Protect Pain Care

Share with others

By nature, I am prone to the use of hyperbole. When I am asked to discuss something that matters to me, such as the treatment of persistent unrelenting pain, I can certainly resort to extreme passion and rhetoric.  And as I lament that anti-opioid zealots, certain lawmakers, and even some healthcare providers continue to criminalize patients with chronic pain syndromes, I thought it was just me being me.  I thought I was being hyperbolic (well at least a little). I no longer believe this to be the case. We are there. We have arrived!

If you doubt my view on this, check out www.protectpaincare.org.stop bugging me

HIPAA, SCHMIPPA. You want opioids?  Talk to our narcotics auditor. Or perhaps our field auditors equipped with handcuffs can help you out. Why didn’t I think of that? Handcuffs can help people stop overusing their meds. If you think I am being hyperbolic about handcuffs check out their website. And, all the while, anti-opioid fringe and the drug warriors have been attempting to handcuff the prescribers.

For 2 decades of expanded opioid use we have been unable to raise the standard of care to the level suggested by Dr. Douglas Gourlay – that those who prescribe controlled substances could qualify, as he calls them, as “talented amateurs” in addiction medicine. Forget about amateurs, we have full on professionals available now.   Oh wait, perhaps those folks are now law enforcement professionals; maybe retired police officers; and perhaps joined by some non-medical folks looking to make a buck.  Don’t worry though, they’re using an “internet based, biometric enabled” technologically advanced platform, so I’m feeling better already.

Don’t get me wrong though.  I have tremendous respect for folks like John Coleman, PhDHe’s not a retired police officer or anti-opioid wannabe, or downtrodden opioid soccermom.  Dr. Coleman served over three decades as a Special Agent of the DEA as one of its top management officials. He knows the real story because he was an undercover drug agent on the streets. I think he’d agree that people on the street that sell and abuse drugs will find another way with or without prescription drugs – but hopefully he’ll chime in here.

This is as foul an indignity as people with chronic pain have yet suffered. And all because we have failed to change our healthcare system to accommodate the use of controlled substances for pain, with training, time, reimbursement and all the things that are needed to make opioids safer. Physicians don’t have the time to assess and monitor people with pain but profiteers and others do.  I can tell you this from experience day in and day out.  In fact, pain management is one of the few areas that I see a drastic need for help from clinical pharmacists that specialize in pain, to collaborate with their physician counterparts – there are just too few Pharm.D.’s trained in the specialty area  to collaborate with physicians.  One thing seems certain; while many pharmacists that are board certified in specialty areas like cardiology, heme/onc, psychology, infectious disease, and other domains are scrambling to find direct patient care jobs right out of their intense residency programs, physicians are begging clinical pharmacists for help in the primary care and the pain space.  “Help us interpret urine screens; help us obtain consent for long-term opioid use from patients; help us educate patients, providers, and families; help us understand serum analysis; help us mitigate against dangerous drug interactions; help us dose-convert opioids; help us to understand pharmacogenetics; help us to understand pharmacokinetics; help us help our patients; and help us keep them alive and treat their pain while doing it.”  Oh, and by the way, “help us figure out who’s a legitimate patient; who’s taking their drugs; who is not; who are taking half; who are selling them; and who flies under the radar because they are using illicit street drugs undetectable by urine screens.”  You see my friends, this is an area where physicians need help and must collaborate with others who largely unavailable BECAUSE OF THE SYSTEM! And if there were enough trained pharmacists to go around, Congress has still not sanctioned them as “providers”, so what’s their incentive?  They can’t be paid for the highly desirable help that is so desperately needed and sought unless they work in a government facility or very large academic setting that is willing to eat the cost to offer better collaborative drug monitoring.

If I had chronic pain and was desperate, would I be willing to sacrifice my privacy and further sacrifice my dignity? Up to now I would only have had to do that at the pharmacy. Now my doctor, the person I hope to trust and have trust me back, is going to farm out the job of assessment and monitoring of me to law enforcement – are you kidding me!?!? And if I don’t want to participate, what choice do I have?

Perhaps instead of all of this, we could have state run opioid distributors for pain. The inside would look a lot like a liquor store in a troubled neighborhood, everything behind plexiglass. We could handle opioids for pain like methadone maintenance. Everyone shows up every day for a one day dose of opioid. It would be like the “Stepford Painers”.  At least then, everyone would be equally stigmatized. Rich or poor if you need pain control, go to the pain maintenance clinic.  Absurd?  You bet it is!  But who do we think will be more hassled when the po-po are part of the treatment team? 

hyperbole definedOr maybe I’m just being hyperbolic…

20 thoughts on “Protect Pain Care

  1. They’re Heeeeeeere…….
    Wow, I didn’t know this farce was being implemented already. I wonder what ‘incidents or infractions disqualify a patient from receiving pain treatment. Perhaps an indiscretion over 20 yrs ago in college over a little reefer perhaps? Jaywalking? 17% disqualified seems a bit high no? Sure would be nice if they revealed what constitutes their ‘various factors’.
    What if an ‘applicant’ has a prior violation that PPC deems marks him/her as an addict [oh my!], does that mean they are forever banned from receiving treatment for legitimate pain? What if they have a legit medical diagnosis and have been ‘clean’ or a ‘good little boy’ for years/decades? My guess is that addicts have real pain issues just like everyone else. If they can follow the guidelines set forth by pain clinics (real ones) why should they not be given a second chance? People change, this is total BS and inhumane.

    *The Hope pain clinics and PPPFD have been working together for four years. Radcliffe says about 10,000 patients have been screened and more than 1,700 have been turned away due to ‘various factors’.

    * “Criminals are messing this industry up, and its life is limited at this point unless we do something to reverse,” said Seth Radcliffe, the operations manager of PPPFD. [*from link below]

    And IMO criminals like PPC are profiteering off the backs of disabled citizens who are under enough financial strain as it is. Not even going to get into issues concerning The Bill of Rights which at this rate will soon be worth about as much as Mr Whipple’s USED cr***** rolls. I wonder what the $75 for subsequent visits entail? Having an agent stop by in the middle of dinner?
    Who’s at the door dear? Oh it’s just my ‘overseer’ stopping by for a weekly pill count. [HOME visits included if you read closely! This kind of scrutiny is for ex-cons out on parole NOT law abiding citizens. Fingerprinting, Home visits, really??????? ] I just lost my appetite.

    * http://www.wowktv.com/story/26549612/ex-narcotics-officers-screening-pain-clinic-patients?clienttype=mobile

    http://spiritofjefferson.com/blog/2014/09/west-virginia-pain-clinics-screening-patients-for-pill-use/

  2. Protect Pain Care used by Hope Pain Center

    IN-STATE PATIENTS

    All new in-state patients must pay $275 for their first visit, and $170 for every visit thereafter. Please note that pricing may differ slightly based on clinic location.

    OUT-OF-STATE PATIENTS

    All new out-of-state patients must pay $330 for their first visit, and $195 for every visit thereafter. Out-of-state patient fees are higher because it is more costly for us to perform our anti-diversion monitoring program when a patient is located in another state. Please note that pricing may differ slightly based on clinic location.

    The new patient fee covers the first physician visit, the first drug screen, and the FIRST NARCOTIC AUDIT. We accept all insurances but at this time, we do not bill any insurance. We can offer our patients a fee ticket that you can submit to your private insurance company for reimbursement. By not billing any insurance, we are exempted from Federal HIPAA laws that would forbid us from fighting diversion effectively by turning over criminal patient information to law enforcement for prosecution. We accept cash, money order, and credit card for new patient visit fees. FOR MORE INFO:

    http://www.hopepaincenters.org/current-patients.html

    http://www.wowktv.com/story/26549612/ex-narcotics-officers-screening-pain-clinic-patients?clienttype=mobile

  3. This is a scary site. The fact that Federal, State, and local county PRISONERS have access to scheduled drugs inside some of the most secure facilities on earth should be enough to sink the USS DEA. For prosecutors and law enforcement officers to advocate up to the point of starting and signing petitions ‘asking’ patients with legitimate disease(s) to give up their 4th amendment rights in order to gain access to pain treatment medications(and to fight diversion) is simply going beyond the pale. Just when one thinks they’ve seen it all and believes nothing would shock them ‘they’ roll something like this out. Thankfully not all law enforcement officers, judges, and prosecutors do NOT feel this way. http://www.leap.cc/

    Years of seeing the effects of doing the same ‘ol same ‘ol have opened their eyes to the futility, corruption, wastefulness, and discrimination that the drug war has brought us with very little but an ever expanding bureaucracy of the DOJ, correctional industry (just as scary are the for PROFIT prisons), addiction treatment specialists, etc, etc. [Prisons now routinely use low security risk drug convicts as virtual slave labor in prison industries to undermine legitimate businesses, just outrageous]. LEAP understand what many citizens do not. While WE, the citizen taxpayers, have lost the drug war, there ARE WINNERS. Drug warriors make their living off of this farce and aren’t about to give up their meal ticket w/out a fight. http://www.washingtonpost.com/news/the-watch/wp/2014/02/17/the-drug-wars-profit-motive/ Legalization of marijuana not only undermines their funding but is a clear message that many Americans are sick and tired of the drug war. (enter opioid ‘epidemic’ and they are needed again) The tide is turning and the prospect that these drug warriors are useless, cause more harm than good, and may be about as scarce as a T-Rex in a decade or two, scares them to death. That SOME politicians can see through the smokescreen is encouraging- http://watchdog.org/163956/minnesota-civil-asset-forfeiture/
    There IS a big puzzle picture that PPCare fits into nicely, the destruction of the Bill of Rights (chipping away little by little).Immigration checkpoints 25-50 miles INSIDE the US/MEXICAN border (actually on state borders) replete with drug dogs (never understood how a dog could help determine whether or not a person was an illegal immigrant or a citizen). I DO know from working with dogs as a job, prior to becoming disabled, that they can be trained to ‘respond’ to other things than smelling a drug. Small actions/directives from the handler, almost invisible to all but the trained eye, (certainly not by an intimidated motorist), work like a charm and make ‘probable cause’ one of the most dubious abuses of power by LE. Once given, the officers have ‘probable cause’ for a search.

    Think you are immune and this only applies to drug couriers? Think again, despite the label on the Rx bottle recommending the patient becoming familiar with the effects of pain medication before driving or operating machinery, motorists are being ARRESTED for DUIs when taking prescription drugs while driving even when taken in prescribed doses which they should be tolerant to. In a show on National Geographic a citizen was arrested because the amount of medicaton did not match up with how many she should have had given the date the Rx was filled! I dont know about anyone else but I dont carry around a bottle w/ 60 methadone tablets inside of it, though I do tend to carry one or two of several medications (controlled and non-controlled) in case I am away from home for longer than anticipated. They could be easily lost or stolen or conversely, officers could ask ‘what is the need for carrying around that much medication? Its a lose/lose situation.

    The apathy of the avg US citizen. This is what they are counting on. If track a past record of giving up liberties and rights for more regulation and ‘protection’ is anything to go by, they should expect only minimal opposition to a system like the one featured in this thread. What about the ACLU? Easily by-passed because signing up would be ‘voluntary’ [despite obvious coercion]. I am still trying to figure out how citizens can approve marijuana even for recreational use yet not oppose efforts to restrict access to opioids for legitimate medical patients.

    Now for the big Question Dr Fudin-
    Could pain advocates launch something similar to what those marijuana advocates did in Colorado and Washington? Putting opioids to the people to vote on in the ballot in place of marijuana? While the OD factor is nil for MJ, there is far more evidence and anecdotes supporting opioids for pain than there ever was for medical marijuana (not even taking into account recreational usage). From some of the talks I’ve listened to and papers I’ve read, the drug war and how it is conducted is resting on shaky ground constitutionally speaking. Could we take an especially egregious case against a physician or patient before the Supreme Court and set a precedent for ousting the neophytes from the doctor’s office? Seems like a job for an organization like the AMA and a few dedicated and talented attorneys no? Seems like doctors (and now pharmacists) should be about sick and tired of being told how to practice medicine by folks who are totally unqualified and unable to tell the difference between the flu and the common cold.

    Again, thank you for all you do to advocate for patients and for keeping the public informed of what is REALLY going on in the medical system.

    1. Coonhound,
      That is a BIG question! It is quite doubtful in my mind for a number of reasons.
      1. Marijuana in the form of leaves is considered schedule I, not a prescription drug, “without medicinal benefit”, and illegal by the current regulations. Opioids do fit fit this, as they are Schedule II which by regulation means they di require an prescriptions, do have medicinal properties, and are legal. So we’re talking many differences here before we even get to the other issues.
      2. Other than synthetic cannabioids, it would be rare to see a death from marijuana alone. That is not the case with opioids – obviously they can cause death.
      3. The abuse potential in regards to physical dependence is also very different. Abrupt cessation of marijuana does not cause physical illness, but that is also not the case with opioids, which obviously do.
      4. The abuse potential for opioids is far greater than marijuana, and drugs are scheduled by the DEAS according to abuse poptential, not inherent danger (if the latter was the case, cytotoxic chemotherapy, warfarin, and perhaps even aspirin and acetaminophen might be scheduled drugs).
      5. Finally, marijuana from batch to batch is variable by many factors, including which cannabinoid receptors they bind to and the extent of that binding and how much agonist verses anti-agonist activity they have. In essence, the sort of mimic a “natural” health food product like rose hips or another herbal.

      In short, I think it would be an impossibility with even getting into the more technical and legal issues of which there are many.

  4. As a chronic pain patient and advocate, I have been disheartened by the turn in our government to make chronic pain patients jump through hoops to get our meds that keep us functioning. My personal doctor actually got calls from the DEA, and all he did was treat my pain. I have never abused my medications, never refilled my prescriptions early, nothing at all to raise concern except for the medications I was taking. Now I am on less medication, I’m certainly less functional, and I fail to see how what I put into my body effects the heroin problem.
    Of course, now I am flagged in the “system”, so even if I have something acute like a broken bone, I’m more likely to be told that I’m already on pain meds so I don’t need anything extra.
    I am truly scared about the way this is going. Where is the research on medications that aren’t opiods that help with pain? I am at the highest dosages of many medications, yet the pain is still there; of course it would be much worse without them, but what happens when you are at the maximum and still in intolerable pain?
    The only way the current system of persecuting pain patients is going to change is if patients, doctors, and pharmacists come together and construct a better system. Otherwise we may as well throw in the towel.

  5. Great as always! I recently posted Doctors’ Group Issues Painkiller Guidelines (Web MD, Sept. 29, 2014). The post was met with some criticism and I replied as follows.

    “Outcome and improved function should always be the goal, regardless of what that is for each individual. We must get chronic pain recognized as a disease so we can approach all aspects of pain care. That said, withholding medications that are helping people live a more productive life, whatever they may be, is not the answer, We must get CAM and functional medicine covered by insurance so patients can make decisions that are not based on their ability to pay.”

    Key words here, “So patients can make decisions.” I feel like my hands are tied behind my back and I am being thrown into a vast sea of political and financial agendas (including alternative medicine). What has happened to our common sense in this country? Let’s see some media hype on what IS working to help people live a more productive life despite their use of opioids or CAM therapies.

  6. If I found the PPFD website on my own I would definitely take it for satire. In fact, if someone other than Dr. Fudin wrote about it, I wouldn’t believe it was real. I am speechless…an exceptionally rare condition for me.

  7. I became a chronic pain sufferer over a period of time but didn’t seek medical treatment till 1995 and things where difficult at first finding the correct pain care. It was like doctors didn’t believe me till I had several test ran MRI’s , Cat Scans ,EMG etc.
    At the time I didn’t know much about pain management and doctors would not prescribe anything stronger than a Hydrocodone. It took too many of these pills to do my unrelenting ongoing chronic pain any good and I kept running out, this looked like abuse . A certain Pain Specialist I was seeing told me he had a surgeon that could alleviate my cervical pain with surgery but was afraid I would say I’m still in chronic pain after surgery and want more Hydrocodone. I told him this is not true if I wasn’t in severe chronic pain I would not need this medication, what can I do to have this surgery. He said two weeks in detox and he will set up the surgery. I was very naïve at the time and did the two weeks. After my time in that hell hole I go back to my trusting doctor that had the answer to my chronic pain problem only to find out he lied to me ,no such surgery existed. I wanted to jump over his desk and strangle him but my better half took over, I was very upset and angry like anyone would be.I was afraid from then on I would be red flagged as a abuser of any medication that would be of any help for my chronic pain. I thought this would show up on my medical records and any type treatment of my chronic pain would cease to exist.

    Even though I finally found pain relief from a compassionate doctor 3 months later for 9 years, all good things must come to a end. Now things have been turned totally upside-down and insane for the world of chronic pain sufferers, along with doctors that try their best treating us and pharmacist that try to fill our scripts .I cant believe the things I’ve been through and heard from other chronic pain sufferers. Over the past 15 years the treatment of chronic pain is a utter disgrace in the year 2014.
    Even though I’m on the lowest dose possible to keep my chronic pain under control I still worry this too will be taken away.
    Our government should go ahead and implant a computer chip in between our thumb and index finger for us that truly suffer from chronic pain to make us legit chronic pain sufferers and okay to prescribe to and okay for pharmacist to fill our scripts. Sounds far fetched , but now days nothing surprises me.
    As far as the PPFD it too sounds a bit far fetched but at least it’s people trying something different.

  8. Dr. Fudin,

    As usual, a very timely, engaging, and instructive blog post. I’m on board with this.

    When you invoke the name of Doug Gourlay, his “Universal Precautions” checklist comes to mind (http://goo.gl/hrjJJB). Over the years, I’ve taken a stab at checklists myself (e.g. “COMPLIANCE” http://goo.gl/5mZoLv). One such “TOP TEN” was penned by me for the journal of the Greater Louisville Medical Society in February 2006 (see excerpt below).

    When I read this statement from your blog post:
    “…physicians are begging clinical pharmacists for help in the primary care and the pain space.”
    I felt I had heard that before. Sure enough, it was item #6 from my 2006 TOP TEN.

    Here’s an abbreviated version of the list published in the February 2006 “Louisville Medicine.” The entire text of the article can be accessed at:
    http://goo.gl/8v6wjW.

    The Top Ten Actions for Avoiding Trouble When Prescribing Controlled Substances for Chronic Non-Malignant Pain

    1. Download the Kentucky Board of Medical Licensure guidelines.

    2. Document document document.

    3. Prescribe in a logical manner.

    4. Do urine drug screens.

    5. Obtain KASPER reports (i.e. state prescription database).

    6. Get to know your local PHARMACISTS and police. Foster a good reputation. Be friendly. Do not act arrogant or obtrusive. Many physician investigations are triggered by calls from pharmacists and police. Make it clear you want to be part of the solution, not part of the problem.

    7. Screen patients for abuse potential.

    8. Use treatment agreements and obtain informed consent.

    9. Do not go it alone. Ask for help.

    10. Obtain CME.

    *
    *
    And, by the way, #9 was pretty much a major theme of your blog post as well. It’s obvious that as long as we have you in our corner, we won’t have to “go it alone.” Thanks Dr. Fudin!

    1. Dr. Murphy,

      You brought up some very interesting points! You made me do some thinking in that I suspect for many primary care providers and for some pain clinicians less focused on pharmacotherapeutics, perhaps some if not most, don’t know what CLINICAL pharmacists could or currently do if well trained in this specialty area. Depending on the state regulations, more and more pharmacists are beginning to work side-by-side with physicians in their clinics and of course in hospital settings as well. In states where this is less supported or for those physicians that have not worked with pharmacist clinicians in any number of federal institutions, the concept of collaborating with a pharmacist clinician is probably foreign. So, for the world to see, here are some of my daily tasks. Perhaps it would be a good idea to post a separate blog encouraging more support for this collaboration. After you see this, maybe you’ll make me an offer I can’t refuse. 😉 Cheers my friend!

      SPECIFIC PAIN RELATED ACTIVITIES INCLUDE:

      1. Comprehensive analgesic pain medication evaluation including all medication therapies but with a focus on analgesic therapies and potential drug interactions.
      2. Medication history review and reconciliation
      3. Initiation, modify and/or recommend medication regimens as allowable by current regulation
      4. Assessment of adherence to medications
      5. Risk assessments evaluations and documentation with validated tools and lab analysis
      a. SOAP-R
      b. COMM
      c. Urine Drug Test evaluations
      i. Immune Assay
      ii. Qualitative Testing (gas or liquid chromatography mass spectrometry (GC-LCMS)
      iii. Adulteration Behavior Checks (ABC) and Specimen Validity Testing (SVT)
      6. Behavior modification techniques and follow-up services for nonadherence
      7. Pharmacokinetic and clinical monitoring of medications
      8. Pharmacogenetic testing and interpretation of results
      9. Patient education regarding self-administration and monitoring of medications
      10. Monitoring for therapeutic effects, drug interactions, and adverse drug events through drug regimen review, laboratory data/vital sign assessment and patient interview
      11. Identification of and monitoring for behaviors of medication misuse, abuse, and/or addiction
      12. Assist with the development of clinical protocols to encourage the systematic approach to and use of various analgesic therapies
      13. Provide educational conferences to staff and affiliates on topics related to pain pharmacotherapy
      14. Conduct academic-detailing and/or drug use evaluations and respective outcomes
      15. Assist with quality improvement projects to improve processes related to patient care

      Competency for position includes
      1. Chronic pain syndromes
      2. Pain pharmacotherapy
      3. Knowledge of interventional therapies
      4. Risk assessment and management
      5. Toxicology and urine drug screening evaluation
      6. Responsible opioid prescribing/universal precautions
      7. Behavioral interventions
      8. Motivational interviewing
      9. Addiction medicine
      10. Inter-professional communication and collaboration
      11. Referrals when appropriate
      12. Prescribe medications

      CLINICAL PHARMACIST IN PAIN MANAGEMENT, GENERAL FUNCTIONS AND SCOPE OF PRACTICE

      1. Conduct comprehensive appraisals of patients’ health status by taking health and drug
      histories. Relevant findings must be documented in the patient’s medical record.
      2. Evaluate drug therapy through direct patient care involvement, with clinical assessment and
      objective findings relating to patient’s responses to drug therapy and communicating and
      documenting those findings and recommendations to appropriate individuals and in appropriate records (i.e., patient’s medical record).
      3. Develop and document therapeutic plans utilizing the most effective, least toxic, and
      most economical medication treatments.
      4. Provide patient and health care professional education.
      5. Order, perform, review, and analyze appropriate laboratory tests and other diagnostic studies necessary to monitor and support the patient’s drug therapy.
      6. Perform the physical measurements necessary to ensure the patients appropriate clinical responses to drug therapy.
      7. Assist in the management of medical emergencies, adverse drug reactions, and acute and chronic disease states.
      8. Identify and take specific corrective action for drug-induced problems.
      9. Order consults ON BEHALF of PROVIDERS (i.e., Anesthesia interventionalists, imaging, dietician, social work, psychology), as appropriate, to maximize positive drug therapy outcomes.

  9. I think that the worse has yet to come… suggest you read this http://www.pharmaciststeve.com/?p=6875
    Your medical record is worth more to hackers than your credit card. All of a sudden the “red flag” of paying cash disappears.. because of faked/forged/stolen ID’s and insurance cards.. It is my firm belief that our system has been constructed to ensure that legal drugs get to the street. For example, the bureaucrats can dictate to pharmacies and pharmacy software provider what and how often controlled Rxs are submitted to the PMP. But we still have in place the same time consuming methodology of retrieving a report.. as opposed to having the pt’s information on the screen and using a menu selection or function key to send a request to the PMP. Reducing the time required to request a report from minutes to ONE SECOND. One state that I am licensed in prefers to use of SSN as ID for the PMP and yet there is a Federal SS database.. but .. it is only to be used by employers screening job applicants to see if they are illegals. Forget validating driver’s licenses against the state’s BMV’s database. Heroin use is going thru the roof.. the DEA can’t keep this ILLEGAL drug off the streets.. they have to have some methodology in place to “bust” someone to show Congress that they are doing something. They are quickly loosing MJ as a illegal drug to go after… As a Pharmacist, I tried talking to several medical practices about managing their chronic pain pts.. “sanitize the pt base” even showed how I could earn my keep.. but.. never could get much interest stirred up.

  10. This may seem trivial, but you never get a second chance to make a first impression — and that Protect Pain Care website speaks poorly at first sight. First, using cap letters is typically a way of shouting in print, and the site has ALL cap letters. Second, the hardest text to read and comprehend is white or colored text against a dark background — guess what the site uses? Hmmm…. there is a message coming from this group and it ain’t good on any level. Just sayin’.

  11. If there was a LIKE button, I would press it!

    One day soon, when pharmacists are hired–
    to interpret urine screens; obtain consent for long-term opioid use from patients; educate patients,
    providers, and families; analyze serum results; mitigate against dangerous drug interactions; help
    physicians keep patients alive and treat their pain while doing it” and figure out who’s a legitimate
    patient; who’s taking their drugs; better the healthcare system
    —-where would their salary come from?

    Why do pharmacists have to keep proving the impact they have on patient care?

  12. The Internet provides great opportunities for people across a wide spectrum of society to communicate and discuss ideas. That said, it also is a medium to advance nonsense, propaganda, grand conspiracies, and just plain old fashioned satire. The PPPFD website, in my opinion, fits at least one and maybe all four of these descriptors. Absent it being a satire, one might rightfully ask what sort of group or person would desire to sew discontent between two important communities — law enforcement and medical — that must work together to protect public safety and health by advancing this cockamamie idea? Subjecting pain patients to an ill-defined regime of “pharmacovigilance biometrics” as a condition for providing them with needed medicines would achieve nothing without a massive database to process collected data for signals of alleged doctor shopping. Believe me, there are better ways to do this that preserve patient and medical record privacy, are more cost effective, and, best of all, do not needlessly treat chronic pain patients and their physicians/pharmacists as suspects.

  13. This whole situation sickens me. I work with hundreds of consumers with spinal injuries and chronic pain. It will get so much worse for them as dangerous procedures are foisted upon them. I am the lead patient navigator for the fungal meningitis outbreak. What a train wreck this has been, and what a huge failure of policy, assumptions, services, and victim support.
    Thank you for your voice.

  14. I am quite concerned where it mentioned patient and pharmaceutical tracking devices……What the heck does that even mean? Will try to write more later on the subject, I am just to dumbfounded at the moment.

  15. The horrors of the book 1984 seem tame by comparison to this living nightmare. Granted, we have had thirty more years to perfect the worst of Big Brother, but this horror show makes science fiction seem unimaginative! Anyone want to guess how quickly the suicide rate will increase with this diabolic plan in action? And it won’t be the real criminals who suffer, I guarantee it. I used to live in that region, and I do not use hyperbole in that statement. Thanks, Dr. Fudin, for exposing this to the world. Now, what do we do about it?

  16. Dr. Fudin,

    I am so discouraged by the “drug police” website, I am speechless. Every time I think things couldn’t get any, or much worse, I am proven wrong. You want to think, “This can’t be real, it must be a joke”, but knowing the whole time, it’s as real as the skimpy little RX I get every month for the ridiculous number of painful conditions I am treated for.

    It goes on and on, we hurt more and more, we are tested, pill-counted, grilled at the pharmacy and now they are going to intimidate us EVEN more. We will all need treatment for pain-management-phobia, then PTSD after we have survived the visit and remained free from imprisonment.

    Who has time to concentrate on trying to feel better, when you’re just trying to stay on the right side of the thin blue line?

    “Opposition to Kentucky HB 1-Reform HB 217 aka “Pill Mill Bill””
    https://m.facebook.com/pages/Opposition-to-Kentucky-HB-1-Reform-HB-217-aka-Pill-Mill-Bill/595049517218134

Leave a Reply to Terri Lewis PhD Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.