PDMP’s, Privacy, Patients, Pharmacies, Physicians, & The Plan
By Passionate Pachyderms
Most Americans haven’t got a clue what PDMP’s are, what they do, how they affect them, their family members, or their rights to privacy.
They have no idea that PDMP’s are tied to NARXCARE, (another similar but different program which works on a national level) so it’s very unlikely you will ever know about Narxcare, what your Narxcare score is, or how it might be adversely affecting the quality of your medical care, and even your ability to obtain it.
It’s unlikely you’ll ever realize that all of the information contained within the PDMP and NARXCARE programs can be shared freely with a host of civilian and government entities and their employees such as, hospital administrators, emergency rooms, doctors, pharmacies, police departments, the DEA, insurance and reinsurance companies, medicare, the FBI, health and human services, colleges doing any number or studies, and others, all without ever having asked your permission or telling you it’s happening, without probable cause, without a warrant, subpoena, or even a court order.
You didn’t give permission because no one ever has nor will ever ask for it in conjunction with the use of PDMP’s and/or NARXCARE programs.
These programs gather sensitive information such as, what medications you take, what you take those medications for, what doctors prescribe them, what other medical issues you and your family members have, what pharmacies you use, what insurance you have, where you work, how many doctors you see, what you see them for, as well as a number of other things.
You have no idea that the gathered information is subsequently used to assign you a NARXCARE score. The higher your score, the more difficulty you will have finding a pharmacy willing to fill certain prescriptions, the more it will lead to your being unable to find doctors or specialists willing to see or treat you regardless of the circumstances or events that created that high score.
Because you are not allowed to see your score, or know anything that went into making it, (we’re told this is because the program is proprietary, and thus, not open to our knowing about its details.) We’re also unable to contest it, disagree with it, or correct mistakes.
Of course if we can’t see it, know anything about it, or determine what exactly created that high score, there is no real way to discover or correct something entered in error, or to add remarks which might explain any extenuating circumstances that might lead to extremely high scores.
Most Americans don’t realize that a high NARXCARE score can, has, and will even affect how our pets are treated when they are hurt or sick, what medications they will or won’t get, even what veterinarians will be willing to treat your pet at all.
ARE YOU ALARMED YET??? YOU SHOULD BE, BUT JUST WAIT, IT GETS WORSE!
(If you think it’s confusing to read this, just imagine how difficult it is to write!! But please stick with me just a bit longer…)
Link to CATO institutes discussion on Patients, Privacy and PDMP’s
https://livestream.com/accounts/5863524/events/8774691/player?fbclid=IwAR2WmsnhztHJrHzPLC1h_52AUqB1j7dX6ZqVGeEG5A2xYtynRmuEQ9FNmcU
PDMP’s were originally made for the dept on justice to track criminal activity
“Prescription Drug Monitoring Programs (PDMPs) are statewide electronic databases that collect designated data from pharmacies and medical offices that dispense controlled substances in the state. PDMPs are maintained at the state level and housed in various statewide regulatory, administrative, or law enforcement agencies. The overseeing agency provides access to the data to individuals who are authorized under state law to receive the information for purposes of their profession.”
“The concept of a PDMP was originally developed by the Department of Justice to assist in prosecutions of criminal violations of the Controlled Substances Act. Over time, they became recognized as a useful decision support tool for prescribers when considering whether to prescribe a controlled substance or a medication that could have harmful drug-drug interactions with a controlled substance prescribed or dispensed by another party.”
“Each state PDMP is set up differently, in terms of which classes of medications are included, who has access to the data, timeliness and accuracy of the data, automatic reporting functions, and use requirements. Best practices for PDMP design and use include enacting and implementing interstate data sharing among PDMPs, integrating PDMP data with health information exchanges and electronic health records, mandating enrollment and utilization, improving data timeliness, allowing delegate access, and conducting user education.2 An ‘ideal’ PDMP would also include peer to peer messaging (in compliance with HIPAA and 42 CFR Part 2) and provider peer review.”
PDMP and NARXCARE are tracking systems for anyone who has ever filled a script for pain meds.
They unconstitutionally invade the privacy of patients without consent, assign them scores which can make it
impossible for them to find doctors, have their pain treated, or fill prescriptions anywhere in the country.
NARXCARE SCORES Description Per article found on Medium written by:Heather Wargo (Link is contained further down in article)
What is this “score”?
It is an addiction/overdose risk assessment score, assigned by an algorithm developed by Appriss, Inc., in Louisville, Kentucky.
It assesses values entered into data fields, then runs them through its weighted algorithm, and PRESTO!
It spits out a score just for you.
Appriss, Inc., began their quest for data mining domination in the middle of the 1990s by the development of the VINE system.
VINE is a victim notification system that alerts the victims of a crime when the perp is released from jail/prison.
Reviews of this system by its users have been mixed at best. The VINE app on iPhone, for example, which is a preferred notification system for most victims, currently sits at a 1.9-star rating on the iTunes Store, with review after review of horrified, scared victim stating they were not informed.
Appriss, Inc., has spent the better part of the last twenty years developing and perfecting their algorithms around schedule prescribed medications, PDMPs (prescription drug monitoring programs), and a specialized PDMP in house profiling project they ultimately named NarxCare.
This is far more lucrative to current management than the altruistic vision of the founder.
Appriss has also been responsible for the program that tracks every person who plunks down their driver’s license for Sudafed from behind the counter, the program Methcheck.
Methcheck is a spectacular failed attempt at slowing methamphetamine abuse by the government.
Failed because between the years 2011–2016 methamphetamine overdose deaths in the United States have more than tripled in number, according to the CDC.
A failure doesn’t get illustrated quite so resoundingly very often.
Yet, they still continue their course of stubbornly throttling prescribed opioid medication to the patients who aren’t abusing it in the first place.
Of course, this is all framed “for the best interest of public health”.
Does anyone else cringe when a public official mouths the words “best interest of public health”?
Every time those words exit a politician’s mouth, you can be certain a civil rights violation will be on its heels.
To wit, “the public” is left in the dark regarding these plots, never asked their input, and, most importantly, never asked for informed consent.
Little is known about the data fields Appriss actually inputs.
The algorithms are proprietary.
Furthermore, the state statutes written around PMP/PDMPs have this little nugget hidden inside:
“Program to contract with vendors/3rd parties for the purpose of “obtaining technical assistance in the design, implementation, operation, and maintenance” of the system. “
Questions addressed to the state agencies /reps regarding them are ignored.
What I have been able to ascertain independently is troubling.
Appriss has introduced a number of “add-on” packages to the basic PDMP that each state has in place- thanks to Brandeis University.
The Brandeis proprietary PDMPassist has been the author of the state PDMP metrics and algorithms for each state PDMP program.
Congressman Hal Rogers, of Kentucky, is the PDMP ‘face man’ at a national level.
The ‘Hal Rogers’ PDMP grant program has funded many states’ programs and gotten them up and running.
The Congressman’s moniker is attached to all things PDMP for no obvious reason.
The only thing Rep. Rogers appears known for besides the PDMP programs in his name is being dubbed “the Prince of Pork” by government spending watchdog groups.
He also served as the chairman of the House Appropriations Committee for a short time.
Appriss, Inc., HQ is located in Kentucky as previously mentioned, same as Rep. Rogers.
One thing I have learned in my research throughout the bizarre turns of the opioid crisis is that there are no coincidences.
One of the add-on programs that almost all states have implemented to their PDMPs is called “PDMP AwaRxe”.
This program is nothing more than Appriss, Inc.’s, insidious NarxCare under a different name.
This is also where the “scoring” comes into play.
With NarxCare, a patient gets what is referred to as a NarxScore.
Herein the problem lies.
The PDMP, NarxCare, PDMP AwaRxe, et al., are all rudimentary algorithm programs.
They do not allow for any inputs by a physician into data fields.
This is a problem.
Why?
It’s a problem because of many factors, firstly, that patients are not told that they are being high scored or “red flagged” for innocent behavior.
Here is an example of how a patient can be pressured into rehab for a computer algorithm decided diagnosis of addiction when it is, in fact, normal behavior.
Betty is a pastor’s wife who suffers chronic pancreatitis. On Sept 1, she went to an appointment with a new pain management physician.
Her new physician wanted her to be committed for treatment for SUD based on what the computer told him and the flag it gave him regarding Betty.
When she refused to go, he called her husband and enlisted his help to try to convince Betty to go.
How did this happen?
The computer algorithm told her new physician that Betty was an extremely high-risk patient.
It said she was a doctor shopper who went to multiple providers and pharmacies over the past 9 months.
It recommended that she seek treatment immediately.
The physician would not listen to Betty when she attempted to explain what happened in the past 9 months.
Addicts are liars.
What did actually happen?
In January, 9 months previously, Betty had her normal pain management appointment.
Three weeks later she was in a terrible car accident (not her fault) and taken by ambulance to a local hospital.
When she was discharged, four days later, it was a Saturday afternoon, around 5 PM.
The orthopedic physician who treated her broken ankle in the hospital wrote her a prescription for pain medication after he spoke to her pain management physician and they came up with a plan.
Her husband filled the prescription at a Walmart pharmacy because their normal pharmacy was closed.
Betty had her normal pain management appointment in March. She was hospitalized at the end of March with appendicitis that had perforated her bowel.
The GI doc discharged her with a few days of pain medication on top of her pain management after consulting her pain management physician.
The prescription was filled at the hospital pharmacy before they left the hospital.
Betty had her normal pain management appointment in May.
She had an infected root canal removed in June and required extensive dental surgery along with a bone graft in her jaw.
Her oral surgeon prescribed pain medicine after consulting with her pain management physician.
Her husband filled the script for her at the Rite Aid near the dentist office because she was in terrible pain and he wanted her to have the medication for the trip home (a 2-hour drive).
Betty had her normal pain management appointment in July.
Her physician told her he was retiring.
He gave her a few names of physicians in the area.
Betty made an appointment with the new physician for September. She had all her records forwarded there.
Betty had a flare-up of acute pancreatitis at the beginning of August.
She was hospitalized for three days, then discharged with a 4 day prescription of extra pain medicine from the hospitalist.
Her husband filled the script at the Rite Aid by the hospital because it was the only pharmacy open on Sunday.
Because Betty had five different physicians and five different pharmacies recorded within the past 9 months in her records dispensing prescribed opioids, the algorithm automatically flagged her and recommended rehab — all per the NarxCare programming.
The literature says to “have a discussion”.
No physician in practice utilizing the NarxCare system is following any of the “recommendations” provided in any of these “guides” past the words; “cut off” or “rehab” that I have heard of, anecdotally.
After all, the entire premise of this is based on the CDC guidelines for opioid prescribing for chronic pain, a voluntary guide for new patients, not existing ones, which have never once been utilized in the way they were written — to include the premise of Narxcare in the first place!
(For examples please follow this link where copies of pages from the APRISS training manual are located)
apprishealth.com NarxCare tutorial
The new physician had a prejudice against her based on NarxScore before he ever laid eyes on her.
There was no way for any of her former physicians to input a note into her “NarxReport” or PDMP AwaRxe report.
No way to clarify extenuating circumstances or about their consultations.
EHRs are incomplete.
Physicians won’t believe the patients when they try to explain.
What are patients supposed to do?
They are fighting a system that 99% of them aren’t even aware is in place.
They certainly have not been told the “rules”.
I have found most physicians don’t even know the “rules” themselves or where to find them.
Indeed, what exactly are “the rules”? They vary state to state.
Innocent, non-pathological, patient appropriate use of prescribed opioid medication as directed by a physician gets a patient flagged as high risk.
Not only that, it guarantees the patient will not be considered for pain management by any physician.
The patient will be forced to undergo extreme pressure to go to rehab for a disorder that doesn’t exist.
Patients are “allowed” to have erroneous information removed from their PDMP/ Narxcare.
As with many “safeguards”, this benevolent statute is rarely practically applied.
This operates under the premise that a patient:
- Has easy access to and regularly reviews their report(s), can afford fees
- Has a physician willing to believe them when they report an error
- Has a physician willing to sign off verifying the error
- The pharmacy will remove the error from the database (physician offices punt on this)
I challenge any doubting Thomas to attempt to have an error stricken from their PDMP.
NO PROFILING BEFORE NOON, PLEASE
As an advocate for the incurable painful disease patient and physician community, I am commonly asked the following:
How did this get to this point? Why weren’t we told?
We have to wonder… why hasn’t anyone ever asked for a signature of consent, saying to the effect of:
”I, (patient), have had PDMP and Appriss Inc. NarxCare fully explained to me. I understand my rights and responsibilities as a citizen and patient as I am enrolled in this database.”
The pain contracts given to patients do not address this issue, outside of vague mentions in some about “monitoring”. These mentions are buried in the contract, not discussed, and of course, a patient cannot object.
Perhaps the practitioners themselves cannot explain these systems?
Or maybe because the entire sham is a civil rights violation of such magnitude there is no way to ask consent.
Therefore we all just play pretend and hope no one ever notices.
The amount of people who have access to the sensitive patient PDMP information who are not bound by HIPAA is stomach churning to contemplate.
There are so many.
Few truly understand this.
It has been well hidden.
A running joke around Appriss HQ is they use the PDMP/NarxCare system to pull up people’s addresses for the company Christmas party invites.
Far from humorous, this illustrates what a joke online security is around our protected, sensitive patient information.
Are the employees of Appriss, Inc. bound by HIPAA? Brandeis University? Yale? The students there?
How many stakeholders, virtually all people in the employ of a veterinary office, billing, coding, law enforcement… I honestly get sick to my stomach when the scope of this is truly considered.
What about HIPAA? Isn’t this a direct violation of that law?
Since HIPAA’s adoption in 1996, we have had less than 24 documented convicted cases of medical records tampering/ abuse/ confidentiality breaches.
24 convictions.
Out of 350 million people over 22 years.
Concern for HIPAA breaches is astounding at HHS, it appears.
This number is derived by going to the HHS website on HIPAA compliance and painstakingly pulling the data out of their “reports”.
Can I opt out?
No.
You cannot.
Therein lies the rub.
Even if you decided today that you were sufficiently freaked out enough to want to try to taper off your medications to see if you could manage your life without them, you are in these databases for life.
No getting out.
How do you opt out of a system you never signed up for in the first place?
Remember, even people who have never been prescribed any schedule meds are in there with scores.
Like my autistic daughter and son, who hit the ground running with a high score solely due to their autism.
They will have one hell of a time getting any opioid therapy if something awful were to happen.
Because, as of right now, a damn few docs are treating any child’s pain.
At all.
Children apparently are immune to any pain as of the 2010s.
Moreover, as soon as a child hits “teenager”, thanks to the idiots who decided to steal prescriptions and party with Grandma’s Percocet, all are painted with the brush of “drug seeker”.
Autistic individuals are considered “high risk” for drug abuse because the algorithm says so. Along with those who have anxiety disorder, depression… if you have any mental health diagnosis.
Autism is a mental deficiency, according to the algorithm’s programming. (NOT ME. I don’t have column space to delve into the fury I feel about this.)
My friend who was raped is another person who is judged unfairly under the scoring.
Assault is another flag for the algorithm.
Her horrible assault makes her have a score that is “at risk”, although she has several years between herself and that awful day.
She worked very hard in therapy to regain her poise, confidence and self-esteem.
Rape victims are more likely to become addicts, according to the algorithm’s programming.
A young man who was molested one summer at camp- he is also tagged high risk.
Children who were abused are more likely to become addicts later in life, as per the algorithm’s programming.
There are several inherent problems with this kind of profiling algorithm.
First of which, the types of studies its engineers used to declare which populations were at risk in the first place.
No inputs, remember?
The computer has no idea if these patients were treated for their trauma.
Unresolved trauma is the key takeaway.
It is true that statistics show those who have suffered a trauma in their past have a higher incidence of addiction.
What of those who have worked hard to get past it?
Moreover, doesn’t everyone deserve appropriate pain management anyway? Or is it just too much work?
Should a patient who trusts his physician with past trauma that is resolved be reminded of it again and again, simply due to the fact an algorithm proclaims he/she may become a drug addict due to that trauma?
Should they be unfairly punished due to “pre-crime” Minority Report–type profiling and denied compassionate care?
Does that one input define them as a person?
Do we deny children of alcoholics the right to purchase or use alcohol, even though the science and statistics overwhelmingly show COA may become alcoholics too?
Why not embrace attaching EHRs (electronic health records) to the PDMPs as suggested? Wouldn’t that help?
EHRs are inherently a horrendous idea, and the reason why is security, and to a lesser extent, data integrity.
Many think the convenience of the EHR is wonderful, game-changing.
Many physicians, however, have complained about the time suck of EHR technology, as well as missing data in EHRs.
They want paper charts.
Many have flat out refused to switch.
Forcing physicians to switch to EHRs for Medicare patients, which CMS has done for 2019, probably ensured massive dumping of thousands of patients by physicians, instead of forcing physicians to switch to EHRs as they hoped.
Framing it as physicians “holding patient records hostage” in a new way to spark patient outrage is a nice touch by CMS.
Who was the marketing genius who thought that up? He deserves a raise.
Telling consumers they will be in control of their records is the best way to get them to pressure their providers into folding.
Kudos.
Also, in attaching EHRs to the PDMPs, government and insurers may get their hands on long coveted information about data on people and potential insurers will screen heavily before deciding to take them as clients.
As Cigna has begun to do with their own “proprietary” algorithm with 16 datasets they won’t disclose. It has begun.
Cigna uses AI to predict prescription opioid abuse
In the government’s case, I shudder to think why.
This is catastrophically bad for the consumer. Imagine the insurer being able to see your entire medical record, every nook, and cranny, before deciding what rate they will charge you.
In light of the government’s track record on honesty, integrity, and compassion, the less detailed information they have on anyone’s medical history, the better.
The laws have not been in line with the technology.
On purpose?
Or is this merely another by product of the digital era?
A google search reveals nothing.
Pages of praise for EHRs. Pages of praise for PDMPs. A few blog posts with warnings. No laws that reflect any patient protections.
As I said previously, legislators either ignore the issue when asked or reveal their ignorance by saying they don’t know anything about the topic.
FOIA requests sit in limbo.
Those Pesky States and their Statutes… That NO ONE Enforces Their Parameters…
If one stops to peruse the state laws on the books regarding PDMPs (prescription drug monitoring programs), there is an abundance of fascinating language buried in our very own state statutes.
For example, many states have what is called “Compacts” with other states.
These are statutes made in state law, usually over roadway or bridge construction, over licensure in nursing or medicine, with other states. They encompass an agreed upon number of states, have rules set governing etc…, have legal language with terms and so forth.
However, in regards to the Opioid Crisis… why would there even need to be a “Compact”?
And furthermore, why would this “Compact” be written like the one in Kentucky legislation has been?
Yes, here we are, back in Kentucky again- the land of Appriss, Inc., and their House of Rep. champion, Hal Rogers, of the “Hal Rogers PDMP programs”.
What a fascinating coincidence.
It appears that stakeholder interests have more to do with this crisis than anything else, whoever plays the game the right way will make the most money.
No patients or their privacy was considered, unless it would “embarrass” a member state.
Government Reveals the Lie
When HR 6, the expansive “Opioid Bill”, the Support for Patients and Communities Act, was signed by Pres. Trump on October 24, 2018, few people actually knew its entire contents.
Few realized it actually underfunded addiction treatment, yet again.
It put into place strict guidelines for treatment and how it was to be carried out.
It granted extension of the “bupe” waiver and more freedoms for the drug Suboxone to be used in substance abuse treatment for Medicaid patients, a huge win for the pharmaceutical company Indivior.
As of this writing, there is still no generic for Suboxone (bupe).
It also expanded funding for PDMP (Prescription Drug Monitoring Program) databases.
A very few people understood that last bit.
Appriss Has Been Played
With the passing of HR 6, the company Appriss, Inc., began to feel a little concerned.
This little company, based in Louisville, KY, has enjoyed a secretive monopoly on PDMP algorithm programs utilized in every state system since their inceptions into the state systems.
Beginning in mid 1990’s with the Clinton White House, but helped along by the first Bush White House, with their encouragement of EHRs.
In the first of hundreds of non coincidental coincidences, push turned into hard shove right after President Clinton signed HIPAA into law.
HIPAA being the smoke and mirrors law that pretends to protect patient privacy.
At the rate of a whopping average of 2 whole convictions per year out of 350 million Americans.
Either the American people are extremely respectful of each other’s privacy in regards to medical information or no one is enforcing HIPAA law in any real way.
As much as I would like to believe the former, the truth is the latter.
No doubt Appriss is helped along by their behind the scenes relationship with Representative Hal Rogers, a House of Representatives official from their state of KY, the “Prince of Pork”, who just so happens to be the face man for their National PDMP grant system.
Did someone say coincidence?
His ‘Hal Rogers’ PDMP grants have been the sole reason most states were even able to implement a PDMP database to enroll patients in the first place.
Now… well… the government is moving in. They are going to fund things.
Rep. Rogers would not be able to wield the power he once did… if this were to come to pass.
What to do?
Appriss Inc., executives also heard whispers that D.C. was considering making the PDMP a utility.
With the push toward a National PDMP and the certainty it will happen within the next decade, the government focus is now shifting toward whether or not the PDMP should be a public utility.
Still not a peep out of a single government official about privacy, patient consent, if PDMPs even actually work (not one study has shown a definitive yes on this), or if we need a National PDMP.
The CDC isn’t even able to say they work in stopping addiction and overdose.
Likely due to the fact PDMPs track the wrong people and wrong drugs.
A National PDMP utility would spell disaster for Appriss, Inc.
The huge checks would come to an end.
On the verge of receiving the Marconi treatment from the government, it seems.
Appriss, Inc. is worried they will become a white elephant if the government takes over the PDMP.
The company has launched a media campaign to highlight themselves, because, in reality, they do have a strict monopoly on this trade in America.
I read a fascinating analysis of this from a anon hospital insider blog, though the post itself was written by David Finney, a partner at Leap Orbit- a healthcare consulting firm in Maryland.
He writes:
“Appriss has done what monopolists do, bidding up contract prices and seeking to monetize every aspect of the data it controls. Given the commitment by states and the federal government to “do whatever it takes” to address the opioid epidemic — including supporting PDMPs with ever-increasing grant funds — PDMP administrators may grumble, but otherwise few people have stopped and taken much notice.”…
The article speaks of a National PDMP and then goes on to point out:
“By all indications, the federal omnibus spending bill and subsequent signals from federal officials and lobbyists seem poised to deliver on this new model. Not surprisingly, Appriss is worried. In recent weeks, it has launched a marketing campaign of its own to highlight the benefits of the current state-based approach to PDMPs and the interstate gateway it developed in collaboration with the National Association of Boards of Pharmacy….”
That has to sting.
This is my take on this.
Basically, the government is giving Appriss the middle finger and a good doggie pat on the head.
Appriss Inc., will be another in a long line who has been played by our dear government, developed a program, only to have it stolen and used with no recourse.
I can’t lie and say it isn’t personally satisfying to see Appriss being treated… despicably…(like a patient)… even though it underlines the treachery of our government in spades.
I will waste no more time reflecting on Appriss’s potential loss here.
When you deal in deceit- you will have it dealt to you in the future.
When you get too greedy- it never works out.
Since the others in the game, Brandeis and Yale, have day jobs, it shouldn’t hit them too hard.
Besides this site and a few other knowledgeable people, no one has said much about their connections to the PDMPs or the Opioid Crisis at all.
They haven’t been connected in the public eye.
Furthermore, the Kentucky Compact will be a moot point if a national PDMP is created.
Bye bye to that huge money generator for all the states involved, and stakeholders- of which I am certain Appriss, Inc., is the biggest one.
Of course, the yearly reports that are required by the statute written in Kentucky law are no where to be found.
There is no public list of the members or stakeholders involved in the Kentucky Prescription Monitoring Program Compact or any reports existing for review.
The Right to Know
Do we, as the patients who exist as members of the very lists involved in these databases, have a right to know who is viewing our protected, sensitive patient information?
What about informed consent?
Who asked us?
Is it right that our information is being traded to other states and stakeholders and profited off of — all without our informed consent?
Make no mistake- this has gone on for years. The Compact was created in 2012.
I wonder how much money has been made off this information in seven years already.
What will become of all the algorithm programs tailored to sell to all the states?
Does the average American understand what has happened in this power play around the Opioid Crisis?
The insurers have copycat algorithm programs now.
Appriss, Inc., has opened Pandora’s box.
There are algorithm programs to tell your physician you need to lose weight, based on your BMI- a flawed system that has no clue of your bone density or muscle mass.
A bodybuilder will be flagged for obesity even with a body fat of 8%, if their weight to height ratio is too high.
There is NO INPUT mechanism on these programs.
This is what happens when you allow computers to practice medicine- and allow the companies to use them without disclosing the fields they use for inputs.
It Takes One
In the patient community, we have tried for years to find just one.
One politician to stand up for us. One lawyer.
We have been unsuccessful.
Isn’t that astonishing?
No one is willing to stand up for patients being harmed by legislation in this opioid hysteria madness in a court of law.
It defies logic.
No one is willing to say in a court of law that privacy is being breached and invaded by these programs.
They are all too afraid.
That, more than anything, should speak to the American public.
Who is in charge? Are we?
The ACLU National has repeatedly turned down requests to represent patients, to include cancer patients, being denied compassionate pain care.
Why?
Yet, they will represent all groups of others being denied medications they require for health.
Why?
We have reams of documents, proof, laws, contradictions, and evidence already gathered to ease the process.
No one in a position of importance will defend a single patient who is suffering.
That should make any American pause, make any American question who really is in charge of this country.
No one will care when you are suffering and in need of help, except other people who are also suffering and in need of help.
The agencies charged with helping those who are disabled, suffering, and in need of help will let you know how they cannot help you.
You will be gaslighted to death, told to accept your lot, look on the bright side, and be mindful.
Oh, and here is a list of places who offer services.
A list of the cottage industry’s finest that sprung up around the “Opioid Crisis”.
Line the Pockets of Crony Capitalists
- In this district, a politician’s BFF has a company that manufactures drug testing kits.
How interesting that he introduces a bill requiring that every patient be drug tested before they ever receive an opioid prescription? No exceptions.
And they award the contract for the state to his buddies firm.
- In this district, a woman owns a share in yoga franchises.
Patients in this medical network are highly pressured to attend yoga before they receive an opioid prescription, and they have to go to this place, contracted by the medical network. If it doesn’t work, they are shamed heavily.
- This politician has invested heavily in CBD.
Patients are pressured heavily to try CBD, and refused an opioid prescription. His CDB is the only kind in the area.
A politician with pain psychology.
A politician with mindfulness.
A politician with acupuncture.
Do you understand?
This is all true, how the politics has become around the opioid crisis and state legislation. The sharks moved in and have been having a field day.
A drug screening, which costs under $50 over the counter at Rite Aid, now costs upwards of $500 at a doctor’s office visit and is rarely covered by insurance.
An out of pocket cost to a patient who can ill afford it and who should not have to bear the humiliation of having one in the first place.
That patient did nothing to deserve a drug screening. It is a waste of money, period.
Join Together
When will the American public speak out for the patients who are suffering beside them?
Those of us who are fighting for ALL of us, not just ourselves.
We are fighting so that all of us can be treated with dignity and compassion.
If we don’t fight together, it will soon be too late to do anything at all.
We must force consent to be obtained for all patients to be entered into any PDMP or state tracking system- to include all the Appriss Inc., add on programs.
We must also push our politicians to fight for transparency in the algorithms used in all healthcare system programs.
Why so secretive? Competition is a great excuse to use for being discriminatory.
Is it because of racist and sexist field inputs?
Religious profiling?
We don’t know.
Until we require transparency in the algorithms, we won’t know.
Until we compel the statutes to be actually adhered to, we won’t even know what they have done the last 7 years with the patient information they collected in the PMDC- as the statute said they were to annually report.
Where are the reports?
Until America comes together and demands transparency, we will remain in the dark, allowing injustice and harm to happen to those who have done nothing wrong.
The only crime in America where you have zero, and I do mean zero, recourse…
Where no one, NOT ONE, will stand for you…
Is the crime of having the misfortune to fall ill with a incurable painful disease.
(Special Thanks to Heather who wrote all of this in such an incredibly succinct manner that I can’t possibly imagine any of it being explained any more clearly or on point. Some of this article has been edited for time reasons, but I encourage you to follow the link posted and read the entire article as well as see the pictures she has included within it which again I have not included here in the interest of time and attention spans.)
ALL OF THIS HAVING BEEN SAID, HERE IS WHAT I GOT OUT OF THE DISCUSSION ON PDMP’s AT CATO INSTITUTE IN WASHINGTON D.C. OCTOBER 3, 2019
The first individual to speak was Dr. Springer. Dr, Springer is a SR. Fellow advisor at the Cato institute. He began with telling us that since the PDMP’s have been instituted, there has been a 40% drop in the number of prescriptions written by Dr’s for the treatment of pain.
Dr. Springer went on to say that in spite of this huge drop in prescriptions, there has been a huge increase in overdose deaths, 90% of which are due to poly substance, (the use of more than one drug and or alcohol at the same time) involved in the deaths. 75% of all overdose deaths are caused by heroin and illicit fentanyl.
In most states, PDMP’s rank the physicians according to how many scripts they write, and they each get a monthly report which shows them where they stand amongst all the physicians in that state. Dr. Springer states that for his particular state, doctors are ranked as one of three categories, Normal, outlier, or extreme outlier.
Because of this, Doctors have effectively been intimidated into not prescribing medications for pain.
Springer also goes on to mention that the PDMP programs are extremely inconvenient and time consuming. They are plagued with constant technical glitches which require IT specialists to resolve, further placing mounting time constraints on doctors who are often already running behind.
Dr. Springer admits that because of this, he has found himself avoiding inquiring about patients pain levels, because he doesn’t want to have to take the considerable amount of time it inevitably requires to treat their pain due to the PDMP’s, so he ends up under-treating or failing to treat his patients pain, and this is primarily due to the PDMP.
The next speaker was Dr. David Fink, an epidemiologist with Columbia University. Dr. Fink basically studies all of the studies, and has a special interest in the mental health aspect of things.
It was my personal impression that Dr. Fink is one of the individuals who frequently associates Chronic pain patients with addicts as if they are one in the same, which as a CPP myself, and a CPP advocate, I know well could not be farther from the truth.
I have often wondered why this seems to be the case in those who are insistent that chronic pain patients should not be taking pain medications to treat their pain. I mean where does this notion come from? Why do they insist upon grouping the two together as if they are one in the same?
The differences could not possibly be more starkly highlighted. Chronic pain patients take pain medications to be more functional, to be more active in life, and have the ability to actually go to work, have relationships with family and friends, raise their children, care for themselves and their homes, as well as fulfill the expectations one tends to have of adults in our society. They need those medications to engage in life, not to escape it.
On the flip side, Addicts take illicit drugs to escape life, to withdraw from it, to run away from responsibilities and relationships. They are desperate to find their next dose, and doing so consumes them. They will lie, cheat, steal, betray, and basically do what ever it takes, legal or not to obtain their next fix, and their lives are filled with negative consequences from the use of these drugs. Addicts don’t go to their doctors, pay sky high insurance premiums, or worry about whether or not their local pharmacy will fill their script because they don’t have scripts. They don’t worry about the fact that they can’t find physicians willing to treat them, or worry that their needed medications will be reduced to a level which is ineffectual, or stopped all together. They don’t worry about these things because they get their drugs on the street.
They buy illicit drugs flowing into this country by the tons, dangerous drugs laced with deadly amounts of illegally manufactured fentanyl. Dangerous drugs the DEA is too busy raiding innocent physicians offices to have the time or inclination stop.
But hey, our doctors don’t shoot back. They don’t cut off heads, kidnap families, carry guns, or work nights for the most part. Our Doctors don’t move from place to place selling their goods, and the DEA doesn’t have to chase them.
Rather, our physicians are safe. They have offices, homes, schedules, employees, records, and books! They file insurance claims and medicare claims. They’ll always be in their office when the DEA comes to call, or raid as the case may be, when 40-50 Agents rush into offices with huge guns drawn, scaring everyone half to death, barking demands which are always immediately complied with.
They don’t have to worry that the disabled pain patients waiting to see the doctors in those offices will draw guns and shoot them, or run out the back door. Hell most of us couldn’t run to the next chair let alone out a door!
They know that they can blast into those offices and they will be treated with respect and given anything and everything they want immediately without hesitation, unlike what they would encounter if they were to go after the illegal drugs they are supposed to be stopping, and encountering cartel members, drug dealers, and those involved with them.
Doctors assets are clear to see, they own houses, have bank accounts, businesses, and families. The DEA takes one look at a doctor and see’s a huge bounty right there for the taking, no fuss no muss. Drug cartels, dealers and smugglers have to be chased down. Their assets are well hidden, often in other counties or off shore. Drug cartels aren’t likely to cooperate, they typically won’t just hand over everything the DEA agents demand, they make them work for it. So tell me, if you were a DEA agent, which one would you rather go after if you wanted to be home to put your kids to bed at night?
But I digress….
Back to Dr. Fink… I got the impression Dr. Fink is unaware of the collateral damage being done to 16 million + chronic pain patients. That he is for the most part, completely oblivious to the growing numbers of suicide deaths among them, patients who, when cut off or severely restricted from their needed pain medications, are so despondent, so hopeless, and in such horrendous pain, that rather than continue suffering for one more minute, commit suicide due to pain. Leaving their families to deal with the trauma and live with the pain.
I don’t think Dr. Fink understands that a huge number of chronic pain patients who have been abandoned by those doctors they were supposed to be able to count on and trust to have their best interest at heart, Count on to fight for them, to advocate for them and take care of them, treat their illnesses and disabling conditions, that once abandoned by these doctors too afraid or intimidated to treat their patients pain any longer, these patients will and are turning to the very dangerous illegal drugs our government is trying to stop, because they can no longer get the safe effective medications they count on and need to treat their pain.
Medications that have been used for thousands of years, that have been tested and developed for the treatment of moderate to severe chronic pain and are VERY effective in most cases.
Dr. Fink wrote a study in May 2018 “The association Between PDMP’s and non fatal/fatal Drug overdoses, A systematic Review”
The purpose of this study was to examine whether PDMP implementation is associated with fatal and non-fatal overdose numbers
Identify features of programs differentially associated with those outcomes and investigate any potential unintended consequences of the programs.
The conclusion of this study was that after more than 8 years since the implementation of PDMP’s there is little to no evidence that PDMP’s have made any appreciative difference in curbing overdose deaths.
In fact, opioid overdose deaths have skyrocketed since the inception and implementation of PDMP’s.
Because of various issues with PDMP’s such as doctors being intimidated into not prescribing pain medications to their patients, difficulty in using PDMP’s, and errors in entering information to them, doctors are reluctant to bother with them.
This opens the doctors up to complaints of poor treatment, non treatment, and under treatment. They are damned if they don’t, damned if they do, Which no doubt is contributing to doctors resigning, burning out, and stress related issues.
I mention this because it’s important to understand our physicians perspective in all of this. Many of them are “unintended victims too.”
More and more we see doctors as the ones holding all the power, and being the ones who use that power, wielding it in what ever direction suites them at the moment.
They have the power to take our lives away; then make what’s left of those lives a living hell until some in the CPP community, (far too many) become so consumed with the horrendous pain they are suffering, and the mess it has made of their lives, Commit suicide. Others in attempts to escape that pain any way possible, decide to go to the streets in search of the relief they used to be able to get safely and legally from their doctor.
We feel abandoned by our medical professionals, we’ve been treated like criminals when we’ve committed no crimes.
We’ve been regarded as addicts when we’ve exhibited ZERO addictive tendencies or behaviors.
We’ve NEVER abused drugs,
Never shown abhorrent behaviors.
Never failed a drug screening, which we’ve been forced to submit to monthly.
Never failed a pill count. Never asked for early refills of our meds, never had scripts lost or stolen,
Never taken our medications in ways other than directed; we have mountains of objective proof of our “legitimate medical conditions” which are often rare, degenerative, incurable, and for the most part untreatable, with the exception of treating the pain the results from those conditions. Pain that in the majority of cases, multiple doctors in various specialties, often in different parts of the country have consulted upon and given up on treating.
WE’RE STILL OUT HERE!
Many have lost homes, jobs, careers, spouses, friends, they’ve been confined to walkers, canes and wheel chairs, they’ve gone from independent productive members of society to unable to leave their homes except for short periods to go to the doctor, or maybe a quick trip to the grocery store.
They have given up all social interaction, their friends no longer call, come around or invite them to things because they’ve long since tired of getting the same answer, that we’re unable to go due to our health, due to our being in pain.
We’re no longer able to travel, go on vacations, spend time with our families, play with our children or grandchildren, hell in many cases we can’t even make it down the drive way to get the mail.
We’ve lost our savings, our friends, our security. We’ve lost EVERYTHING that makes life worth living.
WE ARE THE UNINTENDED CONSEQUENCES DR. DAVID FINK!
We are the unintended consequences that in the ten years since PDMP’s began, that no one, not one doctor, not one scientist, not one CDC employee has bothered to study.
NOT ONE!
Why is that?
What makes every other aspect of this “experiment” so compelling, and so important that it is studied from every possible direction, but “unintended consequences”, the most costly aspect of this “EXPERIMENT” to the subjects involved, NEVER rises to a level that is important enough to investigate or report on?
Ten years with lives ripped apart, careers ruined, marriages ended, lives snuffed out in horrific pain, relationships collapsed, friendships surrendered, millions of tears shed, money lost, hopes melted away to nothing, dreams transformed into an inescapable nightmare we can’t wake up from.
More than 16 million chronic pain patients who need pain medication to function. 16 million patients with spouses, children, parents, friends, grandchildren, sisters, brothers, aunts, uncles, all of us living the hell of those “UNINTENDED CONSEQUENCES” that have been completely ignored, inconsequential to all but those having to live and suffer them over that 10 years.
None of it important enough to worry about for those fixated on the DATA those PDMP’s bring forth, the same PDMP’s which allow them to unconstitutionally steal from each of us.
The raw data, personal medical information NO ONE should be able to see or gain unfettered access to, data which will, in the future be the determining factor behind whether or not you, your children or grandchildren will even get medical care, what kind it will be, and how good it will be.
That data, the prospect of getting it, and continuing the journey down this road we’ve all been started on is far more important than the lives of 16 million American citizens who suffer chronic pain.
It’s more important than the loss of freedom to choose our healthcare, how we will be treated and with what. Who will be forced to live in abject misery, writhing in pain, and who will be allowed pain control.
I understand how this sounds, and believe me, if I could find any other possible explanation for it backed up with the ever growing mountains of research and proof we’ve managed to uncover, I would be pleased as punch to accept it.
The thing is, as much as you don’t want to think about it, as much as you don’t want this to be true, want there to be some other explanation, some other reason for it, and want to stick your head in the sand pretending it’s not happening, IT IS!
Our Government and those involved within it have been allowed to get away with quite literally crapping on our constitution and the laws of the land.
They are breaking these laws right in front of you, and manipulating you into not only thinking it’s okay, but encouraging them them to keep doing it!
“Oh my Gawd, we have addicts dying, they are overdosing!”
The coroners report says simply “Drug overdose.”
We demand to know what drug, and the government and media respond in exactly the way they’ve planned to all along.
“OPIATES!! THE KIND YOUR DOCTOR PRESCRIBES FOR PAIN!” They all shout in unison.
“Well then since its the kind doctors give us, it surely must be the doctors who are at fault! They are all bad! they should never be able to prescribe these horrible deadly drugs, not to pain patients, not to anyone!”
STOP RIGHT THERE!!
Why weren’t coroners immediately directed to investigate all drug related deaths with in depth complete Toxicology screens with differentiate exactly which drugs were killing which people where?
Had that happened, we would have all known known that need DR’s were not writing scripts for opiates which were killing addicts.
But rather>
The D.E.A. was allowing illicit opiates made illegally in other countries to look exactly like the real thing, Addict found they could get these drugs for dirt cheap, certainly for far less than they could get the real thing for, so they started buying and using the drugs available to them at the lowest price. Simple supply and demand.
D.E.A. doesn’t want to go after the real bad guys, hell the real bad guys shoot back!
It’s sooo much easier to blame the doctors!
The same doctors we encouraged 10 years ago to treat pain as the fifth vital sign, to aggressively treat it with everything it took!
Then, the D.E.A. starts raiding those doctors for doing exactly what they were told to do!
The media screams even louder “it’s the doctors!” The government jumps on board, via Obama care, healthcare rationing, death panels, and cost effective medical care that ends up costing us twenty times what it ever used to, and here we are. The “unintended consequences” who are rattling cages and screaming as loud as we can.
Now that you know, now that you have this information, do you still think any of this isn’t planned and orchestrated to achieve their end game? Their goal?
The bad news is, PDMP’s aren’t going to go away. In fact they are deciding how to change them so they can get more info, delve deeper into our personal business, make it more difficult for us to get the medical care we need, continue collecting and no doubt selling the data that results.
The good news is, people are beginning to catch on to what’s happening. Acute pain patients are being denied medical care all across the country, and they are joining our ranks. We are beginning to make a lot of noise, and we’re starting to turn head in our direction. We’re pointing out that one group is at the bottom of nearly all the hype and hysteria, One group who PROPoses using one particular drug for all things. One group who now PROPoses that chronic pain patients be involuntarily committed to drug rehab centers and given addiction diagnosis. They are beginning to be called out and seen for exactly who and what they are.
That said, KEEP SCREAMING! KEEP FIGHTING! Keep researching, and keep sharing what you find!
I am Passionate Pachyderms, The Brutally Honest Elephant In EVERY ROOM, And I Tell It Like It is!
2 Comments on “PDMP’s, Privacy, Patients, Pharmacies, Physicians, & The Plan”
As an intractable pain patient, I have to say this article was one if the best l have read on the plight of the pain patients ,of which I am one. It was very informative and very well written. It was easy to understand. After reading it, I am amazed there is not one attorney out there not willing to take on a class action suit for 16 million pain patients whose constitutional rights have been totally ignored. Great piece of work.
Thank you.
Of course You’re correct.
How sad is it that the rest hate truth???