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opioid crisis
June 5, 2019

Researchers have discovered a troubling trend while looking into why so many addicts go without treatment in America.

As part of a study that covered the areas of the U.S. with the highest rates of overdose-related deaths, scientists discovered that about 40 percent of providers were unable or unwilling to provide an appointment to seek treatment. Even more concerning, the number of denied appointments was higher for people who were on Medicaid, which applies to "nearly 4 in 10" adults with an opioid addiction in the U.S., The Associated Press reported.

To conduct their research, two callers posed as adult heroin users, calling over 500 clinics in Maryland, Massachusetts, New Hampshire, Ohio, West Virginia, and the District of Columbia. The study, published on Monday in the Annals of Internal Medicine, paints a dire picture for opioid addicts who are trying to get help.

As for the difference between being uninsured and relying on Medicaid, while 38 percent of the calls were denied for people paying in cash, 46 percent were denied for Medicaid patients. It may be that "doctors have room in their schedules, but are shunning Medicaid because it pays less than other insurance," AP explained.

"I found it surprising how many calls I had to make before being offered an appointment," said Tamara Beetham, one of the researchers who conducted the calls. The number of calls and the frequency of being turned away can be a deterrent to people seeking addiction treatment, which makes this study a troubling revelation for people struggling with addiction across the country. Read more at The Associated Press. Shivani Ishwar

May 29, 2019

The marketing tactics that allegedly helped spur the current opioid crisis in the United States also played a role in at least one foreign market, a report from The Associated Press reveals.

Hundreds of pages of investigative files reviewed by AP show that a well-known Italian doctor, Guido Fanelli, was receiving "kickbacks" from pharmaceutical executives as incentive to increase sales of opioid painkillers in Italy. The executives include managers of Mundipharma, the international wing of Purdue Pharma, the American pharmaceutical giant which is facing more than 2,000 lawsuits stateside because of its role in the opioid crisis. Two Mundipharma managers reportedly accepted plea bargains in January after allegations that they paid Fanelli to push drug sales, though they did not admit guilt.

AP reports this is the first known instance outside the U.S. in which employees of the Sackler family-owned pharmaceutical empire have been implicated in criminal activity. It is worth noting, however, that while Mundipharma and Purdue are both owned by a share of trusts that benefit the Sacklers, a spokesman for Mundipharma's European branch said the two companies have different managers and portfolios and do not share strategies.

That said, the way opioids were sold in Italy mirror the tactics used in the United States in the eyes of some observers. "They're using the same playbook that worked in the United States, despite knowing that it led to a public health catastrophe" Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing, told AP. Read more at The Associated Press. Tim O'Donnell

May 28, 2019

The epidemic of opioid addiction in our country has gotten plenty of attention over the years. But a new study points out that a pretty significant population of the country might be sitting right in our blind spot.

The study, published in the journal Pediatrics on Tuesday, revealed that adolescents are being prescribed a worrying amount of opioids. Researchers analyzed 11 years of data taken from patients in emergency rooms and outpatient clinics who were between 13 and 22 years old. That 11-year span, from 2005 to 2015, encompassed 78,000 total visits, in which 15 percent of ER visits and 3 percent of outpatient visits resulted in an opioid prescription.

Among the most common situations when the patients were prescribed opioids were dental disorders (60 percent), collarbone fractures (47 percent), and ankle fractures (38 percent). These figures were "strikingly similar" to the prescription rates for adults, said Joel Hudgins, the study's lead author.

But when it comes to adolescents, medical guidelines aren't as clear about how much to prescribe — "at least not on a national level," Hudgins explained, like they are for adults. And besides that, teens and young adults are at a higher risk for misusing opioids, CNN reported. All of this adds up to a dangerously high chance for opioid addiction at a young age.

Read more at CNN. Shivani Ishwar

May 3, 2019

A federal jury in Boston convicted John Kapoor, the founder and former chairman of Insys Therapeutics, and four former colleagues on Thursday in connection with a scheme to bribe doctors to prescribe the highly addictive and potent opioid fentanyl, sold by Insys in spray form. Kapoor, 76, is now the highest-ranking pharmaceutical executive convicted in a case related to America's opioid crises. He and his four co-defendants — Michael Gurry, Richard Simon, Sunrise Lee, and Joseph Rowan, all former Insys managers and executives — each face up to 20 years in prison.

The five pharmaceutical executives were convicted of racketeering conspiracy; prosecutors said the scheme included not only bribing doctors also defrauding insurance companies, misleading them into paying for the expensive fentanyl spray, Subsys, approved only for terminal cancer patients. The co-defendants denied wrongdoing and will appeal, their lawyers said. Insys, which agreed to pay $150 million or more in a settlement with the Justice Department last summer, said Thursday that the scheme was limited to "the actions of a select few former employees." Peter Weber

April 17, 2019

A federal sting operation led to prosecutors charging 60 doctors, pharmacists, nurse practitioners, and other medical professionals for illegally prescribing opioids in Kentucky, Ohio, Tennessee, Alabama, and West Virginia. All told, 32 million pain pills were doled out illegally in the five states.

One Tennessee doctor alone, who the The Washington Post writes branded himself the "Rock Doc," allegedly prescribed nearly 500,000 hydrocodone pills, 300,000 oxycodone pills, 1,500 fentanyl patches, and more than 600,000 benzodiazepines. The prescriptions were reportedly sometimes written up in exchange for sexual favors.

Per the Post, another doctor in Dayton, Ohio worked with several pharmacists to a run a "pill mill," through which they dispensed more than 1.7 million painkillers between October 2015 and October 2017.

Some doctors were writing 100 prescriptions per day, NPR reports.

The Center for Disease Control has reported that 130 Americans die every day of opioid-related overdoses and Attorney General William Barr has called the epidemic "the deadliest drug crisis in American history." It's no surprise, then, that the Justice Department has targeted doctors, health care companies, and drug manufacturers for their alleged roles in perpetuating the addiction cycle.

However, Brian Benczkowski, the assistant attorney general for the DOJ's criminal division, did say that the sting operation revealed "outliers" and the doctors, pharmacists, and other medical professionals who face charges do not represent the norm. "We're targeting the worst of the worst doctors in these districts," he said. Tim O'Donnell

April 1, 2019

It's become well known that the Sackler family, founders of Purdue Pharma, have come under scrutiny for their company's role in America's current opioid epidemic. Purdue and the Sacklers now face upwards of 1,600 lawsuits.

But not only do the lawsuits attempt to show that the Sacklers, who have so far avoided legal consequences, were heavily involved in marketing opioids to patients, The New York Times reported on Monday. The family also allegedly sought to profit by selling treatments to patients who became addicted to Purdue's painkillers.

Details of the marketing push, referred to as Project Tango, are reportedly laid bare in lawsuits filed by the attorneys general of Massachusetts and New York.

The New York complaint highlights one Project Tango document which depicted a blue funnel — the larger end of which was labeled "pain treatment," the narrow end labeled "opioid addiction treatment." The document said that "pain treatment and addiction are naturally linked," suggesting the profits from one could lead to profits from the other. The Times reports that an email included in the Massachusetts filing shows that Kathe Sackler, one of the eight family members on Purdue's board, told employees to direct 'immediate attention" to the idea.

Purdue also reportedly pursued a plan to sell naloxone, an overdose-reversing drug and in 2016, three Sacklers "discussed buying a company that used implantable drug pumps to treat opioid addiction." Purdue has continued to develop products for opioid treatment, though it says it is also taking charitable steps to curb addiction. The Sacklers denied the allegations against them in a statement provided to the Times. Read more at The New York Times. Tim O'Donnell

March 26, 2019

The public still won't hear details regarding Purdue Pharma's push to market the painkiller OxyContin. Testimony from members the company's founding family, the Sacklers, won't happen either.

The pharmaceutical giant reached a $270 million dollar settlement on Tuesday with the state of Oklahoma, and legal experts argue that the settlement could help set a floor amount for other lawsuits filed against Purdue and the Sacklers, The Wall Street Journal reports. Oklahoma's attorney general claimed that Purdue's aggressive marketing tactics for OxyContin and other prescription painkillers helped fuel America's opioid crisis; the two sides reached the agreement just two months before the scheduled trial.

The New York Times reports that $100 million from the settlement will fund an addiction treatment and research center at Oklahoma State University in Tulsa, $70 million will pay Oklahoma cities, counties, and Native American tribes and to reimburse the state for its litigation costs. The Sacklers, who were reportedly not named in the lawsuit, will contribute an additional $75 million over five years.

Other companies involved in the lawsuit, such as Johnson and Johnson, have not settled, however. The trial, therefore, is still scheduled for May 28.

Purdue and the Sacklers, meanwhile, still face more than 1,600 opioid lawsuits from 37 states, and numerous cities, counties, and tribes across the United States. For the time being, though, the public won't hear "full recounting of Purdue's actions in promoting OxyContin to doctors and underplaying its addictive properties," writes the Times. Tim O'Donnell

March 5, 2019

Facing more than 1,000 lawsuits, Purdue Pharma is exploring filing for bankruptcy, people familiar with the matter told Reuters Monday.

Purdue Pharma makes OxyContin, and the lawsuits allege the company was a major contributor to the nation's opioid crisis by not being up front with doctors and patients about long-term use of the powerful drug. Filing for Chapter 11 bankruptcy would halt those suits, Reuters reports, and Purdue could negotiate with plaintiffs under the supervision of a bankruptcy judge. People with knowledge of the matter said no final decision has been made, and Purdue could decide to continue to fight the lawsuits instead.

Owned by the Sackler family, Purdue denies any wrongdoing and says it placed warning labels approved by the Food and Drug Administration on its bottles, notifying users about the risk of misusing the product. Last June, Massachusetts Attorney General Maura Healey (D) sued Purdue and members of the Sackler family, claiming that while they amassed a fortune of $4.2 billion, they were knowingly misleading the public through deceptive marketing.

OxyContin sales have dropped to $1.74 billion in 2017 from $2.6 billion in 2012, Symphony Health Solutions reports. The Centers for Disease Control and Prevention says that in 2017, opioids contributed to 47,600 overdose deaths in the United States. Catherine Garcia

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