States and Status of Legislation Protecting CPP's and Providers:

• Arizona  - Signed into law
• Colorado  - Signed into law
• Illinois HB 2046 - In Committee
• Minnesota  - Signed into law
• New Hampshire - Signed into Law
• Oklahoma Bill SB57 - Signed into Law
• Rhode Island Bill 384 - Signed into Law

Watch Claudia interview Bev Schechtman about her experience in the hospital when she was denied pain medication for kidney stones due to being a victim of sexual abuse.  

"Everything is looked at as drug-seeking.  No matter we do, they think we're drug-seeking." ~ Bev Schechtman

"We are taking on this fight for you. I've heard your voice and I've put it into the briefs we submitted." ~Atty Ron Chapman

We posted an article last week about the Supreme Court case coming up on March 1, 2022. On Jan 4, Claudia interviewed Ron Chapman, who submitted an Amicus Brief in support of the doctors in this case.  Ron broke it down for us explaining what this means for CPP's and doctors. Listen to the interview to find out what Ron thinks the best and worst case scenarios are depending on the outcome of this hearing.

Summary of the issue

• Under the Controlled Substance Act (CSA), the criminal standard for prescribing says a physician can't prescribe outside the course of professional practice other than for a legitimate medical purpose, When a doctor elects to prescribe a medication, he needs to make sure he establishes a physician patient relationship and that the prescription is for a legitimate medical need. That should be the extent of the discussion. Courts should not debate about whether it's the right or effective treatment. All the court should ask is if the doctor was acting like a doctor and if he was, then it should be done, acquitted. No conviction.
• Over the last ten years the federal government has decided to crack down on opioids. They took out pill mills because there were bad doctors. So they hired a bunch of prosecutors and DEA agents, and they started going after these doctors. Once the government ran out of nails (doctors) to hammer and already had all these hammers (DEA agents/prosecutors), it needed more nails to go after. So, they started asking judges and juries to decide closer and closer calls in the practice of medicine, so more doctors would be caught up in its net. This started around 2011.They hired experts to get on the stand and say "here is what the standard is, and if you don't do what I think you should do then you're committing a crime." They got on the witness stand and started spouting their theories of what doctors should and shouldn't do.
• In 2016 the federal government decided to take these theories of expert witnesses and they codified them in the CDC Guidelines. Now federal courts are using the Guidelines to convict physicians. The problem is there is no consensus on how a physician should prescribe, it's patient specific and can't be reduced to these ideas. The idea that it can is nonsense.

Episode 17- 2/2/23

Link to Episode

Caught up in a war against illicit Fentanyl and Heroin, 50 million Americans who suffer from chronic, daily pain have been marginalized and discarded.  

Please join Arizona's Don't Punish Pain Rally page to network with other CPP advocates from Arizona

In April of 2022, Arizona passed a law, Bill SB1162,  protecting pain patients. 

Dr. Jeffrey Singer testified if favor of the bill

Governor Doug Ducey Signs SB1162 into Law Helping Arizonians with Chronic Intractable Pain Get the Treatment They Need

Senator Nancy Barto introduced Arizona SB1162 in January 2022. This new law will give protections to chronic intractable pain patients in Arizona. This amendment to ARS Section 32-3248.01, will improve access to care, give physicians the ability to treat their patients as medically appropriate, and confirm that providers and their state governing boards have oversight on the proper treatment for these patients.

Episode 3 - 8/29/22

Link to this episode

"Interview with attorney Ron Chapman about the targeting of the doctors by the DEA"

Read our FAQ's on NarxCare and our NarxCare article, If you need a little refresher on what it is. 

As you know, one of our issues with NarxCare is that it has never been externally validated. Bamboo Health/Appriss held a webinar on October 27, 2021. The webinar was named "External Validation of NarxCare as Useful Clinical Decision Support Tool." Here is a recording in case you're interested in watching the 30-minute webinar. They state the aim of the paper the webinar was based on is to "validate the NS metric compared to WHO ASSIST and identify high, moderate and low opioid risk thresholds and to provide actionable data."

Before I go into detail about this webinar, I want to tell you a story about a hypothetical patient named Rachel. 

Rachel has had the same prescriber for years, but is moving across the country and has to find a new doctor.  According to Rachel's Narcotic Score (NS), Rachel now has two prescribers. This new doctor has a PA in his office that sometimes writes Rachel's prescriptions. Rachel now has 3 prescribers within the last two years. Six months after Rachel started seeing this new doctor, he is raided by the DEA and can no longer prescribe. Rachel finds a new doctor. She now has had 4 prescribers. Rachel's new doctor gives her the first two prescriptions and then transfers her to his NP. This would be Rachel's 5th prescriber. Sadly,18 months after Rachel moved, she is in a terrible car accident and is admitted to the hospital for 4 weeks. Upon discharge, the nurse has Rachel's prescriptions filled at the hospital pharmacy for Rachel so she doesn't have to stop on the way home. This would now be a 6th prescriber. According to the PDMP and NarxCare, she will be flagged as a doctor shopper.

Let's talk about Rachel's pharmacies. Once Rachel moves, she obviously has to get a new pharmacy. Rachel now has 2 pharmacies showing in the PDMP. Rachel's new pharmacy is CVS. CVS starts to give Rachel a hard time about getting her prescriptions filled and her doctor suggests she start going to a small mom and pop pharmacy. Rachel now has 3 pharmacies listed in her PDMP NarxCare score. After a few months, her current pharmacy tells Rachel that due to DEA quota cuts, they can't keep filling her meds consistently and suggests she go to a different, larger pharmacy. Rachel does, and now has 4 pharmacies listed in her PDMP. Remember Rachel's terrible car accident she was in? The pharmacy at the hospital would be Rachel's 5th pharmacy in the past two years. According to her Narcotic Score, she will be flagged as a pharmacy hopper.

After Rachel's nearly fatal car accident, she is given a prescription for sleeping pills because she has a really hard time sleeping. She also is given 10 Ativan because she has PTSD from her accident and gets panic attacks every time she gets in the car to drive to PT. Both of these medications increase her NarxCare Narcotic Score even though they aren't opioids.

Rachel sees her doctor after being discharged from the hospital and he tells her that her Narcotic Score is too high and he can no longer prescribe. Her NS skyrocketed bc she had 6 prescribers, 5 pharmacies, a prescription for sleeping pills and a prescription for Ativan. The only medication her doctor is now willing to prescribe is Suboxone, which means she would now have a diagnosis of Opioid Use Disorder in her EHR. Rachel declines and thankfully, she is able to find a new pain doctor. Her NS now shows she has had a total of 7 prescribers in the last 2 years. Her new doctor receives a warning letter because he is prescribing controlled substances to someone with a very high NS. Rachel's new doctor dismisses her from his office saying he's not willing to risk his license for her. Not only is Rachel unable to find a new pain doctor, she can't even find a regular doctor.

So, was this Narcotic Score helpful?  In black and white it looks like Rachel is playing games and has definite signs of OUD. The reality is, she doesn't struggle with addiction, but is now medically abandoned and her only option for pain relief is to go to the streets and hope to get pills that aren't laced with illicit fentanyl. Since Rachel is too afraid to do that, she has to quit her job and file for SSDI since she is no longer able to work due to uncontrolled pain and anxiety.

Now let's discuss this webinar.

Many of you have heard Kolodny or other anti-opioid zealots make comments like "pharma pays doctors to prescribe opioids." So first, let's address that. It is illegal for a pharmaceutical company to pay doctors specifically to prescribe their medication. What they can do, though, is pay them as "consultants" or for "speaking engagements." Do I think it's ethical? Probably not, but that's how it works. Medical device companies do the same thing. Well, actually, they often pay more than pharma, as seen in this article called "Medtechs top pharma in cash to doctors for consulting, travel.."  If you ever want to look up a company and see how much they pay doctors, or look up doctors to see how much they've accepted, you can look up these two websites. Open Payments and Dollars For Docs. So, do opioid makers specifically "pay doctors to prescribe"?  I would say no more than any other company does. For anyone to specifically state that companies that make opioids pay doctors to prescribe is incredibly misleading. But, that doesn't stop doctors from making that statement or from media repeating it. Why would people want to mislead the general public about opioids? It helps vilify these companies for the litigation narrative we're always talking about. This whole narrative was done in preparation for opioid litigation, which we see taking place across the country now. There are around 3,000 lawsuits that the Attorneys General have brought against pharma, pharmacies, and manufacturers. 

What they don't mention is that doctors are now getting paid more money to NOT prescribe opioids? Yes, you read that correctly. BCBS of Michigan actually incentivizes doctors by paying them 35% more money if they don't prescribe opioids after certain procedures. Read all about it in this article called Fewer Opioids, More Pay: New Tack on How Doctors Prescribe Them . So, if you live in Michigan and have BCBS, this might be the reason why your surgeon isn't treating your post-op pain with opioids. I'll include the rest of the article below.

Rally founder, Claudia A. Merandi, discusses the difficulties the pain community is enduring accessing pain management.
Click this link to view the Dr. Drew Podcast

Episode 15 - 12/9/22

Link to Episode

Listen to this informative and riveting interview.

Learn all about the anti-opioid zealots and how their lies have caused suffering and deaths.

"Americans have been bamboozled into believing that prescription opioids are causing the opioid epidemic." ~Claudia Merandi

Episode 38 - 11/16/23

Link to Episode

Show Notes

We interview Dr. Stanton Peele and Zach Rhoads about addiction, Suboxone, pain patients, Harm Reduction, and more! You won't want to miss this episode.

Dr. Stanton Peele is a psychologist who has pioneered, among other things, the idea that addiction occurs with a range of experiences and recognition of natural recovery from addiction. He developed the ⁠Life Process Program⁠ for addiction. He has authored many books since the 1975 publication of ⁠Love and Addiction⁠ (co-authored by Archie Brodsky); his latest is ⁠A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction⁠.

Zach Rhoads- Zach is a behavior specialist in Vermont schools and his school's PBiS (Positive Behavior Interventions and Supports) coordinator. Zach is a counselor and family systems developer for the online Life Process Program - an addiction coaching program developed by psychologist Dr. Stanton Peele. He also writes articles about health and drug policy for Filter Magazine and is coauthor (with Dr. Stanton Peele) of the book, Outgrowing Addiction. (He is currently working on a forthcoming book about student-led education in the United States). Zach believes that community collaboration and cohesion is a bulwark against many forms of mental illness and addiction, and helps people find these resources in ways that makes sense in their own lives.

The Doctor Patient Forum is a national non profit organization fighting for the rights of pain patients and their providers. We bring awareness to the untreated pain and patient abandonment crisis. We are also knows as Don’t Punish Pain Rally.

⁠https://www.patreon.com/thedoctorpatientforum

#thedoctorpatientforum  #dontpunishpainrally #chronicpain #opioids #chronicpainpatient #patientabandonment #harmreduction #chronicillness #medicalgaslighting #dpfpatreon #pain #opioideliminationindustry #opioidelimination #patreon #thedoctorpatientforumpatreon #harmreduction #medicalgaslighting

The information in this podcast is not to be considered medical or legal advice

Gabapentin lawsuits: Please don't email or call Claudia, the information is in the following links:

• Gabapentin injuries
• Gabapentin deaths

• WHAT IS GABAPENTIN

• HARMS FROM GABAPENTIN (NEURONTIN)

• CLAUDIA'S TIK TOK VIDEOS ABOUT GABAPENTIN (NEURONTIN)

• LAWSUITS FOR THOSE HARMED BY GABAPENTIN (NEURONTIN)

• HAS THERE EVER BEEN OTHER LAWSUITS ABOUT GABAPENTIN?

• WILL THERE BE A PODCAST ABOUT GABAPENTIN?

WHAT IS GABAPENTIN?

Gabapentin (Neurontin) is a seizure medication that has been promoted for off-label use as an opioid sparing medication. Interestingly, the updated draft of the CDC Guidelines mentions Gabapentin 30 times. 30. Pfizer, maker of this drug, is a a huge donor to CDC Foundation. Is that why they mention it so often in the new guidelines? Who knows? 

HARMS FROM GABAPENTIN (NEURONTIN)

Read Dr. Josh Bloom's article "The Devil You Know - Neurontin's Massive Flop as an Opioid Alternative"for more information. 

"Wanna hear something sickening? Neurontin, a drug developed for epilepsy and used off-label for neuropathic pain, had its sales grow 250% between 2004 and 2019. Why? We don't have 250% more epileptics. No, it's because the drug is being forced down the throats of people who can no longer get sufficient pain relief. The result? Abuse and also more overdose deaths. Just another chapter in our psychotic war against legitimate opioid drugs and the people who need them."

CLAUDIA'S TIK TOK VIDEOS ABOUT GAPABENTIN (NEURONTIN)

• Tik Tok #1
• Tik Tok #2
• Tik Tok #3
• Tik Tok #4
• Tik Tok #5
• Tik Tok #6

Check out the other Tik Toks on our new main Tik Tok account thedoctorpatientforum1

Our old account is Claudia A. Merandi

LAWSUITS FOR THOSE HARMED BY GABAPENTIN (NEURONTIN)

Please don't email or call Claudia regarding the lawsuits.

The information is in the following links: 

• Gabapentin injuries 
• Gabapentin deaths

"Gabapentin and Neurontin deaths and injuries dramatically increased recently. Contact us to report your injuries and get help. Free case evaluation. Fill out the form on this page or call 424-245-5505. You don’t pay for attorney fees until we win.

If you have lost a loved one or you have suffered from breathing or heart problems or other issues like memory loss and blurry vision, contact us to report exactly what has happened. Free case evaluation.

In a recent article published May 13, 2022 by the Center for Disease Prevention,  “Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020“, research scientists reported that there are many serious new developments in serious side effects and death resulting from gabapentin use. Contact us for a free case evaluation."

HAS THERE EVER BEEN OTHER LAWSUITS ABOUT GABAPENTIN?

Yes, in 2004 Pfizer agreed to $190 million settlement over generic Neurontin.

Interestingly, this lawsuit was used to create the Attorney Generals' prescriber and consumer education grant. This grant was then used to create Pharmed Out by PROP member, anti-opioid zealot, and expert witness profiteer Adrianne Fugh-Berman. 

Dr. Jeffrey Singer debated Dr. Fugh-Berman in June 2022. Read about the debate in this article called "A Surgeon and a Non-Practicing Anti-Opioid Zealot Walk Into a Bar: The Singer and the Fugh-Berman Debate." Then, oddly enough, PROP declared Fugh-Berman the winner when she wasn't. The head of the debate, Gene Epstein, wasn't thrilled and tweeted about it.

Another interesting tidbit about Fugh-Berman, is she was asked to testify at the McGaskill hearing about her first investigation into opioids. Here, Fugh-Berman didn't declare a COI of being a paid expert witness in litigation and told McGaskill that to solve the opioid crisis, they needed to investigate "fake pain advocacy orgs" and their ties to opioid pharma. They did. Many of the lawyers who donated to McGaskill turned around and used her investigation to participate in opioid litigation. The investigation was key in opioid litigation, and many of her PROPcolleagues benefitted financially such as Andrew Kolodny and Anna Lembke. But, they claim anyone who stands up for CPP's must be industry funded. What a scam.

Now let's watch Fugh-Berman push back when Dr. Stefan Kertesz presented his study on suicides due to cutting off opioids from CPP's.

WILL THERE BE A PODCAST ABOUT GABAPENTIN?

Yes, and we plan to interview Dr. Josh Bloom along with some other experts. We will post it here when it is published. Check out the other podcasts by The Doctor Patient Forum. 

nytimes.com

In a newly published guide, federal health officials say doctors “should never abandon” pain patients and warn of acute withdrawal and other risks.

Doctors need to have a compliance plan in place in order to stay protected when prescribing scheduled drugs. Please contact Chapman Consulting Groupwith any questions.

"If you don't follow up on red flags you're being labeled as a criminal prescriber" ~Compliance Officer

"The government has chosen to target doctors instead of the cartels, who are brining in the drugs that are killing people." ~Compliance Officer

Locating a pain management doctor has become a daunting task. Click here to find one in your area.

This article contains the following information:

• What is Harm Reduction?
• What is Harm Reduction in relation to drugs?
• What does Harm Reduction have to do with pain patients?

We cover the following Harm Reduction information/resources:

• Illicit Fentanyl testing strips
• Never Use Alone Hotline and Information
• Naloxone (Narcan)
• Kratom

What is Harm Reduction?

There isn't one standard definition, but I asked Maia Szalavitz, a Harm Reduction expert who wrote the first comprehensive book on the history of Harm Reduction and drugs called Undoing Drugs , how she would define it. She said "It's policy that focuses first on stopping people from getting hurt, not stopping them from getting high or engaging in other risky behavior. Importantly, that definition doesn't exclude abstinence approaches for those who seek them." The concept of Harm Reduction has been used for years in this country.

For example:

1. Seat belts - We know people will drive carelessly and there will always be car accidents. So, we use seat belts to reduce harm of the accidents.
2. Condoms - We know people are going to have sex and teaching abstinence only won't prevent unwanted pregnancies and STD's. So, we have things like condoms to try to prevent pregnancies and STD's.
3. Designated Driver - We know some people will drink when eating dinner out. So, there is the recommendation to have a designated driver who won't drink to prevent driving while intoxicated.

What is Harm Reduction In Relation to Drugs?

 National Harm Reduction Coalitionexplains it like this: "National Harm Reduction Coalition works for the Harm Reduction movement built on a belief in and respect for the rights of people who use drugs. Our strategies include building leadership among people who use drugs and supporting communities in reducing the negative consequences associated with drug use." So, basically it means instead of telling people to not use drugs (like Nancy Reagan's just say no movement) Harm Reduction acknowledges that people are going to use drugs, so they do what they can to keep them  safe and alive by using different strategies and techniques. In the last year, there have been over 100,000 drug related deaths in the USA, so clearly what we are doing (the war on drugs) isn't working. As Maia mentioned, if people choose abstinence like with a 12 step program, that is included in Harm Reduction. Although Harm Reduction has been accepted in USA in relation to cars or alcohol, Maia explains that "it's a very old idea, but in drug policy it is radical because we've always focused on stopping drugs, not on harm and we cause lots of harm trying to stop drugs." There are many techniques used in Harm Reduction in drug use. I'll list some examples, and then will add content about each one. As we add each category listed below, we will link each one to the information we add. This isn't an exhaustive list.

1. Illicit Fentanyl testing strips
2. Never Use Alone Hotline and Information
3. Naloxone (Narcan)
4. Kratom
5. Lock Boxes/Safe for controlled substances
6. Safe or safer supply
7. Needle exchange (syringe service programs)
8. Safe Injection Sites

What does Harm Reduction Have To Do With Pain Patients?

You might be asking how this relates to pain patients and why this information is even on our website. As more and more pain patients are cut off from their medication, many are going to the streets to purchase pain medication out of desperation for pain relief. Since up to half of the supply of medication on the street is actually counterfeit containing illicit fentanyl, we feel it's very important for pain patients to know how to access Harm Reduction techniques so they can test their medication and not die from drug poisoning. I didn't know much about Harm Reduction (HR) until last year. Several prominent CPP advocates have been trying to join the CPP community with the HR community for a few years. Lelena Peacock, Carrie Judy (a researcher with our org), and D. S. Nelson were the first CPP advocates I saw who understood early on how HR and CPP's need to be working together and not against each other. 

An article in Reason came out yesterday about the ruling for the Defendants (four drug companies-Teva, Johnson & Johnson, AbbVie, and Endo) in opioid litigation. This is huge for our community. The Judge said the  Plaintiffs failed to prove the charges of public nuisance and false advertising. Superior Court Judge, Peter J. Wilson wrote a 42 page ruling. This was the first of thousands of cases filed across the country regarding the "opioid crisis," filed in 2014. The Plaintiffs' claims were:

1. The companies used false advertising
2. They engaged in unlawful business practices
3. They created a public nuisance

Judge Wilson ruled the Plaintiffs failed to prove any of these claims. Some direct quotes from Judge Wilson's ruling: