Just “Say No” to Drugs

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A Flash-Back in History

[By Staff Reporters]

This photo was sent in by one of our ME-P readers for your enjoyment.

Nancy

[First Lady Nancy Reagan at a “Just Say No” to Drugs Rally at the White House in the 1980’s]

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Conclusion

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Why President Nixon Signed the Controlled Substances Act in 1970

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The DEA History

[By Staff Reporters]

Doctors prescribe harmful and potentially addictive drugs, and they all hold a DEA license to do so.

But, did you know that one of the foundations upon which the Drug Enforcement Administration was created is the Controlled Substances Act (CSA)? It was signed into law as part of a broader set of laws called The Comprehensive Drug Abuse Prevention and Control Act of 1970.

The CSA

As all doctors and nurses know, the CSA created five schedules for controlled substances ranging from Schedule I, the most restrictive classification to Schedule V, the least so.

Schedule I drugs have a 1) High potential for abuse 2) No currently accepted medical use in treatment in the United States and c) Lack of accepted safety for use under medical supervision.

Medicare and Medicaid drug capsules

Definition of Controlled Substance Schedules

An updated and complete list  of the schedules is published annually in Title 21 Code of Federal Regulations  (C.F.R.) §§ 1308.11 through 1308.15.

Substances are placed in their respective schedules based on whether  they have a currently accepted medical use in treatment in the United States,  their relative abuse potential, and likelihood of causing dependence when  abused.  Some examples of the drugs in  each schedule are listed below.

Schedule I Controlled Substances

Substances in this schedule have no currently accepted  medical use in the United States, a lack of accepted safety for use under  medical supervision, and a high potential for abuse.

Some examples of substances listed in Schedule I are:  heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote,  methaqualone, and 3,4-methylenedioxymethamphetamine (“Ecstasy”).

Schedule II Controlled Substances

Substances in this schedule have a high potential for abuse  which may lead to severe psychological or physical dependence.

Examples of Schedule II narcotics include: hydromorphone  (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone  (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®).  Other Schedule II narcotics include:  morphine, opium, and codeine.

Examples of Schedule II stimulants include: amphetamine  (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate  (Ritalin®).

Other Schedule II substances include: amobarbital,  glutethimide, and pentobarbital.

Schedule III Controlled Substances

Substances in this schedule have a potential for abuse less  than substances in Schedules I or II and abuse may lead to moderate or low  physical dependence or high psychological dependence.

Examples of  Schedule III narcotics include: combination products containing less than 15  milligrams of hydrocodone per dosage unit (Vicodin®), products containing not  more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine®), and  buprenorphine (Suboxone®).

Examples of Schedule III non-narcotics include:  benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such  as Depo®-Testosterone.

Schedule IV Controlled Substances

Substances in this schedule have a low potential for abuse  relative to substances in Schedule III.

Examples of Schedule IV substances include: alprazolam  (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate  (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®),  temazepam (Restoril®), and triazolam (Halcion®).

Schedule V Controlled Substances

Substances in this schedule have a low potential for abuse  relative to substances listed in Schedule IV and consist primarily of  preparations containing limited quantities of certain narcotics.

Examples of Schedule V substances include: cough  preparations containing not more than 200 milligrams of codeine per 100  milliliters or per 100 grams (Robitussin AC®, Phenergan with Codeine®), and  ezogabine.

The Nixon Connection

CSA as part of the Comprehensive Drug Abuse Prevention and Control Act was signed into law by President Richard Nixon on October 27, 1970.

RMN

[President Nixon Signs the Controlled Substances Act] 

Assessment

This picture was taken on that day at the White House. Behind the president is Attorney General John Mitchell and next to the president is BNDD Director Jack Ingersoll.

Conclusion

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Understanding Physician Assisted Suicide

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Right-2-Die Issues for Financial Planners

By Dr. David Edward Marcinko; MBA, CPHQ, CMP™

By Hope Rachel Hetico; RN, MHA, CPQH, CMP™

[Publisher-in-Chief and Managing Editor]dave-and-hope8

There are few topics in the field of medicine – and end of life financial planning – that are more controversial than physician assisted suicide.

Historical Review

So, let’s start with a little history for financial advisors [FAs] to understand. In the State of Oregon, the “death with Dignity act, a citizens initiative, was first passed by Oregon voters in November 1994.  While the margin was a close 51% to 49% the act was immediately delayed by legal injunction. The case was the product of the debate, moral, medical and political, over assisted suicide. But interestingly, the issue before the Supreme Court had to do with interpreting a federal statute, the “Controlled Substances Act,” to see whether it gave the attorney general the authority to prohibit physicians from prescribing regulated drugs for assisted suicide even when its state law allows them to do it. This was an important topic for both of us, as prescribers, and as FAs.insurance-book3

Center for Ethics in Health Care [CEHC]

While the appeals were underway, the Center for Ethics in Health Care [CEHC] convened a task force to improve the care for the Terminally-Ill Oregonians. Although remaining neutral on the issue of physician assisted suicide, the task force took on the objective of promoting excellent medical care for the dying. One of its goals was to promote professional standards related to the “Death with Dignity Act.”  The purpose therefore was to offer guidance to health care, and financial, professionals whose terminally ill patients and clients may have an interest in exploring their new options.dhimc-book10

Assessment

After multiple proceedings and rejection by the US Supreme Court, the Ninth Circuit Court of Appeals lifted the injunction and physician assisted suicide became a legal option for terminally ill patients. So, as for Physician Assisted Suicide, it is not clear whether, or how many more states, will enact similar laws since the court wasn’t necessarily giving its support for the practice itself. And, this is a contentious topic for further debate; as is medical marijuana use for pain control, and others.

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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