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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

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A 4/20 [Medical] Cannabis Culture Day Pictorial

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About Four-Twenty Day

[By Anonymous DEA Agent]

Today is … 420, 4:20, or 4/20 (pronounced four-twenty).

And, it refers to consumption of cannabis and, by extension, a way to identify oneself with cannabis subculture. Observances based on the number include the time (4:20 p.m.) as well as the date (April 20).

Again … that’s today as this ME-P was published @ 4:20 p.m., EST!

THE DEA DESTROYS A POT FARM

PHOTOS: 

  1. Photo taken after the “grow” was eradicated. There is still no “pot” of gold at the end of the rainbow.
  2. DEA taking one of many seized vehicles/equipment.
  3. The marijuana farm was operating under the name “Brian’s Green Thumb Farm.”
  4. Inside the barn, Agents found rows and rows of drying marijuana.
  5. Over 2,000 pounds of drying marijuana from the barn, bagged and ready for destruction.
  6. Air view of the massive “grow” from the guard tower.
  7. One of two sleeping shelters, each guarding the middle perimeter. In the back, one of four tents, each positioned in the corners for guards.
  8. The plant being ripped out of the ground by the backhoe.

© iMBA Inc. All rights reserved.

Assessment

Link: http://en.wikipedia.org/wiki/420_(cannabis_culture)

UPDATE 2019: Carl’s Jr. will become the first major fast-food chain to debut a cannabis-infused burger:

LINK: http://www.msn.com/en-us/foodanddrink/foodnews/carls-jr-will-become-the-first-major-fast-food-chain-to-debut-a-cannabis-infused-burger/ar-BBW1Q7H?li=BBnbfcL

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National Prescription Drug Take Back Day

October 26, 2019 – 10:AM to 2:PM

The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.

Prescription Pill Bottles

MORE: https://www.bing.com/videos/search?q=dea+take+back+day&&view=detail&mid=0D5B986D9C5FD79B077B0D5B986D9C5FD79B077B&&FORM=VRDGAR

MORE: https://takebackday.dea.gov/

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Ambulance DEM

***

About the Opioid Crisis

And, Drug Distributors

[By Vitaliy Katsenelson CFA]

I don’t know anyone personally who has been affected by the opioid epidemic in the US. And I truly hope I never will. I don’t know if I would be able to maintain objectivity in my analysis of drug distributors and their involvement in this epidemic if I had experienced getting a call at night informing me that my loved one had died from a drug overdose. Drug overdoses killed 70,237 Americans in 2017. Of these deaths, 47,600 (67.8%) involved opioids and 17,000 involved prescription opioids (24% of total overdose deaths). Legally prescribed opioids are killing 47 of us every day.

How did we get here?

According to the National Institute on Drug Abuse: “In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive.”

Today pharma distributors are used as scapegoats for the opioid epidemic – not because they are guilty but because they have money and they are “drug distributors.” They are dragged through the same mud as the tobacco companies and British Petroleum (after it spilled millions of gallons of oil in the Gulf of Mexico). Despite negative headlines, we own drug distributors.

Here is why:

They distribute legally prescribed medicine to pharmacies that are approved by several government agencies, including the DEA. Doctors write scripts; pharma distributors order medicine from pharma manufacturers and deliver them to pharmacies. The sad truth about the opioid epidemic is that 21-29% of patients who were prescribed them for chronic pain misused them, and 8-12% of those who received an opioid prescription developed an opioid use disorder.
However, just as truck drivers cannot be held liable for delivering cigarettes to convenience stores, pharma distributors are not manufacturers of drugs and cannot be held liable for the addictive properties of the drugs they distribute or the fact that doctors overprescribe them and patients misuse them.
Also, the DEA should be responsible for limiting the illegal use of opioids. That is its job – DEA stands for Drug Enforcement Agency. It has legal and enforcement resources that distributors lack. And it has a lot more data and tools. Drug distributors do their part and provide data to the ARCOS database that DEA manages.
***
drugs
***
However, each individual distributor has data only for the drugs it distributes, while DEA has data (which it doesn’t share with distributors) for all opioid sales to pharmacies. The DEA is in a much better position to spot suspicious activity in orders than distributors. The DEA controls how much legal opioid is manufactured in the US every year and has been increasing quotas of opioids produced.
Opioids constitute only a very small percentage of the $450 billion in drugs distributed in the US, and thus incentives for distributors to overdistribute opioids are very limited. Though lawyers and the media keep saying that distributors are some of the largest companies in the S&P 500 by sales, they forget to mention that distributors operate on razor thin margins of less than 2%. Comparing the distributors (not even the makers) of legal medicine, that helps millions of people cope with excruciating pain, to cigarette companies that have a 40% pretax profit margin on a product that doesn’t have a societal benefit, and is almost guaranteed to cause cancer if you use it long enough, creates awesome headlines but has little substance.
  • What if DEA was the one distributing all the opioid drugs to pharmacies instead of McKesson, Cardinal Health, and Amerisource Bergen?
  • Would fewer people get addicted to opioids?
  • Would opioids be less accessible? Remember, DEA sets the production targets every year.
Maybe DEA would catch a few bad actors sooner – it has more data than distributors and a specific skillset and mindset aimed at catching criminals.
But in the big scheme of things, even if DEA distributed opioids nothing would really change. Doctors would still prescribe them; some patients would still get addicted to them … and so on. Distributors will likely settle lawsuits for two reasons:
First, McKesson already settled with the FDA for $150 million for “failure to report suspicious orders of pharmaceutical drugs.”
***
Second, McKesson and other drug distributors don’t want to be involved in costly and protracted litigation. We don’t know how much the settlement will be, but it is very unlikely to be in the hundreds of billions of dollars and likely (see reasons above) to be hundreds of millions or a few billion dollars.
***
Assessment
Today McKessonʻs market capitalization is $25 billion. We think the company is worth at least $50 billion (at 15 times earnings), thus there is a $25 billion of margin of safety. If the lawsuit costs the company less than $25 billion, McKesson will be a profitable investment; if not, then the market is right and we are wrong.

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***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

The Pill Mill Epidemic

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What it is – How it works?

michelle

[By Michelle Peterman]

miche.peterman@gmail.com

People who are getting access to prescription medication illegally are on the rise, thanks to what the government and drug addiction specialists call “Pill Mills.”

The United States has a significant enough problem with people addicted to illegal substances, such as heroin, cocaine, and methamphetamines.

What Is A Pill Mill?

You may be asking yourself, “What’s A Pill Mill?” All over the US there are legitimate doctors and pain management centers that are in place to assist patients with managing pain. These centers take great care to make sure patients do not become addicted to their medications and will provide assistance if they do.

Unfortunately, there are pain management centers that operate as these “Pill Mills” and are glorified drug dealers. These people are as bad as the drug suppliers and traffickers who sell Heroin or Ice on the streets. Pill Mills will often have a walk in appointment policy, minimum record keeping methods, and armed guards. Other signs include accepting cash-only, no physical exams, and supplying patients with doses of narcotics that are over the authorized limits.

Many people who are legally prescribed medication may start self-medicating and become addicted, needing more and more drugs. These same individuals often turn to pill mills to gain access to prescriptions that more ethical doctors would not give them.

***

pill mill

***

Pill Mill Issues in Florida

It has been said that Florida is the epicenter of the pill mill industry. In 2010, as many as seven people were dying every day as a result of a prescription medication overdose in the State of Florida, and countless other deaths were occurring throughout The States. Authorities believed that Florida had become a haven for drug abusers and distributors to make huge profits in dispensing narcotics illegally.

In 2011, government took action and many pain management centers, medical practices, and clinics were raided. This happened in South Florida with the intention to crack down on the many “pill mills” that the authorities strongly suspected were prescribing Oxycodone in extremely high doses outside of controlled substance authority guidelines.

The authorities also found during their investigation that patients were recruited via the Internet. Six clinic owners and various other staff were indicted on charges that they conspired together to illegally supply patients with over 660,000 high and illegal doses of Oxycodone and collected over $22 million in profits.

***

pill mill

***

The DEA Wages War Against Pill Mills in the South

In 2010, Florida had over nine hundred registered pain management centers. As of January 2014, that number dropped to around three hundred and fifty clinics.

However, it seems that Georgia is now dealing with many of those businesses that fled Florida after stricter measures were implemented. Huffington Post reports that “The DEA is prosecuting pain clinic operators who used to do business in Florida and picked up and moved to Georgia immediately after Florida passed tougher restrictions in 2011.”

Moreover, just recently, Drug Enforcement Administration Raids ‘Pill Mills’ in Four Southern States, including Arkansas, Alabama, Louisiana, and Mississippi.

Assessment

Prescription drug abuse has been declared a massive epidemic in the United States and yet another fight the authorities are trying to win. Tougher regulations and crackdowns from the DEA seem to be making a dent in this major issue.

More:

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ABOUT

Michelle is a former communications associate who transitioned into building her own freelance business. She enjoys health and staying on top of the latest news.  Sitting by the beach is one of her favorite activities in her free time.

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Today is “World Pharmacist” Day

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Brainchild of the International Pharmaceutical Federation [IPF]

[By Dr. David Edward Marcinko MBA CMP™]

DEM blue tieWorld Pharmacists Day was the brainchild of the International Pharmaceutical Federation (IPF), with the council of this organization voting to establish the event in the late 2000s during a conference they staged in Istanbul, Turkey.

The aim of the day is to bring attention to pharmacies and the positive benefits they offer when it comes to health and FIP encourages all its members to get involved to make the event a success.

***

WPD

***

Each year the organization announces a different theme so that associations and individuals in the pharmaceutical industry can put together national campaigns or local projects to showcase the good work they do in helping to improve the health of people around the world. This can include giving lectures, holding exhibitions, or organizing an activity day for adults and kids to demonstrate the many ways that a pharmacy can help them.

Link: http://worldpharmacistsday.org/

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3 Steps to Take Before Buying Healthcare E-Signature Solutions

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More on Paperless Healthcare Records

[By Patrick McTosh]

The movement towards paperless healthcare is growing. Every year, more and more health professionals are beginning to implement EMRs and EHRs as a way to turn their file cabinets into data on a hard drive. While EHRs help the problems of storing paper, they do not create documents that can be legally, securely and efficiently shared with third parties and patients during day to day activities.

These issues can be addressed by implementing an electronic signature solution. These types of solutions allow professions to create documents for physician orders, prescriptions, patient admissions, consent forms and other important medical documents in a timely and relatively paper free manner.

Verify EHR or EMR Integration

It’s important to ensure that whatever electronic signature software is compatible with your current EHR and EMR software. While most e-signature solution providers claim they have specialized services for healthcare organization, it’s best to confirm with a phone call or email that they have experience integrating their services with the EMR that is currently in use.

Verify Local Legislation & Signature Guidelines

Hospital accreditors have already recognized e-signatures as equivalent to paper signatures. However, it’s always important to verify federal and state regulations regarding e-prescriptions and electronic signatures.

For example, the latest DEA regulations on electronic prescriptions require digital signatures to have at least a biometric authentication. In addition, some states have not adopted the Uniform Electronic Transactions Act and therefore have difference laws pertaining to the legality of e-signatures.

Most e-signature providers specializing in healthcare tend to be on top of these things because better legal compliance is one of the benefits of e-signatures as a whole, but it’s always better do double check.

eHRs

Ensure It’s Human Error Proof

Many e-signature solutions attempt to reduce the risk of human error due to lost, damage or incorrectly completed forms which can cause significant delays. As most e-signature software will actually guide the signer through the complete process ensuring that the document meets necessary requirements before sealing the document with a tamper-evident digital seal.

Assessment

However, not all providers have such precautions against human errors, but it is definitely a must in the healthcare industry.

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Fake Sandwich Drug Concealment

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Hiding illegal drugs in a plastic “sandwich”

By Anonymous

[Click to View]

Fake Sandwich Concealment

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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.

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The DEA’s [Original] Model Paraphernalia Law

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Drug use in the 60s and 70s

By Staff Reporters

In the 1960’s and 1970’s drug use in the United States continued to grow, peaking in 1979. This was, in part, due to the wide, legal availability of drug paraphernalia like that captured in this picture of a dealer on a street corner near DEA headquarters (then located at 1405 I Street NW in Washington DC) in the late 1970’s.

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DEA

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In order to combat this trend, DEA was asked by the White House to create a model Drug Paraphernalia Law to be implemented and enforced at the state and local level, giving DEA and other partners another tool in the fight against drug abuse.

Conclusion

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Do Foreclosures Promote Clandestine Pot Houses?

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About Indoor Marijuana Grow Farms and Labs

[By DEA Agent]

Marijuana growers are shifting to the suburbs from rural and commercial areas, helped by a housing crisis that created a glut of affordable home and basement farms like the images below.

BASEMENT POT HOUSE

CLOSE-UP VIEW

Assesment

Unlike traditional earthen farming methods in the photos above, hydroponic grow boxes may be large stealth cabinets that produce fresh marijuana, or other herbs and vegetables, in an indoor garden and grow on water, nutrients and grow-lights alone.

Conclusion

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About Next-Gen Bath Salts

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By The DEA Agent

Innocent Name – The Dangerous Consequences of MDPV

The recent media explosion over bath salts is not unwarranted. Over the past two years, the public eye has zoomed in on dangerous drug, still legally sold in some states. And, there’ve been many bizarre cases of violence and psychotic outbursts from users.

About MDPV

But, what exactly are bath salts?

Assessment

Keep reading the above to learn about the history and effects of bath salts.

Source: rehab-international.org

More info: http://en.wikipedia.org/wiki/Methylenedioxypyrovalerone

Conclusion

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Actual DEA “Meth Lab” Drug Raid [POV Photo Essay]

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Just say No to “Illegal” Drugs

By Anonymous DEA Agent

Preparing for a clandestine night-time lab raid – inner city row-house; Baltimore, MD

Spot lights and infrared beams cast a luminescent hue.

Note the armed agent silhouetted in the attic window.

Assessment

Danger – these guys mean business.

Conclusion

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About Drug Use and Abuse in America

The United States of Drug Addicts?

By Muhammad Saleem with ME-P Staff Reporters
http://muhammadsaleem.com
msaleem@gmail.com

Example 1:

Georgia meth seizure near US record
[Augusta Chronicle 12/01/2010]

Gwinnett County police seized nearly half a ton of methamphetamine with an estimated street value of $44.6 million from a home in Norcross, one of the biggest meth seizures ever made in the United States.

Police raided a house off  Beaver Ruin Road between Interstate 85 and Buford Highway late Monday after authorities got a report that a large amount of meth was being produced there.

Officers found 150 pounds of crystal methamphetamine ready for sale and 200 gallons of liquid methamphetamine oil in a large drug lab.

Gwinnett County police called in the U.S. Drug Enforcement Administration and a fire department hazmats team because of the size of the drug lab.

“This would feed hundreds and hundreds of addicts and destroy who knows how many lives, countless lives,” said Rodney Benson of the DEA field office in Atlanta. No one was in the home at the time of the raid, police said.

Authorities said they suspect a Mexican-based drug trafficking organization in the drug-making operation, but added investigators have not determined what group was responsible.

Police arrested 33-year-old Jose Galvez-Vela of Weslaco, Texas, and charged him with trafficking in meth. Police didn’t say exactly where he was arrested and didn’t know if he had a lawyer. Authorities said they are seeking others following the raid in Norcross, in the Northern Atlanta suburb of Gwinnett County.

The discovery underscored a growing trend of Mexican drug trafficking organizations smuggling liquid meth into the United States to be converted into a crystal form for sale, Benson said. The liquid can be converted to crystal form within 48 hours, he said.

Investigators in hazmats suits cautiously removed the meth and flammable drug-making chemicals from the house Monday. It didn’t appear that anyone was living in the house and that it was used strictly for manufacturing meth, police said. The house was “really a powder keg, ready to blow at any time,” Benson said. “Clearly removing that threat from that house is clearly making that neighborhood much safer today.”

The house is set in a quiet, low-to middle-income subdivision, Gwinnett police Cpl. Edwin Ritter said.

Example 2:

Georgia police seize meth worth $44.6M from house
[Los Angeles Times 12/01/2010]

NORCROSS, Ga. (AP) — Investigators have seized hundreds of pounds of methamphetamine with an estimated street value of $44.6 million in suburban Atlanta, one of the biggest meth seizures in the country, authorities said Tuesday. Investigators said the raid was conducted late Monday at a house in Norcross, just north of Atlanta, after authorities were told a large amount of meth was being produced there. They reported finding 150 pounds of crystal methamphetamine ready for sale and 200 gallons of liquid methamphetamine oil in a large drug lab.

“This would feed hundreds and hundreds of addicts and destroy who knows how many lives, countless lives,” said Rodney Benson with the federal Drug Enforcement Administration’s field office in Atlanta.

No one was in the home at the time of the raid, police said. Authorities said they suspect a Mexican-based drug trafficking organization in the drug making operation, but added investigators have not determined what group was responsible.

Investigators said they arrested 33-year-old Jose Galvez-Vela of Weslaco, Texas, and charged him with trafficking in meth. Police didn’t say exactly where he was arrested and didn’t know if he had a lawyer. Authorities said they are seeking others following the raid in Norcross, in the northern Atlanta suburb of Gwinnett County.

The discovery underscored a growing trend of Mexican drug trafficking organizations smuggling methamphetamine in liquid form across the border with the United States to be converted into a crystal form for sale, Benson said. The liquid can be converted to crystal form within 48 hours, he added. Investigators in hazmat suits used extreme caution as they removed the meth and highly flammable drugmaking chemicals from the house. It didn’t appear that anyone was living in the house and that it was used strictly for manufacturing meth, police said.

The house was “really a powder keg, ready to blow at any time,” Benson said. “Clearly removing that threat from that house is clearly making that neighborhood much safer today.”

The house is set in a quiet, low-to middle-income subdivision, Gwinnett police Cpl. Edwin Ritter said. Benson said the lab’s location was typical of Mexican drug organizations known to operate sophisticated networks from nondescript houses in suburban Atlanta for distribution along the East Coast.

Investigators said they were following several leads to others allegedly involved but declined further comment, citing an ongoing investigation.

Citing the size of the drug lab and the hazardous chemicals involved, police said they requested help from the DEA and a hazardous materials team with a local fire department.

Editor’s Note

Although Georgia is the home of the ME-P, these Georgia State examples were purely coincidental.

Source: http://www.criminaljusticeusa.com

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Doctor’s Lawsuit Targets Parents of Patient Who Overdosed

By Marshall Allen
ProPublica, Aug. 26, 2011, 10:57 am

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The dramatic rise in prescription narcotics use [1]—and the subsequent increase in overdose deaths—has led to a spate of lawsuits around the country targeting doctors for malpractice or running pill mills [2]. But legal experts say the case of one family physician in Henderson,Nev., stands out.

The case of Kevin Buckwalter

Dr. Kevin Buckwalter has turned the tables, filing a lawsuit against the parents of a young woman who died from an overdose of narcotics that he prescribed.

Buckwalter’s suit accuses John and Maggie DeBaun of abusing the legal process, intentionally inflicting emotional distress and interfering with his ability to do business by filing a medical malpractice case against him for the death of their daughter.

“I’ve never heard of such a lawsuit,” said Stacey Tovino, a professor at the William S. Boyd School of Law at theUniversity of Nevada, Las Vegas. Tovino and otherNevada legal experts said it appears to them that Buckwalter abused the legal process in an attempt to intimidate the DeBauns.

Buckwalter did not respond to a call for comment. His brother Bryce, who serves as his attorney, declined to comment about the lawsuit. In an email, he accused this reporter of harassment for attempting to contact his brother, said he would seek a restraining order and threatened to sue ProPublica.

A Controversial Subject?

Buckwalter has been a subject of controversy for several years. A 2008 Las Vegas Sun investigation [3], also by this reporter, highlighted the opinions of four pain-management specialists who reviewed Buckwalter’s care of patients and said it appeared to be negligent.

Staci Voyda, a teenager addicted to prescription narcotics, wrote in her journal that she went to Buckwalter to get off drugs. But his treatment included ramping up her dosages of narcotics. She killed herself in August 2007, and family members say the drugs pushed her over the edge.

Another Buckwalter patient, 69-year-old Barbara Baile, was prescribed large doses of narcotics, which caused constipation so severe it ruptured her bowels. A subsequent infection killed her.

These are prescriptions for Xanax and morphine written by Dr. Kevin Buckwalter for Andrea and Clint Duncan. (Sam Morris/Las VegasSun) | See Las Vegas Sun’s full investigation on Painful Painkillers [4].

The DeBauns’ daughter, Andrea Duncan, died in 2005 from intoxication with opiates and benzodiazepines [5], a class of drugs that includes Valium and Xanax. Four days earlier, her husband Clint, also a Buckwalter patient, had overdosed on prescription narcotics and died.

In a 2007 videotaped deposition [6] for an unrelated lawsuit, Buckwalter described the treatment he provided Duncan. Under oath, Buckwalter said he did not examine Duncan on her first visit because he “did not have time,” yet prescribed her 300 tablets of Xanax, an anti-anxiety medication, and the painkiller hydrocodone, a synthetic opiate.

The following year, the U.S. Drug Enforcement Administration and Nevada State Board of Medical Examiners stripped Buckwalter of his license to prescribe controlled substances. The DEA attributed at least eight overdose deaths [7] to Buckwalter. The medical board blamed him for four cases of malpractice [8], including one in which the patient died. Buckwalter closed his practice.

Dallaslawyer Kay Van Wey, who specializes in pill mill cases, filed six lawsuits against Buckwalter on behalf of patients who died or were harmed. The DeBaun case was filed in April 2009, past the statute of limitations in Nevada. But Van Wey argued in the complaint that the deadline should be extended because Buckwalter allegedly concealed his negligence and altered medical records.

A judge didn’t buy the argument and dismissed the case. Buckwalter claims in his lawsuit that the DeBauns sued to harass and annoy him.

Buckwalter has denied all of the allegations that he provided substandard care. His lawsuit against the medical board to get his prescribing privileges reinstated was unsuccessful.

Jeffrey Stempel, a professor at the UNLV law school, said that for the DeBauns’ lawsuit to be considered an “abuse” of the legal process, there would have to be some ulterior motive other than seeking damages for their daughter’s death.

Assessment

Ann McGinley, another professor at the UNLV law school, said it takes more than simply filing a lawsuit to support a claim of intentional infliction of emotional distress. And given that Buckwalter lost his ability to prescribe controlled substances in 2008, it’s difficult to see how the DeBauns interfered with Buckwalter’s ability to conduct his business, she said.

McGinley said that if lawsuits like Buckwalter’s became more common, they could have a chilling effect, discouraging patients from pursuing legitimate malpractice claims. “My concern is that other doctors will take this on as something that they will do regularly,” she said.

Link: http://www.propublica.org/article/doctors-lawsuit-targets-parents-of-patient-who-overdosed

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Settlement Reached with Temple University Health System

Diversion of Controlled Substances

By Anonymous

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NOV 01, 2010 — PHILADELPHIA – The Temple University Health System (“TUHS”), today, agreed to pay $130,000 to the U.S. government for failing to keep proper receiving, dispensing and inventory records of controlled substances, and failing to take effective precautions to prevent theft or loss of controlled substances, announced United States Attorney Zane David Memeger. In addition, TUHS agreed to implement a detailed Compliance Assessment Plan to review and monitor its policies and procedures relating to controlled substances.

“Hospitals must have effective controls to prevent and detect drug diversion, in order to
prevent people from suffering significant physical harm, addiction or death when they use controlled substances without appropriate supervision from their doctor”,
Memeger said.

Back to 2004

In 2004, Temple University Hospital’s lack of control over controlled substances allowed its then chief resident of anesthesiology to steal 107 vials of Ketamine and smaller amounts of Fentanyl, Midazolam and Morphine. The resident doctor, who attempted to sell the drugs to an undercover Drug Enforcement Administration (DEA) operative was charged and convicted. In addition, from January 2007 to February 2007, an anesthesiologist at Jeanes Hospital, a Temple University Health Systems facility, manipulated the computerized controlled substance distribution system to extract 35 vials of Fentanyl and five vials of Morphine for his own personal use. DEA Special Agent in Charge John J. Bryfonski stated:

“The public expects our health professionals to honor their oath and follow both regulations and the law to assure the health and safety of the people they treat. When these professionals depart from their oath and the law by diverting controlled substance-pharmaceuticals from legitimate medical uses to illegal uses, DEA will investigate and hold them accountable.”

The DEA Audits

Following these thefts, DEA audited five Temple University Health Systems facilities and found that the hospital failed to keep dispensing records for certain controlled substances; failed to note on the required DEA form the number of packages of controlled substances the pharmacy received and the date it received them; failed to verify the amount of controlled substances coming into the pharmacy on each invoice; and kept inaccurate inventory of certain controlled substances.

Stricter Future Controls

TUHS voluntarily initiated changes to their drug dispensing system, to provide stricter measures for accessing the medication and frequent counts of the facilities’ inventory. In addition to the monetary settlement, TUHS agreed to implement an innovative Compliance Assessment Plan whereby an independent consultant will survey the Temple facilities and recommend remedial changes as necessary. The agreement requires TUHS to report to DEA discrepancies revealed during these audits.

Assessment

This resolution is part of the Eastern District of Pennsylvania’s Special Focus team Health Care Fraud initiative. The case was investigated by DEA Philadelphia Division Diversion Group. The case was handled by Assistant United States Attorney Susan R. Becker, Auditor Allison Barnes and Healthcare Fraud Consultant Ray Uhlhorn.

Conclusion

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On the New Pot Health Policy in NJ?

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It’s Medicinal – Man!

By Staff Reporters

Did you know that in January 2010, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses?

Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington; around a dozen more states are weighing pending bills.

Jersey is Toughest State

The New Jersey law is the most restrictive in the nation and authorizes prescribed marijuana for only a handful of chronic illnesses, such as multiple sclerosis, cancer, glaucoma, epilepsy, Crohn’s disease, AIDS, muscular dystrophy and Lou Gehrig’s disease. Unlike other states, physicians in New Jersey will not be able to prescribe medical marijuana for anxiety, headaches, or chronic pain.

Dispensaries

According to reports, the state of New Jersey plans to authorize six dispensaries, and patients will receive identification cards authorizing them to purchase the drug. They will not be able to grow their own marijuana or use it in public, however. And, individuals without a prescription will still be subject to criminal prosecution if caught in possession of marijuana.

http://www.hcplive.com/oncology/articles/Marijuana?utm_source=Listrak&utm_medium=Email&utm_term=%2foncology%2farticles%2fMarijuana&utm_campaign=Legalizing+Medical+Marijuana

Assessment

Do you support the use of medical marijuana? If you are a doctor that lives in a state where medical marijuana is legalized, have you prescribed it to any patients? If you live in a state where medical marijuana is not legalized, do you want it to be? What about you patients, out there?

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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