There was a big, huge, yuuuge hearing at the Mississippi Medical Board of Licensure last week on proposed opioid regulations. That hearing will be the subject of an upcoming post. The proposed regs were based upon recommendations made in September by Governor Phil Bryant's Opioid and Heroin Study Task Force. However, JJ will first take a look at the task force's recommendations before diving deep into what was covered at the hearing last week so don't get lost in the weeds. Most of the issues that will be discussed in related posts begin with this task force.
Make no mistake, there is a serious problem with opioid abuse. The Clarion-Ledger reported in June:
Mississippi drug overdose deaths have reached a record high — boosted in part by heroin, sometimes laced with the even more dangerous fentanyl.
“Mississippi is emerging on the brink of a super pandemic,” said state Bureau of Narcotics Director John Dowdy. In 2016, Mississippi saw at least 211 deaths from drug overdoses — the highest in state history.
Dowdy derived that number from death certificates. He suspects the real number is much higher as evidenced by drug tests, which would increase the deaths to 220 (with oxycodone detected in 45 deaths and fentanyl detected in 33 deaths).....
(Commissioner of the Department of Public Safety) Marshall Fisher said heroin had almost vanished from the landscape when he moved in 2003 to Mississippi to head the Drug Enforcement Administration office.
Fisher said the only heroin cases he saw then were when authorities busted cars heading for other places, such as Chicago and Atlanta.
In 2011, he began to witness a wave of overdoses involving opioids — a family of the often addictive painkillers derived from the morphine molecule, including morphine, fentanyl, oxycodone, hydrocodone and their illicit cousin, heroin.
Mississippi is one of a handful of states where there are more opioid prescriptions than there are people.... Rest of article
Governor Phil Bryant appointed a task force last year to study the rise in opioid-related deaths and addictions in Mississippi. 4 of the 13 members represented law enforcement while the rest represented the health care industry in some capacity (See p.3 in the documents posted below for a roster of the members.).
The report includes recommendations for increased monitoring, better reporting, including all medial professions that can write prescriptions,more aggressive use of the Prescription Monitoring Program (PMP), and don't laugh, increased funding for treatment facilities (Sarcasm. This is Mississippi. We don't do no treatment 'round here.).
*The task force recommended playing a limit on prescribing opioids for acute non-cancer pain: "Providers should be discouraged from writing more than a 3 day supply of opioids for acute non-cancer pain, and shall not provide greater than a 7 day supply for acute non-cancer pain. Providers may issue an additional 7 day supply if clinically necessary, but must be issued in accordance with Title 21 CFR § 1306.12...."
*Drug Testing: "Point of service drug testing should be done each time a Schedule 2 medication is written for the treatment of chronic non-cancer pain. Point of service drug testing should be done at least every 90 days for patients on benzodiazepines for chronic medical and/or psychiatric conditions."
*Discourage the use of methadone
*Increase the tax (actually called a "surchage) on all schedule 2 and 3 medications sold in Mississippi. The report later recommends taxing all pharmaceuticals to generate revenue to fund treatment program and marketing campaigns.
*Exclude from drug courts anyone who has a charge of sale of controlled substances.
*Increase prison sentence for those who sell illegal drugs that result in death or serious bodily injury to 40 years to life.
Kingfish note: There is one interesting appointment: One Joey East, Chief of the Oxford Police Department and past-President of the Mississippi Association of the Chiefs of Police. Where have we heard of his name before? Oh yes, Sixty Minutes and other media reported on the controversial use of confidential informants in by Chief East and other law enforcement officials in Lafayette County. East also led the charge against Rivers' Law after it passed the House this year.
What is ridiculous is the recommendation that the state impose a sentence of at least 40 years on people who sell drugs that result in death or serious injury. 40 years? We don't even give out that kind of sentence for manslaughter most of the time. Indeed, DPS Commissioner Marshall Fisher was complaining about the overcrowded prison population when he was MDOC Commissioner. He said at the hearing last week that "we can't arrest our way out of this problem." Square that comment away with the recommendation of a sentence from 40 years to life.
Thus the task force wants to lock 'em up, raise taxes, spend more money, and place more doctors under the control of the police.
More will be posted. Stay tuned.
24 comments:
Surgeons are furious that every patient who gets a prescription for a pain me after surgery must have their history checked in the statewide data base mentioned above to see if they have any current prescriptions outstanding, and their data has to be printed and placed in the chart and the physician has to certify that he/she has reviewed their data.
Now, no one is getting released from a hospital after major surgery without pain medicine, so this mandatory charge is a huge waste of time. Remember, time = money, so guess who will be paying for this additional and unnecessary expense.
Rumor in town is that one large single-specialty group has notified the Board that they will no longer write any prescription for any narcotic (these are not surgeons, and don't write nearly as many pain scripts). Some have suggested they should just refer all patients who need pain meds to the pinheads on the Medical Board and insist they write the scripts according to their own poorly thought-out rules.
Pinheads?
Or grandstanders running for office?
You’re right Kingfish, and Fisher is right when he said we can’t arrest our way out of this. So they should stop trying by incarcerating low level users and sellers (they are usually the same people). Excluding them from drug court is a terrible idea. Prison doesn’t work for these folks because heroin is readily available there.
Like with lottery tickets.....drive to Louisiana.
I think you do a lil more time in LA.
And, in other news, somebody smart who actually studies the problem and wants to help with the problem: http://www.msnewsnow.com/story/36874856/rep-joel-bomgar-does-analysis-of-cdc-opioid-data
I suspect these are foreign made drugs mainly from Afghanistan or Pakistan being brought into the state by our own military aircraft...
I'm looking forward to your reports. KF, were you at the meeting?
"Point of service drug testing should be done at least every 90 days for patients on benzodiazepines for chronic medical and/or psychiatric conditions."
Why do they always try to overextend their authority? This is about the opioid crisis. There is no benzodiazepine crisis. But yet, as they seemingly always do, throw in another unassociated regulation. For what?
We are from the government and are here to help you.
How has that plan worked to date?
It's always a good thang to control stuff we can get legally. Creates another level of bureaucracy. Lots of money for grants and studies. Keeps caterers in business. Solves problems. Gets elected officials appointed to national committees and task forces. Take whiskey control in Mississippi for example.....
From what I understand, the street drugs proporting to the Oxycodone are often a small amount of oxy and cut with Fentnyl, which is much cheaper. The drug dealers are using pill pressers to make this mixture look just like legitimate pills, when in actuality, they can be lethal. This is why such a strong sentence should be given, because their deception is causing death. Granted the user (addict) is complicit in their own death but so is the dealer whose deceptive product causes death.
That’s a weak argument for a dumb lock ‘em up approach, 9:28. Many of these folks are overdosing on legitimate, prescribed opioids and benzodiazepines, often used with alcohol. Should we also prosecute the pharmacist, physician, and bartender? This won’t solve anything, but will cost a lot of taxpayer dollars and do absolutely nothing to make us safer.
Does that 40 years to life include the doctors who continually write prescriptions for anyone with the money to pay for an office call?
Because the dealers are not poor black men, they are allowed to keep doing it. The doctors and pharmacists are flooding the streets with this stuff.
I don't know what the solution is, but I want to get this off my chest because it's something I've had to deal with every day for a couple years now and has recently come to a head. My grandmother was prescribed a large amount of painkillers for her "chronic pain" after falling at her work a few years ago and having a knee replacement. I think she's prescribed something like 4-6 percocets a day. At first my biggest concern was her being a victim of a home invasion by someone who knew she had a large amount of these pills in her home, then slowly realized that my biggest concern should really have been her abuse of these pills. It all came to a head in September when her son (a heroin abuser) died, maybe killed himself (walked in front of a semi truck). Her oldest son (also a heroin abuser) died when I was in middle school (also struck by a vehicle and killed), so the loss of both her sons was obviously very traumatic for her, and two days later she ended up overdosing on her pills, whether intentionally or because she "forgot" how many she took (as she told the doctors in the hospital). I stayed in the hopsital with her along with her mother (great-grandma). On the third day in the hospital, my great-grandmother had a stroke. She hadn't been taking her stroke meds because she'd been too concerned with her daughter's well-being. She spent a month in stroke rehab, and is now released with her own prescription for these "pain killers". Whenever I talk to her, she is totally out of it, high as a kite just like her daughter. My mom has illegally abused these drugs too - in fact, as a teen when I got all my wisdom teeth removed and was prescribed these drugs, my mom stole them all from me. It's really so depressing - I feel like I've lost my entire family to these drugs both legally and illegally and there's not a damn thing I can do about it. Anyway, sorry for the worthless novel, but I don't think there's a single person in this state who hasn't been affected by this epidemic in some way. My little sister is a counselor at a methadone clinic in AR and I don't think "done" is the solution either. I've worked with "done-heads" in construction when I lived in Memphis and they were zombies, just living their lives until they could get the next "fix." I pray that Trump keeps bombing the hell out of those poppy fields and drug labs because it's at least that much of the crap that won't end up in someone's blood stream somewhere down the line.
Or, you could just end the ignorant drug prohibition? Then, say if someone were addicted, they could get treatment with far fewer fears of prosecution, loss of job, social stigma (look into Portugal's decriminalization)? Or, were someone not willing to seek treatment, at least they could go to Wal Mart and get a bottle of whatever that had a known dosage value and eliminate both a great number of overdoses, but any violence inherent to trading in illegal drugs. It would be like alcohol (you can stop preening, moralizers, alcohol kills way more people)...far fewer overdoses, liquor and beer reps don't have running gun battles in the street so violence would greatly decrease, and we could quit incarcerating so many people for violating government drug laws. Completely legal to sell a handle of Everclear to anyone with the money to heft over the counter, but good gracious forbid one buy a bottle of pills.
Won't happen. Why?
Tough on crime. And by that, I mean anyone that isn't wealthy and white. Sure, your scion does a little blow and gets caught dealing to his friends...court gives him 'treatment' and a little supervision. Poor black kid sells some weed to someone and he's doing hard time. Can't have those darkies getting all hopped up and attacking all the white women. And let's be honest, the wealthy are still going to be allowed to doctor shop and buy their pills illegally.
Those assets aren't going to seize themselves. Big business in taking property from drug offenders. Besides, then cops wouldn't get to dress up in tactical gear, throw flash bangs in kids' cribs, kill pets, or ruin someone's life so they don't use a product of which they don't approve of or profit from.
Prisons and probation industries won't continue to thrive. And drug testing, can't forget them. Policing might actually then have to focus on solving crimes that have a victim. Tracking down thieves is way harder than controlled buys from a high school drop out...especially once you go down the 'confidential informant' rabbit hole.
One could walk out right now and shoot a neighbor dead in broad daylight in Jackson and get less time than a drug 'offender.' Our moral compass is far beyond broken.
10:58 - I was going to read you post but I refuse to read 540 words strung together without benefit of the first 'paragraphing' click.
I had a total ankle replacement at the end of September- the pain was horrible. My Doctor prescribed Norco to help with the pain. I had to stay off of my foot for six weeks. The doctor prescribed 50 pills. I have been very careful on what I take - It has been two months since my surgery- The nurses at St D told me when I felt the pain coming on to take one. Let me reinterate that I had a total ankle replacement, which takes the weight of your body fully. It has been eight weeks and I still have about ten pills left. If the surgeons are not allowed to prescribe pain medication for a ankle or for that matter a hip, a knee, a shoulder surgery. If you are only given a prescription for seven days, you are going to have to jump thru hoops (I can't do, by the way) to get another seven days supply. All this is going to do is make people that do need the drug buy it on the streets. I think of the 24 year old young man who bought it on the street. He later died and they found out it was about 100% fentanyl. I hope that they will reconsider this policy. I also see that the vice chairman of the Governor's commission is in the runoff for Representative from Vicksburg. We have a lot of good doctors in this state, but as with any profession, you have a few bad ones.
I am 71, take 3 tramadol a day for 9 years. Thus far I've sold none, never get high and run amuck, can get out of bed each day after my 1st pill kicks in and do a somewhat normal day of caring for myself. Had to retire at 52 due to severe rheumatoid arthritis, have some surgery needed but can't do it at this time due to embolisms last year, and have a variety of other health problems which make NSAIDs and other painkillers wrong for me according to physicians. Specialists in 3 different areas plus gen practitioner agree the current set of meds I take is what I need. Failing to get moving each day, which is too painful without tramadol, is going to result in worse problems. Let's see: 3 day supply, my pharmacy isn't open Sat/Sun, don't always have transportation & am not physically able to drive some days, am driven out of state nearly every month for a few days to visit relatives. That should make simply getting that one medication a life's purpose for me. Are they crazy or just cruel?
7:16 I understand. I am 40 with a pinched nerve in my back that can not be fixed with surgery due to risk of complications. Or so I am told by numerous experts. I have done therapy, chiro, I exercise as best that I can and lost weight to try and “help myself.” I can take four Advil and four Tylenol four times a day and still not be able to work and raise my family. But by taking three norco a day I am able to survive and compared to most people in the world have a good life. But I have never sold stolen or doctor shopped for meds, which my prescription records would confirm. I work in a professional job and otherwise would be on disability as a drain to the taxpayer. I understand there are problems that need to be addressed but don’t stop legit doctors from treating legit patients. Chronic pain is depressing and difficult to deal with for those who have not experienced it. I was perfectly healthy until a car accident and it ruined my life. Just wanted to share my story. It is very touchy when you can’t phyaically play with your children or do basic tasks. Celebrex raises my bloood pressure too much so I can’t take it every day.
Some of y’all need to learn how to read...
@716 — those day limits are for ACUTE pain, not for chronic pain
It's quite obvious that the people who own the Governor, find addicts PROFITABLE. More addicts equal more profit. Treatment centers and for-profit prisons, are grand cash cows.
As a relative of an addict (who finally died - but not before her addiction ripped-apart our family, and bankrupted her father), I speak from experience, when I say that their death comes as a huge relief - to EVERYONE, including the addict.
When the state's "leaders" were up in the news, a few months back, announcing the new policy concerning LEOs carrying anti-overdose meds, I was livid. This is the poorest state in the union. Not only can we not afford the meds, we cannot afford the addicts. We cannot afford the thefts, the embezzlement, the damage to property, the empowerment addicts give to drug dealers, and all the other problems addicts create.
The lives of addicts are hugely expensive, in every way. The sooner those lives END, the better. Addicts are miserable, and the misery only ends, when they die. It is a MERCY, when they die.
But addiction is making certain people rich. 'Feel' wants more addicts, because addicts enrich the people who own him. OF COURSE none of the state's new drug initiative makes sense. They WANT the situation to get WORSE - not better. Worse = MORE PROFIT.
Great idea. We could use this for smoking and drinking. Maybe we limit drinking to only 5 drinks for which you have to go to the specialist to get a press. They go back to see him when you run out where he will test you and if nothing is in your system he will only prescribe 3 more for the month. Same with cigarettes. Smoking and drinking cause far more deaths and cost to citizens. Phil we need a new committee.
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