Pharmacists fight back: Age discrimination lawsuits in retail pharmacy

http://drugtopics.modernmedicine.com/drug-topics/news/pharmacists-are-talking-age-discrimination-lawsuits-retail-pharmacy?page=0,0

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Forfeiture Financial Specialist Supporting the DEA

Company Name FSA Company Location Atlanta, GA, US

https://www.linkedin.com/jobs/view/forfeiture-financial-specialist-supporting-the-dea-at-fsa-501090882/

 Does this job description suggest that the DEA has a spread sheet(s) with estimated net worth of prescribers and/or others that they believe could be “targets” of civil asset forfeiture ?

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Four cities file lawsuit against Joint Commission on Accreditation of Health Care Organizations

https://wvrecord.com/stories/511258712-four-cities-file-lawsuit-against-joint-commission-on-accreditation-of-health-care-organizations

CHARLESTON – Four West Virginia cities have filed a lawsuit against the Joint Commission on Accreditation of Health Care Organizations, alleging its misinformation of dangerous pain management standards encouraged the over-prescription of opioids in the state.

The JCAHO sets standards and certifies virtually every health care organization in the United States and West Virginia. Certification is viewed by health care organizations as critical to their continued operation, according to the Nov. 2 lawsuit filed in the U.S. District Court for the Southern District of West Virginia.

Charleston, Huntington, Ceredo and Kenova claim in 2001, JCAHO announced a new set of pain management standards.

In a campaign to explain the standards, JCAHO spread misinformation about the addictive nature of opioids, which included statements such as, “Some clinicians have inaccurate and exaggerated concerns about addiction, tolerance and risk of death. This attitude prevails despite the fact there is no evidence that addiction is a significant issue when persons are given opioids for pain control,” according to the suit.

An April 13, 2016, letter signed by 61 health care professionals informed JCAHO that “the pain management standards continue to encourage unnecessary, unhelpful and unsafe pain treatments that interfere with primary disease management,” and “foster dangerous pain control practices, the endpoint of which is often the inappropriate provision of opioids with disastrous adverse consequences for individuals, families and communities,” according to the suit.

According to Physicians for Responsible Opioid Prescribing (PROP), which built the coalition that sent the letter, JCAHO “responded defensively” and denied “any relationship between its pain management standards and opioid overprescribing.”

The lawsuit seeks class action status in part to enjoin JCAHO from enforcing its dangerous standards nationwide. It also seeks damages to remedy the impact of JCAHO’s continued promulgation and enforcement of the standards. The lawsuit is unique in its approach and is the product of ongoing, intensive research on how to stem the opioid epidemic plaguing West Virginia and the rest of the nation. 

Huntington Mayor Steve Williams believes that this is the next logical step in the city’s role as a nationwide leader in the fight against opioid addiction. 

“This lawsuit is a critical move toward eliminating the source of opioid addiction and holding one of the most culpable parties responsible,” Williams said. “For too long, JCAHO has operated in concert with opioid producers to establish pain management guidelines that feature the use of opioids virtually without restriction. The JCAHO standards are based on bad science, if they are based on any science at all.”

Williams said the cities need to take this opportunity to prevent a new generation of individuals from becoming addicted to opioids.

“At the same time, we need resources to help those who are suffering to recover and return to productive lives,” Williams said.

The plaintiffs are represented by special counsel Talcott Franklin P.C., The Webb Law Centre, PLLC, and City Attorney Scott Damron.

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Lawsuit filed after mom says pharmacist refused to fill daughter’s prescription

www.krqe.com/2017/11/02/lawsuit-filed-after-mom-says-pharmacist-refused-to-fill-daughters-prescription/

ALBUQUERQUE, N.M. (KRQE) – A lawsuit has now been filed against Walgreens after an Albuquerque mother says a pharmacist wouldn’t fill her teenage daughter’s prescription.

The mother says it happened at the Walgreens pharmacy on Coors and Montano. When the mom tried to pickup a drug used to prepare patients getting an IUD – a form of birth control – the pharmacist on duty denied her, citing personal reasons.

The ACLU of New Mexico and the Southwest Women’s Law Center have filed suit against the drug store chain saying as a business that serves the public, they are prohibited from discriminating against women related to their reproductive health needs.

They say the incident left the mother judged, disrespected and embarrassed.

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Her pharmacy of 5 yrs no longer will fill her oxycontin script. She is 80 yrs. Old and has been on oxycontin for 5 + yrs. She just can’t quit abruptly and we have been to so many pharmacies and turned away from every one with different reasons such as: “I don’t feel comfortable filling this prescription” ,  ” this pharmacy doesn’t fill for this docor”,  to ” if it were in stock , I would fill it. I called the doctor and I verified a great patient/doctor relationship, but I’m just a fill in , talk to the main pharmacist ” ,  which we did , and she just no she won’t do it and when I asked her to call my moms doctor,  she walked away from us. I asked her if she won’t atleast try to speak with my moms  doctor , she walked away and ignored us. . You are a avocate of pharmacist’s and patients . Please tell me what I do to help my mom. We live in the 91342 area  ,  california. If you know of any pharmacies that will fill her medication, please refer us to them . Thank you sir for your time

Who believes that they type of “professional behavior” has crossed the “unprofessional conduct line” ?

I have a retired pharmacist friend in CALF and who is on first name basis with the executive officer of the CA Board of Pharmacy…  He is a strong pt advocate … let’s see if I hear anything..  I am not holding my breath…

We have a serious – and growing – pharmacist surplus in this country. It is estimated that by 2025 there will be 50,000 Pharmacists looking for a job that doesn’t exists. If a chain pharmacy cares if their employed pharmacists are denying care to pts that are suffering with chronic conditions that require controlled medications… they would be firing them and hire someone who are really focused in caring for pts. The only pharmacists that I hear about getting fired are 50+ y/o and have maxed out their salary and weeks of vacation and other benefits and replaced by a “much younger version “

Here is a website that will help anyone find a independent pharmacy in their zip code   http://www.ncpanet.org/home/find-your-local-pharmacy  when you get tired of being “just a number” at the local chain pharmacy

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Fibromyalgia and Lady Gaga: 5 things to know about the condition

knowridge.com/2017/11/fibromyalgia-and-lady-gaga-5-things-to-know-about-the-condition/

In a new Netflix documentary, Lady Gaga will publicly share her struggle with fibromyalgia, leaving many fans and viewers asking: What exactly is it?

“Fibromyalgia is a chronic disorder of the brain that causes widespread pain throughout the body,” says Daniel Clauw, M.D., director of Michigan Medicine’s Chronic Pain and Fatigue Research Center.

“In fact, patients with fibromyalgia often have pain and disability that are worse than almost any other chronic pain condition.”

Fibromyalgia can develop at any time during a person’s life — and with no apparent triggers, he notes.

“We know more about this condition now than ever before, but we need to better understand the mechanisms of it to improve treatments,” Clauw says.

Complicating things for many fibromyalgia patients: Their peers and physicians may not even acknowledge the ailment.

Which is why the singer’s influence could help fight the stigma.

“I believe, given her fame and popularity, that she is getting better recognition and treatment for the condition,” Clauw says. “Many patients struggle to even find a doctor who will see them and take them seriously.

“Hopefully, the increased attention around Lady Gaga will bring more awareness to the condition.”

He spoke more about fibromyalgia and what patients need to know:

5 facts about fibromyalgia

It isn’t uncommon: Fibromyalgia affects 2 to 8 percent of the population.

“It sounds strange to say a range, but we don’t know the exact percentage of people affected by fibromyalgia because it depends on the diagnostic criteria physicians are using,” Clauw says. “And most people with the condition go undiagnosed.”

It varies by patient: “There isn’t one specific symptom that signifies this person has fibromyalgia,” Clauw says.

The most common indicator is widespread pain throughout the body, but he notes that other warning signs might include fatigue, sleeplessness and memory and mood problems.

It can impair quality of life: Most patients with fibromyalgia can carry on with normal activities, Clauw says. For some, though, the condition can ruin their lives.

Pain is widespread, so it can affect any or all parts of a person’s body at once — meaning not moving one body part to avoid pain is generally out of the question.

It can deceive others: People with fibromyalgia might struggle to voice their discomfort. “Unfortunately, those that don’t understand the condition or the pain often think the affected are making it up,” Clauw says.

“Even in the medical profession, we only started taking this condition seriously in terms of research in the past 30 years.”

It’s tough to treat: There are many drug and nondrug treatments that can help people with fibromyalgia, but none of them work in everyone.

Patients typically need to try several treatments. Still, notes Clauw, “we generally strongly recommend against these patients using opioids, which often worsen this type of pain.”

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James Gill: Putting a star lawman on trial

http://www.theadvocate.com/new_orleans/opinion/james_gill/article_6a621a34-be4c-11e7-9c7d-7b848a3b0d02.html

If prosecutors fail to convict Chad Scott, it will not be because his alleged misdeeds took them by surprise.

The feds received a tip that he was a crook thirteen years ago, although whether that panned out is unknown. What we do know is that Scott’s supervisors at the DEA were disciplining him for at least the fourth time when yanking his gun and badge in March after drugs and cash turned up missing. A whiff of corruption has attended pretty much his entire career, and his indictment has now been greeted in some circles with a shrug.

Scott has his fans too, however, and Matt Coman calls him “a fine upstanding public servant.” That endorsement might have carried more weight if Coman were still a federal prosecutor himself, but he quit that line of work for private practice a couple of years ago. He is gushing now in his capacity as Scott’s defense attorney.

Scott was long regarded as the star agent, making collars and seizing cash and drugs with such effect that he rated a line in a number composed by the Houston rapper Scarface. Scott’s “work has gone a long way toward continuing to eradicate the scourge of illegal drugs in this community. He’s a fantastic person, a fantastic agent — a credit to that agency,” according to Coman.

In his regard for Scott, Coman defers only to Scott himself, who evidently liked to assure suspects that he was the “baddest” law enforcer along the I-10 corridor and burnished his macho image by nicknaming himself, “the white devil.”

Scott, 49, is also a winner on the Big Dawg tour, a major event in the water ski world, and has been described in the public prints as “tall, athletic and handsome.” It would be unnatural if he hadn’t been wondering who would play him in the movie.

Perhaps he still is, but he is now more likely to be the villain than the hero in any scenario, for the grand jury does not share Coman’s high opinion.

According to the indictment, Scott has framed suspects, lied on the witness stand, falsified public records and embezzled cash seized from drug dealers. He denies it all and is scheduled for trial next month, when he could be sentenced to 17 years.

It is obvious that the Department of Justice has no doubt he is guilty. Prosecutors are not waiting to dismiss charges in cases handled by Scott, closed or open. Last year two drug dealers, facing 10 years, had their convictions overturned because Scott had suborned witnesses. And, such is the distrust of Scott that a few months ago, charges were dropped after a defendant had pleaded guilty in a double murder, although that prosecution will be revived in state court.

Scott is hardly the first law enforcer to be accused of breaking the rules. It is no doubt extremely rare for detectives and prosecutors to traduce defendants they know to be innocent, but dirty tricks have seem justified to prevent a guilty suspect getting away with it. They never are, of course; a zeal to convict does not excuse the perjuries of which Scott is accused.

But his alleged crimes go beyond such standard tricks as hiding exculpatory evidence. Scott, according to the indictment, wasn’t out just to win convictions, but, in cahoots with another member of a drug task force, to line his own pockets with cash lifted from the evidence room. A couple of other former agents have pleaded guilty and agreed to testify at Scott’s trial.

More charges in cases handled by Scott will no doubt be dismissed as the Justice Department goes back decades in search of further evidence that he perverted the course of justice. Guilty parties will presumably be let off the hook, while innocents will turn out to have been wrongly convicted.

This just goes to show that a single agent can bring the entire system into disrepute if he is given free rein long enough. Scott has attracted suspicion from time to time since at least 2004, when an informant accused him of “supplying narcotics,” but always skated away from trouble, perhaps because he racked up enough busts to be the blue-eyed boy. But that left his bosses with an even bigger tangle of dubious convictions to re-examine when his antics got so out of hand that they finally had to act.

Email James Gill at Gill1407@bellsouth.net

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https://www.nbcsandiego.com/news/local/Experts-Urge-Caution-With-Natural-Legal-Drug-Kratom–454685203.html

Users and health professionals are debating over the benefits and risks of Kratom, a natural substance, from the leaves of a tree that grows in Thailand.

The legal drug can be bought online and in stores. Users say Kratom is a stimulant that in small doses gives them energy and boosts their mood but if you take more of it, the drug has the opposite effect, working like a sedative or narcotic.

Jane Babin, a Kratom user said the natural drug is harmless, and helps with her joint pain.

“You know, my joints ache sometimes,” she said. “(I’m) probably getting arthritis, and you know, it works well, for me.”

Babin is a lawyer and biochemist. She said she buys Kratom legally on the internet, from sellers who import it from Southeast Asia.

“The euphoria or addiction potential is overstated,” she said. “It doesn’t really have that effect on me at all.”

NBC 7 Investigates found numerous overdoses associated with Kratom, causing sickness and death. According to the state Poison Control System, since 2015, there have been more than 100 calls for help to poison centers in California, 11 of those calls were reported in San Diego County.

In the last four years, according to the San Diego County Medical Examiner’s Office, 11 deaths have been linked to Kratom in the county with four of those deaths happening this year. According to the medical examiner reports, all but one of those fatalities involved other addictive drugs as well.

“People say it’s natural, so it has to be safe,” Dr. Clark Smith, a drug and addiction expert said. “You know what? Arsenic is natural.”

Smith said it’s foolish to assume Kratom is safe and no one should use it until clinical studies prove it’s not dangerous.

“Who knows, maybe somebody uses it casually for a couple of years, and they get kidney failure, or they go blind,” he said.

Last year, the DEA labeled Kratom as a dangerous substance, with no medical benefit. The agency planned to classify it as a schedule one controlled substance, making it illegal, everywhere. As news of those plans was made public, Babin and thousands of Kratom users flooded the agency with phone calls and petitions. They argued drug addicts use Kratom to help soothe withdrawal pains.

“It’s a better solution than prescription opioids for a lot of people,” Babin said.

In the end, 51 members of Congress and nine U.S. Senators supported that effort, and the DEA backed off.

“So, there’s really no control over it,” Smith said.

While not federally regulated, states and cities can, and have, passed laws related to Kratom, including the city of San Diego, which outlawed it last year.

Adults can legally buy Kratom in 17 of San Diego County’s 18 cities. Smoke shops sell bags and capsules of the natural substance.

Babin said responsible adults should have access to Kratom, but others disagree.

“The fact that there are deaths associated with it should give anyone a healthy fear of it,” Smith said.

“You know, when we have 91 people dying every day from opioid overdoses, the last thing we need is to have another opioid out there,” Amy Roderick with the DEA said. “Something else that somebody could really use for the first time, and become addicted to.”

In the city of San Diego, seven people have been charged with illegal possession for the sale of Kratom. If convicted, defendants face six months in jail and a $1,000 fine.

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Hello Steve I’m writing to ask for some clarification on a problem I had today. I went to fill a prescription for my wife who is afflicted with PTSD, rapid cycling bipolar, and BPD. despite being on the medication for a month and the risks of going without the medication the pharmacist refused to fill the medication due to a possible interaction between two drugs. Now one of these a had already been filled so we were unable to fill her mood stabilizes which had her so distraught that having been without it for a week, due to a mishap with her doctor not the pharmacy, that she was afraid she was going to need her 6th hospitalization in 5 years. I drove to the Dr’s office and had him call and force the prescription through, and I talked with the pharmacist about the issue. She informed me she had a right to refuse the medication and I subsequently informed her that the ADA provided her certain rights including getting her medication since the prescription was due to be refilled and was her not one but two conditions explicitly mentioned by the ADA. I spoke with two RNs as well as a LPN and they said they saw no reason for it not to be filled. I was hoping you might be able to offer some insight about the conflict between these two conflicting laws from your unique and experienced point of view. 

The typical pharmacy computer system throws out so many “potential interactions warnings” that most pharmacists come NUMB to all the warnings that require a override… that all to many get into the habit of not really paying attention to the warnings and just hitting the “OVER RIDE KEY” and keep going… after all the chain headquarters is always watching over your shoulder on how many prescriptions you are filling/verifying per hour – in the industry referred to as “METRICS “.

Here is a survey done in Chicago about one year ago where it was alleged that pharmacists missed about 50% of serious drug interactions when presented certain medication combination that was used in the test.  http://www.chicagotribune.com/news/watchdog/druginteractions/ct-drug-interactions-pharmacy-met-20161214-story.html

The most serious drug to drug interaction is classified as a LEVEL ONE… and those you really should pay attention to… those tend to be ones that you don’t just hit the “over ride key” and keep going… but  apparently this pharmacist claimed that there was a POTENTIAL INTERACTION, but since the pt had been taking these two medications for some time.. would suggest that the POTENTIAL is really not there. There is often a VERY WIDE GAP .. between a “potential text book interaction” and an “observed clinical interaction”

The job of a pharmacist is to talk to the prescriber and work out any concerns about the potential drug to drug interaction.. I can think of only a few times in my decades of practicing pharmacy do I remember just flat putting my foot down and saying NO..

IMO …What should have been done… is call the prescriber… if you can’t get the prescriber to change one of the meds to avoid the potential interaction… the pharmacist should document the conversation and  make the pt aware of what the potential interaction is and what to be on the lookout for and discontinue the medication and contact the prescriber if symptoms appear.

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Senators call for crackdown on pharmaceutical industry ‘revolving door’

https://www.washingtonpost.com/investigations/senators-call-for-crack-down-on-pharmaceutical-industry-revolving-door/2017/11/02/d0c3e6a2-bf34-11e7-959c-fe2b598d8c00_story.html

Seven Democratic U.S. senators today introduced legislation designed to slow the “revolving door” between federal agencies such as the Drug Enforcement Administration and the pharmaceutical companies they regulate.

“The pharmaceutical industry has a deep-rooted and strong influence in Washington, and a revolving door between drug companies and government cannot undermine the safety of our communities,” said Sen. Tammy Baldwin, (D-Wis.), who sponsored the bill.

The legislation would impose a two-year “cooling off” period on former officials from the DEA and the Food and Drug Administration, barring them from assisting pharmaceutical companies with lobbying efforts.

It is not unusual for corporations to hire federal employees directly from the government, nor for industry officials to join the government in high-ranking positions. Industry representatives say the pharmaceutical industry is highly specialized, and they rely upon the expertise of former government officials to help them comply with complex drug laws.

The current restrictions include a lifetime ban on participating “personally and substantially” on a “particular matter” that the official had handled while working for the federal government.

Government ethics experts say some of those laws are easily skirted.

“The bill could go further, but this is a nice step toward slowing the revolving door that is responsible for steering public policy in favor of the drug companies and distributors rather than in the favor of the public,” said Scott Amey, general counsel for the Project on Government Oversight, a Washington, D.C. watchdog group.

The proposed legislation follows a joint Washington Post/“60 Minutes” investigation into the opioid industry and its influence in Washington. Companies that manufacture or distribute highly addictive pain pills have hired dozens of high-ranking officials from the DEA during the past decade, many of them from a division that regulates some of the same companies.

A decade ago, DEA investigators began to crack down on large drug companies they suspected of failing to report unusually large orders of painkillers, many of which were winding up in the hands of street dealers and users. Since then, drug companies and the law firms that represent them have hired at least 46 DEA officials — 32 of them directly from the agency’s division that regulates the industry.

One of those DEA officials left the agency and formed a law practice to represent opioid companies. He later helped to write a law that undercut the agency’s enforcement efforts against large companies accused of violating federal drug laws, according to government documents and a legal analysis of the law by the DEA’s chief administrative judge.

In the wake of the Oct. 15 Post/“60 Minutes” investigation, Marino withdrew his nomination to be the nation’s drug czar under the Trump administration.

Several co-sponsors of the Marino bill have since come under fire from their constituents and political opponents for backing the measure at the height of the nation’s worst drug crisis. The prescription drug epidemic has claimed nearly 200,000 lives, more than three times the number of U.S. military deaths in the Vietnam War.

Baldwin said her proposed legislation would serve as a check on the power the pharmaceutical industry wields on Capitol Hill. She cited an investigation by the Associated Press and the Center for Public Integrity that found that the makers of prescription painkillers spent $880 million on campaign contributions and lobbying efforts between 2006 and 2015.

The bill is co-sponsored by Sens. Dianne Feinstein (D-Calif.), Kamala D. Harris (D-Calif.), Edward J. Markey (D-Mass.), Maggie Hassan (D-N.H.), Jeanne Shaheen (D-N.H.) and Tom Udall (D-N.M.) So far, no Republicans have signed onto the measure.

“Patients, families and the public need to have trust that the DEA and FDA are working for them, not powerful Washington interests,” Baldwin said.

Isn’t there a substantial REVOLVING DOOR between previous members of Congress and various industries… especially the LOBBYING INDUSTRY?

Don’t see any bills being put forth to shut down that revolving door ?

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