Day: 12/18/2014

9/30/2014, Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers

http://blogs.kqed.org/stateofhealth/2014/09/30/prop-46-was-inspired-by-tragic-accident-pits-doctors-against-lawyers/

After passing similar laws, both Tennessee and New York saw a significant reduction in the number of narcotics prescriptions written. Studies have verified the correlation, but acknowledge that some of the reduction may be due to drug abusers turning to alternative sources or street drugs, like heroin…

A study from Emory University shows that medical malpractice caps limit access to legal representation for up to 95 percent of victims. Children, the elderly and other people with no or very low incomes who cannot claim economic damages are the most affected…

In a review of studies from the 1970s to the early 2000s, researchers writing for the Milbank Quarterly found that damage caps do reduce malpractice insurance premiums, but to what degree is a matter of debate, with study results ranging from 6 to 25 percent.

No evidence was found that this savings gets passed on to consumers in the form of lower health insurance premiums, partly because malpractice insurance constitutes such a small percentage – less than 2 – of overall health care costs.

Mandates Drug & Alcohol Testing for Doctors

This has been the centerpiece of the “Yes on Prop. 46″ campaign, inspiring campy ads of airline pilots and police officers dancing through the stalls of a public restroom.

“All…of…the….pilots do it. Astronauts do it. Even the school bus drivers do it,” the ad goes. “Let’s do it. Let’s pee in a cup.”

Adding doctors to that list seemed like an easy sell. Early polls indicated voters strongly favored the idea -– many thought it was already law. In fact, if Prop. 46 passes, California would be the first state in the country to require drug testing of doctors…

Studies of workplace drug testing programs are actually inconclusive on whether testing deters employee drug use or reduces workplace accidents. A review of 23 studies in the upcoming issue of Accident Analysis and Prevention concluded: “The evidence base for the effectiveness of testing in improving workplace safety is at best tenuous.”

http://www.mercurynews.com/breaking-news/ci_26866635/propositions-45-and-46-losing-early-returns

11/4/2014, California voters reject Propositions 45, 46, 48; pass 47

http://www.motherjones.com/politics/2014/10/californias-complicated-proposition-46-explained

Drugs, Doctors, and Death Threats: Inside the Battle Over California’s Prop. 46

Nebraska, Oklahoma File Federal Suit Against Colorado Over Marijuana Legalization

http://www.huffingtonpost.com/2014/12/18/lawsuit-colorado-marijuana_n_6350162.html

But Colorado Attorney General John Suthers isn’t backing down. In a statement, he said he intends to defend the state’s marijuana laws.

Wow, an Attorney General that works for the people…

The clause states that in general, federal law takes precedence over state law.

Ha!  Republicans suing against state’s rights…  Over a plant 🙂

So far, the federal government has mostly taken a hands-off approach to state medicalizations and legalizations, but in January 2017, the country will have a new president. That person could order the attorney general to enforce federal prohibition regardless of state law.

Time to register to vote.

It is getting CRAZY hard to get pain meds in TN

http://www.healingwell.com/community/default.aspx?f=16&m=2765047

Excerpts from posts:

I can only say many pain patients here in Florida are using the methadone clinic for PM until they get a regular Dr to help.

***

yes, I am on Medicaid, I’m on SSI. I have found that all these clinics that have commercials, ads in the paper and stuff, seem to be willing to write the first few scripts, do all these injections that don’t work, and then after about 3 months, say there is nothing else they can do to help. i think some of these clinics do nothing but get some pts. hooked on the pills, and after a few months, just move on to another group of people. This office is always full, they even have chairs in the hallway lined up in order of who is next for their injections. Its just get em in, move em out, get some more. Repeat.

***

Indiana has become as bad as Tennessee and Kentucky are being described. I was left “high and dry” March 27. My doc’s office was raided in February…. Two hours before my appointment to have my meds refilled I received a call stating my appointment had to be canceled and that I would need to find a new doctor. I live in a city of approximately 70,000 people. I called every single doctor who has a practice here. I was told either they were not taking new patients or when I was asked who my previous doc was I got an immediate NO. Thankfully the nurses from the office were able to get me referred to a PM doc a week later. Going there was an immediate wake up call. All my meds were either taken away or the doses were cut drastically. I was told I needed to see a psychiatrist and get a primary care doc. She also told me to “deal with it” and that once I get through the withdrawal my hair will look better, my skin will look better and I will look better.

5/10/2014, Tennessee docs tightening pain, anxiety prescriptions

http://www.tennessean.com/story/news/2014/05/09/tennessee-docs-tightening-pain-anxiety-prescriptions/8916783/

The latest action occurred Friday when a committee of physicians appointed by the Tennessee commissioner of health agreed on new guidelines for prescribing opioids in an attempt to curb the state’s addiction problem. The guidelines set limits on daily doses doctors can prescribe to patients, spell out protocols for giving the drugs to women of childbearing age and establish new certification requirements for pain medicine specialists.

They also establish two levels of doctors who can prescribe controlled substances. Most doctors can write prescriptions for daily doses up to 120 milligrams of morphine equivalents. For example, this measure works out to four 30 milligram dosages of hydrocodone a day. Anything above that requires doctors to refer their patients to a pain medicine specialists.

You mean, addiction specialists?

Bottleneck fears

There is concern this rule could create a bottleneck because about 90,000 Tennesseans get pain meds that exceed this daily dosage, and the number of certified pain specialists may not be able to handle that patient load…

Doctors do not have to transfer patients taking more than 120 milligram morphine equivalents a day to a pain specialist, but they do have to refer them to a pain specialist for an least one annual visit.

Dr. James Choo, a pain specialist and committee member, said the 90,000 number should decrease as opioid prescriptions taper off and more patients are referred to addiction experts.

So, are pain patients being referred to pain specialists or addiction experts?  Or are they now one and the same?  Tennessee is going to send 90,000 pain patients to addiction experts to be treated for pain… what could go wrong?

Who says we have to suffer quietly?

What should pain patients do about the medical industry and the DEA continuing to restrict and remove access to one of the few drug therapies (opioids) that work for chronic pain?

Should we run for cover? I dunno, it seems like a lot of us have already tried that, and it didn’t work.

Should we go quietly into the night? Hide behind closed doors, hang our heads in shame, and suffer quietly?  And I got to thinking, who says we should suffer quietly?

A Google search for the phrase “to suffer quietly” returned some interesting responses — the most obvious being one of the definitions for “bear”:  verb, to accept or endure (something).

Hmmm… when I think of the word “bear,” I think of bearing children.  So you won’t be surprised that a number of hits for “to suffer quietly” were related to women.

But very few of these websites advocated for suffering quietly, many indicating how unhealthy it is to do so. One link was on “How To Be Fine After An Abortion” (Womenworld.org), indicating the likelihood of depression for those who “choose to suffer quietly.”

Another silently suffering group is African Americans, who have certainly been made to bear the weight of the drug war. Of course, it’s not hard to suffer quietly and anonymously when you’re behind bars.

In a 2009 book entitled, “Family Affair: What It Means to Be African-American Today,” describing his mother’s death, Gil L. Robertson, IV says: “My ability to suffer quietly has become a curse.”

And no one would argue that the mentally ill do a lot of quiet suffering. Here’s a quote from a mental health professional (drdeborahserani.com): “One of the greatest things I’ve been able to do,” Serani says, “Is to let others know that there’s no shame in living with a mental illness. Help is out there – and you don’t have to suffer quietly or alone.”

“Silently Suffering” is the title of a song by The Rosies about their father who has suffered from mental illness for over 30 years. (https://www.facebook.com/TheRosies)

Another group mentioned for suffering quietly was veterans.  From http://www.fallenheroesfund.org: “So many of our men and women in uniform have returned from service in Iraq and Afghanistan to suffer quietly with psychological health conditions that are invisible to the public,” said General Richard Cody, USA (Ret.), former Vice Chief of Staff of the Army.

It appears the self-employed also “continue to suffer quietly in the Great Recession,” or at least according to workplacediva.blogspot.com in 2010.

An interesting link was from a sports website, in which a fan responds to being told to suffer quietly with, “Don’t tell me how to suffer.” (Ramsrule.com, 2013)

I think pain patients should get business cards printed up with that saying. I mean, basically the medical industry and the DEA are telling pain patients to suffer — but they can’t tell us HOW to suffer, can they? And I think we should suffer… in their faces.

I can see it now… An activist dressed from head-to-toe in dark, angry red, with a blank mask for a face and a white nametag that reads, “I AM PAIN.” I see a bunch of IAmPains hovering around politicians, actors, and famous people… quietly, just always being around… reminding, photobombing… And there’s one of the IAPs doing something with his hands around his head that makes it look like he’s miming a throbbing headache… Another one miming how it feels to have a bad back… Wait, I think I see an IAP miming fibro-fog hanging around a Kardashian…

Finally, we come to the subject for most of the hits on “to suffer quietly”: religion. Here are some examples:

From GraceBaptist.ws: “To suffer quietly doesn’t mean to deny all feelings or pretend everything is right. No, it means to submit to the pains of life without yelling at God, sulking…”

From the Institute for Creation Research (www.icr.org): “If we would really be like Him, we must be willing to suffer quietly on behalf of others, even when they are the ones who deserve it. This is acceptable with God!” (Yikes!)

There were a few positive signs in the religious community:

At https://www.facebook.com/sthelenaYYAM/posts/545801505524454:

“You and I were not made to suffer quietly,…” I Am Not Depression. LifeTeen.com for Catholic Youth.

And from the Hindustan Times (www.hindustantimes.com/…/article1-1231748.aspx), we have:

Jun 20, 2014 – A generation of women brought up to suffer quietly now increasingly tells its daughters to speak up, to fight back, to resist.

So, what should pain patients do about the medical industry and the DEA continuing to restrict and remove access to one of the few drug therapies (opioids) that work for chronic pain?

Well, who wants to be a squeaky wheel? I’ve obviously given up suffering quietly (on the internet) — won’t ya’ll join me?

Harrison Narcotics Act Still Fostering Violence, Addiction 100 Years Later

http://www.hemp.org/news/node/4478

In 1940, Indiana University psychologist Professor Alfred R. Lindesmith echoed his predecessors, “Solemn discussions are carried on about lengthening the addict’s already long sentence and as to whether or not he is a good parole risk. The basic question as to why he should be sent to prison at all is scarcely mentioned.

“Eventually, it is to be hoped that we shall come to see…that the punishment and imprisonment of addicts is as cruel and pointless as similar treatment for persons infected with syphilis would be,” Lindesmith wrote. “The treatment of addicts in the United States today is on no higher plane than the persecution of witches of other ages, and like the latter it is to be hoped that it will soon become merely another dark chapter of history.”