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Thread: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

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    Default Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    20 Dec 2016 Posted by Isaac Davis


    Just under the radar of the American dream is a terrible crisis ruining families, destroying communities and killing people who are just too young to die. Overdoses from opioids, synthetic opioid drugs, and heroin have become a genuine epidemic, killing tens of thousands of Americans a year, swamping emergency emergency services and creating a booming economy out of rehab.

    There a number of causes to this problem, and while hardcore drug addiction may have complicated roots, there’s no denying that our society is absolutely flooded with many different types of opioid drugs. The market for legal and illegal opioids has become so huge that prescription pills and fake or hybrid pills are being mass-produced and shipped into the U.S. from places like China.

    Furthermore, pharmaceutical makers have continued to develop stronger and stronger pain medications, and doctors are contributing by over-prescribing these drugs, but in a truly shocking case, several pharmaceutical executives have just been arrested for scheming to create addicts painkiller based on the strongest, most addictive, and most deadly synthetic opioid in the world today, fentanyl. So powerful, in fact, that many are calling it the ‘kill pill.’

    “Fentanyl is an opioid. Its effect on the body is exactly like heroin, or any other opiate-based medication. But fentanyl is 50 times stronger than heroin, up to 100 times stronger than morphine. It is stronger than any prescription painkiller on the market.” [Source]

    Earlier this month, federal prosecutors in the State of Massachusetts announced the arrest of six former pharmaceutical executives of Insys Therapeutics, Inc., manufacturer of a fentanyl based pain medication called ‘Subsys.’ Their nefarious scheme was a well-organized plot to have doctors overprescribe this medicine and ensure that pill shoppers were well-supplied.

    Related Reading: The Sweeping Epidemic Affecting You and Your Children

    “…conspired to bribe practitioners in various states, many of whom operated pain clinics, in order to get them to prescribe a fentanyl-based pain medication. The medication, called “Subsys,” is a powerful narcotic intended to treat cancer patients suffering intense episodes of breakthrough pain. In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer”

    Details of the conspiracy, as outlined in the indictment and paraphrased by Slate include the following allegations:

    Insys paid doctors to give educational lectures about the use of Subsys. That’s ostensibly legal, except that prosecutors allege that the company paid said doctors in direct proportion to the frequency with which they wrote Subsys prescriptions, with one Insys employee allegedly texting another that the doctors hired to give lectures “do not need to be good speakers” so long as they were high-volume Susbys prescribers. These “lectures,” meanwhile were allegedly often nothing more than dinners at high-end restaurants attended only by the doctors getting paid, the Subsys employees paying them, and the doctor’s friends. One Florida doctor is alleged to have made $275,000 in speaking fee bribes in three years.
    Insys allegedly continued to work with some doctors who prescribed Subsys frequently even after becoming aware internally that those doctors were known for running dubiously legal Dr. Feelgood “pill mills.” Wrote one Insys employee in an email about an Illinois doctor that the company would continue to work with and pay speaking fees to: “He is extremely moody, lazy and inattentive. He basically just shows up to sign his name on the prescription pad, if he shows up at all.”
    Insys allegedly hired support staff employees to mislead insurance companies into approving payments for Subsys prescriptions. These support staff employees allegedly misled insurers into believing they were interacting with representatives of doctor’s offices rather than representatives of Insys—employees were allegedly instructed to hang up the phone when insurers “pursued the identity of their employer.” These support staff employees are also accused of systematically falsifying specific diagnosis information—claiming patients had difficulty swallowing, for example—that they knew would make insurers more likely to authorize Subsys purchases.

    Final Thoughts

    Remarkably, pharmaceutical medications have become the gateway to heroin use, not the other way around, and in particular, Fentanyl, and derivative drugs are especially dangerous. Few things are more nefarious and diabolical than plotting to turn members of your community and nation into addicts, knowing full well their lives will be ruined, their families destroyed, and that it could very well kill them. All for money.

    “The surge in opioid deaths is one of the reasons that United States life expectancy declined in 2015 for the first time in 22 years. In that same year, Insys reported a profit of $58.5 million.” [Source]

    The evidence is revealing that the nation’s overdose crisis is a complex, multi-layered conspiracy, and the arrest of these conspirators is but one more piece of the puzzle.
    I feel like there is a post ,maybe started by me on this subject .. something about a billionaire in Arizona 70 years old, paying doctors to prescribe his spray fentanyl .



    31st October 2017 12:34 Link to Post #1

    Default “Drug company founder John Kapoor arrested for alleged opioid scheme”

    CBS News 10-27-17… “Drug company founder John Kapoor arrested for alleged opioid scheme”


    This is perhaps an indication that these companies promoting “sell whatever drugs we can by pushing doctors to sell them for us” are finally being called out. Time to put an end to this. For these pharmaceutical giants, more and more people waking up is their main cause for “alarm”. This ain’t working anymore.

    Some other executives were indicted back in December.

    For those wondering about what kinds of things are opioids, check this WikiPedia entry.

    “Federal agents arrested the founder of a major drug company in an early-morning raid Thursday on charges stemming from an alleged scheme to get doctors to illegally prescribe a powerful opioid to patients who don’t need it… Kapoor is the most significant pharmaceutical executive to be criminally charged in response to the nationwide opioid crisis.

    “The company [Insys] makes a spray version of fentanyl, a highly addictive opioid intended only for cancer patients. Authorities allege Insys marketed the drug as part of a scheme to get non-cancer doctors to prescribe it. Numerous physicians were allegedly paid bribes by the company to push the painkilling drug.”


    Drug company founder John Kapoor arrested for alleged opioid scheme

    Last Updated Oct 27, 2017 12:47 AM EDT

    Federal agents arrested the founder of a major drug company in an early-morning raid Thursday on charges stemming from an alleged scheme to get doctors to illegally prescribe a powerful opioid to patients who don’t need it.

    John Kapoor, 74, was taken into custody in Phoenix, Arizona. Kapoor is the billionaire founder and former CEO of the pharmaceutical company Insys Therapeutics. He faces charges including racketeering, conspiracy, bribery and fraud.

    Kapoor is the most significant pharmaceutical executive to be criminally charged in response to the nationwide opioid crisis.

    Brian Kelly, an attorney for Kapoor, said his client “is innocent of these charges and intends to fight the charges vigorously.”

    Kapoor stepped down as CEO of Insys in January but still serves on its board. The company makes a spray version of fentanyl, a highly addictive opioid intended only for cancer patients.

    Authorities allege Insys marketed the drug as part of a scheme to get non-cancer doctors to prescribe it. Numerous physicians were allegedly paid bribes by the company to push the painkilling drug.

    CBS News correspondent Jim Axelrod reports Insys made 18,000 payments to doctors in 2016 that totaled more than $2 million. CBS News has identified headache doctors, back pain specialists and even a psychiatrist who received thousands of dollars to promote the drug last year.

    A federal judge on Thursday set bail for Kapoor at $1 million and ordered him to wear a electronic monitoring bracelet and to surrender his passport, CBS News’ Pat Milton and Laura Strickler report.

    Last December, six other Insys executives were indicted on federal charges in Boston in connection with the alleged scheme to bribe doctors to unnecessarily prescribe the painkilling drug.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    I'll be glad when I see the day when they get arrested for vaccine crimes as well. And psychotropic drugs. And all dangerous meds prescribed just for profit that damage people's health.

    The truth is getting out. The day will come.

    I'm glad to hear this news of holding those in these schemes accountable.

    Thank you!
    ~*~ "The best way to predict the future is to create it." - Peter Drucker ~*~ “To laugh often and much; to win the respect of intelligent people and the affection of children...to leave the world a better place...to know even one life has breathed easier because you have lived. This is to have succeeded.” -Ralph Waldo Emerson ~*~ "Creative minds always have been known to survive any kind of bad training." - Anna Freud ~*~

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    We have to begin somewhere and this is as good a place as any

    Opiods, narcotics, chemo, statins, vaccines, fluorides, antibiotics, anti depressants......If we can breakthrough on 3 key areas we may well see some progress.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit


    According to Fortune, he has resigned, but remains the major shareholder. Expected to plead not guilty.

    Company has already been thwacked with lawsuits from Attorneys General in various states.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    What goes around, comes around..... And it's their turn to cry. The amount of money spent by the different states for treatment, hospital emergency rooms,ambulances , police , should come from the pharmaceutical companies involved. I hope it's billions.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Hrm...how about civil asset forfeiture...as in, take everything and give it to the state...sort of the opposite of how foreign states are seized up in private hands. Oh, and then a criminal case...is there a charge for "attempted genocide?" I mean, this is about as "Opium War" as it gets...fentanyl spray?!?

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Dont we need addicts to sell the heroin from Afghanistan to. They cover all the bases.

    The Axman
    And ?

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    12-13-17 ON 60 MINUTES ..... https://openload.co/f/Pr3rKYesRJc/ ... 3 MIN. IN




    Bill Whitaker: Did a DEA attorney actually tell you that they were not going to pursue McKesson because they had lawyers who had gone to Harvard and Yale?

    David Schiller: They told me those exact words, because the case would take too much time and too much effort and, by the way, "What if we lost?" I said, "What if you lost?" I go, "You-- you can't have a better case on a silver platter."

    Bill Whitaker: Were they scared?

    David Schiller: Yes.

    Bill Whitaker: Scared of going after McKesson?

    David Schiller: A better word might be "intimidated."

    Joe Ranazzisi
    CBS News

    This was at the time whistleblower Joe Ranazzisi, the DEA's then deputy assistant administrator, was sounding alarms that the DEA and Congress were bending to the will of the pharmaceutical industry. In our October report, he told us Justice Department attorneys were pressing him and his investigators to take a softer approach toward the industry.

    Bill Whitaker: The summer of 2014 -- you get a request to play nice with the pharmaceutical industry.

    Joe Ranazzisi: Yes.

    Bill Whitaker: What do you think of that?

    Joe Ranazzisi: I didn't think it was appropriate. We told 'em what they need to do. We told 'em what compliance is and how to comply with the act. We met these people over and over again. The time for meetings and reports are over. You either comply or you lose your registration.

    But in the McKesson case, negotiations with company attorneys went on for more than two years. In the end, instead of the billion-dollar fine DEA investigators wanted, the company was fined $150 million. That was a record for the DEA, but Schiller called it a slap on the wrist for a fortune five company and a second-time offender.

    David Schiller: There was backdoor deals being cut that we didn't know about, I didn't know about, and I was representing DEA nationally on the investigation at the highest level. How do you settle? How do you say it's okay just, "Here, write this check this time and-- and close this place for a little bit, sign this piece of paper." How do you do that? No. Put 'em in jail. You put the people that are responsible for dealing drugs, for breaking the law, in jail. Nobody's in jail. They wrote a check.

    Bill Whitaker: Did you think McKesson was getting special treatment?

    David Schiller: I don't think -- I know they were getting special treatment. They were getting treatment like I'd never seen in my 30-year career.

    Getting special treatment, he said, from lawyers at his agency. In an e-mail, a member of DEA's senior leadership team, who sided with Schiller, told him she was overruled.

    "David... I am totally against settling," she wrote, "but how do we hold their feet to the fire...? Our attorneys have us over a barrel with their refusal to go to court."

    David Schiller: There is not a man or woman in DEA today that's happy with the settlement and morale has been broken because of it.

    Bill Whitaker: Why did you ultimately decide to sit down and talk to us?

    David Schiller: I saw what's happening to our country now with this epidemic. I saw the limitations being placed on it-- on us by our own people and chief counsel fighting with our own agents and investigators. And I know I'm gonna make a lotta enemies, because people don't like to hear the truth. I'm doing it because the truth needs to be told.

    David Schiller and correspondent Bill Whitaker
    CBS News

    Schiller pointed out to us the $150 million fine was only about $50 million more than McKesson CEO, John Hammergren's compensation last year. He was the third-highest paid CEO in the country; only Tim Cook of Apple, and Reed Hastings of Netflix earned more. In the last earning period McKesson's revenues were up $8 billion.

    We wanted to speak to a McKesson representative on camera but they declined. But in a statement, McKesson said, "In the interest of moving beyond disagreements… The company agreed to settle with the DEA and DOJ." And McKesson promised to do a better job flagging suspicious orders.

    We asked the DEA about allegations its attorneys went easy on McKesson. A spokesperson told us the agreement was a good deal; that the priority was to get McKesson to do the right thing going forward. And now an independent monitor has been put in place to watch McKesson more closely.

    Maggie Hassan: The pharmaceutical industry is doing everything it can to keep this epidemic going.

    Bill Whitaker: That's pretty strong.

    Maggie Hassan: Yeah. It is.

    New Hampshire Senator Maggie Hassan has been critical of Congress for not aggressively investigating industry's role in this epidemic. New Hampshire has the second highest rate of drug overdose deaths in the country.

    Bill Whitaker: What more is it going to take to convince Congress to act?

    Maggie Hassan: Well, one of the things we have to do is begin to hold the pharmaceutical companies accountable for this. And right now, when you see a fine for the McKesson Company of $150 million when they make a $100 million a week in profits, that isn't gonna do it.

    Bill Whitaker: What incentive do they have to change their behavior?

    Maggie Hassan: Well, right now, they don't have a lot of incentives and that's something that has to be changed. This in many ways reminds me of the situation with big tobacco-- and, you know, I think it's one of the reasons you see attorneys general around the country--beginning to file lawsuits against the pharmaceutical industry--to hold them accountable for the cost of this terrible epidemic.

    41 state attorneys general have banded together to sue the opioid industry. While at McKesson, John Hammergren begins his 18th year as CEO. This year, the board awarded him an additional $1.1 million performance bonus. A bonus based on ethics and accountability.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    I think everyone has heard about the trade routes of the Afghanistan Poppy Trade and all sorts of drugs having been shipped, smuggled, etc., into the USA by the military and others in order to support the Black Ops and Underground Construction, etc., etc. It appears that the Elite or someone wants seven billion humans DEAD and drugs apparently do that very nicely; why they are even starting on kindergarten. It takes a very corrupt system, from stem to stern, to kill off people. The love of money? Do you know what a dead planet is like? The pharmaceutical system needs to be replaced and definitely those people running it. The same goes for those drugging the elderly into memory loss in "nursing homes." Kill the children, kill the elderly, stupefy the stupid with drug/sex and we will soon all be gone.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Armed with new data, officials target 'drug-dealing' doctors
    Sadie Gurman, Associated Press

    ,Associated Press•January 1, 2018

    Armed with new data, officials target 'drug-dealing' doctors


    In this Dec. 21, 2017, photo, Assistant U.S. Attorney Robert Cessar, shows a map
    illustrating the rates of opioids prescriptions by county during an interview in
    Pittsburgh. The Justice Department is giving federal prosecutors in 12 regions
    ravaged by the opioid abuse epidemic a trove of data officials say will help
    them stop over-prescribing doctors. But some experts say doctors are just a
    small part of a problem that won't be cured without prevention and treatment.
    (AP Photo/Keith Srakocic)

    PITTSBURGH (AP) -- The pain clinic tucked into the corner of a low-slung
    suburban strip mall was an open secret.

    Patients would travel hundreds of miles to see Dr. Andrzej Zielke, eager for
    what authorities described as a steady flow of prescriptions for the kinds of
    powerful painkillers that ushered the nation into its worst drug crisis in

    At least one of Zielke's patients died of an overdose, and prosecutors say
    others became so dependent on oxycodone and other opioids they would crowd his
    office, sometimes sleeping in the waiting room. Some peddled their pills near
    tumble-down storefronts and on blighted street corners in addiction-plagued
    parts of Allegheny County, where deaths by drug overdose reached record levels
    last year.

    But Robert Cessar, a longtime federal prosecutor, was unaware of Zielke until
    Justice Department officials handed him a binder of data that, he said,
    confirmed what pill-seekers from as far away as Ohio and Virginia already knew.
    The doctor who offered ozone therapy and herbal pain remedies was also
    prescribing highly addictive narcotics to patients who didn't need them,
    according to an indictment charging him with conspiracy and unlawfully
    distributing controlled substances.

    Zielke denied he was overprescribing, telling AP he practiced alternative
    medicine and many of his patients stopped seeing him when he cut down on pain

    His indictment in October was the first by a nationwide group of federal law
    enforcement officials that, armed with new access to a broader array of
    prescription drug databases, Medicaid and Medicare figures, coroners' records
    and other numbers compiled by the Justice Department, aims to stop fraudulent
    doctors faster than before.

    The department is providing a trove of data to the Opioid Fraud and Abuse
    Detection Unit, which draws together authorities in 12 regions across the
    country, that shows which doctors are prescribing the most, how far patients
    will travel to see them and whether any have died within 60 days of receiving
    one of their prescriptions, among other information.

    Authorities have been going after co-called "pill mills" for years, but the new
    approach brings additional federal resources to bear against the escalating
    epidemic. Where prosecutors would spend months or longer building a case by
    relying on erratic informants and only limited data, the number-crunching by
    analysts in Washington provides information they say lets them quickly zero in
    on a region's top opioid prescribers.

    "This data shines a light we've never had before," Cessar said. "We don't need
    to have confidential informants on the street to start a case. Now, we have
    someone behind a computer screen who is helping us. That has to put (doctors) on
    notice that we have new tools."

    And Rod Rosenstein, deputy attorney general, told AP the Justice Department will
    consider going after any law-breaker, even a pharmaceutical company, as it seeks
    to bring more cases and reduce the number of unwarranted prescriptions.

    Attorney General Jeff Sessions has been in lock-step with President Donald Trump
    about the need to combat the drug abuse problem that claimed more than 64,000
    lives in 2016, a priority that resonates with Trump's working-class supporters
    who have seen the ravages of drug abuse first-hand. The president called it a
    public health emergency, a declaration that allows the government to redirect
    resources in various ways to fight opioid abuse.

    But he directed no new federal money to deal with a scourge that kills nearly
    100 people a day, and critics say his efforts fall short of what is needed. The
    Republican-controlled Congress doesn't seem eager to put extra money toward the

    While the effectiveness of the Trump administration's broader strategy remains
    to be seen, the Justice Department's data-driven effort is one small area where
    federal prosecutors say they can have an impact.

    The data analysis provides clues about who may be breaking the law that are then
    corroborated with old-fashioned detective work — tips from informants or
    undercover office visits, said Shawn A. Brokos, a supervisory special agent in
    the FBI's Pittsburgh division. Investigators can also get a sense for where
    displaced patients will turn next.

    Authorities acknowledge there are legitimate reasons for some doctors to
    prescribe large quantities of opioids, and high prescribing alone doesn't
    necessarily trigger extra scrutiny. What raises red flags for investigators are
    the dentists, psychiatrists and gynecologists who are prescribing at
    surprisingly high rates.

    The effort operates on the long-held perception that drug addiction often starts
    with prescriptions from doctors and leads to abuse of more dangerous black
    market drugs like fentanyl, which, for the first time last year, contributed to
    more overdose deaths than any other legal or illegal drug, surpassing pain pills
    and heroin.

    But that focus can cause law-abiding physicians to abandon disabled patients who
    rely on prescriptions, for fear of being shut down, said University of Alabama
    addiction researcher Stefan Kertesz. Those patients will turn to harder street
    drugs or even kill themselves, he said.

    "The professional risk for physicians is so high that the natural tendency is to
    get out of the business of prescription opioids at all," he said.

    Another addiction expert, Dr. Andrew Kolodny, founder of Physicians for
    Responsible Opioid Prescribing, said prosecutors' emphasis on "drug-dealing
    doctors" is appropriate but inadequate on its own.

    "It's just not really going to have that much of an impact on an epidemic," he
    said. The bigger change will come from a stronger push for prevention and
    treatment, he said. And, he added, "They should go after the bigger fish.... the
    legal narcotics distributors and wholesalers who have literally been getting
    away with mass manslaughter."

    Investigators said Zielke charged $250 a visit and made patients pay in cash.
    But Zielke said prosecutors unfairly targeted him. Instead of more prosecutions,
    he said, the government "should promote more alternative therapies," he said.
    "And they should find out why so many people have pain."

    A second indictment by the anti-fraud unit involved a cardiologist in Elko,
    Nevada, accused of routinely providing patients fentanyl and other painkillers
    they did not need. Justice officials hope to expand the data-driven work

    Will it work? As Soo Song, who watched addiction warp communities while serving
    as acting U.S. attorney in western Pennyslvania, put it: "The best measure of
    success will be if fewer people die."

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Quote Posted by ramus (here)
    ...Investigators said Zielke charged $250 a visit and made patients pay in cash.
    But Zielke said prosecutors unfairly targeted him. Instead of more prosecutions,
    he said, the government "should promote more alternative therapies," he said.
    "And they should find out why so many people have pain."

    well, he does make a couple of very valid points there, IMO.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    There is NOT Just a US “Opioid Crisis” – There is Something Far Worse Happening…
    Quote Here it is…
    Note from Tim Bolen – Our newest writer, Jonelle Elgeway, is, due to personal experience (major injuries), an EXPERT on US Pain Management issues. Jonelle was on the 1996 Olympic Field Hockey Team. With the Opioid Crisis sweeping the nation I recruited Jonelle to give us an “Insiders View” of what’s happening. When I first read her draft article (below) I was astounded to find out how bad the OFFICIAL US Pain Management system really is. Jonelle is addressing Congress April 26th, 2018 on pain issues- Below is why she is doing that.
    By Jonelle Elgaway
    There is no playbook on what to do when your life is turned upside down and inside out from a life altering car accident or major health issue. YOU’RE SCARED!

    And you would expect that living in the United States the healthcare system would be there to not only save your life, but give you effective treatments and medications.

    The United States healthcare system STINKS! And WE need to change it!One of the biggest current U.S. healthcare FAILS is the so called “Opioid Crisis.”
    First off, the United States isn’t dealing with a prescription opioid crisis.

    It’s not even a heroin crisis.

    The United States is currently in an Illicitly Manufactured Fentanyl Crisis.

    In 2016 the Centers For Disease Control (CDC) created guidelines for primary care physicians prescribing for patients that are first time prescription pain medication users. The group of panelists were primarily made up of the Physicians for Responsible Opioid Prescribing (PROP) specializing in substance abuse.

    Somehow these guidelines were taken as law and have created an out of control brush fire that’s turned into a forest fire, focusing on patients needing pain medication to have any quality of life.

    How the “Opioid Epidemic” all started and the SCARY TRUTH about Illicit Manufactured Fentanyl (IMF)
    1996 OxyContin was marketed as a low habit forming pain medication.

    In 2010 the reformulation of OxyContin forced illegal pill users to turn to heroin, due to the tamper resistant pills.

    In 2011-2012 the CDC states that heroin use took off. Debra Dowel from the CDC testified that we are now in an era of synthetic drugs.

    China and Mexico now creates and illegally exports carfentanyl, which is an analog of the synthetic analgesic fentanyl. A unit of carfentanyl is 100 times as potent as the same amount of fentanyl, 5,000 times as potent as a unit of heroin and 10,000 times as potent as a unit of morphine. They have changed the molecules of heroin just enough that illegal drug users are able to get that “original high” that they always chase. We need to let the public know how dangerous this is.

    All street drugs are showing up with IMF and essentially are POISONED!
    To Main Stream Media and the White House… IMF IS YOUR PROBLEM! We must warn the public that they are playing Russian Roulette when buying anything from the streets. Recently one county in Ohio stated that 99% of the overdoses were different types of carfentanyl. Only 3 cases were plain heroin.

    Who is being affected?
    There are 116 million chronic pain patients in the U.S.

    There are 25-26 million intractable pain patients, which are noncancerous rare and painful diseases like Complex Regional Pain Syndrome (CRPS), Arachnoiditis and Rheumatoid Arthritis to name a few.

    Out of these intractable pain patients, 5-6 million patients have been stripped of their pain medications due to forced tapers or forced reductions because of the CDC Guidelines. This was supposed to be about overdoses and addiction wasn’t it?

    Instead this is causing entirely new issues.
    Three things will happen to these patients… 1) They will commit suicide 2) They will turn to street drugs, which they won’t know what they are getting, leading to possibly more overdoses 3) More health issues will be created from having high levels of out of control pain for long periods of time such as; heart attacks, stroke, high blood pressure, cancers and auto immune issues.

    How do we fix this issue?
    (1) Lawmakers should start by NOT creating any new laws or policies with data used from the CDC, because we now know that the CDC data is flawed and manipulated. The CDC recently admitted that they inflated the overdose numbers.

    (2) The CDC guidelines should be revoked and instead use the Federation of State Medical Boards (FSMB) written by doctors and medical boards specializing in pain management. When chronic pain patients use their medication properly, they rarely become addicted. Within the US there are less than 2% of the population that become addicts. This number hasn’t changed in the last 60 years.

    (3) Many states now accept and doctors need to use a Palliative Care Certificate and Exceptions. This will allow doctors to prescribe pain medication over the CDC guidelines of 90 mme. Centers for Medicare and Medicaid Services (CMS) plan to use the CDC guidelines, which have NO scientific studies supporting that CDC’s 90 mme or CMS’s 200 mme levels are dangerous and will cause overdose or addiction for intractable pain patients. Again, there are no studies! In fact, FDA scientists did a study finding that there is no difference between pain from cancer and noncancerous pain.

    (4) Doctors should be given reimbursements as a palliative care visit instead of an office visit.

    (5) Fund programs to help build institutions like what the VA or other countries are setting up all over the world to take care of patients properly through multidisciplinary programs. Let’s be real about the limitations on alternative therapies within the US, if doctors provide them, health insurance doesn’t cover them.

    (6) Fund education for physicians on how to properly use pain medication and deal with patients having rare and painful diseases and chronic health issues.

    (7) Create harm reduction strategies for people with substance abuse issues.

    (8) Stop trade with Mexico and China until they deal with their illegal trade of IMF.

    There is no “One Size Fits All” approach to pain management…
    The is a really SIMPLE issue with a SIMPLE solution. Allow patients to have access to the correct medications and treatments that they need to have any quality of life.

    Intractable pain patients dealing with severe and painful diseases are not a one-size-fits-all. They are not going to become addicts or overdose on the pain medication that they safely have taken for many years.

    We need to let doctors treat their patients how they deem fit. The government needs to realize the real battle is with IMF coming in from Mexico and China!
    Each breath a gift...

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    "The CDC guidelines should be revoked."

    Better if the whole CDC is revoked.
    Medicine without ethics is genocide in progress.

    ~*~ "The best way to predict the future is to create it." - Peter Drucker ~*~ “To laugh often and much; to win the respect of intelligent people and the affection of children...to leave the world a better place...to know even one life has breathed easier because you have lived. This is to have succeeded.” -Ralph Waldo Emerson ~*~ "Creative minds always have been known to survive any kind of bad training." - Anna Freud ~*~

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit


    House panel to question OPIOID distributors about pill dumping in West Virginia


    WASHINGTON – Top executives from five major drug distributors will face questions Tuesday from lawmakers investigating how millions of prescription painkillers ended up flooding into small towns in West Virginia, feeding the opioid epidemic in a state with the nation’s highest drug overdose rate.

    The hearing before a House subcommittee comes on the one-year anniversary of the panel opening a bipartisan investigation into possible pill dumping in the Mountain State.

    “As we work to develop solutions to combat the opioid crisis, we must fully understand the root causes of it — and this investigation is an important part of that process,” said Rep. Gregg Harper, R-Miss., chairman of the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations.

    The subcommittee will hear from the leaders of five drug distributors — the McKesson Corp., Cardinal Health Inc., AmerisourceBergen Corp., Miami-Luken Inc., and H.D. Smith Wholesale Drug Co. — that are at the heart of the investigation, Harper said.

    “Through their testimony, we hope to gain a more complete picture of the crisis that unfolded in West Virginia and across our nation,” he said.

    The executives’ testimony could become a pivotal moment in the investigation and evokes comparisons to a hearing more than two decades ago in which leaders of the nation’s seven largest tobacco companies appeared before a different House subcommittee and testified they did not believe that cigarettes were addictive.
    Heads of the nation's largest cigarette companies are sworn in before a House Energy subcommittee hearing on Capitol Hill on April 14, 1994.

    Heads of the nation's largest cigarette companies are sworn in before a House Energy subcommittee hearing on Capitol Hill on April 14, 1994. (Photo: Associated Press)

    That 1994 hearing is now viewed as a turning point in the anti-smoking debate and opened the door to a torrent of lawsuits and legislation that eventually led to the federal regulation of cigarettes.

    In the opioids probe, lawmakers want to know about the companies’ practices in West Virginia in light of reports that distributors may have supplied the state with questionably high quantities of the drugs.

    In the small community of Kermit, which sits across the border from Kentucky and has a population of just 406, a single pharmacy received nearly 9 million opioid pills over two years, according to the House subcommittee.

    In nearby Williamson, population 3,191, drug distributors shipped nearly 21 million pain pills over a 10-year period to two pharmacies — Tug Valley Pharmacy and Hurley Drug Co., the panel said, citing data from the Drug Enforcement Administration. The pharmacies are located just four blocks from each other.

    “How could this happen?” Harper asked.

    In a series of letters to distributors, congressional investigators requested that the companies provide a list of the 10 largest pharmacy customers in West Virginia, based on the shipped dosage units of hydrocodone and oxycodone.

    They also asked for the results of any internal or external investigations related to suspicious order monitoring and for an accounting of West Virginia customer orders that exceeded limits set by the distributor, including any explanation of why the drugs were released for shipment.

    The letters, citing government data and news reports about the extent of the opioid crisis, provide some details about shipments of hydrocodone and oxycodone into West Virginia, many into small communities with just a few hundred or a few thousand residents.

    Two Family Discount Pharmacy locations in Mount Gay-Shamrock, population 1,779, and Stollings, population 316, received shipments of more than 20 million doses of hydrocodone and oxycodone between 2006 and 2016, according to the committee data. The two pharmacies are just 3 miles apart.

    McKesson supplied nearly 6 million of the pills to the Mount Gay-Shamrock location between 2006 and 2014. Cardinal Health supplied more than 6 million pills to the pharmacy between 2008 and 2012. That means Cardinal Health shipped an average of 3,561 pills every day to this single pharmacy, the House panel said.

    AmerisourceBergen distributed nearly 70 million doses of hydrocodone and 29 million doses of oxycodone into the state over a five-year period.

    Miami-Luken shipped more than 24 million doses of the two drugs to five West Virginia pharmacies between 2005 and 2015.
    Last edited by ramus; 9th May 2018 at 14:52.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Quote Posted by Axman (here)
    Dont we need addicts to sell the heroin from Afghanistan to. They cover all the bases.

    The Axman
    Indeed Axman. These Big Pharma execs were either working in cahoots with the CIA who brings the heroin over or told they would not be prosecuted.
    And then came Trump. My man!!!

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Billionaire Opioid Executive Stands to Make Millions More on Patent for Addiction Treatment
    September 26, 2018
    An estimated 202,600 Americans died from opioid overdoses between 2002 and 2015; 74 percent of farmers report being addicted to opioids, or know someone who is
    Addiction to narcotic pain relievers places an enormous economic burden on society, costing the U.S. an estimated $504 billion each year (2.8 percent of gross domestic product)
    The massive increase in opioid sales and subsequent addiction rates have been traced back to an orchestrated marketing plan aimed at misinforming doctors about the drug’s addictive potential
    Sackler family members who own Purdue Pharma were intimately involved in the false advertising of OxyContin. A recent investigation reveals the Sacklers also own Rhodes Pharma — one of the largest producers of generic opioids
    Dr. Richard Sackler — who was deeply involved in the marketing of OxyContin — was recently awarded a patent for a new, faster-dissolving form of buprenorphine, used in the treatment of opioid addiction, thus making money both on the promulgation of addiction and its treatment
    By Dr. Mercola

    An estimated 202,600 Americans died from opioid overdoses between 2002 and 2015,1 and drug overdoses are now the leading cause of death among Americans under the age of 50.2

    Chronic opioid use also accounted for 20 percent of the increase in male unemployment between 1999 and 20153 and, remarkably, 74 percent of farmers report being addicted to opioids, or know someone who is.4

    Aside from the staggering death toll, addiction to narcotic pain relievers also places an enormous economic burden on society, costing the U.S. an estimated $504 billion each year (2.8 percent of gross domestic product), according to a November 2017 White House report.5,6

    Opioid Epidemic Is No Random Fluke
    Adding insult to injury, evidence suggests opioid makers are directly responsible. They knew exactly what they were doing when they claimed opioids — which are chemically very similar to heroin — have an exceptionally low addiction rate when taken for pain.

    In fact, the massive increase in opioid sales and subsequent addiction rates have been traced back to an orchestrated marketing plan aimed at misinforming doctors about the drug's addictive potential, and it is this false advertising campaign that seeded the current opioid epidemic — an epidemic so great it has even lowered the national life expectancy.

    Purdue Pharma, owned by the Sackler family, was one of the most successful in this regard, driving sales of OxyContin up from $48 million in 1996 to $1.5 billion in 2002.7

    Studies now show addiction affects about 26 percent of those using opioids for chronic non-cancer pain, and 1 in 550 patients on opioid therapy dies from opioid-related causes within 2.5 years of their first prescription.8

    Meanwhile, Purdue's sales representatives were extensively coached on how to downplay the drug's addictive potential, claiming addiction was occurring in less than 1 percent of patients being treated for pain.

    Evidence also shows Sackler family members were intimately involved with the marketing machinations behind OxyContin.9,10 In fact, attorney Mike Moore — who represents Ohio, Louisiana and Mississippi in lawsuits against Purdue Pharma — claims to have evidence connecting the Sackler family "directly, and personally, to corporate misdeeds" committed in the 1990s and 2000s.11

    In 2007, Purdue Pharma did plead guilty to charges of misbranding "with intent to defraud and mislead the public," and paid $634 million in fines.12 Alas, a decade later, it's quite clear the company has not changed its ways to any significant degree. It, and the Sackler family, is still in the business of profiting from addiction.

    OxyContin Maker Patents Opioid Addiction Treatment
    As reported by STAT News earlier this month, Dr. Richard Sackler — who, according to Esquire journalist Christopher Glazek,13 was deeply involved in the marketing of OxyContin as head of the company's research and development, sales and marketing divisions — was recently awarded a patent for a new, faster-dissolving form of buprenorphine, a mild opioid drug used in the treatment of opioid addiction. As noted by STAT News:14

    "… Sackler is listed as one of six inventors on the patent, which was issued in January [2018] … Critics told the [Financial Times] that they were disturbed that the patent could enable Sackler to benefit financially from the addiction crisis that his family's company is accused of fueling."

    Indeed, the company is currently fighting more than 1,000 lawsuits brought by tribes, cities, counties and states across the U.S., which claim Purdue Pharma helped orchestrate the opioid addiction epidemic and should therefore help pay for the societal costs.

    President Trump has also stated he would like to see a federal lawsuit be brought against opioid makers.15

    Apparently, Sackler decided to pursue avenues to cash in on the epidemic instead. Salon magazine16 reported on the patent saying, "Sackler made billions off of sales of a drug that caused a massive public health crisis — and now he stands to make more billions by selling the public a solution." But that's not all. The Sacklers have actually been profiting from addiction in more ways than one for over a decade.

    Purdue Pharma Secretly Owned Generic Oxycontin Too
    As reported by Financial Times17 and the New York Post,18 the Sackler family also secretly owns Rhodes Pharma, "one of the biggest producers of generic opioids, which had never before been linked to the family."

    What's more, this company was launched just four months after Purdue Pharma's guilty plea back in 2007. When combined, Purdue Pharma and Rhodes Pharma account for about 6 percent of the total opioid market in the U.S.

    So, "not only did the Sacklers fail to scale back its marketing of OxyContin after the plea, they further cashed in on the pill crisis — by launching the second firm and selling more of the drug under a different name," the New York Post writes, adding:

    "Rhodes [Pharma] was set up as a 'landing pad' in case the under-fire drug maker needed a clean start amid the 2007 criminal charges, a former senior manager at Purdue told the paper.

    Together, both firms accounted for 14.4 million opioid prescriptions in 2016. Rhodes Pharma also makes other highly addictive opiates such as morphine, oxycodone and hydromorphone, according to the FDA."

    Purdue Pharma to Offer Free Opioid Addiction Therapy
    Sackler's new buprenorphine patent is actually held by Rhodes Pharma and, according to Bloomberg, Purdue has offered to donate an undisclosed number of treatment doses of this drug as part of any settlement that might come out of the 1,000 lawsuits currently pending. University of Kentucky law professor Richard Ausness told Bloomberg:

    "I'd have to say this is a pretty clever move. Over the last 20 years, Purdue hasn't shown any real contrition or remorse, so I see this offer of free step-down drugs as a savvy negotiating tactic to limit what they have to pay in any settlement."

    Opioids Still Being Widely Overprescribed
    In related news, recent research19 published in the Annals of Internal Medicine shows nearly one-third of opioid prescriptions given in an outpatient setting are not backed by a documented medical reason for the prescription,20 suggesting the drugs are still being widely overprescribed and misused.

    According to the authors, their findings "show the need for stricter rules on patients' needs for the highly addictive drugs."

    Of the opioid prescriptions handed out during 809 million doctor's visits across the U.S. between 2006 and 2015, only 5 percent were prescribed for cancer-related pain; more than 66 percent were given for non-cancer pain — the most common being back pain, diabetes-related pain and arthritis — while just over 28 percent were prescribed in cases where no pain-related condition could be ascertained in the patient's medical record.

    Curiously, the most common nonpain conditions for which an opioid was prescribed were high blood pressure and high cholesterol.

    Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital in New York City, who was not part of the study, told HealthDay News,21 "Despite numerous policy changes, recent analyses suggest national opioid prescribing rates have not meaningfully decreased … Lax prescribing practices remain widespread."

    Seeing how doctors are largely failing to significantly cut down on opioid prescriptions, might cutting insurance coverage do the trick? Both Cigna and Blue Cross Blue Shield of Florida have stopped paying for OxyContin, and as of January 2019, Blue Cross Blue Shield of Tennessee will no longer pay for it either.22

    They all still pay for other brands of opioids, though, which may water down the impact of the decision. According to Blue Cross Blue Shield of Tennessee, the decision to drop OxyContin was primarily based on the fact that it still has a higher street value and is easier to crush, snort or inject than other opioids.

    Struggling With Opioid Addiction? Seek Help!
    Regardless of the brand, it's vitally important to realize that opioids are extremely addictive drugs that are not meant for long-term use for nonfatal conditions. Chemically, opioids are very similar to heroin, and if you wouldn't consider shooting up heroin for that toothache or backache, you really should reconsider taking an opioid to relieve the pain as well.

    The misconception that opioids are harmless pain relievers has at this point killed hundreds of thousands of people, and destroyed the lives of countless more, including the families and friends of those who have died. Don't be so quick to be the next in line.

    Some marketing materials for opioids still claim the drug will not cause addiction "except in very rare cases," describing the adverse effects patients experience when quitting the drug as a "benign state" and not a sign of addiction. This simply isn't true.

    Panic is one psychological side effect commonly experienced when quitting these drugs, and this can easily fuel a psychological as well as physical dependence on the drug.

    It's important to recognize the signs of addiction, and to seek help. If you've been on an opioid for more than two months, or if you find yourself taking higher dosages, or taking the drug more often, you're likely already addicted and are advised to seek help from someone other than your prescribing doctor. Resources where you can find help include:

    Your workplace Employee Assistance Program
    The Substance Abuse Mental Health Service Administration23 can be contacted 24 hours a day at 1-800-622-HELP
    Treating Your Pain Without Drugs
    With all the health risks associated with opioid painkillers, I strongly urge you to exhaust other options before resorting to these drugs. The good news is there are many natural alternatives to treating pain. Following is information about nondrug remedies, dietary changes and bodywork interventions that can help you safely manage your pain.

    Medical cannabis — Medical marijuana has a long history as a natural analgesic and is now legal in 31 states. You can learn more about the laws in your state on medicalmarijuana.procon.org.24

    Kratom — Kratom (Mitragyna speciose) is a plant remedy that has become a popular opioid substitute.25 In August 2016, the DEA issued a notice saying it was planning to ban kratom, listing it as Schedule 1 controlled substance. However, following massive outrage from kratom users who say opioids are their only alternative, the agency reversed its decision.26

    Kratom is safer than an opioid for someone in serious and chronic pain. However, it's important to recognize that it is a psychoactive substance and should be used with great care. There's very little research showing how to use it safely and effectively, and it may have a very different effect from one person to the next. The other issue to address is that there are a number of different strains available with different effects.

    Also, while it may be useful for weaning people off opioids, kratom is in itself addictive. So, while it appears to be a far safer alternative to opioids, it's still a powerful and potentially addictive substance. So please, do your own research before trying it.

    Low-Dose Naltrexone (LDN) — Naltrexone is an opiate antagonist, originally developed in the early 1960s for the treatment of opioid addiction. When taken at very low doses (LDN, available only by prescription), it triggers endorphin production, which can boost your immune function and ease pain.

    Curcumin — A primary therapeutic compound identified in the spice turmeric, curcumin has been shown in more than 50 clinical studies to have potent anti-inflammatory activity. Curcumin is hard to absorb, so best results are achieved with preparations designed to improve absorption. It is very safe and you can take two to three every hour if you need to.

    Astaxanthin — One of the most effective oil-soluble antioxidants known, astaxanthin has very potent anti-inflammatory properties. Higher doses are typically required for pain relief, and you may need 8 milligrams or more per day to achieve results.

    Boswellia — Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites, as it worked well for many of my former rheumatoid arthritis patients.

    Bromelain — This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind most of the bromelain is found within the core of the pineapple, so consider eating some of the pulpy core when you consume the fruit.

    Cayenne cream — Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain.

    Cetyl myristoleate (CMO) — This oil, found in dairy butter and fish, acts as a joint lubricant and anti-inflammatory. I have used a topical preparation of CMO to relieve ganglion cysts and a mild case of carpal tunnel syndrome.

    Evening primrose, black currant and borage oils — These oils contain the fatty acid gamma-linolenic acid, which is useful for treating arthritic pain.

    Ginger — This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea, or incorporated into fresh vegetable juice.

    Dietary Changes to Fight Inflammation and Manage Your Pain
    Unfortunately, physicians often fall short when attempting to effectively treat chronic pain, resorting to the only treatment they know: prescription drugs. While these drugs may bring some temporary relief, they will do nothing to resolve the underlying causes of your pain. If you suffer from chronic pain, making the following changes to your diet may bring you some relief.

    Consume more animal-based omega-3 fats — Similar to the effects of anti-inflammatory pharmaceutical drugs, omega-3 fats from fish and fish oils work to directly or indirectly modulate a number of cellular activities associated with inflammation. While drugs have a powerful ability to inhibit your body's pain signals, omega-3s cause a gentle shift in cell signaling to bring about a lessened reactivity to pain.

    Eating healthy seafood like anchovies or sardines, which are low in environmental toxins, or taking a high-quality supplement such as krill oil are your best options for obtaining omega-3s. DHA and EPA, the omega-3 oils contained in krill oil, have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief.

    Radically reduce your intake of processed foods — Processed foods not only contain chemical additives and excessive amounts of sugar, but also are loaded with damaging omega-6 fats. By eating these foods, especially fried foods, you upset your body's ratio of omega-3 to omega-6 fatty-acids, which triggers inflammation. Inflammation is a key factor in most pain.

    Eliminate or radically reduce your consumption of grains and sugars — Avoiding grains and sugars, especially fructose, will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production, which contributes to pain.

    While healthy individuals are advised to keep their daily fructose consumption below 25 grams from all sources, you'll want to limit your intake to 15 grams per day until your pain is reduced. Eating sugar increases your uric acid levels, which leads to chronic, low-level inflammation.

    Optimize your production of vitamin D — As much as possible, regulate your vitamin D levels by regularly exposing large amounts of your skin to sunshine. If you cannot get sufficient sun exposure, taking an oral vitamin D3 supplement, along with vitamin K2 and magnesium, is highly advisable. Get your blood level tested to be sure you're within the therapeutic range of 60 to 80 ng/mL year-round.

    Bodywork Methods That Reduce Pain
    The following bodywork methods have also demonstrated effectiveness for pain relief and pain management.

    • Acupuncture — An estimated 3 million American adults receive acupuncture annually,27 most often for the treatment of chronic pain. A study28 published in the Archives of Internal Medicine concluded acupuncture has a definite effect in reducing back and neck pain, chronic headache, osteoarthritis and shoulder pain, more so than standard pain treatment.

    • Chiropractic adjustments — While previously used most often to treat back pain, chiropractic treatment addresses many other problems, including asthma, carpal tunnel syndrome, fibromyalgia, headaches, migraines, musculoskeletal pain, neck pain and whiplash.

    According to a study29 published in the Annals of Internal Medicine, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain-free in 12 weeks compared to those who took medication.

    • Massage therapy — Massage releases endorphins, which help induce relaxation, relieve pain and reduce levels of stress chemicals such as cortisol and noradrenaline. A systematic review and meta-analysis30 published in the journal Pain Medicine, included 60 high-quality and seven low-quality studies that looked into the use of massage for various types of pain, including bone and muscle, fibromyalgia, headache and spinal-cord pain.

    The study revealed massage therapy relieves pain better than getting no treatment at all. When compared to other pain treatments like acupuncture and physical therapy, massage therapy still proved beneficial and had few side effects. In addition to relieving pain, massage therapy also improved anxiety and health-related quality of life.

    • Emotional Freedom Techniques (EFT) — EFT continues to be one of the easiest and most effective ways to deal with acute and chronic pain. The technique is simple and can be applied in mere minutes. A study31 published in Energy Psychology examined the levels of pain in a group of 50 people attending a three-day EFT workshop, and found their pain dropped by 43 percent during the workshop.

    Six weeks later, their pain levels were reported to be 42 percent lower than before the workshop. As a result of applying EFT, participants felt they had an improved sense of control and ability to cope with their chronic pain. In the video below, EFT expert Julie Schiffman, teaches you how to use EFT to address chronic pain."
    Each breath a gift...

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit


    How the whole thing came about:

    The making of an opioid epidemic: This was no accident

    Chris McGreal The Guardian
    Thu, 08 Nov 2018 06:00 UTC

    © Illustration by Guardian Design Team/Christophe Gowans

    Jane Ballantyne was, at one time, a true believer. The British-born doctor, who trained as an anaesthetist on the NHS before her appointment to head the pain department at Harvard and its associated hospital, drank up the promise of opioid painkillers - drugs such as morphine and methadone - in the late 1990s. Ballantyne listened to the evangelists among her colleagues who painted the drugs as magic bullets against the scourge of chronic pain blighting millions of American lives. Doctors such as Russell Portenoy at the Memorial Sloan Kettering Cancer Center in New York saw how effective morphine was in easing the pain of dying cancer patients thanks to the hospice movement that came out of the UK in the 1970s.

    Why, the new thinking went, could the same opioids not be made to work for people grappling with the physical and mental toll of debilitating pain from arthritis, wrecked knees and bodies worn out by physically demanding jobs? As Portenoy saw it, opiates were effective painkillers through most of recorded history and it was only outdated fears about addiction that prevented the drugs still playing that role.

    Opioids were languishing from the legacy of an earlier epidemic that prompted President Theodore Roosevelt to appoint the US's first opium commissioner, Dr Hamilton Wright, in 1908. Portenoy wanted to liberate them from this taint. Wright described Americans as "the greatest drug fiends in the world", and opium and morphine as a "national curse". After that the medical profession treated opioid pain relief with what Portenoy and his colleagues regarded as unwarranted fear, stigmatising a valuable medicine.

    These new evangelists painted a picture of a nation awash in chronic pain that could be relieved if only the medical profession would overcome its prejudices. They constructed a web of claims they said were rooted in science to back their case, including an assertion that the risk of addiction from narcotic painkillers was "less than 1%" and that dosages could be increased without limit until the pain was overcome. But the evidence was, at best, thin and in time would not stand up to detailed scrutiny. One theory, promoted by Dr David Haddox, was that patients genuinely experiencing pain could not become addicted to opioids because the pain neutralised the euphoria caused by the narcotic. He said that what looked to prescribing doctors like a patient hooked on the drug was "pseudo-addiction".

    Portenoy toured the country, describing opioids as a gift from nature and promoting access to narcotics as a moral argument. Being pain-free was a human right, he said. In 1993, he told the New York Times of a "growing literature showing that these drugs can be used for a long time, with few side-effects, and that addiction and abuse are not a problem".

    Long after the epidemic took hold, and the death toll rose into the hundreds of thousands in the US, Portenoy admitted that there was little basis for this claim and that he had been more interested in changing attitudes to opioids among doctors than in scientific rigour.

    "In essence, this was education to destigmatise and because the primary goal was to destigmatise, we often left evidence behind," he admitted years later as the scale of the epidemic unfolded.

    Likewise, Haddox's theory of pseudo-addiction was based on the study of a single cancer patient. At the time, though, the new thinking was a liberation for primary care doctors frustrated at the limited help they could offer patients begging to get a few hours' sleep. Ballantyne was as enthusiastic as anyone and began teaching the gospel of pain relief at Harvard, and embracing opioids to treat her patients.
    "Our message was a message of hope," she said.

    "We were teaching that we shouldn't withhold opiates from people suffering from chronic pain and that the risks of addiction were pretty low because that was the teaching we'd received."
    But then Ballantyne began to see signs in her patients that experience wasn't matching theory. Doctors were told they could repeatedly ratchet up the dosage of narcotics and switch to a new and powerful drug, OxyContin, without endangering the patient, because the pain, in effect, cancelled out the risk of addiction. To her dismay, Ballantyne saw that many of her patients were not better off when taking the drugs and were showing signs of dependence.

    Among those patients on high doses over months and years, Ballantyne heard from one after another that the more drugs they took, the worse their pain became. But if they tried to stop or cut back on the pills, their pain also worsened. They were trapped.
    "You had never seen people in such agony as these people on high doses of opiates," she told me.

    "And we thought it's not just because of the underlying pain; it's to do with the medication."

    As Ballantyne listened to relatives of her patients talk about how much the drugs had changed their loved ones, her misgivings grew. Husbands spoke of wives as if a part of them were lost. Mothers complained that children had become sullen and distant, their judgment gone, their personality warped, their character altered. None of this should have been happening. Pain relief was supposed to free the patients, not imprison them. It was all very far from the promise of a magic bullet.

    As the evidence that opioids were not delivering as promised piled up, the Harvard specialist began to record her findings. By then, though, there were other powerful forces with a big financial stake in the wider prescribing of painkilling drugs. Pharmaceutical companies are not slow to spot an opportunity and the push for wider prescribing of opioids had not gone unnoticed by the drug-makers, including the manufacturer of OxyContin, Purdue Pharma, which rapidly came to play a central role in the epidemic.

    As the influence of the opioid evangelists grew, and restraints on prescribing loosened, the pharmaceutical industry moved to the fore with a push to make opioids the default treatment for pain, and to take advantage of the huge profits to be made from mass prescribing of a drug that was cheap to produce.

    Bottles of painkiller OxyContin, made by Purdue Pharma. © Reuters

    The American Pain Society, a body partially funded by pharmaceutical companies, was pushing the concept of pain as the "fifth vital sign", alongside other measures of health such as heart rate and blood pressure. "Vital signs are taken seriously," said its president, James Campbell, in a 1996 speech to the society. "If pain were assessed with the same zeal as other vital signs are, it would have a much better chance of being treated properly. We need to train doctors and nurses to treat pain as a vital sign."

    The APS wanted the practice of checking pain as a vital sign as a matter of routine adopted in American hospitals. The key was to win over the Joint Commission for Accreditation of Healthcare Organizations, which certifies about 20,000 hospitals and clinics in the US. Its stamp of approval is the gateway for medical facilities to tap into the huge pot of federal money paying for healthcare for older, disabled and poor people. Hospitals are careful not to get on the wrong side of the joint commission's "best practices" or to fail its regular performance reviews.

    In response to what it called "the national outcry about the widespread problem of under-treatment" - an outcry in good part generated by drug manufacturers - the commission issued new standards for pain care in 2001. Hospital administrators picked over the document to ensure they understood exactly what was required.

    Every patient was to be asked about their pain levels, no matter what the reason they were seeing a doctor. Hospitals adopted a system of colour-coded smiley faces, to represent a rising scale of pain from 0-10. The commission ruled that anybody identifying as a five - a yellow neutral face described as "very distressing" - or above was to be was to be referred for a pain consultation.

    The commission told hospitals they would be expected to meet the new standards for pain management at their next accreditation survey. Purdue Pharma was ready. The company offered to distribute materials to educate doctors in pain management for free. This amounted to exclusive rights to indoctrinate medical staff. A training video asserted that there is "no evidence that addiction is a significant issue when persons are given opioids for pain control", and claimed that some clinicians had "inaccurate and exaggerated concerns about addiction, tolerance and risk of death". Neither claim was true.

    Some doctors questioned the value of patient self-assessment, but the commission's regulations soon came to be viewed as a rigid standard. In time, pain as the fifth vital sign worked its way into hospital culture. New generations of nurses, steeped in the opioid orthodoxy, sometimes came to see pain as more important than other health indicators.

    Dr Roger Chou, a pain specialist at Oregon Health and Science University who has made long-term studies of the effectiveness of opioid painkillers and helped shape the Centers for Disease Control and Prevention's policy on the epidemic, said the focus on pain caused patients to give it greater weight than made sense.
    "When you start asking people: 'How much pain are you having?' every time they come into the hospital, then people start thinking: 'Well, maybe I shouldn't be having this little ache I've been having. Maybe there's something wrong.' You're medicalising what's a normal part of life," he said.
    One consequence was that people with relatively minor pain were increasingly directed toward medicinal treatment while consideration of safer or more effective alternatives, such as physiotherapy, were marginalised. Another, said Chou, was the increased expectation that pain can be eliminated. Chasing the lowest score on the pain chart often came at the expense of quality of life as opioid doses increased. "It's better to have a little bit of pain and be functional than to have no pain and be completely unfunctional," said Chou.

    Health insurance companies piled yet more pressure on doctors to follow the path of least resistance. This meant cutting consultation times and payments for more costly forms of pain treatment in favour of the direct approach: drugs.

    The joint commission needed a way to judge whether its 2001 edict on pain was being adhered to and latched on to patient satisfaction surveys. It took a determined doctor to resist the pressure to prescribe. Physicians could spend half an hour pressing a person to take more responsibility for their own health - eat better, exercise more, drink less, find ways to deal with stress - only to watch an unhappy patient make their views known on the satisfaction survey and face a dressing down from hospital management. Or they could quickly do what the patient came in for: give them a pill and get full marks.

    In Detroit, Dr Charles Lucas's three decades of experience as a surgeon told him it was possible to do what was easy and sign the prescription, or to do what was hard. Lucas grew up in the city and had been instrumental in establishing Detroit's publicly owned hospital as the highest-level trauma centre in Michigan and one of the first top-tier centres in the country.

    Activists in New York, during a protest denouncing the city’s ‘inadequate and wrongheaded response’ to the opioid overdose crisis. © Getty

    Emergency departments became beacons for the opioid dependent, who quickly learned to game the system to get drugs on top of their prescriptions. They turned up feigning pain, knowing harassed medical staff under pressure of time and the commission's standards were likely to prescribe narcotics and move on without too many questions.
    "Some of the old-time nurses, they have that jaundiced look in their eye and say 'So-and-so's complaining of pain'. You can tell by the look in their eye that they don't think it's justified that they get any more medicine," said Lucas.

    "The younger nurses, they say we have to treat this pain - because they've been indoctrinated - they've got to get rid of the pain. God forbid you don't get rid of the pain. That would be like a mortal sin."
    But there was a price for resisting the pressure to prescribe ever higher doses of pain relief.

    Lucas was knocked back in surprise, and then infuriated, to be summoned to appear before his hospital's ethics committee after a nurse reported him for failing to provide adequate pain treatment.

    The surgeon's longstanding patients included Gail Purton, the wife of a well-known Michigan radio personality. Lucas operated on Purton a few times, and she was back for surgery after her ovarian cancer spread. "It was a big operation. Cut off all sorts of cancer." The next day, a nurse asked Purton if she was in pain. Purton said she was. The nurse reported Lucas for failing to properly address a patient's pain. "I got reported because I wasn't giving her enough pain medicine. She had a big cut from here to here," Lucas said, running his finger across the front of his shirt and scoffing at the idea that she could be pain-free after an operation like that.

    The surgeon responded with a five-page letter to the ethics committee chairman, whom he happened to have trained, challenging the questioning of his professional judgment. Purton wrote her own letter, praising Lucas's care and saying that she never expected not to have pain after a major operation.

    The case was dropped, but it was not an isolated incident. Lucas has worked closely with another surgeon, Anna Ledgerwood, since 1972. She too was hauled before the ethics committee on more than one occasion, on the same charge. It cleared Ledgerwood, but Lucas said more junior surgeons buckled to the pressure to administer opioids just to stay out of trouble.

    Lucas regarded the new pain orthodoxy as a growing tyranny. He also thought it was killing patients. He began to collect his own data.

    As the joint commission was pushing out its new standards for pain treatment in the early 2000s, the industry was driving a parallel effort to influence the prescribing habits of doctors in small clinics and private practices across the country. Many were still hesitant to prescribe narcotics, in part because of fear of legal liability for overdose or addiction.

    The American Pain Society and Haddox, who was by then working for Purdue Pharma, were instrumental in writing a policy document reassuring doctors they would not face disciplinary action for prescribing narcotics, even in large quantities. The industry latched on to the Federation of State Medical Boards because of its influence over the health policy of individual US states which regulate how doctors practise medicine.

    In 2001, Purdue Pharma funded the distribution of new pain treatment guidelines drawn up by the FSMB that sounded many of the same themes as the standards written by the joint commission.

    The document picked up on Haddox's pseudo-addiction theory. "Physicians should recognise that tolerance and physical dependence are normal consequences of sustained use of opioid analgesics and are not synonymous with addiction," it said.

    The FSMB pressed state medical boards to adopt the guidelines and to reassure doctors that adhering to them would diminish the likelihood of disciplinary action.

    Over the following decade, the FSMB took close to $2m (£1.52m) from the drug industry, which mostly went to promote the guidelines and to finance a book, Responsible Opioid Prescribing, written with the oversight and advice of a clutch of doctors who were strong advocates of wider use of prescription narcotics. The book was sold to state medical boards and health departments for distribution to physicians, clinics and hospitals. The drug industry paid for the publication but the FSMB kept the $270,000 profits from sales.

    Within a few years, the model guidelines were adopted in full or in part by 35 states, and the floodgates were open to mass prescribing of what Drug Enforcement Administration agents came to call "heroin in a pill". Opioids were soon the default treatment even for relatively minor pain. Dentists gave them to teenagers after pulling their wisdom teeth. Not just one or two days' worth of pills, but a fortnight or a month's worth, which, if they did not draw the intended recipient in, frequently sat in the medicine cabinet waiting to be discovered by someone else in the family. The lack of caution in prescribing left an impression among the users that the drugs were harmless, and some people shared them with others as easily as they might an aspirin. Prescribing escalated year on year. So did profits. OxyContin sales passed $1bn a year in 2000. Three years later they were twice that. Other opioid makers were pulling in huge profits too.

    By the time the FSMB guidelines were landing in doctors' inboxes in the early 2000s, Ballantyne had reached her own conclusions about the impact of escalating opioid prescribing. In 2003, she co-authored an article in the New England Journal of Medicine highlighting the dearth of comprehensive trials and saying that two important questions remained unanswered even as mass prescribing of opioids took off. Do they work long term? Are higher doses safe to take year after year? The drug industry and opioid evangelists said yes, but where was the evidence for it?

    Ballantyne wrote that there was evidence that putting some patients on serial prescriptions of strong opioids has the opposite of the intended effect. High doses not only build up a tolerance to the drug, but cause increased sensitivity to pain. The drugs were defeating themselves.

    Her assessment seemed to warn that if there was an epidemic of pain, it was partly driven by the cure. On top of that, there was evidence that the drugs were toxic. Then came the conclusion that stuck a dagger into the heart of the campaign for wider opioid prescribing.
    "Whereas it was previously thought that unlimited dose escalation was at least safe, evidence now suggests that prolonged, high-dose opioid therapy may be neither safe nor effective," she wrote.
    Ballantyne was also increasingly aware that the claim that pain neutralised the risk of addiction was false. Quantifying addiction, and who may be vulnerable, is notoriously difficult. Ballantyne, like a lot of doctors, estimated that between 10 and 15% of the population is vulnerable, but that it depends on the substance and circumstances. What she was certain of was that Purdue's high-strength pill, OxyContin, had been a game changer.
    "The long-acting opiates suddenly put much higher doses into people's hands and much more of it, and taking it around the clock made them dependent on it."
    From her research, Ballantyne concluded that OxyContin supercharged what was already widespread dependence on weaker opioid pills by drawing a new group of people into the category at risk of addiction and death. The danger was compounded by OxyContin's failure to live up to its promise of holding pain at bay for 12 hours. For some patients, it wore off after eight, causing them to take three pills a day instead of two, greatly increasing their overall dose of narcotic and with it the risk of addiction.

    Ballantyne thought the article would at least cause her profession and the drug industry to take stock of the impact of mass prescribing. By the time the article appeared, the documented death toll from prescription opioids was running at around 8,000 a year.
    "When the 2003 New England journal article came out, I thought it was going to make the medical community sit up and say: 'Wow. These drugs that we've been thinking are helping people are not. We have a real problem.' But the medical community didn't at all say: 'Wow,'" Ballantyne said with half a laugh, 15 years later.
    "People in my field who had been, like me, taught we have to do this - people who'd been lobbying to try and increase opiate use, like the palliative care physicians - said:
    'What are you doing? We worked so hard to get to this point, and now you're going to turn it all around.'
    They become so rattled when you suggest you shouldn't give the opiates - it's partly people in the pain field and especially people in pharma - because it's big business."
    Lucas and Ledgerwood had their own study on the impact of opioids in the works. They came to believe the tyranny of the colour-coded smiley faces was costing lives. Years of surgery have given Lucas a healthy respect for pain as a tool for recovery. To suppress it was dangerous. But as large doses of opioids became the norm, the surgeon noted an increasing number of incidents of patients struggling to breathe after routine operations and being moved to intensive care.

    Lucas and Ledgerwood visited trauma centres to collect data on deaths before and after the joint commission standards on pain treatment. In 2007, the two doctors published their findings. Before the commission's dictum, 0.7% of trauma centre patients died from "excess administration of pain medicines". The death toll rose to 3.6% after the commission's policies kicked in.
    "In each case, administration of sedation led to a change in vital signs or a deterioration in the respiratory status requiring some type of intervention which, in turn, led to a cascade of events resulting in death," the paper said.
    Those were only the deaths in which there was little doubt opioids were responsible, and the real toll was almost certainly higher.
    "Overmedication with sedatives/narcotics ... clearly contributed to deaths," the study concluded.

    A memorial in Washington DC, consisting of 22,000 engraved white pills representing the face of someone lost to a prescription opioid overdose in 2015. © Mark Wilson/Getty
    "I'm convinced that because of the pressures brought to bear by the joint commission, we are killing people," Lucas told me.
    The study said the medical staff lived in fear of the joint commission standards which created "great psychological pressure on caregivers" to use narcotics.

    In a damning critique, the paper said that the commission's reliance on pain scales to guide treatment had created an "excessive emphasis on undermedication at the same time ignoring overmedication". The obsession with ensuring people were not in pain came at the expense of ignoring the dangers of giving large amounts of opioids to people recovering from surgery or serious injury. The drugs may kill the pain but they also risked killing the patient.

    The two doctors made no secret of who they blamed for "this preventable cause of death and disability".
    "It's about money. Money has influence, and it influenced the joint commission," said Lucas.
    The surgeon presented the paper to a meeting of the Central Surgical Association and saw it published by the Journal of the American College of Surgeons under the headline:
    "Kindness Kills: The Negative Impact of Pain as the Fifth Vital Sign."
    Afterwards, Lucas got a stream of letters and emails from doctors who recognised the problem. But, unlike Ballantyne, he wasn't surprised when the policy remained the same.
    "Did I expect a change? No. It is too ingrained into the medical profession. It's become financial just like the drug industry is financial. It's nothing to do with right or wrong. It's about how the money flows," he said.

    "When you write a paper you want there to be unemotional data out there. You want that unemotional data to be analysed and interpreted in one way or the other, but you don't expect the Renaissance."
    In 2012, nine years after Ballantyne's cautioning against the mass prescribing of opioids as a quick fix for pain was published in the New England Journal of Medicine, a renowned British pain specialist, Cathy Stannard, called the doctor's paper "a distant warning bell", challenging the opening of the floodgates to strong opioids.

    Ballantyne continued to collect data and publish ever more detailed insights into the impact of painkillers. A less rapacious drug industry might have paused in its headlong charge to sell opioids, and less blinkered and compliant regulators might have determined that this was the moment to weigh the claims made in favour of permitting such widespread prescribing.

    Instead the pharmaceutical companies took the warnings as a challenge to their business interests. Through the 2000s, industry poured money into a political strategy to keep the drugs flowing. It funded front groups and studies to claim that there was indeed an epidemic - but it was of untreated pain. The millions coping with chronic pain were the real victims, the industry said, not the "abusers" hooked on opioids they often bought on the black market or obtained from crooked doctors. That one frequently became the other was conveniently overlooked.

    Pharma's lobbyists worked to persuade Congress and the regulators that to curb opioid prescribing would be to punish the real victims because of the sins of the "abusers", and it worked. As a result, the devastation ran unchecked for another decade and more. By 2010, doctors in the US were writing more than 200m opioid prescriptions a year. As the prescribing rose, so did the death toll. Last year, more than 72,000 Americans died of drug overdoses, the vast majority from opioids, nearly 10 times the number at the time Ballantyne published her warning.

    The head of the FDA at the time OxyContin was approved for distribution two decades ago, Dr David Kessler, later described the opioid crisis as an "epidemic we failed to foresee". "It has proved to be one of the biggest mistakes in modern medicine," he said.

    Kessler was wrong. It wasn't a mistake. It was a betrayal.
    This is an edited extract from American Overdose by Chris McGreal, published by Guardian Faber on 15 November (£12.99), and published by PublicAffairs Books in the US on 13 November. To order a copy for £9.99, go to guardianbookshop.com or call 0330 333 6846. Free UK P&P over £10, online orders only. Phone orders min P&P of £1.99.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Wait until this hits the streets, we haven't seen nothing yet.

    10 times more potent than fentanyl, and 1,000 times more potent than morphine.

    But they say they will keep it distribution well restricted, like all other drugs ... what a joke ....

    Should FDA Have Approved ‘Super Opioid’ That’s Stronger Than Fentanyl?


    Dsuvia is a tablet that would be used in hospital settings only. Some experts say it will fuel the opioid addiction crisis.
    The drugmaker says Dsuvia would be easier to administer and more effective than current IV painkillers.

    When Dr. Pamela Palmer was the head of the pain management center at the University of California San Francisco Medical Center, she also testified in wrongful death lawsuits against hospitals.

    Too often, she says, those cases involved intravenous painkillers that were administered at too high of a dose.

    “I saw enough of these that I wanted to start a company that could address these problems,” she told Healthline.

    So, in 2005, she co-founded AcelRx Pharmaceuticals, Inc.

    Their latest product, called Dsuvia, was approved today by the Food and Drug Administration (FDA).

    It’s a tablet that dissolves under a patient’s tongue to deliver fast pain relief during extreme trauma, such as a broken femur or a gunshot wound.

    Because of its capabilities on the battlefield, it even received funding from the U.S. Army Medical Research and Materiel Command.

    Dsuvia is meant to be used only in a supervised setting, such as an emergency room.

    It contains 30 micrograms of a synthetic opioid painkiller known as sufentanil, which is 5 to 10 times more potent than fentanyl, and 1,000 times more potent than morphine.

    Sufentanil itself is nothing new. It’s been approved in intravenous form since 1984.

    Palmer says this new version would help with dosing problems, as well as patients who might not be fit for an IV.

    “There’s a huge advantage to not sticking a person with a needle,” she said.

    AcelRx estimates Dsuvia’s market potential to be approximately $1.1 billion in the United States alone, according to its website.
    Last edited by ramus; 11th November 2018 at 18:03.

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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    New York City is taking legal action against pharmaceutical companies involved in the opioid crisis.

    Quote New York sues Big Pharma for deadly opioid epidemic
    Published time: 24 Jan, 2018 17:27

    New York City is suing eight companies that make or distribute prescription opioids for their role in the ongoing opioid crisis. The suits aim to recover $500 million for current and future costs combating the epidemic.

    Mayor Bill de Blasio said opioids killed more people in the city in recent years than car crashes and homicides.

    “Big Pharma helped to fuel this epidemic by deceptively peddling these dangerous drugs and hooking millions of Americans in exchange for profit,” Mayor de Blasio said in a statement about the suits filed in New York State Supreme Court on Tuesday. “It’s time [to] hold the companies accountable for what they’ve done to our city, and help save more lives.”

    The complaint, City of New York v Purdue Pharma LP et al, said the opioid crisis has had a serious impact on NYC, with the number of overdose deaths increasing in each of the last six years. More than 1,100 people died from opioid-induced overdoses in 2016.

    The opioid crisis was caused by the deceptive marketing of drugmakers, and by distributors bringing large amounts of prescription painkillers into the New York market, according to the complaint. It further argues that this has caused the city to spend millions of dollars on substance abuse treatment programs, hospital services, emergency medical services and law enforcement.

    New York City said in its press release that roughly 2.5 million to 2.7 million opioid prescriptions were filled each year from 2014 to 2016.

    ‘Deadly mess’: Ohio sues 5 pharma companies over opioid crisis
    The defendants named in the suit include manufacturers Allergan Plc, Endo International Plc, Johnson & Johnson, Purdue Pharma LP and Teva Pharmaceutical Industries and distributors AmerisourceBergen Corporation, Cardinal Health Inc and McKesson Corp.

    The suit alleges that manufacturers and distributors created a false perception that “using opioids to treat chronic pain was safe for most patients and that the drugs’ benefits outweighed the risks,” and that this was achieved through deceptive marketing and promotion which began in the late 1990s, became more aggressive around 2006 and “continue today.”

    Allergan, Endo, Johnson and Johnson, Purdue, Teva, AmerisourceBergen and McKeeson in separate statements emphasized the importance of using opioids safely.

    Endo, Johnson & Johnson and Purdue denied the city’s allegations, while McKesson declined to comment on the lawsuit.

    New York City has a population of 8.54 million and joins a list of other states and municipalities that have sued drug companies over opioid abuse, which President Donald Trump has called a national public health emergency.

    Opioids, including prescription painkillers and heroin, played a role in the 42,249 deaths in 2016, up 28 percent on 2015 and 47 percent on 2014, according to US Center for Disease Control and Prevention.
    From: https://www.rt.com/usa/416886-new-yo...mpression=true
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    Default Re: Pharma Execs Arrested in Conspiracy to Create Opioid Addicts for Profit

    Opioid crisis: Johnson & Johnson hit by landmark ruling

    By Russell Hotten
    BBC News, New York

    Oklahoma Attorney General: Johnson & Johnson built its brand out of 'greed'

    Drugmaker Johnson & Johnson must pay $572m (£469m) for its part in fuelling the opioid addiction crisis in Oklahoma, a US judge has ruled

    The company said immediately after the judgement that it would appeal.

    The case was the first to go to trial out of thousands of lawsuits filed against opioid makers and distributors.

    Earlier this year, Oklahoma settled with OxyContin maker Purdue Pharma for $270m and Teva Pharmaceutical for $85m, leaving J&J as the lone defendant.

    Judge Thad Balkman said prosecutors had demonstrated that J&J contributed to a "public nuisance" in its deceptive promotion of highly addictive prescription painkillers.

    "Those actions compromised the health and safety of thousands of Oklahomans. The opioid crisis is an imminent danger and menace to Oklahomans," he said in his ruling.

    The payment would be used for the care and treatment of opioid addicts, he said.


    The outcome of the case is being closely watched by plaintiffs in about 2,000 opioid lawsuits due to go to trial in Ohio in October unless the parties can reach a settlement.

    Opioids were involved in almost 400,000 overdose deaths from 1999 to 2017, according to the US Centers for Disease Control and Prevention. Since 2000, some 6,000 people in Oklahoma have died from opioid overdoses, according to the state's lawyers.

    During Oklahoma's seven-week non-jury trial, lawyers for the state argued that J&J carried out a years-long marketing campaign that minimised the addictive painkillers' risks and promoted their benefits.

    The state's lawyers had called J&J an opioid "kingpin" and argued that its marketing efforts created a public nuisance as doctors over-prescribed the drugs, leading to a surge in overdose deaths in Oklahoma.

    J&J vigorously denied wrongdoing, arguing that its marketing claims had scientific support and that its painkillers, Duragesic and Nucynta, made up a tiny fraction of opioids prescribed in Oklahoma.

    America is the biggest consumer of opioids, followed by Canada and Germany.
    The state's case rested on a "radical" interpretation of the state's public nuisance law, J&J said.

    The company said in a statement that since 2008, its painkillers accounted for less than 1% of the US market, including generics.

    "The decision in this case is flawed. The State failed to present evidence that the company's products or actions caused a public nuisance in Oklahoma.

    "This judgment is a misapplication of public nuisance law that has already been rejected by judges in other states," it added.

    The Oklahoma case was brought by the state's Attorney General Mike Hunter. "Johnson & Johnson will finally be held accountable for thousands of deaths and addictions caused by their actions," he said after the ruling.
    Last edited by Peter UK; 27th August 2019 at 00:14.

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