Author: Justin Mckibben
Ever since the true nature of the opioid epidemic in America began to come to light, and people started to see the gravity of its impact in communities across the country, there have been plenty of efforts to find out how we ever got this far. We continue to ask who should be held accountable. Was it the black market drug trade? Was it the synthetic opioids coming from overseas? How did it get this bad?
Just this past week 60 Minutes and The Washington Post joined forces to interview Joe Rannazzisi, who is said to be the most important whistleblower ever on 60 Minutes.
Joe Rannazzisi is a former agent of the Drug Enforcement Administration (DEA) who ran the Office of Diversion Control; the department in charge of regulating and investigating the pharmaceutical industry. He is a former DEA deputy assistant administrator with a law degree, and a pharmacy degree, who believes the great injustice done to the American people cannot go overlooked.
Bad Business with Big Pharma
Through this inside look with Rannazzisi, he implicates Big Pharma drug makers in willingly distributed hundreds of millions of drugs to rogue pharmacies and pain-clinics-turned-pill-mills for over two decades.
Rannazzisi believes that the Big Pharma companies, some even multi-billion, Fortune 500 companies, have contributed to the problem by ignoring the truth; that powerful prescription pain medications were being diverted from doctors, clinics and pharmacies for illicit use. In the interview, Rannazzisi calls out a number of key drug makers, including:
He also calls out the three largest drug distributors:
- Cardinal Health
Saying they control probably 85%- 90% of drugs “going downstream.”
In fact, Rannazzisi said the way pain clinics seemed to pop up overnight all over the country made the whole crack-cocaine epidemic look like nothing, saying he had never seen anything like it, adding:
“These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.”
Rannazzisi says after prosecuting pain doctors and pharmacists didn’t seem to put a real dent in the problem, he knew he had to work his way up; they went after distributors.
While drug distributors tried to defend themselves saying it was all on the doctors for over-prescribing medications, Rannazzisi says they know exactly how many pills are being sent out. Under the Controlled Substances Act, these distributors are required by law to report and stop what the DEA refers to as “suspicious orders”.
So what might “suspicious orders” look like? Probably something lie unusually large and/or frequent shipments of opioids being made to a location. Kind of like what was happening all over the nation for years and years.
For example, just one pharmacy in Kermit, West Virginia ordered 9 million hydrocodone pills in just over 2 years. That’s for a town of only 392 people. That’s over 11,479 pills a person each year! Almost 1,000 pills a month! From only one of the town’s pharmacies.
DEA investigators say many drug distributors ignored the DEA requirements and shipped anyway.
DEA Fighting Back
Rannazzisi wasn’t the only DEA agent to speak up about Big Pharma’s bad business. Several other DEA veterans say they saw thousands of suspicious orders and tried to fight the growing problem. Others said they tried on multiple occasions to get these companies to fix the issue, but they did nothing.
Eventually, in 2008 the DEA was able to hit some distributors with hefty fines for filing hundreds of suspicious orders, including:
- $13.2 million fine against the country’s largest drug distributor, McKesson
- $34 million fine against second-largest distributor, Cardinal Health
The fines for drug distributors over the last 7 years add up to around $341 million.
The High Rollers
In 2011, Cardinal Health attorneys called Rannazzisi’s boss at the Justice Department, who called Rannazzisi and pressed for an explanation for his policies. Rannazzisi believes that even after they had gone after small companies hundreds of times before, as soon as they went after the Fortune 500 drug makers, their power and influence started getting in his way.
Rannazzisi says that with these massive Big Pharma empires there was now money and influence being used to pressure top lawyers at the DEA to pursue a softer approach on penalizing drug distributors who broke the rules.
Former DEA attorney Jonathan Novak noticed that shocking shift in the way these kinds of cases were handled. Stating:
“These were not cases where it was black — where it was grey… These were cases where the evidence was crystal clear that there was wrongdoing going on.”
But suddenly the higher ups started to demand more and more evidence to stall the system. Fewer cases against Big Pharma companies were being approved, and road-blocks from Novak’s bosses seemed to pop up everywhere.
Novak also said he saw a huge migration of DEA lawyers switching sides to defend the drug industry in higher paying positions.
Taking it to Congress
While drug distributors started successfully stalling the progress of cases against them from the DEA, they also began to lobby Congress to get legislation that would destroy the DEA’s power over them.
Then one day Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee introduced a bill to the House that was promoted as a way to ensure that patients had access to the pain medication they needed. However, Jonathan Novak, who worked in the DEA’s legal office, claims that what the bill really did was strip the agency of its ability to immediately freeze suspicious shipments of prescription narcotics to keep drugs off U.S. streets.
The bill’s author… Linden Barber, a former employee of the DEA.
Congressman Tom Marino, along with Congresswoman Blackburn, later wrote the inspector general for the Justice Department, demanding that Rannazzisi be investigated for trying to quote “intimidate the United States Congress.” Even though this went nowhere, Rannazzisi was stripped of his responsibilities soon after.
Some former DEA agents believe that the Big Pharma industry not only used lobbying groups to donate money to politicians to get laws passed in their favor, but also to try and push Joe Rannazzisi out of his office.
In the end, the DEA signed off on the final version of the “Marino bill.” A senior DEA representative claiming that even though they fought to stop it, growing pressure from Congress and industry lobbyists forced them into a deal it did not want.
The bill was presented to the Senate in March of 2016.
Majority Leader Mitch McConnell introduced the legislation in the Senate.
It passed by unanimous consent with no objections and no recorded votes.
It passed the House the same way, and President Obama signed it into law.
Where Are We Now?
This whole thing reminds you of the saying- if you can’t beat em, join em.
It would seem that’s exactly what a lot of DEA agents did after fighting a losing battle against powerful Big Pharma companies.
Since it all began, the pharmaceutical industry and law firms that represent them have hired at least 46 investigators, attorneys, and supervisors from the DEA, including 32 directly from the division that regulates the drug industry.
Remember that guy Linden Barber, who authored the bill that many say stripped the DEA of the power to go after Big Pharma companies? Well 3 months ago Cardinal Health, that second-largest drug distributor we were talking about that went after Rannazzisi through his boss, hired Linden Barber as the senior vice president!
Other former DEA agents and lawyers have gone on to take up so pretty prestigious positions working for drug companies, or law firms and other organizations working in the pharmaceutical industries best interest.
Joe Rannazzisi now consults with state attorneys general who have filed suit against distributors for their role in the opioid crisis.
Oh… and let us not forget Congressman Marino, who was just nominated to become President Trump’s new drug czar.
Remarkably, there are a lot of instances of people in the DEA being influenced by pharmaceutical companies and lobbyists to stand up for drug companies instead of the tens-of-thousands of Americans dying from opioids each year. In many of these instances, the individual’s go on to get high-earning jobs defending the interests of the Big Pharma industry.
So is it a made-up conspiracy? Or are pharmaceutical companies buying their way out of trouble at every turn and pushing out people like Rannazzisi who stand up to them? Is it really that hard to believe when you connect the dots?
With an ongoing opioid epidemic doing major damage to the country, we have to acknowledge everything that has contributed to this issue. Even if we set aside the idea of placing blame, we cannot prevent it from getting worse or happening again if we don’t acknowledge what helped cause it. Every drug company, policy maker, pharmacy, crooked doctor and individual should be accountable to taking action to make things better. It starts with accepting the issue and building a foundation to recover. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
The Global Commission on Drug Policy (GCDP) is an international institution of global leaders and intellectuals working to help study and inform initiatives on addressing drug use all around the world. This think tank offers recommendations concerning drug use and its consequences for societies across the globe.
The GCDP consists of members from various nations, including but not limited to:
- The United States of America
- The United Kingdom
Former U.S. President Jimmy Carter wrote an op-ed in The New York Times explicitly endorsing the recommendations of the Global Commission on Drug Policy, and the group has released various reports over the years focusing on the efforts to curb the spread of drug abuse.
Recently the GCDP released a position report on the North American opioid epidemic. In this report, the commission issues recommendations that appear to endorse the expansion of harm reduction techniques to battle the ongoing crisis.
The Turning Point for America
According to the GCDP’s new report, North America is at a turning point in the way that drug addiction is viewed. This is not too much of a surprise, considering now more than ever there has been a push for a more compassionate perspective on drug use and addiction. America now finds itself in a unique position where the stigma that has so long been attached to addiction is starting to be abandoned, and more progressive action is being taken.
Now the Global Commission on Drug Policy believes national policymakers should take advantage of this unique opportunity to reduce opioid-related deaths through harm reduction. In the report the authors state:
“While in recent years media and politicians have been more open to viewing addiction as a public health problem, leadership is needed to turn this into an urgent and commensurate response to the crisis,”
One way that the Global Commission on Drug Policy ideals clashes with that of the Trump administration, currently steering drug policy in America is that the GCDP does not endorse the old policies of the War on Drugs.
GCDP vs War on Drugs
Back in June of 2011, the GCDP stated:
“The global war on drugs has failed, with devastating consequences for individuals and societies around the world.”
Again, this recent report echoes that sentiment, saying that attempting to cut off the opioid supply is not the answer. The new report notes how this approach has been tried before, as the first reactions to the opioid epidemic were to limit prescriptions and to introduce pills that were harder to manipulate.
The report goes on to note that this response drove people to use cheaper and often much more potent street drugs instead of prescription pills. Fentanyl is one of the worst synthetic opioids to contribute to the outbreak of overdoses and deaths across the country.
The Global Commission on Drug Policy says cutting off the supply of opioids into the country cannot be effectively executed until after supportive measures are put in place. This means supporting not only both people battling addiction but also people with chronic pain. The report insists:
“The aim is to achieve the right balance in regulation to provide effective and adequate pain care, while minimizing opportunities for misuse of these medications.”
To reduce the harmful impacts of opioids, the commission calling for the acceptance and implementation of harm reduction strategies.
The Global Commission on Drug Policy Suggests Harm Reduction
So if they are saying that the War on Drugs did not work, and neither will bulking up borders, then what will?
Well, according to the GCDP, harm reduction is the right move. The new report calls on American lawmakers to promote programs like:
Naloxone Distribution and Training
As the opioid overdose antidote, Naloxone is an invaluable tool to have in the fight against the opioid epidemic in America, but the price for the drug continued to skyrocket as the epidemic got worse. Making it more available could give access to and train people with life-saving medication to thousands or even millions more.
Safe locations where IV drug users can trade old, contaminated needles for new, sterile needles to help prevent the spread of blood-borne illness like HIV.
Facilities where drug users can go to use their drugs with sterile equipment safely, reducing the number of overdose deaths by providing a place free of punishment for them to use with medical emergency resources on site.
These kinds of programs would allow for users to check their drugs for the presence of any unknown substances it may have been diluted with. For example, most fentanyl users do not know they are using fentanyl.
Decriminalizing Drugs in America
In another aspect of the report, GCDP also makes a much more revolutionary and more radical suggestion that many may consider qualifying as harm reduction: decriminalization.
The report states:
“The Global Commission on Drug Policy also calls for the elimination of illicit drug markets by carefully regulating different drugs according to their potential harms. The most effective way to reduce the extensive harms of the global drug prohibition regime and advance the goals of public health and safety is to get drugs under control through responsible legal regulation.”
With this philosophy in mind, the GCDP made two more drastic recommendations:
- End the criminalization and incarceration of people who use drugs nation-wide in Canada and the United States.
- Allow and promote pilot projects for the responsible legal regulation of currently illicit drugs including opioids.
The idea is that by decriminalizing drugs, they can bypass criminal organizations and ultimately replace the current black market.
“Do not pursue such offenses so that people in need of health and social services can access them freely, easily, and without fear of legal coercion,”
We have begun to see a watered-down variation of this kind of strategy with many Police Assisted Addiction and Recovery Initiative (PAARI) programs, where law enforcement is helping addicts get into treatment instead of arresting them when they ask for help.
Better Treatment Research
The report insists that more research is necessary in a few critical areas in order the effectively address the opioid crisis and the overall drug problem in America.
One of the key points of research the GCDP proposes is for finding the most effective treatments for addiction, specifically to prescription opioids. In addition, the report shows support for medication-assisted treatment (MAT) and opioid substitution therapy (OST) as a means to preserve life to assist in the recovery process. While these programs are met with some of the same contentions as safe injection sites or decriminalization, the commission seems adamant about using harm reduction to keep people alive long enough to get better.
Michel Kazatchkine, a doctor and commission member, said in a recent interview:
“Repression is harmful. Wherever repressive policies are in place, people will not be in the best condition to access services.”
While he and other commission members are in no way naïve to the fact there is no way decriminalization will happen at the federal level soon in the U.S., they remain hopeful that states or cities will make decisions which don’t require federal approval, or for which they are willing to enter to fight with the federal process.
Overall, the hope of the GCDP is that these suggestions, coming from a group of world leaders fully invested in understanding the issue, will convince American and Canadian lawmakers to take a progressive approach to the crisis.
What could some of these changes mean for those trying to recover from opioid abuse? How could some of these ideas change the way addiction treatment operates within America?
One thing is for certain, in fighting opioid addiction, whether as a society, as a family or as an individual, there needs to be compassion and action. It takes courage and it takes a degree of uncertainty. But with the right resources, there is hope for a greater future. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
While the entire country has been impacted by this ongoing issue, more options for prevention and treatment have become paramount to changing the tides. Just this week Rick Scott, the governor of the state of Florida, proposed a strategy for fighting the opioid epidemic that has gained a lot of attention. Scott has decided to ask local lawmakers to impose a three-day limit on opioid prescriptions during the upcoming legislative session. This latest development is one new piece of recent initiatives to combat the opioid crisis.
Florida Governor Opioid Initiatives
During two press conferences on Tuesday, the Florida Governor announced a pushback on an abundance of opioid prescriptions, while also introducing other ideas for fighting addiction.
One of the initiatives Rick Scott is pushing is to require all health-care professionals who prescribe controlled substances to participate in the Florida Prescription Drug Monitoring Program, also known as the PDMP. This database involves health-care professionals to report important information on patients receiving powerful narcotic medications, including:
- Name of the doctor
- Patient name
- Prescription information after the prescription is filled
But this is not the last of Florida Governor Scott’s opioid initiatives. His office also plans to seek additional reforms such as:
- Fight unlicensed pain management clinics
- Requiring education on responsible opioid prescribing
- Creating more opportunities for federal grants
Scott apparently plans to put some more investments toward helping those already struggling. He is also pushing for more than $50 million for services including:
Part of this initiative is also boosting up the budget of the Florida Violent Crime and Drug Control Council.
At the moment the finer details of the Florida Governor’s proposals are not yet available. However, what it does tell us is that Scott is not ignoring the contribution Big Pharma makes in this current crisis. What we can tell from this outline is that Rick Scott says he is aiming to address prescription opioid pain medication, recognizing it as a key source of the growing problem.
Why 3 Days?
It has been reported time and time again that we should be paying attention to how powerful opioid medications impact rising addiction rates. Now the Centers for Disease Control and Prevention (CDC) has released a recent study showing how quickly someone could get hooked on these kinds of drugs. In this study it is shown:
- After three days of use, about 6% of patients were still using opioids a year later.
- Five days into use, about 10% of patients were still using opioids a year later.
- After 11 days of use, it jumps to 25% of patients still taking opioids a year later.
So it would seem that between 3-5 days, the chances of continued use almost doubled. Then between 5-11 days the chances of use more than doubled. This development may have helped inspire the idea to limit prescriptions to 3 days.
Back in March, Bradley Martin of the CDC, one of the study authors, told Vox magazine:
“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,”
So while day 5 and day 6 may not be a dramatic leap over the edge, some may see this proposed limit as an attempt to at least slow a process down.
The Opposing Argument
The Florida Governor will probably face strong criticism, or at least skepticism, from crowds such as:
The opposition is still very real. This isn’t even the first time Florida lawmakers have seen something like this brought to the table. Just last year Florida legislatures quietly rejected an effort last year to impose a five-day cap on opioid prescriptions for acute pain.
Legislatures and doctors are the only concerns Florida Governor may have to tangle with in order to push this idea through. Other potential obstacles standing against this proposal include:
- Additional out-of-pocket co-pays that patients will incur
- The ability of patients with chronic pain and terminal illnesses to refill prescriptions
The Florida Society of Interventional Pain Physicians will discuss caps on prescriptions during a board meeting today. Dr. Sanford Silverman is a past president of the Florida Society of Interventional Pain Physicians. In regards to the 3 day limit he stated:
“We don’t think the cap is reasonable since it is a completely arbitrary number,”
“A better idea would be to mandate usage of the PDMP prior to writing an opioid for acute pain.”
Other states have created caps on prescriptions, although some may not seem as strict as the 3 day rule.
- Massachusetts limits the supply to seven days.
- New Jersey set it so that first-time prescriptions for acute pain cannot exceed a five-day supply. Also, patients being treated for cancer or under hospice care are exempt.
- Ohio caps distinguish between patients with chronic pain and those with acute pain.
At the end of the day, similar strategies may not be left up to the lawmakers. If pharmacies decide to impose their own limits on certain prescription drugs the Florida Governor might not have to push very hard to get the limits he is looking for.
CVS announced Friday that the company plans to:
- Limit the daily dosage of pain pills based on their strength
- Require the use of quick-release painkillers before extended-release opioids are dispensed
- Limit opioid prescriptions to seven days for certain conditions
This restriction will specifically apply to patients who are new to pain therapy.
Only time will tell how far Florida Governor Rick Scott’s new pitch will go, but it seems one thing people can agree on is that the opioid crisis does require some new approaches to prevention.
With more prevention we may be able to slow down the rising rates of opioid addiction. Meanwhile, the need for safe and effective treatment still means a lot for helping those already suffering. Real treatment resources matter. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
The Center for Disease Control and Prevention (CDC) announced on September 5th it would be allocating more than $28.6 million in funding to assist dozens of states, not to mention the District of Columbia, with overcoming the issues they face concerning opioid abuse, addiction, overdose and opioid related death. Many states are still struggling to make headway in the uphill battle. Thanks to the CDC fighting opioids with such a large contribution people in these areas have a better chance of gaining access to crucial resources.
It All Adds Up
The Omnibus Appropriations Bill in 2017 added funding for fighting the opioid epidemic with a $103 million dollar contribution. Combined with this new money from the CDC there will be even more support for things such as:
Addiction prevention programs
Drug monitoring programs
Improved toxicology testing for medical examiners/coroners
This isn’t the first time this year the CDC has dropped a big sum into the opioid outbreak.
Just a few months back in July the CDC fighting opioids led to a $12 million pledge to state overdose prevention efforts. This contribution was made as part of the plan from the Department of Health and Human Services’ (DHHS) in response to the nationwide opioid epidemic.
Who Gets the Money?
So which states are receiving funding through this latest pledge, and why? This money is being distributed out to various states that participate in the CDC’s Overdose Prevention in States Program (OPiS). The OPiS program includes 3 unique programs designed for prevention efforts:
Prescription Drug Overdose: Prevention for States (PfS)
This program will provide $19.3 million in funding to 27 states to expand various of their prevention programs, which also use community outreach.
Data-Driven Prevention Initiative (DDPI)
$4.6 million will go through DDPI to 12 states and Washington, D.C. for similar programs. Other states getting funds through the DDPI include:
Enhanced State Opioid Overdose Surveillance (ESOOS)
Across the country around $4.7 million will go to medical examiners and coroners in 32 states and D.C. to track and prevent overdoses. The top 5 states on the list of highest rates of overdose death will receive funding, which includes:
-as well as-
How is CDC Fighting Opioids?
Not only is the OPiS program a big portion of the plan to fight opioids from the DHHS, but there are 4 other key components to these efforts.
Naloxone expansion programs
Improving public health data related to opioid crisis
Advancing practices for pain management
Greater research and support on addiction and pain
DHHS Secretary Tom Price states that the funding expansion was made possible through legislation signed by the Trump administration earlier this year. He insists it is an important part of committing help to states combating opioid addiction and overdose.
Many are hopeful that this will be the beginning of a trend for allocating funds toward more resources for CDC fighting opioids and the damage they cause across America. Advocates are still hopeful to receive more support, but for now there is at least some hope that something is being done. As far as each individual, recovery begins with taking advantage of any opportunity in front of you to do better. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
Back in September of 2013 doctors in Arizona were understandably alarmed after two potentially related cases of a now infamous flesh eating Krokodil drug appeared in the state, one of the first ever reports of the drug in America. That year doctors in Illinois also reported treating individuals suffering serious damage due to use of the corrosive recreational narcotic. Since then the drug has seemingly been absent from the front lines of the opioid epidemic in America. However, after a few recent reports, some are worried it might make a surprising comeback. This time, it appears Krokodil has resurfaced on the East Coast.
What is Krokodil?
The main ingredient in Krokodil is the drug desomorphine. It is a derivative of morphine that is 8 to 10 times more potent. Desomorphine was first patented in the United States in 1932.
The drug got its now notorious nickname from the Russian word for crocodile; due to the fact users often develop scale-like, green skin. Other permanent effects of the drug include:
- Speech impediments
- Erratic movement
Krokodil can be manufactured illicitly from products such as:
- Hydrochloric acid
- Red phosphorus
However, artificially producing desomorphine like this causes the drug to be dangerously impure. It contains toxic and corrosive byproducts from the home-made chemical combination. The rotting effect these chemicals have on the flesh is why many people call it the ‘zombie drug’.
Krokodil in Europe
As a recreational and injectable drug, ill-reputed and home-made Krokodil was first reported in the middle and eastern areas of Siberia way back in 2002. According to medical reports, it then quickly spread across Russia and other Soviet republics with a distressing impact on those it came into contact with. The drug became so popular because compared to the more mainstream opioids like heroin the high is much stronger and it was extremely cheap to produce. The drug is also highly addictive.
This drug has devastating effects on its users, who have an average life span of only 2 to 3 years after they start using. The chemicals within Krokodil literally rot and eat people away from the inside.
Krokodil Coming to America
In 2013 the leg of a young woman in Lockport Illinois named Amber Neitzel, 26 at the time, was photographed because of the intense damage Krokodil had done to her tissue. Most of the previous reports of Krokodil in the U.S. appeared mostly in the Southwest. Now one story has some worried it’s back and getting around.
An overdose patient found all but rotting alive in Manchester, New Hampshire last week told responders he believed he’d been injecting the drug Krokodil. In relation to the story, reporters spoke with Chris Hickey with American Medical Response, who said,
“It’s pretty much the dirty sister of morphine and heroin,’ Hickey said. ‘A lot of times, it’s cut with something like gasoline or the ground-up red phosphorus from the tips of matches or drain cleaner.”
“With someone who is literally rotting away in front of you it turns the stomach of even the most seasoned provider.”
The opioid epidemic is already affecting the vast majority of Americans in one way or another, whether they are struggling or someone they know, and most experts predict we still haven’t reached the pinnacle of the problem.
Already there are awfully hazardous synthetic drugs like fentanyl and carfentanil being slipped into the illegal drug trade through heroin and home-pressed prescription pill form. These two substances alone have supplied most states with a surge of opioid overdoses and deaths.
If Krokodil is really making a comeback, how much worse could the opioid epidemic get and how quickly will law enforcement, public health officials and communities be ready to respond? Will this be the deciding factor in pushing the overdose death rates to new and demoralizing peaks?
Drugs like these are far too real and costing far too many people their lives. There is another way, but it begins with taking action. Seeking safe and effective treatment can be a crucial step to changing your life. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135