Scientists warn Trump administration that banning kratom will result in more opioid deaths

Posted on February 8, 2018 by Pharmaciststeve

http://www.washingtonexaminer.com/scientists-warn-trump-administration-that-banning-kratom-will-result-in-more-opioid-deaths/article/2648561

A group of scientists who have studied kratom are warning the Trump administration that banning the drug would worsen the opioid epidemic, following a declaration from the Food and Drug Administration that kratom has “opioid properties” and is associated with 44 deaths.

The drug, a Southeast Asian tree leaf, is legal under federal law, but FDA officials have recommended it be categorized as a Schedule 1 drug, which would effectively mean that scientists would be unable to study its effects. People who take the drug, which can be sipped in a tea or taken as a pill, say that is has helped them beat off cravings for opioids and has alleviated chronic pain and depression.

The scientists pleaded against a kratom ban in a letter sent to Robert Patterson, acting administrator of the Drug Enforcement Administration, and Kellyanne Conway, counselor to the president who is overseeing the administration’s efforts on the opioid crisis.

They raised doubts about the deaths determined to be associated with kratom and drew attention to surveys that have indicated that kratom was being used as “a lifeline away from strong, often dangerous opioids for many of the several million Americans who use kratom.” For these users, they wrote, a ban would result in “relapse to opioid use with the potential consequence of overdose death.” Instead, they wrote, the government should be encouraging research on the product to assess its safety and effectiveness.

 “Placing kratom into Schedule I of the [Controlled Substances Act] will … have a profound and pervasive chilling effect on this needed additional research,” they wrote.

The latest available federal data show that 42,249 people died from an opioid overdose in 2016, whether from heroin, fentanyl, or prescription painkillers. Of the deaths, 3,373 were caused by methadone, a medication often prescribed to treat people with addictions to opioids.

FDA Commissioner Scott Gottlieb has said that his agency was concerned about reports that people had been using kratom to wean themselves off opioids, saying “there is no reliable evidence to support the use of kratom as a treatment for opioid use disorder and significant safety issues exist.” He has warned in the past that kratom can cause seizures and liver damage.

The DEA has not said whether it intends to take action given the latest analyses and recommendations by the FDA and does not have a specific deadline. The agency said in October 2016, during the Obama administration, that it would hold off on banning kratom as a Schedule I substance such as heroin, marijuana or LSD, as it waited for additional public comment as well as FDA recommendations.

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Secrecy rules at Georgia medical board

Posted on February 7, 2018 by Pharmaciststeve

 

http://investigations.blog.ajc.com/2018/02/07/secrecy-rules-at-the-georgia-composite-medical-board/

 

Shoddy care by doctors. Sexual misconduct. Malpractice cases that led to $1 million settlements. Violations involving prescription drugs. Those are among the serious allegations made against Georgia doctors last year in formal complaints.

But the public will never know the details of how the Georgia Composite Medical Board handled the vast majority of these complaints. That’s because almost everything the medical board does related to doctor discipline is kept top secret.

The board’s secrecy came to light again recently in the case of Dr. Paul Harnetty. The board had investigated the former Georgia doctor, a criminal case revealed, but he was never publicly disciplined. Harnetty was convicted last month of sexually assaulting patients in a Wyoming. The AJC investigated the doctor’s Georgia history in a story published Sunday. 

If the Georgia board issued Harnetty a private order, or dismissed the case, that would be the usual order of business, judging by the board’s latest data.

 The board got 1,787 new complaints in the 2017 fiscal year that it determined were within its jurisdiction, according to the board’s annual report for the 2017 fiscal year, which runs from July 2016 through June 2017.

During that year, the board issued only 36 disciplinary actions, the report says. Among them, one doctor had his license revoked, and two had their licenses suspended. The most common public actions the board took were 23 public reprimands, according to the report.

The medical board staff did not respond to the AJC’s request for more information about confidential letters and orders and the disciplinary actions summarized in its annual report.

Dr. Paul Harnetty

The board dismissed a lot of cases, and it will never have to justify why. In fact, Georgia law bars the board from discussing any case, even a case in which it has imposed public discipline.

The board’s meeting minutes reveal that the doctor-dominated board takes many more private actions than public ones.

In just one month last year, for example, the board accepted two “private consent orders” and amended another one. The only information the board provided about those doctors was the case number. No names. No description of the case. No public information at all.

At the same meeting, the board also accepted one of its committee’s recommendations to “require a private consent order as a condition of licensing” a pain clinic. The owner of the clinic had been interviewed by the committee, the minutes show. Pain clinics need special licenses because their focus on treating pain generally leads to lots of prescriptions for highly-addictive opioid pain pills.

The same month — May of 2017 — the board closed 14 cases with “Letters of Concern,” according to the meeting minutes. What were the concerns? That’s something the public simply has no right to know. It’s between the doctor and the board.

Not every state handles so much of its doctor discipline privately. Georgia is among 21 states where the law allows secret actions in physician discipline, according to a 2016 AJC national investigation.

When Dr. Paul Ruble surrendered his license last April, the medical board didn’t reveal that he was on his way to federal prison after a 2015 indictment in a pill mill case.

The Georgia board also usually provides no details if a doctor gives up a license. The AJC found some 30 cases in Georgia where physicians who were facing criminal charges involving controlled substances, or who were facing sanctions in other states, surrendered their licenses without the medical board noting any reason.

If the doctor instead keeps practicing after being arrested, the board often remains silent,  routinely letting a case play out in court before taking any action against a doctor’s license.

The AJC investigated the board’s handling of doctors who improperly prescribe opioids in a series published in December. The AJC also studied improper prescribing in all 50 states in its 2017 national investigation, Healers or Dealers?

The AJC discovered in its 2016 Doctors & Sex Abuse national investigation that the Georgia board has handled even serious allegations in private.  The board placed Dr. Jacob Ward on probation after he pleaded guilty in a criminal sexual misconduct case. But that criminal case revealed a back story. Two other patients had made similar charges against Ward four years earlier and the board did nothing other than write a “personal and confidential” letter to the doctor expressing its “concern regarding exams and patients of the opposite sex.”

The Georgia Composite Medical Board is a 16-member board made up of 13 physicians, two consumer members and one nonvoting Physician Assistant member. All voting members are appointed by the Governor and confirmed by the State Senate.

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Could this explain why CDC stats are all F-upped ?

Posted on February 7, 2018 by Pharmaciststeve

Death investigation highlights problematic coroner system in state

https://www.columbiamissourian.com/news/state_news/death-investigation-highlights-problematic-coroner-system-in-state/article_e1e4b5f0-0b98-11e8-897b-7fa32d65f210.html

FAYETTE — Missouri’s coroners don’t have many requirements to get the job. Some do not even attend training sessions, according to the coroners’ professional association.

Some county coroners are concerned cases are being mishandled, deaths are going under-investigated, and too few autopsies are being ordered. They say most of the state’s laws are antiquated, some not having seen a governor’s signature since the 1940s.

At just 27 years old, Jayke Minor died in his home in Fayette in 2011. His girlfriend found him and by the time paramedics got there, it was too late. Six and a half years later, his dad still doesn’t know why his son died.

“I’m never going to have the answers I need to know what happened to Jayke,” Jay Minor said.

Jayke Minor had a history of drug use, according to his father and police, but officers said there was no evidence of drug use on the scene. Even so, Howard County Coroner Frank Flaspohler decided the death was an accidental drug overdose.

“That’s what he listed it as. With no evidence,” Jay Minor said. “He didn’t do an autopsy. He didn’t contact me to ask for one.”

Flaspohler said Jayke Minor’s history of drug use factored heavily into his decision that evening.

“Talked to the two policemen on scene. They said nope, there’s nothing suspicious. There was some history there,” Flaspohler said.

But two years later, a toxicology report from the Missouri State Highway Patrol brought everything in the original determination into question.

“When we got the toxicology report back, it started falling apart,” Jay Minor said. “It came back negative for anything but marijuana. And you don’t die from marijuana.”

Another year passed, and Flaspohler changed his report to indicate Jayke Minor died from a heart issue, with the manner of death listed as “natural.”

But now, all evidence that could help get a definitive answer is gone: Jayke Minor was cremated, the blood samples were destroyed per lab protocol, and there was no autopsy.

Six years ago, Flaspohler said, only autopsies involved in criminal cases would be paid for by the county, with few exceptions.

Fixing inconsistencies

Other coroners call the case flawed, and are pushing for legislation to improve training for the career.

Flaspohler is being accused of mishandling the case by fellow coroners for a number of reasons, from the wrong name being on his coroner’s report to obvious discrepancies KOMU 8 News identified between his report and police reports, including the location and temperature of the body.

Saline County Coroner Willie Harlow, who sits on the board of the Missouri Coroners’ and Medical Examiners’ Association, said he is frustrated with the case, calling it flawed and directly blaming Flaspohler.

“He made a quick decision that (Minor) was a drug user, so he died of a drug overdose. And at that moment in time, Frank Flaspohler was done with that case,” Harlow said.

Harlow supports a bill in the Missouri House that would collect a fee on death certificates that would fund better training for coroners. Currently, there are only age and residency restrictions to become a coroner in the state. Even though coroners may have no experience with medicine, the training requirement is just 20 hours a year, a requirement not everyone is completing. House Bill 2079, introduced by Rep. Dan Houx, R-Warrensburg, would prohibit coroners who are not up-to-date on training from being able to sign death certificates.

“There are many coroners who do not attend training of any kind, yet there is nothing that our association can do about that,” Harlow said.

There are also few requirements dictating how a coroner must handle a death investigation. According to coroners, children under 1 year old who die must be autopsied, but there are few set standards after that.

“There really needs to be a standard guideline for coroners to follow to tell them, ‘This is when you should be doing autopsies, and this is when you should be ordering toxicology,’” said Kathleen Little, executive director of the Missouri Coroners’ and Medical Examiners’ Association.

Jay Minor and his girlfriend, Debby Ferguson, have spent years asking anyone who will listen for help. They recently launched a letter-writing campaign to reach every coroner and medical examiner in the state, as well as lawmakers.

“Our goal is that no other parent has to go through this and wonder what happened to their child,” Jay Minor said.

Some states, like Kansas, require coroners to be doctors, according to the Centers for Disease Control and Prevention. Other states require a death investigator certification; Little said the association may push for that in Missouri.

When it comes to the Minor investigation, Flaspohler said it has made him think about changes.

“I will tell you, it took way too long. I totally agree with that,” Flaspohler said. “I’ve had 1,000 calls, never had one that took this long.”

He said he is now tracking his cases using a new computer system and is making sure records are done faster. He said he does attend training, including additional, optional training, and he is in favor of upping the training requirements for coroners across the state.

Flaspohler also said a recent coroner’s inquest related to a teen’s suicide death related to bullying has made him look at things differently.

“I’ve actually spent the last year dealing with this inquest and saying we need to look at the schools and say we can do better. So, I can look at me and say, I can do better. We can find a better way. We can get more training. We can get a better computer program,” Flaspohler said.

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SD: bill to limit opiates for acute pain – DIED IN COMMITTEE TODAY

Posted on February 7, 2018 by Pharmaciststeve

South Dakota lawmaker looks to rein in opioid painkiller prescriptions

http://www.argusleader.com/story/news/politics/2018/02/06/south-dakota-lawmaker-looks-reign-opioid-painkiller-prescriptions/306626002/

PIERRE — Doctors would only be able to prescribe seven days’ worth of opioid painkillers to children or patients taking the drugs for the first time under a bill up for consideration Wednesday in the Statehouse.

Under Senate Bill 176, physicians would be required to consider and discuss with patients alternatives to the painkillers before prescribing opioids for pain management. They would also be required to discuss with patients the risks associated with opioids and proper methods of disposing of the drugs.

The restriction wouldn’t apply to patients receiving hospice or end-of-life care or those with chronic pain that cannot be treated without the painkillers.

More: Avoiding opioids: Avera, law enforcement aim to prevent crisis in S.D.

Supporters said the bill could help rein in opioid addiction and diversion in the state. Meanwhile, opponents said the bill would prevent physicians from making individual choices based on patients’ needs.

Sen. Arthur Rusch, R-Vermillion, brought the bill in an effort to curb opioid addiction in the state. He pointed to National Conference of State Legislature data which showed first-time patients were less likely to develop addictions when prescribed smaller amounts of the drugs.

 

“I read a lot about the issue and it just seemed to be the right thing to do,” Rusch said. 

More: Senate panel votes to drug test Legislature, splitting with peers

Doctor Bob VanDemark Jr., president of the South Dakota Medical Association, said the proposal is well-intended but doesn’t take into account the distinct situations physicians face in weighing opioid prescriptions.

“It’s such a complex issue, and it’s really hard to legislate one prescription program for everybody,” he said. 

The Senate Health and Human Services Committee is set to take up the bill Wednesday morning.

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John Stossel: The war on drugs is just like Prohibition. And it won’t work either

Posted on February 7, 2018 by Pharmaciststeve

FILE -- In this Aug. 9, 2016, photo, a bag of 4-fluoroisobutyrylfentanyl, which was seized in a drug raid, is displayed at the Drug Enforcement Administration (DEA) Special Testing and Research Laboratory in Sterling, Va.

http://www.foxnews.com/opinion/2018/02/07/john-stossel-war-on-drugs-is-just-like-prohibition-and-it-wont-work-either.html

Ross Ulbricht was a quiet nerd — an Eagle Scout who never cursed.

Then he became a libertarian, and he decided, “I want to use economic theory as a means to abolish the use of coercion.”

By coercion, Ulbricht meant force.

He viewed laws against drugs as coercion — government force that stops people from living the way they want.

So he created a website called Silk Road. Silk Road let people buy and sell contraband — mostly drugs — using bitcoin. The site became successful quickly. It soon carried a billion dollars in transactions.

Because Silk Road didn’t use dollars, it was also private, said Ulbricht. “The State is unable to get its thieving murderous mitts on it.”

But he was wrong. Ulbricht slipped up, using his real name in an internet forum, and the FBI found him and jailed him.

A jury, looking at his former website, convicted him of things like “conspiracy to traffic narcotics.” He was clearly guilty of that.

But then Judge Katherine Forrest said that because “Silk Road was a black market of unprecedented scope” she would sentence Ulbricht to “double life plus 40 years, without parole.”

That’s a longer sentence than many murderers get.

My former Fox colleague Bill O’Reilly applauded it.

“We all agree here,” he told his TV panel. “Life in prison without parole! Any other wiseguys want to do it, that’s what you are gonna get.”

Give me a break. Locking some people up forever will not stop sales of drugs.

Americans should have learned that from our last attempt — Prohibition.

Making popular things illegal rarely diminishes their use. People still buy the banned items, but now they buy them from criminals. Violence increases. Sellers, instead of resolving disputes in courts, settle them with violence.

The illegal activity doesn’t go away. It just becomes more dangerous.

What we saw during alcohol prohibition, we now see in the drug market.

What did government accomplish by closing Silk Road? Nothing lasting. Other illegal sites opened. Today, they offer more contraband than Silk Road ever did. Silk Road had 12,000 listings. Now several sites carry more than 100,000 listings.

“So I guess they weren’t scared by Ross’s life sentence, as the judge said,” says his mother, sarcastically.

But law enforcement still brags about brief successes. “The dark net is not a place to hide!” crowed Attorney General Jeff Sessions after one bust. “We will use every tool we have to stop criminals from exploiting vulnerable people.”

“Our critics will say we shutter one site, another site emerges, and they may be right,” says Andrew McCabe, who recently stepped down as Deputy Director of the FBI. “But that is the nature of criminal work. It never goes away.”

Never. Ever.

But the criminality would go away if we just legalized drugs. Today, there are no shootouts over alcohol sales.

But what about sketchier products — like hackers selling people’s credit card information?

“Silk Road had some rules at least, like nothing that harmed or defrauded,” says Ulbricht’s mother. “No child pornography was allowed.”

Also, the drugs were high quality. The FBI made more than 100 purchases from Silk Road and concluded that the drugs had “high purity levels.”

Still, I find it hard to sympathize with Ulbricht because police now also have charged him with hiring a hit man to kill someone.

Ross’s mom believes that threat was faked, possibly by law enforcement agents themselves.

No one was actually killed, and the government didn’t charge Ulbricht with murder-for-hire in the trial that jailed him for life.

A typical sentence for murder-for-hire when no murder occurs is about 10 years. But Ulbricht got much more than that. Was the sentence for damage Ulbricht allegedly did, or because the State resents its inability to control this sort of online trade?

“He was a libertarian,” says his mother. “Believed in free markets and volunteerism. He’s not a dangerous person.”

No American is safer because Ross Ulbricht is in jail for life. He is just one more casualty of our futile war against drugs.

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Opioid epidemic prompting prescription changes

Posted on February 7, 2018 by Pharmaciststeve

http://www.dailytimesleader.com/content/opioid-epidemic-prompting-prescription-changes

WEST POINT, MS

The opioid epidemic has gotten so bad in Mississippi and other states that doctors are beginning to make their patients sign waivers agreeing to take random drug tests if the doctor suspects the patient may be abusing the drugs or diverting them to others.

It’s one of several changes the state medical licensing board, nursing board and pharmacists are talking about with the Legislature to try to get a handle on the problem.

“We’re trying to get our hands around the problem, looking at all kinds of options,” said Dr. Charles Miles, a West Point gynecologist and obstetrician who is on the State Board of Medical Licensure.
The board is meeting with legislators and other medical groups this week to try to finalize some proposals.

“The problem is people who are in chronic pain, pain that last for more than six months. We are going to ask for a urine screen three times a year to make sure the drugs aren’t being abused one way or the other. If you suspect something is up, like you give a 30-day prescription and they are back in 10 days because the dog ate the pills, then you might ask sooner,” Miles explained of some of the options being considered.

Other changes are limiting prescriptions for pain killers after surgeries to three days or a maximum of 10 days so the doctor can meet with the patient and refill the prescription if needed.

“The problem with opioids is that if you are on them for 20 days or more, the addiction risk increases significantly. And many of the opioid addicts got started with a legitimate prescription. That’s what we are trying to balance and it is a balancing act,” Miles continued, noting the number of opioid prescriptions written in the state dropped 6 percent last year, but the number of pills actually increased.
Some doctors already have taken steps to better monitor their patients. And patients still are adjusting to those changes, setting the stage for reactions as the state debates new rules.

For instance, Columbus resident Brennan Stanford’s doctor recently made her sign a statement agreeing to random drug tests if he suspected she was mishandling her Xanax prescription. He also makes her come in for appointments every two months to get new prescriptions. Up until recently he could write six months worth of prescriptions at a time. But new rules limited that to three months and her doctor has taken it one step further.

“I understand it, I may not necessarily like it, but I understand it,” Stanford said. “I just think it is sad it is coming to things like this, that doctors can’t even use their best judgment.

“And in my case, it means two more trips to the doctor every six months, that’s $50 more in co-pays. Not everyone can afford that,” she continued.

“It sounds like he is just being proactive with all his patients. It’s part of the balancing act,” Miles said of the doctor, noting one of the issues with Xanax is mixing it with potent pain killers like oxycontin, Lortab, and Percoset.

The extra cost is a big issue for others, too.

“I signed it because I had to. And I’ve had friends who are addicts. But there’s got to be a balance somewhere. I can’t afford to pay for extra doctor visits, not with a $40 co-pay. And I probably am better off than some people. I think that is going to be an issue before it’s all said and done,” said Starkville resident Bud Adamson, whose doctor also has imposed stricter prescription guidelines and potential drug testing.

“The drug test is just a nuisance and I doubt I ever will have to take one because I take my medicines like I’m supposed to. But who is going to pay for those extra drug tests? Me, the insurance company? This only adding to medical costs and health care is too expensive as it is. I tell you what, I am a whole lot more careful about keeping my meds locked up or hidden if people are around,” Adamson added.

Those and a number of other questions are being discussed this week in Jackson, Miles said. But addressing a problem that has its roots more than 20 years ago makes it even more difficult.

“In the 1990s, the federal government told doctors we weren’t doing enough to properly treat pain. It became the fifth vital sign. At about the same time, drug companies came out with oxycontin. I can remember reps in my office talking about how it had no side effects, how it was the perfect drug…no side effects other than it is highly addictive. That’s when the opioid crisis got started,” Miles recalled.

The issues behind the opioid are many. But money certainly plays a role. At the pharmacy, an oxycontin tablet is about 25 cents. On the street, a pill sells for $86.

“It’s easy to see why people are stealing them, taking them from their mothers and grandmothers,” Miles said.

Drug enforcement agents welcome the medical community’s involvement.

“That’s where in the long run we can do more to stop the cycle, or at least slow it down. It takes everyone communicating. It may inconvenience some people, but the problem is costing us all right now, trust me. And it’s killing people,” said Capt. Archie Williams, who heads the Lowndes County Drug Task Force.

In addition to prescription limits, drug testing, and increased patient monitoring, other potential changes include more requirements on pharmacies and better cross-referencing among all medical fields — doctors pharmacists, hospitals, and clinics.

“We have a database to check to make sure people aren’t double- or triple-dipping with charities. Certainly we can do the same thing with doctors and pharmacies and prescriptions,” Stanford said in frustration.

“A lot of people are going to have to be part of the solution. But legislators have been very cooperative so far. They understand we have a serious problem,” Miles concluded. 

this quote

“The problem with opioids is that if you are on them for 20 days or more, the addiction risk increases significantly. And many of the opioid addicts got started with a legitimate prescription. That’s what we are trying to balance and it is a balancing act,” Miles continued, noting the number of opioid prescriptions written in the state dropped 6 percent last year, but the number of pills actually increased.

just shows how myopic these people are… It is like we shouldn’t be getting new chronic pain pts every day…

we have 5 + million vehicles accidents every year… 45,000 die.. how many of the survivors will end up being chronic pain pts ?

We have 50,000 suicides – with half being done with a gun – but ONE MILLION attempts… how many attempts end up throwing someone into chronic pain.

How about the Las Vegas shooting 59 killed and 527 injured .. how many of those will end up being chronic pain pts ?

Sure you can approach many/most/all of these people will be dealing with acute pain.. will heal… 1%-2% being exposed to a opiate will cause their undiagnosed mental health disease of addictive personally to come to the surface.. how many are already alcoholics and being exposed to opiates they will discover that they have a new “drug of choice” ?

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Assoc representing 300,000 healthcare providers… lining up with those who want to focus on opiate addiction

Posted on February 7, 2018 by Pharmaciststeve

Pharmacy coalition to Trump administration: Meet with us about opioid crisis

The National Conference of Pharmaceutical Organizations (NCPO), a coalition of organizations representing more than 300,000 pharmacy practitioners, pharmaceutical scientists, pharmacy regulators, and pharmacy educators, has invited the Trump administration to meet to discuss ways of addressing the nation’s opioid crisis. Noting that each day more than 90 Americans die from overdosing on opioids, the coalition, of which APhA is a part, said in a statement that it supports immediate action on components of the report of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.

“We ask the White House and the Administration to work with the pharmacy community to establish and implement specific programs to address this crisis, and to identify specific goals for these programs,” said Lucinda L. Maine, PhD, RPh, executive vice president and CEO of the American Association of Colleges of Pharmacy and NCPO president.

In a related statement, APhA executive president and CEO Thomas E. Menighan, BSPharm, MBA, ScD (Hon.), FAPhA,  said, “APhA, along with the other NCPO members, is individually and jointly committed to combating this public health crisis as we implement best practices across the country. We believe such collaborative efforts are essential to meeting our country’s needs for high quality health care while working together to reduce the impact of this crisis on American families.”

Menighan highlighted pharmacists’ long-standing contributions in the fight against opioid misuse and abuse. “We work actively with patients and their communities on a daily basis, and APhA’s priority is to make sure that policy makers and our fellow health care providers know what pharmacists can do to make meaningful progress in the fight against opioids.”

 

 

 

According to the statement from the nearly a dozen healthcare organizations representing over 300,000 healthcare providers aligning themselves with those who believe that those who are suffering from the mental health issue of addictive personality are more deserving of appropriate care than the 100+ million chronic pain pts. Basically those with chronic pain are being

LEFT OUT IN THE COLD ?

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OPS !!! Fentanyl found in naloxone kit given out at pharmacy

Posted on February 7, 2018 by Pharmaciststeve

https://www.thestar.com/news/gta/2018/02/06/fentanyl-found-in-naloxone-kit-a-freak-accident-says-ontario-government.html

Kits used to reverse opiod overdoses that has caused thousands of deaths in recent years.

In what the province is calling an “isolated incident,” fentanyl was found in a naloxone kit assembled at a pharmacy, the Star has learned.

A person received a naloxone kit, which is used to reverse opioid overdoses, on Monday from a Shoppers Drug Mart in an undisclosed location in Ontario, only to find fentanyl inside.

Fentanyl is an opioid that has caused thousands of deaths in recent years, spurring concerns of a crisis across North America.

Opioids are medically used for pain relief, but people have also used them to get high.

In a statement, Shoppers Drug Mart called the incident “a considerable error, and one that absolutely should not have happened.”

The owner-pharmacist retrieved the fentanyl from the customer and apologized, the statement said.

“It is important that customers understand that this isolated event should not reduce their confidence in naloxone kits as an effective response for accidental opioid overdose.”

The Ontario College of Pharmacists is investigating the incident.

“The pharmacy is fully cooperating, and we’re confident that immediate action has been taken to begin to determine how it happened and what could have been done to prevent it,” said college spokesperson Todd Leach.

“We are not aware of similar incidents happening at any other pharmacies.”

According to multiple pharmacists at Shoppers Drug Mart across the GTA, the pharmacies order the components of the kit and assemble them in house.

“In most pharmacies, there is no access to fentanyl,” Laura Gallant, press secretary for Ontario’s ministry of health, said in a phone interview.

She said the pharmacy that gave away the kit with fentanyl inside had the opioid because it is close to a hospice where the drug is sometimes administered.

“This was an isolated incident at one location only and there is no known risk to the public,” she said in a statement.

Naloxone can be administered through injection or nasal spray, and kits are available for free at pharmacies, shelters and community agencies across the province.

The province distributed about 80,000 kits last year. At least 1,460 Canadians died from apparent opioid-related deaths in the first half of 2017, according to the latest report from the Public Health Agency of Canada.

Between July and September 2017, there were 2,449 emergency department visits related to opioid overdoses in Ontario.

In August, the province invested $222 million into fighting the opioid crisis. This year, the province began providing naloxone kits to police and fire services.

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AG Sesssion: take two ASPIRIN and just SUCK IT UP .. don’t call anyone !

Posted on February 7, 2018 by Pharmaciststeve

U.S. Attorney General Talks Opioid Crisis: ‘Take Some Aspirin’

http://wusfnews.wusf.usf.edu/post/us-attorney-general-talks-opioid-crisis-take-some-aspirin

As he addressed a crowd of prosecutors and police officers at the U.S. Attorney’s Office for the Middle District of Florida, Sessions offered his opinion for preventing addiction.

“I believe – and I am operating under the assumption – that this country prescribes too many opioids,” he said. “I mean people need to take some aspirin sometimes and tough it out a little.”

Some people in the crowd laughed. Sessions then imitated Gen. John Kelly, President Trump’s chief of staff, whom the attorney general says refused to take pain medication after a recent surgery on his hand.

“He said, ‘I’m not taking any drugs!’” said Sessions. “It did hurt though, he did admit it hurt. But a lot of people, you can get through these things.”

Sessions says stopping addiction before it starts is the most important element in the nation’s fight against opioids.

He outlined ways the federal Drug Enforcement Agency is working to curb addiction. Sessions says the DEA announced earlier this week that the agency will now ask individual practitioners applying for licenses or renewing their licenses whether they have received continuing education on prescribing and dispensing opioids.

“DEA can ensure that doctors have the CDC’s latest guidance on opioid prescribing so they don’t accidently over-prescribe,” Sessions said.

Florida Gov. Rick Scott and some members of the state legislature are pushing for a three-day cap on opioid prescriptions, and a seven-day cap when medically necessary.

But opponents of the bill, including many physicians, say those limits are unreasonable for people in intense pain, like those recovering from major surgery.

While Florida has cracked down on pill mills notorious for pumping out unnecessary prescription drugs, the state is still one of the hardest hit by the opioid crisis.

During his remarks in Tampa, Sessions suggested the rise in fentanyl sold on the streets is to blame.

“Fentanyl-related deaths [in Florida] jumped 97 percent [from 2015-2016],” he said. “So the driving factor, you can see in Florida maybe more than in the nation, is fentanyl.”

Sessions told members of law enforcement in the audience that as of Tuesday, all fentanyl-related substances would become scheduled on an emergency basis by the DEA.

“Fentanyl is the No.1 killer in America,” he said. “Scheduling and restricting all forms of this drug will make it easier for you and your agents to prosecute drug traffickers.”

Over the summer Sessions deemed central Florida one of 12 opioid “hot spots” in America. That led to the appointment of Kelly Howard-Allen, who has been with the U.S. Attorney’s Office in Tampa for more than 15 years, as the area’s “opioid fraud prosecutor.”

Howard-Allen will focus solely on investigating and prosecuting opioid-related health care fraud. Sessions said her new position allowed the office in Tampa to hire another assistant U.S. attorney, Greg Pizzo.

 

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Congress Let an Important Disability Rights Program Expire — Now People Are Trapped In Institutions

Posted on February 7, 2018 by Pharmaciststeve
Handicapped Parking Spot

https://www.aclu.org/blog/disability-rights/integration-and-autonomy-people-disabilities/congress-let-important

Imagine spending your life under someone else’s control, having to ask for permission each time you wanted to go out to eat, invite someone over, stay out late, or use the internet. For many Americans, this is their reality. Life in institutions and nursing homes often involves severe deprivations of the basic freedoms others take for granted. People with disabilities deserve better.

Over the course of the last several decades, the disability rights movement has fought to expand home and community-based services that assist people with disabilities to transition from institutions to the community. The 1999 US Supreme Court case, Olmstead v. LC, found that holding people in institutions, when they want to live in the community and can medically do so, is unnecessary segregation. Doing so violates both the Americans with Disabilities Act and our constitutional liberties.

The expansion of Medicaid home and community-based services offers people with disabilities a meaningful alternative to institutionalization. Now Congress has an opportunity to expand access to this vital pathway to freedom and independence.

Since 2005, the Money Follows the Person program has been a crucial resource for people with disabilities, supporting the transition of over 75,000 individuals with disabilities into their communities across 44 states. These transitions represent an opportunity for true integration after extended periods within the restrictive and regimented environments of nursing homes and institutions.

Money Follows the Person participants report significant and lasting improvements in quality of life and integration after returning to the community. In addition, their costs to Medicare and Medicaid decrease by approximately 20 percent. This represents an opportunity to improve a beneficiary’s quality of life and freedom of choice, while helping to control long-term Medicaid cost-growth.

Unfortunately, Money Follows the Person expired on Sept. 30, 2016, and states are running out of funding. Sens. Rob Portman (R-Ohio) and Maria Cantwell (D-Wash.) have introduced legislation to reauthorize the program for five years. The EMPOWER Care Act would ensure that states continue to have access to the federal funding they need to transition people into the community. 

Last summer, the ACLU joined forces with disability rights advocates to defend the Medicaid program. We recognize that for the disability community it’s not just a health care program — it is the vehicle that allows people to live independently instead of in a nursing home or institution.

Opening the door to community life can be a costly proposition for states, but the federal funding from Money Follows the Person can help bridge that gap and allow people with disabilities to enjoy community living. Congress should act today to reauthorize this program by passing the bi-partisan EMPOWER Care Act. Every person deserves a chance to life in freedom on their own terms.

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