled as a “opiate related death” if a opiate shows up in their toxicology.

Doing nothing more than providing more fodder for the bureaucrats to keep pressing for fewer and fewer opiate prescribed for pain management ?

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