Opioid crisis made worse by big-money influence and DEA disablement

Healthcare industry stakeholders who are working tirelessly to address the opioid crisis were disheartened by Sunday’s “60 Minutes”/Washington Post report that showcased a 2016 law that has dramatically hampered the Drug Enforcement Administration’s (DEA) ability to police prescription opioids before they move into communities. The report includes a tale of profitable drug distributors influencing policy with their lobbying dollars while at the same time recruiting DEA agents over to their ivory towers.

Lee Arian, partner with Nelson Hardiman and a former federal prosecutor, tells Behavioral Healthcare Executive the report was disturbing.

“Anyone who works in the healthcare industry would find it to be sad that the primary agency involved in combatting the opioid crisis has been hand-tied by Congress as the result of lobbying by the drug industry,” Arian says.

Freezing distributors’ shipments of prescription drugs is DEA’s most powerful tool, but it’s been almost two years since such an action has been taken. Arian says the law Marino shepherded through Congress made it more difficult for the DEA to suspend shipments that were potentially suspicious.

For example, the “60 Minutes” report cites an instance where a distributor shipped 11 million pain pills to Mingo County, W.Va., which only has a population of 25,000. DEA agents were stymied by internal roadblocks that prevented them from taking any action to stop the flow of pills into that community. It seemed to be a combination of the law’s roadblocks and the internal forces that had been influenced by the multimillion-dollar drug distributors.

On Monday, Senator Claire McCaskill (D-Mo.) introduced legislation repealing the law, piggybacking on her other efforts to pin some responsibility for the opioid crisis on drug manufacturers and distributors.  Marino—a House Republican from Pennsylvania—was also nominated by President Donald Trump to lead the Office of National Drug Control Policy, but withdrew from consideration Tuesday morning, according to a tweet by the president.

Legal course of action

Additionally, Arian believes the lawsuits that state and local governments have been filing against opioid manufacturers—for the disingenuous way they historically marketed addictive pain drugs—will have some impact down the road. Policy changes and stiff penalties could also drive better behavior from the drug distribution companies as well.

“At end of day, it all comes down to money,” Arian says. “If these distributors are hit in the pocketbook sufficiently, they will change their practices.”

To a degree, “Big Tobacco” changed its ways in 1998 after a $206 billion settlement, which also included restrictions on advertising and funding for an education program. Arian says the comparison is reasonable but it’s difficult to predict how the current lawsuits will play out.