When stores, like pharmacies, can’t stay open as promised, it’s time to shop elsewhere

https://www.blueridgemuse.com/node/64327

Often, Floyd’s CVS Pharmacy is closed, without notice, for days at a time . They’re not alone.

A lot of Floyd County residents found themselves without access to needed prescription medications because the pharmacy at CVS on Main Street in the town is closed for a third straight day, citing a failure to have a licensed pharmacist on the premises.

To make matters worse, those who need to save money with lower prices at the Dollar General store a few blocks north are closed as well. Unanticipated closures during normal business hours have become the norm at both stores.

An increasing number of county residents have shifted to The Pharm House, which stays open during its posted hours and provides needed prescriptions, often at better prices while honoring insurance discount cards.

Others tell us that they are now driving to Christiansburg at least once a week to obtain prescriptions at Walmart at better prices. The store is open, as is a CVS location and the pharmacy at Kroger.

“CVS is a pathetic, pitiful operation that leaves people in danger when they can’t provide needed prescriptions on time,” says one resident, who asked not to be identified. Calls to CVS’s headquarters for comment were not returned. Emails, too, were not answered.

The problem is not limited to pharmacists. Pharmacy technicians are quitting at CVS, Walgreens, Rite-Aid, and other locations around the nation, citing increased stress and an inability to keep up with an increasing backlog of prescriptions.

“It got to the point that it was just such an unsafe working environment, where you are being pulled a thousand different directions at any given time,” said technician Heidi Strehl, who worked for Rite-Aid in Pittsburgh for 16 years before quitting in disgust. “You’re far more likely to make a mistake and far less likely to catch it.”

Strehl told NBC News that low wages, few raises, and rude customers were just too much.

“I always thought I would retire from that place,” Strehl said. “But all of the parts of my job that I truly enjoyed over the years had slowly just gone away.”

She’s not alone. The more than 400,000 pharmacy technicians in America work in jobs with little training, even though they are working with serious medications where mistakes can threaten and cost lives Most are paid very little, get few if any raises and have meager benefits.

In Floyd, Dollar General is often closed early or sometimes even all day because of employee shortages, COVID-19, and other problems. Those trying to shop at Dollar General on North Main Street just outside the town limits found a hand-written sign on doors that were locked tight.

The retail chain is facing worker revolts throughout the country. One of Dollar General’s managers in Florida posted a series of Tik Toc videos

INC reports:

Employee hours were severely limited by the company, she said, leading to her or another employee often working alone in the store. Shipments arrived unexpectedly, and with no staff to unpack them, she was forced by company policy to leave boxes stacked up in the aisles, blocking the store shelves and leading to customer complaints.

Sound familiar? The aisles are often blocked in the Floyd Dollar General while some shelves are empty. A call to the company was not returned. Neither was an email request for comment.

Need a prescription or a loaf of bread? Best to call and see if the stores or pharmacy or other retail operation is open.

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This farmer uses NO FERTILIZER…. NO PESTICIDES … MAYBE NO DIESEL TRACTORS

Armed Feds Pay a Visit: Amish Farmer Faces Hundreds of Thousands in Fines

https://www.westernjournal.com/armed-feds-pay-visit-amish-farmer-faces-hundreds-thousands-fines/

Amos Miller, an Amish farmer who runs a holistically managed small farm in Bird-In-Hand, Pennsylvania, grows and prepares food in tune with nature, the way he believes God intended. This seems like a sound idea to the approximately 4,000 customers who purchase Miller’s meat, eggs and dairy products from his private, members-only food club.

The federal government, however, appears to disagree. A federal judge recently ordered Miller to cease and desist all meat sales, Our Organic Wellness reported. U.S. marshals were deployed to search Miller’s property. They inventoried his stock to assure he doesn’t sell or slaughter more animals. In other words, the feds shut Amos Miller down.

Miller claims he is being persecuted by the federal government for practicing his religious freedom to grow and prepare food according to his religious beliefs.

“To believe your own thought, to believe that what is true for you in your private heart is true for all men, — that is genius.” So wrote American philosopher Ralph Waldo Emerson in his influential 1841 essay Self-Reliance. Once upon a time, Americans respected the notion of self-reliance. It was at the heart of the American mythos. Not anymore.

In March, George Lapsley, a court-appointed expert, was to receive “unimpeded access” to Miller’s farm to inspect the facilities, according to Food Safety News. On March 11, Lapsley reported that Mr. Miller did not fully cooperate and requested assistance from the U.S. Marshals Service.

Federal Judge Edward G. Smith of the Eastern District of Pennsylvania then ordered that the USMS was authorized to use whatever reasonable force was necessary to gain entry into the facilities it is authorized to inspect.

Furthermore, according to Food Safety News, the court’s order permited Lapsley to make unannounced visits to Miller’s farm. Presumably, this meant anytime, day or night. Never mind God, Big Brother is here.

If this isn’t an escalation, I’m not sure what would qualify as such.

Why is the USMS authorized to use force on an Amish farmer? The USDA contends Miller is slaughtering meat and poultry animals at these locations and distributing them to other states without federal inspection.

To be fair, in 2016 the U.S. Centers for Disease Control and Prevention reported that an outbreak of listeria had been traced to unpasteurized raw milk produced by Miller’s Farm, as reported by CBS News. The incident occurred in 2014. The “outbreak” impacted two people, one in California and one in Florida. One of them died.

At the time, Miller told CBS News that he was not aware of any health problems. “I don’t know that it was proved it’s on the farm here,” he said.  It’s not clear why it took the CDC two years to conclude that it was.

Whatever the case, that was then. This is now.

In the summer of 2021, Miller was ordered to pay $250,000 for “contempt of court.” He was also told to pay the salaries of the USDA investigators assigned to his case. To avoid going to jail, he was ordered to pay $50,000 upfront as a gesture of “good faith,” as reported by Our Organic Wellness.

The notion of self-reliance can be dangerous.  “To believe that what is true for you in your private heart is true for all men,” can be a green light to nightmare land. The 20th century was full of monsters like Mao, Stalin, Hitler and Pol Pot, who believed they were doing the right thing. Villains don’t often see themselves as the bad guy. They think of themselves as heroes.

All the monsters mentioned above, however, have one thing in common — they vied to replace God with government.

Amos Miller isn’t so audacious. He’s simply trying to do what he believes God intends — be a steward of the earth by growing and naturally preparing food. There’s nothing far-fetched or crazy about that. One might go so far as to say it’s good old common sense.

Miller practices rotational grazing. His cattle are raised on organic pastures, with the chickens following behind to eat bugs from the droppings. Whey-fed pigs then trample the fertilizer back into the earth.

Again, there’s nothing sinister going on on Miller’s farm. He just wants to be left alone to go about his business. He just wants to be self-reliant.

Why would the feds resort to force and heavy fines to bring Amos Miller into compliance? Why is his private business any of their business? If Millers’ customers were getting sick from his products, he’d know about it, because they’d either sue him, make a big stink or quietly spread the word. His business would suffer.

It’s fair to ask if the feds are attempting to squeeze religious belief out of the marketplace. They’ve managed to all but banish it from our public schools. During the pandemic, they attempted to selectively clamp down on churches. There’s a pattern here.

One of my readers shared this today

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I have highlighted several sentences in this article that suggest that the people doing the study were making some  GUESSES …like this one…Patients who die of overdose may have more than one prescribing physician and may overdose on illicitly obtained drugs. Just in one sentence they used the WORD MAY… but these medial examiners are sending letters to docs that ONE OF YOUR PTS – OD/DIED FROM A BENZODIAZEPINE in their toxicology. They converted all benzodiazepine to a “diazepam mg equivalent”.  We all know how accurate all those MME comparison work out. What was the toxicology values of these pts… the typical OD… has 4 to 7 different substances in their toxicology, one typically be the drug ALCOHOL. This study reminds me of all the things  I heard during the COVID-19 primary epidemic … when pts were claimed to have died of COVID-19 … when they really died from their existing comorbidity issues BUT… had tested positive for COVID-19.

Letter on Patient’s Fatal Overdose May Curb Benzodiazepine Prescribing

https://www.medpagetoday.com/publichealthpolicy/healthpolicy/100343

Physicians who received a letter from a medical examiner notifying them of a recent patient’s fatal overdose prescribed fewer benzodiazepines, a secondary analysis of clinical trial data showed.

Daily 2-mg diazepam pill equivalents decreased more in an intervention group that received a medical examiner letter and injunction to prescribe safely compared with a control group (-3.7%, 95% CI -6.9% to -0.5%, P<0.05), reported Jason Doctor, PhD, of the University of Southern California in Los Angeles, and co-authors.

On average, 2.9 fewer 2-mg diazepam pills were dispensed per prescriber per month in the intervention group compared with controls, Doctor and colleagues noted in JAMA Internal Medicine.

“The results of this secondary analysis of a randomized clinical trial suggest that having medical examiners send out letters informing clinicians of a fatal scheduled drug overdose in their practice is a low-cost approach to curtailing the overprescribing of benzodiazepines,” they wrote.

“The observed moderate reductions that were associated with the letter seemed to concentrate among continuing prescriptions, which is what was associated with the increase in benzodiazepine prescribing from 2005 to 2012,” they added.

The report extends the trial’s earlier finding that showed physicians in San Diego County who were informed by the medical examiner of a patient’s fatal overdose from July 2015 to June 2016 prescribed 10% fewer opioids.

These notifications may be effective reminders of the potential harm of opioids and benzodiazepines, observed JAMA Internal Medicine deputy editor Mitchell Katz, MD, of NYC Health and Hospitals, in an editor’s note.

“It is important to understand that the prescribed drugs may have been appropriate and that the patients did not necessarily overdose on the drugs that were prescribed by the physician who received the notification,” Katz pointed out. “Patients who die of overdose may have more than one prescribing physician and may overdose on illicitly obtained drugs.”

“Nonetheless, when we prescribe opioids and benzodiazepines, the risks and benefits to patients should always be weighed,” he continued. “Even appropriately prescribed scheduled drugs may be associated with long-term use and abuse, purchase of illicit drugs, and death owing to overdose.”

In their analysis, Doctor and co-authors assessed the change in benzodiazepines dispensed 3 months before (pre-period) and 1 to 4 months after (post-period) the letters and injunctions were sent. The researchers measured benzodiazepine prescriptions in daily 2-mg diazepam pill equivalents.

Overall, patients of 743 prescribers (353 in the intervention group and 390 in the control group) filled a benzodiazepine prescription during the study period. Alprazolam and lorazepam were the most frequently dispensed benzodiazepines.

In the intervention group, an adjusted average of 76.0 pills monthly were dispensed in the pre-period and 72.3 were dispensed in the post-period. In the control group, adjusted mean monthly pills were 82.9 in the pre-period and 82.0 in the post-period.

There was no significant difference by group in new treatment initiations from pre- to post-period.

One limitation to the study was that it did not evaluate the clinical well-being of patients or physicians in the intervention group, Doctor and colleagues acknowledged.

Other localities, like Los Angeles County and Washington State, have adopted the practice of sending letters to prescribing physicians alerting them of patient overdoses, Katz noted.

“As physicians, we do not always know why patients are no longer coming to see us,” he wrote. “Follow-up information can help us to be better physicians.”

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laurendeluca19

Lauren Deluca

· 889 Followers

Executive Director, Chronic Illness Advocacy & Awareness Group a NonProfit Org.

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I just happened to stumbled on to this while looking for something else…  Maybe I am wrong, but to develop a whole system that comes to a conclusion that a particular person’s risk of being or become addicted when they are taking controlled meds, is based on just using the data on 1523 pts.  Back in the last of 2021, the company that owns Narxcare is Bamboo, which was sold to Equifax  https://apprisscorp.com/press-relea…nsights-llc-to-equifax-in-1-825-billion-deal/.  I have read that all the data collected and maintained by Narxcare has been moved and stored outside of the USA… so that our HIPAA law has no authority over the prohibition of sharing/selling our personal health information.

There is some 330-340 million in our country and it is claimed that abt 100 million are dealing with some sort of chronic pain and as a country we purchase about 4 billion prescriptions per year and I have seen statements that abt 20% of those 4 billion prescriptions are for controlled meds…   that is a sampling of 0.001523 % sampling of the estimated number of chronic pain pts. Ohio has been one of the states with a very high substance abuse and OD rates.

According to this https://www.scrapehero.com/kroger-store-locations/ Kroger has 242 stores in Ohio and 160 stores in Indiana. So the sampling was in < 5% of the Kroger stores in those two states.  There are 88 counties in Ohio and 92 in Indiana.

Peer-Reviewed Study Validates Bamboo Health’s NarxCare as Effective Patient Screening Solution for Opioid Risk

https://bamboohealth.com/news-pr/peer-reviewed-study-validates-bamboo-healths-narxcare-as-effective-patient-screening-solution-for-opioid-risk/

Research funded by NIDA and NIH evaluated Narx Score rating system as compared to World Health Organization ‘gold standard’ for substance screening

BOSTON, October 26, 2021 – Bamboo Health, formerly Appriss Health and PatientPing, a healthcare technology solutions company focused on fostering care collaboration and providing information and actionable insights across the entire continuum of care, has announced that a newly published peer-reviewed study concludes the company’s NarxCare solution is effective as an “initial universal prescription opioid-risk screener.”

The peer-reviewed study was conducted through the National Institute on Drug Abuse’s (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) and funded by the National Institutes of Health’s (NIH) HEAL Initiative. The study’s goal was to evaluate the validity of the NarxCare Narcotic Score as a clinical measure of opioid misuse and substance use disorder. Researchers assessed NarxCare risk thresholds relative to the “gold standard” World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHO ASSIST).

“Prescription Drug Monitoring Programs (PDMPs) are critical for pharmacists and clinicians to identify risky prescription medication use, but before our study the association between the Narx Score and other indicators of opioid use or risk had not been externally evaluated,” said Dr. Gerald Cochran, associate professor of internal medicine and director of research for the Program on Addiction Research, Clinical Care, Knowledge, and Advocacy in the Division of Epidemiology at the University of Utah School of Medicine, one of the leaders of the study team. “Our research shows that Bamboo Health’s NarxCare metric is a useful initial screening tool for prescribers to determine whether a patient is at risk for opioid misuse.”

Researchers recruited 1,523 participants from 19 Kroger community pharmacies located in both urban and rural Ohio and Indiana who were picking up prescribed opioids. The study was led by Dr. Cochran. The researchers have no relationship with Bamboo Health.

“This independent peer-reviewed study confirms what we at Bamboo Health have known about NarxCare’s ability to provide prescribers with clinical decision support to assess a patient’s vulnerability to opioid use disorder and misuse,” said Rob Cohen, company president and general manager. “We’re proud of the role our technology plays in helping clinicians and pharmacists make more informed prescribing and dispensing decisions to improve patient safety and health outcomes.”

NarxCare is a clinical decision support tool and care management solution that helps prescribers and dispensers analyze controlled substance data from PDMPs and manage substance use disorder. NarxCare automatically analyzes a patient’s PDMP data and provides risk scores along with interactive visualizations of usage patterns of opioids, sedatives, and stimulants to help identify potential risk factors.

The study used narcotic scores to divide participants into three groups representing low-, moderate- and high-risk for misuse; the thresholds proved clinically useful as a universal screen to advise providers on next steps with the patient, such as further review of the data or an additional screening with the patient.

“Pharmacists and physicians can use the thresholds as calls-to-action to further review details in the patient’s prescription history in conjunction with other relevant patient health information as they attend to the patients,” added Cohen. “The analysis, thresholds, and associated scores are not intended to work as sole determinants of a patient’s potential risk. We instruct our customers and clinician users that the purpose of NarxCare and the PDMP is to support their clinical decisions, not displace them.”

A Narx Score is a set of three-digit numbers that correspond to dispensing information for three different types of controlled substances (prescriptions). A separate score exists for narcotics, sedatives, and stimulants. The scores range from 000 to 999. The third number in the score indicates the number of current dispensations. The first two numbers are calculated based on data from the PDMP, including number of prescribers, number of pharmacies where prescriptions were dispensed, strength of the prescriptions, and overlapping prescriptions. More recent prescriptions and changes are weighted more heavily than older prescribing patterns.

Bamboo Health’s PDMP solutions are used in more than 40 states and territories and are leading the nation in prescription data monitoring.

About Bamboo Health

Bamboo Health, formerly Appriss Health and PatientPing, is a healthcare technology solutions company, focused on fostering care collaboration and providing information and actionable insights across the entire continuum of care. As one of the largest, most diverse care collaboration networks in the country, our technology solutions equip healthcare providers and payers with software, information, and insights to facilitate whole person care across the physical and behavioral health spectrums. By serving 2,500 hospitals, 7,800 post-acute facilities, 25,000 pharmacies, 37 health plans, 45 state governments, and over one million acute and ambulatory providers through more than 500 clinical information systems electronically, we impact over 1 billion patient encounters annually in provider workflow. Health systems, payers, providers, pharmacies, governments, individuals, and other organizations rely on Bamboo Health to improve care and reduce cost. Visit www.BambooHealth.com to learn more.

Study published in Drug and Alcohol Dependence journal

https://www.sciencedirect.com/science/article/abs/pii/S0376871621005627

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In ancient Greece, Socrates had a great reputation for wisdom. One day someone came to meet the great philosopher and said:

Let’s improve our individual life for good and society will change too.

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When I first started working in a pharmacy – in the summer of 1967 – while I was a student. There was NO PBM’s… 95%+ was brand name meds and everything was CASH… The average Rx price was $4-$5.  The PBM industry was created by the national UAW contract in the fall of 1969 – that covered the big three auto makers, John Deere & International Harvester. You could say that I had a “front row seat” to watching the PBM industry evolve since the beginning.

Here is graphic that demonstrates where the $$$ you pay at the Rx dept register really goes. Looking back, as the PBM industry starting controlling more and more of all prescriptions filled … the faster the wholesale price from the pharmas went up. Today, abt 85% of all Rxs are filled with generics and  the PBM’s control the price for 80%-90% of the 4 billion Rxs that we fill every year.  Today the average Rx price is pushing $70.00.

The PBM now are able to DEMAND a kickback/rebate/discount from the pharmas for any med that the pharma doesn’t want to require a prior authorizations.  It has been reported that money from the pharma can be up to 75% of the AWP (average wholesale price)

The new Inflation reduction act, that now laws Medicare to negotiate prices for Medicare covered medications… the Insurance/PBM industry was not included as a entity that should be included in the negotiation of Rx prices. Perhaps that we are having a national election in Nov, maybe a lot of money was put into some re-election campaigns by the insurance/PBM industry to make sure that they were not included in that new law. If you have a family, a business, or others who depend on you, visit here to get life insurance.

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I have been maintaining and adding to my blog for over 10 yrs .. I have actually lost count.  There has always seem to be some infighting within the chronic pain community.  Over the last few years, the in fighting has been escalated from in fighting to attempting to be down right DISRUPTIVE.

The community is – and been for decades – dealing with bureaucrats/politicians that regardless of what facts and studies that contradict their “facts” and their “agenda”  they are not going to change their policies and procedures.  They are going to continue to prevent people who have a valid medical necessity for being prescribed opiates and controlled substances from getting their needed medications.

These bureaucrats probably feel very emboldened about continuing to  curtail the prescribing of opiates and controlled substances, because some within the community is trying to just tear the community apart.  They have little concern about the community attempting to change the path that the bureaucrats/politicians are one… because the community is too busy destroying itself from within.

They are going to use such number as within this decade, illegal drugs/substances from cartels will kill MORE OF OUR CITIZENS… than all our soldiers that were killed in all the years of wars in the LAST CENTURY.  Recently, I have read where “they” are admitting that the vast majority of OD/poisoning are from illegal fentanyl analogs… but… they still use their 5 decade old fact “all addicts stated with Rx opiates”

Only those within the community can put a end to this disruptive behavior… If those in the community continue to support, align and otherwise condone the actions of those who are doing this… things will not only remain… it will most likely get worse and those doing the disrupting will only get  more aggressive, until the community has self destructed.

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Is it just me… or according to this ––Jennifer Lofland, Field Intelligence Manager for DEA Washington division, says pills have been seized in and around D.C. for at least the last 18 months. – what other major shift happened in our country 18 months ago ?  In the article this is stated She said they’re increasingly finding animal tranquilizers added to pills as well  Are they talking about  carfentanil which is about 100 times more potent than most fentanyl analogs and according to this article methamphetamine is also in these tablets.  Does it really matter who is creating all of these illegal substances, some say it is China, other suggest India and still others claim that the drug cartels themselves are concocting these illegal substances…  It appears pretty plain that the Mexican cartels are targeting OUR CHILDREN and GRANDCHILDREN.

As I remember, when we first declared the war on drugs, elite teams of our armed services would go to those clandestine labs and blow them up – DESTROY THEM.  With the number of illegal substances and fake tablets looking like real Rx meds and now with the appearance of “candy” that are being confiscated… either none of those clandestine labs are being destroyed or the cartels are able to create new ones quicker that we can “take them out”.  

During the 20th century, our county lost 600,000 kids in four different wars ( WW I, WW2, Korea, Vietnam). At the current rate of poisoning of mostly 20-45 y/o people from illegal substances ( opiates, meth, cocaine, crack, etc)… we may reach or exceed the number of soldiers killed in all the years of wars in the last century by the END OF THIS DECADE.

I recently watched a video debate between 4 gentlemen about the opiate crisis and one gentlemen put out a educated guess that the illegal substance OD/poisoning will reach 150,000/yr before the end of the decade.  IMO, we may hit that number by the middle of this decade and this could become more of a likelihood now that our CHILDREN ARE BEING TARGETED BY THE DRUG CARTELS.  Especially, if they are mixing in animal tranquilizers (Carfentanil ?),  OD/poisoning could accelerate quite rapidly.

And if the politicians/bureaucrats follow what they have done historically… they will continue to reduce the supplies of legal opiates and deprive all those people who have a legit medical necessity for those medications.

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If you haven’t heard,,, Youtube removed this video of our song Take a Knee..My Ass!! After 5.4 million viewed it. Doesn’t fit their guidelines. Hope you’ll watch it and find it in your heart to Share!!! #KAG

This video is now SAVED on my hard drive…. it is not going to get taken down from my blog !

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