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View Poll Results: Do you trust Elixir Guerrero?
Yes, with all my heart 4 13.33%
No, he's a bad man Boss 9 30.00%
not sure but Something stinks in the septic tank 13 43.33%
Thomas is Alex, Elixir is Thomas144 and Spaghetti Monster controls him 6 20.00%
Multiple Choice Poll. Voters: 30. You may not vote on this poll

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Old 06-13-2018, 05:35 PM   #196
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Quote:
Originally Posted by PatsFan09 View Post
Uh, no. CBD definitely has its uses, but as a post-surgery painkiller? Not yet.


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I'll concede that for only the most severe operations and burn victims. Everything else is probably way better served with CBD over an opiate.

I know you're skeptical about the utility of weed but I'm telling you, CBD is a much better way to deal with all but the most extreme pain.
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Old 06-13-2018, 05:53 PM   #197
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Quote:
Originally Posted by Dwight Schrute View Post
No shit it ends up from the street. And usually migrated to heroin.
Because the price of Oxy becomes unbearable but the monkey gets too big to stop. So itís on to cheaper, stronger street heroin coupled with the even more dangerous fentonol.

But the introduction comes from the all too willing Drs.

Thereís other alternatives.

Most patients are far too trusting and just go with whatís recommended.

The bottom line is thereís a MASSIVE problem. There are many guilty parties. To let one sect off because you have a friend or relative is ridiculous imo.

And to have regular back and forth discussion with different thoughts and takes was what I thought an awesome internet forum was precisely existent for, not to put on you teaching shoes and Mr Rogers sweater and come off like some pretentious prick.

Iím out.

The problem isn't doctors. A few bad eggs can't supply the huge demand narcotics have become. These drugs are going straight to the street and that's how the overwhelming number of new addicts are born. Doctors get no extra money from prescribing narcotics. There's no incentive. Pharmacists on the other hand can order 1000 tablets of 20mg oxy for $75 and sell them to a street urchin for $30/tablet cash. That pharmacist just made $30K cash tax free and has any number of ways to explain the inventory reduction until it gets way out of hand.



I had someone use my DEA number to open an account with a wholesaler. She ordered over 20k tabs in a 10 month period. She used her credit card in her name to pay for the drugs. That's how easy it is to do. The 2 wholesalers she used didn't give a shit bc they had a DEA that made it legal but they knew. After 10 months of this I got paid a visit by the DEA and the State Police who never suspected me but they did next to nothing to find out the culprit. Finally I called the wholesalers who shipped the drug and found out her name. I passed that info along to the DEA agent who didn't have a clue bc she was still waiting for a court order to make the wholesaler tell all. This girl got caught but was never tried in court so she got off scott free after pocketing over $250K. The wholesalers got off too bc they had a valid DEA number to protect them.



That's how drugs get on the street. It's the street urchins who make new addicts. They give away pills and within 3-4 weeks they have a new customer. Doctors are small potatoes compared to the drug diversion market.



"Thereís other alternatives."
No there aren't. Ask somebody with terminal cancer if ibuprofen does it for them. Ask someone who just had a major surgical procedure if tylenol touches their pain. Ditto joint replacement, ACL, fracture repair or burn victims. There are NO other alternatives when the pain is severe. A doc writing a script for a 10 day supply of hydrocodone is doing his/her sworn obligation to control pain & that 10 day supply is NOT creating an addict.



"To let one sect off because you have a friend or relative is ridiculous imo."
It has nothing to do with defending my parents or siblings. But I do know how it works and for anyone to say doctors are the cause of the narc epidemic is irresponsible and ignorant of the real cause. Doctors risk everything by prescribing illegally and they make far too much money for the risk to be worthwhile. Prescriptions are monitored and tracked for controlled substances - it's automatically logged at the Drug Enforcement Agency. Those few who do it are busted quickly and get their license revoked in short order by the state board of medicine - no court trial needed. Doctors can't order narcs from wholesalers like pharmacists can. You're wrong, DS. Read and learn.
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Old 06-13-2018, 06:47 PM   #198
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I am seeing both sides in this.

I see Dwight’s point that a lot of the people we know, white guy about 40-50 in age, start with an injury. The doctor doesn’t make the addict, the addict is within the person lurking - I believe it is 75% your genes. Patients are given the meds because what alternative is there for pain? My issue is there should be a database of who is getting what.

I know of people who travel a lot to Florida, pick up a boat load of them, by script, and ring them up. If we want a national data base for guns, why not pain meds?


At the same time it is the big pharma out of control. They don’t give two shits who gets what. Like chef posted a lot of crap is traveling to certain areas yet it is not stopped. Big pharma knew Chev was not buying 20k pills a month, it they didn’t care. It was “legal” according to the paperwork despite common sense telling you otherwise.

Yes drugs are out of control and kids are deep into them, it is scary but a lot of adults are too. And they have multiple doctors to hit up for the stuff,
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Old 06-13-2018, 07:37 PM   #199
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Well well well.....

@tomecurran on @adamjones985 just said Bill send clients to Alex Guerrero, especially for soft tissue issues

This is uhh...kinda major news
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Old 06-13-2018, 08:02 PM   #200
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Quote:
Originally Posted by Jaric View Post
I'll concede that for only the most severe operations and burn victims. Everything else is probably way better served with CBD over an opiate.



I know you're skeptical about the utility of weed but I'm telling you, CBD is a much better way to deal with all but the most extreme pain.


Iím 100% on board. Iím just referring to extreme pain post-op.


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Old 06-13-2018, 08:55 PM   #201
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Originally Posted by PatsFan09 View Post
Iím 100% on board. Iím just referring to extreme pain post-op.

After my Quad B/P They started giving me those bastards (drainage gear still in place, pain like none I've ever known) Day two refused them. End of story.
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Old 06-13-2018, 09:18 PM   #202
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Originally Posted by PatsFan09 View Post
Iím 100% on board. Iím just referring to extreme pain post-op.


Sent from my iPhone using Tapatalk Pro
Even still, I'm not sure there's ever a time for phentanol or however you spell that horrible shit that kills everyone.

Unless the point is to kill them then it might not be a bad way to go.
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Old 06-14-2018, 04:29 AM   #203
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Quote:
Originally Posted by mikiemo83 View Post
I am seeing both sides in this.

I see Dwightís point that a lot of the people we know, white guy about 40-50 in age, start with an injury. The doctor doesnít make the addict, the addict is within the person lurking - I believe it is 75% your genes. Patients are given the meds because what alternative is there for pain? My issue is there should be a database of who is getting what.

I know of people who travel a lot to Florida, pick up a boat load of them, by script, and ring them up. If we want a national data base for guns, why not pain meds?


At the same time it is the big pharma out of control. They donít give two shits who gets what. Like chef posted a lot of crap is traveling to certain areas yet it is not stopped. Big pharma knew Chev was not buying 20k pills a month, it they didnít care. It was ďlegalĒ according to the paperwork despite common sense telling you otherwise.

Yes drugs are out of control and kids are deep into them, it is scary but a lot of adults are too. And they have multiple doctors to hit up for the stuff,

Addictive tendencies in a person is very real and it's not limited to narcotics. People can be addicted to video games, alcohol, narcotics, cigarettes, food, sex, gambling, shopping and exercise - yes, exercise. Furthermore, when a child becomes addicted to video games that kid is much more likely to become obsessively addicted to other behaviors as an adult such as any of those mentioned above. Addictive behavior does run in families but it can also begin brand new when a person is exposed to an environment that facilitates compulsive behavior such as a child given endless access to video games. That's called process addiction.


Quote:
Originally Posted by Jaric View Post
Even still, I'm not sure there's ever a time for phentanol or however you spell that horrible shit that kills everyone.

Unless the point is to kill them then it might not be a bad way to go.

Yes. Fentanyl is a super scary, super potent synthetic narcotic that has found its way to the illegal drug trade. Heroin, cocaine & now weed laced with fentanyl has been documented. Death is all too frequent.

Just google 'Fentanyl-laced' and you'll see dozens of articles.
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Old 06-14-2018, 05:34 AM   #204
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Jesus, I'm glad I know where my weed comes from
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Old 06-14-2018, 05:35 AM   #205
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Originally Posted by chevss454 View Post
Yes. Fentanyl is a super scary, super potent synthetic narcotic that has found its way to the illegal drug trade. Heroin, cocaine & now weed laced with fentanyl has been documented. Death is all too frequent.

Just google 'Fentanyl-laced' and you'll see dozens of articles.
Carfentanyl takes it to a whole different level. The effects can be transmitted simply by touch from the addict to anyone who touches him/her. My wife meets regularly with local law enforcement to get updates on what's going through the area. The Chief told her that carfentanyl is now one of their greatest concerns. First responders have been hospitalized trying to help victims. Now, if there's any overdose they respond to, they must suit up with protective gear before treating.

Really, really bad stuff.
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Old 06-14-2018, 05:40 AM   #206
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That sounds like a bad Hollywood script.
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Old 06-14-2018, 05:54 AM   #207
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The world is now put on Hazmat suits to give Narcan, unfreaking real
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Old 06-14-2018, 06:53 AM   #208
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Quote:
Originally Posted by chevss454 View Post

"Thereís other alternatives."
No there aren't. Ask somebody with terminal cancer if ibuprofen does it for them. Ask someone who just had a major surgical procedure if tylenol touches their pain. Ditto joint replacement, ACL, fracture repair or burn victims. There are NO other alternatives when the pain is severe. A doc writing a script for a 10 day supply of hydrocodone is doing his/her sworn obligation to control pain & that 10 day supply is NOT creating an addict.
I was in the hospital for 2 1/2 weeks back in 2013 with 3 fractured ribs and a collapsed lung and had tubes hanging out of my chest for almost a week. It hurt to blink my eyes. Every time I moved I literally saw stars. I was one hurting boy.

You better believe that I took all the morphine I could to get through the worst of it and that didn't turn me into a wild-eyed opiate addict.

Ultimately, you just want to be able to get some sleep so that you can heal and get the hell out of there, because as Vince Lombardi famously said "fatigue makes cowards of us all."
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Old 06-14-2018, 12:48 PM   #209
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https://www.washingtonpost.com/graph...=.542fcc3bcdd8
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Old 06-14-2018, 02:20 PM   #210
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https://www.google.com/amp/s/amp.cnn...ise/index.html

CNN Exclusive: The more opioids doctors prescribe, the more money they make
Story by Aaron Kessler, Elizabeth Cohen and Katherine Grise, CNN Video by Elizabeth Cohen and John Bonifield, CNN
Updated 8:45 AM EDT, Mon March 12, 2018


(CNN) As tens of thousands of Americans die from prescription opioid overdoses each year, an exclusive analysis by CNN and researchers at Harvard University found that opioid manufacturers are paying physicians huge sums of money -- and the more opioids a doctor prescribes, the more money he or she makes.

In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time.

Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid.


"This is the first time we've seen this, and it's really important," said Dr. Andrew Kolodny, a senior scientist at the Institute for Behavioral Health at the Heller School for Social Policy and Management at Brandeis University, where he is co-director of the Opioid Policy Research Collaborative.

"It smells like doctors being bribed to sell narcotics, and that's very disturbing," said Kolodny, who is also the executive director of Physicians for Responsible Opioid Prescribing.

View this interactive content on CNN.com
The Harvard researchers said it's not clear whether the payments encourage doctors to prescribe a company's drug or whether pharmaceutical companies seek out and reward doctors who are already high prescribers.

"I don't know if the money is causing the prescribing or the prescribing led to the money, but in either case, it's potentially a vicious cycle. It's cementing the idea for these physicians that prescribing this many opioids is creating value," said Dr. Michael Barnett, assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.

CNN spoke with two women who've struggled with opioid addiction, and they described the sense of betrayal they felt when they learned that their doctors had received large sums of money from the manufacturers of the drugs that had created such havoc in their lives.

Carey Ballou said she trusted her doctor and figured that if he was prescribing opioids, it must be because they were the best option for her pain.

Then she learned that opioid manufacturers paid her doctor more than a million dollars over two years.

"Once I found out he was being paid, I thought, 'was it really in my best interest, or was it in his best interest?' " she said.

To do the analysis, CNN -- along with Barnett and Harvard's Dr. Anupam Jena -- examined two federal government databases. One tracks payments by drug companies to doctors, and the other tracks prescriptions that doctors write to Medicare recipients.

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.

View this interactive content on CNN.com
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.

View this interactive content on CNN.com
"The correlation you found is very powerful," said David Rothman, director of the Center on Medicine as a Profession at the Columbia University College of Physicians and Surgeons. "What's amazing about the findings is not simply that money counts but that more money counts even more."

Paying doctors for speaking, consulting and other services is legal. It's defended as a way for experts in their fields to share important experience and information about medications, but it has long been a controversial practice.  

Pharmaceutical company payments to doctors are not unique to opioids. Drug companies pay doctors billions of dollars for various services. In 2015, 48% of physicians received some pharmaceutical payment.

It's illegal, however, for doctors to prescribe the drug in exchange for kickback payments from a manufacturer.

Dr. Steven Stanos, president of the American Academy of Pain Medicine, said he wasn't surprised that doctors who frequently prescribe a drug are often chosen and paid to give speeches about the drug to other doctors.

"They know those medicines, and so they're going to be more likely to prescribe those because they have a better understanding," Stanos said, adding that some of the money paid to doctors may have been to teach other doctors about new "abuse-deterrent" opioid drugs.

Stanos' group accepted nearly $1.2 million from five of the largest opioid manufacturers in the United States between 2012 and 2017, according to a recent report by the Senate Homeland Security and Governmental Affairs Committee.

Stanos said the money was used for various projects, including courses on safe opioid prescribing.

"I would obviously hope that a physician would not prescribe based on some type of kickback or anything like that, that they'd obviously be prescribing [in] the best interest of the patient," he said.

But Dr. Daniel Carlat, former director of the Prescription Project at the Pew Charitable Trusts, said the CNN and Harvard findings are in line with other studies suggesting that money from drug companies does influence a doctor's prescribing habits.

"It's not proof positive, but it's another very significant data point in the growing evidence base that marketing payments from drug companies are not good for medicine and not good for patient care," said Carlat, a psychiatrist who blogs about conflicts of interest. "It makes me extremely concerned."

Barnett, one of the Harvard researchers who worked with CNN, said pharmaceutical companies pay doctors for a reason.

"It's not like they're spending this money and just letting it go out into the ether," he said. "They wouldn't be spending this money if it weren't effective."

According to a statement by the Pharmaceutical Research and Manufacturers of America, drug companies support mandatory and ongoing training for prescribers on the appropriate treatment of pain.

"PhRMA supports a number of policies to ensure patients' legitimate medical needs are met, while establishing safeguards that prevent overprescribing," according to the statement from the group.

Angela Cantone at her home in Greenville, South Carolina.
Angela Cantone at her home in Greenville, South Carolina.
'I trusted my doctor'

Angela Cantone says she wishes she had known that opioid manufacturers were paying her doctor hundreds of thousands of dollars; it might have prompted her to question his judgment.

She says Dr. Aathirayen Thiyagarajah, a pain specialist in Greenville, South Carolina, prescribed her an opioid called Subsys for abdominal pain from Crohn's disease for nearly 2Ĺ years, from March 2013 through July 2015.

Subsys is an ultrapowerful form of fentanyl, which is 50 to 100 times more potent than morphine, according to the US Centers for Disease Control and Prevention.

"He said it would do wonders for me, and it was really simple and easy. You just spray it in your mouth," Cantone said.

She says Subsys helped her pain, but it left her in "a zombie-like" state. She couldn't be left alone with her three young children, two of whom have autism and other special needs.

"I blacked out all the time. I'd find myself on the kitchen floor or the front lawn," she said.

She says that if she missed even one day of the drug, she had uncontrollable diarrhea and vomiting.

She said she brought her concerns to Thiyagarajah, but he assured her it couldn't be the Subsys that was causing her health problems.

"I trusted him. I trusted my doctor as you trust the police officer that's directing traffic when the light is out," she said.

She says that when she eventually asked Thiyagarajah to switch her to a non-opioid medication, he became belligerent.

"He said it was Subsys or nothing," she said.

Cantone would later learn that from August 2013 through December 2016, the company that makes Subsys paid Thiyagarajah more than $200,000, according to Open Payments, the federal government database that tracks payments from pharmaceutical companies to doctors.

CNN compared the $190,000 he received from 2014 to 2015 with other prescribers nationwide in the same medical specialty and found that he received magnitudes more than the average for his peers.

Nearly all of the payments were for fees for speaking, training, education and consulting.

Cantone is now suing Thiyagarajah, accusing him of setting out to "defraud and deceive" her for "the sole purpose of increasing prescriptions, sales, and consumption of Subsys to increase ... profits."

Through his attorney, Thiyagarajah denied any wrongdoing but declined to comment on this story due to the pending litigation.

In a court filing responding to Cantone's lawsuit, Thiyagarajah denied all of the allegations against him and said that all medical care provided to Cantone was "reasonable and appropriate and in keeping with the standard of care."

His attorney, E. Brown Parkinson, said the doctor is currently practicing medicine, alternating weeks between his practices in South Carolina and New York.

Thiyagarajah might be expected to write a relatively high number of prescriptions for opioid painkillers, given that he's board-certified in physical medicine and rehabilitation with a subspecialty in pain medicine.

But he wrote an unusually high number of prescriptions for Subsys and other opioids even when compared with other doctors with the same certifications.

In 2014 and 2015, physicians with Thiyagarajah's certifications wrote an average of 3.7 opioid prescriptions per Medicare patient per year, according to the analysis by CNN and Harvard. Thiyagarajah, however, annually wrote more than seven opioid prescriptions per patient per year.

After about two years on Subsys, Cantone says, she took herself off the drug cold turkey.

According to an affidavit by an investigator for the Drug Enforcement Administration, Thiyagarajah's office was inspected by the agency in June 2015 and found to be prescribing another opioid, buprenorphine, "for non-legitimate medical need" in violation of federal law.

In March 2016, the agent conducted another inspection and seized 45 medical records related to Subsys.

The DEA did a compliance review and referred its findings to the Department of Health and Human Services, according to Robert Murphy, associate special agent in charge of the agency's Atlanta Field Division.

Cantone is also suing Insys, the company that makes Subsys. Insys denied allegations of wrongdoing in a court filing responding to Cantone's lawsuit.

Separate from Cantone's lawsuit, John Kapoor, the founder and largest shareholder of Insys, was arrested and arraigned in federal court in October on charges of bribing doctors to overprescribe the drug.

"Dr. Kapoor engaged in no wrongdoing and refutes all of the charges in the strongest possible terms," said Tom Becker, a spokesman for Kapoor. "He looks forward to being fully vindicated after having his day in court."

Kapoor resigned from the Insys board of directors in October, according to a company news release.

Several other Insys executives were arrested in connection with an alleged racketeering scheme.

Separately, Sen. Claire McCaskill, a Democrat from Missouri, is conducting an investigation into the opioid industry.

According to her investigation and the federal indictment, Insys used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company.

Saeed Motahari, president and CEO of Insys, wrote a letter in September to McCaskill, noting that he was "concerned about certain mistakes and unacceptable actions of former Insys employees." He added that most of the field-based sales staff were no longer with the company.

"I stand with you and share the desire to address the serious national challenge related to the misuse and abuse of opioids that has led to addiction and unnecessary deaths and has caused so much pain to families and communities around the country," Motahari added.


(contíd)
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