Robertson said that her niece had been struggling with mental illness, including depression and bipolar disorder, since her mother died when she was four. She had been hospitalized twice in recent years after suicide attempts. One time, she tried to hang herself. Another time, she drank toilet bowl cleaner. Since arriving in Longview in December, Coignard had been taking medication and regularly seeing a therapist. She had no criminal record and “was only violent with herself, ” Robertson said…
Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.
Mr. Palermo, 82, was devastated by the petition, brought in the name of Sister Sean William, the Carmelite nun who is the executive director of Mary Manning Walsh…
“The average cost for a woman opting for nitrous oxide is less than a $100, while an epidural can run up to $3,000 because of extra anesthesia fees,” Dixon said.
The U.S. Food and Drug Administration approved new nitrous oxide equipment for delivery room use in 2011, which could also explain the resurgence, Dixon told ABC News…
Another advantage is that the chemical gets out of your system shortly after stopping inhalation.
“With my first child, I had an epidural, I was numb for so long after the delivery and it took a while to get back to normal,” Zurawski said. “But with the nitrous oxide, I was walking around and taking pictures almost right after.”
Both Goodoien and Zurawski said they didn’t experience any adverse side effects.
Nitrous oxide’s possible side effects are usually just minor nuisances such as nausea, dizziness or drowsiness, medical experts told ABC News…
“When I was working in New Zealand, I told one of my patients, [laughing gas] wasn’t really used in the U.S. and you know what she said?” Dixon asked. “‘I thought they have everything in America!'”
How about laughing gas for chronic pain?
A newly-published paper by UNM Cancer Center’s Dr. Finlay describes methods to help cancer survivors cope with lingering pain
“There are lots of ways to treat post-cancer pain,” says Dr. Finlay, who is a University of New Mexico Cancer Center physician. “The intent of this paper is to educate all the different types of providers who are seeing patients after their cancer is cured.” Dr. Finlay hopes that raising awareness that cancer survivors may have chronic pain after their treatment will guide more people to seek help…
Cancer survivors can have pain from surgery, especially if their surgeon had to cut nerves to remove their tumor. For example, women who undergo a lumpectomy or mastectomy may feel a shooting or burning pain in their chest wall. Many head or neck cancer patients, too, may have pain after their surgeries if they needed neck surgery to remove lymph nodes. The pain may persist even years after surgery.
Cancer survivors might also have pain from their chemotherapy drugs. “Some chemotherapies are toxic to our nerves,” says Dr. Finlay. “Over time we get cumulative damage to the nerves in our fingers and toes. People can have chronic burning, numbness or discomfort.”
The review paper describes many different methods to combat pain. Dr. Finlay uses the methods in her practice at the UNM Cancer Center. “In my practice, I often need to use very strong pain medicines to get people through their treatment,” says Dr. Finlay. “Sometimes that means [using] opioid pain medicines. But we don’t want people to be on strong opioids for a long time if they don’t need them.” Opioid drugs like morphine or oxycodone can be addictive and have side effects and risks with long-term use. “Chronic pain specialists really try to use non-opioid strategies,” she says, “whether it’s medicine or physical or psychological interventions, like acupuncture, physical therapy, or cognitive behavioral therapy, to manage pain.”
Dr. Finlay uses a non-addictive group of medicines that ease nerve pain. She also prescribes physical therapy to ease pain and lymphedema after surgery and radiation treatment. The physical therapist Dr. Finlay and her colleagues at UNM Cancer Center refer to specializes in physical therapy for cancer survivors and in lymphedema therapy. Dr. Finlay also has strong ties with the UNM Center for Life and refers her patients there for massage and acupuncture when needed.
Like many oncologists, Dr. Finlay follows her patients for at least five years after cancer treatment. For most patients, pain subsides within the first two years. For some, though, the pain persists and can be very severe. “With chronic pain and symptoms, it’s important that people transition to a primary care doctor who understands those pain issues,” she says. “If their pain is really complex, they need to use a multidisciplinary pain clinic.” UNM has a multidisciplinary pain clinic with physical therapists, a pharmacist, psychologists and many physicians trained in pain management.
“Pain makes people less functional,” says Dr. Finlay. “I think the key thing people need to know is to ask for help if they have chronic pain after cancer. They need to know that there are lots of different ways to address pain. Just because the cancer is gone doesn’t mean you’re going to be 100 percent the way you were before you were treated.” Survivors shouldn’t suffer in silence.
Center for Life Participates in National Integrative Medicine Survey. The UNM Center for Life (CFL) has been included in a recent national survey of patient populations and health conditions most commonly treated with integrative medicine strategies. Twenty-nine select integrative medicine centers affiliated with hospitals, health systems and/or medical and nursing schools in the U.S. were surveyed regarding trends in prevention and wellness, patient outcomes, emerging norms of care and reimbursement. The Bravewell Collaboration study showed that 75 percent of integrative medicine centers reported success using integrative practices to treat chronic pain, and more than half reported positive results for gastrointestinal conditions, depression and anxiety, cancer, and chronic stress.
Two years ago, a 40-year-old woman with bipolar disorder and fibromyalgia came to Elaine LeVine, PhD, in Las Cruces, N.M., for treatment. “Jane” had just been released from a psychiatric hospital, after trying to kill herself with an overdose of tranquilizers. She was on 11 medications: three psychotropics for her bipolar disorder and eight others for back pain, gastric distress and high blood pressure. She had gained 60 pounds within the year, wasn’t working, couldn’t do housework and was so emotionally distraught she couldn’t drive. She also had marital problems and difficulty communicating with her teenage son.
“She was homebound, in bed a majority of the time,” says LeVine, one of New Mexico’s first civilian prescribing psychologists. Some of Jane’s problems, says LeVine, stemmed from “polypharmacy.” She had visited several physicians and obtained numerous prescriptions, making it difficult to tell where the effects of her medical conditions ended and the medications’ side effects began…
Cases like Jane’s are why many psychologists seek prescription privileges, says LeVine. They want to improve patient care by offering treatments that blend assessment, psychotherapy and medication, and to streamline the number of medications a patient is taking. So far, prescribing for appropriately trained psychologists is limited to two states, New Mexico and Louisiana. In New Mexico, 13 of the state’s 681 psychologists are certified by the state to prescribe, and in Louisiana, 42 of the state’s 630 psychologists are certified by the state as “medical psychologists” and prescribe…
Psychologists with prescriptive authority are also finding that primary-care physicians increasingly refer patients with mental health concerns to them. Robert Mayfield, PhD, and Marlin Hoover, PhD, work with physicians at the Southern New Mexico Family Practice Center in Las Cruces, where they train family practice residents in behavioral health…
June 6 – 7, 2011 Board Meeting Minutes
New Mexico Board of Pharmacy Regular Board Meeting
e. Det. Robert Garcia, Santa Fe Police Department – Request for “Agent of Board” status for: Agt. Robert A. Garcia, Agt. Robert F. Vasquez, and Sgt. Andrew Padilla: Mr. Harvey stated that Detective Robert Garcia was not able to be present to make the request himself. The officers listed will be authorized to be agents of the board.
August 29 – 30, 2011 Board Meeting Minutes
New Mexico Board of Pharmacy Regular Board Meeting
g. 2010-072 Settlement Agreement Walgreens #11960…
Mr. Harvey stated that due to the big issue of substance abuse he is considering appointing more agents and contacting the Secretary of Public Safety regarding enrolling State Police Officers to handle the increase of forgeries and forgery rings consisting of 30 to 40 people in these rings.
l. HM 77 Task Force: Addresses substance abuse and require practitioners and/or ER doctors to access real time PMP reports to verify prescriptions and patient use. Mr. Harvey stated that in the future it may serve as a valuable tool for pharmacists to access the PMP to verify controlled substance prescriptions of first time patients that they have never filled for. Mr. Loring stated that the task force will be reporting to the legislature in November 2011 and will be addressing the treatment guidelines of abuse of chronic opioids and the training and education component of practitioners prescribing long acting opioids. The DEA is currently working on developing the training. The task force will also address getting every health care board that has practitioners prescribing controlled substances to use the PMP to report on new patients and if not the legislature will be asked to pass a law to require the use of the PMP.
m. PMP status: NMMRA funding: Discussed under budget 2013
New Mexico Men’s Recovery Academy “NMMRA”
Contracting Agency: New Mexico Corrections Department – Probation & Parole Division
n. Proposed additions to Schedule I: NMAC 16.19.20: Mr. Harvey discussed the numerous synthetic cannabinoids and bath salts that are in New Mexico and reported as being abused. The board agreed to the substance additions to 16.19.20 NMAC.
January 17 – 18, 2013 Board Meeting Draft Minutes
New Mexico Board of Pharmacy Regular Board Meeting
f. Governor’s Pain Council Bill…
4. Dr. Megan Thompson – “Generation Rx”: Dr. Megan Thompson discussed the
growing issues with drug abuse and overdoses of students within our state. The board and
audience viewed the “No Exceptions Video” that was also broadcasted on August 17, 2012
on stations KOAT and KOB. The video has been provided to every school. She can be
contacted at UNM @ 505-272-4121.
June 20 – 21, 2013 Board Meeting Draft Minutes
New Mexico Board of Pharmacy Regular Board Meeting
c. 16.19.20 NMAC Controlled Substances
Require electronic reporting of pseudoephedrine sales
Det. Brian Sallee, Mr. Jose Ramirez and Mr. William Harvey were present to discuss the
need for using the PSE electronic reporting web based system provided by HIDTA. Data will
be transferred from agent to agent and state to state, with reasonably easy access and the
system will be managed as directed from the state boards. The system is scheduled to be
up and running by January 2014…
Mr. Cross thanked Det. Sallee, Mr. Ramirez and Mr. Harvey for the hard work that has been done as this has been implemented to protect the public health and safety, this will accomplish that goal far more than creating a burden on the pharmacies in the state.
8. 10:00 a.m. Walgreens Good Faith Dispensing Policy:
Mr. Rex Sword, Mr. Dwayne Pinon and Ms. Natasha Polster were present from Walgreens to provide a response regarding the correspondence received by NMBOP from Michelle Lujan Grisham. Written comments from the New Mexico Medical Society, Ernest Dole and Brian Starr and their concerns and frustration regarding the implementation of the GFD policy has been met with inconsistency and led to further problems.
Upon lengthy discussion between the board and representatives from Walgreens that covered “red flags” regarding select controlled substances such as oxycodone, methadone and hydromorphone. Red Flags included, does the patient live in the trade area, high doses, high quantities and other documentation requests needed to evaluate and fill prescriptions. Walgreens stated that they have always had the GFD policy. Further discussion of the written comments submitted, opposing the “Good Faith Dispensing” policy, with concerns such as DEA guidelines, misinformation on reasons for the policy, delays in dispensing pain medications, patient withdrawal, alleged time delays of 2-3 days in obtaining required information prior to dispensing, dosage changes, additional prescription requests based on quantity limitations, lack of uniform understanding of company directives by Walgreens pharmacists, decreased quality of patient care, among many other issues.
In conclusion the board received several written comments regarding this issue. The board did not receive an actual copy of the Walgreens Good Faith Dispensing Policy and stated that they would like to view the Walgreen’s “Good Faith Dispensing” policies and expressed their concern regarding the messaging from Walgreens pharmacists that these policies were implemented by the New Mexico board of pharmacy. Walgreens indicated they were going to retrain pharmacists to ensure this misperception was not perpetuated.
A written correspondence received from Congresswoman Michelle Lujan Grisham has asked the board to look into the Walgreens GFD policy and its potential negative impact on patient care. Mary Smith, the boards counsel, Ms. Mendez-Harper and Mr. Cross will work together in responding to Ms. Grisham’s concerns and present at the August 2013 board meeting.
Ms. Angela DiPaolo was present and asked the board to allow the inclusion of C2-C5 controlled substances and at least C3-C5 in the EKIT that will be placed at their facility by Albuquerque Pharmacy. She stated due to the nature of the residents served it is necessary to have certain pain, anxiety and sleep medications readily available. The only people that will have access to the medications are licensed nurses and the system will be closely monitored and will only allow certain individuals at any given time and the on-call pharmacist who must approve access
at any time after hours and weekends. Mr. Loring stated his concerns regarding the DEA allowing C2’s. Mr. Cross stated that a better solution would be for the facility to be licensed as an LTCF.
Motion: Approve the waiver for one year for schedules 2-5 with the use of the advanced monitoring technology and will maintain a nurse, they will explore licensing as a LTCF, motion made by Mr. Cross, seconded by Ms. Buesing, the board voted unanimously to pass the motion.
Walgreen’s Good Faith Dispensing (GFD) Policy A Bustos of Walgreen’s presented a brief overview of Walgreen’s goals and rationale for the GFD. EDole opinioned that the corporate policy does (and has) resulted in delay of dispensing of patient medications and that such activity could result in patient harm. After some discussion, the Committee represents that it is not certain that consideration of this policy falls within the committee charge. The Committee is willing to comment on this policy if so directed by the Board. The Committee recommends that the Board consider potential aspects of patient safety when reviewing this policy.
c. Emily Jerry Foundation: Mr. Christopher Jerry from the Emily Jerry Foundation was present stating his opposition to the change of the pharmacy technician rule 16.19.22 NMAC regarding the ratio changing from the previous four technicians to one pharmacist ratio. As of 6/29/13 the ratio is to be determined by the pharmacist in charge. Mr. Jerry asked the board to reconsider
implementing the ratio back to its original 4-1 ratio.
d. NMAG Rx Drug Abuse Summit: Mr. Loring, Mr. Mazzoni and Ms. Buesing attended the summit. Mr. Loring stated the presentations went well and had a good turnout, also that he is waiting for the AGO to summarizing all the responses that were gathered during the summit. Mr. Mazzoni stated that the AGO did a great job putting on the summit and that the presentation Mr. Loring gave on the PMP was well received…
f. Main Street Family Pharmacy-Newbern, TN: Mr. Loring stated that this is a compounding pharmacy licensed with the board that was discovered to have shipped contaminated sterile products to Roswell. He informed the board that a case will be assigned and brought back to the board.
Ms. Mendez-Harper discussed the NABP Prescription Medication Distribution for Resale – The 5% Rule resolution. This resolution urges stated boards of pharmacy to eliminate “five percent” rules which allow for the transfer, distribution, and sale of prescription drugs between pharmacies for resale or the transfer between pharmacies to wholesalers for resale, or from pharmacists to practitioners for resale.
August 26th and 27th, 2013 Meeting Minutes
New Mexico Board of Pharmacy Regular Board Meeting
h. Walgreen’s Good Faith Dispensing Policy/Inquiry from Congresswoman Michelle Lujan: The board expressed their concerns and made recommendations to the Walgreens representatives regarding communication and education within Walgreens and its pharmacists. In response to into the Walgreen’s Good Faith Dispensing Policy, the final draft is being prepared by Ms. Mendez-Harper, Mr. Cross, Mr. Anderson and Ms. Saavedra…
i. Letter from Retta Ward, NM Secretary of Health: The board will consider Ms. Retta Wards’ request regarding the board enacting regulations that would require all dispensers reporting to the PMP within 24 hours of dispensing controlled substances in order to reduce doctor shopping and dangerous prescribing.
l. 16.19.20 Proposed additions to schedule I: Proposed language regarding additions of hallucinogenic substances to schedule I was discussed and approved.
January 17 – 18, 2013 Board Meeting Agenda (as of January 15, 2013)
New Mexico Board of Pharmacy Regular Board Meeting
a. 16.19.4 (10), (17) NMAC Pharmacists – Every Health care board that has practitioners licensed to write scripts for opioids shall be trained in opioid prescribing practices.
e. FDA – Inter-Governmental Meeting on Pharmacy Compounding
f. Governor’s Pain Council Bill
g. 16.19.29 PMP proposed change
I’ve been looking for a study or information that would answer that question, but it appears no one knows. However, it’s instructive to look into the past…
Narcan: The Next Big Thing In Pain Management
(12/24/2008) Tchort said:
…It all started with Talwin; a few low-level healthcare workers came up with the T’s & Blues combination, and shooting Pentazocine (which was unscheduled at the time) and Pyribenzamine (a.k.a. Tripellenamine, a common Rx cold/flu anti-Histamine of the day) spread across the country.
Then it started: Talwin NX. Pentazocine and Naloxone, combined in one pill. To stop intravenous abuse, they said. And it did: only, abuse never stopped, it just switched to oral and insufflation. A new combination was then discovered to be adequately euphoric to abuse: Talwin NX and Ritalin…
(12/25/2008) Tchort said:
-The correlation between low dose / ultra-low dose antagonists + / – partial or full agonists has not been adequately established, for abuse, as an adjuvant for analgesia, or for slowing tolerance. There is only a very short history of this being studied; the cart is coming before the horse. Long term ramifications of these combo’s are not understood…
-The evidence with Suboxone and Vivitrol is that regular, daily use of opioid antagonists can bring about nasty side effects, from headaches to severe nausea. The seriousness of these side effects was all but left out of the Suboxone prescribing guide, aside from the note that if the patient doesn’t tolerate Suboxone to switch them to Subutex. I bet the already vulnerable chronic pain population will really appreciate these added health problems.
(12/25/2008) lenses said: Thats a pretty ultra low dose of naloxone. That kind of dose actually makes the opiate work BETTER. It forget the pharmacology of it right now, but that low of a dose will not block . Thats like a microgram (ug) dose , right?
Naloxone isn’t impossible to seperate if you wanted to badly enough. Theres a way you can with cheap, easy accessible chemicals. I won’t say yet right now, but you should be able to figure it out. PM if you really need to know.
Toman added that the new drug treatment, using naltrexone or vivitrol for prisoners as well as people undergoing court-ordered treatment, gives those individuals and their families a “fighting chance at receiving the message of recovery, to becoming educated to recovery skills, and time away from the substance.
Yeah, treatment with buprenorphine started in the prison system, too. In New York, if I remember correctly.
“It works by blocking the opioid receptors in the brain and therefore blocking the effects of heroin and other opioids, she said. “It has also helped to reduce or prevent cravings.”
Wikipedia: “Naltrexone (INN, BAN, USAN) is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. It is marketed in generic form as its hydrochloride salt, naltrexone hydrochloride, and marketed under the trade names Revia and Depade. In some countries including the United States, a once-monthly extended-release injectable formulation is marketed under the trade name Vivitrol. Also in the United States, Methylnaltrexone Bromide, a closely related drug, is marketed as Relistor, for the treatment of opioid induced constipation. Naltrexone should not be confused with naloxone nor nalorphine, which are used in emergency cases of opioid overdose.”
Early experimentation and regular abuse of alcohol among youth, she said, is directly linked to subsequent prescription drug abuse and heroin use…
North Fork teens, she said, experiment with marijuana. “That’s become acceptable. Kids say, ‘It’s just marijuana,’” she said. “But we know that marijuana is a gateway drug to heroin and more.”
Marijuana a gateway drug to heroin? Do you think teenagers really believe something so silly?
No one can decide which drug is actually a “gateway” to other, more dangerous drugs, but blaming drugs is just… illogical.
Drug-sniffing dogs, she added, should be brought into local schools without no advance warning to students.
Wow, police state. Sure, make your kids hate you even more, then watch them rebel and… turn to drugs.
Riverhead Police Chief David Hegermiller said while statistics were not immediately available on heroin-related crimes and deaths…
Doesn’t matter, because…
In April, New York State Senator Ken LaValle, Assemblyman Fred Thiele and Assemblyman Anthony Palumbo announced the formation of a new Heroin Addiction Legislative Task Force, or H.A.L.T, with a focus on identifying causes and solutions to fight the growing heroin epidemic.
HALT, HOPE, all these anti-drug groups love to use names that disguise what they’re really about.
In light of upcoming legalization for cannabis, and a decrease in funding for law enforcement and all of these anti-drug groups, I guess opioids were the only drug left for them to go after. A matter of being in the wrong place at the wrong time.
You know, there used to be a time, not too long ago, when opiates and heroin weren’t automatically linked together. I guess those times are over now.
I wonder how a diabetic would feel if her medication was part of the drug war… The Heroin and Insulin Task Force?
1/25/2015, Federal Officials Participate In New Mexico Pharmacists’ Association Meeting
“The Prescription Drug Epidemic in New Mexico: How Promoting a Partnership between the DEA and Pharmacists Can Help.” Assistant U.S. Attorney Joel R. Meyers, Supervisor of the Organized Crime Section of the U.S. Attorney’s Office, discussed the New Mexico Heroin and Opioid Prevention and Education (HOPE) Initiative. This Initiative, which was launched earlier this month, is a collaboration between the U.S. Attorney’s Office and the University of New Mexico Health Sciences Center in partnership with the Bernalillo County Opioid Accountability Initiative with the overriding goal of reducing the number of opioid-related deaths in the District of New Mexico.
4/7/2014 (Wisconsin), Heroin bills signed into law
The legislation is part of the “H.O.P.E.” (Heroin, Opiate, Prevention and Education) initiative to address opiate addiction throughout the state.
Dismantling stigma is high on her agenda… “One of the biggest regrets that I have is not talking to my mom about it and letting her support me,” said Hughes.
1/17/2015, Star investigation: Canada’s invisible codeine problem
In Canada, codeine painkillers like Tylenol No. 1 are widely available without prescription. But do they work better than household painkillers like Tylenol or Advil?
I know the answer to that question, but I’m guessing my opinion isn’t the same as the writer of this article…
These millions of dollars and doses obscure a crucial problem: there is a startling lack of evidence that these drugs work better than household painkillers like Tylenol or Advil…
I suppose personal experience isn’t exactly “evidence,” but I find it hard to believe that my experiences would be that different from anyone else’s. And my experience is that codeine is stronger than Tylenol or Advil, hands down, no question.
But it doesn’t take much to grow addicted; a U.K. parliamentary inquiry in 2009 found that low-dose codeine drugs can cause addiction after just three days…
This is why people don’t believe their governments anymore.
This question is especially pertinent in light of Canada’s growing opioid epidemic, which is costing the federal government millions to tackle. In Ontario, deaths linked to opioids like morphine, codeine and oxycodone have jumped 242 per cent in two decades…
Well, what do you know, America’s opioid “epidemic” has been exported to Canada.
Barnes said addicts hooked on stronger opioids often resort to non-prescription codeine when trying to stave off withdrawal symptoms. Low-dose codeine can also “unmask a fondness” for opioids, leading people to even stronger drugs, said Dr. David Juurlink , a toxicologist and drug safety researcher with Sunnybrook Health Sciences Centre.
“Unmask a fondness”? Is this toxicologist talking about the brain and addiction or giving an anti-drug lecture to 10th graders?
But for many people, non-prescription codeine is the primary problem. In Ontario, more than 500 people have entered methadone treatments over the last three years for addictions to “over-the-counter codeine preparations,” according to a database maintained by the Centre for Addiction and Mental Health (CAMH). Methadone is a substitute drug initially used as a treatment for heroin addicts and often considered a lifetime commitment.
Using methadone to treat a codeine addiction? That doesn’t make much sense. Say, is the Centre for Addiction and Mental Health a subsidiary of the NIDA?
The number of deaths is unknown, however. An analysis of Ontario coroners’ reports by the Ontario Drug Policy Research Network showed codeine played a role in 1,870 fatalities between 1991 and 2010 — but there is no way of knowing how many might be linked to non-prescription codeine.
They must be pretty desperate to show this “epidemic” by using statistics that cover a 20-year period.
For Juurlink, anyone with pain serious enough to require an opiate should get a doctor’s advice. Non-prescription codeine allows people to bypass that step.
I’m guessing that Dr. Juurlink has lots of money and doesn’t have to worry about deciding between food, health care, and medicine, even in Canada’s much better system.
“A sugar pill outperformed 60 mg of codeine,” Shah said… Shah now refuses to sell non-prescription codeine at his pharmacy.
Sorry, I don’t believe a sugar pill outperformed codeine, and Mr. Shah is obviously using his prejudices to limit access — which says a lot about him, but nothing about the effectiveness of codeine to treat pain.
Sorry, Canada, it looks like America’s war against pain patients is now part of your drug war, too.