12/8/2014, Addicted Oklahoma — Profiting from pain

http://newsok.com/addicted-oklahoma-profiting-from-pain/article/5373925

Public officials and experts in the field say allowing non-physician ownership of clinics makes them more difficult to regulate and helps explain why Oklahoma has among the highest prescription drug abuse and overdose death rates in the country.

“To me, one of the most important things is who gets to own these clinics,” said Sandra LaVenue, deputy general counsel of the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. “The clinics that end up in trouble tend to have ownership that is separated from the primary physician…Essentially, what they’re trying to do is separate the money from the prescribing.”

Following the enactment of its new pain-clinic restrictions and a series of enforcement raids across the state, more than 250 pain clinics were shut down, the CDC reported. Prescription drug overdose deaths fell 23 percent. Deaths caused by oxycodone plunged 52 percent…

What happened to all those pain patients?  Or was every single patient at those 250 pain clinics a drug dealer or addict?  And if they were all drug addicts, what happened to them?  Why doesn’t the media ever report on that part of the story?

“They’ve clearly cut down on the number of pill mills,” said Sarah Kelsey, CEO of the National Alliance for Model State Drug Laws in Charlottesville, Va…

Who wants to bet that the federal government is funding this group?

Oklahoma already was a pioneer in some areas of narcotic prescribing oversight. It created the nation’s first computerized prescription monitoring program in 1991. Three years ago, it became the first state to require pharmacists to log narcotic prescriptions online within five minutes of filling them…

If Oklahoma was a pioneer, why is it facing these same problems now?

State narcotics officials say they are powerless against non-physician owners.

“We don’t have any control over that outside party. He doesn’t have a license with us or a registration. We can’t do anything,” LaVenue said.  “We don’t even know where the pain clinics are.”

So, you’re going to blame the opioid “epidemic” on this one issue?  Let me ask, how will these new regulations make a difference in the current heroin “epidemic”?

Standridge’s bill defined a pain management clinic as any facility in which more than 50 percent of patients receive prescriptions for opioid painkillers, benzodiazepine tranquilizers, barbiturate sedatives or carisoprodol, a muscle relaxer. The definition also included any clinic that advertises itself as a pain management business…

It’s so easy for the DEA to control all of this, with even more regulations meant to constrict the supply of certain prescription medications.  And yet, even after decades of this strategy (the failed drug war), the DEA was unable to do anything about the current drug abuse and overdose epidemic. Seriously, if the DEA had never existed, would we still have this boom-and-bust cycle of drug overdoses?  Perhaps if the DEA wasn’t a government organization, it would have been fired by now.

“I’m kind of torn,” Standridge said. “I’m not saying it’s not a worthy objective to try to eliminate drug abuse and addiction. But to me, it looks like the way we’re going down this road may not help any of them, while at the same time curtailing access to all of these medications.”

Is sanity in the house?

According to the National Alliance for Model State Drug Laws, indicators of “pill-mill” activity can include:

Guess not… How come the media never explains who these groups are and how they’re funded?  If the name has “national” in it, are we supposed to assume… what?

High-volume practices.

Limited appointments, walk-ins accepted.

Cash payments required.

Failure to screen for substance abuse disorders.

Missing or deficient patient histories.

Missing or deficient prior medical records.

Inadequate physical examinations.

Inadequate diagnostics.

Limited non-narcotic care strategies.

Controlled substances as primary therapy.

Physicians or prescribers near the end of their careers.

Physicians or prescribers with abuse or addiction problems.

Patients who travel long distances to clinic.

Patients whose physical appearance suggests abuse or addiction.

Discrimination 101.  Texas and Oklahoma, two peas in a pod.

Unum is requiring me to see a doctor to fill out more forms, and I was just thinking how funny it would be if I showed up to this appointment looking like a “patient whose physical appearance suggests abuse or addiction.”  I mean, it’s such a stereotype, it wouldn’t be hard to do.  Heck, I don’t even have to try to look like a drug addict — I’m a chronic pain patient, remember?  I wasn’t planning on asking for “legal” drugs at this forced appointment, but hey, wouldn’t it be fun to see what a pain doctor would say if I did?  What, is a doctor going to look at my history and say I should try massage?

Could I create my own lawsuit and win the lottery?  (Do lawyers read WordPress blogs?)

Some suspect clinics have smartened up and now cover their tracks with more complete patient records, LaVenue said. But that doesn’t mean the patient records are legitimate. “They can come up with an X-ray, MRI, from 10 years ago,” she said.

The clinic doctors, in turn, “don’t order any testing…no blood work, no additional MRIs, X-rays,” LaVenue said.

So, if you had an MRI 10 years ago showing, say, Degenerative Disk Disease, the DEA says you now need another one?  Because?  The only reason to have additional MRIs is in contemplation of surgery.

And a blood test for pain?  How about a lie detector test too?

Jill Smoot said she never knew her son, Aaron, 43, who suffered from mental illness, was one of Moore’s patients who died of an overdose until recently contacted by a reporter. Smoot died in August 2011 from a fatal combination of oxycodone and other prescription narcotics, according to the medical examiner…

“I didn’t like having a layman tell me how to practice medicine,” Beasley said. “I wanted to get people off of pain meds and back to work and he thought they should continue to return (for treatment). It’s all about money.”

The goal of treatment is to stop taking medicine for your pain and return to work? Interesting. Pretty soon, pain patients will just skip the medical industry altogether and go straight to the underground market.  I guess that’s happening already…

And sure, it’s all about money — taken from desperate and poor people in pain.  Which is their right — to choose the “legal” treatment — or it used to be.  I can’t even begin to imagine how large the underground drug market is, and it keeps growing because the medical industry doesn’t know how to treat pain (and a lot of other illnesses, too).  And now it refuses to treat pain.

In August 2014, Valuck, 72, pleaded guilty in Oklahoma County District Court to eight counts of second-degree murder and was given an eight-year prison sentence. Because of the nature of his crimes, he will have to serve nearly seven years before being eligible for parole…

Helen Broadbooks, 63, of Lexington, lost her daughter, Carie Marie Simmons, 27, to an overdose of prescription drugs in May 2013…

By the end of 2013, that doctor, Michael E. Salrin, was the 10th-highest prescriber of oxycodone to Medicaid patients in Oklahoma, according to the Oklahoma Health Care Authority. Through the first eight months of 2014, Salrin, 69, is the second-highest prescriber…

I wonder how doctors feel about having their prescribing habits reviewed, rated and published. In this case, being number one on the list is a bad thing.  If you’re a doctor that treats, say, cancer, then you will always be one of the “highest prescribers.”  If I had cancer, I think I would be looking for a doctor that was willing to treat my pain, which would include the highest prescribers.

Like Dr. Rosenberg in the New Mexico Medical Cannabis Program (and also with the Department of Health).  He says he only certifies like 60% of his patients, and I’ve always wondered — what happens to the other 40%?  Are they just refused treatment?  Or does Dr. Rosenberg make these patients pay for other “standard” treatments before being willing to certify?

It blows my mind. I think it should be shut down,” Michelle Casson, 53, said when told that another doctor with a history of overprescribing had replaced Valuck at Vista. Her son, SaShawn Saatian, 33, died August 8, 2013, of a drug overdose, a day after Valuck prescribed him 240 pills…

Since February, the families of four of Valuck’s patients who overdosed and died have filed medical negligence lawsuits against Vista, Valuck, Hume and others…

Lots of lawsuits to continue the drug war, but none to try to stop it… how very sad.

But it just goes to show you that until pain patients start filing civil (or even criminal) lawsuits, nothing’s going to stop this train back to the past.

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