Front Page: Arrests Made in the Death of Anna Nicole Smith

March 13, 2009

by CitizenSugar 24

Los Angeles prosecutors allege that Anna Nicole Smith's two psychiatrists and her companion Howard Stern were responsible for feeding her addition to prescriptions that eventually killed her. They have been arrested for conspiring to furnish her drugs before her death. — CNN
Stocks opened with a strong start today after a good week, showing the markets are ready to rally again. — Market Watch
China is concerned about its US Treasury holdings. — Guardian UK
In separate cases two federal judges have ruled that employees of the federal court are entitled to health benefits for their same-sex partners. The ruling puts President Obama in the middle of the gay marriage debate. — New York Times

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24 Comments

3 years 51 weeks

Very nice site!

expensiveguy 4 years 9 weeks

PRESS CONFERENCE INTRODUCTION - Rep. Domino For years Florida has been searching for the best solution to the growing problem of prescription drug abuse that now comprises 30% of our illegal drug use and claims the life of approximately 6 Floridians each day. In the past, there was no ideal answer since systems were too expensive, took 35 days to provide information rather than immediately in “real time“, and created privacy and theft identity issues. We now have technology which will do what has been done for years with license testing and other situations requiring secure information….biometric ID for the purchase of Level II-V drugs. HB 143 (Domino) and SB 614 (Aronberg) provide an economical system to pharmacies and dispensing doctors which simply does a biometric scan, gives the scan an ID number without disclosing the name, social security number, driver’s license number, or address of the patient to anyone other than the pharmacist who already has the information. That scan then allows the pharmacist to see immediately if there have been numerous other controlled drug prescriptions already dispensed. It can also assist pharmacists and dispensing doctors in identifying a medication prescribed which will not interact well with others the patient takes. Florida has one of the bigger problems of prescription drug abuse in the nation. This legislation will allow us to take the lead with effective technology while providing Floridians both privacy and safety. FACTS FOR POSTERS AT PRESS CONFERENCE Bill numbers and sponsors - HB 143 (Rep. Domino) and SB 614 (Sen. Aronberg) Prescription drug abuse accounts for 1/3 of the illegal drug abuse nationwide and is rapidly rising to the #1 drug problem. In 2004 48% of the drug overdose deaths (6,035) involved prescription drugs and directly caused 2,181 - approximately 6 per day. HB 145 and SB 614 FACT SHEET THE PROBLEM Prescription drug abuse accounts for 1/3 of the illegal drug abuse nationwide and is rapidly rising to the #1 drug problem. In 2004 48% of the drug overdose deaths (6,035) involved prescription drugs and directly caused 2,181 - approximately 6 per day. In 2004, Schedule IV drugs (such as Xanax and Valium) were found to be present in more overdose deaths than cocaine. The number of Americans who abuse controlled drugs nearly doubled from 7.8 million to 15.1 million from 19992 to 2003 and more than tripled among teens in that time. Over the past few years, Florida has seen a high demand for prescription drugs on the street where the profit margin is high. The majority of illegal prescription drug diversion begins with a stolen, forged, counterfeit, or altered prescription form. Patients may seek out multiple doctors to prescribe (doctor shopping), fill the same prescription at multiple pharmacies (pharmacy shopping), or present fraudulent prescriptions to pharmacies. There are also some unscrupulous physicians who simply sell prescriptions to patients (known as a drug mill). HISTORY In 2001 Florida passed a law making it a 3rd degree felony for doctors to write prescriptions for fictitious persons, write prescriptions solely to make money, or knowingly assist patients in fraudulently obtaining controlled substances. It also makes it a 3rd degree felony for a patient to withhold information regarding previous receipt of a prescription for a controlled substance (doctor shopping). The National Schedules Prescription Electronic Reporting ((NASPER) Act in 2005 provided a framework and incentive for all states to establish an electronic database to monitor the prescription and use of Schedule II, III, IV and V drugs. However, lack of funding and HIPPA privacy issues have hindered the implementation. To date roughly half the states have a monitoring program in place. FLORIDA HAS NOT PASSED A PRESCRIPTION MONITORING BILL DUE TO COST, NO SYSTEM TO ADDRESS THE PROBLEM IN “REAL TIME” PROVIDING THE PHARMACIST/DISPENSING PHYSICIAN IMMEDIATE INFORMATION, AND PRIVACY CONCERNS. HB 145 AND SB ADDRESSES THOSE CONCERNS. HB 143/145 AND SB 614/612 1. The War on Drugs has changed. It was focused on heroin, cocaine & marijuana in the 1980’s. Now 30% of the drug problem involves prescription drugs Prescription drug abuse is rapidly rising to #1. 2. In Florida, 8% of all prescriptions or 18 million scripts annually are written for medicines with high abuse potential. 3. In 2005, the National All Schedules Electronic Reporting (NASPER) Act was signed into law. The provisions were not funded, so only around half of states have a prescription monitoring program (PMP) 4. The current programs are little more than passive databases. Each suspicious script must be individually queried to the database and does not interrupt drug diversion at its point of occurrence. 5. Past proposed database systems raised security & confidentiality concerns. They also did not operate in “real time” and required approximately 35 days to discover abuse. Solution: 1. The system uses unalterable biometric data such as fingerprints which are already in frequent use for such events as license testing when privacy and security is needed and to prevent identity theft. The biometric is obtained at the time a controlled substance is dispensed, delivered or administrated to an outpatient. 2. Biometric data, prescription information & notes are sent anonymously using only an identifying ID for the print to a secure server. The patient’s privacy is completely secure. 3. The system analyzes all prescription information associated with each individual’s biometric data. An alert is generated to the pharmacist and the physician if there are changes to the script, there has been over prescribing, the patient is attempting to fill scripts from multiple providers, there are potentially adverse interactions between the various medications a single individual is taking. 4. Pilot programs are currently running successfully at 14 sites in South Florida on voluntary basis. 5. Doctor shoppers and organized prescription diversion are already being identified & prosecuted. HB 145 and SB 614 PROVIDE THE LONG SOUGHT AFTER SOLUTION AND TECHNOLOGY FOR A SECURE AND SIMPLE SYSTEM. FLORIDA CAN NOW LEAD THE NATION IN THIS GROWING DRUG PROBLEM. ADDITIONAL INFORMATION COST: Approximately $300/system if implemented in volume and $150 or less per month to operate. Many financial incentives and saving to this cost are available also, such as continuing education credits. THERE IS NO REQUIRED COST TO THE STATE OF FLORIDA. HOW WILL SURROGATES (OTHERS PICKING UP THE MEDICATION) BE HANDLED? All pharmacists currently have in place some system by which they determine to whom they will dispense. Working within that framework, the identifying code can be provided by the patient to the surrogate and then the surrogate can be given an ID. The system provides room for comments. Consulting Team: Louis Fischer- retired DEA pharmacist; was one of DEA’s top managers in drug diversion program; national speaker on drug abuse Mike McManus- retired DEA investigator; was chief of DEA’s Central & South American operations; a well known speaker nationally on drug abuse Marcella Gravalese- extensive experience in healthcare administration in Michigan & Florida; has managed programs at North Broward Hospital District and Nova SE School of Medicine Steve Ballenger- practicing attorney experienced in health law; professor of health law at Nova SE law school Moe Afaneh- practicing pharmacist; extensive experience in multiple types of pharmacies; owns & operates successful pharmacy in Ft. Lauderdale area Larry Hooper, MD- medical physician; extensive & varied clinical background; current CEO of a medical device company in the R&D stage; previously chief flight surgeon for US Air Force’s B-2 Stealth Bomber www.BioScriptRx.com 800-797-4711 954-548-7800

Michelann 4 years 9 weeks

Really interesting information, Philip. That's just another example of politicians pretending they know what's best for people when they really only care about getting votes. We need to get back to letting to most qualified people make medical decisions, and those people are the patients and their doctors.

philipcfromnyc 4 years 9 weeks

No problem -- thanks for noticing my message...I suffer from a chronic and painful condition, but I was lucky; my doctor in New York City was not afraid to prescribe the necessary medications in the necessary quantities. However, for every satisfied person who is treated for severe, chronic pain, there are probably 10 patients who are not properly treated. I remember reading about a case several years ago involving a doctor in Oregon who would not prescribe anything stronger than Tylenol to a patient who was dying of cancer, for fear that the patient would become addicted to drugs! This would be funny were it not in fact so tragic and so sad. Fortunately, the state medical board stepped in and disciplined this particular doctor -- but in almost all cases, "discipline" is in the other direction, and competent physicians find themselves having to justify prescribing Schedule II medications to patients in legitimate medical need of such medications.In 1990, the State of New York succumbed to this trend, and passed a law mandating that all prescriptions for benzodiazepines (e.g. Valium, Xanax, Dalmane) be written up on Schedule II prescription blanks (although technically these drugs remained Schedule IV drugs). The result was a sharp drop in the number of prescriptions issued for such medications -- accompanied by a great leap backwards, as doctors substituted dangerous, older drugs such as meprobamate and chloral hydrate for the more effective benzodiazepines. There was a correspondingly sharp increase in emergency room admissions for overdoses involving these obsolete and dangerous (not to mention less effective) drugs – all because a politician, or group of politicians, was determined to look “tough on drugs” in the State of New York (which, incidentally, still labors under the draconian Rockefeller drug laws, and which still has the worst drug problem of any state in the nation).When I moved to the UK about two years ago, I immediately noticed a stunning difference in attitudes of physicians towards patients with legitimate medical need of powerful painkillers AND anxiolytics (tranquillizers). Doctors in the UK (based on my experience) are quite willing to prescribe powerful opioids and opiates, and do so routinely and without being bullied by the nation's criminal justice system, or by medical oversight boards. Yet the "drug problem" in the US dwarfs anything experienced in any other western nation. One reason I have chosen to remain in the UK is because I may have difficulty obtaining appropriate medical care should I ever return to the US.Now this case comes along, and already we read misleading headlines about drug combinations “exploding” in patients. I foresee this case being used by the hysterics to restrict, even further, access to powerful painkillers. The cost, in terms of human suffering and misery, is impossible to calculate…PHILIP CHANDLER

philipcfromnyc 4 years 9 weeks

No problem -- thanks for noticing my message... I suffer from a chronic and painful condition, but I was lucky; my doctor in New York City was not afraid to prescribe the necessary medications in the necessary quantities. However, for every satisfied person who is treated for severe, chronic pain, there are probably 10 patients who are not properly treated. I remember reading about a case several years ago involving a doctor in Oregon who would not prescribe anything stronger than Tylenol to a patient who was dying of cancer, for fear that the patient would become addicted to drugs! This would be funny were it not in fact so tragic and so sad. Fortunately, the state medical board stepped in and disciplined this particular doctor -- but in almost all cases, "discipline" is in the other direction, and competent physicians find themselves having to justify prescribing Schedule II medications to patients in legitimate medical need of such medications. In 1990, the State of New York succumbed to this trend, and passed a law mandating that all prescriptions for benzodiazepines (e.g. Valium, Xanax, Dalmane) be written up on Schedule II prescription blanks (although technically these drugs remained Schedule IV drugs). The result was a sharp drop in the number of prescriptions issued for such medications -- accompanied by a great leap backwards, as doctors substituted dangerous, older drugs such as meprobamate and chloral hydrate for the more effective benzodiazepines. There was a correspondingly sharp increase in emergency room admissions for overdoses involving these obsolete and dangerous (not to mention less effective) drugs – all because a politician, or group of politicians, was determined to look “tough on drugs” in the State of New York (which, incidentally, still labors under the draconian Rockefeller drug laws, and which still has the worst drug problem of any state in the nation). When I moved to the UK about two years ago, I immediately noticed a stunning difference in attitudes of physicians towards patients with legitimate medical need of powerful painkillers AND anxiolytics (tranquillizers). Doctors in the UK (based on my experience) are quite willing to prescribe powerful opioids and opiates, and do so routinely and without being bullied by the nation's criminal justice system, or by medical oversight boards. Yet the "drug problem" in the US dwarfs anything experienced in any other western nation. One reason I have chosen to remain in the UK is because I may have difficulty obtaining appropriate medical care should I ever return to the US. Now this case comes along, and already we read misleading headlines about drug combinations “exploding” in patients. I foresee this case being used by the hysterics to restrict, even further, access to powerful painkillers. The cost, in terms of human suffering and misery, is impossible to calculate… PHILIP CHANDLER

Michelann 4 years 9 weeks

Thanks for posting, Philip. It's really a shame that the ridiculous scheduling system is bullying doctors and ultimately harming patients.

philipcfromnyc 4 years 9 weeks

I am disturbed by this news account for entirely different reasons.It is now clearly established that doctors in the USA actually UNDERTREAT severe and chronic pain, for fear of being audited -- and sometimes jailed -- by the D.E.A. and / or by state regulatory bodies. Some doctors are so fearful of this issue that they don't even bother to order the triplicate prescription blanks required for Schedule II drugs (unadulterated preparations containing methadone, oxycodone, hydrocodone, morphine, etc.). Instead, they prescribe Schedule III drugs, which consist of acetaminophen combined with opiates / opioids; the result is all too frequently liver damage due to overdose of acetaminophen. Persons who live with chronic pain often receive Schedule III preparations (an example is hydrocodone mixed with acetaminophen, in varying ratios) when they should properly be treated with Schedule II drugs.This high-profile case risks fueling the flames of hysteria. Clearly, any doctor who knowingly issues prescriptions to a person who uses false names is abusing his or her right of prescription; but my great fear is that Americans will once again confuse abuse of a measure with its proper usage, as happens over and over again, and that already fearful doctors will retreat further and further into denial, undertreatment of severe and chronic pain, and underprescription.People have committed suicide as a direct result of not being able to obtain adequate pain relief, and this is a very serious issue in the USA.Let us not use this tragedy as an opportunity to confuse legitimate pain control with drug abuse.PHILIP CHANDLER

philipcfromnyc 4 years 9 weeks

I am disturbed by this news account for entirely different reasons. It is now clearly established that doctors in the USA actually UNDERTREAT severe and chronic pain, for fear of being audited -- and sometimes jailed -- by the D.E.A. and / or by state regulatory bodies. Some doctors are so fearful of this issue that they don't even bother to order the triplicate prescription blanks required for Schedule II drugs (unadulterated preparations containing methadone, oxycodone, hydrocodone, morphine, etc.). Instead, they prescribe Schedule III drugs, which consist of acetaminophen combined with opiates / opioids; the result is all too frequently liver damage due to overdose of acetaminophen. Persons who live with chronic pain often receive Schedule III preparations (an example is hydrocodone mixed with acetaminophen, in varying ratios) when they should properly be treated with Schedule II drugs. This high-profile case risks fueling the flames of hysteria. Clearly, any doctor who knowingly issues prescriptions to a person who uses false names is abusing his or her right of prescription; but my great fear is that Americans will once again confuse abuse of a measure with its proper usage, as happens over and over again, and that already fearful doctors will retreat further and further into denial, undertreatment of severe and chronic pain, and underprescription. People have committed suicide as a direct result of not being able to obtain adequate pain relief, and this is a very serious issue in the USA. Let us not use this tragedy as an opportunity to confuse legitimate pain control with drug abuse. PHILIP CHANDLER

Grandpa 4 years 9 weeks

No it states that these guys should not get off easy. Let other "providers" have something to fear.

Michelann 4 years 9 weeks

"Make an example" implies that you make their sentence harsher than it would otherwise be in order to scare other possible perpetrators. Justice is treating like cases alike, regardless of the celebrity status of the case.

Grandpa 4 years 9 weeks

What they did to that lady was what, and "oopsie, nevermind"?

Michelann 4 years 9 weeks

Nobody should be made into an example. That's not justice.

Grandpa 4 years 9 weeks

if convicted, they should be made an example of.

hausfrau 4 years 9 weeks

star - Maybe they just not have the evidence? I dunno... Overmedicating is too nice of a term; its out and out fraud.

hausfrau 4 years 9 weeks

star - Maybe they just not have the evidence? I dunno... Overmedicating is too nice of a term; its out and out fraud.

zeze 4 years 9 weeks

Color me surprised!I could have told you this just looking at the two of them.

zeze 4 years 9 weeks

Color me surprised! I could have told you this just looking at the two of them.

Kimpossible 4 years 9 weeks

I agree Haus.and just a side note what is up with all the typos on sugar articles lately? I've seen them all over the site.

Kimpossible 4 years 9 weeks

I agree Haus. and just a side note what is up with all the typos on sugar articles lately? I've seen them all over the site.

stephley 4 years 9 weeks

I think calling it 'overmedicating' in this case is too kind.

starangel82 4 years 9 weeks

I'm very curious as to why charges are being pressed now. I mean, Anna Nicole has been dead for a few years now. I'm not saying it's not a good thing... just curious about the timing.