WV Board of Pharmacy dismisses director

Posted on July 18, 2017 by Pharmaciststeve

WV Board of Pharmacy dismisses director

http://www.wvgazettemail.com/news-health/20170718/wv-board-of-pharmacy-dismisses-director

The West Virginia Board of Pharmacy has dismissed its executive director amid a review of rules that require drug distributors to report on pharmacies that order a “suspicious” number of painkillers and other powerful prescription medications.

David Potters, who also was the pharmacy board’s general counsel, departed after 10 years with the agency.

Asked for the reason for Potters’ dismissal, board Chairman Dennis Lewis said, “I’m not at liberty to discuss that. You just don’t do that.”

The board has appointed Mike Goff, an agency administrator and former West Virginia State Police trooper, as acting executive director. Goff oversees the state’s prescription monitoring database. The board plans to advertise for a new general counsel to handle legal matters.

Earlier this year, the pharmacy board hired a chief financial officer for the first time — a move designed to lessen Potters’ workload. The board dismissed Potters during an emergency meeting late last month. He declined to comment Tuesday.

In December, a Gazette-Mail investigation found that the pharmacy board failed to enforce rules to report suspicious orders for controlled substances in West Virginia. Potters acknowledged that the rules, which were adopted years before he was hired, weren’t on the agency’s radar.

Those same years, the pharmacy board was giving spotless inspection reviews to small-town pharmacies that ordered more pills than could be possibly taken by people who really needed medicine for pain, the newspaper found.

In response, the board has spent the past six months developing a reporting system to flag suspect drug orders.

Drug wholesale distributors — companies that ship drugs from manufacturers to pharmacies — are cooperating with the review, Lewis said.

 “We’ve been pushing very hard on the suspicious orders, to get that up and as strong as possible,” Lewis said. “We’ve been working on that as hard as we can. It takes more time than we would like.”

The board is developing a standard form for drug distributors to report suspicious orders from pharmacies for painkillers and anti-anxiety medications, Lewis said. The reporting system is designed to curb the proliferation of controlled substances.

Drug distributors must submit the reports monthly, according to the board’s proposed rules.

“We’ll use the reports to make an evaluation of what is really going on,” Lewis said. “We want something that is readable and usable.”

The proposed changes also will require wholesalers to disclose whether they have had any questionable drug orders from pharmacies.

“We’re wanting them to do ‘zero’ reporting if they don’t have any suspicious orders, or if they do have them, we want them,” Lewis said. “And we want to be able to pin down what the suspicious order is for.”

Also, the board plans to require wholesalers to report when they refuse to ship controlled substances to specific pharmacies.

“If they’re going to cut off a pharmacy, we want to know about it,” Lewis said.

The pharmacy board is expected to discuss the proposed rules to track suspicious drug orders at a meeting next week.

Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.

Isn’t it a number of different city, county, state agencies that are contemplating suing just about anyone and everyone in the prescription distribution system… accusing them of being the cause of the “opiate epidemic” in WV ?

I think that it was  William Shakespeare in the 1600 play Hamlet that stated  “The lady doth protest too much, methinks ”

Perhaps those in WV… should first clean up their own house before they start suing others for their problems ?

 

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Pharmacist: I was COMFORTABLE with a high opiate dose BEFORE SOMEONE TOLD ME THAT I WASN’T ?

Posted on July 18, 2017 by Pharmaciststeve

I read your article several times and I am really upset over what transpired tonight at CVS when trying to fill my script for OxyContin 80mg. I take it 3x a day as the time released med and Oxycodone 30 mg for short acting  medicine for my chronic pain too many diagnosis to list. Been a chronic care patient for 13 years. Never had a problem until recently.

I switched from my mail order to going to my local pharmacies as it was getting expensive trying to pay for ups overnight.

It Seems that this female CVS pharmacist who gladly filled my scripts last month and said it would not be a problem now tells me she thinks I am taking too many pills and refused to fill my scripts.

I was just in an auto accident and fractured my wrist, along with many other injuries. I Was in severe pain and on my last day of pills. She said she thought my Dr was overprescribing and wanted to talk to him. Well he was out of the country getting married and would not be back for two weeks so she let me go and did not give two shits that I was going to be without my meds. In pain and going through withdrawals. I don’t know what to do.

I drive to 30 different pharmacies. All walgreens and cvs pharmacies and they all said they did not have my medicine. I know that’s a lie!!!

30 stores and not one had even one of my scripts?

I am now in severe pain. I am ready to go to the ER but I need my scripts filled.

If my Dr can’t talk to anyone for two weeks what am I supposed to do?

What action can I take against this pharmacist who made her own decision like she is my Dr and question my Drs valid script? Pain meds I have been on for years. I never had this happen before.

Help. 

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America: we only care about human rights violations in other nations ?

Posted on July 17, 2017 by Pharmaciststeve

I am a 60 yr old female from ME, I have had a sleep disorder that is genetically related my paternal side with my g-mother, my dad, his 2 sisters and sadly i passed it to our son who i see going thru struggles in treatment but he is not as severe as i am. i was able to control it in my teens by taking a daily nap but around my 30’s it seemed to change overnite with sleep episodes while driving ,while standing eating etcc and this caused multiple auto accidents and falls with fractures and the impact on my marriage by not being able to go places with my husband, surprisingly we are still together, but my children beared the worse like always watching me if my head started to nod at the wheel and they would yell and shake me, and i am embarrassed to tell you that during those cold snowy ME winters my kids waited for me to pick them up as thay had to stay over for some activity, i was suppose to be there at 3pm but after work i layed downed set alarm and never woke til 6pm never hearing the phone ring and here thye were out in the cold. 

But what floors me my doctors knew all that was gaing on and my 10 MSLT/PSG sleep studies that i was put thru all showed the same results sleep latency 0.5-1 min to sleep but no REM onset. the positive HLA test thye said meant nothing. i was told “BE CAREFUL DRIVING” Thye refused me stimulants for fear addiction, i had been contacting Stanford University Narcolepsy research on my untreated disease and the fears my docotrs had even though these specialist claimed and boosted how they were the only ME expert  in Narcolepsy?? 

Well when i told the doctor that Dr Mignot from Stanford would speak with my doctors to lessen there fear and to educate them about the research and how important it is to treat the symptoms asap , he also stated that  many doctors are unaware that each patient has to be treated individual to lessen the symptoms and for safety to avoid accidents and that the PDR was not appropriate as many need much higher doses and that addiction was not evident in Narcolepsy research. My doctor flatly refused as did 2 others and they were not happy with my suggestion of working with Dr Mignot, they took it as a insult so i was never followed up and a letter by one wrote derogatory remarks about my personality and that all Narcoleptics were “hard to deal with as they have psych issues” I was so angery . I was a RN and loved my career and caring for patients but i can not advocate for myself. i finally was treated when i went to live in AZ by a Indian doctor that was familar with this disease, he put me on Desoxyn up to 60 mg day and i could not believe i had a life again, but upon return to Maine i was not given this med and sent to a shrink who gave me Dexedrine 40 mg and whjile on that i got into another accident rearending a car as the doctor made me drive 1 hour away knowing my driving history. Know i am dealing with chronic pain have MGUS, urine protein 498, IgG low and Kappa/Lambda FLC and Kappa FLC high with beta fraction abnormal , i have widespread livedo vasculopathy or livedo as it was diagnosed “google search” my face also get pasty white which my family states i look like dead person walking, i am bedridden practically and also hgad a fully detached ball socket R shoulder that was missed in ME and found in Fl 1st viisit , had surgery 4 disposible rods placed in 2013 and rods still there , had mri which showed severe Chrondomalacia with raggeity bicep but my surgeon refuses surgery asked why he said your wife shoulder was detached for too long and the damage was severe and she must of been in severe pain, i also had a Catacholamine attck and was kept overnight . the opiods i am on help but ties i could use more and my pain doctor says i can do no more for you. i am on Percocet 10/325 4 day and Morphine ER 3 day. poor quality life not dependable to go places as i get to much pain and ask to leave, i do not eat much and i would rather die than live like i am as i have no joy even my children i dread to come visit as i am bed , it takes everything out of me to sit up and viisit, i am catholic so suicide is not a optiion for me, i have asked Pallaitive care but get a deer in headlite and told i am too young. in ME i had to fly back alone to FL as Govener made patients like me unable to get meds. what do u suggest. i am on ssdi medicare

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Daughters: Mother died “excruciating” death she didn’t want

Posted on July 17, 2017 by Pharmaciststeve

Family sues UCSF for agreeing, then refusing to help woman die

http://www.mercurynews.com/2017/07/17/family-sues-ucsf-for-agreeing-then-refusing-to-help-woman-die/

In what may be the first-of-its-kind lawsuit related to California’s End of Life Option Act, the family of a San Francisco terminally ill cancer patient is suing the UC San Francisco Medical Center alleging that her physician and the system misrepresented that they would help the dying woman use California’s right-to-die law when her time came.

Instead, according to the July 7 civil lawsuit filed in San Francisco Superior Court, Judy Dale’s wish for a peaceful death through the state’s new aid-in-dying law was denied to her by the defendants’ “conscious choice to suppress and conceal’’ their decision that they would not participate in the law, despite her repeated requests to doctors and social workers throughout last summer that she intended to have a peaceful death via aid-in-dying. The suit also names the university’s Helen Diller Family Comprehensive Cancer Center, UCSF Health, a UCSF oncologist and the UC Board of Regents.

UCSF declined Monday to comment on the matter.

The 17-page lawsuit alleges that Dale “repeatedly requested” the reassurance of UCSF doctors and social workers that they would participate in the end of life law, “which they gave her over and over.’’ On Aug. 18, the suit says, Dale “was shocked to learn from her UCSF social worker’’ that her doctors had decided to deny any eligible patient who requested aid in dying, “notwithstanding their many prior representations that they would provide it.’’

After caring for the 78-year-old Dale as an inpatient throughout the summer of 2016, UCSF discharged Dale to her home to die without their assistance, the lawsuit says.

That set in motion “an urgent, panic-filled search for a physician who would be willing’’ to help her fulfill the process required by the End of Life Option Act, and obtain a prescription for the lethal medication in time to use it.

According to the lawsuit, Dale’s frenzied search occurred even though UCSF’s website says, “if you doctor does not feel comfortable using the act, your social worker will assist you in finding a doctor who has agreed to participate in the act.”

California’s legislation, which was enacted on June 9, 2016, requires that patients must be at least 18 years old and mentally competent to make health care decisions — and that the lethal medication be self-administered. Two physicians must confirm a prognosis of six months or less to live, and a written and two oral requests must be made at least 15 days apart.​

But by the end of August, when Dale made contact with a willing Berkeley-based doctor who agreed to work with her, the clock started running over again on the statutorily mandated 15 day waiting period, the suit says, and it was too late for Dale.

Every day until her death on Sept. 13, according to the lawsuit, Dale repeatedly asked her daughters if it was the day she could obtain the aid in dying medication, but the 15-day waiting period had not yet expired.

“Her daughters had to tell their mother that she could not yet have the medication which would enable her to achieve a peaceful death as she wished,’’ the lawsuit says.

Dale died one day shy of the 15th day, “precisely the way she did not want to die, in bed, in a diaper, bleeding from her rectum and urinary tract, too confused by pain medications needed to manage the excruciating pain of terminal colorectal cancer to say goodbye,’’ the lawsuit says.

Filed on behalf of Dale’s two adult daughters by plaintiff’s attorneys Kathryn Stebner and Deena Zacharin,

the lawsuit alleges elder abuse and neglect; negligent infliction of emotional distress; misrepresentation/fraud and negligence.

It also demands a jury trial and seeks unspecified general, special and punitive damages.

Filed under: General Problems | 1 Comment »

the mere finding of abusable drugs at autopsy doesn’t necessarily mean that the drugs caused the death

Posted on July 17, 2017 by Pharmaciststeve

Sudden, Unexpected Death in Chronic Pain Patients

https://www.practicalpainmanagement.com/sudden-unexpected-death-chronic-pain-patients

Severe pain, independent of medical therapy, may cause sudden, unexpected death. Cardiac arrest is the cause, and practitioners need to know how to spot a high-risk patient.

Sudden, unexpected death may occur in a severe, chronic pain patient, and the terminal event may be unrelated to medical therapeutics. Fortunately, sudden death is not as commonly observed in pain patients as in past years most likely due to better access to at least some treatment. Sudden death still occurs, however, and practitioners need to know how to spot an “at-risk” patient.

Unexpected, sudden death due to severe pain is poorly appreciated, since many observers still view severe pain as a harmless nuisance rather than a potential physiologic calamity. In many cases, just prior to death, the patient informs their family that they feel more ill than usual and seek relief in their bed or on their couch. Unfortunately, some of these patients don’t awaken. Other patients die, without warning, in their sleep or are found collapsed on the floor. Modern medicine’s aggressive toxicology and forensic procedures after death have contributed to the poor understanding of pain’s death threat. In some cases, a pain patient that was being treated appropriately with an opioid or other agent with overdose or abuse potential has suddenly and unexpectedly died. Drugs were found in body fluids after death, and in my opinion a coroner wrongly declared the death to be an “accidental overdose” or “toxic reaction” to drugs rather than implicate the real culprit, which may have been an “out-of-control” pain flare.

This article is partially intended to call attention to the fact that the mere finding of abusable drugs at autopsy doesn’t necessarily mean that the drugs caused the death. In fact, the drugs may have postponed death. Some physicians have been falsely accused of causing deaths due to drug overtreatment when, in fact, undertreatment of pain may have caused the death. Additionally, opioid blood levels assessed at autopsy of a patient who died suddenly are all too often wrongfully considered accidental overdoses because the pathologist is unaware that chronic pain patients on a stable dose of opioids can be fully functional with serum levels of their prescribed opioids that far exceed lethal levels in opioid-naïve patients.1

Given here are the mechanisms of sudden, unexpected death in pain patients and some protective measures that practitioners must take to keep from being falsely accused of causing a sudden, unexpected death. More importantly, given here are some clinical tips to help identify the chronic pain patient who is at high risk of sudden, unexpected death so that more aggressive pain treatment can be rendered.

A Brief Anecdotal History
As a senior medical student at Kansas University in the early 1960s, I was required to take a rural preceptorship with a country doctor. In making our rounds one day to the county’s nursing home, I heard a farmer’s wife declare, “pain killed my mother last night.” Since then, I’ve repeatedly heard that pain killed a loved one. Folklore frequently mentions that people die “from,” as well as “in” pain. There is, however, little written detail of these events.

In the early years of my pain practice, which I began in 1975, I had several patients die suddenly and unexpectedly. This rarely happens to me today as I’ve learned to “expect the unexpected” and to identify which patients are at high risk of sudden death. In recent years, I’ve reviewed a number of litigation and malpractice cases of sudden, unexpected death in chronic pain patients. In some of these cases, physicians were accused of over- or misprescribing and causing a sudden, unexpected death, even though the patient had taken stabilized dosages of opioids and other drugs for extended periods. Also, the autopsy showed no evidence of pulmonary edema (a defining sign for overdose and respiratory depression). In cases where the physician was falsely accused, the post-death finding of abusable drugs in body fluids caused a family member, regulatory agency, or public attorney to falsely bring charges against a physician.

Setting and Cause
Unexpected deaths in chronic pain patients usually occur at home. Sometimes the death is in a hospital or detoxification center. The history of these patients is rather typical. Most are too ill to leave home and spend a lot of time in bed or on a couch. Death often occurs during sleep or when the patient gets up to go to the toilet. In some cases, the family reports the patient spent an extraordinary amount of time on the toilet just prior to collapse and death. Sudden and unexpected death, however, can occur anywhere at any time, as pain patients who have died unexpectedly and suddenly have been found at work or in a car.

Coronary spasm and/or cardiac arrhythmia leading to cardiac arrest or asystole is the apparent cause of death in the majority of these cases, since no consistent gross pathology has been found at autopsy.2-5 Instant cardiac arrest appears to account for sudden collapse or death during sleep. Perhaps constipation and straining to pass stool may be cardiac strain factors as some pain patients die during defecation. Acute sepsis due to adrenal failure and immune suppression may account for some sudden deaths.

Two Mechanisms of Cardiac Death
Severe pain is a horrific stress.6,7 Severe pain flares, acute or chronic, cause the hypothalamic-pituitary-adrenal axis to produce glucocorticoids (cortisol, pregnenolone) and catecholamines (adrenalin and noradrenalin) in an effort to biologically contain the stress.8,9 Catecholamines have a direct, potent stimulation effect on the cardiovascular system and severe tachycardia and hypertension result.10 Pulse rates may commonly rise to more than 100 beats per minute and even rise to more than 130 beats per minute. Blood pressure may reach more than 200 mmHg systolic and more than 120 mmHg diastolic. In addition to adrenal catecholamine release, pain flares cause overactivity of the autonomic, sympathetic nervous system, which add additional stimulation to catecholamine-induced tachycardia and hypertension. Physical signs of autonomic, sympathetic overactivity, in addition to tachycardia and hypertension, may include mydriasis (dilated pupil), sweating, vasoconstriction with cold extremities, hyperreflexia, hyperthermia, nausea, diarrhea, and vomiting.

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CVS/Caremark Complaints State of Florida Employee Plan 2015-2016

Posted on July 17, 2017 by Pharmaciststeve

CVS/Caremark Complaints State of Florida Employee Plan 2015-2016

www.truthrx.org/2017/07/16/cvscaremark-complaints-state-florida-employee-plan-2015-2016/

Thanks to tax watch dog liberal public records laws in Florida, PUTT was able to obtain through the public records request process from the Department of Management Services the complaints from the state of Florida employees regarding their PBM – CVS/Caremark.  The request was specific for: 1 number of complaints and 2 nature of the complaints.

What was received were the “escalated” complaints with specific notes from the CSR (customer services representatives) who field the 800 number for CVS/Caremark.

The volume of requests (for 2015 and 2016) were overwhelming to say the least, so we’ve attempted to compile and condense the complaints in a document that will be forthcoming to our members, members of the media, plan sponsors, pharmacy association executives, pharmacy school professors and legislators.  If you are interested in the compilation, send us an email to info@truthrx.org.

2015 January CVS Complaint to Customer Care Escalation

2015 February CVS Complaint to Customer Care Escalation

2015 March CVS Complaint to Customer Care Escalation

2015 April CVS Complaint to Customer Care Escalation

2015 May CVS Complaint to Customer Care Escalation

2015 June CVS Complaint to Customer Care Escalation

2015 July CVS Complaint to Customer Care Escalation

2015 August CVS Complaint to Customer Care Escalation

2015 September CVS Complaint to Customer Care Escalation

2015 October CVS Complaint to Customer Care Escalation

2015 October CVS Complaint to Customer Care Escalation

2015 November CVS Complaint to Customer Care Escalation

2015 December CVS Complaint to Customer Care Escalation

2016 January CVS Complaint to Customer Care Escalation

2016 February CVS Complaint to Customer Care Escalation

2016 March CVS Complaint to Customer Care Escalation

2016 April CVS Complaint to Customer Care Escalation

2016 May CVS Complaint to Customer Care Escalation

2016 June CVS Complaint to Customer Care Escalation

2016 July CVS Complaint to Customer Care Escalation

2016 August CVS Complaint to Customer Care Escalation

2016 September CVS Complaint to Customer Care Escalation

2016 October CVS Complaint to Customer Care Escalation

2016 November CVS Complaint to Customer Care Escalation

2016 December CVS Complaint to Customer Care Escalation

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How broad is the definition of “medical error” and “adverse effects” ?

Posted on July 17, 2017 by Pharmaciststeve

“1,000 Preventable Medical Deaths a Day”: U.S. Senate Committee Investigating Epidemic of Medical Errors

www.hovdelaw.com/1000-preventable-medical-deaths-a-day-u-s-senate-committee-investigating-epidemic-of-medical-errors/

On July 17th, Sen. Barrie Sanders (I – Vt.) opened a hearing of the U.S. Senate Subcommittee on Primary Health and Aging by reciting some harrowing statistics:

  • As many as 400,000 people die each year from preventable medical errors in U.S. hospitals;
  • Approximately 180,000 Medicare patients die every year from adverse and preventable medical errors in hospitals
  • One in twenty-five patients acquire an infection while in the hospital, which led to 700,000 people getting sick and 75,000 people dying in 2011.
  • Medical errors cost the U.S. health care system more than $17 billion in 2008. If you include indirect costs, medical errors may cost in excess of $1 trillion per year in the United States.
  • Preventable medical errors in hospitals are the third leading cause of death in the United States.

All of the foregoing statistics, shocking as they may be, are only estimates because hospitals and health care providers are not accurately compiling the data necessary to fully understand and address the scope of the problem. That was the focus of the hearing led by Sen. Sanders, entitled “More Than 1,000 Preventable Deaths a Day Is Too Many: The Need to Improve Patient Safety.”

Six experts testified before the subcommittee, and all of them cited the need to improve the health care system as a whole to stem the tide of these avoidable deaths. Ashish Jha, MD, MPH, Professor of Health Policy and Management at the Harvard School of Public Health, told the panel that “medical errors are largely the result of bad systems of care delivery, not individual providers … The strategy for improvement has to focus on three main areas: metrics, accountability, and incentives.” Another expert, Dr. Peter Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine, told the panel that”Our collective action in patient safety pales in comparison to the magnitude of the problem. We need to say that harm is preventable and not tolerable.”

Among the suggestions for addressing the problem was a proposal to establish a National Patient Safety Board — similar to the National Transportation Safety Board — to investigate patient harm. Jon James, a scientist and patient advocate who lost a son due to a medical error, also proposed a national patients’ bill of rights that would contain protections similar to those for workers and minority groups.

It is indeed inexcusable that so many Americans needlessly die every year due to medical errors that could and should be prevented. Any efforts to shed more light on the problem and come up with solutions to reduce the number of these deaths should be strongly supported.

Hovde Dassow + Deets: Indiana Medical Malpractice and Medical Error Attorneys

If you believe that you or a family member has suffered adverse effects as a result of a medical error, you are encouraged to contact the law firm of Hovde Dassow + Deets today at (317) 818-3100 or toll-free at (888) 404-6833 for a free, initial, and confidential consultation to discuss your case.

This article has been prepared by Hovde Dassow + Deets for informational purposes only and does not, and is not intended to, constitute legal advice. The information is not provided in the course of an attorney-client relationship and is not intended to substitute for legal advice from an attorney licensed in your jurisdiction.

If a prescriber reduces a pt’s opiate medication that has been stable and has been functioning fairly well and the reduction causes a reduced quality of life and function. Is that a “medical error” or just an intentional infliction of “adverse effects” ?

If a pt has been patronizing the same pharmacy for some time, getting the same pain management meds filled from the same prescriber and suddenly they refuse to fill the same legit/on time/medically necessary prescription(s)…  Is that a “medical error” or just an intentional infliction of “adverse effects” ?

Perhaps this is the first of  – hopefully – many law firms that are seeing the “personal injury” that has been INTENTIONALLY INFLICTED on hundreds of thousands or millions of chronic pain pts… and looking at trying to force the pendulum to move back to a more reasonable point.

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Genocide at Veteran’s Administration Hospitals ?

Posted on July 17, 2017 by Pharmaciststeve

 

 

 

 

 

 

 

 

 

 

 

 

Is this how our country repays their service to our country to protect our way of life ?

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Opioid Drug Misuse: Emerging Trends and Alerts Webcast on Thursday, July 27th at 10a EDT

Posted on July 16, 2017 by Pharmaciststeve

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Indiana State Department of Health (ISDH), in collaboration with the U.S. Department of Justice Drug Enforcement Administration (DEA), will provide an overview of opioid drug epidemic trends.

To view ISDH webcasts, please test your access to view streaming videos several days prior to the event.  Please use the following link for the test and to view the webcast: http://videocenter.isdh.in.gov/videos/

To test, simply “click” on any of the thumbnails.  The video should play, but your network may have restrictions that prevent you from watching streaming content.  If you experience problems with accessibility, please contact your system administrator. Also, please be aware that WiFi connectivity should be avoided given variable connection speeds and the risk of buffering problems.  At the appointed date and time, the webcast will be available via the Live Video options at the top and right side of the webpage.

This will be a great educational opportunity and allow you to ask questions.  Questions can be submitted to: indianatrauma@isdh.in.gov

 

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CONCLUSIONS: reached using FACTOIDS, OPINIONS, QUESTIONABLE DATA ?

Posted on July 16, 2017 by Pharmaciststeve

Study: Opioid Rx were down in Waynesboro in 2015. but still thrice national average

http://www.dailyprogress.com/newsvirginian/news/local/study-opioid-rx-were-down-in-waynesboro-in-but-still/article_73f8b0ca-69bb-11e7-8017-4b87e2fecfc0.html

WAYNESBORO — A recently released study  by the Centers for Disease Control and Prevention says opioid prescriptions peaked in the United States in 2010, but adds that narcotic painkiller prescriptions remain high nationally — and more than three times the national average in Waynesboro. Staunton’s figures also were high, nearly two-and-a-half times the national average.

According to the CDC, the average amount of opioids prescribed nationally peaked in 2010 at 782 morphine milligram equivalents (MME) per person. That number had declined to 640 MME in 2015.

While the numbers for Waynesboro and Staunton show similar declines, figures for both years were still well above average. The CDC study indicates 1955.1 MME for Waynesboro in 2015, and 1592.8 MME for Staunton in 2015. 

In 2010, the figures for the two cities were 2232.7 MME per person in Waynesboro, and 1967.1 MME for Staunton.

Area police and health officials say coordination has improved in combating opioid abuse in Virginia, including a prescription monitoring program that allows physicians to look at a patient’s controlled substance prescription history. And one local police officer said an area drug task force he is a member of is now working with a physician to stem the tide of valid prescriptions being used to illegally sell opioid pain pills such as Percocet, Vicodin and Oxycontin.

While the study doesn’t touch on non-prescription opioid drugs such as heroin, which makes up a significant portion of the opioid epidemic, doctors and law enforcement say prescription drug abuse is nonetheless a big part of the problem. In many areas, in fact, it’s a far worse problem than heroin and other so-called “street” drugs.

The acting director of the CDC, Dr. Anne Schuchat, said “the amount of opioids prescribed in the U.S. is still too high, with too many opioid prescriptions for too many days at too high a dosage.”

Schuchat said healthcare providers “have an important role in offering safer and more effective pain management while reducing risks of opioid addiction and overdose.”

Dr. Laura Kornegay, health director of the Central Shenandoah Health District in Staunton, said there are some potential drawbacks and limitations of the CDC study, though she notes that those issues are acknowledged by the report’s authors. The drawbacks, Kornegay says, include the fact that the data was gathered from a third party warehouse and has not been validated. She also points out that the county-level analyses in the study are aggregated by the county where the opioid is dispensed, and not where the prescription is written or where the patient lives.

Nevertheless, Kornegay said “the issue with opiates is a significant public health emergency in our state and country as a whole,” and that any data that helps to shed light on the problem, and potential solutions, are welcome.

Last December, Virginia’s health commissioner declared opioid addiction a public health emergency in the commonwealth and issued a standing prescription for any resident to get the drug Naloxone, a drug used to treat overdoses, without a doctor’s specific OK.

Kornegay said there have been multiple actions taken by the Virginia Board of Medicine and medical societies, hospitals and clinics with the goal of ensuring the proper prescribing of opiates.

Recently updated guidelines from the Virginia Board of Medicine call for limiting the amount of medication prescribed, as well as continuing the close monitoring of patients for abuse potential, and also to know when the medication can be stopped. The guidelines also says doctors should avoid combinations of different kinds of controlled medicines, such as opioid painkillers and sedatives such as Valium or Ativan.

Police in the area are also working with medical professionals on opioid abuse. Capt. Mike Martin is the commander of the Waynesboro Police Department’s special operations division and a member of the Skyline Drug Task Force.

He said one area physician has reached out to the task force to identify people who are abusing and selling their prescriptions, including opioid prescriptions.

“For the first time we have created a direct line of communication between the prescribers and the enforcers,’’ said Martin. Now officers can let doctors know when one or more of their patients is selling their prescriptions — information the doctor can use to ensure that those patients either receive no more opioid prescriptions, or, if it’s absolutely needed, such as in the case of terminal cancer, that it is dispensed and monitored under strict guidelines. 

Previously, the CDC has provided guidelines for prescribing opioids for chronic pain. Those guidelines include using the drugs only when the benefits outweigh the risks, and starting with the lowest effective dose.

I am seeing more and more evidence that the “powers to be” are using questionable data and ignoring other more solid data to come to a conclusion(s) that may be preconceived and/or feed an agenda.

Highlighted text in this article – IMO – clearly demonstrates this. I see – all to often – where people – on both sides of the issues – are jumping to conclusions after reading a HEADLINE and/or after reading certain words, sentences or paragraphs.

Federal officer or employee may NOT exercise any supervision or control over the practice of medicine  A 1935 federal law recently came to my attention – link above.  It appears that this federal statue would put into question the legality of a number of federal laws, regulations, guidelines that is attempting to compromise appropriate therapy for those with chronic health issues… especially those with subjective diseases.  There is an increasing number of various bureaucratic entities on the city, county, state, federal level that are determined to impose their will on those suffering from subjective diseases.  Getting a law declared unconstitutional, will cost several millions of dollars and will not have any monetary payback… it will only mean that the laws can no longer be enforced.  This means that unless those suffering from subjective diseases starts putting their dollars together and hire a law firm to take this on… Nothing will be reversed … will only continue to progress on the path which is currently on.

 

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