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youarewithinthenorms.com
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. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS MD, PH.D., IN THE SPIRIT OF 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 KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, 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
EXCEPT AS AUTHORIZE
Jeff Singer MD
During the late 1990s and early 2000s, as opioid prescribing increased, prescription pain pills were easier to divert into the black market for non-medical users.
When policymakers decided that opioid prescribing was the cause of the overdose crisis, federal and state policymakers took measures to reduce opioid prescribing. Furthermore, the Drug Enforcement Administration placed quotas on the manufacturing of all types of prescription opioids, ratcheting those quotas downward year after year. By 2019, the reduction in the prescribing rate led the DEA to announce that less than one percent of controlled substances distributed to retail purchasers were getting diverted.
OVERDOSE DEATHS INCREASE WHILE PRESCRIPTION NARCOTIC PRESCRIBING VOLUME DROPPED
Cont…
“However, Overdose deaths soared while prescription volume dropped as nonmedical users migrated to cheaper and more readily available heroin and now fentanyl. Between 2011 and 2017 the proportion of opioid-related overdose deaths due to prescription pain relievers dropped precipitously while those due to heroin and fentanyl surged.
Preliminary data for 2018 point to this trend continuing. The share of opioid-related deaths involving fentanyl rose from 14 percent in 2010 to 60 percent in 2017. Based on data from the Centers for Disease Control and Prevention, fentanyl or heroin was involved in 75 percent of opioid-related deaths in 2017.
Just 30 percent involved prescription opioids, down from 52 percent in 2010, but 68 percent of those cases also involved heroin, fentanyl, cocaine, barbiturates, benzodiazepines, or alcohol—meaning fewer than 10 percent of opioid-related deaths involved prescription opioids without those other dangerous substances.”
EXPOSING PROSECUTORIAL AND JUDICIAL CORRUPTION
THE 90 MORPHINE MILLIGRAM EQUIVALENT FRAUD STANDARD PERPETRATED BY DEA LAW ENFORCEMENT
Perhaps where our opioid policies fail worst is the insistence that doctors and patients adhere to the 90 MME or less rule, something I have thoroughly taken apart.
Not only is the SCIENTIFIC origin of the 90 MME maximum daily dose mysterious but there is no evidence that it is anything more than an arbitrary number – a dose that could be too high for one patient and too low for another. Safety is one of the arguments for establishing a maximum daily dose, but the Frontiers in Pain Research paper suggests that this is dead wrong.
** Chart was edited for clarity and to remove unnecessary data. The five values indicate that between 2006-2010, There was an excellent correlation (strong model) between:
- Per capita prescribed MME (morphine milligram equivalents) and opioid sales – something that should be obvious. When more opioids are prescribed more will be consumed.
- Total overdose deaths and prescribed per capita MME (from any opioid) and overdose deaths. The more prescription opioid pills available, the more overdose deaths.
- Overdose deaths (from any opioid) and prescribed per capita MME and overdose deaths. The more opioid pills available, the more overdose deaths.
- Overdose deaths (from all opioids) and prescribed per capita MME and overdose deaths.
- The more prescriptions, the more hospital admissions.
So, it is not surprising that Aubry and Carr conclude (4):
For the years covered in the CDC’s original chart (for which MME per Capita data are available, i.e., 2006–2010), the CDC’s claim of positive/direct relationships between TOD [total opioid deaths], AOD [all opioid deaths], POD [prescription opioid deaths], and OTA [Opioid Treatment Admissions/addiction] and Annual Prescription Opioid Sales (i.e., MME per Capita) were validated (91% < R2 <97%), with statistically significant, positive slopes.
Aubry and Carr, Front. Pain Res., 04 August 2022
Sec. Pain Research Methods, https://doi.org/10.3389/fpain.2022.884674
Renn Blare RPH, New Castle, Wyoming:
“So, the DEA says doctors can’t dose opioids for chronic pain outside the 90MME range since that would be against the CDC Guidelines or, in other words, OFF-LABEL. BY THE WAY, MME is a false dosing parameter since opioid medications are dosed as per their own specific drug-to-weight effect ratio as determined through pre-release chemical and biological studies. Correct?
However, according to the CDC and the DEA, it is alright to use buprenorphine alone or in combination with naloxone as an OFF-LABEL treatment for chronic pain, although it is not comprehensively proven to actually be a better treatment in chronic pain, especially complex pain over opioids.
What is wrong with this picture?”
must prove beyond a reasonable doubt that the de- defendant knowingly or intentionally acted in an unauthorized manner. We vacate the judgments of the Courts of Appeals below and remand the cases for further proceedings consistent with this opinion.
It is so ordered.
HOW DOJ-DEA PROSECUTORS HAVE TO MANIPULATE DATA TO OBTAIN INDICTMENTS AND CONVICTIONS AGAINST PROVIDERS DOING THEIR JOBS
It is so ordered.
Renn Blare RPH, New Castle, Wyoming:
It’s a shame the prosecutors want to come up with anything to win, and throwing justice out of the window is appalling! The Holy Trinity was not in any way connected to medical professionals.
Just because the police or DEA uses those words doesn’t mean it’s medically disallowed. I would rather trust a doctor on the legal prescribing standard, not the government. What proof did they have? Just someone says so?
Of course, we all know what happened: non‐medical users migrated to more dangerous drugs supplied by the black market—first to heroin, then to heroin and fentanyl, and now roughly 90 percent of opioid‐related overdose deaths involve fentanyl.
Along with that migration came a surge in overdose deaths—directly resulting from non‐medical users switching from pharmaceutical-grade diverted prescription pain pills (of known purity and dosage) to more potent, impure, and deadly opioids made and sold in the black market.
Beginning with the reversal of Dr. Shakeel Kahn’s conviction and now the reversal of Dr. Steven Henson’s, my office continues its efforts to dismantle a corrupt system that has scapegoated doctors for an opiate crisis for which they are not responsible. No more will mere negligence be morphed into drug trafficking by federal prosecutors who want to appear to be fighting the opiate crisis while, in actuality, punishing chronic pain patients who need their doctors.
…Atty, Beau Brindley Chicago, Illinois
Meanwhile, patients whose pain had been well-controlled with long-term opioid therapy were abruptly tapered or cut off from pain meds by doctors, afraid they may get a visit from law enforcement or lose their license for “overprescribing” pain meds. Many patients become “pain refugees,” some seeking relief in the dangerous black market or sometimes turning to violence or suicide. Similarly, many patients are undertreated for acute pain.
DEMONSTRATION BY DR. NEIL ANAND, MD, ON DOJ-DEA OUTLIER DATA MIS-USED IN GOVERNMENT TARGETING PACKAGES AGAINST HEALTHCARE PROVIDERS
“if you torture the data for long enough, you can make them say anything.” I believe that is exactly what US CDC and DEA have been doing with their deliberate conflation and mischaracterization of research results on medical prescribing versus opioid-involved overdose mortality.
…richard lawhern ph
ANDREW KOLODNY, MD OF PROP THE ULTIMATE SUBJECT MATTER COCKSUCKERS
“DEA IS AN ORGANIZATION OF REPROBATES A CULTURE OF CORRUPTION WITHIN LAW ENFORCEMENT WHICH IS TOLERATED”
FOR NOW, YOU ARE WITHIN
THE NORMS
