This Week's News in Substance Use: 2/22/19

How Massachusetts Will Pilot an Addiction Treatment Rating System [LISTEN], WBUR

Massachusetts is working on a new pilot system to rate the quality of addiction treatment programs.

According to the state, beginning next month the national non-profit Shatterproof will work with substance use treatment programs and the Massachusetts Department of Public health to collect data for their ratings.

Purdue’s Sackler Embraced Plan to Conceal OxyContin’s Strength from Doctors, Sealed Deposition Shows, STAT

In May 1997, the year after Purdue Pharma launched OxyContin, its head of sales and marketing sought input on a key decision from Dr. Richard Sackler, a member of the billionaire family that founded and controls the company. Michael Friedman told Sackler that he didn’t want to correct the false impression among doctors that OxyContin was weaker than morphine, because the myth was boosting prescriptions — and sales.

“It would be extremely dangerous at this early stage in the life of the product,” Friedman wrote to Sackler, “to make physicians think the drug is stronger or equal to morphine. … We are well aware of the view held by many physicians that oxycodone [the active ingredient in OxyContin] is weaker than morphine. I do not plan to do anything about that.”

“I agree with you,” Sackler responded. “Is there a general agreement, or are there some holdouts?”

More States Say Doctors Must Offer Overdose Reversal Drug Along with Opioids, California Healthline

The Food and Drug Administration is considering whether to recommend naloxone co-prescribing nationally (an FDA subcommittee recently voted in favor), and other federal health officials already recommend it for certain patients. And the companies that make the drug are supportive of the moves. It’s not hard to see why: An FDA analysis estimated that more than 48 million additional naloxone doses would be needed if the agency officially recommended co-prescribing nationally.

Most states have limited the volume of opioids doctors can prescribe at one time and dramatically expanded access to naloxone. In California, for example, pharmacists can provide naloxone directly to consumers who are taking illegal or prescription opioids or know someone who is.

Oklahoma Could Provide First Test of Who Will Pay for the Opioid Crisis — And How Much, The Washington Post

Big pharma is facing a major test in a small courthouse 20 miles south of here: the first trial at which a jury could decide whether drug companies bear responsibility for the nation’s opioid crisis.

Thousands of cities, counties, Native American tribes and others have filed lawsuits up and down the opioid supply chain, advancing various allegations of culpability for the crisis that began with widespread [misuse] of powerful painkillers. Most of the cases have been consolidated in a major federal action in Cleveland. But as that case lags, smaller state cases like the one in Oklahoma are moving quickly to hear the allegations, creating an early test of how costly the opioid crisis might be for the pharmaceutical companies that made billions of dollars off the drugs.

Elizabeth Warren’s Ambitious Plan to Fight the Opioid Epidemic, Explained, Vox

Warren is now running for president, and her record could set her apart on one of America’s worst public health crises. In 2017, there were a record 70,000 drug overdose deaths, about two-thirds of which were linked to opioids. The number of overdose deaths was so high that the Centers for Disease Control and Prevention linked it to a rare drop in US life expectancy that year. Preliminary data suggests 2018 was about the same, or perhaps a bit worse, nationwide.

There’s wide agreement, among activists and drug policy experts, that much more action is needed to reverse the opioid crisis. Congress has changed some regulations and rules to open up access to treatment, and it’s allocated some funds here and there, in the single-digit billions, to the crisis. But advocates and experts argue something far more comprehensive — tens of billions of dollars over the next few years — is needed. Republicans, however, have resisted such calls, voicing skepticism of running up government spending (outside tax cuts for the wealthy).