A slow death sentence

I guess I should thank the New York Times for finally publishing an article that tells the side of pain patients. But, it’s a matter of too little, too late, so the Times can go jump in a lake.

I’ve been reading all of the articles on the CDC’s new opioid guidelines this week, and really, I just don’t know what to say. There are millions of pain patients in this country who will be affected by these new rules, and I know they are now grieving for the lives they’ve been able to live while under opioid therapy. And I grieve with them, for even though I’m not taking opioids at this time, I know that in the future, I may very well need them.

Under comments:

Kaleberg port angeles, wa 1 day ago
For God’s sake, look at these poor people, with their fractured bones, compressed spines, and stroke damage. Look at the pictures of their pain-wracked faces, and then ask yourself what kind of a society tells these desperate souls that their only relief is counseling, anti-depressants, and acupuncture.

J Earth 23 hours ago
My mother has been chronically ill for 16 years. She is in excruciating pain 24 hours a day. The pain is often so bad that she throws up. One of her many diseases includes a blood disorder that destroys her platelets. Because of this blood disorder, she cannot take standard over-the-counter medications, like Advil (Iburofin). She has tried every alternative treatment available. Nothing works. She takes approximately 1-2 percocet each day, which allow her to get a few hours a sleep at night, and perform some basic daytime routines. In the past few years, she’s been forced to jump through hoops to get these life-saving pills. She has had to sign a contract, like the one mentioned in the article. She has to have random drug screening from her doctor. It makes her feel like a criminal. When I told her about these new guidelines, it literally struck fear in our family. We know she will commit suicide if she cannot control the pain. Those who have not experienced this type of pain cannot imagine it. It destroys every part of your life — every part of your soul. A person in this much pain just wants it to end. I’m deeply afraid my mother’s only alternative will be suicide. The ‘war on the sick’ will continue until we start to reconsider this important question — whose rights are more important? Those of the very sick? Or those of the addicts? It’s clear that politicians have decided that addicts are more important. That’s a shame.

GLK Cambridge 1 day ago
Physical therapy, acupuncture, anti-inflammatories, antidepressants, counseling. Have done it all. So much physical therapy in 2015 that I ran out the allowed number of sessions on my insurance. Counseling, mindfulness? Being mindful of one’s physical and mental state is counterproductive when you’re in constant, chronic, mind-robbing pain. Exercise, diet, all of that, there isn’t anything I haven’t tried. And after five years of being able to function reasonably on a never-increased daily maintenance dose of oxycodone, I gave it up voluntarily, because of the hand-wringing over addiction and misuse, because I felt ashamed filling the prescription; no, it would be more accurate to say that I was made to feel ashamed, by ever more contemptuous glances from the pharmacists, and the increasingly difficult task of finding a pharmacy that stocked the proper generic in the proper dose. So now I suffer, and don’t sleep, and work only by dint of intense, exhausting re-focusing. And I suppose some readers will think that if I was able to stop just like that, the pain couldn’t have been that bad to begin with. No, it’s just that I was raised old-fashioned, and suffering wins out over shame every time. Thank you, government scolds, and thank you, hyperbolic media, for this slow death sentence.

RC is a trusted commenter MN 1 day ago
A few questions for the investigative journalists at the NYT: will wealthy politicians or their relatives, when suffering intractable pain, be restricted to “aspirin and ibuprofen” or only 3-7 days of opioids? Will medical personnel, or injured soldiers, or famous celebrities, also follow the same restrictions? Are we potentially creating a two-tiered system, similar to income inequality, which forces those without “clout” to suffer pain unnecessarily?

https://painkills2.wordpress.com/2015/06/02/no-turning-back/

I’m Tired

http://www.painnewsnetwork.org/stories/2016/3/3/sherris-story-a-final-plea-for-help

“Several documents found inside the location underscored her pain, suffering and suicidal ideations,” reads the coroner’s report. “A check of the decedent’s laptop also contained a pictured document written by the decedent titled ‘Why I Killed Myself’ by Sherri Little.”

http://www.nydailynews.com/new-york/ex-nyc-journalist-sarah-kershaw-planned-life-article-1.2545443

The former New York journalist who was found dead in her home in the Dominican Republic told friends that she planned to end her life, according to reports. Sarah Kershaw, 49, was found with a plastic bag tied over her head and pill bottles beside her…  The writer had been suffering from chronic pain due to occipital neuralgia…

I can feel it

flying away

my will to live

my will to stay

ER Horror Story

https://www.facebook.com/PatientsUnitedForDeaReform

‎Donald Moore‎
December 23 at 9:17pm · Belfast, ME

I recently moved to Maine from Portland, Oregon… I have been in chronic, 24 hour a day pain for almost 15 years…

But the story I’d like to relate today happened to me last week at the St.Joseph Hospital in Bangor, Maine.

When I arrived in Maine about 3 months ago, I had about 6 weeks of pain medication remaining. I thought that, even under the worst conditions, I would be able to find a doctor to take over my treatment. I was mistaken. Because an outright “drug war” declared on Heroin and other forms of opioids declared by Governor LaPage, “opioidphobia” (not my word) has met, or surpassed Islamophobia in popularity. I waited six weeks for an appointment at a pain clinic, and after driving two hours and forking over nearly $400 of my own money, I was informed that it would be my only appointment there, as they had decided to close the practice. It’s a story that is repeating all over the United States: Doctors with hundreds of patients who come to them for the medications they need for legitimate medical conditions are closing down with little or no notice. Even as I sat waiting for my first and last appointment, three different people, coming for their monthly refills, were informed of the closure. One was in shock, one was angry and the third sat on the chair across from me and wept.

I called more pain management clinics. Several of them I spoke with were either not taking anymore patients, while several others made it very clear that they were no longer prescribing narcotic pain medications for chronic pain…PAIN CLINICS! …

So it was that I found myself forced to discontinue the regimen that had kept me a productive member of society for 15 years… As many of you know, the withdrawal symptoms were acute; I spent a better part of six weeks going form the couch to the bed to the chair to the bed in a losing battle to find some position, any position that would give me some relief from the pain. There wasn’t any.

Even though the withdrawal symptoms eventually eased, the pain didn’t. I now suffer from 8/10 to 10/10 pain that has no end. It is entirely life consuming. I can’t sleep, eat or stand long enough to shower. I’ve gone from a person who owned and operated a restaurant for 10 years, spent the last 4 years driving a cab 12 hours a day, and then drove, alone from Oregon to Maine, rented a house and moved myself in. Now I don’t go outside, can’t take care of myself, and literally stood at the bottom of the stairs and peed myself because the pain was so bad I couldn’t get to the top of the stairs.

Finally I could take no more and we drove the hour to St.Joseph Hospital in Bangor to go to the ER. In triage, I told the intake nurse that what I felt like I needed was an emergency neurosurgical consult and an MRI. My last neurosurgeon had instructed me that if I had new or worsening symptoms (the bottom of my left foot seems to have gone numb permanently, and clearly I am having some control problems with my bladder.) I told them I was scared. I told them I didn’t feel like my life was worth living this way and I felt like what I really needed was to be admitted to a hospital until a solution could be found.

I want to be very clear here: AT NO POINT DURING MY VISIT DID I EVER MENTION OR REQUEST ANY KIND OF PAIN MEDICATION, ESPECIALLY OPIOID PAIN MEDICATION. I know better…

For 7 hours, during which time I was not seen by a doctor, a physicians assistant, or a nurse practitioner. After 5 hours, and more repeated requests for a neuro consult and MRI, a nurse appeared and gave me two Tylenol, and two Ibuprofen. A man with 9/10 pain and multiple surgeries on my Lumbar spine was left to writhe on a 2-inch-thick foam pad on top of a hospital gurney, without so much as a interview, physical examination, or even a visit with an M.D…

Continuing to do my best to be “calm and compliant”, I asked again for a neuro consult, an MRI, or to be admitted. Dr. Matthew Duhl, M.D. informed me that I did not meet the criteria for a neruo consult or an emergent MRI. He went on to tell me that there was no way he was going to give me anything substantive for pain and that he believed that I was using a suicide threat “as a bargaining chip to get narcotics” …

Hey, CDC, can you hear us now?

At this point, there are 486 comments on the CDC’s new opioid guidelines. And while I didn’t read every single one, I think it’s extremely important for the voices of pain patients to be heard — which is why I copied and pasted some of the comments (mostly excerpts) here on my blog. Now these comments can be found by a simple Google search, instead of being buried on the CDC website (for however long).

I think it’s also important for patients to know which doctors agree with the CDC (you know, so you can avoid them). (See comments under “Doctor” heading.)

Just like I want my story to be read, other pain patients want the same thing, so please take a little time to read a few of these comments. You can find my story here:

https://painkills2.wordpress.com/2014/11/15/medical-cannabis/

In my overall review of the comments, I’d say that 95% of them are from patients and are against the CDC.  I also noticed that there were a significant number of comments from patients with CPRS, EDS, Arachnoiditis, Interstitial Cystitis, and Fibromyalgia.

I’d also like to mention the defensiveness and fear within all the comments from patients. Many comments include lengthy descriptions of medical conditions, along with adamant protestations of innocence for abusing medications, such as:

“I take my medication exactly as my dr has prescribed it.”

“BUT, I DO NOT ABUSE MY PAIN MEDICATION AND I’M NOT A ADDICT”!!!

I hate to break it to pain patients, but I don’t think that matters to the CDC. See, in this agency’s view, almost EVERY non-cancer pain patient on opioids is taking too high of a dosage. In fact, the CDC believes chronic pain patients shouldn’t be taking opioids at all, so it doesn’t matter if you’re taking your medications as prescribed.

I also noticed that too many commenters posted under “Anonymous,” obviously afraid to use their real names.

Lastly, I noticed that many pain patients are rooting for doctors, saying these decisions are between doctors and patients. Until your doctor abandons you, I suppose you might still have faith in him or her… Yeah, good luck with that.

Because if you believe that the medical industry is on the side of pain patients, I’m afraid you’re in for a rude awakening. If you believe your current doctor will never abandon you, I don’t see how you’ll be prepared for the eventuality. And as a pain patient, if you have to find another doctor for any reason, you’ll be up shit creek (right next to suicide alley).

In fact, many doctors are taking advantage of the opioid war by taking advantage of pain patients — overcharging and other abuses (including sexual abuse) against patients are not reported, but believe me, the medical industry is rife with abuse against patients. Ya’ll be careful out there…

PAIN PATIENTS:

Comment from Anonymous

It is very frustrating to have my orthopedic Dr. be with a group that has passed a policy to not give out pain meds after a certain number of months post surgery, then sends me to a pain clinic who won’t prescribe narcotics either…

Comment from Emily Valtreaux

Why are your “professional panels” made up of people that will greatly benefit by throwing us all in detox I wonder? Why do you cry “hyperalgesia” (apparently the new fear mongerer word favorite) even when an individual is still in pain, just to the point that is tolerable? …

Comment from S S

Announcing this with no notice and over the holiday season keeps the PATIENTS (the citizens who need these medicines) from having any input on the topic…

Comment from Jaymie Reed

One of the biggest problems we face is that the very people who are suffering are the ones that need to speak out but won’t because of fear of reprisal from the DEA. They won’t sign petitions or comment on public forums such as this, because they are afraid that they won’t even be able to fight to get the pain medication they need that it will simply be taken from them completely… The number of heroin deaths are increasing and it isn’t because the chronic pain patient who is being treated for their pain. It is because of the chronic pain patient that is no longer receiving treatment for their pain. They turn to the streets and buy a drug they have no idea how to use and end up overdosing…

Comment from Rebecca

In Colorado they had me try medical marijuana and that also helped but I had to move back to West Virginia and the medical marijuana is not legal here so I haven’t had any real relief in over a year. I need help…

Comment from John Bocchicchio

A colleague of mine who had a similar condition and had been battling out the pain management paradox, I.e. You are treated like a drug seaker until further proven. He dealt with the suspicions, urine tests, and intense scrutiny as he was fighting for his life with the pain that sought to kill him. Unfortunately, the pain won. Faced with disability battles, and struggles obtaining relief from chronic pain that is constantly screaming at you to give up, he took his own life in 2009 rather face another day of pain and frustration. I don’t want to end up being like my colleague…

Comment from Shelley Anderson

Do you know what it’s like to feel split open from the waist down, have red ants dumped on you, and be eaten alive from the inside out…. YEAH… THAT’S HOW I FEEL EVERY SINGLE DAY… and yet – the answer I get from our local clinic is…just go to the ER to get some pain relief. REALLY? For Gods sake – I DESERVE TO LIVE A SOMEWHAT NORMAL LIFE…I feel like a begging junkie every single month when I have to pick up my “piece of paper”….how gross to live like this. It’s just so damn frustrating. Today…I’d be better off dead. What a sad and pathetic way to try and get my point across. So so so sad. No one should have to live like this. No one.

Comment from Kevin Howerton

I have a degree in neuroscience… Likewise “they aren’t terminal” seems like a very poor argument for denying someone treatment that has the potential to drastically improve their quality of life. I’d rather a short and painful life to a long and painful one.

Some of the more “serious” arguments seem to revolve around the idea that opiate use increases exponentially. “Opiates require an infinite increase to quench an ever increasing tolerance”. You’d be surprised but this idea is preposterous. You have a finite number of receptor sites in your brain; your head occupies a finite amount of space … how could you expect an infinite amount of tolerance. Tolerance does increase with chronic opiate use though it is far from infinite. Having to titrate up a patient to a useful therapeutic dose as their treatment and disease progresses is not something physicians have to uniquely do with opiates … rather this is the nature of all drugs…

Comment from Dana Spencer

I will never get better. I will only get worse.

Comment from Anonymous

SHAME ON YOU

Comment from Anonymous

I just notice the comment I submitted 12/20 was not listed. In fact, comments between 12/19-20 were missing. [This was not the only mention of disappearing comments.]

Comment from Lori Mahloch

I am appalled that the CDC thinks that the only people who deserve to be treated humanely are people with Cancer. I have Reflex Sympathetic Dystrophy, This rates the HIGHEST on the McGill pain scale for pain. Yet I am unable to get treatment by physicians because of CDC guidelines. Walking into a doctors office for a first visit and the first words out of a doctors mouth should NOT be we don’t give pills here. Because of the audacity of the CDC many doctors will not see, nor treat anyone who has a chronic pain disease. I have not been able to see a doctor for a year because of these guidelines. I have lost friends to suicide , due to not being able to get pain meds for their pain…

Comment from Rebecca Scarbrough

Do you think regulations that label sick people as drug addicts or dealers helps with the personal anxiety and depression that almost always accompanies chronic pain? Why add to this? I wonder how many lives were lost when a pharmacist stare and judgement was the final straw. Have you ever thought of that? …

Comment from George Gregorich

I no longer respect or trust doctors…

Comment from Rhonda Barth

You all should be ashamed! My husband is 100% service connected disabled Veterans who is being made to suffer in agony now because you have made it to where the VA is taking away his pain medication. He is now bedridden and has no quality of life, he does not want to be here anymore…

Comment from Theresa Schramm

After 32 years of dealing with temporomandibular joint pain and dysfunction, I had both of my jaw joints replaced and all of my remaining natural teeth pulled earlier this year. The TMJ dysfunction has improved, and is still improving as I slowly get used to dentures, but the headaches and myofascial pain have not. The surgeon was very clear in warning me up front that the pain might not improve with this surgery, and he was right. It seems that the 32 years I spent trying to find ways to treat this has left me with incurable scar tissue all around my jaw joints on both sides. This scar tissue affects every move I make with my face, from simple carrying on a conversation all the way up to eating. My mouth will never open as wide as it should, nor will it move from side to side. I experience pain on a daily basis, sometimes in my jaw joint areas and more often all over my head. It hurts to talk on the phone for more than 15 minutes. Singing causes such pain I have almost completely given it up…

Comment from George Gregorich

I can’t wait for the day when I watch the news and see you people being arrested for crimes against humanity. You are just as bad as chronic pain , you don’t know when to quit…

Comment from Richard Osband

Opiates (of one form or another) have been the sovereign analgesics for centuries. The CDC’s efforts to essentially criminalize them when no other really effective alternative to their use exists is simply sadistic. While there are many ways to treat addiction there are no other ways to treat intractable pain. The proposed guidelines seem to make pain management a matter of morality rather than of proper clinical practice…

Comment from Anonymous

I have lived with Severe pain since I was 14 years old. There is no doubt what the cause is behind the pain. I have had 13 brain surgeries since then and 4 spine surgeries. If I did not have access to my daily dose of Morphine, and Hydrocodone I would not be able to get out of bed because of Hydrocephalus, and a spine disorder called Arachnoiditis. Please stop the madness surrounding to restrict access to much needed life-improving medications. Doctors have all said to me, I may not have cancer but its clear from my vital signs, my labwork and scan results I am living in constant severe pain, and need to be treated adequately before it kills me. It’s proven that chronic pain can put a strain on your heart and other vital signs if not treated appropriately patients can die prematurely.I am fearful that the government wants to do is kill off all chronic pain patients rather than helping us have a better quality of life. The pain we are in isn’t psychological.

Comment from Paul Clay

I work in emergency medicine and critical care. Here’s what happened to opiod abusers. They couldn’t get prescription pills easily enough so the abuser went to heroin,which resulted in more overdose deaths in a few months more than i had seen in my 20 yrs. . If your goal was to kill off the abuser and make it more difficult for true needs patients then congratulations you have succeeded…

Comment from barbara williams

I was nave in thinking that when people are in pain that going to a pain clinic would fix everything. Going to the pain clinic did nothing. Tramadol took a bit of the edge off, but ganglion blocks, injections, trial l with spinal chord stimulator did nothing. We then tried alternative methods of chiropractor care acupuncture, calmare scrambler, ozone injections, dry needling and biofeedback to the tune of $10,000…

Comment from Arianne Grand-Gassaway

Relief from pain should not be a crime…

Comment from Angela Farthing

I am a victim of the 2012 Fungal Meningitis outbreak. I was injected with a contaminated vial of methylprednisone acetate to treat sciatic pain. Shortly thereafter I was diagnosed with fungal meningitis, suffered a stroke, a brain aneurysm, an intradural abscess, and ultimately adhesive arachnoidits. The arachnoiditis left me in horrific pain, pain that literally made me wish I never survived the meningitis (which I almost didn’t). When I initially told my doctors about the pain that left me crying on the floor, my plea for pain relief began…  I now take Low Dose Naltrexone and am completely opioid and synthetic opioid free…

https://edsinfo.wordpress.com/2015/12/22/one-pitfall-of-chronic-oral-low-dose-naltrexone/

DOCTORS:

Comment from Stephen Pew, Ph.D.

My own Mother ended her own life by starving herself because her chronic pain was mismanaged and the doctor would not allow her IV morphine to be administered even in the hospital because “she might get addicted”… I myself ended up in the emergency room with a kidney stone. I was shuffled around for over two hours in terrible pain because the ER was hesitant to administer care for pain. After an hour I was finally given an IV for pain and it was explained to me by the doctor that new regulations limited their ability to treat efficiently. No follow up opioid medication for pain was allowed…

Comment from Elayne Baumgart, Ph.D.

It would be one thing to remove opiates if you had something with which to replace them. Something that would effectively manage pain. But, you don’t…

Comment from Kathryn Rosenberg

I am a Family Physician with 33 years experience in the field. I began to see a pain specialist for back pain about 3 years ago mainly to prevent any questions about my use of opiates. Since then I have started Lyrica and ymbalta for pain control. I have found Tylenol to be of little use… I simply do not see how I could go on living if opiates were not available to me.

Comment from Paul McCurry

As an anesthesiologist, pain physician and addictionologist [made-up term], I applaud the CDC’s efforts to assist in curbing the current opioid addiction epidemic our country is experiencing… All of these adverse consequences are due to continued prescribing of drugs that have NO LONG TERM PROVEN EFFICACY…

Comment from Nathan Hitzeman

These recommendations look reasonable… As a primary care doc losing the war on chronic pain, I applaud the CDC for coming up with these guidelines!

Comment from Blaise Vitale

I am a family physician who regularly sees that chronic narcotics are simply ineffective for chronic pain. I know there are a lot of people who are addicted who think their lives will be ruined by stopping narcotics, but they simply can’t see how the narcotics are harming them. These guidelines may not go far enough to discourage opioids for chronic non-cancer pain. In particular, any patient who has any history of addiction to substances like tobacco or alcohol should never be prescribed these medications chronically. [This is what discrimination looks like.]

Comment from Adrian Bartoli

As a physician specializing in chronic pain management for the past 20 years, double board certified in Anesthesiology and Pain Management, involved in clinical research and the pharmaceutical industry, I strongly and unequivocally SUPPORT the CDC recommended guidelines for restrictions on opioid prescriptions…

Comment from Dr. Edwin Cabassa, DNP, FNP, BC

Unfortunately, there is a significant abuse for opiods in all socio-economic communities. Doctors and Nurse practioners are a major source for those seeking illegal use of such asnd ssimilar substances. My experience is such I will not prescribe opioids unless there is a definitive diagnosis indicating its use. From my panel of patients, I’ve been able to isolate my patients to just 3 who require opiods…

Comment from Maryn Sloane

As an MD board certified in addiction medicine with a sub specialty in the hopefully growing field of effectively treating opiate dependent chronic pain pts… [Someone is seeing lots of dollar signs…]

2. ANYONE on an opiate >30 days will develop opioid induced hyperalgesia… [Liar, liar, pants on fire.]

Opiates ARE NOT INDICATED EVER for neuropathic pain. They WORSEN IT. [Maybe in some patients, but not all.]

Man up docs! – JUST SAY NO!

it takes the simple writing of a prescription to create a substance dependent patient… [Speak for yourself, not everyone else.]

Chronic opiate users should be registered

detoxes should be offered for any pt on opiates for >1y

SUBOXONE MUST BE STANDARD OF CARE

Comment from Richard Webb, MD, Addiction Psychiatry

The use of opiates should be used with extreme caution in anyone with a personal or family history of addiction. [How many Americans don’t have a personal or family history of addiction?]

Comment from Maxwell Stepanuk

I am an orthopedic surgeon and the abuse of opioids is appalling… The problem, as I see it, is with the GPs. [Doctors turning against each other?]

Comment from Barry Saver

As a family physician who has spent my career working in the health care… I would say I have seen some patients genuinely helped by chronic opioid therapy for pain – but far more harm, including addiction, overdose, and diversion… Based on conversations with colleagues, at least 99% would happily accept a time limitation for how long they could prescribe opioids to an individual patient (with exceptions for oncology and palliative care)…

Too bad there aren’t many doctors who commented that still believe in medical science. (Still think doctors are on your side?)

Maybe you’re wondering if I made a comment? No, and I’m not sure I will. However, considering I am currently without bud and in a really bad mood, I might just change my mind. And since I don’t see a rule about how many comments one person can make, I’m sure I could wrangle some fun out of the experience. 🙂

Note:  Comments are due by January 13, 2016.

Thinking of you, Jane Disbrey

http://www.pharmaciststeve.com/?p=12864

THE former headteacher of Havelock School was suffering from chronic pain in her face when she jumped off the Humber Bridge…

http://www.hulldailymail.co.uk/Torment-Malet-Lambert-headteacher-Jane-Disbrey/story-28348390-detail/story.html

Mrs Disbrey’s husband Stephen told an inquest into her death she had suffered severe facial pain since August, last year. He said: “She suffered long periods of pain, sometimes up to 14 hours at a time.

“All she wanted was someone to give her a tablet to make the pain go away.”

Mrs Disbrey had been diagnosed with atypical facial pain, for which she had been prescribed gabapentin and carbamazepine.”  Jane always wanted an instant solution to the pain that she was in, but it was explained to her that it was a very difficult illness to treat,” said Mr Disbrey.”

She had told herself she would never get better.” …

Mr Disbrey said his wife had stopped taking the medication, which she was intolerant to, and had been about to try another type of drug to combat her pain.

Mrs Disbrey’s GP, Dr Richard Taylor, based at Willerby Surgery, said in a statement she attended with severe pain on the left side of her face. She told him the pain had coincided with dental treatment…

During another appointment on June 29, Mrs Disbrey was “tearful and upset” and said gabapentin had left her feeling “foggy” and experiencing severe nightmares.

Victoria Bell, a specialist liaison practitioner, told how Mrs Disbrey “became tearful and distressed” as she disclosed the impact of the death of a student, who had taken their own life.

Ms Disbrey’s pain was so severe she spent a week in to Hull Royal Infirmary in July.

Professor Paul Marks, senior coroner for Hull and the EastRiding, recorded a narrative conclusion, saying: “Jane Disbrey developed atypical facial pain in 2014, which was compounded by high levels of anxiety. Her pain was refractory to pharmacological treatment.

“She did not express any suicidal ideation on the last day of her life, but was seen to jump from the Humber Bridge on the 4th of August, 2015 after 6pm, and died instantaneously from multiple injuries sustained as a result of the fall.”

Lawsuit claiming DEA paid New Mexico man in crack tossed

http://krqe.com/2015/09/30/lawsuit-claiming-dea-paid-new-mexico-man-in-crack-tossed/

ALBUQUERQUE (AP) — A federal judge has dismissed a lawsuit filed by a New Mexico man who says federal agents wrongfully supplied him with crack cocaine, reigniting his addiction to the drug.

U.S. District Judge Martha Vazquez dismissed the lawsuit Wednesday and said the law doesn’t allow for damages when a person’s own wrongful conduct is the cause of injury.

Aaron Romero says he was unknowingly targeted during an undercover investigation because he was a struggling addict and did not know he was helping agents break up a Las Vegas, New Mexico, drug operation…

Heroin, Murder, and the New Front in the War on Drugs

https://www.vice.com/read/heroin-murder-and-the-new-front-in-the-war-on-drugs-928

Sean Harrington has been in jail for more than 16 months. He was extradited from Philadelphia to Polk County, North Carolina, to face a second-degree murder charge. But he didn’t shoot or stab anyone. Instead, he allegedly mailed heroin and cocaine to a friend and fellow addict named Elisif Bruun. She ingested them, probably as a speedball, and was found dead on February 11, 2014, lying face-down in her room at the CooperRiis Healing Community in Western North Carolina.

She was 24, her latest go at recovery her last…

It can be tough to find a true villain among the legions using and selling opioids, two groups that often overlap. This is especially true given that for many, heroin use was preceded by the abuse of widely-prescribed opioids like OxyContin, which as of 2013, was responsible for more deaths than heroin. That includes Bruun who, according to her father, got started on opioids thanks to a friend selling OxyContin taken from his grandmother’s medicine cabinet…

In September 2013, Joseph L. Robinson, an Illinois man living near near St. Louis, was sentenced to 20 years in federal prison for selling a man who later died two-tenths of a gram of heroin—for $30…

In February 2014, beloved actor Philip Seymour Hoffman became the public face of the heroin crisis after he died from an overdose involving heroin, cocaine, amphetamines, and benzodiazepines. The New York Police Department was eager to find a culprit other than the actor’s long-term addiction, and quickly settled on Robert Aaron—legal name Robert Aaron Vineberg—a musician and addict who said he sometimes sold heroin to friends. But it was never proved that Aaron’s heroin was involved in Hoffman’s death, and charges were later downgraded from serious distribution to possession, to which he pleaded guilty…

Federal prosecutors in states around the country, including Oregon, Texas, Pennsylvania, and West Virginia, are filing these kinds of charges in response to opioid deaths. In Southern Illinois, Porter says that their office began to file such charges after Wigginton’s 2010 appointment, and that he has so far won 11 convictions. In July, a federal judge in Kentucky sentenced a man to life without parole for dealing oxycodone to a user who died; that district’s US Attorney’s Office said it was “the first time in Kentucky that a life sentence was imposed in an overdose death case involving prescription drugs.” (There is no parole in the federal system for crimes committed on or after November 1, 1987.) …

State prosecutors also appear to be pursuing harsh charges with growing frequency. In Wisconsin, prosecutors charged 71 people with first-degree reckless homicide by drug delivery in 2013, an increase from 47 in 2012, according to USA Today.

In New Jersey, Ocean County Prosecutor Joseph Coronato has made these sorts of charges a focus, and his office is training police around the state on how to investigate heroin-related deaths…

Thinking of you, Martin Szczupak

http://www.reuters.com/article/2015/09/02/us-usa-rehab-phoenixhouse-specialreport-idUSKCN0R21PY20150902

(9/2/2015) Special Report: Renowned U.S. drug-rehab program spun out of control

Martin Szczupak had already been in and out of rehab when, for a misdemeanor possession charge, a judge sent the 21-year-old heroin addict to a century-old estate in the wooded hills of upstate New York for another chance to clean up…

By December 2012, he had given up on the treatment program. He felt he would be stuck going from “dead end job and rehab and jail until I eventually drop dead,” he wrote in a letter to his fiancée. “You deserve better than that.” He didn’t want to use drugs anymore, he wrote, “but realistically the odds are against me.”

Szczupak never sent the letter. Three weeks later, he walked out of Belle Terre without permission. One day after that, police visited Szczupak’s mother, Inez, at her Staten Island home to tell her that her son had been found dead from a drug overdose…

In 2012, the U.S. criminal justice system sent 580,000 people to drug treatment…

At Belle Terre, criminal-justice referrals account for the majority of residents. The facility is run by Phoenix Houses of New York, whose parent foundation is one of the nation’s largest drug treatment nonprofits, operating in 10 states and the District of Columbia. In the year ended June 20, 2014, the Phoenix House Foundation and its affiliates reported operating revenue of $141 million.

Phoenix Houses of New York is 95 percent publicly funded and enjoys star-studded endorsements. Beyonce donated a cosmetology center at a Brooklyn facility. Financier Pete Peterson chaired a summer fundraiser in 2013 in the posh Hamptons on New York’s Long Island…

The closures that preceded Szczupak’s arrival weren’t the last. And nor is Belle Terre an anomaly. In November last year, OASAS suspended admissions to Belle Terre and four other Phoenix Houses of New York facilities. In a letter to Phoenix House’s then-chief executive in November 2014, OASAS said Phoenix House had “persistent regulatory violations and resident/patient care concerns dating back several years.”

An OASAS site report on the five facilities went into graphic detail. The regulator’s findings at some or all of the facilities included use of marijuana, cocaine, heroin and other illegal drugs; sexual activity among residents; reports of violence and sexual assault; insufficient, inadequately trained or abusive staff; dirty premises; and lax security, with residents coming and going as they wished…

In November 2014, regulators again suspended admissions at Belle Terre, as well as four other Phoenix House facilities. State regulators noted high staff turnover and need for improved clinical practices at Belle Terre. They also warned the facility to let clients speak to their attorneys without staff present.

OASAS let Belle Terre reopen in January 2015. Three of the other centers were reopened with limited admissions in late 2014 and early 2015. The Shrub Oak teen residential treatment facility was closed permanently in June 2015.

In March, OASAS inspected Belle Terre again, prompted by unspecified complaints against director Alan Hargrove, OASAS reported. Phoenix House then fired Hargrove, based on OASAS’s feedback.

Hargrove declined to comment.

Phoenix House announced on Aug. 19 it would be closing Belle Terre and the 185th Street facility…

Perhaps Mr. Kolodny should attend to his own affairs, instead of fighting the war against pain patients.

Thinking of you, Michael James Tyree

http://www.huffingtonpost.com/entry/jail-deputies-arrested-for-allegedly-beating-mentally-ill-inmate-to-death_55e8dacce4b002d5c07597b3

Police in Santa Clara, California, arrested three corrections deputies on Thursday and accused them of beating to death a mentally ill inmate last week in a cell at the county jail, officials said.

Santa Clara County Sheriff Laurie Smith said corrections deputies Matthew Farris, Jereh Lubrin and Rafael Rodriguez faced murder charges in the killing of 31-year-old Michael James Tyree…

Smith said Tyree was in a protective custody wing of the Santa Clara County main jail on the night of Aug. 26, after his arrest on misdemeanor drug possession and theft charges.

The three deputies were conducting a clothing search on the wing before entering Tyree’s single-person cell, Smith said. She added that no one else had any contact with Tyree before Lubrin came back to discover his naked body, which was covered in feces and vomit, about an hour later during a welfare check.

County medical examiner-coroner Joseph O’Hara told the news conference that Tyree died of internal bleeding from multiple blunt force injuries…

Family attorney Paula Canny told reporters that Tyree suffered from mental illness and was being housed in the jail because space at a mental health facility was not available…

Thinking of you, Zachary Hammond

A Cop Killed A White Teen And The #AllLivesMatter Crowd Said Nothing

http://www.huffingtonpost.com/entry/zachary-hammond-police-killing_55c0e240e4b0c9fdc75dfda3?cps=gravity_2246_809321444327820864&kvcommref=mostpopular

On the evening of July 26, Zachary Hammond pulled into the parking lot of a Hardee’s in Seneca, South Carolina. Seated next to him was a young woman who had arranged to meet someone there to sell a bag of weed. It’s unclear what Hammond knew about the transaction, but neither the 19-year-old nor his passenger had any idea that the buyer was actually an undercover police officer. Moments later, another officer fatally shot Hammond…

(Photo taken 7/14/2015.)

Thinking of you, Amelia and Hardy Leighton

http://www.rcinet.ca/en/2015/07/30/couple-dies-opioid-drug-use-increasing/

Photo caption:  North Vancouver couple Amelia and Hardy Leighton were found dead after inhaling a street drug laced with fentanyl.

A coroner has confirmed that a couple in the province of British Columbia died July 20th after ingesting toxic levels of fentanyl, a synthetic opioid painkiller 50 to 100 times more powerful than morphine. This comes at a time when researchers have found recreational drug users are switching to alternative opioids after the much-abused prescription drug, oxycodone was changed to make it more difficult to tamper with.

The drug’s manufacturer changed the formulation of the drug in 2010 to one that could not be crushed for snorting or injecting. Shortly afterwards, the province of Ontario began to monitor doctors’ prescription patterns for narcotics.

That and media reports about the abuse of oxycodone and overdose deaths prompted Ontario doctors to reduce the prescriptions they wrote for the drug, according to the study. But there were substantive increases in the prescription of other strong opioids like fentanyl and hydromorphone.

So while the deaths due to oxycodone dropped 30 per cent by the end of 2013, fatal overdoses from all opioids jumped 24 per cent between 2010 and 2013. While Ontario reports the highest opioid abuse, it would be reasonable to suspect the trend was similar in other provinces like British Columbia.

Officials across Canada continue to struggle to try to find ways to stem the illegal and sometimes fatal use of prescription opioids.

Hardy and Amelia Leighton were in their 30s when they were found dead in their suburban home, leaving their two-year-old son an orphan.

The reason drugs wind up in the underground market is because of restrictions placed upon them in the legal market.  If the Leightons had been able to buy their drug of choice at Walgreens, like any adult can buy a bottle of aspirin, they would still be alive.

(Photo taken 6/10/2015.)

Thinking of you, Sandra Bland

http://time.com/3968875/sanda-bland-pulled-over-by-a-cop/

There are still a lot of questions to be answered about the arrest and death of Sandra Bland, who recently died tragically after three days in a Texas jail. A video released by the Texas Department of Public Safety captured a portion of the confrontation between Bland and a police officer after she was pulled over on July 10 for a routine traffic stop. Perhaps most striking is how quickly the situation escalated, leading to the forcible arrest of Bland, and culminating in her untimely demise. It’s also a reminder of how important it is to know your legal rights, and what is and is not permissible when you are pulled over by a police officer.

There’s the law—what is legally permissible for the police officer and the motorist to do. And then there’s the sad reality of how such encounters with the police sometimes play out in practice. Given that reality, there are some things to keep in mind in order to try to prevent the situation from becoming contentious or dangerous…

5. As difficult as it can be, try to remain calm and be as polite as you can. Even if your rights have been violated, you’re not going to argue your way out of the problem. It’s also always a good idea to make sure the police can see your hands, and that you don’t make sudden movements, interfere with what the police are trying to do, or give false statements. In other words, don’t give the police an excuse to mistreat you or pile on additional charges.

Generally, the best advice is to pay close attention to the situation whenever you are interacting with a police officer. If you’ve had a negative experience, or believe that your constitutional rights have been compromised, you should take note of all of the circumstances surrounding the encounter, including the police officer’s name and badge number, and pursue a complaint afterwards.

Jason Williamson is a lawyer with the ACLU.

This is probably good advice for white people.  But I’m sure for many people in black, Hispanic, and poor communities, this advice will not help them.

http://www.texasstandard.org/shows/current/10-things-about-the-sandra-bland-traffic-stop-every-texan-should-know/

Man ‘hogtied’ by Mississippi police dies

http://www.pharmaciststeve.com/?p=11088

(Troy Goode with his son. Photograph: Courtesy the Goode family)

The family of a man who died after being “hogtied” by police in Southaven, Mississippi, say they were threatened with arrest after they requested to visit him in hospital before his death.

Troy Goode, a chemical engineer from Memphis, Tennessee, died on Saturday evening after Southaven police were called to a reported disturbance. Goode was arrested after “acting strange” and resisting officers, according to police. Goode and his wife, Kelli, had attended a rock concert in the city and the 30-year-old father had taken LSD, according to police.

Eyewitness video shows Goode was placed face-down on a stretcher with his arms and legs bound during the arrest, before he was placed in the back of an ambulance. He told officers he was having trouble breathing in this position, according to lawyers for the Goode family. He died in hospital about two hours later…

“Paramedics arrived on scene, and I see them put him in a four-point restraint or hogtie, I don’t know how else to describe it,” McLaughlin told the Clarion-Ledger. “His legs were crossed, pulled back, by my vantage point, his hands were pulled back, and I think affixed to at least one of his legs…

Goode’s is the second death in police custody to occur in Mississippi this month, according to The Counted, an ongoing investigation into officer-involved deaths in the United States. Jonathan Sanders, a 39-year-old unarmed black man, died after reportedly being placed in a 20-minute chokehold by a Stonewall police officer. The medical examiner has provisionally ruled Sanders died of asphyxiation, according to attorneys.

Goode was the father to a 15-month-old son and worked as a plant engineer for nexAir, a local industrial supply company. He was also a local charity volunteer, according a statement from the family’s lawyers…

(7/17/2015) VA must strike better balance in managing veterans’ pain.

http://www.startribune.com/va-must-strike-better-balance-in-managing-veterans-pain/316371311/

The two-part Star Tribune series, which ran Sunday and Monday, documented a different though equally disturbing facet of pain medication mismanagement. The series’ findings suggest that the VA system swung too suddenly in the other direction after the national spotlight on overprescribing. Veterans with a legitimate need for powerful pain medications aren’t getting them or are facing unacceptable delays in getting refills. The VA also appears to have been ill-prepared to help veterans access alternative therapies — such as acupuncture — during pain medication tapering.

The series’ findings merit the same kind of scrutiny that overprescribing did. Veterans should not be imprisoned by pain because doctors are unwilling or unable to prescribe the medications they need…

http://www.startribune.com/cut-off-veterans-struggle-to-live-with-va-s-new-painkiller-policy/311225761/

Part 1

Williams eased the chronic pain with the help of narcotics prescribed for years by the Minneapolis Veterans Medical Center. Then the VA made a stark and sudden shift: Instead of doling out pills to thousands of veterans like him — a policy facing mounting criticism — they began cutting dosages or canceling prescriptions, and, instead, began referring many vets to alternative therapies such as acupuncture and yoga.

At first, the change seemed to work: Worrisome signs of prescription drug addiction among a generation of vets appeared to ebb. But the well-intentioned change in prescription policy has come with a heavy cost. Vets cut off from their meds say they feel abandoned, left to endure crippling pain on their own, or to seek other sources of relief.

Or worse.

On Sept. 20, 2013, police were called to Williams’ Apple Valley home, donated to him by a veterans group grateful for his sacrifice. Williams, 35, lay dead in an upstairs bedroom. He had overdosed on a cocktail of pills obtained from a variety of doctors.

Authorities ruled his death an accident, officially “mixed drug toxicity.” Advocates for veterans and some treatment counselors angrily call it something else: the tragic result of the VA’s failure to provide support and services for vets in the wake of the national move away from prescription pain pills.

At the VA’s Medical Center in Minneapolis, for instance, there is one chiropractor on staff for the more than 90,000 patients it sees a year…

Before alternative therapies can work, Kolodny said, the VA needs to better tend to the addicts it has created…

The Minneapolis VA, which had one of the highest rates of high-dosage prescription pain medications, has embraced the new directive to reduce painkiller use among its patients. It pioneered a program that emphasized education and alternative therapies like yoga, chiropractic treatment and acupuncture. In a three-year period from 2011 to 2014, it reduced the number of veterans on long-term high-dose opioids by 78 percent…

In their published findings, Marshall and his colleagues wrote that there were fewer complaints than expected. “Patients mostly appreciated what we were doing,” said Marshall, who now directs pain management programs at the Minneapolis VA and the VA’s Upper Midwest region. While the paper recommended further research into patient satisfaction, the study surveyed only providers and pharmacists…

Although statistics aren’t available, deaths of vets linked to the VA’s pain policy are showing up in headlines around the country.

Last July, Navy veteran Kevin Keller drove himself to a drugstore parking lot next to a VA community clinic in Wytheville, Va., late at night, walked to the door of the clinic and shot himself in the head.

In recent years Keller had complained that VA doctors were reducing his pain medication. Keller had scribbled a note to a friend. In capital letters it read: “SORRY I BROKE INTO YOUR HOUSE AND TOOK YOUR GUN TO END THE PAIN! FU VA!!! CAN’T TAKE IT ANYMORE.”

In October 2013, Todd Roy, a 45-year-old Persian Gulf veteran, shot himself in the head with a shotgun in friend Charlie Bollman’s garage in Watkins, Minn. In 2008, the VA, citing alcohol and drug abuse, had cut off Roy’s Vicodin for pain in his arm and shoulder…

For more than 40 years, Vietnam vet Peter Ingravallo has suffered back pain after being hit with shrapnel during an ambush. With a 100 percent disability rating, Ingravallo took 25 milligrams of oxycodone every four hours until the Minneapolis VA sent him a letter telling him it was reducing his medications by 70 percent. It also warned that he would lose his benefits if he got meds from somewhere else…

Some vets have been warned that if they don’t take part in educational programs, they won’t get prescriptions. Failure to submit urine samples could result in expulsion from the program.

Vets also complain of being kicked out of programs for failing “pain contracts” they were ordered to sign. The contracts require the vets to agree to submit to urine screenings and to take one of several VA opioid safety classes or risk being denied their medications…

Ryan Trunzo’s descent from promising soldier to drug addict is detailed in more than 500 pages of medical files and Army reports…  Trunzo, who was 19 when he joined the Army, served in Iraq from February to November 2008 and was injured when his convoy was hit by a roadside bomb. He suffered several small fractures in his back and was given some painkillers.

There were other traumas: the death of a close friend, the shooting death of an Iraqi boy and an incident in which he said he was ordered to stand guard while a superior officer sexually assaulted an Iraqi woman…

But, because of a history of addiction during his military service and the change in VA policy, for the pain Trunzo got tablets of nothing stronger than over-the-counter-strength ibuprofen…

http://www.startribune.com/the-new-goal-at-the-va-treating-the-root-causes-of-veterans-pain/311225971/

Part 2

The Minneapolis VA hired its first chiropractor in 2014 and was overwhelmed by the response, with more than 850 visits in less than five months. Because of the demand, 23 veterans have been allowed to make appointments with chiropractors outside the VA. The Minneapolis VA said it hopes to have its second chiropractor in place this summer.

Dr. Carolyn Clancy, then the interim VA undersecretary of health, told a congressional committee in June that the VA is conducting research to identify predictors for veterans who abuse opioids and which veterans might respond best to nonnarcotic treatments…

Pain doctor in Kentucky charged in 5 deaths

http://www.pharmaciststeve.com/?p=10937

Pharmacist Steve says:  Barb saw this particular pain doc for a couple years. I was a lot more impressed by this particular doc’s pt care than the doc that owned the clinic nor the doc that replaced him… shortly afterwards Barb left the clinic’s practice. Dealing with chronic pain pts that are suffering from pain, depression, anxiety and other issues… are at a twice the risk of committing suicide. SOOOO.. 5 pts committed suicide over a several year period.. in this country we have 40,000 commit suicide every year.. IT HAPPENS..

The fraudulent billing is nothing but “fluff charges”… the report is that Jamie was headed off to some sort of conference/seminar/medical convention and was rushing to make sure that all his pts had their needed medication.. and there was some sort of mis-communication to the individual/company that did the billing for the practice. Fraudulent billing practices tend to be more routine and ongoing for more than THREE DAYS.

LOUISVILLE, Ky. — A pain doctor who promises on his website to help patients “return to a life they once knew” has been indicted by a federal grand jury on charges of illegally prescribing medications that resulted in the deaths of five patients.

Dr. Jaime Guerrero, who has offices in Louisville and Jeffersonville, Ind., was charged in a 32-count indictment with causing the deaths by issuing prescriptions for oxycodone, methadone and hydrocodone for no medical purpose from 2009 through 2012.

He faces a maximum sentence of life in prison if convicted…

One of his patients, Lee Bullock, told WAVE-TV then that Guerrero was treating him for degenerative disc disease and that he thought he was a very good doctor. “He monitors all his patients very close,” he told the station. “He does a lot of drug screens, urine tests and pill counts.”