Addiction psychiatrist questions involuntary tapering of opioids

http://www.wjhl.com/local/addiction-psychiatrist-questions-involuntary-tapering-of-opioids/943940749

JOHNSON CITY, TN (WJHL) – A renowned author and addiction psychiatrist says the efforts of the Department of Veterans Affairs and other institutions across the country to taper people off opioids without their consent is “an outrage.”

“To take a patient who’s doing well off of medication abruptly and without their permission is not unfair. I actually think it’s malpractice,”

Dr. Sally Satel said. “I think it is an outrage when you have a person who’s doing well on a dose of medication, highly functional and their pain is under good control. This is what you want. This is the clinical outcome.”

Dr. Satel is a resident scholar at the American Enterprise Institute and a lecturer at Yale University. She’s a vocal opponent of the involuntary tapering of controlled opioids.

“It shouldn’t be done without their permission,” she said. “Without the patient’s consent, the results are often disasterous.”

Mountain Home VA Medical Center is prescribing half as many opioids as it did in 2012, according to recently released federal data. Since December 2016, several veterans have voiced their frustration over what they’ve said is a mandate to taper their pain medications.

Dr. Satel says many institutions have misinterpreted the Centers for Disease Control’s pain management guidelines as mandates rather than recommendations.

“It doesn’t say anything about taking people off their medications if they don’t want to go off of it,” Dr. Satel said. “Of course, it’s frustrating, especially when it’s misinterpreted in the direction of poor patient care. It’s very frustrating.”

For decades, VA and other doctors have prescribed pain medications because they thought, at the time, that’s what patients needed. However, in recent years, they changed their approach when new research found opioids can be dangerous and ineffective.

“I understand their fear, their anxiety and their anger, but I want them to understand this is driven by our concern for their safety,” Mountain Home VA Opiate Safety Initiative Chairman Dr. Martin Eason said in December 2016.

Most recently, Mountain Home VA Chief of Staff Dr. David Hecht said the facility is proud of its 49% decrease in opioid prescriptions since 2012. He added, doctors consider every patient’s need on a case-by-case basis and taper veterans off opioids in a safe way.

“Many veterans have really understood and bought into it and it has helped us,” Dr. Hecht said. “Any time we reduce these medications, we want to reduce them in a safe environment.”

The VA maintains it has taken patients off opioids gradually and given veterans the opportunity to appeal their tapering decisions. The agency adds while opioids may help with short-term pain, they are not approved to treat chronic pain in non-cancer patients. Mountain Home is now encouraging veterans to try safer and more effective alternatives.

As we reported earlier this month, VA representatives plan to discuss preliminary data that show a link between opioid discontinuation and suicides at an upcoming summit. Dr. Satel has authored several published works alongside one of those speakers.

 

The Opioid Epidemic Has Boosted The Number Of Organs Available For Transplant

https://www.news-line.com/PH_news29932_enews

At this very moment, more than 110,000 people across the United States are lingering on organ transplant waiting lists. The ravages of the opioid epidemic have created an unforeseen opportunity – an increase in the availability of organs for donation.

New research led by investigators at University of Utah Health and Brigham and Women’s Hospital shows that an increase in drug-overdose related deaths has boosted the number of organs available for transplantation. They found a more than 10-fold increase in the proportion of donors who died from drug intoxication between the years 2000 and 2016 in the United States, from 1.2% (59) to 13.7% (1,029).

“We were surprised to learn that almost all of the increased transplant activity in the United States within the last five years is a result of the drug overdose crisis,” said Mandeep R. Mehra, MD, medical director of the Heart and Vascular Center at Brigham and Women’s Hospital and first author on the study.

But are these organs safe?

The researchers examined 17 years of transplantation records andfound no significant change in the recipients’ chance of survival when the organ donation came from victims of drug intoxication. The study publishes online on in the New England Journal of Medicine.

The researchers examined survival rate of 2,360 patients one year after receiving a heart or lung transplant from donors who died from drug intoxication compared to recipients of organs from donors who died from other causes, including gunshot wound, asphyxiation, blunt head injury and intracranial hemorrhage or stroke.

According to Josef Stehlik, MD, MPH, medical director of the Heart Transplant Program at the U of U Health and senior author on the research, the team examinedheart and lung data because these organs are the more sensitive to reduced oxygen supply that may occur during a drug overdose. They focused on survival in the first year, because these concerns would manifest shortly after the transplant. The fact that transplant patients who received these organs had similar survival as other transplant patients relieves the concerns of irreversible organ damage from drug overdose death.

“In the unfortunate circumstances where opioid deaths happen, organ donation can extend life of many patients in need of transplant,” said Stehlik. “Yet, these organs are often not considered suitable for organ donation.”

Clinicians have traditionally been conservative when identifying organs from drug intoxication deaths for procurement. During an overdose, a person may experience prolonged episodes of low blood pressure that can reduce the supply of oxygen throughout the body. There are also considerations that include infection risk, such as Hepatitis B and C and HIV, but this risk can be minimized with modern testing.

“I feel hopeful that doctors across the country will read this and feel confident that organs that pass the required tests are safe for transplant,” Stehlik said. “This awareness is especially important when organ procurement professionals have to decide on use of potential donors with this high-risk history.”

This study can also serve to better inform patients. The United Network for Organ Sharing policy requires patients are made aware of the circumstances of higher risk donations and can decide whether or not to accept it.

As the government invests millions to combat the opioid epidemic, the transplant community does not plan to rely on drug-intoxication deaths as a long-term source of donations.

“We must look to new ways to increase organ donor recovery by concentrating on greater use of marginal organs or by expanding the suitable donor pool by using new technologies to improve organ function before the transplant takes place,” Mehra said.

The research team also examined the Eurotransplant data that tracked transplantation in eight European countries during the same period. They found the number of organ donors dying from drug intoxication in Europe has remained low (less than 1 percent). Stehlik attributes these low numbers to policies in Europe that have kept opioid drug prescriptions low.

Along with Stehlik and Mehra, John Jarcho, MD, and Muthiah Vaduganathan, MD, MPH, at Brigham and Women’s Hospital in Boston, Wida Cherikh, PhD, and Rebecca Lehman, PhD, with the United Network for Organ Sharing and Jacqueline Smits, PhD, with the Eurotransplant International Foundation contributed to this analysis.

Congress’ solution to a solve a problem … throw more money at it.

 

Video may not be viewable on FireFox will work on Microsoft Edge

New call to action!

New call to action!

Vice News from the TV Channel Viceland has reported some stories that are on our side as far as the “opioid epidemic.” I would love to see them do a full show on our cause. This is where you come in! They have a phone number where you can call and leave a message, essentially about anything…this is what we would like you to do.

Call 646-851-0347 and leave a message. Please choose option 1. I suggest you write down what you want to say instead of winging it, that way you know you cover the information that is important. Below is a suggestion of what you should include in your message.

1. Your name and number number (if you are not comfortable leaving your number that is okay, but hopefully they will contact some of us back.

2. State that you are calling as a chronic pain patient and want to dispute the false narrative that the mainstream media is propagating about opioids in America.

3. Explain why you need opioids and how the current hysteria over opioids is affecting your life and report if you have had your meds cut or discontinued. Be specific but do not ramble. try to be concise.

4. Ask them to please do a show sharing the plight of chronic pain patients because no one is telling our side of the story.

This is an easy call to action and imagine the impact if they get 500 calls from us……or 1000. PLEASE participate. No one has the right to complain about the situation if they are not actively trying to change it. No one will fight for us, WE have to fight for ourselves. Please try to do this within the next two weeks. It will make a stronger impression if all the calls come at once. Help make our voices heard!

Opioid Crisis: What People Don’t Know About Heroin

https://www.rollingstone.com/culture/features/opioid-crisis-what-people-dont-know-about-heroin-w520478

As the opioid epidemic rages on, many still have misconceptions about what heroin really does – and how we can end the crisis

The War on Drugs Expanded the Ways People Use Heroin – and Set the Stage for the Opioid Crisis
Spencer Platt/Getty Images

There is nothing new about heroin: What has changed is the way that we consume, dispense and talk about it. Despite the rising rate of opioid abuse and overdose in this country, we continue to mischaracterize heroin, thereby neglecting to understand the indelible hold it has on users. Here’s an attempt to clear up some of the most common misconceptions.

 

Heroin Isn’t Always White Powder


Heroin generally comes in three different forms in the United States: powder heroin – which falls into two subcategories, brown and off-white – tar heroin and heroin pills. Historically, the Mississippi River has been the line of demarcation between the tar and powder markets. Off-white powder heroin, which originates in Southeast and Southwest Asia, is generally considered the most desirable kind. Powder, with its origins in Mexico, often carries a deeper, browner hue, and is usually less powerful. On the West Coast, heroin comes almost exclusively from Mexico and South America and is most often sold in tar form; little balls of goo that look like black earwax. The third, least common form of heroin is “pill” form. “Pills” refer to heroin often sold in gel capsules and mixed with other powders – be it cocaine, methamphetamine or the more common heroin adulterants like powdered lactose, quinine and baby laxative. Pills are usually the cheapest and lowest-quality form of the drug.

What Might Look Like an Opioid High Is Actually the Symptoms of Withdrawal
Outsiders often confuse withdrawal symptoms for the effects of the drug, because the effects of withdrawal are far more noticeable than the euphoria the drug produces. Dilated pupils, sweating, shaking, slurring and vomiting aren’t signs of being high; they’re signs of opioid withdrawal. Quitting heroin is often called “kicking” in reference to the tendency to kick out one’s legs in attempt to stretch away the discomfort.

The War on Drugs Expanded the Ways People Use Heroin – and Set the Stage for the Opioid Crisis
In the Sixties and Seventies, just about all heroin addicts were intravenous users, but as the purity of the drug increased, so did potential methods for use.

During the 1960s, heroin use rose, in part, due to soldiers returning from Vietnam who were exposed to the drug overseas, and drug dealers in urban centers seized on this opportunity. Then, in the summer of 1969, when Nixon declared his war on drugs, he cited New York City’s heroin trade as the core of the problem. The speech apparently roused the NYPD, who proceeded to arrest some of the city’s biggest dealers.

Meanwhile, suppliers in Asia became concerned that they would lose their distribution. In response, they began setting up their own networks in America’s cities to establish a more discrete trade. Heroin sold in the U.S. saw a bump in purity around this time as a result of this more direct supply line. However, purity levels would soon skyrocket as the heroin market was about to become competitive.

Though Nixon targeted heroin in his speech, in practice the drug war mainly targeted toward marijuana.

With cocaine, heroin and marijuana all categorized as Schedule I drugs, DEA agents opted to pursue the smelliest, bulkiest and most conspicuous of those three substances.

Colombian and Mexican drug cartels, who had previously trafficked mainly in marijuana, switched to a product that was less noticeable and carried more value by weight. Ironically, it was the drug war itself that pushed the cartels into the heroin business.

Additionally, in the Eighties, crack appeared almost overnight – and authorities suddenly deprioritized heroin. Meanwhile, as a result of the tenfold rise in heroin purity between 1970 and 1990, nasal administration became a viable option for users. Mexican and Colombian cartels introduced the drug to suppliers and users who previously had only dealt with cocaine. The new, more socially acceptable method of use endeared the drug to an entirely new demographic of trendy, wealthy and often white cocaine users.

The demographic that had previously been most afflicted by heroin addiction took a deliberate step away from the drug. In low-income urban centers, the fallout of the 1970s heroin explosion became a cautionary tale. A generation came up witnessing the long-term effects of the drug, which had hardly existed as a threat in rural and suburban America. “Young African Americans and young Latinos were not going into heroin because they saw the destruction that occurred in their families and in their neighborhoods and they didn’t want to go down that road,” says Philippe Bourgois, a cultural anthropologist and author of the book Righteous Dope Fiend. “It was seen as a loserly thing to do.”

Meanwhile, he says, working-class white people in rural areas – which in the past had not been as affected by drug epidemics – found themselves beset by poverty due to the shifting nature of the American economy. The groundwork was laid for a potential drug crisis. 

The Pharmaceutical Companies Made it Worse
For a true public health crisis to occur, there first had to be an influx of opioids into the country, the likes of which no drug cartel could muster. Enter the major American pharmaceutical companies. In the late 1990s, the pharmaceutical companies successfully lobbied the Joint Commission, an organization responsible for accrediting American health care programs thereby essentially setting the standard for American health care programs, to accept the concept of pain as a vital sign. Before that, pain was a secondary consideration. But now, physicians would be required to ask about and treat their patients’ pain. In the decade that followed, sales of prescription opioids in the U.S. quadrupled. Roughly during the same time period, the overdose rates quadrupled as well. 

And as they made public attempts to reform, it only took the crisis in new directions. Take “abuse-proof” OxyContin. In 2010, OxyContin producer Purdue Pharma introduced a new version of the pill that they claimed was “crush-proof,” turning into a jelly if you tried to crush it into a powder, therefore making it impossible to inject or snort. Almost immediately, though, Internet forums lit up with collective solutions for overcoming the newly implemented safeguards. Meanwhile, anecdotes of addicts visiting the emergency room as a result of injecting the binders contained within the abuse-proof pills began to spread. Other users opted for a better workaround: switching to heroin.

Naloxone Is No Party
The existence of more opioid-dependent citizens continues to benefit the pharmaceutical industry. Naloxone, often sold under the brand name Narcan, counteracts the effects of an opioid overdose. Since 2014, there’s been a near 500 percent increase in sales of the drug. Meanwhile, over the last three years, pharmaceutical companies have steadily raised the price by as much as 50 percent. Now, with first responders throughout the country needing a steady supply of naloxone on hand, Big Pharma doesn’t only see several billion dollars per year off opioids themselves, but they see a growing profit from the sale of anti-opioids.

Thus far, 46 U.S. states have opted to make naloxone available over the counter. Despite this progress, a vocal minority has expressed concern that increased access to naloxone might have dangerous repercussions. The hysteria generated by those who oppose naloxone access may be responsible for the creation of a relatively new heroin myth.

In August 2017, a report from Boston’s Fox News 25 claimed to have identified a new trend where partygoers were intentionally overdosing on opioids so they could take Naloxone, thereby “giving the drug user a rush.” Several similar reports described the practice, dubbed “Narcan Parties.” The supposed trend was touted by Pennsylvania State Senator Lisa Boscola and State Representative Dan McNeil as a reason not to expand access to naloxone in the state. However, there’s no evidence that these parties are actually happening. “I have not been able to verify a single case of this,” Bill Stauffer, Executive Director at the Pennsylvania Recovery Organization, told The Outline. “I suspect it to be an urban legend.” 

Replacement and Maintenance Therapies Gets Results
Maintenance therapies like methadone and subutex have shown better results than non-medication-assisted treatments, both in cases of addicts seeking abstinence from opioids, and for those seeking simply to carry on living relatively normal lives. Replacement therapy with drugs like methadone, subutex, kratom and even cannabis have also shown major promise in helping addicts get clean.

The success rate of addicts getting clean without the help of replacement therapies has been stated to be as low as 3 to 5 percent and as high as 20 to 30 percent. Success rates amongst those using drugs like methadone and buprenorphine to help them taper off opioids have been cited as high as 60 to 90 percent. According to the California Society of Addiction Medicine, addicts who go cold turkey are significantly more likely to relapse than those who taper off with drugs like methadone or Suboxone.

Though Attorney General Jeff Sessions recently shared his opinion that most heroin addiction starts with marijuana “and other drugs too,” the benefits of marijuana as a potential treatment for opioid addiction have become the cornerstone of several controversial treatment modalities. Researchers also believe that painkillers derived from chemicals found in marijuana such as CBD could provide an effective and far less dangerous alternative to prescription opioids.

Safe-injection Sites Reduce Risk, Too
A 2005 study in Switzerland found greater reductions in opioid use and greater rates of complete abstinence among subjects who were given injectable heroin while supervised, over those who were given methadone over the same 12-month period. With the number of supervised injection sites around the world nearing 100, and showing promise in major cities like Sydney, Vancouver and Amsterdam, activists in major cities like New York have begun the fight to bring supervised injection sites to the U.S.

The Cure Could be in Hallucinogens
If anything like a “cure” for opioid addiction ever emerges, it will likely come from outside the medical establishment. For example, many consider Ibogaine, a hallucinogenic plant, to be one of the most promising opioid-dependence treatments on the horizon. The anti-addictive potential of the drug was discovered in the 1960s by Howard Lotsoff, an opioid-addicted beatnik who would spend the rest of his life championing the drug as a treatment for addiction.

The mantle for Ibogaine advocacy has since been taken up by people like Dimitri Mugianis, who after getting clean with Ibogaine put his life and freedom on the line to help suffering addicts with guerilla-style treatments in hotels across New York City. After a DEA sting landed Mugianis in jail in 2011, he became an icon of the harm reduction movement, a movement many consider integral to improving the state of addiction in this country. (After a years-long court battle, he was eventually convicted of a misdemeanor drug charge and served 45 days house arrest.) 

While scientists see promise in drugs like 18MC, a new chemical compound that attempts to make use of the anti-addictive properties of Ibogaine without the hallucinogenic effects, Mugianis believes that too much emphasis is put on chemical solutions.

Mugiainis insists that the only way forward is to begin changing our outlook on those addicted to opioids. “We need to start treating drug users well, like human beings,” he tells Rolling Stone. “We must offer a menu of choices as varied and complex as humans are, and addiction is.”

Addicts Aren’t So Easily Pegged
Mugianis believes that the biggest misconception about heroin addicts is that they are non-functional. During his time treating addicts, Mugianis says he’s seen heroin users with careers and families living what many would consider successful, fulfilling lives. The harm for them mainly came when they didn’t have access to the drug. “To say that people are totally dysfunctional on opiates as Americans, we’d have to discount all that active users have given to this culture, from Billie Holliday to Edgar Allan Poe to Jimi Hendrix; people who not only functioned but excelled and enriched our culture,” he says. “The people who made our culture were high.”

Attorney screws up failing to file timely appeal – client goes back to jail ?

The Florence doctor convicted last year of 22 felony drug counts including two negligent homicides is back in jail.

Dr. Chris Christensen had been free pending his appeal with the Montana Supreme Court. He was sentenced to 10 years in prison. But his bail has been revoked.

According to court documents, Christensen failed to file a timely appeal with the state Supreme Court.

The court report said a stay of execution was lifted and an arrest warrant issued.

Christensen has been arrested and is currently in the Ravalli County Detention Center.

The report said that it is the court’s judgment that Christensen’s stay should be “lifted immediately” and that he should begin serving his sentence “without further delay.”

http://nbcmontana.com/news/local/christensen-back-in-jail

 

investigation found that CVS Caremark was billing the federal government significantly higher prices for seniors’ drugs than was appropriate

Aetna whistleblower alleging CVS gouged Medicare and Medicaid customers put on leave

http://www.the-review.com/news/20180517/aetna-whistleblower-alleging-cvs-gouged-medicare-and-medicaid-customers-put-on-leave/2

A whistleblower with Aetna who accused CVS Caremark of gouging Medicaid and Medicare customers with high prescription-drug costs has been placed on paid administrative leave by the insurance company.

The move comes after the whistleblower’s lawsuit was unsealed in federal court in early April. It also comes as CVS Caremark, one of the country’s largest pharmacy benefit managers, pursues the acquisition of Aetna for a reported $69 billion.

Sarah Behnke, at the time the chief Medicare actuary for Aetna, filed the whistleblower lawsuit, which is pending. Her attorney told The Dispatch that the decision by Aetna to send her home is “retaliatory and inappropriate.”

Behnke said her internal investigation found that CVS Caremark was billing the federal government significantly higher prices for seniors’ drugs than was appropriate.

The scheme has been used by CVS Caremark since 2007, Behnke said, and has cost the federal government more than $1 billion in fraudulent charges, according to her lawsuit.

Some pharmacists say the same practice is happening in Ohio. CVS Caremark is the pharmacy benefit manager for four of Ohio Medicaid’s five managed-care companies.

A pharmacy benefit manager, or PBM, is the middleman entity that negotiates with drug manufacturers and then sets the prices for insurance companies and pharmacies. Those prices are what the public pays for prescription drugs.

State legislators in Ohio have requested that CVS provide pricing lists to see whether so-called “spread pricing” is happening in Ohio. Spread pricing is when the PDM negotiates a lower or discounted price with a drug manufacturer and then negotiates another price with the pharmacy. PBMs also negotiate different payments to pharmacies to make money. Those discounts typically are not passed on to the health-insurance provider.

CVS Caremark officials, who have rejected allegations of spread pricing or wrongdoing, say they will turn over documents by June 1. They say they were not aware of who filed the lawsuit until after announcing the plan to buy Aetna.

“We believe this complaint is without merit, and we intend to vigorously defend ourselves against these allegations,” CVS Health spokesman Michael DeAngelis said in an email response. Should CVS Caremark acquire Aetna, he said, “CVS Health policy prohibits the taking of punitive action against a whistleblower.”

Aetna officials declined to comment.

The lawsuit and CVS Caremark’s planned acquisition of Aetna both have significant implications for taxpayers, who fund Medicare and Medicaid programs.

Aetna would be the first health-care provider owned by CVS. If the purchase is approved by the U.S. Department of Justice, it would give the pharmacy giant a health-care conglomerate of managed-care and pharmacy benefit management operations.

That control of the entire chain of health care by CVS would, in effect, create a vertical monopoly and directly affect how much customers end up paying for health care, including prescription drugs.

The Trump administration has heavily criticized these types of conglomerations as being “monopolies” that allow companies in the prescription-drug chain to conceal prices. Last week, President Donald Trump’s Food and Drug Administration chief called it a “rigged system” against the public.

PBMs such as CVS Caremark were created to lower prescription-drug costs in the marketplace. During the past five years, prescription-drug costs have been the fastest growing facet of the health care chain, according to a recent study by U.S. News and World Report.

Three PBMs control between 80 and 90 percent of the prescription drugs in the marketplace, with an estimated $400 billion in gross sales, according to the IMS Institute for Healthcare Informatics. PBMs conceal how they affect drug prices from insurance providers and the public.

Behnke filed a federal False Claims Act lawsuit in 2014 under seal. Whistleblower lawsuits are sometimes filed under seal to allow federal prosecutors time to review the allegations and get involved.

Behnke’s attorney, Susan Schneider Thomas, said the government deferred participation for now. That allowed the judge to unseal the lawsuit in April.

That meant that CVS officials didn’t formally know the allegations or who filed the lawsuit until April.

Whistleblower advocates expressed concern that the acquisition by CVS could be bad for Behnke and affect the lawsuit. They said it’s unlikely, though, that CVS pursued the acquisition to choke off the lawsuit.

“I think if there is an acquisition by CVS, she has a reason to be concerned,” said James Mowery Jr., a Dublin-based lawyer whose firm specializes in whistleblower lawsuits. “She needs to be sure that her employer will always be Aetna, and she needs to be keeping a diary of everything that happens up until the acquisition.”

Mowery said the proposed acquisition makes the lawsuit a “significantly complex piece of litigation.”

Whistleblower Advocates, a whistleblower-lawyers firm based in Chicago, said that until the federal government demands to be a party in the suit, CVS will not feel pressure to address Behnke or her accusations.

Behnke said she took her concerns to corporate executives for Aetna and CVS Caremark in 2013, according to court records. Nothing happened.

Thomas said in the complaint she filed against CVS Caremark that the company was charging Aetna 25 to 40 percent more for drugs than its competitors.

Behnke also said that during meetings in February of 2013 with CVS officials to present her findings, CVS Vice President Allison Brown said Caremark had negotiated lower prices for those drugs but was not contractually obligated to show Aetna those prices.

Thomas called the exchange a “virtual admission of liability,” according to court records.

attrib? CVS Caremark officials also confirmed at those meetings that they had re-created Behnke’s analysis of drug prices and confirmed that she was accurate, according to court records. Behnke asked whether CVS Caremark could use the information to negotiate better prices for Aetna’s policyholders.

“Caremark defendants … stated that improving or increasing the discounts Aetna received would adversely impact” CVS Caremark’s profits due to “retail contracting methodology,” according to court records.

In an email sent in July of 2013, Aetna’s head of its Medicare division marveled at how much money CVS Caremark was making on the “hidden spread.”

By September of 2013, Aetna indicated it would shop around for another PBM to see whether it could find better rates, according to the lawsuit.

CVS Caremark officials immediately offered to lower the costs of drugs for Aetna. When Aetna started shopping for a better deal, CVS Caremark offered an even steeper discount, according to the lawsuit.

Attorneys for CVS Caremark filed a motion April 20 to permanently seal the case again, saying the lawsuit would cause significant financial harm. The company’s attorney said Behnke provided sensitive information.

“These details concern the financial guarantees and pricing terms to which Caremark and Aetna agreed as well as financial terms allegedly offered during negotiations and data allegedly revealing specific prices paid by Aetna as well as Caremark’s performance on financial guarantees,” the motion read.

Behnke’s attorneys have until Friday to respond to the request to seal the case.

lsullivan@dispatch.com

Dr. William Mangino talks about the fight to clear his name for supposedly over prescribing opiates to his chronic pain patients.

Are many PBM’s – especially CVS/Caremark – guilty of self-dealing

 

 

The PBM’s are forcing me to rant on Facebook, which I thought I would never do! Please, band together with me, watch, educate, share and help stop these BULLIES!!

Here is a recent article from the State of Arkansas discovered that the PBM Caremark – part of CVS – is paying themselves (CVS Pharmacies) – on average – $60.00 MORE PER PRESCRIPTION than when a pt had the very same prescription filled at one of CVS’ competitors.

Lawmakers, Pharmacists Meet with CVS over Regulation of Pharmacy Benefit Managers

 

Here is another article from the state of Illinois where the same PMB (Caremark) has cut reimbursement on prescriptions paid for by Medicaid and handled by Caremark has been reduced to a level that is BELOW THE COST OF DOING BUSINESS

state contracts conceal the profits being made by pharmacy benefit managers for squeezing pharmacies

***URGENT CALL TO ACTION***

***URGENT CALL TO ACTION***

WE ARE FIGHTING FOR OUR LIVES HERE!

DUE TO THE GROWING NUMBER OF PAIN PATIENTS LOSING THEIR ACCESS TO PAIN MEDICATION & DOCTORS UNWILLINGNESS TO PRESCRIBE, WE HAVE BEEN INUNDATED WITH MESSAGES, AND THERE’S A HIGH DEMAND FOR INFORMATION ABOUT HOW TO GET PROPER TREATMENT.

WE NEED HIGHLY EXPERIENCED TECH SAVVY INTERNS (YOUR HIGH SCHOOL KIDS, GRANDKIDS, NEIGHBORHOOD KIDS, ETC.) TO VOLUNTEER TO HELP US CONTINUE TO SPREAD OUR MESSAGE ACROSS FACEBOOK, TWITTER, YOUTUBE, INSTAGRAM, ETC. AS OUR MOVEMENT IS IMMENSELY GROWING DAY BY DAY. THE CLOCK IS TICKING & TIME IS OF THE ESSENCE SINCE OUR GOVERNMENT IS RUSHING TO PASS MORE RESTRICTIONS WHICH WILL FURTHER IMPACT THE PAIN COMMUNITY.

IF YOU WOULD LIKE TO HELP MAKE A DIFFERENCE, PLEASE REPLY  EMAIL PAINWARRIOR55@GMAIL.COM – REMEMBER, OUR LIVES DEPEND ON IT AND SADLY, FOR MANY IT’S ALREADY TOO LATE! THANK YOU!