Day: 05/05/2015

Killer Pharmacy: Inside a Medical Mass Murder Case

http://www.newsweek.com/2015/04/24/inside-one-most-murderous-corporate-crimes-us-history-322665.html

But NECC wasn’t a promising drug supplier—it was a lethal, venomous scourge. This seemingly innocuous pharmacy in a Framingham strip mall was making millions of dollars by cutting corners, fabricating records and ignoring laws designed to keep contaminated drugs off the market. NECC perpetrated what may be one of the most murderous corporate crimes in U.S. history by pumping out deadly medicines that infected more than 800 people with fungal meningitis in 2012, 64 of whom died…

Also, although the entire batch was required by law to be tested for sterility by an independent laboratory, Chin sent only 10 milliliters of drugs in two vials for analysis. On June 5, after the lab found that the first vial tested was sterile, officials at NECC declared the entire lot ready for shipment. In other words, the batch was deemed safe for injection into humans based on the testing of just 0.0004 percent of the total…

This is similar to how cannabis is tested.  They send one or two buds to the lab, but what about the rest of the lot?  And the buds that are sent to the labs are usually the ones from the top of the plant — the ones that will test the strongest — but that doesn’t mean all the buds in the rest of the lot will be the same.  Yet dispensaries are allowed to use these test results for every single label in that lot, when it only applies to the few buds that were tested.

Keep in mind that we’re talking about a plant, and each plant is different, as well as each bud on that plant.  I don’t know how different, but dispensaries shouldn’t be able to advertise and sell buds under these kinds of loose testing protocols.  It’s too expensive to test every bud, so maybe they should just switch to a system that has a range — like, 15% to 17% of THC, instead of just saying it’s got 17%.

‘Sex on the Beach’ Couple Found Guilty

http://patch.com/florida/bradenton/sex-beach-couple-found-guilty-0

It only took a jury 15 minutes of deliberation to find a Bradenton couple accused of having sex on a beach back in July guilty on two counts each of lewd and lascivious behavior. Jose Caballero, 40, and Elissa Alvarez, 20, were arrested after visitors to Bradenton Beach recorded video of the couple engaged in the act…

The convictions carry a maximum sentence of 15 years each… Caballero is no stranger to the inside of a jail cell.

Previous arrests have included such charges as disorderly conduct, possession of a controlled substance and contempt of court… Assistant State Attorney Anthony Dafonseca said during a post-trial press conference that the state will likely seek the full penalty for Caballero. This is in light of the fact Caballero had been out of prison for less than three years on a prior cocaine trafficking conviction before this most recent felony arrest, he said.

Alvarez, who has no prior record, will likely face time in the county jail.

Both also have to register as sex offenders.

Medical pot being sold in Los Lunas

http://www.news-bulletin.com/2015/04/29/news/medical-pot-being-sold-in-los-lunas.html

Medical marijuana is now available in Los Lunas. A medical cannabis dispensary store, Natural Rx, opened late in February at 3414 N.M. 47 and another, Minerva Canna Group, is slated to open June 1 at 336 Main St. Two other dispensaries are interested in village locations, but they are still in the state licensing process, according to Adolph Lopez, the village’s code enforcement supervisor.

Lopez said they have to have a permit from the state and follow state medical cannabis regulations, such as having a security system and not setting up shop within 300 feet of a school, day care or church…

When did dispensaries start having to be a certain distance away from a church? In New Mexico, there’s like a church on every corner.  Do stores that sell alcohol and cigarettes have to be 300 feet from a school, day care or church?  Pharmacies?

“I think the village needs to be very aggressive in making sure that these facilities meet the letter of the law,” Griego said. “I understand that some people have medical needs for the use of marijuana. I understand that, however, I think we have to be very careful that we don’t create a negative situation with these facilities.” Law enforcement work to ensure the safety of the community, local businesses, their employees and patrons, said Los Lunas Police Chief Naithan Gurule…

Has there been a “negative situation” with alcohol and cigarettes being sold on every street corner, along with religion?  And we mustn’t forget prescription medications, also sold on every street corner CVS, Walgreens, Walmart and grocery store. How about tanning salons? Should they also be 300 feet from schools, day cares and churches?  Stores that sell Coke, Dr. Pepper and energy drinks?

The negative situation is the drug war, creating discrimination of a plant and those who choose this treatment.

The reason the dispensaries have come to Los Lunas is because the state now allows individual producers to open more than one dispensary. The New Mexico Department of Health public information officer Ken Vigil wrote in an email that the new rules went into effect on Feb. 27. The state also opened up the license application process for up to 12 more licensed nonprofit producers.

“The state allowed multiple dispensing locations and we felt that Valencia County was undeserved, so we opened down there,” said Natural Rx manager Trevor Reed, in an interview at his Albuquerque location. Natural Rx is owned by the Natural Rx Foundation and governed by a board. It owns an Albuquerque store, three dispensaries in Oregon and the new Los Lunas location…

My review for Natural Rx:

http://forum.nmcannabisreview.com/viewtopic.php?f=3&t=17

Briones, who has a degree in horticulture, also has plans to open an additional dispensary in a different city, but wouldn’t disclose the location…

“We’re vertically integrated, meaning we have to grow and sell our own product,” he said. “There is a little glitch — we can buy from other producers, but unlike most states, we can’t buy from people (individuals).” …

I understand that California and Colorado dispensaries are able to buy from individual growers and caretakers, which is probably one of the reasons the price is more affordable for patients in those states.  And why there’s a better and more varied selection of strains to choose from.

They’re coming for your benzos…

http://www.peoplespharmacy.com/2015/05/04/anti-anxiety-drugs-pose-hazards-for-seniors/

Americans are anxious. That is the inescapable conclusion of a recent analysis of anti-anxiety drug use (JAMA Psychiatry, Feb. 2015). The study shows that more than 10 percent of women over 60 are taking such medications over a long time. (In men, the proportion is about 6 percent.)

Is 10 percent a lot?  I wonder what the percentage is for antidepressants?

The drugs are known by the almost unpronounceable name “benzodiazepines,” or benzos for short…

Experts in the field of neuropharmacology caution, “Benzodiazepines are drugs that should be used at most for a few days or weeks in selected patients, carefully monitored, and stopped as soon as possible…” (JAMA Psychiatry, Feb., 2015). This warning is especially relevant for older people…

Ketamine’s Troubled Past, Promising Future

http://www.medpagetoday.com/

In addition, through its action as an NMDA receptor antagonist, ketamine can also potentiate the analgesic effect of opioids, allowing lower doses of opioids. These properties are the reason there is now a growing body of evidence supporting the analgesic potential of sub-anesthetic, or low dose ketamine for acute pain in the emergency department (ED)…

The next logical question that follows is–who should receive low dose ketamine? Consider ketamine if the use of opioids is problematic — patients with opioid tolerance, opioid-induced hyperalgesia, true allergy — or if opioids are inadequate for pain control. A colleague recently shared an anecdote with me: a patient with renal colic had received ketorolac, 8 mg morphine and 4 mg of Dilaudid. Relief finally came after low dose ketamine, and the patient was able to be discharged home…

Paying Medicaid Enrollees To Quit Smoking, Lose Weight

http://www.medpagetoday.com/

In Las Cruces, N.M., Isabel Juarez had her eyes tested, her teeth cleaned and recorded how many steps she walked with a pedometer. In exchange, she received a $100 gift card from Medicaid to help her buy health care products including mouthwash, vitamins, soap, and toothpaste.

Taking a cue from workplace wellness programs, Iowa and New Mexico are among more than a dozen states offering incentives to Medicaid beneficiaries to get them to make healthier decisions — and potentially save money for the state-federal health insurance program for the poor…

For years, private employers and insurers have used incentives to spur employees and members to quit smoking, lose weight and get prenatal care, although the record of those programs for changing long-term behavior is mixed, studies show. “Financial incentives are effective at improving healthy behaviors, though the effect of incentives may decrease over time,” said a report last year by the Center for Health Care Strategies, a research group based in Hamilton, N.J…

The Affordable Care Act is behind the latest push of wellness incentives in Medicaid. Besides Iowa and New Mexico, several other states that have expanded Medicaid under the health law have incorporated such incentives, including Indiana, Pennsylvania, New Hampshire and Michigan. Montana, which is about to become the 29th state to extend Medicaid, also plans to include such incentives…

But getting them to participate in incentive programs can be challenging. For example, an Idaho program that offered a $100 voucher to entice Medicaid recipients to lose weight or quit smoking attracted less than 2% of eligible adults after 2 years.

Among the biggest obstacles is simply getting the word out to enrollees, Crawford said. But there are other issues, too: Poor people are less likely to understand how the incentives work and to face transportation and other barriers to get to doctor appointments or educational classes that are part of the program…

Separate from the health law, one of the largest incentives program is New Mexico Medicaid’s Centennial Rewards, which gives most of the state’s 600,000 recipients the chance to earn points to buy health care items.

They gain points each time they engage in a healthy behavior, such as getting a checkup or seeing a dentist. So far, only about 45,000 have registered and only half of those have redeemed points for gift cards.

I sure wish Medicare paid for dental care.  And I’ve heard some good things about this state’s Medicaid program, including the telemedicine program.

Charles Milligan, who until last month was senior vice president of Presbyterian Health Plan in New Mexico, another Medicaid plan, said he’s seen an increase in members seeking preventive care, such as diabetes screenings and prenatal care. “The rewards program helps us engage with our members,” he said. Still, only about 30,000 of their 200,000 members have registered for it…

Prescription for Pain: Florida Patients denied medication

Prescription for Pain: Florida Patients denied medication

Under pressure from the DEA he says he created a nine item checklist to decide whose prescriptions his pharmacy can fill. “It’s just continuously gotten tighter and tighter on the supply side from the wholesaler. Only 20 percent of my medicines can be controlled substances.”

At his pharmacy in order to get a prescription for a controlled substance like morphine, oxycodone or hydrocodone filled you must be over the age of 35, undergo a criminal background check and your doctor must be vetted.

“If it’s a new patient, say they have a new cancer, well they are just out of luck,” said Napier. “Especially towards the end of the month I have a lot of people say my pharmacy is out of it, and I try to explain every pharmacy is out of it because every pharmacy has a quota. Once you meet a quota you are done.” …

Special Agent Mia Ro with the DEA’s Miami Field Division says the DEA is aware of the problem and concerned, and even its own agents have been denied pain medication at pharmacies. “I wish we could say there is an easy answer, but we really don’t know why legitimate patients, such as terminally ill patients and cancer patients are not able to get their prescriptions filled,” said Special Agent Ro…

Here’s the problem:  The DEA gets to decide who is a “legitimate” pain patient.  You see how the agent defines the terminally ill and cancer patients as legitimate?

If you read between the lines, it appears Ms. Ro is saying that the DEA agents who have been denied pain medications aren’t actually “legitimate” pain patients.  I mean, are there cancer patients or anyone who’s terminally ill still working as DEA agents?  If they want pain medications, they have to be one or the other.

Ro is adamant the DEA does not set quotas for how much a distributor can sell to a pharmacy or how much a pharmacy can purchase from the wholesaler. “I think the DEA has become a convenient excuse for many pharmacies not to fill prescriptions,” said Ro. “I want pharmacies to know they don’t have to fear the DEA for doing their jobs for filling legitimate patient’s prescriptions.” …

I beginning to feel sorry for the DEA. They try really hard, but they just don’t make sense. Why would a pharmacy not want to fill prescriptions? That’s what they do.  And as soon as the DEA comes out with a public definition of what “legitimate” means — you know, in the law, from a legal standpoint — well, I guess we’re stuck with the continuation of the drug war.

Doctors and pharmacists no longer get to decide.  Patients don’t get to decide.  The drug war makes all the decisions.  (I mean, the DEA.)

Johnson is now on a mission to fight for patient’s rights. He created the website paincareislegal.com and within a few weeks already has hundreds of supporters. He’s urging supporters to sign a petition he started to get the White House to address the problem…

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