Tuesday, May 29, 2018

The Truth about the Opioid Problem


The Truth about the Opioid Problem

It won’t stop.

When it comes to illegal drugs the people who abuse them will find a way, and those who make huge profits will supply them. The illegal drug supply is like one of those long skinny balloons. You can squeeze it all you want, but you can’t stop it, it just pops up in another place.

All I have to say about the supply of legal drugs is the right for people who need them should not be impaired by the government. When someone needs a drug or medication for medical needs, they will find a way to obtain the medication.

What we need to ask is how many lives we want to destroy in the pursuit of a drug free America, a totally unrealistic goal by the way.

We have spent years using education and social pressure to lower the use of tobacco. According to the CDC cigarette smoking is still responsible for more than 480,000 deaths per year in the United States. 1300 people a day

The good news is that using education and social pressure we lowered tobacco us from 43% of adults in 1965, to 16% in 2014. We didn’t put anyone in prison, we didn’t destroy any families, we didn’t tear apart any homes, nor have men in black masks break down doors leaving children with PTSD.
We did spent millions of dollars in the pursuit of the Sinaloa Cartel’s leader El Chapo. When arrested it was a big deal, everybody celebrated capture. We won, the Sinaloa Cartel closed its doors and drugs stopped flowing across the border.

Right, there was and will be a bloody battle for control of the Sinaloa Cartel. According to Guardian News there were 142 homicides in March of 2002 alone… www.theguardian.com/world/2017/may/02/mexico-captures-sinaloa-cartel-leader-el-chapo

It doesn’t matter if drugs come from huge powerful pharmaceutical companies, or huge powerful drug cartels, drugs are worth too much money, and supply will follow demand.

We have had a knee jerk reaction to the media reports of the Opioid Epidemic. In 2015, more than 33,000 Americans died as a result of an opioid overdose. Remember 13,000 Americans died from tobacco each DAY. Every 2.5 days as many Americans died from tobacco as died in all of 2015 from opioids. Why don’t we just create a prohibition on tobacco? Because prohibition doesn’t work, that’s why.

Do your research only 10% of overdoses are from pills alone. Most are from illegal sources or a combination of pain pills and alcohol, or other drugs not prescribed.

Look at what the government has done, by limiting opioids for pain patients the government has created a monster that can’t control, drug cartels. When you prohibit something, or regulate it to the point they have pain medications today you create a black market and loose the control.
CNN reports the Nebraska State Patrol seized nearly 120 pounds of the drug fentanyl -- enough to kill about 26 million people, according to estimates by the US Drug Enforcement Administration. https://www.cnn.com/2018/05/25/health/nebraska-fentanyl-bust/index.html

This is the monster they create when law enforcement plays doctor. The new laws trying to limit medical use of pain medications will cause the death of so many more people than opioids alone would have if we just educated patients, physicians, and people.

Saturday, May 26, 2018

Arizona No requirement for Patients above 90MME taper down to a lower dose

I asked to talk to the governor about the problem of pain patients receiving their medications. I told the governor that pain management physicians were continuing to cut patients doses.

The Arizona Governor's Office said again: "Opioid dosage limits of 90MME/day do not apply to individuals currently receiving a dose in excess of this amount".  "There is no requirement that individuals who take prescriptions above 90MME taper down to a lower dose"

Friday, May 18, 2018

FDA Commissioner Listening to Chronic Pain Patients. Pain News Network

Pain News Network reports the Food and Drug Administration is seeking comments from patients only on the challenges they face finding treatment and on the effectiveness of opioids and other types of pain medication. Patients are invited to submit their comments by mail or in the Federal Register, and to attend a public meeting on July 9. Click Here for more details.

Pain News Network LINK to whole story

PLEASE TELL YOUR STORY

Has a Pharmacist Lowered Your Pain Medication Without Your Physicians Permission?

Pharmacist are telling patients all over Arizona they can't fill a prescription for 6 pain pills, only 3-4 and lowering the patients dose without contacting the physician first?

FILE a COMPLAINT with the Arizona Board of Pharmacy at the link in the email below....


Send email to the governor and Kam Gandhi, PharmD the Executive Director of the Arizona Board of Pharmacy and ask why this is allowed to happen. Her email address is  kgandhi@azpharmacy.gov


I asked Kam Gandhi – Executive Director Comments: Can a pharmacist change a patients prescription dose without contacting the prescribing physician? If not please send me a complaint form..


Copy of email
Kamlesh Gandhi
 to me
Show more
May 17
Hello,

A pharmacist needs to call the practitioner to change the dose (strength) on a prescription.

Below is a link to file a complaint.


Thank you,

Kam Gandhi, PharmD
Executive Director

KGandhi@AZPharmacy.gov


---------- Forwarded message ----------
From: Arizona State Board of Pharmacy <admin@azpharmacy.gov>
Date: Thu, May 17, 2018 at 2:22 PM
Subject: - CONTACT US -
To: kgandhi@azpharmacy.gov


Submitted on Thursday, May 17, 2018 – 14:22 Submitted by user: Anonymous Submitted values are:
Your Name: Jay Fleming Email Address: leapspeaker@gmail.com Phone Number: Business Name: Select Staff Member: Kam Gandhi – Executive Director Comments: Can a pharmacist change a patients prescription dose without contacting the prescribing physician? If not please send me a complaint form..

Why Can't Pain Management Physicians Understand the 2018 Arizona Prescribing Law?

My pain doctor's office called today to tell me the physician was refusing to sign my refill prescription unless I agreed to lower the dose again.... 

Why is it so hard for otherwise smart people like physicians to read and understand the laws that govern them?

The 2018 opioid prescribing law says it has exemptions for current patients... 

This is what the law says.....
New Prescribing Limits on Opioids

Under the new Arizona Opioid Epidemic Act, beginning April 26, 2018, the prescribing of opioids will be limited in two significant ways. 

First, a health professional shall limit the initial prescription for a schedule II opioid to a five-day supply, except an initial opioid prescription following a surgical procedure is limited to a 14-day supply. 

Additionally, the Act prohibits a prescriber from issuing a new prescription for a schedule II opioid that exceeds 90 morphine milligram equivalents (MMEs) per day. 

There are exemptions to these prescribing laws and a complete list of exemptions can be found in A.R.S. §§ 32-3248 and 32-3248.01. SEE BELOW


Dose Limits 2018
Arizona Revised Statute 32-3248.01. Schedule II controlled substances; dosage limit; exceptions; morphine; opioid antagonist; definition
A. A health professional who is authorized under this title to prescribe controlled substances may not issue a new prescription order for a schedule II controlled substance that is an opioid that exceeds ninety morphine milligram equivalents per day.
B. The limit prescribed by subsection A of this section does not apply to:
1. A continuation of a prior prescription order that was issued within the previous sixty days.

In other words they shouldn't reduce the dose to under 90 mg's if the patient was already receiving a higher dose.