12.23.2016
policy

The DEA Has a Massive Pill Problem, and Now It's the World's Problem Too

America could be ground zero for a global opioid crisis.

The Charleston Gazette-Mail revealed earlier this week that pharmaceutical companies saturated West Virginia with 780 million hydrocodone and oxycodone pills during the six years between 2007 and 2012. The Drug Enforcement Administration, West Virginia’s Attorney General Patrick Morrisey, and the state’s major drug wholesalers were all reluctant to make public the obscene quantities of addictive, lethal painkillers pumped into the West Virginia population, and no wonder.

• Split evenly, the 780 million doses of hydrocodone and oxycodone would grant every adult, child, and baby in West Virginia a stash of 433 pills.
• U.S. Centers for Disease Control and Prevention statistics show that four West Virginia counties—Wyoming, McDowell, Boone, and Mingo—were leading the country in overdose deaths tied to pharmaceutical painkillers during those six years.
• West Virginia’s hydrocodone and oxycodone fatalities increased 67 percent between 2007 and 2012, coinciding with the glut of pills.
• Hydrocodone and oxycodone killed 1,728 West Virginians during the six years under consideration.

During the time these people were dying, drug wholesalers were in court, scrambling to keep the increasing pill shipments secret from the victims’ families and the public at large.

Usually, when a direct correlation exists between cause of death and the agent of that cause of death, who to blame is obvious. In the case of West Virginia’s 1,728 pain-pill fatalities, no one is owning the fault.

From the Associated Press report:

McKesson Corp., Cardinal Health and AmerisourceBergen Drug Co. together control about 85 percent of the U.S. drug distribution market by revenue and provided more pills to West Virginia than other wholesalers.
The drug distributors say they're just middlemen in a highly regulated industry and that pills would never get in the hands of addicts and dealers if not for unscrupulous doctors who write illegal prescriptions, and pharmacists who turn a blind eye.

AmerisourceBergen declined even to acknowledge a correlation between the massive numbers of pain pills shipped to West Virginia and a rise in overdose deaths. A spokesman for the company demurred that health experts and law enforcement might be better qualified to draw that connection.

Ellen Barry, a spokeswoman for Cardinal Health, responded that state officials, among others, were responsible for curtailing opioid dependence in West Virginia.

But before taking office as West Virginia’s Attorney General, state official Patrick Morrisey represented Cardinal Health and lobbied for drug wholesalers in Washington, D.C., according to the AP. Drug companies also supported Morrisey in his winning run for Attorney General; so it’s not like you could expect him to put up any substantive interference to an influx of deadly, widely diffused medications. (In January 2016, Morrisey’s office did take McKesson Corp. to court.)

Pain-pill companies have hired away at least 42 officials from the DEA since 2005, with 31 of those poaches coming from the Office of Diversion Control.

Among the parties cited by Cardinal Health’s Ellen Barry as responsible for fighting pain-pill addiction— pharmacies, doctors, hospitals, manufacturers, patients, and state officials—law enforcement is notably absent. Former DEA agent Joseph Rannazzisi has a perspective on why that might be.

Rannazzisi, who headed the agency’s Office of Diversion Control for a decade, went public this year with a detailed and annotated narrative of how DEA higher-ups, perhaps in collusion with former DEA personnel who had been recruited by drug companies, sat on evidence, refused to pursue cases, and meddled in investigations that targeted opioid producers and distributors.

The Washington Post's reporting that pain-pill companies have hired away at least 42 officials from the DEA since 2005, with 31 of those poaches coming from the Office of Diversion Control, supports Rannazzisi's sense of a collaborative relationship between DEA decision makers and the executives who were pushing deadly drugs all across America. 

Pills to be turned in to the DEA (via)

Accounts agree that Rannazzisi consistently opposed a soft, collaborative approach to enforcing violations of established opioid control policy. In 2015—following Rannazzisi’s intransigent criticism of the Ensuring Patient Access and Effective Drug Enforcement Act—Rannazzisi was removed from the DEA’s Office of Diversion Control. He resigned soon after.

Proposed by Reps. Tom Marino, R-Pennsylvania, and Marsha Blackburn, R-Tennessee, the Ensuring Patient Access and Effective Drug Enforcement Act attracted heavy lobbying support from painkiller distributors McKesson Corp., AmerisourceBergen and Cardinal Health.

The law went into effect in 2016. It’s ramifications, from the Washington Post:

It raises the standard for the diversion office to obtain an immediate suspension order. Now the DEA must show an "immediate" rather than an "imminent" threat to the public, a nearly impossible burden to meet against distributors, according to former DEA supervisors and other critics. They said the new law gives the industry something it has desperately sought: protection from having its drugs locked up with little notice.

Toward the end of 2015, representatives from drug distributors and pharmacy chains met with acting DEA administrator Chuck Rosenberg and hashed out exactly the kind of working relationship Rannazzisi had resisted. A DEA press release summed up the fresh partnership: “The pharmaceutical industry has a vital role on the front lines of preventing drug misuse and abuse across America, as do we, and we plan to work closely with them.”

Former agent Rannazzisi told the Washington Post he views the arrangement as the DEA rolling over for Big Pharma: "This idea that they're going to say, 'I'm sorry I violated the law, give me another chance and I'll make it right,' without having some type of punishment, to me is outrageous," he said. "Every time I talked to a parent who lost a kid, I'm pretty sure they didn't want me to say, 'Oh, give them another chance because corporate America needs another chance.' "

There’s a big world outside the borders of the United States. Much of it has yet to be strung out on corporate-concocted narcotics.

In October 2016, the DEA published a notice that it would be cutting production of prescription narcotics by 25 percent in 2017. The reductions of heavily abused drugs such as oxycodone, hydromorphone, codeine, and fentanyl are presented as a move toward curbing the country’s opioid epidemic, which caused 18,893 U.S. deaths in 2014 alone. Heroin, in comparison, claimed only 10,574 lives during the same year.

Some observers blame the DEA’s generous production limits for driving up opioid deaths. But the pharmaceutical industry spent $880 million from 2006 through 2015 lobbying Congress against opioid limits, and that money had to buy something.

From the Huffington Post:

DEA quotas played a role in empowering pharmaceutical companies to flood the market with pills. In 1993, three years before Purdue released OxyContin, the agency capped oxycodone manufacturing at just 3,520 kilograms. But by 2007, this number had shot up to 70,000 kilograms, an almost twentyfold increase. Production peaked in 2013, with pharma companies churning out more than 150,000 kilograms of oxycodone.

With the revised quotas for 2017, America’s drug companies and drug addicts will be forced to get along with only 108,000 kilograms of the lab-grade killer dope.

Meanwhile, the Drug Enforcement Administration has refused to allow for even an ounce of marijuana to escape its Schedule 1 classification.

If America’s pain-pill pushers are dissatisfied with the DEA’s cutback in production quotas, don’t expect them to sit back and absorb their losses. There’s a big world outside the borders of the United States. Much of it has yet to be strung out on corporate-concocted narcotics.

OxyContin 80 (via)

A December 18, 2016, report from the Los Angeles Times reveals that the Sackler family, owners of Purdue Pharma, the Connecticut company that manufactures OxyContin, is rushing to push their pills in Latin America, Asia, the Middle East, and Africa. The family controls a network of international companies known as Mundipharma, giving it a truly global reach that the most ambitious narco terrorist could only dream of.

From the L.A. Times:

In this global drive, the companies, known as Mundipharma, are using some of the same controversial marketing practices that made OxyContin a pharmaceutical blockbuster in the U.S.
In Brazil, China and elsewhere, the companies are running training seminars where doctors are urged to overcome “opiophobia” and prescribe painkillers. They are sponsoring public awareness campaigns that encourage people to seek medical treatment for chronic pain. They are even offering patient discounts to make prescription opioids more affordable.

Psychiatrist brothers Mortimer and Raymond Sackler bought Purdue, a small New York pharmaceutical firm, in 1952. The L.A. Times says that OxyContin sales have generated nearly $35 billion for Purdue and helped make the Sacklers one of the richest families in America.

The potential to increase this dope dynasty’s riches by flooding the worldwide market with highly destructive pills that defy regulation, with no DEA quotas or Office of Diversion Control to ineffectually rein them in, is limitless.

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