reported by 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., DAVID STEIN, MD 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., EVELYN J. CLEMENT, 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
“…these things which has been hidden from you shall be brought to the light…”
PROLIFERATION OF JUNK SCIENCE
Once again, we demand the AMA to stop the criminalization of medicine. Dr. Ehrenfeld, you have articulated in your prepared remarks.
“At a time when so many aspects of society have become dangerously polarized, we have seen the proliferation of medical disinformation, junk science, the criminalization of medical care, and a growing distrust in medical institutions and experts.”
According to Dan Martin, JD, a partner in Jones Walker’s Litigation Practice Group, article, “Federal agencies using generative AI, analytics to search for health care fraud,” Medical Economics, Sep 12, 2023:
“Data analytics is a good tool to suggest the need for further investigation, but it should not be used to determine misconduct conclusively. The DOJ and HHS boast a yield of $4 or greater return on investment for every $1 spent on healthcare fraud detection and enforcement – and they point specifically to their reliance on data analytics as a key driver of this return.”
Unfortunately, the government’s resultant rush to use its new tools in such a sweeping manner has resulted in many innocent physicians, clinics, hospitals, and health systems being accused of wrongdoing for simply being different from their peers. The fact is that being a statistical outlier or anomaly should only be treated as a basis for further inquiry, not as proof of fraud.
Most importantly, the Federal officials have admitted their data “is not the truth…while it may point in the right direction, they still must go out and investigate.”
Yet regrettably, the government has often not heeded these warnings, as many innocent providers have spent millions on legal defense after being targeted through erroneous conclusions drawn from defective data analytics.
Two stories illustrate what the DEA and FBI do to doctors who manage chronic pain patients.
Dr. Ehrenfeld, someone needs to answer for all of the deaths and suicides of pain patients who were stripped of their pain medications and could not handle the pain any longer–many of them our veterans, who deserve much better.”
The American Medical Association must immediately demand Congress to do its job and investigate (Oversight) these ‘backdoor’ criminal tactics and abusive activities of the DEA.
Further, the AMA must demand an end to the CDC opioid Guidelines, which have resulted in the deaths of thousands of our Veterans whose critical pain and anxiety treatments are being withheld because the Veterans Administration and States are compelled to follow them blindly.
They should immediately trash any so-called guidelines they instituted based on both CDC’s 2016/2022 Opioid Guidelines.
Mary Cremer asked Dr. Ehrenfeld, as President of the American Medical Association:
“How can someone who went through Medical School and received their license to practice medicine be called “pretending to be Drs”? This is a 30-second video of David Abrams (attorney, or “pretending”, but NOT an MD or DO).”
Dr. Ehrenfeld, AMA must shed light on the abuses of prosecutors, state and federal judges, and SO-CALLED medical experts (SMCS) grifters.
“Mr. David Abrams is an adamant man with thick skin, and he, like his many other prosecutorial brethren, has been very effective in their courtroom presentations.
However, when one sheds light on their methodologies, which go against the basic foundation of criminal law within the United States, supported by a Foundation of Junk Science and Neo-Eugenics, they all run like Cockroaches.”
… norman J. clement rph, dds., terence sasaki, md
“MME IS NOT A STANDARDIZE CLINICAL METRIC”
THE CRIMINALIZATION OF MEDICINE
US Opioid Guidelines 2022 – More and Less Than Meets The Eye
This Critical Policy Review by Richard Lawhern, Ph.D. briefly outlines US public health policy’s history on regulating prescription opioid pain relievers. The author then compares recommendations and data sources of the updated November 2022 CDC guidelines against findings from a wide range of pertinent clinical literature.
Lawhern et al. found that the most recent effort by the CDC is fatally flawed by weak evidence and methodologically unsound research, disproportionate emphasis on risk, and failure to address genetically mediated variability in minimum effective opioid dose between individuals.
IS YOUR DOCTOR GUILTY OR NOT GUILTY? A-I AND OPIOID DATA ANALYTICS INFLUENCE WHETHER ONE CAN GET PAIN CARE TREATMENT A PODCAST
JOSH BLOOM OF THE AMERICAN COUNCIL ON SCIENCE AND HEALTH: “PROMOTING SCIENCE AND DEBUNKING JUNK SINCE 1978,” REPORTED:
According to Josh Bloom, Ph.D., Director of Chemical and Pharmaceutical Science,:
“In recent years, the press, the general public, and healthcare professionals have begun to acknowledge that illicit fentanyl and its analogs, not prescription painkillers, are responsible for the surge in deaths.
A critically important paper in the journal Frontiers in Pain Medicine concludes that while the rationale for reducing opioid prescriptions to minimize overdose deaths was sound between 2006 and 2010, the opposite was confirmed during the ensuing decade.
Reducing opioid prescriptions during this time dramatically increased deaths and hospitalizations. In other words, what worked 15 years ago is an unmitigated disaster at this time.”
DOES THE SACRED 90 MME LIMIT MAKE OPIOID USE SAFER?
Dr. Bloom further articulates:
” 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.
This dose 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.
The Morphine Milligram Equivalent (MME) was automatically flawed because it ignored even the most basic tenets of pharmacology, which made it impossible to determine the relative strength of one drug to another rationally.
Unfortunately, this methodology, which became the foundation of the CDC’s catastrophic 2016 publication Prescribing Guideline for Prescribing Opioids, has metastasized ever since as one state after another has passed laws limiting the prescribing of opioid analgesics, often based on the Guideline’s erroneous conclusions.
Studies by the American Medical Association and empiric evidence of what healthcare providers have been seeing ever since policymakers began pressuring them to taper or discontinue prescribing opioids to their patients in pain: tapering the opioids that were controlling their pain was associated with a 68% increase in overdoses and doubling of mental health crises, which can be subdivided into depression (up 346%), anxiety (up 79%), and suicide attempts (up 430%).”
“The United States is currently embroiled in a contentious and multi-dimensional public conversation about addiction-related mortality, chronic pain, and government regulation of clinicians who employ opioid analgesic pain relievers in treating pain.
The US Centers for Disease Control and Prevention (CDC) has published an updated guideline to clinicians concerning appropriate practices for managing severe chronic pain utilizing opioid analgesic pain relievers.
Compounding these difficulties are indications of professional conflicts of interest and persistent anti-opioid bias by authors of the most recently released CDC guidelines.”
…richard lawhern ,phd.
HOWARD ADELGLASS, MD
DOING 150 MONTHS PRISON TIME BASED ON “JUNK SCIENCE AND THE NEO-EUGENICS OF MORPHINE MILLIGRAM EQUIVALENCE (MME)
In the case of Howard Adelglass, MD, et al., the government’s medical expert, Dr. Christopher Gharibo, was a pain specialist at NYU Langone Health who saw between 20 and 40 patients daily, virtually all of whom had health insurance.
He also had supervisory and administrative duties as medical director of pain management within the anesthesiology department. He was board-certified in anesthesiology and pain medicine and had published extensively in various medical journals.
He also has spoken at conferences and conducted clinical research. Gharibo stated that:
“…The CDC considered MME higher than 90 per day to be unacceptable. Sixty milligrams of Oxycodone was equivalent to 90 MMEs. Six 30-milligram oxycodone pills were equivalent to 270 MMEs, which is the level or approximate level eventually reached by several of Dr. Adelglass’s patients whose files Gharibo reviewed…”
Opioid Policies Based On Morphine Milligram Equivalents Are Automatically Flawed,”
However, in 2018, Josh Bloom wrote in his report titled:
“In today’s anti-opioid climate, a “one-size-fits-all” mindset has become the foundation of government-dictated medicine. And it’s very bad medicine.
“…The deeply flawed policies that are being enacted as law all over the country are based on the “one-size-fits-none” concept of morphine milligram equivalents (MME) – the maximum amount of opioid medication that is permitted per patient per day. While MME values are touted as useful predictors of the total “opioid load” a patient can receive, they are nothing of the sort. And MME-based policies don’t just fail because of differences in the size of patients; they fail for multiple reasons.”
Flawed science yields meaningless results.
Bloom pointed out:
“Below is a chart published by the CDC, a “guide” (2) for physicians who prescribe pain drugs. Morphine is normalized to 1.0, and the conversion factor reflects the relative potency of other opioid drugs.
So, if the daily MME – the maximum dose of a drug allowed – is 90 mg (3), then a patient may receive no more than 90 mg of morphine, 90 mg of hydrocodone, 60 mg of oxycodone, or 30 mg of oxymorphone per day. Although the conversion table seems to be straightforward enough, it is based on the assumption that all opioids behave similarly in the body. But this assumption could not be less accurate.
Once we see the profound differences in the properties of the drugs and the difference between individuals who take them, it becomes clear that not only is the CDC chart flawed, but the MME is little more than a random number. “
Not all opioids are created equal, especially in the body
Bloom further writes:
“Anyone with even a passing knowledge of pharmacology would immediately be skeptical of the data in the chart. Let’s take, for example, the two drugs at the bottom.
Although Table 1 above tells us that oxymorphone is twice as “strong” as oxycodone it does not take into account a number of critical properties that paint a more complete picture of the fate of the drug once swallowed. In other words, there is no information about pharmacokinetics – the effect of the body on the drug. “
APPEAL OF ADELGLASS’s CONVICTION FILED 24TH OF AUGUST, 2023
HIGHLIGHTING THE FABRICATED DATA ANALYTIC FRAUD METHODOLOGY USED BY PROSECUTORS IN THE DR. HOWARD ADELGLASS, MD CASE, WHICH IS CURRENTLY UNDER FEDERAL APPEAL
The CDC MME chart, in fact, the entire concept of morphine milligram equivalents, may be convenient for bureaucrats. Still, because of differences in the absorption of different drugs into the bloodstream, the half-life of different drugs, the impact of one or more other drugs on opioid levels, and large differences in the rate of metabolism caused by genetic factors is not only devoid of scientific utility but actually causes far more harm than help by creating “guidelines” that are based upon a false premise. When a policy is based on deeply flawed science, the policy itself will automatically be fatally flawed. It cannot be any other way.”
FOR NOW, YOU ARE WITHIN