Author: Justin Mckibben
Earlier this week we talked about a story that shook things up in politics as a former DEA agent threw some serious accusations at the Big Pharma industry, Congress and a number of key officials for their involvement in policies some believe helped create the enduring opioid crisis in America. Among those accused of tipping the scales in favor of Big Pharma and stripping power away from those charged with regulating the industry was Republican Representative Tom Marino.
Of course, we know that Tom Marino was President Donald Trump’s top nominee to be the nation’s drug czar.
Now, after withdrawing from the nomination to head the White House Office of National Drug Control Policy, Tom Marino says he is proud of his role in writing a 2016 law that many critics say paved the way for the current epidemic.
The Tom Marino Factor
What kind of role did Tom Marino have in the creation of the Ensuring Patient Access and Effective Drug Enforcement Act? Why is it that so many are up in arms about the bill in the first place?
To recap- Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee introduced a bill to the House. It was advertised to officials as a way to ensure that patients had access to the pain medication they needed. In a statement released by Marino’s office, he claims the law would help “facilitate a balanced solution” by ensuring access to certain medications while allowing the Drug Enforcement Administration to prevent the sale and abuse of prescription drugs.
In essence, Tom Marino was supposedly pushing for a way to let pain management patients still get the useful medications they needed, without impeding on the process of curbing abuse.
But that isn’t how everyone sees it, especially after the 60 Minutes story.
Why it Matters
According to the opposition, the bill ultimately did little else besides weaken the DEA and the government’s authority to stop companies from distributing opioids in suspicious shipments.
For years prior to the passage of the “Marino Bill” some big-time drug distributors were getting fined thousands of dollars for repeatedly ignoring DEA warnings to shut down suspicious sales of hundreds of millions of pills. These companies were racking up billions of dollars in sales while turning a blind eye to obnoxious overprescribing of dangerous drugs.
Back then the DEA was able to immediately prevent drugs from reaching the street by freezing suspicious shipments. If the DEA judged that the drugs posed an “imminent danger” to a community, they could take action to prevent the flood of powerful narcotic medications from overwhelming the area.
However, the Tom Marino bill is argued to make it virtually impossible for the DEA to freeze suspicious narcotic shipments from the companies. Now, the agency is required to demonstrate that a drug distributor’s actions represent “a substantial likelihood of an immediate threat,” which officials say is far more difficult criteria to meet. The report against the Tom Marino bill even cited internal DEA and Justice Department documents and an independent assessment by the DEA’s chief administrative law judge.
The DEA even fought the bill, according to people within the agency, but in 2015 the law gained momentum again when the Justice Department named a new chief of the DEA- Chuck Rosenberg. After some reluctance, the report on 60 Minutes that included exclusive insight from Joseph T. Rannazzisi states the DEA ultimately took a deal they did not want.
Champion for Big Pharma
Marino disputed that, calling the reports “false accusations and unfair reporting.”
Tom Marino spent years pushing versions of this bill through Congress. He argued that it was to put an overly-aggressive DEA in check and protect drug companies from what he believed was unfair or misguided federal interference. In other words, he spent a lot of time fighting for Big Pharma’s ability to send millions of pills to communities that didn’t have half the population to justify them. All because the DEA was being aggressive?
The irony here is that the same people who pushed so hard for drug distributors ability to traffic obscene among of pills without the pesky DEA would probably be the same people demanding mandatory minimums for low-level drug offenders on the streets.
And again, many are still suspicious of those involved in pushing for this kind of legislation because of their connections to Big Pharma industry. The Post reports that the drug industry worked behind the scenes with lobbyists and key members of Congress, including Tom Marino.
Some reports indicate the Big Pharma industry poured more than a million dollars into election campaigns, including Marino’s, who received nearly $100,000 in campaign contributions from political action committees supporting the drug industry.
Utah Republican Senator Orrin Hatch calls the report “complete baloney” after it gained serious momentum earlier in the week.
Why are we not surprised? Because Hatch himself has received hundreds of thousands in donations from Big Pharma companies and health contributors over the years.
Holding Big Pharma accountable for their contribution to the opioid epidemic has become an increasingly popular cause. Lawyers and politicians at all levels have been pushing to put a spotlight on the shady side of the pharmaceutical industry. Now it seems that spotlight may extend more and more to exposing the politics that allow these issues to spread.
Another crucial element to putting an end to the opioid epidemic is providing safe and effective treatment for those who need help the most. A lot of people are still out there suffering because of prescription drug abuse or other dangerous substances. But we want to help. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
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
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
Author: Justin Mckibben
Big Pharma has been called out several times in the past couple years for pricing, aggressive marketing and misrepresenting their products. Big Pharma companies have also been called to court a few times for the contribution prescription opioid drugs have made on the opioid epidemic that has damaged the country. The financial and emotional toll of the opioid epidemic has hit hard in several states. South Florida is no exception. Delray Beach has experienced their fair share of strain from the opioid problem, especially when it had been an epicenter of the huge illegal pill mill problem.
Now community leaders in Delray Beach are seeking restitution from the Big Pharma empires, making it the first city in Florida to take this shot at holding Big Pharma accountable.
The Big Suit
That’s why the Delray Beach commission Tuesday decided to sue drug makers for the part they played in the heroin crisis. The city has enlisted the national law firm of Robbins Geller Rudman & Dowd from their office based in Boca Raton. So far the suit has set its sights on at least 8 major drug makers and distributors. Two of these have already seen similar cases; Purdue Pharma and McKesson Corp.
Mayor of Delray Beach, Cary Clickstein, has stated:
“With virtually no help from our federal government and little from our state … cities like ours are now frantically searching for answers for our own population,”
“We’re right for turning our eyes to those who are known conspirators in this ongoing atrocity.”
According to the law firm representing Delray Beach, the Big Pharma companies being pursued are responsible for:
- Downplaying the addictive nature of opioids
- Forcing the burden of dealing with the resultant overdoses on state, county and city governments
One of the more impressive features of this case is that the lawsuit won’t cost the city of Delray Beach. The expenses will be covered by Robbins Geller. However, the case supposedly has the potential to garner millions in damages for the parties pressing the matter.
According to a partner of the law firm, who compared the Big Pharma tactics to the now infamous tactics of Big Tobacco,
“They went out and said that opioids are less than 1 percent addictive. That is obviously not true.”
The Mayor and the law firm seem hopeful, while other states have been laying the groundwork for these powerful fights.
States VS Big Pharma
Back in 2015, two counties in California sought damages against 5 Big Pharma companies for the same reasons, and in no time at all the case had been dismissed. However, recently one of these drug company agreed to pay 1.6 million for substance abuse treatment to settle the lawsuit. 4 others remain as defendants in this ongoing battle.
In 2014, Chicago’s Mayor Rahm Emanuel took a similar stance, but in 2015 the case was also dismissed. However, the court did state in one of these cases:
“The Purdue entities made misstatements about opioids on their own websites with the intention that Chicago doctors and consumers rely on those misrepresentations are sufficient to state claims against the Purdue entities for violations…”
And while U.S. District Judge Jorge L. Alonso dismissed many of the complaints, the battle over whether these companies deliberately misrepresented the drug benefits and risks continues.
Even recently Ohio Attorney General Mike DeWine announced the state is suing 5 pharmaceutical companies, including:
- Purdue Pharma
- Endo Health Solutions
- Teva Pharmaceutical Industries and subsidiary Cephalon
- Johnson & Johnson and subsidiary Janssen Pharmaceuticals
- Allergan, formerly known as Actavis
There are numerous other suits that have been filed against Big Pharma companies.
- Four counties in New York
- The Cherokee Nationfiled a lawsuit against distributors and pharmacies in tribal court over the opioid epidemic.
- The city of Everett, Washington
While some of these suits may go over better than others, the fact is Big Pharma is under some serious scrutiny.
Delray Beach Making a Case
The Delray Beach lawsuit will seek damages based on the claims that drug makers and distributors violated laws of:
- State consumer protection
- Public nuisance
- Unjust enrichment
According to city officials, every overdose in Delray Beach costs the city about $2,000 in manpower and lifesaving materials. With 690 overdoses last year, that puts the bill around $1,380,000. The only problem is finding a way to prove that pharmaceutical companies can be linked to these overdoses. While many, if not all, of those overdoses were heroin-related, the city may still have grounds to go after opioid drug makers in Big Pharma because these dangerous drugs are considered an underlying problem in the opioid epidemic.
Between 72 and 82 opioid prescriptions are written for every 100 people in Florida, the law firm reports.
While the law firm anticipates other governing bodies will join as plaintiffs, Delray Beach leaders insist they will not wait for other plaintiffs to join the lawsuit. At this point there is not telling how long the lawsuit will last.
There should definitely be accountability for the damage that has been done thanks to the misrepresentation of drug risks and benefits. The misguided and underestimated use of powerful opioids has destroyed countless lives over the years. But beyond holding Big Pharma accountable, there should also be some effort put forth by the state and community officials to promote safe and effective addiction treatment. Innovative and holistic recovery programs can make a huge impact. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135