BY
NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., IN THE SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NDJOU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
Inspired by Pope Frances and the little girl:
“These agencies have failed to recognize a people’s chronic disease conditions of intractable pain, while further failing to understand or comprehend human suffering, the science of clinical medical treatment and the value of human life.”
A REFLECTION
On Saturday, October 12, 2019, I was on the Campus of Florida A&M University celebrating the homegoing of one of the greatest professors of Pharmacy known throughout the world, Leonard Inge.
Leonard Inge, a simple poor kid, youngest of 13 siblings, from Pritchard Al., served as President of The National Pharmacist Association, 12 years Florida Board of Pharmacy, 34 years Florida A&M University College of Pharmacy (and I could go on and on never complete this discussion) where his specialty was teaching Pharmacy Law and Compounding.
I was fortunate to be trained by one of the greatest professors of Pharmacy, and I’ve been practicing pharmacy the same way, using the same concepts, methodology, procedures, and techniques in Pharmaceutical Compounding as taught at Florida A&M University for over 45 years. Our continuing education on Compounding Pharmaceuticals (from various sources) mirrors what was taught at Florida A&M by Leonard Inge and other professors.
So I asked myself, what has changed? The answer points to one very questionable and dangerous practice; LAW ENFORCEMENT has intruded into defining medical procedures and protocols. We see this in the so-called Opioid Crisis. Therefore, the idea that Narcotic Analgesic Medications (NAM) cannot be used for chronic pain is not true and misleading.
Further, the thought that these medications are not to be used combined with other medications such as those used to relieve anxiety ( benzodiazepines), mood disorders, or sleep is in error.
KATHERINE ROSENBURG-DOUGLAS CHICAGO TRIBUNE REPORT WRITES:
” I broke my back while Rollerblading when I was 21. After three surgeries beginning at age 30, I’ve recovered enough that I’ve gone on to what looks like a normal life. I’m a married mother of twin 4-year-olds, so I am relatively stressed, but fortunately, I’m otherwise relatively healthy.
I’m also on a fentanyl patch delivering slow and steady pain relief to keep me feeling like I can get out of bed, and morphine for breakthrough pain when life requires more of me than merely getting out of bed — and anyone who has ever had a 4-year-old knows each day is far more demanding than that. Just driving my kids to school or sitting for longer than 20 minutes at a time is a struggle.
So is driving to the pharmacy, or to my doctor, both of which I must do every 30 days. To obtain a controlled substance in Illinois, one must visit a pain specialist because family physicians can’t prescribe this type of medicine long-term.
When we moved to Illinois in 2016, I had been on prescription opioids for almost a decade. I called up doctors and asked receptionists if they were taking new patients and if the doctor prescribed opioids. After what I took to be stunned silence, I was either told they didn’t give that information on the phone or they couldn’t say because it was on a case-by-case basis.
I understand now that amid a deadly opioid crisis I must have sounded like a drug-seeker, though I just wanted to avoid wasting time or money. I have been dealing with this pain for close to half my life, and we move often. I know how hard it can be to find a new doctor and transfer records to receive continuous care. In my first few weeks here I visited nine doctors, including neurosurgeons, orthopedic doctors, and pain management specialists. They all agreed I needed strong pain medicine but said they weren’t the correct doctor to help me.”
Dr. Jeff Singer’s podcasts on “Following the Science”.
https://www.cato.org/multimedia/cato-daily-podcast/follow-science-opioids
OXYCODONE BECOMES DANGEROUS WHEN ABUSED THEN USED DANGEROUSLY
Narcotic Analgesic Medications (NAM) will result in dependency when prescribed and used for long-term chronic pain. Therefore, it then becomes the Pharmacist’s role to inform the patient who is being treated for chronic pain on how to use this class of medications correctly to ensure their safety.
For example, Oxycodone is a very effective medication for treating chronic pain when used and taken at a therapeutic dose. Oxycodone is effective against most chronic pain generated from the central nervous system. However, as with any medication used to treat a chronic condition to sustain life, the patient may become permanently dependent on these medication classes for the rest of their life.
These medications are safe when used correctly, and like all medications controlled or non-controlled when taken beyond their therapeutic dosages are dangerous and may result in death. The literature clearly shows death due to drug toxicity will likely occur when prescription narcotic analgesic medications are taken beyond their therapeutic amounts or commitment use with alcohol or other substances.
To date, except in the case of extreme anaphylaxis, there is no case within the literature where individuals have succumbed to death when given a therapeutic dose of a medically prescribed Narcotic Analgesic Medication (NAM).
Relieving pain is a pain
KATHERINE ROSENBURG-DOUGLAS CHICAGO TRIBUNE REPORT WRITES:
“The doctor I chose is about 30 miles from my home. He tells me it’s troublesome keeping up with his patient load as other area doctors leave the specialty. Thankfully, many pill mills have been shut down, but even good doctors have closed up shop as keeping up with ever-changing restrictions imposed by legislators has become increasingly arduous, my doctor told me.
Among the most asinine of guidelines pushed by various plans to end the opioid epidemic: A pain doctor’s records should show he or she is trying to reduce the number of medications and the dosage patients are on. If your formerly high cholesterol returned to a healthy level with a certain dosage, can you imagine your doctor cutting the dose in half on your next visit?
It’s not clear to me what purpose the every-30-day visits serve, other than to pick up my written prescriptions — controlled substances can’t be called in. But just as these rules unnecessarily hurt those of us in real pain, they also won’t deter those battling addiction who want a fix.“
THE DEA AND UNITED STATES ATTORNEY GENERAL’S OFFICE GONE ROGUE
There is an equally disturbing trend within the medical/pharmaceutical community wherein medical practitioners are targeted. Law enforcement agencies have conducted raids and arrested medical personnel for dispensing legally prescribed medications to the community.
The DEA approach to chronic intractable pain disease and narcotic addiction disease disorder fails to address clinical issues; a 360-degree view of life, requiring treatment. If addiction is a disease process, then how does law enforcement become the primary healthcare provider to treat a clinical disease process?
DEA focuses is that of law enforcement, linear thinking, unidirectional, at best a duality, binary of good versus evil, good vs. bad, black vs white. The law enforcement approach is designed to keep one in their place to deny your rights and to instill fear. Most importantly their role is to maintain “THE DRUG INDUSTRIAL COMPLEX.”
The DEA has become a rogue agency that must be disbanded. These agencies have failed to recognize a people’s chronic disease conditions of intractable pain while further failing to understand or comprehend human suffering, the science of clinical treatment, and the value of human life.
It is the single most heinous governmental agency whose tactics have led to the increased cost of medications and healthcare across America by misinterpreting the purpose and roles of medications needed to treat acute, chronic, neuropathic, and psychological pain.
MAINTAINING THE ELEMENTS OF THE DRUG INDUSTRIAL COMPLEX
The DEA has waged misinformation to persuade the public that these medications are dangerous drugs whose dosages are “RED FLAGS,” indicating abuse and trafficking, contributing to the so-called opioid crisis in America.
The DEA has become a rogue agency that has lost its mission, using threats and intimidation such as;
1. Tactics of no-knock raids and arrest,
2. Forfeiture,
3. Threat of prison time
4. 3 strikes you are out, hands up don’t shoot
5. Economics of Employment: Judges, Bail Bondsman, Barbwire and Prisons
These agents lacking in both knowledge and understanding of Opioid Pain receptors come armed with “BADGES, GUNS AND PROFOUND STUPIDITY.” They impose their will on the medical profession (nurses, pharmacists, physicians, dentists, especially drug wholesalers) and their patients.
DEA’S RED FLAGS OF DISTORTION
“stigmatizes the disease state and traumatizes the afflicted”
When, returning to the United States from Johannesburg on Air France flying to Paris, and I came across TED.com lectures and specifically with the lecture of a Ghanan Professor Sangu Delle concerning the view of mental health in many African countries, in which he says;
“…when it comes to mental illness our ignorance eviscerates our empathy,…… we stigmatize the disease and traumatize the afflicted……”
Professor Delle elaborated, according to a study done by Arboleda-Flores, when directly asking people about the causes of mental illness the result was staggeringly sad;
4. 34% sited drug mis-used
5. 19% Divine raft of will of God
6. 12% sited witchcraft and spiritual possession
Professor Delle summarizes mental health includes our emotional, psychological, and our social well-being. Unfortunately, most people ignore or fail to understand the causes of mental illness, including genetics, social, economic status, war, conflict, or losing a loved one.
The DEA uses malicious law enforcement tactics to seek greater power and authority in which they “stigmatize the disease state and traumatize the afflicted.” These tactics are the RED FLAGS OF MEDICAL REDLINING, targeted toward licensed professional people of color and the patients in their care. Patients who pay by cash, credit, or debit card do so because they are either uninsured or their pharmacy does not accept insurance. As a result, they become “RED Flagged” and deemed abusers and criminals by the DEA.
These tactics also include patients who have been profiled by other Pharmacists of large pharmacy chains, who often tell patients of color, “I feel uncomfortable filling your prescription,” particularly pain medications. These patients often report Pharmacists even questioning their need to take these medications and recommending over-the-counter pain meds.
Absent throughout these encounters is the failure of the pharmacist to discuss disease state or conduct a physical exam of the patient, order radiographs, blood work, review the entire patient’s medical and medication profile, which they are not licensed to do. Therefore, to recommend that the patient use over-the-counter pain meds or refuse to fill their prescription for pain meds is blatantly biased.
The patient is then forced to travel long distances to find a pharmacy that will treat them fairly, with dignity and respect. However, this results in both the Pharmacist and pharmacies that fill their prescriptions becoming DEA’s RedFlag targets, as well as the patient.
Thus, in this so-called Opioid Crisis or War on Drugs, we must begin to ask, are these the tactics of THE DEA RED FLAG of RACISM, or even more succinctly, THE DEA RED FLAG OF JIM CROW, in which the disease state is stigmatized and the afflicted become traumatized.
IN THE SPIRIT OF SANKOFA
FOR NOW
YOU’RE WITHIN THE NORMS
