FDA Warns of 'Serious' Respiratory Problems With Gabapentin

Gabapentin a drug given many pain patients that is known for making patients aggressive is now causing respiratory problems according to this Medscape article FDA Warns of 'Serious' Respiratory Problems With Gabapentin

If you take Gabapentin or know someone who does, please share this with them.

Cocaine and Meth Related Overdoses on the Rise.... Just My Opinion

Just My Opinion...

I've been speaking on drug policy for 16 years or so and I keep telling people that overdoses are caused by blackmarket drugs, but nobody gets it.

According to the article in The Drug War Chronicle the annual number of drug overdose deaths is still more than 68,000. The majority of these are from various drug mixtures that include Fentanyl.

While working undercover in the 70's and 80's I saw quite a few people shoot up. If they had a know product whether pill or powder, they knew how much to use. 

The problem came when a new batch or product came to town. If it was heroin was it 30% or did someone really score and is it 90%? If you have ever been around people who abuse drugs they think if one pill is good then 2 or 3 must be better. 

Some of these guys didn't even know what they were taking. Billy told Donny he had some pills he was going to sell. Donny aked to see them, so Billy pulled out a few. Before Billy could say they were his sisters birth control pills he was going to sell to a high school kid, Donny ate 5 of them.... 
Like I said, some of these guys didn't even know what they were taking. 

My point is many people who abuse drugs don't make good decisions. When testing the heroin someone would usually take the normal amount they use because they want to get high. If the tester lives or dies, the others have a starting point.

Eleven states and Washington, DC, have now legalized marijuana for recreational use for adults over 21, and 33 states have legalized medical marijuana.

People who sell black market marijuana usually don't mess with selling other types of drugs. But with marijuana becoming legal and DEA's new opioid epidemic forcing patient to the street as they're doses are cut or stopped all together black market sellers have switched to heroin or Fentanyl containing products.

The black market sellers of heroin usually don't have a problem with being a poly-drug dealer, so adding cocaine or meth to heroin isn't a big deal for them.

I told everyone several months back that Cocaine was going to be the next big Drug Epidemic I don't see the cartels adding meth but it makes good business sense.

Powered drug overdoses will level off or increase over the next two years and then slow, it will be education and not enforcement that lowers the overdose level. 

Who is Doctor Timothy Munzing? Why Does DEA Pay Him Over $300,000 a year?

Every pain patient needs to know this guys name and share it with others. Point out how much he make sending good doctors to prison using fake news and false testimony... Jay

This is part of an article from Doctors of Courage read the rest here The Pain News Network Shields Doctor Forest Tennant Calling DEA’s Expert Dr. Timothy Munzing Unaware and Ignorant

Who is Doctor Timothy Munzing? Dr. Munzing is a self-proclaimed expert witness for the DEA and other government agencies, like the Medical Board of California. Expert witnesses for the DEA and the Medical Boards are paid for their services and their 
testimony is based on investigative narratives. There are a lot of good expert witnesses who are honest and objective about how they review cases against doctors, but there are just a many crooked so-called expert witness doctors who would knowingly testify to harm other doctors and people in general, using false testimony. In this case, I believe Dr. Timothy Munzing’s evaluation and findings are based on what the DEA wants him to find and say. The Pain News Network hits the donkey right on the tail; Dr. Munzing is not only unfamiliar with Dr. Tennant’s practice, but he is not an honest expert witness because he tends to follow narratives given to him by the prosecution, instead of following what he know is ethical and correct. Experts like Dr. Munzing are responsible for jailing thousands of U.S. doctors, calling them drug dealers and associating their practices with the black market, a false, “fake news” narrative that has been widely debunked and exposed.

Doctor Michael Schatman, a research specialist in pain management, exposed a national scheme by the Drug Distributors who control the CDC, DEA, Medical Boards, and Congressional Members like Tom Morino; this is a scheme to criminalize medicine and call doctors drug dealers and their patients addicts. This scheme involved creating a “Fake” opioid prescription pill crisis and thousands of overdose deaths blamed on doctors when the fact shows that 90 percent of overdose deaths in the United States are caused by illegal drugs pouring into this country from China and other countries. The DEA has been criticized from its inability to stop illegal drugs for hitting the streets in this country and under the guidance and control of the Drug Distributors, the DEA has launched its war against U.S. Trained doctors for treating legitimate people with valid pain problems.

Kingman Regional Medical Center ER Did Great This Time..

If you read my blog you know I haven't had very good luck at the Kingman Regional Medical Center ER. But when my wife went there the other day they were great. 

She told them she was tired of being treated like a drug addict or drug seeker because she takes pain medications. They said they were sorry for how she had been treated and asked her if she would give their team a chance. 

She did, and she said everybody from the doctors to the nurses and tech people did a great job and treated her with respect.They treated her pain, did the testing to find a diagnosis, and got her on some medications to take care of the problem.

I hope the Kingman Regional Medical Center Emergency Department is changing for the better in the way they treat pain patients. 

Thank you for treating my wife with respect...

🆘 URGENT, PLEASE READ TAKE ACTION Contact Your Representativess 🆘

🆘 URGENT, PLEASE READ EVERY WORD🆘

The AMA has finally passed resolutions in an attempt to fix the damage done to patients by the CDC Guidelines for Prescribing Opioids... Please Read and Share

AMA RESOLUTIONS: 

1. RESOLVED that our AMA affirms that some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines for Prescribing Opioids for chronic pain and that such care may be medically necessary and appropriate. 

2. RESOLVED that AMA advocate against the misapplication of the CDC Guidelines for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia

3. RESOLVED that our AMA advocate that no entity should use MME (morphine milligram equivalents) thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guidelines for Prescribing Opioids.

At its interim meeting in Maryland last week, the AMA House of Delegates adopted a series of resolutions that recognize the mistreatment of pain patients and call for restraint in implementing the CDC guideline – particularly as it applies to the agency’s maximum recommended dose of 90mg MME (morphine milligram equivalent units).

This CAN be AMAZING & life changing news, IF it gets into the hands of those who are limiting our doctor’s ability to prescribe opioid pain medication!

These are the FULLY RESOLVED AMA resolutions contained in their report.  Resolution 235 is regarding the Misuse of the 2016 CDC Guidelines for Prescribing Opioids! 

CLICK HERE FOR QUICK OVERVIEW OF AMA RESOLUTIONS

Below is the full version of the AMA report.  Please see Resolution #235 on pages 24-25.

Full Version of (AMA) American Medical Association's Preliminary Report of Actions taken by the House of Delegates (Pages of Interest 24 and 25) 

**** Attention ALL CPP'S ****

Urgent IMMEDIATE Action Needed NOW!

In order to expedite & use this information to our advantage, we need YOU to take the following steps:

We need every single pain patient and advocate to CALL their state and federal representatives including   Governors Office, State Medical Board, State Narcotics Board, and State Attorney Generals and ask them for an ACTIVE email address (or their health staffers email) AND tell them to expect an extremely important resolution by the AMA about the CDC Guidelines. 

Once you have a list of all the email addresses, please copy & paste the FORM LETTER below to email each of them.  A few days after sending the emails, please call back to follow up and confirm that the email was received and forwarded to the correct person or department. 

CLICK HERE to access the FORM LETTER to send this URGENT information to your State and Federal Representatives 

EVERYTHING YOU NEED TO FIND & CONTACT YOUR STATE AND FEDERAL REPRESENTATIVES & GOVERNMENT AGENCIES  IS LISTED BELOW FOR YOUR CONVENIENCE:

———————————————————

Here is a link to locate your Federal Representatives, Senators & Governors with phone numbers and their health staffers email addresses. 

Link to find contact info for you State Medical Boards

Link to Contact Your State Legislators

Link to find your State Attorney General contact information

Link to find your State Controlled Substance/Narcotics Board

———————————————————

There are also a couple of other resolutions that refer to prescribing, mostly in regards to Opioid Use Disorder (Methadone specifically) it would benefit everyone to be educated.

The State of Rhode Island is addressing the damage done by the CDC Pain Treatment Guidelines PLEASE SHARE

The State of Rhode Island is addressing 

the damage done by the CDC Pain Treatment Guidelines 

PLEASE SHARE

State of Rhode Island

6/20/2019

Rep. Amore bill that excludes chronic intractable pain from medication prescribing guidelines passed by House

STATE HOUSE – Rep. Gregg Amore’s (D-Dist. 65, East Providence) legislation (2019-H 5434A) that would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication was passed by the House of Representatives.

“We want to make sure that our public policy in regard to addressing the opioid crisis does not have the unintended consequence of hurting patients who are trying to manage chronic pain.  These patients are not addicts, they are suffering with pain associated with cancer, palliative care, and in many cases, chronic intractable pain.  We need to let physicians determine how best to manage their patients’ pain,” said Representative Amore.

Chronic intractable pain is defined as pain that is excruciating, constant, incurable, and of such severity that it dominates virtually every conscious moment.  It also produces mental and physical debilitation and may produce a desire to commit suicide for the sole purpose of stopping the pain.

The bill calls for new guidelines for the treatment of chronic intractable pain be based upon the consideration of the individualized needs of patients suffering from chronic intractable pain.  The legislation acknowledges that every patient and their needs is different, especially those suffering from chronic pain.

The bill now heads to the Senate for consideration.

For more information, contact:

Andrew Caruolo, Publicist

State House Room 20

Providence, RI 02903

(401)222-6124

http://www.rilegislature.gov/pressrelease/_layouts/RIL.PressRelease.ListStructure/Forms/DisplayForm.aspx?List=c8baae31-3c10-431c-8dcd-9dbbe21ce3e9&ID=370434&fbclid=IwAR3F-013Z8RlL7aYQMCHIrJM2TfgVRLuAjE13osplZBHJ3e5UPbHXHI-vG4

Do No Harm... Physicians Just Don't Get It

Family says Pleasant Grove man committed suicide after going off pain meds too quickly

NEWS

Utah lobbyist works with lawmakers to stop "force-tapering"

If someone abuses opioids and overdose it sad.

If someone ends their life for lack of pain control, that's a tragedy 

Stop persecuting doctors for legitimately prescribing opioids for chronic pain

It's time we stop treating physicians like drug dealers...

Must read Article from Stat News

Stop persecuting doctors for legitimately prescribing opioids for chronic pain

I Understand

I understand why pain patients give up. You get to a level of meds that work and you can get out and do things, then it get taken away.

It just get's old so I understand why people just give up the fight....

Pain Patients Sample Civil Rights Complaint U.S. Department of Health and Human Services

If you feel you have been discriminated against by a pain management physician, please file a complaint with U.S. Department of Health and Human Services Office for Civil Rights. If your pain medications were force tapered or stopped all together with little to no justification, file a complaint.

Recently a settlement between the United States of America and Selma Medical Associates Inc. under the Americans with Disabilities Act DJ # 202-80-64  

https://www.ada.gov/selma_medical_sa.html 

Civil Rights Complaint Sample

U.S. Department of Health and Human Services

Office for Civil Rights

Disability Rights Section

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

Civil Rights Complaint RE: Dr Benjamin 

123 That Street

Ft Mohave, AZ 86426

I was a patient of Dr Venger  from 2010 to 2017 including several months working as his compliance officer. I feel by reducing my pain medication without medical justification Dr Venger  caused significant pain and suffering, lowered my ability to function and decreased my quality of life

Dr Venger  discriminated against me by failing to provide services or items reasonable and necessary for the diagnosis and treatment of chronic pain from injury and to improve my functioning and quality of life.

By reducing my level of narcotic pain medication including morphine without medical justification Dr Venger  failed to alleviate severe pain by not taking into account my physical dependence and tolerance to opioids and therefore failed to take reasonable and necessary steps to prevent significant disability and alleviate severe pain.

The across the board reduction of opioid pain medications by Dr Venger failed to consider the medical needs of the individual patient causing significant pain and suffering for me as well as other patients who were being treated with pain medications including controlled substances narcotics.

Arizona Medical Board Complaint MD-17-0722A

In July 2017 I filed complaint number MD-17-0722A with the Arizona Medical Board. Before becoming disabled I spent a number of years in law enforcement working undercover narcotics. Because of my background I recorded visits with Dr Venger so there was no discrepancy on what was said during visits. I included the audio recordings in my complaint to the Arizona Medical Board.

 I feel I was discriminated against by may pain management physician and here is a copy of my complaint. If you feel your physician did the wrong thing by reducing or stopping your pain medications, file a complaint.

I hope it helps.

Jay

CDC Say it's Opioid Guideline Should Not Be Used to Abruptly Taper or Suddenly Discontinue Opioids

The Pain News Network Reports CDC Back Peddles on Opioid Guideline............

The authors of the 2016 CDC opioid guideline say it should not be used to abruptly taper or suddenly discontinue opioid pain medication. The agency's long awaited "clarification" was cheered by some patient advocates, while others wondered why it took the CDC so long to act amid widespread reports of patient harm.

It's not clear what the CDC will do next to address the misapplication of the guideline by states, doctors, insurers, pharmacists and law enforcement agencies.

READ the Whole Story HERE

TWO FEDERAL AGENCIES SPEAK AGAINST MANDATED OR PRECIPITOUS OPIOID REDUCTIONS IN CHRONIC PAIN PATIENTS

FOR IMMEDIATE RELEASE APRIL 10, 2019

TWO FEDERAL AGENCIES SPEAK AGAINST MANDATED OR PRECIPITOUS OPIOID REDUCTIONS IN CHRONIC PAIN PATIENTS 

On April 10, the Director for the Centers for Disease Control and Prevention, Dr. Robert Redfield, wrote to Health Professionals for Patients in Pain (HP3) to state that the CDC’s 2016 Guideline offered no support for mandatory opioid dose reductions in patients with long-term pain. Coming on the heels of an April 9 warning from the United States Food and Drug Administration of “serious harm” to patients after rapid dose reduction or discontinuation, the Director’s letter flags the need for a recalibration of care decisions imposed by a wide range of private and governmental agencies that have invoked the CDC to justify coverage restrictions, quality metrics, legal threats and other actions to force dose reductions on nonconsenting patients.

READ MORE 

The Blue Balloon Campaign

The Blue Balloon Campaign

for humane laws and policies in the treatment of chronic and severe pain

 

FDA identifies harm reported from sudden discontinuation of opioid pain medicines

FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering

Safety Announcement READ FDA PAGE HERE

4-9-2019] The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased. These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.

While we continue to track this safety concern as part of our ongoing monitoring of risks associated with opioid pain medicines, we are requiring changes to the prescribing information for these medicines that are intended for use in the outpatient setting. These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued.

Rapid discontinuation can result in uncontrolled pain or withdrawal symptoms. In turn, these symptoms can lead patients to seek other sources of opioid pain medicines, which may be confused with drug-seeking for abuse. Patients may attempt to treat their pain or withdrawal symptoms with illicit opioids, such as heroin, and other substances.

Opioids are a class of powerful prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. They have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.

Health care professionals should not abruptly discontinue opioids in a patient who is physically dependent. When you and your patient have agreed to taper the dose of opioid analgesic, consider a variety of factors, including the dose of the drug, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. No standard opioid tapering schedule exists that is suitable for all patients. Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress (For tapering and additional recommendations, see Additional Information for Health Care Professionals).

Patients taking opioid pain medicines long-term should not suddenly stop taking your medicine without first discussing with your health care professional a plan for how to slowly decrease the dose of the opioid and continue to manage your pain. Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal (See Additional Information for Patients). Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.

We are continuing to monitor this safety concern and will update the public if we have new information. Because we are constantly monitoring the safety of opioid pain medicines, we are also including new prescribing information on other side effects including central sleep apnea and drug interactions. We are also updating information on proper storage and disposal of these medicines that is currently available on our
Disposal of Unused Medicines webpage.

To help FDA track safety issues with medicines, we urge patients and health care professionals to report side effects involving opioids or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.

Any Positive Change - AZ Harm Reduction Conference 2019

I'm in Phoenix today for Arizona's first Harm Reduction Conference Any Positive Change 2019 at Black Canyon Conference Center in Phoenix.

As I attend harm reduction events I remind those who attend that the people who abuse opioids aren't the only victims of the opioid crisis.

Pain patients are victims too. Patients by the thousands have been forced tapered off medications they've used for many years forcing some to turn to the streets, and others to simply end the pain.

If someone abuses opioids and overdose it's sad. If a pain patient ends their life for lack of pain control, it's a tragedy 

Arizona legislators passed the Arizona Opioid Epidemic Act limiting the dose a pain patient can receive, but there is no limit on dose for those who choose to abuse opioids.

Study Finds 90% of Medicare Patients Have Little Risk of Opioid Overdose

Pain News Network

Study Finds 90% of Medicare Patients Have Little Risk of Opioid Overdose

March 22, 2019

By Pat Anson, PNN Editor

Current methods used to identify Medicare patients at high risk of overdosing on prescription opioids target many people who are not really at high risk, according to a team of researchers who found that over 90% of patients have little to no risk of overdosing. 

The computer models developed three risk groups that predict which patients are at risk of overdosing over a 12 month period.

·         Low risk patients (67.5%) have 0.006% risk of overdose

·         Medium risk patients (23.3%) have 0.05% risk of overdose

·         High risk patients (9.1%) have 1.77% risk of overdose

Put another way, out of 100,000 Medicare patients in the low risk group, six would have an overdose; while there would be 1,770 overdoses in a high risk group of the same size

READ the whole Article at Pain Network News

Some Brave Physicians Stand Up for Pain Patients, Some Brave Reporters Tell the Truth About Opioids

 Some Brave Reporters are Telling the Truth About Opioids

Some brave reporters like George Knapp an investigative reporter for the Channel-8's I-Team tell the truth about opioids and pain patients in stories like his I-TEAM report on Opioid Addiction Versus Dependency

When the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain came out most of the pain management physicians in my area misunderstood that: 
1. they were guidelines and not a rule, regulation, or law.
2. the guidelines were for Primary Care Physicians and NOT pain management.

In Northern Arizona I was unable to find one, not one pain management physician who understood the 2018 Arizona Opioid Epidemic Act 

Every so called pain management physician I contacted told me they were limited by the 90 or 120 mg MME limit. Read the law, that's not what the law says... 

Is it they can't read and understand the law? Or are they so afraid of the government they're willing to violate their oath to do no harm and let patients suffer and die in pain?

Could you? Could you watch someone suffer in pain if you had the power to lessen their suffering? Could you? If you had the power to allow someone in pain to get up and get out of their house, to do things that improve their quality of life. Could you? Could you just watch them suffer in pain?

The legislature put protections in the  2018 Arizona Opioid Epidemic Act to protect current chronic patients, but physicians simply ignore these protections. Even when I hand them this email from Governor Ducey's Office outlining the protections.

They read the governors email and actually say, "I'm not going to break the law". When I tell them this is the law, they just say "I'm not going to break the law".... 

Many of the current problems with pain patients turning to street drugs and overdosing are caused because physicians refused to follow the protections the legislature placed in the Arizona Opioid Epidemic Act to protect current pain patients.

It was well known that forced tapering of current pain patients who had built a tolerance to opioid pain medications over years of use would have no choice but turn to the street if doses were reduced too low.

Some Brave Physicians Stand Up for Pain Patients

Dr Marx is one of a hand full of pain management specialists who understand pain management are standing up for pain patients. 

In the I-TEAM story Opioid Addiction Versus Dependency 
Dr. Marx says pain patients do develop a dependence on their medication, but they can take it basically forever without harm it allows them to keep their jobs, remain active, have a life. Those who've had their meds cut have suffered terribly, and many have committed suicide. Their need for medication is not addiction

"Dependence is not addiction," Ziegler said. "Withdrawal is not addiction. Addiction is a completely separate matter. As lot of people can be managed well on prescription therapy. For those who can be managed well, why are you trying to change their treatment?"

WATCH: Opioid Crisis - Reporter George Knapp's complete interview with Dr. Stephen Ziegler