ROC Weekly News Bites

Counterfeit Drugs Bought On Social Media Poisoning Teens, National Addiction Treatment Center to Pay $4.5 Million For Violations, and Risk of SUD Increases With Prescription Drug Abuse Later In Life

Here is a recap of some of the top industry-related news stories of the week:

Killed By a Pill Bought on Social Media: The Counterfeit Drugs Poisoning US Teens

As more fentanyl-laced pharmaceuticals are sold on social media, deaths among young people are increasing.

There is an explosion of drug-related deaths among US high school and college-aged youth, in large part caused by the flood of fentanyl-filled counterfeit pills being sold on social media and sometimes delivered straight to kids’ homes.

Since the pandemic, there has been a large surge in drug-related deaths, with fatalities surpassing 93,000 in 2020, a 32% rise from 2019. The age group under 24 has been most severely affected; accidental drug deaths increased by 50% in a single year, taking 7,337 young lives in 2020. Experts say a large portion of this increase is due to the vast quantities of fentanyl streaming into the US.

Federal agents seized nearly 10 million counterfeit pills in the first three quarters of 2021, more than the previous two years combined. Tests conducted on the pills showed that 2/5 of the counterfeits contained enough fentanyl to kill.

“These are not overdoses; these are poisonings,” said Shabbir Safdar, director of the Partnership for Safe Medicines, a non-profit fighting pharmaceutical counterfeits. “Nobody dies from taking a Xanax; nobody dies from taking a single Percocet. These are fake pills.”

Sam Quinones, author of the book “The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth,” says the staggering quantities flooding into the country means “the days of recreational drug use are over (…) Every drug you try now is a game of Russian roulette.”

Law enforcement and other experts agree that buying illicit pills has never been easier. Dealers have moved from the dark web to openly selling what they label as Oxycontin, Percocet, Xanax or Adderall on platforms like Snapchat, Instagram and Craigslist.

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National Addiction Treatment Center to Pay $4.5 Million in First-Of-Its-Kind Settlement of Laboratory Self-Referral Violations and Claims of Unnecessary Drug Tests

A national addiction treatment center chain has agreed to pay $4.5 million to the state’s Medicaid program, known as MassHealth, and Medicare to resolve allegations that the company submitted false claims for urine drug tests that were medically unnecessary and were illegally performed at the company’s own laboratory. This resolution is the first civil settlement under the Massachusetts clinical laboratory anti-self-referral law, originally proposed by the Attorney General’s (AG) Office.

The AG’s Office and the U.S. Attorney’s Office (USAO) negotiated these settlements with Total Wellness Centers, LLC, CleanSlate Centers, Inc., and CleanSlate Centers, LLC (collectively, “CleanSlate”), and the founder and former company owner Dr. Amanda Louise Wilson, to resolve lawsuits from both the AG’s Office and a whistleblower alleging violations of the False Claims Act and federal and state self-referral statutes with respect to CleanSlate’s Massachusetts patients.

“As we face a worsening opioid crisis in Massachusetts, it’s important that treatment centers follow the rules and not cut corners to increase their bottom line,” said AG Healey. “Our resolution with CleanSlate will bring millions of dollars back to the state and implement the oversight needed to protect patients and prevent these violations from happening again. We are grateful to our federal partners for their work to help bring accountability in this case, and to the whistleblower for bringing these issues to our attention.”

The AG’s lawsuit alleged that CleanSlate required patients, depending on their stage of substance use disorder treatment, to submit to a variety of urine drug tests, some of which were medically unnecessary, causing false claims to be submitted to MassHealth. The AG’s complaint also alleged that the company’s policies, which directed clinicians at CleanSlate to refer laboratory work to its own Holyoke laboratory, violated federal and state self-referral statutes. Dr. Wilson owned both the clinic and laboratory in Massachusetts and developed the policies directing the self-referrals.

According to the AG’s Office, from 2011 through 2016, CleanSlate and Dr. Wilson also engaged in practices that led to backdating of prescriptions for Suboxone by physicians, causing the submission of false claims. After MassHealth patients had already picked up prescriptions that were sent to pharmacies by midlevel clinicians, CleanSlate physicians later reviewed the notes from the patient visits and backdated the prescriptions to the office visit dates. CleanSlate previously resolved similar allegations involving Medicare in a 2016 settlement with the USAO.

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Prescription Drug Misuse Later in Life Greatly Increases Risk for Substance Use Disorder

Nearly half of people in a large U.S. study reported misusing prescription drugs between ages 18-50, which made them more likely to develop substance use disorder symptoms as adults, especially those whose misuse peaked later in life.

The new study from University of Michigan School of Nursing recommends screening for prescription drug misuse and substance use disorder from adolescence through middle adulthood. Currently, the recommendation is to screen adults for unhealthy drug use in some instances, but not adolescents.

“The findings of the current study add to growing evidence that prescription drug misuse at any age, including adolescence, is a strong signal for substance-related problems, and that screening during adolescence can identify high-risk individuals before they develop more severe substance-related problems,” said Sean Esteban McCabe, professor and director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the U-M School of Nursing.

Researchers identified unique prescription drug misuse trajectories associated with each drug class, and found that the risk for developing substance use disorder symptoms (cannabis, alcohol, opioids, stimulants, or other drugs) between ages 35-50, varied considerably across these trajectories.

“For example, we found that almost every individual (94%) in the group that misused prescription drugs frequently for a sustained period, and 70% of those in the trajectories that peaked in middle adulthood, had two or more substance use disorder symptoms between ages 35-50,” McCabe said. “This is a very important finding. Clinicians and researchers are very interested in identifying subgroups of individuals with increased risk of developing substance-related problems.”

Binge drinking, cigarette smoking and marijuana use were all associated with increased odds of belonging to a prescription drug misuse trajectory group. Black (non-Hispanic) adolescents and adults had a lower risk of belonging to a trajectory group than white adolescents.

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