Travis In Austin

mow that was cool

She was arrested for misdemeanor possession of marijuana? They arrest for possession of marijuana in NC? In Texas she would have received a citation to appear in court. http://abc11.com/news/nc-$188m-jackpot-winner-cited-for-drug-possession-/878114/

That was all clearly a front set up by the DEA, NSA and the CIA. http://mobile.nytimes.com/2013/10/28/business/fda-shift-on-painkillers-was-years-in-the-making.html?referrer=

Apparently, this guy started it all. A Physican from Syracuse, New York who first petitioned the FDA to upschedule HCPs back in 1999. A pain specialist who also specialized in addiction. He was probably was on loan from the CIA to the NSA at the time. Travis http://www.syracuse.com/news/index.ssf/2013/10/syracuse_doctor_paved_the_way_for_tighter_controls_on_highly_addictive_painkille.html

Journal of American Medical Association on overdose deaths. http://jama.jamanetwork.com/article.aspx?articleid=1653518

Drug overdoses in Utah http://www.sltrib.com/sltrib/news/51689248-78/prescription-drugs-drug-watson.html.csp

In 2009 therenwas apparently a pill junket between Kentucky and Florida, n with overdoses happening backnin Kentucky. http://www.kentucky.com/2009/04/12/758845_ky-sees-rise-in-overdose-deaths.html?rh=1

Article by Forbes that speakes a little about liver toxicity with acetaminophen. But no ddtail on deaths. http://www.forbes.com/sites/davidkroll/2014/08/22/what-you-need-to-know-about-new-restrictions-on-hydrocodone-combinations/

Because a lot of street pills are generated by this connection. Maybe some, but from what I'm reading, they make it sound like the stuff is everywhere. For that to happen, almost everyone would have to be selling their prescriptions. I also learned that the new laws and changes in scheduling has barely put a dent in it -- so where's all of this crap coming from? Where is it coming from? That is the big question. The short answer is that the DEA requested the FDA to reschedule it. They have been requesting an upscheduling for the last five years which the FDA always turned down. In 2011 or 2012 Congress passed a bill about one thing, but had a provision that required the FDA to look at it again. They looked at it again in 2012 and Health and Human Services told FDA it didn't need to be upscheduled and it ended there. They voted 11 to 1 ro reccomend no upscheduling. Then in 2012 new data was released showing a big upswing in number of hydrocodone prescriptions. At the same time CDC issued information that drug overdoses had become the biggest cause of accidential death in the US exceeding automobile accidents for the first time, and that approximately 15,000 deaths a year were from the overdose of prescription drugs containing hydrocodone. The DEA requested a rehearing based on the "new" information. The two day hearing was conducted in January of 2013. They voted 19 to 10 to reccomend upscheduling, and the head of the FDA followed and approved that recommendation. He then sent it over to the DEA to amend the Schedules and regulations. It went through the DEA process and the changes were announced in the summer of 2014 with an effective date in October if 2014. That is the general flow of what happened procedurally. Doctors, patients, pharmacists and othet stakeholders were allowed input, testimony, etc. Probably too soon to tell if it having any effect. Travis

The commercial guys I know swear by Honda power for their "small push behind" mowers. They also say it is very important to change the oil per Honda's reccomendations, or at least once a year, minimum. Not sure what it is about Honda, but apparently it is the way to go. Travis

Was it lawyer driven? Was it doctor driven? Do you know? Do you care?The head of the FDA is a doctor, an MD. I doubt they had politicians testifying regarding at hearings about whether to change the classification. yeah, I care because I am affected. 1. the DEA is how drugs get on different schedules, right? pasted The Obama administration moved Thursday to restrict prescriptions of the most commonly used narcotic painkillers in the U.S. in an attempt to curb widespread abuse. The Drug Enforcement Administration said it would reclassify hydrocodone combination drugs such as Vicodin and put them in the category reserved for medical substances with the highest potential for harm. The "rescheduling" means people will be able to receive the drugs for only up to 90 days without obtaining a new prescription. The opioid pills are taken by millions of Americans, including after dental surgery, for back problems and broken bones. Currently the pills can be refilled up to five times and prescriptions can cover a 180-day period. The new classification will take effect in 45 days, the DEA said. "Today's action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available," said DEA Administrator Michele Leonhart. ------------------------------------------ 2. who is michele leonhart? A doctor? Um, no. she is not a doctor. pasted--Leonhart graduated from Bemidji State University in 1978 with a degree in criminal justice, ------------------------------------ drugs is politics my friend. did you watch the colorado changover to legal pot? yes, therre are doctors in agencies, but rules are made by legislators, cops and lawyers. so do I care? yes I care. I care that my health is in the hands of actual doctors, not cops lawyers and legislators with their political and money agendas. i was on pain meds for several years with no problems of any kind BEFORE michele leonhart, a bureaucrap cop and politician changed the rules and schedules. the change? more inconvenience and insults and cost and much indignity. but why would lawyers and pols care about any that??? LOL!!! jus teasin ya~! your chasin a fly when you should spend your time chasin the big game - booze and cigs. christ, leave the sick people alone, they have enough problems already, don't they? It is good you care, because, as you say, it directly affects you.The DEA does not control which drugs are on what schedule. The FDA provides the determination on the classification of drugs, the DEA implements the determination by the FDA by amending current federal regulations, or implementing new ones. In January of 2012 the Public Advisory Committee met to consider whether HCPs should be reclassified from from III to II. That committee has doctors and pharmacists on it. Not a single lawyer or politician are on that committee. That committee has a consumer representative and an industry representitive on it. They voted 19 to 10 in favor of recommending upscheduling. From there it went to the Director of the FDA, a doctor, who approved and adopted and approved that recommendation. They then sent it to the DEA requesting that they issue new regulations. They are required to go through a rule making process, with more testimony and opportunity for public comment. They implimented the reccomendation of the FDA, announced a New Rule" in the summer of 2014, which became effective in October of 2014. Here is the best synopsis I could find, it happens to be by the pharmacists'association, which took a neutral position.http://www.pharmacist.com/fda-advisory-committee-votes-favor-hydrocodone-rescheduling Here are the minutes of the Advisory Committee meeting which show who the members were and their backgrounds. All if the testimony from that meeting is available in line, it was available for live streaming at the time. All submissions are available, as well as all of briefing materials given to the members prior to the meeting. 19 to 10 is about a 2 to 1 ratio. It doesn't mean they were right. There obviously 10 members with an opposing viewpoint. In 2012 there was also a meeting to upschedule Hydocodone, this was opposed by HHS, and the vote was about 11 to 1 against as I recall. So what changed? New data about rise in prescriptions for HCPs, overdose data, epidemogical studies, etc. At this meeting in 2013 some family members of on people who overdosed on HCPs testified, which I am sure had an emotional impact. Hydrocodone had always been a schedule II drug. Hydrocodone, less than 15mg, mixed with other substances was a class III. It looks to me, the big concern of the doctors on the committee is that oxycodone, including Oxycotin, prescriptions have remain flat along with production, while hydrocodone has surged over the same time period. The facts just do not support your conclusion that the upscheduling was the result of politicians and lawyers. Lawyers, I am sure, wrote the amended regulations, but that is what lawyers do. If the committee of the FDA had reccomended against upscheduling, it never would have happened. So if you want to paint with broad strokes, yes politicians and lawyers are to blame, for everything you find right with the country, and everything you find wrong. But the reccomendation in this specific instance wad 19 doctors and pharmacists against 10 of the same. Travis That's the process. My concerns are the political motivations. You can say DEA is just some "typists" following direction of doctors, but that's politically naive. Here's a quote from the director of the American Academy of Pain Management:"Despite the efforts of the Academy’s policy and advocacy staff to suggest less restrictive alternative strategies to reduce misuse, abuse, and diversion of HCCP, rescheduling is soon to be a reality. While we remain concerned about the potential implications of this change for patients’ access to HCCP, we hope that pain management clinicians will find ways to accommodate patients’ needs with minimal disruption. Please inform us if you encounter unanticipated problems, or if you have suggestions for practices that you have found helpful in responding to the change in scheduling. And, as always, thank you for being a member of the Academy, the nation’s premier organization for all clinicians who provide pain care." Our total drug policy in USA is derived from the global war on drugs, devised and directed by the USA. in that realm, no one is concerned about health matters of sick people. No one. The little people at the bottom of all that heap of policing are always the losers, just like this time. From prison terms to pain patients, none of this war on drugs that is about health or helping people. That's never the motivation of these laws and regulations. If health was of interest BOOZE and CIGARETTES would be the targets. Doesn't take a genius. There is an old expression that people can not comprehend the meaning of a forest when they are counting branches on a tree. I'm way too stupid to argue the inner detail of government rule making processes with you that are filled with legal jargon. But not so stupid that I don't understand what motivates kings, crooks, moneymen, and power mongers in any society. Just because the weak are powerless doesn't mean they can be fooled by legal snowjobs. Why? Because we can all see the forest no matter how many trees put up. My doc is extremely wise and experienced and not a politician. She explained the great financial pressure through Medicare that is always a federal hammer. This is far more involved than is being represented here. Thanks for the discussion. Note: dictated to, and typed by Jessica for Joe. It is all politics, but not necessarily elected officials. It is all about money, even if it is only to increase the size of one's own agency. They took a vote, 19 to 10, that sounds pretty political to me. Even so, it was pretty transparent. You would think the doctors would be all for it, reclassification, they get you in twice as often. But about a quarter of hydrocodone scripts are written by GP, family practice doctors, I could see them being against it big time. I don't understand why the pharmacists' association took a neutral position, I would think that there would be more money in it for them, but maybe it is more paperwork and money they can't be paid for. The good news is you apparently have good doctors and you are able to get what you need. Unfortunately my friend Joe's wife could not, and I am really pissed off about that. Travis

Great quote, from a great book. Which is why we have a Republic. James Madison expressed it very well in Federalist Paoer No. 10.

Was it lawyer driven? Was it doctor driven? Do you know? Do you care?The head of the FDA is a doctor, an MD. I doubt they had politicians testifying regarding at hearings about whether to change the classification. yeah, I care because I am affected. 1. the DEA is how drugs get on different schedules, right? pasted The Obama administration moved Thursday to restrict prescriptions of the most commonly used narcotic painkillers in the U.S. in an attempt to curb widespread abuse. The Drug Enforcement Administration said it would reclassify hydrocodone combination drugs such as Vicodin and put them in the category reserved for medical substances with the highest potential for harm. The "rescheduling" means people will be able to receive the drugs for only up to 90 days without obtaining a new prescription. The opioid pills are taken by millions of Americans, including after dental surgery, for back problems and broken bones. Currently the pills can be refilled up to five times and prescriptions can cover a 180-day period. The new classification will take effect in 45 days, the DEA said. "Today's action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available," said DEA Administrator Michele Leonhart. ------------------------------------------ 2. who is michele leonhart? A doctor? Um, no. she is not a doctor. pasted--Leonhart graduated from Bemidji State University in 1978 with a degree in criminal justice, ------------------------------------ drugs is politics my friend. did you watch the colorado changover to legal pot? yes, therre are doctors in agencies, but rules are made by legislators, cops and lawyers. so do I care? yes I care. I care that my health is in the hands of actual doctors, not cops lawyers and legislators with their political and money agendas. i was on pain meds for several years with no problems of any kind BEFORE michele leonhart, a bureaucrap cop and politician changed the rules and schedules. the change? more inconvenience and insults and cost and much indignity. but why would lawyers and pols care about any that??? LOL!!! jus teasin ya~! your chasin a fly when you should spend your time chasin the big game - booze and cigs. christ, leave the sick people alone, they have enough problems already, don't they? It is good you care, because, as you say, it directly affects you.The DEA does not control which drugs are on what schedule. The FDA provides the determination on the classification of drugs, the DEA implements the determination by the FDA by amending current federal regulations, or implementing new ones. In January of 2012 the Public Advisory Committee met to consider whether HCPs should be reclassified from from III to II. That committee has doctors and pharmacists on it. Not a single lawyer or politician are on that committee. That committee has a consumer representative and an industry representitive on it. They voted 19 to 10 in favor of recommending upscheduling. From there it went to the Director of the FDA, a doctor, who approved and adopted and approved that recommendation. They then sent it to the DEA requesting that they issue new regulations. They are required to go through a rule making process, with more testimony and opportunity for public comment. They implimented the reccomendation of the FDA, announced a New Rule" in the summer of 2014, which became effective in October of 2014. Here is the best synopsis I could find, it happens to be by the pharmacists'association, which took a neutral position. http://www.pharmacist.com/fda-advisory-committee-votes-favor-hydrocodone-rescheduling Here are the minutes of the Advisory Committee meeting which show who the members were and their backgrounds. All if the testimony from that meeting is available in line, it was available for live streaming at the time. All submissions are available, as well as all of briefing materials given to the members prior to the meeting. 19 to 10 is about a 2 to 1 ratio. It doesn't mean they were right. There obviously 10 members with an opposing viewpoint. In 2012 there was also a meeting to upschedule Hydocodone, this was opposed by HHS, and the vote was about 11 to 1 against as I recall. So what changed? New data about rise in prescriptions for HCPs, overdose data, epidemogical studies, etc. At this meeting in 2013 some family members of on people who overdosed on HCPs testified, which I am sure had an emotional impact. Hydrocodone had always been a schedule II drug. Hydrocodone, less than 15mg, mixed with other substances was a class III. It looks to me, the big concern of the doctors on the committee is that oxycodone, including Oxycotin, prescriptions have remain flat along with production, while hydrocodone has surged over the same time period. The facts just do not support your conclusion that the upscheduling was the result of politicians and lawyers. Lawyers, I am sure, wrote the amended regulations, but that is what lawyers do. If the committee of the FDA had reccomended against upscheduling, it never would have happened. So if you want to paint with broad strokes, yes politicians and lawyers are to blame, for everything you find right with the country, and everything you find wrong. But the reccomendation in this specific instance wad 19 doctors and pharmacists against 10 of the same. Travis

Was it lawyer driven? Was it doctor driven? Do you know? Do you care? The head of the FDA is a doctor, an MD. I doubt they had politicians testifying regarding at hearings about whether to change the classification.

So I am guessing you checked out webmd link and saw that Hydrocodone is in fact the most prescribed drug in the United States, because this response seemed to come out of left field and glossed over the fact that it is the number 1 Rx. You mentioned that education was the key, I think it probably is, but I don't know what you mean precisely when it comes to opioid pain killers. Education works pretty well with legal substances such as cigarettes and alcohol. However, who does education work with prescription pain medication? Should we teach in schools that pain medication can be habit forming and you should never take another person's medication? Or that you can die from it if you take too much. Or are you saying education is key by trying to change the public's perception about people who are on long term pain meds? Your facts about who abuses HCPs are simply mistaken. Over 15,000 deaths a year overdosing on prescription HCP PILLS. More than Cocaine and Heroin combined. That is just a fact. I do not see any problem with people taking HCPs long term, under a doctor's care and supervision. I don't think that the public believes that it is inappropriate. I think with all substances people are going to have different viewpoints about every kind of drug, based on personal experience, hearing from close friends, whatever. Some reformed smokers will tell you that cigarettes should be banned from the face of the earth. Some recovering alcoholics say the same about alcohol. Some people believe that caffeine is a gateway drug. People are frequently misinformed about a lot of drugs. For example, what are the long term effects of long term daily use of HCPs? For many there is no alternative in order to have any quality of life. However, to say there is no consequences to being on HCPs based on personal experience isn't really responsible in my opinion. Someone might be the one in a million who suffers no side effects. People shoukd be made aware of what the possible problems are, the probable risks, wtc. They should be asking their doctor, and double checking him or her with other valid medical sources. How many people said "I have been smoking for 30 years and it hasn't caused me any problems whatsoever. I can quit anytime." The science and the studies were against them, the fact that nicotine is more addictive than heroin has been well established. So, the question is, should HCPs have been moved to a Schedule II drug? Is it too restrictive for those in real need? Will it work to solve the perceived problems? I haven't made u0 my mind yet, but I think it is important for people to know the facts underlying this, or any other, issue.

I think you have accurately stated the problems that were used as part of the rationale for the Schedule change. In many states the schedule change allows the regulating drug authority to see in real time what a doctor is prescribing and also allows pharmacies to see if a patient is filling multiple prescriptions from multiple physicians. It will be interesting to see if the schedule change reduces the abuse, without restricting their availability to those who really need them. Travis

Yes, I think that is true, let the doctors and medical professionals practice. However, there is a problem, real or perceived, that there is a significant number of people that are not really in pain requesting HCPs, and a significant number of doctors willing to write those prescriptions. The FDA is pretty much run and staffed by MDs, with plenty of advanced degrees in public health policy. As I said before, the move from schedule III to II was a 10 or 15 year process. This last go around there were public hearings, hearings, etc. I do not know what the AMA's position on the schedule change was. The doctors I have talked to about it, less than 10, are generally split, so the AMA may have taken no position on it. I really haven't formed an opinion one way or the other on the rule change, but I was quite surprised several years ago when I learned that OxyContin was a schedule III drug. Travis

Dean,GPs are no longer allowed to prescribe opiate pain killers period! Roger To me that is overboard. A dentist can prescribe opioid pain killers. A lot of GPs perform minor surgery in their office, it seems to me that it would be perfectly appropriate for then to perscribe 3 or 5 days worth of pain meds.The whole world is off its rocker. Travis, I just read this yesterday looking for another article as I was not previously aware of it. If I could find the link, I would have posted it. Roger It could be a state by state thing. FDA reclassified it from III to II. I just checked, any licensed physician in Texas with a DEA number can prescribe Class II drugs, including HCPs. It is going tohurt NPs and PAs who were allowed to write HCPs when they were class III. Now only the only NPs and PAs who can write Class II HCPs are those who work in a hospice or hospital.

Dean, GPs are no longer allowed to prescribe opiate pain killers period! Roger To me that is overboard. A dentist can prescribe opioid pain killers. A lot of GPs perform minor surgery in their office, it seems to me that it would be perfectly appropriate for then to perscribe 3 or 5 days worth of pain meds. The whole world is off its rocker.

From the NIH The Link Between Early Alcohol Use and Alcohol Dependence Early alcohol use may have long–lasting consequences. People who begin drinking before age 15 are four times more likely to develop alcohol dependence at some time in their lives compared with those who have their first drink at age 20 or older (25). It is not clear whether starting to drink at an early age actually causes alcoholism or whether it simply indicates an existing vulnerability to alcohol use disorders (26). For example, both early drinking and alcoholism have been linked to personality characteristics such as strong tendencies to act impulsively and to seek out new experiences and sensations (27). Some evidence indicates that genetic factors may contribute to the relationship between early drinking and subsequent alcoholism (28,29). Environmental factors may also be involved, especially in alcoholic families, where children may start drinking earlier because of easier access to alcohol in the home, family acceptance of drinking, and lack of parental monitoring (27,26).

88,000 deaths a year due to alcohol. 15,000 overdose deaths from prescription pain meds a year. I do not know how many, if any, they say die from years if taking pain medicine. I know most people on long term pain meds have to have their liver panels checked regularly, so I assume there was be some number associated with early death due to liver disease. It would seem that alcohol, given the numbers, is more in need of regulating than opioids. We all know that we triednthat, it was an utter failure, and was repealed. I think alcohol is one of those things that education at home, at an early age that works. Especially if their is alcoholism on either side of the family. There is very strong data that every year a child delays trying alcohol for the first time significantly reduces the risk of being an alcoholic or problem drinker later on. Many parents, including my own, weremof the opinion that being expised to it at, in moderation, at 16, 17, in a controlled environment was beneficial as opposed to trying it away from home. The research seems to disagree with that philosophy.

Sure you can ask, but I don't think it is going to get any answers in a discussion about a medical issue, the treatment of chronic pain, as it relates to a public policy issue, is it appropriate to regulate the drugs commonly prescribed for chronic pain, and if so, to what degree. They don't typically go to people to give anecdotal accounts in order to answer those types of questions. Nor do they formulate oublic policy because someone says, "hey I have been using X for 5 years and it totally saved my life." There is no question that the best we have right now for the treatment of chronic pain, at least in the short term, is opioids. I don't believe that anyone, certainly mot me, would argue that should be the case. The specific question at issue here is whether drugs such as Vicoden and Oxycotin should have been moved from Schedule III to II. That is all that hapoened, and some feel that is appropriate, others feel that is way too restrictive. That wasn't a knee jerk reaction by the way, it has onky been under consideration by the FDA for at least 15 years, and was debated back in '70 when the schedules first came out. Back then they were brand names, the ones we all know, and the AMA and drug lobby was heavily involved. Funny you shoukd mention Bill Cosby, Lemmon/Roehr took quaaludes off the market beca6se they were "highly addictive." They were at one time the most prescribed sleeping pill in the US and in the market for over twenty years. Darvocet, an opioid was recalled by the FDA after over 2000 deaths between 1981 and 1999. It was finally removed from the market, after 55 years, in 2010. The FDA was petitioned 3 times to remove it, and finally did no a full five years after Great Britin pulled it for being a major risk if heart problems. I am sure there were many, many individuals who received significant benefit from each of those drugs, with no harmful side effects. But that isn't really the issue. The issue isn't the individual, it is how it effects a large group of people. More and more data comes in, some drugs are proven to be very, very safe, and eventually made available without a prescription. Others are show to be too risky to benon the market even though they help a majority of people who take them. Others are shown to have risk factors like dependency/addiction and are more tightly regulated such as diet pills, Methylphenidate, and methamphetamine (Ritilan, Adderall, etc.). The pubic policy discussion doesn't concern itself with the individual, by definition. It is whether there is a real issue that creates a problem to the PUBLIC, if so, how to address it, and then whether that plan is effective. So the first question is whether low dose opioids, the classification of drugs in question, were creating a problem for the public. Where they being over prescribed,? subject to abuse? to easy to obtain from doctors? That resulted in too many deaths. Those, to me, are the questions to be asked and discussed initially, nit whether you, or I, or anyone else never had a problem with them. If there was/is a problem, was it appropriate to reclassify it? Has reclassification made it difficult or impossible to get the treatment they need. Finally, are there better alternatives to deal with the problem. The history of how the US has dealt with opioids, from oure heroin being contained in liquid products sokd by Bayer when there was no regulation, through three waves of oublic policy debate resulting in federal and state regulation isnin the times article. Those are the facts abiut the regulation and some facts about what was discussed in this latest round. The facts are the facts, whether that justified a policy change is for people to reach there own conclusion. As for the facts about pain meds, I have cited to a peer reviewed journal by one of thenleading experts in the US on opioids and their pitential for addiction and the problems that causes doctors. Again, that is peer reviewed science, the conclusions to be drawn from that are certainly going to differ based on individual perspective. I doubt Dr. Fields has been on a morphine drip, had chronic pain or been on pain meds for any significant duration. But he is one of the guys who discovered their pathways, what exact neurotransmitters and receptors are involved, and specifically what hapens in the limbic system when opioids enter the blood stream. Here are the l7mks again for easy reference. http://www.ncbi.nlm....33/#!po=2.27273 Here is a great history of opioid use and regulatiin in the United States: http://www.nytimes.c...?abt=0002&abg=0

Double

What then is the education you suggest?

You were not dependent/addicted/hooked because you were on a relatively low dose, or short time, or were weaned according to proper protocols. You should leave the hospital with no cravings. Some don't, for a variety of reasons. Others leave the hospital pain free but with a script for high does of ms cotin or oxycotin for pain to take "as needed" for pain without any regulation and run into problems. So what is the answer? Go back to Schedule III? Keep it where it is? Should a doctor even have to prescribe it? We are in our third major cycle of regulation on oral pain meds in the US, which appears to be a reaction to dramatic rise in prescriptions being written and overdose deaths, over 15,000 a year. I don't think the families of the 15,000 really care if it is drug dependence, addiction, or abuse. People with chronic pain have posted on here they can get their meds, they go to their doctor, get the Rx, take as directed. That seems to be working to some degree, with some hassle that is livable. Yet I went to a forum friend's wife's funeral this year, they cut off or restricted her pain meds and she just got to the point she couldn't deal with it anymore and took an alternate way out. Things obviously were not working the way they should in that situation. You can get any Rx pain meds you want in the street, morphine, in all forms, codine, in all forms. Seems to me you can work in it from supply or demand, or balance the two.