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View Poll Results: Do you trust Elixir Guerrero?
Yes, with all my heart 3 10.34%
No, he's a bad man Boss 9 31.03%
not sure but Something stinks in the septic tank 13 44.83%
Thomas is Alex, Elixir is Thomas144 and Spaghetti Monster controls him 6 20.69%
Multiple Choice Poll. Voters: 29. You may not vote on this poll

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Old 06-14-2018, 02:23 PM   #211
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The analysis

Sometimes, pharmaceutical companies pay doctors to do medical research. They also pay doctors for promotional work: for example, to speak with other doctors about the benefits of a drug.

Among the doctors who prescribe the highest volume of opioids, the CNN/Harvard analysis found that the largest amount of money was paid for that second category, which includes speaking fees, consulting, travel and food.

Concerns about payments to doctors by opioid manufacturers were brought to light last year in a study by researchers at Boston University.

Several studies published in medical journals in recent years have found an association between payments by pharmaceutical companies for various types of drugs and doctors' prescribing habits.

For example, researchers at the University of North Carolina examined the two government databases analyzed by CNN and Harvard and found that when doctors received payments from manufacturers of certain cancer drugs, they were more likely to prescribe those drugs to their patients.

"This study suggests that conflicts of interest with the pharmaceutical industry may influence oncologists in high-stakes treatment decisions for patients with cancer," the authors concluded.

Some studies have looked at whether the amount of money a doctor receives makes a difference. Studies by researchers at Yale University, the George Washington University Milken Institute of Public Health and Harvard Medical School have all found that the more money physicians are paid by pharmaceutical companies, the more likely they are to prescribe certain drugs.

Dr. Patrice Harris, a spokeswoman for the American Medical Association, said that the CNN and Harvard data raised "fair questions" but that such analyses show only an association between payments and prescribing habits and don't prove that one causes the other.

It's "not a cause and effect relationship," said Harris, chairwoman of the association's opioid task force, adding that more research should be done on the relationship between payments and prescriptions.

"[We] strongly oppose inappropriate, unethical interactions between physicians and industry," she added. "But we know that not all interactions are unethical or inappropriate."  

Harris added that relationships between doctors and industry are ethical and appropriate if they "can help drive innovation in patient care and provide significant resources for professional medical education that ultimately benefits patients."

Stanos, the pain physician, said a doctor who gets paid by a pharmaceutical company and prescribes that company's drug might truly and legitimately believe that the drug is the best option for the patient.

"I hope physicians that do promotional talks prescribe because they think the medicine has a benefit," he said.

But Jena, one of the two Harvard researchers who collaborated on the CNN analysis, said he worries that money from opioid manufacturers -- especially large amounts of money -- could influence a doctor to prescribe opioids over less dangerous options.

"Every decision, every recommendation a physician makes, should be in the best interest of the patient and not a combination of the patient's interest and the financial interest of the doctor," said Jena, associate professor of health care policy at Harvard Medical School.

"If we lived in a different world where none of these payments to physicians occurred, how many fewer Americans would have [been prescribed] opioids, and how many fewer deaths would have occurred?" he asked.

From 1999 to 2015, more than 183,000 people in the United States died from overdoses related to prescription opioids, according to the CDC. In October, President Donald Trump declared the opioid epidemic a national public health emergency.

At least one company has decided to stop paying doctors for promotional activities such as speaking engagements.

Purdue Pharma discontinued its speakers program for the opioids OxyContin and Butrans at the end of 2016 and the program for Hysingla, another opioid, in November, according to company spokesman Robert Josephson.

"We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers," a company statement said.

More than $1 million in three years

Though Thiyagarajah's opioid prescription rates were particularly high, many other doctors who have prescribed large amounts of opioids have also been paid large amounts of money by pharmaceutical companies that make the drugs.

Several patients have filed lawsuits against these high prescribers.

From August 2013 through December 2016, Dr. Steven Simon of Overland Park, Kansas, was paid nearly $1.1 million by companies that make opioid painkillers, according to the federal Open Payments database.

Most of the payments were fees for speaking, training and education.

Ballou, one of his patients, says she remembers Simon bragging about how drug companies were flying him across the country to give lectures to other doctors.

"He said he was going to Miami, and they were going to give him a convertible, and he was going to stay in the best hotel and eat the best Cuban food he'd ever had," said Ballou, who filed a lawsuit against Simon after she says she became addicted to opioids.

Simon's lawyer, James Wyrsch, said he would not comment on pending litigation.

In court documents, he asked for the case to be dismissed, saying in part that Ballou's complaints that Simon improperly prescribed Subsys were "simply incorrect."

Bridget Patton, a spokeswoman for the FBI's Kansas City field office, said federal agents went to the office where Simon works, Mid-America PolyClinic, in July.

The clinic said in a statement that it is "fully and willingly cooperating with all investigations" and that Simon has not been employed there since July 24.

"We had a lawful presence at that facility," Patton said. She declined to say whether investigating Simon himself was the purpose of the FBI visit.

The owner of the pain clinic, Dr. Srinivas Nalamachu, told The Kansas City Star that the agents showed up with a search warrant for Simon's medical records involving fentanyl prescriptions.

Simon and his lawyer told CNN they couldn't comment due to the pending litigation.

Ballou said that when she was Simon's patient, it didn't give her pause that the same doctor who was prescribing opioids to her was also taking money from the companies that made the drugs.

But now she looks back with anger.

A Mother's Day card Angela Cantone's daugher made for her reads, "Best of all mother likes to sleep," alluding to the many instances when Cantone says her opioid medication caused her to pass out.
A Mother's Day card Angela Cantone's daugher made for her reads, "Best of all mother likes to sleep," alluding to the many instances when Cantone says her opioid medication caused her to pass out.
Cantone, the patient who went to Thiyagarajah, the pain specialist in South Carolina, looks back with sadness.

She cries as she remembers the Mother's Day card her daughter made her in preschool. The teacher asked each child what their mother liked to do and wrote it on the card.

Her card said her mother liked to sleep.

"Instead of saying 'she gives me hugs and kisses or takes me to the park,' it was the years of her finding me on the floor," Cantone said. "I feel like I failed as a parent."

She becomes angry when she thinks about the hundreds of thousands of dollars her doctor was paid by the drug company.

"The medication that was being prescribed to me was for his benefit, not my own," she said.

CNN's John Bonifield contributed to this story. Janette Gagnon contributed research and David Heath contributed data analysis.
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Old 06-14-2018, 07:54 PM   #212
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Quote:
Originally Posted by Dwight Schrute View Post
The analysis

Sometimes, pharmaceutical companies pay doctors to do medical research. They also pay doctors for promotional work: for example, to speak with other doctors about the benefits of a drug.

Among the doctors who prescribe the highest volume of opioids, the CNN/Harvard analysis found that the largest amount of money was paid for that second category, which includes speaking fees, consulting, travel and food.

Concerns about payments to doctors by opioid manufacturers were brought to light last year in a study by researchers at Boston University.

Several studies published in medical journals in recent years have found an association between payments by pharmaceutical companies for various types of drugs and doctors' prescribing habits.

For example, researchers at the University of North Carolina examined the two government databases analyzed by CNN and Harvard and found that when doctors received payments from manufacturers of certain cancer drugs, they were more likely to prescribe those drugs to their patients.

"This study suggests that conflicts of interest with the pharmaceutical industry may influence oncologists in high-stakes treatment decisions for patients with cancer," the authors concluded.

Some studies have looked at whether the amount of money a doctor receives makes a difference. Studies by researchers at Yale University, the George Washington University Milken Institute of Public Health and Harvard Medical School have all found that the more money physicians are paid by pharmaceutical companies, the more likely they are to prescribe certain drugs.

Dr. Patrice Harris, a spokeswoman for the American Medical Association, said that the CNN and Harvard data raised "fair questions" but that such analyses show only an association between payments and prescribing habits and don't prove that one causes the other.

It's "not a cause and effect relationship," said Harris, chairwoman of the association's opioid task force, adding that more research should be done on the relationship between payments and prescriptions.

"[We] strongly oppose inappropriate, unethical interactions between physicians and industry," she added. "But we know that not all interactions are unethical or inappropriate."  

Harris added that relationships between doctors and industry are ethical and appropriate if they "can help drive innovation in patient care and provide significant resources for professional medical education that ultimately benefits patients."

Stanos, the pain physician, said a doctor who gets paid by a pharmaceutical company and prescribes that company's drug might truly and legitimately believe that the drug is the best option for the patient.

"I hope physicians that do promotional talks prescribe because they think the medicine has a benefit," he said.

But Jena, one of the two Harvard researchers who collaborated on the CNN analysis, said he worries that money from opioid manufacturers -- especially large amounts of money -- could influence a doctor to prescribe opioids over less dangerous options.

"Every decision, every recommendation a physician makes, should be in the best interest of the patient and not a combination of the patient's interest and the financial interest of the doctor," said Jena, associate professor of health care policy at Harvard Medical School.

"If we lived in a different world where none of these payments to physicians occurred, how many fewer Americans would have [been prescribed] opioids, and how many fewer deaths would have occurred?" he asked.

From 1999 to 2015, more than 183,000 people in the United States died from overdoses related to prescription opioids, according to the CDC. In October, President Donald Trump declared the opioid epidemic a national public health emergency.

At least one company has decided to stop paying doctors for promotional activities such as speaking engagements.

Purdue Pharma discontinued its speakers program for the opioids OxyContin and Butrans at the end of 2016 and the program for Hysingla, another opioid, in November, according to company spokesman Robert Josephson.

"We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers," a company statement said.

More than $1 million in three years

Though Thiyagarajah's opioid prescription rates were particularly high, many other doctors who have prescribed large amounts of opioids have also been paid large amounts of money by pharmaceutical companies that make the drugs.

Several patients have filed lawsuits against these high prescribers.

From August 2013 through December 2016, Dr. Steven Simon of Overland Park, Kansas, was paid nearly $1.1 million by companies that make opioid painkillers, according to the federal Open Payments database.

Most of the payments were fees for speaking, training and education.

Ballou, one of his patients, says she remembers Simon bragging about how drug companies were flying him across the country to give lectures to other doctors.

"He said he was going to Miami, and they were going to give him a convertible, and he was going to stay in the best hotel and eat the best Cuban food he'd ever had," said Ballou, who filed a lawsuit against Simon after she says she became addicted to opioids.

Simon's lawyer, James Wyrsch, said he would not comment on pending litigation.

In court documents, he asked for the case to be dismissed, saying in part that Ballou's complaints that Simon improperly prescribed Subsys were "simply incorrect."

Bridget Patton, a spokeswoman for the FBI's Kansas City field office, said federal agents went to the office where Simon works, Mid-America PolyClinic, in July.

The clinic said in a statement that it is "fully and willingly cooperating with all investigations" and that Simon has not been employed there since July 24.

"We had a lawful presence at that facility," Patton said. She declined to say whether investigating Simon himself was the purpose of the FBI visit.

The owner of the pain clinic, Dr. Srinivas Nalamachu, told The Kansas City Star that the agents showed up with a search warrant for Simon's medical records involving fentanyl prescriptions.

Simon and his lawyer told CNN they couldn't comment due to the pending litigation.

Ballou said that when she was Simon's patient, it didn't give her pause that the same doctor who was prescribing opioids to her was also taking money from the companies that made the drugs.

But now she looks back with anger.

A Mother's Day card Angela Cantone's daugher made for her reads, "Best of all mother likes to sleep," alluding to the many instances when Cantone says her opioid medication caused her to pass out.
A Mother's Day card Angela Cantone's daugher made for her reads, "Best of all mother likes to sleep," alluding to the many instances when Cantone says her opioid medication caused her to pass out.
Cantone, the patient who went to Thiyagarajah, the pain specialist in South Carolina, looks back with sadness.

She cries as she remembers the Mother's Day card her daughter made her in preschool. The teacher asked each child what their mother liked to do and wrote it on the card.

Her card said her mother liked to sleep.

"Instead of saying 'she gives me hugs and kisses or takes me to the park,' it was the years of her finding me on the floor," Cantone said. "I feel like I failed as a parent."

She becomes angry when she thinks about the hundreds of thousands of dollars her doctor was paid by the drug company.

"The medication that was being prescribed to me was for his benefit, not my own," she said.

CNN's John Bonifield contributed to this story. Janette Gagnon contributed research and David Heath contributed data analysis.
He wont buy any of this...he wants evidence.
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Old 06-15-2018, 05:08 AM   #213
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First, this article makes my point that a small percentage of doctors are over prescribing.

Second, just as I said, prescriptions are electronically monitored and over prescribers are identified & investigated quickly.

Third, 2 doctors and 2 lawsuits doesn't show that doctors are primarily responsible for the 183,000 overdose deaths the article cites.

Fourth, I've already agreed that there are charlatan doctors preying on the public but they are monitored, identified & caught quickly. I agree more should be done. I also agree more can be done so doctors have full access to a patient's medical records to identify addicts before they write a prescription. (Patients withhold that info or lie about it to get what they need.) This communication gap is well known to health providers and steps have been made to identify addicts who go to physicians strictly to get a prescription for narcotics.

Fifth, this doesn't even start to compare to the amount of narcotics flowing into just 1 small town in West Virginia that end up on the streets of America.

Sixth, CNN. Ambiguous writing with an agenda without citing all the facts of the national study. "Many doctors" was used often...how many is "many"? Is 5 many? Is 10? There's a reason CNN didn't state the actual number of doctors over prescribing. What percentage of doctors did the study find clean as a whistle? Not a mention of that but that would undermine the article.
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Old 06-15-2018, 05:50 AM   #214
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Quote:
Originally Posted by chevss454 View Post
F

Fourth, I've already agreed that there are charlatan doctors preying on the public but they are monitored, identified & caught quickly. I agree more should be done. I also agree more can be done so doctors have full access to a patient's medical records to identify addicts before they write a prescription. (Patients withhold that info or lie about it to get what they need.) This communication gap is well known to health providers and steps have been made to identify addicts who go to physicians strictly to get a prescription for narcotics.
when I want Sudafed I have to show an ID and am limited to the number I can buy.

why? sudafed can make meth yet they do not track scripted narcotics.
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Old 06-15-2018, 05:53 AM   #215
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Quote:
Originally Posted by mikiemo83 View Post
when I want Sudafed I have to show an ID and am limited to the number I can buy.

why? sudafed can make meth yet they do not track scripted narcotics.

Every prescription for narcotics is electronically tracked by the DEA.
That info on patients receiving narcotics should be shared with doctors
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Old 06-15-2018, 05:55 AM   #216
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Quote:
Originally Posted by mikiemo83 View Post
when I want Sudafed I have to show an ID and am limited to the number I can buy.

why? sudafed can make meth yet they do not track scripted narcotics.
I'm with you in your sentiment, but technically, that's not the case.

https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm

It's not every state, but MA is one of them. (New Hampshire is not) Pharmacists can get in big-time trouble if they don't check against the database.
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Old 06-15-2018, 06:05 AM   #217
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Quote:
Originally Posted by TommyD420 View Post
I'm with you in your sentiment, but technically, that's not the case.

https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm

It's not every state, but MA is one of them. (New Hampshire is not) Pharmacists can get in big-time trouble if they don't check against the database.

State programs are different than the national program run by the DEA. It's great to see the states are taking action for quicker responses.
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Old 06-15-2018, 06:18 AM   #218
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Quote:
Originally Posted by chevss454 View Post
Every prescription for narcotics is electronically tracked by the DEA.
That info on patients receiving narcotics should be shared with doctors
yes it should be - all meds not just Narcotics, who knows how viagra works with High Blood pressure pills

Quote:
Originally Posted by TommyD420 View Post
I'm with you in your sentiment, but technically, that's not the case.

https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm

It's not every state, but MA is one of them. (New Hampshire is not) Pharmacists can get in big-time trouble if they don't check against the database.
Ah so Vacation in New Hampshire when you need a fix, I bet Florida is not part of the database - too many people vacation there and returned rattling with pills they deal around here.
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Old 06-15-2018, 06:35 AM   #219
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Originally Posted by mikiemo83 View Post
yes it should be - all meds not just Narcotics, who knows how viagra works with High Blood pressure pills

Ah so Vacation in New Hampshire when you need a fix, I bet Florida is not part of the database - too many people vacation there and returned rattling with pills they deal around here.

Illegal manufacturers (China) and the internet are the primary sources for street drugs these days. Anonymous purchases using Bitcoin have been a boon for the illegal drug trade. Prescriptions, even by charlatan doctors, contribute very little to the street urchins. Times have changed.

https://www.bmj.com/content/361/bmj....d&utm_term=1-A
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Old 06-15-2018, 08:25 AM   #220
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I know it’s a very long article for those who read it. This stood out to me.

Quote:
The CNN/Harvard analysis looked at 2014 and 2015, during which time more than 811,000 doctors wrote prescriptions to Medicare patients. Of those, nearly half wrote at least one prescription for opioids.

Fifty-four percent of those doctors -- more than 200,000 physicians -- received a payment from pharmaceutical companies that make opioids.

Doctors were more likely to get paid by drug companies if they prescribed a lot of opioids -- and they were more likely to get paid a lot of money.


Among doctors in the top 25th percentile of opioid prescribers by volume, 72% received payments. Among those in the top fifth percentile, 84% received payments. Among the very biggest prescribers -- those in the top 10th of 1% -- 95% received payments.

On average, doctors whose opioid prescription volume ranked among the top 5% nationally received twice as much money from the opioid manufacturers, compared with doctors whose prescription volume was in the median. Doctors in the top 1% of opioid prescribers received on average four times as much money as the typical doctor. Doctors in the top 10th of 1%, on average, received nine times more money than the typical doctor.
I am NOT saying Drs are the SUPPLIERS. They are where MOST get their first taste of the world of pharmaceuticals. All too often people with next to zero incidence of drugs in their life get a script for injury or pain and these things are so powerful and so addictive it changes lives.

They’re too willing to prescribe. And they know the problem out there. So you have to ask why.

Both myself and mikie cited multiple instances in our own health history where these things were virtually pushed. Cmon, wisdom tooth recovery? A 3 stitch umbilical hernia? Where I played competitive ice hockey 7 days later? I really need to be offered Oxy? Then Vicodin?
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Old 06-15-2018, 04:37 PM   #221
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Originally Posted by Dwight Schrute View Post
I know it’s a very long article for those who read it. This stood out to me.



I am NOT saying Drs are the SUPPLIERS. They are where MOST get their first taste of the world of pharmaceuticals. All too often people with next to zero incidence of drugs in their life get a script for injury or pain and these things are so powerful and so addictive it changes lives.

They’re too willing to prescribe. And they know the problem out there. So you have to ask why.

Both myself and mikie cited multiple instances in our own health history where these things were virtually pushed. Cmon, wisdom tooth recovery? A 3 stitch umbilical hernia? Where I played competitive ice hockey 7 days later? I really need to be offered Oxy? Then Vicodin?

This is where we differ then. Street drugs are the major cause of substance abusers. It's a combination of availability and peer pressure. Kids too young to know better, especially those with ADD, ADHD or anxiety, are given drugs by friends and say to themselves "It won't happen to me". Only it helps their behavioral problem immediately so they take another and another & before they realize it, they're hooked. Doctors aren't getting these Jr. High Schoolers and High Schoolers addicted. Their friends are doing it.



Prescriptions of narcotics to control post-op pain is the standard of care for adults. Adults have the right to refuse to take them. Even so, the ethical doctor doesn't write a script for enough drug to get people hooked.
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Old 06-15-2018, 04:53 PM   #222
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Originally Posted by chevss454 View Post
This is where we differ then. Street drugs are the major cause of substance abusers. It's a combination of availability and peer pressure. Kids too young to know better, especially those with ADD, ADHD or anxiety, are given drugs by friends and say to themselves "It won't happen to me". Only it helps their behavioral problem immediately so they take another and another & before they realize it, they're hooked. Doctors aren't getting these Jr. High Schoolers and High Schoolers addicted. Their friends are doing it.



Prescriptions of narcotics to control post-op pain is the standard of care for adults. Adults have the right to refuse to take them. Even so, the ethical doctor doesn't write a script for enough drug to get people hooked.
I've had experiences with both ethical and non/ethical doctors...there is a good and bad in most everything.

The doctors don't pipe in the drugs either...but, they are a cog in the machine though.
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