Big pharma fox

Cecil Whig - - FRONT PAGE -

Amidst all the talk of dis­cov­ered emails and tax strate­gies, an im­por­tant rev­e­la­tion was lost among the tenor of this year’s elec­tion cy­cle.

In a new en­try to their news­pa­per’s on­go­ing in­ves­tiga­tive series, Wash­ing­ton Post re­porters Lenny Bern­stein and Scott Higham dug into the story of the Drug En­force­ment Ad­min­is­tra­tion and big phar­ma­ceu­ti­cal com­pa­nies, and how lob­by­ists likely helped ex­ac­er­bate Amer­ica’s sub­stance abuse epi­demic.

The re­porters in­ter­viewed nu­mer­ous for­mer high-rank­ing DEA of­fi­cials who were in charge of the agency’s di­ver­sion con­trol pro­gram over the past decade. The pic­ture they paint is bleak. The ad­vent and mar­ket­ing of Pur­due Pharma’s OxyCon­tin, a pow­er­ful, long-act­ing opi­oid, kicked off more than a decade of suf­fer­ing, the Post re­ported. From 2000 to 2014, 165,000 peo­ple died of over­doses of pre­scrip­tion painkillers na­tion­wide. The cri­sis has also fos­tered fol­low-on epi­demics of heroin, which caused nearly 55,000 over­dose deaths in the same pe­riod, and fen­tanyl, which has killed thou­sands more. The num­ber of U.S. opi­oid pre­scrip­tions has risen from 112 mil­lion in 1992 to 249 mil­lion in 2015.

As the epi­demic was reach­ing record pro­por­tions, how­ever, the DEA and Depart­ment of Jus­tice be­gan to back off en­force­ment ac­tions on the com­pa­nies tasked with dis­tribut­ing the nar­cotics to phar­ma­cies, doc­tors’ of­fice, clin­ics and more.

Civil case fil­ings against dis­trib­u­tors, man­u­fac­tur­ers, phar­ma­cies and doc­tors dropped from 131 to 40 be­tween fis­cal years 2011 and 2014. The num­ber of im­me­di­ate sus­pen­sion or­ders, the DEA’s strong­est weapon of en­force­ment, dropped from 65 to nine dur­ing the same pe­riod, the Post re­ported.

The judge who over­saw the cases filed by the DEA was alarmed by the lack of work, cal­cu­lat­ing one ad­min­is­tra­tive en­force­ment ac­tion for ev­ery 625 fa­tal­i­ties by av­er­age rates. With­out cases to hear, he was forced to send his col­leagues to work on other fed­eral cases while they awaited ac­tion from the DEA. Why? Be­cause the hard-nosed DEA di­ver­sion chief, who over­saw the dra­matic in­crease in ac­tions against ques­tion­able dis­tri­bu­tion of pre­scrip­tion painkillers, was be­ing squeezed by the po­lit­i­cal will of his bosses and Congress. In the sum­mer of 2014, the chief even said that the Jus­tice Depart­ment wanted to meet with se­nior rep­re­sen­ta­tives of drug dis­trib­u­tors and phar­macy chains — in­clud­ing those that were ei­ther un­der in­ves­ti­ga­tion or in the midst of set­tle­ment ne­go­ti­a­tions with the DEA — to foster bet­ter re­la­tions with in­dus­try. He balked, but it was just a mat­ter of time.

The three largest drug dis­trib­u­tors along with their in­dus­try as­so­ci­a­tion poured $13 mil­lion into lob­by­ing House and Se­nate mem­bers and their staffs on the leg­is­la­tion, which ul­ti­mately passed this year af­ter Congress was suc­cess­ful in oust­ing the DEA’s di­ver­sion chief. It raises the stan­dard for the di­ver­sion of­fice to ob­tain an im­me­di­ate sus­pen­sion or­der, which for­mer DEA su­per­vi­sors ar­gued would be hard to reach.

Joseph T. Ran­nazz­isi, who ran the di­ver­sion of­fice for a decade be­fore he was re­moved from his po­si­tion and re­tired last year, per­haps put it best when he told the Post: “This idea that (dis­trib­u­tors) go­ing to say, ‘I’m sorry I vi­o­lated the law, give me an­other chance and I’ll make it right,’ with­out hav­ing some type of pun­ish­ment, to me is out­ra­geous. Ev­ery time I talked to a par­ent who lost a kid, I’m pretty sure they didn’t want me to say, ‘Oh, give them an­other chance be­cause cor­po­rate Amer­ica needs an­other chance.’”

Th­ese latest dis­cov­er­ies only un­der­score the dan­ger­ous con­nec­tions be­tween lob­by­ists, politi­cians and bu­reau­crats and re­mind us of the im­por­tance of cam­paign fi­nance re­form. Only by re­strict­ing in­dus­tries’ ac­cess to our govern­ment can we be­gin to keep the fox out of the hen­house.

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