Tag Archives: opioids

As the feds crack down on opioid prescriptions, patients are taking their own lives, doctors are losing their jobs and overdose rates continue unabated.

The Government’s Solution To The Opioid     Crisis Feels Like A War To Pain Patients

By Art Levine

Meredith Lawrence's late husband died by suicide after his opioid pain prescription was severely restricted.

Jay Lawrence, an energetic truck driver in his late 30s, was driving a semitrailer across a bridge when the brakes failed. To avoid plowing into the car in front of him, he swerved sideways and slammed the truck into a wall, fracturing his back. For more than 25 years, he struggled with the resulting pain. But for most of that time, he managed to avoid opioid painkillers.

In 2006, his legs suddenly collapsed beneath him, due to a complex web of neurological factors related to his spinal cord injury. He underwent multiple surgeries and tried many medications to alleviate his pain.

The next year, he began to experience some semblance of relief when his doctor prescribed morphine, one of a class of opioid drugs. By 2012, he was taking 120 milligrams per day.

But this isn’t a story about opioid addiction. Lawrence managed a relatively productive, happy life on the medication for the better part of 10 years.

“This isn’t the life I thought I’d have,” he told his wife, Meredith Lawrence, in December 2016. “But I’m all right.”

Living on disability payments, he could still walk around their two-bedroom trailer home using his cane, take a shower on his own and, on his good days, even help his wife make breakfast.

Then, in early 2017, the pain clinic where he was a patient adopted a strict new policy, part of a wide-ranging national effort to respond to the increase in opioid overdose deaths. 

Citing 2016 guidelines from the U.S. Centers for Disease Control and Prevention, her husband’s doctor abruptly cut his daily dose by roughly 25 percent to 90 mg, Meredith Lawrence said. That was the maximum dose the CDC recommends, though does not mandate, for first-time opioid patients. 

The doctor also told Jay Lawrence that the plan was to lower his dose to 45 mg over the next two months, a cutback of more than 60 percent from what he had been taking.

At the end of that traumatic visit, his wife said, Jay Lawrence’s doctor dismissed their concerns and shared his own fear about losing his license if he continued to prescribe high doses of opioids. (When HuffPost followed up, the doctor declined to comment on the case, citing patient privacy.)

For a month, Lawrence suffered on the 90 mg dose. At times, his pain was so bad that he needed help to get out of the recliner, and when his wife looked over, she sometimes saw tears streaming down his face.

He dreaded his next appointment when his dose would be slashed to 60 mg. In the weeks before that scheduled visit on March 2, 2017, Lawrence came up with a plan.

On the day of his appointment, on the same bench in the Hendersonville, Tennessee, park where the Lawrences had recently renewed their wedding vows, the 58-year-old man gripped his wife’s hand and killed himself with a gun.

Meredith Lawrence sits in the living room of the home in Gainesville, Georgia, that she bought after her husband's death

Dustin Chambers for HuffPost Meredith Lawrence sits in the living room of the home in Gainesville, Georgia, that she bought after her husband’s death.

There are at least nine million chronic pain patients in the United States who take opioid painkillers on a long-term basis. As law enforcement and medical regulatory bodies try to curb the explosion in opioid deaths and the rise in illegal opioid use, they have focused on reducing the overall opioid supply, whether or not the drugs are provided by prescription. 

There’s mounting evidence this won’t work ― that curbing patient access to legal prescription opioids does not stem the rate of overdoses caused primarily by illegal drugs ― and that patients are being denied desperately needed relief. There are also troubling indicators that cutting back on opioids increases the risk of suicide among those with chronic pain.

Some chronic pain patients and advocates have even begun compiling lists of individuals they know who have died by suicide after they were no longer able to treat their pain with opioid medication.

“There is no doubt in my mind that forcibly stopping opioids can destabilize some of the most vulnerable people in America,” said Dr. Stefan Kertesz, a professor of medicine and an addiction researcher at the University of Alabama at Birmingham. “And the outcomes for those folks include suicide, overdose and falling apart medically.”

I mean, people need to take some aspirin sometimes and tough it out a little. Attorney General Jeff Sessions

For a decade or so, government officials in the U.S. have sought to drive down the opioid supply through a range of tactics ― from increased seizures of diverted opioid medications to state crackdowns on “pill mills.” The Trump administration has embraced the hard-line approach.

In late January, Attorney General Jeff Sessions announced a “surge” in Drug Enforcement Administration activity targeting pharmacies and physicians that, in the agency’s view, oversupply opioids. In February, the Justice Department doubled down with the announcement of a new task force that would focus on manufacturers and distributors of opioids. In March, President Donald Trump unveiled a plan to lower opioid prescriptions by a third within three years. And in late June, the federal government arrested 600 people, including 165 medical professionals, for allegedly participating in $2 billion worth of fraud schemes involving opioids.

The Trump administration’s efforts are dramatic even within the context of the CDC’s opioid dose guidelines. The guidelines were originally intended to advise primary care physicians treating chronic pain patients and other pain sufferers. They were urged to exercise caution in prescribing opioids, to use alternatives whenever possible and to prescribe daily doses of no more than 90 morphine milligram equivalents (MME) for new opioid users.

For pain patients like Jay Lawrence who had already been on opioids for years, however, the guidelines simply recommended regularly assessing the harms and benefits of the dosage. They didn’t advise either mandatory cutoffs or any set limits. (The Tennessee Department of Health’s guidelines would also have allowed Lawrence to stay at 120 mg of morphine when prescribed by a pain specialist.)

But “the CDC guidelines have been weaponized,” said Kertesz. The ramped-up enforcement by the DEA and state regulators has led some doctors to choose caution and to overcorrect in their prescribing, lest they lose their ability to practice medicine at all. Kertesz decried these policies as “simplistic” in a definitive new article published last week in the journal Addiction.

In February, Sessions struck a particularly harsh tone by suggesting that the fate of chronic pain patients was not high on his list of concerns. “I am operating on the assumption that this country prescribes too many opioids,” the attorney general said. “I mean, people need to take some aspirin sometimes and tough it out a little.”

Attitudes like that are based on a series of mistaken assumptions about pain, according to Dr. Thomas Kline, a North Carolina-based family practitioner and former Harvard Medical School program administrator. Kline regularly updates a list of pain patients, published on Medium, who’ve killed themselves in the wake of draconian restrictions on pain medication.

“I ask people to imagine the very worst pain they’ve ever experienced in their lives,” Kline said. “And then that they’re denied relief by a doctor with the one medicine proven effective for pain control for 50 centuries.” (Historical records show that people in ancient Mesopotamia cultivated the poppy plant for medical use.)

The CDC guidelines have been weaponized. Dr. Stefan Kertesz

The government’s aggressive focus on doctors and patients is unlikely to address the very real menace of opioid-use disorders and sharply escalating overdose deaths. Fraud ― driven by pharmaceutical company policies ― and diversion ― the phenomenon of prescription medications being sold as street drugs ― initially spurred a wave of opioid abuse in the late 1990s, as some doctors turned their practices into pill mills. But new reports by the CDC and a drug data firm, the IQVIA Institute for Human Data Science, suggest that prescription drugs play a much smaller role in today’s crisis.

The reports show that total opioid prescriptions dropped 10 percent in 2017 ― the sharpest annual decline in such prescribing in 25 years. While opioid prescriptions peaked back in 2010, the studies found that growth rates in opioid-linked deaths, overwhelmingly due to illegal fentanyl and heroin, have skyrocketed in the last seven years.

Indeed, although two-thirds of the 64,000 overall drug overdose fatalities were linked to opioids in 2016 ― the most recent year for which there is data ― more than 80 percent of those opioid drug deaths came from illegal street drugs such as heroin and fentanyl. Prescription opioid drug deaths alone ― excluding methadone ― amounted to less than 15 percent of all drug overdose deaths, or about 9,500 fatalities.

Still, the CDC’s guidelines have triggered restrictive laws in at least 23 states that mandate ceilings on opioid dosage. (Oregon, in fact, is moving to taper dosages down to zero for all Medicaid chronic patients over a year.) That makes relief less attainable for pain patients and threatens the practices of doctors who treat them. These laws have been augmented by the growth of state prescription monitoring programs that use the software NarxCare, which is designed to flag addiction but can also rope in pain patients based on their prescription history and use of multiple doctors.

And in June, the House of Representatives passed over 50 bills that would establish dramatic new restrictions on opioid prescribing, eliciting alarm among patients and some disability rights groups.

The side effects of the current enforcement efforts are disturbing enough, from patients denied relief to drug shortages to suicides.

No health agency has kept track of all pain-related suicides that may be linked to doctors cutting back on prescriptions. But some preliminary findings from Department of Veterans Affairs researchers indicate that VA pain patients deprived of opioids were two to four times more likely to die by suicide in the first three months after they were cut off, compared to those who remained on their pain medications.

“To protect people, you have to take care of the patient, not the pill count,” said Kertesz, who worked on the VA’s April 2017 study but spoke to HuffPost only as an independent researcher. “The findings suggest that the discontinuation of opioids doesn’t necessarily assure a safer patient.”

Even terminally ill cancer patients are increasingly getting less relief, and there are growing shortages of injectable opioids at local hospitals and hospices, spurred in part by DEA-ordered reductions in opioid manufacturing quotas.

Leah Ilten, a 53-year-old physical therapist who lives in Kennewick, Washington, told HuffPost that as her 86-year-old father lay dying of pancreatic cancer in a hospice, the medical staff ignored her pleas to provide appropriate opioid pain relief, even cutting his dosage in half on the last day of his life. A few days earlier, when he was in the hospital, one nurse explained to her that opioids could lead to an overdose or could potentially cause the man, who lay moaning in pain, to “get addicted.”

“I was horrified,” Ilten said.

In mid-April, the DEA responded to the injectable opioid shortage by lifting production quotas. An agency spokesman told HuffPost that it was “a manufacturers’ problem, not the quotas,” while asserting that progress is being made.

There have been production issues, including Pfizer’s foul-ups with a plant in Kansas. But the DEA’s delay in taking action ― shortfalls were flagged in February in a letter from the American Society of Anesthesiologists and other health groups ― definitely contributed to the shortage, according to Dr. James Grant, president of the ASA. He told HuffPost that quotas were among the factors creating the crisis.

I’m not willing to go back to the state I was in before I started treatment. Anne Fuqua

Faced with the hardline national crackdown on opioid prescriptions, people with chronic pain are trying to raise awareness of the suffering caused by the loss of medications. Some are gathering the names of those patients who ended up taking their own lives, both as a memorial to those who died and as a protest against the health establishment that has seemingly abandoned them. Others are seeking comfort from each other on social media.

Lelena Peacock, who declined to name her southeastern city of residence for fear of retaliation from doctors, is struggling with how to treat the pain associated with fibromyalgia. The 45-year-old found that her social media posts drew other pain patients who turned to her for help.

By her own count, Peacock has thus far convinced more than 70 chronic pain patients to call 911 or suicide prevention hotlines instead of killing themselves.

For Anne Fuqua, a 37-year-old former nurse from Birmingham, Alabama, the motivation for compiling a list of chronic pain-related suicides is to track the damage done by what she sees as policies that have left people like her behind. 

“There’s so many people who have died,” she said. “We have to remember them.”

Fuqua has an incurable neurological illness known as primary generalized dystonia that causes Parkinson’s-like involuntary movements and painful muscle spasms. She started taking about 60 mg of Oxycontin a day in 2000. Her doctor began to limit her access to high doses of opioids in 2014, the same year she started chronicling those friends who had killed themselves or otherwise died after being denied pain medications. Her informal list is now up to roughly 150 people, augmented by lists that other pain patient advocates have compiled.

On July 9, Fuqua joined other chronic pain patients at a meeting at the Food and Drug Administration campus in Maryland to express their fears and outrage at the cutbacks. Sitting in the front row in her wheelchair, she told FDA officials about that list and declared, “I’m not willing to go back to the state I was in before I started treatment.”

Anne Fuqua needs exceptionally high doses to manage her pain because of opioid malabsorption.

Courtesy of Anne Fuqua Anne Fuqua needs exceptionally high doses to manage her pain because of opioid malabsorption.

Fuqua’s own difficulties are compounded by the fact that her body does not respond to even large doses of opioids the way others do ― she suffers from severe malabsorption that hampers her ability to benefit from everything from opioids to vitamin D. Since 2012, she has relied on a strikingly high daily regimen of 1,000 MME of opioids, including fentanyl patches, to manage her pain.

But her physician, Dr. Forrest Tennant, was driven to retire this year after a DEA raid and investigation. The Los Angeles-area physician mailed her a final series of prescriptions, which will run out at the end of July.

“It’s terrifying,” she said looking at her future. “If these were people who had asthma or diabetes and weren’t stigmatized because of opioids, this wouldn’t be allowed to happen.”

Another doctor has quietly stepped forward to continue treatment for Tennant’s remaining patients, Fuqua said, although there’s no assurance that this physician won’t also be investigated in the future.

If these were people who had asthma or diabetes and weren’t stigmatized because of opioids, this wouldn’t be allowed to happen. Anne Fuqua

The raid on Tennant’s home and office last November illustrates the hard-line regulatory and enforcement approach that critics say doesn’t distinguish between pill-mill doctors who deserve to be shut down and legitimate pain doctors who use high-dosage opioids. The wide-ranging search warrant served to Tennant essentially accused him of drug trafficking even though he’d earned a national reputation for deft treatment of ― and research about ― pain patients.

“He’s highly respected and prominent in pain management,” said Jeffrey Fudin, a clinical pharmacy specialist who heads the pain pharmacy program at the Albany Stratton VA Medical Center in Albany, New York, and serves as an associate professor at the Albany College of Pharmacy and Health Sciences. “Most of his patients had no other options, and they came from around the country to see him.”

Tennant was known for taking on difficult-to-treat patients, including those suffering from pain as a result of botched surgeries and other forms of malpractice. His research included innovations in the use of hormones to alleviate pain and lower opioid use up to 40 percent, as well as work on genetic testing for enzyme system defects that lead to opioid malabsorption.

“The DEA can trigger an investigation every time they misapply the CDC guidelines without paying attention to the population the physician treats or issues of medical necessity,” said Terri Lewis, a patient advocate and a Ph.D. clinical rehabilitation specialist with Southern Illinois University who trains clinicians on how to manage seriously ill patients with incurable pain.

Special Agent Timothy Massino, a spokesperson for the DEA’s Los Angeles division, declined to comment on the agency’s approach to Tennant. “It’s an ongoing investigation,” he noted.

Tennant’s isn’t alone. Physicians must now balance their prescribing obligations to their patients with legitimate fear for their livelihoods.

DEA enforcement actions against doctors have risen some 500 percent in recent years ― from 88 in 2011 to 449 last year, according to an analysis of the comprehensive National Practitioners Data Bank by Tony Yang, a professor of health policy at George Washington University. Even though that’s a relatively small number of arrests compared to the roughly one million physicians in the country, such arrests can have an outsized impact.

“They make big news, and they serve as a deterrent for physicians whose specialties require them to use a lot of pain medications,” Yang said. “It makes them think twice before prescribing opioids.”

Meredith Lawrence shows the tattoo she got after her husband'€™s death. The bluejay represents her husband, Jay; a cup of cof

Dustin Chambers for HuffPost Meredith Lawrence shows the tattoo she got after her husband’€™s death. The bluejay represents her husband, Jay; a cup of coffee is the way she loves to start her day; and the quote is “Sail away with me, what will be will be.”

Dr. Mark Ibsen of Helena, Montana, found himself in a five-year battle against the state licensing board that’s still not over ― even though a judge last month reversed the board’s decision to suspend his license because of due process violations. The court has remanded the case back to the licensing board for potential further investigation of his opioid prescriptions, but Ibsen has decided he won’t resume his medical practice.

That’s bad news for Montana, which has the highest rate of suicide in the country, according to the CDC. What’s more, chronic pain-related illnesses account for 35 percent of all the state’s suicides, as a recent state health department study found.

In the course of his fight with the medical board, the 63-year-old doctor said three of his former chronic pain patients have killed themselves after he and other doctors stopped prescribing opioids. The first of those patients died shortly after attending a hearing to show his support for Ibsen.

The deaths of pain patients haunt those who treated them and loved them. Meredith Lawrence, who sat with her husband to the very end, said, “It was as horrifying as anything you can imagine.”

“But I had the choice to help him or find him dead someday when I came home,” she added.

Lawrence was arrested and sentenced to a year’s probation for assisting a suicide. Now her goal is to fight restrictions on opioid prescriptions.

“If we don’t stand up, more people will die like my husband.”

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

Art Levine is the author of Mental Health, Inc: How Corruption, Lax Oversight, and Failed Reforms Endanger Our Most Vulnerable Citizens.

CONTINUE READING…

That study isn’t without flaws. Veterans die by suicide at higher rates than average ― currently accounting for 20 suicide deaths a day ― so they are not a nationally representative sample. And the VA study, which was released at a national opioid summit in early April, has not yet been submitted for peer review.

But another study, published last year in the peer-reviewed journal General Hospital Psychiatry, looked at nearly 600 veterans who in 2012 were cut off from dosages after long-term opioid use and found similar results. Twelve percent of the vets showed suicidal ideation or took violent action to harm themselves ― a rate nearly 300 percent higher than the overall veterans community.

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The House Just Passed a Bill That Could Make Kratom Illegal

Kratom Pills

By Peter Hesson June 18, 2018

Kratom, an herbal drug used by chronic pain patients and people with opioid use disorder, has been on the Drug Enforcement Administration’s chopping block for years, but it could become illegal a lot sooner than expected. On Friday, 239 members of the US House of Representatives voted to pass H.R.2851, the Stop the Importation and Trafficking of Synthetic Analogues Act — SITSA Act for short — which is intended to help fight the growing opioid epidemic in the US. Unfortunately, it could also have the side effect of giving the Department of Justice broad authority to make kratom illegal.

The SITSA Act, which has not yet been approved by the Senate, would expand the Controlled Substances Act to include one additional category of drugs: Schedule A. Currently, the CSA includes five categories — or “Schedules” — of drugs, numbered I through V. Schedule I contains illegal drugs like heroin and LSD, and Schedules II through V contain drugs that could be abused but are available with prescriptions (for instance, oxycodone is Schedule II and Ambien is Schedule IV).

See also: Kratom Could Be Illegal Before It Gets a Chance to Solve the Opioid Crisis

Under the SITSA Act, the Justice Department could quickly place any analogues of existing drugs into Schedule A. An analogue is any drug that has a similar chemical structure and an “actual or predicted” effect that’s similar to a drug that’s already scheduled. That’s what worries advocates of kratom, an herbal drug that is not currently illegal but has opioid properties.

On its face, the bill is focused squarely on synthetic opioids that are fueling the opioid crisis. The only specific drugs it lists are 13 chemical analogues of fentanyl, the powerful opioid that the US Centers for Disease Control and Prevention blames for a large portion of the recent increases in opioid overdose deaths. If passed, the SITSA Act will give the Justice Department broad authority to quickly assign these fentanyl varieties a similar legal status as fentanyl, making it possible to swiftly prosecute anyone distributing substances that aren’t actually illegal.

But as concerned critics have pointed out, the SITSA Act also opens the door for an even broader interpretation of the law, in which the Justice Department could quickly add other chemicals to Schedule A without much oversight. Compounds can remain for up to five years in that category until there’s sufficient research to back up a permanent scheduling decision.

This is what kratom advocates are specifically worried about. In February, the US Food and Drug Administration warned that kratom is chemically similar to opioids and could therefore fuel the opioid crisis. As Inverse has reported, experts question the FDA’s assessment of the danger posed by kratom. Nevertheless, if the SITSA Act passes, that FDA report could be all the evidence the DEA needs to place kratom into Schedule A. At that point, the Justice Department would have five years to place it into a more permanent category.

The #SITSA Act (HR 2851) attempts to address the very real problem of synthetic #opioid overdoses in the U.S., but we believe that its methods are misguided.
Read our letter to House reps to learn more about our opposition: https://t.co/5txjpifMNF pic.twitter.com/38D7oa7dM9

— FAMM Foundation (@FAMMFoundation) June 14, 2018

In an open letter to Congress published on June 14, Human Rights Watch, the ACLU, the NAACP, and over a dozen other organizations expressed opposition to the bill, arguing that it would disproportionately punish drug users rather than manufacturers or distributors. “The legislation attempts to address the very real problem of synthetic opioid overdoses in the United States, but we believe that its methods are misguided,” the letter reads. “Instead of punishing people who use drugs and low-level dealers, legislation should focus on expanding treatment opportunities and targeting the international drug trade.”

Additionally, the SITSA Act includes language outlining criminal penalties (fines and prison time) rather than treatment or rehabilitation. So, while the prime motivation behind the SITSA Act may be public health, it could do more harm than good by further criminalizing drug addiction instead of helping expand treatment resources for people who need them.

And as far as kratom goes, if the rules of the SITSA Act eventually make it illegal, then researchers will have a much harder time investigating whether it could actually be a safer alternative to opioids.

CONTINUE READING…

(KY) GOV. MATT BEVIN AND AG ANDY BESHEAR GET SUED OVER MEDICAL MARIJUANA!

BECAUSE THIS STORY IS SO IMPORTANT IN KENTUCKY I HAVE INCLUDED TWO SOURCES OF INFORMATION.

PLEASE FOLLOW THE LINK TO THE VIDEO BELOW TO HEAR THE PRESS CONFERENCE WHICH WAS AIRED ON WLKY.

THE LAWSUIT WAS FILED TODAY, JUNE 14TH, 2017, IN JEFFERSON COUNTY KENTUCKY AGAINST GOV. MATT BEVIN AND AG ANDY BESHEAR BY DANNY BELCHER OF BATH COUNTY, AMY STALKER OF JEFFERSON COUNTY, AND DAN SEUM JR OF JEFFERSON COUNTY.

ky mj lawsuit

ABOVE:  LINK TO PRESS CONFERENCE VIDEO ON WLKY

FACEBOOK – WLKY PRESS CONFERENCE WITH COMMENTS

Mark Vanderhoff Reporter

FRANKFORT, Ky. —

Three people are suing Kentucky Gov. Matt Bevin and Attorney General Andy Beshear over Kentucky’s marijuana laws, claiming their rights are being violated by not being able to use or possess medicinal marijuana.

The lawsuit, filed Wednesday morning in Jefferson Circuit Court, was filed on behalf of Danny Belcher of Bath County, Amy Stalker of Louisville and Dan Seum Jr., son of state Sen. Dan Seum, R-Fairdale.

Seum turned to marijuana after being prescribed opioid painkillers to manage back pain.

“I don’t want to go through what I went through coming off that Oxycontin and I can’t function on it,” he said. “If I consume cannabis, I can at least function and have a little quality of life.”

The plaintiffs spoke at a press conference Wednesday afternoon.

Seum does not believe the state can legally justify outlawing medical marijuana while at the same time allowing doctors to prescribe powerful and highly addictive opioids, which have created a statewide and national epidemic of abuse.

That legal justification lies at the heart of the plaintiffs’ legal challenge, which claims Kentucky is violating its own constitution.

The lawsuit claims the prohibition violates section two of the Kentucky Constitution, which denies “arbitrary power,” and claims the courts have interpreted that to mean a law can’t be unreasonable.

“It’s difficult to make a comparison between medical cannabis and opioids that are routine prescribed to people all over the commonwealth, all over the country, and say that there’s some sort of rational basis for the prohibition on cannabis as medicine when we know how well it works,” said Dan Canon, who along with attorney Candace Curtis is representing the plaintiffs.

The lawsuit also claims Kentucky’s law violates the plaintiffs’ right to privacy, also guaranteed under the state constitution.

Spokespeople for Gov. Bevin and Beshear say their offices are in the process of reviewing the lawsuit.

In a February interview on NewsRadio 840 WHAS, Bevin said the following in response to a question about whether he supports medical marijuana:

“The devil’s in the details. I am not opposed to the idea medical marijuana, if prescribed like other drugs, if administered in the same way we would other pharmaceutical drugs. I think it would be appropriate in many respects. It has absolute medicinal value. Again, it’s a function of its making its way to me. I don’t do that executively. It would have to be a bill.”  CONTINUE READING…

Lawsuit challenges Kentucky’s medical marijuana ban

By Bruce Schreiner | AP June 14 at 6:38 PM

LOUISVILLE, Ky. — Kentucky’s criminal ban against medical marijuana was challenged Wednesday in a lawsuit touting cannabis as a viable alternative to ease addiction woes from opioid painkillers.

The plaintiffs have used medical marijuana to ease health problems, the suit said. The three plaintiffs include Dan Seum Jr., the son of a longtime Republican state senator.

Another plaintiff, Amy Stalker, was prescribed medical marijuana while living in Colorado and Washington state to help treat symptoms from irritable bowel syndrome and bipolar disorder. She has struggled to maintain her health since moving back to Kentucky to be with her ailing mother.

“She comes back to her home state and she’s treated as a criminal for this same conduct,” said plaintiffs’ attorney Daniel Canon. “That’s absurd, it’s irrational and it’s unconstitutional.”

Stalker, meeting with reporters, said: “I just want to be able to talk to my doctors the same way I’m able to talk to doctors in other states, and have my medical needs heard.” CONTINUE READING…

SITSA creates a new “Schedule A” that gives the Attorney General of the United States the power to ban any “analogue” of an opioid that controls pain or provides an increase of energy.

Image may contain: 1 person, plant, nature and outdoor

Kratom Advocates:

If you’ve had one of those days that starts with friends calling you with bad news, and the news just gets worse and worse as the day goes on – then that describes my day perfectly.

On Friday of last week, Sen. Chuck Grassley of Iowa, and Sen. Dianne Feinstein of California, dropped a bill in the U.S. Senate that our lobbyists believe will give the FDA and DEA a backdoor way of banning kratom completely in the United States.

S. 1327 is euphemistically called the SITSA Act.  And a companion bill in the US House of Representatives has already been filed, H.R. 2851, by Representative John Katco of New York.

The SITSA Act stands for the “Stop Importation and Trafficking of Synthetic Analogues Act of 2017.”
SITSA creates a new “Schedule A” that gives the Attorney General of the United States the power to ban any “analogue” of an opioid that controls pain or provides an increase of energy.

That is kratom. Because kratom’s 2 primary alkaloids, mitragynine and 7-hydroxymitragynine, though not opioids, act similarly in some ways.
They could of just called this bill the “Schedule Kratom” Act.

This legislation will allow the Attorney General, and his supporters at the DEA, to add kratom to Schedule A on a “temporary basis” that will last for 5 years.
And once added to Schedule A, the Attorney General can convert it to a permanent schedule.
After everything that we’ve fought successfully against and endured together as a movement, our lobbyists are concerned that this is now the perfect storm for banning kratom.

Under the current Controlled Substances Act, the FDA and DEA have to prove conclusively that kratom is dangerously addictive and unsafe for consumer use. That’s why we were able to stop them in their tracks when they tried to ram through an “emergency scheduling” ban on kratom.

And it is why the FDA is having such a tough time in finding some justification to schedule kratom under regular rulemaking.

So now the anti-kratom bureaucrats in Washington want to ban kratom simply by claiming it has the same effects as an opioid – calling it an “analogue” of the opioid.

And the SITSA Act can enforce a ban on kratom by criminalizing any manufacturer or distributor of kratom. Ten years imprisonment just for manufacturing or selling a kratom product, and a fine of $500,000 if you are an individual, $2,500,000 if the defendant is a company.

If you import or export kratom, it is a 20-year sentence.

And then there are harsh penalties for what they call “false labeling” of a Schedule A substance.
That’s why am writing – because I need your help again.

We have to convince Sen. Grassley, Sen. Feinstein, and Representative Katko that they have to exempt natural botanical plants from the SITSA Act.
We have to act quickly, because I learned today that the House Judiciary Committee is looking to schedule a Hearing before they leave for recess next month.

So I hope you will help by doing three specific things:

1.    Click on the link below and sign our petition that the AKA will have delivered to every member of the Senate and House Judiciary Committees. 

PLEASE SIGN THIS PETITION URGING LAWMAKERS TO REMOVE KRATOM FROM THE SITSA ACT.

2.    I need you to pick up the phone and call Sen. Grassley’s office, Sen. Feinstein’s office, and Representative Katco’s office. When the staff member answers the phone, tell them that their boss should exclude natural botanicals like kratom products from the SITSA Act.

Here are the phone numbers you should call:

Senator Grassley:    (202) 224-3744
Senator Feinstein:    (202) 224-3841
Congressman Katco:    (202) 225-3701

When you call, be polite, but firm.  Kratom should be exempted from SITSA.

3.    Please click on the donation link below and help us once again to take on this fight with a team of lawyers, lobbyists, and public relations professionals.  Please consider making a monthly contribution to the AKA.

DONATION LINK TO HELP THE AKA FIGHT THIS LEGISLATION.

I know I am asking a lot.

But we need to fight back hard, or they will steal our freedoms from us to make our own decisions about our health and well-being.

So please, sign the petition, call the the sponsors of SITSA, and please, please, give as generous a contribution as you can to help us put our team on the ground in Washington, D.C.

With your help, we have established ourselves as a real force in Washington.

With your continued help – help that I am so grateful for – we can win this battle against the enemies of kratom.

Your contribution will help us hire the lawyers we need for a brief on why this legislation violates due process and current law; our lobbyists to knock on doors on Capitol Hill; and our public relations team to rally the press to tell our story.

We will stand up for freedom.

Thank you for your continued support.

Sincerely,

Susan Ash
Founder and Spokesperson
American Kratom Association
www.americankratom.org

http://mailchi.mp/americankratom/new-legislative-attack-on-kratom?e=2709219685

https://www.facebook.com/kratom.us/photos/rpp.260289027341069/873568049346494/?type=3&theater

Why Donald Trump’s Agenda for the Drug War Is the Dopiest Thing You’ve Ever Seen

A frightening mix of cruel and superficial.

By Phillip Smith / AlterNet

November 2, 2016

One means of judging the competing presidential candidates is to examine their actual policy prescriptions for dealing with serious issues facing the country. When it comes to drug policy, the contrasts between Hillary Clinton and Donald Trump couldn’t be more telling.

The country is in the midst of what can fairly be called an opioid crisis, with the CDC reporting 78 Americans dying every day from heroin and prescription opioid overdoses. Both candidates have addressed the problem on the campaign trail, but as is the case in so many other policy areas, one candidate has detailed proposals, while the other offers demagogic sloganeering.

Hillary Clinton has offered a detailed $10 billion plan to deal with what she calls the “quiet epidemic” of opioid addiction. Donald Trump’s plan consists largely of “build the wall.”

That was the centerpiece of his October 15 speech in New Hampshire where he offered his clearest drug policy prescriptions yet (though it was overshadowed by his weird demand that Hillary Clinton undergo a drug test). To be fair, since then, Trump has also called for expanding law enforcement and treatment programs, but he has offered no specifics or cost estimates.

And the centerpiece of his approach remains interdiction, which dovetails nicely with his nativist immigration positions.

“A Trump administration will secure and defend our borders,” he said in that speech. “A wall will not only keep out dangerous cartels and criminals, but it will also keep out the drugs and heroin poisoning our youth.”

Trump did not address the failure of 40 years of ever-increasing border security and interdiction policies to stop the flow of drugs up until now, nor did he explain what would prevent a 50-foot wall from being met with a 51-foot ladder.

Trump’s drug policy also takes aim at a favorite target of conservatives: so-called sanctuary cities, where local officials refuse to cooperate in harsh federal deportation policies.

“We are also going to put an end to sanctuary cities, which refuse to turn over illegal immigrant drug traffickers for deportation,” he said. “We will dismantle the illegal immigrant cartels and violent gangs, and we will send them swiftly out of our country.”

In contrast, Clinton’s detailed proposal calls for increased federal spending for prevention, treatment and recovery, first responders, prescribers, and criminal justice reform. The Clinton plan would send $7.5 billion to the states over 10 years, matching every dollar they spend on such programs with four federal dollars. Another $2.5 billion would be designated for the federal Substance Abuse Prevention and Treatment Block Grant program.

While Trump advocates increased border and law enforcement, including a return to now widely discredited mandatory minimum sentencing for drug offenders, Clinton does not include funding for drug enforcement and interdiction efforts in her proposal. Such funding would presumably come through normal appropriations channels.

Instead of a criminal justice crackdown, Clinton vows that her attorney general will issue guidance to the states urging them to emphasize treatment over incarceration for low-level drug offenders. She also supports alternatives to incarceration such as drug courts (as does Trump). But unlike Trump, Clinton makes no call for increased penalties for drug offenders.

Trump provides lip service to prevention, treatment and recovery, but his rhetorical emphasis illuminates his drug policy priorities: more walls, more law enforcement, more drug war prisoners.

There is one area of drug policy where both candidates are largely in agreement, and that is marijuana policy. Both Clinton and Trump have embraced medical marijuana, both say they are inclined to let the states experiment with legalization, but neither has called for marijuana legalization or the repeal of federal pot prohibition.

If Clinton’s drug policies can be said to be a continuation of Obama’s, Trump’s drug policies are more similar to a return to Nixon’s.

Phillip Smith is editor of the AlterNet Drug Reporter and author of the Drug War Chronicle.

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Heroin use and addiction are surging in the U.S., CDC report says

Heroin use

Rate of heroin use in the U.S. has climbed 63% in the past decade, according to experts at the CDC and FDA

The rate of heroin abuse or dependence has jumped 90% between 2002 and 2013, new CDC report says

Heroin use surged over the past decade, and the wave of addiction and overdose is closely related to the nation’s ongoing prescription drug epidemic, federal health officials said Tuesday.

A new report says that 2.6 out of every 1,000 U.S. residents 12 and older used heroin in the years 2011 to 2013. That’s a 63% increase in the rate of heroin use since the years 2002 to 2004.

Opioids prescribed by doctors led to 92,000 overdoses in ERs in one year

The rate of heroin abuse or dependence climbed 90% over the same period, according to the study by researchers from the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention.

Deaths caused by heroin overdoses nearly quadrupled between 2002 and 2013, claiming 8,257 lives in 2013.

In all, more than half a million people used heroin in 2013, up nearly 150% since 2007, the report said.

Heroin use remained highest for the historically hardest-hit group: poor young men living in cities. But increases were spread across all demographic groups, including women and people with private insurance and high incomes — groups associated with the parallel rise in prescription drug use over the past decade.

The findings appear in a Vital Signs report published in the CDC’s Morbidity and Mortality Weekly Report.

"As a doctor who started my career taking care of patients with HIV and other complications from injection drugs, it’s heartbreaking to see injection drug use making a comeback in the U.S.," said Dr. Tom Frieden, director of the CDC.

Overdoses fell after 2 narcotic painkillers were taken off the market

All but 4% of the people who used heroin in the past year also used another drug, such as cocaine, marijuana or alcohol, according to the report. Indeed, 61% of heroin users used at least three different drugs.

The authors of the new study highlighted a “particularly strong” relationship between the use of prescription painkillers and heroin. People who are addicted to narcotic painkillers are 40 times more likely to misuse heroin, according to the study.

Once reserved for cancer and end-of-life pain, these narcotics now are widely prescribed for conditions ranging from dental work to chronic back pain.

“We are priming people to addiction to heroin with overuse of prescription opiates,” Frieden said at a news conference Tuesday. “More people are primed for heroin addiction because they are addicted to prescription opiates, which are, after all, essentially the same chemical with the same impact on the brain.”

 

Frieden said the increase in heroin use was contributing to other health problems, including rising rates of new HIV infections, cases of newborns addicted to opiates and car accidents. He called for reforms in the way opioid painkillers are prescribed, a crackdown on the flow of cheap heroin and more treatment for those who are addicted.

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Why Do Clinics Deny Painkillers To Medical Marijuana Patients?

By Steve Elliott ~alapoet~

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Should health care facilities have the power to make lifestyle decisions for you — and punish you when your choices don’t measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana — even legal patients in medical marijuana states. Apparently, these places don’t mind looking exactly as if they have more loyalty to their Big Pharma benefactors than they do to their own patients.

A new policy at one Alaska clinic — requiring patients taking painkilling medications to be marijuana free — serves to highlight the hypocrisy and cruelty of such rules, which are used at more and more health care facilities, particularly the big corporate chains (the clinic in question is a member of the Banner Health chain).

Tanana Valley Clinic, in Fairbanks, started handing out prepared statements to all chronic pain patients on Monday, said Corinne Leistikow, assistant medical director for family practice at TVC, reports Dorothy Chomicz at the Fairbanks Daily News-Miner.


"We will no longer prescribe controlled substances, such as opiates and benzodiazepines, to patients who are using marijuana (THC)," the statement reads in part. "These drugs are psychoactive substances and it is not safe for you to take them together." (This statement is patently false; marijuana has no known dangerous reactions with any other drugs, and in fact, since marijuana relieves chronic pain, it often makes it possible for pain patients to take smaller, safer doses of opiates and other drugs.)

LIAR, LIAR: Corinne Leistikow, M.D. says "patients who use opiates and marijuana together are at much higher risk of death." We’d love to see the study you’re talking about, Corinne.

"Your urine will be tested for marijuana," patients are sternly warned. "If you test positive you will have two months to get it out of your system. You will be retested in two months. If you still have THC in your urine, we will no longer prescribe controlled substances for you."

TVC patient Scott Ide, who takes methadone to control chronic back pain, also uses medical marijuana to ease the nausea and vomiting caused by gastroparesis. He believes TVC decided to change its policy after an Anchorage-based medical marijuana authorization clinic spend three days in Fairbanks in June, helping patients get the necessary documentation to get a state medical marijuana card.

"I’m a victim of circumstance because of what occurred," Ide said. "I was already a patient with her — I was already on this regimen. We already knew what we were doing to get me better and work things out for me. I think it’s wrong."

Ide, a former Alaska State Trooper, said he was addicted to painkillers, but medical marijuana helped him wean himself off all medications except methadone.

Leistikow admitted that the new policy may force some patients to drive all the way to Anchorage, because there are only a few chronic pain specialists in Fairbanks. Still, she claimed the strict new policy was "necessary."

The assistant medical director is so eager to defend the clinic’s new policy that she took a significant departure from the facts in so doing.

"What we have decided as a clinic — we’re setting policy for which patients we can take care of and which ones we can’t — patients who use opiates and marijuana together are at much higher risk of death, abuse and misuse of medications, of having side effects from their medications, and recommendations are generally that patients on those should be followed by a pain specialist," Leistikow lied.

Patients who use opiates and marijuana together are NOT in fact at higher risk of death, abuse, misuse and side effects; I invite Ms. Leistikow to produce any studies which indicate they are. As mentioned earlier, pain patients who also use marijuana are usually able to use smaller, safer doses of painkillers than would be the case without cannabis supplementation.

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