health care

AG Sessions rolls out plan to “turn the tide” on opioid crisis

U.S. Attorney General Jeff Sessions is launching three initiatives designed to “turn the tide” on the opioid crisis gripping Florida and the nation.

Sessions is steering $12 million in grants to state and local law enforcement agencies “to take heroin methamphetamines, cocaine, and other illicit drugs off our streets,” according to a press release issued by the DOJ today. The release did not include details about the grants.

Sessions also announced “a restructuring at the DEA, with the establishment of the first new Field Division in nearly 20 years.” The field division, will cover West Virginia, Kentucky and Tennessee.

Sessions is also ordering all of the country’s U.S. Attorney offices to designate an “opioid coordinator” to “serve as a kind of quarterback” regarding anti-opioid efforts locally..

Here’s the full text of Sessions’ announcement:

Good morning, and thank you all for being here. I’d like to especially thank DEA Administrator Patterson for being here and for his leadership on this issue. DEA plays a vital role in our efforts here as you all know.

Today, we are facing the deadliest drug crisis in American history.  Based on preliminary data, at least 64,000 Americans lost their lives to drug overdoses last year.  That would be the highest drug overdose death toll and the fastest increase in that death toll in American history.  For Americans under the age of 50, drug overdoses are now the leading cause of death.

This crisis is driven primarily by opioids – prescription pain medications, heroin, and synthetic drugs like fentanyl.

Fortunately, President Trump understands this and has a passion for this issue.  He has taken the rare step of declaring a public health emergency, and requested more than $1 billion in anti-opioid efforts in the President’s FY 2018 budget.

And I want to thank Kellyanne Conway for being here today. The President has made this a top priority for his administration—including every senior official and cabinet member—as her presence here today can attest.

The day I was sworn in as Attorney General, the President sent me an executive order to go after transnational criminal organizations—including the cartels who exploit the vulnerable and profit off of addiction.

I am convinced that our law enforcement efforts save lives—because they prevent new addictions from starting.  By enforcing our laws, we help keep illegal drugs out of our country, reduce their availability, drive up their price, and reduce their purity.

The Department of Justice has taken a number of steps this year to make these efforts more effective.

In this year’s two drug take-back days, we took more than 900 tons of unused prescription drugs off of our streets—before they could fall into the wrong hands.

In July, the Department announced the largest health care fraud takedown in American history.  The Department coordinated the efforts of more than 1,000 state and federal law enforcement agents to arrest and charge more than more than 120 defendants for opioid-related crimes.

In August I announced a new data analytics program called the Opioid Fraud and Abuse Detection Unit, which will help us find the tell-tale signs of opioid-related health care fraud.

I have also assigned experienced prosecutors in 12 opioid “hot-spots” across America to focus solely on prosecuting opioid-related health care fraud.  Armed with better data, these prosecutors have already begun to issue indictments.

Additionally, the Department has indicted two Chinese nationals for separate schemes to distribute massive quantities of fentanyl—the number one killer drug in America. The truth is clear. Most fentanyl enters the United States from China. I have raised it with a recent Chinese delegation, Deputy Attorney General Rosenstein has raised it, and President Trump was emphatic on the subject during his recent trip to China. We need more support.

Earlier this month, the DEA announced its intent to issue emergency restrictions on all forms of fentanyl—which will make it harder for criminals to circumvent our laws.

As deadly as fentanyl is, you can go online and order it through the mail.  That’s why in July, the Department announced the seizure of the largest dark net marketplace in history.  This site hosted some 220,000 drug listings and was responsible for countless synthetic opioid overdoses, including the tragic death of a 13 year old in Utah.

These steps are important, and I believe that they have saved lives already.  But still, we need to do more.  And we will.

Today I am announcing three new initiatives to turn the tide.

First, the Department will continue to back the blue.  I am announcing more than $12 million in grants to state and local law enforcement agencies across America to take heroin methamphetamines, cocaine, and other illicit drugs off our streets.

Second, I am announcing a restructuring at the DEA, with the establishment of the first new Field Division in nearly 20 years.

The current Louisville district office will now be the 22nd DEA Field Division, with about 90 special agents and 130 task force officers.  This field division will cover West Virginia, Kentucky and Tennessee. These areas covered by this new division face similar drug threats, enabling this division to better focus on those threats.

They will be led by Special Agent in Charge Christopher Evans, who has served DEA for more than 25 years.

Third and finally, I am ordering all of our U.S. Attorney offices to designate an opioid coordinator to serve as a kind of quarterback of our anti-opioid efforts in their community.

They will convene a task force of state, federal, and local law enforcement and help determine which cases to take federal.  And they will help customize and evaluate the effectiveness of every U.S. Attorney’s Office’s strategy to combat the opioid epidemic, a strategy based on local conditions on the ground.

I believe that these changes will make law enforcement more effective—and make the American people safer.

But our work is not finished.  We will not slow down for one day or even for one instant.  With one American dying of a drug overdose every nine minutes, enforcing our drug laws is more important than ever.

We will not cede one city, one neighborhood, or one street corner to gangs, violence, or drugs.

We need to use every lawful tool we have—and we will.  This Department will continue to take whatever steps we deem appropriate and effective toward our goal of turning the tide.

I know that this crisis is daunting- the death rates are stunning- and it can be discouraging.  But we will turn the tide. When the men and women of law enforcement work effectively in a focused way, we can stop the growth of destructive addiction, keep the American people safe, and save lives.  Thank you. Now I’ll turn it over to Rob to discuss DEA recent efforts in more detail.

New report puts $500 billion price tag on opioid crisis

Nearly all of the focus on the opioid crisis gripping the nation has been on the human toll, with 14 Floridians a day dying from drug-related causes and twice that number experiencing non-fatal overdoses.

But the opioid epidemic has a whopping fiscal cost as well, according to a new report by the White House Council of Economic Advisers released this morning.

The report found that previous estimates of the economic costs associated with opioids “greatly understate” the true amount because they don’t include the economic impact of fatalities.

The report found that the economic impact of the opioid crisis was more than $500 billion in 2015, a six-fold increase over previous estimates.

Over 50,000 Americans died of drug overdoses in 2015, and 63 percent of those deaths involved opioids, according to the report.

“The problem is worsening at an alarming pace, with opioid-involved deaths doubling in the past ten years and quadrupling in the past sixteen,” the council wrote.

The new figure quantifies the costs of opioid-related deaths by relying on the “value of a statistical life,” figures usually used when evaluating “fatality-risk reduction” benefits of policies or proposals.

The numbers in the report, however, are certain to be questioned. The use of VSL is controversial. And the council adjusted the numbers of deaths in its total to reflect the under-reporting of opioid-related deaths by 14 percent, based on a 2014 study.

The authors of the report offered an explanation for why their estimates were so much higher than prior analyses.

The council relied on VSL and included heroin-related deaths as well as prescription drug deaths. The White House report also used the upward adjustment for under-reported deaths. And the opioid problem has worsened, the authors noted.

The report was aimed at giving policymakers the “economic analysis needed to review and assess” potential solutions to the opioid epidemic, the council wrote.

“A better understanding of the economic causes contributing to the crisis is crucial for evaluating the success of various interventions to combat it,” the report reads.

And the CEA concluded by pointing the finger at drug companies for contributing to the use of street drugs by hiking prices.

“Supply-side interventions that raise the economic costs of supplying legal prescriptions of opioids may have unintended consequences depending on the extent of demand side substitution induced towards illicit opioids,”  the report concluded.

 

Good pot cop, bad pot cop?

With all of the tension between the House and Senate, it’s unlikely that there’s a coordinated effort between the chambers regarding the treatment of Florida pot czar Christian Bax.

But it seems there’s a good cop, bad cop thing going on.

After a major spanking by a Senate committee earlier this year, the House Health Quality Subcommittee gave Bax the kid-glove treatment this morning.

And a key member of the panel, Rep. Ralph Massullo even acknowledged it.

“I know you got beat up in the Senate but we try to do things more in the House with martial arts, where the effect is the same but we use less force,” Massullo, a Lecanto Republican who is a doctor, said.

Senators were furious with Bax over delays in issuing new medical marijuana licenses, which Bax, the director of the Office of Medical Marijuana Use, blamed on pending legal challenges. The Senate Health Quality Committee

“I’m not buying that just because there’s litigation out there you can’t fulfill your statutory duty to issue these additional licenses,” Senate Health Quality Committee Chairwoman Dana Young, a lawyer, scolded Bax during an appearance before her panel last month.

Senate committees have also been frustrated about delays patients are facing in getting their ID cards from Bax’s shop. Patients have to be cleared by Bax’s office before they can obtain the medical marijuana treatment.

The House committee this morning spent a good chunk of time querying Bax about the ID cards, but much more gently than his treatment by its Senate counterpart.

Bax blamed delays in the issuing the ID cards on a couple of things, mostly having to do with paper.

The company that processes electronic payments for the state won’t handle the $75 charge for the ID cards, so patients are forced to pay by check, which takes longer, Bax said.

And there’s a bid war going on regarding the outsourcing of the ID cards. A losing bidder is protesting the Department of Health’s selection of a vendor to process and produce the ID cards. That probably won’t be resolved until February, according to health officials.

Of the 52,000 patients in the medical marijuana registry, about 31,000 have received ID cards. Another 17,000 haven’t applied for one, after being entered into the registry by their doctor, Bax said.

About 4,500 patients are “moving through that process” of applying for a card, he said, eschewing the word “backlog” when asked about it.

Bax said he’s hired 19 new employees and 18 temp workers, and all but three of them are devoted to handling the cards.

“Any time a person has to lay hands on a piece of paper, scan it, sort it, organize it…Anytime that happens, it takes time and resources to do,” he said. “So patients watching at home, please apply on line.”

 

 

Nation’s deputy AG blames opioid crisis on docs and big pharma

Gov. Rick Scott’s boasted about the $53 million in his budget proposal targeted toward the state’s opioid epidemic.

But more than half of that money — $27 million — is from a federal grant.

It’s the second year of the “State Targeted Response to the Opioid Crisis” grant in Florida, which the feds recently approved, according to a state Department of Children and Families deputy secretary who spoke at a House committee meeting last week.

Like Scott, his pal President Donald Trump and his administration have targeted the opioid crisis as public health crisis.

Here’s an excerpt from a speech U.S. Deputy Attorney General Rod Rosenstein made at the 50 State Summit on Public Safety in Washington, D.C., this morning. (Maybe his boss, AG Jeff Sessions, was tied up nearby testifying before a House panel).

We are also facing the challenges resulting from the unprecedented opioid crisis.  The news is full of heartbreaking stories of parents burying their teenage children, of Neonatal Intensive Care Units overflowing with opioid-addicted babies, of EMS workers racing from one drug overdose to another, and of medical examiners running short of resources to handle the somber extra business.

The overdose numbers are astounding.  In 1990, there were 8,000 deaths. The rate was relatively constant as a proportion of the American population for decades.  Then it increased approximately 700 percent over the next 26 years.

In 2016, more than 64,000 Americans died of drug overdoses.  On average, that means during this speech – another American will have died from a drug overdose.  This is unacceptable.

Opioids are driving this increase in overdose deaths.  The opioid problem began several years ago when doctors — aided by pharmaceutical companies and pharmacies — began overprescribing and diverting powerful prescription opioids.

In some instances, the doctors were untrained and unaware of the addictive nature of the drugs they were prescribing.  In other instances, the doctors were little more than drug dealers with advanced degrees. They operated “pill mills” where medical care was nonexistent, cash was king, and prescription opioids flowed freely.

Our newest challenge is fentanyl, a synthetic drug produced primarily in China. It is up to 50 times more potent than heroin.  It is so powerful that a quantity equal to a few grains of table salt can kill a person.

Chinese chemists try to stay a step ahead of law enforcement by making chemical analogues of fentanyl, such as carfentanil. It is 100 times more potent than fentanyl and 10,000 times more potent than morphine. In fact, carfentanil is intended as an elephant tranquilizer. It is manufactured in Chinese laboratories, shipped to the United States or Mexico, mixed with heroin, and then sold to addicts who are often unaware of what they are ingesting. Just last week, the DEA announced its intent to emergency schedule these fentanyl analogues.  This is a major step in cracking down on these deadly drugs.

The President recently declared that the opioid crisis a “public health emergency.”  The declaration will redirect federal resources to help fund treatment efforts.

At the Department of Justice, we use every tool at our disposal to stop the rise in violence and to end the drug crisis.

Philip “I’m like Lincoln” Levine takes to airwaves to promote Obamacare

Miami Beach Mayor Philip Levine, a Democrat who recently announced his formal entrée into the race for governor, is hitching his wagon to President Barack Obama and his signature health care reform, the Affordable Care Act.

Levine launched a “five-week, six-figure” statewide radio campaign this week to encourage Floridians to sign up for the health care benefits before the open enrollment period runs out on Dec. 15, according to a press release issued by his campaign this morning.

In the ads, in both English and Spanish, Levine praises Obama and likens himself to another president.

“Like Thomas Jefferson, I believe that here in America, we do have inalienable rights to liberty, life and the pursuit of happiness. I’m adding one more – the right to health care,” he says.

Rene Garcia on mental health & substance abuse: “Americans are hurting”

The day after a mass shooting in Texas, a Florida state senator promised on Monday to be “more vocal” about the state’s mental health and substance abuse needs.

Senate Children, Families and Elder Affairs Committee Chairman Rene Garcia, a Hialeah Republican, said legislators need to focus on more than just a partisan debate over gun control.

“It’s far too easy for us to go to our corners and say we either need more gun control or less gun controls. But the reality is Americans are hurting,’’ Garcia said.  “And if we look at the common denominator for most of these shootings, it’s always lack of a mental health diagnosis or someone who did not receive mental health treatment. We can no longer move on in society until we start addressing this fundamental issue and stop ignoring it.”

Garcia’s committee oversees the agencies responsible for providing mental health and substance abuse services in the state.

Speaking to an audience of lobbyists and interested parties, Garcia asked them to bring him recommendations and suggestions on improvements that can be made.  But he warned them against asking the Legislature simply for more money, saying the Senate “gets it” that there is additional need for residential treatment beds.

Now is the time “to figure out what the next step  is,” Garcia said.

“Whether it’s dealing with  managed care companies, more mandates or less mandates, making sure that we stop over-prescribing medications to our citizens, whatever the case may be. I just don’t want it to be all about the money situation,” he said.

Armed with an assault-style rifle and a handgun, 26-year-old-Devin Patrick Kelley on Sunday opened fired inside the First Baptist Church in Sutherland Springs, Texas, killing 26 churchgoers and injuring 20 others. Police said the shooting was related to a domestic dispute and that it wasn’t motivated by race or religion.

By Christine Sexton.

Bondi, other AGs target drug industry in opioid probe

Florida Attorney General Pam Bondi and other attorneys general are targeting drug manufacturers and distributors as well as the insurance industry, in an effort to address the nation’s opioid epidemic.

Drug overdose is the leading cause of accidental death in the country, with 52,404 fatal overdoses reported in 2015, according to the American Society of Addiction Medicine. Opioid addiction drove the epidemic with 20,101 overdose deaths related to prescription pain relievers and 12,990 deaths related to heroin.

Florida, where overdose deaths have spiked over the past two years, is one of the epicenters of the opioid crisis, fueled in part by the widespread use of fentanyl, a deadly painkiller sometimes mixed with heroin.

Bondi and a group of attorneys general are demanding documents and information from pharmaceutical manufacturers and distributors related to their opioid business.

The information requests are part of an effort by 41 states to crack down on the opioid crisis.

Bondi, who was appointed by President Donald Trump to serve on the White House’s Opioid and Drug Abuse Commission, has made prescription drug abuse one of her top priorities since she took office in 2011.

“Florida citizens continue to become addicted to opioids and die daily—meanwhile, prescription drug manufacturers, distributors and the medical profession all point fingers at each other as the cause of this national crisis,” Bondi said in a press release issued Tuesday. “This far-reaching multistate investigation is designed to get the answers we need as quickly as possible. The industry must do the right thing. If they do not, we are prepared to litigate.”

On Monday, Bondi joined a separate group of attorneys general who want insurers to make it easier for patients to receive alternative pain management treatments.