PHARMACIST STEVE

A fairly visible chronic pain advocate just re-posted a video she did abt four years ago about another chronic painer who had her pain management reduced, given the date on the video would suggest that happened sometime after the 2016 CDC guidelines published and the 2019 posted date on the video.  Apparently this pt over that 2-3 yr period had suffered FIVE HEART ATTACKS with the 5th one being FATAL.

The CSA was signed into law in 1970, the same year I was first licensed as a Pharmacist. So I  have had a front row seat to its evolution over the years. That created the BNDD ( Bureau of Narcotics & Dangerous Drugs) which created the bureaucratic foundation for when in 1973 Congress created the DEA with 1200 employees and a 42-43 million/yr budget.

Most of the active Heroin addicts was in the NY area and the mafia was the primary supplier of Heroin. During the 80’s the DEA/law enforcement got more and more creative with Civil Asset Forfeiture seizure and since the mafia and their assets were USA based and a good target for the DEA/law enforcement.

It would appear that the mafia gave up on the illegal Heroin distribution and apparently the Mexican cartels moved in to pick up the distribution of Heroin.  Since the Cartels’ assets were outside of the DEA jurisdiction, confiscating the Cartel’s assets proved a challenge. All the assets the DEA had previously confiscated, they were able to put them into the DEA’s coffers… to spend as they wished.

In 2000, our Congress passed the DECADE OF PAIN LAW, that encouraged ALL DOCTORS to treat pain.  the FIFTH VITAL SIGN was created and the Joint Commission made it a MAJOR STANDARD for hospitals to meet.  Pt discharge questionnaires included if/how the pt’s pain was treated. The number of Rx prescribed during the decade and when the bill was up for renewal, the political party in charge of Congress when it was passed was no longer in the majority and the law was not renewed.

Rx opiates filled peaked in 2011-2012.  In Jan 2009, we have a new President (Obama) in office and in 2011 FL gets a new Governor Rich Scott and a new state AG Pam Bondy.  Florida had become a major source of opiate prescribing, mostly because they had a “loose licensing system” and they did not have a state wide PDMP.

The Decade of pain law – in essence – created a lot of “low hanging fruit” for the DEA to go after – prescribers who were following the Decade of Pain law and as DEA was losing MJ as states were making MJ legal in many states. which was a “cash cow” for the DEA.  The Decade  of pain law disappeared and FL implemented a PDMP and AG Bondy what she called “oxy docs” and according to her re-election campaign ads she chased out 200 oxy docs from FL in her first 4 years.

The first blog post on my blog was June 2012. In the ensuing 10 yrs, yes chronic pain pts have died. Especially after the 2016 CDC guidelines were published. What was put on their death certificate ?  Opiate related death because there was some record of them receiving a Rx opiate, or they committed suicide using their own meds ?  Was it because of “natural causes”, because their blood pressure spiked and they had a stroke, heart attack, ruptured aortic aneurysm.  Maybe a GI bleed or kidney failure because of the excessive use of a NSAID  or excessive use of Tylenol/Acetaminophen and liver failure.

How many petitions have been published ? Has anyone see any action because of those petitions ?  How many letters, phone calls, faxes, emails, in person meetings has there been with members of Congress ?  How many responses/letters focused on the problems with the war on drugs and little/nothing about the context of the original communication ?

The 2016 CDC guidelines, they tried to have them created behind closed doors, with anonymous committee members and no public comment.  They didn’t follow the statutory requirements – any consequences to CDC/anyone ?

The 2022 CDC guidelines, how many comments from the community, how many comments were read, some claim that many comments “disappeared”.  Was there any changes from the proposed 2022 guidelines and those that were published as FINAL ?

Recently, Walgreen, CVS, Walmart agreed/settled to a combined 13.8 billion settlement for contributing to the opioid crisis and as I remember within the settlement they are agreed to FILL FEWER OPIOID Rxs.

J&J was found guilty of being a “PUBLIC NUISANCE” and a 572 million settlement for being the wholesaler of raw opioid powder to the pharma industry to produce FDA approved Rx meds – it was overturn later.  Teva agreed to a 4.25 billion settlement to untold number of “wronged parties” and contributed to the opioid crisis.

I has not been until the last year or so that it has came to light some of the shenanigans that federal prosecutors and federal judges will pull to help assure a conviction. I now understand why I have numerous attorneys have claimed that 90%+ of those taken to federal court – are found GUILTY !

Here is a letter from Kaiser from 2019 from their “medical clinic team” that they are limiting opioid Rx to < 50 MME, most/all below the FDA’s recommended max daily dosing.  The MME system that  has no science nor double blind clinical studies supporting its conclusion.  https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154  they are also using a “broad brush” to prohibit the concurrent prescribing of 4 different categories of FDA approved meds as safe for human use. ( Opioids, benzos, muscle relaxants & sleeping meds)

Since the letter by “medical clinic team”  and it is on Kaiser’s letter head, one can only presume that this committee’s decision is supported by the BOD of Kaiser.

One of the core functions of the practice of medicine is the starting, changing, stopping a pt’s therapy. So is Kaiser limiting/restricting the professional discretion and prescriptive authority that is granted each prescriber by their state medical license.

In 2021 https://www.statista.com/statistics/401547/kaiser-permanente-members/ it is reported that Kaiser had 12.6 million members. If one uses the low end figure of 20% chronic painers in our general populations.  That would suggest that this policy could impact up top 2.5 million pts.

This is just one of a unknown number of large heath care corp doing the same/similar thing and that is not counting the number of chain pharmacies and insurance/PBM corporations doing same/similar thing.

Law firms like to find large corporations – with deep pockets – that has harmed people and the more “bodies” the better. To start a class action by a law firm only needs 1-2 lead plaintiffs.  All it is going to take is 1 or 2 chronic pain pt reaching out to a law firm that deals with civil rights violations that a interest to investigate

To date, all those chronic pain pts that are suffering from under/untreated pain or have died is doing so because of laws & illegal guidelines that have been used against them. The only way that the chronic pain has a chance to get their appropriate pain management back is using the laws that these corporations are using against them and/or laws they are breaking.

Filed under: General Problems