Orthopedists Due Major Blame for Opioid Crisis? – PART II

And then things got worse

In the Post stories, agents described foot-dragging by superiors on cases against distributers from around 2012 to mid-2016, as the crisis hit new peaks every year. DEA headquarters (HQ) stopped using the agency’s most powerful weapon—immediate suspension of the license and shutdown of warehouses of a distributor caught selling large quantities to suspect pharmacies.

Why did DEA HQ seem to go easy on McKesson and others? A DEA investigator told the Post that his superiors said McKesson had been treated lightly because it has hordes of Ivy League lawyers.

Then, investigators’ jobs were made even more difficult.

In April 2016, with the crisis spiraling out of control, Republicans pushed through Congress, and President Obama signed, a law with an innocent-sounding name, “The Patient Access And Effective Drug Enforcement Act.”

This law made it much more difficult for field agents to immediately suspend illicit opioid sales. It passed Congress by unanimous consent, which means every member of Congress in both political parties went along rather than demand a vote.

The House sponsor of the bill, who had pushed it for years, was Rep. Tom Marino (R-Pa.), whom President Trump subsequently nominated to head the Office of National Drug Control Policy, a job informally called the nation’s drug czar. Marino received $100,000 in campaign funding from drug companies.

It sailed through the Senate on the reputation of Sen. Orrin Hatch (R-UT), who still defends it.

Headlines on the anger of DEA field officials over the foot-dragging and then this law put DEA headquarters under a harsh spotlight. Personnel changed, and now, attitudes seem to have changed. Marino was out as the drug czar nominee.

On May 4, 2018, the DEA issued its first immediate suspension of a drug wholesaler since 2012.

The DEA alleges that this wholesaler, Morris & Dickson of Shreveport, Louisiana, “failed to properly identify large suspicious orders for controlled substances sold to independent pharmacies with questionable need for the drugs…primarily purchases of Oxycodone and Hydrocodone…in some cases, pharmacies were allowed to purchase as much as six times the quantity of narcotics the pharmacy would normally order…[and] failed to identify these large suspicious orders resulting in millions of dosage units of Oxycodone and Hydrocodone being distributed in violation of the law,” according to a DEA May 4, 2018 press release.

The independent pharmacies “were purchasing more narcotics than several of the largest chain pharmacies combined within the same zip code,” the DEA said.

The company said in a statement that it had done nothing wrong, and that the DEA was mistaken about the impropriety of the orders.

No one knows the total numbers of opioid pills diverted to the black market through “pill mill” physicians and pharmacies and the dozens of Internet “pharmacies” to which the manufacturers and distributors sent big-batch orders of pills without asking questions. However, the numbers in the Washington Post stories alone add up to many tens of millions of pills (20.8 million pills to two pharmacies in West Virginia alone).