Filed under: drug overdoses/mis-use, General dumb-ass problems, General Problems, Insurance companies, Medication withdrawal | 3 Comments »
I have not seen anything that would suggest that the controlled meds allocated to this drug wholesaler – 4th largest in the country.. will be divided among the existing drug wholesalers across our country, or will what has been allocated to them JUST DISAPPEAR ?
But here is a settlement between 50 state AG’s and others that got the THREE LARGEST WHOLESALERS to agree to reduce the number of controls that they sell to ALL PHARMACIES.
So now the DOJ/DEA & our judicial system has got three largest drug wholesalers to sell less controls to all pharmacies and may be cutting the controls that were being sold by the 4th largest drug wholesaler. I just wonder how many of these pharmacies that are going to find themselves without access to their normal purchases of controls are long term nursing home providers?
https://www.policymed.com/2023/07/morris-dicksons-controlled-substance-license-revoked.html
Recently, the United States Drug Enforcement Administration (DEA) announced that, barring a settlement, it will revoke Morris & Dickson’s license to sell and ship opioid medications and other controlled substances as of August 28, 2023. In the decision and order published in the Federal Register on May 30, 2023, the DEA affirmed a 2019 Administrative Law Judge’s (ALJ’s) decision to revoke DEA registrations held by Morris & Dickson, the United States’ fourth largest wholesale drug distributor.
Background
Morris & Dickson was accused of failing to accept responsibility for its prior actions, including shipping 12,000 unusually large orders of opioids to pharmacies and hospitals from 2014 to 2018. The DEA notes that Morris & Dickson received purchases from “high-volume independent pharmacies” in Louisiana that were “purchasing quantities which were not indicative of the pharmaceutical market” and some were purchasing more Oxycodone and Hydrocodone than the larger chain pharmacies – sometimes more than 10 times the amount of narcotics the average Louisiana pharmacy purchased per month. Despite the large number of unusual orders, the company only filed three suspicious order reports with the DEA during that time frame, an indication that the company did not have a suspicious order monitoring system in place. Additionally, the company failed to maintain effective controls against diversion of drugs by distributing controlled substances without performing adequate customer due diligence.
On May 4, 2018, the DEA announced an Immediate Suspension Order on Morris & Dickson, immediately suspending the DEA Certificate of Registration issued to the company as the DEA felt that “the continued registration of this company constitutes a substantial likelihood of imminent danger to public health and safety.”
Morris & Dickson appealed that decision, and an administrative hearing was held on the matter in May 2019. After that administrative hearing, that suspension was recommended to become a revocation by ALJ Charles W. Dorman in November 2019. According to the Associated Press, the 2019 ALJ decision noted that while Morris & Dickson may have made some revisions to their procedures, anything less than revocation of the license “would communicate to DEA registrants that despite their transgressions, no matter how egregious, they will get a mere slap on the wrist and a second chance so long as they acknowledge their sins and vow to sin no more.” The judge went on to note that “allowing [Morris & Dickson] to keep its registration would tell distributors that it is acceptable to take a relaxed approach to DEA regulations until they are caught, at which point they only need to throw millions of dollars at the problem to make the DEA go away.”
However, instead of issuing a decision and order shortly after the ALJ decision, the DEA took several years. During that time, Morris & Dickson was still able to distribute controlled substances, despite the strong words in the ALJ’s decision – and the DEA’s strong words in the final decision and order. The decision and order took “longer than typical for the agency” in part because of the COVID-19 pandemic and actions taken by the company.
Complicating matters – and frustrating some – was an Associated Press investigation that found that a top DEA official previously served as a consultant for Morris & Dickson as part of the company’s attempt to avoid revocation or other punishment. The DEA says after the individual returned to work for the DEA, they were recused from any participation in the Morris & Dickson matter.
Filed under: General Problems | 4 Comments »
The person who published this came out on Twitter, who claims that he has FOUR DIFFERENT TWITTER ID’s and also penned this article under an assumed name ( George Bailey). On Twitter, his tweets seem to follow a pattern one would expect from a TROLL or a SPAMMER. So I have taken this article down…
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If a person is stable on long term low-dose opioid therapy AND shows no signs of addiction, abuse or serious side effects: 1. WHY have Medical Authorities chosen to taper chronic pain patients from their mobility-restoring opioids, without supports in place? 2. WHY are chronic pain patients being advised they will experience “no long-term side effects from tapering”, yet many suffer from a life-changing condition known as Post-Acute Withdrawal Syndrome? 3. WHY have demonstrably flawed and “one-size-fits-all” Guidelines for Deprescribing Opioid Analgesics been released in Australia on 26-5-23?
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Filed under: General Problems | 8 Comments »
So how many chronic pain pts with under/untreated pain get a “good nights sleep”? Another contributing factor to premature deaths of chronic pain pts with poorly treated pain ?
https://www.medscape.com/viewarticle/992942
Maintaining a regular healthy sleep schedule may help guard against premature death, new research suggests.
In a diverse group of older adults, those with regular and optimal sleep had about a 40% lower risk of dying of any cause during follow-up than peers who with irregular and insufficient sleep.
“If sleep were an eight-hour pill, it would be beneficial to take the full dose at regular times consistently,” lead researcher Joon Chung, PhD, with Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, said in a news release.
The findings were presented at SLEEP 2023, the 37th annual meeting of the Associated Professional Sleep Societies.
“Evidence is mounting that irregular sleep is associated with pretty broad adverse health outcomes, most prominently cardiometabolic disease, obesity, and cardiovascular disease,” Chung told Medscape Medical News.
In the current study, the researchers estimated the association of regular sleep of optimal sleep duration with all-cause mortality using data from 1759 adults the Multi-Ethnic Study of Atherosclerosis Sleep Study.
Sleep regularity and duration were classified using 7 days of data gathered by wrist actigraphy. Adults were categorized as “regular-optimal” sleepers (n = 1015) or “irregular-insufficient” sleepers (n = 744).
During 7 years of follow up, 176 people died. In the fully adjusted model, the regular-optimal group had a 39% lower mortality risk compared to the irregular-insufficient sleep group (hazard ratio, 0.61; 95% CI, 0.45 – 0.83). The findings were robust in sensitivity analyses.
The regular and optimal duration sleep pattern maps behaviorally to regular bed and wake times, suggesting potential health benefits of adherence to recommended sleep practices, the researchers note.
“Results suggest benefits of expanding the public conversation on getting ‘a good night’s sleep’ and broadening this goal to getting many good nights of sleep, in a row, on weekdays and weekends,” Chung said in the release.
He further told Medscape Medical News that “getting adequate, regular sleep seems to be something that is good for all. I don’t know of anyone who wouldn’t benefit.”
Fariha Abassi-Feinberg, MD, spokesperson for the AASM and sleep specialist with the Millennium Physician Group, Fort Myers, Florida, agrees.
“We know our bodies have an internal clock, known as the circadian rhythm, which regulates various biological processes, including sleep-wake cycles. Sticking to a consistent sleep schedule allows your body to align its natural rhythm with the external day-night cycle. This synchronization promotes better sleep quality and therefore better health,” said Abassi-Feinberg, who wasn’t involved in the study.
“The AASM recommends adults try to aim for at least 7 hours of sleep and I often tell my patients that keeping a regular routine is best for your sleep and health,” she told Medscape Medical News.
Funding for the study was provided by the American Academy of Sleep Medicine Foundation and the National Institutes of Health. Chung and Abassi-Feinberg report no relevant financial relationships.
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Authorities in Mexico raided several Los Cabos drugstores last month and arrested four people as part of an ongoing investigation into pharmacies selling counterfeit pills laced with fentanyl and methamphetamine.
The flurry of law enforcement action in the peninsular municipality comes on the heels of a Los Angeles Times investigation that found pharmacies from Tulum to Tijuana were passing off powerful drugs, including fentanyl and methamphetamine, as weaker medications commonly sought out by tourists. Of the 55 opioid painkillers and ADHD medications The Times tested over a four-month period, slightly more than half proved to be counterfeit.
Alejandro Torres Pineda, a delegate of the attorney general’s office in Baja California Sur, said Mexico’s investigation was sparked by local media coverage of the issue — coverage that was based on and extensively credited The Times’ reporting.
In total, authorities confiscated nearly 25,000 pills in the raids. None of them tested positive for fentanyl or methamphetamine, according to Pineda, but came back as other controlled substances that the pharmacies did not have authorization to sell.
“We’re continuing the investigations,” he said in a phone interview last week.
The raids are important, Pineda said, “because the sale of controlled medicines is inhibited, the health of citizens is protected and the type of medicines sold in pharmacies is controlled.”
A judge then granted law enforcement authorities permission to search the pharmacies in Cabo San Lucas and San José del Cabo. Two were raided June 3 and three others were raided June 20. Authorities found diazepam and clonazepam, anti-anxiety medications usually known in the U.S. by the brand names Valium and Klonopin.
The raids by law enforcement — including federal police, the attorney general’s office and the Mexican navy — netted a cache of money and boxes of pills. Images released by Mexico’s attorney general showed clusters of gun-toting, camouflage-clad police wearing balaclavas standing in front of blurred-out drugstores.
Of the people arrested, Pineda said, three were pharmacy employees and the fourth was an owner of one of the businesses. There’s nothing yet that points to cartel involvement, he added.
The municipal director of public safety in Los Cabos, Jesús Antonio Gómez Rodríguez, framed the recent operation as a positive step.
“In terms of security, the work coordinated by three levels of government is yielding good results, with the aim of guaranteeing the safety of locals and visitors,” Gómez said. “It’s protecting the health of our young people who can fall into the clutches of drugs, as well as the numerous groups of visitors who come to our municipality to enjoy its natural beauties and tourist services.”
Drugstores in Mexico have long been known for selling a wide range of medications over the counter, including many that would require a prescription in the U.S. Until recently, drug market experts had generally believed that pills sold in stores — unlike those sold on the street — were at least what the store owners said they were.
But in February, The Times published an investigation after testing pills from pharmacies in three cities, including San José del Cabo and Cabo San Lucas. In each city, some of the pills sold over the counter as either oxycodone or Adderall tested positive for fentanyl or methamphetamine. Around the same time, a UCLA research team recorded similar findings.
Over the next few weeks, reporters identified at least half a dozen people who overdosed or died after taking pills they’d purchased at pharmacies in Mexico. Grieving families had been alerting U.S. government officials as early as 2018. It was not until March, however, that the U.S. State Department explicitly warned the public about the danger.
On June 14, The Times published a broader investigation, documenting the problem across the country, from Mexico’s southeastern tip in the Yucatán Peninsula to its border with California. Of the 55 pills reporters tested, 28 were counterfeit.
According to El Sudcaliforniano, a regional news site in Mexico, last year Baja California Sur health officials inspected 628 pharmacies, including 175 in Los Cabos. During those visits, inspectors checked licenses and documentation and found everything to be in order. But they later told the outlet it was not up to state officials to do the laboratory testing to confirm the chemical makeup of the drugs.
Health officials also told the news site in February that they found no records of people dying due to adulterated medicine — though there has been a lack of the kind of postmortem toxicology testing in Mexico that would be needed to make that determination.
After similar inspections in the spring, the Cabo Sun reported that state health officials visited more than 100 pharmacies in Baja California Sur. In Los Cabos alone, the news site said, officials shut down nine pharmacies for distributing controlled substances.
When The Times first contacted the attorney general’s office in February, a federal prosecutor there — who has since asked to not be named due to safety concerns — said it was the first time she’d heard of fentanyl-tainted pills appearing in pharmacies. She called it “a new modus operandi that we haven’t detected before” and said that officials were “concerned.”
To better understand the problem, she said, authorities would “need to find where in the process they’re faking the pills” and determine “if pharmacies are involved in criminal activity or they don’t know if they are selling medications with fentanyl.”
In June, the prosecutor told reporters in an email that federal health officials were interested in The Times’ investigation and hoped to file a complaint with her office for potential prosecution. The Times did not provide Mexican authorities with information about the pharmacies reporters visited.
After prosecutors and police opened an investigation, a judge granted them permission to search several pharmacies.
But for Mary Harrell — whose son overdosed and died after he bought a fentanyl-tainted pill at a pharmacy in Cabo San Lucas in 2019 — the enforcement actions came as little consolation. The Camarillo woman said she wished authorities in Mexico had taken action sooner.
“It’s not going to stop,” she said. “If it were a real cleanup you’d have the president going after it — but you don’t.”
Filed under: General Problems | 1 Comment »
Yes, it has been this hot in the deep south.
Roberta Wright, who lives in a suburb of Houston, Tx., decided to try something we’ve always wondered about, can you bake bread in your mailbox during the summer months?
Well, according to the photos here that have gone viral, the answer appears to be yes.
Wright’s friend Howard Ceasar posted the photos on Facebook and he says that the bread baked for 45 minutes in the mailbox.
Now, we all know how hot it can get in a mailbox during the summer, but to see a full loaf of bread baked in it is really eye-opening.
I don’t know how it tasted, but now I am intrigued and I too want to try baking a loaf of bread in my mailbox.
Disclaimer, if you try this, you may want to leave a note taped to your mailbox so that the mail delivery person is shocked when he or she opens your box to drop off the mail.
Imagine if you get your prescriptions from a mail order pharmacy and they were left in your mailbox during the summer months. Required storage for Rx meds typically tops out in the mid-80F.
Rule of thumb, is that any medications stored outside of the required temp range for >24 hrs is considered compromised and their quality/potency is questionable.
Of course, this picture is loaf of bread being baked after 45 minutes and notice that this mailbox is somewhat insulated by two layers of bricks surrounding the metal mail box. This demonstration has nothing to do with a package of meds being in various USPS vehicles in transport
Filed under: General Problems | 1 Comment »
https://michaelhayeslaw.com/operating-under-the-influence-of-a-controlled-substance/
If you have been charged with operating under the influence of a controlled substance or with a restricted controlled substance, you are probably asking many questions about how the law enforcement officer made the determination, what evidence will be used against you, and what you can do to challenge the charge. The absence of any scientific standard for measuring impairment by the use of a controlled substance and the irrelevance of whether a restricted controlled substance impaired your ability to drive will probably be of great concern to you.
In fact, the “reasonableness of legislative measures” such as these was questioned by the Wisconsin Court of Appeals, which ultimately decided that no legal reason compelled the Court to overturn the law. State vs. Smet, 288 Wis.2d 525, 709 N.W.2d 474, 2005 WI 263.
You may face prosecution under one or both provisions of the law which subjects anyone convicted to the same penalties as a conviction for operating under the influence of alcohol. For example, if you have two previous convictions for operating under the influence of alcohol and you are now charged with operating under the influence of a controlled substance or operating with a restricted controlled substance, you face the penalties for operating under the influence 3rd offense despite the fact that neither of your first two offenses involved the use of controlled substances.
For an outline of the procedure in court, some of the motions available for your defense, and the penalty structure if convicted, see the other pages of our website addressing the charge you are facing based on the number of previous convictions.
Here is the pertinent statutory language:
346.63 Operating under influence of intoxicant or other drug. (1) No person may drive or operate a motor vehicle while: (a) Under the influence of an intoxicant, a controlled substance, a controlled substance analog or any combination of an intoxicant, a controlled substance and a controlled substance analog, under the influence of any other drug to a degree which renders him or her incapable of safely driving, or under the combined influence of an intoxicant and any other drug to a degree which renders him or her incapable of safely driving; or (am) The person has a detectable amount of a restricted controlled substance in his or her blood. (b) The person has a prohibited alcohol concentration. (c) A person may be charged with and a prosecutor may proceed upon a complaint based upon a violation of any combination of par. (a), (am), or (b) for acts arising out of the same incident or occurrence. If the person is charged with violating any combination of par. (a)(am), or (b), the offenses shall be joined. If the person is found guilty of any combination of par. (a), (am) or (b) for acts arising out of the same incident or occurrence, there shall be a single conviction for purposes of sentencing and for purposes of counting convictions under ss. 343.30 (1q) and 343.305. Paragraphs (a), (am) and (b) each require proof of a fact for conviction which the others do not require. (d) In an action under par. (am) that is based on the defendant allegedly having a detectable amount of methamphetamine, gamma!hydroxybutyric acid, or delta-9-tetrahydrocannabinol in his or her blood, the defendant has a defense if he or she proves by a preponderance of the evidence that at the time of the incident or occurrence he or she had a valid prescription for methamphetamine or one of its metabolic precursors, gamma-hydroxybutyric acid, or delta-9-tetrahydrocannabinol.
967.055(1m) Definitions. In this section:
(a) “Drug” has the meaning specified in s. 450.01 (10)
(b) “Restricted controlled substance” means any of the following:
- A controlled substance included in schedule I under ch. 961 other than a tetrahydrocannabinol.
- A controlled substance analog, as defined in s. 961.01 (4m), of a controlled substance described in subd. 1.
- Cocaine or any of its metabolites.
- Methamphetamine.
- Delta-9-tetrahydrocannabinol.
The two most common scenarios involve a motorist lawfully taking per prescription the
prescribed dosage of a painkiller such as Percocet (Oxycodone and acetaminophen), Oxycontin (time-release Oxycodone), or Vicodin (hydrocodone), or a motorist who has smoked marijuana in the last few days. The usual scenario involves a preliminary breath test showing .00 for alcohol and a blood test result showing .00 for alcohol.
In most cases, the law enforcement agency then requests the State Laboratory of Hygiene or the State Crime Laboratory to test the blood for the presence of a panel of legal and illegal controlled substances. Because of a backlog based on a claimed deficiency in funding, the state agency will not be able to perform the analysis for many months.
If at trial there is admissible evidence of a blood analysis showing a detectable amount of Delta 9 THC, cocaine or any of its metabolites, or one of the other substances referenced in the Sec. 967.055(1m), there will be no issue at trial as to whether the substance impaired your ability to operate a motor vehicle. The prosecutor is not required to present any evidence that the marijuana or cocaine, which may have been consumed days earlier, had any effect on your ability to safely operate a motor vehicle.
The scientific literature clearly supports the defense position that the use of marijuana or cocaine a few days before the operation of a vehicle can result in a detectable amount of the substance while there is no evidence that the level of the restricted controlled substance caused any impairment of your ability to safely operate the vehicle.
There are many challenges that can be filed including a motion challenging the blood draw absent a warrant under circumstances where the prosecutor is not able to demonstrate the exigent circumstances that would otherwise justify a warrantless blood draw. This situation is substantially different from an arrest involving alcohol that dissipates on average at a rate of .015 g/210 L per hour.
If your blood test result is positive for an opiate such as Hydrocodone there will be a specific concentration such as 300 ug/L in the Confidential Report of Laboratory Findings. For arrests occurring on or after February 1, 2011, the admissibility of this evidence at trial is dependent upon the prosecutor presenting a person who is qualified to testify under Sec. 907.02 and 907.03 as to the relevancy and effect of the quantity of the controlled substance detected in your blood.
If the prosecutor obtains admissibility of the evidence, the prosecutor must convince the jury that the quantity of the controlled substance impaired your ability to operate a motor vehicle – that is, that the opiate or other controlled substance, whether prescribed or not prescribed, rendered you incapable of safely driving a vehicle. What qualification does a chemist possess to provide a reliable opinion regarding how a drug, at a certain level, affected your ability to safely drive a motor vehicle?
The chemist has no knowledge of your individual body chemistry and has no knowledge of your history of usage of the controlled substance. Neither the chemist nor anyone else has ever performed any testing using various levels of the controlled substance to see how your motor skills may be affected.
Strong consideration should be given in your case to a rigorous challenge to any effort made by a prosecutor to gain admissibility of any chemical evidence or to gain admissibility of any opinion from a chemist or any other witness claiming to be an expert. Furthermore, a strong challenge should be made to any attempt by the prosecutor to admit evidence from an officer who claims to have special training in the detection of individuals who are operating under the influence of a controlled substance.
For a detailed explanation of what challenges can be made by the Law Office of Michael Hayes, LLC, you need to schedule an appointment to explain exactly what happened so a determination can be made as to what evidence is needed to challenge the decision of the law enforcement officer to make the arrest. If the officer did not have probable cause to make the arrest, your Fourth Amendment rights were violated, and all evidence obtained as a result of the illegal arrest must be suppressed.
If you have been charged with operating under the influence of a controlled substance or with a restricted controlled substance, contact Mike online or call him at 414.405.5678.
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Alabama hospitals trying to speed up relief in the opioid crisis will face manufacturers in the first opioid state trial involving hospitals July 24.
Hospitals across the country are taking a two-pronged approach to get opioid relief funds faster from opioid manufacturers: They are suing in state courts for faster trials in addition to federal courts. Alabama hospitals are seeking $300 million to $500 million from the defendants in the state suit.
The hospitals say their state suits are distinct from the multidistrict litigation being overseen by a federal court in Ohio, which involves cities and counties nationwide. As providers on the front lines of the opioid crisis, they say the operational impact felt by hospitals and the rest of the health-care system is different from the harms governments have alleged in their suits.
The state court strategy is to advance hospitals’ claims toward resolution, complementing the national litigation, said David McMullan, an attorney of Barrett Law Group, which represents 945 hospitals in 43 states and has filed 25 cases in state and federal courts on behalf of hospitals in the opioid crisis.
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