ROC Weekly News Bites

$41B in Drug Policy Efforts, 12 Physicians Sentenced to Prison for Distributing 6.6 Million Opioid Pills, and Synthetic Opioids Stronger than Fentanyl Circulating

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

Biden budget would spend $41 billion on drug policy efforts

President Joe Biden's 2022 budget calls for $41 billion for drug policy efforts to deal with drug addiction and overdoses.

The White House said the budget proposes $23.5 billion for public health to reduce drug use and its consequences. This includes $10.7 billion in discretionary funding for the Department of Health and Human Services to pay for research, prevention, harm reduction, treatment and recovery support services.

It also provides $5.8 billion for drug interdiction efforts and $17.5 billion for drug trafficking supply reduction efforts. The policy also calls for universal access to medication for opioid use disorder by 2025.

The White House said Biden is seeking to increase funding for public health and illicit drug supply reduction, to remove barriers to drug abuse treatment, and to reduce harm and save lives while fighting drug trafficking.

That includes efforts to eliminate unnecessary barriers that prevent medical providers from prescribing FDA-approved medications to their patients; lifting the moratorium on mobile vans providing methadone; supporting states funding the purchase of such vans; and beginning work on meeting individual treatment needs when people at high risk for an overdose need care and support.

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16 defendants, including 12 physicians, sentenced to prison for distributing 6.6 million opioid pills and submitting $250 million in false billings

Sixteen Michigan and Ohio-area defendants, including 12 physicians, have been sentenced to prison for a $250 million health care fraud scheme that included the exploitation of patients suffering from addiction and the illegal distribution of over 6.6 million doses of medically unnecessary opioids. Five physicians were convicted in two separate trials, while 18 other defendants pleaded guilty. Seven defendants await sentencing.

“It is unconscionable that doctors and health care professionals would violate their oath to do no harm and exploit vulnerable patients struggling with addiction,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “These are not just crimes of greed, these are crimes that make this country’s opioid crisis even worse – and that is why the department will continue to relentlessly pursue these cases.”

According to court documents and evidence presented at trial, the scheme involved doctors refusing to provide patients with opioids unless they agreed to unnecessary back injections. Perpetrated through a multi-state network of pain clinics from 2007 to 2018, the evidence established that the clinics were pill mills frequented by patients suffering from addiction, as well as drug dealers, who sought to obtain high-dosage prescription drugs like oxycodone. The doctors working at the clinics agreed to work only a few hours a week to “stay under the radar” of the DEA, yet were among the highest prescribers of oxycodone in the State of Michigan.

To obtain prescriptions, patients had to submit to expensive, unnecessary, and sometimes painful back injections, known as facet joint injections. The injections were selected because they were among the highest reimbursing procedures, rather than based on medical need. Trial testimony established that, in some instances, patients experienced more pain from the shots than from the pain they had purportedly come to have treated, and that some patients developed adverse conditions, including open holes in their backs. Patients largely agreed to these unnecessary procedures because of their addiction or desire to obtain pills to be resold on the street. Evidence further established that the defendant physicians repeatedly performed these unnecessary injections on patients over several years and were paid more for facet joint injections than any other medical clinic in the United States.

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Synthetic opioids stronger than fentanyl have cropped up in the US

A group of synthetic opioids called nitazenes, even more powerful than fentanyl in some of its forms, has emerged.  

A form of nitazene called isotonitazene first cropped up on the illicit drug market just a few years ago. The drug, which was first synthesized by the pharmaceutical industry in the 1950s, was identified in postmortem forensic toxicology reports and in national and international drug seizures starting in April 2019.  

Since then, nitazenes have been associated with drug overdose deaths in the Midwest and found in drug seizures in many parts of the country. Protonitazene and isotonitazene — both of which are thought to be several times more powerful than fentanyl —were identified in syringes examined by scientists at the D.C. Department of Forensic Sciences in September and October of 2021.  

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