____the DEA master Pharmacy Plan 15DDHQ20R00000021, 9/20/2020, by Amanda Vanderveen, (1)

” Yes, we would expect that pharmacies that have an established mechanism to expose their business data to be incorporated with the provided data. “

BY

NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, JOSEPH SOLVO ESQ., REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., BRAHM FISHER ESQ., JOSEPH WEBSTER MD., ESTER HYATT PHD., BRAHM FISHER ESQ., MICHELE ALEXANDER, CUDJOE WILDING BS, DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS

THE CONGRESSIONAL COMMITTEES ON GOVERNMENT OPERATIONS, CONGRESSIONAL COMMITTEE ON THE JUDICIARY, THE CONGRESSIONAL COMMITTEE ON HOMELAND SECURITY, CONGRESSIONAL BLACK CAUCUS MUST BEGIN INVESTIGATIONS OF THE CORRUPTION WITHIN THE THE UNITED STATES DEPARTMENT OF DRUG ENFORCEMENT (DEA) IMMEDIATELY

WALMART PHARMACIES VS UNITED STATES DRUG ENFORCEMENT ADMINISTRATION

Case No. 4:20-cv-00817-SDJ

When a group of Black Pharmacists formed together to expose the targeting of their establishments by the DOJ/DEA, both agencies got even more clever and filed an unjustified complaint against Wal-Mart Pharmacies.

“Unfortunately, certain DOJ officials have long seemed more focused on chasing headlines than fixing the crisis. They are now threatening a completely unjustified lawsuit against Walmart, claiming in hindsight pharmacists should have refused to fill otherwise valid opioid prescriptions that were written by the very doctors that the federal government still approves to write prescriptions.”

Our group has developed strong evidence these actions were done by DOJ/DEA as a publicity stunt to disguise to the American taxpayer that their aberrant behavior is not targeted at any group particularly black pharmacy owners. DEA will argue to the Pubilc they are just doing their jobs. We of course “know better.”

BACKGROUND OF WAL-MART PHARMACIES VS DEPARTMENT OF JUSTICE AND UNITED STATES DRUG ENFORCEMENT ADMINISTRATION

WAL-MART PHARMACY PRESS RELEASE

” We are bringing this lawsuit because there is no federal law requiring pharmacists to interfere in the doctor-patient relationship to the degree DOJ is demanding, and in fact, expert federal and state health agencies routinely say it is not allowed and potentially harmful to patients with legitimate medical needs.

DOJ is forcing Walmart and our pharmacists between a rock and a hard place. At the same time that DOJ is threatening to sue Walmart for not going even further in second-guessing doctors, state health regulators are threatening Walmart and our pharmacists for going too far and interfering in the doctor-patient relationship. Doctors and patients also bring lawsuits when their opioid prescriptions are not filled.

Walmart and our pharmacists are torn between demands from DEA on one side and health agencies and regulators on the other, and patients are caught in the middle. We need a court to clarify the roles and legal responsibilities of pharmacists and pharmacies in filling opioid prescriptions.”

THE MISSION OF THE DEA

DEA’s mission is to enforce the controlled substance laws and regulations of the United States and bring to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets. 

Regulatory enforcement by DEA will focus on DEA required records, the security of controlled substances, and the “Due Diligence” placed on a registrant to know their customers. Failure to maintain complete and accurate records, inventory, the security of controlled substances, and the lack of a “Due Diligence” program may result in administrative and civil actions on their DEA registration. (2)

EXPOSING DEA’S FRAUDULENT METHODOLOGIES AND WHY WALMART SHOULD NOT SETTLE

Notably, DEA’s evidence always relies upon exaggerations on numbers of “pills” and street language such as “pill mills,” “Holy Grails,” and “Cocktails,” not on medical disease states, clinical conditions, or medical terminology. Prosecutors have found these forms of distortion, redefinition of medical procedures effectively sells juries.  Further, Judges often instruct the juries to ignore any clinical presentation or will not allow such testimony on the record.  

The actions of the DOJ/DEA are Federal Government overreach and the attorney representing companies like Walmart, CVS Purdue Pharma do a tremendous disservice to small family-owned pharmacies and to the taxpayers when they enter into settlements with the DOJ/DEA. Our answer is even more clear, don’t settle!

CONGRESS MUST INVESTIGATE

DISBANDING THE DEA

When understanding the level of corruption of the DEA and why this Federal Agency must be disbanded, defunded, or redirected out of medicine, One needs only to ask themselves two fundamental questions.

A. How long has the DEA been around?
B. How long have pain and anxiety been around?

The DEA has gained power in 3 ways:

1 . Through its Kangaroo Court System, which is permitted to operate outside the Rules of Federal Evidence and Civil Procedures.

2. Through threats and intimidation and using forfeiture clauses, the DEA has managed to muscle their way into the Medical/Dental/Pharmacy professions until they have literally redefined,  reinterpreted medical procedures/ protocols and have criminalized them. (examples include terms such as addiction and dependency)

3. Through the use of Junk Science, the DEA has been waging a clandestine campaign of disinformation to sway the public into believing prescribed narcotic analgesic medications are indeed dangerous drugs and their high dosages are red flags indicating abuse and trafficking which have contributed to the so-called opioid crisis around America. (12)

In fact, DEA is the single most heinous government agency whose tactics have increased the cost of medication and healthcare all across America by misinterpreting the purpose and roles of medications needed to treat acute, chronic, neuropathic, and psychological pain.

Healthcare Providers are assumed by DEA to be lacking due diligence if they don’t prove beyond a shadow of a doubt that they have addressed any red flags, but in DEA court tribunals the agencies hardly ever produce evidence of real diversion. They rely on suspicions and glitzy non-scientific presentations. (13)

Let it also be noted, patients being treated for chronic pain who travel to a Black-owned pharmacy are called “RED FLAGS” by the DEA and these pharmacies  are  classified as imminent dangers to the “Public Health.” While the same patients traveling to non-black owned pharmacies, with the same prescriptions, using the exact same payment methodology, the fictitious label of “red flags” does not truly exist.  

“AND THE LORD SAID UNTO PAUL DO NOT BE AFRAID FOR I AM WITH YOU”

THE DEA PHARMACY EXPERT

“FALSUS IN UNO, FALSUS IN OMNIBUS” 

The DEA and the United States Department of Justice have relied upon a cadre of pharmacy experts such as Dr. Sullivan, Tracey Gordon PharmD, whose analysis and methodologies are questionable, anecdotal, and seriously flawed. Oftentimes their review, which is an analysis of a patient’s medical records doesn’t capture sufficient information to conclusively establish the illegitimacy of a prescribing practitioner’s reasoning for issuing a specific prescription to a patient for a specific disease state. (6) 

In many cases, the pharmacy experts don’t often have the full patient’s record because the DEA Diversion Investigator never obtains them, and almost never consults with the treating medical practitioner or fails to conduct a thorough investigation.

It is further noted that one can easily find these flaws being committed by so-called pharmacy experts, like Don Sullivan and Tracey Gordon. These experts and flaws are found in nearly the entire DEA’s case files over the past 20 years. This has resulted in thousands of pharmacists, small pharmacy owners, and large pharmacy chains being subjected to extortion through fines, and may lead to consequences of which pharmacists and physicians can lose their licenses/property, serve liberty and cause patients committing suicide. (7) 

DALE SISCO, ESQ, LAW TAMPA, FLORIDA EXPOSED THE DECEPTIVE MOTIVATION OF A DEA PHARMACY EXPERT ROBERT B J DORION PHARMD

Robert BJ Dorion was once hailed as a renowned DEA Pharmacist expert, testifying on behalf of the Government (DEA) against partitioners in both Civil and Criminal court proceedings. Dorion was noted for use of the terms “red flags”, and “corresponding responsibility.” However, his court credibility became questionable after the below statements he iterated to Tampa defense Attorney Dale Sisco.

Robert B J Dorion:

To get back to your practical question…..Then who is correct in the eyes of the law…… You have to demonstrate as an expert witness that you have taken the means and are knowledgeable in whatever you are promoting…… Whether it’s a conclusion…… Or a method that you have adopted to arrive at that conclusion.

Robert B J Dorion:

 You will be cross-examined critically

Robert B J Dorion:

 That’s where you may buckle and fold unless you can demonstrate that you are competent

Robert B J Dorion:

 So it’s not a question of the law………. It’s a question of convincing the judge (or the jury)

THE CONGRESS MUST INVESTIGATE AND DEFUND THE UNITED STATES DRUG ENFORCEMENT AGENCY (DEA)

DEA’S EXPERT TWINS OF DECEPTION

“FALSUS IN UNO, FALSUS IN OMNIBUS”

They’ve (DEA) exploited the use of a network of medical practitioner hustlers such as Donald Sullivan RPh., PhD., Timothy Munzing, MD., in courtrooms who have been well paid by the Government. See GovTribe. (1),(2),(3) Their testimony often relies on tacit bias without examining radiographs (X-rays) of the patients or interviewing prescribing practitioners. In many cases, it is equivalent to the discredited bite mark evidence once used in courtrooms.

AMERICA WE ARE BETTER THAN THIS!!

The DOJ, DEA idea is to starve us out of business through harassment, intimidation, and fraudulent misrepresentations by their network of so-called DEA experts like Timothy Munzing, MD. (1)

According to GovTribe, a website that tracks payments to federal contractors, Munzing is paid $300 an hour by the DEA. (1) In the past few months, Munzing has been paid over $250,000 by the DEA to review patient records and testify as an expert witness in DEA cases. (1) 

AMERICA WE ARE BETTER THAN THIS!!

Dr. Munzing who works with Kaiser Permanente and Donald R. Sulivan, Professor at Ohio State University College of Pharmacy never appears to have examined or interviewed the patients or prescribing physicians and relied on conclusions of Junk Science in their courtroom testimonies. 

JACK FOLSON RPH

CLINICAL PHARMACIST EXPERT IN PHARMACY PRACTICE: HOSPITAL, RETAIL CHAIN, RETAIL INDEPENDENT, STERILE COMPOUNDING, NON-STERILE COMPOUNDING, FORMER DIRECTOR OF PHARMACY.

DEA DIVERSION OF THE TRUTH

“As it pertains to corresponding responsibility we do not have primary responsibility and this is because we do not have the training in diagnostics that would be required to proffer a second opinion.”(4)(12)

Once a diagnosis is given, the only thing that the pharmacist can do is make a recommendation as to the proper drug therapy for that particular patient, within that particular diagnosis, and at best it can only be a recommendation that lacks a full understanding of the diagnostic criteria.

To require the pharmacist to be the final arbiter of what is or is not reasonable therapy based upon inferior knowledge of diagnostics would be erroneous

Jack Folson RPh., expert pharmacist Consultant from Michigan stated in his May 2020 report known as The Folson Amicus Brief:

“Presently, because of the criminalization of pain management, suffering has increased and has led to an increase in heroin use.  Due to the dangers associated with heroin, use this, more than anything else, in this case, is an immediate threat to public safety.  To put it plainly, the actions by the DEA are causing the thing that they are trying to avoid.”  (3),(4)

RICHARD L. WYNN, RPH, Ph.D., PROFESSOR OF PHARMACOLOGY, UNIVERSITY OF MARYLAND DENTAL SCHOOL

THE PHARMACIST ROLE

Richard L. Wynn Rph, Ph.D opins

The Pharmacist’s role is to make sure they accurately dispense what the provider request and to check for possible drug interaction. (see video)

JOSEPH L.WEBSTER, SR., MD, MBA, FACP, BS. PHARMACY

Joseph Webster MD, writes:

“Once the provider has met all of the aforementioned and other ‘requirements to write a prescription, then and then ONLY  should a healthcare practitioner write a prescription.  I do not see where Dr. Sullivan obtained his evidence that the pharmacist in question attempted to do any of these steps in the ‘chain of authority’ in the cases in question. Furthermore, as stated above, a pharmacist IS NOT AUTHORIZED TO WRITE A CONTROL PRESCRIPTIONS by any of the regulatory boards of health.”

“It is my professional opinion that the pharmacist in question had ‘no reason’ and more importantly the pharmacist had ‘no power’ to question or interrogate each provider on ‘each prescription’ that is received as long as the ‘safety, efficacy and convenience’ of the medications being prescribed meet the standards of Medication Dispensing. Any given medication can be and certainly will be given for multiple different diagnoses and it is not even feasible for the pharmacist to ‘contact and question’  each and every diagnosis.”

These harms to medical practitioners have occurred specifically based on these DEA so-called expert’s (like Sullivan) fraudulent analyses and methodologies. The level of DEA’s corruption and abuse has been so pernicious that the entire 20-year case files of charges against healthcare practitioners must be re-examined and convictions, fines, and sanctions reversed, overturned, and dismissed with prejudice. (4)

DEA pharmacy experts failed basic standards of care as a Pharmacist. Instead, they have engaged in a self-serving crusade of fraud, deception, billing the taxpayers of the United States of America for services they did not perform, and received payments for their ill-gotten gains.

THE MEDICAL SIDE OF THE SO CALLED OPIOD EPIDEMIC

The idea that medically prescribed opioid medications (MPOM) or narcotic analgesic medications (NAM) cannot be used for chronic pain is simply not true and is misleading. Further, the idea these medications are not to be used in combination with other medications such as those used to relieve anxiety; mood disorders, or sleep is further in error.

MPOM or NAM, when prescribed and use for long term chronic pain will result in dependency. It is therefore the role of the Pharmacist to ensure the patient who is being treated for chronic pain is properly instructed on how to use this class of medication correctly, for their safety.

These medications are safe when used correctly and like any medications control or non-control when taken beyond their therapeutic dose are dangerous and may result in death. More importantly, to this date, unless is the case of extreme anaphylaxis there is no case in the literature when any individual has succumbed to death when given a therapeutic dose. (10)

In fact, other medications may cause a higher level of mortality in therapeutic doses.  Warfarin, an anticoagulant for example has an extremely narrow therapeutic index and cranial hemorrhage is somewhat common.  Antibiotics, are too widely prescribed and create a need for newer and stronger antibiotics and will be the death of all humankind eventually.  The CDC is well aware of these dangers.  Anti-Neoplastic medications in the treatment of cancer are extremely toxic and what is considered a “cure” is remission for just 5 years.  

RICHARD A. “RED” LAWHERN, PH.D

Richard A. “Red” Lawhern, Ph.D., is a non-physician patient advocate, moderator of online patient communities, and co-founder and former director of research for The Alliance for Treatment of Intractable Pain. @lawhern1 facebook.com/red.lawhern (5)

Stop persecuting doctors for legitimately prescribing opioids for chronic pain

According to Richard Lawhern, June 19, 2020 article, “STOP PERSECUTING DOCTORS FOR LEGITIMATELY PRESCRIBING OPIOIDS FOR CHRONIC PAIN” in STAT+ online news states:

The damage to healthcare providers and the chronic pain patient population is devastating and the DEA never takes into account the clinical needs of the patients.  It’s as if they have criminalized pain management without the benefit of clinical knowledge. (5)

“Doctors should have gotten the message by now that deserting patients is a violation of medical practice standards, not to mention human rights. But they haven’t. On the contrary, they’ve been hearing about other doctors who got raided by Drug Enforcement Agency swat teams, their patients terrorized, medical records seized, and practices ruined by announcements in local news media. Compounding such brutal tactics, chain pharmacies have compiled high prescriber lists, blacklisting “top prescribing” physicians and denying prescription pain medication to their patients.” (5) (6)

Richard Lawhern points out;

In November, 2018, the American Medical Association’s House of Delegates issued its groundbreaking Resolution 235. It reads in part:

“… no entity should use MME (morphine milligram equivalents) thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guideline for Prescribing Opioids.”

” In April 2019, under fire from medical professionals across the country, the CDC advised against “misapplication” of the guideline. Writing in the New England Journal of Medicine, three authors of the guideline said it was never intended to become a mandated standard, even though more than 30 states had incorporated it into legislation in the three years since its publication. At about the same time, the FDA issued a safety warning against rapidly tapering individuals off opioids or suddenly stopping their administration, based on known harms to patients.“

Lawhern further writes:

“Much of the mess described by patients stems directly from the 2016 Centers for Disease Control and Prevention’s “Guideline for Prescribing Opioids for Chronic Pain.” In it, the CDC urged practitioners to avoid increasing opioid doses for new patients above daily doses of 50 morphine milligram equivalents (MME). For patients maintained on doses above 90 MME, doctors were told to conduct and document risk and benefits reviews.

“The CDC guideline became controversial almost immediately after it was published. Despite major criticism, it was widely interpreted by physicians, hospitals, insurance providers, state legislators, medical boards, and the DEA as a mandate for hard limits on prescribing opioids — even for so-called legacy patients for whom long-term or high-dose opioids had already proven safe and effective.“

“Since the publication of the guideline, the American Medical Association, the American Association of Family Physicians, and other organizations have repudiated the science, logic, and conclusions of the CDC guideline and of the DEA’s witch hunt. But nobody in government is listening to medical professionals any more than they are listening to patients.” (5),(6)

THE AMERICAN MEDICAL ASSOCIATION DEMANDS IMMEDIATE SUSPENSION OF CDC GUIDELINES

The American Medical Association wrote on June 16, 2020: (7)

“The nation no longer has a prescription opioid-driven epidemic. However, we are now facing an unprecedented, multi-factorial, and much more dangerous overdose and the drug epidemic is driven by heroin and illicitly manufactured fentanyl, fentanyl analogs, and stimulants. We can no longer afford to view increasing drug-related mortality through a prescription opioid-myopic lens. This is why the AMA continues its aggressive advocacy efforts in support of patients with pain and those with a substance use disorder as well as broad support for harm reduction policies and practices that address the wide range of factors affecting patients. “

The nation’s opioid epidemic has never been just about prescription opioids, and we encourage CDC to take a broader view of how to help ensure patients have access to evidence-based comprehensive care that includes multidisciplinary, multimodal pain care options as well as efforts to remove the stigma that patients with pain experience on a regular basis. CDC has a great opportunity to demonstrate its commitment to patients with pain through a detailed re-examination of the CDC Guideline, and the AMA urges CDC to work with physicians and patients to ensure that the revisions support patients with pain and the physicians who care for them.”

“While the AMA understands that the apparent goal of the CDC Guideline was to reduce opioid prescribing, we believe the proper role of CDC is to improve pain care. It follows that a dedicated effort must be made to undo the damage from the misapplication of the CDC Guideline.“

The AMA writes:

Accordingly, the CDC Guideline could be substantially improved in three overarching ways. First, by incorporating some fundamental revisions that acknowledge that many patients experience pain that is not well controlled, substantially impairs their quality of life and/or functional status, stigmatizes them, and could be managed with more compassionate patient care.

Second, by using the revised CDC Guideline as part of a coordinated federal strategy to help ensure patients with pain receive comprehensive care delivered in a patient-centric approach. And third, by urging state legislatures, payers, pharmacy chains, pharmacy benefit management companies, and all other stakeholders to immediately suspend the use of the CDC Guideline as an arbitrary policy to limit, discontinue or taper a patient’s opioid therapy.

The AMA further writes:

“We are concerned that such a careful approach to identifying the precise combination of pharmacologic options could be flagged on a prescription drug monitoring program as indications wrongly interpreted as so-called “doctor shopping” and cause the patient to be inappropriately questioned by a pharmacist. The AMA strongly supports a pharmacist carrying out his or her corresponding responsibility under state and federal law, but the past few years are rife with examples of patients facing what amounts to interrogations at the pharmacy counter as well as denials of legitimate medication. The AMA urges CDC to provide strong guidance and support for physicians and pharmacists to work together rather than jumping to conclusions about a patient’s PDMP report.” (7)

” Clinicians are encouraged to have open and honest discussions with their patients so as to avoid stigmatizing the decision to start, continue, or discontinue opioids or non-opioid therapy. This discussion also must account for the treatment options accessible to the patient based on their health condition, social determinants of health (e.g. transportation, employment, childcare responsibilities, race, gender, age) and insurance coverage.” (7)

JOSEPH L.WEBSTER, SR., MD, MBA, FACP, BS. PHARMACY

Joseph Webster MD, writes:

” It is statutorily the purview of the pharmacist to ‘inspect and assure’ that the drug that is being given is safe and has no known incompatibilities with the patient and its holistic environment. 

According to Joseph Webster MD:

“It is not the purview nor is the pharmacist trained to ‘challenge the diagnosis’ of the physician and to do so verbally or otherwise with the patient. It erodes the ‘doctor-patient’ relationship and destroys the ‘confidence’ of the patient in his/her physician. At the very least it is ‘unethical’ and may very well be a HIPPA violation and beneath the standard of care as a pharmacist. “

CONGRESS MUST INVESTIGATE!!!

“Any healthcare provider that is licensed to ‘prescribe’ is governed by the set of conditions and circumstances under which a prescription can be written. Thus it is illegal to write a prescription for a person that the prescriber has not conducted the ‘chain of authority’ that would qualify him/her to write a prescription:  history and physical examination, formulation of a diagnosis, and discussing such with the patient as well as the proposed manner of treatment in a culturally sensitive and ethically appropriate manner; and provision of an opportunity for the patient to ‘question and discuss alternative forms of treatment; etc.” 

WE HAVE NO LOVE FOR THE LARGE CHAIN PHARMACY BUT!!!

Let it be clear, we have no love for Walmart and the other large chain pharmacies but there is an injustice being done to Walmart and the other large chains which affect us all.

Pronto Pharmacy is a small family-run business and often times we are excluded from many insurance plans who contract with large chain pharmacies. More importantly, insurances simply don’t pay their bills to the small family-owned pharmacy. Simply put they cheat us with extraordinary fee attachments. 

DEA/DOJ PRACTICE OF EXTORTION OF WALMART, LARGE CHAIN PHARMACIES, AND DRUG MANUFACTURERS

However, the large chain pharmacies and their parent companies clearly violate laws through false billings and even forged prescriptions on their part, while the DEA collects billions of dollars in what amounts to “extortion fines” and the large chains are given a pass. These warnings remain ever so obliterated, and one cannot ignore the functions of how race works in these types of proceedings.

Most noticeable, the chain pharmacies (CVS, Walgreens) are now owners of the drug insurance companies. So they now own the Market, the Pricing, and who plays in their market, and who is excluded. The problem is so extensive, Walmart had to lay-off 40% of its pharmacy staff around the country in part because of a dispute with CVS CAREMARK over reimbursements. (9)

PRECONCEIVED AS ARROGANT

DEA: THE CRIMES OF A BLACK-OWNED PHARMACY, PUNISHED FOR PAYMENT OF THEIR SERVICES

Black-owned pharmacies are punished by DOJ/DEA for being paid for their services they render to their patients. Once again it cannot be ignored how race is used in the decision-making process to target or ignore the economic (stratification) injuries when Black healthcare providers are reimbursed by third-party insurance payers differently based solely on zip codes. This is precisely why an increasing number of medical/dental/pharmacy providers are electing to do business solely in cash, credit cards, or debits to ensure their healthcare practices can sustain economic stability. (12)

THE AMAZING DOUBLE STANDARDS

However, DEA’S actions are fraudulent while the Black-owned pharmacies who become victims, can only helplessly watch the very patients who have been tagged as red flags. These red flags will have the same prescription(s), from the same prescriber, using the same payment methodology, filled at a non-black owned pharmacy and the DEA says nothing. This is an amazing double standard. The DEA’s intent appears to reflect the mindsets of its creators like “Richard M. Nixon, President of The United States” to destroy Black Society along with Blacks owning pharmacies. (11)

Yet, the United States Drug Enforcement Agency (DEA) will prosecute black pharmacists and black-owned pharmacies for accepting cash as a form of payment. (12)(11). The problem here directly falls on the incompetence of the DEA and their private vendors (Appriss Health) who have failed to develop the software of the Prescription Drug Monitoring Program (PDMP) which can distinguish when a person pays in cash, credit card, or debit cards.

TRAPPED IN THE PURGATORY

These pharmacists are then perceived and classified as arrogant, uppidty, public health threats, imminent dangers, trapped in the purgatory of someones else’s definition of who they are and who they should be. Their certificate of control registration gets suspended for allegedly ignoring red flags in filling legally prescribed narcotic analgesic medications. (14)

Norman J Clement, Aaron Howard, Rick Fertil demand the return of our DEA pharmacy Control Substance Registrations Immediately.

FOR NOW YOU ARE WITHIN THE NORMS

ENDNOTES

1. DEA Master Plan to unmask patient private healthcare data for every person receiving a prescription within 3 days: https://static1.squarespace.com/static/54d50ceee4b05797b34869cf/t/5fac5d699a1aef48f6f43d39/1605131626625/DEA+RFP+amendment.pdf

2. Practicing Pharmacy Wile Black, Norman J Clement, Beres Muschett, Debra Lynn Shephed, et all

____” when we feel a pang of shock and resentment, a personal wounding Absence of unfairness and perhaps even shame at our discomfort upon seeing someone from a marginalized group in a job or a car or house or college or appointment more prestigious than we have been led to expect when we assume that the senior citizen should be playing Parcheesi rather than developing software,” 

_____” we are reflecting the efficient encoding of caste, the subconscious recognition that the person has stepped out of his or her assumed place in our society. We are responding to our embedded instructions of who should be where and who should be doing what, the breaching of the structure and boundaries that are the hallmarks of caste.”

Yet, we have further and properly been schooled by our ancestors, teachers, professors, within our hairdressers, and barbershops to resist, to not ever accept or yield to subordination. We know that the built-in institution of racial caste injustice, particularly within the Judicial System or in the fields of medical science, sports, politics, or the military. will default to all knowledgeable, educated Black persons as arrogant and uppity. 

We especially observe and experience these attitudes of ill will in our history, particularly in the United States, when one is right and dares to challenge these societal mores.

3. https://youarewithinthenorms.com/2020/06/09/the-folson-amicus-brief/

4. https://youarewithinthenorms.com/2020/06/17/when-priviledge-takes-the-stand-deas-judge-mark-d-dowd-and-his-court-of-the-kangaroo-the-congress-must-defund-the-dea/

5. https://www.statnews.com/2019/06/28/stop-persecuting-doctors-legitimately-prescribing-opioids-chronic-pain/

6. Richard A. “Red” Lawhern, Ph.D., is a non-physician patient advocate, moderator of online patient communities, and co-founder and former director of research for The Alliance for Treatment of Intractable Pain.

7. AMERICAN MEDICAL ASSOCIATION JUNE 16, 2020, https://searchlf.ama-assn.org/undefined/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2F2020-6-16-Letter-to-Dowell-re-Opioid-Rx-Guideline.pdf

8. Drug Policy Alliance: Its time to Dismantle the DEAhttps://www.drugpolicy.org/DEA

9. Richard Wynn, PhD, is a nationally recognized speaker, author, columnist and consultant relative to dental drug therapeutics and drug information for the dental professional. He keeps the profession informed about current issues relative to drugs in dentistry including new therapeutic agents, new drug interactions and newly reported adverse reactions in dental patients. He researches the literature daily for new reports which would be of interest to the profession. Dental schools which have provided support for his update courses have included U Mississippi, Loma Linda, UCLA, UCSF, U Washington, U Minnesota, U Pittsburgh and U Florida. State dental and dental hygiene associations providing support have included Maryland, Arkansas, Florida, Pennsylvania, Mississippi and California. Professional associations supporting Dick in his efforts include the American Dental Association and the Academy of General Dentistry. He is the lead author of the most recognized chairside dental drug reference book entitled Drug Information Handbook for Dentistry now in its 9th edition, avaliable in print and electronic formats. Dick continues to be the “source for dental drug information” because of his academic interests and his ready access to commercial, private and governmental drug data bases.

10. https://youarewithinthenorms.com/2019/12/21/when-did-it-become-the-job-or-role-of-the-department-of-drug-enforcement-dea-to-re-define-and-then-dictate-medical-procedures-and-protocols-reflectionsshort-by-norman-j-cle/

11. https://youarewithinthenorms.com/2020/11/14/danger-danger-congress-must-stop-the-united-states-drug-enforcement-agencys-dea-intrusion-on-patients-privacy-medical-records-and-the-criminalization-of-anxiet/

12. https://youarewithinthenorms.com/2020/11/15/how-the-deas-war-on-drugs-has-gone-off-the-rails/

13.

14.  Caste: The Origins of Our Discontents, April 2020, pg. 47, pg. 50, pg. 72, pg. 116-117, Wilkerson, Isabelwilkerson.com

….Miseducation of a targeted population plays an essential component in maintaining dominance… the Bantu Education Act was to ensure that blacks would have only just enough education to work as unskilled laborers….”

FROM THE TAMPA BAY TIMES

NOVEMBER 22, 2020

BY NEIL BEDI ANDKATHLEEN MCGRORY

*CONTRIBUTION BY NORMAN J CLEMENT RPH., DDS

The Pasco Sheriff’s Office keeps a secret list of kids it thinks could “fall into a life of crime” based on factors like whether they’ve been abused or gotten a D or an F in school, according to the agency’s internal intelligence manual.

The Sheriff’s Office assembles the list by combining the rosters for most middle and high schools in the county with records so sensitive, they’re protected by state and federal law.

School district data shows which children are struggling academically, miss too many classes or are sent to the office for discipline. Records from the state Department of Children and Families flag kids who have witnessed household violence or experienced it themselves.

According to the manual, any one of those factors makes a child more likely to become a criminal.

Four hundred and twenty kids are on the list, the Sheriff’s Office said.

The process largely plays out in secret. The Sheriff’s Office doesn’t tell the kids or their parents about the designation. In an interview, schools superintendent Kurt Browning said he was unaware the Sheriff’s Office was using school data to identify kids who might become criminals. So were the principals of two high schools.

The Department of Children and Families didn’t answer when asked if it knew its data was being fed into such a system.

AMERICA WE ARE BETTER THAN THIS!!

Pasco County Sheriff Chris Nocco Times file

Sheriff Chris Nocco declined requests to be interviewed, and his agency did not make anyone from its intelligence-led policing or school resource divisions available for comment.

In a series of written statements, the Sheriff’s Office said the list is used only to help the deputies assigned to middle and high schools offer “mentorship” and “resources” to students.

Asked for specifics, it pointed to one program where school resource officers take children fishing and another where they give clothes to kids in need.

Pasco’s sheriff uses grades and abuse histories to label schoolchildren potential criminals. 

The kids and their parents don’t know they are targeted | A Times investigation

* THE IMPORTANCE OF MISEDUCATION AND MAINTAINING IGNORANCE

The miseducation of a targeted population plays an essential component in maintaining dominance. Moreover, despite the fact, “we have overcome” the dragon-colonialism legacy of “Jim Crow and Apartheid in both the United States and South Africa, we continue to observe the residuals effects of these practices on children struggling academically.

*HENDRIK FRENSCH VERWOERD PRIME MINISTER UNION OF SOUTH AFRICA

Among the laws which were drawn and enacted during Hendrik Verwoerd’s time as the Minister for Native Affairs were the Population Registration Act and the Group Areas Act in 1950, the Pass Laws Act of 1952, and the Reservation of Separate Amenities Act of 1953.

Verwoerd wrote the Bantu Education Act, which was to have a deleterious effect on the ability of black South Africans to be educated as Verwoerd himself noted:

that the purpose of the Bantu Education Act was to ensure that blacks would have only just enough education to work as unskilled laborers.[1]

THE BANTU EDUCATION ACT

The Bantu Education Act ensured that black South Africans had only the barest minimum of education, thus entrenching the role of blacks in the apartheid economy as a cheap source of unskilled labor. In June 1954, Verwoerd in a speech stated:

“The Bantu must be guided to serve his own community in all respects. There is no place for him in the European community above the level of certain forms of labor. Within his own community, however, all doors are open.”[1]

see below link to THE article in Tampa Times November 22, 2020

https://projects.tampabay.com/projects/2020/investigations/police-pasco-sheriff-targeted/school-data

ALSO SEE BELOW LINK TO CONGRESSIONAL BLACK CAUCUS WEEKEND SEPTEMBER 29, 1990

JAILS, PRISONS, AND DRUGS: THE TARGETING OF YOUNG BLACK MALES

“The US ‘War on Drugs’ has had a profound role in reinforcing racial hierarchies. Although Black Americans are no more likely than Whites to use illicit drugs, they are 6–10 times more likely to be incarcerated for drug offenses. Meanwhile, a very different system for responding to the drug use of Whites has emerged.” (2)  

JOHN CONYERS (D) DETROIT, CHAIRMAN GOVERNMENT OPERATION COMMITTEE 1990

https://www.c-span.org/video/?14263-1/jails-prisons-drugs

During the 1990 Congressional Black Caucus Weekend, a discussion lead by Professor Dr. Ron Daniels. The panel discussed the question of crime and drugs in relation to young black men. Topics discussed included the amount of money spent on law enforcement versus crime prevention and does race influences the death penalty. See link below Chairman John Conyers (D) Detroit, “Jail, Prisons, and Drugs: The Targeting Young Black Males,” Omnibus Crime Bill, 1990.

THE CONGRESSIONAL COMMITTEES ON GOVERNMENT OPERATIONS, CONGRESSIONAL COMMITTEE ON THE JUDICIARY, THE CONGRESSIONAL COMMITTEE ON HOMELAND SECURITY, CONGRESSIONAL BLACK CAUCUS MUST BEGIN INVESTIGATIONS OF THE CORRUPTION WITHIN THE THE UNITED STATES DEPARTMENT OF DRUG ENFORCEMENT (DEA) IMMEDIATELY

AMERICA WE ARE BETTER THAN THIS!!!

FOR NOW, YOU ARE WITHIN THE NORMS

ENDNOTE

1. https://en.wikipedia.org/wiki/Hendrik_Verwoerd

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501419/#R28/

” EXPOSING THE DEA’S PAIN FRAUD SCAM”

REPORTED BY

NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, JOSEPH SOLVO ESQ., REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., BRAHM FISHER ESQ., JOSEPH WEBSTER MD., ESTER HYATT PHD., BRAHM FISHER ESQ., MICHELE ALEXANDER, CUDJOE WILDING BS, DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS

BY

Johnson, Sandra H., JD, LLM

Legal and Ethical Perspectives on Pain Management

Ethics First

As Brennan et al. emphasize, the relief of pain is a core ethical duty in medicine. Unrelieved pain blocks the enjoyment of all other human goods and values. In the words of an oncology nurse who herself suffered from chronic pain: “This malady has been the most frightening, the most humiliating, and the most difficult ordeal of my life …. I became withdrawn, completely disabled by my terrible, relentless pain. I was unable to function professionally. I was unable to be much of a wife or a mother, a daughter, or a friend.” And, from a man with terminal cancer: “Pain is my biggest fear … it puts me in a darkness … you can’t find peace in that darkness of pain … Pain blinds you to … all that’s positive.” An individual with sickle cell describes emergency room visits: “They wanted to know why the medication was not working? Why are you still in pain? If you are crying, why are you crying; if you are not crying, how can you be in pain? … You are not only experiencing your pain … you are experiencing other peoples’ opinions and feelings; that makes it worse.” (⁴).

If we could come to understand that pain is not merely a cloak that a patient carries and that we can simply push aside, but that it is instead an attack on the human being’s core, we might see some progress. As in most medical matters, it is best if ethics takes the lead and law follows.

Trends in the Law

There have been some considerable improvements in the state of the law. Brennan et al. describes many of the developments in legal standards that affect the practice of pain management. The adoption of guidelines for state medical boards, for example, is very significant and considerably improved the environment for doctors treating pain patients (⁵). These guidelines specifically recognize that doctors have a duty to relieve pain and that medical boards must be as vigilant for cases of neglect in this regard as they have been in monitoring prescriptions of controlled substances. Moreover, at least half of the states have enacted legislation that protects doctors from disciplinary action and criminal prosecution (on the state level) if their treatment of patients meets general practice standards.

This is not to say that there are not still problems with the medical boards in particular states, but a great deal of progress has been made.

In addition, although one may believe that increasing the risk of liability for doctors can never be positive, the Bergman case, discussed in their article as well as the very similar Tomlinson case (8), are landmark legal cases. They establish that pain, standing alone and without another physical injury, can be recognized as an injury at law. They demonstrate how patients who suffer in the most egregious cases can seek a remedy in the courts—raw comfort though that may be. When the risk of legal penalty arises only for health care professionals who aggressively treat patients for pain, and not for health care providers who neglect their patients, the scales are out of balance and they could encourage substandard care.

Unfortunately, the law has not moved all in one direction. In fact, after some promising developments in 2001 and early 2003, the Drug Enforcement Administration (DEA) took steps backward by withdrawing the consensus document described by Brennan et al. and issuing policy statements that went in the opposite direction. Even the National Association of Attorneys General expressed concern that “state and federal policies are diverging with respect to the relative emphasis on ensuring the availability of prescription pain mediations to those who need them.” The prosecution and conviction of a Virginia physician for violation of the Controlled Substances Act, and other similar prosecutions, certainly affects doctors’ perceptions of legal risks, even though that conviction was later reversed by a federal appeals court. Although the number of doctors subject to DEA investigation is quite small, the consequences of such an action are quite severe. The DEA has since issued further statements on its policy, leaving its 2003 statement largely intact. On the same day, however, the DEA proposed new regulations that would allow doctors to write multiple sequential prescriptions for controlled substances for single patients (¹²).

The Practice Context Matters

It is customary to place pain into one of several broad categories; i.e., cancer pain, chronic nonmalignant pain, or acute pain. From the perspective of public policy and law, however, other categories are more useful. The legal environment for specific practice settings varies considerably, and the challenges faced by health care providers are also quite distinctive. Strategies to improve care cannot be “one size fits all.”

For example, treating pain in nursing homes, an area where neglect of pain is particularly prevalent, operates in a legal environment that has created a culture that resists extensive reliance on pharmaceuticals, especially those that may have an impact on alertness. In addition, nursing home patients can present particular challenges in pain management because of the incidence of dementia or other forms of mental confusion. Physicians in that institutional context, however, should feel free of concerns about diversion or addiction. Likewise, physicians treating patients who have cancer or terminal illness, in whatever practice setting and including office-based practice, face essentially no legal risk of the medical board or DEA actions for treating patients for pain. In contrast, concerns about diversion are extreme among physicians practicing in the emergency department, perhaps because doctors and patients are strangers to one another, even though emergency departments are not significant sources of diverted drugs. Emergency departments are not a prime target for investigation and prosecution. It is not the legal risk that explains the hypervigilance in emergency medicine.

In fact, most concerns about legal risks that might lead physicians to allow patients to suffer arise in the office-based practices that treat patients in chronic pain. The fear of DEA action, in particular, may lead doctors to avoid patients with chronic pain (although there is more to that avoidance than concerns about the DEA) and may steer those who do treat chronic pain patients with controlled substances to undertreat their pain. However, the practice management techniques described in the medical board guidelines will help to reduce those risks considerably.

Where Next?

We have persuasive evidence, as discussed in the article by Brennan et al. that neglect of pain persists in all practice settings. Although treatment for pain can be quite complex, neglect occurs even when that is not the case. It is not the law that explains that phenomenon in most practice settings, although the legal risk may be having an adverse impact in the office-based chronic pain practice. There surely is room for further development of legal standards and practices that are more conducive to improvements in pain management. As Brennan et al. argue so forcefully, it will take movement on many fronts to improve both cares for patients in pain and the environment for those who treat them.

Senator Hatch on DEA and Opioid Crisis and Abuse (6)(7)(8)

C-SPAN.org https://www.c-span.org/video/?435395-3/senator-hatch-dea-opioid-crisis

Improvement must begin, again, with professional ethics. The literature on obstacles preventing access to effective pain relief tends to treat these as matters of social or institutional fact. Instead, each of the barriers is essentially a question of ethics. Inadequate skills may be a result of inadequate training in medical or nursing school, but failing to learn while in practice breaches the professional’s ethical duty to maintain their competencies and continue to learn. Similarly, many of the common “red flags” used to screen out “drug seekers” are ineffective and inaccurate, and unethical, as they cause injustice in excluding entire groups of people solely for irrelevant characteristics.

Perhaps the greatest hope is to expand our view of the treatment of pain beyond a question of medical practice and toward a view of pain as a public health crisis. The shift is certainly justified on the basis of the staggering data on the financial costs of untreated pain. A public health approach may shift the focus to systems that will improve outcomes rather than on blaming doctors and other health care professionals. Personal and professional accountability for failing to treat patients competently and compassionately is critical, but so is creating environments that make effective care for patients in pain the norm.

THE CONGRESSIONAL COMMITTEES ON GOVERNMENT OPERATIONS, CONGRESSIONAL COMMITTEE ON THE JUDICIARY, THE CONGRESSIONAL COMMITTEE ON HOMELAND SECURITY, CONGRESSIONAL BLACK CAUCUS MUST BEGIN INVESTIGATIONS OF THE CORRUPTION WITHIN THE THE UNITED STATES DEPARTMENT OF DRUG ENFORCEMENT (DEA) IMMEDIATELY

AMERICA IS BETTER THAN THIS!!!

FOR NOW YOU ARE WITHIN THE NORMS

REFERENCES

1. Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right. Anesth Analg 2007;105:205–21.

• Cited Here | 
• View Full Text | PubMed | CrossRef

2. Snyder CA. An open letter to physicians who have patients with chronic nonmalignant pain. J Law Med Ethics 1994;22:204–5.

• Cited Here | 
• PubMed | CrossRef

3. Coyle N. Opioids, cancer pain, quality of life and quality of death: patient narratives and a clinician’s comments. In Meldrum ML, ed. Opioids and pain relief: a historical perspective. Seattle: IASP Press, 2003.

4. Johnson, Sandra H., JD, LLMAuthor Information, from the Tenet Endowed Chair in Health Law and Ethics, Center for Health Law Studies, Center for Health Care Ethics, Saint Louis University, St. Louis, Missouri. Accepted for publication March 29, 2007.

5. Address correspondence to Sandra H. Johnson, JD, LLM, Tenet Endowed Chair in Health Law and Ethics, Center for Health Law Studies, Center for Health Care Ethics, Saint Louis University, 3700 Lindell Boulevard, St. Louis, MO 63108. Address e-mail to johnsosh@slu.edu. Anesthesia & Analgesia: July 2007 – Volume 105 – Issue 1 – p 5-7 doi: 10.1213/01.ane.0000268148.38688.e7

6. https://justice4all.blog/2020/01/07/opioid-orrin-hatch-2/

7. https://www.modernhealthcare.com/article/20180920/SPONSORED/180929983/the-abcs-of-pharmacy-compliance-fda-dea-and-epa

8. https://www.congress.gov/bill/114th-congress/senate-bill/524/text?

By Norman J Clement RPH., DDS,

Oral Health is an essential component of overall health. Yet the most likely tragedy perhaps will be how many well-meaning Dental Boards, (Louisiana, Pennsylvania) Public Health spoke persons, Governors and News Media outlets have failed to comprehend the importance of Oral Healthcare during the Corona Virus Pandemic. Dental Care is healthcare.

Now think about it. We are told to wash our hands, not touch our face and cover our mouths. According to the CDC SARS-CoV-2,:(1)

“the virus that causes COVID-19, is thought to be spread primarily through respiratory droplets. Airborne transmission from person-to-person over long distances is unlikely. However, the contribution of aerosols, or droplet nuclei, to close proximity transmission is currently uncertain. The virus has been shown to survive in aerosols for hours and on surfaces for days. There are also indications that patients may be able to spread the virus while pre-symptomatic or asymptomatic. Covid-19 can survive on surfaces such as counter tops for 5 days, your cloths for 5 hours plastic surface for 2 days”.

Yet what happens after you wash your hands and the virus still gets into your mouth? The CDC has not clearly addressed how long this virus survives in dental plague or even its relationship to poor oral hygiene. So now ask yourself if the virus can stick to a golf flag pole several hours, then how many days can it live on a dental restoration or a poorly cared for mouth? Rather than waiting for CDC to respond, I suggest:

1. That COVID-19 sticks to dental plaque and on dental restorations(particularly those that are poorly surfaced), dentures, partial and implants.
2. I believe many who have succumbed to this outbreak were likely to have maintained poor oral hygiene.

Therefore, along with washing your hands frequently, one should brush and floss at least 6 to 8 times daily, as well as rinsing your mouth with an over-the-counter mouthwash, swish and expectorate at least 5 to 7 times daily.

The significance of poor oral health and its effects on overall systemic disease should neither be ignored nor dismissed. A precise alarming study on “Oral Health in Relation to Pancreatic Cancer Risk in African American Women,” by Hanna Gerlovin, Dominique S. Michaud, Yvette C. Cozier, and Julie R. Palmer DOI: 10.1158/1055-9965.EPI-18-1053, (2) reported in the Journal of Cancer Epidemiology Biomarkers and Prevention April 19, 2019, demonstrated a high prevalence of pancreatic cancer in Black women who had poor oral health and missing teeth.

Portrait Western Cape, Cape Town South Africa

So, again, along with washing your hands frequently, brushing(teeth, tongue roof mouth and flossing at least 6 to 8 times daily, you should rinse your mouth with an over-the-counter mouthwash, swish and expectorate at least 5 to 7 times daily.

FOR NOW

YOU ARE WITHIN THE NORMS

1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

2. http://youarewithinthenorms.com/2020/02/03/poor-oral-health-in-african-american-women-risk-increase-pancreatic-cancer/

REPORTED BY NORMAN J CLEMENT RPH., DDS

“Rapid and accurate SARS-CoV-2 diagnostic testing is essential for controlling the ongoing COVID-19 pandemic. The current gold standard for COVID-19 diagnosis is real-time RT-PCR detection of SARS-CoV-2 from nasopharyngeal swabs……..saliva has exhibited comparable sensitivity to nasopharyngeal swabs in the detection of other respiratory pathogens, including endemic human coronaviruses, in previous studies.”

SALIVA IS MORE SENSITIVE FOR SARS-CoV-2 DETECTION IN COVID PATIENTS THAN NASOPHARYNGEAL SWABS, YALE UNIVERSITY REPORT SAYS

Saliva sampling is an appealing alternative to nasopharyngeal swab, since collecting saliva is non-invasive and easy self-administered, states a Yale University study, which supports You’re Within The Norms (YWTN) earlier conclusions. Clearly, COVID-19, is and Oral pharyngeal disease, detectable in the mouth and there is a need for Oral Healthcare Armed Intervention, before it expresses itself as a Systemic Pulmonary disease with horrific deathly outcomes.(1)(3)

In a study conducted at Yale University School of Public Health, Yale School of Medicine, abstract published April 22, 2020, reported:

“Our (The Yale University) study demonstrates that saliva is a viable and preferable alternative to nasopharyngeal swabs for SARS-CoV-2 detection. We (Yale) found that the sensitivity of SARS-CoV-2 detection from saliva is comparable, if not superior, to nasopharyngeal swabs in early hospitalization and is more consistent during extended hospitalization and recovery. Moreover, the detection of SARS-CoV-2 from the saliva of two asymptomatic healthcare workers despite negative matched nasopharyngeal swabs suggests that saliva may also be a viable alternative for identifying mild or subclinical infections. With further validation, widespread implementation of saliva sampling could be transformative for public health efforts: saliva self-collection negates the need for direct healthcare worker-patient interaction, a source of 14–16​ several major testing bottlenecks and overall nosocomial infection risk​ , and alleviates supply demands on swabs and personal protective equipment.”

YALE SCHOOL OF PUBLIC HEALTH AND YALE UNIVERSITY SCHOOL OF MEDICINE STUDY SUPPORTS DENTAL HEALTHCARE INVOLVEMENT

“As SARS-CoV-2 viral loads differ between mild and severe cases​, a limitation of our (Yale)study is the primary focus on COVID-19 inpatients, many with severe disease. While more data are required to more rigorously compare the efficacy of saliva in the hospital setting to earlier in the course of infection, findings from two recent studies support its potential for detecting SARS-CoV-2 from both asymptomatic individuals and outpatients​. As the infectious virus has been detected from the saliva of COVID-19 patients​ , ascertaining the relationship between virus genome copies and infectious virus particles in the saliva of pre-symptomatic individuals​ will play a key role in understanding the dynamics of asymptomatic transmission​ .”

“Stemming from the promising results for SARS-CoV-2 detection in asymptomatic individuals, a saliva SARS-CoV-2 detection assay has already gained approval through the U.S. Food and Drug Administration emergency use authorization​. To meet the growing testing demands, however, our findings support the need for immediate validation and implementation of saliva for SARS-CoV-2 diagnostics in certified clinical laboratories.“

WHAT AND WHY IS DENTISTRY SITTING ON THE SIDELINES?

My Letter to the Dean, University of Michigan School of Dentistry

Dr. McCauley:

The Field of Dentistry, including its specialties, can ill-afford to sit at home and must change their roles as providers of oral dental health to “a covered person” during this SAR-COV-2 pandemic. We cannot permit those most knowledgeable in Oral Health and Oral Pathology to be sidelined. The failure to implement Oral Health protocols will result in unnecessary deaths and destruction of the Worlds Economy. We are at war. Dentistry has a role in our Healthcare Armed Forces and will primarily be:

a) Oral and nasal testing to identify the presence or non-presence of COVID-19 Virus

b) Intervention and Prevention

c) Adopting an Oral-Healthcare Guideline.(4) 

COVID-19 is an oral pharyngeal disease before it becomes a pulmonary and systemic disease.(id.) Once this virus gets past your hands and into your mouth and nose, your dentist, the dental office, Dental schools must be brought on board and utilized for testing and identification of preventive, intervention procedures.(2) 

Dr. McCauley, please, if you can, USE YOUR MIGHTY POWERS to help publish these articles in the Michigan Dental Journal, University of Detroit Dental Journal, America Dental Association Journal, Yale University School Medicine Journal, National Dental Association Journal, Yale University School of Public Health Journal, because your authority in Dentistry may mean life existence to the World.

THE JOURNAL OF THE AMERICAN DENTAL ASSOCIATION

The Journal of the American Dental Association, Vol 135, issue April 4, 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D.;(2)

” The saliva and nasopharyngeal secretions also may contain other pathogenic organisms. These may include common cold and influenza viruses, herpes viruses, pathogenic streptococci and staphylococci, and the SARS virus. The use of universal precautions with all patients initially was based on the assumption that all patients may have an infectious bloodborne infection, such as with hepatitis B virus, hepatitis C virus, and HIV. It also should be assumed that all patients may have an infectious disease that has the potential to be spread by dental aerosols; thus, universal precautions to limit aerosols also should be in place.”

THE AMERICAN DENTAL ASSOCIATION POSITION ON COVID-19 TESTING

In the letter to Adm. Brett P. Giroir, M.D., HHS assistant secretary for health, the ADA explained that administering these types of tests falls under licensed dentists’ scope of practice. The Association said by issuing federal recognition; dentists would qualify as “covered persons” under the Public Readiness and Emergency Preparedness Act, which may extend protection from liability associated with the administration or use of FDA-authorized COVID-19 tests. 

Living in the Spirt of Sankofa

FOR NOW:

YOU ARE WITHIN THE NORMS

ENDNOTES

1. MedRxiv preprint doi: https://doi.org/10.1101/2020.04.16.20067835.this version posted April 22, 2020. 
2. The Journal of the American Dental Association, Vol 135, issue April 4 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D

3. Sample collection Inpatients, Nasopharyngeal, and saliva samples were obtained every three days throughout their clinical course. Nasopharyngeal samples were taken by registered nurses using the BD universal viral transport (UVT) system. The flexible, mini-tip swab was passed through the patient’s nostril until the posterior nasopharynx was reached, left in place for several seconds to absorb secretions then slowly removed while rotating. The swab was placed in the sterile viral transport media (total volume 3 mL) and sealed securely. Saliva samples were self-collected by the patient. Upon waking, patients were asked to avoid food, water, and brushing of teeth until the sample was collected. Patients were asked to repeatedly spit into a sterile urine cup until roughly a third full of liquid (excluding bubbles), before securely closing it. All samples were stored at room temperature and transported to the research lab at the Yale School of Public Health within 5 hours of sample collection.

4. http://youarewithinthenorms.com/2020/04/10/the-failure-to-adopt-oral-health-care-guidelines-during-the-covid-19-crisis-will-be-our-greatest-tragedy/

BY NORMAN J CLEMENT RPH., DDS

WARNING: THIS ARTCLE CONTAINS GROSS HUMAN AND NECK DISSECTIONS FOR EDUCATIONAL PURPOSES AND MUST BE USED WITH DIGNITY AND THE UTMOST RESPECT

This article advances the theory of the Clement Postulate of The Jumping Penguin, that Dentistry may save millions of lives once the COVID-19 Virus enters the oral pharyngeal(mouth and nose) region by the increase brushing teeth, tongue and roof of the mouth, and most importantly, gargling with an antiseptic mouth rinse (Listerine, Crest Pro-Health Advanced, Hydrogen Peroxide)

GOOD ORAL HYGIENE MAY HELP SAVE YOUR LIFE

COVID-19 is an oral pharyngeal disease before it becomes a pulmonary and systemic disease.(1) Once this virus gets past your hands and into your mouth and nose, your dentist, the dental office, Dental schools must be brought on board and utilized for testing and identification of preventive procedures. Therefore, along with washing your hands frequently, one should brush your teeth/ tongue and roof of your mouth, along with flossing at least 6 to 8 times daily, as well as rinsing your mouth with an over-the-counter antiseptic mouthwash and swishing, and expectorate(spitting)and at least 5 to 7 times daily. It may save your life.

THE CLEMENT POSTULATE and THE JUMPING ROCK HOPPER PENGUIN

Both the United States Center for Disease Control (CDC) and the World Health Organization(WHO) have failed to address the mechanism of action of the COVID-19 virus once it goes beyond your hands and masks and enters the oral pharyngeal cavity. More importantly, CDC and WHO have failed to address how long the virus survives in dental plague or its relationship to poor oral hygiene. Think about it, if the virus can stick to a golf flag pole several hours, it will likely live on dental restorations, tongue, throat, inside your nose several days, and especially a poorly cared for mouth.

The Clement Jumping Penguin Postulate(CJPP) is designed around the anatomy of oral pharyngeal structures and their relationship to the Nasopharynx, Oropharynx, Hypopharynx, followed by the larynx which lies in front of the esophagus. Below the larynx, as seen here in orange is the trachea or windpipe and most importantly is the relationship of these structures to the tongue.

• 

• 

MOUTH ANATOMY (ORAL ANATOMY) 101

Once the COVID-19 virus passes one’s hand and enters the mouth through either the oral cavity and/or nasal cavity, it sticks onto or between teeth , dental plaque, dental restorations (fillings), inside the cheeks (buccal mucosa), the tongue, roof of mouth (palate, palatal rugae), tonsillar crypts and fissures within the oral cavity, where it accumulates to grow or multiply. (2)

1.) The virus is moved around by saliva or food or simple breathing. Therefore brushing alone does not totally rid a person of the virus. In order for the virus to live the dirtier, the mouth the better.

2.) At some point a person, may notice a loss or change of taste. This is because the outside of the tongue is sensory and detects taste within the mouth or when something within the mouth is bitter or sweet. These symptoms to a oral health specialist would indicate involment of some kind to the glossopharyngeal nerve or the ninth cranial nerve (IX), (see above or above diagram)

3.) Within the nasal cavity the Covid-19 virus begins to affect sense of smell. This would indicate involvement of the Olfactory Nerve (smell nerve) cranial nerve one (I).

Here’s where it gets interesting:

4.) The COVID-19 Virus moves into the deep oral pharyngeal structures (the Nasopharynx, Oropharynx Hypopharynx), The effected person(s) might complain of a slight sore throat, tingling or scratchy sensation. While on the Back of the tongue the COVID-19 virus sits there and waits for the opportunity to jump similar to the Rock Hopper Penguin .

5) When the virus has accumulated on the back of the tongue and pharyngeal walls, coughing allows the COVID-19 Virus to fall into the esophagus where it is neutralized. However, some of the virus will be successful in jumping into the larynx, and descend into the trachea, and then to the lungs where it goes to work.

More importantly, it has been reported in the literature, The Journal of the American Dental Association, Vol 135, issue 4 April 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D.;(1)(2)

” The saliva and nasopharyngeal secretions also may contain other pathogenic organisms. These may include common cold and influenza viruses, herpes viruses, pathogenic streptococci and staphylococci, and the SARS virus. The use of universal precautions with all patients initially was based on the assumption that all patients may have an infectious bloodborne infection, such as with hepatitis B virus, hepatitis C virus and HIV. It also should be assumed that all patients may have an infectious disease that has the potential to be spread by dental aerosols; thus, universal precautions to limit aerosols also should be in place.”

THROUGH DENTISTRY WE CAN REDUCE OR CONTROL DENTAL THE DENTAL VIRAL LOAD

As the coughing increases, negative pressure causes the COVID virus, to jump into the lungs. Thus the understanding of the Clement Jumping Penguin Postulate(CJPP). However, through dentistry and dental oral hygiene, followed by COVID-19 dental intervention guidelines ,we can reduce Oral Viral Load (OVL).

In gross dissected structures, we can see the anatomical relationship between the nasal sinus. oral cavity. and tongue to get a better understanding of the oral physiological component

In the next gross dissection, the tongue is drawn back to demonstrate the teeth, tongue, and nasal sinus relationship.

Also seen here, is very a small section of the lower part of the nasopharynx wall and the oropharynx wall which sits directly behind the back part of the tongue. It is from this section of the oral structures where it is theorized the COVID virus jumps into the esophagus and trachea.

This photo gives the reader a clear understaning of the relationship of the nasal sinus, oral cavity and tongue for a better understanding of dental oral anatomical components

DON’T DISCOUNT GRANDMA’S HAND

While having attained degrees in both health sciences of Pharmacy and Dentistry, let’s not forget our faith, spiritual beliefs and some of those cultural and generational remedies from those who have endured and gone before us or Grandma’s hands.

Every person whom I’ve spoken to that has recovered from COVID-19, has had two strong beliefs in common:

1. A strong sense of Spirit, Faith and God; “…after you’ve done all you can…you just stand and let the Lord see you through“
2. Ginger, Ginger root, Jamaican Ginger Beer warmed and with a slice of lemon.

While Grandmas may have not been physicians, pharmacists, dentists or lawyers, their remedies work because warm ginger with lemon reduces the Oral Viral Load(OVL) in the oral pharyngeal Cavity because the Achilles heel of the COVID virus is heat.

I grew up in Detroit so my preference has always been warm Vernors Ginger Ale with a slice of lemon, sipped slowly. Of course one can use Ginger Beer, Ginger Root boiled and served, but there is a third belief which comes from Grandma.

3. “USE GOOD COMMON SENSE,” because, ” A HARD HEAD WILL MAKE A SOFT BEHIND”

BRUSH YOUR TEETH, YOUR TONGUE AND THE ROOF OF YOUR MOUTH, AND FLOSS 6 TO 8 TIMES PER DAY. RINSE WITH STRONG MOUTH WASH 5 TO 7 TIMES PER DAY AND DON’T WAIT ON THE CDC

So, once again, along with washing your hands frequently, brushing your teeth, tongue and roof of the mouth, floss at least 6 to 8 times daily. Rinsing with an over-the-counter mouthwash, swish, and expectorate (spit) at least 5 to 7 times daily, along with Grandma’s remedies will reduce the viral load within the mouth (Oral Cavity) and MAY SAVE YOUR LIFE.

FOR NOW: FOR BETTER DENTAL HEALTH CARE

YOU ARE WITHIN THE NORMS

END NOTES

1. https://reader.elsevier.com/reader/sd/pii/S0002817714612277?token=41CD393AB2087BC88AD9D8C560B22A061E406565CDBC6817398BDF347DF9C8D1148CE8899CD49D42AD25812A4DD9E27C
2. https://www.sciencedirect.com/…/pii/S0002817714612277

BY NORMAN J CLEMENT RPh., DDS.

COVID-19 has been proven to be an oral pharyngeal disease before it becomes a pulmonary and systemic disease.(id.) Once this Virus gets past your hands and into your mouth and nose, your dentist, the dental office, Dental schools must be brought on board and utilized for testing and identification of preventive, intervention procedures.(1) 

In China’s State Key Laboratory of Oral Disease, National Center for Clinical Research in Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu China, a study done by J. Xu’, Y.Li’, F.Gan’, Y.Du’, and Y.Yao’ called “Salivary Glands: Potential Reservoirs for COVID-19 Asymptomatic Infection,” these authors had drawn attention to dental risk in asymptomatic patients. Stating the following:

“Previously, researchers have shown the role of oral mucosa in COVID-19 infection (Xu, Zhong, et al. 2020). We would like to draw attention to salivary glands in the epidemic process of asymptomatic infections.”

“ACE2 is an important receptor for COVID-19 (Xu, Chen, et al. 2020). In a previous study about severe acute respiratory syndrome–coronavirus (SARS-CoV), salivary gland epithelial cells with high expression of ACE2 were infected (Liu et al. 2011). We analyzed the expression of ACE2 in human organs in the GTEx portal (https://www.gtexportal.org/home/gene/ ACE2#geneExpression).

“The expression of ACE2 in minor salivary glands was higher than that in lungs (lung medium PTM [transcripts per kilobase of exonmodel per Million mapped reads] = 1.010, minor salivary gland medium PTM = 2.013), which suggests salivary glands could be potential target for COVID-19. In addition, SARS-CoV RNA can be detected in saliva before lung lesions appear (Wang et al. 2004). This may explain the presence of asymptomatic infections. For SARS-CoV, the salivary gland could be a major source of the virus in saliva (Liu et al. 2011). The positive rate of COVID-19 in patients’ saliva can reach 91.7%, and saliva samples can also cultivate the live virus (To et al. 2020). This suggests that COVID-19 transmitted by asymptomatic infection may originate from infected saliva.”

“Therefore, the cause of asymptomatic infection might be from salivary glands. We should not ignore the potential infectivity of saliva alone.”

YALE UNIVERSITY SARS-CoV-2 SALIVA DETECTION TESTING

The Yale University study April 22, 2020, more than demonstrated that “saliva is a viable and preferable alternative to nasopharyngeal swabs for SARS-CoV-2 detection. The Yale University study found that the sensitivity of SARS-CoV-2 detection from saliva is comparable, if not superior, to nasopharyngeal swabs in early hospitalization and is more consistent during extended hospitalization and recovery.”

Moreover, the detection of SARS-CoV-2 from the saliva of two asymptomatic healthcare workers despite negative matched nasopharyngeal swabs suggests that saliva may also be a viable alternative for identifying mild or subclinical infections. With further validation, widespread implementation of saliva

THE JOURNAL OF THE AMERICAN DENTAL ASSOCIATION

The Journal of the American Dental Association, Vol 135, issue April 4, 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D.;(2)

” The saliva and nasopharyngeal secretions also may contain other pathogenic organisms. These may include common cold and influenza viruses, herpes viruses, pathogenic streptococci and staphylococci, and the SARS virus. The use of universal precautions with all patients initially was based on the assumption that all patients may have an infectious bloodborne infection, such as with hepatitis B virus, the hepatitis C virus, and HIV. It also should be assumed that all patients may have an infectious disease that has the potential to be spread by dental aerosols; thus, universal precautions to limit aerosols also should be in place.”

A SPECIFIC DENTAL HEALTH SPECIALTY KNOWN AS COVIDONTICS IN OUR HEALTHCARE ARMED FORCES

We are at War, and Oral Health will likely be the key to controlling the Novel Corona Virus COVID-19. Thus what will be needed a group called Covidontist consisting of General Dentist, Specialist (oral surgeons, periodontist, endodondist, orthdontists, oral pathology, dental hygienist, etc.) lead in the United States by the Oral health Assistant Surgeon General coordinating his/her efforts around the World with health ministries around the World, specifically to identify and treat COVID-19 pandemic or any disease which results in a pandemic that can be prevented and treated in the Oral Cavity; we can no longer be ordered out of the valued regiments of our healthcare armed forces to sit home (on the sidelines).

The Field of Dentistry, including its specialties, can ill-afford to sit at home and must change their roles as providers of dental oral health to “a covered person” during this Sars-2 pandemic. We cannot permit those most knowledgeable in Oral Health and Oral Pathology to be sidelined. The failure to implement Oral Health protocols has resulted in unnecessary deaths and destruction of the world/s economy. We are at war. Dentistry has a role in our Healthcare Armed Forces and will primarily be:

a) Oral and nasal testing to identify the presence or non-presence of COVID-19 Virus

b) Intervention and Prevention

c) Adopting an Oral-Healthcare Guideline.(1) 

WHAT CDC, WORLD HEALTH AND FDI WORLD DENTAL FEDERATION GOT WRONG “BETTER HEALTH THROUGH THROUGH BETTER HEALTH PARTNERSHIPS“

Contributing to this misguided short sidedness of CDC, World Health Organization, FDI World Dental Federation, and their failure to mobilize those who are knowledgable of oral diseases such as dental practitioners in the testing, detection, and prevention of COVID-19 during this pandemic. What they failed to understand in better health comes directly from “Better Health Partnerships.” Thus, this simple oversight on their part has resulted in prolonging this War and causing unnecessary deaths world wide and disastrous outcomes.

JUST THE USE OF A PERIODONTIST AND DENTAL HYGIENIST

One area these groups got wrong was the critical role Periodontist and Dental Hygienists should be playing in working together with the physician and medical personnel in maintaining Oral Health before a patient has been placed on a respirator.

Instead, in most of the United States of America and likely around the World, those who are most learned and knowledgeable of oral diseases and know the ORAL CAVITY were ordered to the sidelines and sent home to apply for SBA PPP, and watch the SARS-2, VIRUS express itself around the World. 

THE DENTAL SCHOOLS WERE FORCED TO CLOSE INSTEAD BEING OF USED FOR TREATMENT

Even more tragically, Dental Training Institutions such as The University of Michigan School of Dentistry, University of Oregon School of Dentistry, University of Florida College of Dentistry, The Ohio State College of Dentistry, Meharry Medical College Dental School, Howard University School of Dentistry are closed and shut down. These earlier warnings fell upon death ears and of bureaucrats and politicians whose ego jump far ahead of the issues at hand-further, many within the dental profession who choose to remain silent in fear of ridicule and retribution.

As we have now seen, the failure to utilize Oral Health Care practitioners and not recognize them as a part of the healthcare armed forces has become our greatest tragedy. Hundreds of thousands of lives have been unnecessarily lost during this pandemic because of the dismissing of the importance of Oral Health as an essential component of overall well being. Thus it is the fear of this author the pandemic crisis will only become worst:

1. Implement “Better Health Through Better Health Partnerships.”
2. The Formation of a Healthcare Armed Forces

THE UNITED STATES SURGEON GENERAL JEROME ADAMS MD

The United States Surgeon General Dr. Jerome Adams has rightly stated his concept: “Better Health Through Better Health Partnerships.” Each one will teach one, Dr. Adams concept using the Pharmacist/Dental partnership will lead to better health outcomes and success in places such as New York City, Cape Town, Lisbon, Johannesburg, Tokyo, Detroit, Tampa and Weewawhitchka. (3)

Yet, success can only be possible with more testing, testing, testing. Sanjay Gupta MD. has estimated in the United States we must test 2.5 million persons per day Nation-Wide. The success of the Covidontic Program rests upon one most important inclusion, testing, testing, testing.

FOR NOW

YOU ARE WITHIN THE NORMS

1. http://youarewithinthenorms.com/2020/04/22/it-is-dentistry-that-may-save-your-life-during-the-covid19-pandemic/
2. The Journal of the American Dental Association, Vol 135, issue April 4 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D
3. Release Philip Adams from Prison.

By Jack Folson – Clinical Pharmacist

Not to overstate the problem but the DEA is attacking healthcare providers with artificial metrics.  The so-called RED FLAGS OF DIVERSION are part of an algorithm that the DEA uses to assign criminality to oftentimes legitimate medical treatments.  Most practitioners believe that the DEA is purposely turning a blind eye to emerging techniques and even the American Medical Association has weighed in on this shortcoming of the DEA’s approach to diversion control.

In fact, as opioid-induced deaths have skyrocketed the deaths attributable to prescribed opioids have actually decreased while death due to illicit drugs such as heroin, cocaine, and fentanyl which comes across our borders from other countries continues to rise.  In fact, the term opioid epidemic no longer applies to prescription medications.  

What is particularly troubling is the intent for the DEA to increase their intrusion into the Doctor-Patient-Pharmacist relationship without a clear understanding of all the parameters involved.  In fact, patient care is totally lost in their conversation.  Upon searching the cases tried in DEA court one notices a glaring deficit.  Nowhere is the patients’ conditions a factor that is elucidated.  

Common-Law jurisdiction requires an actual injured party of which they never present.  Maritime Jurisdiction requires that there be a contract in force in which all the parameters are known by both parties but this fails because the DEA never publishes the names of suspect prescriber before they attack the pharmacies, nor do they publish the actual definitions that they use to assign criminality to their red flags of diversion. 

SAVINGS FOR UNINSURED PATIENTS

They use the spurious standard of “standard of care” which is very much open to interpretation but if they come after a provider what they say is the standard of care does not represent the standard of care that is published in the medical literature.  They have become nothing more than a political organization that has lost its way.  

Furthermore, the selection process of who to go after seems to be aimed at those that are the least able to defend themselves from the regulatory overreach.

Let’s look at a few scenarios.

1. Long Distance

If you see a prescriber in one area and live in another area and see a pharmacy in yet another area you could trip the RED FLAG of distance.  The funny thing is that the DEA never gives a definition of how far the distance is that is acceptable for them.  Furthermore, the Constitutionally guaranteed right of choice is trampled upon with impunity.  

This means that if you are on vacation in one part of the state and go to the hospital in that same area but hold onto your prescription until you get home and your pharmacy fills that prescription the DEA might indict your pharmacist.  

Another common issue is for a patient who lives in one area but works in another and sees their doctor close to where they work and fill the prescription near home.  This could be a big problem for you, your doctor, and your pharmacist.

Can you see how this might cause a lot of confusion and pain for a person who is suffering from pain, anxiety, depression, or other conditions?

2. Multiple Short Acting Opiod Prescriptions

Although the medical literature is quite available to show that one treatment that is very effective in minimizing the escalation of opioid dosing in patients that have intractable pain after they have developed enzyme induction that leads to tolerance of the normal treatment the DEA seems to be unaware of this clinical reality.  

In fact, the “expert” witnesses that the DEA employs in their witch hunt of healthcare professionals always testify that they can not see any reason to use the alternating short-acting opioid protocol because they themselves have never heard of it.  However, they are not pain management specialists and as such would not be expected to understand this often end-of-life protocol that is commonly used.

EXAMPLE OF SCHEDULE-II PRESCRIPTION FOR OXYCODONE

3. Cash

Even though more than 50% of Americans do not have health insurance that pays for certain pain medications the DEA assigns the RED FLAG of CASH to any opioid or benzodiazepine prescription that is paid for by cash.  Cash in their estimation includes credit and debit cards.  So if your insurance company will not pay for preexisting conditions and you have arthritis that requires an opioid for treatment you can find yourself in the midst of controversy concerning the DEA.  

4. Doctor Shopping

Let’s say that you go to a clinic system that includes several prescribers and each time you go there is a different prescriber handling your treatment.  Even though your prescribers have a shared protocol and are on the same page as to your treatment if you go from one location to the other you might feel the ire of the DEA because you are labeled as a DOCTOR SHOPPER.  If a pharmacy fills your prescription they might be indicted.

5. Multiple People on the Same Day

Let’s say that you and your cousin live in the same house.  Both of you have a medical condition that is hereditary, but you need the same pain or anti-anxiety medications, but you are both indigent.  So, you plan your trips to the Doctor and Pharmacy on the same days to save on transportation costs.  The DEA has now criminalized this behavior.  If a pharmacy fills both of the medications that you need that pharmacy might get indicted.

6. Compounding

Let’s say you need a narcotic medication every month for whatever reason and your copay for the commercially available dosage form is too high for you to afford.  But you find a pharmacy that is willing to compound the medication into a cheaper version specifically for you.  Well, under the law compounding for such medication is allowed as long as the dosage form does not contain more than 20% active ingredient.  

The pro-manufacturer bias of the DEA assigns criminality to that solution to your problem unless you are given a dose that is individualized.  But here’s the thing.  The law allows for this solution, but the DEA does not want the pharmacy to save you that money because they are in bed with Big Pharma.  Even though the wording of the law says may they concoct an artificial and extrajudicial standard of must or shall which is not in the law to the detriment of the patients, prescribers, and dispensers of these medications.

People Are Talking

In a recent article in the online news organization “Filter” 

DEA Pursues Vast Expansion of Patient Surveillance

The Drug Enforcement Administration (DEA) is looking to expand its anti-diversion surveillance infrastructure by being able to search and analyze myriad patient behaviors for the vast majority of controlled and scheduled drug prescriptions—all accompanied by a rapid process for legally unveiling personally-identifying information.

The implications of such massive invasion of privacy should not be allowed in light of the fact that the DEA can not be trusted with the information that they currently have.  

FOR NOW YOU ARE WITHIN THE NORMS

Footnotes:

Pharmaceutical Compounding Versus Manufacturing: Renewed Interest in an Old Question

2012-12-11 14:41:28

James A. Jorgenson, RPh, MS, FASHP

https://www.pharmacytimes.com/publications/ajpb/2012/AJPB_NovDec2012/Pharmaceutical-Compounding-Versus-Manufacturing-Renewed-Interest-in-an-Old-Question

“By substituting opioids and using lower doses than expected according to the equivalency conversion tables, it is possible in the majority of cases to reduce or relieve the symptoms of opioid toxicity in those patients who were highly tolerant to previous opioids while improving analgesia and, as a consequence, the opioid responsiveness. Cancer 1999;86:1856–66. © 1999 American Cancer Society.”

Cancer – Original Article – Opioid Rotation for Cancer Pain Rationale and Clinical Aspects

Sebastiano Mercadante M.D.

First published: 20 November 2000

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/%28SICI%291097-0142%2819991101%2986%3A9%3C1856%3A%3AAID-CNCR30%3E3.0.CO%3B2-G

“Opioid switching and opioid rotation, at different stages of therapy, represent two clinical strategies used to optimize opioid response for patients with moderate-to-severe pain.”

Review Article – Opioid switching and rotation in primary care: implementation and clinical utility

Neal E. Slatkin

Pages 2133-2150 | Accepted 16 Jun 2009, Published online: 14 Jul 2009

https://www.tandfonline.com/doi/abs/10.1185/03007990903120158

“The reality is that Portugal’s drug situation has improved significantly in several key areas. Most notably, HIV infections and drug-related deaths have decreased, while the dramatic rise in use feared by some has failed to materialise. “

Transform Drug Policy Foundation Journal

Drug decriminalisation in Portugal: setting the record straight.

What Does “Rat Park” Teach Us About Addiction?

June 10, 2019

Lloyd I. Sederer, MD

The implications of such massive invasion of privacy should not be allowed in light of the fact that the DEA can not be trusted with the information that they currently have.  

Drug decriminalisation in Portugal: setting the record straight.

BACKGROUND

Jack Folson is a renowned Expert in Pharmacy Practice: Hospital, Retail Chain, Retail Independent, Sterile Compounding, Non-Sterile Compounding, Former Director of Pharmacy,

1. June 9, 2020, by Jack Folson, DONALD SULLIVAN Ph.D. AND THE FOLSON AMICUS BRIEF, STORY BEHIND THE ECONOMIC LYNCHING OF BLACK OWNED PHARMACY BUSINESSES BY THE DRUG ENFORCEMENT AGENCY (DEA) IN AMERICA 

DONALD SULLIVAN RPH., PHD., AND THE FOLSON AMICUS BRIEF

2. https://youarewithinthenorms.com/2020/09/04/the-probity-of-justicethe-harlem-wisdom-table-interviews-norman-j-clement-rph-dds/

MICHAEL BARNES ESQ, of dcbalaw.com________

“DEA AGENTS HAVE NO BUSINESS SECOND-GUESSING HEALTH CARE PROVIDERS’ DECISIONS ON MEDICAL NEEDS AND PATIENT CARE. THAT’S A JOB FOR STATE LICENSING BOARDS – AND ONLY WHEN THERE IS A VALID COMPLAINT TO INVESTIGATE.”

REPORTED BY

NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, JOSEPH SOLVO ESQ., REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., BRAHM FISHER ESQ., JOSEPH WEBSTER MD., ESTER HYATT PHD., BRAHM FISHER ESQ., MICHELE ALEXANDER, BERES E. MUSCHETT, STRATEGIC ADVISOR

Norman J Clement, Aaron Howard, Rick Fertil demand the return of our DEA pharmacy Control Substance Registrations Immediately.

BY PAT ANSON, EDITOR PAIN NEWS NETWORK

November 11, 2020

!!! WARNING!!! DANGER!!! DANGER!!! DANGER!!!

DEA Expanding Surveillance of Prescription Drug Data

The U.S. Drug Enforcement Administration is making plans for a major expansion of its monitoring of prescriptions for opioids and other controlled substances, with the goal of identifying virtually every prescriber, pharmacy, and patient in the country that shows signs of drug diversion or abusing their medication. (5)

In a request for proposal (RFP) made in early September, the DEA asked software contractors to submit bids for the creation of a nationwide data system that would track “a minimum of 85 percent of all prescriptions” for Schedule II through V controlled substances. The RFP was first reported by the website Filter. (1)

Critics say the surveillance program will have a chilling effect on many healthcare providers, who are already fearful of being flagged by law enforcement for prescribing and dispensing opioids and other medications to patients suffering from pain and other illnesses.  

“This RFP illustrates that the DEA, and U.S. Department of Justice more broadly, remains fixated on monitoring and scrutinizing the medical decisions of licensed health professionals while illegal fentanyl and heroin contribute to two-thirds of opioid-involved drug poisonings in the U.S.,” says attorney Michael Barnes, who is managing partner at DCBA Law & Policy, a law firm that advises healthcare providers. (2)

“DEA agents have no business second-guessing health care providers’ decisions on medical needs and patient care. That’s a job for state licensing boards – and only when there is a valid complaint to investigate.”

!!! WARNING!!! DANGER!!! DANGER!!! DANGER!!!

‘UNLIMITED ACCESS’ TO PRESCRIPTION DATA

Hundreds of medications would be covered under the DEA’s surveillance program, including drugs used to treat pain, opioid use disorder, anxiety, and attention deficit hyperactivity disorder (ADHD).  Under the program, DEA investigators would have “unlimited access” to prescription data compiled over the last five years, including the names of prescribers and pharmacists, types of medication, quantity, dose, refills, and forms of payment.

The names of patients would be encrypted, but if investigators suspect a medication was being abused or diverted, they could get a subpoena to quickly identify the patients involved.

“The subpoena process would be that we would generate a DEA Administrative Subpoena and send it to you for the unmasking of specified patients. The data provider would then need to respond to us providing the unmasked patient information that was requested within three business days,” the DEA said in response to a contractor who inquired how the subpoena process would work. (3)     

!!! CONGRESS MUST INVESTIGATE !!!

!!!! THERE COULD BE THOUSANDS !!!!

!!! CONGRESS MUST INVESTIGATE !!!

Asked how many DEA investigators would have access to the prescription data at any given time, the agency said there could be over a thousand.

“We would start with 1,100 users and would renegotiate if more were needed. It is unlikely that 1,100 users will all access the system concurrently but is hypothetically possible in the future,” the agency replied.

Why the DEA is seeking to expand its monitoring of opioid prescriptions is unclear. In recent years, the number of prescriptions has fallen by about a third and the DEA itself estimates that less than one percent of legally prescribed opioids are diverted.

!!! WARNING!!! DANGER!!! DANGER!!! DANGER!!!

BYPASSING PDMPS

State-run prescription drug monitoring programs (PDMPs) already track much of the information DEA is seeking, but law enforcement access to the data usually requires an active investigation or warrant – no data mining or fishing expeditions allowed. To maintain patient privacy, some states prohibit sharing prescription data with federal or out-of-state law enforcement agencies. Last year, the DEA had to sue Colorado to get access to the state’s PDMP data. (4)

The DEA’s plan would bypass these privacy safeguards and effectively create a national PDMP for law enforcement. The agency would even be allowed to share some prescription data with unnamed “outside agencies and/or organizations without prior review by the Contractor.”      

The DEA did not respond to multiple requests for comment. In the RFP, the agency said it was required to maintain “comprehensive, detailed, accessible, and timely prescription, pharmacy, and prescriber information.”

Much of the data mining the agency is planning appears to go beyond the prescription data that is currently covered by PDMPs.  For example, the DEA wants to know the distance patients travel to see their doctors and pharmacies; whether patients living at the same address are getting the same drugs; whether a patient pays in cash for their medications; and whether a patient is getting a combination of opioids and benzodiazepines to treat their pain and anxiety.

“This DEA program will increase the fear associated with prescribing and dispensing controlled medications, making it even more difficult for people with pain, opioid use disorder, anxiety, insomnia, and ADHD to access individualized treatment. More such patients will be left in despair. It’s as though the federal government is unaware or does not care that the U.S. is in the midst of a suicide epidemic,” Barnes told PNN. 

!!! WARNING!!! DANGER!!! DANGER!!! DANGER!!!

‘APPALLING FOR PEOPLE’S HEALTH’

The software contractor is also expected to provide DEA with a list of top prescribers and pharmacies that are writing and filling prescriptions for fentanyl, oxycodone, hydrocodone, buprenorphine and other opioids. The inclusion of buprenorphine is troubling to substance abuse treatment experts, because it is a primary ingredient of Suboxone. 

“The impact of including buprenorphine will be appalling for people’s health,” said Dr. Hannah Cooper, the chair of substance use disorder research at Emory University. Cooper fears the DEA surveillance program would make doctors and pharmacies reluctant to supply Suboxone to patients who need addiction treatment. 

!!! CONGRESS MUST INVESTIGATE !!!

“The idea that patient-level data is available to the DEA is quite frightening. We don’t want to make people worry that their decisions will be monitored by this highly punitive federal agency,” Cooper told Filter. “If you’ve been inhabiting a space where you’ve been persecuted by the federal government for some time, and they now have access to your private medical information, there will be tremendous consequences for population health and health equity.”

“This program will undoubtedly decrease the prescribing of controlled medications, including buprenorphine for opioid use disorder,” said Barnes. “Why in the world would the federal government, in the midst of a worsening drug-poisoning epidemic, discourage the prescribing of a medication to treat opioid use disorder and prevent opioid poisonings?”

The DEA deadline for receiving proposals from software contractors was October 20. No contract awards have been announced. The surveillance program could begin as early as December 1, 2020, and continue for a minimum of one year, with an option for up to four years The potential cost of the program has not been disclosed.

!!! WARNING!!! DANGER!!! DANGER!!! DANGER!!! WARNING!!!

!!! CONGRESS MUST INVESTIGATE !!!

In 2017 Former Utah Senator 
This video is the game changer which exposes the nature of DEA/DOJ abuses in targeting BLACK OWN PHARMACIES: Senator Hatch on DEA and Opioid Crisis and Abuse| C-SPAN.org

https://www.c-span.org/video/?435395-3/senator-hatch-dea-opioid-crisis

FOR NOW YOU ARE WITHIN THE NORMS

END NOTES

1. https://static1.squarespace.com/static/54d50ceee4b05797b34869cf/t/5fac5d699a1aef48f6f43d39/1605131626625/DEA+RFP+amendment.pdf
2. https://dcbalaw.com
3. https://static1.squarespace.com/static/54d50ceee4b05797b34869cf/t/5fac5d699a1aef48f6f43d39/1605131626625/DEA+RFP+amendment.pdf
4. https://coloradosun.com/2019/11/11/dea-subpoena-opioid-pharmacy-board/
5. https://www.painnewsnetwork.org/stories/2020/11/11/dea-planning-expanded-surveillance-of-prescription-data

Norman J Clement, Aaron Howard, Rick Fertil demand the return of our DEA pharmacy Control Substance Registrations Immediately.

THE CONGRESS MUST INVESTIGATE AND DEFUND THE UNITED STATES DRUG ENFORCEMENT AGENCY (DEA)

BY 

NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, JOSEPH SOLVO ESQ., REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., BRAHM FISHER ESQ., JOSEPH WEBSTER MD., ESTER HYATT PHD., BRAHM FISHER ESQ., MICHELE ALEXANDER, CUDJOE WILDING BS, DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS

THE DEA IS OUT OF CONTROL

The DEA is out of control, while they attack and discriminate against black-owned pharmacies and their own employees from within the agency.  The DEA enforcement practices are such that agents prepare warrants to fit a scenario and narrative based on a notion that African American Pharmacists are committing crimes, even though no criminal activities are taken place.  It is clearly obvious the culture of the DEA is race-based. The ability of the DEA to enforce the laws adequately and accurately is lost. Therefore, it stands to reason if the DEA discriminates from within, it discriminates with enforcement.   (4)(5)(7)

CONGRESS MUST INVESTIGATE!!!

These same behavior sets are found within society are expressed within the DEA itself.  African American employees are systematically denied promotions through the systemic race bias in promotionally a system to the detriment of black agents. We can clearly see that within the DEA, there is a culture of deceit. From within to levels of enforcement, on the streets, the culture of indifference is expressed within the DEA’s enforcement practices.  

The below 2017, C-span video of Former Utah Senator Orin Hatch on the US Senate floor. Senator Hatch exposes the behavior of DEA and DOJ. This video further exposes the prevailing nature of DEA/DOJ abuses in targeting Black-owned pharmacies:

Former Senator Hatch on DEA and Opioid Crisis and Abuse| C-SPAN.org

https://www.c-span.org/video/?435395-3/senator-hatch-dea-opioid-crisis

According to ABC News Jim Mustian of Associated Press and the Baltimore Sun-Times Justin Fenton June 18, 2020;

The group of retired agents said in a statement sent to news organizations this week that Attorney General William Barr was out of touch with racial disparities that permeate not only local police departments but federal law enforcement. (5) AG William Barr has chosen to bury his head in concrete.

“This is a culture,” said Karl Colder, who previously oversaw the DEA’s Washington field division, served on the agency’s diversity committee and was one of 76 former agents involved in drafting the statement. “You still don’t have African Americans in positions to really monitor and ensure things are equal. 

Gary Tuggle, who was a special agent in charge of the Baltimore field office and served as interim Baltimore Police commissioner in 2018, said he thinks the problem has worsened in recent years.

Ernie Howard, who was the special agent in charge in Houston from 1997 to 2001, said there is “not an even playing field.”

“The DEA hasn’t had an African American female special agent in charge in years,” Tuggle said. “That’s ridiculous.”

June Werlow Rogers, who previously led the DEA’s New England field office from 2002 to 2008. “I’m really glad we’re at a point now where people are listening, but in order for us to change things, we’ve got to change minds and hearts.” 

” Rogers recalled while an agent in Baltimore she was pulled over and questioned despite showing her DEA credentials until a white DEA supervisor intervened and that a magistrate judge once confused her for a defendant in court.“

We can easily relate with former Agent Rogers and share our experience,  Transcripts from January 28, 2020, DEA v Pronto Pharmacy LLC Tampa Florida. DOCKET 19-42, before Judge Mark D. Dowd held in Tampa, Fl. (12)

“I MEANT THE MONKEY”

Jim Mustian of Associated Press further reported and wrote:

At the Drug Enforcement Administration’s Training Academy in Virginia last year, an instructor on the firing range called out a name that was shared by two trainees, one Black and one white.

When both responded, the white instructor clarified, “I meant the monkey.”

That behavior, as alleged in an internal complaint, didn’t stop there. The instructor also was accused of going on the loudspeaker in the tower of the outdoor firing range to taunt black trainees by making “monkey noises.”

The instructor,  Special Agent Jay Mortenson, was “removed from his post on the firing range. But to the disappointment of the recruits, he was not disciplined before retiring.”(1)(8)

Meanwhile, the growing cost of the drug war is now impossible to ignore: billions of dollars wasted, bloodshed in Latin America and on the streets of our own cities, and millions of lives destroyed by draconian punishment that doesn’t end at the prison gate; one of every eight black men have been disenfranchised because of a felony conviction.

THE DRUG ENFORCEMENT AGENCY (DEA) ” IN THE BEGINNING THERE WAS RICHARD M. NIXON PRESIDENT OF THE UNITED STATES”

The DEA lacks a moral compass. The agency further lacks the ability to clearly see that African American agents and the African American pharmaceutical community are people.  Their bias-based policing is a directive assault upon the criminal justice system and African American pharmacist.  The power and enforcement ability of the DEA has allowed this agency to apply unrestricted acts upon African American pharmacists.  If the DEA mistreats its Black employees with disdain then it is even more believable the agency has greater disdain for Black-own pharmacies. Thus the action of the DEA is an act of terrorism upon African American pharmacists and has become a present danger for America.  How can DEA fairly administer and enforce drug policies and laws? If this agency is not stopped, how far will they go? 

According to Erik Sherman of Harper Magazine, reporting on an interview by Dan Baum of Richard Nixon’ s “War on Drugs.”

It is April 2016, writer Dan Baum, interviewed John Ehrlichman Nixon’s Domestic Policy Adviser, Ehrlichment explained, the purpose behind Nixon’s War on Drugs:

” The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. Do you understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course, we did.” (2)(3)

 The United States Department of Justice has been turned into a private system of injustice to targeted Black people, in particular, its leadership class and educated professionals. According to Erick Sherman drug war and excuse to lock Blacks and protestors up:

“The realization that Nixon turned the U.S. justice system into a private army to punish those who didn’t love him for too many good reasons is shocking. That this is news today, and that the mechanisms once started as a personal vendetta continue to crush people born to the “wrong” parents, should be nauseating.“

They have created a slippery slope of analysts to justify moving in under public health threat, probable cause a simple close examination of the Order to Show Cause (OTSC) or record shows no the warrants to be Fraud defected. The question becomes how is it they been able to get away with this for so long. 

Erick Sherman Writes: 

“And so, the United States government developed a major policy, with massive implications on spending and societal impact, to declare that two classes of people should be destroyed, locked up if possible, for the convenience and pleasure of people in power. The justice system was warped into a private enforcer.”

CONGRESS MUST INVESTIGATE!!!

Norman J Clement, Aaron Howard, Rick Fertil demand the return of our DEA pharmacy Control Substance Registrations Immediately.

CONCLUSION

The DEA has and is failing America as they systematically focus their attention on Black-owned pharmacists, while they are missing the real drug trafficking problems.   Today, the DEA claims there is a drug epidemic problem in America, however, President Richard Nixon’s invention of the “War on Drugs” as a political tool was cynical, but every president since — Democrat and Republican alike — has found it equally useful for one reason or another.” (2)  

Norman J Clement, Aaron Howard, Rick Fertil demand the return of our DEA pharmacy Control Substance Registrations Immediately.

CONGRESS MUST INVESTIGATE!!!

FOR NOW YOU ARE WITHIN THE NORMS

END NOTES

1. https://boingboing.net/2020/10/16/dea-instructor-called-black-recruit-a-monkey-and-made-monkey-noises-at-black-trainees.html
2. https://harpers.org/archive/2016/04/legalize-it-all/
3. Such is how Ms. Breonna Taylor was murdered having been erroneously targeted in an illegal raid by law enforcement. These types of illegal targeting occur too frequently and have remained hidden from the Public.  Congressional Oversight must expand to the illegal activities of the DEA, Now.
4. https://youarewithinthenorms.com/2020/09/30/the-united-states-department-of-justice-united-states-drug-enforcement-administration-great-fentanyl-misinformation-campaign-during-the-covid-19-pandemic-congress-must-act-now-to-defund-the-dea/
5. ” It has been said many times, there are two systems of Justice in America… however, we must include the third system of injustice, FOR UPPITY, ARROGANT NEGROES. THOSE WHO DARE TO BECOME EDUCATED IN MEDICINE. Let it further be clear  patients being treated for chronic pain who travel to a Black-owned pharmacy are called “RED FLAGS” by Don Sullivan and these pharmacies  are  classified as imminent dangers to the “Public Health.” While the same patients traveling to non-black owned pharmacies, with the same prescriptions, using the exact same payment methodology, the fictitious label of “red flags” does not truly exist.”
6.  https://youarewithinthenorms.com/2020/09/30/the-united-states-department-of-justice-united-states-drug-enforcement-administration-great-fentanyl-misinformation-campaign-during-the-covid-19-pandemic-congress-must-act-now-to-defund-the-dea/
7. THE FRAUDULENT WORK OF THE OHIO STATE UNIVERSITY PHARMACY PROFESSOR DONALD SULLIVAN AND WHY HE MUST BE TERMINATED
    https://youarewithinthenorms.com/2020/10/04/the-fraudulent-work-of-donald-sullivan-phd-the-ohio-state-university-college-pharmacy-professor-of-ethics/
8. Caste: The Origins of Our Discontents, April 2020, pg. 128-129, Wilkerson, Isabelwilkerson.com
9. Oak Hill Pharmacy, Oak Hill West Virginia; https://youarewithinthenorms.com/2020/01/05/federal-judge-stops-dea-once-again-in-oak-hill-pharmacy-wv-ruling/
10. OF ROLE MODELS AND THE INVISIBLE PEOPLE: THE ALGORITHM OF MEDICAL APARTHEID, A SUMMARY, August 3, 2020https://youarewithinthenorms.com/2020/08/03/of-role-models-and-the-invisible-people-medical-redlining-and-payments-by-the-zip-code-a-summary/
11. ALGORITHMS OF MEDICAL APARTHEID, by Michelle Alexander MD., https://youarewithinthenorms.com/2020/08/12/the-algorithms-of-medical-apartheid-of-role-models-and-the-people-made-to-be-invisible/
12. THE WITNESS (DEA Richard James Albert): 

“Mr. Clement, one question. When you served that document on the pharmacy, were these printed out for you at that time, or were these maintained at the pharmacy in a logbook, or do you know where these actually came from?

THE WITNESS(DEA Richard James Albert):

But one c o r r e c t . I‘m Mr. Albert. You called me Mr. Clement.

JUDGE DOWD: Oh, I’m sorry. Excuse me. It’s old age creeping up. “Old Age,” 

13. Order to Show Cause Pronto Pharmacy: CASH: Excessive Cash Payments: The DEA’s expert opined that cash payments can be a red flag of abuse or diversion because patients typically have to pay very high prices for drugs that are not covered by insurance. The DEA’s expert noted that, on average, approximately 11 percent of all prescriptions filled by independently owned pharmacies in 2018 were paid for in cash nationally. The DEA’s expert noted that over 90 percent of the prescriptions for oxycodone 30 mg and hydromorphone 8 mg filled by Pronto Pharmacy were paid for with cash. The DEA’s expert opined that this is a significant red flag that the prescriptions being filled by Pronto Pharmacy were being abused and/or diverted and that a pharmacist who was properly exercising his corresponding responsibility would have recognized this and refused to fill most of these prescriptions.

The DEA’s expert reviewed the above-referenced prescriptions and concluded that they presented numerous red flags that were highly indicative of abuse and diversion. These red flags could not have been resolved by a pharmacist acting in the usual course of professional practice, and, therefore, each prescription was filled outside the standard of care in Florida. Accordingly, these prescriptions were filled in violation of federal and state law. See 21 U.S.C. § 842(a)(1); 21 C.F.R. § 1306.04(a); Fla. Admin. Code r. 64B16- 27.810.

14. The Pig Laws of where implemented when reconstruction collapsed:https://videopress.com/embed/mMYxulGA?preloadContent=metadata&hd=1Laura Coates Show, August 8th 2020, XM 126, Pig Laws