VENDOR DATA FRAUD: BAMBOOZLED BY “BAMBOO” STUDY SHOWS DEA HAS OPERATED AS A CRIMINAL ENTERPRISE RESULTING IN THOUSAND OF DEATHS AND FALSE IMPRISONMENT OF DOCTOR’S

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STUDY BY CENTER FOR UNITED STATES POLICY SHOWS DEA’s PDMP “NARXCHECK” SYSTEMS USED BY NEARLY ALL HOSPITAL AND PHARMACIES TO BE MISBRANDED, DANGER TO HEALTHCARE, and USE MUST BE SUSPENDED IMMEDIATELY BY FDA

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Recently I share the hyperlink below outlining the 13+ billion settlement between 50 state AG’s & others with Walgreen, CVS, Walmart. While I have not seen the agreement there has been some leaks that these three chains agreed to fill fewer opioid and/or controlled med Rxs.  Below is a 23 item questionnaire apparently given to a pt to have their prescriber to fill out. Apparently so that Walgreens could decide if they were going to fill this particular prescriber’s Rxs going forward. I have no idea which Walgreens store it came from since there is no address on the form.  So it must be a generic form that is used for all the 9,000 odd Walgreen USA pharmacies.

Notice # 14 – asking about prescribing > 50 MME’s/day. Apparently someone has read the 2022 CDC opioid dosing GUIDELINES and maybe decided to make them a hard/fast limit rule.

Is this questionnaire something like a psychological test – there are no really WRONG ANSWERS ?  Some of the questions require a narrative response.  I guess the leaked parts of the agreement – to reduce the number of controlled Rxs seems to have some merit.

the questions on this form is more invasive into the prescriber’s practice than the last colonoscopy I had, at least they sedated me to do that.

50 states sign up for Walmart’s opioid settlement framework -3.1 billion

Here is another lawsuit by the 50 state AG’s & others where the nearly 600 page agreement the three major wholesalers agreed to reduce the number of opioids and/or controlled meds sold to ALL  PHARMACIES

Here is the SMOKING GUN to prove civil rights violations – could support a class action lawsuit – but the community needs to stand up

Is this how the DEA is directly/indirectly observing the June 2022 SCOTUS (9-0 vote) ruling that basically stated that the DEA could not use objective criteria to judge prescribers when/how they are treating pts dealing with subjective diseases ( pain, anxiety, depression, ADD/ADHD, various mental health issues)

Opioids In Good Faith: Dr. Jay Joshi Weighs In On The Supreme Court Decision On Opioid Prescribing

Let’s take a “long view” of what is happening. The DEA has annually reduced the pharma’s controlled med production quotas. The DEA – thru their surrogates ( 50 state AG) they are forcing drug wholesalers and at least major chain store to find justification for wholesalers to sell fewer controlled meds to ALL PHARMACIES and at least some major chain pharmacies to find “reasons” to dispense fewer controlled Rxs.

I may be wrong, but it does appear that the FDA approved controlled meds in the Rx distribution is being THROTTLED ?  Given the DEA statistical justification in 2024 to reduce – ONCE AGAIN –  the pharma control med production quotas.

Since I have a pilot’s license, it appears to me that the availability of controlled meds is in a DEATH SPIRAL. When a pilot finds themselves in such a death spiral, the pilot has two options.. make the appropriate correction to level the wings and maintain appropriate altitude – OR DIE WHEN YOU CRASH INTO THE GROUND.

 

 

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My mind works is mysterious ways… From all my years of writing software, in that environment, it is referred to as “background tasks”. My mind seems to collect bits and pieces of data from may appear on the surface to have no connection to each other, my mind will try to create over time a “mental picture” of some concept.

If you ever got a email from me you will see this quote as a tag line at the bottom of all emails:

“The fellow that can only see a week ahead is always the popular fellow,
for he is looking with the crowd. But the one that can see years ahead,
he has a telescope, but he can’t make anybody believe that he has it..” Will Rogers

After I read the Citizen Petition on Narxcare below, it confirmed what I suspected of Narxcare after I read some of their initial press releases a few years back. Not to long ago, I read where Narxcare had moved all of their databases OFF SHORE and according to Wikipedia.. their HQ in in DUBLIN, IRELAND.. where our HIPAA LAWS do not apply. 

I was sitting at my desk and my laptop and up popped a email  – YOUR FICO SCORE HAS CHANGED – all of sudden a large piece of a puzzle apparently my mind had been working on in my subconscious.  WTF, Experian is same entity that generates my FICO score and owns Narxcare and has information on 235 million Americans… which is near or all  adults ( >18 y/o) in the USA. What if this company has links to the huge EMR systems – like Epic – which I understand is one of the most used in large hospital system with a lot of outlying office practices.

And they send notices to these EMR systems … this pt’s Narxcare score as increased, and the particular hospital system has a process that puts different color flags on the pt’s medical records in the system- based on their Narxcare score – to alert any prescriber in their system.. that a particular pt’s Narxcare score has increased and it has exceeded the hospital’s “line in the sand” and won’t let any of their employee prescribers to prescribe certain medications and/or above certain mgs/day of certain medications.

The algorithms that Narxcare uses to come up with “addiction risk score” are proprietary (SECRET), I suspect that getting them to untangle more than one pt’s data being mixed together could be nearly impossible to get corrected.  The hyperlink to the petition below outlines what pt data points that Narxcare tracks are known and lists some of the potential databases that Narxcare could use to gather pt’s data points.

Yet many in healthcare are functioning under a confirmation basis, that it is probably right/correct data so much of the time, that it is correct all the time and won’t challenge what seems “not normal” on a particular pt’s Narxcare score. Nothing is perfect, how many pts may or could be harmed by mixed up pt data points ?

FDA citizen petition to deem the Bamboo Health (“Bamboo”) NarxCare software a misbranded device

Experian is a multinational data analytics and consumer credit reporting company headquartered in Dublin, Ireland. Experian collects and aggregates information on over 1 billion people and businesses including 235 million individual U.S. consumers and more than 25 million U.S. businesses  https://en.wikipedia.org/wiki/Experian

 

 

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Brain Atrophy with Chronic Pain: A Call for Enhanced Treatment

https://www.practicalpainmanagement.com/pain/other/brain-injury/brain-atrophy-chronic-pain-call-enhanced-treatment

Recent studies clearly show that chronic pain unto itself causes brain atrophy and altered neurochemistry and sensory function of the central nervous system.

As unpleasant as it may be, the evidence is in: chronic pain may produce a loss or atrophy of brain tissue.¹⁻⁸ All practicing physicians and their surrogates and allies must immediately begin understanding the ramifications of this finding. All parties must be educated about this fact and aggressively attempt to prevent brain atrophy in chronic pain patients. While our knowledge about this dire complication—and what tools we should employ to prevent and treat it—are admittedly meager, we have to begin a new chapter in practical pain management. In situations where chronic pain results from an injury, consulting a traumatic brain injury attorney New York might also be beneficial to address any legal aspects related to the injury and its long-term effects.

The Evidence

In 2004, Apkarian and colleagues at Northwestern University published their initial findings on patients with chronic back pain.1 By use of brain scans they determined that chronic pain caused brain shrinkage by as much as 11%—equivalent to the amount of gray matter that is lost in 10-20 years of normal aging. The decrease in volume in the prefrontal cortex and the thalamus of the brain was related to the duration of time spent in pain. Every year of pain appeared to decrease gray matter by 1.3 cubic centimeters. The good news about this study is that the shrinkage was accompanied by only minimal neuronal loss suggesting that proper treatment might reverse this portion of the decreased brain matter.

Since this seminal report, a number of investigators—from a variety of institutions, using a variety of techniques—have documented loss of brain tissue in chronic pain patients, including those with chronic headaches, fibromyalgia, back pain, and irritable bowel syndrome.²⁻⁶Most of the major studies involving chronic pain and brain tissue loss are referenced here for readers who wish to explore these findings in greater detail.²⁻⁸

In any discussion or study of chronic pain complications, the question about drugs—particularly opioids, as a causative factor—is naturally asked. All the studies noted above had at least some subjects who did not take opioids. To determine whether brain structural changes occur independent of opioids, Buckalew and colleagues at the Universities of Pittsburgh and West Virginia carefully studied a group of older adults with chronic pain who did not take opioids and who had none of these confounding conditions: hypertension, diabetes, major depression disorder, post-traumatic stress disorder, or a previous stroke.⁸ They found essentially the same altered and reduced brain matter as all of the other studies.¹⁻⁷It is also cogent to point out that long term opioid therapy has not been found to produce significant decreases in neuro-cognitive abilities.⁹˒¹⁰ In fact, adequate pain relief may improve them.⁹

Not only have scans and magnetic imagery documented the loss of gray matter, a number of other studies complement these findings in that the brains of chronic pain patients demonstrate altered neurochemistry and central nervous system processing of input signals such as odors, taste, heat, emotions, and touch.¹¹⁻¹⁶Studies show that chronic pain patients do not process external stimuli in a normal fashion.¹¹ Patients with chronic back pain have altered dopamine and opioid availability in the forebrain.¹⁷˒¹⁸ Fibromyalgia patients appear to have a reduction in the receptor availability of dopamine and opioid mu-receptors in parts of the forebrain.¹⁹˒²⁰ In summary, it appears that brain neurochemicals important for pain modulation are not responding as they do in healthy individuals.¹¹⁻²⁰

Not only have scans and magnetic imagery documented the loss of gray matter, a number of other studies complement these findings in that the brains of chronic pain patients demonstrate altered neurochemistry and central nervous system processing of input signals such as odors, taste, heat, emotions, and touch.¹¹⁻¹⁶ Studies show that chronic pain patients do not process external stimuli in a normal fashion.¹¹ Patients with chronic back pain have altered dopamine and opioid availability in the forebrain.¹⁷˒¹⁸ Fibromyalgia patients appear to have a reduction in the receptor availability of dopamine and opioid mu-receptors in parts of the forebrain.¹⁹˒²⁰ In summary, it appears that brain neurochemicals important for pain modulation are not responding as they do in healthy individuals.¹¹⁻²⁰

Weight loss is a significant challenge for many obese women, and finding effective solutions can be daunting. Weight loss pills have emerged as a potential aid in the journey towards a healthier weight. These medications play a crucial role in addressing obesity by assisting in weight reduction and management. By incorporating weight loss pills into a comprehensive lifestyle program that includes healthy eating habits and regular exercise, obese women can increase their chances of achieving sustainable weight loss. So, if you’re searching for an effective obesity treatment option, read on to discover more about weight loss pills for obese women.

Understanding the Effectiveness of Prescription Weight Loss Drugs

Prescription Weight Loss Drugs vs. Over-the-Counter Options

Prescription weight loss drugs are often considered more effective than over-the-counter options due to their regulated formulation and targeted approach. Unlike over-the-counter pills, prescription medications undergo rigorous testing and approval processes by the Food and Drug Administration (FDA). This ensures that they meet specific safety standards and are backed by scientific evidence.

How Prescription Drugs Promote Weight Loss in Obese Women

Prescription weight loss drugs work through various mechanisms to help obese women shed excess pounds. Some medications act as appetite suppressants, reducing feelings of hunger and helping individuals consume fewer calories. Others may increase metabolism or interfere with the absorption of fat in the body. Certain prescription drugs can enhance satiety, making people feel fuller for longer periods.

Importance of Medical Supervision

It is crucial for obese women to use prescription weight loss drugs under medical supervision. These medications can have potential side effects and interactions with other medications or health conditions. A healthcare provider will evaluate an individual’s overall health status before prescribing a specific drug, ensuring it is safe and suitable for them.

Lifestyle Changes Alongside Prescription Medications

While prescription weight loss drugs like ozempic can be effective, they are most successful when combined with lifestyle changes. These changes may include adopting a balanced diet, increasing physical activity levels, managing stress, getting enough sleep, and avoiding unhealthy habits like smoking or excessive alcohol consumption. By incorporating these lifestyle modifications into a treatment plan alongside medication use, obese women can maximize their chances of achieving sustainable weight loss.

Comparison of Weight Loss Medications: Benefits and Side Effects

Obese women often seek additional help in the form of weight loss medications. These medications can provide an extra boost to their weight management efforts.

Effectiveness of Weight Loss Medications

Weight loss medications have been extensively studied for their effectiveness in aiding weight loss. Clinical studies have shown that these medications can help individuals lose more weight compared to lifestyle changes alone. However, it is important to note that results may vary from person to person.

Benefits of Weight Loss Medications

Increased Weight Loss: Weight loss medications can accelerate the rate at which individuals shed pounds, helping them achieve their goals faster.

Appetite Suppression: Many weight loss medications work by suppressing appetite, making it easier for individuals to control their food intake and reduce cravings.

Metabolic Boost: Some medications can increase metabolism, allowing the body to burn calories more efficiently.

Improvement in Health Conditions: In addition to promoting weight loss, certain weight management medications have been found to improve health conditions associated with obesity, such as high blood pressure and diabetes.

Potential Side Effects

While weight loss medications offer benefits, they also come with potential side effects that need consideration:

Gastrointestinal Issues: Common side effects include nausea, diarrhea, and constipation.

Increased Heart Rate: Certain medications may cause an increase in heart rate or palpitations.

Sleep Problems: Some individuals may experience insomnia or disrupted sleep patterns while taking these medications.

It is crucial for obese women considering weight loss medication to consult with a healthcare professional who can assess their individual needs and guide them towards the most suitable option. Lifestyle changes should still be prioritized alongside medication use for long-term success.

Liraglutide (Saxenda): Powerful Weight Loss Pill

Liraglutide, marketed as Saxenda, is a potent weight loss pill specifically designed for obese individuals. It belongs to a class of medications called GLP-1 receptor agonists and was initially approved for the treatment of type 2 diabetes. However, it has gained popularity as an effective weight loss aid.

How Liraglutide Works

Liraglutide works by mimicking the action of a hormone called glucagon-like peptide-1 (GLP-1) in the body. This hormone helps regulate blood sugar levels and appetite. By activating GLP-1 receptors in the brain, Liraglutide suppresses appetite and promotes feelings of fullness or satiety. This can be particularly beneficial for obese women who struggle with overeating or constant hunger.

Clinical Studies on Effectiveness

Clinical studies have shown that Liraglutide can lead to significant weight reduction in obese individuals. In one study involving overweight or obese participants with type 2 diabetes, those who took Liraglutide experienced an average weight loss of 8% over a year-long period compared to those who received a placebo.

Side Effects and Precautions

While Liraglutide can be an effective weight loss tool, it’s important to note that it may also have some side effects. Common side effects include nausea, vomiting, diarrhea, and constipation. In rare cases, more serious side effects such as pancreatitis and gallbladder problems have been reported.

It’s crucial for individuals considering Liraglutide as a weight loss option to consult with their healthcare provider before starting the medication. They should discuss any pre-existing medical conditions or medications they are taking that may interact with Liraglutide.

Implications of These Findings

The findings in chronic pain patients of brain tissue loss and altered central nervous system physiology and neurochemistry is a profound discovery that should be known to all physicians. Implications of this discovery are clear. Recently, in an educational document published by the American Academy of Pain Management, Dr. Catherine Bushnell of McGill University in Montreal, who is a principal investigator in many of the studies referenced here stated, “The data suggest that patients should receive treatment as early and as aggressively as possible. The old adage “no pain, no gain” appears to be diametrically opposed to current findings about the impact of pain.” She, and possibly some previous fence-sitters, now want to call chronic pain a disease unto itself.

It is now clear that the risk-benefit ratio of aggressive treatment versus moderate treatment—which leaves the patient with some degree of constant pain—needs to be reevaluated. Brain atrophy, along with altered brain physiology and neurochemistry, now joins the risk profile of undertreated chronic pain. To date, this risk profile has consisted of hypertension, tachycardia, altered adrenal hormone levels, suppression of the immune system, depression, and interference with physical function and activities of daily life (see Table 1). It is now abundantly clear that chronic pain, particularly the severe intractable form, is a disease unto itself whose risks, per se, appear to far outweigh those of essentially all applicable medical treatments—including high dose opioid therapy.⁹˒¹⁰

Clinical Ramifications

A review of the anatomic, physiologic, and neurochemistry studies of chronic pain on the brain clearly suggests that some chronic pain patients will develop clinical syndromes of poor attention span, cognitive abilities, and possibly dementia.¹⁻⁸˒¹¹⁻¹⁸ Is this happening? This author believes this to be the case based on long-term observations of chronic pain patients. Although chronic pain patients, in my experience, seldom admit to a loss of cognitive or mental abilities, they often complain of a poor memory. Is it time that chronic pain patients in treatment be sequentially monitored over time with mental scales such as the “Mini-Mental Exam?” Should we be trying to provide better diets, nutritional supplements, and dementia-preventing mental exercises such as crossword puzzles? Perhaps the pain patient who claimed her B-12 shot really helped knew what she was talking about. Can psychologists who specialize in dementia prevention help us? Shown in Table 2 are four cases from my personal practice which were undertreated for years before referral to me and who, I believe, developed mental deterioration. At this point, I have a poor understanding of how to diagnose, prevent, or treat mental deterioration in chronic pain patients, but these studies on brain atrophy provide insight into clinical observations.

Mechanism of Brain Atrophy

There should be no better subject to discuss in the hallways of medical practice than the possible causes of brain atrophy and neurochemical abnormalities that occur in chronic pain. Considering that some studies also show a loss of nerve density of peripheral nerves and spinal cord of pain patients, an electrical phenomenon must be considered as a cause. Is electricity being retained by damaged peripheral nerves (e.g., change in electrical capacitance) and thus causing a “hot wire” affect that fundamentally inflames, dissolves, and scars tissue? Does pain cause a hormonal or immune dysfunction that can literally dissolve gray matter? Hypercortisolemia has been observed in chronic pain patients and is known to cause a demented state.²¹⁻²³ Severe pain is also well-known to cause hypertension and tachycardia, particularly during pain flares. Both are known to affect cerebral blood flow. Whatever future research points to as causation, physicians should take their best shot now at preventing the disappearance of gray matter. In addition to better pain control, it is obvious that we need better strategies to normalize electrical conduction, hormone metabolism, and restoration of tissue.

Start Education Immediately

The number one thing physicians should immediately do with this new research information is educate all concerned parties including patients, families, psychologists, pharmacists, surrogates, insurance carriers, and medical boards (see Table 3). In particular, any party—such as a family member who is critical of opioid treatment—needs to be bluntly told that withholding treatment, including opioid therapy, may subject the patient to brain atrophy and the loss of intelligence, memory, and possible development of dementia. Simply, the risks of delayed or undertreatment appear too great. On the other hand, we do not yet know whether opioids or any other treatment can prevent or restore brain atrophy or altered brain physiology and neurochemicals.

Clinical Recommendations

It must be recognized that we may not be able to either prevent or restore brain tissue in chronic pain states. Nevertheless, these new research findings suggest some intuitive and logical measures. Education of ourselves and patients is, naturally, first on our list. Second is sooner and more aggressive treatment with all methods that are currently available. For example, alcoholic as well as some other forms of dementia respond to nutritional therapies. Since excess electricity produced in chronic pain states may be a causative factor, techniques to reduce and control electrical flow may be in order. Certainly, the encouragement of mental exercise, increased physical activity, and social interaction should help keep brains active. If you’re still struggling to lose weight, liv pure ingredients are all natural and can help with organ health and give you more energy.  Above all, doctors who treat severe chronic pain patients should focus on this complication and eagerly share any hints and tips they uncover. It’s also my recommendation that we attempt to identify psychologists who have interest and skills in working with dementia.

Conclusion

Chronic pain, particularly the severe intractable forms, should be considered a disease unto itself. The finding that chronic pain, per se, causes brain atrophy and altered physiology and neurochemistry is a profound discovery and joins the already known risks of under-treatment, namely cardiovascular, hormone, immune, and physiologic function. At this time, there is no guarantee that we can prevent or restore brain atrophy with any known treatment or measures yet aggressive pain control clearly outweighs the risk of undertreatment. Now that we are aware that this complication may occur, it is time to experiment, observe, and develop strategies to prevent or ameliorate it.

 

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The petition is the last hyperlink on this page. It is a 21 page PDF file and I don’t have the time to convert 21 *.pdf pages to a *.jpg pages so that they would display on my blog. When you click on that hyperlink it will show a BLANK graphic  – click on the graphic and the PDF will download.

When Narxcare first “came around” the press releases stated that they were going to use various databases to come to the pt’s potential for abuse or addiction. When I read press releases – especially in areas that I have some depth of knowledge, I not only look at what they say and especially what they DON’T SAY.

It Narxcare’s press release, they stated that they were going to gather data on the pts from various databases, they did not specify from “public databases”.  Narxcare was original owned by Appriss Health and it was sold to Bamboo Health, who sold it to Experian – one of the companies that created financial FICO scores. It has been reported that Experian has moved their healthcare databases off shore … where our HIPAA laws do not apply, so Experian can slice and dice all that pt health data and sell it too any entity that will come up with the $$$ to pay for the selective pt health data that they want – for whatever reason.

The petition pretty well “gets into the weeds” as to what Narxcare is doing with pt’s data and how they are presenting that data to prescriber via various state’s PDMP’s and how it has impacted the pain management care pts are getting.  I know in Indiana PDMP INSPECT, when I request a PDMP report… it goes directly to a Narxcare report format and data. The former format for a report from Indiana’s PDMP is GONE.   The second hyperlink below has the Narxcare report format – with pt info redacted. I believe that they have updated the format and they have expanded the 3 risk levels to 9 or 10. It is still a Zero to 999 score.

Until I pulled up a Narxcare report, I never heard of a LME ( Ativan/ benzodiazepine ) Lorazepam Milligram equivalent, but they assign a value to a pt taking one of that class of medications.

Some of the things that I suspected that Narxcare was doing or causing… the complaint confirmed my suspicions.  

Of course, the algorithm that Narxcare uses is claimed to be proprietary information, so no one knows for sure what is included to develop a pt’s risk score and/or how much weigh each category of data used affects the final score.

The “BAD AND THE UGLY – there is NO GOOD” of the PDMP’s and Narxcare and the INACCURATE CONCLUSIONS from those databases

Images from a Narxcare report – PLEASE SHARE

Center for US Policy FDA Citizen Petition

 

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HFPP SECRET ALGORITHM UNIQUELY TARGETED “OLDER WHITE PHYSICIANS,” BASED ON ASSETS, AGE, AND SPECIALTY IN MASSIVE GOVERNMENTAL OVERREACH: PT-2

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“LET THEM DIE-OFF” UNITED STATES GOVERNMENT EXPERT ANDREW KOLODNY, MD., THE MOST DANGEROUS PSYCHIATRIST IN AMERICA AND EXPOSING “THE OPIOIDGATE MEDICAL SCANDAL”

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