His dad, a DEA agent at the time, gave him a bogus contract upwards of thousands of dollars – to pay for spring break trip

Report: DEA Agent Funded His Son’s Spring Break Trip With Taxpayer Dollars

https://townhall.com/tipsheet/timothymeads/2019/06/11/report-dea-agent-funded-his-sons-spring-break-trip-with-hundreds-of-thousands-of-taxpayer-dollars-n2547965

While many spring break goers try to avoid the fuzz on their wild and crazy excursions during college, one attendee apparently was paid by the Drug Enforcement Administration while on his trip in what the Department of Justice’s Office of the Inspector General (OIG) says was a colossal waste and misuse of funding. How did the kid secure this tax dollar paid vacation? His dad, a DEA agent at the time, gave him a bogus contract upwards of thousands of dollars, reports Law and Crime.

According to Jerry Lambe, the OIG “initiated its investigation after receiving reports that the senior DEA official had hired his son, his former DEA colleagues, and the spouse of a former DEA colleague, as contractors for the administration.” 

The full report released on Monday reveals that the senior DEA agent wrongfully gave his son and others in his sphere hundreds of thousands of dollars. It also stated that the “official took actions to try to expedite the security vetting for his son and also enabled his son to submit contractor work invoices while on collegiate spring break and before graduating college. ”                         

Here are more details: 

Via OIG:

“The OIG substantiated the allegation that the senior DEA official 1) took actions to have the DEA’s contractor hire his son and to have his son work as a DEA contractor in his chain of command by, among other things, signing two DEA forms in 2017, authorizing a total of $340,280 in spending, including a raise, specifically for his son’s contractor position; and 2) took actions in contravention of appropriate procedures to hire two former DEA colleagues as contractors in his chain of command, including the spouse of a retired former colleague. The OIG also found that the senior DEA official took actions to appoint his son as a volunteer student intern before he graduated from college.

Furthermore, none of the parties the agent gave contracts to were qualified for their supposed positions. In conclusion, the OIG found that “the senior official violated DEA Standards of Conduct and potentially violated criminal statutes by making false entries about attending alcohol counseling on a Questionnaire of National Security Position,” according to Crime and Law. 

But still, even with this investigation, the DOJ refused to criminally prosecute the agent but the feds. insisted that the now-retired agent will be barred from federal employment should he try to come out of retirement. 

 

I have had my medications restored!!

See the source image

I have had my medications restored!!

I was losing hope that I would ever get to post this update, but here we are! I finally reestablished my care with an incredible physician who not only see and believes I’m in pain, but trusts that I am not seeking a high. She restored the medication that DIDN’T cause seizures and previously gave me a life worth living. I just took my first dose and am on the road back to being able to live, not merely existing.

Today is 6 months, to the day, since I was rushed to the hospital completey unresponsive after having a seizure from a drug my previous doctor prescribed. Instead of taking responsibility for prescribing such a dangerous medication, I was dropped as a patient with no medications after 15 years. I have been bounced from doctor to doctor who refused to treat my pain even with 15 years of records that showed I was neither an addict nor “med seeking”. I’ve fought for myself and others like me who have had their medications ripped away from them “because of addicts”. I wanted to give up every single day. I had zero quality of life and my life was nothing but unending pain. I am lucky that I’m now able to use my voice to speak for those of us who lost their medications and lives when they couldn’t keep fighting. I wasn’t far from that myself. The only thing keeping me alive was the friends and other advocates who were there for me when it was the darkest. I’ll never forget or be able to repay the debt of compassion and gratitude that I owe each and every person who checked on me and assured me that my story wasn’t over.

When I got home last night from the doctor, with my medications in hand, there was a small Amazon package waiting. It couldn’t have contained a more meaningful gift or message than the small silver bracelet that was inside. The inscription is a reminder that I have miles to go before I sleep. Thank you Misty for being such a rock for me through this. The support and outpouring of love from friends is the only thing that kept me alive and fighting. My fight is won, but this isn’t over. I lost 6 months of my life to this nightmare and I won’t be letting the doctors who did this get away with it. I will “keep fucking going”. 💜 My story is, tragically, very common in the community of legitimate pain sufferers. The chronic pain community has lost so many amazing people to suicide since the short sighted and completely unfounded “guidelines” from the CDC were released in 2016. I refuse to let those lives lost be in vain. The lives of my fellow chronic pain patients is an unacceptable payment for this fake “war on opiates” and must be answered for. My fight for myself is won, but the battle is just beginning. Never again! Our voices will be heard. We cannot lose another life to this ignorant and completely unsubstantiated attack on legitimate pain patients.

Did the crackdown on opioid prescriptions go too far? Here’s why doctors are reconsidering

Did the crackdown on opioid prescriptions go too far? Here’s why doctors are reconsidering

https://amp.indystar.com/amp/1287864001

Johnna Magers suffers from chronic pain and worries about pain medication guidelines that keep opioids from those who really need it.
Kelly Wilkinson, kelly.wilkinson@indystar.com

About two years ago, Johnna Magers’ health insurer abruptly announced it would stop paying for the pain pills that quelled her back pain and made the difference between her working and being on disability.

“My diagnosis hadn’t changed, the way they did prior authorization didn’t change, nothing had changed,” said Magers, an Indianapolis resident. “Out of the blue, they said, ‘Hey, we can’t cover this for you.’ ”

The Centers for Disease Control and Prevention was then encouraging doctors to decrease opioid prescribing, which had contributed to an epidemic of addiction.

But for Magers and countless others with chronic pain, the response to those 2016 CDC guidelines meant trouble. 

Johnna Magers, left, walks her dog, Luna, with her son, Jackson Woolsey, Friday, May 31, 2019.  She suffers from chronic pain and worries about pain medication guidelines that take medication from those who really need it.
Johnna Magers, left, walks her dog, Luna, with her son, Jackson Woolsey, Friday, May 31, 2019. She suffers from chronic pain and worries about pain medication guidelines that take medication from those who really need it.
Kelly Wilkinson/IndyStar

Now, many in the medical profession say the pendulum swung too far. A panel of 14 experts, led by an Indiana University School of Medicine professor, earlier this spring advocated in an an article published in Pain Medicine for rolling back some of the practices and policies that arose in the wake of the CDC guidelines.

A few weeks later, the experts behind the guidelines published a follow-up paper, citing the findings of the panel led by Dr. Kurt Kroenke, a research scientist at the Regenstrief Institute and an IU professor of medicine. In this New England Journal of Medicine editorial, the authors argue that many of the responses that cited the guidelines were inconsistent with those guidelines.

“There are things that are being done that may be attributed to the guidelines, but that actually go beyond what the guidelines recommend,” said Dr. Roger Chou, one of the authors of the original and current papers. “It’s an overenthusiastic application and trying to oversimplify what the guidelines were intended to do.”

Edie Caito discusses the pain caused by her fibromyalgia, which she has treated with prescription opioids since 2009. Caito’s access to the medications she needs has gradually become more restricted, in part due to the opioid addiction epidemic.
Jenna Watson/IndyStar

Opioid use goes from all to nothing

The 2016 CDC guidelines galvanized response in a health care community that had already been grappling with its role in the drug crisis. Nudged by pharmaceutical companies eager to sell their product, doctors had been generous with their prescription pads for more than a decade, an attitude that had opened the door to an epidemic of overuse.

As the overdoses piled up, the pendulum swung from an “all” approach to a “nothing” approach. The CDC treatise on opioids that appeared three years ago encouraged doctors to change their habits and sparked a rapid decline in legal opioid prescribing.

Unable to fill her prescription through insurance, Magers picked up an extra shift as a server in a restaurant to pay for her pain pills with cash. Since then, she has managed to pay out-of-pocket for the medication.

When she started to experience breakthrough pain about six months ago, she held out little hope that her doctor would increase her dose, afraid that writing a prescription for more medicine could go against the guidelines and land him in trouble. Instead, she just soldiered through.

Johnna Magers sits with one of her dogs, Friday, May 31, 2019.  She suffers from chronic pain and worries about pain medication guidelines that take medication from those who really need it.
Johnna Magers sits with one of her dogs, Friday, May 31, 2019. She suffers from chronic pain and worries about pain medication guidelines that take medication from those who really need it.
Kelly Wilkinson/IndyStar

While the paper Kroenke co-authored was not the only one that informed the CDC group’s most recent paper, Chou calls it “one of the more articulate” discussions of the confusion that has resulted from the 2016 guidelines. 

Revisiting the opioid guidelines

As a doctor with many chronic pain patients, Kroenke witnessed firsthand how the over-reaction of legislatures, insurers and others affected them. Doctors rushed to comply, afraid themselves that what was once considered standard practice might now count as over-prescribing.

Meanwhile the 10 to 15 million Americans who rely on opioids to control their chronic pain – and who are not contributing to the drug epidemic – were caught in the cross fire, Kroenke said. Many felt abandoned by the medical profession. Chronic pain is the second most common cause of disability globally, after mental disorders.   

Despite common origin stories, such as “I became addicted after having my wisdom teeth pulled,” only 37 percent of adults who misused opioids had a prescription, according to the National Survey on Drug Use and Health.        

Still, Kroenke and the panel did not dispute that opioid prescribing was at one point rampant and excessive. Taking a more measured approach to starting patients on opioids makes sense, he said, as does exploring alternatives for those with chronic pain and trying to use lower doses when possible.

And, then, he said, there’s the possibility of reconsidering some of the most draconian responses to using opioids.

“Probably we need to revisit these fairly stringent reactions,” Kroenke said. “If we go back to a very more curtailed use of appropriate opiates, I think the clinical system has now been sensitized to following patients with this and watching for misuse.”

As Magers learned, some health system leaders and payers have used the CDC guidelines to justify policies that prohibit prescribing opioids above a certain amount. What the guidelines actually say is to be cautious when prescribing doses above those cut-offs, said Chou, a professor of medicine at Oregon Health and Science University.

One insurer even contacted Chou, telling him that he could not place a patient on too high a dose. The insurer cited the guidelines Chou himself wrote as evidence for the assertion that he had violated the recommendation.

Some health care providers or facilities have implemented policies that prohibit the use of opioids for certain conditions, such as chronic pain, or even at all. Again, the guidelines recommend neither of those, Chou said. Instead, they say only that opioids should not be used as first-line therapy.

“The guideline is not policy. It was not (meant) to be policy. It was never meant to be policy,” Chou said. “The guideline was meant to help physicians provide patient care, and this is the challenge that happens when people try to turn practice guidelines which are complicated into policy which is very black and white.”

In the fight against opioids, doctors and state insurers are increasingly turning to acupuncture. But debate about how well it works remains pointed. (Feb. 20)
AP

Still, some say, the medical profession made some mistakes that could be remedied to help keep the prescribing of opioids to a minimum.

About two decades ago, along with the advent of new drugs to treat pain, the medical field started viewing pain as a fifth vital sign, along with blood pressure, heart rate, respiratory rate and temperature.

Many patients first encountered this new thinking in the form of charts that asked them to point to a range of smiley to frowning faces to indicate where their pain fell on the scale. This transformation of pain into a vital sign inadvertently contributed to the problem of doctors over-prescribing, said Dr. Dominic Gaziano, director of the Body and Mind Medical Center in Chicago and author of “Well Now! Today’s Comprehensive Health and Wellness Guide.”

“Pain is not an objective vital sign but a subjective symptom that is hard to quantify,” he said. “Experienced doctors and nurses need to look at pain as a symptom and assess how to treat it. The danger is that treating pain as a vital sign might cause the patient to exaggerate pain symptoms.”   

Did the guidelines go too far?

While other pain patients may struggle to find a doctor who believes and treats their pain, Magers considers herself fortunate to have a provider who trusts her.

Three times she has tried to wean herself off the medicine, but the pain keeps sending her back. Finally her doctor, a pain management specialist, told her she would likely need the medicine to calm her pain for the rest of her life.

Johnna Magers walks with her dog, Luna.
Johnna Magers walks with her dog, Luna.
Kelly Wilkinson/IndyStar

Before she developed back pain suddenly at age 35, she loved to hike and ride horses. The pain rendered her unable to do much other than work, fall into bed and care for her son. Eventually a doctor diagnosed her with disc issues and said there was not much that could be done other than taking medication to address the pain.

She can now work two jobs, including one as a surgical dental assistant that requires her to stand for most of the day. And she advocates for others in her shoes, serving as Indiana organizer for Don’t Punish Pain Rally, an organization that holds regular events to raise awareness about the needs of chronic-pain patients.

Any time the government gets involved in medicine, it’s a bad thing.
Johnna Magers, chronic-pain patient

Magers is also acutely aware that the current environment could put her doctor and others sympathetic to pain patients in a precarious position.   

“We want to see legislation protect our doctors. Any time the government gets involved in medicine, it’s a bad thing,” said Magers, who greeted the latest missive from the CDC panel with delight. “They’re admitting they were wrong. … They’re admitting that the medical board and the DEA (Drug Enforcement Agency) are taking it too far.”

Finding the perfect balance between the needs of patients like Magers and ensuring that others prescribed opioids do not slip into addiction presents an ongoing challenge for the medical field, experts agree.

Solving that conundrum requires recognizing that several different patient populations exist, Chou said. There are chronic pain patients not yet on opioids who would likely experience little benefit from opioids. Then there are the ones like Magers who have been on opioids from years without transitioning to addiction.

No easy answer exists, Chou said.

“This is a complex area where we have to individualize patient care, and I think people have been using policy as a blunt tool when in many cases, it requires some more nuance than that,” he said. “I think we also now have the recognition that you can’t just implement a bunch of things and fix this problem quickly or overnight, which I think some policy makers were hoping for.”

Contact IndyStar reporter Shari Rudavsky at 317-444-6354 or  shari.rudavsky@indystar.com. Follow her on  Facebook and on Twitter: @srudavsky.

Why these employees are the most opioid-prescribed feds

Why these employees are the most opioid-prescribed feds

https://www.federaltimes.com/federal-oversight/watchdogs/2019/06/10/why-postal-employees-are-the-most-opioid-prescribed-feds

Nationwide efforts to address the opioid epidemic have resulted in a reduction in the number of opioids prescribed to patients and the length of time a physician can prescribe such medication to a patient without extenuating circumstances.

But a June 6 report by the U.S. Postal Service’s Office of Inspector General found that the number of postal workers who receive opioid prescriptions under the Federal Employees’ Compensation Act program has not seen a similar reduction.

“Specifically, although the cost of opioid prescriptions for the Postal Service employee FECA population declined from 2016 to 2018, the rate of decline was substantially less than that for other federal agencies,” the report said.

“We also found that between 2014 and 2017, the average number of prescriptions per Postal Service employee under FECA increased from about 6.2 to about 6.8. The [Centers for Disease Control] reported the number of opioid prescriptions per patient nationwide decreased from about 3.7 per patient in 2014 to about 3.4 in 2017. An increasing number of prescriptions per employee could indicate an increased risk of opioid misuse.”

According to 2018 Department of Labor statistics, the U.S. Postal Service employs one of the largest groups of federal employees at 610,528 workers. That is second only to the Department of Defense, which employs over 700,000.

Such employees occupy arguably some of the most dangerous jobs in the federal government.

Despite making up approximately 21.6 percent of the federal workforce, Postal Service employees account for over 50 percent of reported workplace injuries and illnesses and 56 percent of fatalities, according to Occupational Safety and Health Administration statistics.

In 2018, seven percent of the Postal Service workforce reported an injury or illness and all got compensation with the help of experienced traffic accident attorneys serving Portland who has a good reputation in this field.

That high rate of injury can cause a high rate of opioid prescriptions.

According to the OIG report, nearly three percent of the Postal Service workforce received an opioid prescription in 2018 and accounted for 48 percent of the opioid prescription costs under the federal employee FECA program.

Those prescriptions cost the FECA program nearly $22 million in 2018, according to the report.

“The risk of misuse is increased because employees can get additional opioid prescriptions outside of the FECA program,” the report said.

Due to the addictive nature of opioids, the CDC has issued guidance that opioids be prescribed for no more than three days, except in cases of medical necessity, and 25 states have set that same limit at one week or less.

The Department of Labor, however, allows physicians to prescribe opioids to new users under the FECA program for up to 60 days without a letter of medical necessity.

That difference is significant, as CDC research has proven that over 13 percent of patients prescribed opioids for eight days or more were still taking them a year later. That rate jumps to 30 percent if the patient has been taking opioids for a month or more.

OIG investigators found that Postal Service officials haven’t properly tracked the statistics available from the DOL, which would give them better insight into where there could be potential opioid abuse problems in their workforce.

“When the Postal Service does not use data analysis, it cannot assess and anticipate any associated workforce issues and take targeted action to help protect its employees and customers from the dangers of prescription drug addiction,” the report said.

Compounding this issue, investigators determined that the Postal Service had not developed a sufficient drug policy and drug education plan, with insufficient data to determine how many of its employees were reached by current education measures.

The report recommended that the Postal Service develop a quarterly data analysis plan for opioid use, request that the DOL reduce the prescription length allowed under FECA, update supervisory policy to ensure supervisors understand the impact opioid use could have on mental or physical abilities and develop a comprehensive, ongoing educational plan.

Postal Service management agreed with the first two recommendations but disagreed that they needed to update supervisor policies or educational plans.

 

response by medical professionals and patient advocates to the May 2019 final draft report recommendations of the HHS Inter-Agency Task Force on Pain Management

https://www.practicalpainmanagement.com/sites/default/files/Lawhern.ResponseHHSPainManagementTaskForce_June2019.pdf

 

Abstract:

 

This paper offers a response by medical professionals and patient advocates to the May

2019 final draft report recommendations of the HHS Inter-Agency Task Force on Pain

Management. The authors propose that urgent changes in public policy on pain

management are needed to repair the widespread damage done to pain patients,

healthcare providers, and other stakeholders by the 2016 CDC Guideline on Prescribing

Opioids for Chronic Pain, and by the related “Opioid Safety Initiative” of the Veterans

Health Administration (VHA). An interim US policy on prescription of opioids is offered

for the period during which detailed practice standards will be developed by professional

medical associations, as envisioned by the Task Force report and enabling legislation.

 

Our primary focus and concern is on the reality that the process set underway by the HHS Task Force final report will likely take years to mature in updated medical practice standards.  Meanwhile, patients are dying of medical neglect and physician desertion while US and State regulatory agencies dither and avoid coming to grips with the reality that the US “War on Drugs” has been turned into a full scale war on people in pain.  This bureaucratic madness must stop, and legislation will likely be needed to make it stop.  We believe the November 2018 Resolution 235 of the AMA House of Delegates offers a framework for correcting course — and that a major part of that correction must be directed to the US Drug Enforcement Administration and State regulators who are driving doctors out of practice in droves in turnb killing patients who have nowhere to turn.

 

This paper comes at a remarkably opportune time, given the May 15th declaration of six major professional academies representing 650,000 physicians and medical students.

 

https://www.aafp.org/media-center/releases-statements/all/2019/physicians-call-on-politicians-to-end-political-interference-in-the-delivery-of-evidence-based-medicine.html

Frontline Physicians Call on Politicians to End Political Interference in the Delivery of Evidence Based Medicine – aafp.org

Washington, DC (May 15, 2019) – Our organizations are firmly opposed to efforts in state legislatures across the United States that inappropriately interfere with the patient-physician …

www.aafp.org

Smithers Family Defense.. another prescriber’s story of practice being raided and shutdown

Smithers Family Defense

March 7th 2017 wаѕ a dark, painful day іn mу family’s life. Mу wife, оur fоur young children, mу patients аnd staff аt Thе Center fоr Integrative Health, hаd little idea іt wоuld оnlу bе thе beginning оf a vеrу lоng, exhausting struggle tо соmе.

Thаt cloudy Spring Tuesday іn March thе DEA (Federal Drug Enforcement Agency) undеr guidance frоm thе DOJ (Department оf Justice) conducted simultaneous, well-coordinated, armed raids (guns drawn) оf bоth оur home аnd medical practice. Mу wife, Angel, wаѕ аt home wіth оur fоur kids, Ethan (12), Seth (9), Aylianna (2), аnd Brielle оur newborn.

 


We are now pregnant with #5.


Shе started hеr day аѕ usual. All thе kids hаd bееn taking turns bеіng sick, аnd ѕhе wаѕ busy getting thе kids’ homeschooling day situated. Mу family wаѕ held аgаіnѕt thеіr wіll іn a small frоnt room оf оur home fоr mоrе thаn ѕіx hours wіthоut food оr water whіlе thе Federal DEA agents roamed freely thrоughоut оur house ransacking, searching, аnd occasionally destroying items tо gаіn access еvеn thоugh wе cooperated consistently. Wе еvеn gave access tо оur iPhones wіth оur thumb prints еvеrу tіmе thе agents requested аѕ thеіr electronic equipment began ripping аll thе contents frоm thе devices. Despite thіѕ оur twеlvе old son, Ethan, offered thеm water whіlе еvеrуоnе remained calm, іn shock mоѕtlу, аnd respectful.

I wаѕ аt mу office аnd hаd started seeing patients thаt morning whеn a member оf mу staff urgently interrupted mу meeting wіth a patient tо inform mе thаt twо DEA agents hаd arrived stating thеу wanted tо speak wіth mе аnd hаd bееn taken tо оur staff break room/kitchen whеrе wе соuld meet. I spent thе nеxt twо hours оr mоrе answering thеіr questions аnd іn ѕоmе wауѕ bеіng interrogated bу thеm. Hoping thеу wоuld leave knowing аll thеіr questions wеrе thoroughly answered tо thе best оf mу ability, demonstrating mу transparency, thеу wоuld return mу honesty wіth professional courtesy bу letting mе know whаt thеіr true purpose wаѕ. Thеу did nоt.

DEA agents returned, guns drawn, storming thrоugh mу lobby аbоut 10 minutes аftеr leaving, аnd thеу proceeded tо flood mу office wіth оvеr 40 agents, separating mу staff individually іntо different rooms tо bе interrogated. Thеу yelled аt mу patients іn thе lobby, corralling thеm. Thеу immediately sequestered mе іn mу office tо search mе personally. Thеn thеу led mе bасk tо thе break room kitchen area fоr whаt wоuld bе аnоthеr ѕеvеrаl hours оf sporadic interrogations thrоughоut thе day. Thеу spent оvеr 12 hours аt mу office. Durіng thаt tіmе, thе ѕаmе level оf cooperation аnd courtesy mу family wаѕ providing thе agents ransacking оur home, wаѕ provided bу mу staff аnd myself. At оnе point mу wife аnd I wеrе allowed tо speak fоr a fеw brief moments оvеr thе supervising DEA agent’s mobile phone. Thаt wаѕ whеn I learned fоr thе fіrѕt tіmе thаt mу home wаѕ аlѕо bеіng raided.  Thіѕ іѕ a branch оf thе law thаt deal wіth domestic relations аnd family matters like marriage, adoption, child abuse, child abduction, property settlements, child support аnd visitation, аnd mоrе. Visit Merrillville family law office for the issues regarding family law attorney. It іѕ аlѕо referred tо аѕ matrimonial law. In mаnу jurisdictions, family courts аrе thе ones wіth thе most-crowded court dockets. Thе attorney whо handles thеѕе types оf cases іѕ called a Fort Worth Family Attorney оr lawyer.

When navigating the complexities of divorce, especially when children are involved, consulting with Naperville guardianship lawyers can help ensure that your children’s best interests are protected throughout the legal process.

If you need spousal support, divorce, or custody to be resolved in a timely and consistent manner outside of litigation, a divorce attorney Kane County is here to help. Our experienced attorneys are dedicated to providing compassionate and effective legal support tailored to your unique situation. If уоu want tо hire professional family law attorney thеn get redirected here.

During legal separations and divorces, a divorce lawyer Gaithersburg MD would handle dividing marital property, advocating for appropriate alimony and child support, settling child custody matters, and establishing visitation rights. Their expertise ensures that clients receive fair treatment and comprehensive legal support throughout the process. If you’re in Salt Lake City, seeking assistance from a reputable divorce and family law practice Salt Lake can provide comprehensive legal guidance tailored to your specific situation, ensuring your rights and interests are protected throughout the process. Their expertise can be invaluable as you navigate these challenging circumstances.

In divorce аnd separation cases, еасh party wіll hаvе thеіr оwn family law attorney, try these out.

Domestic violence, Legal separation, Adoption thіѕ type оf family law attorney for Roanoke іѕ easy tо solve fоr thеm. If nо settlement саn bе reached fоr аnу issues thеу соuld bе taken іntо thе court аnd thеу judge wоuld usually issue thе final order оn thе issues. Adoption іѕ аnоthеr field thаt a family law attorney handles. If уоu аrе оn a limited budget, уоu саn ѕtіll fіnd аn effective attorney. Whіlе ѕоmе divorce attorneys саn bе quite expensive bесаuѕе оf thеіr high reputation, уоu саn ѕtіll fіnd оnе thаt уоu саn afford оr аn attorney whо іѕ willing tо make payment arrangements wіth уоu. Tо fіnd a reliable divorce attorney, іt іѕ important tо dо уоur research. At www.adamdivorcelaw.com/divorce/ site уоu wіll gеt reliable divorce attorney. Speak wіth оthеrѕ whо hаvе used thе attorney’s services оr learn аbоut whаt thеіr practices аrе іn thе courtroom. If finances аrе keeping уоu frоm finding a dependable divorce attorney, research legal services thаt аrе available fоr low-income families аnd individuals.

Thе Holmes, Diggs & Sadler attorney wіll help thе couple thrоugh thе mаnу steps thаt hаѕ tо bе taken іn order tо make thе adoption legal. In еvеrу jurisdiction, thе laws аrе different аnd mау vary according tо hоw old thе child іѕ. In ѕоmе locations thе birth parents wіll аlwауѕ retain ѕоmе rights whіlе іn оthеr jurisdictions, аll оf thеіr legal parental rights hаvе bееn given uр completely.“What great crime оr great criminal operation wаѕ thе саuѕе fоr аll this?” уоu mау ask уоurѕеlf. Thеrе wеrе nо arrests thаt day. Well just this page аnd уоu wіll able tо meet best divorce lawyer. Thеrе wеrе nо indictments оr criminal complaints prior tо thеѕе raids, thеѕе abrupt, traumatic, violent intrusions іntо thе lives оf mу patients, mу staff, аnd mу family. Thеу wеrе simply based оn warrants, signed іn secret bу unelected federal judges, аt thе request оf eager DOJ attorneys looking fоr thеіr nеxt scalp оr trophy оf a physician persecuted аnd incarcerated durіng оur government’s highly politicized wаr оn drugs. Physicians аrе nоw thе highest prize target іn thе federal government’s ongoing wаr аgаіnѕt thе opiate crisis. Thіѕ wаѕ nоt thе case ѕеvеrаl years ago whеn thе highest priority targets wеrе thе actual criminals іn Mexico, Central аnd South America, China, аnd оthеr places thе DEA spends іtѕ best tіmе аnd resources investigating аnd stopping thе devastating street drugs thаt continue tо pour іntо оur country еvеn today. Mаnу оf uѕ іn America nоw know whаt іt means tо live іn fear, fоr trusting уоur patients аnd trying tо uphold уоur oath “to dо nо harm,” whіlе аlѕо helping уоur patients іn еvеrу ethical wау possible.

It іѕ thе misapplication оf law. Thе twisting оf thе narrative аnd facts. Thе misuse оf thе DEA/DOJ tо interfere іn whаt wаѕ оnсе considered a sacred relationship bеtwееn a doctor аnd a patient. Thе sanctity оf thіѕ relationship іѕ nоw bеіng destroyed bу thіѕ malicious, unwarranted, witch hunt. Thеrе used tо bе thrее ѕuсh sacred relationships іn thіѕ country (four іf уоu include marriage). Thе thrее outside оf marriage wоuld bе bеtwееn a person аnd thеіr minister, a person аnd thеіr attorney, аnd a person аnd thеіr physician. Wе Americans hаvе gradually аnd іn mаnу cases abruptly lost access tо care fоr ѕоmе оf оur mоѕt devastating diseases оvеr thе past fеw years. Especially іf уоur disease relates tо уоu suffering frоm severe chronic pain. Thаt іѕ thе diagnosis оf folks whо I, Dr. Smithers, treated, lеѕѕ thаn 150 patients реr month. Thе federal government intrusion іntо thе practice оf medicine, аnd thеrеbу thе disruption оf thе doctor/patient relationship, nоw jeopardizes ALL patients аnd ALL physicians еvеrуwhеrе, bесаuѕе уоu nеvеr know whеn care wіll bе denied tо уоu. Whеthеr іn thе emergency room, thе doctor’s office, оr thе urgent care, bесаuѕе оf thе inscrutable, аlmоѕt unbearable pressure оn medical providers whо fear thе government аnd it’s powerful enforcement mechanisms.

And thіѕ іѕ a Hail Mary, аn 11th hour аnd 59 seconds attempt, a lеѕѕ thаn оnе second оn thе clock final push tо raise funds fоr thе defense оf myself, mу legal defense, аnd fоr mу family. Ovеr thе past twо years wе hаvе bесоmе indigent, оur family continues tо bе оn food stamps fоr оvеr a year whіlе I work mаnу jobs. Wіth аn issue like thіѕ hanging оvеr mу head wе аrе barely surviving financially, аnd mу wife hаѕ еvеn bееn working part-time whіlе homeschooling thеѕе mаnу weeks. Wе continue tо trust God аnd Hіѕ wisdom іn thіѕ situation. Wе continue tо homeschool аnd try tо provide аѕ mаnу meaningful learning opportunities fоr оur kids аѕ possible. Quality family tіmе іѕ rare duе tо thе аmоunt I muѕt work fоr оur family tо survive, аll whіlе facing thе possibility оf a life sentence, іf I аnd mу court-appointed attorney fail аt trial.

Anу assistance wоuld bе greatly appreciated! Updates tо оur situation wіll bе available оn thіѕ page аѕ thе case progresses. Thank уоu fоr аnу support уоu аrе able tо provide аt thіѕ tіmе оr іn thе future. Mау оur Lord аnd Savior Jesus Christ richly bless уоu.

 

The Smithers Family
Joel, Angel, Ethan, Seth, Aylianna, Brielle

Joel Smithers, DO–the incarceration of Marcus Welby, MD through government collusion.

 

U.S. Attorney in Colorado Jason Dunn Navigates Federal Drug Policy And States’ Rights

U.S. Attorney in Colorado Jason Dunn Navigates Federal Drug Policy And States’ Rights

https://www.cpr.org/news/story/for-us-attorney-jason-dunn-part-of-the-job-is-balancing-colorados-more-liberal-drug

Colorado’s drug laws live up to its wild, wild west past, at least in the eyes of the federal government.

Weed is legal, Denver decriminalized psychedelic mushrooms and the city also teased the idea of opening a supervised injection site. The job of balancing the Centennial State’s substance policies with more stringent federal laws falls to Colorado U.S. Attorney Jason Dunn, appointed last June.

Dunn talked to Colorado Matters about bringing down black market marijuana, his stance on safe injections sites and handling the opioid crisis.

Interview Highlights

On the prevalence of marijuana grown and sold on the black market:

“I’ve been told anecdotally by the DEA that the black market marijuana that’s being produced illegally under federal or state law, is being almost exclusively produced for out-of-state shipment. The DEA’s finding it virtually in every state in the country, and they think that it may be a larger industry in Colorado than the retail industry. These are almost all primarily home grows. We held a press conference recently where we announced the results of a two year investigation in which we executed search warrants on approximately 250 homes that were being used to grow 400, 500, all the way up to 1,000 plants in the basement with, in most cases, with nobody living there.

All over, from Colorado Springs, Pueblo, all the way up to Greeley, but primarily concentrated in the metro area. And these are not homes that are run down, abandoned homes. The average value of the homes that we actually filed forfeiture actions on was about $400,000. These are homes that are in suburban, working class neighborhoods. The lawns are maintained. They don’t look like drug houses, but they are.”

On why he took a stance against Denver establishing a safe injection site:

“My view on it was, if we were going to normalize or authorize conduct that is otherwise illegal, we should have a really good reason to do that. We should have demonstrable proof that it works and has a dramatic impact on a problem, and I couldn’t find that.

There’s no question that if somebody overdoses in a facility, and is hit with Narcan and is saved, that that person has been saved. The problem is that people don’t just shoot up once a day, and they don’t do it just in those facilities. They will do it four or five times a day, and they’ll do it many times outside that facility, so I’m not sure it even has a measurable impact on the death rate. Moreover, I don’t think people, people who live in an apartment or are doing heroin other places or prescription opioids are not going to be driving down to this facility to do it, so you’re really just facilitating one population. And second, Narcan, only works on heroin. It doesn’t work on meth or cocaine or anything else, and all of those drugs would arguably be allowable in the facility.”

On his office’s work investigating medical professionals who are over-prescribing opiates:

“We have really smart lawyers in our office who are taking federal data, federal Medicare, Medicaid, TRICARE, which is the military insurance, and we’re mining that data to figure out how the statistical outliers are in terms of prescribers, doctors, pharmacists, nurse practitioners, and figure out who are the statistical outliers so we can figure out who to target as who are distributing opioids.

We’ve targeted a number of pharmacies and prescribers who we think are violating, so what that allows us to do from the civil side is we can either file False Claims Act, the DEA can suspend their license, Health and Human Services can suspend their ability to seek Medicaid, Medicare reimbursement. While it’s not a criminal penalty, it can be referred for criminal prosecution, but that’s a higher standard. We can put them out of business.”

Answers have been edited and condensed for clarity.

Full Transcript

Ryan Warner: This is Colorado Matters from CPR News. I’m Ryan Warner.

Colorado might look like the wild, wild west in the eyes of the federal government. Legal weed is just one example. The drug, of course, is still a no-no federally. Then came the idea to open the country’s first safe injection site for IV drug users in Denver. That’s been scuttled for now. And, of course, the mile high city recently decriminalized psychedelic mushrooms. The man chosen by President Trump to tame this lawless land is Colorado’s US Attorney Jason Dunn. Jason, welcome to the program.

Jason Dunn: Great to be with you, Ryan. Thanks for having me.

RW: How do you walk the line between adhering to federal law, which places marijuana alongside heroin, and Coloradans decision to legalize it? Maybe put another way, what are your enforcement priorities when it comes to marijuana?

JD: Sure. As you know, under federal law, marijuana is a controlled substance and it’s illegal period. That said, our job is to figure out what we can do to most impact public safety, so when we prioritize our criminal enforcement efforts, we think about what impacts public safety the most and where we can use our resources. And that’s true for the Drug Enforcement Administration as well here in Colorado.

RW: Okay, so where is public safety most affected, do you think?

JD: Our priorities are, and this is true across the country for the entire Department of Justice. Number one is national security and terrorism. That’s always job one post 9/11. But second, we are focused on violent crime, and I can go into lengths about some of the things we’re doing on that, but then illicit drugs is the second, and that includes going after large drug trafficking organizations that are bringing large quantities of methamphetamine and heroin into Colorado and through Colorado. Opioids, opioids get a lot of attention lately and rightly so. That’s a huge problem. And then third really is, as you’ve seen recently, is black market marijuana. That’s a huge problem in Colorado as well, so we’re focused on that.

RW: Okay. In April, in an interview with the Colorado Sun, you said the size and scope of the marijuana black market in Colorado was stunning to you. Help us understand what stunned you.

JD: Yeah, well the size, as you said. The retail market in Colorado as I understand it is something like a billion and a half dollars a year. I’ve been told anecdotally by the DEA that the black market, and that’s, just to be clear, that’s marijuana that’s being produced illegally under federal or state law, and that’s being almost exclusively produced for out-of-state shipment. The DEA’s finding it virtually in every state in the country, and they think that it may be a larger industry in Colorado than the retail industry. These are almost all primarily home grows. We held a press conference recently where we announced the results of a two year investigation in which we executed search warrants on approximately 250 homes that were being used to grow four, five hundred, all the way up to 1,000 plants in the basement with, in most cases, with nobody living there.

RW: These were homes where in Colorado?

JD: All over, from Colorado Springs, Pueblo, all the way up to Greeley, but primarily concentrated in the metro area, and these are not homes that are run down, abandoned homes. The average value of the homes that we actually filed forfeiture actions on was about $400,000. These are homes that are in suburban, working class neighborhoods. The lawns are maintained. They don’t look like drug houses, but they are.

RW: Who’s behind these grows?

JD: We’re working on that. It’s a complex analysis, and it’s an investigation that I can’t go into a lot of detail on, but we think there may be some connection among them, and I’m talking … These are hundreds of homes, but we’re still working on that and trying to figure out what the connection is. It’s a complicated effort. It may involve the dark web and cryptocurrency, so we’re investigating all of that.

RW: Do you think that there are foreign actors involved in this?

JD: There are certainly, as our arrests that were disclosed show, there are people who are of foreign nationality. Primarily, in those arrests were primarily Chinese.

RW: Chinese. And what do you think this would be funding?

JD: You know, that’s what we’re trying to figure out.

RW: Okay.

JD: It’s got to be a huge amount of cash. I was trying to crunch the numbers just on what one house can generate in cash, and it could be upwards of a couple million dollars a year. That’s a cash business, so that money has to be flowing somewhere.

RW: How do you know that marijuana makes it out of Colorado? You say that this black market is primarily serving other places. How do you know that?

JD: Yeah, that’s what the DEA tells us, that when they have seizures in other states and they talk to the people that they’re catching, they’re asking where they got this 50 or 100 pounds of marijuana, and a lot of reports are coming back that it’s coming from Colorado.

RW: Okay. If marijuana business people, legit ones, are listening, from dispensary owners to … There are payroll firms that work with the cannabis industry, and frankly, if marijuana users are listening, how do they stay right by your office?

JD: There is no right by our office. Marijuana is illegal under federal law, but as I said, we have to make enforcement decisions and make priorities, and so we monitor closely what the state is doing through the Marijuana Enforcement Division to ensure they’re doing what they’re required to do under state law from an enforcement perspective. That helps us be more comfortable that there’s a robust regulatory scheme and that the state is a good partner in enforcing marijuana laws under state law.

RW: Is the state a good partner? Is the state doing a good job policing this?

JD: I think Colorado, because it was such an early actor in adopting legalization, has a more robust system than many states, and I know the folks over at the Marijuana Enforcement Division, they’re working very hard, and I know under some current legislation, I think they’re going to expand the number of people they have. I think they could always be doing more.

RW: It occurs to me that, if you think the black market is as you have said, “stunning,” that Colorado, in your mind, is falling short to some degree.

JD: Yeah. I think the Marijuana Enforcement Division has its hands full with regulating the regulated market. I certainly would like to see the state do more to go after the black market. I know I’ve talked to local law enforcement, sheriffs, police chiefs who have said, “We know where lots of illegal grows are. We just can’t get to them all.”

RW: A little background: You’ve been in this job for about eight months. That is, the job of US Attorney in Colorado. You’re a native who attended CU, worked at the big Denver law firm Brownstein Hyatt, at the State Attorney General’s office. Jason Dunn, have you always been a law and order guy? What did the younger Jason Dunn make of things like the push to legalize marijuana?

JD: You know, I don’t know. I was probably a typical teenager. I’m not sure I would’ve thought at that time I would’ve wound up in law enforcement, but I have a real love for Colorado. I left the state twice when my dad became a school superintendent in Montana, and came right back for undergrad. And then after college, I lived on the East Coast for three years, and quickly came back to Colorado. I’m just most interested in making sure that Colorado’s a great place for people to live and raise a family.

RW: Do you respect its decision to legalize marijuana?

JD: I’m a states’ rights guy, and I think we have an intractable problem between federal law and state law that has to be resolved.

RW: You put that onus on Congress, I gather?

JD: I do. I think we’ve got to resolve it. We cannot have a situation where the federal government is saying, “We won’t enforce federal law,” for one reason or another, so we need resolution.

RW: Okay. I’m Ryan Warner, and our guest is US Attorney for Colorado Jason Dunn. He was nominated by President Trump, confirmed by the Senate less than a year ago. In May, Jason, Denver voters decriminalized so-called magic mushrooms, making psychedelic ‘shrooms a low law enforcement priority for people 21 and over. Proponents say they can relieve depression and anxiety. Again, the clash here of local and federal law. Is this on your office’s radar? When the vote came through, did it …

JD: Not really. One correction, it wasn’t decriminalized. It was more what you said, which is they instructed Denver police to make it a low priority, so it’s still illegal, even under state or city law, but from our perspective, it is … I’m not sure in recent, we have a mushroom case in recent memory. I’d have to ask at the office, but it’s certainly not something that has been a high drug.

RW: Instead of heavily trafficked [crosstalk 00:09:04].

Correct.

RW: Okay. Helpful to understand. Let’s talk about the possibility of a supervised injection site. This is where IV drug users could inject in private booths, but near trained professionals that could help if there’s an overdose or refer people to treatments. A bill paving the way for such a site in Denver was ejected in the state legislature. You wrote a letter to the city warning about opening such a location. What was your motivation?

JD: I went into that issue … It was sprung on us when city council did what it did, and I went into it with a fairly open mind, to look at that and think, “Is this something that actually could have a positive impact?”

RW: Right. This is often referred to as harm reduction.

JD: Right. They cited, and people cite frequently to a cite in Vancouver. So we did, I can’t say we spent weeks looking at it, but we spent a couple days digging into the issue and looking at it. My view on it was, if we were going to normalize or authorize conduct that is otherwise illegal, we should have a really good reason to do that. We should have demonstrable proof that it works and has a dramatic impact on a problem, and I couldn’t find that.

I don’t think it’s been successful in Vancouver. I don’t think it’s a good idea for Denver. In fact, in Vancouver, it arguably increased usage rates around the facility, crime rates around the facility. Obviously heroin is a serious narcotic, an illegal drug under any law, and in our view, it would only exacerbate the problem and my view is that, if we’re going to do something that arguably normalizes otherwise harmful conduct, we ought to have a really good reason to do it.

RW: But if someone is injecting in an alleyway with no supervision versus in a facility that has a nurse, isn’t there an inherent benefit in the latter?

JD: There’s no question that if somebody overdoses in a facility and is hit with Narcan and is saved, that that person has been saved. The problem is that people don’t just shoot up once a day, and they don’t do it just in those facilities. They will do it four or five times a day, and they’ll do it many times outside that facility, so I’m not sure it even has a measurable impact on the death rate. Moreover, I don’t think people, people who live in an apartment or are doing heroin other places or prescription opioids are not going to be driving down to this facility to do it, so you’re really just facilitating one population. And second, you’re not even … The antidote, the Narcan, only works on heroin. It doesn’t work on meth or cocaine or anything else, and all of those drugs would arguably be allowable in the facility.

RW: In our first half, you brought up opioids. What exactly is your office’s role as US Attorney in fighting the opioid epidemic? Who are the bad actors that you’re looking at?

JD: We’re addressing that in two ways. One is, of course, we’re going after large drug trafficking organizations that are bringing heroin in to the state, and-

RW: There’s obviously a very strong link between heroin use and opioid use.

JD: Absolutely.

RW: Prescription opioids.

JD: That’s right. The estimates I’ve heard is 70-80 percent of heroin users started by abusing prescription pills, so we have a focus on that as well. I’m really proud of one of the things we’re doing in our office is actually on the civil side, not on the criminal side, but we have really smart lawyers in our office who are taking federal data, federal Medicare, Medicaid, TRICARE, which is the military insurance, and we’re mining that data to figure out how the statistical outliers are in terms of prescribers, doctors, pharmacists, nurse practitioners, and figure out who are the statistical outliers so we can figure out who to target as who are distributing opioids.

JD: You might see, for example, a pharmacy where they have a really high incident rate of distributing or supplying a three drug cocktail that has no purpose other than to give a high of an opioid, an anti-depressant, and a muscle relaxant. Or you might have a pharmacy where the average patient is traveling an inordinate distance to pick up their prescription. Why would that be? We’re trying to use the complex analysis to target and then conduct further investigations.

RW: And has that yielded anything yet?

JD: It’s starting to. We have some ongoing investigations that I can’t talk about, but it is actually, and we’ve targeted a number of pharmacies and prescribers who we think are violating, so what that allows us to do from the civil side is we can either file False Claims Act, the DEA can suspend their license, Health and Human Services can suspend their ability to seek Medicaid, Medicare reimbursement. While it’s not a criminal penalty, it can be referred for criminal prosecution, but that’s a higher standard. We can put them out of business.

RW: Presumably a doctor could lose his or her license under this.

JD: Yep.

RW: Okay.

JD: Absolutely.

RW: Before we go, and we have about a minute, you were nominated, as I said, by President Trump, who has arguably made immigration the key issue of his presidency. Denver, the largest city in your region, has declared itself to be a sanctuary city for immigrants. What’s your approach in regards to immigration?

JD: I think … People asked me a lot about that during the confirmation process. Probably that and marijuana were the things I was asked most about. I think there’s a misperception though about our role in the immigration process. It’s actually fairly small. People may not know, when somebody enters the country illegally and they’re caught, that typically is a deportation proceeding conducted by ICE as an administrative matter, and they’re deported. If they reenter the country, then it becomes a felony under federal law.

We can certainly prosecute that case, but typically we only take those kinds of cases if the person has a prior felony conviction in the United States of a violent nature. If it’s somebody who, while they’re here the first time, was prosecuted for domestic violence or dealing drugs or gang activity, then we will go after those people and charge them with illegal reentry.

RW: So this, again, goes back to the priorities of terrorism and of violent crime. Jason Dunn, thanks for being with us. He’s US Attorney in Colorado, taking the job about eight months ago. He also works closely in this region with the FBI, Drug Enforcement Administration, and the Bureau of Alcohol, Tobacco, Firearms, and Explosives.

10-20 YEAR “PIPE DREAM ” ?

Could you become an opioid addict? We may soon have a test for that.

https://www.nj.com/healthfit/2019/03/could-you-become-an-opioid-addict-we-may-soon-have-a-test-for-that.html

The only way we know how to deal with opioid addiction is after the fact — only after a person has become hooked.

But what if one day there were a genetic test that could spot whether a person was susceptible to opioid abuse later in life? It would be like 23andMe, but instead of telling whether someone is predisposed to heart disease, this would tell us whether someone might be at risk for opioid dependency.

A New Jersey-based research institute along with scientists, academics and medical leaders is trying to crack this genetic code underlying opioid addiction.

The Coriell Institute for Medical Research, Cooper University Health Care and Cooper Medical School of Rowan University have partnered to launch the Camden Opioid Research Initiative, which will investigate the genetic and biological factors that contribute to opioid abuse.

One delicate but vital part of the study will be collecting and testing the tissue samples of people who have died from opioid overdoses.

Researchers will also be studying people being treated for opioid addiction as well as people who are receiving opioids for chronic pain but are not addicted to them. The team will then compare the findings of these groups.

“The dream would be in 10 or 20 years … some sort of profile or algorithm that would give doctors some useful information — patients with genetic factors that might influence those things. And that’s the idea, to make the information available to physicians,” said Stefan Zajic, principal research scientist and scientific lead for CORI.

Zajic said many addicts’ first encounter with opioids are prescription pills they got from a doctor. While regulations have improved prescription opioid abuse in recent years, many people are still getting hooked from prescribed medication.

But a genetic test showing who might have a predisposition to opioid dependency would give doctors a profile of who is or is not at risk, allowing them to adjust what they prescribe.

“Many people are still encountering opioids in the form of prescriptions,” Zajic said. “So we thought if some patients were predisposed to a use problem … they could be prescribed with nonopioid (medications), something more mild, or they could adjust the dose or they could adjust the number of pills and just monitor a little more closely.”

In 2018, more than 3,000 people died in New Jersey from opioid overdoses, a death toll that set a state record for the fourth year, according to preliminary data collected by the state Attorney General’s Office.

The samples from those who have died from opioid overdoses will play an essential role in the study.

With the help of the medical examiner’s office and permission of families, the team will establish a biobank of those tissue samples, which Zajic believes will be the first of its kind in the country and will be made available to researchers studying opioid abuse for the years to come.

“This initiative has the potential to define risk factors for opioid addiction and develop strategies to prevent people from developing opioid use disorder and to thereby save lives,” Dr. Annette Reboli, dean of Cooper Medical School of Rowan University, said in a statement. “This collaboration is perhaps one of the most important we could undertake for the health of so many at-risk individuals.”

The toxicology research on those who have died from opioid overdoses may also save lives on the streets of Camden, where the research is being conducted. If a bad batch of heroin is going around the city’s neighborhoods, causing a spike in overdoses, instead of waiting a typical month to learn that information from public health officials, the team would be able to learn that in almost realtime from its research.

“That is information we could share to public health officials,” Zajic said, particularly if it’s a heroin supply that has been laced with fentanyl, which has been causing a rise in overdoses in recent years.

“By sharing these samples, they may actually be helping prevent other deaths,” he added.

Then there is this psychological profile test to help isolate people that have a tendency towards an addictive personality… but.. few in healthcare seem to use it when dealing with the prescribing of opiates .. especially long term  https://www.scribd.com/document/346103162/SOAPP-R

VA care of chronic pain pt

 

 

Opioid Evangelist Switches Sides in Case Alleging Pharma Abuse

See the source image

Opioid Evangelist Switches Sides in Case Alleging Pharma Abuse

https://www.bloomberg.com/news/articles/2019-04-08/opioid-evangelist-switches-sides-in-case-alleging-pharma-abuse

  • Doctor now says industry promoted drugs and ignored the risks
  • Portenoy agrees to aid lawsuits seeking billions in damages

Russell Portenoy

A doctor who was an early evangelist for increased use of highly addictive opioids like OxyContin to treat chronic pain — and who was paid to promote the idea — has switched sides and now says drug makers helped to create a U.S. epidemic by failing to acknowledge the risks of abuse.

Dr. Russell Portenoy, a medical-school professor who studied pain for more than 30 years, has agreed to testify against the industry in trials of lawsuits brought by local governments seeking billions in social costs associated with addiction, according to unsealed court filings. In a sworn statement, he said drug makers were too aggressive in promoting opioids for all kinds of ailments.

“The opioid manufacturers should have tempered their positive messaging about opioids with a greater focus on risk, particularly as early signals of opioid risk emerged,” Portenoy said in his court declaration. Drug makers also “should have responded as evidence of increasing adverse affects mounted” to increased awareness and “reduce inappropriate or risky prescribing,” he said.

Portenoy switched sides last year after U.S. cities and counties agreed to drop their lawsuits against him in exchange for his cooperation, the court records show. A settlement was reached, and he provided documents and testimony that could be used in the lawsuits against opioid manufacturers including Purdue Pharma, Johnson & Johnson’s Janssen unit and Teva Pharmaceutical Industries Ltd.

According to a 2017 investigation conducted by then Missouri Senator Claire McCaskill, more than 50,000 Americans died from drug overdoses in 2015, with a third of those deaths caused by prescription opioids including Purdue Pharma LP’ OxyContin and Insys Therapeutics Inc.’s Subsys.

How the U.S. Opioid Crisis Spiraled Out of Control

Recognized as one of the leading U.S. experts on pain treatment and a “key opinion leader,’’ Portenoy will testify that companies “overstated the benefits of chronic-opioid therapy’’ and “understated the risks of opioids, particularly the risk of abuse, addiction and overdose,’’ according to the federal-court filing.

That backs up the contention of local governments that illegal marketing by opioid makers fueled a public-health crisis that consumed billions of tax dollars. The plaintiffs say those misleading sales tactics created a “public nuisance’’ that puts the companies on the hook for social costs tied to the epidemic.

Robert Josephson, Purdue’s spokesman, declined to comment on Portenoy’s defection.

Portenoy’s 36-page declaration about his change of heart was made public Friday as part a pre-trial ruling in a consolidation of more than 1,600 suits filed by public entities before a federal judge in Cleveland. The doctor didn’t immediately respond to an interview request Monday.

A special master overseeing discovery in test trials set for October is recommending that Portenoy be barred from testifying because plaintiffs’ lawyers didn’t notify the companies of the doctor’s settlement until months after it was signed. Portenoy would be free to testify in future opioid cases if U.S. Judge Dan Polster signs off on the recommendation.

For analysis of companies facing opioid litigation, click here.

Portenoy, a professor of medicine at New York-based Albert Einstein College of Medicine at Yeshiva University who oversees hospice care at Memorial Sloane-Kettering Cancer Center, was an early adopter of the idea that opioids used mostly to treat cancer patients could be safely and effectively used for chronic pain from arthritis and bad backs.

Government regulators generally limited prescription opioids — some of which are 1,000-times more powerful than morphine. While doctors have wide discretion to prescribe medicines beyond what they’ve been approved to treat, drug makers can only market their products for ailments approved by regulators.

Portenoy’s assertion that opioid therapy is effective and safe for non-cancer pain was used in doctor-training videos backed by opioid makers and in the companies’ marketing brochures, he said. Portenoy said he was hired as a consultant by several drug makers. He has been identified in court filings as a “spokesman” for Purdue and an expert who provided “a critical component” of drug-marketing efforts.
Changed Views

But Portenoy now says he’s changed his view. After more than 20 years of experience with opioids, he has determined that the drugs should not be prescribed widely, and instead should only be targeted to patients who don’t have a high risk of addiction, according to the declaration.

The pain doctor said opioid makers selectively cited his work to market their products in an “unbalanced’’ way that contributed to physicians prescribing the painkillers inappropriately. During that period, he was receiving compensation from pharmaceutical companies for speeches, research and consulting. He didn’t say how much he was paid in total, but cited examples of almost $80,000 from 2006 to 2011, as well as a $500-an-hour consulting contract in 2008 with Insys, court filings show.

Those kind of prescribing habits — influenced by opioid makers’ relentless marketing of their painkillers — “contributed to rising incidences of drug addiction and overdoses,’’ Portenoy said in his declaration.

Not all the plaintiffs’ lawyers are impressed with Portenoy’s change of heart.

“Although it’s nice that Dr. Portenoy has changed his view on the use of opioids, it doesn’t help the millions who have died and become addicted over the years while he was a shill for Purdue, J&J and the rest of the opioid industry,” Hunter Shkolnik, an attorney for some cities and counties, said in an emailed statement.

The case is In Re National Prescription Opioid Litigation, 17-md-2804, U.S. District Court, Northern District of Ohio (Cleveland).