Revolving Door: DEA’s No.2 quits amid reports of previous consulting work for Big Pharma

Revolving Door: DEA’s No.2 quits amid reports of previous consulting work for Big Pharma

https://apnews.com/article/opioids-oxycontin-fentanyl-purdue-pharma-dea-72726613cd30be246905fe1f171c2ed8

WASHINGTON (AP) — The U.S. Drug Enforcement Administration’s second-in-command has quietly stepped down amid reporting by The Associated Press that he once consulted for a pharmaceutical distributor sanctioned for a deluge of suspicious painkiller shipments and did similar work for the drugmaker that became the face of the opioid epidemic: Purdue Pharma.

Louis Milione’s four years of consulting for Big Pharma preceded his 2021 return to the DEA to serve as Administrator Anne Milgram’s top deputy, renewing concerns in the agency and beyond about the revolving door between government and industry and its potential impact on the DEA’s mission to police drug companies blamed for tens of thousands of American overdose deaths.

“Working for Purdue Pharma should not help you get a higher job in government,” said Jeff Hauser, the executive director of the Revolving Door Project, a watchdog for corporate influence in the federal government. “Too much collegiality is a problem. It’s hard to view your past and potentially future colleagues as scofflaws. Any independent person would find this abhorrent.”

Milione initially left the DEA in 2017 after a 21-year career that included a two-year stint leading the division that controls the sale of highly addictive narcotics. Like dozens of colleagues in the DEA’s Office of Diversion Control, he went to work as a consultant for some of the same companies he had been tasked with regulating.

New reporting has found that during his time in the private sector, Milione also served as a $600-per-hour expert for Purdue Pharma as it fought legal challenges from Ohio to Oklahoma over its aggressive marketing of OxyContin and other highly addictive painkillers. Milione left the DEA again in late June just four days after AP sought comment from the Justice Department about his prior work for Purdue.

Milione said in a statement this week that he stepped down for personal reasons unrelated to AP’s reporting. Both he and the Justice Department said he recused himself at the DEA from all matters involving his private-sector work where there was even the appearance of a conflict of interest.

Milione added that his consulting stint helped drug companies comply with DEA rules, just as his return to government gave the DEA insight into how business decisions are made in the real world.

“I care deeply about the DEA, its mission and the brave men and women that sacrifice so much to protect the American public,” he said.

But Milione never faced scrutiny from lawmakers over his consulting before taking the DEA’s No. 2 position because the DEA has for more than a decade not filled the job of deputy administrator that requires a presidential appointment and Senate confirmation. Instead, the DEA directly hired Milione to fill a career position with essentially the same duties but a slightly different title – “principal deputy administrator” – that requires no such oversight.

“DEA has demonstrated a willingness to take painstaking measures to avoid the Senate’s watchful eye – including by potentially using a technicality to shirk Senate confirmation of a key agency decision maker,” said U.S. Sen. Chuck Grassley, an Iowa Republican and member of the Senate Judiciary Committee. “Avoiding congressional oversight is a tired game the DEA can’t stop playing. It begs the question: What else is the DEA trying to hide?”

John Coleman, who was head of operations for the DEA in the 1990s, said the Biden administration likely never nominated Milione to serve as deputy administrator, despite his many qualifications, because his conflicts would have surely raised questions.

“Someone at the agency had to be aware of the implications of bringing someone back who was employed in the industry regulated by the agency,” Coleman said. “It was an obvious and classic conflict.”

The DEA didn’t respond to requests for comment. The Justice Department told the AP that Milione disclosed his potential conflicts when he returned to the DEA and that the principal deputy administrator’s position was created before Milgram’s tenure. It said the process for filling the confirmed deputy administrator position is ongoing and referred further questions to the White House, which did not respond to a request for comment.

The DEA made no announcement of Milione’s most recent retirement but removed his bio from the agency’s website over the July 4 holiday and replaced it with that of his successor, career DEA official George Papadopoulos. But in an internal email to staff, Milgram hailed the 60-year-old Milione as a “DEA legend” best known for leading the overseas sting that in 2008 nabbed Russia’s notorious arms trafficker Viktor Bout.

“I was thrilled that he agreed to come back home to DEA,” she wrote in a June 26 email obtained by AP. “Lou has used his skills as a master case maker to help us bring cases against entire criminal networks and to investigate the entire globally fentanyl supply chain.”

Milione’s exit adds to the turmoil at the top of the DEA following a number of other high-level departures, misconduct scandals and the launch of federal watchdog investigation into millions in no-bid contracts awarded to past associates of Milgram.

Mostly Republican members of Congress grilled Milgram during a routine budget request in April, and the administrator also is expected to testify later this month in a House oversight hearing looking into the DEA’s operations and effectiveness combating the flood of fentanyl into the U.S. from Mexico.

Since Milgram took the reins of the DEA two years ago, she has cycled through almost three dozen senior aides, many of them veteran agents who were pushed out or quit due to differences with Milgram. That includes the heads of all of the DEA’s principal divisions as well as the DEA’s chief counsel, its congressional affairs liaison and the top agent in Mexico.

Milgram’s defenders say that house cleaning is part of an agency-wide reset to combat the fentanyl crisis. She’s also exhibited a zero tolerance for racism and sexism that has festered inside the old-boy network that has long shaped personnel decisions inside the DEA.

“Change is hard and some people don’t like it,” Chuck Rosenberg, a former DEA administrator, told AP this spring. “Time will tell whether she was right or wrong, but my money is on Anne.”

Most of Milione’s consulting work was done as a senior managing director of Guidepost Solutions, a private investigative firm based in New York. Under his watch, Guidepost expanded its DEA compliance practice, which now includes nine former DEA employees.

Guidepost declined to comment. Purdue said in a statement that its retention of Milione as an expert on DEA compliance issues ended when the Connecticut-based company filed for bankruptcy protection in September 2019. “To the best of our knowledge, no one at Purdue had any business communications with Mr. Milione after he returned to government,” it said.

For Purdue, which has twice pleaded guilty to federal criminal charges for its role in fueling the opioid crisis and last year reached a $6 billion nationwide settlement aimed at staunching a flood of lawsuits from states, Milione produced a 16-page expert report in 2019 that was never introduced into evidence. That report, obtained by the AP, praises Purdue’s efforts going back to 2000 to track the illegal sale of opioids by rogue pharmacies and “pill mill” doctors.

“These are the kinds of programs DEA encourages and supports manufacturers in undertaking,” Milione wrote, “as it considers them a valuable part of diversion control efforts.”

Former DEA official Coleman questioned why Milgram chose Milione as her No. 2 despite his corporate entanglements and whether it was ever realistic for him to be walled off from many of the position’s leadership functions.

“There’s no way to isolate that person from the day-to-day business of the agency, which includes regulating companies that make and distribute controlled substances,” said Coleman, who is now president of Drug Watch International, a not-for-profit that seeks to reduce drug abuse. “I don’t see how that’s possible.”

Johnson & Johnson sues Biden administration over Medicare drug price negotiations

This could prove to be interesting. It has been reported that the PBM industry will extract a discount/rebate/kickback of up to 75% of AWP (Average Wholesale Price) to put a pharma med on the PBM’s approved formulary – NO PRIOR AUTHORIZATION NEEDED. I suspect that the price that the FEDS are demanding will not change AWP… and the pharma has an agreement with the PBM industry that the agreed upon rebate/kickback/discount is based on AWP and not the FED’S SO CALLED negotiated price. In the end, the pharma could end up getting less $$$ per bottle than it cost the pharma to make the med.

 

 

Johnson & Johnson sues Biden administration over Medicare drug price negotiations

https://www.cnbc.com/2023/07/18/jj-sues-biden-administration-over-medicare-drug-negotiations.html

on Tuesday sued the Biden administration over Medicare’s new powers to slash drug prices, making it the third pharmaceutical company to challenge the controversial provision of the Inflation Reduction Act.  

The lawsuit filed in federal district court in New Jersey argues the Medicare negotiations violate the First and Fifth Amendments of the U.S. Constitution.

Earlier suits brought separately by drugmakers Merck and Bristol Myers Squibb, as well as by the U.S. Chamber of Commerce and PhRMA, the pharmaceutical industry’s largest lobbying group, made similar arguments.

J&J’s complaint asks a judge to block the U.S. Health and Human Services Department from compelling the drugmaker to participate in the program.

The company said its suit aims to stop the “innovation-damaging congressional overreach that threatens the United States’ primacy in developing transformative therapies and in patients’ access to those treatments.”

President Joe Biden’s Inflation Reduction Act, which passed in 2022 by a narrow party-line vote, empowered Medicare to negotiate drug prices for the first time in the program’s six-decade history. 

The provision aims to make drugs more affordable for older Americans but will likely reduce pharmaceutical industry profits. 

The Centers for Medicare and Medicaid Services will publish a list of which drugs were selected for a first cycle of negotiations on Sept. 1, with prices taking effect in 2026. The companies that make those drugs face an October deadline to sign agreements to participate in those negotiations.

J&J said its patented drug Xarelto, which treats blood clots and reduces the risk of stroke, will be subject to price negotiations in 2023 because it is among the 10 most widely reimbursed drugs for Medicare Part D patients.

J&J argues that Medicare negotiations “inflict an uncompensated physical taking” of the company’s drug and essentially force J&J to provide access to Xarelto on terms set by the government that the company “would never voluntarily” agree to.

The company claims this violates Fifth Amendment protections against the government seizing private property without just compensation.

J&J last year booked $2.47 billion in revenue from Xarelto.

J&J also argues that the new provision forces the company to agree that the federal government is negotiating fair drug prices. That compels J&J to make “false and misleading statements” in violation of the First Amendment, according to the complaint.

The company believes the provision doesn’t involve true negotiations since the government “unilaterally dictates” drug prices. 

Real negotiation involves finding a way for both parties to freely agree on terms, J&J said.

“While the Government may choose to deceptively describe the Program as involving an ‘agreement’ to ‘negotiate’ a ‘fair’ price, it cannot force manufacturers to echo its misleading messaging,” J&J said in the complaint. 

HHS said in a statement it will “vigorously defend the President’s drug price negotiation law, which is already helping to lower health care costs for seniors and people with disabilities.”

“The law is on our side,” the agency added, reiterating previous remarks made by HHS Secretary Xavier Becerra.

Walgreens: The Pharmacy America Trusts, The “corner of happy and healthy”

My, how times have changed at the “Pharmacy America Trusts” ?  Walgreen states that they are “invested in your safety and wellness”, but we are refusing to fill the controlled meds that your prescriber has deemed are medically necessary for treating your specific health issues.  This IN NO WAY IMPACTS YOUR RELATIONSHIP WITH WALGREENS and WE APOLOGIZE FOR ANY INCONVENIENCE. On Walgreens you can find any medicine you need like for example if you are having prostate problems  and you are looking for a medicine like prostadine you can go there and I’m pretty sure you will find them.

So one of the basic functions of the practice of medicine is the starting, changing, stopping a pt’s therapy. So if this pt can’t find another pharmacy to fill her controlled med Rxs… could Walgreen be considered the genesis of this pt’s medications being stopped ? They clearly state in the letter that the pharmacists at her local Walgreens had no involvement with this decision, which would imply that it was done by someone or some computer algorithm at Walgreen’s corporate HQ.  NOTHING PERSONAL !

AMERICAN MEDICAL ASSOCIATION MUST INVESTIGATE AND STOP THE RECKLESS ACTIVITIES OF GOVERNMENT “OPIOID TASK FORCES” AND IT’S CRIMINALIZATION OF MEDICINE/ PROTOCOLS

Jesse M. Ehrenfeld, MD, MPH Specialty: Anesthesiology/Clinical Informatics Conflict Of Interest Members Only AMA Affiliated Groups President, AMA, Board of Trustees Members Term: 2023-2024 Email:Jesse.Ehrenfeld@ama-assn.org

IT’S TIME THE AMERICAN MEDICAL ASSOCIATION (AMA) INVESTIGATE ACTIONS OF AUSA KENNETH POLITE’S “OPIOID TASK FORCE,” CRIMINALIZATION OF MEDICINE

 

Morris & Dickson’s Controlled Substance License Revoked

I have not seen anything that would suggest that the controlled meds allocated to this drug wholesaler – 4th largest in the country.. will be divided among the existing drug wholesalers across our country, or will what has been allocated to them JUST DISAPPEAR ?

But here is a settlement between 50 state AG’s and others that got the THREE LARGEST WHOLESALERS to agree to reduce the number of controls that they sell to ALL PHARMACIES.

Here is the SMOKING GUN to prove civil rights violations – could support a class action lawsuit – but the community needs to stand up

So now the DOJ/DEA & our judicial system has got three largest drug wholesalers to sell less controls to all pharmacies and may be cutting the controls that were being sold by the 4th largest drug wholesaler. I just wonder how many of these pharmacies that are going to find themselves without access to their normal purchases of controls are long term nursing home providers?

 

Morris & Dickson’s Controlled Substance License Revoked

https://www.policymed.com/2023/07/morris-dicksons-controlled-substance-license-revoked.html

Recently, the United States Drug Enforcement Administration (DEA) announced that, barring a settlement, it will revoke Morris & Dickson’s license to sell and ship opioid medications and other controlled substances as of August 28, 2023. In the decision and order published in the Federal Register on May 30, 2023, the DEA affirmed a 2019 Administrative Law Judge’s (ALJ’s) decision to revoke DEA registrations held by Morris & Dickson, the United States’ fourth largest wholesale drug distributor.

Background

Morris & Dickson was accused of failing to accept responsibility for its prior actions, including shipping 12,000 unusually large orders of opioids to pharmacies and hospitals from 2014 to 2018. The DEA notes that Morris & Dickson received purchases from “high-volume independent pharmacies” in Louisiana that were “purchasing quantities which were not indicative of the pharmaceutical market” and some were purchasing more Oxycodone and Hydrocodone than the larger chain pharmacies – sometimes more than 10 times the amount of narcotics the average Louisiana pharmacy purchased per month. Despite the large number of unusual orders, the company only filed three suspicious order reports with the DEA during that time frame, an indication that the company did not have a suspicious order monitoring system in place. Additionally, the company failed to maintain effective controls against diversion of drugs by distributing controlled substances without performing adequate customer due diligence.

On May 4, 2018, the DEA announced an Immediate Suspension Order on Morris & Dickson, immediately suspending the DEA Certificate of Registration issued to the company as the DEA felt that “the continued registration of this company constitutes a substantial likelihood of imminent danger to public health and safety.”

Morris & Dickson appealed that decision, and an administrative hearing was held on the matter in May 2019. After that administrative hearing, that suspension was recommended to become a revocation by ALJ Charles W. Dorman in November 2019. According to the Associated Press, the 2019 ALJ decision noted that while Morris & Dickson may have made some revisions to their procedures, anything less than revocation of the license “would communicate to DEA registrants that despite their transgressions, no matter how egregious, they will get a mere slap on the wrist and a second chance so long as they acknowledge their sins and vow to sin no more.” The judge went on to note that “allowing [Morris & Dickson] to keep its registration would tell distributors that it is acceptable to take a relaxed approach to DEA regulations until they are caught, at which point they only need to throw millions of dollars at the problem to make the DEA go away.”

However, instead of issuing a decision and order shortly after the ALJ decision, the DEA took several years. During that time, Morris & Dickson was still able to distribute controlled substances, despite the strong words in the ALJ’s decision – and the DEA’s strong words in the final decision and order. The decision and order took “longer than typical for the agency” in part because of the COVID-19 pandemic and actions taken by the company.

Complicating matters – and frustrating some – was an Associated Press investigation that found that a top DEA official previously served as a consultant for Morris & Dickson as part of the company’s attempt to avoid revocation or other punishment. The DEA says after the individual returned to work for the DEA, they were recused from any participation in the Morris & Dickson matter.

Kaiser Permanente Whistleblower Reveals that the story was fabricated.

Kaiser Permanente  Whistleblower Reveals that the story was fabricated.

The person who published this came out on Twitter,  who claims that he has FOUR DIFFERENT TWITTER ID’s and also penned this article under an assumed name ( George Bailey).  On Twitter, his tweets seem to follow a pattern one would expect from a TROLL or a SPAMMER. So I have taken this article down…

Enforced Tapering: The Dangers of PAWS

If a person is stable on long term low-dose opioid therapy AND shows no signs of addiction, abuse or serious side effects: 1. WHY have Medical Authorities chosen to taper chronic pain patients from their mobility-restoring opioids, without supports in place? 2. WHY are chronic pain patients being advised they will experience “no long-term side effects from tapering”, yet many suffer from a life-changing condition known as Post-Acute Withdrawal Syndrome? 3. WHY have demonstrably flawed and “one-size-fits-all” Guidelines for Deprescribing Opioid Analgesics been released in Australia on 26-5-23?

VP Kamala Harris Calls To ‘Reduce Population” – heart beat away from being our President

Regular, Optimal Sleep Tied to Lower Mortality Risk

So how many chronic pain pts with under/untreated pain get a “good nights sleep”?  Another contributing factor to premature deaths of chronic pain pts with poorly treated pain ?

Regular, Optimal Sleep Tied to Lower
Mortality Risk

https://www.medscape.com/viewarticle/992942

Maintaining a regular healthy sleep schedule may help guard against premature death, new research suggests.

In a diverse group of older adults, those with regular and optimal sleep had about a 40% lower risk of dying of any cause during follow-up than peers who with irregular and insufficient sleep.

“If sleep were an eight-hour pill, it would be beneficial to take the full dose at regular times consistently,” lead researcher Joon Chung, PhD, with Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, said in a news release.

The findings were presented at SLEEP 2023, the 37th annual meeting of the Associated Professional Sleep Societies.

Broad Adverse Health Effects

“Evidence is mounting that irregular sleep is associated with pretty broad adverse health outcomes, most prominently cardiometabolic disease, obesity, and cardiovascular disease,” Chung told Medscape Medical News.

In the current study, the researchers estimated the association of regular sleep of optimal sleep duration with all-cause mortality using data from 1759 adults the Multi-Ethnic Study of Atherosclerosis Sleep Study.

Sleep regularity and duration were classified using 7 days of data gathered by wrist actigraphy. Adults were categorized as “regular-optimal” sleepers (n = 1015) or “irregular-insufficient” sleepers (n = 744).

During 7 years of follow up, 176 people died. In the fully adjusted model, the regular-optimal group had a 39% lower mortality risk compared to the irregular-insufficient sleep group (hazard ratio, 0.61; 95% CI, 0.45 – 0.83). The findings were robust in sensitivity analyses.

The regular and optimal duration sleep pattern maps behaviorally to regular bed and wake times, suggesting potential health benefits of adherence to recommended sleep practices, the researchers note.

“Results suggest benefits of expanding the public conversation on getting ‘a good night’s sleep’ and broadening this goal to getting many good nights of sleep, in a row, on weekdays and weekends,” Chung said in the release.

He further told Medscape Medical News that “getting adequate, regular sleep seems to be something that is good for all. I don’t know of anyone who wouldn’t benefit.”

Fariha Abassi-Feinberg, MD, spokesperson for the AASM and sleep specialist with the Millennium Physician Group, Fort Myers, Florida, agrees.

“We know our bodies have an internal clock, known as the circadian rhythm, which regulates various biological processes, including sleep-wake cycles. Sticking to a consistent sleep schedule allows your body to align its natural rhythm with the external day-night cycle. This synchronization promotes better sleep quality and therefore better health,” said Abassi-Feinberg, who wasn’t involved in the study.

“The AASM recommends adults try to aim for at least 7 hours of sleep and I often tell my patients that keeping a regular routine is best for your sleep and health,” she told Medscape Medical News.

Funding for the study was provided by the American Academy of Sleep Medicine Foundation and the National Institutes of Health. Chung and Abassi-Feinberg report no relevant financial relationships.

Mexican authorities raid pharmacies in inquiry into fentanyl-tainted pills

Mexican authorities raid pharmacies in inquiry into fentanyl-tainted pills

https://www.latimes.com/world-nation/story/2023-07-07/mexican-authorities-raid-pharmacies-in-inquiry-into-fentanyl-tainted-pills

A man walks past a storefront advertising prescription drugs
Pharmacies in Cabo San Lucas, Mexico, are selling counterfeit prescription pills laced with illicit substances and passing them off as legitimate pharmaceuticals.

Authorities in Mexico raided several Los Cabos drugstores last month and arrested four people as part of an ongoing investigation into pharmacies selling counterfeit pills laced with fentanyl and methamphetamine.

The flurry of law enforcement action in the peninsular municipality comes on the heels of a Los Angeles Times investigation that found pharmacies from Tulum to Tijuana were passing off powerful drugs, including fentanyl and methamphetamine, as weaker medications commonly sought out by tourists. Of the 55 opioid painkillers and ADHD medications The Times tested over a four-month period, slightly more than half proved to be counterfeit.

Alejandro Torres Pineda, a delegate of the attorney general’s office in Baja California Sur, said Mexico’s investigation was sparked by local media coverage of the issue — coverage that was based on and extensively credited The Times’ reporting.

In total, authorities confiscated nearly 25,000 pills in the raids. None of them tested positive for fentanyl or methamphetamine, according to Pineda, but came back as other controlled substances that the pharmacies did not have authorization to sell.

“We’re continuing the investigations,” he said in a phone interview last week.

The raids are important, Pineda said, “because the sale of controlled medicines is inhibited, the health of citizens is protected and the type of medicines sold in pharmacies is controlled.”

Ahead of the raids, federal police went to different pharmacies around Los Cabos and interviewed people — including one from North America — as they left the businesses. One person told police that she was buying medicine for back pain. When authorities tested the pills, they found that her purchase also ran afoul of regulations.

A judge then granted law enforcement authorities permission to search the pharmacies in Cabo San Lucas and San José del Cabo. Two were raided June 3 and three others were raided June 20. Authorities found diazepam and clonazepam, anti-anxiety medications usually known in the U.S. by the brand names Valium and Klonopin.

The raids by law enforcement — including federal police, the attorney general’s office and the Mexican navy — netted a cache of money and boxes of pills. Images released by Mexico’s attorney general showed clusters of gun-toting, camouflage-clad police wearing balaclavas standing in front of blurred-out drugstores.

Of the people arrested, Pineda said, three were pharmacy employees and the fourth was an owner of one of the businesses. There’s nothing yet that points to cartel involvement, he added.

The municipal director of public safety in Los Cabos, Jesús Antonio Gómez Rodríguez, framed the recent operation as a positive step.

“In terms of security, the work coordinated by three levels of government is yielding good results, with the aim of guaranteeing the safety of locals and visitors,” Gómez said. “It’s protecting the health of our young people who can fall into the clutches of drugs, as well as the numerous groups of visitors who come to our municipality to enjoy its natural beauties and tourist services.”

Drugstores in Mexico have long been known for selling a wide range of medications over the counter, including many that would require a prescription in the U.S. Until recently, drug market experts had generally believed that pills sold in stores — unlike those sold on the street — were at least what the store owners said they were.

But in February, The Times published an investigation after testing pills from pharmacies in three cities, including San José del Cabo and Cabo San Lucas. In each city, some of the pills sold over the counter as either oxycodone or Adderall tested positive for fentanyl or methamphetamine. Around the same time, a UCLA research team recorded similar findings.

Over the next few weeks, reporters identified at least half a dozen people who overdosed or died after taking pills they’d purchased at pharmacies in Mexico. Grieving families had been alerting U.S. government officials as early as 2018. It was not until March, however, that the U.S. State Department explicitly warned the public about the danger.

On June 14, The Times published a broader investigation, documenting the problem across the country, from Mexico’s southeastern tip in the Yucatán Peninsula to its border with California. Of the 55 pills reporters tested, 28 were counterfeit.

According to El Sudcaliforniano, a regional news site in Mexico, last year Baja California Sur health officials inspected 628 pharmacies, including 175 in Los Cabos. During those visits, inspectors checked licenses and documentation and found everything to be in order. But they later told the outlet it was not up to state officials to do the laboratory testing to confirm the chemical makeup of the drugs.

Health officials also told the news site in February that they found no records of people dying due to adulterated medicine — though there has been a lack of the kind of postmortem toxicology testing in Mexico that would be needed to make that determination.

After similar inspections in the spring, the Cabo Sun reported that state health officials visited more than 100 pharmacies in Baja California Sur. In Los Cabos alone, the news site said, officials shut down nine pharmacies for distributing controlled substances.

When The Times first contacted the attorney general’s office in February, a federal prosecutor there — who has since asked to not be named due to safety concerns — said it was the first time she’d heard of fentanyl-tainted pills appearing in pharmacies. She called it “a new modus operandi that we haven’t detected before” and said that officials were “concerned.”

To better understand the problem, she said, authorities would “need to find where in the process they’re faking the pills” and determine “if pharmacies are involved in criminal activity or they don’t know if they are selling medications with fentanyl.”

In June, the prosecutor told reporters in an email that federal health officials were interested in The Times’ investigation and hoped to file a complaint with her office for potential prosecution. The Times did not provide Mexican authorities with information about the pharmacies reporters visited.

After prosecutors and police opened an investigation, a judge granted them permission to search several pharmacies.

But for Mary Harrell — whose son overdosed and died after he bought a fentanyl-tainted pill at a pharmacy in Cabo San Lucas in 2019 — the enforcement actions came as little consolation. The Camarillo woman said she wished authorities in Mexico had taken action sooner.

“It’s not going to stop,” she said. “If it were a real cleanup you’d have the president going after it — but you don’t.”