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Opioid Litigation Media Update -2/12/18

McCaskill Report

BREAKING: Millions in Payments Among Findings of McCaskill Opioid Investigation into Ties Between Manufacturers and Third Party Advocacy Groups (PRESS RELEASE)
Feb 12, 2018 | US Senate Committee On Homeland Security and Governmental Affairs
By Sen. Claire McCaskill

Report details history of downplaying addiction risks, advocacy against landmark 2016 CDC guidelines by multiple advocacy organizations; Homeland Security and Governmental Affairs Committee Minority report finds millions in payments from opioid manufacturers to advocacy organizations, affiliated individuals
Opioid makers gave $10M to advocacy groups amid epidemic
Feb 12, 2018 | Associated Press
By Matthew Perrone & Geoff Mulvihill

Companies selling some of the most lucrative prescription painkillers funneled millions of dollars to advocacy groups that in turn promoted the medications’ use, according to a report released Monday by a U.S. senator.
Opioid makers paid millions to advocacy groups: U.S. Senate report
Feb 12, 2018 | Reuters
By Nate Raymond

Five opioid manufacturers including OxyContin maker Purdue Pharma LP have paid more than $10 million to advocacy groups and doctors tied to them, many of whom amplified industry messages supporting the use of the painkillers, a U.S. Senate report said on Monday.
Drugmakers Funded Groups Promoting Opioid Use, Senator’s Report Finds
Feb 12, 2018 | Wall Street Journal
By Jeanne Whalen

Five manufacturers of opioid painkillers gave nearly $9 million between 2012 and 2017 to patient advocacy groups and other nonprofits that have a history of promoting opioid use, according to a probe by the top-ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee.
How drug company money turned patient groups into
Feb 12, 2018 | USA TODAY
By Deirdre Shesgreen, Jayne O'Donnell and Terry

The five biggest opioid manufacturers shelled out more than $10 million to patient advocacy groups, professional medical societies and affiliated individuals — who then “echoed and amplified” messages that encouraged use of those highly addictive drugs and set the stage for the current opioid epidemic.
McCaskill report: Opioid manufacturers gave millions to advocacy groups
Feb 13, 2018 | The Hill
By Rachel Roubein

A new report from Sen. Claire McCaskill (D-Mo.) found that five opioid manufacturers paid nearly $9 million to 14 outside groups between 2012 to 2017, alleging that the advocacy groups often “amplified messages favorable to increased opioid use.”
Drugmakers Spent Millions Promoting Opioids To Patient Groups, Senate Report Says
Feb 13, 2018 | NPR
By Scott Neuman

Drug-makers gave millions of dollars to pain-treatment advocacy groups over a five-year period beginning in 2012, in effect promoting opioids to individuals most vulnerable to addiction, a new report released Monday by a U.S. Senator says.
Senate report says patient advocacy groups get kickbacks from opioid manufacturers
Feb 12, 2018 | CNN
By Nadia Kounang and Debra Goldschmidt

A new report alleges that five of the United States' largest opioid manufacturers paid patient advocacy groups nearly $9 million between 2012 and 2017 to help push an agenda that promoted opioid use.
Opioid Manufacturers Paid Millions To Groups That Lobbied For More Opioid Usage, Senate Investigation Claims
Feb 12, 2018 | Newsweek
By Melissa Delkic

Major opioid manufacturers paid millions of dollars to groups that lobbied for increased opioid usage in the last five years, a Senate investigation claimed on Monday.
Opioid makers gave millions to patient advocacy groups to sway prescribing
Feb 12, 2018 | STAT News
By Ed Silverman

As the nation grapples with a worsening opioid crisis, a new report suggests that drug makers provided substantial funding to patient advocacy groups and physicians in recent years in order to influence the controversial debate over appropriate usage and prescribing.
McCaskill report says top opioid manufacturers gave millions to pain groups
Feb 12, 2018 | St. Louis Post-Dispatch (MO)
By Chuck Raasch

Sen. Claire McCaskill released a report Monday alleging that from 2012 to 2017, leading manufacturers of opioids gave $9 million to pain treatment advocacy groups, an arrangement the report says “may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic.”
Report: Patient advocacy groups pushed opioids after getting industry money
Feb 12, 2018 | McClatchy DC Bureau
By Lindsay Wise

Opioid manufacturers funneled millions of dollars to patient advocacy groups that in turn issued “opioid friendly” guidance and policy recommendations, a congressional report has found.
Opioid Manufacturers Paid Millions to Groups That Lobbied for More Opioid Usage, Senate Investigation Claims
Feb 12, 2018 | Infosurhoy
By Denis Bedoya

Major opioid manufacturers paid millions of dollars to groups that lobbied for increased opioid usage in the last five years, a Senate investigation claimed on Monday.
McCaskill report says opioid manufacturers provided $9 million to advocacy groups
Feb 13, 2018 | St. Louis Business Journal (MO)
By Angela Mueller

Five manufacturers of opioids gave nearly $9 million to outside advocacy groups working on opioid-related issues, according to a newly released report from Sen. Claire McCaskill's office.

Purdue Marketing Announcement

Purdue Pharma, maker of OxyContin, backs off aggressive marketing amid lawsuits
Feb 12, 2018 | CBS News
By Jim Axelrod

Monday marked a change of culture for Purdue Pharma, the drug company that makes OxyContin and other opioids. The company will no longer market those drugs to doctors and is laying off half its sales force. Video Link: https://www.cbsnews.com/news/purdue-pharma-oxycontin-maker-backs-off-aggressive-marketing-amid-lawsuits/
The maker of OxyContin will finally stop marketing the addictive opioid to doctors
Feb 13, 2018 | Vox
By German Lopez

The drugmaker at the center of America’s opioid crisis is halting one of the practices that helped cause an epidemic of addiction and death.

Commentary and FYIs

Will Big Drugmakers Mimic Purdue On Opioid Marketing?
Feb 12, 2018 | Law360
By Emily Field & Jeff Overley

Purdue Pharma’s decision to scale back its opioid marketing amid an onslaught of litigation will force many big drugmakers to consider similar moves, potentially marking a seminal moment in the nation’s brutal opioid epidemic.
America’s Corporate Drug Pushers
Feb 12, 2018 | The Indypendent
By Jonathan Fudd

For many Americans suffering from opioid addiction overdosing is only the first step in a horrifying cycle of relapse and re-treatment. Some individuals in the throes of addiction experience months or years of sobriety only to be triggered into relapse and overdose. This is a phenomenon I’ve come into personal contact with through the struggles of family members and friends.
Local Dr., Lawmakers React To OxyContin Maker's Change In Marketing
Feb 13, 2018 | WWNYTV (NY)
By STaff

Dr. Ivan Montalvo is a pain management doctor in Watertown. Dr. Montalvo prescribes prescription opioids to his patients when needed and has had to deal with sales representatives from major pharmaceutical companies for years.
Naloxone, the medicine helping fight the opioid crisis, explained
Feb 12, 2018 | Vox
By German Lopez

The woman’s lips were blue and her skin was gray. She wasn’t getting enough oxygen.
Trump budget sharply cuts White House office leading opioid crisis response, shifts funds to other agencies
Feb 12, 2018 | ABC News
By Kendall Karson

The Trump administration's FY2019 budget released Monday requests more than $30 billion for drug control efforts, while at the same time proposing a sharp cut to the Office of National Drug Control Policy, which has been leading the fight in the opioid crisis.

Northeast (PA, NY, DE)

Cumberland County sues opioid companies
Feb 12, 2018 | ABC27 (PA)
By Myles Snyder

Cumberland County has filed a lawsuit claiming more than 20 drug makers and distributors “strongly contributed” to the opioid crisis.
Cumberland County files lawsuit against opioid manufacturers, distributors
Feb 12, 2018 | The Sentinel (PA)
By Staff

The Cumberland County Board of Commissioners Monday approved filing a complaint against the manufacturers and distributors of opioid pain medication.
Cumberland County joins lawsuit against opioid makers
Feb 12, 2018 | PennLive (PA)
By Matt Miller

Cumberland County has joined the swelling ranks of government agencies that are suing the makers of opioid pain medications.
Niagara legislature will declare opioids a 'public nuisance'
Feb 13, 2018 | Niagara Gazette (NY)
By Tim Fenster

Niagara County legislators advanced a measure Monday to declare opioids a 'public nuisance" in a move to aid the county's lawsuit against several manufacturers and distributors of painkillers.
Niagara County opioid suit moves forward
Feb 12, 2018 | WGRZ (NY)
By Danny Spewak

A measure to declare the opioid epidemic a "public nuisance" sailed through Niagara County legislative committees on Monday night, intended as a move to bolster the county's ongoing civil lawsuit against major drug manufacturers.
Niagara County lawmakers consider taking next step in opioid fight
Feb 12, 2018 | WIVB (NY)
By Chris Horvatis

In Niagara County, lawmakers are taking an important step in their lawsuit against pharmaceutical companies that make opioids.
Dover City Council announces lawsuit against ‘Big Pharma’
Feb 12, 2018 | Delaware State News (DE)
By Matt Bittle

Dover City Council on Monday announced a lawsuit against the pharmaceutical industry, alleging it has played a major role in the current opioid epidemic.
Dover Plans to Sue Pharmaceutical Companies Over Opioid Epidemic
Feb 13, 2018 | WBOC 16 (DE)
By Tom Legman

The Dover City Council on Monday night voted to retain attorneys to sue pharmaceutical companies over the opioid epidemic, adding the city to a number of other municipalities across the country taking similar legal actions.

Southeast (FL, SC)

City of Sarasota picks legal team for suit against opioid manufacturers
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Pinellas Commission picks opioid litigation team
Feb 12, 2018 | Tampa Bay Newspapers (FL)
By Suzette Porter

Pinellas County commissioners unanimously agreed Feb. 6 to negotiate with the No. 1-ranked firm to represent them in a lawsuit against manufacturers and distributors of prescription opioids.
County fights opioid epidemic with lawsuit
Feb 13, 2018 | WJCB (FL)
By Staff

Alachua County is joining in the fight against the opioid crisis
Beaufort County sues pharmaceutical companies, doctors over opioid crisis
Feb 12, 2018 | Bluffton Today (SC)
By Dan Hunt

Beaufort County filed a lawsuit last week against several national pharmaceutical companies and nine unnamed local clinics and physicians for their alleged roles in the opioid crisis that has increasingly affected the state and county.

West (UT, CO)

This state lawmaker wants to force the Utah attorney general to sue prescription opioid manufacturers
Feb 12, 2018 | Salt Lake Tribune (UT)
By Courtney Tanner

After months of perceived inaction, a state lawmaker is calling on Utah Attorney General Sean Reyes to “lead out” and sue prescription drug companies for the damage the opioid crisis has inflicted.
Huerfano County sues opioid manufacturers
Feb 12, 2018 | Center Post-Dispatch (CO)
By Teresa L.Benns

Huerfano County has become the first local government in Colorado to file suit against pharmaceutical companies that saturated southern Colorado with opioids several years ago, resulting in the current opioid epidemic in the Valley.

Midwest (ND)

Standing Rock Sioux Tribe sues opioid industry
Feb 12, 2018 | Williston Herald (ND)
By Amy Dalrymple

The Standing Rock Sioux Tribe filed a lawsuit Monday against major manufacturers and distributors of opioids, joining other tribes that have filed similar lawsuits.

Broadcast Media Coverage

Morning Express With Robin Meade
Feb 13, 2018 | HLN (CNNH)
By National Programming

Video Link: http://app.criticalmention.com/app/#clip/view/32639849?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Power Lunch
Feb 12, 2018 | CNBC (CNBC)
By National Programming

Video Link: http://app.criticalmention.com/app/#clip/view/32640062?token=1b13e32d-bcfe-4797-af2c-72478377ce97
2 on Your Side at 10
Feb 12, 2018 | WUTV (Fox)
By Buffalo, NY

Video Link: http://app.criticalmention.com/app/#clip/view/32639894?token=1b13e32d-bcfe-4797-af2c-72478377ce97
KIRO 7 News at 5AM
Feb 13, 2018 | KIRO (CBS)
By Seattle, WA

Video Link: http://app.criticalmention.com/app/#clip/view/32639932?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Wake Up 7am
Feb 13, 2018 | WNLO (CW)
By Buffalo, NY

Video Link: http://app.criticalmention.com/app/#clip/view/32639938?token=1b13e32d-bcfe-4797-af2c-72478377ce97
The Delta News Morning
Feb 13, 2018 | WABG (ABC)
By Greenwood, MS

Video Link: http://app.criticalmention.com/app/#clip/view/32639963?token=1b13e32d-bcfe-4797-af2c-72478377ce97
40/29 News Sunrise
Feb 13, 2018 | KHBS (ABC)
By Ft. Smith, AR

Video Link: http://app.criticalmention.com/app/#clip/view/32639969?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Fox 2 News in the Morning
Feb 13, 2018 | KTVI (Fox)
By St. Louis, MO

Video Link: http://app.criticalmention.com/app/#clip/view/32639935?token=1b13e32d-bcfe-4797-af2c-72478377ce97
KCTV News This Morning
Feb 13, 2018 | KCTV (CBS)
By Kansas City, MO

Video Link: http://app.criticalmention.com/app/#clip/view/32639981?token=1b13e32d-bcfe-4797-af2c-72478377ce97
WBOC News This Morning
Feb 13, 2018 | WBOC (CBS)
By Salisbury, MD

Video Link: http://app.criticalmention.com/app/#clip/view/32639985?token=1b13e32d-bcfe-4797-af2c-72478377ce97
FOX8 News at 6:00A
Feb 13, 2018 | WGHP (Fox)
By Greensboro, NC

Video Link: http://app.criticalmention.com/app/#clip/view/32639975?token=1b13e32d-bcfe-4797-af2c-72478377ce97

McCaskill Report

BREAKING: Millions in Payments Among Findings of McCaskill Opioid Investigation into Ties Between Manufacturers and Third Party Advocacy Groups (PRESS RELEASE)

Feb 12, 2018 | US Senate Committee On Homeland Security and Governmental Affairs

By Sen. Claire McCaskill

Report details history of downplaying addiction risks, advocacy against landmark 2016 CDC guidelines by multiple advocacy organizations; Homeland Security and Governmental Affairs Committee Minority report finds millions in payments from opioid manufacturers to advocacy organizations, affiliated individuals
U.S. Senator Claire McCaskill, the top-ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee, today released the latest product of her wide-ranging investigation into opioid manufacturers and distributors. “Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups” describes how manufacturers of opioids have made significant financial investments into third party organizations—groups which in turn have engaged in pro-opioid advocacy over a long period of time, including through guidance minimizing the risks of opioid addiction and the endorsement of opioid use for the long-term treatment of chronic pain—an approach not backed up by medical science.
READ THE REPORT: Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups
McCaskill’s is the first Congressional report on these critical relationships, and illustrates an under-investigated dimension of the connections between the pharmaceutical industry, the medical community, government, and the general public that ultimately generated a national public health crisis.
“The pharmaceutical industry spent a generation downplaying the risks of opioid addiction and trying to expand their customer base for these incredibly dangerous medications and this report makes clear they made investments in third-party organizations that could further those goals,” McCaskill said. “These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history.”
The report’s key findings include:Contributions from five leading opioid manufacturers of nearly $9 million to 14 third party advocacy organizations over a five year period.Additional payments of $1.6 million from the five manufacturers to physicians affiliated with these groups between 2013 and the present.Several of the groups profiled received the majority of their outside contributions and grants for certain years between 2012 and 2017 from opioid manufacturers.Initiatives from the groups in this report often echoed and amplified messages favorable to increased opioid use—and ultimately, the financial interests of opioid manufacturers. These groups have issued guidelines and policies minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for overprescription and misbranding. For example:According to lawsuits filed across the country, the American Academy of Pain Medicine, which received almost $1.2 million from the five manufacturers under investigation between 2012 and 2017, issued a 2009 patient guide stating that “opioids are rarely addictive when used properly for the management of chronic pain.”The Washington Legal Foundation criticized 2016 Centers for Disease Control and Prevention (CDC) prescribing guidelines that recommended limits on opioid prescriptions for chronic pain—the first national standards for prescription opioids and a key federal response to the ongoing epidemic—as procedurally flawed and tainted by bias—and also received $500,000 from Purdue Pharma between 2012 and 2016. Notably, a majority of the groups profiled in McCaskill’s report strongly criticized these guidelines.The Academy of Integrative Pain Management, which received over $1.2 million from the five manufacturers, has partnered with the American Cancer Society Cancer Action Network on opioid-related lobbying in 18 states as of 2016, including efforts to block limits on opioid prescribing.
“The fact that these same manufacturers provided millions of dollars to the groups described [in this report] suggests, at the very least, a direct link between corporate donations and the advancement of opioids-friendly messaging. By aligning medical culture with industry goals in this way, many of the groups described in this report may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic,” the report states.
McCaskill’s report also details a troubling lack of transparency surrounding the advocacy organizations. Due to their classification under the U.S. tax code, the groups profiled in the report have no obligation to disclose their donors publicly. As a result, each group maintains different levels of transparency regarding its financial connections to the pharmaceutical industry and has no obligation to publicly disclose their funding sources. These organizations have the ability to selectively disclose donors, donations, and other support—or no information at all. No organization profiled in McCaskill’s report provides an online list linking donors, their specific donations, and the projects or events benefiting from each donation for each of the years between 2012 and 2017—an area in which McCaskill says a legislative solution is necessary.
“The financial relationships between these groups and opioid manufacturers should be clear to the general public,” McCaskill said. “We passed a law ensuring the public had information on payments to doctors by pharmaceutical companies, and I can’t imagine why the same shouldn’t be done in this space.”
Earlier this year, McCaskill launched an investigation into opioid manufacturers—the most comprehensive Congressional investigation into the crisis to date—when she requested information related to sales and marketing materials, internal addiction studies, details on compliance with government settlements and donations to third party advocacy groups from major opioid manufacturers. She expanded her investigation, requesting documents and information from opioid manufacturers Mallinckrodt, Endo, Teva, and Allergan, while a request to McKesson Corporation, AmerisourceBergen Corporation, and Cardinal Health, Inc., focused on their distribution of opioid products. In September, McCaskill announced the first round of findings, detailing systemic manipulation of the prior authorization process by Insys Therapeutics. McCaskill is currently working on legislation to strengthen the Drug Enforcement Administration’s opioid enforcement abilities. After media reports indicated that the Ensuring Patient Access and Effective Drug Enforcement Act of 2016 had dramatically restricted the agency’s ability to crack down on opioid distributors suspected of wrongdoing, McCaskill introduced a bill to repeal the law, and she led a Senate roundtable on her bill.

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Opioid makers gave $10M to advocacy groups amid epidemic

Feb 12, 2018 | Associated Press

By Matthew Perrone & Geoff Mulvihill

Companies selling some of the most lucrative prescription painkillers funneled millions of dollars to advocacy groups that in turn promoted the medications’ use, according to a report released Monday by a U.S. senator.
The investigation by Missouri’s Sen. Claire McCaskill sheds light on the opioid industry’s ability to shape public opinion and raises questions about its role in an overdose epidemic that has claimed hundreds of thousands of American lives. Representatives of some of the drugmakers named in the report said they did not set conditions on how the money was to be spent or force the groups to advocate for their painkillers.

The report from McCaskill, ranking Democrat on the Senate’s homeland security committee, examines advocacy funding by the makers of the top five opioid painkillers by worldwide sales in 2015. Financial information the companies provided to Senate staff shows they spent more than $10 million between 2012 and 2017 to support 14 advocacy groups and affiliated doctors.

The report did not include some of the largest and most politically active manufacturers of the drugs.

The findings follow a similar investigation launched in 2012 by a bipartisan pair of senators. That effort eventually was shelved and no findings were ever released.

While the new report provides only a snapshot of company activities, experts said it gives insight into how industry-funded groups fueled demand for drugs such as OxyContin and Vicodin, addictive medications that generated billions in sales despite research showing they are largely ineffective for chronic pain.

“It looks pretty damning when these groups were pushing the message about how wonderful opioids are and they were being heavily funded, in the millions of dollars, by the manufacturers of those drugs,” said Lewis Nelson, a Rutgers University doctor and opioid expert.

The findings could bolster hundreds of lawsuits that are aimed at holding opioid drugmakers responsible for helping fuel an epidemic blamed for the deaths of more than 340,000 Americans since 2000.

McCaskill’s staff asked drugmakers to turn over records of payments they made to groups and affiliated physicians, part of a broader investigation by the senator into the opioid crisis. The request was sent last year to five companies: Purdue Pharma; Insys Therapeutics; Janssen Pharmaceuticals, owned by Johnson & Johnson; Mylan; and Depomed.

Fourteen nonprofit groups, mostly representing pain patients and specialists, received nearly $9 million from the drugmakers, according to investigators. Doctors affiliated with those groups received another $1.6 million.

Most of the groups included in the probe took industry-friendly positions. That included issuing medical guidelines promoting opioids for chronic pain, lobbying to defeat or include exceptions to state limits on opioid prescribing, and criticizing landmark prescribing guidelines from the U.S. Centers for Disease Control and Prevention.

“Doctors and the public have no way of knowing the true source of this information and that’s why we have to take steps to provide transparency,” said McCaskill in an interview with The Associated Press. The senator plans to introduce legislation requiring increased disclosure about the financial relationships between drugmakers and certain advocacy groups.

A 2016 investigation by the AP and the Center for Public Integrity revealed how painkiller manufacturers used hundreds of lobbyists and millions in campaign contributions to fight state and federal measures aimed at stemming the tide of prescription opioids, often enlisting help from advocacy organizations.

Bob Twillman, executive director of the Academy of Integrative Pain Management, said most of the $1.3 million his group received from the five companies went to a state policy advocacy operation. But Twillman said the organization has called for non-opioid pain treatments while also asking state lawmakers for exceptions to restrictions on the length of opioid prescriptions for certain patients.

“We really don’t take direction from them about what we advocate for,” Twillman said of the industry.

The tactics highlighted in Monday’s report are at the heart of lawsuits filed by hundreds of state and local governments against the opioid industry.

The suits allege that drugmakers misled doctors and patients about the risks of opioids by enlisting “front groups” and “key opinion leaders” who oversold the drugs’ benefits and encouraged overprescribing. In the legal claims, the governments seek money and changes to how the industry operates, including an end to the use of outside groups to push their drugs.

U.S. deaths linked to opioids have quadrupled since 2000 to roughly 42,000 in 2016. Although initially driven by prescription drugs, most opioid deaths now involve illicit drugs, including heroin and fentanyl.

Purdue Pharma, the maker of OxyContin, contributed the most to the groups, funneling $4.7 million to organizations and physicians from 2012 through last year.

In a statement, the company did not address whether it was trying to influence the positions of the groups it supported, but said it does help organizations “that are interested in helping patients receive appropriate care.” On Friday, Purdue announced it would no longer market OxyContin to doctors.

Insys Therapeutics, a company recently targeted by federal prosecutors, provided more than $3.5 million to interest groups and physicians, according to McCaskill’s report. Last year, the company’s founder was indicted for allegedly offering bribes to doctors to write prescriptions for the company’s spray-based fentanyl medication.

A company spokesman declined to comment.

Insys contributed $2.5 million last year to a U.S. Pain Foundation program to pay for pain drugs for cancer patients.

“The question was: Do we make these people suffer, or do we work with this company that has a terrible name?” said U.S. Pain founder Paul Gileno, explaining why his organization sought the money.

Depomed, Janssen and Mylan contributed $1.4 million, $650,000 and $26,000 in payments, respectively. Janssen and Mylan told the AP they acted responsibly, while calls and emails to Depomed were not returned.

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Opioid makers paid millions to advocacy groups: U.S. Senate report

Feb 12, 2018 | Reuters

By Nate Raymond

Five opioid manufacturers including OxyContin maker Purdue Pharma LP have paid more than $10 million to advocacy groups and doctors tied to them, many of whom amplified industry messages supporting the use of the painkillers, a U.S. Senate report said on Monday.

The report, released by Democratic Senator Claire McCaskill, said groups who received the donations aligned themselves with industry goals and may have played a role in an epidemic that in 2016 led to 42,000 opioid overdose deaths.

The report released by McCaskill, the U.S. Senate Homeland Security and Governmental Affairs Committee’s ranking Democrat, said the groups issued guidance promoting opioids for chronic pain and lobbied against laws to curb their use.

“These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history,” McCaskill, of Missouri, said in a statement.

Purdue Pharma, which on Saturday announced it would stop promoting opioids to doctors, was the biggest donor, giving $4.15 million to 12 groups from 2012 to 2017, the report said.

The groups include patient advocacy organizations and medical professional societies.

One recipient was the Academy of Integrative Pain Management (AIPM), which partnered with another group to lobby state legislatures on opioid-related issues and fight efforts to restrict opioid prescribing, the report said.

Purdue said in a statement that it supported organizations interested in helping patients receive appropriate care. AIPM Executive Director Bob Twillman said that financial contributions had not influenced its positions.

The report said Insys Therapeutics Inc, which markets the fentanyl-based cancer pain drug Subsys, gave $3.15 million to U.S. Pain Foundation and others, ranking No. 2 in donations to the 14 groups examined.

Federal prosecutors have accused several former Insys executives and employees, including billionaire Insys founder John Kapoor, of engaging in a scheme to pay kickbacks to doctors to prescribe Subsys. Kapoor has pleaded not guilty.

U.S. Pain Foundation said the $2.5 million Insys donated in 2017 was for a fund to help cancer patients pay for pain drugs, and that the money did not influence its values. Insys said it strives to follow regulations.

The report said the groups also received $1.07 million from Depomed Inc, $465,142 from Johnson & Johnson and $20,250 from Mylan NV.

Doctors affiliated with the organizations received $1.6 million, the report said.

Depomed declined to comment. J&J said it co-operated with McCaskill. Mylan emphasized its small opioid marketshare.

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Drugmakers Funded Groups Promoting Opioid Use, Senator’s Report Finds

Feb 12, 2018 | Wall Street Journal

By Jeanne Whalen

Five manufacturers of opioid painkillers gave nearly $9 million between 2012 and 2017 to patient advocacy groups and other nonprofits that have a history of promoting opioid use, according to a probe by the top-ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee.
Those same firms gave more than $1.6 million to doctors and other individuals affiliated with the groups between 2013 and the present, according to a probe conducted by Sen. Claire McCaskill’s office. The investigators received the payment information from the companies and groups after requesting it last year.

“The fact that these same manufacturers provided millions of dollars to the groups…suggests, at the very least, a direct link between corporate donations and the advancement of opioids-friendly messaging,” said the report, published by Sen. McCaskill’s office, which is investigating various aspects of the opioid-addiction crisis.

The nonprofit groups, which include patient-advocacy organizations and professional societies for doctors who treat pain, said they aim to improve pain treatment, and denied corporate influence on their work.

Sen. McCaskill of Missouri said she planned to draft legislation requiring greater disclosure of drug-company funding of such groups. “The public has a right to know. Doctors have a right to know what is behind these organizations, who is paying the bills,” she said in an interview.

More than 80% of the $8.9 million in drug-company payments to the groups came from two firms—Purdue Pharma LP, which sells the painkiller OxyContin, and Insys Therapeutics Inc., seller of the painkiller Subsys, according to the report. Most of the rest came from Depomed Inc., which sold the opioid Nucynta until late last year, and Johnson & Johnson , which sells the opioid Duragesic. Mylan NV, which sells generic opioid painkillers, contributed the least—$20,250—over the six-year period.

Purdue said it supports organizations that are interested in helping patients get appropriate care. Insys said its charitable contributions are patient focused, but that it is scaling them back to focus investment on research and development. Johnson & Johnson said it couldn’t comment because it hadn’t seen a copy of the report. Depomed said it has a strong compliance program in place overseeing its marketing, advertising and corporate sponsorship activities. Mylan said it made very limited payments to the American Pain Society as part of its participation in the organization’s annual conferences.

According to the report, many of the nonprofit groups criticized the Centers for Disease Control and Prevention’s efforts to draft guidelines aimed at limiting opioid prescribing for chronic pain. In one example, the report cited a 2016 comment by the president of the American Academy of Pain Medicine, Daniel Carr, saying the CDC prescribing guidelines made “disproportionately strong recommendations based upon a narrowly selected portion of the available clinical evidence.”

The American Academy of Pain Medicine said it is “committed, as a professional medical society, to act with integrity and transparency.” Dr. Carr didn’t respond to a request for comment.

As the CDC was developing the guidelines in 2015, several of the pain groups cited in the report argued the CDC “failed to disclose the names, affiliations and conflicts of interest of the individuals who participated in the construction of these guidelines,” according to the report.

The Washington Legal Foundation, a nonprofit group that received $500,000 from Purdue over the six-year period covered by the probe, said the CDC had developed the guidelines in an “overly secretive manner,” and called “into question the viability of the entire enterprise,” the report said, quoting from a November 2015 letter the group wrote to the CDC. The foundation, which describes itself as advocating for a “limited and accountable government,” didn’t immediately respond to a request for comment.

The CDC didn’t immediately respond to a request for comment on the assertions by the nonprofits.

In 2014, two of the groups—the Academy of Integrative Pain Management and the American Cancer Society Cancer Action Network—lobbied to protect a Tennessee law “that made it difficult to discipline doctors for overprescribing opioids and prohibited them from refusing to prescribe opioids unless they referred the patient to another ‘opioid-friendly’ doctor,” the investigators said.

The Academy of Integrative Pain Management confirmed that it opposed efforts to repeal the law, but said the senator’s report overstated some of the law’s effects. It also denied allowing funders to determine policy. The ACS’s Cancer Action Network said its “only constituents are cancer patients, survivors, and their loved ones nationwide.”

The U.S. Pain Foundation received the largest amount of drug-company payments over the period—$2.9 million—about 85% of which came from Insys, according to the report. The foundation said it promotes a “balanced, multidisciplinary approach to pain care.” It said most of the drug-company money it received went “toward a large copay assistance program for cancer patients dealing with pain.”

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How drug company money turned patient groups into

Feb 12, 2018 | USA TODAY

By Deirdre Shesgreen, Jayne O'Donnell and Terry

The five biggest opioid manufacturers shelled out more than $10 million to patient advocacy groups, professional medical societies and affiliated individuals — who then “echoed and amplified” messages that encouraged use of those highly addictive drugs and set the stage for the current opioid epidemic.
That’s according to a new Senate committee investigation, released on Monday, which examined the financial ties between the pharmaceutical industry and outside groups over the last five years, from 2012 through 2017.

"I think these groups were cheerleaders too often ... cheerleaders for opioids," said Sen. Claire McCaskill, a Missouri Democrat who launched the probe last spring. McCaskill is the ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee, a post she has used to investigate other drug-company practices.

McCaskill's staff sought information from the five largest opioid drug-makers, measured by global sales in 2015. Those companies are: Purdue Pharma, Janssen Pharmaceuticals, Mylan, Depomed and Insys Therapeutics.

Purdue was by far the largest donor to outside advocacy groups, which often bill themselves as grass-roots organizations supporting patients struggling with chronic pain. Among the recipients of drug company largesse: The U.S. Pain Foundation, the National Pain Foundation, and the Academy of Integrative Pain Management.

McCaskill said some of these organizations are doing good work on public policy. But others are "totally dependent" on drug companies for their funding, McCaskill said, and their advocacy is suspect.

"Our report indicates that in some instances they are merely fronting for these manufacturers, especially if you look at the lobbying they’ve done against restricting prescribing levels of opioids," she said.

The report charges that many of the advocacy groups, buoyed by drug company money, started undercutting state and federal efforts to curb opioid prescribing and using other "opioids-friendly messaging."

The report notes, for example, that the American Academy of Pain Medicine and the American Pain Society have promoted opioids as safe and effective for treating chronic pain and minimized the risk of addiction.

Purdue and other drugmakers "have a lot of explaining to do," for their contention that use of oxycodone "for patients in pain wouldn't lead to addiction," says Army Col. Chester Buckenmaier, an anesthesiologist and professor at the Uniformed Services University in Bethesda, Md. "We now know that’s not true and use these medications with more respect and more caution."

The report also notes that the American Academy of Pain Medicine and the Center for Practical Bioethics spoke out against the federal efforts to limit opioid prescribing. That effort was led by Centers for Disease Control and Prevention, which issued guidance in 2016 to doctors on when to prescribe opioid pain medication in primary care settings. The CDC recommended offering non-opioid therapies for chronic pain except in cases of active cancer treatment, palliative care and end-of-life care.

Some of the groups and their funders say there's a public health crisis being created by the response to the opioid epidemic. Chronic pain patients say they now have difficulty getting narcotics, which is often the only thing that can address their unremitting pain.

"There are serious moral questions on both sides," says John Carney, executive director of the Center for Practical Bioethics in Kansas City, Mo. The opioid epidemic is "a national crisis, but there are lives ravaged by pain and that's a crisis too and should not be ignored."

As states moved to restrict the length and frequency of opioid prescriptions, drug companies and the patient groups fought back with aggressive lobbying campaigns.

Purdue Pharma, the maker of Oxycontin, said in a statement that it supported groups through annual dues and "unrestricted grants" when they were "interested in helping patients receive appropriate care."

Purdue also said it supports the CDC's guidance as "an important public health tool" and that it has been recommending it to doctors since it was released. And starting Monday, Purdue's employees would no longer visit doctors offices to pitch opioids and it would cut its salesforce by half to 200 people. The drugmaker's medical affairs staff will handle questions pertaining to the drugs, Purdue said.

McCaskill called Purdue's announcement "a major step forward," and said she believed the U.S. was starting to turn a corner on the opioid epidemic. But she said the Senate report was "the tip of the iceberg" in terms of how drug company money shapes heath care policy debates and legislative outcomes.

Seeking legislation
She said she planned to pursue legislation that would force advocacy groups to disclose their funding sources.

"I’m not saying these groups can’t take funding from manufacturers," she said. "I’m saying the pubic needs to know about it. It needs to be clear disclosed on their website."

The Senate report's findings are especially painful for Melissa Dye to hear as her son, Daris, died of an overdose of fentanyl and heroin about two years ago after he could no longer get Oxycontin prescribed.

For the advocacy groups, Dye says, "I would have one question: How would you feel if your child died of an overdose after being prescribed narcotics?" asks Dye. "It’s great that they don’t have the DNA that leaves them addicted, but why would they want the rest of us to risk it?

Dye says Daris was first prescribed Oxycontin as a 14 year old after a sledding accident and again when he was 21 after he tore his rotator cuff in the Marines.

"I believe with all my heart that cautious prescribing would have saved my son," she says.

Dye, a nurse, says she's angry she was "lied to and in turn, I lied to hundreds of patients" when she said, ‘No, you cannot become addicted if you have true pain."

“In my opinion, my son should have never been prescribed OxyContin after hand surgery at the age of 14 or at 21 after a torn rotator cuff injury," says Dye,

Buckenmaier, program director of the Defense and Veterans Center for Integrative Pain Management, says opioid alternatives including non-steroidal anti-inflammatory drugs, acupuncture and massage have "really good documented science behind them with very minimal side effects," says Buckenmeier.

Dye said she’s been a nurse in acute, long-term and critical-care settings, “And I find most people do not need narcotics," especially after they're educated on the risks and the alternatives.

Opioids prescribed too easily
During a recent hospitalization for pnemonia, Buckenmaier said the first thing he was offered was the opioid morphine. He asked for the injectbile non-steroidal anti inflammatory Toradol instead.

Pain-related patient groups say they too support opioid alternatives and, especially, insurance coverage of them. Carney denies his group is trying to push opioids.

"We're not trying to push any message," he says. "Our job is to go to these people...and amplify their voices and give them credibility."

Pharmaceutical industry funding of his group in 2017 will probably be down to about 3% when it's fully calculated, he says.

Patient groups overall have been under fire for their drug industry funding and many have responded by reducing the percentage compared to other donors. But as Carney notes, "people are going to interpret what they interpret" when it comes to pharmaceutical influence.

The Senate report noted, for example, that the Academy of Integrative Pain Management and the American Cancer Society Cancer Action Network led an effort to protect a 2001 Tennessee law that made it difficult to discipline doctors for overprescribing opioids. Bob Twillman, the academy's executive director, said the law was more of "an imagined impediment than a real impediment" and his group wanted to revise it rather than repeal it.

Dye is doing her part to fight industry influence. She started the non-profit Project Daris, which stands for Drug Awareness Resources in Schools, and speaks at schools starting as early as kindergarten to get the message about about the risks of opioids.

“We know that using narcotics at a young age changes the brain chemistry, and looking back, I can clearly see that’s exactly what happen to Daris,” she said. “He should have been taught mostly non-pharmaceutical therapies along with ibuprofen and potentially suffered with a little bit of pain.”

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McCaskill report: Opioid manufacturers gave millions to advocacy groups

Feb 13, 2018 | The Hill

By Rachel Roubein

A new report from Sen. Claire McCaskill (D-Mo.) found that five opioid manufacturers paid nearly $9 million to 14 outside groups between 2012 to 2017, alleging that the advocacy groups often “amplified messages favorable to increased opioid use.”
The groups — many of which work on chronic pain and other opioid-related issues — lobbied to defeat prescriber limits on opioids and many criticized facets of 2016 guidelines that limited the prescribing of painkillers from the Centers for Disease Control and Prevention (CDC), according to the report.
Additionally, the report noted a “lack of transparency” around the donors who give to the advocacy groups. While the groups aren’t required to disclose their donors publicly, McCaskill said that should be changed.
“The financial relationships between these groups and opioid manufacturers should be clear to the general public,” McCaskill said. “We passed a law ensuring the public had information on payments to doctors by pharmaceutical companies, and I can’t imagine why the same shouldn’t be done in this space.”
This is the second report on opioids from McCaskill, the ranking member of the Homeland Security and Governmental Affairs Committee. The reports come at a time when deaths from opioid overdoses continue to rise.
Purdue Pharma said in a statement: “We have supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care and share our commitment toward addressing the opioid crisis.”
The company views the 2016 CDC guidelines as “an important public health tool.”
Depomed said its contributions averaged $20,000 per year to nine groups and that it believes it acted responsibly when it marketed its drugs. It said the money covered items such as corporate advertising and conference booth fees.
Mylan pushed back on its inclusion in the report, saying it had a “minuscule role in the manufacturing and marketing of opioids” and made limited payments, amounting to $20,250 over three years, to one group.
Several organizations said the money didn’t influence their groups, according to news reports.
Bob Twillman, the executive director of the Academy of Integrative Pain Management, told The Associated Press that “we really don’t take direction from them about what we advocate for.” His group received nearly $1.3 million from four opioid manufacturers.
The U.S. Pain Foundation said $2.5 million it received from one company went toward a fund to help cancer patients pay for pain drugs, and also noted that the money did not alter the group's values in any way, according to Reuters.

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Drugmakers Spent Millions Promoting Opioids To Patient Groups, Senate Report Says

Feb 13, 2018 | NPR

By Scott Neuman

Drug-makers gave millions of dollars to pain-treatment advocacy groups over a five-year period beginning in 2012, in effect promoting opioids to individuals most vulnerable to addiction, a new report released Monday by a U.S. Senator says.
The 23-page report, put out by Missouri Democratic Sen. Claire McCaskill, sheds light on the pharmaceutical industry's efforts to shape public opinion and to fuel demand for such lucrative and potentially addictive drugs as OxyContin, Fentanyl and Vicodin that have played a key role in the addiction crisis that has swept the U.S. in recent years, claiming hundreds of thousands of lives.
Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups describes how the arrangement between pharmaceutical makers and advocacy groups "may have played a significant role in creating the necessary conditions for the U.S. opioid epidemic."
"The pharmaceutical industry spent a generation downplaying the risks of opioid addiction and trying to expand their customer base for these incredibly dangerous medications and this report makes clear they made investments in third-party organizations that could further those goals," McCaskill said. "These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history."
The report follows a similar investigation in 2012 carried out by Sen. Max Baucus, D-Mont., and Chuck Grassley, R-Iowa, that looked into financial ties between drug makers and medical providers who helped establish guidelines for prescribing opioids. That investigation was ultimately shelved.
"It looks pretty damning when these groups were pushing the message about how wonderful opioids are and they were being heavily funded, in the millions of dollars, by the manufacturers of those drugs," Lewis Nelson, a Rutgers University doctor and opioid expert says, according to The Center for Public Integrity.
The report says that nearly all health advocacy groups accept funding from drug manufacturers, adding that "These financial relationships—and the lack of transparency surrounding them—have raised concerns regarding the information and initiatives patient advocacy organizations promote."
The report cites the Journal of the American Medical Association as saying that 8 percent of such patient groups responding to one study "reported [that] pressure to conform their organizations' positions to the interests of industry funders is of concern."
A single company, Purdue Pharma, the maker of OxyContin, funneled $4.7 million to advocacy groups over the five-year period, according to the report.
Also mentioned are Depomed, which markets the narcotic Nucynta, the brand name of the opioid pain reliever tapentadol and three makers of fentanyl, a powerful and potentially addictive pain reliever: Janssen Pharmaceuticals, Mylan and Insys Therapeutics, whose CEO was charged in October for using bribes and kickbacks to promote unacceptable uses of the company's flagship fentanyl spray, Subsys.
The companies gave more than $10 million between 2012 and 2017 to 14 advocacy groups and affiliated doctors, the report says.
In that period, Insys gave $2.5 million to the U.S. Pain Foundation for one of the group's patient assistance programs, the report says.
The U.S. Pain Foundation said "any funding we receive has never nor will it ever influence what we will do to help people with chronic pain," according to a statement published in The St. Louis Post Dispatch.
The Associated Press writes: "The findings [in the report] could bolster hundreds of lawsuits that are aimed at holding opioid drugmakers responsible for helping fuel an epidemic blamed for the deaths of more than 340,000 Americans since 2000."

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Senate report says patient advocacy groups get kickbacks from opioid manufacturers

Feb 12, 2018 | CNN

By Nadia Kounang and Debra Goldschmidt

A new report alleges that five of the United States' largest opioid manufacturers paid patient advocacy groups nearly $9 million between 2012 and 2017 to help push an agenda that promoted opioid use.
The report is the second to be published as part of a wide-ranging investigation by the Senate Homeland Security and Governmental Affairs Committee into the marketing and sales practices of opioid manufacturers. Sen. Claire McCaskill, D-Missouri, has been spearheading the effort, which started in March. A report released in September found that manufacturers falsified medical records, misled insurance companies and provided kickbacks to doctors.

McCaskill's office investigated the marketing and sales practices of the pharmaceutical companies Purdue Pharma LP, Janssen, Mylan, Depomed and Insys based on their roles in manufacturing some of the opioid painkillers with the highest sales in 2015.

According to the new report, 14 patient advocacy groups, including the Academy of Integrative Pain Management and the US Pain Foundation, received $8,856,339 in payments from the pharmaceutical companies over five years. The US Pain Foundation received the largest share of payments, totaling nearly $3 million.

The report found that the Academy of Integrative Pain Management and the American Academy of Pain Medicine each collected about $1.2 million in that same period.

The most generous payer was Purdue Pharma LP, which provided nearly half the manufacturers' almost $9 million in payments. In the five years tracked, the report found, its payments to outside advocacy groups totaled just over $4.1 million.
On Sunday, Purdue, which has been criticized for its aggressive marketing of the painkiller OxyContin, said it will no longer send sales representatives to doctors' offices to promote the drug.

In response to Monday's report, Purdue noted in a statement its "significant sales force reduction of more than 50%" and said those remaining on the job will be promoting "non-opioid products."

Purdue acknowledged the donations, but Executive Director for Communications Robert Josephson said in a statement, "We have supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care.

Christine Dusek, head of global communications at Mylan, said in a statement, "Over the past few years, Mylan made very limited payments to the American Pain Society solely as part of its participation in the organization's annual conferences. We did not sponsor or fund any speakers or presentations at these conferences."

Depomed said in an email that it made contributions to nine of 14 foundations identified in the Senate committee report, totaling $1.07 million over six years.

"These contributions covered corporate advertising, conference booth fees, sponsoring training certifications and membership fees," said Christopher Keenan, vice president for investor relations and corporate communications. He added that Depomed believes it acted responsibly.

Insys also confirmed that it made such payments but characterized them in a statement as "patient focused."

"With regard to the US Pain Foundation specifically, our donation was directed to a disease-state fund for cancer patients with breakthrough pain, which many medical experts and health care providers believe is significantly undertreated in the US." The statement specified that such "charitable contributions" are allowed because they benefit patients.

The company also noted a 77% decrease in contributions to these groups during the second half of 2017 as part of a shift to focus more on research and development.

The manufacturers who offered responses to the report said they had not seen it in its entirety.

Payments to physicians
On top of payments directly to the advocacy groups, the investigation found that $1.6 million was paid to physicians affiliated with these groups since 2013.

In a statement, McCaskill said, "The pharmaceutical industry spent a generation downplaying the risks of opioid addiction and trying to expand their customer base for these incredibly dangerous medications and this report makes clear they made investments in third-party organizations that could further those goals."

The investigation noted that the patient organizations were heavily critical of the US Centers for Disease Control and Prevention's opioid-prescribing guidelines to look at alternatives, published in 2016.

For example, Monday's report noted that the past president of the American Academy of Pain Medicine, Dr. Daniel Carr, said, "The CDC guidelines makes disproportionately strong recommendations based upon a narrowly selected portion of the available clinical science." Other groups were cited for trying to undermine the CDC's process by calling the guidelines "biased" and a result of "conflicts of interest."

Josephson said Purdue agrees with the CDC guidelines for prescribing opioids and has been recommending that they be followed since they were issued.

Lobbying efforts

The report also found that advocacy groups have been involved in lobbying efforts to defeat legislative measures to limit prescribing. The investigation offered a 2014 example in which the Academy of Integrative Pain Management teamed up with the American Cancer Society Cancer Action Network to protect a 2001 law in Tennessee that made it difficult to discipline doctors who may have been overprescribing opioids.

Academy of Integrative Pain Management Executive Director Bob Twillman said "there is no proof that the [Tennessee] law in question ever prevented anyone from being either prosecuted or having disciplinary action taken by a licensing board." He added that the law was "poorly written" and said "it was much more of an imagined impediment than a real impediment. The problem was that those wanting to repeal the law misrepresented what it actually said when debating the bills in the legislature."

Twillman criticized Monday's report -- which he said he had seen only parts of -- as being limited. "It appears that they've simply looked at how much money we got from a set of pharma companies, constructed a narrative about what that means and published it." Twillman said that's only half the story, adding that his group and others like it are part of the solution to the opioid crisis.

"The fact that these groups registered their opposition while receiving funding from the opioids industry raises the appearance -- at the very least -- of a direct link between corporate donations and the advancement of opioids-friendly messaging," the new report states.

Dusek said Mylan's priority is patient safety and noted that opioid-containing medications are a small fraction of the medications it manufactures, amounting to approximately 1% of opioids sold in the United States in 2016. She noted that the company has not seen the report but believes "the inquiry should be inclusive of all opioid manufacturers, rather than a select few, and certainly those with more than 1% of the volume."

Janssen, a Johnson & Johnson company, said, "While we cooperated with the senator and provided her staff with the requested information, we have not yet received a copy of the final report and can't comment on it's content."

According to the investigation committee, the donors to these advocacy groups did not have to be disclosed by law because of the groups' nonprofit status.

"The financial relationships between these groups and opioid manufacturers should be clear to the general public," McCaskill said. "We passed a law ensuring the public had information on payments to doctors by pharmaceutical companies, and I can't imagine why the same shouldn't be done in this space."

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Opioid Manufacturers Paid Millions To Groups That Lobbied For More Opioid Usage, Senate Investigation Claims

Feb 12, 2018 | Newsweek

By Melissa Delkic

Major opioid manufacturers paid millions of dollars to groups that lobbied for increased opioid usage in the last five years, a Senate investigation claimed on Monday.
The investigation explored the financial ties between major opioid manufacturers and advocacy groups working in opioid policy. It found that many of the advocacy groups may have "played a significant role" in the U.S. opioid epidemic. Between 2012 and 2017, five companies that produce top opioid products—Purdue, Janssen Pharmaceuticals, Mylan, Insys Therapeutics and Depomed—together paid $8.8 million to 14 organizations that, according to the report, promoted opioid prescription, attempted to downplay the risk of addiction to opioids and lobbied against restrictions on overprescription.

“Many of these opioid manufacturers engaged in a long, systemic campaign to increase prescriptions and profits at the expense of the American public,” Senator Claire McCaskill (D-Mo.), who spearheaded the investigation, told Newsweek. “It’s appalling that some companies deliberately misled patients and doctors, helping to fuel the epidemic we have today.”

Some of the companies dispute the report.

Purdue, the maker of OxyContin and the largest contributor of the five to those organizations, paid $4.1 million over the five years. In a statement to Newsweek, a spokesperson said the company "supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care." He pointed to a recent company decision to stop promoting opioids to prescribers and a more than 50 percent reduction in sales staff.

Janssen paid $465,152 and, in an email, referred to an announcement that it, too, had recently made the decision to stop promoting opioids (in 2015). "Since 2008, the volume of Janssen opioid medications always has amounted to less than one percent of the total prescriptions written per year for these medications," a spokesperson wrote.

Mylan, in its response, said the inquiry showed "Mylan’s limited role in the manufacturing and marketing of opioids." A spokeswoman noted that Mylan made limited payments ($20,250, according to the report) to the American Pain Society, solely for its annual conferences.

The president of the U.S. Pain Foundation (which received over $2.9 million from the opioid manufacturers), Paul Gileno, wrote in an email to Newsweek, "We have never lobbied for the increased use of opioids and never would. It's appalling to me that this would be suggested." He continued: "We certainly have not contributed to the opioid epidemic. We work hard to educate and empower patients on all options of treatments."

A spokesman for another advocacy organization, the Academy of Integrative Pain Management, emphasized that it took a "balanced approach that is not inappropriately 'opiophilic.'"

In an email to Newsweek, Bob Twillman, the executive director of the Academy of Integrative Pain Management, wrote, "Sen. McCaskill and the others haven’t spent the necessary time talking to us to understand how we do things and what we have to offer. It appears that they’ve simply looked at how much money we got from a set of pharma companies, constructed a narrative about what that means, and published it."

The report comes at a time when the opioid crisis has left Americans reeling. Opioids were involved in 42,249 deaths in 2016, according to the Center for Disease Control. And opioid overdose deaths in 2016 were five times higher than in 1999. President Donald Trump in October declared the crisis a public health emergency and on Monday released a budget proposal allotting $13 billion to the crisis.

For the Senate investigation, McCaskill requested information from the companies on their payments to 14 advocacy groups—including the American Academy of Pain Medicine, the U.S. Pain Foundation, the American Pain Society and the American Academy of Pain Medicine, the four that received the most contributions—as well as the sales and marketing strategies the organizations used to promote opioid use.

Because of the organizations' classification under the tax code, they don't have a legal obligation to disclose their donors. McCaskill, in letters to the companies, asked them to willingly disclose the information.

The report, titled "Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups" was part of a U.S. Senate Homeland Security and Governmental Affairs Committee investigation. It's the second in a series of reports into the opioid epidemic.

Depomed did not immediately respond to requests for comment.

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Opioid makers gave millions to patient advocacy groups to sway prescribing

Feb 12, 2018 | STAT News

By Ed Silverman

As the nation grapples with a worsening opioid crisis, a new report suggests that drug makers provided substantial funding to patient advocacy groups and physicians in recent years in order to influence the controversial debate over appropriate usage and prescribing.

Specifically, five drug companies funneled nearly $9 million to 14 groups working on chronic pain and issues related to opioid use between 2012 and 2017. At the same time, physicians affiliated with these groups accepted more than $1.6 million from the same companies. In total, the drug makers made more than $10 million in payments since January 2012.

“The fact that these same manufacturers provided millions of dollars to the groups suggests, at the very least, a direct link between corporate donations and the advancement of opioid-friendly messaging,” according to the report released on Monday night by U.S. Sen. Claire McCaskill, who has been probing opioid makers and wholesalers.

“By aligning medical culture with industry goals in this way, many of the groups described in this report may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic.” The companies cited in the report are Purdue Pharma, Mylan, Insys Therapeutics, Depomed, and Janssen, a unit of Johnson & Johnson.

The report noted that, at various times, the groups issued guidelines and policies “minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for over-prescription and misbranding.”

Yet the groups often did not disclose ties to opioid makers while, in some cases, actively lobbying in many states to oppose restrictions on opioid prescribing or use. In one instance, two groups worked to protect a Tennessee law that made it hard to discipline doctors for overprescribing opioids and prohibited them from refusing to prescribe unless patients were referred to an “opioid-friendly” doctor.

In addition, most of the groups also objected to voluntary guidelines issued two years ago by the Centers for Disease Control and Prevention that recommended doctors prescribe opioids only after other therapies have failed and rely on the lowest possible doses. The agency relied on evidence and expert opinions indicating opioids are not appropriate for chronic pain, but can quickly cause addiction.

The report arrives as opioid makers face a growing number of lawsuits filed by state, county, and city governments accusing the companies of downplaying addiction risks and improperly encouraging prescribing. The governments want compensation for the cost of the medicines and addiction treatment, and emergency and law enforcement costs attributed to rising crime caused by the crisis.

More than 42,000 Americans died from opioid overdoses in 2016, with deaths from natural and semi-synthetic opioid painkillers such as hydrocodone and oxycodone rising 14 percent compared to 2015, according to the CDC. Fatal overdoses from fentanyl and other synthetic opioids more than doubled in the U.S. between 2015 and 2016, according to the National Center for Health Statistics.

“The pharmaceutical industry spent a generation downplaying the risks of opioid addiction and trying to expand their customer base for these incredibly dangerous medications and this report makes clear they made investments in third-party organizations that could further those goals,” McCaskill said in statement. “These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history.”

Opioid makers have long been accused of using surreptitious means — notably, patient advocacy groups — to influence the medical community and the public about the safety and effectiveness of their prescription painkillers. But the McCaskill report provides the first detailed breakdown of company payments made to these groups, although not all opioid purveyors were included in the report.

“This isn’t history. The campaign is still happening today, despite overwhelming evidence opioids are not safe or effective for the vast majority of people with chronic pain,” said Andrew Kolodny, who heads the Opioid Policy Research Collaborative at Brandeis University. “They’re still taking money from opioid makers and blocking methods to prevent inappropriate prescribing.”

One of the groups that received $500,000 in funding was the Washington Legal Foundation, a nonprofit that has often sided with the pharmaceutical industry in marketing matters and, in 2015, wrote the CDC to argue that the agency violated the law by the way it went about convening an expert panel to draft the guidelines. We asked the WLF for comment and will pass along any reply.

In this case, the payments were used for advertising and sponsorship related to group events; special projects and restricted grants; and non-education grants for providing support for healthcare-related organizations or initiatives focused on patient and public education, scientific research, and other programs, according to the report. The report culled financial data supplied and filed by the groups.

Purdue accounted for about half of the payments. A spokesman wrote us that Purdue has “supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care. We agree the CDC’s guideline is an important public health tool and have been directing prescribers to the guideline and its recommendations” since March 2016.

Meanwhile, Purdue late last week disclosed plans to end opioid marketing. The drug maker is reducing its sales staff by more than half, and remaining salespeople will no longer visit physician offices to push their products. Instead, Purdue plans to direct prescribers to CDC materials. The announcement, which was widely publicized, appears to have been timed to blunt the effects of the McCaskill report.

A Mylan spokeswoman argued the company had a “limited role in the manufacturing and marketing of opioids. The inquiry should be inclusive of all opioid manufacturers, rather than a select few, and certainly those with more than 1 percent of the volume. Over the past few years, Mylan made very limited payments to the American Pain Society solely as part of its participation in the organization’s annual conferences. We did not sponsor or fund any speakers or presentations at these conferences.”

A spokesman for Depomed, which until recently marketed two painkillers, acknowledged providing about $1 million to nine of the 14 groups over a six-year period, but maintained that the company “acted responsibly” in marketing and advertising the medicines. A J&J spokeswoman said the company had not yet seen the report and so could not comment. Insys did not reply to a request for comment.

Among the groups that received some of the largest funding were the U.S. Pain Foundation and the American Academy of Pain Medicine, which received $2.9 million and $1.2 million, respectively. We asked the U.S. Pain Foundation for comment and will update you accordingly. The American Academy of Pain Medicine issued a statement that addressed funding, but not the specific findings in the report.

“The Academy relies on a number of sources of revenue, including membership dues, registration fees, unrestricted educational grants, sponsorships, and the sale of trade show exhibit space and advertising…. While the Academy has a policy that helps to ensure appropriate standards of accuracy are maintained in these transactional messages, it does not impose strict editorial control over them.”

Another group that received substantial industry support was the Academy of Integrative Pain Management, which received $1.2 million, although its executive director, Bob Twillman, contended that “we determine our policy advocacy positions on the basis of an annual survey of our members and other stakeholders —other professional groups and patient advocacy groups, not our funders.”

“When we have advocated on opioid issues, we’ve advocated against policies that would tie the hands of our members to such a degree that they would be unable to provide optimal care to their patients, some of whom, like it or not, need opioids for pain relief.

“We have supported some legislation that limits the amount of medication that can be prescribed for acute pain; we’ve supported legislation that requires prescribers to check the (Prescription Drug Monitoring Program) before prescribing opioids; we’ve supported legislation that requires continuing education on pain management and substance use disorders; and we’ve worked with regulators to craft treatment guidelines that direct prescribers toward safe opioid prescribing,” Twillman argued.

He also disputed the characterization of the lobbying effort to protect the 2001 Tennessee law. “What it says here is not entirely accurate,” he said. “There is no proof that the law in question ever prevented anyone from being either prosecuted or having disciplinary action taken by a licensing board. While the law was poorly written, it was much more of an imagined impediment than a real impediment.”

Such ties are hardly new. The reported cited studies last year in The New England Journal of Medicine and the Journal of the American Medical Association that found a majority of patient advocacy groups received industry funding. And the Senate report underscores that industry provides financing to ensure its message is conveyed, according to one expert.

“The solution to the opioid epidemic is prescribing fewer opioids, and that is not a message opioid manufacturers want to promote,” said Dr. Adriane Fugh-Berman, an associate professor of pharmacology at Georgetown University who runs Pharmed Out, a project that examines the influence drug makers have on the practice of medicine.

“The primary message they do want to promote is that opioids should remain available for long-term use and they support organizations that convey that message. You see from the report how much they spend — and how much they admit they spend. It’s worth it to protect their market.”

One final note: In 2012, the Senate Finance Committee launched an investigation into financial ties between drug makers, medical organizations that set usage guidelines, and patient advocacy groups, but a report has not yet been released.

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McCaskill report says top opioid manufacturers gave millions to pain groups

Feb 12, 2018 | St. Louis Post-Dispatch (MO)

By Chuck Raasch

Sen. Claire McCaskill released a report Monday alleging that from 2012 to 2017, leading manufacturers of opioids gave $9 million to pain treatment advocacy groups, an arrangement the report says “may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic.”
The leading opioids manufacturer named in the report, Purdue Pharma, just announced it would stop promoting opioids to doctors. The founder of the top association taking drugmakers’ money — the U.S. Pain Foundation — said that “any funding we receive has never nor will it ever influence what we will do to help people with chronic pain.”

Congress and the Trump administration have started attacking the opioid epidemic by promising more money — including an additional $6 billion last week — for prevention and treatment.

McCaskill, D-Mo., began an investigation last year into drugmakers’ policies in advocating for the use of opioids and the industry’s relationships with third-party groups, many of them nonprofits, that dot the medical industry landscape.

McCaskill released her first report in September, alleging that some drugmakers lacked policies to prevent overuse. The report released Monday concluded that the top opioid manufacturers helped fund advocacy organizations in the anti-pain sphere.

“Notably, a majority of these groups also strongly criticized 2016 guidelines from the Centers for Disease Control and Prevention that recommended limits on opioid prescriptions for chronic pain — the first national standards for prescription opioids and a key federal response to the ongoing epidemic.” McCaskill’s investigators concluded.

“The fact that these same manufacturers provided millions of dollars to the groups described below suggests, at the very least, a direct link between corporate donations and the advancement of opioids-friendly messaging.”

Opioid overdose killed more than 42,000 Americans in 2016, and McCaskill cited state statistics showing that in Missouri that year, about 60 percent of the 1,300 drug overdose deaths came from opioids. Total cost to the state in treatment and other expenses was $12.6 billion in 2016, McCaskill said.

Her report said that Purdue, Janssen, Mylan, Depomed and Insys provided almost $8.9 million to 14 outside groups working on chronic pain and other opioid-related issues between January 2012 and March 2017.”

Purdue was the largest, at just over $4 million granted to an array of third-party health and pain-related groups, the report concluded. The maker of OxyContin, which has been the target of numerous lawsuits, announced Saturday it would stop promoting opioids to doctors. The company also produced another opioid called Hysingla.

“We have supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care,” Purdue spokesman Robert Josephson told the Post-Dispatch. “We agree that the CDC’s guideline is an important public health tool and have been directing prescribers to the guideline and its recommendations since it issued in March 2016.”

The largest recipient of opioid manufacturers’ donations was the Connecticut-based U.S. Pain Foundation, which received just under $3 million from 2012-2017, McCaskill’s investigators found.

Paul Gileno, founder and president of the U.S. Pain Foundation, said that “our funding is used for positive programs,” and that “U.S. Pain has never issued guidelines” on what remedies people in pain should use.

McCaskill and Sen. Ron Johnson, R-Wis., last month got into an argument at a hearing when Johnson asserted that the expansion of Medicaid had a role in the opioid crisis. McCaskill said there was no evidence of that.

McCaskill’s report is entitled, “Fueling the Epidemic; Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups.”

The McCaskill report touches only one corner of the political influence industry as it relates to opioids. In 2016, the Associated Press and the Center for Public Integrity concluded that from 2006-2015, drug makers spent more than $880 million in state lobbying and campaign contributions, much of it fighting further restrictions on opioids, while groups attempting to curb opioid use put forward only about $4 million.

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Report: Patient advocacy groups pushed opioids after getting industry money

Feb 12, 2018 | McClatchy DC Bureau

By Lindsay Wise

Opioid manufacturers funneled millions of dollars to patient advocacy groups that in turn issued “opioid friendly” guidance and policy recommendations, a congressional report has found.
Five major pharmaceutical manufacturers paid nearly $10 million to 14 patient advocacy groups and medical professional societies — as well as affiliated doctors — who were working on opioid-related issues between 2012 and 2017, according to the report released on Monday by Missouri Sen. Claire McCaskill, the Senate Homeland Security & Governmental Affairs Committee’s top Democrat.

After receiving the donations, these groups and and professional societies minimized the risk of addiction, promoted opioid use, lobbied against legislation that would curb abuse and fought attempts to hold physicians and industry executives responsible for over-prescribing opioids, the report maintains.

Most of the groups that received manufacturers’ money also opposed the first national standards for prescription pain killers issued by the Centers for Disease Control and Prevention in 2016, according to the report. The CDC’s guidelines recommended limits on opioid prescriptions for chronic pain — “a key federal response to the ongoing epidemic,” the report notes.

It accuses the groups of playing “a significant role” in creating the conditions that led to America’s deadly opioids epidemic.

“These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history,” McCaskill said.

Some of the advocacy groups and professional societies mentioned in the report pushed back against the suggestion that receiving funds from manufacturers “amplified and reinforced messages favoring increased opioid use.”

Professional medical societies rely on numerous sources of revenue, including membership dues, registration fees, educational grants, sponsorships and the sale of exhibit space and advertising, said the American Academy of Pain Medicine in a statement.

“While the Academy has a policy that helps to ensure appropriate standards of accuracy are maintained in these transactional messages, it does not impose strict editorial control over them,” the statement said.

Regarding grants, the academy said accrediting standards “require that professional medical societies exclude industry from any influence, direct or indirect, over speakers and educational content.”

More than 42,000 Americans died from opioid overdoses last year alone. In Missouri, about 60 percent of drug overdose deaths in 2016 involved opioids, according to the Missouri Hospital Association.

McCaskill’s report is based on information voluntarily provided by the five opioid manufacturers and 14 advocacy groups to the committee at her request in 2017. Her committee staff warns in the report that the data might not capture the full extent of payments between manufacturers and advocacy groups and professional societies because the Internal Revenue Service does not require such groups to disclose their donors.

Purdue Pharma, one of the manufacturers, noted in a statement on Monday that it is no longer promoting opioids.

“We have supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care,” said Robert Josephson, a Purdue spokesman.

He added: “We agree that the CDC’s Guideline is an important public health tool and have been directing prescribers to the Guideline and its recommendations since it issued in March 2016.”

A Mylan spokeswoman, Lauren Kashtan, said in a statement that the company’s top priority is the health and safety of its patients and that Mylan shares McCaskill’s concerns about the opioid crisis.

“Over the past few years,” Kashtan said, “Mylan made very limited payments to the American Pain Society solely as part of its participation in the organization’s annual conferences. We did not sponsor or fund any speakers or presentations at these conferences.”

The American Pain Society, a nonprofit professional organization that supports pain research and treatment, said it needed more time to review the document and craft a response.

Kashtan pointed out that Mylan manufactures a broad range of medications, only a small fraction of which contain opioids.

“While we have not received the report from Senator McCaskill, we believe the inquiry further underscores Mylan’s limited role in the manufacturing and marketing of opioids,” she said. “The inquiry should be inclusive of all opioid manufacturers, rather than a select few, and certainly those with more than 1 percent of the volume.”

A spokeswoman for another manufacturer, Janssen Global Services, said while the company cooperated with the senator and provided her staff with information, “we have not yet received a copy of her the final report and can’t comment on its content.”

Pharmaceutical company Depomed said in an email it “believes it has a strong Compliance program in place that oversaw the marketing, advertising and corporate sponsorship activities tied to the Lazanda and NUCYNTA franchises.”

The report cites Dr. Richard Payne, a physician affiliated with the Kansas City-based Center for Practical Bioethics, for “criticizing the CDC guidelines as the product of ‘conflicts of interests in terms of biases (and) intellectual conflicts’—while himself maintaining ‘financial links to numerous drug companies.’”

The center allegedly received $145,095 from Purdue and $18,000 from Janssen, for a total of $163,095 from companies that manufactured opioids, according to the report.

“Over the course of the last five years support from the pharmaceutical and device manufacturers represents less than 5 percent of the center’s operational support,” said John G. Carney, president and CEO of the center in a statement. “The center prides itself on the breadth, scope and diversity of our benefactors, and we will work to continuously maintain that distinction.”

Carney said he hadn’t seen McCaskill’s full report and so he couldn’t comment on it. But he pointed out that lives destroyed by substance abuse and by pain carry the same moral weight.

“We need better care and more safeguards,” he said. “We need more evidence-based approaches to treatment. We need more compassionate and comprehensive care, including effective alternative therapies and options not currently covered by insurance.”

The center will continue advocating both for patients “who live with chronic pain as well as those who live with substance use disorders,” he said.

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Opioid Manufacturers Paid Millions to Groups That Lobbied for More Opioid Usage, Senate Investigation Claims

Feb 12, 2018 | Infosurhoy

By Denis Bedoya

Major opioid manufacturers paid millions of dollars to groups that lobbied for increased opioid usage in the last five years, a Senate investigation claimed on Monday.
The investigation explored the financial ties between major opioid manufacturers and advocacy groups working in opioid policy. It found that many of the advocacy groups may have “played a significant role” in the U.S. opioid epidemic. Between 2012 and 2017, five companies that produce top opioid products—Purdue, Janssen Pharmaceuticals, Mylan, Insys Therapeutics and Depomed—together paid $8.8 million to 14 organizations that, according to the report, promoted opioid prescription, attempted to downplay the risk of addiction to opioids and lobbied against restrictions on overprescription.
“Many of these opioid manufacturers engaged in a long, systemic campaign to increase prescriptions and profits at the expense of the American public,” Senator Claire McCaskill (D-Mo.), who spearheaded the investigation, told Newsweek. “It’s appalling that some companies deliberately misled patients and doctors, helping to fuel the epidemic we have today.”
Some of the companies dispute the report.
Purdue, the maker of OxyContin and the largest contributor of the five to those organizations, paid $4.1 million over the five years. In a statement to Newsweek, a spokesperson said the company “supported third-party organizations, including with annual dues and unrestricted grants, that are interested in helping patients receive appropriate care.” He pointed to a recent company decision to stop promoting opioids to prescribers and a more than 50 percent reduction in sales staff.
Janssen paid $465,152 and, in an email, referred to an announcement that it, too, had recently made the decision to stop promoting opioids (in 2015). “Since 2008, the volume of Janssen opioid medications always has amounted to less than one percent of the total prescriptions written per year for these medications,” a spokesperson wrote.
Mylan, in its response, said the inquiry showed “Mylan’s limited role in the manufacturing and marketing of opioids.” A spokeswoman noted that Mylan made limited payments ($20,250, according to the report) to the American Pain Society, solely for its annual conferences.
The president of the U.S. Pain Foundation (which received over $2.9 million from the opioid manufacturers), Paul Gileno, wrote in an email to Newsweek, “We have never lobbied for the increased use of opioids and never would. It’s appalling to me that this would be suggested.” He continued: “We certainly have not contributed to the opioid epidemic. We work hard to educate and empower patients on all options of treatments.”
A spokesman for another advocacy organization, the Academy of Integrative Pain Management, emphasized that it took a “balanced approach that is not inappropriately ‘opiophilic.'”
In an email to Newsweek, Bob Twillman, the executive director of the Academy of Integrative Pain Management, wrote, “Sen. McCaskill and the others haven’t spent the necessary time talking to us to understand how we do things and what we have to offer. It appears that they’ve simply looked at how much money we got from a set of pharma companies, constructed a narrative about what that means, and published it.”
The report comes at a time when the opioid crisis has left Americans reeling. Opioids were involved in 42,249 deaths in 2016, according to the Center for Disease Control. And opioid overdose deaths in 2016 were five times higher than in 1999. President Donald Trump in October declared the crisis a public health emergency and on Monday released a budget proposal allotting $13 billion to the crisis.
For the Senate investigation, McCaskill requested information from the companies on their payments to 14 advocacy groups—including the American Academy of Pain Medicine, the U.S. Pain Foundation, the American Pain Society and the Academy of Integrative Pain Management, the four that received the most contributions—as well as the sales and marketing strategies the organizations used to promote opioid use.
Because of the organizations’ classification under the tax code, they don’t have a legal obligation to disclose their donors. McCaskill, in letters to the companies, asked them to willingly disclose the information.
The report, titled “Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups” was part of a U.S. Senate Homeland Security and Governmental Affairs Committee investigation. It’s the second in a series of reports into the opioid epidemic.
Depomed did not immediately respond to requests for comment.

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McCaskill report says opioid manufacturers provided $9 million to advocacy groups

Feb 13, 2018 | St. Louis Business Journal (MO)

By Angela Mueller

Five manufacturers of opioids gave nearly $9 million to outside advocacy groups working on opioid-related issues, according to a newly released report from Sen. Claire McCaskill's office.
Between 2012 and 2017, Purdue Pharma, Mylan NV, Depomed Inc., Insys Therapeutics and Janssen Pharmaceuticals, which is part of Johnson & Johnson, provided the payments to 14 groups working on chronic pain and other opioid-related issues, according to the report. In addition, doctors affiliated with these groups accepted more than $1.6 million in payment from the manufacturers over the past five years.
Payments from Purdue accounted for nearly half of the total amount, according to the report. Organizations that received the funding included the U.S. Pain Foundation, the Academy of Integrative Pain Management, the American Academy of Pain Medicine and the American Pain Society, among others.
The fact that opioid manufacturers provided millions of dollars to these 14 groups "suggests, at the very least, a direct link between corporate donations and the advancement of opioids-friendly messaging," the report states. "By aligning medical culture with industry goals in this way, many of the groups described in this report may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic."
The nonprofit groups have denied corporate influence on their work, the Wall Street Journal reports.
Purdue, which manufactures Oxycontin, told USA Today that it supports groups interested in helping patients receive appropriate care. Insys told the Wall Street Journal that its charitable contributions are patient-focused but it is scaling back on them to focus on research and development, while Depomed said it has a strong compliance program in place to oversee its marketing and sponsorship activities. Mylan told the Journal that it made limited payments to one organization as part of its participation in the group’s annual conferences, and Johnson & Johnson declined to comment because it had not yet seen the report.

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Purdue Marketing Announcement

Purdue Pharma, maker of OxyContin, backs off aggressive marketing amid lawsuits

Feb 12, 2018 | CBS News

By Jim Axelrod

Monday marked a change of culture for Purdue Pharma, the drug company that makes OxyContin and other opioids. The company will no longer market those drugs to doctors and is laying off half its sales force.
Video Link: https://www.cbsnews.com/news/purdue-pharma-oxycontin-maker-backs-off-aggressive-marketing-amid-lawsuits/
After years of marketing testimonial videos and handing doctor's pamphlets claiming only about 1 percent of opioid users become addicted, Purdue Pharma -- the nation's largest opioid manufacturer -- now says it will back off aggressive marketing techniques, no longer sending sales representatives to doctors offices to push opioids.
While these techniques helped opioid sales spike in the last two decades, so too did the number of opioid overdose deaths. In 1999, there were 4,000 deaths, a number that spiked to 32,000 in 2016 -- an increase of more than 700 percent. OxyContin, the brand name version of the drug oxycodone, made the company billions of dollars and was at the heart of the crisis.
"The genie is out of the bottle," said Andrew Kolodny, the co-director of the Opioid Policy Research Collaborative at Brandeis University. He said he doesn't take Purdue's motivations at face value.
"I don't think that this is coming out of good intentions. I think sales that for OxyContin have already been declining," Kolodny said. "There is generic competition."
Purdue is currently facing multiple lawsuits filed by more than 400 cities and states alleging the drug maker misrepresented OxyContin's risks, creating an expensive public health crisis taxpayers had to handle. Late last year, they were asked to end their aggressive push with OxyContin and refused.
As Mississippi's attorney general in 1994, Michael Moore sued big tobacco to recoup the state's cost of treating smoking-related illnesses. He's now helping to sue Purdue.
"These guys and others created this huge opioid epidemic in our country, and they need to clean up the mess," Moore said.
While Purdue said they now want to be part of the solution, and denies any wrongdoing, sources tell CBS News that Purdue was already wearing out its welcome in doctor's offices, and had moved on to targeting insurance companies and other parts of the health care system to drive sales of OxyContin.

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The maker of OxyContin will finally stop marketing the addictive opioid to doctors

Feb 13, 2018 | Vox

By German Lopez

The drugmaker at the center of America’s opioid crisis is halting one of the practices that helped cause an epidemic of addiction and death.
Last week, OxyContin maker Purdue Pharma announced it will stop marketing its painkillers to doctors. According to Bloomberg, the company told its employees that it will eliminate half of its sales force and send a letter to doctors this week telling them that salespeople will no longer go to clinics to talk about their opioid products.
“We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” Purdue said in a statement.
The beginning of the opioid crisis can be traced back to the release of OxyContin, which is Purdue’s best-selling drug. After its release in 1996, Purdue carried out an aggressive marketing campaign that described OxyContin as both safe and effective — misleading doctors into thinking the pills could be prescribed with minimal problems.
That was not the case. Starting in the late 1990s, drug overdose deaths began to climb in large part due to a rise in overdoses from opioid painkillers. Over time, the misuse and addiction of opioid painkillers also enabled the growth of the market for illicit opioids like heroin and fentanyl. In 2016, there were nearly 64,000 drug overdose deaths in the US — an all-time high — and at least two-thirds of those deaths were linked to opioids. (More on the roots and causes of the opioid crisis in Vox’s explainer.)
Purdue’s decision to stop marketing OxyContin comes at a convenient time for the company. Purdue, along with other opioid companies, has over the past several years faced an increasing number of lawsuits from cities, counties, and states blaming the drug manufacturers for irresponsibly fostering the current overdose crisis. At the same time, the company’s profits from OxyContin, as well as opioid prescriptions in general, have recently dropped — OxyContin generated $1.8 billion in 2017, down from $2.8 billion in 2012, Bloomberg reported.
So Purdue perhaps saw the writing on the wall — after two decades of an overdose crisis that it helped cause.Purdue misleadingly marketed OxyContin
Purdue was a driving force in America’s opioid epidemic, marketing its product as a safe and effective way to treat pain — claims that proved to be misleading and even deadly.
Several public health experts explained Purdue’s role in the Annual Review of Public Health:
Between 1996 and 2002, Purdue Pharma funded more than 20,000 pain-related educational programs through direct sponsorship or financial grants and launched a multifaceted campaign to encourage long-term use of [opioid painkillers] for chronic non-cancer pain. As part of this campaign, Purdue provided financial support to the American Pain Society, the American Academy of Pain Medicine, the Federation of State Medical Boards, the Joint Commission, pain patient groups, and other organizations. In turn, these groups all advocated for more aggressive identification and treatment of pain, especially use of [opioid painkillers].
The marketing focused largely on telling doctors that they suffered from what opioid companies described as “opiophobia,” the idea that physicians were too reluctant to prescribe opioids due to supposedly outdated notions about the drugs. Purdue led much of the marketing effort, but campaigns were also carried out by other drug companies like Endo, Teva, and Abbott Laboratories.
As the opioid crisis has demonstrated, doctors’ initial resistance to opioids was well warranted: Opioids are, indeed, very addictive and dangerous. Yet the marketing proved profitable for Purdue and others — as opioid misuse and overdoses grew, so did profits from the drugs.
It’s not just that the drugs were deadly. They also weren’t anywhere as effective as Purdue and others claimed. There’s simply no good scientific evidence that opioid painkillers can effectively treat long-term chronic pain as patients grow tolerant of opioids’ effects — but there’s plenty of evidence that prolonged use can result in very bad complications, including a higher risk of addiction, overdose, and death. In short, the risks outweigh the benefits for most chronic pain patients.
OxyContin in particular seemed to have specific problems. As an extensive Los Angeles Times investigation found, Purdue marketed OxyContin for its supposed ability to provide 12 hours of pain relief. But as Harriet Ryan, Lisa Girion, and Scott Glover reported, “Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief. Since the drug’s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research.”
This was critical to Purdue’s competitive advantage: If it really didn’t provide 12-hour relief, then it wasn’t more effective than other similar painkillers on the market. In the face of the evidence, though, Purdue stood by its claim for years. And it told doctors that if patients weren’t seeing the promised results, then the problem was that doses were too low.
These efforts, it seems, were in the name of profit. One sales memo uncovered by the Times was literally titled “$$$$$$$$$$$$$ It’s Bonus Time in the Neighborhood!”
This is alarming for public health: As the Centers for Disease Control and Prevention (CDC) warned, higher doses and longer use of opioids increase the risks of the drugs. Yet Purdue encouraged such practices, despite a lack of evidence for effectiveness, for profit.
In 2007, Purdue Pharma and three of its top executives paid more than $630 million in federal fines for their misleading marketing. The three executives were also criminally convicted, each sentenced to three years of probation and 400 hours of community service.
In lawsuits filed by cities, counties, and states, officials have argued that Purdue and other opioid companies continued their misleading marketing after Purdue paid federal fines. It wasn’t until 2011 that overdose deaths linked to common opioid painkillers began to level off — and the deaths have remained elevated, at well above 10,000, since then. Until 2015, commonly prescribed opioid painkillers were the No. 1 cause of drug overdose deaths in America.It’s too late
Purdue’s pullback from opioid marketing, at this point, simply comes too late. America is hundreds of thousands of deaths into its opioid crisis, and there aren’t any signs that the crisis is slowing down — with preliminary data suggesting that 2017 was even worse than 2016 for overdose deaths. The damage is done, and the crisis is now ingrained.
But it’s a convenient time for Purdue to pull out. As Bloomberg noted, OxyContin profits have dropped over the past few years. This seems to be part of a broader national trend: According to the CDC, opioid painkiller prescriptions have fallen since 2010 — although in 2015, the amount of opioids prescribed per person was more than triple what it was in 1999. So Purdue’s marketing efforts didn’t seem to be paying off anymore as awareness of the current epidemic spread.
Purdue is also among the opioid companies now facing up to hundreds of lawsuits due to their involvement in the current crisis. These lawsuits, filed by several levels of government, are not just an attempt at getting vengeance on these drugmakers for what they did; the litigants hope they can get a lofty settlement that will come with money to pay for a lot more addiction treatment and place restrictions on marketing that could help prevent future drug crises and slow down the current one.
There’s a precedent for this: In 1998, tobacco companies signed the Master Settlement Agreement with 46 states — forcing the companies to pay tens of billions of dollars and putting restrictions on the marketing of tobacco products. But there are big differences between opioid and tobacco companies; for one, opioids were approved and regulated by the Food and Drug Administration (while tobacco products weren’t at the time of the Master Settlement) and prescribed by doctors, so some of the blame for the opioid crisis falls on government regulators and doctors in a way it did not for the tobacco epidemic.
Still, the legal threats seem serious: In Cleveland, a federal judge has now convened talks between governments around the country and drug companies to try to come up with a settlement that all parties can agree to.
It’s in the context of reduced revenue and mounting legal threats that Purdue has pulled back its marketing of opioids. So while the move is being welcomed by activists and public health experts, it’s also self-serving in that it may protect the money Purdue has already made from OxyContin by potentially making the company look a little more responsible and forward-looking to the courts.

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Commentary and FYIs

Will Big Drugmakers Mimic Purdue On Opioid Marketing?

Feb 12, 2018 | Law360

By Emily Field & Jeff Overley

Purdue Pharma’s decision to scale back its opioid marketing amid an onslaught of litigation will force many big drugmakers to consider similar moves, potentially marking a seminal moment in the nation’s brutal opioid epidemic.
Purdue announced over the weekend that it cut its sales force in half and stopped sending opioid promoters to physician offices "effective immediately." The decision comes as Purdue and other opioid sellers are embroiled in multidistrict litigation in Ohio federal court, where U.S. District Judge Dan Polster is hoping for a quick settlement that would sharply cut the number of narcotic painkillers in circulation.

Experts say that Purdue's move puts other opioid makers in the uneasy position of weighing the financial blow in lost sales against the reputational hit and litigation risks of continuing to promote opioids.

“Purdue took a bold step with this decision, and anyone who doesn’t follow Purdue is going to be asked why they didn’t, especially now that so much is known about opioids,” Blackwell Burke PA partner Peter Goss said.

Hunter Shkolnik of Napoli Shkolnik PLLC, who represents plaintiffs in the MDL, said that at this point in the epidemic — which caused average U.S. life expectancy to drop in 2015 and 2016, according to federal researchers — no company will want to be the one that keeps marketing opioids directly to physicians.

“I think we’re entering a new phase, and hopefully we’re rolling the clock back to 20-some years ago, when doctors thought twice about ever using an opioid,” Shkolnik said.

But despite concerns about appearances, other companies are only likely to curtail opioid marketing if it makes financial sense, said Michael Carome, director of Public Citizen's health research group.

“If they think that doing the same thing might help their bottom line, they would do it,” Carome said.

One likely part of Purdue's calculus — and something that other drugmakers will likely consider — is whether proactive limits on opioid promotion will help when negotiating legal settlements.

“To the extent they can portray themselves as being a reformed corporate wrongdoer, maybe they hope to get more favorable treatment in those negotiations,” Carome said.

Trade group Pharmaceutical Research and Manufacturers of America did not respond on Monday to a request for comment on its take on Purdue’s move and whether it anticipates that its other members will follow suit.

Attorneys saw Purdue’s decision as one driven by a constellation of factors: bad press the company has received for marketing OxyContin, the tsunami of opioid litigation swamping the company, and pressure from Judge Polster to quickly reach a settlement.

“They seem like such villains now, and if a case ever went the jury, they’d probably [get] hammered,” said Richard Ausness, a professor at the University of Kentucky College of Law who has written about the opioid litigation. “So if they can maybe overcome a little of that and improve their reputation with the public, I could see where they might be willing to do that.”

Preliminary settlement talks were held two weeks ago, unusually early for an MDL. Judge Polster is maneuvering to avoid prolonged litigation and to broker settlements that fund addiction treatment and dial back opioid prescribing.

The MDL involves more than 300 lawsuits targeting various drugmakers, including Endo Pharmaceuticals Inc., Johnson & Johnson and Mallinckrodt PLC. The plaintiffs — mostly local governments — are seeking billions of dollars in damages.

“It seems to me like what they’re trying to do is position the case in a way takes [away] the incentive for states to continue to go after them,” said Nicholas Harbist of Blank Rome LLP. “'To the extent that we were doing things that you think were inappropriate ... we’re not doing it anymore, so really all [that's] left is if there is any damage that we caused that we owe you for.'”

In interviews on Monday, plaintiffs attorneys welcomed Purdue's action, but cautioned that it doesn't come close to making their clients whole.

“Hopefully this will be beneficial for the future ... but it doesn't do anything for the folks who are already in trouble,” said Paul J. Hanly Jr. of Simmons Hanly Conroy LLC, a lead plaintiffs attorney in the MDL.

OxyContin is so widely known and prescribed that Purdue may have decided that it wouldn’t lose very much money if it laid off half of its sales representatives, Harbist said.

There’s also the possibility that Purdue may rely on other forms of marketing, Ausness said, noting that the face-to-face approach is expensive and has fallen out of favor with a new generation of doctors.

“The younger doctors don’t seem to care for that as much as they like PowerPoint presentations and continuing medical education things, so it may be that they’re just shifting to those kinds of methods of communication,” Ausness said.

Purdue is a privately held company. OxyContin has reportedly generated $35 billion in sales since its debut in 1995; annual sales of OxyContin peaked at $3.1 billion in 2010 and have since declined slightly, according to the Los Angeles Times.

Purdue’s move does raise questions of timing, attorneys said, noting the company resolved a criminal case with the U.S. Department of Justice a decade ago for $600 million over its marketing of OxyContin.

“It’s a positive, good step, but it’s just a little too late,” Shkolnik said. “You would have thought $600 million in fines, indictments, would have stopped this 10 years ago, but it didn’t.”

Purdue's changes probably give it ammunition at a possible trial to tell juries what it has done to combat the opioid crisis. At the same time, those changes won't wash away all questions about the company's conduct.

“It’s a bold, proactive move by Purdue,” Goss said. “The risk is the next question: ‘Why didn’t you do it sooner?’”

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America’s Corporate Drug Pushers

Feb 12, 2018 | The Indypendent

By Jonathan Fudd

For many Americans suffering from opioid addiction overdosing is only the first step in a horrifying cycle of relapse and re-treatment. Some individuals in the throes of addiction experience months or years of sobriety only to be triggered into relapse and overdose. This is a phenomenon I’ve come into personal contact with through the struggles of family members and friends.
With the proliferation of the life-saving Narcan syringe, many lives have been saved. However, when life is returned to the paling body of an overdose survivor, it is just the first step in a long and painful process of recuperation. Jobs are often lost, children taken away. Loved ones keep their distance and survivors are left with the overwhelming stigma of their addiction. A recovering addict must enter the thicket of adversity. Without a proper support network of counseling and care, relapse becomes a looming given.
Working class communities across the country have been shaken to their core by the increasing strain and extremity of the opioid epidemic. Opioid-related deaths have taken the lead as the number one cause of death in Americans under 50. The statistics are in for 2016 with 64,000 deaths from opioid overdoses on record and 2017 set to see an even greater increase. Over the next decade, unless drastic measures are taken to upend the trend, over 500,000 more deaths could result from the crisis.
Death tolls continue to rise at exorbitant rates in rural communities in West Virginia, Ohio, Indiana, Utah, Pennsylvania and Massachusetts, where working-class individuals foster deadly addictions from painkillers prescribed for injuries and chronic pain. The underemployed, unemployed, working class and elderly are extremely vulnerable to opioid addiction due to their general lack of resources to combat it. With the budget for Medicaid and Medicare shrinking and a Republican-led House and Senate that can barely manage to fund the government from one week to the next, resources remain scarce.
Once individuals become addicted to opioid prescriptions their inability to continually renew and/or pay the cost of prescriptions or opioid addiction treatment drives them to purchase heroin and other substances on the street. A close friend tells me that she has been forced to buy her naltrexone (an opioid addiction treatment medication) from a dealer because her insurance won’t cover the treatment. Medicaid recipients can lose the insurance coverage they desperately need for the addiction they are fighting if they test positive for controlled substances, including marijuana.
Despite these ongoing developments, politicians continue to add to the ignorance and misinformation that surrounds the epidemic — explicitly using it for their own political gains. This was evident from Trump’s reference in his State of the Union Address to influxes of drugs from across the border. The President would like to make the health crisis an issue of border control and “criminal immigrants” yet, it is anything but. In reality, the crisis is one from within. Profiteering pharmaceutical giants are overloading the market with cheap opioids and negligent MDs are willing to prescribe them ad infinitum to vulnerable patients. It is no secret that ‘Big Pharma’ has functioned here as many drug cartels have in destabilized nations.
Despite Trump’s October declaration of the opioid epidemic as a ‘public health emergency,’ his administration has failed to take action against the pharmaceutical industry or the complicit doctors in its pocket. Former Democratic Representative Patrick Kennedy of Rhode Island — one of six people appointed to an opioid commission by the President last year — described it as a “charade” and a “sham.”
“The emergency declaration has accomplished little because there’s no funding behind it,” Kennedy told CNN. “You can’t expect to stem the tide of a public health crisis that is claiming over 64,000 lives per year without putting your money where your mouth is.”
This seems like an obvious conclusion, but we are living under a regime that pays lip service to the possibilities of an infrastructural overhaul, immigration reform and health care reform with no will to or belief in allocating funds and resources. Where Congress is failing, hope may spring on a local level.
A wave of over 200 lawsuits from states and municipalities have the potential to provide a legal framework for dealing with the opioid epidemic and garner the necessary monetary relief needed to prevent further deaths. New York City filed a lawsuit in January against leading pharmaceutical companies, seeking $500 million to combat the epidemic, which killed over 1,000 in the five boroughs in 2016, the latest year statistics are available. In Alabama this month, Attorney General Steve Marshall filed a lawsuit against Purdue Pharma LP, accusing the OxyContin maker of deceptive marketing practices that generated billions in sales for the company while spurring a public health emergency.
In a moonshot, U.S. District Judge Daniel Polster of Ohio has initiated talks between pharma executives, the Food and Drug and Drug Enforcement administrations and various states attorney generals that could lead to a nationwide plan of action. But Big Pharma has been resistant. “I haven’t gotten the least indication that they are willing to take responsibility,” New Hampshire assistant attorney general Jim Boffetti, who is participating in the talks, told Bloomberg. “We’re hoping the judge can change that attitude.”
Painfully apparent here is an evolving state of emergency created by a radically unfettered pharmaceutical market producing and distributing lethal-addictive-substances. Big Pharma’s deadly profiteering has become the status quo. Where lawmakers and regulators have failed, court-enforced payouts could lead to real action, being as they speak a language Big Pharma can understand: money.

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Local Dr., Lawmakers React To OxyContin Maker's Change In Marketing

Feb 13, 2018 | WWNYTV (NY)

By STaff

Dr. Ivan Montalvo is a pain management doctor in Watertown. Dr. Montalvo prescribes prescription opioids to his patients when needed and has had to deal with sales representatives from major pharmaceutical companies for years.
"They were mentioning the advantage of using a long acting product over a short acting product so instead of you giving to the patient let's say eight pills per day, six pills per day, you were giving one or two per day," he said.
One or two very strong pills per day, like OxyContin, a prescription opioid. Now, Purdue Pharma, which manufactures OxyContin, says it's going to stop promoting the drug to doctors and is cutting its sales force in half. Dr. Montalvo says this move by Purdue Pharma is sending a message.
"That indeed these type of medications, they have abuse, they have potential abuse," said Dr. Montalvo.
Purdue Pharma denies any wrongdoing and says its products account for only 2 percent of opioids prescribed in the nation. Lawsuits have been filed against the pharmaceutical company and others like it. St. Lawrence County is part of one.
"By removing their advertising wing or marketing wing from being engaged with the direct providers of these medicines, they sort of stop the practice that is being complained about," said St. Lawrence County Attorney Stephen Button.
Lewis County is also part of the same lawsuit as St. Lawrence County. Legislature Chair Larry Dolhof said he hopes this doesn't compromise the availability of OxyContin for those who need it.

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Naloxone, the medicine helping fight the opioid crisis, explained

Feb 12, 2018 | Vox

By German Lopez

The woman’s lips were blue and her skin was gray. She wasn’t getting enough oxygen.
Thirty-thousand feet in the air, the airplane staff’s resources were limited. They called over any medical professionals who happened to be onboard the Spirit Airlines flight from Boston to Minneapolis. They administered glucose and an EpiPen, but neither worked. At one point, a syringe fell out of the woman’s clothes. This was an opioid overdose.
The airplane, however, did not carry naloxone, the antidote that can reverse opioid overdoses. Staff and other passengers were forced to rely on CPR to keep the woman alive. After 25 minutes, the plane made an emergency landing in Buffalo, New York, where the woman was quickly taken to an ambulance and given naloxone. Within a minute, she was walking, Boston.com reported.
This story, from last year, exemplifies the scope of America’s opioid epidemic and how important naloxone is to fighting it. In 2016, nearly 64,000 people died of overdoses in the US, about two-thirds of which were linked to opioids — the highest number of drug overdoses for any single year in US history. Some of those opioid overdoses very well may have been reversed with better access to naloxone.
Yet naloxone remains inaccessible in many cases — often to dangerous results. Take the 2017 story: What if medical staff weren’t on-board? What if an emergency landing wasn’t an option? What if just one more person acting to save the woman’s life here — the flight attendants, the pilot, the ambulance on the ground — responded a minute too late?
A Federal Aviation Administration spokesperson told me that the agency doesn’t require naloxone in planes’ emergency medical kits, explaining that “we do not have any data to confirm adding [naloxone] to the required contents would be necessary at this time.” Currently, individual airlines decide whether to carry the drug. Spirit Airlines did not respond to multiple requests for comment.
It goes beyond airplanes. Naloxone is still limited across the country by its prescription requirement. Not all police and fire departments carry it, even though they’re often the first to respond to an overdose. And naloxone can be fairly pricey, making it difficult to ensure greater access even if a governing body wants to do so.
This has left some experts with a simple rallying cry for policymakers: Every person in the US should be able to obtain naloxone without a prescription. It should be readily available in first aid kits. We should even place it on street corners, as some cities are doing.
“It’s such a straightforward argument: Naloxone works, it reverses overdose, everybody should have it, and it should be much more available,” Corey Davis, a senior attorney at the National Health Law Program, told me.
Naloxone alone is not a silver bullet. The research on improved access to it is still early, so we don’t know just how much it could reduce overdose deaths. But more accessible naloxone would almost certainly save some lives — just like it saved the Spirit Airlines passenger.
Yet local, state, and federal policymakers still haven’t done everything they can to make this lifesaving drug accessible.Naloxone is a lifesaving drug
Naloxone temporarily reverses the effects of opioids such as fentanyl, heroin, and prescription painkillers like OxyContin and Percocet. It’s known by its brand name, Narcan, although there are several other brands of the drug. It’s typically applied to overdose victims through a nasal spray or injection.
Naloxone effectively pushes out and blocks off opioids from receptors in the brain. In doing this, it halts all the effects of opioids — the positive effects, such as the high and painkilling benefits, and the negative, including a potentially deadly overdose.
The effects of naloxone last for about 30 to 90 minutes, which is usually enough to stave off an overdose that could turn deadly. That not only can save a person’s life, but it also extends the opportunity to link someone to addiction treatment, such as highly effective medications like buprenorphine and methadone that are shown in the longer term to cut all-cause mortality among opioid addiction patients by half or more.
One risk: Naloxone can wear off before an overdose does. So someone could be fine while naloxone is in their system but then go back to overdosing as soon as it runs out. That’s why it’s often recommended that someone seek other emergency care quickly after applying naloxone.
Sometimes naloxone also requires multiple doses to overcome opioids. This has been reported more and more in the past few years as more powerful strains of illicit opioids, such as fentanyl and its analogs, have become more common.
While naloxone reverses opioid overdoses, it also stops the other effects of opioids. This can temporarily reverse all the painkilling benefits of opioids, bringing back someone’s pain if they’re using opioids for those reasons. And if someone is physically dependent on the drugs, it can also induce opioid withdrawal — which is often described as a mix of the worst imaginable flu, a horrible stomach bug, and hyper-anxiety.
Otherwise, naloxone has no common big side effects. Mild side effects include dizziness, tiredness, weakness, nervousness, and diarrhea.Naloxone could help fight the opioid epidemic — but there are lingering questions
There are no good estimates for how many people are saved by naloxone each year, but it’s likely used to reverse thousands of overdoses annually.
Whether this means that expanding access to naloxone would translate to thousands more lives saved every year, however, remains unclear.
There’s certainly some suggestive research out there. A 2017 study published by the National Bureau of Economic Research (NBER) found that naloxone access laws are linked to a 9- to 11-percent reduction in opioid-related deaths — which, nationwide, would add up to thousands of saved lives each year. And a 2013 study in Massachusetts found that communities with higher rates of training for a naloxone program had larger reductions in opioid overdose death rates than those with no enrollment.
But there are major questions about the research done so far. For one, these studies only establish correlation, not causation — so it’s unclear if improved access to naloxone alone is to credit for the reduced number of deaths. Experts have also raised concerns about the underlying data; studies show, for instance, that opioid overdose deaths are almost certainly underestimated — by as much as the thousands — in the US, so it’s hard to draw any reliable conclusions from analyses of opioid overdose data.
The public health experts I’ve spoken to still say that greater access to naloxone would help reduce opioid overdose deaths. The question is how big that reduction would be — or if it would even be that large of a drop.
Consider just how much naloxone demands of opioid users even if it’s easily accessible. First, opioid users would have to actually get naloxone. Then, they would have to either use opioids while someone is watching them — so a person is there to apply naloxone or call 911 if help is needed — or be stable enough during an overdose to use naloxone on themselves. And naloxone would have to be administered correctly and at the right dose.
“That’s a complex process with many opportunities to fail,” Harold Pollack, a researcher at the University of Chicago, told me.
Even if someone is saved with naloxone, that doesn’t mean that they’ll be freed from the risk of overdose forever. Police, for example, have repeatedly complained about reviving the same person multiple times with naloxone. In these cases, naloxone is essentially increasing the number of overdoses at a population level, because someone who may have only overdosed once before (and died) is now able to overdose multiple times (and live).
For public health, that’s still a better outcome than no naloxone — someone who’s revived is capable of getting treatment and going down a better path eventually, while someone who’s dead obviously isn’t. But it shows that naloxone’s ability to save a person’s life one time or more doesn’t guarantee that the person will never be at risk of a possibly deadly opioid overdose: What if police arrive too late next time? What if they’re not called at all?
So while naloxone is a lifesaving drug at the individual level, that doesn’t ensure that improved access to it would put a huge dent on overdose deaths at a population level.
Still, public health and drug policy experts broadly agree it’s worth trying — often citing improved access to naloxone as one part of a broader policy package to fight the opioid crisis, which would also include improving treatment options, reducing access to opioid painkillers while keeping them accessible to patients who truly need them, and adopting harm reduction approaches on top of naloxone, like safe injection sites and prescription heroin. Together, these policies could begin to reverse the opioid crisis.There’s a push to make naloxone more accessible
While more could be done, states have tapped naloxone in their responses to the opioid epidemic. According to the Network for Public Health Law, every single state has enacted some sort of policy to make naloxone more accessible.
Davis, who’s a deputy director at the Network for Public Health Law, said that there are four different kinds of policies that states, counties, and cities have generally leveraged:Standing orders: Naloxone is a prescription medication, and prescribers can typically only write prescriptions for their own patients. Standing order laws, however, permit a prescriber to write a prescription for naloxone to be dispensed to any member of a group specified in the order, such as a person at risk of overdose or a person who might be able to use naloxone on someone who is overdosing. For example, the health commissioner in Baltimore, Dr. Leana Wen, issued a citywide standing order that effectively let anyone in the city obtain naloxone from a pharmacy or harm reduction group.Lay dispensing: Traditionally, only pharmacists (and sometimes other medical professionals) can physically dispense prescription medications. Lay dispensing provisions make it so others can dispense naloxone, letting more people distribute it.Third-party prescribing: With this policy, individuals can ask doctors to prescribe naloxone on behalf of other people who are at risk of an overdose. So a brother might ask for a naloxone prescription so he can administer it to his sister who’s addicted to heroin.First-responder access: First responders like police and firefighters are often the first to respond to the scene of an overdose. So some laws and policies have tried to equip these first responders with naloxone, whether by letting them administer it or by providing the funding to pay for it. Otherwise, these first responders could be forced to wait for medical services — which can take longer, increasing the odds of serious injury or death.
Not every jurisdiction has taken all of these steps. As one example: By Davis’s count, fewer than half of states have fully adopted a standing order or something similar to it.
Some places have even resisted access to naloxone. The Butler County, Ohio, sheriff, for one, has refused to let his deputies carry it, arguing that it’s the “wrong approach” to the opioid crisis.
There are other steps that individuals and community groups could take. Doctors could recommend and prescribe naloxone with opioid painkiller prescriptions or for patients with opioid use disorders. More people could carry the drug, even if they personally don’t need it. Naloxone could be packed in more — or all — first aid kits, as some airlines are now considering.
Davis has also been pushing to make some version of naloxone over-the-counter, which could eliminate the need for a prescription or standing order.
The Food and Drug Administration (FDA) told me that it is taking some steps in this direction, working on a model drug facts label that’s required for over-the-counter products and a simple image intended to educate consumers about how to use naloxone. But the FDA said it ultimately needs a request — from a naloxone maker or a citizen petition — with hard data supporting the switch to actually make the move.
So far, no company has filed the paperwork. Thomas Duddy, spokesperson for Narcan producer ADAPT Pharma, said that the company isn’t necessarily opposed to the idea, but it’s concerned that not enough people are educated on how to use naloxone to cut out the doctors and pharmacists who often act as the educators. Eric Edwards, vice president of innovation, research, and development at Kaléo (which produces Evzio, another naloxone product), pointed out that over-the-counter naloxone may not be covered by insurance like prescribed naloxone — although Davis argued this could be remedied with legal or regulatory changes.
Short of making naloxone over-the-counter, though, there are several steps policymakers could take — but haven’t.Other barriers to naloxone remain
There are two big hurdles to increased access to naloxone: the price and concerns about harm reduction policies in general.
Depending on the product, naloxone can run in the tens, hundreds, or even thousands of dollars. This can make it very expensive for individuals and organizations, including police departments and harm reduction groups, trying to obtain the drug.
Insurers often cover naloxone, although they can require a copay. Adapt Pharma, Kaléo, and other manufacturers also sometimes offer discounted prices and donations.
But costs are still a commonly cited barrier, according to Davis and other experts. This is often true for drug prices in America, largely because the US does a poor job regulating its drug prices compared to other wealthy nations.
The other big barrier is the belief that expanding access to naloxone would enable more and riskier drug use. The claim: If naloxone is easily available, then would-be drug users may feel like their drug use is no longer as risky. And that might make them more likely to use drugs in general or use drugs in a riskier manner.
This is a frequent argument with all harm reduction efforts — such as needle exchange programs, even though separate studies by Johns Hopkins researchers, the World Health Organization, and the Centers for Disease Control and Prevention have found no evidence to support the idea that needle exchange programs lead to more drug use.
Similarly, there’s no strong evidence that naloxone leads to more drug use.
“There hasn’t been evidence — that I’m aware of — that suggests an increase in risk behavior,” Ingrid Binswanger, a senior investigator at the Kaiser Permanente Institute for Health Research in Colorado, told me. “That’s why I feel confidence as a physician prescribing it.”
Binswanger provided one reason you wouldn’t expect a trend toward riskier behavior: “Because a major adverse side effect of getting naloxone is very uncomfortable withdrawal symptoms, it’s hard to imagine why anyone would want to induce that kind of reaction. I don’t have any patients who want to go through withdrawal. So it’s unlikely that people would want to receive naloxone and not do everything they can to avoid that.”
Davis, of the National Health Law Program, drew a comparison between car safety efforts and naloxone.
“It’s the seatbelt thing,” Davis said. “Can we say that nobody drives faster than they otherwise would because they have airbags and seatbelts and so on? No, I’m relatively confident that some people do drive more recklessly because there’s all that safety stuff. Does that mean we should not have airbags and seatbelts in cars? Of course not.”
He added, “Even if somebody somewhere is going to use more or use more dangerously than they otherwise would, so what? We know that the stuff works. We know that, on net, it’s still a huge gain.”

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Trump budget sharply cuts White House office leading opioid crisis response, shifts funds to other agencies

Feb 12, 2018 | ABC News

By Kendall Karson

The Trump administration's FY2019 budget released Monday requests more than $30 billion for drug control efforts, while at the same time proposing a sharp cut to the Office of National Drug Control Policy, which has been leading the fight in the opioid crisis.
The administration says it's shifting responsibility for spending on anti-drug programs to the Departments of Justice and Health and Human Services — and away from the White House office — so it can better focus on policy.
While the exact proposed cut was unclear, a report from Politico last month said the plan was to reduce ONDCP's budget by 95 percent.
In October, President Donald Trump called the opioid epidemic “the worst drug crisis in American history,” and the ONDCP took the lead in coordinating the federal response across the government.
According to the new budget, the White House “drug czar’s” office is “charged with developing policies, objectives, and priorities for the National Drug Control Program.”
Last month, a spokesperson at ONDCP told ABC News, “This crisis remains a top priority for President Trump and his administration.”
Citing an estimate from the White House drug control office, the FY19 budget says that “more than $7 billion” is needed to confront the opioid crisis for “prevention, treatment, interdiction, international operations, and law enforcement across 14 Executive Branch Departments, the Federal Judiciary, and the District of Columbia.”
While the official budget recommends investing “$5 billion in new resources for the Department of Health and Human Services (HHS) over the next five years, including $1 billion in 2019, to combat the opioid epidemic,” the budget appendix also recommends redirecting the ONDCP’s two main grant programs, the High Intensity Drug Trafficking Areas (HIDTA) grant and the Drug Free Communities (DFC) Act, to the Departments of Justice and Health and Human Services.
Despite this recommended funding, the proposed $68.4 billion budget for HHS is a 21 percent decrease from the previous fiscal year.
Defending the move, the White House says “This proposal will enable ONDCP to focus resources on its core mission: to reduce drug use and its consequences by leading and coordinating the development, implementation, and assessment of U.S. drug policy.”
Office of Management and Budget press secretary Meghan Burris reinforced the White House's decision, saying, "HIDTA and DFC management are resource intensive, forcing ONDCP to focus on administering grants, rather than what should be its primary mission of policy development, implementation and evaluation.”
"DOJ and HHS are both major grant management organizations that can look holistically at allocations across law enforcement and drug prevention and treatment resources,” she added.
Over the last year, the ONDCP has been operating without a permanent director. Richard Baum has served as acting director since March 2017. On Feb. 9, the president nominated Jim Carroll, who serves as Assistant to the President and Deputy Chief of Staff to John Kelly, to head the agency.
Despite the sharp cuts to the drug control office's budget, White House press secretary Sarah Sanders said in a statement last week, “We have full confidence in Jim to lead ONDCP to make significant strides in combating the opioid crisis, reducing drug use, and coordinating U.S. drug policy.”

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Northeast (PA, NY, DE)

Cumberland County sues opioid companies

Feb 12, 2018 | ABC27 (PA)

By Myles Snyder

Cumberland County has filed a lawsuit claiming more than 20 drug makers and distributors “strongly contributed” to the opioid crisis.
The Board of Commissioners approved the lawsuit on Monday. The board said the companies intentionally misled the public and medical community, and they failed to inform the public of the dangers of using opioids.
The law firm of Napoli Shkolnik PLLC filed the suit on behalf of the county. Napoli Shkolnik also represents York County and other municipalities in similar cases.
The commissioners said there is no financial cost to county residents.
Opioid overdoses were linked to the deaths of 83 people in the county last year.

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Cumberland County files lawsuit against opioid manufacturers, distributors

Feb 12, 2018 | The Sentinel (PA)

By Staff

The Cumberland County Board of Commissioners Monday approved filing a complaint against the manufacturers and distributors of opioid pain medication.
The county said it is seeking to recover public resource damages, which will be used in continuing efforts to respond to opioid overdoses and addiction in the county.
The county said there is no cost to county taxpayers with this filing.
“Every day we hear in the news, through social media and from our neighbors the devastating effects this crisis is having in our county,” said Vince DiFilippo, chair of the board of commissioners. “As a county, we have a significant number of programs and initiatives in place to respond to this crisis. The complaint we have filed, at no financial cost to our residents, is another step we are taking to address this crisis and provide our communities with the resources they need.”
The complaint against more than 20 opioid manufacturers and distributors alleges the companies intentionally misled the public and medical community, failing to inform them of the dangers of using opioids, the county said in a news release.
The county said 83 people died of overdoses in 2017, about one person every four days, whereas, a person died from an overdose roughly once every two weeks in 2013.
For the lawsuit, the county has partnered with Napoli Shkolnik PLLC, which also represents York County in similar litigation. About 100 other counties and cities have filed similar cases.

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Cumberland County joins lawsuit against opioid makers

Feb 12, 2018 | PennLive (PA)

By Matt Miller

Cumberland County has joined the swelling ranks of government agencies that are suing the makers of opioid pain medications.
County commissioners made that call Monday, following the lead of their counterparts in Dauphin and York counties and dozens of other county and municipal governments nationwide. The complaint is filed against more than 20 opioid manufactures and accuses the companies of intentionally misleading the public and medical community.
The manufactures failed to warn the public of the dangers of using opioids, which is a breach of the manufacturers responsibility under the law, according to the lawsuits. The suits seek compensation from the drug makers for costs governments are incurring from the opioid addiction crisis that is sweeping the nation.
Opioid pain medications are addictive in their own right and are often gateways to the use of illegal drugs, including heroin. Vince DiFilippo, chairman of the Board of Commissioners, said the county is joining in the suit -- at no cost to residents -- in order to address the crisis and fund local treatment intiatives. Napoli Shkolnik PLLC is representing the county and several other municipalities that have filed similar cases.
"We're looking at this as just another piece of a complex picture with the opioid epidemic," DiFilippo said. "We believe this type of lawsuit might be able to provide us with additional funds to help folks who are addicted."
Cumberland County logged 83 fatal drug overdoses last year, which equals a rate of once every four days, the commissioners noted. The overdose death rate in 2013 was about once every two weeks. Opioid overdoses were the leading cause of death for Americans under age 50 in 2017.
Within the past eight or so years, DiFilippo said people in the county began to look at substance abuse addiction differently, which has helped address the root causes and issues at hand. Instead of attacking drug abuse punitively, officials are working to fight problems over-prescription and ease of access to drugs, while also holding people accountable in a way that helps rehabilitation, DiFilippo said. This paved the way for treatment opportunities rather than packing people into prisons and turning correctional facilities into de facto detox centers.
Still, a funding barrier exists because of the high costs of treatment programs and treatment drugs like Vivitrol that have been proven to be more effective in fighting addiction, DeFilippo says. If this lawsuit is successful, and it could take years, DiFilippo says the money from the contingency lawsuit could be put towards the efforts run by the county.
"Every day, we hear in the news, through social media and from our neighbors the devastating effects this crisis is having in our County," DiFilippo said. "As a County, we have a significant number of programs and initiatives in place to respond to this crisis."
DiFilippo noted the many reasons the epidemic has spiked while saying litigation isn't the only answer to helping curb opioid addiction. With greater awareness, community involvement, increased funding, treatment programs and the like, the commissioner said he is hopeful the epidemic ends sooner than later to end the strain on the county's families.
"We're hoping the epidemic will reach its peak and things will reverse themselves," DiFilippo said. "How long it's going to take? We don't know."
Earlier this year, the county launched an Opioid Intervention Court for those who fall afoul of the law because of addiction. Prospective candidates are currently being identified.
The court exists in addition to the county's drug court. Judge Jessica Brewbaker, who will oversee the court, said in January that the court will "help keep participants alive until they are stable enough to fully invest in their own recovery." Brewbaker said officials of the opioid court - billed as a "triage" operation - will intervene with opioid addicted defendants immediately to try to ensure they don't add to the death toll.
Officials in Cumberland and Perry counties are cooperating to start an intervention Warm Handoff Program for overdose survivors through Just For Today Recovery and Veterans Support Services. Another grassroots intercounty program, "I am the Solution," is aimed at fighting addiction through adult volunteers working with youth to prevent substance abuse of opioids, alcohol, marijuana and other drugs.

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Niagara legislature will declare opioids a 'public nuisance'

Feb 13, 2018 | Niagara Gazette (NY)

By Tim Fenster

Niagara County legislators advanced a measure Monday to declare opioids a 'public nuisance" in a move to aid the county's lawsuit against several manufacturers and distributors of painkillers.
The public nuisance declaration, which will be put to a vote at the legislature's Feb. 20 business meeting, states that the "overabundance" of painkillers has fueled heroin addiction, and that opioid manufacturers and distributors should bear some of the cost of addressing the crisis.
"Everyone knows the epidemic and (that) all families have been affected by this, dollars have been spent on this," said Majority Leader Randy R. Bradt, R-North Tonawanda. "The problem is we have to make a local law to ... declare it a public nuisance, before we can do anything else we may or may not want to do."
Deputy County Attorney John Ottaviano, who recommended the declaration, explained that it confirms the purpose of the county's lawsuit against five manufacturers and three distributors of opioid painkillers.
In June 2017, the legislature voted to pursue litigation against those pharmaceutical companies. Representing the county is Napoli Shkolnik, PLLC, a Manhattan-based law firm that is representing dozens of other New York State counties in similar lawsuits.
At the time, Niagara County became one of the first in Western New York to sue pharmaceutical companies for their role in the heroin and opioid epidemic. Dozens of New York counties have since filed similar lawsuits, as have other states and municipalities.
"It's something you're seeing happen all across the country in many communities, and we are certainly at that point," said Legislator Rebecca Wydysh, R-Lewiston. "It is a problem for all of us."
Wydysh, who chairs the county's opioid addiction committee, said the lawsuit aims not only to "help our taxpayers with the budget issues we're having, but also to get (opioid manufacturers) to play a bigger part in solving this problem that they helped create."
Critics of pharmaceutical product makers like Purdue Pharma say the companies misled doctors and patients on the addictive nature of opioid medications, and continued to market the pain relievers despite growing rates of addiction. Critics also say these companies ignored the fact that continued use of opioids diminishes their pain-relieving nature, requiring increases in dosage which increases the risk of addiction.
New York counties are also filing lawsuits against three opioid distributors, for allegedly filling large and suspicious orders of opioids like OxyContin.
“They failed in their duty to report what were obviously very suspicious orders," Napoli associate Joe Ciaccio said previously.
Niagara County is retaining Napoli on a contingency basis. According to information provided by Ottaviano, the county would pay Napoli 7.5 percent of a pre-complaint recovery, 15 percent after ruling on a motion to dismiss, 20 percent after the close of pre-trial discovery and 25 percent after a ruling on summary judgment.
Ciaccio said he doesn't expect the lawsuit to be settled for years.
Bradt said the county has not yet set a price on damages it's seeking to recover.
"That is still up in the air," Bradt said. "It's an ongoing lawsuit."
Bradt, who lost his nephew to a heroin overdose brought on by prescription opiate addiction, acknowledged that the fight against opiates is a personal issue for him.
"It's very tough for me. It affects my family personally," Bradt said. "It affects thousands of families out there personally. I will keep doing everything in my power as a legislator to combat this and help every family to get them the help, so that it doesn't happen in their families."

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Niagara County opioid suit moves forward

Feb 12, 2018 | WGRZ (NY)

By Danny Spewak

A measure to declare the opioid epidemic a "public nuisance" sailed through Niagara County legislative committees on Monday night, intended as a move to bolster the county's ongoing civil lawsuit against major drug manufacturers.
The full Niagara County legislature is now widely expected to pass the local law with bipartisan support.
Rebecca Wydysh, a county legislator and chairwoman of the committee on opioid addiction, said the county attorney recommended a public nuisance law as a legal strategy. The designation could give the county leverage in court as it seeks to recover damages associated with the opioid crisis.
Niagara County is one of at least three local governments in Western New York to officially file a lawsuit against pharmaceutical companies, along with Erie and Chautauqua counties. The suits accuse the nation's largest drug companies of misleading doctors and patients about the addictive nature of painkillers and opioids.
Instead of joining a class-action suit, however, Niagara County enlisted New York City-based Napoli Shkolnik PLLC to represent it in an individual suit.
"Certainly, it has been a huge financial burden on the taxpayers of Niagara County, as it has all over the country," Wydysh said. "That's something that, hopefully, we will get a little bit back from the pharmaceutical companies to help cover the costs that the crisis has caused here."
Overdoses killed 31 people in Niagara County last year, according to Wydysh. The county also tallied 308 non-fatal overdose calls, and it ranked fourth statewide in opioid prescriptions per capita.
In all, at least seven Western New York counties have either filed a lawsuit or explored the possibility of legal action against major drug companies.
It is not an isolated trend.
Hundreds of local governments across the United States -- and even some individual states -- have filed nearly identical lawsuits against manufacturers like Purdue Pharma and Johnson & Johnson, among others. The wave of lawsuits even led Purdue Pharma to announce this weekend it will stop promoting OxyContin to doctors.
The companies have long insisted that the lawsuits are an oversimplification of the problem and unfairly lay the blame solely on their shoulders. In a statement to 2 On Your Side last year, Purdue Pharma's spokesperson noted that OxyContin accounted for only two percent of its painkiller prescriptions, adding that the company was an "industry leader" in abuse deterrence. Another company, Janssen Pharmaceuticals, called the allegations "legally and factually unfounded."
However, county and state governments still feel the companies should essentially reimburse them for the costs of the opioid crisis.
In Niagara County, the skyrocketing number of overdoses places an increased financial burden on public health, law enforcement and mental health departments.
"This is something that has hit every department in the county," Wydysh said.
The question for public officials, however, is this: Will the money recovered through lawsuits actually go toward addiction treatment and recovery? The tobacco settlements of the '90s, for example, paid out billions of dollars to governments, but the money wasn't always used for anti-smoking or health initiatives.
Wydysh promised any earnings would be used for the right purposes.
"Certainly," she said. "That's something we have to focus on."
First, of course, the county must prove in court that it is entitled to actually collect damages from the drug companies. It appears the "public nuisance" law, which is still subject to public hearings before a vote, will factor into those arguments.
Randy Bradt, the Niagara County Legislature Majority Leader, called the public nuisance proposal an example of "bipartisanship at its finest."
The issue is especially personal for Bradt, who lost a relative to the opioid epidemic.
"I will keep doing everything in my power, everything in my legal means as legislator, to combat this, and help every family," Bradt said, "so that it doesn't happen to any other families."

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Niagara County lawmakers consider taking next step in opioid fight

Feb 12, 2018 | WIVB (NY)

By Chris Horvatis

In Niagara County, lawmakers are taking an important step in their lawsuit against pharmaceutical companies that make opioids.
According to Legislator Rebecca Wydysh, stats show Niagara County is fourth per capita statewide in opioid prescriptions. In 2017, 31 people died from an overdose, and more than 300 survived an overdose there.
Lawmakers are looking to fight back against pharmaceutical companies that develop and market these drugs. At legislative committee meetings Monday night, Wydysh will push legislation that would allow the county to officially declare the opioid crisis a “public nuisance”.
Wydysh says it comes at the recommendation of the county attorney, and will bolster the county’s lawsuit against pharmaceutical companies. Lawmakers voted to file that suit last year. They are looking to recoup costs associated with fighting the problem.
“The increase to our law enforcement departments,” Wydysh gave as an example, “the increase to things like medical insurance to treat programs, the recidivism rates you see at the law enforcement level with the people you see committing crime after crime because of their drug dependency and addictions.”
The legislation could be voted on by the full legislature as soon as March 20th.

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Dover City Council announces lawsuit against ‘Big Pharma’

Feb 12, 2018 | Delaware State News (DE)

By Matt Bittle

Dover City Council on Monday announced a lawsuit against the pharmaceutical industry, alleging it has played a major role in the current opioid epidemic.
Following an executive session, council members approved a resolution to hire legal counsel to sue “Big Pharma.”
“I am just sick and tired of this being considered the new normal, that we live with this opioid addiction crisis as if it just kind of grew naturally,” Council President Tim Slavin said afterward. “It didn’t grow naturally.
“It was by design, and I feel like as a city, we’ve expended a tremendous amount of money policing that with police, with fire, with EMS, but also with a variety of other social services while other services in the city have suffered because all those things cost money.
“I feel like with the opioid crisis we’ve been swimming uphill, and it’s been very, very difficult. So, it’s time to just call them on the carpet and get what we’re deserved, which is to stand up for the taxpayers and get some money back.”
City Council retained Marc J. Bern & Partners, a New York-based firm that has been involved in previous opioid-related suits.
The defendants have not yet been named.
“That’s the specifics of the litigation that our attorneys will sort out,” Councilman Tanner Polce, who came up with the idea for the lawsuit, said.
The cost of the lawsuit was not publicly released, and Mr. Polce said he could not reveal that information. He said the closed-door vote was unanimous.
Opioids, ranging from painkillers to heroin, have ravaged the country in recent years, and President Donald Trump officially declared the opioid epidemic a public health emergency in October.
According to the National Institute on Drug Abuse, more than 115 Americans die from opioids every day.
“In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates,” the institute’s website states. “This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive.”
While no other municipalities in the First State have filed lawsuits against opioid-related companies, Delaware Attorney General Matt Denn last month announced litigation against manufacturers Purdue Pharma and Endo Pharmaceuticals, distributors McKesson, Cardinal Health, Amerisource Bergen, Anda Pharmaceuticals and H.D. Smith and retailers CVS and Walgreens.
New Castle County last week said it had retained the law firm Motley Rice, which was involved in the record $246 billion tobacco Master Settlement Agreement and other opioid-related litigation.
New York, Philadelphia and Chicago are among the cities taking drug companies to court over the spread of opioids.
According to the state’s lawsuit, more than 50 opioid pills are shipped into Delaware for every resident. Delaware saw 308 people fatally overdose in 2016, per the Delaware Department of Health and Social Services.
“This is a way that the city of Dover can be proactive to one small piece of this giant puzzle,” Mr. Polce said.

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Dover Plans to Sue Pharmaceutical Companies Over Opioid Epidemic

Feb 13, 2018 | WBOC 16 (DE)

By Tom Legman

The Dover City Council on Monday night voted to retain attorneys to sue pharmaceutical companies over the opioid epidemic, adding the city to a number of other municipalities across the country taking similar legal actions.
The council voted in an executive session meeting to retain Marc J. Bern and Partners, and all other required associates, to file a lawsuit against a list of recommended pharmaceutical companies "that mass manufacture and distribute opioids," which the council believes to be a root of the opioid addiction epidemic.
Dover's action follows a lawsuit filed by Delaware Attorney General Matt Denn against some of the nation’s largest manufacturers, distributors, and retailers of prescription opioid drugs, alleging that their failures to meet their legal obligations have fueled an opioid addiction epidemic that is devastating individuals, families, and communities across the First State.
The state lawsuit seeks to hold them financially responsible for the harm they have caused to the state and its citizens and to require them to change their conduct to help end the epidemic, according to the lawsuit.
Last week, New Castle County also announced it was exploring similar legal actions.
Terms of Dover's planned lawsuit and the companies it plans to sue were not immediately available Monday night. Councilman Tanner Polce said it's believed Dover would be the first municipality in Delaware to file such a lawsuit.

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Southeast (FL, SC)

City of Sarasota picks legal team for suit against opioid manufacturers

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Pinellas Commission picks opioid litigation team

Feb 12, 2018 | Tampa Bay Newspapers (FL)

By Suzette Porter

Pinellas County commissioners unanimously agreed Feb. 6 to negotiate with the No. 1-ranked firm to represent them in a lawsuit against manufacturers and distributors of prescription opioids.
County Attorney Jewel White said seven firms had submitted a response to the county’s request for quotes, which a committee had thoroughly reviewed. She asked commissioners for permission to negotiate a contract with the law firms of Levin, Papantonio, Thomas, Mitchell, Rafferty & Proctor P.A., which is a consortium claiming to be among the national leaders in pharmaceutical litigation.
White said the consortium already represents a number of government entities, including Pasco County. The consortium has filed cases in West Virginia, Ohio, Kentucky, Illinois, Alabama, Pennsylvania and North Carolina, according to information with the firms’ response. Additional cases are being filed in Florida, Indiana, Mississippi, Maryland, Tennessee and Massachusetts.
No fees are associated with the contract; however, the consortium has asked for a 25 percent contingency fee plus costs with a cap of 50 percent. If no monies are recovered, the consortium doesn’t get paid. If money is recovered, the maximum it can receive is 50 percent.
White gave some examples of costs, including filing dispositions and hiring expert witnesses, which she said could be expensive.
Commission Chair Ken Welch said 50 percent seemed high.
“I’d like to see that be less,” he said.
Commissioner Charlie Justice said a large firm that has many clients, such as the ones that make up the consortium, should be able to divide some of the costs. White agreed. She said part of the proposal included splitting costs except for the ones unique to Pinellas.
White explained that the attorneys would be going after manufacturers and distributors that misrepresented the effects of the opioids on certain groups with false advertising.
Commissioner Janet Long asks about the possibility of a settlement. White said a settlement was possible. The top three manufacturers have expressed willingness to settle but not necessarily with a cash payout but by doing something to help a community recover – more of a holistic approach, she said.
White expects to bring a negotiated contract back to the commission Feb. 27.
Resolution against oil drilling
Commissioners also unanimously approved a resolution opposing oil and gas drilling in the eastern Gulf of Mexico as included in the Bureau of Ocean Energy Management’s 2019-2024 draft proposed program.
In a letter to Kelly Hammerle, chief of the National Oil and Gas Leasing Program, Welch outlined the county’s opposition, particularly its displeasure to the plan to offer two leasing sales in the eastern Gulf of Mexico, which is currently under a moratorium for oil and gas development through 2022. The commission supports making the moratorium permanent.
Welch explained the importance of the tourism industry as well as the recreational and commercial fishing industries to the county, which is a peninsula “dependent on the health of our waterways.” The county also is home to threatened and endangered species, which could be negatively impacted by offshore drilling activities. In addition, drilling could affect flight training and tests at military bases, which require unrestricted access to the Eastern Gulf of Mexico.
Welch referred to the issues caused by the Deepwater Horizon Oil Spill in 2010 and a “more localized” tanker spill that directly affected the county’s beaches, economy and wildlife in 1993 as evidence of potential harm.
“Given the known circulation pattern in the Gulf of Mexico, oil released into Gulf waters, particularly the eastern Gulf, can easily travel hundreds of miles under the loop current and be deposited on Pinellas County’s shoreline,” Welch said.
The draft proposed plan has been the subject of heightened controversy since Secretary of the Interior Ryan Zinke met with Gov. Rick Scott Jan. 9 and announced that Florida had been removed from the draft plan.
However, Walter Cruickshank, director of the Bureau of Ocean Energy Management, said Jan. 19 that no formal decision had been made to remove Florida from the plan.
The public can submit comments on the plan through March 9. Visit https://www.boem.gov/National-Program-Comment/.
In other business, commissioners:
• Approved the first amendment to the contract with the state Department of Health for school nurses among other things.
• Approved the second amendment to Economic Development Funding Agreement with STAR-TEC Enterprises to provide economic development incubation and acceleration services.
• Approved spending $432,531 for a medium-duty rescue squad truck for use by the county’s Technical Rescue Team.

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County fights opioid epidemic with lawsuit

Feb 13, 2018 | WJCB (FL)

By Staff

Alachua County is joining in the fight against the opioid crisis.
At the end of last month, the county filed a lawsuit in state court against various pharmaceutical manufacturers and doctors.
The county's concerns include not just the illegal trade of opioids, but also what county officials describe as overprescribing by medical professionals.
"I think our board just decided it's come to a point in the United States where this has to be addressed. Self-policing in the industry has not seemed to have done it. Our board wants to be proactive in protecting its citizens," said county spokesperson Mark Sexton.
County officials expect the lawsuit to eventually consolidate with other similar suits throughout the country.

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Beaufort County sues pharmaceutical companies, doctors over opioid crisis

Feb 12, 2018 | Bluffton Today (SC)

By Dan Hunt

Beaufort County filed a lawsuit last week against several national pharmaceutical companies and nine unnamed local clinics and physicians for their alleged roles in the opioid crisis that has increasingly affected the state and county.
The county joins several others across the state and country that are suing drug companies and local prescribers for their alleged negligence toward the health issues related to opioids and addiction.
A sentence from Beaufort County’s 126-page complaint says the “defendants have manufactured, promoted, and marketed opioids for the long-term management of chronic pain… by misleading consumers and medical providers through misrepresentations or omissions regarding the appropriate uses, risks and safety (of) opioids.”
The primary financial motive in many of these cases, Beaufort County included, is compensation for costs related to serious incidents involving opioids, particularly overdoses.
The complaint says, “Plaintiff spends millions of dollars each year to provide or pay for the health care, pharmaceutical care, and other necessary services and programs on behalf of indigents and otherwise eligible residents, including payments for prescription opium-like painkillers, which are manufactured, marketed, promoted, sold, and/or distributed by the defendants.”
The three law firms Beaufort County has employed for the case are Yelverton Law Firm LLC, Finger Melnick & Brooks PA, and Marc J. Bern & Partners LLP. The first two operate locally while Marc J. Bern & Partners operates out of Pennsylvania and is involved in several opioid suits nationwide.
Ben Shelton, an attorney who will be representing the county via Finger Melnick & Brooks, said prosecutors have not asked for a particular dollar amount for actual and punitive damages but he expects “actual damages to be in the millions for Beaufort County.”
Shelton explained how the county’s alleged financial losses to the opioid crisis have occurred.
“They are defined losses that are fairly easily ascertainable, for example the coroner’s office,” Shelton said. “They have to respond to deaths that would otherwise not be there. But they do because opioids are deceptively marketed, overly sold, overly prescribed, etc. And then folks get hooked on prescribed opioids and end up going to cheaper sources and better highs such as heroin and fentanyl.
“In addition, you have first responders, the sheriff’s office and different emergency services responding. In a lot of townships now, fire departments respond more to medical calls than they do to actual fire emergencies and the majority of those medical calls, from my understanding, are opioid overdose-related.”
Shelton cited other health services and contributions the county “has to make,” including “increasingly expensive” Narcan pens — overdose antidotes that now are carried by most first responders — specialized training for county workers related to overdoses, and police officers tending to overdoses when they would otherwise be “monitoring the streets.”
“Those are things that can be defined by manpower and dollars spent in the county budget,” Shelton said. “Beyond that, what could end up being much greater in terms of economic loss in the community, you have people hooked on drugs that are no longer contributing to society in ways that they once were in terms of wages.
“Statistics show that many of those individuals are mid-life males. So these folks have families and children that are no longer being provided for, which becomes another drain for county resources.”
Shelton also said loss of life to overdoses is a strain on tax dollars.
“I don’t want to sound crass because this is a tragedy to each and every one of them, but these are taxes that are no longer collected because we have a drain on the economy,” he said.
The long list of pharmaceutical companies being sued includes household names like Rite Aid of South Carolina Inc. and Johnson & Johnson. At the end of the defendants list is a section with four assumed prescribers referred to as “John Doe” and another five clinics that also are anonymous.
Shelton said he and his associates are choosing to keep certain parties anonymous while they gather more information. He also said the number of defendants won’t necessarily stay the same.
“At this point, we’re still working to define who those responsible parties are,” he said. “Upon some information, we believe that those folks are operating in Beaufort County, but we’re not going to name any of those parties until an appropriate time.”
Shelton said he wants the public to understand that prosecutors are “not trying to put every physician out of business.”
“This isn’t about every single doctor out there that is prescribing opioids,” he said. “There are certain conditions where they need to be prescribed. This is about folks that are prescribing vastly too many and are not prescribing them for medical services.”
It is not clear how long the legal battle will take to play out, but prosecutors are preparing for a lengthy case.
“We fully expect this case to be like any other lawsuit in that it could take a number of years to resolve. It could also be a matter that comes to a fairly quick resolution, but we don’t expect that,” Shelton said.

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West (UT, CO)

This state lawmaker wants to force the Utah attorney general to sue prescription opioid manufacturers

Feb 12, 2018 | Salt Lake Tribune (UT)

By Courtney Tanner

After months of perceived inaction, a state lawmaker is calling on Utah Attorney General Sean Reyes to “lead out” and sue prescription drug companies for the damage the opioid crisis has inflicted.
“This is an epidemic,” said Rep. Michael McKell, R-Spanish Fork. “And it’s time for the state to move forward.”
Already, six counties in Utah — Cache, Davis, Salt Lake, Utah, Washington and Weber — have announced plans to sue the $11 billion pharmaceutical industry, citing criminal justice systems and social services overwhelmed by the widespread reach of addiction. So, McKell wonders, what’s taking the state so long to file a similar suit?
He hopes his HJR12, introduced Friday in the House, will force Reyes to action. “Our counties are leading out, but it should be our state,” he said.
A lawsuit would likely seek financial damages — possibly hundreds of millions of dollars — to repay the costs of treatment. McKell said it would also allege “deceptive marketing” on the part of companies for failing to disclose the high risk of addiction.
The attorney general, however, does not intend to rush into filing suit.
“[Reyes] has fire in his belly to file this kind of thing, but he’s also a prudent litigator,” said Spencer Austin, Reyes’ chief criminal deputy.
Utah is currently part of a 41-state coalition investigating opioid abuse and talking to manufacturers. Reyes plans to consider that information, as well as the potential cost to taxpayers, before deciding what to do next, Austin said. That might include joining another state’s filing — something McKell expressly argues against in his resolution, suggesting that Utah should instead “seek the maximum award for damages from prescription opioid manufacturers for [its] citizens.”
On average, 23 Utahns die each month from prescription opioid overdose, according to the Utah Department of Health. And the state is ranked seventh nationally for all overdose deaths, which outpace car crash fatalities.

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Huerfano County sues opioid manufacturers

Feb 12, 2018 | Center Post-Dispatch (CO)

By Teresa L.Benns

A 60 Minutes episode that aired Dec. 16, 2017 fingered the country’s largest drug distributor, McKesson as literally getting away with murder in saturating the San Luis Valley with opioids.

The corporation, headquartered in San Francisco, Calif., raked in billions distributing addictive opioids over the years, the segment’s producers noted. But the Drug Enforcement Agency (DEA) was unable to prosecute the company despite the growing opioid epidemic because with the Department of Justice and Congress cut a backdoor deal with McKesson in 2014.

Huerfano County, however, also names Johnson & Johnson, Purdue Pharma, Janssen Pharmaceuticals Inc., Teva Pharmaceuticals USA Inc. and numerous subsidiaries, according to an article in the Denver Post.
Rather than fine the company a billion dollars, revoke their license to distribute products and jail their chief executive, which DEA agents had hoped to do, agents were forced to settle the case with a $150 million dollar fine, for a company that reportedly makes $100 million a week. One New Hampshire senator who criticized Congress for the settlement told CBS the pharmaceutical companies are doing all they can to keep the epidemic going.

According to the report: “DEA investigators discovered McKesson was shipping the same quantities of opioid pills to small-town pharmacies in Colorado’s San Luis Valley as it would typically ship to large drugstores next to big city medical centers.” Twenty-nine year DEA veteran Helen Kaupang, now retired commented: “McKesson [was] supplying enough pills to that community to give every man woman and child a monthly dose of 30 to 60 tablets…I found it shocking.”

And that was only one of many other suspicious orders the company was engaged in. They also were fined for supplying drugs to shady Internet drug companies and even organizations with criminal connections.

In 2014, San Luis Valley-area healthcare providers began limiting how opioid drugs are prescribed. As often happens, that decision resulted in the recourse of prescription drug abusers to heroin, also an opiate.
Retired doctor and Colorado Springs lawyer Stephen Ochs, one of several attorneys handling the lawsuit for the county, says county officials that they would not have to pay if the case did not succeed.

Ochs spoke to Alamosa County commissioners in December “urging them to join in multidistrict litigation against pharmaceutical manufacturers,” the Denver Post article related. But there has been no word so far on whether any Valley counties are expected to join the suit.

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Midwest (ND)

Standing Rock Sioux Tribe sues opioid industry

Feb 12, 2018 | Williston Herald (ND)

By Amy Dalrymple

The Standing Rock Sioux Tribe filed a lawsuit Monday against major manufacturers and distributors of opioids, joining other tribes that have filed similar lawsuits.
The case in U.S. District Court in North Dakota against 24 opioid industry defendants seeks monetary damages, alleging the companies have seen “blockbuster profits” while the use of opioids has taken an enormous toll on the tribe.
It’s the second lawsuit filed by former North Dakota U.S. Attorney Tim Purdon and former South Dakota U.S. Attorney Brendan Johnson, who now work for national firm Robins Kaplan.
“The opioid epidemic has hit Indian County hard, and the Standing Rock Sioux Reservation is no exception,” Purdon said in a statement.
The complaint notes that Native Americans suffer the highest per capita rate of opioid overdoses. It alleges the defendants used false and misleading advertising and failed to prevent drug diversion, creating a “virtually limitless opioid market.”
While Purdon was U.S. Attorney, he announced a 14-month federal drug trafficking investigation on the Standing Rock Sioux Reservation in 2012 that yielded multiple arrests, including several defendants accused of distributing prescription opioids.
Robins Kaplan attorneys filed a similar lawsuit on behalf of the Rosebud Sioux Tribe, Flandreau Santee Sioux Tribe and the Sisseton Wahpeton Oyate in South Dakota in January. That case is among several lawsuits filed by communities around the country that are consolidated before a federal judge in Ohio.
Like the South Dakota case, the lawsuit from Standing Rock seeks unspecified damages for allegations of deceptive trade practices, fraudulent and negligent conduct and alleged violations of the Racketeer Influenced and Corrupt Organization Act. It seeks injunctive relief that would prevent defendants from continuing unlawful conduct.
Purdon said in an interview he thinks additional tribes from the Great Plains will file similar lawsuits.
John Parker, senior vice president of the trade association Healthcare Distribution Alliance, said in a statement that the abuse of prescription opioids is a complex challenge that requires “a collaborative and systemic response.”
“Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated,” Parker said. “Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

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Broadcast Media Coverage

Morning Express With Robin Meade

Feb 13, 2018 | HLN (CNNH)

By National Programming

Video Link: http://app.criticalmention.com/app/#clip/view/32639849?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: new this morning drug makers funded groups that promoted opioid use. that's what at least according to a senator's report. you're talking beyond marketing and sales reps. >> we're talking about money that went to patient advocacy groups. so those are groups who talked to doctor all the time to say hey this is what we think is good for patients. these are five drug companies that made those prescription pain killers giving money to these groups, also nonprofits that sometimes really have a sheen of we're really out to do good according to the senator's report and then those groups would then influence the doctors and became another voice supporting the use of these opioids. if you think about it the senator says they are getting paid if they were up on opioids. they were fighting any laws to limit them. senator mccaskill says that's the kind of murky relationship that ends up being part of the deadly drug epidemic.

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Power Lunch

Feb 12, 2018 | CNBC (CNBC)

By National Programming

Video Link: http://app.criticalmention.com/app/#clip/view/32640062?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: we have another topic, perdue phar pharma, the maker of oxycontin, announcing it's going to stop promoting opioids to doctors this is a big deal >> this a big deal the company makes oxycontin, which is a huge prescription opioid they have eliminated about half of their sales force and they're not going to promote opioids this comes as purdue pharma and other makers are facing multiple state and municipal lawsuits over their marketing of opioids. a lot of people saying why didn't it happen before? the company say it's being responsible. >> would others follow suit? >> potentially what's really interesting today is there's a stock of another company that makes opioids which is up on this. a much smaller company, and it makes an extended release what it calls abuse deterrent form of oxycodone, that stock is up more than 10%, because analysts are saying less competition.

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2 on Your Side at 10

Feb 12, 2018 | WUTV (Fox)

By Buffalo, NY

Video Link: http://app.criticalmention.com/app/#clip/view/32639894?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: niagara county legislators voted tonight to declare the opioid crisis a "public nuisance. the term may sound unusual... but it could help bolster the county's 10:01 PMongoing lawsuit against major drug companies. two on your side's danny spewak asks the tough questions about why niagara county... and so many other government groups... have decided to take these companies to court. nats: "alex colville.. ... dane harrison weaver..." the names... and faces of the opioid epidemic... are the motivating forces behind a wave of lawsuits across the united states. montage of lawsuits: "this lawsuit is abou justice... we've had enough of the fraudulent marketing... and distribution of these opioids by the manufacturers and distributors... that have made billions of dollars in profits from the opioid epidemic." hundreds of local governments are suing drug companies like purdue pharma, johnson & johnson and others. the lawsuits accuse them of pushing painkillers on doctors and patients without disclosing how addictive the opioidsreally were. for niagara county, the goal was the same: wydysh: "go afte the pharmaceutical companies, for their part in this issue." to give them leverage, rebecca 10:02 PMwydysh and her fellow county legislators moved a "public nuisance proposal through committee. the designation could help them recover more damages to help pay for costs associated with the opioid crisis. bradt: "all the mone being spent by the police, sheriff's, ems, first responders, and treatments of the individuals... to help them and get them back to the life they deserve." niagara county is one of at least three western new york counties to officially file suit so far, joining chautauqua and erie. but much like the tobacco settlements of the 1990s, the question for local governments is this: danny: "if this come to fruition, and you do get some money out of this, can you promise the taxpayers of niagara county that this will go toward treatment and recovery? rebecca: certainly, that's something that we have to focus on. this is something that his hit every department in the county." before that can happen, though... the county will need to prove in court that it deserves the money. i mentioned that niagara, chautauqua i mentioned that niagara, chautauqua and erie counties have all officially filed their lawsuits in court. but by my count, seven out of eight counties in western new york have at least explored or discussed the idea of a lawsuit. as for niagara county, this "publi nuisance" proposa now goes to the full legislature.

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KIRO 7 News at 5AM

Feb 13, 2018 | KIRO (CBS)

By Seattle, WA

Video Link: http://app.criticalmention.com/app/#clip/view/32639932?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: a new congressional report says patient advocacy groups promoted opioids - after receiving money from opioid manufacturers.the report says five major pharmaceutical manufacturers paid nearly 10-million dollars to 14 patient groups. it goes on to say the advocacy groups allegedly minimized the risk of addiction, promoted opioid use and lobbied against legislation that would curb abuse.some of the groups mentioned in the report - have denied the money influenced them.

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Wake Up 7am

Feb 13, 2018 | WNLO (CW)

By Buffalo, NY

Video Link: http://app.criticalmention.com/app/#clip/view/32639938?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: niagara county lawmakers took another step forward in the fight against the opioid epidemic. they introduced a resolution last night declaring opioidsa "publi nuisance." lawmakers say this will help niagara county in its lawsuit against opioid manufacturers. they want the drug companies to cover the costs they've had to pay to fight the drug epidemic. ((multiple families besides mine have been affected by this and its something we really need to get a handle on and everything we do on this is for that exact same reason, for all of the other families that have been struck by this epidemic.--:11)) 31 people in niagara county died from drug overdoses last year. the resolution will go through several committee votes. the county legislature could approve it as soon as next month.

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The Delta News Morning

Feb 13, 2018 | WABG (ABC)

By Greenwood, MS

Video Link: http://app.criticalmention.com/app/#clip/view/32639963?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: [candi]two law groups discuss the possibility of representing leflore county in the opioid litigation.[take vo][take l3]the leflore county board heard the proposals yesterday ... voting on rogers law group to represent them in the case ... the law group bares all expenses ...the 30 percent contingency fee would be based on the total amount if recovered.[take sot][take l3] "i've been in the opioid litigation for probably about 8 months. i think right now, to my knowledge their have been 7 lawsuits that have been filed by counties in mississippi, they may have been more , but i have filed 4 of them personally, myself. i represent along with my group. we represent approximately 20 counties in the state of mississippi right now. nationwide we represent 250 cities, and governments. the communities we represent comprise almost 9 percent of the united states population, so to say we have a big client base would be an understatement." (runs 43;35)[cont vo]judge polster is managing litigations and says he's pushing to have a resolution this year.

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40/29 News Sunrise

Feb 13, 2018 | KHBS (ABC)

By Ft. Smith, AR

Video Link: http://app.criticalmention.com/app/#clip/view/32639969?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: city and county leaders join a legal fight in the opioid epidemic. addressed the crisis during the meeting and joined efforts of municipal league defense fund in the lawsuit against opioid manufacturers and distributors. several factors led to the decision, including the fact that arkansas is ranked second in the nation in per capita prescriptions of opioid medications. benton county officials announce they are joining in the lawsuit.

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Fox 2 News in the Morning

Feb 13, 2018 | KTVI (Fox)

By St. Louis, MO

Video Link: http://app.criticalmention.com/app/#clip/view/32639935?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: groups fighting for her patients are patients are now accused of adding to the opioid epidemic after they got funding from drug companies. >> major drunk -- major drug companies $10 million between 2012 and 2017. the senate turn launch the investigation looking at ties between drug companies and patient advocacy groups. they found the at see-through promoted advocacy groups promoted the use of opioids and filed fall against loss that do the abuse and try to block a push tool doctors accountable for over prescribing opioids. >> they were first filled with the the manufacturers producing these. americans had no idea if things it things to go to organizations many times, they do the bidding of a the very people that were over prescribing and over pushing opioids in this country. >> this just after the country's largest drug companies. they announced, it wouldn't no longer would no longer sell opioid painkillers to doctors.

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KCTV News This Morning

Feb 13, 2018 | KCTV (CBS)

By Kansas City, MO

Rough Transcript: new this morning, missouri senator claire mccaskill's released a bombshell report in her investigation of the opioid crisis. it accuses prescription painkiller manufacturers of funneling millions of dollars to advocacy groups that promoted the medications. experts say the findings give insight into how industry-funded groups led the demand for the pain killers. representatives for the company said they did not instruct the advocacy groups on what to do with the money, nor did they demand endorsements.

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WBOC News This Morning

Feb 13, 2018 | WBOC (CBS)

By Salisbury, MD

Video Link: http://app.criticalmention.com/app/#clip/view/32639985?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: the city of dover is filing a lawsuit against a list of pharmaceutical companies that manufacture opioids. it joins many other cities across the country in taking this type of action due to the growing opioid epidemic.. but it's believed to be the first municipality in the state of delaware to do so

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FOX8 News at 6:00A

Feb 13, 2018 | WGHP (Fox)

By Greensboro, NC

Video Link: http://app.criticalmention.com/app/#clip/view/32639975?token=1b13e32d-bcfe-4797-af2c-72478377ce97
Rough Transcript: five opioid manufacturers dished out more than 10-million dollars to advocacy groups and doctors over the past few years. that's according to a new report from a senate committee. officials have blamed the manufacturers for supporting the over-prescription of painkillers. one of the companies -- purdue pharma -- announced it will no longer promote opioids to doctors.

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