I was never addicted to anything…was taking up to 20 to 30 pain pills per day

‘Prescription Thugs’: New documentary looks at America’s legal drug abuse problem


The United States makes up about 5 percent of the world’s population, yet consumes more than 75 percent of the world’s prescription drugs, according to the 2011 UN World Drug Report.

It’s a sobering statistic that’s highlighted in the new documentary “Prescription Thugs,” which takes an intimate look at what many addiction experts agree is the worst epidemic in America today.

“The subject kind of picked me. My older brother died from a prescription drug, basically, an overdose – his body gave out from all the prescription drugs he was doing,” director Chris Bell told FoxNews.com’s Dr. Manny Alvarez. “I wanted to find some answers why that happened to him.”

In the follow-up to his last documentary, “Bigger, Stronger, Faster,” which examined the role of anabolic steroids and other performance-enhancing drugs in sports and the lengths some athletes will go to in order to reach their dreams, Bell takes viewers inside the world of prescription drug abuse through the stories of several addicts from all walks of life. There’s the Michigan mother of four who started taking her daughter’s Adderall prescription; the 16-year-old student who got hooked on pain pills after having surgery; former athletes who admit to taking dangerous cocktails of painkillers, tranquilizers, sexual dysfunction medications and supplements; and the suburban father who almost lost it all.

In a surprising twist, Bell reveals his own struggles with prescription painkiller addiction in the film.

“I was never an addict, I was never addicted to anything – I was always somebody who was into sports – I was a power lifter … I was excited to go to the gym every day,” Bell said. “But once I was hurt, and on these painkillers, everything started going slowly in reverse.”

By the time he finally sought help, Bell was taking up to 20 to 30 pain pills per day.

“It’s something that you have to come to terms with yourself, it’s something that you have to want to quit and want to get off of,” Bell said. “It’s tough, it’s a disease where it’s a behavior problem … it’s a brain chemistry problem … and the only way to fix it is to work on those behaviors and sort of modify those behaviors.”

A national epidemic

The most abused prescription drugs fall under three categories: painkillers, tranquilizers and stimulants. In 2010, enough prescription painkillers were prescribed to medicate every American adult every four hours for a month, according to the National Institute on Drug Abuse.

“I think the biggest eye-opener was I always thought that like prescription drugs … were in the business of health and healing, and they wanted to get you better,” said Bell. “And I just realized that … people benefit and there’s a lot of money being made off of keeping people on drugs.”

It’s no secret the pharmaceutical industry rakes in billions of dollars producing drugs to treat symptoms and manage medical conditions. In fact, over the past decade, the Big Pharma raked in $711 billion. And in 2013, Bell points out, the industry spent upwards of $422,000 per United States Congressman to lobby their causes.

Pharmaceutical executives and government officials Bell appealed to for his documentary denied his requests for interviews.

And while he doesn’t deny that the pharmaceutical industry is also responsible for many life-saving drugs on the market, Bell said he hopes his film will inspire people to be their own advocate when it comes to their health.

“This isn’t a movie that’s there to condemn the pharmaceutical industry or say ‘If you get sick, don’t go to the doctor,’” he said. “I think [people] should go in and ask their doctor not what drug is right for them, but go in and ask their doctor why the doctor had put them on this specific drug.”

We’re just taking too many pills, and we have to be careful, he added.

For more information, visit PrescriptionThugs.com.

More about the puzzle and the solution


I have learned that when Barb asked me what I was talking about in one of my posts that I have gotten “too deep into the weeds” on a issue. The post in question this time is

Are we losing pieces of the “solution puzzle ” ?

The government, bureaucrats, politicians, and regulators are all about numbers.. Some times they don’t pay attention to the people they are suppose to be serving. Maybe it is just me, but there seems to be an ever enlarging gap between “the people” and the bureaucracy. This past week a Fed Rep or Senator was on “the tube” complaining that Congress passes laws and those agencies that are suppose to implement and enforce these rules – DO NOTHING !

Some 140,000+ people signed a petition to get the head of the DEA fired because he stated that MJ/MMJ was a joke. outcome ? no change to date Some 4000+ made comments on the new CDC guidelines, mostly against them… outcome ? the original guidelines will be implemented unchanged Our previous AG (Holder) left office while still being held in contempt of Congress.. outcome ? No action..

Unlike the civil war 150 yrs ago over slavery, there is no doubt about it .. we are in the middle of another civil war.. declared by Congress in 1970 by the Controlled Substance Act and being carried on by the DOJ/DEA and the entire judicial system from the cop on the street… all the way up to the Federal AG. 51 billion dollars being expended every year fighting this civil war…

Congress is taking our tax money to fund the war against 106 million chronic painers, untold number with mental health (including addiction) and untold number of healthcare professionals trying to practice their profession and help pts who are suffering. All told, over HALF of our population is the target enemy of this civil war.

I can almost assure you that if you and a friend sent a letter/email/fax to a Fed Rep or Senator.. one supporting how the war on drug is being fought and the other against how the war is being fought.. Each of you will receive a return letter agreeing with your position and your concerns and will take your opinion into consideration when they have to vote on a proposed bill/law concerning the war on drugs.

wethepeopleLet’s face it.. politicians only care about $$$ funneled into their reelection campaign and your vote. It is claimed that politicians spend 70%+ of their time – while in office – running for reelection.

All one has to do is watch all the “goings on” in Iowa this week. I was listening to the Republican debate the other night. At times, it sounded like a Christian revival meeting… nothing wrong with such.. but.. they were tripping all over themselves to “court” that vote in Iowa.. It is estimated that the “evangelical vote” is about 39% of the USA population.

The chronic pain community and other groups having war declared against them is somewhere north of 150 million. In the last presidential election the total votes were 126 million .. and 5 million separating the winner from loser.

There are 535 members of Congress.. if the group established a network a coalition of those affected by the war on drugs. All would be needed is one person as national coordinator, one state level coordinator in each state and one person to be a regular contact with the appropriate LA (Legislative Aid) in each Senator/Representative’s office. Total of less than 600 people.

Imagine how much attention this group would draw.. if the state coordinator contacted a specific legislator/LA and stated that “we want …” and when they get the run around.. a email is sent out to all the members in the state which would commence a tsunami of emails, faxes to that particular office.

gorillaThe 800 lb gorilla in the room is how does someone get all this coordination together. Given the 4,000 comments on the CDC guidelines.. would suggest that the vast majority of those being impacted by the war on drugs…are unwilling/unable to get involved for whatever reason.

I am not sure if all this attention to those in the chronic pain community by the DEA/CDC and others in the bureaucracy is at the direction of this administration or they have colluded to “go off the reservation together”.

Without a organized..highly visible… resistance … they will continue to use YOUR TAX DOLLARS to bury you. Create all the individual organizations and FaceBook groups you like… raise funds for a cure.. that may not be realized in your lifetime… Or band together to seek to get your pain properly treated in the very near term. They can interfere with you getting your meds.. they can’t interfere with your vote.. to VOTE THE BUMS OUT !

It is like a dog chasing its tail.. when he stops still in the same place


Committees Support CDC Opioid Guidelines


By Pat Anson, Editor

Two advisory committees expressed broad support Thursday for the controversial guidelines for opioid prescribing being developed by the Centers for Disease Control and Prevention (CDC). Those guidelines discourage primary care physicians from prescribing opioids for chronic non-cancer pain and recommend other therapies such as over-the-counter pain relievers, acupuncture, and cognitive behavioral therapy.

One newly formed committee — which the CDC calls a “workgroup” — did express “significant concern” about the cost of those alternative pain therapies and whether they are covered by insurance. The workgroup’s report to the CDC’s Board of Scientific Counselors (BSC) also suggested that the guidelines be “framed with positive rather than negative language” that supports “integrated care for people with chronic pain.” It also recommends the impact of the guidelines be monitored for “unintended consequences” after they are implemented.

The BSC voted to support the workgroup’s report, which can be found here.

“The BSC voted unanimously: to support the observations made by the BSC Opioid Guideline Workgroup; that CDC adopt the guideline recommendations that, according to the workgroup’s observations, had unanimous or majority support; and that CDC further consider the guideline recommendations for which the workgroup had mixed opinions,” said CDC spokesperson Courtney Leland in an email to Pain News Network.

“CDC is taking the BSC’s recommendations, as well as comments received from the public, into consideration in revising the guideline. The guideline is a priority for our agency. Given the lives lost and impacted every day, we have an acute sense of urgency to issue guidance quickly.”

The CDC planned to implement the guidelines this month with little public input, but was forced to change course after widespread criticism about its secrecy and lack of transparency during the drafting of the guidelines. In response to critics, the 10-member workgroup was formed three weeks ago and met four times by teleconference to review the guidelines. A potential legal problem for the CDC is that none of the workgroup’s meetings were open to the public. The workgroup also reviewed the guidelines with outside consultants without publicly disclosing who they were.

The Washington Legal Foundation (WLF) has threatened to sue the agency for its “culture of secrecy” and “blatant violations” of the Federal Advisory Committee Act (FACA), which requires meetings to be open to the public.

Over 4,300 online comments were received by CDC during a public comment period that ended earlier this month. Many opposed the guidelines as being too restrictive, while others wished the guidelines were stronger to combat the so-called epidemic of opioid abuse and overdoses. There were passionate arguments on both sides, but in the end the workgroup decided that the case for the guidelines was stronger.

“Comments from patients and family members, in particular, expressed the desire that patient-centered care is enhanced rather reduced by these Guidelines. Members felt that the guidelines could be implemented in a manner consistent with patient centered care,” the workgroup said in its report.

As many as 11 million Americans use opioids for long-term chronic pain and many fear losing access to the drugs if the guidelines are adopted.

“The purpose of the guideline is to help to primary care providers offer safer, more effective care for patients with chronic pain and to help reduce opioid abuse disorder and overdose from these drugs,” said Debra Houry, MD, director of the CDC’s National Center for Injury Prevention and Control, which is overseeing development of the guidelines.

“The guideline itself is not a rule, regulation or law. It is not intended to deny access to opioid pain medication as an option in pain management. It is not intended to take away physician discretion and decision making.”

“Pain specialists and their patients fear the Guidelines will not be used that way though and adoption by boards, professional organizations, and insurers will pressure even specialty pain providers to taper patients,” said Anne Fuqua, a chronic pain sufferer and patient advocate. “Pain patients nationwide have been experiencing dose reductions and losing access to care altogether for several years, with the situation becoming more acute in the past year. In an environment where physicians are tapering patient doses or ceasing opioid prescribing altogether, I feel these guidelines will serve like an accelerant in a growing fire.”

Although the CDC has said it doesn’t want the guidelines implemented until they are finalized, Fuqua said many doctors are already doing just that. She said her faith in democracy “took a swift kick in the teeth” as she listened to the workgroup’s presentation during a conference call. Fuqua was not given an opportunity to speak, although the president and founder of Physicians for Responsible Opioids Prescribing (PROP) were given time to address the BSC in support of the guidelines they helped draft.

“There were 28 comments supporting the Guidelines and 4 dissenters. One physician made statements partially supportive of our needs. CDC will no doubt use this ‘overwhelming support’ to justify adoption of the guidelines. I fear they see us as simply a casualty of war, much like those with tuberculosis who were quarantined to prevent disease spread. The only difference is that harming us doesn’t save other lives,” she said.

CDC has not released a timetable on when it plans to finalize or implement the guidelines.

Are we losing pieces of the “solution puzzle ” ?


It seems like nearly every week.. I get a request to “like” another FaceBook page concerning some chronic pain or disease where chronic pain is a major part of the disease state. IMO, it is getting to be like a piece being removed from a puzzle of a picture of the real basic issues of the chronic pain community. As every piece is removed.. the “picture” becomes less and less definite of what it is suppose to represent.

It is like being a noisy restaurant/bar.. everyone is talking…but .. it is nothing but a ROAR… it is difficult to hear/understand the people at your table.. let alone what is being said by anyone else in the facility.

The DEA/CDC/PROP and others are speaking with a nearly unified/clear voice and they get others to regurgitate what they have said. While the chronic pain community is “talking ” from many points of view – about the same subject – but it may sound just like a ROAR to anyone listening.

To probably make things worse… the chronic pain community to a certain degree piles on with the anti-opiate groups about how BAD those who have been labeled as addicts… These people are just like those in the chronic pain community.. they suffer from the chronic mental health disease of addictive personality disorder. BOTH GROUPS are suffering from chronic diseases.

Our society believes that addicts are criminals … by the very fact that they have a mental health disease and is the chronic pain community doing more harm to those in that community by not speaking with a united/clear voice and by not point out not only are they not getting proper therapy but so are those who our society has labeled as addicts.

The common denominator is that both groups use opiates to help manage their disease states and thus those in power are using that very similarity to manipulate both groups… and to a certain degree getting the chronic pain community to help them, by condemning those that self-medicate their mental health issues with opiates.. to silence the demons in their head and/or monkeys on their backs.

Those 3-6 million chronic substance abusers are not going to stand up for themselves… they are too busy trying to get their next fix… and their ILLEGAL lifestyle. They do not want to stand out because it will probably just get them incarcerated and thrown into cold turkey withdrawal.

There are a few thousand of those trying to control the 106 million + with chronic diseases that use opiates.. it is sort of a Oligopoly where the few control the many.

IMO.. the chronic pain community doesn’t need more voices speaking from different platforms…. a disjointed voice… I think that the old saying goes “united we stand.. divided we fall”.. should apply to the chronic pain community

Medication rationing … Genocide American style… or death panels ?

Drug Shortages Forcing Hard Decisions on Rationing Treatments


CLEVELAND — In the operating room at the Cleveland Clinic, Dr. Brian Fitzsimons has long relied on a decades-old drug to prevent hemorrhages in patients undergoing open-heart surgery. The drug, aminocaproic acid, is widely used, cheap and safe. “It never hurt,” he said. “It only helps.”

Then manufacturing issues caused a national shortage. “We essentially did military-style triage,” said Dr. Fitzsimons, an anesthesiologist, restricting the limited supply to patients at the highest risk of bleeding complications. Those who do not get the once-standard treatment at the clinic, the nation’s largest cardiac center, are not told. “The patient is asleep,” he said. “The family never knows about it.”

In recent years, shortages of all sorts of drugs — anesthetics, painkillers, antibiotics, cancer treatments — have become the new normal in American medicine. The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products. But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public.
When a shortage developed for a decades-old drug to prevent hemorrhages in patients undergoing open-heart surgery, “We essentially did military-style triage,” said Dr. Brian Fitzsimons, an anesthesiologist at the Cleveland Clinic, restricting the limited supply to patients at the highest risk of bleeding complications. Credit T.J. Kirkpatrick for The New York Times

At medical institutions across the country, choices about who gets drugs have often been made in ad hoc ways that have resulted in contradictory conclusions, murky ethical reasoning and medically questionable practices, according to interviews with dozens of doctors, hospital officials and government regulators.

Some institutions have formal committees that include ethicists and patient representatives; in other places, individual physicians, pharmacists and even drug company executives decide which patients receive a needed drug — and which do not.

An international group of pediatric cancer specialists was so troubled about the profession’s unsystematic approach to distributing scarce medicine that it developed rationing guidelines that are being released Friday in The Journal of the National Cancer Institute.

“It was painful,” said Dr. Yoram Unguru, an oncologist at the Children’s Hospital at Sinai in Baltimore and a faculty member at the Berman Institute of Bioethics at Johns Hopkins University. “We kept coming back to wow, we’ve got that tragic choice: two kids in front of you, you only have enough for one. How do you choose?”
“Two kids in front of you,
you only have enough for
one. How do you choose?”
Dr. Yoram Unguru

At the Cleveland Clinic, which has been unusually proactive in dealing with shortages and allowed a reporter access to personnel making decisions about them, one scarce leukemia drug, daunorubicin, was saved for patients in clinical trials, to avoid making the results invalid by substituting another drug. But when a different drug, methotrexate, was in short supply, pediatricians stopped giving it to all patients who required high doses, including those in research trials. “We didn’t want to say just because you’re on a clinical trial you get an advantage,” Dr. Rabi Hanna said.

Patients’ weight can be taken into account. Obese patients, who researchers found needed up to three times the amount of an antibiotic before surgery than average-size patients, were given only the standard dose at the Cleveland hospital until a shortage subsided.

Some institutions prioritize based on age; others do not. Marc Earl, a Cleveland Clinic pharmacist, said children were not favored over adults during chemotherapy shortages. But at other hospitals, they have been, because of their potentially longer life span or because they sometimes require smaller doses of a drug.

“We do play the pediatric card for sure,” said Alix Dabb, a pharmacy specialist in pediatric oncology at Johns Hopkins Hospital. Dr. Kenneth Cohen, director of pediatric neuro-oncology there, and his colleagues were close to being forced into making “very, very hard decisions,” he said. “The discussions became, ‘Why are two kids more important than one adult?’”

Ning-Tsu Kuo, a pharmacist at the Cleveland hospital’s home infusion pharmacy, said children came first during shortages of nutritional products such as intravenous vitamins and fats for patients who cannot absorb food. The logic was that adults have more reserve. But after one man pleaded not to have his dose cut, Dr. Kuo agreed. When reprimanded by colleagues, she recalled saying: “Patients are not equally the same. You need to look case by case.”
‘Downright Scary’

Such decisions have real consequences. For some shortages, doctors can soon see the effects of rationing, such as increased pain or nausea when drugs typically used to control symptoms are withheld, or patients who have to undergo invasive surgery to control cancer when anti-tumor medications are delayed.

Studies have associated alternative treatments during drug shortages with higher rates of medication errors, side effects, disease progression and deaths. For example, children with Hodgkin’s lymphoma who received a substitute to the preferred drug had a higher rate of relapse, researchers found, and adults with a genetic disorder called Fabry disease had decreased kidney function when their medication was cut by two-thirds. One alternative guideline adopted during a shortage of intravenous nitroglycerin “was downright scary from a clinical perspective,” according to Dr. Nicole Lurie, a senior federal health official.
“Patients are not equally
the same. You need
to look case by case.”
Ning-Tsu Kuo

Physicians say that many of the changes they are compelled to make appear to do no harm. But, they acknowledge, typically no one is tracking outcomes in patients who get a drug and others who get a substitute or delayed treatment.

Doctors and hospitals often do not tell patients about shortages and the resulting rationing because they do not want them to worry, especially when alternative drugs are available, or because they feel it would stir up too much anger.

Dr. Ivan Hsia, an anesthesiologist in Ontario, Canada, said many physicians in his field adopt what he called “the paternalistic model — like I’ll inform them when I think it’s unsafe enough to inform them.”

When he and his colleagues surveyed hundreds of patients at the Mayo Clinics in Arizona and Florida and others in Canada about their preferences, the results surprised him. Most wanted to know about a drug shortage that might affect their care during elective surgery, even if there was only a minor difference in potential side effects, and many said they would delay surgery.

When the study was published last year in the journal Anesthesia and Analgesia, an accompanying editorial urged health professionals to disclose shortages and their implications. “Patients want to know and they should know,” the editorial said. “There is no ethical ambiguity.”

Beverly Smith, a Cleveland Clinic patient who has Crohn’s disease, said she had no idea that an important ingredient had been removed from the daily intravenous nutritional treatments she depends on until she developed side effects from the deficiency. “Why didn’t anybody tell me?” she asked. Credit Andrea Bruce for The New York Times

Dr. Eric Kodish, a children’s cancer doctor who heads the Cleveland Clinic’s center for ethics, humanities and spiritual care, said patients should be told. “It’s their bodies and their lives that are on the line.”

Indeed, Beverly Smith, a Cleveland patient who has Crohn’s disease, said she had no idea that an important ingredient had been removed from the daily intravenous nutritional treatments she depends on until she developed side effects from the deficiency. “Why didn’t anybody tell me?” she asked.
Who Gets Preference?

In a basement storeroom filled with plastic crates and cardboard boxes, Chris Snyder, a Cleveland Clinic pharmacist and the point man for drug shortages, spends part of each workday poring over the hospital’s drug orders.

He tracks a list of shortages that included more than 75 drugs the first week of January. Dr. Snyder moves stocks among the hospital’s campuses, identifies alternatives, and — in the most dire situations — helps devise and enforce restrictions on which drugs can be ordered for which types of patients.

Top, Chris Snyder, a pharmacist at the Cleveland Clinic, tracks a list of shortages that included more than 75 drugs the first week of January. Bottom, pharmacy technicians in a compounding clean room that is used to prepare drugs for use within the clinic. Credit T.J. Kirkpatrick for The New York Times

Many drugs are made by only one manufacturer, so production or safety problems at a single plant can have big effects. For another company to begin making the products and getting them approved by regulators requires the right combination of manufacturing capabilities and economic incentives.

The chances of getting a drug also depend in part on where a patient happens to live, how adept the local hospital is at finding — and hoarding — scarce drugs, or a patient’s access to a major medical center.

The Cleveland Clinic, for example, has an advanced compounding room where workers swaddled in disposable gowns, bouffant caps and blue gloves mix up remedies from raw ingredients. During a shortage of papaverine, a drug used for surgery on blood vessels, the clinic produced its own version. When other hospitals began asking about it, Dr. Snyder said he had to tell them, “It’s a franchised recipe we can’t give out.”

At Cleveland, decisions about conserving, substituting and allocating scarce drugs typically are made by small groups of doctors and pharmacists; Dr. Kodish’s ethics committee is not involved. But such decisions are not always made by doctors or hospitals. One company, Janssen, chose to ration its ovarian cancer and multiple myeloma drug Doxil on a first-come-first-served basis during a prolonged shortage.
Continue reading the main story

“We’ve been forced
into what we think is a
highly unethical corner.”
Dr. Peter Adamson

Another company, Jazz Pharmaceuticals, recently consulted a small group of oncologists to recommend how to allocate its cancer drug, Erwinase, if it ever became necessary. “Who deserves the drug more than anyone else?” said Dr. Wendy Stock, a leukemia specialist at the University of Chicago Medicine, who participated in the discussion. “We gave them some guidelines on that. ”
There is a huge disconnect with these comments and reality, and I think it has to do with the difference between the evil Big Pharma making…
Carley 5 hours ago

Healthcare for everyone will make everything better… I’m not saying everyone shouldn’t be able to access healthcare but it takes many…
Helena 5 hours ago

Drug shortages perfectly exemplify all that is wrong with our health care system. Poor government oversight. Faulty business practices….

In a survey of cancer doctors conducted in 2012 and 2013, 83 percent of respondents who regularly prescribed cancer drugs reported having been unable to provide the preferred chemotherapy agent at least once during the previous six months. More than a third of them said they had to delay treatment “and make difficult choices about which patients to exclude,” according to a letter published in The New England Journal of Medicine.

The threat of future shortages in children’s treatments is serious enough that Dr. Peter Adamson, who leads the Children’s Oncology Group, the largest international group of children’s cancer researchers, assigned his organization to set priorities. “We’ve been forced into what we think is a highly unethical corner,” he said in an interview.

The effort, led by Dr. Unguru, the Baltimore oncologist, recommended that the drugs be rationed based on the ability to save lives or years of life, including curability of a child’s cancer and the importance of the drug in improving the chances. It also recommended that children participating in clinical research should not get priority over those who are not, because of concerns about coercing families into trials. The group also advised that allocation decisions be public.

Dr. Yoram Unguru, an oncologist at the Children’s Hospital at Sinai in Baltimore, said that developing rationing guidelines for scarce medicines “was painful.” Credit Matt Roth for The New York Times

A recent shortage of a therapy for bladder cancer, BCG, demonstrates how the lack of national guidance can lead to very different decisions. One Cleveland Clinic urologist, Dr. Andrew Stephenson, said he came up with BCG rationing guidelines that were used with dozens of patients after being shared with colleagues. “We tried to reserve the BCG for those patients who needed it the most,” he said.

Merck, the manufacturer, said it filled requests from a waiting list in the order received, and left rationing decisions to doctors. Some cancer centers reduced the length of BCG treatment from three years to one, because the benefit may be smaller after the first year. Others restricted BCG to patients whose tumors were mostly likely to spread or recur. And still others decided to reduce the typical dose so that each vial could be used for three patients instead of one, which some experts say raises questions about efficacy. Some outpatient clinics just ran out.

In interviews and comments on a support website, Inspire, patients seemed confused about why they were or were not getting BCG. “I found out people were getting it in different parts of the country,” said Don Keating, whose bladder cancer was diagnosed in 2014. He was told by his doctor in Boston that he needed BCG, but that it was not available.
Continue reading the main story

“I believe if I had gotten it
when it was first prescribed,
I wouldn’t have had to go
through those operations.”
Don Keating, a cancer patient

Mr. Keating had to wait about six months before obtaining the drug, during which time his cancer recurred. “I believe if I had gotten it when it was first prescribed, I wouldn’t have had to go through those operations,” he said.

Many urologists said they saw similar recurrences possibly due to the shortage, and that some patients underwent high-risk bladder removal surgery that probably would have been avoided if BCG had been fully available.

Dr. Kamal Pohar, a urologist at Ohio State University’s cancer hospital, said he remembered driving home, wondering if he was making the right calls for his patients. “I can still feel the stress,” he said. “I’ve never been faced with this.” Supplies of BCG are again adequate, Merck and doctors report.

The vagaries in distribution and inconsistencies in rationing have led to calls for change. Doctors and others have suggested the creation of a clearinghouse of scarce drugs and voluntary sharing to promote equitable access for patients. Others argue that there should be a registry of patients given nonstandard treatments so the results can be tracked.

Dr. Lurie, the federal health official in charge of emergency preparedness and response, said that the government was working to encourage hospitals to conserve and substitute drugs to avoid a crisis and trying to fill gaps in manufacturing. Steps taken by the Food and Drug Administration have also helped reduce the number of shortages, she said.

Still, she argued that tools developed for disaster response, including ethical and procedural guidelines, should be applied. “Different places around the country are each doing their best to patch together their own guidelines,” she said, adding, “if they’re doing anything at all.”

Jury orders Wal-Mart to pay pharmacist $31.22 million in bias case

Jury orders Wal-Mart to pay pharmacist $31.22 million in bias case


Wal-Mart Stores Inc (WMT.N) was ordered by a federal jury in New Hampshire to pay $31.22 million to a pharmacist who claimed she was fired because of her gender and in retaliation for complaining about safety conditions.

The Concord jury deliberated for 2-1/2 hours before ruling on Wednesday for the plaintiff, Maureen McPadden, after a five-day trial, her lawyers said.

McPadden claimed that Wal-Mart used her loss of a pharmacy key as a pretext for firing her in November 2012, when she was 47, after more than 13 years at the retailer.

McPadden also said her gender played a role, alleging that Wal-Mart later disciplined but stopped short of firing a male pharmacist in New Hampshire who also lost his pharmacy key.

According to the jury verdict form, most of the damages award stemmed from McPadden’s gender bias claims, including $15 million of punitive damages.

Bentonville, Arkansas-based Wal-Mart said it plans to ask trial Judge Steven McAuliffe to throw out the verdict or reduce the damages award.

“The facts do not support this decision,” spokesman Randy Hargrove said. “We do not tolerate discrimination of any type, and neither that nor any concerns that Ms. McPadden raised about her store’s pharmacy played a role in her dismissal.”

Lauren Irwin, a lawyer for McPadden, in a phone interview said the jury reached “a fair and just verdict.”

The case is McPadden v. Wal-Mart Stores East LP, U.S. District Court, District of New Hampshire, No. 14-00475.

DOJ GREED may hinder local war on drugs activities ?

Federal money grab will increase crime in our city


One week before Christmas, police chiefs across the country received a letter from the Justice Department entitled “Deferral of Department of Justice Equitable Sharing Payments.”

It explained that drug forfeiture funds which local agencies received for working with Drug Enforcement Agency would be “deferred” until further notice. The DOJ referred to this as a $1.2 billion “rescission” needed to balance their budget.

Here’s why this should concern you. The Farmington Hills Police Department has a police officer assigned to a DEA Group in Detroit. We also have a sergeant and police officer assigned to the South Oakland Narcotics Interdiction Consortium. The Oakland County Sheriff, and our neighbors in West Bloomfield and Novi, and many of our neighboring communities also have personnel assigned to SONIC and the DEA in Detroit.

These personnel do more than just drug enforcement. Drug problems, especially high-level dealers, are a regional problem. We would not have the resources to deal with this on our own. Our officers are deputized as federal agents so they have police authority outside our jurisdiction.

The federal agents we work with have equipment and police authority we would not otherwise have. We have access to data and intelligence information necessary to take down drug cartels. Local police agencies sharing resources with drug task forces means better results and reduced crime.

We frequently receive assistance from the Task Force investigating drug dealers in our community. The DEA has provided resources to us that have helped solve major cases, including the arrest of a homicide suspect in 2014. Our officers gain invaluable training and experience that they bring back to our department.

If this “money grab” is not reversed, the effectiveness of drug investigations would diminish drastically in the Detroit area, where local police officers make up 47 percent of the total Detroit DEA task force staffing. Local communities like ours will not be able to afford to dedicate full-time resources to these Federal Task Forces.

Drugs would flourish without the ability to seize drug dealer assets, including their money and property which is re-invested in the war against drugs.

The return of forfeiture funds to local communities through the Equitable Sharing Program is only fair since considerable local tax dollars fund the salaries of local officers participating in federal task forces.

In our community these funds have been used to purchase things like Argos, our drug sniffing dog, bringing educational programs like Drugs 101 to parents, equipment like bullet-proof vests and even specially equipped police vehicles. Our community has received hundreds of thousands of dollars of drug forfeiture funds in the last few years alone.

This does more than just offset the costs associated with devoting staff to Federal task forces. It helps make our community a safe place to live. It reduces drug crimes, and all of the associated crimes that accompany drug use.

Sadly, this change may be just politics. The administration has made the claim that our country incarcerates too many people for drug offenses, and they want to change that. Eliminating the funding for almost half of DEA Task Force staffing will certainly result in fewer arrests.

However, it will not in any way reduce the drug problem, only our ability to enforce the existing laws and make arrests. This will be a great relief for the drugs dealers, but not for our residents. We will likely see increases in other crime categories such as larceny from automobiles, petty theft, breaking and entering, home invasions, etc. These are all crimes frequently linked to drug use. Even the U.S. Attorney in Detroit is unhappy about this recent Justice Department money grab.

If you feel so inclined, please take a moment to write to your legislators, who have the ability to influence this poorly thought out decision. Let them know that the equitable sharing of Drug Forfeiture Funds must be restored to insure that local municipalities can continue to participate in Federal Task Forces. Write to:

Write to U.S. Sen. Gary Peters, www.peters.senate.gov; U.S. Rep. David Trott, www.trott.house.gov; U.S. Rep. Brenda Lawrence, www.lawrence.house.gov; and the U.S. Department of Justice, 950 Pennsylvania Ave, NW, Washington, DC, 20530-0001.

Our goal is to reduce actual crime and remain a safe city, not to improve crime statistics by limiting funding and enforcement capabilities.

Richard Lerner is a Farmington Hills City Councilmember.

Don’t CRIMINALS and others breaking the law .. wear MASKS ?


Burlington police commissioner disturbed by masks on officers


BURLINGTON — Police Commissioner Jerry O’Neil, a former federal prosecutor and longtime observer of law enforcement in the city, has recently noticed a trend he finds disturbing.

Police have started to wear balaclavas — masks that cover their faces — something he hasn’t seen in 40 years watching policing in Burlington, O’Neil said.

“The balaclavas have just come into Burlington. I’ve never seen them before here, and I find it incredibly disturbing, because I think they’re very upsetting to citizens,” O’Neil said during a Police Commission meeting Tuesday night.

Police Chief Brandon del Pozo said he opposes the wearing of balaclavas on principle but that they serve a legitimate purpose in a narrow range of circumstances. Currently, the only Burlington officers allowed to wear the masks are the six members of the narcotics unit and only when they’re making a drug arrest, he said. They must also be in uniform if they’re wearing a balaclava, del Pozo said.

Narcotics officers work with confidential informants and do plainclothes patrols, so when they’re in uniform and tactical gear making an arrest they don’t want people to see their faces. That’s because neighbors or others involved directly or indirectly in the drug trade may recognize them in the future, del Pozo said.

O’Neil responded that those same officers don’t wear balaclavas when they testify to put drug dealers behind bars. He also questioned why the department doesn’t send officers who aren’t part of the narcotics unit to make arrests.

Del Pozo said it’s a resource issue. Sending other officers to make drug arrests would mean pulling them away from their regular duties.

“I don’t like balaclavas. I’m alarmed by the way it looks. I think it sends the wrong message,” del Pozo said. But he argued that has to be balanced against the need of narcotics officers to be unrecognized.

The masks smack of police militarization, del Pozo said, a trend he believes is detrimental to building trust with residents. That’s why Burlington recently stopped participating in the U.S. Department of Defense military surplus program.

O’Neil said he still didn’t understand why the use of balaclavas appears to have increased recently. He suggested it might have to do with Drug Enforcement Administration agents’ “propensity” to conduct operations masked. He said the recent DEA-led raid where the target was shot and killed highlighted the issue for him.

There could be an element of what O’Neil described as “me-tooism,” where local police officers are emulating a practice of federal agents that is perceived to be cool.

“That has crossed my mind,” del Pozo acknowledged. As a department, Burlington police need to examine whether that’s the case.

Del Pozo said that when he arrived at the deadly DEA raid he saw more officers in one place wearing balaclavas than he’d ever seen in any one place, including his time in the Army.

Most were federal agents, but members of the Burlington narcotics unit were wearing them as well, del Pozo said. The first thing del Pozo said he did upon assuming command was order the masked officers off the street so they wouldn’t “terrorize citizens.”

“I can’t order the DEA to unmask, and there may be reasons not to, but I said, ‘At least just get them out of the public eye. It’s very alarming,’” he said.

Indiana panel OKs allowing prescriptions for cold medicines


Indiana panel OKs allowing prescriptions for cold medicines


For several years, all Indiana Pharmacies have been using this national database for PSE sales called NPLEx http://www.appriss.com/nplex.html not sure how much tax money Indiana had to spend to fund this system’s operation. IMO.. the system had to major flaws, first of all a driver license is required and there is no way to validate the driver’s license against something like the BMV’s online database and once a driver’s license number and information is entered into the system.. the next time that the (unverified) driver’s license is presented and the number is entered into the NPLEx website… the rest of the screen’s data points SELF POPULATE and confirmation bias kicks in for the pharmacy staff. As long as that particular driver’s license had not tried to purchase more PSE than required by law.. the PSE is sold to the person presenting the driver’s license. The fact that Indiana is one of the states with the most meth lab busts… so it would appear that the NPLEx system is a absolute failure without the ability to validate driver’s licenses… BUT does the politicians do the obvious thing and give pharmacies the ability to validate licenses so as to make NPLEx workable.. NOPE !!!!

Pharmacists are one step closer to gaining the authority to require a prescription for certain cold medicines as the Indiana House explores proposals to undermine methamphetamine cooks.

With no opposition, the measure passed the House Public Health Committee on Wednesday.

The bill is a stripped-down version of a prescription-only mandate for pseudoephedrine, a key ingredient for meth production.

Republican Rep. Ben Smaltz of Auburn originally wanted that mandate for all sales of pseudoephedrine, but decided to scale the measure back after skepticism from House Public Health Committee chairwoman Cindy Kirchhofer and other House members.

“We have done almost everything we can to stop meth labs in Indiana, short of making pseudoephedrine a prescription drug,” Smaltz said in a statement. “After working closely with pharmacists and physicians, I believe we have crafted a bill that would take a significant step toward curbing meth production in our state, while also considering the convenience of law-abiding Hoosiers.”

Oregon and Mississippi are the only two states to require a prescription for all pseudoephedrine sales, although many other states have attempted to pass similar legislation.

Indiana has led the nation in meth lab seizures for the last three years.

The prescription requirement has been considered several times in Indiana to combat the trend but foundered amid fierce debate between pharmaceutical companies and law enforcement organizations.

Under this year’s revised proposal, people who have rapport with pharmacies will be able to buy as much pseudoephedrine medicine as federal law permit. For those with whom the pharmacy is not familiar, pharmacists may recommend tamper-resistant products or a limited amount of pseudoephedrine. If a customer refuses both of those options, the pharmacists can request a proof of prescription.

Smaltz said the state Board of Pharmacy will set guidelines for how pharmacists will make determinations and have the authority to punish pharmacists who violate the guidelines. The board was unavailable for comment Wednesday.

Rep. Steve Davisson of Salem said empowering the pharmacists to decide makes sense. He is a licensed pharmacist and voted for the measure.

“That’s what pharmacists do,” he said. “They consult. And as you ask those questions, you get a feel for the type of people.”

The committee also passed a bill to ban drug offenders from buying pseudoephedrine without a prescription.

Budget to address rural heroin epidemic increased by > 33% this year.

Here’s how the White House plans to address rural America’s struggle with heroin


The White House will announce Friday that President Obama is appointing Agriculture Secretary Tom Vilsack, his Cabinet’s longest-serving member, to lead a new interagency effort focused on addressing rural America’s struggle with heroin and opioid abuse as well as other pressing problems.The decision to centralize federal decision-making on drug abuse as well as other major problems in rural areas — rising suicide rates, declining physical and mental health, and increased financial stress — comes as addiction to heroin and other opiates has become a crisis in many areas.

In an interview Thursday, White House Chief of Staff Denis McDonough said the work Vilsack has done since 2011 chairing the White House Rural Council, a group focused on these areas, has given him “firsthand experience” seeing how substance abuse and poverty have continued to keep Americans in some parts of the country from making headway.

“The whole point is to have the secretary of agriculture look across the [federal government] to see what unique capabilities agencies have to invest in blowing through these obstacles to opportunity in rural communities.”

The Rural Council encompasses 15 departments and multiple agencies, including Health and Human Services, Veterans Affairs and the Office of National Drug Policy, among others.

 Heroin and prescription opioid drug overdoses kill about 30,000 people a year — heroin-related death rates increased 28 percent from 2013 to 2014 alone — and state, local and federal law enforcement officials have begun to rethink how best to treat addicts who often have trouble getting treatment.

And as opioid addiction has emerged as a more pressing political issue — with presidential candidates from both parties addressing the concerns of voters in Iowa and New Hampshire, the two states that will cast votes on the parties’ 2016 nominees next month — both GOP and Democratic lawmakers have shown a willingness to expand federal support for tackling it.

The budget agreement struck last month provided the administration with more than $400 million to address the epidemic, an increase of more than $100 million from the previous year. It also cut language barring the use of federal funds for needle-exchange programs, a move that many public health advocates had sought.

Vilsack will unveil the new initiative during a town hall discussion on Friday at Ohio State Universirty in Columbus, where he will be discussing the expansion of the administration’s rural-development efforts in 11 counties experiencing persistent poverty in the part of Appalachia that extends into southern Ohio.

In an interview Thursday, Vilsack said that while any long-term solution to the problem will have to be pursued by the next president, the current administration could help develop a comprehensive strategy and elevate the issue in the American consciousness. Obama held a forum on the subject in October in Charleston, W.Va., a state where more than one-third of the overall injury deaths stem from drug overdoses.

“For me, as presidential candidates talk about this, the importance to me is to bring this issue out of the shadows,” Vilsack said, noting that the “rugged” image of independence often prized in rural America “really makes it hard for people to seek help.”

 Vilsack, whose adoptive mother struggled with addictions to alcohol and prescription medication, said he was optimistic that there could be bipartisan support because it affects so many families.

Matt Chase, executive director of the National Association of Counties, said in an interview that the new initiative is “very timely and much-needed federal attention.” He described the increase in drug and alcohol abuse in rural areas as “symptoms” of an economy where there is more automation and a lower need for workers.

“To me, it really boils down to the lack of economic opportunity in so many of these areas,” he said, adding that although the administration has looked at the issue in the past, Vilsack’s appointment shows “more presidential focus.

In many cases, state and local groups are banding together to try to combat rising overdoses. The National Association of Counties and several other state and local government groups announced Thursday that they have successfully negotiated with drug companies to purchase Narcan nasal spray, which can counteract the effects of an overdose, at a 40 percent discount.

Mark Publicker, past president of the Northern New England Society of Addiction Medicine, said that while he was “utterly pessimistic” that a government task force could have a major impact on the problem, he had been encouraged by some of the efforts the administration had been taking to address the fact that the rural poor are “most stricken by the epidemic and have the least access to treatment.”

“There’s value in identifying the fact that we’re dealing with a multidimensional, complex problem that deserves more than the simple answers that are being floated,” said Publicker, who treats addiction patients in rural Maine.