The Doctor Patient Forum

Why is my doctor afraid to prescribe?   Bev discusses a recent webinar by BJA TTAC - COSSAP - Bureau of Justice Assistance's Comprehensive Opioid, Stimulant, and Substance Abuse Program Resource Center. Link to their website and webinars The Doctor Patient Forum's Podcast Episodes on: Red Flags/Drug-Seeking Behavior PDMP/NarxCare - Part 1 PDMP/NarxCare - Part 2 PDMP/NarxCare - Part 3 PDMP/NarxCare - Part 4 Patient Abandonment and Forced Taper Questionnaire Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

Mark Scheeren and his colleague, Michelle Dunbar, developed the Freedom Model of Addiction. Listen as Claudia and Bev discuss this, agreeing on some things and disagreeing on others. It's always interesting to listen to different points of view. Both Mark and Michelle have struggled with addiction.  Is addiction a brain disease? Can someone recover? Is medication always needed to stop using substances? Do people with addiction have to stop using all substances for the rest of their lives? Is the hijacked brain idea true? Who created it and why? The Freedom Model research - The Baldwin Research Institute The Freedom Model Website  "Here are some really informative opiate/MAT-centered articles written by FM co-author and BRI Research Fellow, Steven Slate on his site www.thecleanslate.org" https://www.thecleanslate.org/the-facts-buprenorphine-treatment-for-opioid-use-disorder-is-widespread/ https://www.thecleanslate.org/how-the-new-york-times-and-everyone-else-keeps-getting-one-major-fact-about-opioid-addiction-and-treatment-wrong/ Mark Scheeren's co-author and BRI Research Fellow, Steven Slate’s Ted Talk  You can contact Mark at info@thefreedommodel.org Information on opioid MDL settlement dollars - $54 billion and counting Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

"Jeffrey A. Singer is a senior fellow at the Cato Institute and works in the Department of Health Policy Studies. He is President Emeritus and founder of Valley Surgical Clinics Ltd., the largest and oldest group private surgical practice in Arizona and has been in private practice as a general surgeon for more than 35 years. He is also a visiting fellow at the Goldwater Institute in Phoenix. Singer is a member of the Board of Scientific Advisors of the American Council on Science and Health. From 1994 to 2016, he was a regular contributor to Arizona Medicine, the journal of the Arizona Medical Association. He served on the Advisory Board Council of the Center for Political Thought and Leadership at Arizona State University from 2014 to 2018 and is an adjunct instructor in the Program on Political History and Leadership at ASU. He writes and speaks extensively on regional and national public policy, with a specific focus on the areas of health care policy and the harmful effects of drug prohibition. He received his BA from Brooklyn College (City University of New York) and his MD from New York Medical College. He is a fellow of the American College of Surgeons." Links to articles discussed in this podcast episode: Nitazenes Cops Practicing Medicine Dr. Singer's Twitter  Dr. Josh Bloom's article about the Dr. Singer vs. Dr. Fugh-Berman debate Dr. Singer vs. Dr. Fugh-Berman debate Dr. Singer and Dr. Bloom's article discussing pain and tylenol Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

On November 7, 2022 chronic pain patient, Danny Elliot and his wife Gretchen, tragically took their lives after the DEA shut down Danny's doctor. Listen to our podcast from November 13, 2022 discussing Danny and Gretchen's suicides. We interview Danny's brother, Jim Elliot. Jim talks about Danny's life, his accident that caused his severe intractable pain, and what Danny was like when he had adequate pain medication compared to when he didn't. Here are Danny and Gretchen's obituaries. Jim's comment to us and the chronic pain community: "I'd like to add  how appreciative our family is of the chronic pain patient community which was so supportive and helpful during Danny's struggle; after he lost his Georgia doctor, the others he saw were all referrals from friends he made through social media. He was articulate and knowledgeable and tried to help others even when he wasn't getting much help himself. As I said in our interview, all we want is for Danny and Gretchen's story to help others and to expose how apathetic the federal government is toward people in need. Thank you ladies for this opportunity." This is the second suicide to to pain we've covered on our podcast. The first was Sonya Slone discussing the death of her husband, Brent. Unfortunately, nobody is measuring patient outcome and the consequences of the crackdown on opioid prescribing. Nobody records what happens to the patients after a doctor is shut down by the DEA, or if a doctor retires. Danny's wife had contacted 17 doctors to try to find continuity of care, and couldn't even get an appointment. This was the third time Danny had lost a doctor due to DEA action. We, at the Doctor Patient Forum, created a Google Document to attempt to collect stories of patient outcome from forced tapers and abandoned chronic pain patients. Please share the following: Patient Abandonment and Forced Opioid Taper Questionnaire If you have any questions about this form, please email Bev at bev@thedoctorpatientforum.com For a list of studies showing accurate statistics including the tapering studies mentioned, please visit thedoctorpatientforum.com Suicide hotline: 988 or 911 Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

Claudia and Bev interview Dr. Carl Hart. We discuss how pain patients are being harmed by horrible drug policy. Dr. Hart discusses his view of anti-opioid zealots like Dr. Andrew Kolodny and offers to use his platform to help us fight for pain patients.  I took this bio from his website, drcarlhart.com "Carl Hart is the Chair of the Department of Psychology at Columbia University. He is also the Ziff Professor of Psychology in the Departments of Psychology and Psychiatry. Professor Hart has published numerous scientific and popular articles in the area of neuropsychopharmacology and is co-author of the textbook Drugs, Society and Human Behavior (with Charles Ksir). His most recent book, “High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society,” was the 2014 winner of the PEN/E.O. Wilson Literary Science Writing Award. Professor Hart has appeared on multiple podcasts, radio and television shows including Real Time with Bill Maher and The O’Reilly Factor. He has also appeared in several documentary films including the award-winning “The House I Live In.” His essays have been published in several popular publications including The New York Times, Scientific American, The Nation, Ebony, The Root, and O Globo (Brazil’s leading newspaper)." Check out Dr. Carl Hart's Twitter account Here is a link to our survey for pain patients who have lost their pain doctor or are being force tapered. Disclaimer: The information provided to you in this podcast is not to be considered medical or legal advice.

Danny Elliot was a chronic pain patient who has been vocal on Twitter about what it was like for him after he lost his doctor because of actions of the DEA. Danny lost his doctor a few weeks ago for the third time due to the DEA. Where was the CDC's Opioid Rapid Response Program? The following article in Pain News Network gives a bit more detail. DEA Suspension of Doctor's License Leads to Double Suicide Please go to the following sources to hear/read them in their entirety.  Journalist Barry Meier at Stanford Medicine's Health Policy Forum Roger Chou's interview - PCSS Episode 5 - Applications of the CDC Guidelines Kolodny's quote about suicide due to pain being bogus Adriane Fugh-Berman pushes back against Dr. Kertesz about the need to study suicide due to pain or stopping pain medication Danny's Podcast on Painkiller Links mentioned in this podcast episode: Opioid Rapid Response Program (ORRP) Information Dr. Kertesz's Tweet about California Doctor CDC's recent tweet about ORRP Suicide hotline: 988 or 911 Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

This is part 4 in our NarxCare/PDMP series. We interview Jacob James Rich. This episode focuses on PDMP harms, law enforcement's access to the PDMP, and whether HIPAA protects patients from PDMP data being shared. Jacob James Rich is a researcher at the Cleveland Clinic Center for Evidence-Based Care Research, studying epidemiology and biostatistics at the Case Western Reserve University School of Medicine. Jacob also works as an analyst for Reason Foundation, focusing on healthcare policy. He has written extensively on drug policy topics, such as the consequences of prescription drug monitoring programs (PDMPs) on patient access and overdose mortality. Jacob is currently researching racial disparities in drug enforcement with CWRU Graduate Student Council's DEI Award. Brief: https://reason.org/policy-study/prescription-drug-monitoring-programs-effects-on-opioid-prescribing-and-drug-overdose-mortality/ Reason bio page: https://reason.org/author/jacob-rich/ Twitter: @jacobjamesrich Attorney Jennifer Oliva's article on PDMP and law enforcement in Duke Law Review - Prescription Drug Policing: The Right to Health Information privacy Pre- and post-Carpenter  Links to topics mentioned: Opioid Rapid Response Program content on The Doctor Patient Forum Website OIG Toolkit Links to podcasts or presentations in their entirety that were shared in this podcast -  NASCA - "State PDMP vs National PDMP" Cover 2 Resources - "Strike Force Stops Flow of Illicit Opioids" Cato Institute - "Patients, Privacy, and PDMP's" NPR show 1A - "Against the Pain - The Opioid Crisis and Medication Access" Kate Nicholson's bio - "Kate Nicholson, JD, is a civil rights attorney and a nationally-recognized expert on the Americans with Disabilities Act (ADA). She served in the U.S. Department of Justice for 18 years, where she litigated and managed cases, coordinated federal disability policy, and drafted the current ADA regulations." - Executive Director at NPAC Kate developed intractable pain after a surgical mishap left her unable to sit or stand and severely limited in walking for many years. She gave the TEDx talk, What We Lose When We Undertreat Pain, and speaks widely at universities and conferences and to medical groups." Disclaimer: The information provided to you in this podcast is not to be considered medical or legal advice.

Claudia and Bev discuss PDMP's (Prescription Drug Monitoring Programs) and NarxCare with Atty. Jennifer Oliva.  "Professor Oliva’s research and teaching interests include health law and policy, privacy law, evidence, torts, and complex litigation. She has served as an invited peer reviewer for the American Journal of Public Health, Yale Journal of Health Policy, Law, and Ethics, American Journal of Law & Medicine, Journal of Law and the Biosciences, and Big Data & Society and her scholarship has been published by or is forthcoming in, among other publications, the California Law Review, Duke Law Journal, Northwestern University Law Review, UCLA Law Review, North Carolina Law Review, Ohio State Law Journal, George Mason Law Review, and online companions to the University of Chicago Law Review and New York University Law Review." Jenn is on the Science and Policy Advisory Council for NPAC (National Pain Advocacy Center) Excerpts were played on this podcast that can be found in their entirety in the following links: NPR show 1A - "Against the Pain: The Opioid Crisis and Medication Access" "Patients, Privacy, and PDMP's" - Cato with Dr. Jeffrey Singer and Kate Nicholson Duke Margolis - "Strategies for Promoting the Safe Use of Prescription Opioids" NPR - "To End Addiction Epidemic" - Kolodny quote Cover 2 Resources - Gary Mendell Jennifer Oliva can be contacted on Twitter @jenndoliva Learn more about Jennifer on her website at uchastings Jennifer D. Oliva's paper:  "Dosing Discrimination: Regulating PDMP Risk Scores" Thank you to my co-researcher, Carrie Judy, for her tireless research and advocacy about NarxCare and PDMP. Disclaimer: The information provided to you in this podcast is not to be considered medical or legal advice

Claudia and Bev interview Pharmacist Matt from Tik Tok  Matt is a community pharmacist who works at a local independent pharmacy.  His goal with Tik Tok is to basically give a virtual consultation. A window to the world bringing pharmacy specific information to the world. Along with Tik Tok you, can also tune in to his podcast - the two druggists. It is an entertaining and insightful program with drug information and stories. You can also find Pharmacist Matt on Instagram. Walgreens good faith prescribing checklist Information about Walgreen's good faith prescribing checklist Blog about Walgreen's good faith prescribing checklist  Listen in as Matt gives tips to pain patients for when they go to the pharmacy. He explains what to do if the pharmacist gives you a hard time. He says what the pharmacist is having to deal with.  Disclaimer: The information that has been provided to you in this podcast is not to be considered medical or legal advice. Disclaimer: The information provided to you in this podcast is not to be considered medical or legal advice

Bev interviews Dr. Jay Joshi (from Daily Remedy) about an extremely important survey and we need your help! The opioid epidemic has incurred significant clinical and economic toll on the United States. The human impact of the epidemic has adversely affected communities and many employers. We see the impact on the data. Opioid overdoses continue to rise and more potent forms of illicit heroin and fentanyl flood the streets. The trends affect all aspects of healthcare, including the patient-physician encounter, a microcosm of the social ramifications of the epidemic. But data alone does not capture the perceptions that arise between physicians and patients during a clinic visit. Physicians are concerned about clinical and legal consequences that may arise if they prescribe controlled substances such as opioids to patients. Patients are concerned that their physicians will unnecessarily reduce or outright discontinue their medication, affecting their quality of life and their activities or daily living. As a result, there is an inherent lack of trust that builds between the physician and patient. These are major concerns. But they are lacking in the health data. To evaluate the impact these perceptions have on broader data trends, we propose a series of short one to two question surveys that glean specific patient perceptions that arise during the patient encounter when discussing opioids and pain management. How will we do this? Every week we will release a survey asking one or two pertinent questions on the perceptions patient experience during the patient encounter. We will stratify the responses per county and state and cross-reference them with existing data to evaluate how clinical perceptions affect or are affected by trends in clinical data. When will the questions be released? We will release each question on a Sunday starting October 9th. After that a new question will appear every Sunday for the next 10-12 weeks, excluding holiday weekends. How can we get involved? Foremost, take part in the survey. What you think matters. How you feel during a patient encounter is important. Your perceptions determine clinical outcomes. Once you answer the questions, please share the survey link and repost it across your social media feeds. The more responses we get, the stronger the survey response data. What’s the first question? Does your provider trust you? https://www.daily-remedy.com/survey/how-strongly-do-you-believe-that-you-can-tell-when-your-provider-does-not-trust-you/

This is part 2 of our NarxCare podcast series.   Part 1 We play portions of the radio show 1A of NPR that Maia Szalavitz and Bev Schechtman were on.  They covered the article Maia wrote in Wired about NarxCare called "The Pain Was Unbearable. So Why Did Doctors Turn Her Away?" Full recording of the radio show 1A Watch Dr. Ibsen do a running commentary on the radio show as it happened  Link to NarxCare information on our website.  Contact us at: bev@thedoctorpatientforum.com claudia@thedoctorpatientforum.com  Disclaimer: This information that has been provided to you in this podcast is not to be considered medical advice

In this episode Claudia Merandi and Bev Schechtman interview Dr. Neil.  He has put a tremendous amount of work into researching and analyzing NarxCare.  Part 1 of NarxCare includes an introduction to NarxCare and an interview with Dr. Neil.   Part 2 will come out next week and will have interviews with three women affected by NarxCare, and also portions of a talk show Bev and Maia Szalavitz were on called 1A with NPR.   The following information can be found on our website under FAQ's/What is NarxCare.   Please check out that link for more links including the article in Wired by Maia, the patent for NarxCare, and the Ohio Study the ORS was based on.  From The Doctor Patient Forum website: NarxCare, a product of a company called Bamboo Health, is a proprietary data analytics program. It uses up to 70 data points (that only Bamboo Health knows) and mixes them with your PDMP (prescription history) to assign four 3-digit scores letting your doctor or pharmacy know if you have a high risk of abuse or overdose. There is a Narcotic Score, a Stimulant Score, and a Sedative Score, and an Overdose Risk Score (ORS). According to Bamboo Health, "NarxCare aids care teams in clinical decision making, provides support to help prevent or manage substance use disorder, and empowers states with the comprehensive platform they need to take the next step in the battle against prescription drug addiction." Essentially, NarxCare pulls data from multiple state registries looking for red flags of drug seeking behavior. The three categories of prescription medication it looks at are narcotics (opioids), stimulants (ADHD meds) and sedatives (benzos, sleeping meds, etc.).  "The NarxCare report identifies risk factors with interactive visualizations, as well as an Rx Graph, and a set of scores that numerically correspond to the patient’s PDMP data." Although Appriss states on their website that their product shouldn't be used by itself to make medical decisions, that's not what's actually happening. As shown in this NarxCare article, patients are being denied medication or even being dismissed from a medical practice based on a NarxCare score alone.  Some of the risk factors used in the proprietary algorithm are:  The number of prescribers a patient has had in a two-year period.  The number of pharmacies a patient used in a two-year period.  The dosage (MME-Milligram Morphine Equivalent).  Amount of other medications that may increase potency of other medications.  Number of times prescriptions overlap with prescriptions from other providers.  Any Mental Health Diagnosis Distance from patient to doctor  Disclaimer: The information in this podcast is not to be considered medical or legal advice.

Claudia and Bev speak with a pain provider, Kelly. Kelly gives tips for interacting with your pain provider. What to do. What not to do.  UDT's are discussed. Spinal Cord Stimulators. ESI's.  Kelly is a nurse practitioner. Links from the episode: Opioid Induced Hyperalgesia - from our debunking lies section  Disclaimer: The information in this episode is not to be considered medical or legal advice

So many chronic pain patients are left without a provider for a variety of reasons. A doctor retires, a patient moves, a doctor is investigated, etc. If a patient is fortunate enough to find a new provider, it's difficult to know what to say or what not to say during the initial appointment. This is one of the most common questions we get from CPP's. We give you tips on how to prepare, what to say, what not to say, what the doctor may consider red flags, and more.    Topics we discussed in this episode:   Electronic Health Records (EHR's) - everything you need to know   One party recording consent states - as of 2022    Claudia's main Tik Tok account   The Doctor Patient Forum's other Tik Tok account   Disclaimer: The information that has been provided to you in this podcast is not to be considered medical advice.

Brent Slone had been in a horrific car accident where he became paralyzed. He was receiving pain management. In 2017, his clinic cut his pain medicine by more than half at one time. Although both Brent and Sonya did everything they could to fix the situation, they repeatedly were met with no help. Sonya knew Brent was waiting to hear from his pharmacy about a new prescription. Sadly, when she left work and looked at her phone, she saw this text from Brent - "they denied script im done love you."  He died by suicide. Sonya successfully sued the doctors and the clinic, and was awarded seven million dollars.  Sonya is using her voice to tell Brent's powerful story and plans to open a non profit in his name to bring awareness to the plight of chronic pain patients. We will update the notes here to include the information of the organization when we have it.   From the show:  Kolodny's quote about suicide due to pain being bogus  Maia Szalavitz's article about Brent  Link to the article about Brent Slone on our website Alabama suicide study Physician Liability for Suicide after Negligent Tapering of Opioids | Journal of Law, Medicine & Ethics | Cambridge Core The following is link to a Fundraiser created by Casonya Richardson-Slone : People with chronic pain need your support!  As Sonya stated in the podcast, her hope is to set up a non profit to bring awareness to this cause. From Sonya's fundraiser: "Moving forward...it’s my honor to share Brent’s story, and it’s my mission to make sure that those that need it most get the help, love, and support they need and deserve. This is Brent’s story. We finally have justice for Brent!!!"    Disclaimer: The donations to this fundraiser will go to Sonya and not to The Doctor Patient Forum. Thank you for supporting Sonya and helping her honor Brent's life! Suicide hotline: 988 or 911 Disclaimer: The information that has been provided to you in this podcast is not to be considered legal or medical advice.

Many are well aware of "drama" in the pain community. What we are addressing isn't drama. It is predators preying on vulnerable people. If you think you have been a victim of the same individuals or organizations we have, please contact your local authorities.

Listen to Ron Chapman discuss how prescribers and pharmacists are being targeted by the DEA. He explains how they do it and what a doctor should do if the DEA shows up at their office. He talks about whether or not CPP's can sue the DEA or the CDC. He discusses what the pain community can do to fight back. He explains the RUAN SCOTUS ruling and what it means for prescribers and patients. Also, he touches on whether or not a patient can sue a doctor. Ron has successfully defended many doctors including a recent case, which he mentions. He also runs a compliance company that can protect doctors and pharmacists. This episode is a great resource for prescribers and pharmacists to learn how to protect themselves from being the DEA's next target.   Ron has achieved more acquittals of physicians facing federal indictment than any other lawyer in the country. Recently his client was acquitted of a $540 million healthcare fraud indictment in the Eastern District of Michigan. He also achieved a trial acquittal on behalf of a prominent Mayo Clinic physician and secured the return of $6 million in assets. In West Virginia he secured the acquittal of an addiction medicine provider in a federal indictment against a suboxone clinic. Ron has also achieved great success as an appellate litigator, the United States Supreme Court recently granted certiorari and vacated the conviction of his client, a physician accused of unlawfully dispensing opioid medications in Naum v. United States.  Here are some links of things mentioned in this episode:  Ron Chapman's compliance firm, www.CCGhealthcare.com The Suntree Petition  Disclaimer: The information that has been provided to you in this podcast is not to be considered medical advice.

We've all heard of the term "drug-seeking behavior." But, what is it really? What are the red flags doctors and pharmacists look for and where did these red flags come from? Is the term "drug-seeking behavior" even a helpful term? We break it down for you and explain how to find out if this term is in your medical records, and what to do if you find it there. Please check out our website thedoctorpatientforum.com Links for information we mentioned in this episode:  DEA "Don't Be Scammed by a Drug Abuser    Bev's story of the horrible hospital experience     Electronic Health Record Information    Legislative Efforts    SCOTUS Ruan Ruling    Harm Reduction/Narcan   Frontier Article Disclaimer: The information that has been provided to you in this podcast is not to be considered medical advice.

Listen to how Claudia got the idea to start Don't Punish Pain Rally on Facebook. Claudia and Bev discuss the war on pain patients and prescribers. They discuss an overview of what the podcast will be about. They mention a wide variety of topics that will be covered. The information they discuss can also be found on their website thedoctorpatientforum.com.   Links to topics covered during this introduction episode: The Opioid Rapid Response Program (ORRP), Legislative Efforts, 2016 CDC Guidelines and those who expressed concern, Ruan SCOTUS ruling, Harm Reduction, Table of accurate statistics, Debunking Lies, PROP Disclaimer: The information that has been provided to you in this podcast is not to be considered medical advice.