Can your DNA be used against you?

http://www.knowable.com/a/18-black-people-reveal-the-most-overtly-racist-thing-theyve-ever-experienced/p-2

4. Riding in a car with my cousin, some cops pull us over and wants to search the car. We were young and just assumed they could do that…

http://www.propublica.org/article/dna-dragnet-in-some-cities-police-go-from-stop-and-frisk-to-stop-and-spit

Valutsky told them there had been a string of car break-ins recently in the area. Then, after questioning them some more, he made an unexpected demand: He asked which one of them wanted to give him a DNA sample.

After a long pause, Adam, a slight 15-year-old with curly hair and braces, said, “Okay, I guess I’ll do it.” Valutsky showed Adam how to rub a long cotton swab around the inside of his cheek, then gave him a consent form to sign and took his thumbprint. He sealed Adam’s swab in an envelope. Then he let the boys go.

Telling the story later, Adam would say of the officer’s request, “I thought it meant we had to.” …

Private DNA databases have multiplied as testing technology has become more sophisticated and sensitive, enabling labs to generate profiles from so-called “touch” or “trace” DNA consisting of as little as a few skin cells. Automated “Rapid DNA” machines allow police to analyze DNA right at the station in a mere 90 minutes. Some states allow “familial searching” of databases, which can identify people with samples from family members. New software can even create composite mugshots of suspects using DNA to guess at skin and eye color.

Strict rules govern which DNA samples are added to the FBI’s national database, but they don’t apply to the police departments’ private databases, which are subject to no state or federal regulation or oversight…

In 2012, New York became the first state to require DNA collection from those convicted of any crime, not just violent ones, and at least 29 states now authorize collection from anyone arrested for certain crimes…

Blackledge said building a private database also allowed the city to collect more DNA from juveniles…

Since 2007, the District Attorney’s office in Orange County, California, has offered certain non-violent offenders the chance to have their charges dismissed in exchange for contributing cheek swabs to a special separate DNA database — a “spit and acquit” program, as the local media nicknamed it. As of mid-August, according to the DA’s office, over 145,000 people had voluntarily donated their DNA to this database…

Police in Branford, Connecticut, draw a different line in collecting DNA. They’re instructed to request DNA from people they merely observe acting inexplicably or strangely…

West Melbourne police say they’ve collected “abandoned DNA” from chewing gum or cigarette butts left by people who refused to sign consent forms…

Under comments:

bdaly • 3 days ago
Has anyone considered how much medical info your DNA has? Imagine the damage that could be done to you if that info were to fall into the hands of insurance companies or potential employers. It’s not like these databases are unhackable.

http://www.genome.gov/10002328/genetic-discrimination-fact-sheet/

Genetic discrimination occurs if people are treated unfairly because of differences in their DNA that increase their chances of getting a certain disease. For example, a health insurer might refuse to give coverage to a woman who has a DNA difference that raises her odds of getting breast cancer. Employers also could use DNA information to decide whether to hire or fire workers.

The Genetic Information Nondiscrimination Act of 2008, also referred to as GINA, is a new federal law that protects Americans from being treated unfairly because of differences in their DNA that may affect their health. The new law prevents discrimination from health insurers and employers. The President signed the act into federal law on May 21, 2008. The parts of the law relating to health insurers will take effect by May 2009, and those relating to employers will take effect by November 2009.

The law protects people from discrimination by health insurers and employers on the basis of DNA information. The law does not cover life insurance, disability insurance and long-term care insurance.

http://www.yahoo.com/news/pot-breathalyzer-hits-street-115944220.html

American police have for the first time used a marijuana breathalyzer to evaluate impaired drivers, the company behind the pioneering device declared Tuesday, saying it separately confirmed its breath test can detect recent consumption of marijuana-infused food. The two apparent firsts allow Hound Labs to move forward with plans to widely distribute its technology to law enforcement in the first half of next year, says CEO Mike Lynn…

Though breathalyzers are familiar roadside tools, there are other options for officers looking to rapidly test a person for marijuana or other drugs, including increasingly accepted roadside oral fluid tests or — potentially early next year — a futuristic fingerprint-sweat test.

Dr. Paul Yates, a forensic scientist and business development director at U.K.-based Intelligent Fingerprinting, says the sweat-test devices — which can be calibrated to specific thresholds for marijuana and other types of drugs including cocaine and opiates — can indicate drug use in near-term windows…

Duffy Nabors, vice president for sales and marketing at Smartox, says the company has received inquiries from law enforcement departments in California, Colorado and Texas interested in roadside use of the metabolite test, and he expects law enforcement will be among the first American buyers…

The DrugTest 5000 — one of a handful of similar products — indicates if marijuana or other types of drugs are present in a suspect’s saliva. The company counts the New York Police Department, the Nevada Highway Patrol and Oklahoma tribal police among its customers.

Shaffer says the test detects THC in a user’s saliva for roughly 2-6 hours after they consumed the drug, though a heavy user once tested positive 24 hours later. The test only indicates the presence of THC and does not quantify the amount, though like the Intelligent Fingerprinting technology can be calibrated to a specific threshold…

https://painkills2.wordpress.com/2015/05/18/patients-wrongfully-labeled-by-ameritox-drug-tests/

Now, if you’ve read all of the above information, how do you feel about this:

https://www.yahoo.com/news/u-justice-dept-push-prosecutors-opioid-crisis-usa-134410768.html

WASHINGTON (Reuters) – The U.S. Justice Department will enlist federal prosecutors to help fight the nation’s opioid crisis by sharing information on overprescribing doctors and coordinating with public health officials to address addiction, USA Today reported on Friday…

Lynch said sharing information about physicians tied to prescription drug abuse could help authorities better identify drug traffickers and the routes they use, the report said, adding that working with local health officials will help give equal attention to prevention and treatment efforts…

She said the department would issue the new plan next week in a memo to its 94 U.S. attorney offices…

Tell me, how are federal attorneys going to “work” with local health officials in regards to prevention and treatment efforts? What do attorneys and the justice system have to do with addiction and health care? Are the attorneys going to give patients free legal advice?

To me, this little tidbit of information from Attorney General Loretta Lynch has to do with the PDMPs. There’s been a push to connect all state databases into a federal database that’s accessible across state lines. Like the FBI has a national database for DNA. “Coordinating with public health officials” might mean that U.S. attorneys are going to require states (doctors, government employees, pharmacists) to input the information into the PDMPs, making their use mandatory.

What does this mean for chronic and intractable pain patients? Looks like the federal government has taken the criminalization of opioids to the next level. Perhaps the U.S. Attorney’s Office is getting tired of waiting for the DEA to make a difference.

If you have a DNA test, make sure you read the release forms. Don’t sign a form that says the lab can share or sell your DNA information, and make sure you see HIPAA language. I’m not saying these things will protect you, but that’s all we’ve got.

http://www.nationalpainreport.com/genetic-testing-may-provide-faster-path-to-the-right-fibromyalgia-medication-8831433.html

Someday in the not-so-distant future, before your health care provider decides which medication to prescribe for your fibromyalgia symptoms, they might first swab your cheek for a few cells and send them off for genetic tests. The genetic data hidden in those cells might reveal which medications you are likely to get benefit from, and which to avoid due to higher chance of side effects.

It sounds futuristic, but in fact this technology is available now, though it has not been widely adopted by medical providers. Testing for a person’s gene-drug interactions is called “pharmacogenetics,” and is a rapidly expanding field with multiple companies now offering panels of tests targeted to different illnesses…

Privacy is a thing of the past, better get used to it

http://www.bloombergview.com/articles/2016-03-11/there-s-no-crisis-brewing-in-subprime-auto-loans

But default on your car payment, and you can expect to have your car repossessed almost immediately. How is this possible? In a word, technology. The modern repo man uses a number of devices to find, track, disable and reclaim automobiles:

–Subprime loan underwriters often require borrowers to have their cars equipped with a device that allows the lender to remotely disable the ignition. GPS technology in the devices also lets a lender track a cars’ location and movements. Knowing where the vehicle is, and being able to remotely disable it, makes repossession a snap.

–Photographs are taken of “millions of plates a day, with scanners mounted on tow trucks and even on purpose-built camera cars whose sole mission is to drive around and collect plate scans. Each scan is GPS-tagged and stamped with the date and time, feeding a massive data trove to any law-enforcement agency—or government-approved private industry—willing to pay for it” according to Car & Driver magazine. The license-plate acquisition system called Vigilant, adds 100 million photos a month.

–License-plate-readers, or LPRs as they are known, are now commonly found at mall entrances, mounted on utility poles, parking lots, toll plazas, and at major highway entrances. According to the site Consumerist, the database of scanned license plates contains “over a billion sightings of individual cars ready for companies to mine.” One company, MVTRAC, has 8,000 fixed cameras, and many more mobile cameras mounted on vehicles, constantly scanning plates.

–Some repo companies are using drones to track vehicles and repossess cars; they also can track drivers via their own mobile phones…

This isn’t the first sign of the death of our privacy. HIPAA is a joke and our medical records are passed around like after-dinner mints. And it goes without saying that these technologies are easily abused and hacked into — not only by the government, but also by insurance companies and individuals looking to cause personal harm.

I’m sure some people think, well, I have nothing to hide. And if we can catch terrorists, then a loss of privacy isn’t a big deal.

Until these technologies are used to discriminate against you…

Disqualified after concussions, college football players recruited back onto the field

http://www.statnews.com/2016/01/08/concussions-college-football-players/

But where Syracuse officials saw grave risk, other colleges saw opportunity. Coaches from a half-dozen other universities began wooing Long. His case is not unique. College football players with a history of incapacitating concussions are allowed to transfer to colleges that will permit them to play, a STAT investigation has found. This happens even after doctors at one school determine that the risk to a player’s health is so severe that he should be permanently banned from contact sports…

The National Collegiate Athletic Association sets no limits on the number of permissible concussions. There’s no medical consensus on how many concussions pose an intolerable danger to athletes. And colleges, ever on the lookout for talent that will reap their teams wins and ticket sales, decide on their own when, or if, players should be medically disqualified.

In interviews with doctors and college officials, STAT found cases in which some players were permanently sidelined after three or four concussions, while others with as many as 10 concussions were allowed to still play…

Once college athletes are disqualified, they receive little guidance about what to do. Young men like the 19-year-old Long are left on their own to seek additional tests and evaluations by concussion experts — and to choose whether pursuing their dream of playing college football is worth jeopardizing their health…

Psychology Practice Revealed Patients’ Mental Disorders in Debt Lawsuits

https://www.propublica.org/article/new-jersey-psychology-practice-patients-mental-disorders-lawsuits-debts

The greatest fear of many patients receiving therapy services is that somehow the details of their private struggles will be revealed publicly…

Short Hills Associates in Clinical Psychology, the group based in New Jersey that treated Philip, has filed dozens of collections lawsuits against patients and included in them their names, diagnoses and listings of their treatments.

In cases in which the patients were minors, the practice sued their parents and included the children’s names and diagnoses.

The Health Insurance Portability and Accountability Act, the federal patient privacy law known as HIPAA, allows health providers to sue patients over unpaid debts, but requires that they disclose only the minimum information necessary to pursue them.

Still, the law has many loopholes, which ProPublica has been exploring in a series of articles this year. One is that HIPAA covers only providers who submit data electronically — and apparently Short Hills Associates does not…

The FDA’s response re: annual limit on decongestants

https://painkills2.wordpress.com/2015/11/19/fucked-by-the-dea-once-again/

Mon, Nov 23, 2015 12:11 am
RE: Annual limit on decongestants
From: DRUGINFO@fda.hhs.govhide details
To: painkills2@aol.com

Dear Johnna Stahl,

Thank you for writing the Division of Drug Information, in the FDA’s Center for Drug Evaluation and Research (CDER), regarding the legal limit for pseudoephedrine-containing products.

As you may already be aware, the sale of products containing pseudoephedrine is subject to limitation under the Combat Methamphetamine Epidemic Act of 2005 (CMEA). This Act was passed to control the distribution and sale of drug products that may be used to illicitly produce methamphetamine.

These legal requirements restrict over-the-counter sales of products containing ephedrine, pseudoephedrine, and phenylpropanolamine (PPA) and are enforced by the Drug Enforcement Administration (DEA), not the FDA. For further information regarding CMEA, please visit http://www.deadiversion.usdoj.gov/meth/index.html. For information on registration, enforcement, and policy, please visit DEA’s website at http://www.dea.gov.

The law limits the amount of pseudoephedrine that may be purchased per transaction and per month; no more than 9 grams of pseudoephedrine per month, and no more than 3.6 grams per transaction may be purchased. The table below describes how much pseudoephedrine may be purchased based upon the strength of the drug.

The CMEA, as well as numerous state and local laws, require retailers of products containing pseudoephedrine and ephedrine to capture customer data at the point of sale. In order to help track the purchases of pseudoephedrine, most states utilizes the National Precursor Log Exchange (NPLEx). NPLEx offers a real-time electronic tracking service, free of charge, to law enforcement and state governments. Please be advised that only pharmacies and law enforcement have access to NPLEx. During the application process for access to the system, the registrant is asked to provide verification of either pharmacy or law enforcement status.

The pharmacy scans a government identification or enters the data into the secure MethCheck portal. The information is transmitted instantly to the database where it is available for review by law enforcement. The NPLEx tool, MethCheck, is entirely web-based, with no servers, software, or hardware. The data is housed at the Appriss data center, subject to annual FBI audit, and under tight security policies that include independent security testing and HIPAA compliance. Appriss is also the disaster recovery site for the National Law Enforcement Recovery System (NLETS).

I assume this database is run by the DEA, through state and local law enforcement?

FDA does not have or maintain a database of purchase history. However, you may use the NPLEx website (via https://www.nplexanswers.com/NPLExAnswers/content/startForm.go) to get a summary of the purchase history tied to your identification. You will need to enter the transaction ID from the denied sale and your last name. Please be advised that the FDA does not endorse any of the information contained on non-government websites.

Why would there be a transaction ID from the denied sale? Was the Walmart pharmacy employee supposed to give me a receipt that said I was denied?

Please note that some states do not participate in the above NPLEX system. Please contact your state Board of Pharmacy to determine if they participate in the NPLEX system or for assistance with your purchase denial if your state does not participate in the NPLEX system. Please be aware that some states already have regulations controlling the sale of products containing these ingredients. In instances in which state and federal guidelines conflict, stores are to follow the more stringent of the two. To learn your state requirements, please contact your state board of pharmacy, available through the National Association of Boards of Pharmacy at http://www.nabp.net/.

I can’t find specific information on decongestants on the NABP website, and I’m still waiting to hear back from the New Mexico Board of Pharmacy. (Actually, I’m not really waiting, as I don’t think I’ll ever hear from them again.)

https://painkills2.wordpress.com/2015/11/23/email-responses-to-alleged-annual-limit-on-decongestants/

Lastly, although the Combat Methamphetamine Epidemic Act of 2005 (CMEA) restricts the over-the-counter (OTC) sales of products containing pseudoephedrine, your physician can still write a prescription for pseudoephedrine that will allow you to obtain greater amounts than the maximum OTC amounts allowed by the CMEA. The pharmacist would enter the prescription into the computer as if it were a prescription drug (meeting the regulation for logging/signing a record book), and the product would be purchased at the register, like paying for any prescription medication. Please note that this action would fall under the practice of medicine and is not regulated by the DEA or FDA.

Sure, pay for a doctor appointment and a prescription. Perhaps you can understand why I choose to just pay for over-the-counter allergy medicine? Of course, with all these regulations, Claritin-D is not really an OTC medicine anymore, is it?

Best regards,

KDe
Division of Drug Information
Center for Drug Evaluation and Research
Food and Drug Administration

For up-to-date drug information, follow the FDA’s Division of Drug Information on Twitter: http://twitter.com/fda_drug_info

This communication is consistent with 21 CFR 10.85(k) and constitutes an informal communication that represents our best judgment at this time but does not constitute an advisory opinion, does not necessarily represent the formal position of the FDA, and does not bind or otherwise obligate or commit the agency to the views expressed.

Who would have thought that it would be this hard to buy allergy medicine? And when the beginning of the year rolls around, will I cave in and buy more Claritin-D?  (Achoooooooo!)

Rights for pain patients in New Mexico

http://www.painpolicy.wisc.edu/database-statutes-regulations-other-policies-pain-management

Database of Statutes, Regulations, & Other Policies for Pain Management

Click to access Pain%20Relief%20Act.pdf

New Mexico Pain Relief Act

D. “chronic pain” means pain that persists after reasonable medical efforts have been made to relieve the pain or its cause and that continues, either continuously or episodically, for longer than three consecutive months. “Chronic pain” does not include pain associated with a terminal condition or with a progressive disease that, in the normal course of progression, may reasonably be expected to result in a terminal condition;

Click to access PtRights%20FINAL_English.pdf

As a recipient of Federal financial assistance, the University of New Mexico Hospitals does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, or national origin, or on the basis of disabiilty or age in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by the University of New Mexico Hospitals directly or through a contractor or any other entity which the University of New Mexico Hospitals arranges to carry out its programs and activities.

You Have the Right to Be Treated in These Ways

– Have your pain assessed, and treated.

Click to access pel_00182934.pdf

To not be excluded, denied benefits, or otherwise discriminated against on the basis of race, color, national origin, disability, religion, cultural beliefs, gender, sexual orientation, marital status or age, in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by Presbyterian Healthcare Services directly or through a contractor or any other entity with which Presbyterian Healthcare Services arranges to carry out its programs and activities.

To receive information about pain management, when applicable, and to have your pain recognized and managed as effectively as possible;

Click to access Patient_Bill_of_Rights.pdf

New Mexico Department of Health, Client/Patient Bill of Rights

Right to receive care without discrimination as to your race, creed, sex, sexual orientation, religion, age, disability, country of origin, or source of payment.

Derechos de los pacientes/client, Departamento de Salud de Nuevo M

El derecho a recibir cuidados sin discriminar su raza, credo, sexo, orientación sexual, religión, edad, discapacidad, país de origen o fuente de pago.

http://www.rld.state.nm.us/uploads/FileLinks/

bde0e0d28ef545cba3d8cd277c39749d/Patient_s_bill_of_rights_2_23_2010.pdf

New Mexico Board of Pharmacy, Pharmacy Patient’s Bill of Rights

9. The patient has the right to file a complaint with the New Mexico State Board of
Pharmacy.

Click to access Mental-Health-Legal-Rights-of-Adults-in-New-Mexico.pdf

When you receive mental health services on an in-patient or out-patient basis, you have the same rights under the United States Constitution as any other citizen. In additional to your constitutional rights, New Mexico law guarantees the rights described in this booklet. Some of these rights can be limited or taken away, but only when it is believed to be in the interests of effective treatment. Due process of law must be followed before any of your rights can be limited, unless there is a clear emergency.

Throughout this booklet we have attempted to explain what your rights are in New Mexico, which rights can be limited or taken away, and the procedures that must be followed by those who wish to limit or take away a right because they believe it is in your best interests. It is our hope that this information will provide you with the knowledge you need to protect your rights, preserve your dignity, and advocate on your own behalf…

https://www.facebook.com/aclunm/

IT’S HERE! Turn your smartphone into a powerful tool for police [or doctor and pharmacist] accountability by downloading the free ACLU Mobile Justice NM app today!

#LetDoctorsBeDoctors

http://www.pharmaciststeve.com/?p=12255

Pharmacist Steve brings us a link to a very cool video about electronic health records (EHRs), created by:

Rapper and internist “ZDoggMD”, aka Zubin Damania, M.D., is looking to shake up health care. During his 10-year career as a hospitalist at Stanford and close to burnout, Zubin turned to stand-up comedy and rap to voice his concerns and frustrations about our dysfunctional health system…

Dr. Damania is the Director of Healthcare Development for Downtown Project Las Vegas, an urban revitalization movement spearheaded by Zappos.com CEO Tony Hsieh, where he’s currently developing an innovative model of health care delivery that promotes wellness at both the individual and community level. He recently founded Turntable Health, a primary care clinic within Las Vegas—which he describes as “a revolution in medicine.”

http://www.letdoctorsbedoctors.com/

The video is part rap, with a mixture of lyrics sung to Empire State of Mind (New York). If you’ve never heard Alicia Keys sing this song, you should stop what you’re doing, right this very second, and click on this link:

https://painkills2.wordpress.com/2014/12/21/alicia-keys-empire-state-of-mind-solo/

Be prepared for goosebumps. 🙂

The Real Cost of Tennessee’s New Pain Management Laws

http://www.dailykos.com/story/2015/01/19/1357066/-The-Real-Cost-of-Tennessee-s-New-Pain-Management-Laws

My first shock was when I discovered that it was illegal for a pharmacy in Tennessee to fill a prescription for pain medication which had been written in another state. I mailed them back to my pharmacy in Colorado who filled it for me without question, and then mailed them to me. This gave me thirty days to find a doctor here.

Both of the first two pain management clinics, that I got appointments with, closed after raids by the DEA. The third clinic I tried, refused to write me the medications that I had been on. They wanted to switch me to the extended release form, which runs about 10 times what the instant release tablets cost. I explained that I was on Medicare, which allows me about 2900$ to spend on drugs yearly. What they wanted me to take would have used my benifit in less than three months. I explained, and was told that my financial problems wern’t their problem. They told me to go check into drug rehab. How, exactly, is that going to treat my pain? For that, Medicare paid for a new patient intake, and I paid a 45$ copay. What a total waste of time and money…

I finally found a clinic which writes the medications that I need. They do not accept any type of insurance. I pay them 250$ cash each month. I have been going there for three years now. I am drug tested every month, and I have to pay 50$ a month for it. That is my food budget for two weeks which is just gone. I would love to find a clinic that takes my Medicare. If I go to another pain clinic, even if all I do is check them out, I can be dismissed from my current clinic. I can’t risk that.

If I were to lose my clinic for any reason, they would blackball me in TN, making it almost impossible to find treatment elsewhere…

I used to be allowed to fill three months of all my scripts. That saved me a significant amount of money. The pain clinics in Chattanooga require that you see the doctor once a month. For a long term pain management client like me, that is not needed. I have been on my same regime for over 5 years now. It is the law in Tenneessee. It is designed to bilk me of my money, and give it to someone who already has plenty of cash…

My clinic has cameras and listening devices everywhere. I am certain that the DEA can listen and watch us by taping into that feed. They routinely stand by the entrance and take photos of people going in. They claim that they are searching for fugitives. I don’t believe their lame story. My picture has been taken a few times. I always ask politely if they would like to have my address, so they can send me a copy.

My Medicare Advantage plan took medications that were once Teir 1 and raised them to Teir 3 and 4. My cost went from 8$ per script to 45$ per scrip. That increase alone would feed us for a week…

I have had to muddle through being stopped, and searched, without my consent, by a policeman at a routine traffic stop. I was the passenger. When he asked me for ID, I told him that he has no probable cause to ask me anything. That pissed him off. He searched the car, then he searched us. Then he searched my handbag and found my prescriptions. He accused me of being a drug dealer. I was taken in, for questioning. The first words out of my mouth were, “I wish to assert my legal right to have my lawyer, please.” I used my one phone call to call our lawyer. He had me released within 10 minutes.

I am fed up with being treated like a junkie because I need pain medication to function. Do you know that untreated pain kills? It kills the inner organs. They fail in a sort of cascade. Once the process begins, it can’t be stopped. An ER doctor told me that bit of information…

Texas: Med Board lets DEA sneak peeks at patient records

http://www.pharmaciststeve.com/?p=11625

The Drug Enforcement Administration has been sifting through hundreds of supposedly private medical files, looking for Texas doctors and patients to prosecute without the use of warrants.
Instead, the agents are tricking doctors and nurses into thinking they’re with the Texas Medical Board. When that doesn’t work, they’re sending doctors subpoenas demanding medical records without court approval. The DEA can’t even count how many times it has resorted to the practice nationwide. A spokesman estimated it was in the thousands…

In Texas, the DEA’s criminal investigators do an end run around the Constitution’s warrant requirements by getting the Texas Medical Board to order doctors to open their records…

The problem is this: The medical board has authority to issue “administrative subpoenas,” as they’re called, because it’s in the business of administering the medical industry. The DEA isn’t. It’s in the business of criminal investigations, which can be hindered by the Fourth Amendment.

The entire apparatus of administrative law is something of a shadow government grafted onto a constitutional system back in the New Deal era, and this shadow government has few safeguards. Rather than checks and balances, the regulatory state is characterized by agencies that handle all the investigation, prosecution, adjudication and appeals in-house, with little interference from other bodies…

UNM Project ECHO bites the dust

http://www.pharmaciststeve.com/?p=11648

Just six weeks after New Mexico announced that the overdose death rate had unexpectedly climbed, the state received a federal grant to target opioid overdoses with big data, better monitoring and more education. The New Mexico Department of Health said it received an $850,000-a-year grant for the next four years to enhance prescription drug overdose prevention. If renewed each year, the grant would provide $3.4 million for five more staffers working on overdose prevention initiatives.

“This funding allows the New Mexico Department of Health to develop new partnerships with the Board of Pharmacy and the Workers Compensation Administration. It will increase our capacity to reach communities with a high overdose burden,” Health Secretary Retta Ward said in a statement.

After two years of decline, the number of people in New Mexico who died from a drug overdose in 2014 hit 536, a jump of 20 percent over 2013. Officials say 265 of those deaths were the result of prescription opioids. The statewide rate of 26.4 overdose deaths per 100,000 population stands at one of the worst in the United States, along with West Virginia and Kentucky.

A major focus of the grant will be to better coordinate a Board of Pharmacy registry that is to be used by medical professionals who prescribe pain medication — an online tool called the Prescription Monitoring Program. The information is meant to help monitor patients who misuse pain prescriptions by shopping for several different providers around the state to write scripts.

But because there are seven medical occupations that can prescribe — from medical doctors to dentists — there are inconsistencies in how the database is used, as each reports to a different regulatory board where enforcement varies.

“Sometimes people get introduced to opioids in different ways. They’ll get injured and go see a medical provider and they’ll prescribe opioids. In cases, that person can then get addicted and overdose can result,” said Dr. Michael Landen, an epidemiologist with the state Health Department. “This whole pathway starts with that initial prescription and ensuring that prescription is appropriate is important.”

The grant will not only allow the state to capture more data from prescription writers, but also to deploy caseworkers into areas where they see “prescription hot spots” for drugs such as oxycodone, fentanyl, methadone, hydrocodone and buprenorphine.

“We’ll be able to use the data to work with individual doctor’s offices to improve prescribing in those offices,” Landen said.

Between 2001 and 2011, for instance, oxycodone sales in the state tripled, according to the Health Department.

Another emphasis for how the money is used will be to coordinate education efforts with the state Workers Compensation Administration, which has data on prescriptions for workers who were injured on the job — such as those with back ailments from heavy machine work or long-distance driving.

Landen said Washington state had success reducing overdoses in this population, which might come from a background where they haven’t seen addiction and don’t recognize it.

“We’d be able to analyze the data and make decisions on how to improve prescribing through their program,” he said.

Which means they will be seeking out any doctors prescribing over the maximum morphine-equivalent level and “educating” them about reducing dosages (and abandoning patients).

Some states, for instance, have looked at a “lock in” requirement, in which workers filling pain prescriptions have to use one medical provider and one pharmacy to better monitor usage.

Now only used in Medicaid, but soon coming to Medicare.

New Mexico is one of 16 states that successfully competed for the four-year grant from the U.S. Centers for Disease Control and Prevention. The grant is from a new program called Prescription Drug Overdose: Prevention for States that helps states address the ongoing prescription drug overdose epidemic.

How did the state successfully complete the grant if the programs didn’t work?

The Health Department also will collaborate with the Human Services Department to increase public awareness of potential harm from prescription opioid medications.

Landen said the grant also will pay for an evaluator who can assess the state’s effort on overdose prevention and determine what approach is working.

For a state with a medical cannabis program that’s about 8 years old, it’s surprising that overdoses keep rising. Other states’ programs have reduced overdose deaths by about 25%, yet not here in New Mexico. Perhaps it’s not surprising after all, considering the sad condition of New Mexico’s medical cannabis program.  Without a program that provides adequate access for all, there are few public benefits to be had.

And New Mexico is one of the poorest states in the country, so poverty plays a big role in overdose deaths and suicides.

Targeting opioids doesn’t seem like a very thorough plan. It leaves out so many drugs that contribute to overdoses, like alcohol, anti-anxiety drugs, muscle relaxers, and anti-depressants. And it leaves out one of the most important issues of all:  suicide.  (Way to honor National Suicide Day, Department of Health.) And what’s the deal with the Department of Health working with the Worker’s Compensation Administration? Easy to pick on the disabled, right?

Ironically, in January of this year, the University of New Mexico was announcing it might have found the “holy grail” of stopping opiate abuse (mostly centered around education):

https://painkills2.wordpress.com/2015/01/26/has-university-of-nm-found-the-holy-grail-of-stopping-opiate-abuse/

New Mexico’s Project ECHO is all about reducing opioid usage in chronic pain patients, and last I heard, is working with the Veteran’s Administration. UNM calls it a program for pain patients — I call it a program to treat addiction. The fact that the program doesn’t work just confirms my opinion that addiction in the chronic pain population is not the huge problem it’s made out to be. If you can’t find and don’t treat enough chronic pain patients that suffer from drug addiction, the program won’t work.

Ironic that the federal government is spending so much more money on programs that aren’t working, but I would say that most of the funding is really for the PDMPs, the blacklist for pain patients. And PDMPs are popular with the DEA, insurance industry, government agencies, and now the medical industry.

It’s also ironic that in October, 2013, Dr. Katzman authored a study about the epidemic of chronic pain. From someone who’s recognized the problem, all the way to today with Project ECHO, this doctor has taken a mighty long fall in a really short time. Here are my posts about the director of the program, Dr. Katzman:

https://painkills2.wordpress.com/?s=katzman

“This is a witch hunt of epic proportions.”

http://ravallirepublic.com/missoula/news/local/article_cdbc86b1-205f-5c1c-b547-25cc5eaa5913.html

HAMILTON – A Florence physician was arrested at his home Thursday morning and charged with more than 400 felonies, including two counts of negligent homicide.

Dr. Chris Christensen, 67, has been under investigation since his Florence clinic, Big Creek Family Medicine, and his home were raided by a joint local, state and federal drug task force in April 2014…

Christensen’s business operated almost exclusively in cash, the affidavit stated. Financial records indicated the business earned about $2,500 a day and grossed more than $500,000 annually…

The DEA believes that any pain doctor that doesn’t take insurance is running a pill mill, and of course that’s very far from the truth. And it seems like the DEA can only charge pain doctors if any of their patients die of a drug overdose.  In Dr. Christensen’s case — a doctor that has been practicing for a very long time — all they found were two deaths. Considering the kinds of patients that pain doctors treat, I’d say two patient deaths out of thousands is not bad at all.

At a news conference Thursday, the special agent in charge of the U.S. Drug Enforcement Administration’s Denver Field Division, Barbara Roach, said Christensen’s patients traveled to his clinic from 10 different states, from as far away as Oregon, Nevada and even Ohio. In Montana, Christensen’s patients came from 62 different cities and towns.

Instead of realizing that the reason for this is that pain patients are unable to find access to health care in their own states, the DEA looks at this as criminal activity. Because… drug war.

Roach said investigators compared the number of prescriptions for controlled substances written by Christensen against seven other physicians from similarly sized communities. Christensen wrote more prescriptions for those type of medications than all of the seven doctors combined, she said.

You can’t compare one physician’s prescribing habits against others, unless you are comparing apples to apples. Were these seven physicians practicing pain management? Were they treating cancer pain? Were they treating pain patients from out-of-state?

The case against Christensen focuses on 11 patients selected by the Ravalli County Attorney’s Office and the drug task force. In nearly all of those cases, Christensen neither contacted the patients’ former physicians nor reviewed medical records before prescribing drugs including methadone, oxycodone and Dilaudid, the affidavit stated…

See, they only found 11 patient records out of thousands. And is there a law that says a doctor is required to contact former physicians for every patient they see? Please, someone show me where this law is located.

After the DEA attempted to contact Marchand, he said he alerted Christensen. The doctor allegedly replied “the DEA can’t do anything to me,” the affidavit stated.

Christensen was indicted in U.S. District Court in Idaho in 2005 on 18 counts of distribution of controlled substances outside the course of a professional practice and without legitimate medical purpose. He was acquitted on those charges in 2010…

Looks like the DEA is after revenge.

The maximum penalty Christensen could face is 388 life sentences, plus 135 years in prison and fines of $20 million.

The DEA overloads the charges like this to put fear in the hearts of their victims. And it works. Fear and the inability of victims to pay for an adequate defense gives the DEA an incredible amount of power that is rarely defeated.

“This has been a long process,” Fulbright said. “More than a year of investigation work was completed before search warrants were issued for Dr. Christensen’s office and home. Those searches … resulted in the task force seizing 4,718 medical patient files, and 1,500 additional files for medical marijuana patients…

Does the DEA realize that these pain patients cannot find another doctor without their freaking medical records? (As if they’re going to be able to find another doctor anyway.) Where are these records now? Is the DEA following HIPAA rules while working with them? Will each of these patient’s records now come with warnings:  Treated by a doctor arrested by the DEA. Drug addict.

Where will over 6,000 patients find another doctor willing to treat them? The State of Montana should be prepared for a rise in heroin use and overdoses, new cases of patients suffering from addiction, and suicides.

Citizens of Montana, don’t blame drugs for the additional medical problems and deaths you will be seeing in your family members — blame the DEA.

Thinking of you, Jamycheal Mitchell

http://www.theguardian.com/us-news/2015/aug/28/jamycheal-mitchell-virginia-jail-found-dead

Young black man jailed since April for alleged $5 theft found dead in cell

Mitchell’s family said they believed he starved to death after refusing meals and medication at the jail, where he was being held on misdemeanour charges of petty larceny and trespassing. A clerk at Portsmouth district court said Mitchell was accused of stealing a bottle of Mountain Dew, a Snickers bar and a Zebra Cake worth a total of $5 from a 7-Eleven.

“His body failed,” said Roxanne Adams, Mitchell’s aunt. “It is extraordinary. The person I saw deceased was not even the same person.” Adams, who is a registered nurse, said Mitchell had practically no muscle mass left by the time of his death…

A few hours after Mitchell was arrested on 22 April by Portsmouth police officer L Schaefer for the alleged theft, William Chapman was shot dead by officer Stephen Rankin outside a Walmart superstore about 2.5 miles away in the same city. State prosecutor Stephanie Morales said on Thursday she would pursue criminal charges over Chapman’s death.

Except for a brief item stating that an inmate had been found dead, the story of Mitchell’s death has not been covered by local media in Virginia, and is reported for the first time here.

Adams said in an interview that her nephew had bipolar disorder and schizophrenia for about five years. Nicknamed Weezy, he lived with his mother Sonia and had been unable to hold down work. “He just chain-smoked and made people laugh,” said Adams. “He never did anything serious, never harmed anybody.” …

Adams said prison officials said her nephew had also been declining to eat. She said she saw Mitchell in court in recent weeks and estimated that he had lost 65 pounds since being detained. “He was extremely emaciated,” said Adams…

The public shaming of chronic pain patients

http://www.fortsmithpd.org/NarcoticUnit/PrescDrugCase.asp

The link is to a page full of people who have been arrested for prescription drugs in Arkansas. And I just can’t believe that it includes their photos. When you move your arrow over the photos, they even get bigger. Fancy technology.

Some of the people do, indeed, look like criminals. Some look like drug addicts. Some are old and just look pitiful. Men, women, old, young, all races, but mostly white people. I’m sure there are a few that look like your neighbors. Of course, chronic pain patients are represented in these photos, especially considering the drugs involved in their convictions.

I suppose this police department is showing off, counting the number of people’s lives they ruin by publishing it on the internet. For all eternity. It’s not enough for the criminal injustice system to ruin these people’s lives. No, it’s also important to add all this shame. Because… drug war.

If there’s any police officer out there who wonders why so many people dislike them, well, here you go.

Perhaps chronic pain patients should own this discrimination. Start tattooing bar-code numbers on our forearms so everyone can keep track of us. Perhaps a teardrop for every year we’ve suffered from chronic pain. I suppose we could shave our heads and get “Pain Patient” tattooed on our foreheads — that would be instantly recognizable, just like skin color or sex.

How Identity Theft Sticks You with Hospital Bills

http://www.pharmaciststeve.com/?p=11379

Fueling medical identity theft is the surge in electronic medical records and data breaches at insurers and health-care providers. Medical identity theft-in which someone fraudulently uses data to bill for medical services-affected 2.3 million adult patients in 2014 versus 1.4 million in 2009, according to a survey published in February by the Ponemon Institute LLC, a research concern.

Such identity theft has led about 40 companies, including Blue Cross Blue Shield Association and Aetna Inc., to form the Medical Identity Fraud Alliance. Some hospitals have turned to biometric screening to confirm patient identities…

“Data breaches are increasing and becoming more common,” says Dr. Shantanu Agrawal, director of the Center for Program Integrity at the Centers for Medicare and Medicaid Services. “You can end up with diagnoses being placed in your file without your knowledge.” …

Unlike in financial identity theft, health identity-theft victims can remain on the hook for payment because there is no health-care equivalent of the Fair Credit Reporting Act, which limits consumers’ monetary losses if someone uses their credit information…

Thieves use many ways to acquire numbers for Social Security, private insurance, Medicare and Medicaid. Some are stolen in data breaches and sold on the black market. Such data are especially valuable, sometimes selling for about $50 compared with $6 or $7 for a credit-card number, law-enforcement officials estimate. A big reason is that medical-identification information can’t be quickly canceled like credit cards…

Hospitals are setting up special investigative units to catch medical identity fraud. BayCare Health System, which has hospitals in Florida, is one of hundreds of hospitals that give patients the option to register by scanning veins in the palm. The image is converted into a number that correlates with the patient’s medical record, according to its website…

Some victims say the problems from medical identity theft haunted them for years.

Anndorie Cromar, now a 36-year-old medical-lab supervisor in Salt Lake City, says Utah’s child-protective services called her in 2006 to say her newborn had tested positive for methamphetamine at Alta View Hospital in Sandy, Utah.

Ms. Cromar hadn’t given birth then. Someone had stolen her identification, gone into labor, delivered a baby girl and left the infant at the hospital. The case grabbed headlines at the time, but few knew the ordeal took years to straighten out.

She says she was never able to fully settle the hospital bill the thief had racked up and eventually charged it off when she filed for bankruptcy for unrelated reasons. For months, she continued to get appointment reminders for the baby. She wasn’t able to view her own full medical records because they now contained the thief’s health information. She says she also had to go to court to get her name taken off the baby’s birth certificate.

An Alta View spokesman declines to comment, saying the hospital didn’t have an updated privacy form signed by Ms. Cromar. The Utah Division of Child and Family Services declines to comment.

“To this day, I don’t know if my name is in the baby’s medical record,” Ms. Cromar says. “It’s insidious.”

Kroger and NarxCheck

http://www.pharmaciststeve.com/?p=11355

Appriss Inc., a leading technology provider for risk assessment and analytics in public safety and healthcare, announced that The Kroger Co. has introduced NARxCHECK™ into over 200 stores in Ohio, West Virginia, and Arizona in an effort to improve patient safety and combat prescription drug abuse…

The program provides three key components for prescribers and dispensers: a patient score, an interactive graph depicting the usage pattern of drugs, and detailed analytics about controlled substance prescriptions filled by the patient. The NARxCHECK™ algorithm assesses a patient’s controlled substance history from state prescription monitoring programs, computes a score and highlights potential issues with overuse or abuse of narcotics, sedatives and stimulants.

The NARxCHECK™ system assigns a numerical score that is derived by analyzing the patient’s prescription patterns…

Lower scores improve doctors’ and pharmacists’ confidence that the patient may not have any controlled substance usage concerns. More elevated scores cue the doctors and pharmacists to carefully consider the patient’s controlled substance usage…

https://painkills2.wordpress.com/?s=+NARxCHECK