Another opioid lawsuit.

[sas5814]

For a long while I have heard people talk about Walmart making internal policies about opioid prescriptions with restrictions far above statutory requirements and adding special requirements. Now I read this in this mornings news. Makes me wonder if they didn't see this coming and tried a little preemptive damage control:

 

WalMart and CVS

[CAAdmission]

Enough's enough with this already. No personal responsibly in this country. You want to take highly addictive medications - many of which were likely demanded by the patients themselves - you own what happens. 

[SedRate]

“I am grateful to the Court for recognizing the Opioid Epidemic as a public health crisis. This decision holds Big Pharma accountable for the great harm and lives lost due to the overselling of Opioids."

I think I am missing the actual point of the lawsuit. Were they overfilling? Had automatic refills? 

[sas5814]

1 minute ago, SedRate said:

“I am grateful to the Court for recognizing the Opioid Epidemic as a public health crisis. This decision holds Big Pharma accountable for the great harm and lives lost due to the overselling of Opioids."

I think I am missing the actual point of the lawsuit. Were they overfilling? Had automatic refills? 

They filled prescriptions. That is their "crime". They filled lawfully written prescriptions.

[CAAdmission]

Didn't you hear? Lawsuits have become the great American lottery

https://www.yahoo.com/entertainment/nike-sued-family-murdered-man-100046968.html

In 2015 alone, a staggering 1,200 young American's died because of violence surrounding shoes like Nike Air Jordan and other popular, high-demand/low volume releases, which are destined to create relentless desirability

Edited August 19, 2022 by CAAdmission

[rev ronin]

12 hours ago, sas5814 said:

They filled prescriptions. That is their "crime". They filled lawfully written prescriptions.

I'm sure there's a "should have known" element to this.

[VentiMacchiato]

They should also sue JCAHO :J then. In the 1990s, we (nurses) got in trouble if we did not document patient's pain level and we HAD to address them. The organization and other orgs also came up with their "Pain Management guidelines." Did that also contribute to the opioid crisis? One drug rep told me that, oh, [name drug here] is an extended release form so it can't be addictive! LOL

A few years ago, I met a DEA agent at a function and he said the cartels were going away from street drugs because there was more to be made on the opioids. 

Still, personal responsibility should account for something.

Edited August 19, 2022 by VentiMacchiato
words

[CAAdmission]

1 hour ago, VentiMacchiato said:

Still, personal responsibility should account for something.

I know I'm unfashionably old-fashioned, but I still think personal responsibility accounts for everything. If I take meds that common knowledge states are addictive and get addicted, that's on me. (If you don't have the common knowledge, you have all the instructions and stickers on the bottle that the pharmacist gives you.)

If I buy a gun and shoot myself because I didn't check if it was empty before cleaning it, that's on me. 

If I buy a chainsaw and accidentally cut off my arm, that's on me. 

I'm sure there is no shortage of dimwitted prescribers out there, but people need to take overall responsibility for their lives. 

[SedRate]

On 8/18/2022 at 12:21 PM, sas5814 said:

They filled prescriptions. That is their "crime". They filled lawfully written prescriptions.

No wonder why I didn't understand it. It's nonsensical. 

[wilso2ar]

On 8/19/2022 at 2:35 PM, VentiMacchiato said:

 One drug rep told me that, oh, [name drug here] is an extended release form so it can't be addictive! LOL

 

I have worked in pain management for 14 years.  I have met many opioid drug reps in the past.  I have never had a drug rep tell me this.  

I do agree with CAAdmission, there needs to be some personal responsibility for this as well.  Every single time a patient gets an opioid they sign a consent form that clearly states the dangers of opioids. We have been doing this for the past 4-5 years now.  Does this protect me as a prescriber? Probably not, but at least they can't say they didn't know the potential danger.

One thing I've learned with chronic pain and opioids is I prescribe about 1/4th the dose of opioids that I did 10+ years ago and people are just as miserable now as they were then. But they are safer now due to the lower dose of opioids.  

[sas5814]

1 hour ago, wilso2ar said:

I have worked in pain management for 14 years.  I have met many opioid drug reps in the past.  I have never had a drug rep tell me this. 

Back in the day the Purdue rep was touting, I think, Oxycontin as non-addictive and "impossible" to abuse because of the way it was formulated. When we first started working on getting scheduled drugs in our enabling legislation (late 90s/early 2000s) their medical director wrote letters of support for us. Looking back I now know it was all just part of the marketing hustle. It was still the days of "pain is the 5th vital sign."  A lot has changed since then. 

We created this mess and suddenly the switch got flipped and we were supposed to turn it all off. I inherited my current panel of 1100 people which included 86 people on schedule 2 drugs about 15 months ago. I have worked my ass off getting people off these meds or, when appropriate, transitioned to buprenorphine. I just handed my panel off to a new doc and the number is down to 54.

They all have a "pain contract" though we aren't supposed to call it that any more and mostly they follow it. When they don't they get tapered off their meds. That is when the real fun begins. They don't take any personal responsibility. I had one guy package up all his non-opioid pain meds and Fed-Ex them to me at the clinic with a hate note telling me what I could do with them. Oy vey.

Edited August 24, 2022 by sas5814
Date correction

[SedRate]

5 hours ago, sas5814 said:

When they don't they get tapered off their meds. That is when the real fun begins. They don't take any personal responsibility. I had one guy package up all his non-opioid pain meds and Fed-Ex them to me at the clinic with a hate note telling me what I could do with them. Oy vey.

Oy vey indeed. SMH...

[VentiMacchiato]

7 hours ago, wilso2ar said:

I have worked in pain management for 14 years.  I have met many opioid drug reps in the past.  I have never had a drug rep tell me this.  

 

6 hours ago, sas5814 said:

Back in the day the Purdue rep was touting, I think, Oxycontin as non-addictive and "impossible" to abuse because of the way it was formulated. .

They all have a "pain contract" though we aren't supposed to call it that any more and mostly they follow it. When they don't they get tapered off their meds. That is when the real fun begins. They don't take any personal responsibility. I had one guy package up all his non-opioid pain meds and Fed-Ex them to me at the clinic with a hate note telling me what I could do with them. Oy vey.

That was one of the drugs. The other drug rep was for Kadian in early 2000s. 

sas5814, wow! Stay safe! My collab doc "packs heat" in his private clinic. Curious though, did you have to fill out that DEA form to dispose of those controlled drugs since they were now in your possession? 

 

 

[sas5814]

It was all his non-opioid stuff. Muscle relaxer, Lidoderm, NSAIDS etc. He didn't want those. He wanted his Vicodin

 

Edited August 25, 2022 by sas5814

[wilso2ar]

15 hours ago, VentiMacchiato said:

 

That was one of the drugs. The other drug rep was for Kadian in early 2000s. 

They must have stopped this message directly to prescribers by the time I started in 2008.  

I'm not so naïve that I don't know that there are a lot of terrible things that pharma did in regards to promoting long acting opioids as much safer than they actual are, but they are salespeople.  I see them that way and I tell them that.

I just always find it odd that my experience with patients and opioids is far different than what others experience.  I do prescribe some opioids when indicated, but for the most part I can't tell you the last time I started someone on them, or even continue them from other providers except when end of life matters come into play. I just told three patients no yesterday. Maybe it's my geographical location? Maybe it's because we have other treatments that we can offer? I tell others instead of writing that opioid, make a referral to your local interventional pain clinic. 

I have had one altercation where I was concerned for safety. I'm sorry that others have to deal with it.

[CAAdmission]

Looks like Walmart wants to roll over and make this go away, to the tune of $3 billion:

https://www.cnn.com/2022/11/15/business/walmart-opioid-settlement/index.html

For providing medications to patients with a legitimately written prescription. What's a pharmacy to do? Refuse to fill prescriptions? Just cease stocking opioids?

[sas5814]

26 minutes ago, CAAdmission said:

For providing medications to patients with a legitimately written prescription. What's a pharmacy to do? Refuse to fill prescriptions? Just cease stocking opioids?

Pharmacists make decisions about these things all the time. The (common) problem is people in management want to make global decisions that affect everyone when its <1% of the people in the equation causing the problem.

I call it "bad actor" policies. Make everyone's professional life difficult because of the foolishness of a few people.

[ohiovolffemtp]

I spent 5 years working in a midwestern city with a huge opiate problem (until opiates got expensive and meth took over).

My experience was that the gateway drug to heroin addiction was - heroin.  I saw VERY few folks who turned to street opiates after getting addicted to prescription opiates.  Pill mills were and may still be to a lesser extent in Appalachia and FL, but not where I was.  I was within site of I-75, which is a major FL to Canada drug corridor.

[ventana]

I heard one of these places had some number like this

 

population served 100,000

Sch 2 pills dispensed in one year  100,000,000

 

yeah a pharmacist should be screaming at this point..... but all that would do is get you fired "cause the customer is always right"   

so much for big business acting in the best interest.  

 

Now they are going to make blanket policy which will make it next to impossible for many patients to get meds.....

our system is so broken -the only thing that matter is the $$$$