NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, IN THE SPIRIT OF RETIRED DETROIT POLICE SARGENT WALTER R. CLEMENT BS., MS., MBA., HOWARD ADELGLASS, MD., BELINDA BROWN-PARKER, JOSEPH SOLVO ESQ., REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, SHELLEY HIGHTOWER, BS., PHARMD., LEROY BAYLOR, ADRIENNE EDMUNDSON, NATASHA DUVALL PHARMD., WALTER L. SMITH BS., LEROY BAYLOR, BS., MS., MS., BRAHM FISHER ESQ., MICHELE ALEXANDER, CUDJOE WILDING BS, DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
RICHARD A. LAWHERN, PhD_________
….I call upon the NCIPC to immediately repudiate and withdraw the 2016 CDC Guidelines on prescription of opioid analgesics to adults with chronic non-cancer pain. This class of medications is now known beyond any reasonable contradiction to be safe and effective for the great majority of chronic pain patients. The so-called “opioid crisis” was not created and is not being sustained by doctors prescribing to their patients. That “crisis” is instead sourced in socio-economic factors and fed by street drugs marketed by international cartels…
YOU OWE THE AMERICAN PUBLIC THE COURTESY OF A PUBLIC ACKNOWLEDGMENT OF YOUR ERRORS AND MISDIRECTION. EITHER FIX THE PROBLEMS YOU HAVE CREATED OR RESIGN!
ARTICLE COURTESY OF Richard A. Lawhern, PhDPatient Advocate
DEA-DOJ CORRUPT ORGANIZATIONS AND 2 centuries of wrongdoing
The seizing of Journalists and Congress personnel records and the reporting of attacks on Black-Owned pharmacies by the United States Justice Department and the United States Drug Enforcement Administration under Attorney General William Barr under the Trump administration are one and the same; these attacks included everything and everyone of every hue
in public healthcare. The data used has been based on a foundation of junk science where figures who lie ( Richard Alpert, Donald Sullivan, John Beerbower, Tom Muzzing) and who are liars figured.
They’ve used and are using fraudulent unscientific bogus data which they knew and have known to be flawed/suspect to target and arrest doctors and falsified search warrants by redefining medical procedures and protocols.
Even though much of the data DOJ-DEA had generated was erroneous, they could get away with it through a rigged Kangaroo Court System that the agency created and that operates outside the rules of Federal Civil Procedures.
In some cases, healthcare providers found themselves forced to plea responsible for fictitious DEA medical protocols DEA investigators, Supervisors, and Judges created, which are contrary to the practitioners’ training and licensure.
Skilled Attorneys found themselves powerless to rules which made it impossible to present evidence. Innocent Dr’s also found themselves handcuffed and some went to prison.
In essence, the DOJ-DEA has engaged in wholesale prosecutorial misconduct and corruption to promote their war on medically prescribed narcotic analgesics (opioids) pain medications by extorting both medical practitioners and drug manufacturers and by concocting search warrants, immediate suspension orders(ISO), that lacked any semblances of probable cause.
Based on their actions, the DOJ-DEA used fraudulent and bogus data to target doctors, pharmacist, and their patients around the country, particularly Blacks and Asian providers and went so far as the illegal use of google maps to track patients.
THE PROFILING OF LINCOURT PHARMACY, CLEARWATER FLORIDA
They have forced drug wholesalers to stop doing business with small pharmacies based on fictions quotas or sole because they perceived a Black pharmacist as uppidity, arrogant, and making too much money.
Such is the case of Lewis Ladson, owner of Lincourt Pharmacy Clearwater Fl., in (black-own) business some 35 years and was one of the larges Compound specialty sterile-non sterile pharmacy in America. Yet, Lincourt Pharmacy is not the only business and this happening all over the country everywhere. Ladson states,
“Congress must get character and stop being intimidated by DEA and oversight is needed investigation by Inspector General is needed, The War on us (drugs) must be put to and end.”
THE MEDICAL SCHOOL TO PRISON PIPELINE
Sally Satel is a psychiatrist, a resident scholar at the American Enterprise Institute, and a visiting professor in the Department of Psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons.
THE REALITY OF OPIOID ADDICTION
Dr. Sally Satel, MD., writes:
” Between September 2018 and September 2019, I worked at a local clinic in Ironton, Ohio, an Appalachian Rust Belt town of 10,000 that had been pummeled by the opioid crisis. On Tuesday nights, I co-led group therapy with John Hurley, a seasoned social worker and twinkly-eyed Santa Claus of a man. Every so often, a patient would complain that he was a victim of a doctor who prescribed OxyContin.
This would prompt Hurley to reply with a wink, “Oh, I see, so the directions on the prescription said ‘chop and snort two times a day,’ did they?” The patients sitting in the circle of plastic chairs would chuckle knowingly after Hurley’s comeback. Mostly in their 20s, 30s, and 40s, all were well acquainted with intoxicants before prescription opioids became part of their repertoire.
Our small therapy group mirrored the wider universe of pill abuse. According to an analysis of 2014 data from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH), more than three-quarters of non-medical users of prescription opioids — those who use prescription drugs they were not prescribed or take them for reasons other than pain relief — had at least tried non-prescribed benzodiazepines, such as Valium or Xanax, or inhalants before turning to prescription opioids.
NOW LETS FOLLOW THE SCIENCE
Similarly, a Washington University review of almost 5,000 people who sought treatment for pain-reliever addiction found that 70% had prior experience with cocaine, methamphetamine, hallucinogens, or benzodiazepines. Other data from the same researchers show that over 90% of patients admitted to treatment programs for opioid-use disorders had used at least one additional addictive substance in the preceding month.
These findings are consistent with data from the Centers for Disease Control and Prevention (CDC) showing that four in five individuals who die from overdoses associated with prescription opioids have at least one other drug present in their systems at death.(1)
Patients’ first opioid medication could have come from a doctor, but subsequent supplies were obtained elsewhere. According to a 2014 survey by SAMHSA, only 22% of a national sample of people who misused prescription opioids within the past year obtained their most recent supply from a single doctor. Meanwhile, half of the sample reported having obtained pills from a friend or relative — usually older relatives with cancer or a terminal illness.
Others stole or bought the pills from someone they knew, procured them online, or purchased them from a dealer. The latter’s supply might have come from warehouse or pharmacy robberies, or from stops along delivery routes to pharmacies and hospitals where, again, inventory is subject to theft. Some “doctor-shopped” (obtained multiple prescriptions from multiple doctors), forged prescriptions, or patronized “pill mills” (doctors’ “offices” that are largely pills-for-cash outfits).
At the same time, studies of people taking prescribed opioids routinely reveal that the vast majority take them without incident. The NSDUH reports that among the 91.8 million adults — both patients and non-patients — who took pain relievers in 2015, 1.9 million, or 2%,[correction appended] qualified for a prescription-opioid-use disorder at some point during the year. Another representative study, this one from a research team at Harvard University in 2018, discerned signs of opioid abuse and addiction in only 0.6% of over half a million privately insured patients prescribed opioids for post-surgical or acute pain. And in a 2016 Washington University survey of almost 700,000 patients, 0.3% abused or developed an addiction to opioids within a year after receiving at least one prescription.
Even among patients undergoing treatment for chronic pain, only a small percentage are at risk of abusing or developing an addiction to opioids. A team led by a scholar at the Research Triangle Institute, for instance, found that 0.12% to 6.1% of half a million chronic-pain patients abused or developed an addiction to opioids within 18 months of starting treatment.
The Cochrane Library, a respected independent collection of databases, found that in a combined sample of 2,600 patients drawn from nine separate studies, only 0.27% developed signs of opioid addiction. Another review, co-authored by the director of the National Institute on Drug Abuse and published in the New England Journal of Medicine, found “[r]ates of carefully diagnosed addiction [averaging] less than 8 percent” in chronic-pain patients.
Why do estimates of opiate abuse and addiction range from under 1% to 8% of these patients? Researchers from the University of Miami shed valuable light on the question when, in a review of 24 studies on patients prescribed opioids, they distinguished between patients experiencing pain with a history of substance abuse or addiction and those without. They found that an average rate of new-onset drug abuse or addiction for pain patients overall was 3.27%. But when they examined the four studies that had deliberately excluded patients with a history of substance abuse or addiction, the rates shriveled to 0.19%.
These findings are consistent with abundant evidence confirming that patients with mental-health conditions (particularly depression) and those who report taking extra medication to manage stress are more likely to progress to abuse or addiction than those who do not fit these criteria. For example, an analysis of the National Epidemiologic Survey on Alcohol and Related Conditions — a survey of over 36,000 people — found significantly increased odds of abusing or developing an addiction to pain relievers in those who reported traumatic experiences, as well as those who had been diagnosed with a psychiatric condition.
In the Washington University survey mentioned above, roughly two-thirds of the participants — all of whom sought treatment for pain-reliever addiction — confirmed that they had been diagnosed with and treated for a psychiatric disorder. A similar proportion of subjects reported they had used prescription opioids “to self-treat psychological issues,” while 80% indicated they did so “to ‘escape’ from daily stressors, past trauma, [or other] issues going on in their lives.”
The fact that the vast majority of patients take opioids like Percocet, Vicodin, and OxyContin without incident significantly undermines the popularity of the accidental-addict narrative. At the same time, we know that prescription pain relievers helped set the current crisis in motion. How can both of these statements be true?
Part of the paradox can be explained by the fact that, for decades, otherwise responsible physicians routinely failed to identify patients at higher risk of becoming addicted when prescribing pain relievers. At the same time, many doctors were also overprescribing opioids — either by prescribing them in cases where other pain relievers might have sufficed or by giving patients too many doses. In fact, one representative study published in the Journal of Joint and Bone Surgery in 2016 found that patients prescribed pain relievers typically reported using only about one-third of their supply. Their surplus pills spilled out of unattended medicine chests and into the gray market, where ensuing transactions helped stoke the opioid crisis. (3)
the accidental addict and the exacerbated use of opioids
Some reporters, no doubt, simply hoped to call attention to the opioid epidemic by showcasing sympathetic and relatable individuals — victims who started out as people like you and me. It wouldn’t be surprising if drug users or their loved ones, aware that a victim-infused narrative would dilute the stigma that comes with addiction, had handed reporters a contrived plotline themselves.
Another theory — perhaps too cynical, perhaps not cynical enough — is that the accidental-addict trope was irresistible to journalists in an elite media generally unfriendly to Big Pharma. Predisposed to casting drug companies as the sole villain in the opioid epidemic, they seized on the story of the accidental addict as an object lesson in what happens when greedy companies push a product that is so supremely addictive, it can hook anyone it’s prescribed to.
Whatever the media’s motives, the narrative does not fit with what we’ve learned over two decades since the opioid crisis began. We know now that the vast majority of patients who take pain relievers like oxycodone and hydrocodone never get addicted. We also know that people who develop problems are very likely to have struggled with addiction, or to be suffering from psychological trouble, prior to receiving opioids. Furthermore, we know that individuals who regularly misuse pain relievers are far more likely to keep obtaining them from illicit sources rather than from their own doctors.
In short, although accidental addiction can happen, otherwise happy lives rarely come undone after a trip to the dental surgeon. And yet the exaggerated risk from prescription opioids — disseminated in the media but also advanced by some vocal physicians — led to an overzealous regime of pill control that has upended the lives of those suffering from real pain.
To be sure, some restrictions were warranted. Too many doctors had prescribed opioids far too liberally for far too long. But tackling the problem required a scalpel, not the machete that health authorities, lawmakers, healthcare systems, and insurers ultimately wielded, barely distinguishing between patients who needed opioids for deliverance from disabling pain and those who sought pills for recreation or profit, or to maintain a drug habit.
The parable of the accidental addict has resulted in consequences that, though unintended, have been remarkably destructive. Fortunately, a peaceable co-existence between judicious pain treatment, the curbing of pill diversion, and the protection of vulnerable patients against abuse and addiction are possible, as long as policymakers, physicians, and other authorities are willing to take the necessary” steps.
‘THANK YOU, SALLY ‘
YOU ARE WITHIN THE NORMS
FOLLOW THE SCIENCE
The opioid epidemic has plunged healthcare into a dystopia defined by fear and paranoia. And we never even saw it happening.
Jay K Joshi MD writes:
Healthcare and law interact in a balance, which can be best understood through a framework of medical jurisprudence. A framework that balances the experience of healthcare with the logic of clinical decision-making, the primary clinical risks with the secondary and tertiary clinical risks, and the quality of care with the socioeconomic constraints limiting it.
Look no further than the opioid epidemic, which has spun masterfully Government encroachment into a moral crusade against the healthcare industry. Law enforcement has replaced physicians in clinical decision-making, and prosecutors have supplanted the healthcare industry in determining opioid production and distribution.
“ACCESS TO HEALTHCARE IS A RIGHT. TO DENY ACCESS IS TO DENY “JUSTICE”
3. Dr. Sullivan has never been to Respondent’s pharmacy. Tr. 407:14-16. Dr. Sullivan has never spoken or attempted to speak to any of the patients whose E-FORSCE data he reviewed.