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Opioids EOD 9/20/17

Traditional Media Coverage

The Opioid Crisis Can’t Be Blamed on Big Pharma Alone (OPINION)
Sep 20, 2017 | National Review
By Glenn W. Simon

Attorneys general from across the country have begun to file lawsuits that blame the opioid crisis on large drug manufacturers. Missouri AG Josh Hawley argued that his state’s epidemic is the “direct result of a carefully crafted campaign of deception carried out by [the pharmaceutical companies].” Ohio AG Mike DeWine accused the industry of “unleashing a health-care crisis” and “fueling Ohio’s opioid epidemic.” Oklahoma AG Mike Hunter said that drug “companies are culpable for the tragic, heartbreaking number of Oklahomans who have become addicted or who have died as a result of the opioid epidemic in our state.”
State AGs band together for stepped-up probe into opioid drug marketing
Sep 20, 2017 | FiercePharma
By Eric Sagonowsky

After years of going it alone in investigating opioid drugmakers, attorneys general across the U.S. are joining forces to drill into painkiller marketing practices.
Bipartisan Group of Attorneys General Expand Opioid Investigation
Sep 20, 2017 | CT News Junckie
By Jack Kramer

Connecticut Attorney General George Jepsen took a significant step Tuesday to move forward an investigation over whether drug-makers sought to increase profits by misrepresenting the dangers of prescription opioids and ignoring the public health risks.
Attorneys General Looking Into Pharmaceutical Companies' Role In Opioid Epidemic
Sep 20, 2017 | HPPR.org
By Angie Haflich

The attorneys general from Texas, Oklahoma, Colorado and Kansas, along with about three dozen others have served subpoenas on several opioid manufacturers to determine what role they might have played in the nation’s opioid epidemic. This after the coalition of attorneys general sent a letter asking the insurance industry to re-examine the way it may support over-prescription of the potentially deadly and addictive drugs.
Alabama AG Marshall Among Others Seek Info From Opioid Manufacturers
Sep 20, 2017 | Yellow Hammer
By Daniel Bruce

Alabama Attorney General Steve Marshall has announced that he has joined a coalition of 40 other state attorneys general seeking information from manufacturers of prescription opioids. The coalition is another step in the multi-state investigation into the impending nationwide opioid epidemic.
States Expand Probe Into Big Pharma Opioid Marketing
Sep 20, 2017 | Law.com
By Kristen Rasmussen

A bipartisan coalition of state attorneys general is expanding its investigation into Big Pharma’s alleged role in the prescription painkiller and heroin addiction epidemic gripping the nation.
41 AGs investigating manufacturers' role in opioid epidemic
Sep 20, 2017 | WFBO 88.7 Buffalo
By Jay Moran

While the numbers make it clear that an opioid epidemic is raging across the United States, the origins of that epidemic are subject to debate. New York Attorney General Eric Schneiderman - and 40 of his fellow state attorneys general - want to fully explore the role played by four major manufacturers of prescription opioids.
NC attorney general investigating role opioid manufacturers, distributors play in epidemic
Sep 20, 2017 | WECT 6

Attorney General Josh Stein will discuss new developments in the multi-state investigation into opioid manufacturers and distributors Wednesday.
Attorneys general investigate role pharma companies played in opioid crisis
Sep 20, 2017 | McClatchy DC
By Anne Blythe

Josh Stein, North Carolina’s attorney general, announced on Tuesday that he and 40 other attorneys general had expanded their investigation into manufacturers and distributors of prescription opioids in an attempt to hold the pharmaceutical industry responsible for its part in the nationwide overdose crisis.
Shapiro details massive, multistate probe into drug companies' role in opioid crisis
Sep 20, 2017 | Newsworks

Standing on the turf of Upper Dublin High School's football field, Pennsylvania Attorney General Josh Shapiro drew the connection between prescription pills and the current opioid epidemic by introducing Joe Lubowitz.
W.Va. Attorney General announces support for laws banning sanctuary cities
Sep 20, 2017 | WSAZ 3 (WV)
By Dalton Hammonds

West Virginia Attorney General Patrick Morrisey says he is supporting states' rights to prohibit sanctuary cities.
Nebraska's Attorney General requests documents from opioid manufacturers; distributors
Sep 20, 2017 | NTV ABC Nebraska

Attorney General Doug Peterson announced a bipartisan coalition of attorneys general seeking documents and information from manufacturers and distributors of prescription opioids as part of multi-state investigations into the nationwide opioid epidemic. He said this information will enable the attorneys general to evaluate whether manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids. There are 41 attorneys general participating in the multi-state investigations.
Michigan joins other states in opioid investigation
Sep 20, 2017 | Fox47 MI

Michigan is joining dozens of other states demanding information from both the makers and distributors of prescription drugs.
Jepsen, AG coalition demands info from opioid makers including Purdue Pharma
Sep 20, 2017 | Westfair Online
By Kevin Zimmerman

A bipartisan coalition of 39 state attorneys general, including Connecticut’s George Jepsen, have demanded information and documents from several manufacturers and distributors of prescription opioid drugs, including Stamford-based Purdue Pharma.
AG expands opioid sales investigation
Sep 20, 2017 | Worcester Business Journal (MA)

Naming five manufacturers and three distributors, Attorney General Maura Healey said Tuesday that prosecutors in the state are expanding their investigation into opioid sales and marketing to determine whether profits were put above the importance of describing the potential dangers and risks associated with prescription painkillers.
Lawsuits worked to curb Big Tobacco. Tacoma is right to try the same against opioid makers
Sep 20, 2017 | The News Tribune
By Matt Driscoll

The pressure is mounting on manufacturers of prescription opioids for the misrepresentations they’ve made over the years and the toll those distortions have taken on communities.
A Majority Of States Are Joining To Investigate Big Pharma Over The Drug Crisis
Sep 20, 2017 | Daily Caller
By Steve Birr

Attorneys general from a majority of U.S. states are investigating major pharmaceutical companies and their distributors over the worsening opioid crisis ravaging communities across the country.
Alabama AG to target opioid makers and distributors in national investigation
Sep 20, 2017 | AL.com
By Christopher Harress

A major national investigation was launched Tuesday that will seek to discover if U.S. drug manufacturers and distributors acted unlawfully in the marketing, sale, and distribution of opioids, according to a press release by the Alabama Attorney General's office Tuesday.
Opioids, Addiction and Death: 41 State AGs Demand Answers
Sep 20, 2017 | Marijuana.com
By Monterey Bud

America’s opioid manufacturers may soon reap what they’ve sown.

Traditional Media Coverage

The Opioid Crisis Can’t Be Blamed on Big Pharma Alone (OPINION)

Sep 20, 2017 | National Review

By Glenn W. Simon

Attorneys general from across the country have begun to file lawsuits that blame the opioid crisis on large drug manufacturers. Missouri AG Josh Hawley argued that his state’s epidemic is the “direct result of a carefully crafted campaign of deception carried out by [the pharmaceutical companies].” Ohio AG Mike DeWine accused the industry of “unleashing a health-care crisis” and “fueling Ohio’s opioid epidemic.” Oklahoma AG Mike Hunter said that drug “companies are culpable for the tragic, heartbreaking number of Oklahomans who have become addicted or who have died as a result of the opioid epidemic in our state.”
As a doctor who is board-certified in addiction medicine and spent eight years treating the casualties of the opioid epidemic, I know firsthand that the causes of the crisis are much more complicated than Hawley, Dewine, Hunter, and their fellow attorneys general would have you believe. Mere corporate deceit didn’t precipitate the epidemic. It was, rather, the result of a perfect storm of other factors: lax health-industry accreditation standards, the treatment of pain as a “fifth vital sign,” the practices of insurance companies, and the transformation of our health-care system into what is essentially an assembly line.

THE JOINT COMMISSION

The Joint Commission is an independent board that accredits and certifies nearly 21,000 health-care organizations. When the commission says “Jump!” hospital administrators ask, “How high?” In 2001, the commission published its Pain Management Standards, which required providers to ask every patient about his pain. The consensus at the time was that doctors were doing too little to treat patient pain. Since that time, opioid prescriptions have surged, helping to create the current crisis.

Unfortunately, the Joint Commission has refused to acknowledge any responsibility for encouraging doctors to prescribe more opiates. The Physicians for Responsible Opioid Prescribing (PROP), an education and advocacy organization, requested that the Joint Commission change its pain standards. PROP argued that the “Pain Management Standards foster dangerous pain control practices, the endpoint of which is often the inappropriate provision of opioids with disastrous adverse consequences for individuals, families and communities.” The commission instead disavowed any link between its Pain Management Standards and opioid overprescribing.

This is unfortunate, because just as the Pain Management Standards have contributed to the opioid crisis, new commission policies could become part of the solution. Instead of requiring providers to treat their patients’ pain more aggressively, they could require the aggressive provision of alternatives to pain pills, and hospitals would be forced to comply.

THE FIFTH VITAL SIGN

In 1996, the American Pain Society designated pain as the fifth “vital sign” that doctors should use to detect or monitor medical problems. Doctors don’t test or measure anything without intent to treat, and so making patient pain the fifth vital sign obligated them to address it. Pain control thus effectively became a measure of patient satisfaction, which is sometimes tied to a physician’s compensation.

Yet aggressively treating pain does not invariably result in good medical care. The other four vital signs — blood pressure, heart rate, respiratory rate, and temperature — can be measured in reproducible numbers. Pain cannot, which means that doctors have only their patients’ often-unreliable perceptions to go on when determining its severity and how to treat it.

In recent years, the American Medical Association and others have started to recommend dropping pain as the fifth vital sign. That would be a helpful first step, but I’m afraid much of the damage is already done. Categorizing pain as the fifth vital sign conditioned patients to expect that providers would “normalize” it in the same way that they normalize the other four vital signs. They have, in other words, come to expect an opioid prescription.

State licensing boards already require doctors to obtain a certain number of hours of continuing education each year. If medical licensing boards started mandating pain-management courses as part of those hours, doctors could better serve their patients by recommending non-opioid treatment options for pain.

INSURANCE COMPANIES

While pain specialists advocate using alternative treatments (steroid injections, spinal blocks, or physical therapy) to address chronic pain, primary-care doctors have been treating the problem with opioids. Insurance companies pay for primary-care office visits and for the patient’s pain-pill prescription, but they may not cover specialist visits or alternative treatments. Faced with an out-of-pocket charge they can’t afford, patients may have to chose between living in pain or taking the opioids their doctor offers. Understandably, many patients choose the latter, exposing them to a plethora of side effects and the risk of addiction. Assigning social workers to direct patients to addiction-medicine providers in their area, improving reimbursement for primary-care providers treating addictions, and including coverage for alternative treatments would all improve patient care and decrease costs.

THE BUSINESS OF MEDICINE

As larger medical centers gobbled up private practices, doctors lost control of their autonomy as well as their appointment books. Today, employed doctors are paid based on the number of patients they see in a day and the medical conditions they see those patients for. Stanford addiction specialist Anna Lembke, the author of Drug Dealer, MD, describes this process as “the Toyotazation of medicine.” A patient’s time spent with their doctor has become as much about meeting production quotas as about patient care. The incorporation of the electronic medical record has become a significant factor in this production process. Studies have shown that physicians now spend 37 percent of each patient’s appointment time just documenting the visit. I once saw a patient in the E.R. who came to be treated for hiccups. It took 137 clicks of my computer mouse before I’d satisfied that patient’s encounter-documentation requirements. Medicare should consider reducing such unreasonable and burdensome requirements. Doctors need more face-to-face time with their patients.

OTHER CONTRIBUTING FACTORS

There’s plenty of blame to go around when it comes to America’s opioid epidemic. More than 30 percent of Americans have some form of chronic or acute pain, and the incidence of chronic pain in older adults has been estimated at 40 percent. In the absence of an accepted consensus around how to best manage pain, opioids became the go-to treatment. The genetic and environmental factors that place certain populations at greater risk for prescription-drug dependency — combined with the fact that half of the 20 million adults in the U.S. who experience a substance-abuse disorder have co-occurring mental illness — have made the resulting spike in opioid addiction that much harder to address.

Big Pharma may certainly have contributed to the crisis, too. But it is a calculated overreach to suggest that the industry’s “campaign of deception” is solely to blame. We all bear collective responsibility for the problem, and we will all need to bear collective responsibility for solving it. Once you’ve sailed into a storm, you need all hands on deck to get through it.

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State AGs band together for stepped-up probe into opioid drug marketing

Sep 20, 2017 | FiercePharma

By Eric Sagonowsky

After years of going it alone in investigating opioid drugmakers, attorneys general across the U.S. are joining forces to drill into painkiller marketing practices.
AGs in 41 states issued subpoenas to Endo, Johnson & Johnson's Janssen unit, Teva Pharmaceutical and Allergan, and issued a request for further information to Purdue Pharma, as part of a bipartisan probe into the industry's role in the opioid addiction crisis.
Dozens of states, counties and local governments have independently sued opioid drugmakers, alleging they used fraudulent marketing to sell the powerful painkillers, thus fueling a nationwide epidemic. The newly pooled approach steps up those efforts as officials sift evidence to determine whether companies are culpable in the crisis.
"As we have shown in other contexts, broad coalitions of attorneys general can effectively impact national problems through litigation or settlements, often more effectively than they can when acting alone," Connecticut attorney general George Jepsen said in a Tuesday statement. Michigan AG Bill Schuette said the investigation focuses on the "marketing, distribution and sale of opioids."
As Kansas attorney general Derek Schmidt noted, the announcement is unusual because AGs typically wouldn't confirm or deny an active investigation. The officials aren't just looking at the drug industry, either. They also sent info requests to top drug distributors McKesson, AmerisourceBergen and Cardinal Health, and are reaching out to health insurers to see how they might be able to help.
In a letter to America's Health Insurance Plans (AHIP), which represents insurance companies, the attorneys general urged that industry to tweak its policies to "prioritize non-opioid pain management options over opioid prescriptions for the treatment of chronic, non-cancer pain."
In response to the subpoena, an Allergan spokesperson said the company is "working cooperatively with state attorneys general in the multistate investigation on their requests for information regarding opioid marketing practices." He added that Allergan hasn't promoted its branded opioid Kadian since 2012 and hasn't promoted Norco since 2003. Together, those two meds accounted for .08% of U.S. opioid prescriptions last year, according to the company.
A spokesperson for Johnson & Johnson's Janssen said the drugmaker received and will "address the request from the coalition of state attorneys general, and will continue to work with stakeholders to support solutions."
"Janssen has acted responsibly and in the best interests of patients and physicians with regard to these medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label," he continued. The company also said it gives doctors "complete and accurate" information on prescribing its opioids.
A Teva spokesperson the company is "committed to the appropriate promotion and use of opioids."
"We have programs in place that educate prescribers, pharmacists, and patients on the responsible and safe use of these products," she added. "We are committed to working with the healthcare community, regulators and public officials to collaboratively find solutions."
Endo declined to comment. Representatives for Purdue didn't immediately respond to a request for comment.
As industry watchers know, the investigation comes after numerous states and local governments independently sued opioid drugmakers for their alleged role in the deadly epidemic. Ohio in a lawsuit said the companies borrowed a page from the "Big Tobacco playbook" to convince “key opinion leaders” and professional societies of the benefits of opioids while downplaying risks. As each new suit is filed, the industry's legal expenses and potential liability grows.
The FDA has also gotten involved in the situation, pushing Endo to remove one of its opioids and promising a review of the risks and benefits of similar drugs on the market.
Opioid overdoses kill 91 people in the U.S. each day, according to the CDC.

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Bipartisan Group of Attorneys General Expand Opioid Investigation

Sep 20, 2017 | CT News Junckie

By Jack Kramer

Connecticut Attorney General George Jepsen took a significant step Tuesday to move forward an investigation over whether drug-makers sought to increase profits by misrepresenting the dangers of prescription opioids and ignoring the public health risks.
Jepsen and 38 attorneys general from across the country demanded information and documents from pharmaceutical manufacturers Endo International plc; Janssen Pharmaceuticals; Teva Pharmaceutical Industries Ltd./Cephalon Inc.; and Allergan Inc.
The attorneys general are also seeking documents and information about distribution practices from AmerisourceBergen; Cardinal Health; and McKesson. Those three companies control 90 percent of the opioid distribution in the country.

The number of state’s top lawyers participating, and the bipartisanship it brings, represents a dramatic expansion and coordination of the investigations by the into the nationwide opioid epidemic.

“While some states have taken individual legal actions, the overwhelming majority of attorneys general, from both parties and all parts of the country, have now agreed to work together to investigate the marketing, distribution and sale of opioids, and to take further coordinated legal action as appropriate,” Jepsen said.

A previously announced investigation by a coalition of attorneys general focused exclusively on Purdue Pharma. In addition to extending the investigation to these additional manufacturers, the attorneys general have also served a supplemental investigative demand on Purdue Pharma.

The coordinated action comes a few weeks after Ohio Attorney General Mike DeWine filed a lawsuit stating manufacturers used sales representatives and advertising to downplay the risks associated with opiates, which has led to a rapid increase in prescription drug and heroin addiction across Ohio.

Opioids – both prescription and illicit – are the main driver of drug overdose deaths nationwide and in Connecticut. According to the Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999. The Connecticut Office of the Chief Medical Examiner is projecting that more than 1,000 people will die of opioid-related overdoses in Connecticut in 2017.

“If there have been violations of law, we will find them and work aggressively to address them, Jepsen said.

“We also recognize that time is our enemy and that we should pursue all means to ease this crisis as quickly as possible. For that reason, we have encouraged, and will continue to encourage, the pharmaceutical industry – both manufacturers and distributors – to engage constructively with the attorneys general towards meaningful agreements that may be achievable sooner than full scale investigations and litigation may permit,” Jepsen added.

The 39 attorneys general participating in the overall multistate investigations are organized into subgroups focusing on manufacturers and distributors. Connecticut is taking a leadership role in the subgroup focusing on opioid distributors and is also participating with respect to the investigation of manufacturers.

The investigation follows a lawsuit filed by the city of Waterbury against 11 pharmaceutical companies.

That complaint states that the pharmaceutical companies “knew or should have known that, with prolonged use, the effectiveness of opioids wanes, requiring increases in doses to achieve pain relief and markedly increasing the risk of significant side effects and addiction.
In total, from 2002 through 2015, opioid overdose deaths, including heroin, have risen 280 percent in the U.S., according to findings from the National Institute on Drug Abuse.
States, counties, and municipalities have filed similar lawsuits against pharmaceutical companies.

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Attorneys General Looking Into Pharmaceutical Companies' Role In Opioid Epidemic

Sep 20, 2017 | HPPR.org

By Angie Haflich

The attorneys general from Texas, Oklahoma, Colorado and Kansas, along with about three dozen others have served subpoenas on several opioid manufacturers to determine what role they might have played in the nation’s opioid epidemic. This after the coalition of attorneys general sent a letter asking the insurance industry to re-examine the way it may support over-prescription of the potentially deadly and addictive drugs.
According to the Denver Post, subpoenas were served on Endo Pharmaceuticals, Janssen Pharmaceuticals, Teva Pharmaceuticals/Cephalon, Inc. and Allergan, PLC, and their related entities that seek to uncover if the manufacturers of prescription painkillers misled doctors and patients about the efficacy and addictive power of their drugs.
And as the Topeka Capital-Journal reports, in the letter sent to insurance companies Monday, the attorneys general encouraged insurance industry trade groups and providers to review their coverage and payment policies for pain treatments.

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Alabama AG Marshall Among Others Seek Info From Opioid Manufacturers

Sep 20, 2017 | Yellow Hammer

By Daniel Bruce

Alabama Attorney General Steve Marshall has announced that he has joined a coalition of 40 other state attorneys general seeking information from manufacturers of prescription opioids. The coalition is another step in the multi-state investigation into the impending nationwide opioid epidemic.
The attorneys general served Civil Investigative Demands on several opioid manufacturers, including Endo, Janssen, Teva/Cephalon, Allergan, and Purdue Pharma. The demands subpoena documents related to the marketing and sale of prescription opioids. The attorneys general also subpoenaed information from several opioid distributers, including AmerisourceBergen, Cardinal Health, and McKesson.
Attorney General Marshall weighed in on the importance of the coalition in a press release on Tuesday.
“Opioid abuse has reached a crisis level in Alabama and in many portions of the country, and earlier this year I joined with fellow attorneys general in investigating what role opioid manufacturers may have had in creating or prolonging the opioid abuse epidemic, and to establish the appropriate course of action to help solve this crisis. Our investigation continues as we seek information from drug manufacturers and distributors to help determine whether they engaged in unlawful practices in the marketing, sale, and distribution of opioids.”
Marshall was appointed by Governor Kay Ivey in August to serve as a co-chair on the Alabama Opioid Overdose and Addiction Council. The council is charged with examining the opioid crisis and discovering ways to reduce its harmful impact on Alabamians. It held its first organizational meeting on September 5.
Opioids have become the main contributor to drug overdoses both nationwide and in Alabama over the past few years. According to the Centers for Disease Control and Prevention, there were 33,091 opioid related deaths in the United States in 2015, including 736 in Alabama. Opioid overdoses have quadrupled since 1999. These staggering statistics have led to unprecedented work by legislators and officials across the nation to curtail the harmful effects of this epidemic.

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States Expand Probe Into Big Pharma Opioid Marketing

Sep 20, 2017 | Law.com

By Kristen Rasmussen

A bipartisan coalition of state attorneys general is expanding its investigation into Big Pharma’s alleged role in the prescription painkiller and heroin addiction epidemic gripping the nation.
The group of 41 state AGs announced Tuesday that it is issuing subpoenas to several pharmaceutical drug manufacturers for information about how the companies market their opioids. The original investigation, launched in June, applied only to OxyContin and Dilaudid maker Purdue Pharma Inc. Now the investigation has grown to include Endo Pharmaceuticals Inc., maker of Opana and Percocet; Johnson & Johnson’s Janssen Pharmaceuticals Inc., which makes Duragesic and Nucynta; Teva Pharmaceuticals USA Inc., maker of Actiq and Fentora; and Kadian manufacturer Allergan. The probe also extends to drug distributing giants AmerisourceBergen Corp., Cardinal Health and McKesson Corp.
An email seeking comment from the trade group representing the pharmaceutical industry, the Pharmaceutical Research and Manufacturers of America, declined to comment.
These companies also are facing a spate of lawsuits in federal, state and county courts across the United States brought by plaintiffs lawyers who have teamed with government officials to sue Big Pharma through contingency fee agreements. The suits generally contend prescription opioid drugmakers intentionally engaged in a targeted marketing campaign claiming that their painkillers could be prescribed nonaddictively. Instead, according to the suits and many AGs’ comments issued Tuesday, the marketing techniques led to patients becoming addicted to the prescription opioid painkillers.
“Too often, prescription opioids are the on-ramp to addiction for millions of Americans,” said New York AG Eric Schneiderman in a news release. “We’re committed to getting to the bottom of a broken system that has fueled the epidemic and taken far too many lives.”
Illegal and prescription opioids were involved in 33,091 deaths in 2015, including 2,754 in the state of New York, the New York Attorney General’s Office said, citing statistics from the federal Centers for Disease Control and Prevention, which also said opioid overdoses quadrupled since 1999.
“We deserve to hear from these drugmakers what they knew about the addictive and deadly nature of opioid painkillers, and whether they misrepresented those risks in order to increase corporate profits,” said Massachusetts AG Maura Healey in a statement. “We are expanding our investigation into opioid manufacturers and distributors to help uncover the roots of this deadly epidemic and protect American families and communities ravaged by this public health crisis,” Healey said.
Opioid distributors alone make nearly $500 billion a year in revenue, according to Schneiderman’s office.
The drug distributors that now are the target of the expanded investigation are likewise facing battles in the courtroom. The Cherokee Nation in June named those distributors in its complaint alleging that the companies illegally inundated the Nation with the dangerous drugs.
In addition to Healey, Connecticut AG George Jepsen, Georgia GC Chris Carr and Vermont AG TJ Donovan are among the 41 AGs in the coalition.
New York’s investigation is being conducted by Assistant Attorneys General Carol Hunt, Christopher Leung and Sara Mark of the health care bureau, under the supervision of bureau chief Lisa Landau, counsel to the Medicaid fraud control unit Jay Speers and Special Assistant Attorneys General Kathryn Harris and Elizabeth Kappakas of the Medicaid fraud control unit, under the supervision of director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney, the AG’s office said.

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41 AGs investigating manufacturers' role in opioid epidemic

Sep 20, 2017 | WFBO 88.7 Buffalo

By Jay Moran

While the numbers make it clear that an opioid epidemic is raging across the United States, the origins of that epidemic are subject to debate. New York Attorney General Eric Schneiderman - and 40 of his fellow state attorneys general - want to fully explore the role played by four major manufacturers of prescription opioids.
"Our multi-state investigation is looking - in as comprehensive a way as has ever been done before - to see if any of these companies engaged in any unlawful practices in the marketing or distribution of prescription opioids," Schneiderman said, "and, to that end, we're announcing that we've served investigative subpoenas on four major manufacturers."
The manufacturers are Endo International, Janssen Pharmaceuticals, Tevca Pharmaceutical Industries and Allergan, Inc. According to Schneiderman, opioids, both prescription and illicit, are driving the rising number of drug overdose deaths across the United States.
"What we know so far is troubling," he said. "Lawsuits by some cities and counties and a few states have already chronicled what appears to be some deceptive marketing practices at these companies. There's no doubt that there simply are too many prescriptions for too many opioids in America right now."
In February, Erie County joined those municipalities suing opioid manufacturers. Its lawsuit alleges drugmakers helped fuel the opioids epidemic by spreading the falsehood that the medications are not addictive and potentially lethal.
Opioid manufacturers earn $500 billion each year. The AGs' subpoenas are seeking documents and information regarding marketing and distribution practices. According to Schneiderman, their investigation also wants to review how marketing practices may have ignited the opioid epidemic.
"For millions of Americans, their personal battle with opioid addiction did not start in a back alley with a tourniquet and a syringe. They got hooked on medicine they were prescribed for pain or that they found in a medicine cabinet," he said. "According to the National Institutes of Health, nearly 80 percent of Americans using heroin reported misusing prescription opioids, first."
In 2015, over 33,000 deaths nationwide were attributed to opioid overdoses, according to the Centers for Disease Control and Prevention. That figure includes over 2,700 New Yorkers.
The CDC also reports that drug overdoses were responsible for 37 percent of the deaths of Erie County residents between the ages of 15 and 44 - and numbers are expected to climb.

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NC attorney general investigating role opioid manufacturers, distributors play in epidemic

Sep 20, 2017 | WECT 6

Attorney General Josh Stein will discuss new developments in the multi-state investigation into opioid manufacturers and distributors Wednesday.
The attorney general's office is working to determine what role opioid manufacturers and distributors may have played in creating or prolonging the opioid epidemic.
Stein is requesting documents from manufacturers and distributors . He is investigating whether these companies engaged in the unlawful marketing, sale, and distribution of these drugs.
Opioid manufacturers being investigated include: Endo, Janssen, Teva/Cephalon, Allergan, and Purdue Pharma.
This investigation is looking into the possibility that patients and doctors were misled about the addictive nature of opioid drugs.
Stein has also requested documents from opioid distributors AmerisourceBergen, Cardinal Health, and McKesson.
The investigation into distributors looks to see if they neglected their duty to raise red flags about pharmacies’ suspicious drug orders.
“The opioid epidemic is among the biggest public health threats we face today,” Stein said. “In addition to my work in advocating for policies and funding to promote prevention, treatment and enforcement, it is critical that we look at how this crisis was created and has exploded. I will hold accountable any drug manufacturer or distributor that played a role in creating or prolonging this epidemic and require that they become part of the solution.”
Across the country and in North Carolina, opioids are the main driver of drug overdose deaths, which now top car accidents as the number one cause of accidental death.
In North Carolina, around four people die each day from accidental drug overdose.
Wednesday's meeting will take place at 2 p.m. at Coastal Horizons in Wilmington.
Other speakers include Kenny House, Vice President of Clinical Services at Coastal Horizons Center, Margaret Weller-Stargell, President and CEO of Coastal Horizons Center, and a person recovering from opioid addiction.

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Attorneys general investigate role pharma companies played in opioid crisis

Sep 20, 2017 | McClatchy DC

By Anne Blythe

Josh Stein, North Carolina’s attorney general, announced on Tuesday that he and 40 other attorneys general had expanded their investigation into manufacturers and distributors of prescription opioids in an attempt to hold the pharmaceutical industry responsible for its part in the nationwide overdose crisis.
At a news conference broadcast live on Facebook, Stein, a member of the executive committee leading the probe, announced that the state officials have subpoenaed records of the marketing and sales practices of five manufacturers and three distributors of powerful prescription painkillers.
The investigation builds on one started earlier this year into Purdue Pharma, a company that several states have sued and accused of using deceptive marketing practices related to OxyContin. Their allegations come nearly a decade after three Purdue Pharma executives pleaded guilty and paid a $634 million fine for an OxyContin branding strategy that overstated the benefits of opioids for treating chronic pain.
As part of the expanded investigation, the attorneys general have added Endo, Janssen, Teva/Cephalon, Allergan and their related entities to the list of opioid manufacturers from which they want more information.
The investigation also focuses on AmerisourceBergen, Cardinal Health, and McKesson for information about their opioid distribution practices.
“As millions of Americans were becoming addicted to prescription painkillers and communities were struggling to respond to this crisis, drug companies were reaping enormous profits,” said Stein, a Democrat and former state senator elected attorney general last year. “If these companies broke the law in any way, if they created the misery that the people in North Carolina are suffering, I will hold them accountable.”
The pharmaceutical industry faces dozens of lawsuits brought by states, cities and counties as opioid addiction and overdose deaths spike.
Nationwide and in North Carolina, opioids – prescription and illicit – are the main driver of drug overdose deaths, which now top car accidents as the No. 1 cause of accidental death. In North Carolina, it is estimated that nearly four people die each day from accidental drug overdoses.
Opioids are compounds that bind to the brain’s opioid receptors, blocking pain and slowing breathing. The drugs trigger the release of dopamine, and new users typically feel a calm, happy high while under the influence. Regular users develop a tolerance to the drugs, requiring more and more to achieve the same effect.
The widening epidemic can be traced to the 1990s, when doctors began to treat pain more aggressively.
Prescriptions for hydrocodone or oxycodone, which are also known by brand names Vicodin and OxyContin, have skyrocketed over the years, from 76 million in 1991 to nearly 259 million in 2012, former U.S. Surgeon General Vivek Murthy has said. As of 2013, hydrocodone, the generic version of Vicodin, was prescribed to more Medicare patients than any other drug, according to a ProPublica project.
At the news conference on Tuesday, Stein described his experience traveling the state and hearing from people who have suffered addiction and loss from the crisis.
Steve Shelton, in an emotional few minutes at the podium, shared his story of losing his youngest son Caleb, a former Guilford County high school and college baseball player.
“Addiction is a disease that knows no boundaries. It transcends age, race, gender,” Shelton said, adding that his son’s addiction was rooted in surgeries he had after athletic injuries and a motorcycle accident. “Caleb was caught up in a substance abuse disorder he neither wanted nor could control.”
Ashley Fabrizio, a former Nash County high school cheerleader who was given her first painkillers after an injury, talked about how easy it was to get refills of prescription painkillers from doctors who barely questioned her.
It all started when she came down wrong on her ankle after being thrown in the air. Her ankle popped and she was in severe pain, she said. While in the ambulance, Fabrizio said, the responders “ juiced” her up. She was given Vicodin. Four days later, she went back to see an orthopedic surgeon, complained of more pain and was prescribed Percocet. She returned to the doctor later with more pain complaints and was prescribed 50 more Vicodin, she said, with a refill option for 50 more.
“Now I was 16 and 100 pounds,” Fabrizio said – and at the time, “being in school and walking around, I was high as a kite.”
Fabrizio was able to break her habit and go on to college, but got into painkillers again several years later when her brother introduced her to a street dealer who was selling Oxycontin.
“It was like an old familiar friend,” Fabrizio said as she chronicled the push and pull between using the opioids and clearing her system of them.
Mandy Cohen, secretary of the state Department of Health and Human Services, said for Fabrizio and others, access to insurance and continued treatment and health care was important in the fight against opioids. Cohen and Stein were critical of state lawmakers who have blocked a Medicaid expansion that would have brought millions in federal spending to North Carolina, some of which would have been available to addicts in need of health care.
“This epidemic is affecting too many people,” Stein said as he outlined a multi-pronged effort to go after traffickers, dealers and the pharmaceutical industry.
The attorneys general plan to investigate whether the drug manufacturers overstated scientific backing for their opioid products, their sales strategies “and whether they misled doctors,” Stein said. He also plans to investigate whether distributors noticed a suspicious shift in distribution of the drugs that they failed to report, which would violate law.

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Shapiro details massive, multistate probe into drug companies' role in opioid crisis

Sep 20, 2017 | Newsworks

Standing on the turf of Upper Dublin High School's football field, Pennsylvania Attorney General Josh Shapiro drew the connection between prescription pills and the current opioid epidemic by introducing Joe Lubowitz.
Lubowitz, in his late 20s, used to be a three-sport athlete in the district.
"I played on these fields and in these facilities, behind you. And one pill changed that."
Now in long-term recovery, Lubowitz said it was easy to get the prescription painkillers that eventually led him to heroin.
The sports field was merely a scenic backdrop for an investigation that's been going on behind the scenes. In June, 41 attorneys general kicked off a probe into whether drug companies break the law in the ways they present and sell opioid painkillers.
On Tuesday, officials named the companies under investigation, several of which have business offices spread across the Philadelphia region.
The five manufacturers under investigation include Teva Pharmaceutical Industries, with North American headquarters in North Wales, Pennsylvania; Endo Industries, with a U.S. headquarters in Malvern, Pennsylvania; and Janssen Pharmaceuticals, with offices in Horsham, Pennsylvania, as well as Titusville and Raritan, New Jersey. Investigators also named Cephalon Inc., which Teva took over in 2011, as a target. The state attorneys named three medical distributors as well, among them AmerisourceBergen, headquartered in Chesterbrook, Pennsylvania.
All 41 state prosecutors have signed on to look into Purdue Pharma, which makes OxyContin, while 38 vow to investigate all of the companies.
At stake is whether these companies misled the public and doctors about the drugs they make and sell. This week, investigators subpoenaed documents related to the "development of opioid drugs, the result of those clinical trials, communication with physicians and consumers and internal discussions about regulatory and legal compliance," said Shapiro.
Local targets responded to requests for comment, with varying degrees of acknowledgement of the investigation itself.
A spokeswoman for Endo said that the company would not comment on pending litigation, while Teva and AmerisourceBergen media liaisons called the investigation an opportunity to work more closely with law enforcement and regulators to address the opioid epidemic.
"We welcome the opportunity to educate the attorney general coalition on our role in the health care supply chain," said Lauren Moyer, director of external relations with AmerisourceBergen.
It's not yet clear whether this investigation will lead to legal action, although attorneys general from Missouri, Mississippi and Ohio have independently sued some of the same drug manufacturers, alleging they knowingly downplayed the addictive capacity of their products.
After his remarks, Shapiro opened his mic to the public. Carpenter Benji Eisenstein approached with a snapshot of his daughter.
"I have 13 years in recovery, without a drink or a drug. I work two days a week at Livengrin Foundation [a treatment provider]," he said. "Yet I couldn't save my daughter. Christmas Day, she died of an overdose."
When asked what he thought about going after drug companies, Eisenstein said there's a lot of blame to go around, but none of it will bring his daughter back.

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W.Va. Attorney General announces support for laws banning sanctuary cities

Sep 20, 2017 | WSAZ 3 (WV)

By Dalton Hammonds

West Virginia Attorney General Patrick Morrisey says he is supporting states' rights to prohibit sanctuary cities.
“Sanctuary cities raise an issue of public safety,” Attorney General Morrisey said. “Law enforcement and local officials need to comply with federal immigration law to better protect citizens. States should have the right to do all they can to increase safety for their residents.”
According to a release, Morrisey and Louisiana Attorney General Jeff Landry are leading the multistate coalition with eight other states.
In June, West Virginia and Louisiana led 10 states in defending President Trump’s executive order that directs the federal government to take lawful actions to ensure compliance with laws prohibiting sanctuary cities.
West Virginia and Louisiana filed this week’s brief with Alabama, Arkansas, Georgia, Missouri, Oklahoma and South Carolina.

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Nebraska's Attorney General requests documents from opioid manufacturers; distributors

Sep 20, 2017 | NTV ABC Nebraska

Attorney General Doug Peterson announced a bipartisan coalition of attorneys general seeking documents and information from manufacturers and distributors of prescription opioids as part of multi-state investigations into the nationwide opioid epidemic. He said this information will enable the attorneys general to evaluate whether manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids. There are 41 attorneys general participating in the multi-state investigations.
According to the Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths in 2015 including 126 in Nebraska, and opioid overdoses have quadrupled since 1999.
“The opioid crisis this nation faces today is, in part, due to the past actions of certain players in the pharmaceutical industry. The goal of this investigation is to determine who in the industry should bear responsibility under our consumer protection laws,” said Attorney General Peterson.
According to a statement from the Attorney General's office, Peterson served investigative subpoenas for documents and information, also known as Civil Investigative Demands, on Endo, Janssen, Teva/Cephalon, Allergan, and their related entities, as well as a supplemental Civil Investigative Demand on Purdue Pharma.
The attorneys general sent letters to opioid distributors AmerisourceBergen, Cardinal Health, and McKesson requesting documents about their opioid distribution business.
Peterson said that he will use these investigative tools to determine what role the opioid manufacturers and distributors may have played in creating or prolonging this epidemic and determine the appropriate course of action to help resolve this crisis.

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Michigan joins other states in opioid investigation

Sep 20, 2017 | Fox47 MI

Michigan is joining dozens of other states demanding information from both the makers and distributors of prescription drugs.
Michigan Attorney General Bill Schuette and 40 other Attorneys General are pooling their resources to address the opioid epidemic. Their investigation involves at least five pharmaceutical manufacturers including Purdue Pharma, the maker of oxycontin.
Three distributors that manage nearly 90% of the nation's opioid distribution are also being investigated. Schuette says once the information they're seeking has been reviewed, legal action may follow. He says "highly addictive opioid drugs have destroyed families, robbed children of parents and robbed parents of children."
This is just the latest step in Schuette's ongoing work to address the opioid epidemic. In addition to the multi-state investigation, more than two dozen prescribers have also had their licenses suspended, as well as four dispensers. Two separate prescription forgery rings have also been successfully prosecuted.
Schuette's newly formed Opioid Trafficking and Interdiction Unit has also seen success. It has already taken on 48 cases, with six individuals already convicted and 17 others currently facing charges. The unit is also taking on felony murder cases where the delivered opioids caused death.
Opioids, both prescription and illicit, are the main driver of drug overdose deaths nationwide and in Michigan. In 2015, Michigan saw its third consecutive year of increased drug overdose deaths with 1,981. Compare that to 1999 where just 455 deaths were reported.

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Jepsen, AG coalition demands info from opioid makers including Purdue Pharma

Sep 20, 2017 | Westfair Online

By Kevin Zimmerman

A bipartisan coalition of 39 state attorneys general, including Connecticut’s George Jepsen, have demanded information and documents from several manufacturers and distributors of prescription opioid drugs, including Stamford-based Purdue Pharma.
Jepsen said the attorneys general are pooling resources and coordinating across party lines to address the public health crisis.
Opioids – both prescription and illicit – are the main driver of drug overdose deaths nationwide and in Connecticut. According to the Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999. The Connecticut Office of the Chief Medical Examiner is projecting that more than 1,000 people will die of opioid-related overdoses in Connecticut in 2017.
“This investigation will proceed in a comprehensive and coordinated manner,” Jepsen said. “If there have been violations of law, we will find them and work aggressively to address them.
“We also recognize that time is our enemy and that we should pursue all means to ease this crisis as quickly as possible,” he added. “For that reason, we have encouraged, and will continue to encourage, the pharmaceutical industry – both manufacturers and distributors – to engage constructively with the attorneys general towards meaningful agreements that may be achievable sooner than full scale investigations and litigation may permit.”
The coalition’s latest move targets pharmaceutical manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd./Cephalon Inc., and Allergan Inc.
A previously announced investigation by the coalition focused exclusively on Purdue Pharma. Jepsen said the group has also served a supplemental investigative demand on the Stamford drug maker.
“We share the attorneys’ general concern about the opioid crisis and we are cooperating with their request,” Purdue Pharma spokesman John Puskar said. “This is a multifaceted public health challenge, and we look forward to working collaboratively with government entities to be part of the solution.”
The attorneys general are also seeking documents and information about distribution practices from opioid distribution companies AmerisourceBergen, Cardinal Health and McKesson, who together manage approximately 90 percent of the nation’s opioid distribution.
Meanwhile, Purdue Pharma – which earlier this month asked for the dismissal of a case against it filed by Ohio Attorney General Mike DeWine – has asked state of Washington U.S. District Court Judge Ricardo S. Martinez to dismiss the city of Everett’s lawsuitagainst it. That suit seeks damages for what it alleges was the illegal marketing and distribution of OxyContin and other Purdue opioids.

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AG expands opioid sales investigation

Sep 20, 2017 | Worcester Business Journal (MA)

Naming five manufacturers and three distributors, Attorney General Maura Healey said Tuesday that prosecutors in the state are expanding their investigation into opioid sales and marketing to determine whether profits were put above the importance of describing the potential dangers and risks associated with prescription painkillers.
"We are expanding our investigation into opioid manufacturers and distributors to help uncover the roots of this deadly epidemic and protect American families and communities ravaged by this public health crisis," Healey said in a statement.
Healey, as part of a 39-member bipartisan coalition of attorneys general, said she is investigating manufacturers Purdue Pharma, Endo, Janssen, Teva and Allergan and distributors AmerisourceBergen, Cardinal Health and McKesson.
PurduePharma was the exclusive focus of a previously announced investigation.
Healey's office said attorneys general are using subpoenas and seeking documents about distribution practices at McKesson, Cardinal Health and Amerisource Bergen, who manage about 90 percent of the nation's opioid distribution.
"The investigation into distributors centers on whether these companies properly tracked and reported suspicious orders of controlled substances," Healey's office said. Manufacturers are being investigated for possible deceptive marketing.

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Lawsuits worked to curb Big Tobacco. Tacoma is right to try the same against opioid makers

Sep 20, 2017 | The News Tribune

By Matt Driscoll

The pressure is mounting on manufacturers of prescription opioids for the misrepresentations they’ve made over the years and the toll those distortions have taken on communities.
Rightly so.
As the opioid epidemic grows and worsens, so too do the real-life consequences here in Pierce County.
That surely played into Tacoma’s decision last week to add its name to a growing list of cities, counties and states that have filed lawsuits against major prescription opioid manufacturers. Specifically, Tacoma is asking a federal court to award damages three times the amount of the city’s actual costs — a move permitted under Washington’s Consumer Protection Act and the federal Racketeer Influenced and Corrupt Organizations (RICO) Act.
That surely will add up to millions of dollars.
It doesn’t take an expert in law to realize that the real hope for change and financial retribution likely resides in the cumulative impact that lawsuits like Tacoma’s might have.
That’s the real reason why the City of Destiny’s bold decision to jump into the fray is so important.
Across the country, opioid-related lawsuits like Tacoma’s now number in the 30s, according to David Ko, one of the lead attorneys working on the city’s case. Many have been filed in the last year. Just this week, attorneys general of 41 U.S. states announced plans to investigate the makers and distributors of opioid painkillers.
If that sounds reminiscent to the legal onslaught Big Tobacco faced prior to the landmark tobacco settlement of the late 1990s, it’s because it is, Ko says.
Both, he points out, involve lawsuits brought by state government municipalities against companies “raking in billions of dollars.”
And both, Ko believes, might help to inspire drug manufacturers to be more responsible with their products, especially with revenue increasingly at stake.
Let’s hope he’s right.
When it comes to potential outcomes, keyboard lawyers like myself are left to speculate about what will almost certainly be a lengthy legal process. Ko acknowledges that, at this point, “it’s clear ... that all of the defendants that have been sued thus far plan on defending the claims against them aggressively.”
It’s also no stretch to see that with every additional lawsuit the likelihood of drug manufacturers moving to settle the cases, consolidate them or reach some sort of global resolution only grows.
Legally, and from the cold perspective of the bottom line, such a conclusion looks smarter and smarter for drug manufactures. At some point, perhaps it becomes inevitable.
Which brings us back to Tacoma, and the city’s laudable decision to throw its weight behind the cause.
There’s no question that Tacoma has felt the impacts, both on a human level and financially, of years of over-prescription and drug makers’ false claims of safety. They’re all around us, from the number of people living on the streets and suffering from addiction, to the resources the city has been forced to expend in response.
As The News Tribune reported last week, Tacoma’s lawsuit alleges that the drug manufacturers’ tactics have “fueled the city’s homelessness crisis, strained police resources and caused the city’s health insurance costs to skyrocket.”
“I think that the real strength of the case is that there is no shortage of information available now that reveals that these defendants have been making some serious misrepresentations about opioids,” Ko says. “Since our case is really about these misrepresentations, we feel pretty confident about the claims that we’re making.”
Specifically, Tacoma’s complaint highlights the deceptive practices used by drug manufacturers to support the idea that opioid painkillers were a safe, effective way to treat pain while posing little risk for addiction.
The legal argument cites jaw-dropping numbers, like the 289 million opioid pain-medication prescriptions written in 2016, “enough for every adult in the United States to have more than one bottle of pills,” to the $78.5 billion per year that the Centers for Disease Control and Prevention estimates as the total economic burden of prescription opioid abuse in the United States.
Tacoma’s legal argument repeatedly points to substantial evidence of a “well-orchestrated marketing campaign” over the last two decades, directed at physicians and the public, suggesting “the risk of addiction to prescription opioids was low when opioids were prescribed to treat chronic pain.”
Just as was the case in the legal fight with Big Tobacco, in other words, clear signs of an attempt to mislead the public in a quest for profit are there. Tacoma’s lawsuit helps paints a damning picture of deception, and a city struggling to deal with its effects.
And just as was the case with Big Tobacco, righting that wrong, and reaching a conclusion that helps communities with its consequences, likely depends on a ratcheting up the legal pressure.
Which is precisely why Tacoma’s lawsuit really matters.

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A Majority Of States Are Joining To Investigate Big Pharma Over The Drug Crisis

Sep 20, 2017 | Daily Caller

By Steve Birr

Forty-one state attorneys general are demanding answers from drug manufacturersdetailing their medications and marketing practices as part of their efforts to determine what role pharmaceutical companies may have played in the current addiction epidemic. The bipartisan group announced Tuesday in New York that they jointly filed subpoenas served to Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd./Cephalon Inc. and Allergan Inc., reports USA Today.
Officials also served subpoenas to AmerisourceBergen, Cardinal Health and McKesson, seeking information on their distribution methods for opioid painkillers. Opioid distributors are estimated to rake in nearly $500 billion in annual revenue. A supplemental investigative subpoena was also served against Purdue Pharma, the manufacturers of the painkiller OxyContin.
“Too often, prescription opioids are the on-ramp to addiction for millions of Americans,” New York Attorney General Eric Schneiderman, a Democrat, said in a statement Tuesday, according to USA Today. “We’re committed to getting to the bottom of a broken system that has fueled the epidemic and taken far too many lives.”
The pharmaceutical industry says they are committed to curbing rates of opioid abuse and helping the federal government ultimately solve the addiction epidemic. The major companies, which are facing a growing number of lawsuits from states and localities across the country, generally deny allegations of complicity in the opioid epidemic.
Representatives of Purdue Pharma submitted legal filings against a lawsuit from Ohio Attorney General Mike DeWine, a Republican, launched in May, advising the lawsuit should be dismissed for a litany of reasons including its contradiction of federal drug regulations. They note the U.S. Food and Drug Administration approved the use of their medications.
They also argue the lawsuit fails to identify specific cases of harm caused to patients as a direct result of Purdue’s marketing of OxyContin.
DeWine explicitly likens pharmaceutical companies to big tobacco during the 1990s in the lawsuit, when states won a $206 billion settlement from the companies for misleading the public about the dangers of cigarettes for decades. Experts caution against drawing comparisons between the two, noting the stark difference between a voluntary practice such as smoking and taking drugs recommended by doctors and approved by the FDA.
While the negative health impacts of cigarettes are widely accepted, opinions differ on opioids due to their medical application.
Data from the National Institute on Drug Abuse released Sept. 7 paints a grim outlook for the current opioid crisis ravaging American communities. Drug overdoses are now the leading cause of accidental death for Americans under 50.
The study predicts the addiction epidemic in America will continue to deteriorate, pushing drug deaths to an estimated 71,600 in 2017. If the estimates prove accurate, 2017 will be the second year in a row that drug deaths surpass U.S. casualties from the Vietnam War.

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Alabama AG to target opioid makers and distributors in national investigation

Sep 20, 2017 | AL.com

By Christopher Harress

A major national investigation was launched Tuesday that will seek to discover if U.S. drug manufacturers and distributors acted unlawfully in the marketing, sale, and distribution of opioids, according to a press release by the Alabama Attorney General's office Tuesday.
Steve Marhsall and 40 other state Attorneys General are combining resources to tackle an opioid crisis that has been described as "national emergency" by President Donald Trump.

"Earlier this year I joined with fellow attorneys general in investigating what role opioid manufacturers may have had in creating or prolonging the opioid abuse epidemic, and to establish the appropriate course of action to help solve this crisis," Marshall said in the release. "Our investigation continues as we seek information from drug manufacturers and distributors to help determine whether they engaged in unlawful practices in the marketing, sale, and distribution of opioids."
The various AG offices around the country have already served investigative subpoenas for documents and information on companies such as Endo, Janssen, Teva/Cephalon, Allergan, and their related entities, as well as a supplemental Civil Investigative Demand on Purdue Pharma, according to the Alabama Attorney General's office. The attorneys general also sent information demand letters to opioid distributors AmerisourceBergen, Cardinal Health, and McKesson requesting documents about their opioid distribution business.
Opioids were involved in 33,091 deaths in 2015 including 736 in Alabama, and opioid overdoses have quadrupled since 1999, according to the Centers for Disease Control and Prevention.

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Opioids, Addiction and Death: 41 State AGs Demand Answers

Sep 20, 2017 | Marijuana.com

By Monterey Bud

America’s opioid manufacturers may soon reap what they’ve sown.
A collaborative effort by the attorneys general (AG) in 41 states seeks to investigate the manufacturers and distributors of America’s highly addictive opioids.
The state attorney generals have subpoenaed five major opioid manufacturers and three drug distributors, requesting background on how these companies marketed and distributed their prescription opioids throughout the country.Opioid manufacturers and distributors investigated
Initiated by New York Attorney General Eric T. Schneiderman on Tuesday, the bipartisan coalition of state AGs issued subpoenas to the following pharmaceutical manufacturers and their related subsidiaries: Allergan Inc. Endo International plc Janssen Pharmaceuticals Teva Pharmaceuticals Purdue Pharmaceutical
Responsible for approximately 90 percent of the nation’s distribution network, AmerisourceBergen, Cardinal Health, and McKesson have also come under the microscope of scrutiny for their questionable distribution practices.The ‘on-ramp’ to addiction and death
As New York’s AG explained, “too often, prescription opioids are the on-ramp to addiction for millions of Americans.” Schneiderman, whose office has pledged to utilize every asset available to crush America’s opioid epidemic stated, “We are committed to getting to the bottom of the broken system that has fueled the epidemic and taken far too many lives.”
On board with this life-saving inquiry, Florida AG Pam Bondi issued a press release on Tuesday asking the opioid makers to comply … or else.
“This far-reaching multistate investigation is designed to get the answers we need as quickly as possible. The industry must do the right thing. If they do not, we are prepared to litigate,” said Bondi.
A 2017 report from the Florida Department of Law Enforcement shows “1,616 individuals (440 more deaths than the first half of 2015) died with at least one prescription drug in their system that was identified as the cause of death. These drugs may have been mixed with other prescription drugs, illicit drugs, and/or alcohol.”
A quiet killer by any name, opioids can rob you of your loved ones in less than 90 minutes, according to Florida Department of Health.

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