This Week's News in Substance Use: 1/11/19

Ex-Pharma CEO Pleads Guilty to Kickbacks to Doctors for Opioid Prescriptions, Boston Herald

A former pharmaceutical chief executive pleaded guilty to playing a part in a sophisticated scheme to give kickbacks to doctors who prescribed his company’s fentanyl-based opioid drugs — a move one top lawyer said is one step toward the goal of cutting down the corrupt greed that’s “alive and well in the pharma business.”

Michael Babich, the former CEO at Insys Therapeutics, pleaded guilty in federal court in Boston on Wednesday for his role in a nationwide scheme to bribe physicians to prescribe the company’s oral-spray painkillers meant for cancer patients facing extreme pain.

“It is very important that companies like Insys be held responsible for corrupting the medical community, as well as endangering and sometimes killing innocent patients,” said attorney Mike Moore, who’s leading some efforts to sue pharmaceutical companies two decades after securing a massive settlement against tobacco companies.

Some Drug Users in Western U.S. Seek Out Deadly Fentanyl. Here’s Why, Pew

In San Francisco, the consumer preference for fentanyl and relatively low death rate likely stem in large part from the way the drug is marketed by dealers, said Phillip Coffin, director of substance use research at the city’s public health department.

Fentanyl that is sold here is clearly labeled. It’s rarely disguised as heroin, as it is on the East Coast and in Appalachia. As a result, users who buy fentanyl know what they’re getting and, in most cases, take the necessary precautions, Coffin said.

It’s still a much more dangerous drug than heroin, which is typically sold as black tar in California and tends to be inconsistent in potency and quality, he added.

In Puerto Rico, Growing Opioid Crisis Adds to Island's Post-Hurricane Issues, NBC News

More than 600 fentanyl-related overdoses and 60 deaths were reported in Puerto Rico in 2017, largely before Hurricane Maria, up from 200 and eight the previous year. While that's much less dire than the crisis in some U.S. states, activists and experts say the problem appears to be expanding rapidly as use of fentanyl, the opioid blamed for much of the problem in the U.S., spreads more widely here.

The U.S. Drug Enforcement Administration and local nonprofit groups also say the official data doesn't reflect the true situation because the island's government is not keeping proper count of deaths and overdoses.

Now Mandated to Offer Meds for Opioid Addiction in the ER, Mass. Hospitals Get 'How-To' Guidelines, WBUR

A hospital emergency room is the common place a drug user connects with health care: after an overdose, to treat an infection or deal with an injury. But the vast majority of ERs don't treat the underlying problem: drug addiction. Instead, patients typically leave with a slip of paper and a few names and numbers of programs where they might get help.

In Massachusetts, that is no longer allowed.

A 2018 state law requires roughly 80 hospitals and satellite emergency rooms to offer patients addicted to opioids a medication to help treat their disease. A handful do. For most, this is a new frontier.

For starters, most hospitals don't have enough or any emergency department physicians, nurses and physicians licensed to prescribe buprenorphine, often sold as Suboxone, a drug that curbs cravings for stronger opioids.

Judges and Lawyers Ignorant of MAT Require Urgent Education Efforts, Filter

Some government efforts, particularly at state level, are being made to address misinformation in the courts. For example, Patrick Gallahue, senior press director for the Mayor’s Office of Criminal Justice in New York City, says that the city’s justice system “is adapting many of its processes to be more responsive to the needs of individuals with drug dependencies. We believe that wherever appropriate, people should be guided toward help and support.” Earlier this year, the city helped organize informational sessions to educate judges about medication treatment for opioid addiction.

But a much larger, federally funded educational effort is required. It shouldn’t fall on already-overburdened indigent-aid nonprofits like Legal Services Corporation or Legal Action Center to fund this huge, nationally imperative task.