Pharmacists and Advocacy for Patients in Pain | TWIRx

Pharmacists and Advocacy for Patients in Pain Friday, August 21, 2026 What happens when patients living with chronic pain, their advocates, and the pharmacists responsible for dispensing opioid medications view the same healthcare system from very different perspectives? This special episode of This Week in Pharmacy brings together the Doctor Patient Forum’s founders, Claudia A. Merandi and Bev C. Schechtman, with pharmacist and nationally recognized pharmacy advocate Dr. Shane Jerominski, PharmD—better known as “The Accidental Pharmacist.” The discussion follows a wave of social-media debate surrounding Claudia’s use of the term “Harmacists,” which prompted responses from hundreds of pharmacists who felt the label misrepresented their professional responsibilities and the legal restrictions under which they practice. Rather than allow that controversy to deepen the divide, TWIRx created an opportunity for direct, respectful conversation. The purpose of this episode is to help pain-patient advocates better understand the limits pharmacists face when dispensing opioids—and to identify opportunities for pharmacists and patient organizations to advocate together for safe, compassionate and uninterrupted pain care. Five Legal and Supply-Chain Realities Affecting Opioid Dispensing Pharmacists have a federal “corresponding responsibility.”Under 21 CFR §1306.04, a controlled-substance prescription must be issued for a legitimate medical purpose. Pharmacists share legal responsibility with prescribers for determining whether a prescription is valid. Knowingly filling an illegitimate prescription may expose the pharmacist to federal penalties and professional discipline. Review the federal regulation. Schedule II prescriptions must satisfy strict requirements. Federal law generally requires a valid written or compliant electronic prescription before a Schedule II opioid may be dispensed. Emergency oral prescriptions are permitted only under limited conditions and require prescriber follow-up documentation. Schedule II opioid prescriptions cannot be refilled. Under federal law, every additional dispensing generally requires a new prescription. Partial fills are allowed only under specific circumstances, documentation requirements and time limits. Pharmacists cannot simply extend or refill opioid therapy when a patient or prescriber requests it. State laws add another layer of requirements. Depending on the state, pharmacists may have to verify prescriber authority, review prescription-monitoring information, validate electronic or security-form requirements, confirm identification, document partial fills, or comply with state-specific dispensing limitations. For example, California requires controlled-substance prescriptions to meet defined security and validity standards. California Board of Pharmacy guidance. Wholesaler monitoring can restrict a pharmacy’s opioid supply. DEA-registered distributors must identify and report suspicious controlled-substance orders under 21 CFR §1301.74. National wholesalers therefore operate monitoring programs that may delay, limit or suspend shipments based on ordering patterns, geography, drug mix and internal thresholds. These controls are imposed upstream and can leave a pharmacy unable to obtain medication—even when the pharmacist believes a prescription is clinically and legally appropriate. Review the federal distributor requirements. These examples are not exhaustive. Pharmacists must navigate overlapping federal law, DEA requirements, state pharmacy and controlled-substance laws, prescription-monitoring systems, employer policies, payer rules, wholesaler restrictions and professional standards. Requirements also vary by state and by the circumstances surrounding an individual prescription. The Central Question How can pain-patient advocates and pharmacists move beyond blame and work together to address the policies, supply restrictions, staffing conditions and regulatory pressures th

• 0:28Speaker 00

  Hey, this is, wait, why do I always say that this is, this is, this is this week in pharmacy? It's like two thises is, this is this. This is twerks. Welcome to the show. Very special show today with my friend Pharmacy 50 Most Influential for I think it was the Alumni 2025 Class Shane Jerominski. How are you?

• 0:51Speaker 01

  What's going on, Todd? How are you? Nice to see everybody.

• 0:55Speaker 00

  Hey, we have two returning guests to the Pharmacy Podcast Network and it wasn't called twerks back then. I didn't have my own podcast until I had twerks because the, the network was supposed to be off by itself and I was supposed to have hosts come in and talk about specific things. So I get my own, my very first podcast of doing this 17 years back in 2023 and Claudia and, and Bev, you haven't been on twerks, but you were on other shows that we've had. So welcome back to the Pharmacy Podcast Network.

• 1:29Speaker 02

  Thank you. Thanks for having us.

• 1:32Speaker 00

  Claudia.

• 1:35Speaker 03

  Thanks for having us back.

• 1:37Speaker 00

  Absolutely. All right. I want to start with the two of you, Bev. You were the, the first guest that I had back, you said in 2020. It's making me feel old because of how fast time's going. But set the stage for us. Tell us who you are, a little bit about yourself and your relationship and partnership with Claudia.

• 1:57Speaker 02

  So my name is Bev Scheckman. I am the Vice President of the Doctor Patient Forum. I first reached out to Claudia in 2017. We both have Crohn's disease and she was on a Crohn's group on Facebook after a horrific hospital stay where I was denied opioids for kidney stones because of a question I answered on the opioid risk tool about pre adolescent sexual abuse. They used that to deny me opioids in the hospital for kidney stones. I reached out to Claudia.

• 2:28Speaker 02

  But don't punish pain. Now I started from that and then where we had rallies in all 50 states. And then the Doctor Patient Forum, I think it started 2019, something like that, the nonprofit. And I do a lot of the research and the backend stuff, a lot of the putting together the videos, taking clips, listening to all the CMEs. And Claudia does a lot of the front face stuff on social media where she gets to get attacked and I get to sit back and not get attacked.

• 3:00Speaker 00

  Listen, Claudia is like a social media slash media and it wasn't even called social media when Claudia first started doing this. You are a powerhouse when it comes to media, even if you weren't talking about pain management. If you were out talking about, you were one of TMZ's, you know, reporters or something like that, you're just a good reporter of, of what's going on and you do, you do it with passion for patients. So give her, give an introduction of yourself and, and what you do.

• 3:34Speaker 03

  I think I'm so passionate because I'm a theater kid and I think theater kids are always going to be a little more passionate than, you know, people who, I spent a lot of time in the theater and I'm an Italian Scorpio. So I am 100% passionate about what we do. You know, there's a growing suicide list. I went on social media 2000, gosh, I think it's 2017 and I announced I would organize a national protest for people who couldn't, couldn't get their pain treated. Fast forward to today, we have about, I don't know, all together, people who follow us on Tik Tok, Facebook, probably 700,000 who follow our efforts. We've got chapters in all 50 states and I am primarily the spokesperson.

• 4:19Speaker 03

  So I'm the person that people see on a regular basis. And I think, you know, why we're all here today is because of a video that I made several weeks ago. My job is to make videos, get the message out there. You know, I don't have an easy job. I have the job of telling people to make Oxycontin great again, which is triggering for a lot of people, but we've got to stop the bleeding. So my videos can be extremely controversial to people and I understand there's some big feelings with my videos, but I made a video in response to what I'm seeing on social

• 5:04Speaker 03

  media with a lot of the younger farm Ds and it was just very scary to me, a bit appalling because so many of the younger farm Ds were boasting about not dispensing pain medication. And I had texted Bev and I said, there's a, there's a theme here. They're never talking about withholding abortion medication or Suboxone. It was only, it was always confined to, this is why I'm not going to fill pain medication. But there was like a sense of arrogance in some of the younger farm Ds, but let me say one thing, I have immense respect for the pharmacist role in medicine. You know, I've got a friend whose daughters worked very hard to become pharmacist. So I have a healthy respect for the pharmacist.

• 5:48Speaker 03

  What I don't like is I don't like to see these arrogant farm Ds on social media boasting about not dispensing pain medication and accusing people of being drug seekers, which is why I made the video. And the message need, you know, I need, I had to make the video. It's my job to raise awareness to every aspect of the pain patient being attacked. And I think, you know, I'm, let's face it, that's why we're here today. Many farm, farm Ds were outraged by the video, sparked a lot of controversy, but not one pharmacist was willing to acknowledge that we have a problem. They all, you know, ran, they all stitched the video.

• 6:33Speaker 03

  I was slaughtered on social media. I'm unfazed by that, that my job is the voice and the face. So, but the, but then it got, then it took a nasty turn as it so often does on social media. Once again, I'm not phased by that, but I didn't know Shane was the accidental pharmacist. I think, I think a pharmacist said that his wife, somebody was wishing ill will on his wife. And I don't know if that was you Shane, because I'm really not, I'm not tech savvy, which a lot of people find this hard to believe. I'm, I'm the spokesperson and basically Bev does all of the heavy lifting.

• 7:15Speaker 03

  So I'm awful sorry if that is you Shane, and if somebody was saying ugliness to your wife, I've been on, I'm, listen, I, I'm on that, I'm on the same end that your wife is on, so, but I'm awful sorry that that, that happened. But we, how can we, you know, that, that's for, that's for a different show, but I do want to say if, if anybody was wishing ill on your wife, that shouldn't have happened.

• 7:42Speaker 01

  Well, thank you for saying that. I appreciate that. And it, it comes with the territory. You are absolutely right. You and I probably agree on a lot more than you would imagine. Claudia, I, I am the same thing. I am the mouthpiece for a lot of areas in pharmacy. And I say some of the things that need to be said that a lot of other pharmacists won't say because they're tied to a corporation that would fire them immediately. So I have become the default face in some situations. And I do, first, first off, let me say, I respect the idea of saying those things that need to be said to creating a space for discussion, bringing two, what seemingly opposing groups coming together to have that discussion is important. And what you did, you said you're a theater kid and I, I can see it, but what it is, is

• 8:27Speaker 01

  like a little bit of sensationalizing and sometimes sensationalizing is necessary, but it is a little bit of, of that.

• 8:34Speaker 02

  I don't know. I don't, I don't feel like we sensationalized. I think that people don't understand that our passion comes from the fact that every day, all day, literally every day, all day, our inbox is flooded with messages from people with a gun in their hand, ready to end their lives. Like, we are not being sensationalistic. The fact is, it has been left up to pain patients to fight for patient abandonment, forced opioid tapers, harms from the PDMP and, and analytics, and lack of continuity of care, when there's an entire industry fighting for people to have access for medication for opioid use disorder. This has been left up to us. People reach out to us for their last resort. We've had people reach out to us

• 9:19Speaker 02

  that we knew were gonna kill themselves, that ended up killing themselves with their wife in a double suicide. So I don't feel like, I know that part of the, maybe it's the, a bit of the younger generation of like, trying to sensationalize for social media. We actually don't do that. Um, that's just not, we, we really don't. These are actual, this is real life for us. Like, for us, it's not, I'm not saying it's a game for you, but for us, it's not about making memes. It's not about creating waves. It's not about, you know, having a meme with a cigarette. Like, this is real life for us, and we're the only ones fighting for this, and we have no voice other than us.

• 9:54Speaker 01

  The real, the real stor, the real stor, there's real stories behind all of this, but when you say something like, "Make Oxycontin great again", that is triggering, and it's also sensationalizing, in my opinion, because the, the, to, to, to, to go online and say, "The answer to people with guns in their heads is to make Oxycontin great again", does not sit well with the healthcare community. Uh, you know, the, Oxycontin has a very good place in that. I'll, I'll let Todd bring this in, because I think we're getting off.

• 10:23Speaker 00

  Let me, let me do something, because both of you, um, Bev and Claudia, I want to thank you. You set the stage for what I'm, what I'm trying to pan out for both sides, so that there's, there's audiences that Bev and Claudia are bringing to us that we don't normally get, and I just want to say thank you both. And I also want to shout out to those people listening, those pain patients. This is ultimately about bringing relief to you, and management of your pain, and being empathetic to what your pain is. Remember, guys, I've said this to Claudia and Bev before. I'm the patient on this show, just like you are. I mean, I'm, I'm not a pharmacist. I'm not a, you know, I'm, I'm, I'm a technologist and marketer, and

• 11:04Speaker 00

  somebody that's been in pharmacy for a really long time, and sees what pharmacists are actually doing. But before we get into the, into the, I want this to turn out to be a, a movable debate. I want to just set some, some basics, and that is, the two of you are exposed to people that are, um, for lack of a better word, they're, they're bleeding inside. They're, they're in literal pain. They don't know what to do. And you experience this on a, on a constant basis, boom, boom, boom, boom, and, and it's very intense. And by the way, dentists are, are known to want to leave the profession, because when they inflict pain on,

• 11:44Speaker 00

  there's a whole psychological write-up on this. When they inflict pain on their, um, their patients, and they could see grins, grimacing of the face, it literally took a, an effect on these people, because I think it's like a human thing. You can't help but to, you see somebody in pain, and you're less like, "Fuck, like, let's get them some help. Look, they're in pain." So, we know, we know that you both are sincere in that, and people can look you up on social media and see that passion. Now, I want you to turn off your pain advocacy hat for a second. I want you to come to Pharmacy Land. So, there are listeners that are raised in different generations. Um, I'm closer to your generation, like I said, Gen Xers.

• 12:26Speaker 00

  Um, and we just think a little differently than what I see millennials, and definitely Gen Z, thinking about. Um, but, there is a pharmacist out there. It's a story that she watched her dad as a pharmacist, and she wanted to be nothing more than, than be a pharmacist. And she watched her dad bring in people with, um, problems. They had, you know, ailments, they leukemia, and like, compounding medications, and specializing, and she grows up seeing that the impact that he has on people's lives. He knows them by name. He knows their family history. He, he knows if, if little Jimmy's lying, like, the whole thing. So, the, the whole fundamental of starting this all off is

• 13:12Speaker 00

  pharmacists and what their purposes, uh, what their goals are as healthcare professionals, because they've dreamt about becoming pharmacists since they were like little kids, or, you know, something that they're working on. And, in that batch of people, out of the 330 million Americans that they're taking care of, at least in the United States, obviously much more worldwide, their whole existence and their nerdiness of doing it, they're, they want to take care of seniors, they're the pediatric specialist, they're the, you know, the community pharmacist that's doing more of like, the whole tackle box of stuff. There's the researchers and the medical science liaisons. What they have in common is that pharmacological study of how

• 13:57Speaker 00

  medications literally work on the DNA of individuals in transition, and titration, and compounding, and your enzymes, and your pharmacogenomics, and how your genes respond to opioids, and oh my goodness, we could, this, this is like, this could become a podcast, a new podcast show for the four of us, of how long it would take to get all of this out.

• 14:22Speaker 00

  That's what they do.

• 14:23Speaker 01

  You're, you're right. There's, there's a huge, there's a lot to this argument.

• 14:26Speaker 00

  Yeah.

• 14:26Speaker 01

  But I think the one thing that's misunderstood, and this is where I'd like to start with this, what's misunderstood about opioid therapy is we've turned it into a binary argument. We've turned it into either opioids are dangerous drugs that should be avoided at all costs, or opiates are essential medications that should be dispensed without question by pharmacists in every situation.

• 14:48Speaker 02

  Who is saying that, Shane? Who is saying, because that's what we've been, you've attributed that to us. You've made memes about it, saying, "We want everyone to", who has ever said that? Because we've never...

• 14:57Speaker 01

  You guys keep, you guys keep putting, pushing up that, that, uh, report from the American Medical Association, which essentially, the AMA is advocating, the, the article talking about how the AMA thinks that pharmacists are withholding drugs, and using their clinical judgment to supersede anything

• 15:12Speaker 00

  Right.

• 15:12Speaker 01

  that, uh, that comes out there. And they're using an example of an ophthalmologist, or an optometrist who wrote, oh, sorry, ophthalmologist who wrote for a cream for rosacea, and the pharmacist denied the prescription. Uh, but then they go on to like, trying to put, they're trying to, to change the law to say that pharmacists can be held legally responsible if they don't dispense the medication.

• 15:32Speaker 02

  Well, the thing, so let me just, let me clear this up now, because it's probably better at the beginning. We have never advocated for opioids to be first line, second line, third line, or on their own. Not one time have we ever said that. We have a very healthy respect for the possible harms and benefits of opioids.

• 15:50Speaker 01

  Someone who has, can I just, can I just say one thing right there? Someone who has a healthy respect for opioids wouldn't have a mantra like, "Make Oxycontin great again."

• 15:59Speaker 02

  That's not true, because here's the thing, Shane, there's two separate issues here, okay? When you have an opioid naive person, there's a different set of rules as far as someone who has been what they call a legacy patient who has been on opioids.

• 16:12Speaker 01

  For sure.

• 16:12Speaker 02

  Every, 17, 17 studies show, regardless of dose, duration, or combination of medication, it is always more harmful to cut a patient off of opioids that has been on them than to let them remain on them. The patient population we are fighting for, for the most part, are those pop, is that population where maybe they should never have been put on opioids to begin with, but that's actually moot point at this, it's actually a moot point, because they have been on them, and they're becoming abandoned. They're on higher doses that maybe they should have never been put on, but the fact is, they have been. And so, for pharmacists to joke and make fun on social media, saying, "Oh, my patient on this amount of medication,

• 16:52Speaker 02

  I'm not gonna give it to them", like it's a joke, when these people are going home, and we have so much evidence behind, do not force taper these patients. And that's the difference. Like, yeah, "Make Oxycontin great again", because right now, everything has been about vilifying the full agonist, everything. And, you know, we've said that pharmacists, we've gotten from you guys, like, "Oh, well, how come, don't fight the DEA, it's not our fault", but when it comes to Suboxone, that, the, the NABP and the NCPA, their MOUD guidelines, they know how to fight for Suboxone. They know how to fight against the DEA. The pharmacists know how to fight against the red flags for cash-only pay, and distance from patient to provider,

• 17:35Speaker 02

  what it has to do with a certain population of, of people, and when it has to do with pain patients, all of a sudden, the suspicious order reporting, the Narc Care, the PDMP analytics, the cash pay, the red flags, the DEA, all of a sudden, that becomes our job to fight. How come you guys, pharmacies in general, pharmacists in general, will fight for one group of patients who have a voice? These people have key opinion leaders, and money, and a platform, and will not.

• 18:03Speaker 01

  You really got to the root of the problem, and, and I am, I think this is one place we are both in, in absolute agreement, that we, pharmacists are trapped inside a system that's, that is, is making it easier for us to dispense a drug like Suboxone than it is for us to dispense a full agonist opioid. And the reason why, you were, you're not, you're not saying individual pharmacists, but you were talking about organizations that are advocating for this. And the reason why those organizations are advocating for this is because the money they're taking from companies like CVS and Walgreens, there's liability that exists with full agonist opioids, that don't necessarily exist the same way with things like Suboxone. So I am in agreement that, that you, you follow the money, you will find out the reason why it looks like this.

• 18:47Speaker 02

  Hundred percent.

• 18:48Speaker 01

  What you did say that I can disagree with is that pharmacists are going online and, and laughing, or making light of...

• 18:57Speaker 01

  withholding medication and I I'm I'm advocating for those patients you said what you called legacy patients or you know non opioid patients that have been on opiates for a long time that the risk of of tapering the risk of of cutting them off is terrible but we're in a situation here where it's easier for us to pass the buck where where where it's saying we don't have it in stock and a lot of times we don't thanks to the DEA cutting supply of that now that the wholesalers

• 19:25Speaker 00

  wholesalers will just cut you off yeah wholesalers will cut you off I work know that do you know that if you own a if you own a private pharmacy Claudia's pharmacy right and all of a sudden you get an email out of the blue yeah they're like oh yeah no more

• 19:42Speaker 02

  we hear from independent pharmacies on a regular and we did meet with Senator Sheldon White House two weeks ago to discuss this this problem and

• 19:57Speaker 02

  I get it but but but the organizations pharmacy organizations will fight against the handcuffs for suboxone and not against opioids that's my point

• 20:05Speaker 01

  you're right and that's a that's a great point taken I work for independent pharmacies and the one that I work at primarily is we service hospice patients so we have end of life care really high dose medications and every single month we're fighting with McKesson because we're reaching our limit for liquid morphine we're reaching reaching our limit for benzodiazepines and I I've had to justify our ordering to a non pharmacist that works there just in regulatory compliance and they're saying well why are you dispensing this much I wanted to say it's because we have fucking contracts all over the desert for for patients that are palliative end of life care why do you why else do you think that we're doing this so we are we have multiple masters

• 20:49Speaker 01

  that we're reporting to now and you know pharmacists have so many things that they're fighting for and I don't want them to think that pain patients aren't important to us I just want you to understand that we have so many different things that are going on my my my realm I've been drawn into this argument because of my platform on social media but I would never call my I'd never called myself a pain advocate I I called myself a workforce workforce reform advocate because I was trying to advocate for giving the pharmacists and the people behind the counter enough space to do their job appropriately if we weren't so overwhelmed if we were better

• 21:30Speaker 01

  staffed if we had the resources to take time with every single one of those patients that are legacy opioid patients to make them become instead of customers patients you understand we understand patients when they're just a customer like the way it is in a CVS model where you every time you go in you see a different pharmacist every time you go in you feel like a cattle being that they know nothing about you then you're a customer you're not a patient but when you're a patient you're never going to be denied because we're going to do the extra work to make sure we understand why you're on what you're on make the annotations put in the notes call the doctor's office make sure that even when they're not there the primary pharmacist isn't there you can look at that patient's profile and understand why the drugs are written

• 22:15Speaker 01

  the way that they are

• 22:17Speaker 00

  and think of the attitudes like like Claudia you brought up kind of the snottiness and the disheveled looking you know pharmacist and once again I kind of started this out let's pull this whole conversation on out on its head from a generational perspective I think differently than other generations do so if they're being smart asses or they're kind of being you know pushy about saying about cutting something off even if they said that which I would shame them if that were the case it it's like it could be it could be like one or two jerkos that you know maybe have an attitude about something there don't understand pain management because they've

• 23:00Speaker 00

  never really experienced themselves so when you take an entire industry instead of those individuals and you you know you promote to your the power that you have as we were saying in media and now we know you were in theater my daughter's in theater and I was in theater so yeah I get that when you're pulling all of that attention and you start labeling harm assists and then of course they have to experience and try to start putting the jigsaw puzzle pieces together but they only have 10% of the information which is the most important part because it's their pain but they have no other idea that the other 90% of the whole system to get them their prescription

• 23:41Speaker 00

  their opioid prescription is under attack of like 22 systems that all come back to the freaking pharmacist like and and that kind of pressure on top of the and this is a call out to independent pharmacies by the way because if you want really good pain management go to an independent community pharmacies and sit down with them and slow down the process and stop fast fooding medicine I mean this is freaking pain let let us dial into it maybe add stuff to it or subtract stuff from it or whatever it is but personalizing it that isn't a harm assist that is a pharmacist

• 24:18Speaker 02

  but who said harm assists were all Todd like her video literally said the part that was stitched is the problem because what her video said is I'm seeing a number of younger pharmacists who I'm going to call harm assists making fun of patients that's what her video said but the stitching part it's like to sensationalize they wanted to make it look like she said an entire industry look we've had pharmacists on our podcast we fight for pharmacists all the time we never said an entire industry what what she said and what we've said is some I am seeing a number of who are doing this and it's not just pharmacists it's nurses in the emergency room it's doctors it's nurse

• 25:01Speaker 02

  practitioners they make fun of pain patients they make fun of denying them opioids in the emergency room they make fun of denying them in the pharmacy they make fun of cutting them off they just they mock them for fun because it's sensationalistic but we never ever once said an entire industry that's what was portrayed by those who wanted clicks and likes by stitching a portion of her podcast of of her video

• 25:24Speaker 01

  I think that they I think that they latched on to it because it there was a little bit of there was a touch of irony to it that you know she was saying she ultimately said harm assists and she talked about younger pharmacists looking like unmade beds and unkempt and they were passing judgment by their outward appearance and I think that you would in the same breath say so many pharmacists out there are passing judgment by the outward appearance of a pain patient if they don't look like a classic pain patient if it's pain that you can't see if it's invisible and then they come in and they have this high dose drug you're going to start asking questions and the thing is is I think that asking questions is not evidence of arrogance or cruelty that's

• 26:06Speaker 01

  something that's really important let me say one more time asking questions a pharmacist asking questions is not evidence of arrogance or cruelty it's part of our job

• 26:16Speaker 02

  we never said it was Shane and this is why when you made the the meme or whatever saying Claudia wants us to just fill every whatever that was roll up in the car or whatever one of the memes you made that we just want unending doses that's really not fair and it's actually very harmful to us because we have never ever ever one time advocated for anything like that nor would we because it can harm patients and so the fact that you say there's like it's binary it's not binary I'm not seeing I actually haven't seen any patient advocates or or doctors advocating for pain patients say unending doses all the time no matter what the dose to everyone or none like

• 26:59Speaker 02

  I really don't see that very much I I haven't come across it in our advocacy we certainly have never advocated for that but but it's being portrayed as though we do to kind of almost as a straw man to attack us as though we want everyone to get opioids all the time for everything and that's just not the case

• 27:17Speaker 01

  well when you when you you're saying that I in one in one thing you're saying that you don't want just patients to get opiates for everything you're vilifying all these other drugs you're saying that gabapentin has a a whole list of side effects you're saying that

• 27:30Speaker 03

  I'm sorry it's Shane right

• 27:32Speaker 01

  Shane yeah I get Sean I get Sean all the time and Jane on the phone so don't worry I respond to any one of them

• 27:38Speaker 03

  so I have a 25 year old daughter and a 21 year old daughter and when my 25 year old daughter walks out of the house and looks a certain way I say you're not leaving like that are you are you angry at yourself get back in fix yourself up so I'm I'm showing my age I'm you know I'm 58 years old so I probably think a little bit differently than you do maybe even a little bit differently than than Bev does you know I'm 10 years older so with each generation I think we learn a little bit more I think what was sensational was hundreds of pharmacists stitching my video accusing me of being funded by Purdue Pharmaceuticals let's be honest here if if we could just be honest for a minute

• 28:21Speaker 03

  How dare pain patients have a voice? And when we do have a voice, the default is always to say that we are funded by Purdue. I mean, I've got a doctor who made an account on X calling me Karen Sackler. So I think it's just so easy to assume we're funded by pharma because of our advocacy. What wasn't funny is when I was accused of drug seeking and because of that interaction, I left the hospital with a colostomy bag. And I think if the farm Ds who have stitched my video and mocked me, I think if you folks

• 29:00Speaker 03

  walked a day in my shoes, or bad shoes, you'd probably look at it a little bit differently. I think so many of the younger farm Ds are viewing pain through the lens of addiction. And I'm confident that your education has a lot to do with this. We know what's going on. You know, I'm in Rhode Island, University of Rhode Island. I've met, I've met with farm, with these, with these students and they're telling me what they are being taught. You know, we, we've skewed, if somebody needs pain medication, we're always going to the, the, the place of these are drug addicts because so many people are getting their science from that fictional series, Dope Sick. My, my 90 second, my, I mean, I think my video was 90 seconds.

• 29:46Speaker 03

  Because I'm the most visible, I'm always going to be the person that gets attacked the most, which is fine. But I think farm Ds also, you know, put their touch on my words. My words are always being weaponized, but we have a very serious crisis on our hands and many, many independent pharmacies have reached out to us over the years. There are pharmacists incarcerated with some of our doctors. So we understand every aspect of what the pharmacist is going through, which is why we routinely, why we routinely meet with senators who conduct oversight of the DOJ? Because that's what we need.

• 30:26Speaker 03

  We need a DEA oversight hearing and those are the people in the United States who have the power to make this happen. And so many farm Ds, well, why don't you do, what are you doing? Why don't you challenge the policies? We do challenge the policies. I got a law passed, so other, so 49 states would take a version of my bill and, you know, tailor it to their state. We're only two people. I can't be in all 50 states. I can't be the voice for pharmacists, but we are making headway, which is why we're meeting with these senators. And if you're a farm D who's listening to this, please support our efforts because I would like nothing better than to have 50 Claudius, 50 Bivs in all 50 states where

• 31:12Speaker 03

  they can meet with their senator. I think we've got 20, 20 something senators who conduct oversight of the DOJ. That's what we should all be working towards is removing these red flags. The red flags have caused red flags. Suboxone has become the savior. Oxycontin has become the devil and we need to get back to a place of normalcy. We certainly don't advocate for unfettered access to opioids, but because we advocate for opioids and because people are getting their science from the fictional series, Dope Sick, that's how this comes off to people. Like, how dare you advocate for pain medication?

• 31:53Speaker 03

  How dare you want to, you know, not, how dare you mention gabapentin's linked to dementia? How dare you mention suboxone's linked to catastrophic dental decay? I don't get money to promote any of those lawsuits, but once again, I have a job to do. My job was to let our followers know, 65 million scripts, I believe, were, were written for gabapentin. You know, people have a right to know if you're experiencing cognitive decline and you're on GABA, it, it's something to, you know, to look into.

• 32:28Speaker 02

  And that's to address, yes, and to address what you said, Shane, the reason we so-called vilify those things is because an entire industry that we call opioid elimination has been made out of eliminating opioids, right? And I think when anyone is getting any medication, whether that is remicade or methotrexate, like I get, or Simzia, or, or opioids, or suboxone, or gabapentin, or even a medical device, everyone should be, should have informed consent. They should be told possible harms and possible benefits, period. That includes addiction risk, but the accurate addiction risk, not upstated or overstated. That includes dementia risk. That includes all of it.

• 33:11Speaker 02

  And what's happening that I don't think, maybe you don't know, maybe you do know, but maybe you don't know, is that patients are being extorted. So what happens is pain patients are being told at, at these interventional pain clinics, they'll be told, listen, you can get your 15 Vicodin a month, but you must get these procedures, epidural steroid injection, this, you must take gabapentin, you must take Cymbalta, you must see a therapist, you must, must, must. And they tell them nothing about possible harms of any of those things. And that's the problem we have. The reason we're talking about harms from those things is because they're not being told to the patient. We don't have to talk about the harms of opioids because it's everywhere, literally every day, everyone's talking about Purdue still.

• 33:56Speaker 01

  Those, those things should be explained to the patient. And if pharmacists are doing their jobs, if doctors are doing their jobs and working together, those, those risks are explained for everything. And I would, let me start, there's a lot, there's a lot to unpack in those two things you said. First of all, pharmacists are not getting their science from stories like Dope Sick.

• 34:14Speaker 03

  No, no, I didn't know, I wasn't, no, no.

• 34:16Speaker 01

  You know, I understand the, the general public might see, might see something like Dope Sick and say, oh, everyone who's on opiates is drug seeking. But it does, it does show the risks of what can happen for the wrong patient, starting on that or staying on it for more than, for an extended period of time.

• 34:33Speaker 03

  But why haven't we been shot, but why aren't we talking about the risks of somebody being on suboxone for a long period of time?

• 34:40Speaker 01

  We should be, we should be, we should be talking about all of those.

• 34:42Speaker 02

  What do you think, what, what were you taught is the addiction risk of a, a, a patient on long-term opioids? What would you say in the most recent studies is the risk of addiction?

• 34:54Speaker 01

  What would I say the most recent?

• 34:56Speaker 02

  In the, in the most recent studies, like the most recent statistics out there, what would you consider a percentage of risk of addiction for a patient on long-term opioids, chronic opioids, however you want to say it for pain? What, what, what do you think the risk of addiction is?

• 35:10Speaker 03

  Like, how many people do you think are addicted?

• 35:12Speaker 02

  Yeah, what percentage?

• 35:15Speaker 01

  I mean, I don't want to throw, throw one out there because I'm sure it's, you know, I think that, let, let's go back to what, where you were talking about how in, in our, you said at University of Rhode Island, that these students are being taught to vilify Oxycontin and really push Buprenorphine. I think that it's not just that. I think that what, what students are being taught in school is that their license is at risk for making a mistake. Their license, that there, that there is a lot of liability that ultimately ends with them, even though there are so many people in this food chain of getting, getting the medication to a patient.

• 35:55Speaker 01

  Ultimately, it's on, and I know this because I have been in situations, my wife has been deposed because of, of

• 36:04Speaker 02

  Sure.

• 36:04Speaker 01

  Patients getting things and then families claiming that this is, this was something that should have been stopped.

• 36:09Speaker 02

  Right.

• 36:10Speaker 01

  And so, so, and, and, and a place like the University of Rhode Island, where CVS's headquarters is, well, in socket, I'm sure they fund that university a lot. So CVS probably has a lot to say about what the education should look like there.

• 36:26Speaker 02

  A lot of the pain education is coming from ASAM though, from addiction medicine. But the reason I ask you the percentage-

• 36:32Speaker 01

  You don't think that, you don't think a company like CBS though, has a lot to say about that?

• 36:35Speaker 02

  No, I'm not contradicting you. I'm saying in addition to a lot of the, absolutely. Oh, absolutely.

• 36:40Speaker 03

  And you know, there was a lawsuit filed against CBS, Edie Fuag versus CBS and Walgreens for the pharmacist not dispensing the medication. They had a website, Justice for Chronic Pain Patients. An attorney I used to work for, he's now the judge, or the, the judge that was overseeing that case. So we know this is happening.

• 37:00Speaker 02

  Yeah, of course.

• 37:02Speaker 03

  We know, we know it's a problem.

• 37:04Speaker 01

  Yeah, well, CBS is also, I mean, the CBS and Walgreens and all them have also been sued significantly more for, for dispensing medications.

• 37:12Speaker 02

  Absolutely. And those lawsuits are a big part of the problem. Like, a lot of the issue is because of those lawsuits, the suspicious order reporting and the thresholds from the distributor agreement. That's a huge, as you know, like a huge part of the problem at pharmacies. We totally understand, you don't get notified that you're at your limit until you're at your limit and, and you might not-

• 37:30Speaker 01

  Every, and every area has been overcorrected. And the only people that are really suffering here is chronic pain patients and the pharmacists who have to do all of these extra things and really end up siding- In a, it's defensive pharmacy practice is what it comes down to.

• 37:46Speaker 03

  Yeah, I, I get it. That's why, that's why the time has come for us to come together. I don't know if that's gonna happen, but my work will continue, Beth's work will continue. We have to apply pressure to the DEA. That's the only way around this. And I thought, I have stayed awake at night. Okay, we tried this, we tried this, we tried. What do we, there's only one solution. And Bev and I did meet with the DEA a few weeks ago. And we had this conversation, but here's, we don't have an association behind us. It's just us. It's not only chronic pain patients. It's, we've collected thousands of stories over the years from acute patients, went to the pharmacy, pharmacist said, no, I don't feel, I'm not going to fill it.

• 38:29Speaker 03

  You're better off just taking Tylenol and Ibuprofen, or no, I can't fill this for you unless you also get this filled. Well, I don't need that. It doesn't matter. You need to get that.

• 38:41Speaker 01

  Well, sometimes the insurance company is the one that's doing that. You were saying how, you know, sometimes you went to these, these pain clinics or whatever. And they're saying you have to have this injection, you have to be on gabapentin, you have to be on these other medications. A lot of times, if you're, if you're trying to get certain drugs, certain opiates, there might be a prior authorization for it. There might be, there might be, yeah, step therapy on certain things. So that's the reason why.

• 39:03Speaker 02

  Yeah, I understand that.

• 39:05Speaker 03

  But the reason I made the video to begin with is this really, you see this right here? This has robbed the younger generation of really connecting with people and, and the doctors. I, I've been saying this for years, you know, I have some friends, they're, you know, in their seventies who are doctors and they are just, they shake their head. You know, a lot of doc, older doctors contact me, I was just at a television station, recording a segment and a doctor recognized me. He's like, oh my God, please, I gotta tell you what's happening to my wife. They're not willing to give her, her pain medication, just Suboxone. My wife isn't an addict. So, you know, everybody is going to be affected. It may not be pain medication.

• 39:44Speaker 03

  It may be your kid's ADHD medication. It may be my muscular dystrophy, can't, patients, they can't get their clients. Actually, they can't get their benzodiazepines. I advocated for a judge whose kid held, kid had ALS. He's, he's deceased now, had to choose between the benzo and, or their pain medication. It all goes back to one problem, two problems, lawyers and the DEA. And at the doctor patient forum, we remain committed to raising awareness. We, we lobby for change on both a state and federal level. And if you're a Pharm D listening to this, I'm awful sorry if you interpreted my video as something other than it was.

• 40:28Speaker 03

  But I, I gotta tell you, every day I was seeing those horrible videos of these younger, I would text Bev. I was like, look at this video, another one, another one.

• 40:38Speaker 01

  I would like you guys to show me one of them that really upset you, so I can see as an example. We would love to. Definitely send that to me. And you know what? I agree with the two people that you called out there. But I would also say, looking at these corporations and corporations have gone above to protect themselves. They've given arbitrary MME required limits on that Walmart, you know, there, there are certain drugs that Walmart won't fill. Legitimate pain medications for established patients. And they've said, you know what? We don't need that business. So we're gonna channel that to CVS and Walgreens and independent pharmacies. And, and, and those things are really, so we have not just the DEA, not just state boards of pharmacy coming after us.

• 41:24Speaker 01

  They, you have the corporations trying to protect themselves.

• 41:27Speaker 02

  Yeah. But that's in response to the DEA and the lawyers, though.

• 41:31Speaker 01

  It is, it is. But also, I think even, even, even then, they, they like the idea of not having, limiting risk is, the larger the corporation, the less they want to limit that risk. And if they could say, these prescriptions, they're not really that, they're not, they're not a medication that's going to increase our margins enough for us to incur that risk. So let's push that off to someone else. And I think the same thing happens with young pharmacists. They're, they're assessing their own personal risk. And when you're staring down six figures of student debt, and you're given a situation where it's on the fence, maybe one red flag. Red flag doesn't mean that the prescription is invalid and it shouldn't be filled.

• 42:13Speaker 01

  But in a, in a young pharmacist's head, they haven't seen enough of these things. They have, they realize, okay, wait, I'm a hundred prescriptions behind. I have this red flag. I'm trying to call the doctor's office. I can't get through this. It might need a diagnosis code. I don't have a lot of history on this patient because they're filling here because they're out of town or whatever. They, they're erring on the side of caution and they're, they're doing the wrong thing for that patient. And they, they, because they realize, okay, I'm protecting myself. They don't realize they're gonna send this patient away for a weekend of agony because they can't fill it anywhere else. And I, I always try to side with the patients when I can. I've been a pharmacist for almost 20 years now.

• 42:54Speaker 01

  I've seen, I've seen suffering. I've seen real suffering every day and I feel it. You know, I, I, I'm not the smartest pharmacist to ever be behind the bench, but I feel like I am one of the most empathetic. And when I see someone suffering, I try to do everything I can within, in the confines of the law to, to help those patients.

• 43:15Speaker 03

  Pharmacists shouldn't have to work under this pressure and doctors shouldn't have to work under this pressure. You know, one of the, one of the people from the DEA we met with, they just, that's their job, just to go into the pharmacies and start counting, you know, do an audit. So I know, and you know, if I had a child that was a pharmacist or a doctor, I would probably, you know, be sick. You know, because I would be sick to my stomach worrying, oh my God, my kid could go to prison. But I also, but I gotta go back to, because I gotta stay true to who I am, like this, this has been the demise. This is the demise of the world, the device.

• 43:53Speaker 03

  And, you know, all we ask is, if you're a young nurse, if you're a young Pharm D, if you're a young, you know, emergency room doctor, like leave your bias behind before you go on social media and make a hateful video. Because you are, you are stigmatizing, when you stigmatize oxycontin, you are stigmatizing the user. And I always think back to that gentleman with ALS, who, I mean, he had to choose between his liquid benzo for spasms or his pain medication. And, you know, we, we just have to continue to be, you know, we remain steadfast in our advocacy.

• 44:33Speaker 03

  We have to take this to the DEA. We have, the next step is to get on Capitol Hill with pharmacists by our side, with physicians by our side. You know, I'm not the person that does what I'm told to do. I'm doing something because I, I know it's right.

• 44:50Speaker 02

  Yeah.

• 44:50Speaker 03

  And that's what, I just wish more providers were on our team. So we, we gotta get those people out of prison. We've got doctors, they're in their eighties, they are behind bars. Did they use a lot of discernment? Probably not. Were they good businessmen or women? No. They were far too trusting, but they don't deserve to die behind bars. Neither do those pharmacists. So.

• 45:17Speaker 02

  Right.

• 45:17Speaker 01

  You know, you guys, I'm sure there are people, I'm sure there are people that are in situations, pharmacists and doctors alike, that are behind bars because they dispensed medications, but there's a lot of people there. The system does work. There are pill mills that have existed. There are places where they've dispensed ridiculous amounts. They've taken cash prescriptions, hand over fist. There, there are.

• 45:39Speaker 02

  Those days are so long gone, Shane. Like those days are so long gone, where there's so many pill mills everywhere.

• 45:45Speaker 01

  You're saying that those, that those are so long gone. I will send you what just happened in Inland Empire. How a, a whole clinic was just shut down, down here, that the, you know, that the, all, all of that's just happened recently. We, we can talk about it being like a, a time past. Maybe it was more proliferative back during the height of the opioid epidemic. But it still exists and we do have to have the, some regulation in place. I'm not.

• 46:11Speaker 02

  We do. We have a lot of regulation in place, though. And, and what you were explaining about being empathetic, I want to thank you for that because I can see in your face that you mean it. That you want to be there for the patient and, and that you want to help the patient. And that just sometimes the system stops you from being able to do that. And I respect that. I absolutely, I don't know if I can explain this properly, but there's a difference between what you just said, Shane, and the pharmacists, both on social media and in real life, who just make fun of the patient and say, you think I'm gonna fill this? Get out of here. There's a difference. There's a difference.

• 46:47Speaker 01

  Because I'm not on TikTok as much, I don't see some of the other generations.

• 46:50Speaker 02

  We have people record their, their, their, in, interactions with their pharmacies, where the pharmacist is literally making fun of them to their face, calling their name out in front of everyone, saying, you think I'm gonna fill your, your oxycontin? That's not happening. And it's just not, it's not okay. Like it's not.

• 47:08Speaker 01

  I, I, I'd like to see those too, because we, you know, we put up, we put up everything, the good and the bad. We call out pharmacists that are doing the wrong things. Any pharmacist that's ever in a situation where they're in front of a patient and they're, they're doing that, I. The whole pharmacist community, the whole healthcare community should reject it. I've, I've seen where healthcare communities, where, where the healthcare community has rallied behind patients when something happened. I, I, I don't remember what state it was in, but that whole clinic where they were taking pictures, this happened on TikTok, where they were taking pictures of the, the fluid, the, the fluid that remained on that. So, anything that's egregious like that gets called out. The, the, the farm, the medical student that was making fun of women's health issues.

• 47:50Speaker 02

  Right. Because that's acceptable to call out though Shane. The vast majority on social media, or at least those who are willing to speak, are not going to speak up for somebody on a full agonist opioid who's treated poorly. It's actually applauded, at least where we are on social media, what we see.

• 48:07Speaker 03

  Unless they're affected, unless they're, unless they're affected or their loved one.

• 48:12Speaker 02

  We've never seen.

• 48:13Speaker 01

  Well, you, you advocate harder when you advocate, advocate harder when it's your own loved one.

• 48:17Speaker 02

  We've never seen anyone though Shane, we've never seen, this is the point. We haven't seen healthcare professionals rally behind pain patients, or anyone who needs acute opioids for acute pain, chronic pain, end of life, cancer, whatever. We've not seen that happen. We're the ones having to rally. We see them make fun of us, but we haven't seen the rally. And I guess that's where my, like anger comes from and resentment towards healthcare professionals on social media. Because they're so willing to rally for, for issues that are acceptable. Like you said, like reproductive rights, or, or even opioid use disorder. But when it comes to someone in physical pain, it's just not socially acceptable to rally.

• 48:57Speaker 01

  Let me offer, let me offer my, let me offer my platform and every platform that I touch. From that, I would, I would point you to places like, I know you had your issues with Dr. Katie Forbes, who made a, a crazy statement and said that you, I think it was in a joking way, but she also did some of the same thing. She got, she got, she got everybody talking. She, she had made in passing, oh, was she being funded by Purdue Pharma? But she also brought two communities together that sometimes are at odds and are getting people to talk to each other. I would point you to Pizza's Not Working and Dr. Bled Tannaway. I'd point you to RX Comedy. All of these, all of these platforms, we can advocate for patients. And you're right, the only way we can affect change

• 49:38Speaker 01

  is to have both of these communities come together and rally against the forces that are holding, holding medications.

• 49:45Speaker 02

  Even Buddy Carver, when he came to our event, he listened to our whole presentation, he spoke and literally he said, basically was, you have to understand, you have to be careful. And Claudia said, because it's career suicide. And he was like, yeah. So that's the issue, like for politicians, for doctors, for healthcare professionals. It really, even those who stand up for us, they have to toe that line because if you're seen as someone advocating for a full agonist opioid, access to, it could kill your career. It really can.

• 50:15Speaker 03

  But it's changing, but it's changing now because too many, too many, there's too many suicides. Like, too many people have died for this to go unnoticed. And just that last meeting with the Senator's office, big, big change in the conversation than nine years ago when I first met. Because now people are applying pressure. People are canceling surgeries. People are saying no to those pain clinics. People are saying, you're not going to abuse me anymore. That's it. I'm done being abused. So that's, that's the good part of social media.

• 50:48Speaker 01

  I think that, I think that pharmacists are finding their voice as well. And, and the pharmacist community is, and sometimes they do it the wrong way. And sometimes they say some of those things and you're, and you're seeing the worst of it. I think you see the best and worst of humanity online and through social media. You really do.

• 51:03Speaker 03

  Can I say, I have the most amazing, I'm still friends with two pharmacists who retired many years ago. My pharmacist have, they've always been, they're like, they're like friends. I'm in a state that's teeny, teeny, tiny. So, you know, and people ask me, well, you know, has this happened to you? I was like, no, I've never had a problem. I've, you know, the only problem I ever had was of being accused of being a drug seeker, which left me with a colostomy bag. But other than that, it's been, you know, smooth sailing. I, thank God. But, um, you know, I, I think the time has come now, um, for, for the communities to come together and to take this off social media and take it to Capitol Hill.

• 51:46Speaker 03

  And I think the pharmacists probably have a little bit more power than we do as patients, you know?

• 51:51Speaker 02

  We have no funding. Like I know, I think you made a grifter saying something about, was it you or a different pharmacist? Like Claudia was a grifter. We, um, just so you know, so everyone knows who is listening, we have no grants, no funding. Our only, um, source of income is through donations and through Patreon. Claudia and I make about a thousand dollars a month doing what we do. So there is no grifting happening.

• 52:14Speaker 03

  And that's only recent. For the first eight years, Bev and I, um, you know, just, you know, we, I, like people laugh, but I say, we dedicated our life to serving others and we're going to continue to do that because most of our constituents are bed bound. Um, they're, they're too sick.

• 52:34Speaker 02

  Yeah. And I would, but I would love what you said Claudia, like if we could somehow, Shane, speak off of social media, my dog's gonna bark, I'm sorry. If we could speak off of social media,

• 52:46Speaker 02

  um, and figure out a way to, to try to affect change together. I mean.

• 52:52Speaker 03

  You're welcome to join us on calls when we meet with senators. Um, we'd love to have the, the pharmacist voice because that's what we need.

• 53:02Speaker 01

  Yeah. I, I am all for this. I, I have, uh, like I said, my, my focus has always been trying to help with work, workplace reform because a lot, I don't know if you use CVS or you use Walgreens.

• 53:15Speaker 02

  I do.

• 53:17Speaker 01

  And some of them are really, the pharmacist is in a situation there sometimes where they're just overworked and they're understaffed and there's constant turnover because technicians are not paid appropriately for the amount of work that they need to do.

• 53:30Speaker 02

  It's awful. It's awful when we see them.

• 53:32Speaker 01

  Suffer because of it. There's medication errors that occur constantly because of this situation. So what we're advocating for is for technicians to be paid better. So well-trained staff stay in, in role and they understand all the little intricacies so they can get as many medications out to the patients as necessary. And you talked about all those patients out there that you've dealt with, that you've heard of suicides and, and, and patients that have ended their life because they couldn't deal with it anymore. I can't tell you how many pharmacists' stories that have happened over the last few years and they're increasing.

• 54:08Speaker 02

  Do you have statistics on that? That's something I'd actually like to, to post and, and speak about. If you have any information.

• 54:15Speaker 01

  Recent, the most recent statistic is that the pharmacists have an increased risk over the general population for suicide.

• 54:22Speaker 02

  If you could send me, I would, I'd be happy to speak about that because we hear about that with physicians, but I have not heard about that specifically from pharmacists.

• 54:29Speaker 01

  One of our, one of our own that was advocating online for a long time, Todd and I both know him, uh, Dr. Eric Geier. He ran the, of the political pharmacist page.

• 54:37Speaker 00

  It's amazing.

• 54:38Speaker 01

  Yeah. Was an amazing guy.

• 54:41Speaker 00

  All about the patient, all about advocacy, helps, uh, helped, uh, to start, um, Pizza's Not Working, which then it manifested from just this little hashtag into this enormous campaign. So it's, it's helping to, to change healthcare and, and what the pharmacists are going through and how they're connected. Um, I wanted to take us upstream real quick before we have to wrap up. When I say upstream, there's forces that have pay grades that are much greater than all of our, all the money that all of our families will ever make over the generations of families that we have in comparison to the pharmaceutical manufacturers

• 55:23Speaker 00

  who also are paying attention to the, um, where the money is and how money works and how drugs are being developed. And I mean, there's, there, there's human beings, there's shitty people in every sector of human beings. And there, there's, there's pharmacists who can be jagoffs and there's pain patients who can be jerkos. And I mean, there's all of us and what we go through. The same thing in pharmaceuticals and the, in the entire ecosystem that we live in. I've met with, um, CEOs of pharmaceutical manufacturing companies who are so in tune to the mission because they've had a loved one or they've had someone that they know

• 56:06Speaker 00

  has been impacted by the disease that they're helping to literally eradicate or fight. And then I've seen, you know, um, the, the memes of that, what's his name? Skolikity or his something Pharma Bro? Where he's taking advantage and marking up.

• 56:20Speaker 01

  Martin Shkreli?

• 56:21Speaker 00

  Yeah. So I mean, and he, he, you know, so we have, we have people in every sector of healthcare that can be jerks that make the rest of us look like shitheads. And that, that's just the way it is. We're gonna have to deal with that. But I know the pharmacists that have, I've gravitated towards and supporting. They don't pay me. I promote them over and over and over again. All of my hosts, none of my hosts pay me anything. And I'm putting out their content. It's because I know that they're part of the change. And I know that, that what they're going through to get there. And I don't, I don't think either sides of our courts, uh, really understand the other sides, you know, as people and as humans and the way that Shane has

• 57:04Speaker 00

  just reached out to everybody on the planet from different sectors of, and the way that the two of you have advocated and been connected with. I do think that there's more that we're going to be able to do together, RX, um, you know, together and being together and, and getting something done. And we should have next steps. We should, we should meet back on this week in pharmacy. But I want to bring a Senator or a state representative or someone who wants a platform. And then, um, you know, sprinkle in other pharmacists who are pain advocates because they're out there. A shout out to, like I said, we started this show and I mentioned Dr. Jeffrey, Jeffrey Feuden, who, who's very much missed in pain management. So.

• 57:47Speaker 02

  Yeah.

• 57:48Speaker 00

  There's others.

• 57:48Speaker 02

  He was great.

• 57:49Speaker 00

  There's other champions too. So, um, yeah, I, I want to thank, um, Shane. Um, I'm going to kind of give you, um, the last word on, on your mission. Cause I do want to give you, give a shout out to the, uh, the union work that you're doing. If you'd give us just a short update on that.

• 58:09Speaker 01

  Yeah, so the the update on that is the Pharmacy Guild has active campaigns in almost all 50 states. We've won elections in Rhode Island. We have the two, one of the, two of the 24-hour stores that are some of the busiest CVSs in the country that are bargaining their first contract. We have CVS Specialty in Redlands, California. That's close to their very first contract. We have multiple stores of Safeways in Washington State. We have Providence Hospital. We're all 72 pharmacists have voted to win their elec, won their election. So there's, there's stores in Arizona. We can, we can change a workplace. The Pharmacy Guild can go in and unionize a store with two pharmacists and three technicians, or

• 58:54Speaker 01

  we can unionize a facility like CVS Specialty in Redlands where all 125 technicians are getting close to having their first contract. I think that this is where the intersection of doing the best for chronic pain patients and my work comes together. If we can fix the labor piece inside these pharmacies, a chronic pain patient who's having any difficulty filling a prescription will be able to go in and have a pharmacist that can give them 10 minutes, 15 minutes of their undefined attention and explain what they can do to get their medication today, whether it be in that location, let them know what the

• 59:35Speaker 01

  issue is, what they have to do, whether it be the insurance is stopping it, whether it's the arbitrary rules of the company they're trying to fill it with, anything, what their concerns are. When that discourse happens and you turn a customer into a patient, you avoid all of those problems. And if I can, if our team and the Pharmacy Guild and all the people that I work with can change that culture inside of a pharmacy, we can better serve every patient out there. So it's a win. And I think the way that we can work together is if we're on the same team and we advocate for you and you advocate for us, there's real power in where you go to fill your prescriptions. I want to let every

• 1:00:17Speaker 01

  chronic pain patient know, you said, Claudia, you're the face, you're advocating for people that are bed bound. There's still power in numbers for all of those patients to take their business somewhere else if they're not, if, if they're not bargaining in good faith, if they're, if they're an understaffed pharmacy. Show them with your prescriptions, show them with your business and your insurance and all the things that they're billing. Show them that you have power. You can affect change. And I am all in. I will help you guys wherever I can, even if it's just sharing it, even if we have to put up something a little bit sensational to get people talking. And let me end this by saying I apologize

• 1:00:57Speaker 01

  wholeheartedly for anything that seemed a little bit offensive or off color that I posted after that original pharmacist video, but I was doing it with the intent of getting us together and getting people together to make real change. Thank you guys for having me. I really appreciate it.

• 1:01:14Speaker 00

  Yep. Yeah, thank you. Claudia and Bev, you're going to be coming back for sure. I want to do more maybe focused groups and anything that you need for me to help you guys strengthen our relationships with providers, because like I said, I can't help the patients. You guys are on the front line. So, so are our pharmacists and our technicians and, and they want what's best. I have up on the screen, if you're watching on YouTube or one of our live streams, it says the doctor, the doctor patient forum.com. That's the doctor patient forum.com. But in wrapping up, I want to give last word to Claudia and Bev.

• 1:01:57Speaker 03

  Well, I think, I think people are going to be angry that it wasn't more hostile. And we ended on, so I'm sorry, listeners, that we don't come from a place of hostility. We come from a place of help. So I hope people aren't too disappointed because I'd love to have Sean, Shane, I'm sorry. That's so bad. That's my men, that's my menopause. I probably need an increase in my estrogen. But we'd love to have Shane come on our podcast. Our, you know, our constituents really need to understand what pharmacists are going through because they're in a pressure cooker. I know, I know, I get it. I get it. Like

• 1:02:38Speaker 03

  I said, they're, they're in prison. There's some people in prison. They don't belong there. So thank you, Todd, for this opportunity.

• 1:02:47Speaker 00

  Yeah. Bev, thank you.

• 1:02:49Speaker 02

  I just want to say, like, one thing I didn't touch on, I'll do it really, really fast, that I really want to just address is one thing we fight for with the doctor-patient forum that has to do with pharmacy is actual harms from the PDMP and for data analytics programs like Narc's Care and the red flags, because these red flagging systems tend to flag the sickest patients and then they cause the very thing they're trying to prevent. Like you said, go to a different pharmacy, but see, then that's a red flag for the patients and then their Narc's Care score can go up, or, or if they don't have it in one pharmacy, going to another again. And so a lot of times there aren't pharmacies within 100 miles of a patient. A lot of times the pharmacy doesn't have the medication, a certain MME

• 1:03:31Speaker 02

  or whatever. We have an open Narc's Care petition that we submitted to the FDA, a citizen's petition, asking them to declare it as software as a medical device, that it can be regulated and transparent. So people actually know what goes into it. I'm not saying the PDMP is just harmful, but there is not a lot of focus on the harms that come from the PDMP, what it actually does, what we know it does and what it might do. And so I think there needs to be more research there. So this is just something that we, we're, we focus on also. I just wanted to let you know, Shane, that that, that is part of what we, we focus on. Cause I know you're given those tools to, to try to determine things. And sometimes they're not the best tools that you're given. But I do appreciate your, your kindness and your empathy. And yeah, I, like Claudia, I think people will

• 1:04:16Speaker 02

  be mad that we're not screaming at each other. But Todd, thank you. You're always the best. I love Todd. I like stick up for you. Anytime anyone attacks you on social media, I feel like I need to be like, no, Todd's our friend.

• 1:04:25Speaker 00

  Don't do it. I'll move around. I always dodge it. I got that Gen X skin too, because it's, you had to, you had to. I got, so I got made fun of in Catholic school for having a big head. And you know, it's.

• 1:04:39Speaker 03

  Todd, how old are you?

• 1:04:41Speaker 00

  I'm 53, 52.

• 1:04:43Speaker 02

  So we all, yeah. So you, I was 76, you were born in what, 74?

• 1:04:48Speaker 00

  72.

• 1:04:49Speaker 02

  72, oh, 72.

• 1:04:50Speaker 01

  You mean, I'm the youngest on here?

• 1:04:52Speaker 03

  You are, Shane, for sure.

• 1:04:53Speaker 01

  I'm 48. I am 48. So.

• 1:04:56Speaker 02

  Todd, if you were born in 72, you're not 52. I just wanted to let you know that.

• 1:05:00Speaker 00

  I can't, I'm not, see, I'm not getting, it's just.

• 1:05:04Speaker 03

  But Shane, we would like to have you on the podcast. We'd like to continue this conversation.

• 1:05:10Speaker 01

  And I would, and I believe me, I know that people are going to be a little bit upset because they're going to say, look, but I wanted to try and have that human connection. We could have turned this into a debate, but I didn't want to do that because I don't think that's beneficial for any one of us. Cause we are on the same team ultimately. And we need to fight the forces that are preventing us from really doing our job and really servicing the patients, all patients.

• 1:05:32Speaker 02

  Yes. Shane, can you give us your contact information after so that we can send, I'll send you some of that stuff. And if you want, that one podcast with Tim Atkinson at Pain Week, I can send it to you if you want, so you can see what I'm talking about. I don't, I would love, I called him to see if I contacted him to see if he'd come on our podcast, but he said something like, those who he were, I don't know, he has restrictions on where he can go, but maybe he can go on your podcast. It's been a few years, but he's, he still, he seems great. He's, he's fighting. He did research, I guess, on patient abandonment and forced papers. So.

• 1:06:06Speaker 03

  Shane, are you trying to organize pharmacists? Is that what you're trying to do?

• 1:06:10Speaker 01

  Yeah. So myself, Dr. Bled Tannaway, Dr. Maurice Shaw, and Lonnie, Dr. Lonnie Duong. By the way, I don't call myself doctor ever. The only thing it's on is my checks. So I wanted to let you know, I'm not part of that generation who, who insists on that. I'm a pharmacist and that's what I want to be. I don't want to be a doctor. I, we, we, we started advocating years ago, but during the walkouts that occurred in Kansas City, there was a bunch of pharmacists who got so upset with the CVS targets out there, they decided to walk off the job. And a lot of them wanted to be able to put stuff out, but they worried about losing their job. And I ended up being the voice on television to, to get their word out. So we organized after that, like CBS tried to play it off,

• 1:06:52Speaker 01

  like this is very specific to this area of the country. It doesn't happen everywhere. But because of a platform like the Accidental Pharmacist, everyone was saying how, you know, this is happening everywhere. Pharmacies are understaffed everywhere. There's so many, we're worried about making mistakes because of the way that they're staffing these locations. So during that time, I ended up being on Fox Business and CNBC and NBC, and there was print articles everywhere. And at that point, IEM Healthcare, which is the International Association of Machinists and Aerospace Workers, they have a smaller healthcare wing. They gave us the resources to launch the Pharmacy Guild. So we're part of IEM, but we're our own entity that only represents pharmacists and technicians. And we have

• 1:07:37Speaker 01

  close to 1,000 members right now. We're still bargaining their first contracts and we just, we've, we've grown a lot, but we still need more. We have full-time organizers in, in Florida, in Michigan, in California, in Arizona. And we actually need more because there's lots of people that want to organize these places to have safer working conditions.

• 1:07:59Speaker 02

  Yeah, that's great.

• 1:08:00Speaker 03

  Oh God, yeah. I'm, I'm pro-union all the way. I come from union blood. So I know the importance of organize. I mean, I tried to organize doctors years ago, but apparently it's illegal for doctors to organize. But I was like, who gives a shit?

• 1:08:16Speaker 01

  Well, it's, it's changing now. I mean, it is because I, there's lots of residents that are actually trying to organize. But the, the thing is, is that it would, I, it's very difficult. If it wasn't for IEM taking, I mean, they put a lot of resources in. We've been at the American Pharmacists Association conventions every year. We've had our own convention here in Palm Springs. They've really put a lot of resources into trying to change this industry and really rein in the, the control that CVS Caremark has on, on what pharmacists do and what our careers look like.

• 1:08:49Speaker 02

  Yeah, that's great. Shane, I would love to have you on our podcast just to talk about that.

• 1:08:53Speaker 03

  Can I say something off the record, like really off the record?

• 1:08:56Speaker 01

  Sure, sure.

• 1:08:57Speaker 03

  So, you know, my, oh, really? Oh no, I can't say it then.

• 1:09:01Speaker 00

  All right. Just let me shut, let me shut twerks down. We appreciate you all, listeners out there. Please share this with someone that you know should be hearing it, another pharmacist, somebody in pain management. Also reach out to Claudia and Bev and Shane. Thank you so much for being on twerks. It's always great to, to see you and can't wait to have you back.

• 1:09:22Speaker 01

  Thanks a lot. Pharmacy on.