By Jerri-Lynn Scofield, who has worked as a securities lawyer and a derivatives trader. She is currently writing a book about textile artisans.
The Wall Street Journal reported yesterday that Federal prosecutors have initiated an investigation into whether six drug companies have intentionally allowed opioids to flow into communities, Federal Prosecutors Launch Criminal Probe of Opioid Makers, Distributors:
The investigation, if it results in criminal charges, could become the largest prosecution yet of drug companies alleged to have contributed to the opioid epidemic, escalating the legal troubles of businesses that already face complex, multibillion-dollar civil litigation in courts across the country. Prosecutors are examining whether the companies violated the federal Controlled Substances Act, a statute that federal prosecutors have begun using against opioid makers and distributors this year.
By using statutes typically used to target drug dealers, prosecutors are finally seeing these companies for what they are: drug pushers. This approach is unusual but not unprecedented, according to the Journal:
Earlier this year, federal prosecutors filed major criminal cases in Manhattan and Ohio that, for the first time, employed criminal statutes that are more commonly applied to drug dealers, legal experts say.
When prosecutors from the Southern District of New York announced criminal charges against a pharmaceutical distributor and two executives earlier this year, the Manhattan U.S. attorney’s office said the case was unusual.
“This prosecution is the first of its kind,” Manhattan U.S. Attorney Geoffrey Berman said in April, “executives of a pharmaceutical distributor and the distributor itself have been charged with drug trafficking.”
CNBC notes in Federal prosecutors open criminal probe of opioid makers and distributors, report says:
The investigation marks a significant broadening of the federal government’s focus on pinpointing which parties contributed to the opioid crisis.
The six companies to receive subpoenas from the US attorney’s office for the eastern district of New York are: AmerisourceBergen Corp., Amneal Pharmaceuticals Inc., Johnson & Johnson, Mallinckrodt, McKesson Corp. and Teva Pharmaceutical Industries Ltd., as reported by the WSJ, citing regulatory filings.
This investigation is in its early stages; whether or not other companies have thus far also received subpoenas is not apparent. As federal prosecutors proceed, they will likely widen their probe, drawing in more companies and individuals.
Separately, most states, as well as roughly 2,600 city, county, and municipal governments have sued major players throughout the opioids supply chain. Despite intense pressure on parties to settle, these negotiations have stalled and numerous lawsuits remain pending (see Four Companies Settle Just Before Bellwether Opioids Trial Was to Begin Today in Ohio.)
One manufacturer, Purdue Pharma has already filed for bankruptcy (see Purdue Files for Bankruptcy, Agrees to Settle Some Pending Opioids Litigation: Sacklers on Hook for Billions?).
As yesterday’s WSJ further reports:
…Purdue separately faces civil and criminal probes from the U.S. attorneys offices in New Jersey, Vermont and Connecticut and U.S. Justice Department in Washington and has said that a proposed plan to turn over its operations to creditors is contingent on resolving the federal investigations.
Opioids have made it onto Trump’s personal radar screen. AP reports in Trump donates 3rd-quarter salary to help fight opioid crisis:
President Donald Trump is donating his third-quarter salary to help tackle the nation’s opioid epidemic.
A White House official says Trump has given the $100,000 he would be paid in the quarter to the Office of the Assistant Secretary of Health, which oversees federal public health offices and programs, including the surgeon general’s office.
The White House says the funds are being earmarked “to continue the ongoing fight against the opioid crisis.”
Jerri- Lynn here. Well. Thanks for your concern!!
More from AP:
Trump has made tackling the misuse of opioids an administration priority. More than 70,000 Americans died in 2017 from drug overdoses, the bulk of them involving opioids.
Trump is required to be paid, but he has pledged to donate his salary while in office to worthy causes. Trump donated his second-quarter salary to the surgeon general’s office.
This I didn’t know.
Deaths of Despair
In separate news today, the Journal of the American Medical Association (JAMA) published a study affirming that American life expectancy continues to decline, Life Expectancy and Mortality Rates in the United States, 1959-2017 .
The US trend is in contrast to the state of play in other advanced countries; US life expectancy began to lose pace in the 1980s, according to the JAMA study, and by 1998, had declined to a level below the OECD average. Since 2014, US life expectancy rates have declined for three consecutive years.
Naked Capitalism has covered the rise in “deaths of despair” extensively: the decline in US life expectancy, especially for poorer and less educated Americans, see these posts drawn from numerous examples: Stunning” Rise in Death Rate, Pain Levels for Middle-Aged, Less Educated Whites); Credentialism and Corruption: The Opioid Epidemic and “the Looting Professional Class”; US Life Expectancy Declines in 2015: Unintentional Injuries Rise; and American Life Expectancy Continues to Fall: Rise in Suicides, Overdose Deaths the Big Culprit.
The latest JAMA figures show that the decline extends throughout the country, as the New York Times reports in It’s Not Just Poor White People Driving a Decline in Life Expectancy:
But a new analysis of more than a half-century of federal mortality data, published on Tuesday in JAMA, found that the increased death rates among people in midlife extended to all racial and ethnic groups, and to suburbs and cities. And while suicides, drug overdoses and alcoholism were the main causes, other medical conditions, including heart disease, strokes and chronic obstructive pulmonary disease, also contributed, the authors reported.
From the JAMA study’s abstract:
Findings Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.
This trend has occurred despite the US spending the highest per capita on health of any country in the world – a point made in a JAMA editorial published simultaneously with the study, Confronting the Rise and Fall of US Life Expectancy.
Now, no one would dispute that the US health care system is a mess. From the NYT:
“The whole country is at a health disadvantage compared to other wealthy nations,” the study’s lead author, Dr. Steven Woolf of Virginia Commonwealth University, said. “We are losing people in the most productive period of their lives. Children are losing parents. Employers have a sicker work force.”
The study makes for depressing reading; you can download the full version for free by registering at the above link.
If you lack time for that, some summary from the NYT:
“Mortality has improved year to year over the course of the 20th century,” said Dr. Samuel Preston, a demographer at the University of Pennsylvania. “The 21st century is a major exception. Since 2010 there’s been no improvement in mortality among working-aged people.”
Death rates are actually improving among children and older Americans, Dr. Woolf noted, perhaps because they may have more reliable health care — Medicaid for many children and Medicare for older people. Jerri-Lynn here: my emphasis.
But the problem isn’t wholly related to the dysfunctional US health care system. Extreme inequality doesn’t just harm the poorest and weakest among us. Over to the NYT:
“The fact that it’s so expansive and involves so many causes of death — it’s saying that there’s something broader going on in our country,” said Ellen R. Meara, a professor of health policy at Dartmouth College. “This no longer limited to middle-aged whites.”
The states with the greatest relative increases in death rates among young and middle-aged adults were New Hampshire, Maine, Vermont, West Virginia and Ohio.
Dr. Woolf said one of the findings showed that the excess deaths were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana.
“What’s not lost on us is what is going on in those states,” he said. “The history of when this health trend started happens to coincide with when these economic shifts began — the loss of manufacturing jobs and closure of steel mills and auto plants.”
What do the billionaires and their toadies have to say to that?
And, to return to where I began, note that Ohio is ground zero for the opioids epidemic.
When are we going to start seeing asset forfeiture of the companies and the executives?
If a couple of senior execs end up having to wash dishes for a living, and having to rely on public defenders, and maybe there will be deterrence.
Also, maybe it will prompt a reevaluation of the asset forfeiture laws.
A former Obama official was interviewed today about these investigations. When asked point-black on whether or not pharma executives should go to jail on these charges, there was tremendous hemming and hawing about the “goal is to prevent this from happening again in the future” which is the same stance regarding financial executives after the GFC. https://www.npr.org/2019/11/27/783223378/feds-may-pursue-criminal-charges-against-opioid-makers
So the drug laws incarcerate millions of poor and minority people for minor drug possession offences but effectively running a drug cartel inside US corporations would not be worth jailing somebody for? No wonder people are simply ready to toss the entire system.
Here’s an excellent article about fentanyl smuggling from China. The opioid crisis is not just about US companies. The larger question is why our government largely ignored fentanyl smuggling for years during the Obama administration despite warnings from DEA.
“The larger question is why our government largely ignored fentanyl smuggling for years during the Obama administration”
Umm, because Barack Obama was one of the worst criminal accessories in the entire history of the world across every economic sector?
Do I win a prize for answering that question correctly?
Terrific read. Thank you.
Pain patients who function quite well with medication are caught between the more strident of the War on Drugs Crusaders and the addicts who use opioids recreationally, causing most to think of anyone on pain medication as drug abusers. Pain patients using medication as prescribed are not drug abusers and a safe harbor needs to be created to protect this vulnerable population. They are genuinely in fear and despair has set in. They are consciously and openly stating an intent to commit suicide. We should not forget them as this war continues. They saw what Duarte promoted and understand they are powerless in a fight where their lives are at stake.
Cutting off the supply through criminal prosecutions of manufacturers will harm the most vulnerable. Perhaps that is the plan.
The issue appears to be “prescription” and “control”
You intimate the drugs will be removed from the market, as opposed to being subject to proper and necessary stringent controls.
The issue at hand with the manufacturers is: Have the Manufacturers caused bypass on controls. As I understand it, the drugs are not banned at this point in time.
The manufacturers appear to be investigated for promoting mis-prescription of their products.
Most deaths are caused by fentanyl overdose, and most fentanyl is imported from China through Mexico. The manufacturers are Chinese companies.
The Obama administration didn’t take serious action. Why?
There have been unintended consequences from the war on drugs. To your point, we have seen providers, insurers, and pharmacies set their own limits to avoid liability. Going after the risk-averse pharmaceutical manufacturers will force them to decide whether the profit is worth the risk of financial ruin and possible prison. And legitimate patients are caught in the middle.
Anecdotally, we have this result that impacts the most vulnerable – not the powerful, who will always get their drugs, whether they need them or not:
Protect the vulnerable in this clash.
And I’m reminded of this besides Proverbs 31:6-9, etc.
… even the compassion of the wicked is cruel. Proverbs 12:10
“Very few opioid addictions begin with a patient who has a doctor’s prescription”.
This is very similar to the original marketing line of OxyContin, and I have a hard time believing it. But it’s only a gut feeling along with vague memories of educational materials I’ve seen before but would have to look up.
I think there are pretty forceful (though not equally funded) agendas on both sides of the issue that would want to down- or over-play the impact of prescribed opioids.
Either way, I don’t think it’s necessary to use that quote in order to make the case that people in pain still deserve access to these drugs.
Other sources flatly contradict this claim. This is from an article by a professor of medicine:
Thanks. I knew I wasn’t going crazy but don’t always have references at hand.
I work as a pharmacist in northern Ontario, where the opioid problem is quite acute. To be fair, this region had some insane narcotic prescribing habits — dose/increases that seemed unreasonably high (since well before I started practicing 10 years ago).
Now we’re seeing a combination of new grad physicians seemingly afraid to prescribe opioids, and older doctors either under investigation by their regulatory body, or retiring as fast as they can to avoid getting nailed.
Their patients in the (sadly frequent) worst case, suddenly find themselves without a doctor in an area which already has a shortage. Or they’re put through a forced rapid taper off these meds which seems only a bit less stressful.
Chronic pain patients can definitely benefit from tapering their dose, as opioid-induced hyperalgesia is definitely a thing, and overdose risk increases with dose even taking into consideration tolerance.
A lot of patients with pain can benefit from methadone or Suboxone, which is often the only option remaining as addiction treatment centres are everywhere. But even if those drugs work for them there’s still a lot of inconvenience and stigma attached to them.
I wish the attitude was more accomodating to the patients who have been on these huge doses for years. (usually in their 50s or 60s). Like, say to doctors “try not to get anybody else hooked on opiates, but be gentle with the patients that already are”.
But it seems like the approach taken is mostly based on avoidance of liability. And the profits of addictions chains that provide dubiously valuable treatment.
I guess there’s no perfect solution. It’s a shitshow up here.
Thank you for doing what you can — it must be very stressful. I wouldn’t blame those who fled such responsibility.
There’s no perfect solution but certainly an ethical finance system is part of an optimum solution.
Yeah, off the top of my head the biggest financial issues that could be helped by a government that gave crap would be:
1) increase the welfare/disability payments which have lost ground to inflation since the 90s I believe
2) do something for the awful living conditions and opportunities for our first nations reserves, which are (were?) the biggest centres of despair and addiction
3) free pharmacare would help, though our most vulnerable do already have coverage
4) actually fund mental health programs/psychotherapy
The vaunted Canadian healthcare system doesn’t cover much that doesn’t happen in a doctor’s office or hospital. It’s it’s not heading in the right direction.
Not to discount generous welfare for the needy by any means but those things don’t address the fundamental problem which is economic injustice.
It occurs to me now you might have meant something entirely different by ‘finance system’ but I was on a tangent.
I did; the need for extensive welfare is, by itself, an indication of an unjust economic system.
The indicators are piling up, btw. The latest I’ve heard is the US birth rate is below replacement of the population.
What do the billionaires and their toadies have to say to that? Jerri-Lynn Scofield
Certainly toadies, intentional or otherwise, must include those who support unethical finance – the means by which so many jobs were outsourced in the first place.
Our finance system was designed or evolved to only create wealth – not to share it justly – and we are reaping the bitter fruit of that shortsightedness.
Can’t wait to see how this will all be blamed on the Russians…
Better late than never, I suppose. But, to look only to preventing such things from recurring in the future is to give the current crop of miscreants a pass, as was done with torturing and financial crimes since the turn of the century.
A criminal probe is definitely appropriate. It’s already been established that drug companies and their distributors have flooded the country with 76 billion opioid pills between 2006 through 2012. 76 billion pills amounts to approximately 33 opiate pills per year for every man woman and child in the United States during the 7 year time period covered in this article. And that’s only oxycodone and hydrocodone – it doesn’t include the various types of fentanyl.
That can’t be a mistake.
There is good evidence that providing treatment for the addicted rather than criminalising them is the way to go with a big fringe benefits in terms of less crime etc for the rest of the community, for example the work of Dr John Marks in Widness, England.
I haven’t read the book mentioned but the Liverpool Echo tells of his success – until, that is, the US leaned on the UK to stop him.
Can anyone shed any light on why the US would do that?
Methadone destroys your bones. They become brittle and crumble. Suboxone does very little for pain relief. Suboxone only blocks the craving for opioids. It is obvious most of you posters have little contact with addicts and rely on articles published by individuals who use govt’ info to BS the population.
WHY have there not been at least Criminal Manslaughter charges filed against some of the actors in the dreadful life drama. The doctors, The manufacturers, the distributors. If I give scrip opioids to another and thy die from taking them , I will be charged with a Homicide.