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Notice that the CDC has a WHOLE NEW DIVISION

DIVISION OF OVERDOSE PREVENTION 

Tuesday, May 9th is the second annual National Fentanyl Awareness Day. This observance was founded by parents who have lost loved ones to the drug overdose crisis. The aim of the observance is to raise awareness that people are dying at alarming rates due to illegally made fentanyl, a dangerous synthetic opioid. National Fentanyl Awareness Day is supported by a coalition of issue-area experts, corporations, nonprofits, schools, families and elected officials who are coming together today to spread the word.
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Illegally made fentanyl is a growing threat in the United States and is a major contributor to drug overdose deaths. Even in small doses, it can be deadly. Illegally made fentanyl can be mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids. Fentanyl mixed with other drugs is extremely dangerous, and many people may be unaware that their drugs include fentanyl.

Of note, fentanyl mixed with xylazine, an animal sedative, has recently been declared an emerging threat in the United States due to its impact on the opioid crisis. Xylazine has the potential to be life-threatening, especially when combined with opioids like fentanyl, and has been increasingly detected in the U.S. illicit drug supply.

The Division of Overdose Prevention in the National Center for Injury Prevention and Control has developed a fentanyl campaign which includes sharable resources to help educate and protect the public from fentanyl-involved overdoses. The campaign resources include factsheets, videos, social media ads, and much more to explain the dangers of illegally made fentanyl and share ways to protect yourself, like using fentanyl test strips and carrying the lifesaving medication naloxone.

On May 9th, take action and help us spread the word about of the dangers of fentanyl and help save lives by preventing opioid overdoses.

	May 9th marks National Fentanyl Awareness Day. Illegally made fentanyl is one of the most common drugs involved in overdose deaths. Join us in raising awareness of the dangers of fentanyl and how to protect yourself or your loved ones from an overdose. Learn more: http://bit.ly/41jGthn

	Today is #NationalFentanylAwarenessDay. Visit our #StopOverdose website to learn about the dangers of #fentanyl, the risks of mixing drugs, how #naloxone can save lives, and reducing stigma toward drug use & recovery: http://bit.ly/3KSA99T #JustSayKNOW

	Fentanyl mixed with xylazine, an animal sedative, is an emerging threat to the U.S. due to its increasing presence in the illicit drug supply. #Xylazine can be life-threatening, especially when combined with #fentanyl. This #NationalFentanylAwarenessDay, learn more about this issue: http://bit.ly/42x5gii

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Over the years, if I had not been able to advocate for Barb -numerous times- when she was hospitalized I believe that I would now have been a widower for years, maybe a couple of decades. I have heard of some interesting adjectives used by hospital staff to describe my advocacy, I can just imagine some that were used that I did not hear about. Some of the staff got to experience my personal philosophy up close and personal – I can be your best friend or your worse enemy – chose wisely- there are no mulligans.

This nurse stated some of the things that I suspected what was being done in numerous hospitals. Hospitals had to cancel all elective surgeries – their CASH COW. I was hearing abt pts being put on a vent when their SaO2 were in the low 90’s. When we had our independent pharmacy we were also a very large Home Medical Equipment vendor –  a major home oxygen vendor.  I am sure that most everyone is familiar with those finger tip Oximeter units to measure SaO2… that now cost <$50 – even my Apple watch-8 will measure SaO2. We had one of the first Oximeter, about the size of a cigar box and cost us $5,000.o0. I  knew that vents should not be used until the pt’s SaO2 gets < 85 – unless you are trying to generate revenue with putting pts on vents way before it was necessary.

A article in my inbox today  https://www.medpagetoday.com/opinion/prescriptionsforabrokensystem/104320 

While payers (Insurance companies ) profit, around 50% of hospitals finished 2022 in the red. Hospital closures mean less patient access, which often leads to worse outcomes for patients.

I could take some educated guesses why the top 5 health insurance companies are so profitable, all own PBM’s and mail order pharmacies. It is referred to as “spread pricing”, but there is a lot of SMOKE & MIRRORS in the creative accounting, so that the parent insurance company can justify the premiums they charge.

https://www.facebook.com/erinmarie05          https://www.nurseerin.org/

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Shortage of penicillin limits access to the go-to drug for syphilis

https://www.nbcnews.com/health/health-news/shortage-penicillin-limits-access-go-drug-syphilis-rcna81777

The shortage of injectable penicillin is the latest in a series of drug supply issues. Pfizer said it’s an indirect effect of the amoxicillin shortage.

The Food and Drug Administration on Wednesday reported a shortage of an injectable form of penicillin, an antibiotic used to treat syphilis and other bacterial infections like strep throat.

The drug joins a growing list of medications facing supply shortages in the U.S. Liquid amoxicillin, another antibiotic used to treat strep, has been in short supply since October, according to the FDA.

The form of penicillin affected, called penicillin G benzathine, is the preferred drug for syphilis, because it can be used in adults, children and pregnant people. It’s often administered in outpatient clinics or urgent care settings. Dosages for both children and adults are in short supply, according to the FDA.

“The nice part about penicillin G benzathine is that you can give it to a pregnant mother and if she has syphilis, it will also treat the baby,” said Dr. Jeremy Cauwels, the chief physician at Sanford Health, a medical system in Minnesota and North and South Dakota. He said pharmacists in his network have been dealing with a limited supply of penicillin since the winter.

Syphilis cases in the U.S. reached a 70-year high in 2021, the last year for which data is available, according to the Centers for Disease Control and Prevention. The sexually transmitted infection can result in organ damage or death if left untreated.

The FDA attributed the penicillin shortage to increased demand. Pfizer, the sole supplier of that form of penicillin in the U.S., pointed to the amoxicillin shortage as the main issue, because it prompted doctors to recommend penicillin instead. The rise in syphilis cases most likely further accelerated demand, the company said.

The amoxicillin shortage arose during a surge of respiratory virus infections over the fall and winter, when the antibiotic was prescribed for secondary bacterial infections resulting from Covid, flu or respiratory syncytial virus.

Amoxicillin has also been used to treat a rise in severe strep cases dating to the fall. In November, the American Academy of Pediatrics recommended penicillin G benzathine as an alternative to amoxicillin for strep throat patients.

Strep throat case numbers remain elevated. The CDC said last week that unpublished data from its national surveillance program showed a five-year high in emergency department visits for regular strep infections in February and March.

Pfizer said it has been delivering more of its injectable penicillin to the market than ever before but still can’t keep up with demand. The FDA said on its website that supply issues are expected to resolve sometime from October to December.

The American Society of Health-System Pharmacists has reported an additional shortage of another form of penicillin, penicillin G procaine, which doesn’t last as long in the body or cross the placental barrier. But Michael Ganio, the society’s senior director of pharmacy practice and quality, said “benzathine is probably a little bit more of a challenging shortage, because it is the drug of choice.”

Overall, the Covid pandemic seems to have worsened drug supply issues, Cauwels said.

New medication shortages increased by nearly 30% from 2021 to 2022, according to a March report from Democrats on the Senate Homeland Security and Governmental Affairs Committee. The reasons, it said, include a surge in demand for certain drugs, overreliance on foreign suppliers and manufacturers’ moving overseas.

The U.S. is seven months into a shortage of Adderall, a medication for attention-deficit/hyperactivity disorder.

 Four cancer drugs, including two common forms of chemotherapy, are under shortage as well, according to the FDA.

Injectable medications are more than twice as likely to experience shortages compared to other forms, such as oral or topical drugs, the Senate committee report said.

Cauwels said his health system doesn’t expect to get additional penicillin supply until the fall, although it is likely to have enough until then. Its amoxicillin supply is also limited, he added, but it’s getting a steady allocation based on what it has used in previous years.

He added that although there are alternatives to Pfizer’s penicillin drug for treating syphilis, other antibiotics come with more side effects.

The injectable penicillin became the go-to, he said, because “we know it always works and we know it’s easy to administer.”

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42 U.S. Code § 1395 – Prohibition against any Federal interference

https://www.law.cornell.edu/uscode/text/42/1395

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DEA & surrogates are trying to throttle the availability of controlled meds to pts

I made the above blog post several days ago. I am hearing from pts claiming that some chain pharmacists are telling them that their wholesaler is no longer selling any control meds.

I know that many states’ pharmacy practice acts requires that a pharmacy stock all the meds that are normally  use in the market they operate. I believe that wholesalers are also licensed by the state boards of pharmacy, but not sure if their are provisions within the state Pharmacy practice act that addresses the wholesaler’s operation or there is some separate law covering them.

I understand that some states professional licensing boards considers lying to a pt – unprofessional conduct. I suspect that many Pharmacists are working the – probably correct presumption – that pts don’t know that the Rx dept is required to maintain a perpetual inventory on all C-II’s.  A pharmacy board inspector could come into the pharmacy and request the perpetual inventory on a particular med/strength and be able to tell EXACTLY on a certain day/time… what inventory of any particular med/strength the pharmacy had on hand inventory.

I often wonder what kind a response a pt would get from the Pharmacist that just told the pt that “we are out of inventory” and the pt asked that pharmacist if the pharmacy board inspector asked to see or have the particular page faxed to them, out of their perpetual inventory for the particular med/strength that  their Rx if for and they just stated they had no inventory. Just what inventory on hand would it show ?

And ask the Pharmacist, do you think that the board of pharmacy might consider lying to a pt – UNPROFESSIONAL CONDUCT ?

I would also ask the Board of Pharmacy to verify if the particular pharmacy’s perpetual C-II inventory showed any inventory on hand for the particular med/strength on the particular date/time that you were told they had no inventory.

If I was a pt, I would look up the state’s pharmacy practice act and see if there is a requirement for inventory a pharmacy must/should carry. You don’t have to read the whole thing, some selective word searches should find some appropriate paragraphs.

Pt might be interested in filing a complaint with pharmacy board. Some states allow people to file complaints with the State Attorney General office, because the AG’s office is basically legal counsel for all licensing agencies in the state. If you can file a complaint with the AG and the Pharmacy Board refused to verify if the pharmacy did in fact out of inventory, then I would file a complaint against the pharmacy board for what appeared to not be concerned – or condones – pharmacists lying to pts.

If both agency ends up blowing smoke up your lower posterior orifice … contact your state Senate and House member. They are the people that passed these laws and the Governor is the one who signed them into law.  Ask them, why to you pass laws when those charged with enforcing them, seems to have little interest in doing their job ?

Remember one of the core functions of the practice medicine is starting, changing, stopping a pt’s therapy.  A Pharmacist lying to a pt about inventory on hand as the reason they can’t fill your Rx… and basically they are STOPPING YOUR THERAPY.

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