U.S. Attorneys General in 41 States To Investigate Opioid Drug Manufacturers, Distributors
Last Tuesday, 41 attorneys general of U.S. states announced that they are collaborating on an investigation into drug manufacturers and distributors of opioid painkillers that are now responsible for thousands of deaths each year, as well as widespread addiction.
The group reportedly issued subpoenas requesting information from drug manufacturers such as Allergan, Endo International, Janssen Pharmaceuticals, and Teva Pharmaceuticals. A press release stated that Purdue Pharma was also served “a supplemental investigative subpoena”.
Additionally, the coalition is seeking documents from the distribution companies, Cardinal Health, AmerisourceBergen, and McKesson.
New York Attorney General Eric Schneiderman stated the following during a press conference:
“Our subpoenas and letters seek to uncover whether or not there was deception involved if manufacturers misled doctors and patients about the efficacy and addictive power of these drugs. We will examine their marketing practices both to the medical community and the public.”
Opioid drug manufacturers and distributors have already faced a myriad of lawsuits filed by cities, municipalities, counties, and states, include Missouri, Ohio, and Oklahoma, Mississippi, New Hampshire, New Mexico and South Carolina.
Of note, none of these states are involved in the current multistate investigation. Also, Kentucky and New York filed suits that were settled.
Many are attempting to obtain reimbursement from companies for the costs associated with the spike in opioid-related overdoses.
Indeed, drug Manufacturers such as Purdue Pharma have already paid out hundreds of millions related to allegations that they misled doctors and the public about the safety of opioids.
State prosecutors say that they are going focus on determining if the opioid industry was complicit in fueling the crisis and if it should now be responsible for paying for the damage incurred to communities across the nation.
While the number of prescriptions for opioids has fallen in the past few years due to new regulations and recommendations from officials, state attorneys general note that the reduction in prescriptions has been countered by an increased demand for less expensive, illicit drugs such as heroin.
Indeed, according to the Centers for Disease Control and Prevention, 75% of new heroin users say that they developed a prescription drug addiction before initiating heroin use.
“For millions of Americans, their personal battle with opioid addiction did not start in a back alley with a tourniquet and syringe. They got hooked on medicine they were prescribed for pain or that they found in a medicine cabinet.”
In response to the attorneys general subpoena, Allergan stated that it was working with the coalition on their information request.
AmerisourceBergen stated that it has “take has taken extensive action to help ensure the safe and secure delivery of these drugs” such as “reporting suspicious orders to the Drug Enforcement Agency” and stopping the shipment of “tens of thousands of suspicious orders.”
Cardinal Health said, “We do not manufacture, promote or prescribe prescription medications to members of the public” and they believe that “everyone in that chain, including us, must do their part to address the current crisis.”
Endo International stated their policy was “not to comment” on lawsuits or investigations.
Janssen Pharmaceuticals said, “We have received and plan to address the request from the coalition of State Attorney Generals.”
McKesson stated that the company “agrees that the opioid epidemic is a national public health crisis and plans to cooperate fully with the investigation.”
Purdue Pharma said that it shares “the attorneys’ general concern about the opioid crisis and we are cooperating with their request.”
Teva Pharmaceuticals stated that the company is “committed to working with the healthcare community, regulators and public officials to collaboratively find solutions.”
The History Of An Epidemic
In the mid-1990s, companies such as Purdue Pharma the makers of OxyContin) responded to the demand for undertreated pain relief. However, these companies have been accused of misleading doctors, and even offering perks for writing prescriptions.
Over the next two decades, the number of prescriptions written for painkillers increased at a phenomenal rate. The CDC estimates that at least two million Americans are addicted to prescription opioids.
As the number of overdose deaths began to increase, officials began to crack down on doctors’ opioid prescribing habits, and issue recommendations.
Forty-nine states have also implemented prescription drug monitoring databases, which physicians and pharmacists can use to check the prescription history of patients as a means to prevent doctor shopping.
However, there was a gap in the system. Instead of ensuring that opioid-dependent patients receive treatment, they were sometimes abruptly cut off from their medication.
Also, and the costliness of some drugs led many to turn to street drugs such as heroin, which is cheaper and easily obtainable.
Now, while opioid overdose deaths remain relatively stable, deaths due to heroin and it’s much more deadly cousin fentanyl have continued to skyrocket. The CDC recently announced that the number of drug fatalities in 2016 is poised to reach over 64,000, the highest number on record.
Illicit fentanyl is now the driving force behind overdoses, both those who survive and those who do not. According to the Drug Enforcement Agency, illicit fentanyl is most often manufactured in China and routed through Mexico before landing on U.S. streets where it is cut into heroin or replaced for it outright.
Fentanyl, in a clinical setting, is used only for general anesthesia or for severe pain related to conditions such as cancer or end-of-life scenarios. It is up to 50 times more powerful than heroin, and even minor skin contact may be enough to induce a life-threatening overdose.
~ G. Nathalee Serrels, M.A., Psychology