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Opioid Litigation Daily Media Report - 1/19/18
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Bondi weighs legal fight over opioids
Jan 18, 2018 | News 4 Jacksonville (FL)
By Christine Sexton
Florida Attorney General Pam Bondi on Thursday said Florida could soon pursue legal action against manufacturers and distributors of opioids. -
‘We're prepared to go to litigation’ against opioid manufacturers, AG Bondi says
Jan 18, 2018 | Bradenton Herald (FL)
By Lawrence Mower
Florida officials are meeting with a federal judge in Ohio in a few weeks to try to reach a settlement with the drug manufacturers and distributors who helped create America's opioid crisis, Florida Attorney General Pam Bondi said Thursday. -
AG Pam Bondi: We’re going to Ohio to reach a settlement with opioid makers
Jan 18, 2018 | Tampa Bay Times (FL)
By Lawrence Mower
Florida officials are meeting with a federal judge in Ohio in a few weeks to try to reach a settlement with the drug manufacturers and distributors who helped create America's opioid crisis, Florida Attorney General Pam Bondi said Thursday. -
Florida attorney general tells opioid makers: Admit what you did and pay up
Jan 19, 2018 | Miami Herald (FL)
By Lawrence Mower
Pam Bondi has made cracking down on pill mills the cornerstone of two successful runs for Florida attorney general. -
Springfield plans to sue drug companies over 'crippling' costs of opioid crisis
Jan 18, 2018 | Massachusetts Live (MA)
By Peter Goonan
The city has hired a law firm to sue major drug companies for their alleged role in fueling the opioid crisis and to seek reimbursement for the "crippling" costs associated with it. -
Iron County joins lawsuit against opioid companies
Jan 19, 2018 | Your Daily Globe (WI)
By Richard Jenkins
While the Iron County Board of Supervisors voted in December to join other counties in suing several pharmaceutical companies for their alleged roles in fueling the nationwide opioid crisis, it wasn’t until the lawsuit was actually filed earlier this month that many details in the case were spelled out. -
Vermont Attorney General’s Office Opioid Multi-State Investigation (PRESS RELEASE)
Jan 18, 2018 | Vermont OAG
By Vermont AG TJ Donavan
Ninety-one Americans die daily from an opioid overdose per the Centers for Disease Control and Prevention (“CDC”); 40% of those deaths involve a prescription opioid. As we are all painfully aware, Vermont is a part of this statistic. -
Pharma Industry Scorns Governor's Opioid Surtax Proposal
Jan 18, 2018 | New York Law Journal (NY)
By Josefa Velasquez
A national trade group representing the pharmaceutical industry is vehemently opposed to a proposal by New York Gov. Andrew Cuomo to levy a tax on opioids. -
Opioids in the Suburbs
Jan 19, 2018 | Weekly Standard (VA)
By Christopher Caldwell
In nine days in early December, eight young people died of overdoses in Fairfax County, Va., the second-richest of the 3,007 counties in the United States. Mass events like these happen frequently and in all sorts of places. A half-dozen people died in the small Rhode Island town of Burrillville in the first weeks of 2015. Twenty-eight people overdosed in a single afternoon in Huntington, West Virginia, in 2016, though all but two survived. We describe them as “mass” overdoses, but of course the life of a heroin addict is a solitary one, and most of those involved die alone in alleys, in cars, in the bedrooms they grew up in. Sixty-four thousand Americans died of overdoses in 2016, and early statistics for 2017 hint at a 21 percent rise. It is perhaps natural that observers link the problems to economic or social hard luck, as Bill Clinton did a couple of years ago, when he described white working-class people as “dying of a broken heart.” To look at prosperous Northern Virginia is to see a different sociological picture, in which the drugs are more a cause than an effect. -
Lawmakers propose 7-day limit for pain medications
Jan 19, 2018 | The Daily News (WA)
By Max Wasserman
What Lisa Janicki wished she asked her son, and the pain she hopes no other family has to experience, compelled her to testify on a bill introduced in the state Legislature that would limit the supply of opioids doctors are allowed to prescribe in Washington. -
Governors urge Trump, Congress to do more to solve opioid crisis
Jan 18, 2018 | Associated Press
By Geoff Mulvihill
Less than three months after President Donald Trump declared the U.S. opioid crisis a public health emergency, the nation's governors are calling on his administration and Congress to provide more money and coordination for the fight against the drugs, which are killing more than 90 Americans a day. -
GOP Report Blames Medicaid for Opioid Crisis
Jan 19, 2018 | Pain News Network
By Pat Anson
A new congressional report claims there is “overwhelming evidence” that Medicaid has contributed to the nation’s opioid crisis by making it easy for beneficiaries to obtain and abuse opioid prescriptions. -
Understanding the Opioid Epidemic
Jan 19, 2018 | WNET (PBS)
By New York NY
Video Link 1: http://app.criticalmention.com/app/#clip/view/32135889?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 Video Link 2: http://app.criticalmention.com/app/#clip/view/32135923?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 Video Link 3: http://app.criticalmention.com/app/#clip/view/32135949?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 Video Link 4: http://app.criticalmention.com/app/#clip/view/32136034?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 Video Link 5: http://app.criticalmention.com/app/#clip/view/32136046?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 Video Link 6: http://app.criticalmention.com/app/#clip/view/32136066?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
Fox 14 Your Morning News
Jan 19, 2018 | KARD (Fox)
By Monroe, LA
Video Link: http://app.criticalmention.com/app/#clip/view/32135770?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
FOX 29 Morning News
Jan 19, 2018 | KVHP (FOX)
By Lake Charles, LA
Video Link: http://app.criticalmention.com/app/#clip/view/32135781?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
Western Mass News on FOX6
Jan 19, 2018 | WGGBDT2 (Fox)
By Springfield, MA
Video Link: http://app.criticalmention.com/app/#clip/view/32135807?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
Good Morning Jacksonville
Jan 19, 2018 | WJXX (ABC)
By Jacksonville, FL
Video Link: http://app.criticalmention.com/app/#clip/view/32135816?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
WYFF News 4 at 5:30am
Jan 19, 2018 | WYFF (NBC)
By Greenville, SC
Video Link: http://app.criticalmention.com/app/#clip/view/32135853?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
Eyewitness News at Noon
Jan 19, 2018 | WYOU (CBS)
By Wilkes Barre, PA
Video Link: http://app.criticalmention.com/app/#clip/view/32136225?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18 -
7News This Evening
Jan 19, 2018 | WWNY (CBS)
By Watertown, NY
Video Link: http://app.criticalmention.com/app/#clip/view/32136078?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Florida AG Pam Bondi
Northeast (MA)
Midwest (WI)
Commentary and FYIs
Broadcast Media Coverage
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Bondi weighs legal fight over opioids
Jan 18, 2018 | News 4 Jacksonville (FL)
By Christine Sexton
Florida Attorney General Pam Bondi on Thursday said Florida could soon pursue legal action against manufacturers and distributors of opioids.
Bondi is working with a coalition of state attorneys general in seeking information about the distribution, marketing and sale of opioids from major manufacturers and distributors.
The state hasn’t filed suit. But Bondi’s agency last week posted a request for proposal seeking legal services from a private law firm to serve as co-counsel in “various legal matters relating to the opioid crisis.”
Also, Trish Conners, a Florida chief deputy attorney general, will be at a Jan. 31 meeting with Cleveland federal judge Dan Polster, who is overseeing upward of 200 lawsuits filed against the manufacturers of drugs such as OxyContin and Percocet.
When asked whether she would hold the companies responsible for their actions, Bondi said, “Absolutely. Are you kidding? Look at what we are facing in this state. I’m over them. Over them. They need to fix their conduct.”
Numerous states and local governments, including Delray Beach, have filed lawsuits alleging that manufacturers overstated the benefits of opioids while downplaying the risk of addiction. Other Florida cities that are considering filing suits, according to the Sun Sentinel newspaper, include Palm Beach and Broward counties.
Meanwhile, House Speaker Richard Corcoran told The News Service of Florida last week that although he hasn’t researched the details, he would lean toward litigation.
“Whether it’s cities, counties or state, my inclination would be: Why wouldn’t we? And I would have to be talked out of it as opposed to the other way around,” Corcoran, R-Land O’ Lakes, said when asked about potential legal action.
Opioids are commonly used to treat acute and chronic pain. But abuse of the drugs has become rampant in recent years in Florida. In 2016, there were 5,725 deaths attributed to opioids, a 35 percent jump from the previous year. More than 4,000 babies were born addicted to opioids in Florida that year, a 1,000 percent increase from a decade ago.
The staggering statistics have put the opioid crisis front and center for many lawmakers and Gov. Rick Scott, who has pushed to spend $53 million during the coming year on substance-abuse treatment, including medication-assisted treatment that pairs prescription drugs with counseling and other services.
A Senate health-care panel this week approved a proposal (SB 8) that includes $42 million for outpatient services; residential treatment; medication-assisted treatment, peer recovery support; hospital and first-responder outreach; and services targeted to pregnant women. The bill includes another $6 million for substance-abuse treatment for people in the criminal justice system.
Bondi gave the Senate credit for providing money and called $53 million a “good start.” But she said that “we need much more money for treatment.”
When pressed for what she thought would be an appropriate amount, she replied, “I can’t even give you one because the numbers are so outrageous.”
She said money is needed because the costs for treatment are expensive and that there are a lot of Floridians who simply cannot afford it.
“A lot of people don’t have the insurance, so that’s why it’s so important that people get the treatment. Otherwise, it’s still going to be a revolving door,” she said.
Treatment for opioids would have been covered under a Medicaid expansion under the federal health care law commonly called Obamacare, according to a Kaiser report.
But Bondi helped lead a legal challenge against the law, including a provision that would have mandated states to expand Medicaid. The U.S. Supreme Court ultimately ruled that the federal government couldn’t withhold money from states that didn’t expand Medicaid to childless adults earning 138 percent of the federal poverty level, which is $20,783 annually for an individual.
Bondi supports seven-day limits on opioids that are in pending House and Senate bills. Surgeons have expressed concerns that some patients may need more than seven days’ worth of pain medications and that the policy could result in longer hospitalizations.
But Bondi said the restrictions are necessary.
“We have to interfere with how many pills these doctors are prescribing,” she said, sharing the story of a recent discovery of two people who were given a 90-day supplies of OxyContin after they had what she described as minor outpatient surgery.
“They didn’t need all that,” she said adding that both people saw the same physician. “I’m disgusted with what he did.”
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‘We're prepared to go to litigation’ against opioid manufacturers, AG Bondi says
Jan 18, 2018 | Bradenton Herald (FL)
By Lawrence Mower
Florida officials are meeting with a federal judge in Ohio in a few weeks to try to reach a settlement with the drug manufacturers and distributors who helped create America's opioid crisis, Florida Attorney General Pam Bondi said Thursday.
Bondi said she's sending her chief deputy to a Jan. 31 hearing in Cleveland before U.S. District Judge Dan Polster, who is overseeing more than 200 lawsuits filed by states, cities, counties and individuals against the drug companies.
"Am I optimistic we’re going to resolve it that day? No," Bondi said. "And if we’re not, we’re prepared to go to litigation."
She said her office was also hiring outside counsel to represent Florida, which has not yet filed a lawsuit against the manufacturers.
"I feel it’s in their (the drug companies') best interests to attempt to resolve it as early as possible and at least correct their conduct," she said. "And then we’ll go back and get all the money that they owe these people."
Bondi, who led the crackdown on pill mills that inadvertently led to the heroin crisis, has been a proponent of expanding treatment for addicts. But she has not filed a lawsuit against the manufacturers, distributors and doctors who helped create the crisis, and cities like Delray Beach and some counties have started to pursue legal action on their own. Manatee County is considering filing a lawsuit.
Instead of filing a lawsuit, like attorneys general in Ohio and other states have done, she joined 40 other states in an investigation into the drug companies last year. She would not answer questions Thursday about whether the companies have complied with the investigators' subpoenas.
However, despite not filing a lawsuit, Florida could end up getting money from a settlement that comes out of Polston's courtroom.
The judge has been pushing for plaintiffs and drug companies to reach a settlement, and earlier this month he invited the members of the multi-state investigation to attend the Jan. 31 hearing.
“It’s clear that any resolution has to be a global one and needs to include the states, and lawsuits that have been filed and lawsuits that are contemplated,” Polster told the Associated Press.
Bondi on Thursday called the drug companies' actions over the last two decades "outrageous" and said, "I'm over them."
"It’s about time they all step up to the plate and admit what they’ve been doing, and we won’t back down on that," she said.
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AG Pam Bondi: We’re going to Ohio to reach a settlement with opioid makers
Jan 18, 2018 | Tampa Bay Times (FL)
By Lawrence Mower
Florida officials are meeting with a federal judge in Ohio in a few weeks to try to reach a settlement with the drug manufacturers and distributors who helped create America's opioid crisis, Florida Attorney General Pam Bondi said Thursday.
Bondi said she's sending her chief deputy to a Jan. 31 hearing in Cleveland before U.S. District Judge Dan Polster, who is overseeing more than 200 lawsuits filed by states, cities, counties and individuals against the drug companies
"Am I optimistic we're going to resolve it that day? No," Bondi said. "And if we're not, we're prepared to go to litigation."
She said her office was also hiring outside counsel to represent Florida, which has not yet filed a lawsuit against the manufacturers.
"I feel it's in their (the drug companies') best interests to attempt to resolve it as early as possible and at least correct their conduct," she said. "And then we'll go back and get all the money that they owe these people."
Bondi, who led the crackdown on pill mills that inadvertently led to the heroin crisis, has been a proponent of expanding treatment and services for addicts. But she has not filed a lawsuit against the manufacturers, distributors and doctors who helped create the crisis, and cities like Delray Beach and some counties have started to pursue legal action on their own.
Instead of filing a lawsuit, like attorneys general in Ohio and other states have done, she joined 40 other states in an investigation into the drug companies last year. She would not answer questions Thursday about whether the companies have complied with the investigators' subpoenas.
However, despite not filing a lawsuit, Florida could end up getting money from a settlement that comes out of Polston's courtroom.
The judge has been pushing for plaintiffs and drug companies to reach a settlement, and earlier this month he invited the members of the multi-state investigation get involved and attend the Jan. 31 hearing.
"It's clear that any resolution has to be a global one and needs to include the states, and lawsuits that have been filed and lawsuits that are contemplated," Polster told the Associated Press this month.
Bondi on Thursday called the drug companies' actions over the last two decades "outrageous" and said, "I'm over them."
"It's about time they all step up to the plate and admit what they've been doing, and we won't back down on that," she said.
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Florida attorney general tells opioid makers: Admit what you did and pay up
Jan 19, 2018 | Miami Herald (FL)
By Lawrence Mower
Pam Bondi has made cracking down on pill mills the cornerstone of two successful runs for Florida attorney general.
But it wasn’t until Thursday, after the crackdowns helped worsen an opioid crisis that now kills at least 15 Floridians a day, that she outlined possible legal action against the drug companies that started it all.
Later this month, Bondi is sending her chief deputy, Trish Connors, to a federal courtroom in Ohio to try to negotiate a settlement between hundreds of other plaintiffs suing opioid manufacturers and distributors, she said Thursday.
“Am I optimistic we’re going to resolve it that day? No,” Bondi told reporters. “And if we’re not, we’re prepared to go to litigation.”
Florida isn’t suing the manufacturers — not yet — but the Ohio trip could be the first step towards joining a Big Tobacco-type settlement that could yield untold millions for the state.
A federal judge in Cleveland is trying to combine the more than 200 states, cities and counties that have already sued the drug makers with the 41 other states, including Florida, that are considering suing them.
The hope, U.S. District Judge Dan Polster told the Associated Press last week, is to create a “global” settlement this year. A Jan. 31 meeting between both sides is the first step.
“It’s clear that any resolution has to be a global one and needs to include the states, and lawsuits that have been filed and lawsuits that are contemplated,” Polster said.
But Bondi is not required to join the lawsuit and could sue the companies separately in federal or state court. In the Big Tobacco lawsuits of the 1990s, for example, Florida’s $11.3 billion agreement was separate from the “global” settlement with 46 other states.
Bondi said her office was hiring outside lawyers to represent Florida.
“I feel it’s in [the drug companies’] best interests to attempt to resolve it as early as possible and at least correct their conduct,” she said. “And then we’ll go back and get all the money that they owe these people.”
Bondi, who led the crackdown on pill mills that further inflamed an opioid crisis, has been a proponent of expanding treatment and services for addicts.
But up until now, she’s stayed away from filing a lawsuit. Instead, last year she joined 40 other states in an investigation into the drug companies, which has brought criticism and demands for answers from politicians, including Sen. Jose Javier Rodriguez, D-Miami.
“I would like to know whether your office has taken any steps outside of the multi-state investigation to determine whether these drug companies should be held liable for their role in the opioid crisis,” Rodriguez wrote earlier this month. “As we all know, this is now, and has been for some time, a full-blown public health crisis and there is no time to waste.”
Bondi would not answer questions Thursday about whether the companies have complied with the investigators’ subpoenas.
Cities like Delray Beach and some counties, like Palm Beach and Broward, have sought their own lawsuits.
Today’s heroin crisis was more than two decades in the making. Drug companies like Purdue Pharma, the creator of OxyContin, misled the public about the drug’s addictive properties. Distributors like Cardinal Health ignored suspicious drug orders around the country. Both companies have paid federal fines for their behavior.
In Bondi’s first year in office in 2011, she supported a prescription drug monitoring program and efforts to close down illegal pain clinics, so-called “pill mills.” But the state did little to help those already addicted, and with prescription pills harder to get, addicts turned to a far deadlier substitute: heroin.
Bondi on Thursday called the drug companies’ actions over the last two decades “outrageous” and said, “I’m over them.”
“It’s about time they all step up to the plate and admit what they’ve been doing, and we won’t back down on that,” she said.
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Springfield plans to sue drug companies over 'crippling' costs of opioid crisis
Jan 18, 2018 | Massachusetts Live (MA)
By Peter Goonan
The city has hired a law firm to sue major drug companies for their alleged role in fueling the opioid crisis and to seek reimbursement for the "crippling" costs associated with it.
"Through the impending lawsuit Springfield will seek to recoup the crippling cost that opioid addiction has caused the local government and to hold the culpable parties responsible to assist in the abatement of the public nuisance they created," said Mayor Domenic J. Sarno.
Various communities around the nation, including Greenfield, have stated they have either filed or are planning to file lawsuits, or join a class action lawsuit, against the large pharmaceutical companies. Officials in Westfield recently said they are weighing their options on the issue.
Springfield plans to file suit on its own behalf, City Solicitor Edward Pikula said Thursday. Sarno said the city has retained the national law firm Scott+Scott.
As the fourth largest city in New England, Springfield has expended "substantial resources related to multiple types of services related to opioid addition," Sarno said. The suit is against pharmaceutical manufacturers and distributors "whose conduct has proximately caused and fueled the opioid epidemic," Sarno said.
Under the terms of its agreement with Scott+Scott, Springfield will not be responsible for any attorneys' fees or expenses in connection with the matter, Pikula said. Instead, Scott+Scott will seek 22.5 percent of Springfield's total recovery in the opioid litigation, Pikula said.
Scott+Scott represents a number of municipalities in Connecticut, New Jersey and Florida, and counties in Pennsylvania, in suits against companies such as Purdue Pharma, Teva Pharmaceuticals, Johnson & Johnson, Janssen Pharmaceuticals, Endo Pharmaceuticals and Insys Therapeutics, according to the city.
The suits also name a number of wholesale distributors, including McKesson Corp., AmerisourceBergen Drug Corp., and Cardinal Health, the city said.
Sarno said Springfield is "joining the ranks of hundreds of other governmental entities across the country seeking to hold the wrongdoers accountable for their unlawful conduct by systematically working to deceive doctors and patients - including vulnerable groups such as the elderly and war veterans - about the highly addictive nature of prescription opioids and the appropriateness of these drugs for chronic pain management."
"I am told that approximately 80 percent of current heroin users got their start with prescription opioids," Sarno said. "Massachusetts has been experiencing a heroin overdose outbreak, clothed in a pharmaceutical opioid epidemic. The opioid-related death rate in Massachusetts has surpassed the national average, with an especially sharp rise in the last two years, raising the costs of treatment and social services for years to come."
Sarno said the "flood of opioids pushed into the City has strained virtually every service in the City, from public safety, as well as the care for youth, elderly and the needy."
"The damage inflicted by the opioid crisis to Springfield's most precious resource, its residents, has been tremendous and will take a huge effort to repair," Sarno said.
According to the Massachusetts Department of Public Health, there have been 932 confirmed opioid-related deaths in the state for the first nine months of 2017 alone. Springfield had 41 opioid-related deaths in 2015 and 2016, according to state data.
The city is considering establishing a needle exchange program as a means of helping to reduce the spread of AIDS, hepatitis C and other diseases associated with sharing dirty needles. The program would allow drug users to exchange dirty needles for clean ones and to access counseling and other services.
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Iron County joins lawsuit against opioid companies
Jan 19, 2018 | Your Daily Globe (WI)
By Richard Jenkins
While the Iron County Board of Supervisors voted in December to join other counties in suing several pharmaceutical companies for their alleged roles in fueling the nationwide opioid crisis, it wasn’t until the lawsuit was actually filed earlier this month that many details in the case were spelled out.
Iron County is one of 12 Wisconsin counties listed as plaintiffs in the suit, which was filed Jan. 5 in federal court in Milwaukee; with Brown, Crawford, Juneau, Kewaunee, Outagamie, Ozaukee, Pepin, Portage, Racine, Richland and Winnebago counties also suing the drug companies.
The lawsuit targets a number of companies and their subsidiaries which make opioids — including Purdue Pharma, Teva Pharmaceuticals, Johnson & Johnson and its Janssen Pharmaceutical subsidiaries and Endo Health Solutions — as well as several doctors accused of contributing to the overprescription of opioids.
“The lawsuits filed today on behalf of these additional 12 counties in Wisconsin build upon the important work of addressing the opioid crisis in the state. It is great to see so many Wisconsin counties working together to address this epidemic,” said Erin Dickinson, of Crueger Dickinson LLC, in a news release when the lawsuit was filed. “Together, with Simmons Hanly Conroy, we will work to hold the defendants responsible for the devastating effects their actions have produced across the state and throughout the nation.”
Crueger Dickinson, along with Simmons Hanly Conroy LLC, is representing the counties in the case.
Iron County is also being represented by the law firm of von Briesen & Roper, according to the county board’s resolution.
The firms are working on a contingency basis, according to the resolution, meaning they only make money if the county receives “financial benefit” from the suit.
The effort to sue the companies is largely being spearheaded by the Wisconsin Counties Association — according to information at the December county board meeting — and with the Jan. 5 lawsuit, 60 of Wisconsin’s 72 counties had joined the effort.
The 79-page suit specifies damages the counties have sustained as a result of opioid abuse, which the Federal Drug Administration recognized as a “public health crisis” in March 2016, according to the suit.
“In 2015, the majority of opioid-related deaths in Wisconsin involved prescription opioids. Indeed, the number of Wisconsin citizens who die as a result of drug overdoses now exceeds the number of those who die from motor vehicle crashes, as well as suicide, breast cancer, colon cancer, firearms, influenza and HIV,” the lawsuit reads.
According to the suit, 258 of the state’s 1,824 opiate overdoses during the period from 2013 to 2015 occurred in the 12 counties listed as plaintiffs, including one in Iron County. In addition to the human cost to the issue, the lawsuit alleges there was a financial burden imposed on the counties as they had to devote resources to treating residents impacted by the drugs.
“Apart from … the toll on human life, the crisis has financially strained the services these counties provide to their residents and employees. Human services, social services, court services, law enforcement services, the office of the coroner/medical examiner and health services — including hospital, emergency and ambulatory services — have all been severely impacted by the crisis,” the lawsuit reads.
Iron County alone spent $844,741 on placements in 2016, many of which were related to drug and alcohol issues. The county board voted in July to take out a loan to cover future placements, which will allow the county to pass the cost onto taxpayers, as it could no longer absorb the burden through its general fund.
The lawsuit also details alleged actions of the drug companies, which the suit argues is grounds for them being responsible for the increased costs of treating the opioid problem.
The defendants are alleged to have used a mix of bad science and advertising tactics to make opioids a treatment for long-term pain, whereas they had previously only been used for short-term relief.
“Defendants did not set out to change the medical community’s view, however through legitimate scientific research, because scientific research would not have supported the conclusion defendants desired. … Rather, to accomplish their goal of blockbuster profits and dramatically increased sales, defendants turned to the marketing and PR world to instead create a misperception in the medical community,” the suit reads.
Several of the companies named in the lawsuit denied allegations of impropriety, while pledging to continue to work toward fixing the crisis and continuing to provide care to those in need.
“We are deeply troubled by the prescription and illicit opioid abuse crisis, and are dedicated to being part of the solution. As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge,” John Puskar, director of public affairs for Purdue Pharma L.P., told the Daily Globe. “...We vigorously deny these allegations and look forward to the opportunity to present our defense.”
Puskar said Purdue, which produces OxyContin and other opioids, has taken steps to develop medication with “abuse-deterrent properties” and works with law enforcement to provide access to naloxone, used to counteract opioid overdoses.
Purdue wasn’t the only company named in the suit to deny wrongdoing.
“Responsibly used opioid-based pain medicines give doctors and patients important choices to help manage the debilitating effects of chronic pain. At the same time, we recognize opioid abuse and addiction is a serious public health issue that must be addressed,” said Jessica Castles Smith, a senior manager for global pharmaceuticals communications with Janssen Global Services. “We believe the allegations in the lawsuits against our company are both legally and factually unfounded. Janssen has acted in the best interests of patients and physicians with regard to its opioid pain medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label.”
Stephen Mock, a senior vice-president with Endo Pharmaceuticals, told the Daily Globe the company was “voluntarily ceasing opioid promotion and eliminating its entire product salesforce.”
“It is Endo’s policy not to comment on current litigation. That said, we deny the allegations contained in this lawsuit and intend to vigorously defend the company,” Mock said as part of the company’s statement to the Daily Globe.
The suit doesn’t specify what monetary amount is being sought from the companies, but asks the counties be compensated for their damages, attorney fees, punitive damages, “a declaratory judgement requiring defendants to abate the public nuisance” and any other relief the court feels is appropriate.
While over 80 percent of Wisconsin’s counties have joined in the legal effort, it appears at least one of Iron County’s neighbors — Vilas County — won’t be taking part.
The Vilas County Board’s executive and legislative committee voted 5-1 against sending a resolution to join the legal effort to the full county board Jan. 8.
Board members cited a number of reasons for their reluctance to join the lawsuit, according to a report in the Lakeland Times, including not enough information on the suit, a fear of unforeseen costs down the road, a fear that retirees unknowingly invested in the drug companies could be adversely impacted and questions as to why larger counties such as Milwaukee and Dane counties aren’t participating.
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Vermont Attorney General’s Office Opioid Multi-State Investigation (PRESS RELEASE)
Jan 18, 2018 | Vermont OAG
By Vermont AG TJ Donavan
Ninety-one Americans die daily from an opioid overdose per the Centers for Disease Control and Prevention (“CDC”); 40% of those deaths involve a prescription opioid. As we are all painfully aware, Vermont is a part of this statistic.
In 2016, 112 opioid-related deaths occurred in the State of Vermont, with 106 being reported as accidental and undetermined. In 2014, then Governor Peter Shumlin focused his annual State of the State address on the opioid crisis in Vermont, referring to the problem as a “full-blown heroin crisis.” Four years later the fight continues.
The number of babies born drug dependent has increased 500% since 2000 per White House data. In Vermont, over 33 babies out of every 1,000 hospital births were born with drug withdrawal symptoms as reported in a 2016 CDC study.
Data from the CDC indicates sales of prescription opioids in the United States nearly quadrupled from 1999-2014, with little scientific evidence to show that they effectively manage the long-term treatment of chronic pain.
The Attorney General’s Office is committed to leading the fight to end the opioid crisis. We are working to integrate our criminal justice system with public health providers to enhance treatment options. Our office is taking part in a multi-state investigation involving 44 other states and the District of Columbia. This investigation is focused on whether drug manufacturers such as Purdue, Endo, Janssen, Teva/Cephalon, and Allergan have engaged in unlawful practices in marketing, selling, and distributing opioids. We are also investigating the drug distributors AmerisourceBergen, Cardinal Health, and McKesson.
Some may ask why not go ahead and sue the drug companies right now? That is a good question. The Attorney General’s office has the legal authority to conduct investigations by serving subpoenas and obtaining documents and other information before filing a lawsuit. This allows the State to avoid many of the challenges faced and expenses incurred in litigation. We are investigating right now.
Before deciding whether to file a lawsuit, we will continue to do our due diligence. Our participation in the multi-state investigation serves two important goals: building the best case against the pharmaceutical industry and creating the possibility for settlement. Any settlement must address four factors: accountability; treatment; prevention; and the economic burdens of cities, towns, and states impacted by this epidemic.
The Vermont Attorney General’s Office is committed to holding the pharmaceutical industry responsible for its involvement in the opioid crisis. In doing so, we are guided and reminded by the countless lives lost and ruined because of this terrible disease. We will continue to advocate for the State of Vermont and seek justice against those who may have caused the opioid epidemic.
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Pharma Industry Scorns Governor's Opioid Surtax Proposal
Jan 18, 2018 | New York Law Journal (NY)
By Josefa Velasquez
A national trade group representing the pharmaceutical industry is vehemently opposed to a proposal by New York Gov. Andrew Cuomo to levy a tax on opioids.
On Tuesday, during his annual budgetary address to the Legislature, Cuomo unveiled an “Opioid Epidemic Surcharge,” a 2-cent-per-morphine-milligram tax on opioids pharmaceutical companies sell in the state. The surcharge on opioids is expected to “provide a financial disincentive for the use of these drugs and generate roughly $125 million to support ongoing efforts to address the opioid crisis,” according to Cuomo’s budget briefing book.
“Opioid manufacturers have created an epidemic. We would have an opioid surcharge—2 cents per milligram [that] will be paid by the manufacturer and would go to offset the costs that we’re spending to fight opioid abuse,” Cuomo said during his Tuesday speech.
PhRMA, the powerful Washington-based advocacy group that represents pharmaceutical companies, blasted Cuomo’s proposal, arguing that the narrowed focus doesn’t take into consideration many other factors that have contributed to the spike of opioid use in the country.
“We are opposed to the proposed tax because it ignores all of the factors that resulted in the current crisis and unfairly penalizes and ostracizes vulnerable patients who legitimately rely on these medicines to treat serious, debilitating and sometimes fatal conditions,” said PhRMA spokeswoman Priscilla VanderVeer.
“The proposed tax also ignores the fact that this crisis is the result of a number of factors, including a deeply troubling influx of counterfeit fentanyl and other illegal drugs coming into the U.S. through drug trafficking organizations the DEA [Drug Enforcement Administration] is monitoring, which is contributing to an increase in overdose deaths.”
VanderVeer added that the organization “would welcome the opportunity” to meet with the Cuomo administration to come up with a plan to curb opioid use. Last fall, PhRMA announced support for some state and federal policies aimed at curbing abuse, including support for limiting opioid prescriptions to seven days for acute pain. In June 2016, the governor signed legislation into law that would reduce prescription limits for opioids for acute pain from 30 days to a seven-day supply.
Cuomo spokesman Rich Azzopardi countered PhRMA’s remarks, charging that the industry fueled the opioid epidemic.
“Big Pharma and the health insurance companies just got a big federal tax break while at the same time created the machine that fueled the opioid crisis. Spare me the song and dance about corporations crying poverty, like the tobacco companies, this money is going to help fight the problem they created,” Azzopardi said in an email.
Azzopardi did not immediately say whether the 2-cent surtax would apply to opioid medications used to treat addiction, such as methadone or buprenorphine.
Cuomo is not the first to propose such a tax. Nan Whaley, the Democratic mayor of Dayton, Ohio, who had been running for governor, proposed a similar surcharge on prescription opioids. Hillary Clinton, in her 2016 presidential campaign, endorsed the idea of a 1-cent-per-milligram tax on opioid prescriptions paid by the manufacturer or importer, according to an Akin Gump Strauss Hauer & Feld compilation of the candidates’ tax proposals.
Earlier this month, during his State of the State address to the Legislature, Cuomo announced plans to sue pharmaceutical companies for “perpetuating the opioid epidemic.” The Democratic governor’s remarks come as a growing number of counties in New York and across the United States have sued the makers of opioid medications.
“[Pharmaceutical companies] were conveniently blind to the consequences of their action. They pumped these pills into society and created addiction. Like the tobacco industry they killed thousands. … We will make them pay,” Cuomo said earlier this month.
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Jan 19, 2018 | Weekly Standard (VA)
By Christopher Caldwell
In nine days in early December, eight young people died of overdoses in Fairfax County, Va., the second-richest of the 3,007 counties in the United States. Mass events like these happen frequently and in all sorts of places. A half-dozen people died in the small Rhode Island town of Burrillville in the first weeks of 2015. Twenty-eight people overdosed in a single afternoon in Huntington, West Virginia, in 2016, though all but two survived. We describe them as “mass” overdoses, but of course the life of a heroin addict is a solitary one, and most of those involved die alone in alleys, in cars, in the bedrooms they grew up in. Sixty-four thousand Americans died of overdoses in 2016, and early statistics for 2017 hint at a 21 percent rise. It is perhaps natural that observers link the problems to economic or social hard luck, as Bill Clinton did a couple of years ago, when he described white working-class people as “dying of a broken heart.” To look at prosperous Northern Virginia is to see a different sociological picture, in which the drugs are more a cause than an effect.
Americans are beginning to understand what the lobbyists for pharmaceutical companies successfully concealed from them for two decades: Factory-made prescription opioids like Vicodin, Percocet, and Oxycontin are basically the same drug as the heroin that street addicts buy from their dealers and inject into their veins. When unsuspecting people get prescribed oxycodone for a knee injury or a surgery, a certain percentage will become addicted. That percentage is high: The Centers for Disease Control reported last March that 13.5 percent of people prescribed eight days of opioids were still using them a year later. Unwarned, any patient can get hooked. It happened to quarterback Brett Favre and to radio host Rush Limbaugh. And the over-prescription of these pills created a massive recreational market. Everyone “knew” that pills, which respectable people took, could never be as dangerous as heroin, which respectable people did not. People of modest means who became addicted to these pills discovered they were prohibitively expensive on the streets. Heroin was affordable.
It is usually the arrival of a “bad batch” of heroin or, increasingly, of fentanyl that causes a mass poisoning of the sort Fairfax just underwent. About three years ago, the street heroin market began to be shaped by a pharmaceutical revolution. Organized crime groups got access to fentanyl, an opioid that had been used since the early 1960s to treat people with terminal cancer. They began to substitute it for heroin, wholly or in part. It was chemists and pharmacists in China and Mexico who produced most of the stuff. An investigation by Britain’s Guardian newspaper found that 80 percent of the fentanyl in the New York area came from Mexico’s Sinaloa cartel, while most of Philadelphia’s was Chinese-made, shipped through Mexico. Between 2014 and 2016 fentanyl seizures sextupled in the United States.
Fentanyl could more easily be substituted for heroin east of the Mississippi than west, because it looks like a slightly paler version of the cream-colored powder that is the form East Coast heroin has traditionally been sold in. In the west, most heroin is not “white powder” but “black tar.” To an addict out west, fentanyl doesn’t look trustworthy or right. Fentanyl fatalities doubled nationwide between 2015 and 2016, and those deaths were concentrated in Appalachian states (including Ohio and Pennsylvania) and New England.
When we talk about a “bad batch” of drugs, we usually mean one that is too concentrated. The basic problem with fentanyl is that, fresh out of the lab, it is about 50 times stronger than heroin, and there is no standard process for reliably “stepping on” the drug, to use the dealers’ term for diluting it. Dealers will cut the drug with almost any white powder: inositol (a synthetic, powdered version of the sugar found in cantaloupes and oranges); creatine (an acid body-builders use to gain muscle mass); ground-up Tylenol; meat tenderizer (although it “tenderizes” human flesh, too, and gives people boils). In Baltimore they sell a kind of heroin called “scramble,” which is cut with quinine and various powders and packed into gelcaps.
By the time it arrives on the streets, heroin is usually 6 to 12 percent pure. At levels higher than that, overdoses happen. It is a distressing thing for better-off addicts that one of the only ways to be absolutely certain of opioid dosage— using the pills manufactured by the pharmaceutical companies—is now less reliable. Dealers have learned to press fentanyl into realistic-looking molds of existing pills, with trademark and all.
What went wrong in Fairfax was likely the mistake of a local distributor, involving fentanyl. Most of the heroin in the county comes from Baltimore or Southeast Washington, D.C. Had the miscutting occurred higher up the chain, there would probably have been similar overdoses throughout those two metropolitan areas, and there were not. Although suburbs of Washington are not saturated with fentanyl, as New England is, they have a lot of it. In October, the Fairfax County police submitted to their labs 36 “exhibits” of real heroin, versus 17 of fentanyl. At the time of this writing, the lab reports were not back for the early December overdoses.
It didn’t take long after the early December wave for Fairfax police to understand—by looking at the clinical evidence of the dead and the paraphernalia (needles, powders) left on the scene—that opioids were involved. They soon got another lead. Police in neighboring Loudoun County (the only American county richer than Fairfax) reported three (nonfatal) overdoses of carfentanil. This was striking. Carfentanil is an opioid developed in 1974 by Janssen Pharmaceuticals (now part of Johnson & Johnson) for quieting big animals. Five thousand times as concentrated as heroin, it is often called an “elephant tranquilizer.” The Russian military almost certainly used an aerosolized version of it to knock out the Chechen terrorists who took 850 hostages at a musical theater in Moscow in 2002.
One is tempted to ask, in frustration: How big can the market for elephant tranquilizers be? Who is making this stuff? But we are probably not talking about the American commercial elephant-tranquilizer market. We are more likely talking about Chinese labs that have pirated the formula and now export something like carfentanil into the United States. Until 2017, it was not illegal to manufacture in China. In the American northeast, it sometimes arrives over the Canadian border and goes under the name W-18. Where a toxicologist might see concentrated poison, a criminal sees portability. If you are crossing borders with it, the concentration of carfentanil is a tremendous boon. Indeed it would be surprising if carfentanil didn’t come to dominate the market.
Heroin is what is known as a “respiratory suppressant.” It makes your breathing shallower over time, and if you take too much, you fade away. There are antidotes that sometimes work to jolt people out of this slow suffocation, such as Narcan, a trademark for naloxone, which can be administered by syringe or spray. Many states, including Virginia, have passed laws giving a “standing order” to pharmacies to prescribe Narcan to any comer. Such plans are generally embedded (they are in Virginia) in a “good Samaritan” law, which gives the pharmacist immunity from any civil lawsuits arising from the dispensation and may offer criminal immunity to any fellow user of the overdosing person who calls the police. With heroin, there might be a window of 15 to 45 minutes during which naloxone can be used to rescue a person. With fentanyl this window is dramatically narrower—maybe a matter of a couple minutes.
One of the assumptions that goes into making drug policy is that there is always a business logic underneath the transaction between dealer and pusher. There is, however, a rather frightening truth about the nature of the street market in opioids, and it arises from the nature of the drug. The first couple of times a person uses opioids, he gets an extraordinary high. Unfortunately, that high never comes again. Users develop a tolerance for the drug very quickly, so that feeling anything except relative normality from the drug requires higher and higher doses. In fact, the dosage required to replicate that first high exceeds the fatal dose. Heroin addicts are in the habit of walking up to death’s door. That being the case, a death from an overdose reported in the media, far from scaring addicts away from a certain pusher or neighborhood, often attracts them. One hears this from addict after addict: “He must have the good stuff.” Business booms.
One does not need to believe that a drug pusher is utterly indifferent to his clients’ well-being. But one can still be troubled that incentives exist to water the tree of profit with the blood of addicts.
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Lawmakers propose 7-day limit for pain medications
Jan 19, 2018 | The Daily News (WA)
By Max Wasserman
What Lisa Janicki wished she asked her son, and the pain she hopes no other family has to experience, compelled her to testify on a bill introduced in the state Legislature that would limit the supply of opioids doctors are allowed to prescribe in Washington.
What if she had asked more questions about her son Patrick’s OxyContin pill use — the painkillers he overdosed on on August 4, 2017? What if she checked in more often? What if she encouraged him to seek treatment?
“This story cannot end with Patrick,” Janicki, a Skagit County Commissioner, said Friday, Jan. 12, while testifying in support of a bill that would create limits to the length of opiate prescriptions.
The bill is one of at least seven introduced in the Legislature so far in the 2018 session, reflecting a bipartisan attempt to crack down on prescription opioids and their contribution to what officials have called a state health epidemic.
Another bill, which was requested by Gov. Jay Inslee, would spend $2.3 million a year on expanding a statewide program connecting addicts with treatment, social services, employment and housing opportunities. The proposal would cover all facets of opioid addiction, including heroin use.
In the Legislature, Democrats have introduced a number of bills that would better connect people with services in an attempt to curb prescription opioid-related deaths in Washington. State health officials say there have been more than 5,000 such deaths since 2006. That rate has dropped in the past year, with 76 fewer deaths occurring in the first half of 2017 than had in the year prior.
Among the proposed legislation are bills that would require doctors to warn patients of opioid addiction before prescribing the drugs and add federal health records to the state’s patient prescription database to better track opioid use. Collection of unwanted or unused pills to prevent people from self-prescribing and ensuring addicts have access to health care services also have been proposed.
Another bill would, unless a doctor suggests otherwise, limit opiate prescriptions to a seven-day supply for patients older than 21 and a three-day supply for those under 21.
Some chronic-pain sufferers said they were concerned House Bill 2272 would make filling their prescriptions, which help them function, more difficult.
“That’s ridiculous,” Cindy Hadden, a Tumwater resident suffering from chronic back pain, said of the proposed limits after the bill’s hearing. “When you’re in pain and hurt, you don’t make room to do more work.”
In 2000, Hadden said she injured her spine while moving trade-show displays for her job at the time, leaving her with a pain she’s likened to Babe Ruth slugging her with a bat.
The bill’s sponsor, Rep. Eileen Cody, a Seattle Democrat, said her measure is aimed at limiting prescriptions to those suffering short-term pain and that it won’t affect people in Hadden’s situation.
Cody said she believes the proposal would draw support from across the aisle. A similar bill last year passed in the House but failed to make it to the Senate floor for a vote.
A handful of Republicans have introduced legislation of their own, but some have expressed concern over whether some measures are going too far.
“You’re going to have people in legitimate pain from legitimate surgeries who need pain management,” Rep. Michelle Caldier, a Republican from Port Orchard, said. “Some of these bills will make that very difficult.”
Caldier said she believed the bill would be onerous for patients who have to make co-payments every time they pick up their prescriptions. Rather than limit prescriptions, Caldier has advocated for a bill she introduced to wean patients off opioids by mixing them with less powerful painkillers.
The policy section on the website of Purdue Pharma, the pharmaceutical company which manufactures the powerful painkiller OxyContin, advocates for limiting prescriptions for first-time pain sufferers.
Janssen Pharmaceuticals, another prescription opioid manufacturer, did not comment on specific bills.
“We recognize opioid abuse and addiction is a serious public health issue,” Jessica Castle Smith, a spokesperson for the company, said. “We are aware of legislative initiatives underway at the state and federal level and will continue to do our part in finding ways to address this crisis.”
Inslee on Monday unveiled his proposal to expand so-called hub-and-spoke programs.
“We need to have a better way to prevent people from succumbing to this medical condition of an opioid addiction, and we need better treatment for people who should not be stigmatized and be denied medical treatment,” the governor told reporters at a news conference.
The networks help cut down on a cycle of incarceration among people who commit crimes to sustain their addiction, Inslee said. Six are already in place around the state, including locations in Bellingham, Seattle, Lakewood and Vancouver.
“We simply cannot jail our way out of this issue,” Thurston County Prosecutor Jon Tunheim said at the Monday panel with the governor.
Incarcerating addicts “without treatment or medication and then releasing them to the community really does nothing to improve public safety,” Tunheim said.
The governor also has proposed applying for federally funded vouchers that would provide drug treatment to inmates while they serve time. Those vouchers would be requested through Medicaid, a federal health care program covering low-income people. While not yet guaranteed, one policy adviser close to the governor is optimistic the federal money would be approved in light of President Trump’s recent declaration of a national emergency on opioids.
Top state Republicans said Tuesday they still were reviewing the governor’s proposal.
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Governors urge Trump, Congress to do more to solve opioid crisis
Jan 18, 2018 | Associated Press
By Geoff Mulvihill
The list of more than two dozen recommendations made Thursday by the National Governors Association is the first coordinated, bipartisan response from the nation's governors since Trump's October declaration.
The governors praised him for taking a first step, which included a pledge to support states' efforts to pay for drug treatment through Medicaid, the joint federal-state health insurance program for low-income people. But the governors also called for more action.
"While progress has been made, the consequences of opioid addiction continue reverberating throughout society," the governors said in their recommendations, "devastating families and overwhelming health care providers, law enforcement and social services ..."
They said the crisis was beginning to erode the nation's workforce and undermine companies' ability to hire.
Trump's emergency declaration came in response to recommendations from a commission he appointed to address the toll of opioids, a class of drugs that ranges from prescription painkillers to illegal drugs such as heroin and illicit fentanyl. It was chaired by former New Jersey Gov. Chris Christie, a Republican who left office this week.
The governors' recommendations come after a federal judge in Cleveland pushed for a settlement in a series of lawsuits filed by state and local governments against the pharmaceutical industry.
"The opioid and heroin epidemic knows no boundaries, and governors across the country are keenly aware of the challenges it poses for our communities and the growing need for comprehensive, bipartisan solutions to help end the epidemic," Massachusetts Gov. Charlie Baker, a Republican who serves as chairman of the governors' association health committee, said in a statement.
A spokesman for the White House Office on National Drug Control Policy said the administration is committed to working with states and addressing their recommendations. The office said Trump has called for a coordinated approach to reduce overdose deaths.
The governors are asking for a requirement that drug prescribers undergo substance abuse training and register to use state databases that monitor prescriptions of dangerous drugs. They also seek increased access to naloxone, a drug that reverses overdoses, and asked that Medicare cover methadone treatment for senior citizens.
They said the federal government needs to do more to block illicit versions of synthetic drugs such as fentanyl from being shipped into the U.S. Last year, the Department of Justice issued indictments of two Chinese companies accused of sending fentanyl illegally into the U.S., one of several anti-opioid moves by the federal government.
The governors took a conciliatory tone in their document, calling for state-federal partnerships. That contrasts with a harsher rebuke on Wednesday from a group of 10 Democratic U.S. senators who said Trump was leaving open key administrative positions in agencies tasked with dealing with the opioid crisis.
The senators took aim at the appointment of a 24-year-old former Trump campaign worker, Taylor Weyeneth, as deputy chief of staff at the Office of National Drug Control Policy. The Washington Post reported this week that after the newspaper began asking questions about Weyeneth's rise, he was reassigned to a lower-ranking job. There remains no permanent director at the office.
The governors also called for the White House to put someone in charge of a coordinated effort on opioids. But Elena Waskey, a spokeswoman for the governors group, said the Weyeneth revelations did not factor into the timing of Thursday's announcement.
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GOP Report Blames Medicaid for Opioid Crisis
Jan 19, 2018 | Pain News Network
By Pat Anson
A new congressional report claims there is “overwhelming evidence” that Medicaid has contributed to the nation’s opioid crisis by making it easy for beneficiaries to obtain and abuse opioid prescriptions.
The lengthy report, called “Drugs for Dollars: How Medicaid Helps Fuel the Opioid Epidemic,”was prepared by the Republican controlled Senate Homeland Security and Governmental Affairs Committee. Democrats on the committee complained the report was concocted to discredit and demonize Medicaid expansion under the Affordable Care Act, also known as Obamacare.
The report cites 1,072 people since 2010 that have been convicted or accused of using Medicaid to improperly obtain prescription opioids. That is only a tiny fraction of the nearly 70 million people enrolled in Medicaid, but the report nevertheless draws some sweeping conclusions.
“Overwhelming evidence shows that Medicaid has inadvertently contributed to the national tragedy that is the opioid epidemic, and has taken a toll that is playing out in courtrooms across the nation,” the committee staff reported.
“Other well-intended government programs, such as Medicare, may provide similar incentives for rational actors to engage in bad behavior with highly addictive opioids. These issues hold major ramifications for public policy, along with the nation’s health. They deserve serious consideration and a sober national debate, one we hope this staff report will help to initiate. The victims of this terrible epidemic deserve no less.”
The report cites dozens of examples of doctors and beneficiaries abusing the system, such as a $1 billion scheme to defraud Medicaid and Medicare that involved numerous health care providers.
Committee staff also claimed that drug overdose deaths were rising nearly twice as fast in Medicaid expansion states as in non-expansion states. About 12 million more Americans receive Medicaid coverage under Obamacare.
“While there is clearly no single cause to the epidemic, evidence has emerged that Medicaid is playing a perverse and unintended role in helping to fuel and fund the opioid epidemic,” Sen. Ron Johnson (R-WI) wrote in a letter to Eric Hargan, the Acting Secretary of the Department of Health and Human Services.
“The data uncovered in this examination point to a larger systematic problem – because opioids are easily obtained and inexpensive through Medicaid, the structure of the program itself creates a series of incentives for beneficiaries to use opioids and sell them for potentially enormous profits.”
‘Total Hogwash’
The committee’s ranking Democrat, Sen. Claire McKaskill of Missouri, called the report misleading.
"This idea that Medicaid expansion is fueling the rise in opioid deaths is total hogwash," McCaskill said in a statement. "It is not supported by the facts. And I am concerned that this committee is using taxpayer dollars to push out this misinformation to advance a political agenda."
“Separate scientific studies conducted by other authors show that (the) opioid epidemic predates Medicaid expansion and that recent increases in overdoses stem from fentanyl and heroin, not prescriptions obtained through Medicaid. Unlike the report released by the majority staff today, these studies were both scientific and comprehensive.”
The report’s conclusions were also questioned by a longtime critic of opioid prescribing.
“I believe the access to prescribers that Medicaid, Medicare and commercial insurance offers does increase the likelihood that someone might develop a disease often caused by prescriptions,” said Andrew Kolodny, MD, founder and Executive director of Physicians for Responsible Opioid Prescribing (PROP).
“But I do not believe that Medicaid should be singled out in this regard. Opioid overdoses have been increasing in people with all types of insurance and in people from all economic groups, from rich to poor.”
A report released this week by the Kaiser Family Foundation found that states with above average overdose death rates includes 18 states that expanded their Medicaid coverage and 8 states that did not. Overall, Medicaid covers nearly 40% of the two million Americans estimated to have opioid addiction.
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Understanding the Opioid Epidemic
Jan 19, 2018 | WNET (PBS)
By New York NY
Rough Transcript: -america is in the midst of an opioid drug epidemic. -somebody telephoned 911. we got commotion and using drugs. -all right, 10-4. -driven by escalating opioid addiction, drug overdoses are now the leading cause of death among americans under 50. -people are literally dying in the street. they're dying in their parents' homes. -according to the centers for disease control, the opioid epidemic is fueled by prescription pain medications. -great job -- way to communicate with eye contact... -michael israel dreamed of becoming an architect. in high school, he participated in a video project exploring the architecture of his hometown of buffalo. -these buildings have been here for such a long time. 5:01 AM-michael didn't realize his dream. despondent over an addiction to prescription opioids, he took his own life at the age of 20. -when michael said "i'm addicted," it it was a big surprise. the next question that came out of my mouth was, "to what, mike? and he said his pain pills. -the medical community has been overprescribing opioids. that's really the reason we're in the midst of a severe epidemic of opioidaddiction. -the doctor did prescribe the hydrocodone for your knee pain. it's very important that you only take it as needed. -i think some physicians don't appreciate how potent these drugs are and don't necessarily appreciate how many problems they can create. how did the painkillers work out for you, originally? -it started okay, then i couldn't get enough. -west virginia has been ravaged by a flood of opioids. -the epidemic we have in ohio is fueled, primarily, by the pain-med problem. 5:02 AM-the opioid epidemic has spiraled as many addicted to prescription pain pills turn to cheaper and more available street drugs like heroin and fentanyl. -so, cameron was my son. he was wresting, and he broke his collarbone, so he was prescribed percocet. i never in a million years thought my boy would be a heroin addict. -there's a lot of blame to go around -- patient demand, pharmaceutical companies, doctors that are easy with a prescription pad, health insurance came in that would pay for all this stuff. [ police radio chatter ] -i can't imagine anything else that would happen in our community that would be associated with that many deaths. i don't know where the outrage is. -funding for this program has been provided by blue cross blue shield association and brain research foundation. with passion and dedication, brain research foundation 5:03 AMis working to advance treatment and prevention of all neurological disorders in children and adults. brain research foundation is committed to funding research that can lead to breakthroughs in addiction treatment, with the goal of helping both individuals and families affected by the opioid epidemic. -it's very hard to get over this image every day and every night of your kid taking his last breath. -michael was the child that could put the smile on your face, always. when michael passed away, we just started questioning, you know, "how did this happen and why did it happen?" -"how did michael get addicted what happened to michael?" and then you find out we're all ignorant when it comes to addiction. we don't know very much about addiction, because we never thought that it would happen to us. [ siren wails ] 5:04 AM-according to the centers for disease control and prevention, the number of drug-overdose deaths in america has never been higher. the majority of deaths involve opioids, including popular prescription painkillers, like oxycodone and hydrocodone. -the problem's huge. the rate of deaths from prescription opioids has been exponentially growing, and that's only the tip of the iceberg in terms of how many people's lives are wrecked because of prescription opiates. it's a huge problem. -the most surprising element of this is how it's the legal prescribed painkillers that get people hooked. -our young people see prescription medications as something safe and effective. a doctor has given it, a pharmacy has filled it, so they feel okay about it. -michael was getting everything from our family doctor and two other doctors. we didn't know that that was all addicting. -he was taking his pills as prescribed. -he was taking these pills as prescribed. 5:05 AM-people trust their doctor, and they think that the doctor is prescribing things appropriately and monitoring them appropriately. and they think if the bottle says "take i in such-and-such a way," that it's perfectly okay to do that. [ telephone rings ] hello? -dr. richard blondell is professor and vice chair for addictions at the university at buffalo and director of the national center for physician training in addiction medicine. -how did the painkillers work out for you, originally? -it started okay, and then i couldn't get enough. -mm-hmm. it happens. -i wanted more and more and more, and you keep taking more because you think more is gonna be better. -and the more you take... -the worse you get. -...the worse you get. -and the more you want. -the more you want. i think, the majority of the time, it's just that doctors are trying to do a good job and fall into a trap and end up contributing to the problem. now, was that bothering you when you first got on painkillers? -we've overexposed the u.s. population 5:06 AMto prescription opioids. -dr. andrew kolodny is director of opioid policy research at brandeis university and founder of physicians for responsible opioid prescribing. -i think that the biggest problem has been well-meaning doctors who are intending to help patients with pain, but who are underestimating how addictive these drugs are, and overestimating how helpful they can be when prescribed long-term. -that's enough for 15 days. -yep. -the opioidepidemic is the unintended consequence of the increased use and acceptance of prescription opioids. it is made worse because many who become addicted to prescription pain pills eventually turn to cheaper and more available street drugs, like heroin and fentanyl. -before they're using heroin, they're opioid-addicted, and that addiction develops through prescription opioids. the reason that we're experiencing 5:07 AMrecord high levels of overdose deaths, the reason we're seeing heroin and fentanyl flood into nonurban areas, the reason we're seeing soaring rates of infants born opioid-dependent or outbreaks of injection-related infectious diseases -- the driver behind all of these problems is the increased prevance of opioid addiction in the united states. -used properly, prescription opioids ease short-term pain from surgery or a broken bone. they also manage severe pain for cancer and end-of-life patients. but the amount of opioids prescribed in america greatly exceeds what is required for those uses. -when michael passed away, avi was angry. he was angry that it happened, and it shouldn't have happened. -there. yeah, there you go. -avi wanted a dog so badly that i said, "there's no way i can allow u to have a dog," because michael kept asking for a dog. 5:08 AM-we knew that michael was in pain a lot, and, um, towards the end of his life, um...he really suffered. -we were really terribly lonely, so i finally gave in, and much to my surprise, this dog has given us such joy. -death changes you. it completely does. and you want to know, "why did michael have to die? -at the age of 12, michael was diagnosed with crohn's disease, a painful gastrointestinal condition. as he got older, doctors prescribed powerful opioid medications to treat his pain. after michael's death, his parents obtained pharmacy records that showed michael was prescribed 185 pain pills over a one-month period. -i just couldn't believe that the doctors did this to him. it's indefensible that they did this 5:09 AMto an 18-year-old, you know, young man -- changed him, chemically, forever. -this thing takes a beautiful person... -oh, yeah. -... and turns him into a monster. -yeah. -that's my beautiful, little baby... -who are you? yeah, who are you? -...you know, "what happened to you? -yeah. -you know, "what's going on? and you don't understand what's going on. -the reason that the united states is in the midst of a severe epidemic of -- of opioid addiction is because the medical community began to prescribe opioids very aggressively. and as the prescriptions went up, rates of addiction and overdose deaths went up right along with the increase in the prescribing. -more than 240 million prescriptions are written each year for opioid pain medications -- enough for every adult american to have their own bottle. oxycontin, opana, and vicodin are among the most frequently prescribed and most commonly abused prescription opioids. these powerful drugs can literally hijack the brain. -the effects produced in the brain by oxycodone and hydrocodone are indistinguishable from the produced in the brain by oxycodone and hydrocodone are indistinguishable from the effects produced by heroin. when we talk about opioidpain medicines, we're essentially talking about heroin pills. -it is a very powerful drug. it's a different addiction. the course for opioid addiction is you fall off a cliff, so there's no gentle slope downward with consequences, and an opportunity to evaluate what's going on. it is -- pbht -- right off the cliff. -with repeated exposure to a highly addictive drug, just about anybody can become addicted. -we're acutely aware of the fact that it's fraud 5:11 AMand -- and it's not just one -- one subset of the population that's doing it. it's kind of a problem that's affecting all age groups, all races, both sexes. that allows it to become bigger, because it affects so many people. -unlike previous drug crises in the united states, the opioid epidemic impacts rural, city, and suburban communities and touches every socioeconomic group. opioid addiction is a 50-state epidemic. -wyoming county is a rural county -- population approximately 23,000, very tight-knit, hardworking type communities here. the mountains are beautiful here. i mean, the people are genuine and good people. -oceana is a close-knit community. there's still good here, but through the years, it's progressively gotten worse, and it is getting worse. 5:12 AM-west virginia has been hard hit by opioid addiction. it has one of the highest opioid prescription rates in the country and has one of the highest rates of opioid overdoses and deaths. -the majority of our kids are affected by drugs in their immediate family. -good morning. -good morning. -good morning. -in our career-education class, we've talked about what you want to be when you grow up. we know that we have to meet their basic needs before they'll ever reach out to, you know, english or math. we're gonna talk to each other, kind of be a sounding board -- what does this career really, you know, consist of? -primarily, we focus on keeping and making your kids feel safe. -got it? -and learning does take second to that. if they don't feel safe, how can we expect them to learn? [ applause ] -first of all, let me thank you so much for allowing me to come back to beautiful oceana. -senator joe manchin visited oceana middle school in 2011 as a newly elected senator. 5:13 AMhe came to talk about education and jobs, but the middle-school students had other things on their mind. -so, when i came down five years ago, that's what we were talking about -- about the jobs, opportunities. and then there were some students that wanted to talk to me. they wanted to share the life that they were challenged with, living in an area that had become truly overrun by drugs. -chelsea was a 7th grader when she met with senator manchin in 2011. -he came to our small community, and the conversation led to the problem with drugs in our community. oceana is a wonderful town -- wonderful people, great place to live. but then there's the drug problem. my mom and dad were divorced when i was in the 6th grade, and it was because of drugs. my dad was in a coal-mining accident. and he, um, soon after became addicted to painkillers. 5:14 AMand he started putting the -- those medicines before us. -chelsea was in the audience when senator manchin returned to oceana middle school in 2016. the senator was hoping to hear more-encouraging stories from a new group of middle-school students. he didn't. -i think that what is wrong with our community -- like, the drugs in it -- i haven't really seen a change, because i don't know how it was like before. but my parents and my grandma and my aunt used to talk how it would be safe at night, and you could -- -do whatever you wanted. -you could walk the streets, and you wouldn't have to lock your doors... -mm-hmm. -...and have a doubt about anyone. and now everything is dangerous, and you don't want to go outside alone, even in the daytime. -it's still that way here? you're still seeing that? -yeah. -my stepdad did them. he beat me and my mom, 5:15 AMput a gun to my head -- mom and me. -what did he want you all to do? he wanted you to take drugs, too, or he wanted your mom to take drugs, or he was just out of control? -he wanted my mom to take drugs. she wouldn't do it. -and is he gone now? is he out of your life? -he...shot himself... -hmm. -...'cause of it... after he killed my mom by shooting her up three times with oxycontin. he didn't want a divorce. she did. -how old was your mom? -20. i was 5. -but to have a child tell you that, "my mother was sho with a needle with oxycodone, and the first shot killed her, but the guy shot her two more times to make sure she was dead" - for a little 12-year-old girl to tell you that... now think about it. you've seen the horrific effects it's had on your families. you've seen death in your family at a very young age. no child should go through what you went through. 5:16 AM-yeah, this is life. this is how it is. many kids don't know anything differently. they don't know that, um, another world exists. you know? to them, this is normal. -but i took away from that conversation just as another day. i live that day in, day out from a lot of the cases that we have here -- very sad stories. and i've heard just horrendous stories over the years from this part of the state. -you heard their stories. they were worse than ours were, from five years ago. my story, it's sad, but their stories were devastating. like, it was... it was very upsetting just to hear those. it's unbelievable that it's just getting worse. -every day, we battle this, the effects of the drugs. we battle the addictions right here in school. they're precious kids, 5:17 AMand they all have special qualities. we need to save their lives. we need to. -i was just tell them that they have their future, and i don't want to ever have to go through that with my -- with myself or my -- my family that i will have in years to come. we don't want this for our children, so maybe -- you know, maybe we're not doomed. -children should not have to live like these children have had to live. they didn't ask for it. -teacher debra davis fights the opioid epidemic at school and in the community. we are a faith-based organization. we're a nonprofit. and we were established in 2005 because families had nowhere to go. -so, how was your group of students? -they -- they did really good. -so we started helping mothers and wives and children. and wasn't long till we learned it was the community's problem. -we just got this back from the printer's. -i focus on what happens if i don't do anything. 5:18 AMfor the longest time, no one would talk about anything. it was hidden. therefore, it continued to get worse. so now everybody's talking about it. hopefully, we can stop talking about problems and start focusing on solutions. [ siren wails ] -the crisis of opioid addiction is a relatively new problem in america. prior to the mid-'90s, the use of opioids to treat pain was limited. two factors triggered the dramatic increase in prescribing opioids to treat pain. pharmaceutical companies began telling physicians that opioid pain relievers were safe, effective, and nonaddictive. around the same time, doctors were being pressured to treat pain more aggressively. -there came out some new recommendation from professional medical organizations that pain is really supposed to be the -- the fifth vital sign. -in addition to your blood pressure and your pulse and your temperature, we're also gonna ask you, on a scale of 1 to 10, "how's your pain today. if your pain is a 5 or greater, 5:19 AMthan the physician fills a mandate to medicate that. -taking two a day, so the maximum daily dose... -the medical community begins to hear that we've been allowing patients to suffer needlessly because of an overblown fear of addiction, that the compassion way to treat just about any compliant of pain is with an opioid. -so, there was a -- a perfect storm of public demand for the treatment of pain and the pharmaceutical industry right there creating a whole new generation of powerful drugs. how are your hands doing? -pain is the number-one reason people visit a doctor. pain can be a challenging ailment for doctors to diagnose and treat. but now doctors were being told they had a new way to treat pain that was safe and effective. -don't be afraid to take what they give you. often, it will be an opioid medication. -in the 1990s, new opioid medications were introduced to treat pain. much of the information about these new drugs came from pharmaceutical companies. -some patients may be afraid of taking opioids, because they're perceived as too strong or addictive. but that is far from actual fact. -the reason that the medical community started to prescribe so aggressively is that, in many ways, we were responding to a brilliant marketing campaign. it was in 1996 that purdue pharma introduced oxycontin. it launched a campaign to encourage the medical community to prescribe opioids for common chronic conditions. -the marketing effort included paid trips for doctors to workshops on pain treatment and visits from drug reps who often oversold the benefits and understated the risks of prescribing opioids to treat pain. while oxycontin was the most successful 5:21 AMof the new prescription drugs, other companies were producing painkillers and engaging in similar marketing activities. the aggressive marketing increased the use of prescription painkillers to treat common types of pain -- from toothaches and migraines to sports injuries and back pain. -we start to hear that we shouldn't worry about patients getting dependent on the drug, that you can taper people off easily, and that this is the safe and effective way to help people with chronic pain. and what they were teaching was certainly wrong. -i would describe that as one of the factors that contributed to the current crisis and that never should have happened. it's unfortunate that it did. -anne pritchett is vice president for policy and research at phrma, an organizing representing pharmaceutical companies in the united states. she previously served in the white house drug policy office. -it's very challenging to look back at the history. and i don't think 5:22 AMthat anyone involved could have anticipated that we would be facing the crisis we face today. do i think that if there's inappropriate prescribing and overpromotion, and that's for profit, that that needs to be addressed? yes. do i think that there was inappropriate behavior that contributed to the problem we're in? yes. but do i think that that's the sole reason why we face the opioidcrisis we do today? i don't. -the way that you can do well financially, the way that you can have a blockbuster drug is if you can get the medical community to prescribe your medicine for common conditions, long-term conditions. and if it's a drug that's very difficult to discontinue using, well, then you've got a pretty good recipe for a blockbuster. -as problems with opioid medications emerged, pharmaceutical companies faced increased scrutiny. in 2007, purdue pharma paid $634 million to settle charges that it misled the public about the risk of addiction. -the epidemic we have in ohio... 5:23 AM-in 2017, several states filed suit against a handful of pharmaceutical companies, accusing them of conducting marketing campaigns that misled doctors and patients. despite the concerns, opioids remain one of the most-prescribed drugs in the united states. -my issue is, "why is ther all this surplus product?" i don't know why pharmaceutical companies are not held accountable to that. if there's only this much pain demand but this much product, then obviously you know your product is being used for other purposes. -since 1999, sales of prescription painkillers in the united states have quadrupled. during that same period, the centers for disease control says there was no change in the amount of pain reported by americans. there are enough opioid pain pills prescribed in one year to medicate every adult american for a month. -so, clearly, we have a disconnect here. 5:24 AMwe have a situation where there's overprescribing, because it doesn't seem reasonable to think that for every american, there should be a 30-day supply of a prescription opioid. but how do we address that and still ensure that those with legitimate need are receiving access? i understand and empathize with the incredible pain and suffering that these families are facing. to blame the pharmaceutical industry as having the sole responsibility, i think, is misguided and wrong. i don't think that any one factor has led us to the current opioid crisis. it didn't happen overnight. it's not going to be solved overnight. -and the more you open up this pandora's box, you find -- you find a broken system in this country, where there's parts scattered everywhere, and there's people who need help, and they're broken, and they can't get -- they can't get the help 5:25 AMbecause our healthcare system is based on making money. -blood pressure's good. -that's always an issue, about who pays for anything. we live in a capitalistic society, and our healthcare system is funded through payments -- usually, fee for service. so there's always a discussion about who pays for what, and when. -the department of health and human services estimates the economic impact of the opioid epidemic at $75 billion a year. much of that cost is borne by insurance providers, including government insurance programs -- such as medicaid, medicare, and veterans' programs -- and by private health insurers. public and private insurers confront both ends of the opioid epidemic, paying for prescription drugs for pain patients, and then paying for treatment when patients become addicted. -and we were extremely troubled by all of the headlines that everyone is seeing about the explosion of opioid abuse in this country. and we're mindful of the fact 5:26 AMthat often this starts out with prescription drugs. -dr. harold paz is chief medical officer for aetna. he has an extensive career as a physician and healthcare administrator. -because of the addictive properties of these drugs and the fact that they're very effective at eliminating pain, the pendulum swung way out but at a tremendous cost and in tragic ways. we have to bring it back to the middle. when a physician writes a prescription for a narcotic, we depend on the physician to make the appropriate decisions around, "does the patien need a narcotic?" so our role is not to sit in the room with the doctor and second-guess those decisions. but what we can do is look at the overarching patterns that exist. -health insurers collect information about the prescribing patterns of doctors. aetna initiated a program to contact physicians about their opioid prescribing. 5:27 AM-we really wanted to focus on physicians that are writing a lot of prescriptions for opioids. we started with the top 1%, and we said to the doctors, "based on this data, based o the cdc recommendations, you are an opioid super prescriber." -along with the letter, aetna provided a checklist for doctors to use when prescribing opioids. but some question whether letters are enough to address the problem. -we expect that our physicians are gonna be well-trained, they're gonna practice appropriately and professionally and ethically. and if they aren't, we have in our communities and in our states the mechanisms to identify that and make sure that those problems are corrected. -patients and prescribers really need to understand that opioids are highly addictive. it doesn't mean that they should never prescribe it or that the patient should never take it. 5:28 AMit means we have to be very careful with these drugs. we have to avoid using them when we can. and for many types of pain, we can avoid opioids. we have alternative treatments. -i'm treating the tissue in your neck and around your head. helps relax this area, help with pain, too. okay? -okay. -in 2016, the centers for disease control created the first national guidelines for prescribing opioidsfor chronic pain. a key recommendation encouraged doctors to use nonopioid approaches to treat most pain. but changing doctor and patient reliance on prescription painkillers is challenging. -i have a solution that will make this whole problem go away. dr. daniel alford is professor of medicine at the boston university school of medicine, where he directs an opioid- prescribing education program. -the solution is, if the insurance industry would pay for comprehensive pain-management services. 5:29 AMunder one roof, you can get massage therapy, cognitive-behavioral therapy, acupuncture, medication management, you name it. i want patients to start demanding multimodal comprehensive treatment. i want them to say to their doc, "i need something better, and they should be calling up their insurers and saying, "why don't i have acces to all these other treatment modalities?" -of course we need to continue to find more effective ways to treat pain, and we certainly support every physician that wants to provide an alternative to narcotics. our problem is with other therapies -- alternative therapies that are not clinically proven. until they are, we're not gonna cover it, because we don't have a basis upon which to say it makes sense to cover it. what we have to look for are clinical studies that prove efficacy. -some alternative treatments are covered by insurance, but coverage varies from company to company and state to state. insurers face pressure to pay for pain medications are also challenged to control overprescribing. -the truth is, most insurance companies will pay for physical therapy and some of these alternative treatments. but the easiest thing for a primary care doctor to do is write a prescription. and if i've got 10 minutes to spend with you, and you're complaining of pain, writing the prescription can be the ticket to getting you out of the office quickly so i can see my -- my next patient. -squeeze the shoulder blades together and reach the elbows back. -it's a whole lot easier for me to prescribe them medication than it is for me to get a patient into physical therapy, into acupuncture, into cognitive-behavioral therapy, and all the other treatments that have been shown to be effective in treating chronic pain. we still have a long way to go. -does that feel okay? -mm-hmm. -good. good job. awesome. -it is a daunting task to get doctors and patients to turn away from prescription drugs as the first step for treating pain. -what's important is that 100 million americans are suffering from chronic pain, 5:31 AMso we really need to screen patients better for addiction, decrease the amount of opiates that we're prescribing, and find nonpharmacological approaches to take care of our patients with chronic pain. it's very, very challenging. -at the university of new mexico pain center, an interdisciplinary team works to manage pain, improve quality of life, and reduce use of prescription opioids. -when you integrate care -- right? -- when you provide as many things as you can under one roof, the outcomes are better. -this interdisciplinary approach really offers that patient a co-located home where they can go and receive services all at once. it also allows the clinicians to be able to talk all together about that patient. if i can see a patient for the first time, and i can tell them that their pain is real, i believe their story, they're being heard, and we have a team... 5:32 AMi'd love to hear about your pain story. would tell me how you developed chronic pain? -i had a lot of pain when i was working. i was a veterinary technician. -i gotcha. -and i worked in a clinic at a zoo. i've had pain for a really, really long time. i'm almost 70 now, and i've been retired for about a year. -it's very important to realize that there is an older group that's become opioid-addicted, as well. these are people in their 40s, 50s, 60s, 70s, and 80s. the older group is developing their opioid addiction almost entirely through medical use -- usually opioids prescribed for a chronic-pain problem. -i wanted to continue taking the opioids, because they were the only thing that helped. -the goal of the interdisciplinary team is to reduce reliance on opioid medications. -dr. dole has been really helpful in that respect, because he changes the medication. 5:33 AM-he changes it from one type of opioid to a different type? -yeah. -mm-hmm. -and in doing that, i'm able to take less than i was overall. -it's that communication that's ultimately gonna lead to better patient outcomes. and i think that's what we're doing, which is so heartening. -the interdisciplinary approach to pain management is fairly new and is more expensive than traditional pain management. -it takes money. we don't get reimbursed for some of our services, but i really do think that we have shown that we have a really good return on investment, and the patients are happier because they feel like they're being seen by a whole team, and they don't really need just that one opiate. i'll make that appointment for you. -okay. -how does that sound? -that sounds wonderful. -i think you're doing great, susan. -every time i or one of my colleagues writes a story on the opioid epidemic, 5:34 AMwe get responses from families, fathers, mothers, who have buried children a week earlier, and they want to sit down and talk with us. and sadly, it's the same story, it's the same tragic set of circumstances, except for the names and faces. there's just no end to these stories. -in my job, you deal with a lot of people who suffer losses. and there are people who lose a loved one, and they cannot move on. there are people who lose a loved one, and turn around and say "what can i do? that's what jennifer was doing. -so, cameron was my son. he passed away five years ago of a heroin overdose. i never in a million years thought that, you know, my boy would be a heroin addict. -so like i said before -- and i'll say it again -- i love life, i love all of its fights... -cameron was a student and athlete at one of the top high schools in albuquerque, new mexico. -he was wrestling, and he broke his collarbone, 5:35 AMand he had to have surgery, so he was prescribed percocet. he was injured about three months later again, in a football injury, and broke his other collarbone. and he didn't require surgery the second time, but they gave him more painkillers the second time. you're given 30 pills by a doctor, and you think that they need to take all 30 of them, because otherwise, why would they give you so many? it didn't even cross my mind that it was something that was dangerous or addictive or anything like that. -it's fairly typical. kids would get injured whether they were in wrestling, football, gymnastics. suddenly, they're on a road, and it's -- it's a fast track, and it doesn't take very long. -cameron's road to heroin addiction was paved with prescription painkillers. eventually, he turned to cheaper and more readily available street drugs. nearly half of people who use heroin were first addicted to prescription painkillers. -that wasn't his, you know, goal in life -- to get addicted to opiates and then move on to heroin. i didn't even know that opioids and heroin were related. 5:36 AM-it's not that there are young people out there who are deciding one day that heroin sounds like a fun drug to try. before they're using heroin, they're opioid-addicted, and that addiction develops through prescription opioids. the pills are very expensive on the black market. they switch because it's much less expensive. we've seen overdose deaths in that group rise very rapidly because the heroin supply has become more dangerous. it has fentanyl in it now. -the migration from prescription pain pills to heroin has changed the demographics of drug addiction in america. while heroin use has increased in most socioeconomic groups, some of the greatest increases are in demographic groups with historically low rates of heroin use. -every person i've ever talked to who ends up a heroin addict, they talk about how, when they were doing pills, they would never do heroin, they would never put a needle in their arm. 5:37 AMcrossing those thresholds into the next phase, it's literally five minutes, because you go from, "i've neve had a needle in my arm," to, "a needle was in my arm, and now we're off and running. -i was completely shocked. i quickly found out that, you know, drugs don't discriminate. they're everywhere. -for an addict like cameron, what happens is that drug replaces everything. it replaces your love for your parents, it replaces your love for your friends, your other family members. you steal, lie, cheat, do whatever you can to get the money to get your next fix. that sounds like a cliché, but it's a cliché because it's true. that's what happens. -since my son passed away, my life has completely changed. i felt like nothing was the same anymore, and nothing meant as much anymore. and so it was very difficult, and it's still very difficult. even though it's been five years, 5:38 AMit still feels like it was yesterday. -as with many parents who lose a child to opioid addiction, jennifer has devoted her life to helping others. she started serenity mesa, a youth-addiction recovery program. -does anybody want a sloppy joe? -and we do long-term treatment for young men age 14 to 21, and we provide not only drug treatment and counseling but life skills, high-school education, and job-placement, job-readiness programs -- things like that. and we're able to really dig deep into some of the trauma and, you know, some of the underlying issues that may have caused their substance abuse in the first place. -helping others deal with addiction has helped jennifer face her own loss. -it helps to help other people, and to see, you know, all the young men at serenity mesa and the progress that they make and how well they do. they're battling to save their life right now. they don't realize it, 'cause they're so young, and that was the issue, i think, with cameron, is he was just so young. he didn't -- he didn't know he was dealing with a life-or-death situation. he just thought he could quit whenever he wanted to, and everything would go back to normal. they say that you learn to live with grief. you don't get over it. it doesn't go away, but you learn to live with it. but, you know, i still think about him all the time. -it's been said to me that these people aren't bad people trying to be good, they're sick people trying to get better. -with the opiate population, it's -- it's different in the fact that a lot of times they don't see this train coming down the tracks. you know, it's -- it's an injury, it's a surgery, and oftentimes that's where it starts. -hey, bill. -how are you? -good. nice to see you again. -yeah, it's -- so, it's been -- what? -- two weeks now. -i was 15 years old, and i a tumor in my spine. i spent a week in the hospital, and they sent me home with a bunch of medication.i ended up being addicted to opiates. i have up. i didn't care what happened to me. it's a pretty horrible feeling when you -- you don't really care if you live or die. -okay, so, what's up for this week? what do you have planned? -my son loves dinosaurs, so i think this weekend we're gonna go to a fossil museum. it should be fun. i'm excited. it's amazing, what you think is normal turns out to be this terrible ordeal that i dealt with for the past 15, 16 years. it takes over your life. it's sickening to even think of the things that i've done and the people that i've hurt and just not to even care, at the time, what was going on. i think, deep down, every addict has a desire to not be living that life anymore. i think that desire has to be strong enough to want to change, to outweigh the draw, the pull, from that part of the brain that's been sort of hijacked by the addiction. 5:41 AM-opioids are one of the toughest addictions to break. opioids produce an addictive euphoria that alters the chemistry of the brain. according to the national institute on drug abuse, treatment programs that focus only on abstinence do not result in long-term recovery. -the reality is, there's no fix, there's no cure for this disease. there's a lot of work involved in this. it's not just a quick fix or a miracle cure. -there's not a magic bullet out here. we don't have one and out, or, "come in and we'll save you and you're gonna be all good." it's a long and difficult road. -opioid addiction is a chronic disease like diabetes or heart disease. all need to be managed for a lifetime. treatment for addiction typically includes some form of individual or group therapy. -what you become when you're getting high is not who you are. you know, who you are is sitting in this chair today, fighting, struggling with the courage, the faith, and the hope that tomorrow could be a better day. the disease can be arrested. 5:42 AMyou know, you can lock it up and lock it up forever, you know, and as long as you don't put that key in the lock and turn it and let it loose, you can be -- you can be free from the horrors of addiction. -things got really rough for me before they ever seemed like they were gonna get better. -i can remember one time i was working with a family, and the day the young man was to leave our facility, the mother thanked me. she said, "thank yo for curing my son." and i said, "i'm sorry there's really no cure. this is a daily reprieve contingent upon what your son is gonna do, moving forward." -it's hard as hell to bring yourself to a program like this to do something, to really change you life, and get outside of your comfort zone. -treatment must address changes to the brain caused by opioidaddiction. medication-assisted treated is a proven, effective treatment for individuals with opioid-use disorder. use of medications helps to wean the brain off opioids and improve outcomes for addicted patients. 5:43 AM-one of the most effective treatments is a medicine called suboxone, or buprenorphine. it will control peoples' cravings, and it reduces the risk that they're gonna die of -- of an overdoes. -opioidreplacement with buprenorphine is one of those things that for many people is a -- is a game-changer. -while medication-assisted treatment improves the chances for recovery, there is a lingering issue of why treatment for opioid addiction often fails. -oftentimes, it's not just one treatment, it's multiple treatments. and that's where, i think, the frustration comes in, where people think that, you know, recovery doesn't work -- you know, it's... it's fruitless, it's just not gonna happen. you know, "my loved on has been through this three, four, five times." -once somebody becomes addicted to opioids, it's a lifelong problem. they're not gonna get better by checking into a rehab for 30 days or getting detoxed. the treatment is generally gonna be very long. -what we need to do is look at addiction as a continuum. 5:44 AMtreatment doesn't end at one year, doesn't end at two years. i think what we're faced constantly, is families, friends, employers that think that a stint in a rehab for a month means potential success. but for the most part, people will have lapses. -because information about treatment is not well documented, it is hard to know how many people relapse. but relapse does not mean failure. -you go into treatment, and it doesn't fix you. and you're gonna have people who fall off the wagon, and you know... but the thing is is not to condemn the kid. it's to say "okay, we nee to start all over again." -we have to prepare people for a relapse better, because it is likely. that's what the research tells us. that's what we see on the ground. and families -- people need to be prepared for that. -addiction is looked at as, "you did it to yourself it's your problem. 5:45 AMpick yourself up by your boots, pull your socks up, and go take care of yourself." it doesn't work like that. it doesn't work like that at all. -is everybody excited about getting going here today? -yeah! -yeah! -yeah? all right. let's do this. one of our most popular classes is our cycling -- or "spin," as people know i -treatment goes beyond dealing with the power of the addiction to help patients reconnect to seemingly ordinary activities. -pick up your pace a little bit. it not only helps with your fitness, improve fitness, but it also improves your mood, which will then -- they'll feel better about themselves, they'll have better confidence in themselves, because they are very broken when they first come in to us. -it's not hopeless, but because it's not an easily resolved problem, they're scared out of their minds. -it took me to get hope in myself that i could do this before i could even really make any actions toward recovery. -you walk around here, 5:46 AMand you talk to the people that are here, and for this point in time they have a chance. -the challenge for many is finding access to treatment. the national institute on drug abuse estimates, fewer than 12% of americans suffering from substance-use disorders receive treatment. for many, the stigma associated with opioid and heroin addiction gets in the way of treatment. -but when you talk about addiction, sometimes that triggers responses based on prejudice and ignorance. so there are some who might think that it's not a medical problem at all, it's just a moral, character defect. -it's a really important thing to work on yourself and have goals in the end. -what i don't like about describing this as an abuse problem is i think it puts in peoples' mind the notion that what we're dealing with is a problem of people behaving badly, taking dangerous drugs because it feels good, 5:47 AMand they're accidentally killing themselves in the process. that isn't what -- what's going on. once you're addicted, you're not doing it because it's fun or you're choosing the lifestyle. you're doing it because you have to. -those are things that we can use for our recovery. -you should not be ostracized and you should not be punished because something happened to you unintentionally or accidentally. -the families that are grappling with a loved one that is in the throes of addiction -- our message from personal experience to them is, "grab your child hold them tight, and let them know that you're -- you're in it together." you know, it's not -- it's not just them alone -- you're in it together because that -- that child is in for the fight of their life, for the rest of their life. -this disease has been killing thousands of people in the past few years. 5:48 AM-when avi and julie israel lost their son to opioid addiction, they wanted to help other families. -this is all about awareness to a very horrible, horrible addiction. -avi and julie started save the michaels of the world... [ gunshot, crowd cheers ] ...in hopes of preventing other family tragedies. -this disease is killing people across the country. you know? there's no boundaries to it, there's no class levels, there's no education levels or any of that stuff. there's people dying all over. it should be more of an outrage out there. people should be out there demanding results. -i think there's not more outrage because the people that are not affected don't think it's gonna happen to them, which, you know, that's a false sense of security, because -- you know what? -- you are one car accident, one surgery, one wisdom tooth, one sports injury away from the disease of addiction, 'cause that's how fast it can happen to your family. -there is a growing outrage -- not enough. maybe we might have been at a better place right now if there had been more outrage early on. -and so now we're reaping the consequences of what we have sewn, and now we're trying to undo some of that stuff. and it's -- it's a lot easier to do it than it is to undo it. -there are small signs of progress in combating the opioid epidemic. the centers for disease control reports opioid prescribing peaked in 2010 and decreased each year through 2015. experts say the drop is a sign the culture of overprescribing is changing. but fewer prescriptions have not resulted in a drop in opioid addiction and death. there are no easy solutions to the opioid epidemic. while treatment is essential, any long-term approach must focus on prevention. -if we had the right education, and people were motivated the right way, they wouldn't get this disease in the first place. so there's a great amount of hope if we shift our thinking about our approach to this disease, and shift more towards prevention and early identification. -the way you respond to disease epidemics or outbreaks is really by accomplishing two things. the first thing that you need to do is to prevent new cases of the disease. you want to contain it, keep new people from -- from getting it. and the other thing that you need to do is you need to treat the people who have the disease so they don't die from it. that's really gonna be the only way we can bring down overdose deaths in the short term. -i would start with a massive educational campaign -- 5:51 AMthe same kind of educational campaign and awareness that they did for any other new kind of emerging disease. -so now we we have to start thinking about educating our children better, about educating doctors better, about educating parents better, about educating our public-health officials better, about educating our politicians better. all of those people have to come together to really effect a strategy of prevention. -well, i believe that we need to educate at a much younger age than we do now. but, again, because of the disease of denial, many folks are gonna say, "well, we don't need tha in my town. we don't need that in my school. that's for down the road." but the problem is, "down the road is right in your locale. -we've got to fix this, and it's gonna take some big-time solutions here. this is not gonna be something where you put up a couple of billboards and it's all gonna get better. people want it all fixed next month. you know, "here's the problem now, at 5:00, solution. film at 11:00." 5:52 AMthat ain't gonna happen. everybody has to accept their little piece of responsibility for this and do their part to fix the problem. as long as everybody's saying -- pointing the fingers and blaming somebody else, it's not gonna get done. -but i think what is beginning to have an impact is, increasingly, you're seeing families that have been affected by the problem speaking out. and some of these family-survivor advocates are having an impact. -i think prevention is key -- educating the parents, educating the coaches, educating the kids through the school systems. -how many of you found something interesting? -if we had prevention programs in all the schools and all the districts from an early age on up, then kids would have the education, parents would have the education, and all the people around them, you know, the coaches. it's a community problem. wherever there's a propensity for somebody to get an opiate, whether it's a dentist, a doctor, wherever, the education needs to be there. 5:53 AM-the families that are left behind, who want to tell the stories because they don't want it to be that their child or loved one died in vain, they want to spare other people the agony of losing a loved one. and i think that's gonna be the strongest, you know, boost to really changing society's attitude. -in life...as in death... you fight for your children. it's michael's spirit... ...that drives us. -you don't want the world to forget that there was a kid by the name of michael israel that lived here. he was a good kid. he was a terrific kid. and we miss him. -he has also put us on a path and a journey 5:54 AMwhere we're gonna -- we're gonna take it to the end. there's -- there's no turning back now. -we watched a beautiful boy go from jumping around and everything [sniffles] and being so funny into suffering, and so you fight for him. and we took him all over to get him help, and we're taking michael all over to get other people help. when we first started talking about this, we were like a little flickering candle, and now we have, like, a flashlight beam. it's still not daylight out there. we still got a long way to go. it's moving in the right direction. and unfortunately, it's taken a lot of deaths to get this movement, and it's gonna take more death before this stops. -i see tragedies, for sure, but i also see successes, and that's where the hope comes, 'cause it doesn't have to be like this. our society doesn't have to be riddled with addiction. we -- we don't have to pick up the paper and read about all these kids that overdose every day. we don't have to do that. we -- we can do better. we -- we -- we know how to do this. it's just getting the will to do it. that's the hard part. -funding for this program has been provided by blue cross blue shield association and brain research foundation. with passion and dedication, brain research foundation is working to advance treatment and prevention of all neurological disorders in children and adults. brain research foundation is committed to funding research that can lead to breakthroughs in addiction treatment, with the goal of helping both individuals and families affected by the opioid epidemic.
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Jan 19, 2018 | KARD (Fox)
By Monroe, LA
Video Link: http://app.criticalmention.com/app/#clip/view/32135770?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: an important topic on the agenda at el dorado's city council meeting thursday night. the city council has been asked to help fight the opioidcrisis. the arkansas municipal league is asking all cities in the natural state to get on board. the organization is planning to investigate companies that distribute opiods including: johnson and johnson, watson laboratories and several others. they want the municipalities to endorse the engagement letter that was sent to them. (frank hash/ mayor of el dorado) "it doesn't cost the city anything to support this. the city is not liable for any of the litagation process. it just shows unity in concern." (michelle) the mayor says this was only a discussion for the city council, and they've yet to vote on any action.
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Jan 19, 2018 | KVHP (FOX)
By Lake Charles, LA
Video Link: http://app.criticalmention.com/app/#clip/view/32135781?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: louisiana's governor and attorney general have been unable to reach an agreement on who should hadle the stae's lawsuit against opioidmanufacturers. so, they're heading to court today... governor john bel edwards and attorney general jeff landry both support litigation accusing pharmaceutical companies of worsenng opioid abuse in louisiana. they're just arguing over control now. landry wants to take over the suit so it can include more agencies..
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Jan 19, 2018 | WGGBDT2 (Fox)
By Springfield, MA
Video Link: http://app.criticalmention.com/app/#clip/view/32135807?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: today senator eric lesser plans to speak on alternative treatments to perscription opioids. lessor is proposing a bill which would require schools to include prescription opioid abuse prevention as part of the health education curriculum. he says that treatments such as acupuncture can help manage chronic pain without turning to pills. lessor will speak about other alternatives at "better life whole foods" in springfield at 5pm. the city of springfield filing suit against pharmaceutical companies as they continue to battle the opioid cris.the city says they're going after anyone who they 7:05 AMbelieve has fueled the epidemic that is sweeping the nation.western mass news reporter jeff cramer has more the opioid epidemic continues to hit the country hard.the city of springfield is fighting back against pharmaceutical manufacturers and distributors.the city tells western mass news, they're joing hundreds of other states and cities across the country to hold those they consider responsible for the opioid epidemic accountable. the city claims the companies decieve doctors and patients including vulnerable groups like the elderly and war veterans.and they say the companies don't make it clear about the highly addictive nature of prescription opioids and pain management. in a release, the city says: "through the impending lawsuit springfield will seek to recoup the crippling cost that opioid addiction has caused the local government and to hold the culpable parties responsible to assist in the abatement of the public nuisance they created" springfield mayor domenic sarno says opioids ve really made a dent in the lives of so many saying: "the damage inflicted by the opioid crisis to springfield's most precious resource, its residents, has been tremendous and will take a huge effort to repair."the city says they are seeing a lot of deaths and overdoses and because of that: "springfield will need to incur residual costs for years to come as patients who were deceived by the industry struggle with addiction, or turn to other more dangerous analogues."
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Jan 19, 2018 | WJXX (ABC)
By Jacksonville, FL
Video Link: http://app.criticalmention.com/app/#clip/view/32135816?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: attorney general pam bondi says that she is ready to take on big pharma in the fight against opie lights floor officials are meeting with a federal judge in ohio in a few weeks to try to reach a settlement with the drug manufacturers and distributors who they say help to create america's opioid crisis. bonnie says if they can't reach a deal that they are prepared to go to litigation
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Jan 19, 2018 | WYFF (NBC)
By Greenville, SC
Video Link: http://app.criticalmention.com/app/#clip/view/32135853?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: in state of addicition this morning, the city of philadelphia filed a lawsuit against prescription opioid manufacturers. they want the manufacturers to stop deceptive marketing practices and pay treatment costs for those suffering from opioid addiction. city health officials say they are taking several active measures to combat the opioid problem, and it's draining them financially. >> communicating clearly to doctors just how risky these drugs are. these are unsafe and addictive drugs, and helping pay for treatment and distributing a drug to stop people from overdose. allyson: according to officials, philadelphia ranks at the top among the largest cities in america for opioid deaths.
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Jan 19, 2018 | WYOU (CBS)
By Wilkes Barre, PA
Video Link: http://app.criticalmention.com/app/#clip/view/32136225?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: "city of philadelphia" files a lawsuit against "prescription opioid manufacturers".. looking to stop "deceptive marketing practices" and recover costs for residents suffering from opioid addiction. city health officials say.. they're taking several active measures to combat the opioid problem.. and it's draing them financially.according to officials.. philadelphia ranks at the top among the largest cities in america for opioid deaths. s/ dr. thomas farley, health commissioner"so today we're asking the companies that sell these drugs to stop pushing these drugs in philadelphia and to start helping us clean up the problems that they have caused.the city solicitor says.. they put in the work investigating possible claims against drug companies.. and feel the city is in a position to win the lawsuit.
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Jan 19, 2018 | WWNY (CBS)
By Watertown, NY
Video Link: http://app.criticalmention.com/app/#clip/view/32136078?token=60c71eaf-3ef2-4cd9-a4f4-13c94e72ed18
Rough Transcript: to help fight the state's opioid crisis. during his budget address this week, cuomo brought up the idea of creating what he calls an "opioidepidemic surcharge." essentially, the state would charge manufacturers of prescription opioids two cents per milligram on their products. that money would go back to the state to fund treatment programs. credo community center in watertown relies on about $2 million from the state for its programs. it's executive director says somethi like this could be a big help for their organization. jim scordo - credo community center executive director "it would help us sustain the workforce that we have. our workforce challenged and we need additional medical and additional clincial staff to provide the services to this opioid and heroin population." governor cuomo estimates this surcharge could provide the state with $170 million dollars to fight the opioid epidemic.
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