Can Jeff Sessions Wreak RICO Ruin on America’s Cannabis Industry?

Posted on November 13, 2017 by Pharmaciststeve

www.marijuanapolitics.com/can-jeff-sessions-wreak-rico-ruin-americas-cannabis-industry/

Attorney General Jeff Sessions remains a sworn enemy of all things marijuana. Alarmingly, a half-century old law may now give him the power to soon devastate medical marijuana and the thriving American marijuana businesses. The 1970 Racketeer Influenced and Corrupt Organizations Act (RICO) was designed to attack organized crime, the mafia. Since then vaguely written act has metastasized into any easy,  too easy, way for prosecutors to score wins, with horrendous punishment inflicted upon the prosecuted. Now the RICO law gives Jeff Sessions an easy, too easy, way to bust the robust American cannabis industry.

Even without RICO, Jeff Sessions has, as attorney general, a range of powerful prosecutor tools for his vendetta against cannabis.

Foremost is marijuana’s misplaced but long-standing status as a Schedule I drug, highly dangerous and without medical use, the most restrictive and punitive classification. This horrendous legal blunder has lasted decades. The best hope for change was under the last presidency, but it did not happen. Please see Obama Leaves Behind a Marijuana Nightmare. Marijuana as Schedule I gives Jeff Sessions enormous powers to destroy the lives of Americans involved with cannabis medically or as entrepreneurs.

  • Schedule I confers strict mandatory minimum sentencing, often decades of prison time, along with enormous fines.
  • Schedule I makes cannabis business people pariahs to the banking system, forcing risky, cash-based business practices.
  • Schedule I triggers nightmare IRS 280e tax treatment, disallowing common business deductions.

Another key weapon treasured by Jeff Sessions is asset forfeiture, the taking of citizen’s cash and property of the police and prosecutors. Asset forfeiture allows the DEA and other police to simply take money and property without even making an arrest, simply by declaring the cash to be drug-related. Sharing schemes with the feds allow local and state police to send such lucre to the DEA whereby most of it is returned to the agency who took it, allowing them to spend it as they please while avoiding state laws restricting asset forfeiture.

 

Another discretionary tool available to the attorney general is the direction given to 93 US attorneys and their 5,000 assistant attorneys. As one of his first acts in office Sessions mandated his attorney army to always pursue the harshest treatment of drug defendants.

Potent as these weapons are, RICO adds a dangerous legal opportunity for Sessions to harm the lives of those he chooses. The Racketeer Influenced and Corrupt Organizations Act was written to powerfully assist the prosecution of people working together in what the government considers crimes.

Conservative radio host Hugh Hewitt recently chided Jeff Sessions for his lack of aggressiveness regarding the rapid spread of marijuana legalization. Perhaps unaware of the banking restrictions in place, Hewitt asked,

A lot of states are just simply breaking the law. And a lot of money is being made and banked. One RICO prosecution of one producer and the banks that service them would shut this all down. Is such a prosecution going to happen?

But one prosecution that invokes a supremacy clause against one large dope manufacturing concern, and follows the money as it normally would in any drug operation and seizes it, would shut, would chill all of this. But I haven’t seen on in nine months, yet. Is one coming?

Supposedly a conservative, Hewitt should be ashamed of himself for such anti-Federalist, anti-states rights, and anti-business sentiments.

L. Gordon Crovitz, writing for Reason.com explains some of the prosecutorial advantages of RICO:

With the vague crime of RICO, prosecutors have enormous power to bring cases against targets simply because they are in some way unpopular.

The act is prized by prosecutors and mourned by civil libertarians. It allows the additions of federal crimes on top state charges for ‘predicate acts.’ Growing or transporting marijuana is such a predicate act. The addition of these federal RICO charges add long prison terms, tripled fines, and other crippling punishments.

As scary as Session’s ability to use RICO as a club is the fact that states, even individuals, can use RICO to attack activities they dislike, activities including growing marijuana. The Cannabist documents a recent case where horse farm neighbors complained–and sued through RICO–that the smell of marijuana reduced their property value. 10th U.S. Circuit Court of Appeals in Denver ruled may present big RICO problems. Alicia Wallace reports, “In remanding that case to district court, the judges left the door open for something that legal experts and case attorneys say could rattle the legal marijuana industry: that private-property owners could potentially bring federal racketeering claims against neighboring marijuana grows and dispensaries.”

Whatever their form, RICO laws are a danger to cannabis entrepreneurs. Stay tuned to see how Jeff Sessions and perhaps anti-cannabis citizen groups put them to use. 

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‘My only other option is to die’: N.S. woman dismayed by pain clinic closure

Posted on November 13, 2017 by Pharmaciststeve

‘My only other option is to die’: N.S. woman dismayed by pain clinic closure

http://atlantic.ctvnews.ca/mobile/my-only-other-option-is-to-die-n-s-woman-dismayed-by-pain-clinic-closure-1.3672496

A Nova Scotia woman says if the Dartmouth Pain Clinic closes, she will be left with two options: seek her medication illegally on the streets, or end her own life.

Dawn Rae Downton has been living with chronic pain due to sacroiliitis, a form of inflammatory arthritis, for more than two decades and has been a patient at the Dartmouth Pain Clinic for nearly 10 years. On Thursday, a message on the answering machine at the clinic told patients it would be closing for good on Dec. 31.

“I had a very good pain physician there. He knew how to treat me, he knew that it was appropriate to treat me with fentanyl,” she said.

She says her physician at the pain clinic told her in July that he would be retiring in another three to four years, so it was a shock to hear in October that he planned to close his practice at the end of this year.

“Since then, I’ve looked for anyone – a (general practitioner) who will prescribe, another pain specialist. I’ve looked through Nova Scotia, I’ve looked across the country, I’ve looked into the United States,” she said.

Despite her search she has not been able to find help. Her family physician dropped her as a patient this year, and Downton says it’s because she is an opioid patient.

“My only options are now to go to the street to a street dealer. Not sure if I can afford that, not sure if I will get what I’m hoping to get, rather than something deadly. My only other option is to die,” she said. “And that’s a good option, because if I went back to the kind of pain that I had before I was seen by a pain clinic and put on fentanyl, I just couldn’t tolerate it. It would be pointless to go back to that kind of life.”

“I was unable to stand, to walk, to sit, to lie down and especially not to sleep, there was so much pain involved,” she said.

Downton says she waited nearly four years to get into a pain clinic. Doctors tried to treat her pain with non-medicinal therapies, including acupuncture, mindfulness, and physiotherapy. She says she also tested a number of pharmaceutical options, but nothing worked. As a last resort, she was put on fentanyl patches.

“And they gave me back my life,” she said. “So to be facing a situation now where I don’t have adequate pain meds leaves me with an intolerable life.”

The Nova Scotia Health Authority says a new pain specialist will start working in a private practice in Dartmouth in January. Another specialist is being recruited. It’s not clear how many of the Dartmouth Pain Clinic patients they will take on. In fact, the NSHA is unable to say how many patients the clinic has.

“We are doing our utmost and we are going to try to increase our capacity so we can look after these patients,” said Dr. Romesh Shukla, the chief of anesthesiology for the NSHA’s central zone.

Dr. Shukla says the Dartmouth Pain Clinic’s specialist, Dr. Robert Paterson, may continue to see patients after the closure date.

“He’s going to try to take some time to look after (patients) appropriately so that patients are looked after, whether it’s medication or other treatment he’s providing,” Dr. Shukla said.

For now, the wait list at the Pain Management Unit at the Queen Elizabeth II Health Sciences Centre in Halifax will grow. According to the NSHA, there are 850 patients on the Halifax Pain Clinic waitlist, and the 550 patients from the Dartmouth waitlist will be added to that.

The health authority says because patients are triaged for priority and based on new approaches to managing pain, patients are expected to be seen within 14 to 18 months.

However, if you are looking for experts learn more about Philip Naiman Physiotherapy here as they are know for innovative ways to curb the pain caused by an injury. One of the physicians at the Halifax Pain Clinic has told patients today that the wait list was between 13 and 16 months before the Dartmouth patients were added, and it is now more than two years.

Terry Bremner is an advocate for patients with chronic pain. He’s raised concerns before about patients feeling squeezed because of pressure on physicians to stop prescribing opioids.

Nova Scotia’s College of Physicians and Surgeons endorses a national guideline for prescribing opioids for chronic pain patients that was written this year. It recommends against the use of opioids.

Bremner says news of closure of the Dartmouth clinic is devastating, especially during National Pain Awareness Week, and he warns it will make it more difficult for patients to get care.

“We’re very complex individuals and we take up more time in the doctors’ offices, so the GPs want to pass us along to someone that specializes,” he said. “And that’s where we come into our wait times and these wait times are unacceptable.”

 Dawn Rae Downton has been living with chronic pain due to sacroiliitis, a form of inflammatory arthritis, for more than two decades and has been a patient at the Dartmouth Pain Clinic for nearly 10 years.

 

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The FACES OF PAIN … normally INVISIBLE to all but the pt’s family

Posted on November 13, 2017 by Pharmaciststeve

https://youtu.be/RjrJnriz6y8

https://youtu.be/0CuFEgnz8yA

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Imagine this: A functioning addict… not committing crimes

Posted on November 13, 2017 by Pharmaciststeve

https://www.wsbtv.com/news/2-investigates/prescription-heroin-the-alternative-approach-to-opioid-addiction/643637593

ATLANTA – As deaths continue to escalate from the opioid and heroin crisis across the country and here in Georgia, Channel 2 Action News visited an addiction clinic doing something you may say is unthinkable: giving heroin to addicts.

Despite the controversy, studies and patients experiences back up the success of the approach.

MONDAY AT 6: Miami, Biloxi, NYC: APD spent thousands to recruit in popular tourist destinations

The idea behind it is simple: If addicts are going to use heroin, why not give it to them in a safe environment?

[READ: Georgia among the top states with opioid overdose deaths]

The drugs are not contaminated, addicts don’t turn to crime and they can start to rebuild their lives.

Such treatment may seem irrational, even dangerous, but it’s gaining attention as the U.S. and Georgia battle an epidemic of overdose deaths.

Of the 1,300 overdose deaths in Georgia, in 2015, 900 of them were due to opioids and heroin.

[READ: Fulton County to sue drug manufacturers in fight against opioid epidemic]

Channel 2’s Tom Regan flew to Vancouver, Canada to see the heroin-assisted-treatment program at Providence Crosstown Clinic. The treatment is directed at hard-core heroin addicts who don’t benefit from other medications like methadone and suboxone.

With nurses standing by with naloxone, the clinic said it’s never had a fatal overdose.

2 Investigates take a look at the program’s success and if the approach could work in the United States, and here in Georgia, to fight the opioid crisis, Monday on Channel 2 Action News at 5 p.m.

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CDC guidelines: fewer opiates being prescribed… pt’s pain levels UP… suicides UP

Posted on November 13, 2017 by Pharmaciststeve

2017 CDC SURVEY RESULTS

Thank you for your interest in our survey on the impact of the CDC’s opioid prescribing guidelines. The online survey of 3,108 pain patients, 43 doctors and 235 other healthcare providers was conducted between February 15 and March 11, 2017 by Pain News Network and the International Pain Foundation (iPain).

Questions Q3 through Q10 were answered by pain patients only, while Q11 through Q19 were answered by doctors and healthcare providers.

Thanks to everyone who participated in this valuable survey.

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NY Post Spreads DEA Disinformation Regarding Kratom

Posted on November 12, 2017 by Pharmaciststeve

NY Post Spreads DEA Disinformation Regarding Kratom

www.inquisitr.com/4617297/ny-post-spreads-dea-disinfo-regarding-kratom/

The New York Post recently published an article regarding kratom that relied heavily on blatant misinformation supplied by the DEA. The article claimed 10 percent of the 23,000 respondents to the call for public comments claimed they supported the DEA ban. They relied on a claim of 15 attributable deaths related to kratom that has bee debunked numerous times. There was also an “anonymous source” who alleged serious withdrawal symptoms related to kratom. Kratom is a Southeast Asian plant related to coffee used for hundreds of years as a folk medicine that many consider to be a life-saver.

The claim that 10 percent of users experienced ill effects from kratom is in conflict with the analysis performed by the American Coalition of Free Citizens. The ACFC findings revealed the actual number to be just under 1 percent. The ACFC’s analysis found 99.1 percent of the 23,000 respondents were in favor of kratom. Only 113 of the 23,000 supported the DEA’s proposed extra-judicial ban. In addition, 48 percent of the respondents were veterans, law enforcement officials, health care professionals and scientists. This population of the respondents came out in favor of kratom and against a ban with a support level of 98.7 percent. Twenty-one percent of the filers who indicated age were 55 or older. Many users of kratom prefer the plant to prescribed pain medication because it is more effective and doesn’t have the same side effects of intoxication and addiction that pain pills do. The 90 percent figure offered by DEA spokesperson Melvin Patterson that the NY Post offers is completely fabricated.

Of the “15 cases of death attributed to kratom,” Dr. Babin cites academic papers regarding a forensic study that revealed 9 deaths attributed to kratom were connected to ingestion of the research chemical o-desmethyl-tramadol. Other deaths involved presence of other drugs in combinations that were more likely to prove fatal. To date, no deaths connected to kratom or its active constituents has occurred even in laboratory animals either due to respiratory depression, lethal overdose or other causes.

The New York Post also makes a point to mention how kratom can bind to the same receptors as opioids. This isn’t misinformation, per se, but it would be more honest to point out that milk, dairy products, and cheese have been shown to bind to opiate receptors as well. The coffee plant has also been shown in studies to result in “potent opiate receptor binding activity.” The coffee plant is actually closely related to kratom. Both are members of the Rubiaceae family. The difference is, caffeine overdose actually does lead to a small number of deaths per year, unlike kratom.

In addition to false claims regarding the percentage of people who experienced withdrawal symptoms from kratom and false claims regarding deaths attributable to kratom, the NY Post reported an “anonymous source” who experienced serious withdrawal from kratom involving vomiting. Multiple studies have confirmed that kratom doesn’t cause physical dependence and withdrawal symptoms are mild and comparable to caffeine withdrawal.

As for kratom being responsible for deaths, recently two coroners were debunked by lawyer and molecular biologist Dr. Jane C. Babin, PhD, molecular biology, Purdue University, and JD, University of San Diego School of Law. Dr. Karl V. Ebner, PhD, is a consultant at KETox Forensic Toxicology Consulting and author of numerous depositions, reports, and opinions related to drug and alcohol-related cases. Dr. Ebner concurred that Dr. Babin’s report “very troubling indications” of incorrect attribution of death to kratom, once again.

When the DEA attempted a ban of kratom at the end of the legislative season the kratom community leaped into full force in record time. 142,000 signatures were received on a White House petition to reverse the ban and three separate actions by congressional representatives were also issued including an official letter of objection to the Office of Management and Budget by Rep. Mark Pocan (D-Wis.) and Rep. Matt Salmon (R-Ariz.) signed by 51 members of the House of Representatives, a Dear Colleague objection led by Sen Orrin Hatch (R-Utah) and a letter of opposition to the DEA from Sen. Cory Booker (D-N.J.), Sen. Kirsten Gillibrand (D-N.Y.) and Sen. Ron Wyden (D-Ore.).

Pharmacologist Dr. Christopher McCurdy and several other experts in the field of pharmacology, ethnobotany and drug addiction addressed their concerns about how a proposed ban could “cripple painkiller research” and shut down a valid alternative used by thousands. CNN‘s Dr. Sanjay Gupta has theorized kratom could help end the opioid crisis. Last year, Dr. Babin wrote to DEA’s Office of Diversion Control to note that their initial conception of the plant was based on “contradictory opinions, incomplete knowledge of the most current scientific evidence and without input from the public on their experience with kratom.”

As for the addictive nature of kratom, Dr. Jack Henningfield is a professor at Johns Hopkins University and one of the foremost researchers on addiction performed a comprehensive 8-factor analysis on the addictive potential of kratom. According to Dr. Henningfield, “It’s important to understand that although kratom has some mild effects similar to opioids, its chemical make-up is different, and it appears overall much safer, with apparently relatively small effects on respiration. In fact, kratom’s analgesic effects and impact on energy, combined with its favorable safety profile supports continued access by consumers to appropriately regulated kratom products while research on its uses continues.”

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Montana leads the nation in suicides per capita

Posted on November 12, 2017 by Pharmaciststeve

Montana needs a pain patient bill of rights

http://helenair.com/opinion/letters/montana-needs-a-pain-patient-bill-of-rights/article_4fd8c999-ae65-5cab-9d78-0c7f65290c95.html

“But pain patients are particularly vulnerable. They die by suicide at twice the rate of the general population. In 2014, 28,000 took their lives.” (http://www.painmedicinenews.com/Policy-and-Management/Article/11-17/Opioid-Crisis-Continues-to-Pressure-Physicians-But-Patients-Bear-the-Pain/45054)

This article points out the crisis — currently invisible — of suicides in pain patients. Given that Montana leads the nation in suicides per capita, would it not be prudent to take whatever measures we can to prevent them?

 

There are several high profile suicides that have been noted in the press (Bryan Spece, Bob Mason). Many, of course, are not found in the press, but the agony for their families is no less. Perhaps you could call for hearings on this very subject. Get to what is so, and respond appropriately.

As you already know from all the hundreds of emails and articles I have sent you, and from this article above, palliative care of the 100,000,000 pain patients in America is disappearing, and that would be 100,000 patients in montana. (See the IOM report on pain in America 2011 for the data).

In Montana, as I have noted before, opiate refugees actually have been seeing doctors outside the state, and killing themselves as access has been withdrawn. This is a public health crisis right under our noses, and I am again sounding the alarm today. Please look into this.

As you know, the Board of Medicine takes no policy actions, just punitive ones. They have cast a pall over pain care by punishing doctors for “over-prescribing,” though no one has ever defined that term. And no one has been sanctioned for “under prescribing,” which must exist if over-prescribing does!

“The Board seeks to assure that no Montanan requiring narcotics for pain relief is denied them because of a physician’s real or perceived fear that the Board of Medical Examiners will take disciplinary action based solely on the use of narcotics to relieve pain. Although improper use of narcotics, like any improper medical care, will continue to be a concern of the Board, the Board is aware that treatment of malignant and especially nonmalignant pain is a very difficult task. The Board does not want to be a hindrance to the proper use of opioid analgesics. Treatment of the chronic pain is multifactorial, and certainly treatment with modalities other than opioid analgesics should be used, usually before long-term opioids are prescribed. Use of new or alternative types of treatment should always be considered for intractable pain periodically, in attempts to either cease opioid medications or reduce their use.”

 

This was the board’s policy on pain management until it disappeared from the BOME’s website somewhere around 2013, with no fanfare and no notice to physicians in the state. The MMA has been notified of this issue, and unfortunately has not acted either, as they are controlled more by specialty intervention doctors. This is a sad truth. I learned from MMA leadership courses that “What Don’t We Know?” Is a useful question to use to manage crises.

This problem can be solved by increasing safety in medicine (like was done with cars), sharing knowledge and using good evidence. Since legislators and federal agencies have made this a political issue, I again bring it to your attention.

We need a pain patient bill of rights in Montana, patterned on those of other states and compassion toward the 100,000 patients in pain in our state, as well as the 10-15,000 pain refugees that suffer daily here.

Sincerely,

And in good health, 

Mark Ibsen, MD

Helena

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There are dozens of cases of reported suicides after pain patients had their doses reduced

Posted on November 12, 2017 by Pharmaciststeve

Cracking Down on Opioids Hurts People With Chronic Pain

https://tonic.vice.com/en_us/article/8x5m7g/opioid-crackdown-chronic-pain-patients-suicide

Before he broke his back in a 1980s accident that ultimately triggered years of chronic pain, Jay Lawrence had to make a split-second decision. He was on a bridge with a car in front of him and the brakes on his truck had failed. “He saw a baby seat in the car and he hit the bridge,” says his widow, Meredith Lawrence. She lost her husband to suicide earlier this year after his doctor abruptly decided to cut down his opioid pain medication.

 “He had this great big personality,” she says, describing how Jay loved to be around people and constantly insisted on helping her, even when he was in severe pain.

But in March, Jay Lawrence shot himself with a gun that he insisted she purchase for him. He was 58. They were together in a park in Tennessee, near where, just two years earlier, they had renewed their wedding vows. When he died, Meredith was holding his hand. Afterwards, she called the police and was arrested for assisting a suicide (she’s now on probation).

Jay had warned his wife that there might come a day when the pain became too much for him. He’d had three back surgeries, countless steroid shots and nerve blocks, an electrical stimulator, a morphine pump, and several different types of prescription and non-prescription pain medications. He’d become resigned to the fact that he wasn’t going to regain function, but on good days he could make Meredith coffee before she went to work and help tend to their menagerie of nine cats and two dogs.

Then, in February, his doctor decided he would no longer prescribe the dosage of opioids that allowed Jay this small modicum of function. Since the introduction of the Centers for Disease Control and Prevention’s guidelines for opioid prescribing in 2016, physicians who have chronic pain patients on doses higher than the equivalent of 90 milligrams of morphine a day are under increasing scrutiny, by both civil and criminal authorities.

 Though Jay had not misused the drugs or shown any signs of trouble, he was told that his dose would immediately be cut from 120 milligrams of morphine to 90 and would drop again within two weeks. “I will not do this,” Meredith says he told her. And so, when she couldn’t find another doctor for him and saw that his mind was absolutely made up, she agreed to help. “He was the most stubborn person I ever met,” she says.

“It was either that or I would come home and find him,” she says, adding that she didn’t want that to be her last memory of him and certainly did not want him to die by himself.

“This would not have happened if they’d just left him alone,” she says.

Unfortunately, Jay is far from alone in being subjected to an involuntary opioid dose reduction. Since the guidelines were rolled out, 70 percent of more than 3,000 chronic pain patients who participated in an online survey by Pain News Network reported that doctors had either reduced or simply cut off their medications.

And Jay is also far from the only person to have taken their life in response: several dozen similar cases have been documented by a growing and furious group of pain patient advocates and doctors (who are not funded by pharmaceutical companies), and who are starting to organize in the aftermath of the crackdown.

The stories are nearly unbearable to read: descriptions of various forms of intense agony, mitigated to some extent with medication, which is then stopped regardless of the patients’ pleas. And then, death: often by shooting, sometimes by overdose.

 

“I’ve seen a published list that heavily emphasizes publicly reported events, which includes between 20 and 30 suicides,” says Stefan Kertesz, associate professor of preventive medicine at the University of Alabama, who is trying to raise alarm over the problem with the CDC and other health authorities. Kertesz says he receives numerous emails and social media posts from patients who are suffering and thinks the government needs to fund research to specifically track the outcomes of these patients. “Widespread suicidal ideation should be seen as a signal of a major risk,” he says.

Although the guidelines were intended to be voluntary and to apply only to general practitioners—not pain specialists—they’ve been widely interpreted as a mandate. Doctors who have patients on doses that exceed the guidelines receive letters from insurers and medical boards suggesting that they cut back; state Medicaid policies have been implemented that actually do mandate a maximum legal opioid dose and pharmacies like CVS are imposing their own limits on what they will dispense. The National Committee for Quality Insurance will now rate healthcare organizations on whether they keep doses below the limit—despite a protest letter signed by multiple experts involved in developing the CDC guidelines.

All of this is occurring despite wide individual variation in opioid metabolism (meaning a high dose for one patient will be a low dose for another), tolerance (over time, higher doses can become necessary), pain condition (again, immensely variable) and a complete lack of research showing that forcibly lowering opioid dose is safe or effective.

 

“It remains the case that there is no evidence that mandated prescribing reduction results in better outcomes for patients,” say Kertesz. While some data suggests that some patients improve with voluntary dose reductions—higher doses may sometimes paradoxically increase pain, a phenomenon known as hyperalgesia—none shows that forcible tapers do more good than harm in pain care. A recent study in the The International Journal of Drug Policy found that there was no reduction in addiction rates, either.

“A gradual taper is something every patient on high-dose opioids for chronic pain should be encouraged to do, and doctors owe it to these patients to explain why a taper makes sense,” says David Juurlink, professor of medicine at the University of Toronto, who is a major proponent of decreasing the use of opioids for chronic pain. However, he says, “As much as high-dose opioid therapy is a bad idea, tapering abruptly without the patient’s buy-in makes things worse. I discourage the practice at every opportunity.”

Juurlink says he would never cut opioid dosage as abruptly as was done in Jay’s case. “I would not take someone from 120 to 90 in two weeks, unless he a) really wanted to, and, critically, b) understood that it might be tough, and that I’d take him back up to 120 if things got bad and we’d go more slowly next time.”

In the climate of fear induced by the opioid crisis, however, doctors are focused on self-preservation. Patients report coming into doctor’s offices and seeing signs advising them that medication doses are being dropped, for everyone, no exceptions. “The popular discourse presents opioids as lethal and physicians as no better than heroin dealers,” says Kertesz, “The result of this is that no public authority has been willing to articulate a safe harbor for physicians to protect their patients who need opioids.”

 

These patients need exactly that: some kind of certificate or validation that their doctors are permitted to prescribe for them and they are patients in good standing. The CDC also needs to make a public statement saying that its guidelines cannot be used to prosecute doctors who prescribe higher doses in good faith.

The goal of lowering dosage is supposed to be to protect patients from the overdose death risk associated with high doses. But lowering numbers on a chart isn’t saving lives—and some of these patients could even be overdosing because they’ve had a dose reduction, or fear one.

“Jay said that people need to be held accountable for this,” Meredith says, “My job is to put a face to this problem. Real families are being hurt here. And I’m finding more and more people and hearing more and more stories.”

The CDC, the DEA, and other regulators who oversee our response to the opioid crisis must take heed. Cutting off opioids used by addicted people hasn’t protected them—it’s merely shifted them to more dangerous street supplies like heroin and fentanyl, further increasing the death rate. For pain patients, these suicides and the stories of those whose pain has worsened as their opioids were take away suggest that they, too, are being harmed. Who is being helped here? The operation cannot be a success if the patients die.

If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.

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CVS, Other Pharmacies Update Safety Rules to Prevent Harmful Drug Interactions

Posted on November 11, 2017 by Pharmaciststeve

CVS, Other Pharmacies Update Safety Rules to Prevent Harmful Drug Interactions

www.lawfirmnewswire.com/2017/11/cvs-other-pharmacies-update-safety-rules-to-prevent-harmful-drug-interactions/

Leading national pharmacy chains have updated their safety measures to prevent dangerous drug interactions that could harm patients.

The sweeping changes are the result of a Chicago Tribune investigation that found 52 percent of pharmacies in the Chicago area dispensed risky drug combinations without warning patients about potentially harmful interactions. CVS failed to caution consumers 63 percent of the time, the highest rate among the 255 independent and chain pharmacies tested.

After the report was published in December 2016, CVS upgraded the computer system at its 9,700 stores nationwide to improve patient safety. Pharmacists must now warn patients or consult with the prescribing doctor when an alert shows up for serious drug interactions. The computer system prevents pharmacists from selling medication until they take the required action. Around 30,000 pharmacists and 50,000 technicians received training on the new safety protocol.

“Pharmacies are finally taking steps in the right direction to make significant improvements that address the growing risk of people taking multiple medications that could potentially have harmful, and even fatal, effects,” commented Briskman Briskman & Greenberg medical malpractice attorney Paul Greenberg. “Patients have a right to know about dangerous drug interactions, and it is the pharmacist’s duty to provide that information to them.”

Walgreens announced that it conducted additional training on dangerous drug interactions with the company’s 27,000 pharmacists. Costco, Kmart and Wal-Mart have also updated their computer systems and trained their pharmacists in order to boost patient safety.

While national pharmacy chains have adopted new measures to reduce the number of people hospitalized each year due to dangerous drug interactions, local chain Jewel-Osco did not provide any details about changes implemented after last year’s Tribune report. Investigators found the Chicago pharmacy failed to warn consumers about dangerous medications 43 percent of the time.

According to a statement Jewel-Osco released to the Tribune, “Technological and operational adjustments have been made to assist and monitor our pharmacists as they perform their jobs to ensure patient safety.” The pharmacy did not specify the changes involved. Mariano’s, another local pharmacy chain, now requires all of its pharmacists to undergo training in drug interactions, drug allergy contraindications and other patient safety concerns.

Since all of these pharmacies have “updated their computer software” and “retrained” their Rx dept staff… does this suggest that they knew or should have known all along …that their prescription filling processes was failing to protect pts from known drug interaction(s)  and it took a “damning expose” pointing out the inadequacies of all of these systems/processes and the risk that they were putting the pts that put their trust in these pharmacies to protect them against adverse drug interactions to get them to make changes… that should have been in place … in the first place ?

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DEA: Feds won’t arrest CBD oil users, neither should Indiana

Posted on November 11, 2017 by Pharmaciststeve

DEA: Feds won’t arrest CBD oil users, neither should Indiana

https://www.wthr.com/article/dea-feds-wont-arrest-cbd-oil-users-neither-should-indiana

INDIANAPOLIS (WTHR) — When Scott Wampler picked up his 11-month-old son and felt a lump near his abdomen, he immediately suspected something wasn’t right.

“I knew as soon as I felt it that it wasn’t just a rib,” Wampler recalls.

Doctors confirmed it was a tumor, and they diagnosed the mass inside young Zori Wampler as a rare form of liver cancer.

Zori Wampler’s parents turned to CBD oil to help treat the pain from his cancer treatments.

It meant Zori would spend his first birthday in an Indianapolis hospital, recovering from surgery to remove the cancer. And over the next several months, the toddler endured multiple rounds of chemotherapy.

“He was in a severe amount of pain. We couldn’t even get him to take his medicine,” explained Zori’s mother, Victoria.

That’s when Zori’s parents heard about CBD oil, an herbal supplement derived from cannabis plants. Friends told the Wampler family that CBD oil can calm nerves and effectively treat pain. Scott and Victoria decided to give a few drops to their son, hoping it would reduce his pain with far fewer side effects than the pain medicines prescribed by doctors. They did not expect what happened next.

“He just changed instantly,” explained Victoria. “He was so calm. He was so relieved. He was just happy. It was magical to see him out of pain.”

But what helped the toddler through his cancer treatments is now in legal limbo in Indiana following an Eyewitness News investigation.

State launches CBD Crackdown

CBD oil use is growing in popularity with those looking to treat pain and anxiety. (WTHR Photo)

 
“There’s a lot of confusion about this topic even within state government”

Earlier this year, 13 Investigates exposed a series of CBD raids conducted by state excise police and the Indiana Alcohol and Tobacco Commission. Excise officers confiscated CBD oil products from dozens of stores across Indiana, citing the businesses with violating state law for possessing marijuana.

Marijuana and CBD oil both come from cannabis plants, and that creates a great deal of confusion for law enforcement. While marijuana comes from cannabis plants that have elevated levels of THC (the chemical compound in marijuana that creates a “high” feeling), CBD oil comes a very different variety of cannabis known as industrial hemp. That has little or no THC and causes no high at all.

Immediately following WTHR’s report, state officials met at the governor’s office to discuss the widespread confusion surrounding CBD oil. That meeting prompted the Alcohol and Tobacco Commission to impose a moratorium on the agency’s CBD crackdown, and excise police were ordered to stop confiscating CBD oil products until the attorney general could issue a clarification of state law.

“There’s a lot of confusion about this topic even within state government,” attorney general spokesman Jeremy Brilliant told 13 Investigates this summer. “Our attorneys are trying to figure out in fact what is legal and what is not.”

Months have passed with no clarification from the attorney general and, in the meantime, police departments across the state are interpreting existing law in very different ways.

13 Investigates obtained a copy of an Indiana State Police memo sent in late August. It informed all ISP enforcement staff that possession of CBD oil is not a crime:

“Commercial products manufactured from industrial hemp are lawful to possess and sell in Indiana. A short list of these products may include, but are not limited to, hemp rope, hemp hand lotions, CBD oil, hemp shoes and other clothing articles manufactured from industrial hemp. Keep this information in mind in the event you encounter such products in the course of your duties, and remember these products are lawful to purchase and possess.”

Other police departments in Indiana have a different perspective and, as a result, some Hoosiers now find themselves facing criminal charges for using CBD oil. That is a big concern for families like the Wamplers.

“I think the biggest question for the lawmakers is: What are we supposed to do?” said Scott Wampler. “Nobody really seems to have an answer.”

Illegal under federal law but …

“Anybody who’s in violation always runs that risk of arrest and prosecution”

While state leaders are struggling to figure out CBD law in Indiana, officials at the U.S. Drug Enforcement Administration say federal law on the subject is very clear.

“It’s not legal. It’s just not,” said spokesman Rusty Payne, who met with 13 Investigates at DEA headquarters near Washington, DC.

Payne says cannabis plants are considered a Schedule I controlled substance, and medicinal oils derived from cannabis plants are illegal according to two federal laws: the Controlled Substance Act and the Food, Drug and Cosmetic Act. He said confusion surrounding the Agricultural Act of 2014 (better known as the “Farm Bill”) is frequently cited as legal justification by those who want to manufacture, sell or use CBD oil. The DEA believes the Farm Bill permits only CBD research — not CBD marketing and sales.

“Anybody who’s in violation [of the federal laws] always runs that risk of arrest and prosecution,” he said.

But during the hour-long discussion with WTHR, Payne said families like the Wamplers have little to worry about.

U.S. Drug Enforcement Administration spokesman Rusty Payne (WTHR Photo)

U.S. Drug Enforcement Administration spokesman Rusty Payne (WTHR Photo)

WTHR: We’ve heard from so many people who say this stuff really helps them from a medical perspective.

Rusty Payne: There’s a lot of anecdotal evidence out there – there’s a lot of people out there – telling us the same thing you are: that this stuff has helped their family.

WTHR: What would you tell the mom and dad who are buying this stuff and giving it to their kids because it helps them get through the day?

Payne: Am I speaking as a DEA spokesman or as a father? Because I am a dad. As a father?

WTHR: Yes.

Payne: I’d do the same exact thing — without hesitation. I cannot blame these people for what they’re doing. They are not a priority for us … it would not be an appropriate use of federal resources to go after a mother because her child has epileptic seizures and has found something that can help and has helped. Are they breaking the law? Yes, they are. Are we going to break her door down? Absolutely not. And I don’t think she’ll be charged by any U.S. Attorney.

While that may come as welcome news to the thousands of Hoosiers who use CBD oil, it does not resolve the uncertainty many families are feeling while waiting for clarification from the state.

“I don’t know why anyone would be against this,” Zori’s mother said. “We got to see firsthand what it can do. It’s clearly helpful. This isn’t causing any harm. It only helps.”

A deadly crisis

Officials at the DEA were surprised to learn that state excise officers raided retailers who sell CBD oil and that some Indiana police and prosecutors have been criminally charging Hoosiers who use it. DEA agents could do the same thing if they wanted to, but they are not. Payne says there is a good reason for that.

“We are in the middle of an opioid crisis in this country. That’s our biggest priority right now,” the agency spokesman explained. “People are not dying from CBD. Some would argue lives are being saved by CBD. Are we going to get in the middle of that? Probably not.1“

Asked what advice he might have for Indiana as state leaders wrestle with how to deal with CBD, Payne hesitated, saying the DEA would not weigh in on a state issue. A few moments later, he changed his mind and offered a poignant message for state officials and police.

“I think what they need to do is the same thing we’re doing and that’s prioritize what is truly the biggest issue affecting public safety right now. That would be the opioid epidemic,” Payne said. “According to the CDC, in 2015 we lost 52,000-plus Americans – 52,000 — and a good portion of those are from opioids: heroin, fentanyl, prescription drugs. That has to be our priority right now. Not CBD.”

This spring, Indiana Governor Eric Holcomb told WTHR the opioid crisis is a priority for Indiana and that all options for attacking the crisis would be considered.

“This has got to be front and center on every governors’ mind,” he said. “I’ve just seen case by case by case by case by case by case where these drugs of today are literally hijacking the brains of our fellow citizens.”

But many Hoosiers say when it comes to Indiana’s war on opioids, Indiana is not utilizing a powerful weapon. They say CBD oil could help fight and even prevent opioid addiction — if the state were to embrace it rather than fight it.

“Lets me have my life”

Ruby Houpt believes she is a perfect example.

For years, the Indianapolis resident has taken powerful prescription painkillers and more than a dozen other medications to help manage the painful symptoms of fibromyalgia and degenerative bone disease. Those medical conditions make it hard for Houpt to get out of bed, and she says side effects from some of the addictive pills make her feel like a zombie.

“I didn’t want to live that way. I don’t want to live that way. I shouldn’t have to live that way if that’s the way I don’t want to live,” she told WTHR.

That’s why Houpt decided to try CBD oil, which she takes through a spray or a vape pen, and she likes the results.

“Lets me function. Lets me be normal. Lets me go walk around my house. Lets me load my dishwasher. Lets me make a meal. Let’s me take care of elderly father,” she said. “Just lets me have my life.”

Houpt is not alone. Countless Hoosiers have told 13 Investigates CBD oil gives them incredible pain relief from a wide variety of medical conditions. And the best part, they say, is that their CBD oil drops, pills, balms and sprays helped them to wean off addictive painkillers.

During WTHR’s visit, Houpt dumped out a large bag of pill bottles filled with leftover medications that she no longer needs.

WTHR: After starting CBD oil, you’re not taking any of these?

Ruby Houpt: None. None whatsoever. No opioids. No anxiety medications. No sleeping medications.

WTHR: You mean to tell me, CBD oil could replace all of this?

Houpt: All of it. That’s all the crap I can give back. I don’t want it. The pills, the addiction, it’s not what I want. It’s a high. I don’t want that.

Houpt has been able to discontinue 14 pain killers, anti-depressants, sleeping pills and other addictive drugs because of CBD oil. With countless Hoosiers currently addicted to prescription drugs, she says CBD could make a huge difference, just as it did for her. Houpt plans to keep taking CBD even if the state decides to renew its crackdown.

“I don’t care. They can kiss my ass,” Houpt said when asked what she’d do if the state declared CBD oil illegal. “I’d have to see a judge and say: ‘You know what, your honor, I don’t want to be high; I want to be normal. I don’t want a buzz; I want relief. And this is my relief right here.'”

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Changing federal law

“I think the risk is small and the potential rewards are great”

Ignoring federal regulations, many states have passed their own laws to legalize CBD oil. On a very limited scale, Indiana did the same thing earlier this year when lawmakers passed a bill that creates a CBD registry for a small group of epilepsy patients. (Several studies show CBD oil is effective in reducing seizures.) Once registered with the state, those individuals can legally obtain and use CBD oil in Indiana. It was only after the governor signed that bill into law this spring that excise officers launched their crackdown at stores across the state. It is unclear whether individuals who do not suffer from an untreatable form of epilepsy can now legally use CBD oil in Indiana – something that was occurring without incident prior to passage of the new law.

While clarifying state law would help resolve uncertainty for CBD users in Indiana, some supporters of the controversial pain remedy say what’s truly needed is a new federal law to legalize CBD oil in all 50 states.

“Congress could change the law tomorrow, and if they do, that’s what we’ll follow,” said Payne.

Congress is now considering just that, and a current proposal would impact millions of people by dramatically altering the legal landscape for CBD oil.

“I look at how we take such a hard line against using this substance, and I think ‘What are we doing as a nation?'” said Rep. H. Morgan Griffith (R – Virginia). “I want to change the law … and I think the risk is small and the potential rewards are great.”

The congressman has been moved by stories from constituents who’ve been greatly helped by cannabis products such as CBD oil. In January, he introduced HR 715, a bill that would remove CBD oil from the Controlled Substances Act. Griffith believes CBD oil should be legal to help thousands of families just like the Wamplers.

“The stuff creates miracles,” he said. “[If] my kid needed it, I’d do it, and if I feel that way, then I feel I have an obligation to change the laws here in the halls of Congress.”

The legislation has some bi-partisan support, but it’s not yet clear if the House will move the bill through committee for a full vote.

1 Even if the DEA did want to arrest and prosecute individuals who sell or use CBD oil, the Appropriations Act of 2017 seems to put a freeze on such activity. The act states that federal funds may not be used to “prohibit the transportation, processing, sale, or use of industrial hemp that is grown or cultivated in accordance with section 7606 of the Agricultural Act of 2014.”

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