REPORTED 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., INC.T. SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, LESLY POMPY MD., NANCY SEEFEDLT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., 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 NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
“FIGHTING AGAINST HEALTHCARE INJUSTICE”
THANK YOU RICHARD LAWHERN PH.D. AND NANCY SEEFEDT, PAIN ADVOCATE
‘ IF YOU EVER THINK YOU ARE TOO SMALL TO MAKE A CHANGE THEN YOU’VE NEVER SLEPT WITH A MOSQUITO’
STUDY EXPOSING PDMP VIOLATION OF 4TH AMENDMENTS
BY
CATHLEEN LONDON, MD CIPP/US, Class of 2022
“IS A PRACTICING PHYSICIAN AND 3 YEAR LAW STUDENT AT THE UNIVERSITY OF MAINE SCHOOL OF LAW”
According to a Study called, Predicting Drug Diversion: The Use of Data Analytics in Prescription Drug Monitoring, authored by Cathleen London, MD CIPP/US, Class of 2022, editorArticle states in part:
“Prescription drug monitoring has exacerbated, rather than mitigated the overdose crisis. Some patients may choose to forgo treatment due to unwanted surveillance and law enforcement involvement. Monitoring incentivizes physicians to avoid these substances, even when medically indicated, to avoid scrutiny as they fear the DEA. Prescription drug monitoring has led to a dramatic spike in illicit drug use and overdoses.
The data analytics in PDMPs perpetuate biases and have a disproportionate impact on the underprivileged. Most concerning is that law enforcement can access and mine data without individualized suspicion, probable cause, or any judicial review. This has led to the inappropriate targeting of prescribers.
The PDMPs are criminal and regulatory surveillance tools dressed up as public health.[47] They are used to help the DEA identify who they perceive might be suspicious patients, prescribers, and pharmacists who they feel might be diverting narcotics.[48]
The DEA uses administrative subpoenas to search databases. When challenged by states (on Fourth Amendment and Due Process grounds) the DEA has successfully defended their actions invoking the third-party doctrine.[49] Professor Oliva contends that these warrantless searches violate the Fourth Amendment under Carpenter.[50]
This is particularly relevant since PDMPs are no longer static, passive databases with limited information, but have become smart databases replete with personal health information. They rely on robust data analytics with black-box algorithms that have never been subjected to independent verification.[51]
Overdose deaths have spiked and in fact have been driven by illicitly manufactured fentanyl, an increase of over 540% from 2014-2016 as shown in figure 2 above. The trope that the opioid overdose crisis is due to physician overprescribing is erroneous.[52] Prescription painkiller deaths leveled off and had been overestimated to begin with.[53]
“ONE’S SIZE DOES NOT DICTATE YOUR ABILITY TO FIGHT BUT ONLY DICTATES YOUR FEAR”
Opioid prescribing started declining with the introduction of PDMPs consistent with the discriminatory and chilling effect on prescribing for chronic pain patients many have described:[54] As pictured below, Prescription opioid use declined to 60% of the peak volume in 2011 and continues to decline.
For patients who purportedly became addicted after receiving a pain prescription, over 75% did not get those medications directly from physicians.[55] The implementation of PDMPs has not been associated with a reduction in drug overdoses. In a subsample analysis of states with PDMPs in operation for 5 or more years, the programs were found to be associated with significantly higher mortality rates in legal narcotics, illicit drugs, and other and unspecified drugs.[56]
Despite the harm and disparate impacts on marginalized populations, expansion continues as evidenced most recently by Equifax’s purchase of Appriss and Appriss’s rebranding. In addition, the DEA submitted a Request for Proposal, (“RFP”) for their own nationwide database to streamline the subpoena process.[57] An RFP is a description of the service they are seeking ad a call for bids. They are seeking prescription level data at the national, state, and local levels.
The RFP includes the ability to rank the top prescribers both nationwide and statewide for Schedule II and Schedule III substances, including fentanyl, oxycodone, hydrocodone, tramadol, and buprenorphine (a drug used to treat substance use disorder).
They are also seeking to target pharmacies with the same ranking criteria. Given the amount of data that the Department of Justice would have direct access to on a regular basis, this is the monitoring of the population on an unprecedented scale.”
TO BE CONTINUED
“Thank you, Cathleen Londo, MD for your research you will save the lives of many”
CONGRESS MUST CLEAN UP THIS MESS
FOR NOW, YOU ARE WITHIN
THE NORMS
All the pharmacies and pharmacists are victims of this inappropriate, violation of our constitution, focusing their harm on the marginalized, disproportionately affecting physicians of color and those taken care of the marginalized, pharmacist themselves have been part of the surveillance system. At one time when I worked in a Suboxone clinic, there was a drastic drop in the number of heroin deaths weirton West virginia, with a dramatic drop in Street sales as well, a pharmacist decided to report us, resulting in an investigation by the DEA in the State medical board. Back then, before the white papers, the DEA came by and said everything was good as did the State medical board. Since 2012, before I was investigated or indicted for opiates, multiple pharmacies, including kroger’s, Walmart even Giant eagle not only refused to fill my opiate prescriptions, they refuse to fill all of my prescriptions. This included life sustaining therapy such as antibiotics, antihypertensive etc. Thus the surveillance in the part of the pharmacies, crossed over from opiates. I had a case where a patient had very severe neuropathic pain, she was on opiates, but needed supplementation. She did not respond to classic anti-convulsions like Lyrica or gabapentin. I prescribed mixelitine, the most potent drug in the market targeting the sodium channels, and approved for the use in neuropathy. Despite this, the pharmacist from Giant eagle decided to report me to the State medical board. Launching an investigation. I called the pharmacist and said would you please look in the pdr. She looked in the pdr, and she responded “oh”. I told the State medical board to mind their business, and I pretty much backed off. It’s very conflicting, when I see big pharmacy chains, black boiling doctors yet they themselves are the target of government overreach, prosecutorial and judicial misconduct. This is reminiscent of doctors, like PROP literally “eating their own”for their own selfish agenda, a clear violation of the ama, and the hypocratic oath. Like these pharmacies and pharmacists, PROP base is there opinions on falsified data, personal prejudicial opinions. It is a mess, with everybody fighting everybody, a literal Battle Royale where only one person will end up winning, and the ultimate victims will be the 50 million chronic disease and chronic pain patients as well as the marginalized of society.