Congressional report: DEA failed to stop flow of millions of opioid pills

Congressional report: Drug companies, DEA failed to stop flow of millions of opioid pills

https://www.washingtonpost.com/national/congressional-report-drug-companies-dea-failed-to-stop-flow-of-millions-of-opioid-pills/2018/12/18/5bc750ee-0300-11e9-b6a9-0aa5c2fcc9e4_story.html

The distributors of powerful prescription opioids and the Drug Enforcement Administration failed to stop the flow of millions of pills into rural West Virginia despite rampant warning signs that the pills were being diverted for abuse, inertia that contributed to the nation’s opioid epidemic, a congressional report has found.

A report from the majority staff of the House Energy and Commerce Committee found that distributors, which fulfill orders for prescription drugs to pharmacies, failed to conduct proper oversight of their customers by not questioning suspicious activity and not properly monitoring the quantity of painkillers that were being shipped to individual pharmacies.

The committee also found that the DEA did not properly use a database that aims to monitor the flow of powerful prescription painkillers from manufacturers to sellers, something that could have allowed federal agents — in real time — to notice that millions of pills were being sent to pharmacies in West Virginia. The agency also curtailed enforcement of distributors, the report found, and infighting inside the agency affected the way cases were handled.

The 324-page report, the culmination of an 18-month investigation of alleged pill dumping in West Virginia, shows how mistakes and lack of oversight led to a massive influx of pills there, much of which ultimately fueled the black market sale and illegal abuse of opioids, including oxycodone.

The Controlled Substances Act requires distributors and the DEA to diligently report and track data about such drugs, and the report found that neither did. West Virginia has been the epicenter of the opioid crisis; the state has the highest overdose death rate in the country.

“Taken altogether, the Committee’s report outlines a series of missteps and missed opportunities that contributed to the worsening of the opioid epidemic in West Virginia,” the report says. “While focused on a narrow part of West Virginia, the report raises grave concerns about practices by the distributors and the DEA nationwide.”

The committee investigated the nation’s three largest drug distributors: Cardinal Health, AmerisourceBergen and McKesson Corp. The report said the companies combined sent more than 900 million doses of hydrocodone and oxycodone to West Virginia from 2005 to 2016. It also looked at two regional distributors: Miami-Luken and H.D. Smith. The report said those companies made “inordinate shipments” of opioids to pharmacies in the state during the same time frame.

Cardinal Health said in a statement that it commends the committee for “examining this complex national public health issue.” The company said it will “continue to implement rigorous anti-diversion controls” and continue to raise awareness about the dangers of overprescribing painkillers.

AmerisourceBergen, which recently acquired H.D. Smith, said the report primarily focuses on whether the company did due diligence regarding prescribing physicians, but it says the company has “virtually no interaction with physicians and limited legal ability to gather information on their practices and prescribing behavior.” The company said that heightening standards for all parties in the opioid supply chain “would provide significant value to distributors.”

Richard H. Blake, outside counsel for Miami-Luken, declined to comment, saying he was reviewing the report ahead of its slated public release Wednesday.

McKesson did not respond to requests for comment Tuesday.

On Wednesday, after the report was released, DEA spokesman Melvin Patterson said the agency has upgraded its software program so it can more proactively investigate suspicious opioid orders. He said the changes have led to an increase in investigations into, and prosecutions of, manufacturers, distributors and providers during the past three years.

Starting in 2005, the DEA held one-on-one meetings with distributors to remind them of their legal obligation to prevent pills from being diverted to the black market, and the agency sent letters to all distributors in 2006 and 2007 to reiterate that obligation, according to the report.

Those letters did not work, the report concluded. Cardinal Health was fined $34 million in 2008 to resolve allegations that it failed to report suspicious orders, and McKesson was fined a little more than $13 million.

Despite paying the fines, the report alleges that the distributors continued to look the other way, allowing pills to flood into West Virginia. The report said that many of the distributors shipped pills to pharmacies with no regard for how many pills a store should need to have in stock based on the population it serves; during a two-week period in 2008, Cardinal increased what it sent to a pharmacy in Williamson, W.Va., more than 1,500 percent.

The report also said that distributors continued to pump pills into pharmacies even after it became clear that doctors and physicians who practiced hundreds of miles from the pharmacies were writing suspicious prescriptions to be filled there.

AmerisourceBergen started working with Westside Pharmacy in Oceana, W.Va., in 2011, the report said. In documents provided to the committee, the company gave a list of five pain doctors who wrote prescriptions filled at the pharmacy. One doctor was based in Pembroke, Va., nearly 100 miles from the town, and another practiced in Washington, D.C., 345 miles away. The report said four of the five doctors “have either been subsequently convicted of, or indicted on, criminal charges related to their controlled substance prescribing or are currently under federal investigation.”

The report found that the DEA’s use of administrative enforcement actions against distributors plummeted from 58 in 2011, to five in 2015.

“Our bipartisan investigation revealed systemic failures by both distributors and the DEA that contributed to — and failed to abate — the opioid crisis in West Virginia,” Energy and Commerce Committee Chairman Greg Walden (R-Ore.) and ranking Democrat Frank Pallone Jr. (N.J.) said in a joint statement.

The report lists several legislative and policy recommendations, such as calling on Congress to create more stringent requirements for reporting suspicious orders. It also urges the DEA to create a platform capable of tracking order data in real time and asks the agency to review staffing in the parts of the country hardest hit by the opioid crisis with the goal of ensuring there are adequate resources for scrutinizing pharmacies where there appear to be suspicious orders.

A whole “herd” of attorneys are suing the major pharma companies and the drug wholesalers for  “dropping the ball” on all the theoretical tsunami of opiates into various areas of the country.

According to a Congressional report, the DEA itself had access to the same data in the same time frame that the rest of the industries in the medication distribution channel.. and the primary function of the DEA is – and has been since 1973 – to prevent diversion of controlled substances..

So with Congress being 40% attorneys, the DEA part of the DOJ.. it would seem like they are getting a PASS on their FAILURE to do their job and there is no consequences for them.

There is some 12,000 employees in the DEA at the Federal level… with – it is claimed – that > 50% are DESK JOBS.

All those DEA employees sitting at desk with – I guess – have computers on them .. and NO ONE is looking at these control substance distribution reports.

Anyone want to put money on the fact that Congress will DO NOTHING about the DEA failing to do one of their primary function(s) ?

I’m disappointed, disgusted, and appalled as to what has become of my pharmacy profession

My College daughter has had multiple surgeries for a nasty tumor. Had to share this with you This just happened tonight and yes I did call cvs I still despise them they were just closest at the time As a former CVS employee I have to share my experience with the CVS I went to in Miami just a little while ago. I took three rx’s in-2 antibiotics and one for Vicodin. I’m also a pharmacist so this makes my blood boil even more. My daughter just had invasive oral surgery on the roof of her mouth for a tumor that keeps coming back . The technician took that rx to the pharmacist immediately and came back with the “we don’t have that in stock”“generic response. Hell, I used to tell that to people I thought were seekers. But I had 2 abx rx’s from a reputable surgeon at UM hospital. Furthermore, wtf was I going to do with 12 tabs??? They both gave me the visual once over and trust me: After sitting in a surgical waiting room for 7 hours I was not a pretty sight. They said there were several other CVS pharmacies in Miami and I could try any of them. I politely explained to them that I’m not familiar with the area and I’m really uncomfortable driving around here because of the heavy traffic all the time and I don’t know my way around. I asked if they could recommend other pharmacies close by and neither one would. I even told the pharmacist that I too was a pharmacist and I understood what he was doing and asked if he could please call the other CVS to save me the trip and to keep me from getting lost. He proceeded to tell me that he couldn’t, he was an allowed. OK so the pendulum has swung completely in the wrong direction. is this how we are going to treat people with legitimate prescriptions now, just refuse to fill everything? I’m disappointed, disgusted, and appalled as to what has become of my profession. And you best believe I am contacting CVS and telling them everything. I strongly encourage people to stay away from any CVS Pharmacy. If I would’ve been home I would’ve gone to my local small independent pharmacy who appreciates our business. I would’ve been happy to go to one in Miami but I had no idea where to go. Moral of the story is do not pre judge every hydrocodone rx you get. Refusing to help legitimate patients borders on malpractice. I refuse to be a party to that. Thank you to the Walgreens pharmacist who quickly filled all 3 rx’s.

Laugh of the day – KARMA CAN BE A BITCH

PT has had ONLY 12 SURGERIES on her back

Federal and state government efforts to reduce prescription opioids are inadvertently harming chronic pain patients. Many patients are involuntarily cut off medications that improve their lives or say they are unable to find a doctor willing to care for them. In the last decade, hundreds of thousands of Americans died of drug overdoses each year. By some estimates, nearly half of these deaths have involved prescription opioids. To stem this crisis, government authorities have mounted aggressive attempts to reduce the use of these medicines. They have investigated physicians who prescribe them for no legitimate medical reason and increased monitoring of prescribing by physicians. Some state governments and Medicaid programs have imposed strict upward limits on the dosage physicians are allowed to prescribe.

CVS is the Enron of healthcare

www.reddit.com/r/pharmacy/comments/a6mv04/cvs_is_the_enron_of_healthcare/

CVS is the Enron of healthcare

For anyone thinking about working for CVS, I urge you to look elsewhere.

The entire business model of CVS is based off of theft and deception. How long can a company like this last? I’m willing to bet that the house of cards comes crashing down within a year or two.

For those who are unfamiliar with how they do business, they profit by forcing pharmacists to work so fast that it is dangerous to the patients. As an employee, this means you’ll have higher stress levels and a much higher chance of making mistakes. Of course, when an inevitable error happens it is your fault (not CVS), and they won’t hesitate to throw you under the bus. If you’re a pharmacist, you are degrading yourself and your profession if you work for them.

If you’re a patient, you probably aren’t aware of how corners are cut in order to meet the company speed metrics. The way the business is run is unsafe, and you are putting yourself in danger by filling prescriptions at CVS. You dont even need to take my word for it. The Chicago Tribune did some independent testing and CVS came in LAST compared to the chains in warning patients about dangerous drug interactions CVS execs do not seem to care that they are killing patients in an effort to increase profits.

CVS is actually worse than the tobacco companies. At least someone buying cigarettes will know about the health risks. Patients are generally not aware that CVS business practices put them in danger.

CVS also keeps getting caught stealing from state medicaid, again and again. The company preaches ethics in its internal propaganda videos, but anyone who pays attention sees how they really operate. The company is run by sociopaths who will steal and kill in the name of corporate greed. Anyone who works for CVS and knows these things is an enabler.

TL;DR: CVS kills people in the name of profit. They also steal from poor people. Don’t work for them Don’t shop there. Don’t be an enabler.

At the time that I pulled this… there was 122 comments attached to this post

As seen on the web 12/18/2018

Tuesday, December 18, 2018 8PM EST The Doctor’s Corner with Dr. Kline and Jonelle Elgaway Guest: Dr. Jeff Fudin

Image may contain: Jeff Fudin, smiling, eyeglasses and text

Tuesday, December 18, 2018
8PM EST

The Doctor’s Corner with Dr. Kline
and Jonelle Elgaway
Guest: Dr. Jeff Fudin
Topic: Pharmacology
Tune in www.cawnation.com OR YouTube Channel: “The Doctor’s Corner”
Questions? (415) 915-2291

#TheDoctorsCorner
#CAW360Network #WeR1

New York investigative journalists looking for NY pain pt & docs to speak about opiates and pain

Opioid Crisis: The lawsuits that could bankrupt manufacturers and distributors & disrupt the entire med distribution system

Opioid Crisis: The lawsuits that could bankrupt manufacturers and distributors

https://www.cbsnews.com/news/opioid-crisis-attorney-mike-moore-takes-on-manufacturers-and-distributors-at-the-center-of-the-epidemic-60-minutes/

Mike Moore says he’s, “just a country lawyer from Mississippi.” But this country lawyer has engineered two of the most lucrative legal settlements in American history. As Mississippi’s attorney general, he engineered the historic 1998 settlement under which Big Tobacco paid billions to address smoking-related health issues. In 2015, he convinced BP to settle multibillion-dollar lawsuits over its huge oil spill in the Gulf of Mexico.

Now Mike Moore has taken aim at the manufacturers and distributors of opioid painkillers, claiming they should pay for the epidemic of addiction and death that has swept this nation. As you’ll hear in a moment, he has powerful new evidence that he says proves that states like Ohio, among the hardest-hit by the opioid epidemic, should collect billions from all the companies he’s suing.

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Mike Moore

Mike Moore: If we try the Ohio case, if we win a verdict against these manufacturers and distributors there, it could bankrupt them. It’d put them outta business.In such cases, you could approach lawyers for chapter 13 bankruptcy to protect your assets.

Bill Whitaker: Truly? These are huge, profitable–

Mike Moore: Huge.

Bill Whitaker: –wealthy companies.

Mike Moore: Well, you know– they can be as profitable as they want to. But– Ohio is losing $4 billion or $5 billion a year from the opioid epidemic. And they’re losing 5,000 or 6,000 people a year from overdose deaths. So when a jury hears the evidence in this case, they’re not gonna award just a couple hundred million dollars. It may be $100 billion. And whoever amongst these companies thinks they can stand up to that? Good luck.

Attorney General Mike DeWine: We are hurting now in Ohio. We need help now in Ohio.

Ohio’s Republican attorney general Mike DeWine, who will be sworn in next month as governor, hired Mike Moore as soon as he decided to file suit against opioid manufacturers and distributors.

Attorney General Mike DeWine: They flooded the State of Ohio with these opioid pills that they knew would kill people.

Bill Whitaker: They knew would kill people.

Attorney General Mike DeWine: If they didn’t know it the first couple years, they clearly would’ve seen it after that. You can’t miss it. When one year we had close to a billion– a billion pain meds prescribed in the state of Ohio, you know, 69 per man, woman, and child in the state. And that lies at the feet of the drug companies. They’re the ones who did that.

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Correspondent Bill Whitaker with Attorney General Mike DeWine

Ohio is one of four states Mike Moore formally represents, but he’s coordinating with 30-plus states that have filed suit, and with many of the local governments, nearly 1,500 cities and counties that also are suing. He is the unofficial commanding officer of the army that’s attacking the opioid industry.

Bill Whitaker: This is where your war room is located?

Mike Moore: That’s right.

The unlikely “command center” for Moore’s legal war is the sleepy town of Grayton Beach on Florida’s panhandle.

Mike Moore: You know, in a place like this, you’re not limited with a bunch of tall buildings, and coats and ties, and that kinda thing. You can think outside the box a little bit. So.

When we were in Grayton Beach, about a dozen lawyers from all around the country, some working on state cases, others on local lawsuits, had gathered for all-day strategy sessions, focused on an audacious goal.

Mike Moore: Success for me would be that we would find funding to provide treatment for all the 2.5 million opioid-dependent people in this country.

That would take many billions of dollars, of course, but remember, Mike Moore has done it before.

Mike Moore: Look, when I filed this tobacco case in 1994 there was nobody that thought that we had a chance to win. We showed up for our first hearing, and in our first hearing, so there was three of us there. On the courtroom on the other side they had 68 lawyers.

Despite that early mismatch, within four years Moore had all 50 states lined up against Big Tobacco. He did it partly by going to court, but mostly by going public.

Mike Moore: A case in court is a case in court, and that’s fine. But there’s also the court of public opinion. And the court of public opinion is sometime the most powerful court.

60 Minutes played an important and controversial role in the public case against Big Tobacco. Moore was interviewed for a segment that at first, CBS corporate lawyers refused to allow on the air.

Mike Moore: We’re thinking to ourself, “Look, if 60 Minutes seems to be afraid of these guys for whatever reason, then what about us?” (LAUGH)

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Moore in 1996

60 Minutes finally aired the segment in early 1996 after The Wall Street Journal ran a story featuring the same tobacco industry whistleblower.

Bill Whitaker: You said this in that 60 Minutes story, “This industry,” talking about this– the tobacco industry, “in my opinion is an industry…

Mike Moore in 1996: …who has perpetrated the biggest fraud on the American public in history. They have lied to the American public for years and years, they’ve killed millions and millions of people and made a profit on it.”

Bill Whitaker: Those are pretty strong words.

Mike Moore: Well, it– they were true. Those words were true.

Jeffrey Wigand: The big tobacco whistleblower

Bill Whitaker: And you finally got big tobacco to cry uncle.

Mike Moore: That’s right.

Bill Whitaker: They ended up paying, what, over $200 billion?

Mike Moore: $250 billion, yeah.

Bill Whitaker: So when you look back on what you did what has been the impact?

Mike Moore: We reduced smoking rates to a place that nobody ever thought was possible. So the number one cause of death in America has been reduced dramatically. That’s pretty powerful.

“The distributors are saying things like, ‘We’re just truck drivers. We didn’t know where the pills went.’ Of course, they did”

Now, going after the opioid industry, Mike Moore is using the same playbook he used against tobacco and more recently against BP for the Gulf Oil Spill: build legal and public pressure until the companies see no choice but to settle, and fork over billions.

Mike Moore: Here’s the deal. There’s a huge pill spill in this country. It’s huge.

Bill Whitaker: Pill spill?

Mike Moore: Pill spill. Huge pill spill. It never should’ve occurred. Everybody’s got some fault. But we have 72,000 people dying every year. Let’s figure out a way to resolve this thing. You guys made billions of dollars off of this. Take some of that money and apply it to the problem that you helped cause.

He’s a long way from convincing the drug industry to do that, of course, that’s why all the lawsuits. The first targets are opioid manufacturers like Purdue Pharma, which makes oxycontin, the pill that fueled the opioid epidemic.

Mike Moore: Purdue Pharma created an environment so that opioid use was okay. So if you prescribe your patients this drug, there’s less than 1 percent chance they’ll get addicted. That was a lie, a big lie.

Bill Whitaker: Can you prove that in court?

Mike Moore: Absolutely.

The lawyer who made BP pay

Purdue Pharma declined our request for an interview, but said in a statement that when the FDA approved oxycontin in 1995 it authorized the company to state on the label that “addiction to opioids legitimately used is very rare.” But as evidence of abuse mounted, the company admitted in federal court in 2007 that it had misled doctors and consumers about just how addictive oxycontin can be.

Mike Moore: The Purdue Pharma case is an easy case. I hate to say it, but it’s an easy case to prove. You can prove that they told the lies that they told.

It has been considered tougher to build a case against Mike Moore’s other targets, the huge drug distributors who’ve made billions delivering opioids from manufacturers to pharmacies.

Mike Moore: The distributors are saying things like, “We’re just truck drivers. We didn’t know where the pills went.” Of course, they did. There’s a Controlled Substance Act. Controlled Substance Act. You’re supposed to control these pills. And when you don’t, you have a responsibility for it. It– it’s real simple.

“The stories that you’ve heard from some of the DEA investigative agents concerning the large volumes of pills going into certain parts of our country are absolutely true.”

It’s also simple why Moore is going after the biggest players in drug distribution: because they have much deeper pockets than the manufacturers. Purdue Pharma, for example, had less than $2 billion in revenue last year. Distributor McKesson, by contrast, had $208 billion in revenue.

Mike Moore: McKesson, you’re the sixth largest company in this country. You’re telling the American public you didn’t have systems in place to adhere to the Controlled Substance Act? Seriously?

Mike Moore and his allies now have what they characterize as devastating evidence proving that distributors knew what they were doing. A huge confidential DEA database called ARCOS tracks all transactions involving controlled substances. This spring, a federal judge in Cleveland who is hearing many of the local lawsuits ordered all that data to be handed over to the plaintiffs’ lawyers.

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Burton LeBlanc

Burton LeBlanc: And I can actually tell you which distributor distributed to which particular pharmacy, by year, by volume, and where the pills came from.

Burton LeBlanc is a Louisiana lawyer who regularly huddles with Mike Moore in Grayton Beach. His firm represents hundreds of cities and counties in their opioid lawsuits, and his team has taken the lead in analyzing the ARCOS data.

Burton LeBlanc: In terms of the wholesale distributor’s duty to report suspicious orders, we can immediately look at volume and detect patterns with the data that we currently have.

Bill Whitaker: So, you can see that for every pharmacy in the– in the country?

Burton LeBlanc: I have it for every transaction in the United States.

Bill Whitaker: What’s the most important thing that it has shown you?

Burton LeBlanc: That the stories that you’ve heard from some of the DEA investigative agents concerning the large volumes of pills going into certain parts of our country are absolutely true.

One of those stories concerned Kermit, West Virginia, a town of just 400 people, where nine million opioid pills were delivered in just two years to a single pharmacy.

Bill Whitaker: Did the companies have access to this information?

Burton LeBlanc: It was their data.

That data has now been shared with state attorneys general, including Ohio’s Mike DeWine.

Attorney General Mike DeWine: I’m not allowed to talk about the specifics. But I will simply tell you it’s shocking. Anyone who was looking at those numbers, as those middlemen were, as these distributors were, clearly, clearly should’ve seen that something was dramatically wrong.

“If they cared enough, maybe we would not have lost 500,000 lives from this problem.”

Like Purdue, drug distributors declined our request for an interview, but in a statement from their trade association, said, “it defies common sense to single out distributors for the opioid crisis… distributors deliver medicines prescribed by a licensed physician and ordered by a licensed pharmacy.” But Mike Moore insists that does not let the companies off the legal hook.

Mike Moore: If you’ve got walking around sense and you care, you’re gonna check before you send nine million pills to a little, bitty county in West Virginia or Mississippi or Louisiana or Ohio. You’re gonna check if you care.

Bill Whitaker: You think they don’t care?

Mike Moore: I don’t think they cared enough. And if they cared enough, maybe we would not have lost 500,000 lives from this problem. It’s– it just– it appalls me.

Trial dates have been set for next year in a few of the state and local cases. But rather than go to trial, and just as he did with tobacco, Mike Moore hopes to force a mega-settlement to fund drug treatment, prevention, and education.

Bill Whitaker: You had to have thought about how much money you would need to do the projects that you foresee?

Mike Moore: Oh, I’ve seen all the models. To be effective, we need at least $100 billion to start off with.

Bill Whitaker:  And I know you’ve heard the criticism, that with all these lawyers involved, that this is just a bunch of trial lawyers looking for a great, big payday.

Mike Moore: Right. I don’t care one whit about any money in this case. Not one whit whatsoever about it.

Bill Whitaker: Nobody’s gonna believe that the attorneys are not going to make any money.

Mike Moore: No, no, no. No, no, and I’m not saying that. I was talking about– all I can speak for is me.

Bill Whitaker: You made money off tobacco.

Mike Moore: Nope, not a penny.

That’s because for all the years of the tobacco litigation, and many years after, Moore was working for a modest state salary as Mississippi attorney general.

Bill Whitaker: You made money off of BP spill.

Mike Moore: I made some money on helping resolve the case, yeah.

Moore has made enough money to be comfortable. At age 66, this may be his last big case, and he believes the ARCOS data gives him the ammunition he needs to demolish the opioid industry’s argument that it should not be blamed.

Mike Moore: Nobody in the world’s gonna believe that. And– and don’t go try to tell that to 12 jurors in Mississippi or Ohio who’ve lost people from this. You know what– (LAUGH) you know what those jurors are gonna do? They’re gonna go in the back room, they’re gonna spend about 30 minutes thinking about it, gonna come back out and bam.

Mike Moore wants $$$ to pro

vide treatment to 2.5 million substance abusers/addicts – who does not – may not – even want treatment or to become “clean”

 

Mike Moore doesn’t seem to care if he bankrupts a untold number of manufacturers or wholesalers..

The lawsuits that could bankrupt manufacturers and distributors

Most of these pharmas produce other life saving meds that treats many chronic diseases and there are THREE WHOLESALERS that controls about 80%+ of the entire wholesale market… so how many pts are going to be harmed if the pharma/wholesaler channels in this country are PUT OUT OF BUSINESS over the goal to try and make 2.5 million substance abusers/addicts get clean ?

The DEA had the opiate sales data in their system ARCOS and while Mike Moore is stating that the wholesalers/pharmas should have known from those data points what was going on.. but the DEA had the SAME DATA RIGHT UNDER THEIR NOSE and DID NOTHING… isn’t their primary charge to prevent diversion ?

Mike Moore states that we have 72,000 dying every year – opiates implied – but that number represents the deaths FROM ALL DRUG OVERDOSE OR MISUSE… in that number it is estimated that 15,000 are from the use/abuse of NSAIDS – most of them OTC meds.

Mike DeWine claims that in Ohio there was 69 opiate doses for every man, woman and child… was that 69 doses of 5 mg Oxycodone or Hydrocodone/APAP or 80 mg Oxycontin or Zohydro 50mg/Hydrocodone ?

Of course, a intractable chronic pain pt – if provided adequate pain management – would take 3 long acting and 3 to 6 short acting opiates – EVERY DAY.. So those 69 doses could last a intractable chronic pain pt would last them abt ONE WEEK…

The population of Ohio is 11.66 million and if one presumes that 10% of the population would be suffering from intractable chronic pain… requiring 9 opiate doses a day to properly manage their pain that would take 3.8 BILLION doses per year.  So if you take the 69 doses/person and multiply by 11.66 million and you come up with 804 million doses/yr.. which would only provide 20% of the opiate doses needed for the 10% of Ohio population that is estimated to be dealing with intractable chronic pain.

Where does the opiates come from to treat the other 2.3 million that suffers from at least intermittent or activity induced pain that would require opiate to manage.. and then where does the opiates comes from to treat all of the pain caused by accidents and surgically induced pain.

So if opiates were properly prescribed to treat all the legit pain issues in the population of Ohio … it would – most likely – take more than 69 doses for every man, woman and child in the state.

So when all you have is attorneys LOOKING AT NUMBERS…. and no medical education or experience… they can BEND THE NUMBERS to make them sound like they are MEANINGFUL

Mike Moore: We reduced smoking rates to a place that nobody ever thought was possible... and yet use/abuse of Tobacco/Nicotine kills 450,000/yr – that is a victory ?

Sinaloa Cartel Fentanyl Lab Busted in Mexican City Hall Building – why we need a WALL !

Sinaloa Cartel Fentanyl Lab Busted in Mexican City Hall Building

Mexican federal investigators discovered an active fentanyl lab belonging to the Sinaloa Cartel in Mexico City.

The discovery was the result of an investigation by the Attorney General’s Office of Mexico, according to local media. Authorities executed a search warrant inside a building housing the city hall for the Azcapotzalco municipal government, located in the northwest section of Mexico City. The raid took place on the weekend of December 8, but information was not released to the public until days later. One person who oversaw and managed the lab was arrested, according to the Attorney General’s office.

Federal investigators found various chemical substances, numerous bags containing blue fentanyl pills, approximately 50 cans of a liquid, and a pill presser. All were believed to be used for fentanyl manufacturing. Officials also announced the seizure of several vehicles, communication equipment, and ammunition of various calibers. The seizure was believed bound for the U.S. markets.

 

Fentanyl, often referred to as “synthetic heroin,” is blamed in part for the opioid overdose crisis in the United States. The Attorney General’s office handed over custody of the case to the Office of the Special Prosecutor’s Office for Organized Crime Investigation (SEIDO).

Approximately two months ago, investigative elements of the same agency located a house belonging to the Sinaloa Cartel near the Benito Juárez City Hall. Federal authorities found weapons, drugs, and nearly one million dollars and detained a male identified as Adolfo Jesús Coronel Beltrán, believed to be a cousin of Sandra Aviña Beltrán, better known as the Queen of the Pacific, according to the BBC. Aviña Beltrán was a Mexican drug cartel leader who was extradited to the United States. She was later released and deported back to Mexico. Aviña Beltrán was considered a key link between the Sinaloa Cartel and Colombian drug lords.

The Sinaloa Cartel is stepping up its production and trafficking of fentanyl to the U.S. markets. Many recent seizures are linked to the same organization. These include a 26-pound bust in November in northern Mexico and a 44-pound find in Maryland.